FDA Urges Caution In Negative Pressure Wound Therapy

People often ask us how high-pressure (HBOT) and low-pressure (NPWT) therapy can both be effective in the treatment of diabetic foot ulcers and other chronic wounds. If one works, the other shouldn't, right? In simplest terms, both hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT) promote blood circulation in the healing wound bed. Hyperbaric oxygen works directly through the blood vessels below. Negative pressure, or vacuum, therapy works indirectly through the wound dressing above.

NPWT plays a central role in advanced wound care. Major device manufacturers KCI, Smith & Nephew, and Medela (Mölnlycke) are major contributors to the movement that has swooped up HBOT and helped millions suffering with nonhealing chronic wounds.

Last week the FDA issued a Safety Communication Update on serious complications associated with NPWT. The agency reports "a total of 12 deaths and 174 injury reports since 2007" and notes NPWT contraindications and patient risk factors to consider. Most deaths occurred with use at home or in long-term care facilities. Together the FDA, the industry, and the medical community are educating clinicians and patients and closely monitoring outcomes.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Should Your Hyperbaric Physician Be Board Certified?

Every doctor knows the difference between holding a license to practice and earning board certification in a medical specialty, and every patient should know the difference, too. "How to become a licensed, board certified doctor," by pediatrician Roy Benaroch MD on KevinMD.com, offers some helpful insight into the board certification process and its value to the patient. Benaroch concludes:

Is your doctor board-certified? He or she ought to be—or have a good excuse to have skipped or delayed this step. If you don’t know, ask.

Specifically, you should ask your doctor if her or his certification is up-to-date, as most boards require education, exams, and other qualifying steps every 7-10 years.

The UHMS keeps a list of board certified undersea and hyperbaric physicians. ProfilePlus listings on HyperbaricLink include information on physician board certification, and we give you a rundown of the professional organizations that train, accredit, and certify hyperbaric oxygen therapy treatment centers and clinicians.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.
 

Chatroulette To Empower Patients? Not So Much.

Call us geeks, but we take Medgadget by RSS feed and consider its founders, the brothers Ostrovsky, brilliant healthcare web entrepreneurs. So what's with HealCam? It's like a Chatroulette full of sick people. You remember Chatroulette. It was the hot Internet craze last summer before it flashed like a firework then fizzled. Now the Russian kid who started it, and turned down generous buyout offers, makes all his money off the site's worst offenders: nude dudes. Not exactly an inspiring model for a site where people might go to discuss medical problems.

Still, one can see the utility of live video chat plugged into thriving online patient communities like PatientsLikeMe. Once members get acquainted in chat rooms, they can arrange to speak more freely face-to-face. Got it. And if brisk PR can save anything, it'll save HealCam. But even since the big ABC News story broke, 2 February, there's not a soul there wanting to chat about our (real but not serious) lung condition. You'll find a similar critique on the Target Health Global blog. Now here are we both, spreading the word, because what HealCam is trying to do is so important.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Restorix Health Mixes It Up In Greater Seattle

Suddenly one ambitious new HBOT clinic in Issaquah WA has become the darling of the local newspaper and the chamber of commerce, and raised the hackles of one leading authority in hyperbaric medicine. Restorix Health opened in December with "the largest collection of large monoplace chambers in the country" (6 Perry Sigma 40s) and plans "to lead the country in research using hyperbaric chambers to treat soldiers with traumatic brain injuries" and other investigational conditions by opening "15 to 20 new clinics along the West Coast in the next five years." Followup coverage last week ballyhoos the center's Innovation in Issaquah award for "space-age medical research."

UHMS past president Dr Neil Hampson is having none of it. Read his letter to editor of the Issaquah Reporter (see also our appreciation of his Virginia Mason program). Hampson casts doubt on Restorix's business model and its clinicians' research credentials, concluding:

I am skeptical that the Restorix Foundation will be capable of underwriting the expense of quality research in hyperbaric medicine, as I would be about most foundations in this country. My strongest hope is that they do not plan to charge patients for experimental treatment.

Restorix Research Institute chief medical officer Tommy Love shot off a quick rebuttal, insisting his studies (4 in the works) will be IRB-approved and peer-reviewed, adding:

Our research studies will never charge patients to participate.  Dr. Hampson’s claim that only large institutions can do credible research is simply untrue.

We're captivated by the debate and eager to learn more about the privately funded research Restorix has in the works.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Chronic Fatigue: New Study Of 4 Standard Therapies

You won't find any mention of XMRV in the new large, randomized trial comparing adaptive pacing, cognitive behavior, and graded exercise therapy to specialist medical care for chronic fatigue syndrome (CFS). The study was published today in The Lancet, whose editors last September opined that CFS is not "a physical disease" but, rather, a "heterogeneous family of disorders, and it seems most likely that these disorders arise from a constellation of pathophysiological causes."

The publication is causing quite a stir in the ME/CFS community. Start with the Readers' Comments to the New York Times coverage. Next search #mecfs and #xmrv on Twitter if you've got a deeper interest and a few hours to spare. Then see our previous posts on CFS and the XMRV retrovirus. Still, our Chronic Fatigue Syndrome page on HyperbaricLink shows nothing but scant evidence that hyperbaric oxygen is at all effective.

[Photo: Robert Bukaty/AP]

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Daily Show: Spider-Man's Understudy Kept HBOT Fresh

We promise plenty of real hyperbaric oxygen therapy news soon to follow, but right now this harmless meme demands our participation.

The Daily Show - Intro - Spider-Man's Understudy
Tags: Daily Show Full Episodes,Political Humor & Satire Blog,The Daily Show on Facebook

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Valentine's Day: Science, The Senses, Health, Life

To celebrate Valentine's Day our good friend and colleague Mark Stinson serves up Chocolate: or, An Indian Drinke, by 17th century author and physician Antonio Colmenero de Ledesma. Click here to read Mark's introduction and download the free e-book. Sweet. Health is life, after all, and we experience life with our skin and through the holes in our heads. So may we also highly recommend A Natural History of the Senses, by Diane Ackerman, a book chock-full of science and so finely written you see, hear, smell, touch, taste it.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

#Hyperbaric Tweeting The #Grammys

Watching along with millions of the 190 million Twitter users breathed some life into tonight's ho-hum Grammys telecast, and produced some funny and not-so-funny #hyperbaric tweets. Astounding how many people thought Lady Gaga's egg looked like a hyperbaric oxygen chamber. We're not seeing it. Anyway, top prize goes to this entry by the Village Voice.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Quad Cities Homeless Man Gets HBOT For Frostbite

The pain, the skin and tissue damage, the lack of circulation, the race against the clock to salvage limbs—using hyperbaric oxygen therapy for frostbite must be like treating a burn, a traumatic ischemia, and a chronic wound all at the same time. HBOT is not specifically indicated for the treatment of frostbite. But don't these similarities make good common sense? The online medical literature on HBOT for frostbite dates back to the 1960s. A quick search shows 16 papers on PubMed and over 600 articles on Google Scholar.

Frostbite and hypothermia are much on our minds, as much of the Midwest emerges from dangerous subzero temperatures. Even dashing between warm shelters and warm cars gets our extremities tingling. So we're easily moved by this report of a homeless man in Rock Island, Illinois, now receiving treatment at Trinity Wound Care & Hyperbaric Medicine in Bettendorf, Iowa, in hopes of saving parts of his frostbitten feet. Click here to watch the video. And please follow us on Twitter and join us in sharing this heartwarming story.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

HyperbaricLink Adds Video To ProfilePlus Listings

Now prospective patients and referring physicians can hear straight from the HBOT clinician and take a good look around select treatment centers on HyperbaricLink. Check out our listing for the Colorado Center for Hyperbaric Medicine. Just scroll down the right-hand column and click play to see and hear Kirk Hartley's two-minute hyperbaric oxygen primer and virtual tour of the facility. Video enlivens the connection between healthcare consumers and providers, and energizes the exchange of information with color and character. And of course the richer content adds even more value to our ProfilePlus premium directory listings. Please contact us at (617) 383-7159 or support@hyperbariclink.com for more information.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Bill Gates Chimes In On Vaccine-Autism Debacle

Now here's a man who knows something about the population health benefits of immunization, and he appears sincerely angry about the damage done by Dr Andrew Wakefield and followers. Click the video below. Read the transcript of his interview with Sanjay Gupta on CNN.



The fraud doesn't end with autism. Along the fringes of the hyperbaric community we often hear about the treatment of so-called Gardasil injuries. Gardasil is the brand name of one of the vaccines that protects against human papillomavirus (HPV), which causes cervical cancer. The other brand name is Cervarix. Casually, some HBOT practitioners have approached us, and said, "Well, we're seeing a lot of Gardasil injuries lately." Then they go tell the local TV health beat reporter.

Such scaremongering is a menace to the public health. We urge any patient or parent who wants to get the facts and weigh the evidence on the HPV vaccine to go straight to the Vaccine Safety section of the CDC website. The Centers for Disease Control and Prevention operate the Vaccine Adverse Event Reporting System (VAERS) to track side effects and adverse events following vaccination. See for yourself how vigilant and transparent the medical community and the CDC have been since the HPV vaccine was introduced in 2006. Physicians who suspect adverse events following vaccination should pursue the matter through these proper channels.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

CO Poisoning: A Little Help Reading A Big Study

Thanks to the learned evaluation by Dr Leon Gussow in The Poison Review, we have a much firmer grasp of the large study (385 patients) published 2 December 2010 in Intensive Care Medicine, which casts doubt on the efficacy of hyperbaric oxygen for acute carbon monoxide (CO) poisoning. Gussow rates the paper well worth reading: 3.5 skulls-and-crossbones on a scale of 5. But he finds some potentially serious flaws in the study design. Most important, he concludes that the paper "...doesn’t really answer (or address) the key question: Does treating a CO-exposed patient who at any time lost consciousness with HBO improve long-term neurological outcome?" The rest of the TPR analysis explains why.

Meanwhile, in the news just this last week, HBOT proved instrumental in treating people overcome by carbon monoxide fumes in Hyattsville MD, Baltimore, suburban Dayton, Gunnison CO, and Sebring FL. The Florida incident occurred at a hyperbaric oxygen treatment center.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

Clinical Evidence: Is Any Of It Any Good?

Last week Newsweek told us "Why Almost Everything You Hear About Medicine Is Wrong," and goodness knows there have been times we have wanted to say the same. Facts and skepticism, not commerce or politics, not hopes and dreams, should drive evidence-based medicine. We're all about facts and skepticism. And so we also seriously doubt the article's chief claim, based on some pretty flimsy-sounding mathematical modeling, that the majority of clinical trial results are wrong.

Yet the article's main point strikes home. Human clinical trials are conducted by human beings, all with personal motivations and biases, on human beings, all with minds and bodies wide open to all sorts of suggestions and stimuli. The human experiment is messy. Life is messy. Even the finest, largest randomized prospective trials, using gold-standard placebo controls, may fall to shreds upon closer scrutiny.

One of our favorite scientific papers last year sheds a little light. Kaptchuk et al, publishing in the online journal PLoS ONE, found that "placebos administered without deception may be an effective treatment for IBS" (irritable bowel syndrome). That's right. Patients who were told they were being given "...placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes," did significantly better than patients who received no treatment at all.

Maybe it was the mere act of caring and caregiving, the human touch, that made the difference. We don't know.

So we do the best we can, and we keep our wits about us when we read and interpret (yes, interpret) study results. And here at HyperbaricLink, on our Diseases and Conditions pages, we always provide thoughtfully curated facts and clicks for you to study the state of the HBOT evidence yourself.

In hyperbaric medicine we're used to scathing headlines that make Newsweek's look tame. Who could forget this September gem from Slate: "Don't listen to Tim Tebow: Hyperbaric oxygen chambers are mostly useless." At least the author was kind enough to provide a link to hyperbaric oxygen search results in the Cochrane Reviews, where (equally messy and suspect) meta-analytical techniques abound but domain expertise and independence rule. Surely we're fortunate that HBOT has won the attention of The Cochrane Collaborative. We're also fortunate to have the UHMS, the ACHM, and other professional organizations with peer-reviewed meetings and publications to keep investigators and authors honest.

We'll keep consulting such reliable sources and keep placing our trust in the scientific method. And let's take those papers one at a time, please, and spare the sweeping generalizations.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

The Skin Gun: Stem Cell Sprayer For Thermal Burns

The treatment of thermal burns today often involves the transplant of skin grafts, with notoriously long healing times and high susceptibility to infection. Hyperbaric oxygen therapy aids in speeding healing and controlling swelling and infection. That's a pretty neat trick, but nothing at all like what you are about to see.

Double-click on the (large) video below. Sometimes from the first look you know when a flashy new gadget is a real medical breakthrough.



Developed by a team led by Dr Jörg Gerlach at the University of Pittsburgh's McGowan Institute for Regenerative Medicine, the spray gun device is really just the business end of a 3-stage process. First the patient's own skin and skin stem cells are collected and isolated. Then the skin cell solution is applied directly to the wound with a spray gun. Finally the wound is dressed with an artificial vascular system, a "bioreactor bandage that distributes glucose, sugar, amino acids, antibiotics, and electrolytes" and cleans the treatment area to support stem cells that grow into new skin.

Wow! is about all we have to add.

Read more at the Medgadget blog and in the McGowan press release.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.

HBOT Operational At The Tiger Woods Mansion

Okay, we're feeling a little icky about relaying this tabloid dreck (again!), and we really can't explain why it's in the news (again!), so we've backdated it 48 hours. Let's hope beyond hope we never again stub our toe on a line like: "He has a Michael Jackson hyperbaric chamber."

Now please accept these links as a hyperbaric reminder that, when it comes to HBOT, all your average man and woman on the street knows is Jacko and maybe the local football star slept in one. And when it comes to improving HBOT awareness and education, we've all got our work cut out for us—and miles to go before we sleep, and miles to go before we sleep.

O2.0 is the news blog of HyperbaricLink, the independent web guide to hyperbaric oxygen therapy.