Difference between revisions of "Svalestad"
 
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<span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Evidence:</span></span>'''</span>
 
<span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Evidence:</span></span>'''</span>
  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Measure</span></span>'''</span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Measure</span></span>'''</span></span>
  
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| colspan="2" style="width:109.8pt; border:solid windowtext 1.0pt; border-left:none" width="147" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Control Group</span>'''</span></span></p>  
+
| colspan="2" style="width:109.8pt; border:solid windowtext 1.0pt; border-left:none" width="147" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:">Control Group</span>'''</span></span></p>  
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| colspan="2" style="width:98.35pt; border:solid windowtext 1.0pt; border-left:none" width="131" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">HBO group</span></span>'''</span></span></p>  
+
| colspan="2" style="width:98.35pt; border:solid windowtext 1.0pt; border-left:none" width="131" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">HBO group</span></span>'''</span></span></p>  
−
| style="width:63.8pt; border:solid windowtext 1.0pt; border-left:none" width="85" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Difference</span></span>'''</span></span></p>  
+
| style="width:63.8pt; border:solid windowtext 1.0pt; border-left:none" width="85" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Difference</span></span>'''</span></span></p>  
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| style="width: 106px; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none;" width="83" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">95%CI</span></span>'''</span></span></p>  
+
| style="width: 124px; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none;" width="83" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">95%CI</span></span>'''</span></span></p>  
 
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| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
 
| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
−
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Microvessel density subepidermis (vessels/mm<sup>2</sup>)</span>'''</span></span>
+
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:">Microvessel density subepidermis (vessels/mm<sup>2</sup>)</span>'''</span></span>
  
−
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">49.3</span></span></span></p>  
+
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">49.3</span></span></span></p>  
−
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">10.5</span></span></span></p>  
+
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">10.5</span></span></span></p>  
−
| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">98</span></span></span></p>  
+
| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">98</span></span></span></p>  
−
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">15.9</span></span></span></p>  
+
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">15.9</span></span></span></p>  
−
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">48.7</span></span></span></p>  
+
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">48.7</span></span></span></p>  
−
| style="width: 106px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">39.7 to 57.7</span></span></span></p>  
+
| style="width: 124px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">39.7 to 57.7</span></span></span></p>  
 
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| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
 
| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
−
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Microvessel density connective tiss. (vessels/mm<sup>2</sup>)</span>'''</span></span>
+
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:">Microvessel density connective tiss. (vessels/mm<sup>2</sup>)</span>'''</span></span>
  
−
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">34.4</span></span></span></p>  
+
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">34.4</span></span></span></p>  
−
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">7.8</span></span></span></p>  
+
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">7.8</span></span></span></p>  
−
| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">45.1</span></span></span></p>  
+
| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">45.1</span></span></span></p>  
−
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">16.4</span></span></span></p>  
+
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">16.4</span></span></span></p>  
−
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">10.7</span></span></span></p>  
+
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">10.7</span></span></span></p>  
−
| style="width: 106px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">2.1 to 19.3</span></span></span></p>  
+
| style="width: 124px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">2.1 to 19.3</span></span></span></p>  
 
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| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
 
| style="width:116.75pt; border:solid windowtext 1.0pt; border-top:none" width="156" |  
−
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"="">Microvascular area (%)</span>'''</span></span>
+
<span style="font-size:larger;"><span style="line-height:normal">'''<span style="font-family:">Microvascular area (%)</span>'''</span></span>
  
−
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">1.6</span></span></span></p>  
+
| style="width: 78px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">1.6</span></span></span></p>  
−
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">0.5</span></span></span></p>  
+
| style="width: 73px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="109" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">0.5</span></span></span></p>  
−
| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">4.4</span></span></span></p>  
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| style="width: 64px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="51" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">4.4</span></span></span></p>  
−
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">1.9</span></span></span></p>  
+
| style="width: 66px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="80" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">1.9</span></span></span></p>  
−
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">2.8</span></span></span></p>  
+
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">2.8</span></span></span></p>  
−
| style="width: 106px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:" times="" new="" roman",serif"="">1.9 to 3.7</span></span></span></p>  
+
| style="width: 124px; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext;" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="font-size:larger;"><span style="line-height:normal"><span style="font-family:">1.9 to 3.7</span></span></span></p>  
 
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<span style="line-height:normal"><span style="font-family:"><span style="color:black">Appraised by: M Bennett: m.bennett@unsw.edu.au&nbsp;; Monday, 8 July 2019<br/> '''Kill or Update By:''' July 2022</span></span></span>
 
<span style="line-height:normal"><span style="font-family:"><span style="color:black">Appraised by: M Bennett: m.bennett@unsw.edu.au&nbsp;; Monday, 8 July 2019<br/> '''Kill or Update By:''' July 2022</span></span></span>
 +
<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:x-large;">'''[[Radiation_tissue_injury|BACK]]'''</span></p>

Latest revision as of 01:58, 8 July 2019

Hyperbaric oxygen therapy increases vascularity of the oral mucosa following radiotherapy

1. A course of HBOT increases the vascularity of the superficial mucosa following radiotherapy.

Citation/s:1. Svalestad J, Hellem S, Thorsen E, Johannessen AC. Effect of hyperbaric oxygen treatment on irradiated oral mucosa: microvessel density. International journal of oral and maxillofacial surgery. 2015 Mar 31;44(3):301-7.
Lead author's name and fax: J Svalestad: Jarle.Svalestad@iko.uib.no

Three-part Clinical Question:For patients having received radiotherapy to the oral mucosa, what is the effect of a course of hyperbaric oxygen, compared to no HBOT, on the density of the microvasculature?
Search Terms: Radiotherapy, microvasculature, late radiation tissue injury

The Study:
Non-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Adult patients previoulsy treated for head and neck cancers with radiotherapy (50 to 70 centigray, 3 to 6 years ago).
Control group (N = 20; 18 analysed): No specific intervention
Experimental group (N = 20; 20 analysed): 100% oxygen breathing at 2.4 ATA daily for 90 minutes, average number 29 treatments.

The Evidence:

Measure

Control Group

HBO group

Difference

95%CI

Microvessel density subepidermis (vessels/mm2)

49.3

10.5

98

15.9

48.7

39.7 to 57.7

Microvessel density connective tiss. (vessels/mm2)

34.4

7.8

45.1

16.4

10.7

2.1 to 19.3

Microvascular area (%)

1.6

0.5

4.4

1.9

2.8

1.9 to 3.7

 

Comments:

1. Small study that nevertheless found significant improvement in vascularity in the superficial oral mucosa deeper connective tissue.
2. Patients were being treated for xerostomia, prophylaxis and ORN
3. No significant changes in cellularity or propensity to proliferate – taken as supporting the notion that HBO does not carry an increased chance of recurrence

Appraised by: M Bennett: m.bennett@unsw.edu.au ; Monday, 8 July 2019
Kill or Update By: July 2022

 

 

Sumhorsa.gif

BACK

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