GHP August 2015

ghp August 2015 | 11 industry insight Pseudomonas aeruginosa and Klebsiella spp. These patients were excluded from the study since for one way or another they had to stop treatment for the study. Such reasons could be risk of gangrene, antibiotic treatment or amputation of legs. Discussion Hyperbaric oxygen therapy (HBOT) is a medical treatment in which the patient breathes 100% oxygen inside a pressurized treatment chamber. The aim is to increase the oxygen level in the tissue. It is used in cases where partial or total tissue hypoxia occurs such as acute limb ischemia, diabetic foot lesion, and arterial ulcers. Limb-threatening diabetic foot infections are usually polymicrobial. Commonly encountered pathogens include methicillin-resistant staphylococcus aureus, β-hemolytic streptococci, enterobacteriaceae, pseu- domonas aeruginosa, and enterococci. Anaerobes, such as bacteroides, peptococcus, and peptostrep- tococcus, are rarely the sole pathogens but are seen in mixed infections with aerobes. Antibiotics selected to treat severe or limb-threatening infections should include coverage of gram-positive and gram-negative organisms and provide both aerobic and anaerobic coverage. Patients with such wounds should be hospitalized and treated with intravenous antibiot- icsm (The DCCT Research Group. 1993, Boulton AJ, Malik RA, Arezzo JC, Sosenko JM., 2004, Armstrong DG, Lavery LA, Kimbriel HR, Nixon BP, Boulton AJ., 2003., Armstrong DG, Lavery LA, Wu S, Boulton AJ.,2005) Mild to moderate infections with localized celluli- tis can be treated on an outpatient basis with oral antibiotics such as cephalexin, amoxicillin with clavu- lanate potassium, moxifloxacin, or clindamycin. The antibiotics should be started after initial cultures are taken and changed as necessary. The substance (BioCoool®) is here shown to be an alternative treatment of infected feet. The effect of the substance has been disclosed to be optimal at 2% but from 0.05 to 4% the substance at 370 C can be used as previously shown. If the oxygen bath will be used on a daily basis a concentration of 0.05 % is recommended (Sandström G., Eriksson J-O., and Saeed A., 2014). Not only affected nails and warts are showing dramatic improvement but also skin and feet in general are refined (Sandström G., Eriksson J-O., and Saeed A., 2014) Moreover, witnesses from the included subjects and their physicians clearly point at a patient amelioration. Acknowledgement We acknowledge the support of substance (Bio- Coool®) and technical support from the staff of BioCool, AB, Skellefteå, Sweden. References 1. Hsiao-Chuan L, et al. Enterovirus infection is associated with an increased risk of childhood type 1 diabetes in Taiwan: A nationwide popula- tion-based cohort study. Diabetologia. 2014 2. [Guideline] Diagnosis and classification of diabe- tes mellitus. Diabetes Care. Jan 2010;33 Suppl 1:S62-9 3. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. Jul 2009;32(7):1327-34Vehik K, Beam CA, Mahon JL, et al. Development of Au- toantibodies in the TrialNet Natural History Study. Diabetes Care. Sep 2011;34(9):1897-1901 4. Sandström G., Eriksson J-O., and Saeed A: Successful Treatment of Trichophytonrubrum Onychomycosis and Warts (Verruca Plantae) with BioCool®. International Journal of Applied Science and Technology Vol. 4 No. 1; January 2014 5. Kniel, K. E., Sumner, S. S., Lindsay, D. S., Hackney, C. R., Pierson, M. D., Zajac, A. M., . . . Fayer, R. (2003). Effect of organic acids and hydrogen peroxide on Cryptosporidium parvum viability in fruit juices. [Research Support, U.S. Gov’t, Non-P.H.S.]. J Food Prot, 66(9), 1650- 1657 6. Nandi, N., Sen, A., Banerjee, R., Kumar, S., Kumar, V., Ghosh, A. N., & Das, P. (2010). Hydrogen peroxide induces apoptosis-like death in Entamoeba histolytica trophozoites. [Research Support, Non-U.S. Gov’t]. Microbiology, 156(Pt 7), 1926-1941. doi: 10.1099/mic.0.034066-0 7. The DCCT Research Group: The effect of inten- sive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977 -986, 1993 8. Boulton AJ, Malik RA, Arezzo JC, Sosenko JM: Diabetic somatic neuropathies. Diabetes Care 27:1458-1486, 2004. Also available in free full text online from http://care.diabetesjournals.org/ cgi/content/full/27/6/1458 9. Armstrong DG, Lavery LA, Kimbriel HR, Nixon BP, Boulton AJ: Activity patterns of patients with diabetic foot ulceration. Diabetes Care26 : 2595- 2597,2003 10. Armstrong DG, Lavery LA, Wu S, Boulton AJ: Evalution of removable and irremovable cast walkers in the healing of diabetic foot wounds. Diabetes Care 28: 551-554,2005 Table 1. No. of Patient Sex Age Before treating After treating with the substance with the substance 1. F 58 Staphylococcus aureus Pseudomonas aeruginosa No growth 2. M 53 Staphylococcus aureus Beta Haemolytic Beta Haemolytic streptococcus Streptococcus 3. F 51 Coagulase-negative Staphylococcus aureus and enterococci No growth 4. M 50 Staphlococcus aurues Pseudomonas aeruginosa No growth 5. F 47 Klebsiella spp. No growth 6. M 44 Staphylococcus aureus Proteus spp. Staphylococcus