The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Tome Lopes - One of the best experts on this subject based on the ideXlab platform.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
Tiago Ribeiro De Oliveira - One of the best experts on this subject based on the ideXlab platform.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
Antonio Carmelo J Romao - One of the best experts on this subject based on the ideXlab platform.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
Francisco Gamito M Guerreiro - One of the best experts on this subject based on the ideXlab platform.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
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Hyperbaric oxygen therapy for refractory radiation induced hemorrhagic cystitis
International Journal of Urology, 2015Co-Authors: Tiago Ribeiro De Oliveira, Antonio Carmelo J Romao, Francisco Gamito M Guerreiro, Tome LopesAbstract:Objectives To analyze the efficacy of Hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Methods Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. Results From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with Hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of Hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Conclusions Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with Hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.
Jacek Kot - One of the best experts on this subject based on the ideXlab platform.
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Correction to Mathieu D, Marroni A, Kot J: Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of Hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):2
Diving and hyperbaric medicine, 2017Co-Authors: Daniel Mathieu, Alessandro Marroni, Jacek KotAbstract:Consistent with the Committee on Publication Ethics guidelines, we the above authors are initiating a partial retraction and correction of our paper: Mathieu D, Marroni A, Kot J: Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of Hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. We wish to make the following statement: "Regardless of the strict process of editing and proof-reading of tables included in the above-mentioned publication, we received some comments from readers which showed us that imperfect layout of Table 1 and incorrect layout of Table 2 changed significantly the conclusions which could be drawn from them. Table 1 described the relation between strength of recommendations given by the Jury of the Consensus Conference and the level of evidence based on the GRADE system. There should be a clear and straight relation showing that Level 1 "strong recommendation" should be based on GRADE A "high level of evidence (LOE)", Level 2 "weak recommendation" should be based on GRADE B "moderate LOE", Level 3 "neutral recommendation" should be based on GRADE C "low LOE" and finally no recommendation should be given when only GRADE D "very low LOE" are present. Note that there is no change to the content of the table, but only visual representation of this relationship. Table 2 has been incorrectly printed. In fact, there is no GRADE A LOE. All X marks placed in the column A should be moved to the right, to GRADE B LOE. In the same way, all X marks placed in the column B should be moved to the right, to GRADE C LOE. We voluntarily retract these tables from the above-mentioned publication, expressing our regret for the situation."
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Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of Hyperbaric oxygen treatment.
Diving and hyperbaric medicine, 2017Co-Authors: Daniel Mathieu, Alessandro Marroni, Jacek KotAbstract:The tenth European Consensus Conference on Hyperbaric Medicine took place in April 2016, attended by a large delegation of experts from Europe and elsewhere. The focus of the meeting was the revision of the European Committee on Hyperbaric Medicine (ECHM) list of accepted indications for Hyperbaric oxygen treatment (HBOT), based on a thorough review of the best available research and evidence-based Medicine (EBM). For this scope, the modified GRADE system for evidence analysis, together with the DELPHI system for consensus evaluation, were adopted. The indications for HBOT, including those promulgated by the ECHM previously, were analysed by selected experts, based on an extensive review of the literature and of the available EBM studies. The indications were divided as follows: Type 1, where HBOT is strongly indicated as a primary treatment method, as it is supported by sufficiently strong evidence; Type 2, where HBOT is suggested as it is supported by acceptable levels of evidence; Type 3, where HBOT can be considered as a possible/optional measure, but it is not yet supported by sufficiently strong evidence. For each type, three levels of evidence were considered: A, when the number of randomised controlled trials (RCTs) is considered sufficient; B, when there are some RCTs in favour of the indication and there is ample expert consensus; C, when the conditions do not allow for proper RCTs but there is ample and international expert consensus. For the first time, the conference also issued 'negative' recommendations for those conditions where there is Type 1 evidence that HBOT is not indicated. The conference also gave consensus-agreed recommendations for the standard of practice of HBOT.
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Hyperbaric oxygen therapy for intensive care patients: position statement by the European Committee for Hyperbaric Medicine.
Diving and hyperbaric medicine, 2015Co-Authors: Daniel Mathieu, Beatrice Ratzenhofer-komenda, Jacek KotAbstract:Many of the accepted indications for Hyperbaric oxygen treatment (HBOT) may occur in critically ill patients. HBOT itself may cause a number of physiological changes which may further compromise the patient's state. Guidelines on the management of critically ill patients in a Hyperbaric facility have been founded on the conclusions of the 2007 European Committee for Hyperbaric Medicine (ECHM) meeting. With regard to patient management, HBOT should be included in the overall care of ICU patients only after a risk/benefit assessment related to the specifics of both the Hyperbaric centre and the patient's clinical condition and should not delay or interrupt their overall management. Neither patient monitoring nor treatment should be altered or stopped due to HBOT, and any HBOT effects must be strictly evaluated and appropriately mitigated. With regard to the Hyperbaric facility itself, the Hyperbaric chamber should be specifically designed for ICU patients and should be fully equipped to allow continuation of patient monitoring and treatment. The Hyperbaric chamber ideally should be located in, or around the immediate vicinity of the ICU, and be run by a sufficiently large and well-trained team of physicians, nurses, chamber operators and technicians. All devices to be introduced into the chamber should be evaluated, tested and acknowledged as safe for use in a Hyperbaric environment and all procedures (standard and emergency) should be tested and written before being implemented.
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Staffing and training issues in critical care Hyperbaric Medicine.
Diving and hyperbaric medicine, 2015Co-Authors: Jacek KotAbstract:The integrated chain of treatment of the most severe clinical cases that require Hyperbaric oxygen therapy (HBOT) assumes that intensive care is continued while inside the Hyperbaric chamber. Such an approach needs to take into account all the risks associated with transportation of the critically ill patient from the ICU to the chamber and back, changing of ventilator circuits and intravascular lines, using different medical devices in a Hyperbaric environment, advanced invasive physiological monitoring as well as medical procedures (infusions, drainage, etc) during long or frequently repeated HBOT sessions. Any medical staff who take care of critically ill patients during HBOT should be certified and trained according to both emergency/intensive care and Hyperbaric requirements. For any HBOT session, the number of staff needed for any HBOT session depends on both the type of chamber and the patient's status--stable, demanding or critically ill. For a critically ill patient, the standard procedure is a one-to-one patient-staff ratio inside the chamber; however, the final decision whether this is enough is taken after careful risk assessment based on the patient's condition, clinical indication for HBOT, experience of the personnel involved in that treatment and the available equipment.
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Controversial issues in Hyperbaric oxygen therapy: a European Committee for Hyperbaric Medicine Workshop.
Diving and hyperbaric medicine, 2011Co-Authors: Jacek Kot, Daniel MathieuAbstract:Every few years, the European Committee for Hyperbaric Medicine (ECHM) publishes its recommendations concerning the clinical indications for Hyperbaric oxygen therapy (HBOT). The last recommendations were issued during the 7th European Consensus Conference on Hyperbaric Medicine in 2004. Since then, several publications have reported on the use of HBOT in some indications in which it has not yet been recommended routinely, namely aseptic bone necrosis, global brain ischaemia and autism. Patients or their families push physicians and staff of Hyperbaric facilities to use Hyperbaric treatment regardless of the quality of the scientific evidence. Therefore, the ECHM Workshop "Controversial issues in Hyperbaric oxygen therapy" was convened as a satellite meeting of the 2010 European Underwater and Baromedical Society Annual Scientific Meeting in Istanbul, Turkey in 2010. For each topic, a set procedure was used: first came a general report by specialists in the topic, incorporating a review of current pathophysiological, experimental and clinical evidence. Then, there were reports from Hyperbaric facilities that had gained clinical experience in that condition, followed by a general discussion with specialists present in the audience. Finally, statements regarding each topic were proposed and voted on by the audience and these were presented to the ECHM Executive Board for consideration and possible approval. In conclusion, the use of HBOT in femoral head necrosis will be proposed during the next ECHM Consensus Conference to become an 'accepted' indication; whilst the use of HBOT in global brain ischaemia and autism should retain its current ECHM recommendations, that it should be 'optional' and 'non-accepted' respectively.