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  1. Article ; Online: Investigation of the physiological response of radiation-induced cystitis patients using hyperbaric oxygen.

    Gulli, Farris / Geddes, Timothy J / Pruetz, Barbara L / Wilson, George D

    Clinical and translational radiation oncology

    2022  Volume 38, Page(s) 104–110

    Abstract: Introduction: In this pilot study we have taken a novel functional approach to assess whether differences exist in the activity of key genes involved in the response to radiation and oxidative stress between patients with radiation cystitis.: ... ...

    Abstract Introduction: In this pilot study we have taken a novel functional approach to assess whether differences exist in the activity of key genes involved in the response to radiation and oxidative stress between patients with radiation cystitis.
    Materials and methods: Arm 1 consisted of patients who had previously been treated for prostate cancer and who had received definitive radiation treatment and had subsequently developed cystitis and/or proctitis and were being treated by hyperbaric oxygen (HBO). Arm 2 consisted of patients who had never been treated by radiation but who were scheduled for HBO treatment for another pathology. The genes chosen for the study were HMOX1, NOS2, SOD2, TNFα, IL-6 and TGFβ. Blood and urine was collected pre and post HBO treatment.
    Results: Gene expression showed a significant difference in NOS2 (p = 0.0178) and TNFα (p = 0.037) between the control and cystitis patients. The plasma levels of VEGF-A were significantly elevated in cystitis patients and there was a strong trend for significant overexpression in urine. Comparing pre and post-dive samples showed little difference in both groups of patients except for VEGF-A which was reduced after the dive in plasma from cystitis patients.
    Conclusions: This study uncovered some physiological differences in patients with radiation-induced cystitis using HBO treatment as a stimulus to induce mild oxidative stress. Further research is ongoing to assess whether the acute exposure to HBO might be a physiological screening tool to identify patients susceptible to chronic radiation toxicity.
    Language English
    Publishing date 2022-10-28
    Publishing country Ireland
    Document type Journal Article
    ISSN 2405-6308
    ISSN (online) 2405-6308
    DOI 10.1016/j.ctro.2022.10.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Treatment of ulcerative compared to non-ulcerative interstitial cystitis with hyperbaric oxygen: a pilot study.

    Wenzler, David L / Gulli, Farris / Cooney, Maureen / Chancellor, Michael B / Gilleran, Jason / Peters, Kenneth M

    Therapeutic advances in urology

    2017  Volume 9, Issue 12, Page(s) 263–270

    Abstract: Background: The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner's ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but ...

    Abstract Background: The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner's ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but would be less efficacious for non-ulcerative IC (NIC).
    Methods: Patients with NIC and UIC enrolled in this study. Following informed consent, demographic information was collected. A visual analog pain scale and validated questionnaires were collected; each patient underwent cystoscopy prior to treatment. Each subject met with a hyperbaric specialist and after clearance underwent 30 treatments over 6 weeks. Adverse events were monitored. Patients repeated questionnaires, visual analog pain scale and global response assessment (GRA) immediately, 2 weeks, 3, 6 and 12 months after treatment. Patients also underwent cystoscopy 6 months after treatment. Differences before and after treatment were compared.
    Results: Nine patients were recruited to this study. One was unable to participate, leaving two subjects with NIC and six with UIC. All patients completed HBO without adverse events. Three patients completed HBO but pursued other therapies 7, 8.5 and 11 months after treatment. On GRA, 83% of patients with UIC were improved. This treatment effect persisted, as 66% of UIC patients remained better at 6 months. In contrast, only one patient in the NIC group improved. Questionnaire scores improved in both groups. Pain scores improved by 2 points in the UIC group but worsened by 1.5 points in the NIC group. Two patients with ulcers resolved at 6-month cystoscopy.
    Conclusion: HBO appeared beneficial for both UIC and NIC. Data shows slightly better benefit in patients with UIC compared to NIC; both groups showed improvement. Given the small sample size, it is difficult to draw definitive conclusions from these data. Larger studies with randomization would be beneficial to show treatment effect.
    Language English
    Publishing date 2017-09-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2492591-3
    ISSN 1756-2880 ; 1756-2872
    ISSN (online) 1756-2880
    ISSN 1756-2872
    DOI 10.1177/1756287217731009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Unusual case of calciphylaxis associated with metastatic breast carcinoma.

    Bosler, David S / Amin, Mitual B / Gulli, Farris / Malhotra, Rajwant K

    The American Journal of dermatopathology

    2007  Volume 29, Issue 4, Page(s) 400–403

    Abstract: Calciphylaxis is a relatively rare disorder associated with calcification of small- and medium-sized blood vessels, progressive ischemic skin necrosis, and ulcerations. It is usually seen in patients with end-stage renal disease with secondary ... ...

    Abstract Calciphylaxis is a relatively rare disorder associated with calcification of small- and medium-sized blood vessels, progressive ischemic skin necrosis, and ulcerations. It is usually seen in patients with end-stage renal disease with secondary hyperparathyroidism and is occasionally seen in primary hyperparathyroidism, hypercalcemia of malignancy, and end-stage liver disease. We report an unusual case of calciphylaxis seen in association with metastatic breast carcinoma in the absence of end-stage renal or parathyroid disease. A 73-year-old woman presented with painful leg ulcers. Serum calcium levels and parathormone levels were within normal limits. Skin biopsies from the ulcers revealed small- to medium-sized subcutaneous arteries with calcification of the media. Some of the arteries were narrowed by fibrointimal hyperplasia and fibrin thrombi. Calcification of the subcutaneous fat, fat necrosis, and suppuration were also seen. Calciphylaxis associated with metastatic osteolytic breast carcinoma is rare. Although end stage renal disease with secondary hyperparathyroidism is the most common cause of calciphylaxis, this case demonstrates that less common conditions with normal serum calcium and parathormone levels may also cause it.
    MeSH term(s) Aged ; Breast Neoplasms/pathology ; Calcinosis/etiology ; Calciphylaxis/etiology ; Calciphylaxis/pathology ; Calcium/blood ; Carcinoma/secondary ; Fat Necrosis/etiology ; Female ; Femoral Neoplasms/secondary ; Femur Neck/pathology ; Humans ; Leg Ulcer/etiology ; Leg Ulcer/pathology ; Parathyroid Hormone/blood ; Subcutaneous Fat/pathology ; Suppuration
    Chemical Substances Parathyroid Hormone ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2007-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 448469-1
    ISSN 1533-0311 ; 0193-1091
    ISSN (online) 1533-0311
    ISSN 0193-1091
    DOI 10.1097/DAD.0b013e3180ddb535
    Database MEDical Literature Analysis and Retrieval System OnLINE

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