scholarly journals Efek Proteksi dari Terapi Oksigen Hiperbarik terhadap Ekspresi Bcl-2 Miometrium Rattus norvegicus Bunting yang Terinfeksi oleh Tachyzoite Toxoplasma gondii

2020 ◽  
Vol 9 (1) ◽  
pp. 85
Author(s):  
Arif Rahman Nurdianto ◽  
Aryati Aryati ◽  
Mohammad Guritno Suryokusumo ◽  
Mufasirin Mufasirin
Keyword(s):  
Toxoplasma Gondii ◽  
Hyperbaric Oxygen ◽  
Rattus Norvegicus ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Control Group ◽  
Pregnant Rats ◽  
Pregnant Rat ◽  
Significant Difference ◽  
Group A

Hyperbaric Oxygen Therapy (HBOT) can increase oxygen delivery to tissues and stimulate the formation of H2O2 as a secondary messenger for phosphorylation of nuclear factor kappa beta (NF-kB) which plays an important role in the transcription of the anti apoptotic gene. This study aimed to determine the effects of Hyperbaric Oxygen Therapy (HBOT) in enhancing the expressions of Bcl-2 in the myometrium of pregnant rats infected by Toxoplasma gondii. This study was an experimental study with a randomized control group of post-test only and designed by 37 pregnant Rattus norvegicus Sprague Dawley. Randomly, the rats were divided into four groups. Group A is infected pregnant rats that exposed by 10 sessions of HBOT 2.4 ATA in 3x30 minutes. Group B is non-infected pregnant rats and exposed by 10 sessions of HBOT 2.4 ATA in 3x30 minutes. Group C is infected pregnant rats without any exposure. Group D is non-infected pregnant rats without any exposure. Each infected pregnant rat was given a 103 tachyzoite of T.gondii by intraperitoneal injection. Bcl-2 expressions were measured through immunohistochemistry. All data were analyzed using ANOVA test through SPSS 21 program application. There was a significant difference in Bcl-2 expression between Group A and Group C because p<α (p<0.017). HBOT can increase the expression of Bcl-2 from infected and not infected rat myometrium, in the provision of HBOT 2.4 ATA for 3x30 minutes, twice a day for 5 days.

scholarly journals Elevation of Bcl2 expression in artery spiralis of pregnant Rattus novergicus infected with Tachyzoite of Toxoplasma gondii with hyperbaric oxygen therapy

2019 ◽  
Vol 3 (2) ◽  
pp. 157
Author(s):  
Arif Rahman Nurdianto ◽  
Aryati Aryati ◽  
Mohammad Guritno Suryokusumo ◽  
Mufasirin Mufasirin
Keyword(s):  
Toxoplasma Gondii ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Sprague Dawley ◽  
Pregnant Rats ◽  
Significant Difference ◽  
Post Test ◽  
Group A ◽  
Bcl2 Expression

ABSTRACTSpiral artery apoptosis plays a role in the process of abortion. Low Bcl2 expression found in abortion and in spiral artery. In pregnancy, Toxoplasmosis infection is found to increase apoptosis in spiral arteries. Hyperbaric Oxygen Therapy (HBOT) improves the expression of Bcl-2. This study aims to determine the effects of Hyperbaric Oxygen therapy in enhancing the expressions of Bcl2 in artery spiralis of pregnant rats infected with tachyzoite of Toxoplasma gondii. This is an experiment with a ‘randomized control group of post-test only design’ on 37 Rattus novergicus Sprague Dawley rats. Rats were divided into four groups. The group A is pregnant rats infected with 103 tachyzoites via intraperitoneal injection and received 10 sessions of HBOT 2.4 ATA in 3x30 minutes. Group B is pregnant only and received HBOT. Group C is pregnant and infected with tachyzoite but did not received HBOT. And the last, Group D is pregnant rats with no infection and did not received HBOT. Examinations of Bcl2 expressions were performed on day-5 after HBOT (twice a day). The Bcl2 expression was measured with immunohistochemistry. All data were tested with One-way ANOVA from SPSS 21.  There is an increased expression of Bcl2 spiralis artery in the Group A. There was a significant difference between Group A and Group C with a value of p=0.042. HBOT can increase the expression of Bcl2 from the spiral arteries of rats, in the provision of HBOT 2.4 ATA for 3x30 minutes, 10 times in 5 days.Keywords: Toxoplasma gondii, tachyzoite, Hyperbaric Oxygen Therapy, Bcl2, spiralis arteryCorrespondence to: [email protected]  ABSTRAK Apoptosis arteri spiralis berperan dalam proses aborsi. Ekspresi Bcl2 rendah ditemukan pada aborsi dan di arteri spiral. Pada kehamilan, infeksi Toxoplasmosis ditemukan meningkatkan apoptosis pada arteri spiralis. Terapi Oksigen Hiperbarik (HBOT) meningkatkan ekspresi Bcl-2. Ini adalah penelitian eksperimental dengan desain post-test only pada 37 hamil Rattus novergicus Sprague Dawley, maka tikus dibagi menjadi 4 kelompok. Grup A HBOT adalah tikus hamil yang terinfeksi tachyzoite yang menerima terapi 10 sesi HBOT 2.4 ATA dalam 3x30 menit; kelompok B adalah Hamil saja dan tidak mendapat HBOT; kelompok C Hamil dan terinfeksi tachyzoite T.gondii tetapi tidak menerima HBOT; dan kelompok D adalah tikus hamil normal. Setiap tikus hamil yang terinfeksi diberi 103 Tachyzoite Toxoplasma gondii melalui intraperitoneal. Pemeriksaan ekspresi Bcl2 dilakukan pada hari ke-5 setelah HBOT (dua kali sehari). Tikus terbunuh dan kadar Bcl2 Arteri spiralis diukur dengan pemeriksaan Immunohistokimia. Semua data dianalisis dengan uji ANOVA dengan Program SPSS 21. Pada studi ini menunjukkan terapi Oksigen Hiperbarik dapat meningkatkan Ekspresi Bcl2 Arteri Spiralis dengan dosis 2.4 ATA selama 3x30 menit dalam 10 sesi selama 5 hari terapi. Studi ini menyimpulkan bahwa HBOT dapat meningkatkan ekspresi Bcl2 dalam arteri spiralis, dalam pemberian HBO 2.4 ATA selama 3x30 menit dalam 10 sesi.Kata kunci: HBOT, Arteri spiralis, Bcl2, Tachyzoite Toxoplasma gondiiKorespondensi: [email protected] 

scholarly journals Downregulates of ICAM1 expression in Myometrium from pregnant Rattus novergicus infected with Tachyzoite of Toxoplasma gondii with Hyperbaric Oxygen Therapy

2019 ◽  
Vol 17 (1) ◽  
pp. 77
Author(s):  
ARIF RAHMAN NURDIANTO ◽  
ARYATI ARYATI ◽  
MOHAMMAD GURITNO SURYOKUSUMO ◽  
MUSASIRIN MUFASIRIN
Keyword(s):  
Toxoplasma Gondii ◽  
Hyperbaric Oxygen ◽  
Rattus Norvegicus ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Sprague Dawley ◽  
Pregnant Rats ◽  
Days Of Therapy ◽  
Post Test ◽  
Group B

<p align="center"><strong>Abstract</strong></p><p><strong>Background:</strong> To find the effect of Hyperbaric Oxygen Therapy in the myometrium expressions of ICAM1 from pregnant Rattus norvegicus infected with Tachyzoite <em>Toxoplasma gondii.</em></p><p><strong>Material and Methods :</strong></p><p>This is an experimental study with a post-test only design on 37 pregnant <em>Rattus norvegicus</em> <em>Sprague Dawley</em>, then the rats were divided into 4 groups. The HBOT group A is pregnant rats infected with tachyzoite received therapy 10 sessions of HBOT 2.4 ATA in 3x30 minutes; the group B is Pregnant only and get no HBOT; the group C is Pregnant and infected with <em>tachyzoite T.gondii</em> but not received HBOT, and the group D is normal pregnant rats. Each infected pregnant rats were given a 10<sup>3 </sup>Tachyzoite of <em>Toxoplasma gondii</em> via intraperitoneal. Examinations of ICAM1 expressions were performed on day-5 after HBOT (twice a day). Rats were killed and the myometrial ICAM1 levels were measured with Immunohistochemistry examination. All data were analyzed with the ANOVA test with SPSS 21 Program.<strong></strong></p><p><strong>Results: </strong>The results show that Hyperbaric Oxygen Therapy can downregulate ICAM1 in the administered of HBO 2.4 ATA for 3x30 minutes in 10 sessions over 5 days of therapy.</p><p><strong>Conclusion:</strong> The study concludes that HBOT can downregulate the expressions of ICAM1 in the myometrium, in the provision of HBO 2.4 ATA for 3x30 minutes in 10 sessions.</p>

scholarly journals The Effects of Hyperbaric Oxygen Therapy on Experimental Colon Anastomosis After Preoperative Chemoradiotherapy

2013 ◽  
Vol 98 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Ramazan Yildiz ◽  
Mehmet Fatih Can ◽  
Gokhan Yagci ◽  
Taner Ozgurtas ◽  
Metin Guden ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Preoperative Chemoradiotherapy ◽  
Colon Resection ◽  
Burst Pressure ◽  
Control Group ◽  
Albino Rats ◽  
Colon Anastomosis ◽  
Significant Difference

Abstract The aim of the present study was to investigate the effect of hyperbaric oxygen therapy (HBOT) on colon anastomosis after chemoradiotherapy (CRT). Sixty female Wistar-Albino rats were divided into 5 groups and underwent left colon resection and end-to-end anastomosis. CRT simulation was performed on 2 sham groups before the anastomosis, and 1 of these groups was administered additional postoperative HBOT. Two groups were administered CRT before the anastomosis, and 1 of them received additional postoperative HBOT. On postoperative day 5, all groups underwent relaparotomy; burst pressure was measured and samples were obtained for histopathologic and biochemical analysis. There was a significant weight loss in the CRT groups and postoperative HBOT had an improving effect. Significantly decreased burst pressure values increased up to the levels of the controls after HBOT. Hydroxyproline levels were elevated in all groups compared to the control group. Hydroxyproline levels decreased with HBOT after CRT. No significant difference was observed between the groups regarding fibrosis formation at the anastomosis site. However, regression was observed in fibrosis in the group receiving HBOT after CRT. Preoperative CRT affected anastomosis and wound healing unfavorably. These unfavorable effects were alleviated by postoperative HBOT. HBOT improved the mechanical and biochemical parameters of colon anastomosis in rats.

scholarly journals The Effect of Hyperbaric Oxygen Therapy to the Amount of Lymphocytes in Oral Candidiasis Immunosuppressed Model

DENTA ◽  
2019 ◽  
Vol 12 (2) ◽  
pp. 36
Author(s):  
Agni Febrina Pargaputri ◽  
Dwi Andriani
Keyword(s):  
Immune System ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Wistar Rats ◽  
Oxygen Therapy ◽  
Oral Candidiasis ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference ◽  
The Difference

<p><strong><em> </em></strong></p><p><strong><em>Background: </em></strong><em>Oral candidiasis generally caused by Candida albicans with prevalence of 30-50%. C. Albicans proliferation in the oral cavity was canducted by decreasing immune system of the host. Lymphocytes activation in immune system happened when there is a contact between host cell with cell wall of C. albicans as a result of C. albicans antigen. One of therapy to suppress the Candida infection sistemically is by giving hyperbaric oxygen therapy. <strong>Purpose: </strong>To determine the effects of giving hyperbaric oxygen therapy to the amount of lymphocytes in oral candidiasis immunosuppressed models. <strong>Methods:</strong> This research was post test only control group design. We used 12 wistar rats which were divided into 3 groups(n=4/3): K-(normal/ healthy wistar rats), K+(oral candidiasis immunosuppressed wistar rats), P1(oral candidiasis immunosuppressed wistar rats which were given hyperbaric oxygen therapy 5 days). K+ and P1 groups were immunosuppressed by giving dexamethasone 0,5mg/day/rat orally for 14 days, added with tetrasiklin 1 mg/day/rat. On the 3rd day immunosuppression, the rats were inducted with C.albicans smeared in the dorsum linguae once every two days for 12 days. <strong>Results:</strong> The data were analyzed with one way Anova test and showed significant difference among groups (p&lt;0,05). To show the difference between each groups we used LSD test and showed significant difference (p&lt;0,05) between K+ compared with P1, and K+ compared with K-. <strong>Conclusion:</strong> Hyperbaric oxygen therapy gives effect to the amount of lymphocytes in oral candidiasis immunosuppressed models.</em></p><p><em> </em><strong><em>Keywords:</em></strong><em> Oral candidiasis, immunosuppressed, hyperbaric oxygen therapy, lymphocytes</em></p><p> <strong><em>Correspondence</em></strong><strong><em>: </em></strong><em>Agni Febrina Pargaputri</em><em>, Departmen</em><em>t of</em><em> Oral </em><em>Biology </em><em>F</em><em>aculty of</em><em> </em><em>Dentistry</em><em>, Jl. Arif Rahman Hakim 150, Surabaya, Indonesia. </em><em>Phone:</em><em> 031-5945864, fax: 031-5912191, Email: </em><em><span style="text-decoration: underline;">agni.febrina</span></em><em><span style="text-decoration: underline;">@hangtuah.ac.id</span></em></p><p> </p>

scholarly journals Inhibition of rats extramedullary liver erytropoiesis by hyperbaric oxygen therapy

2007 ◽  
Vol 22 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Ricardo Costa-Val ◽  
Tarcizo Afonso Nunes ◽  
Roberto Carlos de Oliveira e Silva ◽  
Antônio Francisco de Souza ◽  
Irene Edith de Puy e Souza ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Therapy Group ◽  
Control Group ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Significant Difference ◽  
Extramedullary Erythropoiesis ◽  
Group 2

PURPOSE: To research the hyperbaric oxygen therapy effects on rats' livers and spleens. METHODS: 30 adult male Hotzman rats were used, being randomly distributed, by raffle, into 2 groups of 15 animals each: group 1 - control; group 2 - hyperbaric oxygen therapy. Group-2 animals underwent hyperbaric oxygen therapy for 120 minutes daily, 90 minutes of which were under pressure of 2.5 atmospheres. The first and last 15 minutes were used for gradual compression and decompression, respectively, for 20 days in a row. The livers and spleens of the animals from the two groups were taken out for histologic examination, on the day after the end of hyperbaric oxygen therapy in group 2 animals. Liver and spleen histologic changes of the animals from the two groups were compared by using Fisher exact test. P < 0.05 was regarded as a significant difference. RESULTS: The only change in liver and spleen histology was the significant reduction in hepatic extramedullary erythropoiesis in the animals that underwent hyperbaric oxygen therapy (p < 0.05). CONCLUSION: Hyperbaric oxygen therapy reduces hepatic extramedullary erythropoiesis in rats and doesn't jeopardize the other liver and spleen structures.

scholarly journals Serum Albumin Levels of Oral Candidiasis Immunosuppressed Rats Treated With Hyperbaric Oxygen

2020 ◽  
Vol 8 (1) ◽  
pp. 8-13
Author(s):  
Agni Febrina Pargaputri ◽  
Dwi Andriani
Keyword(s):  
Serum Albumin ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Fungal Infections ◽  
Oral Candidiasis ◽  
Immunosuppressive Drugs ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference

Objective: To investigate serum albumin levels in oral candidiasis immunosuppressed rats treated with hyperbaric oxygen. One of the predisposing factors for oral candidiasis was the use of immunosuppressive drugs continuously. It can also affect the work of the liver because it’s one of the organs responsible for drug metabolism. Hyperbaric oxygen therapy was used not only to suppressing fungal infections, but also to improve liver function by evaluating the serum albumin levels. Methods: This study used a post-test only control group design. Fifteen Wistar rats were divided into 3 groups(n=5/3): G1 (healthy group), G2 (oral candidiasis immunosuppressed rats group without hyperbaric oxygen therapy), and G3 (oral candidiasis immunosuppressed rats group with hyperbaric oxygen therapy). G2 and G3 groups were immunosuppressed by giving dexamethasone 0,5mg/day/rat orally for 14 days, added with tetracycline 1 mg/day/rat. Hyperbaric oxygen therapy was given to the G3 group in 5 days. Blood serum of rats in all groups was taken to calculate albumin levels. Results: The average value of albumin levels in G2 group showed a decrease compared to the G1 group, while G3 showed the highest level. One way Anova test showed a significant difference among groups (p<0,05). To compare the difference between each group we used LSD test and showed a significant difference (p<0,05) between G1 compared to G2, G1 compared to G3, and G2 compared to G3. Conclusion: Liver albumin levels of oral candidiasis immunosuppressed rats treated with hyperbaric oxygen therapy showed higher levels than those without therapy.

scholarly journals Effect of hyperbaric oxygen therapy on esophagojejunal anastomosis healing in rats

2008 ◽  
Vol 23 (6) ◽  
pp. 491-496 ◽  
Author(s):  
João Domingos Lionço ◽  
Lívia Caprara Lionço ◽  
Lucas Torely Filippi ◽  
Clarissa Caprara Lionço ◽  
Bernardo Volkweiss ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Breaking Strength ◽  
Suture Line ◽  
Collagen Concentration ◽  
Esophagojejunal Anastomosis ◽  
Group A ◽  
Anastomotic Fistula ◽  
Group B

PURPOSE: To evaluate hyperbaric oxygen therapy (HBO) after esophagojejunal anastomosis in a rat experimental model and the effect of HBO on the healing of esophagojejunal anastomosis in gastrectomized rats. METHODS: Forty adult male Wistar rats, weighing 322 g to 506 g, were divided into two random groups. In group A (control group), 20 rats were subjected to total gastrectomy. In group B, 20 rats were similarly gastrectomized, but also received postoperative HBO treatment for 90 minutes/day for seven days. All rats were sacrificed on the eighth postoperative day and evaluated according to the following study variables: a) presence of anastomotic fistula; b) evaluation of esophagojejunal anastomosis healing by measuring the breaking strength at the suture line as per Hendriks & Mastboom; and c) determining the collagen concentration in the anastomosis, as per Kovács criteria. For the comparative statistical analysis between groups, Student's "t" test was used. A value of p<0.05 was considered significant. RESULTS: There was a 20% mortality rate. There were five deaths in group A and three in group B (p=N.S.). There was only one anastomotic fistula in each group, and neither caused any morbidity or death. Breaking strength measured at the suture line (p=0.528) and collagen concentration determined at the esophagojejunal anastomosis (p=0.89) were not significantly different between Groups A and B. CONCLUSION: Hyperbaric oxygen therapy did not affect the healing process of esophagojejunal anastomosis.

scholarly journals Research on the Possibility of Treating Streptococcal Infections with Hyperbaric Oxygenation

2020 ◽  
Vol 70 (1) ◽  
pp. 43-46
Author(s):  
Władysław Wolański
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Hyperbaric Oxygenation ◽  
Lethal Effect ◽  
Streptococcal Infections ◽  
Group A

AbstractThe aim of the study was to determine the effect of the application of hyperbaric oxygen therapy on the course of an infection with group A type T-3 hemolytic β streptococcus. Experiments were carried out on Porton white mice and in vitro blood plates. General and local infections with streptococci were induced in animals. The infected animals were treated with hyperbaric oxygenation. The lethal effect of infection was significantly inhibited using hyperbaric oxygenation on the first and second day following the infection.

scholarly journals The Impact of Hyperbaric Oxygen Therapy on Serum C-Reactive Protein Levels, Osteoprotegerin Expression, and Osteoclast Numbers in Induced-Periodontitis Diabetic Rats

2020 ◽  
Vol 14 (03) ◽  
pp. 404-409
Author(s):  
Dian Mulawarmanti ◽  
Kristanti Parisihni ◽  
Widyastuti Widyastuti
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Diabetic Rats ◽  
Diabetic Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Serum Crp ◽  
The Impact

Abstract Objectives This study aimed to examine the impact of hyperbaric oxygen therapy (HBOT) on serum C-reactive protein (CRP) levels, osteoclast numbers, and osteoprotegerin (OPG) expression in periodontitis-induced diabetic rats Materials and Methods This study constituted an in vivo laboratory-based experiment incorporating a posttest only control group design. Thirty male Wistar rats were divided into three groups of research subjects: a healthy group (K0), periodontitis-induced diabetic group (K1), and periodontitis-induced diabetic group treated with HBOT for 7 days (K2). After treatment, the subjects were sacrificed to determine the level of serum CRP by the ELISA method. Immunohistochemical analysis was conducted to check the level of OPG expression, while a histological analysis was undertaken to quantify the number of osteoclasts. Statistical Analysis The data was analyzed using a one-way ANOVA and Least Significant Difference (LSD) test on which a result of p < 0.05 was considered statistically significant. Results HBOT appreciably decreased serum CRP levels, significantly enhancing OPG expression in periodontitis-induced diabetic (p < 0.05) and decreasing the number of osteoclasts in -periodontitis-induced diabetic (p > 0.05). Conclusion HBOT reduced the serum CRP level, increased OPG expression, and decreased osteoclast numbers in periodontitis-induced diabetic rats.

scholarly journals Assessing the effect of hyperbaric oxygen therapy in breast cancer patients with late radiation toxicity (HONEY trial): a trial protocol using a trial within a cohort design

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
M. C. T. Batenburg ◽  
H. J. G. D. van den Bongard ◽  
C. E. Kleynen ◽  
W. Maarse ◽  
A. Witkamp ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Intervention Studies ◽  
Control Group ◽  
Radiation Toxicity ◽  
Breast Cancer Patients ◽  
Randomized Controlled

Abstract Background Breast cancer treatment with radiotherapy can induce late radiation toxicity, characterized by pain, fibrosis, edema, impaired arm mobility, and poor cosmetic outcome. Hyperbaric oxygen therapy (HBOT) has been proposed as treatment for late radiation toxicity; however, high-level evidence of effectiveness is lacking. As HBOT is standard treatment and reimbursed by insurers, performing classic randomized controlled trials is difficult. The “Hyperbaric OxygeN therapy on brEast cancer patients with late radiation toxicity” (HONEY) trial aims to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the trial within cohorts (TwiCs) design. Methods The HONEY trial will be conducted within the Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation (UMBRELLA). Within UMBRELLA, breast cancer patients referred for radiotherapy to the University Medical Centre Utrecht are eligible for inclusion. Patients consent to collection of clinical data and patient-reported outcomes and provide broad consent for randomization into future intervention studies. Patients who meet the HONEY in- and exclusion criteria (participation ≥ 12 months in UMBRELLA, moderate/severe breast or chest wall pain, completed primary breast cancer treatment except hormonal treatment, no prior treatment with HBOT, no contraindications for HBOT, no clinical signs of metastatic or recurrent disease) will be randomized to HBOT or control group on a 2:1 ratio (n = 120). Patients in the control group will not be informed about participation in the trial. Patients in the intervention arm will undergo 30–40 HBOT treatment sessions in a high pressure chamber (2.4 atmospheres absolute) where they inhale 100% oxygen through a mask. Cohort outcome measures (i.e., physical outcomes, quality of life, fatigue, and cosmetic satisfaction) of the HBOT group will be compared to the control group at 3 months follow-up. Discussion This pragmatic trial within the UMBELLA cohort was designed to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the TwiCs design. Use of the TwiCs design is expected to address issues encountered in classic randomized controlled trials, such as contamination (i.e., HBOT in the control group) and disappointment bias, and generate information about acceptability of HBOT. Trial registration ClinicalTrials.gov. NCT04193722. Registered on 10 December 2019.

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