Thesis (MScMedSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: A survey was conducted between 3 August and 5 October 2011 to test and evaluate the knowledge and attitudes of the military and civilian medical practitioners at the royal medical Service in the kingdom of Bahrain with regards to the clinical application of hyperbaric oxygen therapy. The survey consisted of a questionnaire and a semi-structured interview in which a total of 93 (out of a possible 302) medical practitioners were included (13 participated in the interviews). Similar to findings of previous studies, the knowledge of medical practitioners in Bahrain regarding hyperbaric oxygen therapy was low. Several practitioners were able to mention at least one indication for the therapy. No single factor had a statistically significant association with knowledge or the lack thereof. A large proportion of the participants had a positive attitude towards the use of hyperbaric oxygen therapy, felt that it is a valid treatment modality and they would refer their patients for such treatment. They would like to receive more information on hyperbaric oxygen therapy. Educational interventions to address the knowledge gap would likely be effective, since most participants have a positive attitude towards the therapy and believe that it is cost-effective.

Hyperbaric oxygen therapy is a treatment method that involves inhalation of 100% oxygen, and under higher pressure than the atmospheric. Blood has the ability to deliver more oxygen authorities. Treatment takes place in facilities called the hyperbaric chamber. During treatment, patients must adhere to certain principles that are given by the doctors and nurses working in these workplaces.The main objectives of this thesis were to map the influence of preparation on the course of treatment in a hyperbaric chamber and to determine how the patients are instructed by nurses during treatment in the hyperbaric chamber. Three research questions were set up to clarify how the preparation affects the patient during treatment in a hyperbaric chamber, as the patient is educated before treatment and what output the patient receives after leaving the hyperbaric chamber. In order to fulfill the objectives qualitative research methods were done, using a semi structured interview. The survey was conducted in two selected hospitals, in the České Budejovice Hospital, and at the University Hospital Plzeň - Lochotin. An individual, semi-structured interview was used as data collection technique, which was initially recorded on a cell phone and then transcribed into written form. At the beginning of the research interviews were conducted with nurses, who gave a comprehensive view of their job description. These conversations only complement the research. We included the brochure with basic information in our research and that was supplemented by information obtained from these interviews. The sample included patients treated in a hyperbaric chamber. They were subsequently divided into three subgroups. The first subgroup consisted of chronic patients, the second subgroup of patients undergoing hyperbaric oxygen therapy for the first time and who got the booklet with background information before their first exposure and in the third were also new patients but who were given a booklet after their first exposure. The survey was conducted in January and February 2015. Analyzed data formed four categories. Careful preparation of the patient is an essential part of treatment in a hyperbaric chamber, largely because of the specificity of this treatment, which consists mainly of placing the patient in an enclosed space, the need for a breathing mask and the inability to quickly leave the hyperbaric chamber without health risks. Therapy in a hyperbaric chamber alone is, in compliance with the indication, contraindication and dosing schedules and well-executed preparation, relatively safe and simple. From the above mentioned reasons it is necessary that the nurses in the area are sufficiently educated and that the patient who enters the hyperbaric chamber is properly prepared. Nurses educate each patient just before their first exposure, but also before every following one. There is very much information given to patients during preparation for entry into a hyperbaric chamber. The research showed that almost all the respondents had difficulty to remember all the details. Nurses tell them about hyperbaroxy essence, indications, contraindications, the exposure pattern, they select a breathing mask with them, and teach the patients to equalize the pressure in their ears, check their clothes and what they have with them. The nurses also check whether they are greased with creams, makeup and other cosmetics, and in the case of wounds if they are treated using a moist treatment instead of greasy. Before each exposure, the patient is asked about their health (a cold is a contraindication), their blood pressure is measured and the necessary nasal drops are applied. Precisely because of the considerable amount of information that patients get at their first exposure, we decided to include the booklet, which contains basic information for patients who are treated in a hyperbaric chamber for the first time, in our research.

Hyperbaric Oxygenation Therapy (HBOT) has a successive history for treating very specific groups of physical conditions. Research by Neubauer and colleagues states that HBOT's ability to increase cerebral metabolism in the brain regenerates dormant neural tissue (Neubauer, Gottlieb, & Pevsner 1994). According to this research, the increase of cerebral metabolism levels restores mental capacity from the neurological insult. Despite promise, uncertainty exists as to whether this is a viable treatment option for people suffering from neural damage. The research results for this experiment will examine the effect of HBOT on cerebral metabolism levels in adults and pediatrics with chronic neurological problems. Fifty individuals diagnosed as having a neurological impairment whom met criteria for the study were analyzed from an archival data set. Criterion required chronic impairment, baseline SPECT, followed by HBOT exposures, and a post SPECT scan. Statistical analyses consisted of a Pearson correlation that examined pre-metabolism rates with total change, a Pearson correlation that examined total change and number of treatments, and a one way ANOVA analysis that examined cerebral metabolism change in patients under 18 and over 18. Results indicated change

Thesis (M.Sc.)--Memorial University of Newfoundland, 2005. / Includes bibliographical references.

Hyperbaric oxygen (HBO) therapy is the intermittent inhalation of 100% oxygen at a pressure greater than one atmosphere absolute. It is an effective treatment for various inflammatory conditions, including chronic wounds which are characterized by an excessive influx of neutrophils and their prolonged persistence at the wound site. Neutrophil apoptosis and clearance have been shown to be required for resolution of inflammation. The mechanisms by which HBO aids wound healing are well documented, but its effects on cellular inflammatory response are not well understood particularly with respect to neutrophils. The hypothesis presented in this thesis is that increased oxygenation via HBO assists chronic wound healing by enhancing non-inflammatory neutrophil defences and cell death through apoptosis. An investigation was carried out into the effects of HBO on neutrophil antimicrobial function and apoptosis using differentiated HL-60 cells as an in vitro neutrophil model. The data clearly showed that a single HBO treatment for 90 min caused an increase in the oxidative burst activity of neutrophil-like cells as shown by increased NBT staining, superoxide (cytochrome c reduction) and H2O2 production (Kruskal-Wallis, P < 0.05), and phagocytosis of Staphylococcus aureus. HBO treatment displayed a pro-apoptotic effect, enhancing caspase 3/7 activity both in the presence and absence of a TNF-α stimulus (Kruskal-Wallis, P < 0.05) and causing morphological changes (observed using Giemsa and SYBR® Safe staining) associated with apoptosis. Although no consistent pattern was observed, both hyperoxia and pressure alone seemed to contribute to both the increase in antimicrobial activity and the increase in apoptosis induced by HBO in these neutrophil-like cells (Chapters 4 and 5). HBO-enhanced neutrophil clearance by macrophages was investigated using bovine neutrophils and monocyte-derived macrophages (MDMФ). A single 90 min HBO exposure significantly increased the clearance of fresh and 22 h-aged neutrophils by MDMФ (two-way ANOVA, P < 0.05), suggesting an increase in phosphatidylserine (PS) exposure in apoptotic neutrophils after HBO treatment (Chapter 6). Importantly, a long-term repetitive exposure to HBO in patients with chronic wounds caused a significant decrease in the antioxidant enzyme defence system (one-way repeated measures ANOVA, P < 0.05), plasma TNF-α and IL-1β after 30 HBO sessions, with down regulation of expression of the anti-apoptotic factors, NF-B and Bcl-2 (Chapter 7). These findings may go some way towards explaining the effectiveness of HBO treatment not only for chronic wounds but also for other inflammatory conditions that may be affected by this treatment.

This study investigated the effects of hyperbaric oxygen (HBO) therapy on acute ankle injuries and determined if HBO therapy shortened time to recovery, decreased edema and pain, and increased range of motion and strength of the ankle. Subjects were randomly assigned to either an experimental (HBO) group (n = 4) or a control group (n = 4). All subjects received the same standardized physical therapy for lateral ankle sprains at the McGill Sport Medicine Clinic. The HBO group received 5 consecutive HBO treatments at 2.5 ATA for 90 minutes starting within 24 hours post injury. The control group received no HBO treatments. All subjects were evaluated by a physician within 24 hours of injury. All subjects suffered a second-degree lateral ankle sprain. Pain, range of motion, strength, volume displacement, and function were evaluated on the day of injury (Day 1), on Day 6 post injury, and on the day of return to play (Day RTP). There was no significant difference in time to return to play. However, the HBO group (25.5 +/- 11.6 days) did return 31% faster than the control group (36.8 +/- 19.4 days). There were no differences found between groups on the variables. There was a decrease in pain found over time (Day 1 was 57 mm, Day 6 was 18.5 mm, and Day RTP was 7 mm). The results of this study suggest that with treatment of HBO there is no effect on ankle sprains for return to play or improved function.

Thesis Ph. D.)(Chemical Engineering)--University of Pretoria, 2003. / Title from opening screen (viewed Oct. 06, 2004). Summaries in English and Afrikaans. Includes bibliographical references (leaves 144-151).

Thesis (Ph. D.)--University of Chicago, Dept. of Radiology, August 2000. / Includes bibliographical references. Also available on the Internet.

Hyperbaric Oxygen Therapy (HBOT) is an old technology which has acquired value in chronic wound care. HBOT is known to promote local and systemic healing effects by improving the oxygenation of the wound tissue. The increased tissue oxygenation hastens removal of the bacterial bioburden, which allows resolution of inflammation and facilitates matrix production, cell division, and ultimately wound closure. Staphylococcus aureus is the most frequently isolated organism from Diabetic Foot Infections (DFI). Therefore, our lab chose to use the treatment paradigm of HBOT to initially look at the single species level as to how HBOT affects S. aureus. DFI are primarily polymicrobial, so the responses of bacterial communities to this therapy were also considered. Previous research focused solely on host response to HBOT, but our pilot testing indicates that HBOT also exhibits a bacterial response. Initial testing with S. aureus indicated that HBOT can create growth defects in bacteria in vitro. In preliminary experiments, our lab discovered that bacterial culture on solid medium is greatly altered under the pressure of hyperbaric oxygen. Normal robust growth and pigmentation are seen in S. aureus cultured in ambient conditions. However, when the same strain is cultured under HBOT conditions, there is a marked decrease in pigmentation and colony size. When other species were exposed to HBOT conditions, growth on solid media was significantly diminished. Interestingly, K. pneumoniae is able to grow normally under HBOT conditions. Normal air mixtures at the increased pressure do not have any discernable effect on bacterial growth, and the limiting effects of oxygen are not seen unless used at the increased pressure. In a broth macrodilution MIC assay, various antibiotics show an increase in susceptibility after exposure to HBOT. Lastly, biofilm formation is altered under HBOT conditions, further supporting a bacterial adjustment to HBOT and an altered mode of growth. In order to better understand the effects of a high pressure high oxygen environment on the bacterial bioburden, this study investigates the effects of HBOT on bacterial species comprising a chronic wound. Primary data has suggested that HBOT increases susceptibility of antibiotics, and can alter bacterial transcription to hinder growth of many organisms. We hypothesize that Hyperbaric Oxygen Therapy affects diabetic foot infections by changing the healing process via transcriptional alteration of bacterial species in the wound. Furthermore, we hypothesize that HBOT alters the efficacy of some antibiotics as well as affecting the biofilm capacity of many bacterial species.

Orientador: Selma Giorgio, Luciana Maria de Hollanda / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia. / Made available in DSpace on 2018-08-18T19:40:07Z (GMT). No. of bitstreams: 1 Lima_FlaviaLuna_M.pdf: 5109370 bytes, checksum: b5d1a1158570ae39829ed8ec9ff682e5 (MD5) Previous issue date: 2011 / Resumo: Pseudomonas aeruginosa é um dos principais patógenos oportunistas responsáveis pelas infecções nosocomiais. Essas infecções representam um grave problema de saúde para pessoas com feridas graves e queimaduras, sendo responsável por altas taxas de mortalidade nos pacientes. Os tecidos cronicamente lesados apresentam microáreas de hipóxia, pouco vascularizadas, que são extremamente difíceis de serem tratadas, diminuem e alteram os efeitos dos medicamentos propiciando que linhagens multiresistentes desse patógeno infectem e sobrevivam. Assim, torna-se imprescindível o desenvolvimento de tratamentos que sejam eficazes tanto no combate do patógeno, como na regeneração do tecido destruído. A terapia com oxigenação hiperbárica (HBO) promove a regeneração tecidual pela formação de novos vasos, apresenta propriedades bacteriostáticas e bactericidas e pode atuar de forma sinérgica com antibióticos. O objetivo geral deste trabalho foi avaliar o papel da HBO no crescimento de P. aeruginosa, na ação de imipenem e em macrófagos e peles artificiais infectadas com esse patógeno. Nossos resultados mostraram que a exposição de seis cepas de P. aeruginosa a HBO (100% de O2 a 3 ATA pressão) diminui o crescimento bacteriano, além de potencializar o efeito de imipenem/cilastatina no combate a esta bactéria. A exposição a HBO durante 90 minutos protegeu macrófagos peritoneais da lise causada pela infecção bacteriana. Quando peles artificiais infectadas com P. aeruginosa foram expostas a HBO a carga bacteriana destes tecidos diminuiu. Os nossos resultados evidenciam a importância do tratamento hiperbárico no controle de infecções causadas por este patógeno / Abstract: Pseudomonas aeruginosa is a major opportunistic pathogens responsible for nosocomial infections. These infections represent a serious health problem for people with severe wounds and burns and are responsible for high mortality rates in these patients. The chronically injured tissues have small areas of hypoxia, these areas, low vascularization, are extremely difficult to treat, reduce and alter the effects of medicines providing that multiresistant strains of this pathogen to infect and survive in these places. Thus, it is essential to develop a treatment that is effective both in combating the pathogen, as in the regeneration of damaged tissue. Therapy with hyperbaric oxygen (HBO) promotes tissue regeneration by new vessel formation, has bacteriostatic and bactericidal properties and can act synergistically with antibiotics. The aim of this study was to evaluate the role of HBO on the growth of P. aeruginosa, in the imipenem action and infected macrophages and artificial skin infected with this pathogen. Our results show that exposure of six strains of P. aeruginosa to hyperbaric conditions (100% O2 at 3 ATA pressure) reduces bacterial growth, and maximize the effect of imipenem/ cilastatina against this bacterium. Exposure to HBO for 90 minutes protected macrophages from lysis caused by bacterial infection. Artificial skins infected with P. aeruginosa and exposed to HBO showed a decrease in bacterial load. These results support the importance of hyperbaric oxygen therapy in control infections caused by this pathogen / Mestrado / Imunologia / Mestre em Genética e Biologia Molecular