Adults With Diabetes More Than Doubled In Last 30 Years

Add some alarming new statistics to our case for increased access to advanced wound care and limb salvage for patients with diabetic ulcers. From 1980 to 2008, the number of adults with diabetes soared from 153 million to 347 million worldwide, according to a large study published this week in The Lancet. In the US the incidence rate rose more than 60% and jumped 79% in women. Population aging accounts for much of the increase, but obesity has played a major role. The study was funded by the Bill and Melinda Gates Foundation and WHO. Click the following hyperlinks to read the Lancet abstract, a summary from the Imperial College of London, and a blurb in The Economist, complete with world maps and a swipe at America's "hefty reputation." Not very cricket.

[Map: The Economist]

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

Evidence-based HBOT Is Not CAM

In our May 16 post we gently admonished integrative medicine guru Andrew Weil, MD, for misstating the clinical evidence on HBOT for stroke. Our criticism pales by comparison to Orac's on the Respectful Insolence blog. In "Dr. Andrew Weil versus evidence-based medicine" the pseudonymous Orac writes:

... no physician that I can think of has over the course of his lifetime done more to promote the rise of quackademic medicine than Dr. Weil. The only forces greater than Dr. Weil in promoting the infiltration of pseudoscience into academic medicine have been the Bravewell Collaborative and the National Center for Complementary and Alternative Medicine (NCCAM).

The swipe at NCCAM seems harsh to us. The National Institutes of Health (NIH) has just launched its NCCAM online portal. We're only too happy there's a new home for evidence-based CAM on the web. Visitors should be impressed by the website's complete and helpful information. They should also be enlightened or frightened by the scarcity of high-quality, supporting clinical evidence on natural products, mind-body medicine, manipulative and body-based practices, and other CAM practices. Just hosting this community will challenge CAM proponents to deliver the goods if they can.

Nowhere on NCCAM's list of Health Topics A-Z will you find hyperbaric oxygen therapy. Evidence-based HBOT is neither complementary nor alternative medicine. It's not integrative, holistic, natural, traditional, new age, or unconventional. Let's keep it that way.

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

HBOT In The News: Stay Classy, San Diego!

We've been meaning to direct your attention to a newspaper article that provides readers with a refreshingly clear, honest, and thorough introduction to hyperbaric oxygen therapy. "Oxygen's medical channels" appeared 27 April 2011 in the San Diego Union-Tribune, subtitled: "Hyperbaric chambers gain new respect for treating wounds, injuries, other conditions." Thank you, R.J. Ignelzi. Sometimes a reporter gets it just right. And we especially enjoyed the accompanying photographs by Charlie Neuman and illustrations by Aaron Steckelberg. With more coverage of this quality, our job of providing information and correcting misinformation about HBOT certainly would be easier.

[Illustration: Aaron Steckelberg, San Diego Union-Tribune]

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

Diseases And Conditions: Further Reading

A favorite new feature of our upgraded Diseases and Conditions page is the "Further Reading" corner. Here visitors will find links to longreads of all sorts: books, journals, magazine and newspaper articles, websites, multimedia. We aim to make our suggestions both illuminating and relevant. But our suggestion on yesterday's new diabetic ulcers page may have left some of you scratching your heads. Readers who have enjoyed A Leg to Stand On will get the connections. Let's consider a few. One. Oliver Sacks is our best clinical writer, period. Two. The story he tells will interest anyone whose identity suddenly revolves around being a patient. Three. One man's odd change of relationship with his leg may help others experiencing neuropathy and living with the prospect or the reality of amputation. If you think this is a stretch, just wait. We will occasionally rotate our selections. And by the time we reach migraine this title will get the heave-ho to make way for Migraine (1970).

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

New On HyperbaricLink: HBOT For Diabetic Ulcers

Today we have added Diabetic Ulcers to our Diseases and Conditions section. In our view this close companion to our updated Chronic Wounds page merits its own space for diabetes-specific content, news, and Patient Resources for people affected by complications of diabetes.

Diabetes presents serious challenges for the wound care clinician and the medical community. An excerpt from our writeup:

Wound healing in people with diabetes is often complicated by poor blood circulation in the feet and legs. Nerve disease (neuropathy) may also cause a loss of sensation in the feet and legs, so even a small cut, sore, or pressure ulcer may go unnoticed for some time and develop into a problem wound. Diabetic ulcers are especially prone to serious bacterial infections that threaten life and limb.

HBOT brings strong clinical evidence to this challenge and has indeed become a standard treatment for infected diabetic ulcers, Wagner Grade 3 or worse. Prevention and early intervention offer the best hope for reducing the rates of amputation and death from infection in the diabetes population. But more people with diabetes today need access to advanced wound care and hyperbaric oxygen treatment centers. And now HyperbaricLink has a page where visitors can get more specific information about their condition and connect with local centers fully staffed and equipped to help heal diabetic ulcers.

[Illustration: Unknown]

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

Update: HBOT For Chronic Wounds

Today we have upgraded our Chronic Wounds page. We find this update particularly satisfying, as hyperbaric oxygen therapy figures so prominently in the advancement of wound care, and advanced wound care figures so prominently in healthcare today.

Our new HyperbaricLink Commentary emphatically states our position:

Hyperbaric oxygen plays an increasingly important role in the treatment of problem wounds and limb salvage. But access to accredited hyperbaric facilities and certified hyperbaric physicians and technicians is a public health problem. In 2004 as many as two-thirds of nursing home patients with NPUAP Stage II  or worse pressure ulcers were not enrolled in wound care treatment programs [NCHS, 2011]. In diabetes-related wounds alone, US hospitals performed 66,000 toe, foot, and leg amputations in 2006 [CDC, 2011], for which health economists have estimated a cost of $3 billion per year [ACA, 2008]. More and more hospitals and health networks today are opening advanced wound care and hyperbaric centers to serve this unmet clinical need. Even if chronic wounds were its only indicated use, HBOT would be assured a place in evidence-based medicine for quality and cost-effective healthcare.

People affected by chronic wounds will find new links to good basic info under Patient Resources. We've also added the Association for the Advancement of Wound Care (AAWC) to our list of Clinical Resources. And we're always happy to plug must-reads from Best Publishing, now in Further Reading.

See our June 7 post, "Diseases/Conditions Upgrades And Updates," for more information about our new page format. And look for regular updates in the days and weeks ahead.

[UPDATE: 31 Aug 2011. Revised NCHS citation to reflect that wound care professionals use NPUAP Stages, not Wagner Grades, to classify pressure ulcers.]

[Photo: Fink Engineering]

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

UHMS 44th Annual Scientific Meeting

As the Undersea and Hyperbaric Medical Society wraps up in Fort Worth today, we're struck once more by the depth and breadth of the science. Download the full program on the UHMS website and see for yourself. Suddenly we've got even more reading to do.

Speaking of the UHMS website, please watch that last hyperlink, and all the UHMS links on HyperbaricLink. We've been assured any bad links will be good just as soon as the Society finishes its new members-only section and spruces up its look and feel. Our best wishes and congratulations on another fine meeting.

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

Evidence-based HBOT: Trust It Or Trash It?

Newspapers, magazines, television, radio, the web—you're showered with health news and views 24/7. How do you know who to believe? One elegant new tool has boiled the challenge down to three simple questions. Who said it? When did they say it? How did they know? Trust It or Trash It? is a tool to help you think critically about health information. Developed by Genetic Alliance in cooperation with the CDC National Center on Birth Defects and Developmental Disabilities and others, the simple interactive guide also urges you to dig deeper using a Content Scale, Quality Scale, and Usability Scale. We think you'll find Trust It or Trash It? fun and informative. We've found it inspiring, and maybe a bit intimidating, as we work to make HyperbaricLink one health information resource you can always trust.

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

HBOT For Chronic Wounds: Evidence, Verdict

It's comforting, as we read up for our upcoming chronic wounds page update, to find a like-minded writer. Dr Tom Serena blogs for WoundSource. In his April post, "Hyperbaric Oxygen Therapy in Wound Care: Evidence that Demands a Verdict," he doesn't pull his punches:

In truth, the evidence for HBOT therapy is robust, while the evidence for most of our dressings and devices is based on poorly conducted trials, case studies, or simple opinion. HBOT for diabetic foot ulcers has been confirmed by four randomized controlled trials (RCTs) with more research underway.... More is known about the mechanism of action of oxygen under pressure than the majority of adjunct therapies.

Bang. He had us at hello, with that quote from G. K. Chesterton. Serena also leads the Serena Group and is vice president of the ACHM, where he is a 2011 Masters Recipient and leads the ACES diabetic foot ulcer registry. (See our 9/2009 post, "Diabetic Foot Ulcer: New ACHM Registry Is ACES.") Now he's got us wondering how ACES is coming along.

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

Hyperbaric Food: Like Pasteurizing With Pressure

Who knew? The foodservice industry uses hyperbaric chambers to kill harmful bacteria, too. And apparently you can shuck a whole lot of shellfish with a whole lot of pressure. Make that 87,000 pounds per square inch, about 5,920 atmospheres. No added oxygen required.

Get a load of the fascinating history of high-pressure food processing, "Warning! Contents Under Extremely High Pressure," in GOOD. And who can resist the continuing adventures of Wholly Guacamole and the Big Mother Shucker? Not us.

Foodborne illness is no laughing matter. Neither are gas gangrene, intracranial abscess, necrotizing infections, osteomyelitis, diabetic foot ulcers, and other chronic wounds and bacterial infections treated with HBOT, where oxygen plays a central role. Lately we're reading like crazy to update our Diseases and Conditions pages for these indications. So please excuse us. But this slightly off-topic discovery was just too good not to share.

[Illustration: Avure Technologies]

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

TBI: Concussion Tests Doing More Harm Than Good?

Baseline concussion tests may be rushing seriously injured athletes back onto the field of play too soon, warns one clinical neuropsychologist. Christopher Randolph, PhD, of Loyola University Chicago, found poor sensitivity and low reliability in the popular ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) program. His paper was published in the Jan/Feb 2011 issue of the journal Current Sports Medicine Reports. Read a short summary report in Yahoo! Health.

In a related postscript to our March post on TBI In The NFL, a postmortem examination has confirmed that Dave Duerson suffered from neurodegenerative disease caused by concussions and other repetitive head trauma. Read the full LA Times story here. Duerson committed suicide in February 2011.

[Image: AP/National Institutes of Health]

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

Update: HBOT For Radionecrosis (Delayed Radiation Injury)

Today we have upgraded our Radionecrosis page. It's a most fitting way to begin updating our section on the Approved indications for hyperbaric oxygen, as delayed radiation injury ranks among the most well researched and common uses of HBOT. In our HyperbaricLink Commentary we also note:

Medical science offers few other options for cancer patients who suffer delayed radiation injuries. As more oncologists employ more powerful and sophisticated radiation therapy technologies, more patients will be healed. And more will be hurt. So the lack of access to accredited hyperbaric facilities and certified hyperbaric physicians and technicians is a growing public health problem.

Just yesterday, on MDNews.com, Dr. Felix A. Pesa wrote, "To date HBOT is the only therapy that reverses the effects of radiation induced tissue damage." Pesa is medical director of Humility of Mary Health Partners Wound Care and Hyperbaric Medicine at St. Elizabeth in Youngstown and St. Joseph in Warren, Ohio.

People affected by radiation injury will find new links to relevant cancer community and support groups under Patient Resources. We now refer visitors directly to the ACHM's Radiation Research Registry (RRR) and the Baromedical Research Foundation's Hyperbaric Oxygen Radiation Tissue Injury Study (HORTIS) pages for more complete information about current research. Find these and other new links under Clinical Resources.

See our June 7 post, "Diseases/Conditions Upgrades And Updates," for more information about our new page format. And look for regular updates in the days and weeks ahead.

[Image: Interactive graphic "Fatal Radiation" by Graham Roberts/Bill Marsh, New York Times.]

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

Autism: Genetic Mutations New Cause For Excitement

Three studies breaking this week in the journal Neuron reveal strong new genetic clues to the riddle: What causes autism? Start with the preview, "Solving the Autism Puzzle a Few Pieces at a Time." Better yet, catch Ira Flatow's discussion with a panel of experts on Science Friday.

Time will tell what might be the primary causes behind the spontaneous genetic mutations described in these papers, and whether hyperbaric oxygen holds any biological plausibility. But surely this work opens an exciting new route of investigation. And how refreshing to see some real science make the autism headlines. There. We said it.

[Image: Daniel Geschwind/UCLA/NIMH via Science Friday]

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

HBOTechBlog.com Going Real-Time, Subscription-Only

The web's best resource for HBOT techs will soon require an email subscription. It's free. HBOTechBlog.com is a nonprofit educational and friendly information sharing site for all hyperbaric techs, nurses, physicians, supervisors, safety directors, and administrators. Editor Roque Wicker tells us he's going subscription-only so he can better provide real-time information, build a larger community, and track hot topics. We're loyal readers, fans, and friends. Go sign up now!

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

Easier Bookmarking And Sharing On HyperbaricLink

It's a small thing, but readers tell us it's important. Our new Diseases and Conditions page format now also includes one-click sharing and bookmarking. Maybe you already noticed the handy AddThis toolbar in the upper right-hand corner of our updated Arthritis page. Soon you'll see these familiar icons popping up all across HyperbaricLink. We do hope this modest improvement makes our content a little more shareable and (literally) remarkable.

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

Update: HBOT For Arthritis

Today we have upgraded our Arthritis page but downgraded our Evidence Index score from promising to scant. We briefly explain the reasons behind the change in our new HyperbaricLink Commentary:

HBOT may provide temporary symptom relief for some people with some forms of arthritis. Compared to other popular and effective treatment options, hyperbaric oxygen therapy may never be cost-effective or practical for the daily management of such a lifelong chronic disease. Still, if further research demonstrates the effectiveness of hyperbaric oxygen therapy, a drug-free regimen might offer a welcome alternative for some physicians and patients to consider.

We now refer visitors to the Arthritis Foundation for more complete information and to PatientsLikeMe for community support. Find the new links under Patient Resources.

See our June 7 post, "Diseases/Conditions Upgrades And Updates," for more information about our new page format. And look for regular updates in the days and weeks ahead.

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

Diseases/Conditions Upgrades And Updates

Look for important new information on HyperbaricLink in the days and weeks ahead. We are busy updating and upgrading our Diseases and Conditions pages and adding new pages for both approved and off-label HBOT indications. Our new format brings you even more information and more links to more resources. Each page will include:

• Definition and Causes - just the basics.
• Treatment with Hyperbaric Oxygen Therapy - distilled from the medical literature.
• Hyperbaric Approval Status - yes or no from FDA and UHMS.
• Evidence Index - our scoring of current evidence.
• HyperbaricLink Commentary - our views and opinions.
• Patient Resources - info, advocacy, and support communities.
• Clinical Resources - links to the evidence and new research.
• News - relevant posts from our blog.
• Related Terms - other key words and synonyms.
• Further Reading - suggested long reads.
• Sources - sites we consulted to write our content.
• Page Data - time stamps and authorship credits.

With these content enhancements HyperbaricLink now meets or exceeds the emerging standards for reliable, trustworthy health information on the web. We will keep working to better inform, guide, and connect our visitors inside and outside the hyperbaric community.

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