Measurement of peripheral arterial tonometry in patients with diabetic foot ulcers during courses of hyperbaric oxygen treatment

Development of a Fuzzy Diagnostic Model of Ischemic Disease of the Lower Limbs for Different Stages of Patient Management

Ischemic disease has severe impact on patients which makes accurate diagnosis vital for health protection. Improving the quality of prediction of patients with ischemic extremity disease by using hybrid fuzzy model allows for early and accurate prognosis of the development of the disease at various stages. The prediction of critical ischemia of lower extremity (CLI) at various disease stages is complex problem due to inter-related factors. We developed hybrid fuzzy decision rules to classify ischemic severity using clinical thinking (natural intelligence) with artificial intelligence, which allows achieving a new quality in solving complex systemic problems and is innovative. In this study mathematical model was developed to classify the risk level of CLI into: subcritical ischemia, favorable outcome, questionable outcome, and unfavorable outcome. The prognosis is made using such complex indicators as confidence that the patient will develop gangrene of the lower extremity (unfavorable outcome), complex coefficient of variability, and reversibility of the ischemic process. Model accuracy was calculated using representative control samples that showed high diagnostic accuracy and specificity characterizing the quality of prediction are 0.9 and higher, which makes it possible to recommend their use in medical practice.

The Effects of Hyperbaric Oxygenation on Oxidative Stress, Inflammation and Angiogenesis

Hyperbaric oxygen therapy (HBOT) is commonly used as treatment in several diseases, such as non-healing chronic wounds, late radiation injuries and carbon monoxide poisoning. Ongoing research into HBOT has shown that preconditioning for surgery is a potential new treatment application, which may reduce complication rates and hospital stay. In this review, the effect of HBOT on oxidative stress, inflammation and angiogenesis is investigated to better understand the potential mechanisms underlying preconditioning for surgery using HBOT. A systematic search was conducted to retrieve studies measuring markers of oxidative stress, inflammation, or angiogenesis in humans. Analysis of the included studies showed that HBOT-induced oxidative stress reduces the concentrations of pro-inflammatory acute phase proteins, interleukins and cytokines and increases growth factors and other pro-angiogenesis cytokines. Several articles only noted this surge after the first HBOT session or for a short duration after each session. The anti-inflammatory status following HBOT may be mediated by hyperoxia interfering with NF-κB and IκBα. Further research into the effect of HBOT on inflammation and angiogenesis is needed to determine the implications of these findings for clinical practice.