Autism Midyear Review

Boy oh boy has 2010 produced a rash of autism stories in the press and in showbiz. From the very beginnings of this blog we've been openly fascinated by the topic, if not wholly persuaded there's any serious role for HBOT in the treatment of children with this all-too-prevalent condition. Our evaluation of the medical evidence stands firmly on scant. Yet we follow the autism news faithfully and here share our bookmarks to mark the midyear.

AWARENESS, RISK & PREVALENCE

As the autism spectrum widens to include more disorders, such as Asperger syndrome, the CDC now reports the prevalence of autism spectrum disorders (ASDs) is approaching 1% of US children aged 8 years, and says: "Although some of these increases can be accounted for by improved identification and awareness, the steady increase in ASD symptoms in the population possibly reflects increased risk, particularly among males."

Searches for risks in environmental toxins or any specific chemicals or pollutants behind local autism clusters turned up little or nothing. (Wow, did Nicholas Kristof ever miss the mark.) But here comes the blockbuster headline from the front lines of the vaccine war.

MEDICAL LITERATURE & RESEARCH

British medical journal The Lancet took the almost unprecedented action of retracting a 1998 paper that suggested vaccines cause autism. At the risk of offending our welcome guests from the autism community, we always found the evidence against vaccines flimsy and Dr Andrew Wakefield's ill-gotten results a menace to the public health.

In the wake of The Lancet news Adam Winkler, writing for The Daily Beast, marvels at "how much ordinary people distrust the major medical associations and health organizations," and so do we. Lian Kupferberg Carter, writing in The Huffington Post, calls for civility, and so do we. Dr Glenn Goodhart of Atlanta Hyperbaric quite astutely observes, "Few minds will be changed by The Lancet retraction," and we reluctantly concur.

A study into the genetic roots of autism, published in Nature and surprisingly well covered by USAToday, produced more questions than answers—just the latest smudge on the shiny hopes for the Human Genome Project.

IN THE COURTS

In another harsh setback for the antivaccine movement, three judges ruled against a class action by 5,000 families of children with autism seeking compensation from the federal vaccine fund.

The father of a 7-year-old Chicago boy, engaged in a bitter divorce and custody battle, sued two Defeat Autism Now! doctors over "medically unnecessary and unjustified" chelation therapy. Litigation is pending.

BOOKS, NEWSPAPERS, FILM & TELEVISION

After watching CNN's Sanjay Gupta interview author Karl Taro Greenfield one Sunday morning, we spent the entire afternoon in an armchair at the local bookstore devouring Boy Alone, a most original and powerful memoir about autism and family and language and memory and buy it.

The New York Times added six must-see autism stories to its excellent Patient Voices series.

There's plenty of Emmy buzz surrounding Claire Danes's portrayal of autism hero/advocate and animal behavior genius Temple Grandin on HBO. We first noticed Grandin some 15 years ago in the book An Anthropologist on Mars by Oliver Sacks. She last drew our attention in February with her amazing TED lecture. The world needs all kinds of minds, indeed.

On Showtime the documentary film "Dad's in Heaven with Nixon" earned rave reviews, too.

Quick, take one more look at that CBC story that stirred up such a hornet's nest in Canada.

Maybe the highlight of the television season was The Vaccine War on PBS's Frontline, whose website also offers a rich page of links to answer the question, What's behind the rise in autism? Absolutely stellar and refreshingly frank reporting on a tough subject.

Finally, in related news, Jenny McCarthy and Jim Carrey are splitsville.

LeBron Disses HBOT To Peddle Vitamin Water

Please don't watch if you can't take a joke. A pretty funny spot, really. And goodness knows we've dipped our skewer in the cheese so have no right to complain. But word to King James: We'll match the medical literature on HBOT against the medical literature on antioxidants any day of the week.

Weekly Web Roundup: 27 June 2010

Sample some more of the HBOT news that fed our RSS page and excited our Twitter followers this week.

SCIENCE

Using mice to study heatstroke, a group from Taiwan publishing in the Journal of Biomedicine and Biotechnology found that "hyperbaric oxygen may improve outcomes ... by normalization of hypothalamic and thermoregulatory function."

Journal of Veterinary Emergency and Critical Care continues its series on hyperbaric oxygen therapy.

Journal of Applied Physiology publishes "hyperbaric hyperoxia and normobaric reoxygenation increase excitability and activate oxygen-induced potentiation (OxIP) in CA1 hippocampal neurons." (Don't be embarrassed. We don't know what it means, either.)

An in vitro study of cancer cells out of Hunan Province, China, published in the journal Undersea & Hyperbaric Medicine, concludes that "simple HBO2 treatment after 48 and 72 hours could inhibit the proliferation of nasopharyngeal carcinoma CNE2Z cells."

PRESS/BUSINESS

The Hyperbaric Oxygen Treatment Trust in Scotland has launched a new web resource for HBOT news and research.

Dr John Jackalone, associate director of the Hyperbaric and Wound Healing Center at St Joseph Hospital (formerly New Island Hospital), Bethpage NY, has been named Physician of the Year by the Metropolitan New York Association of Diabetes Educators (MNYADE).

The wound care centers at Ashland Community Hospital in Ashland OR, Valley View Regional Hospital in Ada OK, and Our Lady of Bellefonte Hospital in Ashland KY have been recognized as a Centers of Distinction by Diversified Clinical Services.

PATIENT STORIES

A father speaks about his two injured sons, both casualties of war, one now undergoing HBOT for traumatic brain injury.

A young woman suffering an alleged adverse reaction to the human papillomavirus (HPV) vaccine Gardasil benefits from HBOT with Dr Ken Stoller at the Hyperbaric Medical Center of New Mexico.

A New Zealand pilot SCUBA diving in Papua, New Guinea, survives life-threatening decompression sickness after an amazing rescue ordeal and successful hyperbaric oxygen therapy.

Italian grand prix motorcyle racer Valentino Rossi is using HBOT to speed recovery from a broken leg.

NEW HBOT CENTERS

The Center for Wellness, Charlotte NC, has added hyperbaric oxygen therapy to its service offerings.

Mercy Suburban Hospital, East Norriton PA, offers HBOT at its Center for Wound Healing & Hyperbaric Medicine.

South Central Regional Medical Center, Laurel MS, opens a Diversified Clinical Services wound care center.

Erie County Medical Center, Buffalo NY, has been cleared by the State Health Department to build a Diversified Clinical Services wound care center.

O2 is a new independent hyperbaric, infusion, and wound care center in Farmington Hills MI.

Sutter Delta Medical Center, Antioch CA, will soon open an Advanced Wound Care Center.

Tennessee Hyperbaric Center, Jackson TN, has opened an independent pain and hyperbaric oxygen therapies clinic.

The Finley Hospital, Dubuque IA, has opened a Center for Wound Healing and Hyperbaric Medicine.

St Mary Medical Center, Apple Valley CA, has opened a Center for Wound Care and Hyperbaric Medicine with Paradigm Medical Management.

Peru: Hyperbaric Entrepreneur Awarded Top Honor

Peru has thousands of miles of Pacific coastline, but it was high-altitude tourism in the Andes that made hyperbaric oxygen therapy a natural pursuit for entrepreneur Gary Urteaga, CEO of Equipar Medical SAC in Lima. Last month Urteaga was awarded the 2010 MYPE President Prize. He earned it by installing the country's first modern hyperbaric chamber and organizing its first International Congress on Hyperbaric Medicine.

Urteaga has worked closely with Life Support Technologies Group (Mount Vernon NY), for whom he created an Advanced Hyperbaric Technologies division to develop low-cost, high-quality HBOT chambers designed in the US and engineered and manufactured in South America and Asia.

[Photo: Urteaga, left, with President Alan Garcia of Peru]

HBOT For Bone Fracture: Fundamental Mechanisms

Out of Taiwan comes a new study with new insights into precisely how hyperbaric oxygen helps fractured bones heal. Scientists observed in vitro cultures of specialized bone-producing cells, called osteoblasts, under normal conditions and with hyperbaric oxygen. They found that "the proliferative effects of hyperbaric [oxygen] on osteoblasts may contribute to the recruitment of osteoblasts at the fracture site."

HBOT has long been used to treat broken bones associated with crush injuries, compartment syndrome, and other traumatic ischemias. Many hyperbaric physicians and patients claim HBOT accelerates the healing process. This primary research may support such claims by describing how hyperbaric oxygen stimulates the fundamental mechanisms of bone production.

A quick Google Scholar search shows nearly 7,000 articles on "hyperbaric AND fracture." Surely the next 7,000 will cite this study. And so will we, in a Bone Fractures page, coming soon to the HyperbaricLink Diseases and Conditions section.

Alzheimer's And Dementia: Working For A Diagnosis

Avid Radiopharmaceuticals may have just surmounted the highest barrier to developing new treatments for Alzheimer's disease: a definitive diagnosis. Gina Kolata files the fascinating story in today's New York Times about the company's breakthrough imaging dye, which enables PET scans to show plaque buildup in the brain. Such a test presents a whole new world of possibilities in Alzheimer's research and drug development.

Not nearly as specific, but equally fascinating to us, is what scientists are uncovering about age-related dementia when they treat words like data. NPR's Radiolab tells how an English professor studying the late works of Agatha Christie and doctors studying the diaries of nuns have stumbled across hidden clues to the mysteries of aging brains. Listen to the Radiolab podcast "Vanishing Words" on WNYC.org.

HBOT In Sports: From Stanley Cup To World Cup

A few weeks ago Chile's top scorer Humberto Suazo, nursing a torn hamstring, was looking iffy for the World Cup in South Africa. But he responded quite well to treatment, "including oxygen therapy sessions in a hyperbaric chamber designed to speed up recovery."

Suazo is playing if not scoring as Chile, fast becoming the international fan favorite, faces Spain this Friday.

In other HBOT sports news, Philadelphia Flyers right wing Ian "Lappy" Laperriere almost got knocked out of the Stanley Cup playoffs after receiving a hard blow to the face and a mild concussion. For speedier recovery he turned to HBOT at Hyperbaric Therapy USA, Newtown Square PA. Here's the local TV interview, in the chamber:



Philly ended up losing the Cup to the Chicago Blackhawks, but Lappy skated his heart out right to the end, earning the title Toughest Player in the NHL for the 2009-2010 season.

Doubly Fatal Chamber Fire: One Year Later, No Answers

So where's the final report from the investigation? All the buzz in the mainstream media, on Twitter, and in the blogosphere around the anniversary date was about the impending lawsuit settlement. But what the family and the hyperbaric community really want is an answer. What went wrong? Apparently a "blast" dislodged a "tube" and caused an "explosion" or "flash fire." We reported these preliminary findings last July and haven't heard a definitive word since. Last month's video report from the Sun Sentinel doesn't much add to our understanding. How can we prevent such a tragedy from happening again? No one can assure anyone until everyone knows the facts.

[Note: The incident occurred 1 May 2009 at Ocean Hyperbaric Neurologic Center, now renamed Neubauer Hyperbaric Neurologic Center, in Lauderdale-by-the-Sea, FL.]

Weekly Web Roundup: 19 June 2010

We've been thinking the weekend's the perfect time for us to share more of the HBOT news that crosses our Blogger dashboard and fills up our Twitter page every week. Do enjoy our first selections, and send along stories you're pretty sure O2.0 readers shouldn't miss.

SCIENCE

A case study out of Intermountain/University of Utah on "Atypical Calciphylaxis in a Patient Receiving Warfarin Then Resolving with Cessation of Warfarin and Application of Hyperbaric Oxygen Therapy."

A WOCN/WCET study on combined HBOT and VAC therapy in complex wounds.

Scandinavian trauma journal article on the "Effect of Hyperbaric Oxygen Therapy on whole blood cyanide concentrations in carbon monoxide intoxicated patients from fire accidents."

Journal of Veterinary Emergency and Critical Care begins a series on hyperbaric oxygen therapy.

MEDIA/ENTERTAINMENT

A first-year medical student vlogger urges doctors on Grey's Anatomy to try HBOT next time they face amputation for a diabetic foot ulcer.

Heavyweight boxing contender Tony Thompson undergoing HBOT at Hyperbaric Therapy USA, Newtown Square PA.

PATIENT STORIES

A blogging mother reports progress with HBOT for her two-year-old with cerebral palsy.

Tucson neurologist Dr Carol Henricks to testify before Congress about her treatment of veterans with traumatic brain injury and posttraumatic stress disorder.

PRESS/NEW CENTERS

The Sioux City Journal plugs the wound healing center at Mercy Medical Center, Sioux City IA.

Genesys Wound and Hyperbaric Center, Grand Blanc MI, plugs itself.

National Healing Corporation recognizes Moore Regional Hospital, Pinehurst NC, with its Front Runner Award. National Healing is also adding 40 employees at its Boca Raton FL headquarters.

Centegra Wound & Hyperbaric Center opens in Huntley IL.

Lexington Memorial Hospital, Lexington NC, opens a Diversified Clinical Services wound care center.

St Joseph's Hospital, Chippewa Falls WI, adds HBOT to its wound care center through Diversified Clinical Services.

Jupiter Medical Center, Jupiter FL, shows off its "largest chambers in the state" on YouTube.

Monongahela Valley Hospital, Monongahela PA, adds HBOT to its wound care center through Shared Health Services.

Dr Arturo M. Volpe has added mild HBOT to his Houston TX chiropractic practice.

HBOT For Autism: Junk Science?

Yesterday "hyperbaric oxygen chambers to cure autism" made the Junk Science Week shortlist in a major Canadian newspaper. National Post financial columnist Terance Corcoran, darting about from fear to hype to hope, fails to build much of a case for such harsh judgment. And his entire tirade stems from a pretty finely balanced television story on CBC's The National.

We're on record, in this blog and on the HyperbaricLink autism page, in favor of more well-designed clinical investigations to build on last year's interesting work by Rossignol, et al, using mild HBOT. The UHMS December 2009 position statement on "The Treatment of Autism Spectrum Disorder with Hyperbaric Oxygen Therapy" concurs:

... there is a strong case for further trials to be done in this area. Any future trials would need to be well planned, appropriately powered and include several relevant treatment arms.... These clinical efforts should be combined with efforts to elucidate the basic mechanisms by which mild hyperbaric therapy might exert a therapeutic effect.

Now does that sound like Junk Science to you? Let's be ever mindful of the canyon that lies between "unstudied" and "disproven" medical claims, especially when seeking effective treatments for such a poorly misunderstood condition as autism.

Virginia Mason Demonstrates HBOT Leadership

Besides last Thursday's plenary and provocative HBO dosing talk by Dr Neil Hampson at UHMS St Pete 2010, the main thing we noticed about Virginia Mason Medical Center (Seattle) was its dominance of the proceedings. Hampson and team gave seven presentations at the Annual Scientific Meeting.

Late last month we also took note when Virginia Mason became the first hyperbaric medicine facility to twice earn UHMS accreditation with distinction. And the center also leads with its beautiful and unique 18-person chamber, by Reimers Systems Inc, the only multiplace chamber in the Northwest and, some say, the largest in the US. Congratulations all around.

Now let's complete the picture by renovating your profile in the HyperbaricLink treatment center directory. Oh, don't you worry, we'll be in touch.

Hyperbaric Oxygen: What Is The Correct Dose?

Ask four experts and you'll get five opinions, as the old joke goes. We were so looking forward to Thursday afternoon's UHMS plenary session but came away even more completely baffled about how your average hyperbaric physician decides what pressure, duration, and number of treatments to prescribe. To say there is wide variation in practice would be a gross understatement.

Only the Navy, the Air Force, and the Divers Alert Network, it seems, stick to some sort of standard dosing tables. Even these standards share a dubious pedigree, which speaker Paul Sheffield traced back to (1) the arbitrary selection of the 90-minute sessions used to treat gas gangrene in 1961 and (2) the strange translation from 45 feet of seawater or FSW to 2.36 atmospheres absolute or ATA. Well, that explains that, anyway.

Practice is one thing. A lack of guidance on dosing also hamstrings the responsible clinical investigator. Dr Neil Hampson, of Virginia Mason Medical Center in Seattle, recounted his quest for "the Holy Grail of HBO2 dosing" when powering his ongoing randomized, controlled trial for carbon monoxide poisoning. He ended the session by suggesting that some measure of cumulative dose, such as ATA-hours, might prove more meaningful than individual doses or numbers of treatments. We seriously doubt it. And we're little comforted by Dr Hampson's claim that "HBOT works, but we still don't know the right dose." Only the right dose works, or are we wrong?

Oxygen is a drug. Pressure is strong medicine. Yet dose ranging studies and so much other basic science has been left undone, for so many decades, we sometimes wonder how hyperbaric physicians expect to gain the respect of the broader medical community.

By holding plenary sessions like this one, is the answer, and sharing a healthy, truthful accounting of the state of affairs. Now to act on the lack of information. Then the applause, applause.

UHMS Annual Scientific Meeting

Greetings from St Pete Beach, FL, where we're kicking back and getting ready to kick off the 43rd Annual Scientific Meeting of the Undersea and Hyperbaric Medical Society. HyperbaricLink Version 2.0 is proudly on exhibit alongside the leading HBOT organizations and suppliers. We'll also sample generously from hundreds of oral and poster presentations. Download the full program PDF if you wish to follow and learn. Topics that grabbed our attention include:

• HBOT for age-related macular degeneration
• Off-label indication year in review
• Photography from the National Geographic Society
• Oxygen and pressure dosing
• Hyperbaric habitats for butterfly longevity
  

Wish you were here? We'll file live updates, as time permits, and go home with plenty of notes for future O2.0 posts.