Background Late radiation tissue injury is a serious complication of radiotherapy for patients with gynecologic malignancies. Strategies for managing pain and other clinical features have limited efficacy; however, hy perbaric oxygen therapy (HBO 2 ) may be an effective option for some patients. Methods

https://www.mdpi.com/1718-7729/18/5/767/pdf

Hyperbaric oxygen therapy for late radiation tissue injury in gynecologic malignancies.

Aim To describe general practitioners' (GPs') knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers. Background Earlier research regarding GPs' knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs' understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs' perspective. Methods Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis. Results Four themes were identified. 'Education and training' describe the GPs' views regarding their knowledge and knowledge development in relation to leg ulcer treatment. 'Experience' refers to GPs' thoughts about the importance of clinical experience when treating leg ulcers. 'Prioritization' describes the issues GPs raised around managing the different knowledge areas in their clinical work. 'Time constraints' explore the relationship between GPs' sense of time pressure and their opportunities to participate in professional development courses. Conclusions The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.

/pdf/general-practitioners-knowledge-of-leg-ulcer-treatment-in-26gmcw3f1f.pdf

General practitioners' knowledge of leg ulcer treatment in primary healthcare: an interview study

Diabetic patients are particularly burdened by foot ulcer as about 2.5% of patients with diabetes will develop a foot ulcer each year leads to lower extremity amputation by 15–40 times in diabetics greater than the rate in patients without diabetes mellitus. The aim of this study was to determine which therapeutic method out from hyperbaric oxygen therapy (HBO); laser and ultrasound, in addition to medical treatment obtain the best improvement in healing rate of foot ulcers in diabetic patients. Forty- five non-insulin dependent diabetic patients of both sexes complicated with foot ulcer grade II. Their age ranged from 35 to 50 years. were included into 3 equal groups ; Group (A) received laser therapy, group (B) received HBO and group (C) received the pulsed ultrasound therapy in addition to medical treatment. Measurements of ulcer surface area and volume for all patients in the three groups were done before treatment and after two months at the treatment program. There was a statistically significant difference between mean levels of the investigated parameters in laser therapy group and HBO group and HBO group & pulsed ultrasound therapy group after treatment. Where there was no significant difference between laser therapy group & pulsed ultrasound therapy group (p>0.05). It is recommended to use HBO in addition to medical treatment to accelerate healing rate of foot ulcers in diabetic patients.

/pdf/impact-of-different-therapeutic-modalities-on-healing-of-4n4ru0s0bt.pdf

Impact of Different Therapeutic Modalities on Healing of Diabetic Foot Ulcers

Background: The management of bleeding originating from the guttural pouch (GP) has a high success rate, but the resolution of the macroscopic inflammatory lesions in the case of mycosis (GPM) is highly variable; the resolution of neurological disorders is inconstant and challenging. Objectives: Our aim was to test the feasibility and safety of topical oxygen therapy (TOT) in horses after induction of GPM and in cases with naturally occurring disease. Study design: This study was an in vivo experimental and retrospective two-phase study. Methods: During phase 1, the pilot study, both GPs were inoculated with Aspergillus fumigatus. One GP was randomly assigned to receive one to four TOT 30 min sessions with 100% medical oxygen at 9 L/min. Follow-up endoscopic images were assessed for scoring macroscopic inflammatory lesions of the pharynx and both GPs. In phase 2, the clinical study, TOT was administered for 45 to 60 min at 15 L/min in six horses presenting with GPM. Results: In phase 1, TOT administration was easy to perform in the standing horse with no adverse effects. After more than two administrations, macroscopic inflammatory lesions decreased more quickly in size in the treated GP. In phase 2, horses were treated with TOT only (n = 1) or combined with a transarterial coil embolization (TACE) procedure (n = 5). After TOT and discharge from the hospital, nasal discharge resolved in three horses, and improvement was noted in the fourth one. Between days 2 and 10 after admission, upper respiratory tract endoscopy (URTE) indicated size reduction and alteration in the appearance of all the macroscopic inflammatory lesions. The partial or total recovery of neurological disorders (2/4 laryngeal hemiparesis, 3/5 dysphagia, 1/2 dorsal displacement of the soft palate (DDSP), and 1/1 Horner's syndrome) was recorded. Main limitations: In phase 1, the small number of horses did not allow for statistically significant conclusions; in phase 2, clinical signs at admission varied between horses, which made comparison difficult. Conclusions: In adult horses, TOT alone or in combination with TACE is feasible and safe with a propensity to reverse the course and the progression of inflammatory lesions without additional local or systemic treatment.

The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series.

Hyperbaric oxygen therapy for chronic diabetic wounds

OBJECTIVE To explore physicians’ knowledge of and attitudes toward hyperbaric oxygen therapy (HBOT) in order to better understand current diabetic foot ulcer management practices and to determine potential barriers to HBOT use. DESIGN A 24-item questionnaire. SETTING Primary Care Today conference in Toronto, Ont, in May of 2006. PARTICIPANTS Physician attendees, 313 of whom completed the survey. MAIN OUTCOME MEASURES Self-reported knowledge of and attitudes toward HBOT. RESULTS Less than 10% of respondents had a good knowledge of HBOT, but 57% had a good attitude toward HBOT. Knowledge of and attitude toward HBOT were positively correlated (P CONCLUSION Primary care physicians have underdeveloped knowledge of HBOT, but their generally positive attitudes toward its use suggest that they might be receptive to educational interventions. Educating both physicians and patients about HBOT, specifically its cost-effectiveness, might encourage future use.

https://www.cfp.ca/content/cfp/56/5/444.full.pdf

Hyperbaric oxygen therapy and diabetic foot ulcers: knowledge and attitudes of Canadian primary care physicians.

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Hyperbaric oxygen therapy and diabetic foot ulcers: knowledge and attitudes of Canadian primary care physicians.