Background and Objectives: Hyperbaric oxygen therapy (HBOT) has shown promise in managing complications due to cancer treatments, particularly those related to radiotherapy and surgery. Despite its clinical benefits, concerns persist regarding its potential to influence cancer progression. This study aimed to evaluate the safety and clinical outcomes of HBOT in patients with active or previously treated solid tumors. Methods: A retrospective analysis was conducted on patients with solid tumors who underwent at least five HBOT sessions. Comprehensive data, including patient demographics, cancer type, total number of HBOT sessions, imaging findings, and clinical outcomes (recurrence, metastasis, and mortality), were collected. Descriptive statistics and the relationship between the number of HBOT sessions and long-term cancer outcomes were analyzed. Results: This study included 45 patients (median age: 64 years; 60% male) who received a median of 27 HBOT sessions. At initiation, 27.9% of the patients were classified as cured, 53.5% were in remission, and 18.6% had active cancer. Over a median follow-up period of 783 days, 8.7% experienced recurrence, 2.7% had persistent active cancer, and 59.5% had no recurrence. No HBOT-related complications were observed during the course of HBOT. Statistical analyses revealed no significant correlations between the number of HBOT sessions and metastasis (p = 0.213) or mortality (p = 0.881). Conclusions: HBOT appears to be a safe and effective adjunctive therapy for managing complications in patients with solid tumors. No evidence was found to suggest HBOT contributes to tumor progression, recurrence, or metastasis. Future prospective studies with larger cohorts are needed to confirm these results and further evaluate the therapeutic role of HBOT in oncology.

Objective: This study aimed to analyze the results of hyperbaric oxygen therapy (HBOT) in addition to assisted reproductive technologies in male infertility cases. Material and methods: Medical records of male infertility patients who had HBOT sessions for any reason between January 1, 2015-December 31, 2019, were analyzed retrospectively. Results: A total of 15 male patients were included. Patients were classified as group 1 [DNA fragmentation (n=5)], group 2 [globozoospermia (n=5)], and group 3 [azoospermia (n=5)]. Round spermatid injection (ROSI), intrauterine insemination (IUI), or intracytoplasmic sperm injection (ICSI) procedures were performed in 10 of the 15 patients. A total of 31 embryos were obtained out of which 19 (61%) were transferred. While a total of 15 embryos were obtained in the globozoospermic group, which was the highest number, 10 were obtained from the azoospermic patients, and 6 from the DNA fragmentation patients (p=0.515). A total of 3 (30%) healthy pregnancies were obtained, overall. The mean sperm count of the patients (n=9) before HBOT was 8.4±11.1 mil/mL, while it was found to be 15.7±15.0 mil/mL after HBOT (azoospermic patients were not included). The TESE results were analyzed for azoospermic patients; positive changes were observed in 4 patients (80%). On the other hand, there was an improvement in 50% of group 1 according to sperm DNA fragmentation after HBOT (p=0.500). Conclusion: While a total of 15 embryos were obtained in the globozoospermic group, which was the highest number, 10 were obtained from the azoospermic patients.. Further studies should be conducted on HBOT and male infertility. Cite this article as: Özgök Kangal K, Özgök Y. Assisted reproductive treatments with hyperbaric oxygen therapy in male infertility. Turk J Urol 2021; 47(2): 98-105

Introduction: Carbon monoxide (CO) poisoning in pregnant women is linked to foetal mortality of 36–67%. This study assessed long-term fetal outcomes following hyperbaric oxygen treatment (HBOT) for acute CO poisoning in pregnant women. The effects of clinical severity parameters and pregnancy trimester were also analysed. Methods: A retrospective review of 28 pregnant patients who received HBOT for acute CO poisoning between January 2013–June 2016 was made. Adverse events, birth week, birth weight-height, birth complications, and the age of crawling, walking independently, talking (first words) of their children were recorded. Results: Twenty-eight singleton pregnancies were included. One fetus was dead before HBOT. Three adverse events were reported: abortion, premature birth, and limb malformation. All remaining patients (n = 24) delivered healthy term infants and reported normal neurophysiological development. At final interview the median age of babies was 34 (8–44) months and none had any diagnosed disease. There was no relationship between clinical severity parameters and long-term outcomes. However, the pregnancy trimester at the time of CO poisoning had a significant relationship to birth weight (P = 0.029). Also, the week of pregnancy at the time of the incident correlated with the age of walking independently (P = 0.043, r = 0.436). Conclusions: This is the largest relevant series and longest follow-up to date. Adverse outcomes were likely incidental because the mothers’ medical histories revealed alternative aetiologies. There was no definite evidence of fetal morbidity or mortality after HBOT in this study. HBOT may improve long-term fetal outcomes after in-utero CO poisoning without complications.

Background: Diving challenges the respiratory system because of the pressure changes, breathing gases, and cardiovascular effects. We aimed to analyse the long term effect of occupational diving on pulmonary functions in terms of diving experience (year), smoking history, and occupational groups (commercial divers and SCUBA instructors). Materials and methods: We retrospectively analysed respiratory system examination results of the experienced occupational divers who were admitted to the Undersea and Hyperbaric Medicine Department for periodic medical examination between January 1, 2013 and February 28, 2019. Results: Sixty-four divers applied to our department. Candidate divers were not included in our study. The mean diving experience (year) was 13.6 ± 7.3. None of the divers complained of pulmonary symptoms. Pulmonary auscultation and chest radiography were normal in all cases. In divers with 20 years or more experience, the FEV1/FVC ratio and FEF25–75(%) was significantly lower (p < 0.001, p < 0.05, respectively). In addition, there was a statistically significant negative correlation between FEV1/FVC ratio and FEF25–75(%) and diving experience (year) (p < 0.05, r = –0.444, p < 0.05, r = –0.300, respectively). As the diving experience increase per 1 year, the FEF25–75(%) value decreases by 1.04% according to linear regression analyses. However, smoking and occupational groups did not show any significant influence on pulmonary function test parameters. Conclusions: Occupational diving seems to create clinically asymptomatic pulmonary function test changes related to small airway obstruction after long years of exposure. Background: Diving challenges the respiratory system because of the pressure changes, breathing gases, and cardiovascular effects. We aimed to analyse the long term effect of occupational diving on pulmonary functions in terms of diving experience (year), smoking history, and occupational groups (commercial divers and SCUBA instructors). Materials and methods: We retrospectively analysed respiratory system examination results of the experienced occupational divers who were admitted to the Undersea and Hyperbaric Medicine Department for periodic medical examination between January 1, 2013 and February 28, 2019. Results: Sixty-four divers applied to our department. Candidate divers were not included in our study. The mean diving experience (year) was 13.6 ± 7.3. None of the divers complained of pulmonary symptoms. Pulmonary auscultation and chest radiography were normal in all cases. In divers with 20 years or more experience, the FEV1/FVC ratio and FEF25–75(%) was significantly lower (p < 0.001, p < 0.05, respectively). In addition, there was a statistically significant negative correlation between FEV1/FVC ratio and FEF25–75(%) and diving experience (year) (p < 0.05, r = –0.444, p < 0.05, r = –0.300, respectively). As the diving experience increase per 1 year, the FEF25–75(%) value decreases by 1.04% according to linear regression analyses. However, smoking and occupational groups did not show any significant influence on pulmonary function test parameters. Conclusions: Occupational diving seems to create clinically asymptomatic pulmonary function test changes related to small airway obstruction after long years of exposure.

Background: A hyperbaric oxygen (HBO) treatment session carries a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission since patients stay in a closed area for 2 hours. The primary aim of this study was to evaluate the effects of the preventive measures taken in the HBO centre. Materials and methods: This study evaluated the measures taken during the coronavirus disease 2019 (COVID-19) pandemic for multiplace hyperbaric chamber operated in department (Health Sciences University-Gulhane Research and Training Hospital, Ankara, Turkey) between March 16th, 2020 and December 31st, 2020. The medical records of patients who underwent HBO treatment during this period were evaluated retrospectively. Their demographic attributes, the presence of risk factors, HBO indications, HBO session data, and COVID-19 inquiry forms were analysed. Results: A total of 122 patients underwent HBO treatment, and 150 people were subjected to pressure tolerance test (PTT). No COVID-19 case was treated with HBO in our department. The hyperbaric chamber was operated 608 times in total. Of these, 9.7% (n = 59) procedures were carried out under emergency conditions, and 10% (n = 61) were PTTs. Accordingly, 59.8% (n = 73) of the HBO-treated patients were considered at risk for a severe clinical presentation of SARS-CoV-2. SARS-CoV-2 was detected in 5.7% (n = 7) of the HBO-treated patients during the HBO treatment period. Besides, two inside attendants (14.3%) were diagnosed with COVID-19. There were only two concurrent cases in the same session among SARS-CoV-2 positive cases. The records revealed that these patients were sitting three seats away from each other. Another patient was sitting in between the two infected patients but was not diagnosed with SARS-CoV-2. Conclusions: There is no clear evidence that these two patients infected each other; on the contrary, since no other patient was infected with SARS-CoV-2 in the same session, we may suspect that the infections were coincidental. The measures taken in our department seem to suffice in preventing in-session transmission of COVID-19 and similar infectious diseases in an HBO centre. Background: A hyperbaric oxygen (HBO) treatment session carries a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission since patients stay in a closed area for 2 hours. The primary aim of this study was to evaluate the effects of the preventive measures taken in the HBO centre. Materials and methods: This study evaluated the measures taken during the coronavirus disease 2019 (COVID-19) pandemic for multiplace hyperbaric chamber operated in department (Health Sciences University-Gulhane Research and Training Hospital, Ankara, Turkey) between March 16th, 2020 and December 31st, 2020. The medical records of patients who underwent HBO treatment during this period were evaluated retrospectively. Their demographic attributes, the presence of risk factors, HBO indications, HBO session data, and COVID-19 inquiry forms were analysed. Results: A total of 122 patients underwent HBO treatment, and 150 people were subjected to pressure tolerance test (PTT). No COVID-19 case was treated with HBO in our department. The hyperbaric chamber was operated 608 times in total. Of these, 9.7% (n = 59) procedures were carried out under emergency conditions, and 10% (n = 61) were PTTs. Accordingly, 59.8% (n = 73) of the HBO-treated patients were considered at risk for a severe clinical presentation of SARS-CoV-2. SARS-CoV-2 was detected in 5.7% (n = 7) of the HBO-treated patients during the HBO treatment period. Besides, two inside attendants (14.3%) were diagnosed with COVID-19. There were only two concurrent cases in the same session among SARS-CoV-2 positive cases. The records revealed that these patients were sitting three seats away from each other. Another patient was sitting in between the two infected patients but was not diagnosed with SARS-CoV-2. Conclusions: There is no clear evidence that these two patients infected each other; on the contrary, since no other patient was infected with SARS-CoV-2 in the same session, we may suspect that the infections were coincidental. The measures taken in our department seem to suffice in preventing in-session transmission of COVID-19 and similar infectious diseases in an HBO centre.

In our study, we aimed to investigate the knowledge, attitude, and behavior of physicians toward hyperbaric oxygen therapy (HBOT). Our study is a cross-sectional study. We included a total of 251 physicians, consisting of Family Medical Specialists, residents of Family Medicine Residency program, contracted residents of Family Medicine Residency program (residents who work actively in primary health units and matched with Family Medicine residency program) and General Practitioners (non-specialized family physicians) working in Ankara, between the dates 01.04.2021 and 26.11.2021. A questionnaire consisting of a total of 51 questions was given to the participants on the internet in order to determine the level of knowledge, attitude and behavior towards HBOT. 251 people, 162 women and 89 men, participated in the study. Of the participants in the study, 137 were residents of the Family Medicine residency program, 57 General practitioners, and 57 Family Medical Specialists. It was observed that 60.2% of the physicians responded with a “no” to the question, “Do you know the indications of HBOT?”. 55% of the physicians did not know about the cost of HBOT therapy. The rate of knowledge of the indication of carbon monoxide poisoning was significantly higher among the physicians who had an HBOT center in their institution (p<0.05). It was observed that 98% of the participants did not know the treatment pressure applied during HBOT, and 97.2% did not know the technique of oxygen administration. While investigating the knowledge, attitudes, and behaviors towards HBOT, we observed that our physicians had some deficiencies, even though they had partial knowledge about it. In our study, we saw that our physicians are aware of their lack of knowledge about HBOT and are open to training on this subject. We think that in order to eliminate this deficiency, a course related to this field can be added to either university curricula or specialist training curricula.