Introduction and Importance: Some experimental studies on brain injury associated with traumatic brain injury (TBI) and hypoxic-ischaemic encephalopathy (HIE) reveal a positive effect of hyperbaric oxygen therapy (HBOT). However, in clinical medicine, most of the scientific evidence available in the current literature relates only to TBI. Methods: The primary objective is to empirically assess the efficacy of HBOT in mitigating the symptoms of disability associated with brain injury in children, with a view to elucidating its therapeutic potential and clinical benefits. Outcomes: A total of 21 patients have been treated with HBOT. The mean age was 6±4.6 years. There were 12 cases (57%) of TBI, 8 cases (38%) of HIE and 1 case (5%) of ischaemic stroke. The mean initial Glasgow Coma Scale (GCS) at hospital admission immediately after accident was 3.3±0.9. The mean time from injury to HBOT was 5.2 ± 3.8 weeks. The mean number of HBOT exposures was 10±4.3. The mean GCS pre-HBOT was 10.7±3.7 and 12.3±3.4 (p=0.004) after post-HBOT, respectively. The mean Glasgow Outcome Scale (GOS) was 3.3±0.8 pre-HBOT, and 3.9±1.1 (p<0.001) after post-HBOT, respectively. Eighteen cases were included in response to HBOT assessment. Six cases (33%) were evaluated as large clinically significant response (CSR), 7 cases (39%) were evaluated as partial response with minimally important difference (MID). Five cases (28%) were evaluated as non-response. The results showed better response to HBOT in cases of starting HBOT up to 4 weeks (p=0.02) after the injury. There was no serious HBOT-related complication or injury. Conclusion: Results of our study demonstrate both clinical and statistically significant patient response to HBOT. Our data also suggest that the earlier HBOT started after diagnosis up to 4 weeks, the more pronounced patients' response to HBOT was achieved. The provision of HBOT to pediatric patients is feasible in large regional hyperbaric centers.

• MeSH
• dítě MeSH
• Glasgowská stupnice kómat * MeSH
• Glasgowská stupnice následků MeSH
• hyperbarická oxygenace * metody   MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mozková hypoxie a ischemie * terapie   MeSH
• poranění mozku terapie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• traumatické poranění mozku terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Background: Complex regional pain syndrome (CRPS) presents as persistent regional pain, both spontaneous and triggered. The demand persists for innovative treatments that patients can endure with minimal adverse effects. Hyperbaric oxygen therapy (HBOT) emerges as a possible intervention in this regard. Methods: The main objective of this work is to retrospectively analyse a case series of patients diagnosed with CRPS treated in the Centre of Hyperbaric Medicine Ostrava over two years (period 2018-2019). The HBOT was applied at 2.0-2.4 absolute atmosphere (ATA) once a day. Results: A total of 83 patients with CRPS were treated with HBOT. 98% of cases reported pain, 92% reported limitation of movement of the affected limb, 87% had swelling of the limb, 41% had lividity and 70% had sensory problems. The mean number of HBOT exposures was 22.0 ± 7.1. At the end of HBOT treatment, 86% of cases had symptoms relief. The mean VAS value of pain at rest before the start of HBOT was 3.2±3.0, after treatment it was 1.6±1.9 (p<0.001). In a pain at activity it was 6.1±2.4 and 3.7±2.4 (p<0.001), respectively, at the end of HBOT. The value of the functional assessment of the limb was 7.0±2.0 and 4.3±2.4 (p<0.001), respectively, at the end of treatment. 79 cases were included in the end-of-treatment assessment. 23 cases (29%) were evaluated as large clinically significant response, 48 cases (61%) were evaluated as partial response with minimally important difference. The results showed larger clinical HBOT effect in cases of disease duration up to 3 and 6 months (p=0.029). Conclusions: The majority of patients improved pain and functional state of the affected limb. Our data also suggests the sooner after diagnosis of CRPS is HBOT started, the treatment has larger clinical effect. There was no serious HBOT-related complication or injury.

• MeSH
• dospělí MeSH
• hyperbarická oxygenace * metody   MeSH
• komplexní regionální syndromy bolesti * terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření bolesti MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The most common pesticide agents are organophosphates and phosphides, aluminum phosphide (ALP) in particular. ALP is a major cause of suicidal poisoning in many countries. In other countries, the problem of accidental, mainly occupational-related, poisoning is also real and actual. Almost two thirds of individuals in poisoning cases have died. This case report describes a case of a patient with accidental ALP intoxication. The origin of the poisoning was the fumigation of stored grain in an agricultural building adjacent to the building in which patient was temporarily housed, while both buildings were connected by an underground corridor, through which the released poison gas penetrated. The case was originally presented by the rescuers as well as healthcare professionals of the local hospital as carbon monoxide intoxication, which has a similar symptomatology as ALP intoxication. The patient was treated comprehensively, including using the HBOT method, which is very unique in the case of phosphine intoxication in human medicine, with an excellent final clinical outcome. This was the first described case of HBOT for ALP intoxication in clinical medicine, although the HBOT indication itself became a coincidence in this case. Further studies must be undertaken to demonstrate the effectiveness of HBOT in treating patients with ALP poisoning.

• Publikační typ
• kazuistiky MeSH

OBJECTIVE: This implementation project compared standard operating procedures, accepted preventive measures, and disinfection procedures between the initial stage of the COVID-19 pandemic (first wave: March 15 to May 31, 2020) and the later stages of the pandemic (second and third waves: September 1, 2020 to January 31, 2021). INTRODUCTION: This project sought to improve compliance with international evidence-based guidelines and clinical standards for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy taking into account the conditions of the local hospital. METHODS: Guided by the JBI evidence implementation framework, seven evidence-based audit criteria were developed for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy. A questionnaire was used to measure compliance in baseline and follow-up audits. RESULTS: Differences between the baseline and follow-up audits were noted for criteria 6 and 7. Criterion 6 increased from 0% to 100% as the hyperbaric facility was equipped with certified ultraviolet-C radiation for air disinfection during the later period, but this equipment was not available in the initial period of the pandemic. Criterion 7 dropped from 100% in the baseline audit to 0% in the follow-up audit because of a significant increase in the operational burden of the treatment capacity of the facility, which made it impossible to comply with the recommended distancing between patients. CONCLUSIONS: Differences were found in preventive measures, disinfection procedures, work organization, and approach to care strategy. The project objectives were met and the implementation strategies proved effective. Larger sample sizes would need be needed to confirm the reproducibility of the results.

• MeSH
• COVID-19 * prevence a kontrola   MeSH
• hyperbarická oxygenace * MeSH
• lidé MeSH
• nemocnice MeSH
• pandemie prevence a kontrola   MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Elevated anti-apolipoprotein A-1 (AAA1) antibody levels associated with cardiovascular risk have been observed in previously SARS-CoV-2-infected or COVID-19-vaccinated individuals. Since patient safety is generally a priority in vaccination, we sought to investigate AAA1 antibody levels in healthy adults after mRNA vaccination. We conducted a prospective cohort study in healthy adult volunteers recruited from military workers of the Transport Air Base in Prague who had received two doses of mRNA vaccines. Anti-apolipoprotein A-1 antibody levels were determined using ELISA from serum samples obtained at three and four time points after the first and second vaccine doses, respectively, within almost 17 weeks of follow-up. The transient AAA1 positivity rate achieved 24.1% (95% confidence interval CI: 15.4-34.7%), i.e., 20 out of 83 participants had at least one positive post-vaccination sample, with a repeat positivity confirmed in only 5 of them. This rate was associated with a BMI > 26 kg/m2, as documented by an adjusted odds ratio of 6.79 (95% CI: 1.53-30.01). In addition, the highest positivity rate of 46.7% (21.3-73.4%) was observed in obese subjects with >30 kg/m2. Since the incidence rate of AAA1 positivity remained unchanged after the first and second vaccine doses, any relationship between AAA1 positivity and mRNA vaccination was inconclusive. The present study showed a transient AAA1 positivity rate associated with overweight or obesity without a proven association with mRNA vaccination.

• Publikační typ
• časopisecké články MeSH

A broad spectrum of conditions including neuropathic pain, complex regional pain syndrome (CRPS) and fibromyalgia, have been implicated as causes of chronic pain. There is a need for new and effective treatments that patients can tolerate without significant adverse effects. One potential intervention is hyperbaric oxygen treatment (HBOT). The case reported here is unique in describing repeated HBOT in a patient who developed recurrent post-traumatic CRPS of the lower as well as the upper limbs. In the first event, two months after distortion and abruption of the external right ankle, the patient suffered leg pain, oedema formation, mild hyperaemia, limited mobility of the ankle and CRPS Type 1. In the second event, the same patient suffered fracture-dislocation of the distal radius 1.5 years after the first injury. After the plaster cast was removed the patient developed pain, warmth, colour changes, oedema formation and limited wrist mobility with CRPS Type 1. Pharmacological treatment as well as HBOT were used with significant improvement of functional outcome in both cases. Some studies suggest that patients with a history of CRPS are more likely to develop secondary CRPS compared to the rates reported in the literature among the general population. Patients with a history of CRPS should be counselled that they may be at risk for developing secondary CRPS if they undergo surgery or sustain trauma to another extremity.

• MeSH
• bolest MeSH
• hyperbarická oxygenace * MeSH
• komplexní regionální syndromy bolesti * etiologie   terapie   MeSH
• kyslík MeSH
• lidé MeSH
• Sudeckův syndrom * terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• kazuistiky MeSH

Background: The goal of our research is to show the effects and impacts of hyperbaric oxygen therapy (HBOT) on acute model wounds in animal subjects. Methods: Three experimental groups were created using injured rabbits (N=36)-randomly divided into three groups (N=12 per group). One group was treated only with standard wound care management. Two groups were additionally treated with HBOT either once or twice a day. The wounds were surgical, uninfected, and in healthy animal test subjects. We compared the immunohistochemical and histological parameters in 4-, 7- and 10-day intervals.Results: The detection of epidermal leaf parameters, the number of microabscesses, the Histopathological Superficial Epithelium Healing Score, Connective Tissue Healing Score, Histopathological Acute Inflammation Score and Total Histopathological Wound Healing Score all showed significant changes between time intervals within the individual groups.Conclusion: The results did not show that HBOT had a significant effect on the healing process of uncomplicated acute wounds.

• Klíčová slova
• Hyperbaric oxygen, Wound healing, Animal models, Adjunctive treatment,
• MeSH
• biopsie MeSH
• hojení ran MeSH
• hyperbarická oxygenace * metody   veterinární   MeSH
• králíci zranění   MeSH
• Check Tag
• králíci zranění   MeSH

Jedním z výrazných ekonomických výdajů pro zdravotnická zařízení v oblasti péči o rány jsou pacienti s diabetickými defekty anebo s ischemickou chorobou dolních končetin vyššího stupně. Léčebným cílem u těchto diagnóz bývá snížení počtu amputací, zejména vysokých, radikálně ovlivňujících kvalitu života pacientů. Mezi adjuvantní léčebné metody patří i hyperbarická medicína, které vliv je již nějakou dobu prokazován a je i součástí některých doporučených postupů. Cílem této práce je představit recentní klinické systematické přehledy a aktuálně platná doporučení pro léčbu obtížně se hojících ulcerací podle 10. evropské konsensuální konference ECHM (Evropská komise pro hyperbarickou medicínu) z roku 2016. Součástí práce je přehled studií zabývajících se farmakoekonomickou nákladovostí, shrnutí nákladů na léčbu u diabetu, jeho komplikací, u pacientů po amputacích a nákladů na léčbu HBO. V závěru je vysvětlen princip a význam metody transkutánní oxymetrie a tzv. kyslíkové výzvy ve vztahu HBO a pacientů s diabetickou nohou, či ischemií.

One of the major economical expense for health providers in wound care management are patients with diabetic foot ulcer or a chronic lower limb ischemia. Main treatment goal in theese patients is usually reduction in a number of amputations, especially high-ones, deeply affecting quality of life of patients. Hyperbaric medicine is already estabilished as an adjuvant method in some of these indications. In some cases it is already part of the national recomendations for diabetic foot ulcer treatment. The aim of this work is to present recent clinical systematic reviews and currently valid recommendations for the treatment of difficult-to-heal ulcers according to the 10th European Consensus Conference ECHM (European Commission for Hyperbaric Medicine) from 2016. Part of the work is an overview of pharmacoeconomic studies, summary of treatment costs for diabetes, its complications, in patients after amputations as well as costs of HBOT. Finally, the principle and significance of the method of transcutaneous oximetry and the so-called oxygen challenge in relation to HBOT in patients with critical ischemia and diabetic foot syndrome are explained.

• Klíčová slova
• hyperbaric oxygen therapy, hyperoxia, diabetic foot ulcer, ischaemia, transcutaneous oximetry, hyperbarická oxygenoterapie, hyperoxie, diabetická noha, ischémie, transkutánní oxymetrie,
• MeSH
• diabetická noha terapie   MeSH
• hojení ran MeSH
• hyperbarická oxygenace metody   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH

• MeSH
• hyperbarická oxygenace * MeSH
• kongresy jako téma MeSH
• lidé MeSH
• nemoci mozku MeSH
• poranění mozku MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH

BACKGROUND: Pneumothorax as a consequence of pulmonary barotrauma during explosive decompression military crew training in a hypobaric chamber is an extremely rare and sparsely diagnosed complication. Extensive bilateral tissue damage is even more unexpected. CASE PRESENTATION: A 26-year-old active duty Air Force pilot was performing an explosive decompression simulation from 8000 ft. (2438.4 m) to 25,000 ft. (7620 m) in a 1.5 s interval. The training was interrupted due to the pilot's apparent health complications. After transfer to the emergency department, a CT scan showed bilateral lung barotrauma with emphysema. CONCLUSIONS: The case report shows extensive emphysema and pneumothorax after a rapid decompression done for training purposes. It is a possible but rare complication. The cause remains unclear, with suspicion of a predisposed lung disease.

• MeSH
• barotrauma etiologie   MeSH
• dekomprese explozivní * MeSH
• dospělí MeSH
• lidé MeSH
• plicní emfyzém komplikace   MeSH
• pneumotorax komplikace   MeSH
• počítačová rentgenová tomografie MeSH
• poškození plic MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH