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1. Hyperbaric oxygen therapy increases the effect of 5-fluorouracil chemotherapy on experimental colorectal cancer in mice.

Author

Machado, Vanessa Foresto, da Rocha, José Joaquim Ribeiro, Parra, Rogério Serafim, Feitosa, Marley Ribeiro, Leite, Caio Abner, Minto, Stefânia Bovo, Garcia, Sérgio Britto, Cunha, Thiago Mattar, and Feres, Omar

Subjects
TRANSFORMING growth factors, HYPERBARIC oxygenation, ADJUVANT chemotherapy, COLORECTAL cancer, CANCER treatment
Abstract

Tumor hypoxia may compromise the results of chemotherapy for treating colorectal cancer because it stimulates angiogenesis and the release of tumor growth factors. Hyperbaric oxygen (HBO) supplementation may potentiate the effects of chemotherapy in such cases. This study aimed to assess the effect of HBO therapy combined with chemotherapy on the treatment of colorectal cancer in mice. C57BL6 mice were submitted to the intrarectal instillation of N-methyl-N-nitrosoguanidine (MNNG) and treated with 5-fluorouracil (5FU) and/or HBO therapy. The MNNG group presented the highest dysplastic crypt rate. The 5FU + HBO group presented the highest rate of apoptotic cells per dysplastic crypt. The 5FU group presented the highest expression of hypoxia-inducible factor-1 alpha and CD44. HBO therapy increased the effect of 5FU on the treatment of the experimental colorectal neoplasia in mice. [ABSTRACT FROM AUTHOR]

Published
2024
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2. ETV4 plays a role on the primary events during the adenoma-adenocarcinoma progression in colorectal cancer

Author

Fonseca, Aline Simoneti, Ramão, Anelisa, Bürger, Matheus Carvalho, de Souza, Jorge Estefano Santana, Zanette, Dalila Lucíola, de Molfetta, Greice Andreotti, de Araújo, Luiza Ferreira, de Barros e Lima Bueno, Rafaela, Aguiar, Graziela Moura, Plaça, Jessica Rodrigues, Alves, Cleidson de Pádua, dos Santos, Anemari Ramos Dinarte, Vidal, Daniel Onofre, Silva, Gyl Eanes Barros, Panepucci, Rodrigo Alexandre, Peria, Fernanda Maris, Feres, Omar, da Rocha, José Joaquim Ribeiro, Zago, Marco Antonio, and Silva, Jr, Wilson Araújo

Published
2021
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3. Factors associated with surgical resection in patients with Crohn’s disease: long-term evaluation

Author

Ferreira, Sandro da Costa, primary, Aprile, Lílian Rose Otoboni, additional, Parra, Rogério Serafim, additional, Feitosa, Marley Ribeiro, additional, Castro, Patrícia Picardi Morais de, additional, Perdoná, Gleici de Castro da Silva, additional, Feres, Omar, additional, Rocha, José Joaquim Ribeiro da, additional, and Troncon, Luiz Ernesto de Almeida, additional

Published
2024
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6. The Interplay among Glucocorticoid Therapy, Platelet-Activating Factor and Endocannabinoid Release Influences the Inflammatory Response to COVID-19

Author

Carvalho, Jonatan C. S. de, Silva-Neto, Pedro V. da, Toro, Diana M., Fuzo, Carlos A., Nardini, Viviani, Pimentel, Vinícius E., Pérez, Malena M., Fraga-Silva, Thais F. C., Oliveira, Camilla N. S., Degiovani, Augusto M., Ostini, Fátima M., Feitosa, Marley R., Parra, Rogerio S., Rocha, José J. R. da, Feres, Omar, Vilar, Fernando C., Gaspar, Gilberto G., Santos, Isabel K. F. M., Fernandes, Ana P. M., Maruyama, Sandra R., Russo, Elisa M. S., Bonato, Vânia L. D., Cardoso, Cristina R. B., Dias-Baruffi, Marcelo, Faccioli, Lúcia H., Sorgi, Carlos A., and Group, on behalf of the ImmunoCovid Study Group on behalf of the ImmunoCovid Study

Subjects
platelet-activating factor, Infectious Diseases, inflammation, Virology, COVID-19, glucocorticoid, endocannabinoid
Abstract

COVID-19 is associated with a dysregulated immune response. Currently, several medicines are licensed for the treatment of this disease. Due to their significant role in inhibiting pro-inflammatory cytokines and lipid mediators, glucocorticoids (GCs) have attracted a great deal of attention. Similarly, the endocannabinoid (eCB) system regulates various physiological processes including the immunological response. Additionally, during inflammatory and thrombotic processes, phospholipids from cell membranes are cleaved to produce platelet-activating factor (PAF), another lipid mediator. Nonetheless, the effect of GCs on this lipid pathway during COVID-19 therapy is still unknown. This is a cross-sectional study involving COVID-19 patients (n = 200) and healthy controls (n = 35). Target tandem mass spectrometry of plasma lipid mediators demonstrated that COVID-19 severity affected eCBs and PAF synthesis. This increased synthesis of eCB was adversely linked with systemic inflammatory markers IL-6 and sTREM-1 levels and neutrophil counts. The use of GCs altered these lipid pathways by reducing PAF and increasing 2-AG production. Corroborating this, transcriptome analysis of GC-treated patients blood leukocytes showed differential modulation of monoacylglycerol lipase and phospholipase A2 gene expression. Altogether, these findings offer a breakthrough in our understanding of COVID-19 pathophysiology, indicating that GCs may promote additional protective pharmacological effects by influencing the eCB and PAF pathways involved in the disease course.

Published
2023
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12. PREVALENCE AND PREDICTIVE FACTORS ASSOCIATED WITH POSITIVITY OF SARS-COV-2 SEROLOGICAL MARKERS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AT AN IBD REFERRAL CENTER

Author

FERREIRA, Sandro da Costa, PARRA, Rogério Serafim, FEITOSA, Marley Ribeiro, FERES, Omar, SANTANA, Rodrigo de Carvalho, and TRONCON, Luiz Ernesto de Almeida

Subjects
serological markers, COVID-19, marcadores sorológicos, Doenças inflamatórias intestinais, Inflammatory bowel diseases
Abstract

Background: Data related to SARS-CoV-2 exposure rates in patients with inflammatory bowel diseases (IBD) are scarce. Objective - Our aim was to determine the prevalence of serological markers of SARS-Cov-2 and the predictive factors for positivity in patients with IBD. Methods: This is a cross-sectional, observational study carried out from May to September 2020. SARS-CoV-2 serological markers were determined using chemiluminescence immunoassay in 233 IBD patients without evidence of COVID-19 symptoms. Patient age was 36.6±11.1 years, 118 patients were male (50.6%), and 63.1% had Crohn’s disease. Patient clinical data were extracted from individual electronic medical records and complemented by a structured interview. Results: Twenty-six out of the 233 patients with IBD had positive serum markers for SARS-CoV-2 (11.2%). Female sex (P0.05). Conclusion: SARS-CoV-2 previous infection in IBD patients was not that uncommon, and its prevalence was 11.2% in our series. Positivity to SARS-CoV-2 serological markers was associated with female sex, extra-intestinal manifestations, use of corticosteroids, and contact with individuals with suspected or confirmed COVID-19. Studies with longer follow-up periods are needed to confirm these findings. RESUMO Contexto: Dados relacionados às taxas de exposição ao SARS-CoV-2 em pacientes com doenças inflamatórias intestinais (DII) são escassos. Objetivo Nosso objetivo foi determinar a prevalência de marcadores sorológicos do SARS-Cov-2 e os fatores preditivos de positividade em pacientes com DII. Métodos: Este foi um estudo transversal observacional realizado no período de maio a setembro de 2020. Os marcadores sorológicos SARS-CoV-2 foram determinados por imunoensaio de quimioluminescência em 233 pacientes com DII sem evidência de sintomas de COVID-19. A idade dos pacientes foi 36,6±11,1 anos, 118 pacientes eram do sexo masculino (50,6%) e 63,1% tinham doença de Crohn. Os dados clínicos dos pacientes foram extraídos de prontuários médicos eletrônicos individuais e complementados por meio de uma entrevista estruturada. Resultados: Vinte e seis dos 233 pacientes com DII apresentaram marcadores sorológicos positivos para SARS-CoV-2 (11,2%). Sexo feminino (P0,05). Conclusão: A infecção prévia pelo SARS-CoV-2 não é tão incomum em pacientes com DII e sua prevalência em nossa série foi de 11,2%. A positividade aos marcadores sorológicos SARS-CoV-2 foi associada ao sexo feminino, manifestações extra-intestinais, uso de corticosteroides e contato com indivíduos com suspeita ou diagnóstico confirmado de COVID-19. Estudos com períodos de acompanhamento mais longos são necessários para confirmar esses achados.

Published
2022

14. EP1310: INDUCTION ANTI-TNF DRUG LEVELS AND ANTIBODIES AT WEEK 6 IN INFLAMMATORY BOWEL DISEASE (IBD) PATIENTS TREATED WITH INFLIXIMAB

Author

Garcia, Karoline S., primary, Queiroz, Natália S., additional, Parra, Rogerio S., additional, Feres, Omar, additional, Chebli, Julio, additional, Chebli, Liliana A., additional, Flores, Cristina, additional, Vieira, Andrea, additional, Azevedo, Matheus, additional, Carlos, Alexandre S., additional, Oba, Jane, additional, Alves, Olivia D., additional, Ceará, Christianne D., additional, Sipahi, Aytan M., additional, and Damiao, Aderson O., additional

Published
2022
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15. EP1311: LONG-TERM CLINICAL AND ENDOSCOPIC OUTCOMES IN INFLAMMATORY BOWEL DISEASE (IBD) PATIENTS FOLLOWING A SIMPLIFIED PROACTIVE DRUG MONITORING ALGORITHM DURING INDUCTION TREATMENT WITH INFLIXIMAB (IFX)

Author

Garcia, Karoline S., primary, Queiroz, Natália S., additional, Parra, Rogerio S., additional, Feres, Omar, additional, Chebli, Julio, additional, Chebli, Liliana A., additional, Flores, Cristina, additional, Vieira, Andrea, additional, Azevedo, Matheus F., additional, Carlos, Alexandre S., additional, Oba, Jane, additional, Alves, Olivia D., additional, Ceará, Christianne D., additional, Sipahi, Aytan M., additional, and Damiao, Aderson O., additional

Published
2022
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17. The Interplay among Glucocorticoid Therapy, Platelet-Activating Factor and Endocannabinoid Release Influences the Inflammatory Response to COVID-19.

Author

de Carvalho, Jonatan C. S., da Silva-Neto, Pedro V., Toro, Diana M., Fuzo, Carlos A., Nardini, Viviani, Pimentel, Vinícius E., Pérez, Malena M., Fraga-Silva, Thais F. C., Oliveira, Camilla N. S., Degiovani, Augusto M., Ostini, Fátima M., Feitosa, Marley R., Parra, Rogerio S., da Rocha, José J. R., Feres, Omar, Vilar, Fernando C., Gaspar, Gilberto G., Santos, Isabel K. F. M., Fernandes, Ana P. M., and Maruyama, Sandra R.

Subjects
COVID-19 pandemic, CANNABINOIDS, INFLAMMATION, INDUCTIVELY coupled plasma mass spectrometry, TANDEM mass spectrometry, BLOOD lipids
Abstract

COVID-19 is associated with a dysregulated immune response. Currently, several medicines are licensed for the treatment of this disease. Due to their significant role in inhibiting pro-inflammatory cytokines and lipid mediators, glucocorticoids (GCs) have attracted a great deal of attention. Similarly, the endocannabinoid (eCB) system regulates various physiological processes including the immunological response. Additionally, during inflammatory and thrombotic processes, phospholipids from cell membranes are cleaved to produce platelet-activating factor (PAF), another lipid mediator. Nonetheless, the effect of GCs on this lipid pathway during COVID-19 therapy is still unknown. This is a cross-sectional study involving COVID-19 patients (n = 200) and healthy controls (n = 35). Target tandem mass spectrometry of plasma lipid mediators demonstrated that COVID-19 severity affected eCBs and PAF synthesis. This increased synthesis of eCB was adversely linked with systemic inflammatory markers IL-6 and sTREM-1 levels and neutrophil counts. The use of GCs altered these lipid pathways by reducing PAF and increasing 2-AG production. Corroborating this, transcriptome analysis of GC-treated patients blood leukocytes showed differential modulation of monoacylglycerol lipase and phospholipase A2 gene expression. Altogether, these findings offer a breakthrough in our understanding of COVID-19 pathophysiology, indicating that GCs may promote additional protective pharmacological effects by influencing the eCB and PAF pathways involved in the disease course. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Additional file 2 of ETV4 plays a role on the primary events during the adenoma-adenocarcinoma progression in colorectal cancer

Author

Fonseca, Aline Simoneti, Anelisa Ramão, Matheus Carvalho Bürger, Souza, Jorge Estefano Santana De, Zanette, Dalila Lucíola, Greice Andreotti De Molfetta, Araújo, Luiza Ferreira De, Bueno, Rafaela De Barros E Lima, Aguiar, Graziela Moura, Plaça, Jessica Rodrigues, Cleidson De Pádua Alves, Anemari Ramos Dinarte Dos Santos, Vidal, Daniel Onofre, Gyl Eanes Barros Silva, Panepucci, Rodrigo Alexandre, Peria, Fernanda Maris, Feres, Omar, Rocha, José Joaquim Ribeiro Da, Zago, Marco Antonio, and Silva, Wilson Araújo

Subjects
stomatognathic system, endocrine system diseases, neoplasms, digestive system diseases, respiratory tract diseases
Abstract

Additional file 2 Table S2. Observed mutations in APC,TP53 and KRAS genes.

Published
2021
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20. Additional file 4 of ETV4 plays a role on the primary events during the adenoma-adenocarcinoma progression in colorectal cancer

Author

Fonseca, Aline Simoneti, Anelisa Ramão, Matheus Carvalho Bürger, Souza, Jorge Estefano Santana De, Zanette, Dalila Lucíola, Greice Andreotti De Molfetta, Araújo, Luiza Ferreira De, Bueno, Rafaela De Barros E Lima, Aguiar, Graziela Moura, Plaça, Jessica Rodrigues, Cleidson De Pádua Alves, Anemari Ramos Dinarte Dos Santos, Vidal, Daniel Onofre, Gyl Eanes Barros Silva, Panepucci, Rodrigo Alexandre, Peria, Fernanda Maris, Feres, Omar, Rocha, José Joaquim Ribeiro Da, Zago, Marco Antonio, and Silva, Wilson Araújo

Subjects
sense organs, skin and connective tissue diseases, neoplasms, digestive system diseases
Abstract

Additional file 4 Figure S2. Apoptosis assay. The HT29 and SW480 cell lines did not show any changes in the apoptosis’ rates (A) and cell viability (B).

Published
2021
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21. Additional file 5 of ETV4 plays a role on the primary events during the adenoma-adenocarcinoma progression in colorectal cancer

Author

Fonseca, Aline Simoneti, Anelisa Ramão, Matheus Carvalho Bürger, Souza, Jorge Estefano Santana De, Zanette, Dalila Lucíola, Greice Andreotti De Molfetta, Araújo, Luiza Ferreira De, Bueno, Rafaela De Barros E Lima, Aguiar, Graziela Moura, Plaça, Jessica Rodrigues, Cleidson De Pádua Alves, Anemari Ramos Dinarte Dos Santos, Vidal, Daniel Onofre, Gyl Eanes Barros Silva, Panepucci, Rodrigo Alexandre, Peria, Fernanda Maris, Feres, Omar, Rocha, José Joaquim Ribeiro Da, Zago, Marco Antonio, and Silva, Wilson Araújo

Abstract

Additional file 5 Table S3. Enrichment of signaling pathways analysis.

Published
2021
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22. Additional file 3 of ETV4 plays a role on the primary events during the adenoma-adenocarcinoma progression in colorectal cancer

Author

Fonseca, Aline Simoneti, Anelisa Ramão, Matheus Carvalho Bürger, Souza, Jorge Estefano Santana De, Zanette, Dalila Lucíola, Greice Andreotti De Molfetta, Araújo, Luiza Ferreira De, Bueno, Rafaela De Barros E Lima, Aguiar, Graziela Moura, Plaça, Jessica Rodrigues, Cleidson De Pádua Alves, Anemari Ramos Dinarte Dos Santos, Vidal, Daniel Onofre, Gyl Eanes Barros Silva, Panepucci, Rodrigo Alexandre, Peria, Fernanda Maris, Feres, Omar, Rocha, José Joaquim Ribeiro Da, Zago, Marco Antonio, and Silva, Wilson Araújo

Subjects
neoplasms, digestive system diseases
Abstract

Additional file 3 Figure S1. Relative expression of the ETV4 gene after its silencing in HT29 and SW480 CRC cell lines. The silencing was efficient with p

Published
2021
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23. Real-world treatment patterns and disease control over one year in patients with inflammatory bowel disease in Brazil

Author

Sassaki, Ligia Yukie, primary, Miszputen, Sender J, additional, Kaiser Junior, Roberto Luiz, additional, Catapani, Wilson R, additional, Bafutto, Mauro, additional, Scotton, António S, additional, Zaltman, Cyrla, additional, Baima, Julio Pinheiro, additional, Ramos, Hagata S, additional, Faria, Mikaell Alexandre Gouvea, additional, Gonçalves, Carolina D, additional, Guimaraes, Isabella Miranda, additional, Flores, Cristina, additional, Amarante, Heda M B S, additional, Nones, Rodrigo Bremer, additional, Parente, José Miguel Luz, additional, Lima, Murilo Moura, additional, Chebli, Júlio Maria, additional, Ferrari, Maria de Lourdes Abreu, additional, Campos, Julia F, additional, Sanna, Maria G P, additional, Ramos, Odery, additional, Parra, Rogério Serafim, additional, da Rocha, Jose J R, additional, Feres, Omar, additional, Feitosa, Marley R, additional, Caratin, Rosana Fusaro, additional, Senra, Juliana, additional, and Santana, Genoile Oliveira, additional

Published
2021
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24. Sa085 EFFICACY AND SAFETY OF USTEKINUMAB IN PATIENTS WITH MODERATE TO SEVERE CROHN'S DISEASE IN BRAZIL

Author

Parra, Rogerio S., primary, Chebli, Julio, additional, Chebli, Liliana, additional, Bertges, Erika R., additional, Junior, Orlando Ambrogini, additional, Schiavetti, Bianca, additional, Alves, Antonio, additional, Flores, Cristina, additional, Lubini, Marcio, additional, Gasparetti, Newton, additional, Bafutto, Mauro, additional, Azevedo, Matheus, additional, Damiao, Aderson O., additional, Queiroz, Natália S., additional, Steinwurz, Flavio, additional, Carvalho, Nayara S., additional, Boratto, Sandra D., additional, Vilela, Eduardo G., additional, Feres, Omar, additional, and Rocha, Jose Joaquim R., additional

Published
2021
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25. Laparoscopic bowel resection of deep infiltrating endometriosis. Comparative outcomes of a public teaching hospital and a referral private hospital 1

Author

Parra, Rogério Serafim, Feitosa, Marley Ribeiro, Valerio, Fernando Passador, de Camargo, Hugo Parra, Zanardi, José Vitor Cabral, Feres, Omar, da Rocha, José Joaquim Ribeiro, and Rosa-e-Silva, Júlio César

Subjects
Hospitals, Public, General Surgery, Outcome Assessment, Health Care, Endometriosis, Humans, Laparoscopy, Female, Clinical Investigation, Public Health, Hospitals, Teaching, Referral and Consultation, Hospitals, Private
Abstract

Purpose To compare the operative outcomes of laparoscopic surgical treatment for bowel endometriosis in a public teaching hospital versus in a private referral hospital. Methods The indications for surgery, type and time of operation, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, and postoperative complications were evaluated. Results One hundred eighty-one patients were included (150 patients, 82.9%, in a private hospital). In the private hospital, there were more patients with infertility [56% vs. 29%; P=0.01] as an indication for surgery) and segmental resection was more common in the private hospital (48% vs. 29%, p=0.05). The average operative time (211.9±83.4 minutes vs. 128 ± 55 minutes, p

Published
2020

28. Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil

Author

Zaltman, Cyrla, primary, Parra, Rogério Serafim, additional, Sassaki, Ligia Yukie, additional, Santana, Genoile Oliveira, additional, Ferrari, Maria de Lourdes Abreu, additional, Miszputen, Sender J, additional, Amarante, Heda M B S, additional, Kaiser Junior, Roberto Luiz, additional, Flores, Cristina, additional, Catapani, Wilson R, additional, Parente, José Miguel Luz, additional, Bafutto, Mauro, additional, Ramos, Odery, additional, Gonçalves, Carolina D, additional, Guimaraes, Isabella Miranda, additional, da Rocha, Jose J R, additional, Feitosa, Marley R, additional, Feres, Omar, additional, Saad-Hossne, Rogerio, additional, Penna, Francisco Guilherme Cancela, additional, Cunha, Pedro Ferrari Sales, additional, Gomes, Tarcia NF, additional, Nones, Rodrigo Bremer, additional, Faria, Mikaell Alexandre Gouvea, additional, Parente, Mírian Perpétua Palha Dias, additional, Scotton, António S, additional, Caratin, Rosana Fusaro, additional, Senra, Juliana, additional, and Chebli, Júlio Maria, additional

Published
2021
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30. Preoperative rectal tumor embolization as an adjunctive tool for bloodless abdominoperineal excision: A case report

Author

Feitosa, Marley Ribeiro, primary, Freitas, Lucas Fernandes de, additional, Filho, Antonio Balestrim, additional, Nakiri, Guilherme Seizem, additional, Abud, Daniel Giansante, additional, Landell, Ligia Magnani, additional, Brunaldi, Mariângela Ottoboni, additional, Rocha, Jose Joaquim Ribeiro da, additional, Feres, Omar, additional, and Parra, Rogério Serafim, additional

Published
2020
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34. Experimental Model of Rectal Carcinogenesis Induced By N-Methyl-N-Nitrosoguanidine In Mice with Endoscopic Evaluation

Author

Machado, Vanessa Foresto, primary, Parra, Rogerio Serafim, additional, Leite, Caio Abner, additional, Minto, Stefania Bovo, additional, Cunha, Thiago Mattar, additional, Cunha, Fernando de Queiroz, additional, Garcia, Sergio Britto, additional, Feitosa, Marley Ribeiro, additional, da Rocha, Jose Joaquim Ribeiro, additional, and Feres, Omar, additional

Published
2020
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35. Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

Author

Parra, Rogerio S, primary, Chebli, Julio MF, additional, Amarante, Heda MBS, additional, Flores, Cristina, additional, Parente, Jose ML, additional, Ramos, Odery, additional, Fernandes, Milene, additional, Rocha, Jose JR, additional, Feitosa, Marley R, additional, Feres, Omar, additional, Scotton, Antonio S, additional, Nones, Rodrigo B, additional, Lima, Murilo M, additional, Zaltman, Cyrla, additional, Goncalves, Carolina D, additional, Guimaraes, Isabella M, additional, Santana, Genoile O, additional, Sassaki, Ligia Y, additional, Hossne, Rogerio S, additional, Bafutto, Mauro, additional, Junior, Roberto LK, additional, Faria, Mikaell AG, additional, Miszputen, Sender J, additional, Gomes, Tarcia NF, additional, Catapani, Wilson R, additional, Faria, Anderson A, additional, Souza, Stella CS, additional, Caratin, Rosana F, additional, Senra, Juliana T, additional, and Ferrari, Maria LA, additional

Published
2019
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36. Hyperbaric oxygen therapy decreases mortality due to Fournier's gangrene: a retrospective comparative study.

Author

Feres, Omar, Feitosa, Marley, Ribeiro da Rocha, José, Miranda, Juliana, dos Santos, Luciana, Féres, Artur, de Camargo, Hugo, and Parra, Rogério

Subjects
*FOURNIER gangrene, *HYPERBARIC oxygenation, *INSTITUTIONAL review boards, *COMPARATIVE studies, *RETROSPECTIVE studies
Abstract

There is no consensus about the role of adjunctive hyperbaric oxygen therapy (HBOT) in the management of Fournier's gangrene. The aim of this study was to compare the evolution of patients with Fournier's gangrene treated with all classical measures with and without adjuvant HBOT. A retrospective comparative study regarding the evolution of patients treated for Fournier's gangrene was conducted in two periods. In period I, from 1990 to 2002, patients received standard treatments for Fournier's gangrene, which consisted of surgical debridement, antibiotic therapy and intensive care. In period II, from 2012 to 2019, adjunctive HBOT was added to the classical management strategy. All patients were assigned into four groups according to the anatomical severity classification and the area affected after the first debridement. This classification ensured that the groups could be comparable. The total number of patients in this study was 197, and these patients were divided into control group (118/59.9%) and HBOT group (79/40.1%). The mean age, comorbidities, and anatomical severity classification were similar between the two groups. In period I, 34 out of 118 (28.8%) patients died, while in the HBOT group, 3 out of 77 (3.7%) patients died (P < 0.001). The use of adjuvant HBOT in combination with classical treatment was associated with reduced mortality. This study was approved by the Institutional Review Board and the Ethics Committee of Ribeirão Preto Medical School, University of São Paulo, Brazil (No. 08/2018) on May 2, 2018. [ABSTRACT FROM AUTHOR]

Published
2021
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