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Introduction: Hyperbaric oxygen therapy (HBO) is approved for difficult-to-treat tissue injury. It also been used as a second-line treatment for refractory infection in hematologic malignancies. However, data on the efficacy of HBO in such population are limited. Here, we reviewed our single-center experience of HBO used in patients with hematologic malignancies. Methods: We identified patients undergoing HBO treatment by insurance authorization data between December 2012 and October 2019 at MD Anderson Cancer Center. Patients with a diagnosis of hematologic malignancies with or without history of stem-cell transplant were included. Clinical and demographic data were collected by retrospective chart review. Results: A total of 50 patients were included: 26 (52%) patients had Acute Myeloid Leukemia, 31 (62%) patients had received an SCT, and 34 (68%) patients had active disease, of whom 28 (56%) had relapsed/refractory disease. The most common infections were: 19 (38%) BK cystitis and 17 (34%) fungal sinusitis. Median number of HBO sessions was 5 (range 1–60), and median HBO duration was 17 days (range 0–109). All patients received initial HBO in the hospital; 25 (50%) patients were discharged from hospital at either completion of HBO or after transition to outpatient treatment. Sixteen (32%) patients were discharged to hospice, and 8 (16%) patients died during the hospitalization. Ninety-day and 1-year mortality were high at 52% and 78%, respectively. Median survival was 3.1 months. Patients with BK cystitis were less likely to respond to HBO (odds ratio 0.16, p=.004). Eight patients had response to HBO and achieved remission of infection at last follow-up. These patients had a higher proportion (50%) of underlying disease in remission, compared to 29% in rest of patients (n=42). The treatment indications in the responding group were 2 BK cystitis, 2 fungal sinusitis, 2 cellulitis, and 2 non-BK cystitis. Other patient characteristics were similar to the rest of the patients. Patients with response/infection remission had better survival with HR 0.18 (95% CI .063–.529, p=.002). Conclusion: A small subset of patients with hematologic malignancies, 16% in our study, had meaningful recovery from infection after HBO treatment. In our experience, patients whose underlying malignancy was in remission and patients with non-BK infection had better outcomes. Additional studies are needed to better identify the population who would benefit from HBO.

Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p

Objectives To assess HIV and sexually transmitted infection (STI) prevalence and associated risk factors in men who have sex with men (MSM) in two cities in mainland Tanzania. Methods We conducted respondent-driven sampling of 300 MSM in Dar es Salaam and Tanga. Results In Dar es Salaam, 172 (86%) men (median age 23, IQR 21–28) consented to HIV/STI testing, and 30.2% were HIV seropositive. Only five reported a previous positive HIV test: >90% were new HIV detections. 2.5% were syphilis-exposed and none hepatitis B positive, but 21.4% had a curable STI. Over 90% of the gonorrhoea and chlamydia was rectal. In Tanga, 11.1% of MSM were HIV seropositive, 8% hepatitis B positive and 0% were syphilis-exposed, with 4.4% having a curable STI. Predictors of HIV infection were number of MSM known, city, identifying as gay and having first sex with a man. Predictors for STIs were recent unprotected receptive anal intercourse, and number of MSM seen in the last month. 30% of the sample reported that they sold sex. There was no significant association between HIV and STI infection. Conclusions HIV and STI rates were substantially lower in MSM in a provincial city than in a large metropolis and rates appear to depend on larger numbers of MSM known. Most HIV detected were new cases, and there was a high burden of asymptomatic curable rectal STIs (>1 in 5 MSM). Owing to stigma, MSM may not report homosexuality and thus not have rectal STIs treated. High need for tailored HIV testing and STI screening and treatment of MSM in Tanzania is apparent.