A new study has found 'Hyperbaric Oxygen Therapy' facilitates healing of chronic foot ulcers in patients with diabetes.

Chronic diabetic foot ulcers are a source of major concern for both patients and health care systems. The aim of this study was to evaluate the effect of hyperbaric oxygen therapy in the management of chronic diabetic foot ulcers.

For more information and to download the report please see the American Diabetes Association website.

The hyperbaricoxygen.se website offers high quality videos of lectures from leading authorities and principal investigators in the field of Hyperbaric Medicine.

The goal of the website is to spread knowledge and to support clinical practice and research for the benefit of patients around the world.

Women and Pressure is a new book edited by Caroline E. Fife, MD and Marguerite St. Leger Dowse and is a remarkable look at women’s progress in the fields of diving and altitude. With content ranging from the history of women divers, combat pilots, and astronauts to the unique physiological characteristics of females working and playing in altered barometric pressure environments, this book is long overdue.

Featuring contributions from 35 authors, many of whom are pioneers in their field, it represents a wide range of disciplines and offers a comprehensive dialogue about the effects of pressure on women. This book is a must-read for women divers, dive instructors, men who dive with women, and anyone involved in these fields.

As an admirable collection of the current research and attitudes regarding the most frequent concerns of divers, instructors, and aviators, topics are explored on a level of seriousness and urgency. The essays included in this text contain crucial discussions of such relevant factors as: pregnancy, the menstrual cycle and decompression illness, decompression illness susceptibility compared with men, fitness to dive, thermal tolerance, equipment, legal issues, and women in the workplace. The pool of information in this book displays the serious nature of a text addressing the past, present, and future of issues of consequence in relation to the well-being of the women involved.

From the Foreword: “...it is obviously important to have a good understanding of how women’s physical and psychological responses might differ from those experienced by men. I believe that this book is a scholarly attempt to answer these questions, and I hope that it will make a valuable contribution to the health and welfare of women engaged in these highly specialized occupations” - HRH Prince Philip, Duke of Edinburgh

The book is available now from Best Publishing (USA, Worldwide) $19.95 and Divernet (UK) £19.95 with proceeds going to the Diving Diseases Research Centre to support further diving research.

Lay title: A trial looking at hyperbaric oxygen (HBO) treatment for people who have long term side effects following radiotherapy for pelvic cancer

This is a multi-centre research collaboration led from The Royal Marsden Hospital by Dr Jervoise Andreyev (Consultant Gastroenterologist in Pelvic Radiation Disease) and Professor John Yarnold (Consultant Clinical Oncologist).

Background

Most patients having radiotherapy to the abdomen or pelvis notice one or more side effects, but these usually clear up once treatment is finished. Once the symptoms have settled, there are, broadly speaking, four long-term outcomes for patients in terms of their bowels:  between 10 and 20 of every 100 patients have no long-term symptoms; between 30 and 40 are able to cope with changes in bowel habit that have little impact on daily life, but about 30 patients develop change in bowel function that interfere to some degree with daily activities and long-term quality of life. Finally, a few develop serious problems that can be very difficult to control. At the present time, these bowel symptoms caused by radiotherapy are not reversible, and as more and more patients are cured of their cancer, the overall number of affected individuals increases.

Fortunately, there are signs of progress in treating bowel symptoms caused by radiotherapy. A recent clinical trial of high pressure oxygen therapy (the kind used in divers who get the ‘bends’ and elite footballers after injury),  provides evidence that radiotherapy side effects can be improved. (Clarke et Al, Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up, Int J Rad Onc Biol, Vol 72, No 1 pp134-143 2008). We aim to repeat this work in a randomised trial comparing high pressure oxygen treatment with sham treatment. We are looking for volunteers to join us in this ambitious research programme.

Aim

The aim is to test the efficacy of hyperbaric (high pressure) oxygen (HBO) therapy in reducing intestinal symptoms caused by pelvic radiotherapy at least 12 months earlier and which persist despite optimal standard measures.

Trial design

Randomised double-blind controlled phase III trial.

Eligibility

Inclusion criteria

i) Age over 18 years.

ii) Past history of a malignant pelvic neoplasm (T1-3 N0-1 M0), including carcinoma of the rectum, prostate, testis, bladder, uterine cervix, uterine corpus and ovary.

iii) A minimum 12 months follow-up post-radiotherapy.

iv) No evidence of cancer recurrence.

v) Gastrointestinal symptoms attributable to prior radiotherapy : Grade 2 or higher in any LENT SOMA category, or grade 1 with difficult intermittent symptoms

vi) Symptoms are not relieved by appropriate life-style advice and medication over a 3-month period.

vii) Physical and psychological fitness for HBO therapy.

viii) Written informed consent and availability for follow up.

Exclusion criteria

i) Surgery for rectal cancer.

ii) Prior hyperbaric oxygen therapy (excluding treatment for decompression illness).

iii) Prior treatment with even a single dose of bleomycin.

iv) Claustrophobia.

v) Epilepsy.

vi) Chronic obstructive airways disease; bullous lung disease, acute or chronic pulmonary infection; uncontrolled asthma, untreated pneumothorax.

vii) Previous middle/inner ear operations (except grommets and similar procedures) &/or irremediable inability to equalise middle ear pressure.

viii) Contra-indication or other inability to undergo magnetic resonance imaging, if required to rule out malignancy.

Referral to the study

For more information about the trial, please contact Sue Martin (Trial Coordinator).
Tel: 020 8661 3273
Fax: 020 8661 3107
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