Publications by authors named "Bengusu Mirasoglu"

14 Publications

  • Page 1 of 1

Hyperbaric oxygen treatment for intrauterine limb ischaemia: a newborn in the chamber.

Diving Hyperb Med 2021 Jun;51(2):220-223

Istanbul Faculty of Medicine, Underwater and Hyperbaric Medicine Department, Istanbul, Turkey.

Intrauterine limb ischaemia is a rare condition that may have devastating results. Various treatments are reported in the literature; however, results are not always promising and amputations may be required for some patients. Post-natal hyperbaric oxygen treatment (HBOT) may be a useful treatment option for the salvage of affected limbs. A patient who was born with total brachial artery occlusion and severe limb ischaemia was referred for HBOT. The patient underwent the first HBOT session at her 48th hour of life. A total of 47 HBOT sessions were completed (243.1 kPa [2.4 atmospheres absolute], duration 115 minutes being: 15 minutes of compression; three 25-minute oxygen periods separated by five-minute air breaks; and 15 minutes of decompression), four in the first 24 hours. Full recovery was achieved with this intense HBOT schedule combined with anticoagulation, fasciotomy and supportive care. The new-born tolerated HBOT well and no complications or side effects occurred. To the best of our knowledge, our patient is one of the youngest patients reported to undergo HBOT.
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http://dx.doi.org/10.28920/dhm51.2.220-223DOI Listing
June 2021

Comment on "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale".

Acta Orthop Traumatol Turc 2021 03;55(2):189-190

Department of Underwater and Hyperbaric Medicine, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey.

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http://dx.doi.org/10.5152/j.aott.2021.20328DOI Listing
March 2021

The evaluation of in-chamber sound levels during hyperbaric oxygen applications: Results of 41 centres.

Diving Hyperb Med 2020 Sep;50(3):244-249

Istanbul Faculty of Medicine, Underwater and Hyperbaric Medicine Department, Istanbul, Turkey.

Introduction: Noise has physical and psychological effects on humans. Recommended exposure limits are exceeded in many hospital settings; however, information about sound levels in hyperbaric oxygen treatment chambers is lacking. This study measured in-chamber sound levels during treatments in Turkish hyperbaric centres.

Methods: Sound levels were measured using a sound level meter (decibel meter). All chambers were multiplace with similar dimensions and shapes. Eight measurements were performed in each of 41 chambers; three during compression, three during decompression, and two at treatment pressure, one during chamber ventilation (flushing) and one without ventilation. At each measurement a sound sample was collected for 25 seconds and A-weighted equivalent (LA) and C-weighted peak (LC) levels were obtained. Recorded values were evaluated in relation to sound level limits in regulations.

Results: The highest sound level measured in the study was 100.4 dB(A) at treatment pressure while ventilation was underway and the lowest was 40.5 dB(A) at treatment pressure without ventilation. Most centres had sound levels between 70 dB and 85 dB throughout the treatment. Ventilation caused significant augmentation of noise.

Conclusions: The chambers were generally safe in terms of noise exposure. Nevertheless, hyperbaric chambers can be very noisy environments so could pose a risk for noise-related health problems. Therefore, they should be equipped with appropriate noise control systems. Silencers are effective in reducing noise in chambers. Thus far, hyperbaric noise research has focused on chambers used for commercial diving. To our knowledge, this is the first study to investigate noise in hospital-based chambers during medical treatments.
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http://dx.doi.org/10.28920/dhm50.3.244-249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819730PMC
September 2020

Sphenoid sinus mucocele as an unusual differential diagnosis in diving injuries.

Diving Hyperb Med 2020 Jun;50(2):168-172

Underwater and Hyperbaric Medicine Department, Istanbul Faculty of Medicine, Istanbul, Turkey.

Sphenoid sinus mucocele is a rare cystic lesion. It grows gradually and causes visual disturbances, ocular motility abnormalities and headache due to cavernous sinus compression. Sudden change in sinus cavity volume by a barotrauma may compress a mucocele and precipitate symptoms that may easily be confused with decompression sickness. A diver suffering from vertigo, nausea, blurry vision and hearing loss following uneventful dives is presented in this report. He underwent hyperbaric oxygen treatment for inner ear decompression sickness but later was diagnosed as sphenoid sinus mucocele. A high index of suspicion is necessary to capture rare conditions like mucocele in the differential diagnosis for divers with symptoms suggesting vestibulocochlear origin. To our knowledge, only one sphenoid sinus mucocele case presenting as a diving injury has been previously reported.
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http://dx.doi.org/10.28920/dhm50.2.168-172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481122PMC
June 2020

Protective effect of hyperbaric oxygen treatment on rat intestinal mucosa after mesenteric ischaemia and reperfusion.

Diving Hyperb Med 2019 Dec;49(4):253-258

Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Introduction: Mesenteric ischaemia results from a lack of adequate blood flow to and oxygenation of the mesentery and intestines. The aim of the present study was to evaluate the effect of hyperbaric oxygen treatment (HBOT) on the healing process in intestinal mucosa of rats undergoing mesenteric ischaemia and reperfusion.

Methods: Thirty-two Wistar-Albino rats were divided into four groups of eight: 1) ischaemia/reperfusion (I/R); 2) sham operation; 3) I/R+HBOT started 6 hours after reperfusion; 4) I/R+HBOT started 12 hours after reperfusion. In the I/R groups, a vascular clamp was placed across the superior mesenteric artery to occlude arterial circulation for 60 minutes, followed by reperfusion. A dose of HBOT consisted of 100% oxygen breathing for 90 minutes at 2.5 atmospheres absolute pressure. Thirteen doses of HBOT were administered after ischaemia. The rats were sacrificed on the eighth day, and their intestinal tissues were harvested for histopathologic analysis. The tissue levels of catalase, malondialdehyde, and glutathione were determined.

Results: The histopathological scores (HSCORE) were consistent with macroscopic examinations. The scores were significantly higher (worse) in Group 1 compared to Group 2, Group 3, and Group 4 (for all comparisons, P < 0.05). Group 4's HSCORE was significantly higher than those of Group 2 and Group 3 (for both comparisons P < 0.05). Group 3's HSCOREs were only marginally higher than Group 2. Group 3 exhibited higher glutathione levels than Group 1 (P < 0.05). There were no significant differences across the groups with respect to malondialdehyde and catalase levels.

Conclusion: A beneficial effect of HBOT was observed on oxidative stress and inflammation in acute mesenteric ischaemia-reperfusion.
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http://dx.doi.org/10.28920/dhm49.4.253-258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039772PMC
December 2019

Hyperbaric oxygen therapy for severe blast injury of lower extremity after terrorist attack: case report.

Undersea Hyperb Med 2019 Jan-Feb;46(1):75-79

Department of Underwater and Hyperbaric Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, 34093 Fatih, Istanbul, Turkey.

More blast injuries are encountered in the civilian setting in recent years as terrorist attacks have increased globally. A 17-year-old male patient with severe blast injury of the right lower extremity was admitted to our department on the fifth day after a terrorist bombing attack. Initially he had been admitted to an emergency department with segmental tibia fracture and arterial injury (Gustilo IIIC). An amputation had been foreseen due to ischemia that persisted even after orthopedic fixation and revascularization interventions, followed by fasciotomy incisions. After consultation with our department hyperbaric oxygen (HBO2) therapy was administered twice daily for the first week. Ischemia improved prominently after 10 HBO2 sessions. HBO2 therapy was continued together with antibiotherapy and wound care. The patient underwent a total of 40 HBO2 sessions and two reconstructive operations and healed without amputation. Vascular injuries with concomitant orthopedic trauma cause most of the delayed amputations in bombing attacks since ischemia can persist at the microvascular level even though adequate treatments are applied. HBO2 corrects hypoxia at tissue level and so provides oxygen for the critically ischemic cells in the injured area. HBO2 also enhances host defense and decreases the ischemia reperfusion injury. In this case, HBO2 was effective in survival and functional recovery (salvage) of the extremity together with regular wound care, antibiotherapy and surgical repair.
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November 2019

Comments on unresponsive decompression illness case.

J Intensive Care 2018 22;6:77. Epub 2018 Nov 22.

Underwater and Hyperbaric Medicine Department, Istanbul Faculty of Medicine, Istanbul, Turkey.

We have read the case report about a decompression sickness that was unresponsive to hyperbaric oxygen treatment in your journal. Presented case is intriguing; however, we think there are some contradictive issues in the discussion of the case. In this letter, we aim to comment on these issues that may raise further question. Bubble formation plays a very important role for decompression sickness, but proposed mechanism is incorrect as nitrogen does not change state during decompression. Use of terminology for diving-related diseases and comments on properties of helium may cause misunderstandings. Also importance of history of the dive in evaluating an accident should be emphasized.
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http://dx.doi.org/10.1186/s40560-018-0347-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251120PMC
November 2018

Eurasian Tunnel Project: the first saturation dives during compressed-air work in Turkey.

Undersea Hyperb Med 2018 Sep-Oct;45:489-494

Department of Underwater and Hyperbaric Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

The Eurasian Tunnel is a 5.64-km crossroad tunnel that connects Europe and Asia. Located under the seabed for the first time, 3.34 km of the tunnel that crosses the Bosphorus was built by advanced tunneling techniques. An exclusively designed tunnel boring machine (TBM), which has an operating pressure of 11 bars and a diameter of 13.7 meters was used for boring the seabed tunnel. The deepest point was 106 meters below sea level. One bounce diving period and seven saturation diving periods were needed for the repair and maintenance of the TBM during the project. Total time spent under pressure was 5,763 hours. A saturation decompression chamber for four divers was used for the saturation interventions, and divers breathed trimix at storage and excursion depths. The longest saturation run was the second, with storage at 10 bars and excursions to 10.4 bars. Twenty-three professional divers who were all experienced in compressed-air work were assigned to work on the project. Four dive physicians provided medical support, which included screening of divers before and during the hyperbaric interventions as well as on-site supervision. There were no diving-related accidents. A minor hand trauma, an external otitis and occasional insomnia were non-diving-related health issues that occurred during saturation and bounce diving. To our knowledge, the Eurasian Tunnel was the first project to perform TBM repair operations at such depths under the seabed and the first saturation diving in Turkey. In this report, we aimed to share our experiences of hyperbaric medical consulting in support of this type of tunneling project.
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October 2019

Is Hyperbaric Oxygen Therapy Effective in Cisplatin-Induced Ototoxicity in Rats?

Clin Exp Otorhinolaryngol 2019 Feb 8;12(1):66-71. Epub 2018 Sep 8.

Department of Underwater and Hyperbaric Medicine, Istanbul University, Faculty of Medicine, Istanbul, Turkey.

Objectives: Cisplatin is an antineoplastic agent, used in the treatment of different types of malignant neoplasms. Side effects such as ototoxicity, nephrotoxicity, and bone marrow toxicity are the main limitations of its clinical use. The aim of the present study was to evaluate the possible effects of hyperbaric oxygen (HBO) therapy as a protective agent in cisplatin-induced ototoxicity in rats.

Methods: A total of 30 adult Wistar rats (60 ears) were divided into five equal groups. Group 1 is a control group; group 2 is HBO therapy group; group 3 received 15 mg/kg cisplatin intraperitoneally; group 4 received 15 mg/kg cisplatin intraperitoneally and HBO treatment on the same day; group 5 received 15 mg/kg cisplatin intraperitoneally and HBO treatment 72 hours later. The effect of ototoxicity was measured with distortion product otoacoustic emission testing performed on the days 1, 3, and 7.

Results: Groups 4 and 5 that received HBO treatment after cisplatin had better signal-to-noise ratio (SNR) values compared with group 3 that received only cisplatin (P<0.05). Compared with group 5, group 4 (same day HBO treatment) had better SNR values (P<0.05).

Conclusion: HBO was found effective for prevention of cisplatin-induced ototoxicity in rats. Our study differs from other studies regarding using a promising treatment, which does not expose subjects to extra stress.
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http://dx.doi.org/10.21053/ceo.2017.01704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315209PMC
February 2019

Turkish recreational divers: a comparative study of their demographics, diving habits, health and attitudes towards safety.

Diving Hyperb Med 2017 Sep;47(3):173-179

Istanbul Faculty of Medicine, Underwater and Hyperbaric Medicine Department.

Introduction: In Turkey, scuba diving has become more popular and accessible in the past decade and there has been a commensurate rise in the number of certified divers. This new generation of recreational divers has not been described in detail previously. The aim of this study was to profile this group, while investigating any gender differences and making comparisons with the global diving community.

Methods: Turkish dive club members and diving forum⁄blog readers were invited to complete an online questionnaire investigating their demography, medical issues and diving history and habits.

Results: The questionnaire was completed by 303 female and 363 male divers. Significant differences were found between the sexes in terms of demographics, diving experience and attitudes toward safety. Previous or ongoing medical conditions were reported by 100 female divers and 141 males. Only 29% of females and 22% of males had been examined by a physician trained to conduct assessments of fitness to dive. Female divers did not report problems while diving during menstruation or while taking oral contraceptives. There was no significant difference in the occurrence of decompression sickness (DCS) and DCS-like symptoms between the sexes.

Conclusion: This is the largest study to date conducted on recreational divers in Turkey and so carries some value. It profiles their physical and behavioral attributes as well as differences in diving practices between the sexes in Turkey. Our findings should have implications for medical screening and dive training standards.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159611PMC
http://dx.doi.org/10.28920/dhm47.3.173-179DOI Listing
September 2017

Hyperbaric oxygen therapy for chronic ulcers in systemic sclerosis - case series.

Int J Dermatol 2017 Jun 23;56(6):636-640. Epub 2017 Feb 23.

Istanbul Faculty of Medicine, Underwater and Hyperbaric Medicine Department, Istanbul University, Istanbul, Turkey.

Background: Digital and leg ulcers are extremely painful, hard to heal manifestations of systemic sclerosis (SSc). Many treatments have been tried for these challenging complications, but use of hyperbaric oxygen therapy (HBOT) is very limited. HBOT has been used as an adjunctive therapy for treating chronic wounds, and nonhealing SSc wounds, which have a hypoxic nature, may also benefit from it.

Methods: This is a retrospective analysis of six SSc patients who underwent HBOT for their ulcers. Patient demographics, ulcer properties, and details of treatments were evaluated.

Results: Three patients had digital ulcers, and the other three had leg ulcers. Three patients (two leg ulcers and one digital ulcer) had bilateral lesions. All patients had been treated for at least one and a half months with various modalities. After HBOT was applied, four patients' ulcers healed completely and two patients had near-complete healing. Amputation was not required for any.

Conclusion: This case series, which has the largest patient population up to present, shows adjunctive HBOT may be helpful in the treatment of SSc ulcers.
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http://dx.doi.org/10.1111/ijd.13570DOI Listing
June 2017

Intralesional application of epidermal growth factor in limb-threatening ischemic diabetic foot ulcers.

Acta Orthop Traumatol Turc 2016 ;50(3):277-83

İstanbul University İstanbul Faculty of Medicine, Department of General Surgery, İstanbul, Turkey.

Objective: The intralesional injection of recombinant human epidermal growth factor (EGF-IL), a new therapy, has been claimed to prevent major amputations in advanced diabetic foot lesions. In this study, the efficacy of EGF-IL on advanced diabetic foot ulcers (DFU) was reviewed.

Methods: Intralesional 75 µg EGF application (Heberprot-P® 75, Heber Biotec, Havana, Cuba) to 12 diabetic foot lesions in 11 patients (8 males, 3 females; mean age: 62.2±10.6 years) was evaluated. Most of the patients had undergone revascularization and received hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT), along with standard care, but failed to heal. After amputation was offered as the final option, EGF-IL was applied to evaluate its effects.

Results: Two patients underwent amputation, while 10 lesions of the remaining 9 patients healed completely.

Conclusion: Our results prove that intralesional application of EGF can prevent amputations in advanced diabetic foot cases with an ischemic component. However, evidence in the literature supporting its use remains lacking, and its high cost presents an additional problem. Thus, we believe that intralesional application of EGF should be an option for ischemic wounds only after vascular evaluation (and intervention when possible), HBOT, NPWT, and standard care have proven insufficient.
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http://dx.doi.org/10.3944/AOTT.2015.14.0434DOI Listing
February 2017

Acute and long-term effects of hyperbaric oxygen therapy on hemorheological parameters in patients with various disorders.

Clin Hemorheol Microcirc 2016 ;62(1):79-88

Koc University, Faculty of Medicine, Department of Physiology, Sariyer, Istanbul, Turkey.

Inhalation of 100% oxygen in a hyperbaric chamber has been accepted as a useful treatment for patients with various pathologies who suffer from hypoxia. The oxidative effects of hyperbaric oxygen (HBO) on RBCs have been investigated in animals but there is not enough data on hemorheological parameters in patients following HBO treatment (HBOT).In this study, we investigated the effect of HBO on hemorheological and haematological parameters during treatment. Red blood cell (RBC) deformability and aggregation, blood and plasma viscosity and superoxide dismutase activity were investigated in patients who underwent HBOT. Hematological parameters were determined by an electronic hematology analyzer. A Laser-assisted Optical Rotational Cell Analyzer (LORCA) was used to measure RBC deformability. RBC aggregation was measured for cells in autologous plasma and for cells resuspended in PBS containing Dextran70 (3% ) by using a Myrenne Aggregometer. A Wells-Brookfield cone/plate rotational viscometer was used for viscosity measurements. According to our results, a significant decrement of the hematocrit and the RBC count was observed after the 20th session of HBOT compared to the baseline, but none of the hemorheological parameters changed significantly. Our results showed that HBOT did not cause any significant changes in hemorheological parameters, thereby not representing any problems for the patients.
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http://dx.doi.org/10.3233/CH-151952DOI Listing
November 2016

Hyperbaric oxygen therapy for hemorrhagic cystitis.

Exp Clin Transplant 2014 Jun;12(3):279-80

Pediatric Hematology-Oncology Division, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey.

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June 2014
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