Treatment of refractory radiation-induced hemorrhagic proctitis with hyperbaric oxygen therapy.

OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy in treatment of severe refractory radiation-induced hemorrhagic proctitis. METHODS: Nine patients with median age 75 (range, 66-83) treated with hyperbaric oxygen (HBO) at University of Cincinnati were reviewed. Pre- and post-therapy bleeding was graded on a 5-point scale. Five patients had previous hospitalizations for anemia and required transfusions. Three patients had undergone electrocautery or argon plasma coagulation before hyperbaric oxygen therapy (HBOT). The remainder had medical therapy before HBO. No patients experienced resolution of symptoms before HBO. The median follow-up after HBO was 17 months (range, 1-77). RESULTS: Seven patients had complete resolution of rectal bleeding. Two patients exhibited a partial response, but continued to experience intermittent bleeding. The Wilcoxon signed rank test determined that HBOT significantly reduced rectal bleeding. CONCLUSIONS: HBOT is a very effective treatment of hemorrhagic radiation-induced proctitis.

Youth access laws: in the dark at the tanning parlor?

OBJECTIVE: To compare laws governing youth access to UV irradiation at indoor tanning facilities with laws governing youth access to tobacco. DESIGN: Tobacco and UV irradiation youth access laws were assessed via correspondence with public health offices and computerized legal searches of 6 industrialized nations with widely differing skin cancer incidence rates. SETTING: National, provincial, and state legal systems in Australia, Canada, France, New Zealand, the United Kingdom, and the United States. PARTICIPANTS: Public health, legal, information science, and medical professionals and government and tanning industry representatives. MAIN OUTCOME MEASURES: Statutes specifying age restrictions for the purchase of indoor tanning services or tobacco products. RESULTS: The 5 English-speaking countries with common law-based legal systems unilaterally prohibit youth access to tobacco but rarely limit youth access to UV irradiation from tanning salons. Only very limited regions in the United States and Canada prohibit youth access to indoor tanning facilities: Texas, Illinois, Wisconsin, and New Brunswick prohibit tanning salon use by minors younger than 13, 14, 16, and 18 years, respectively. In contrast, French law allows minors to purchase tobacco but prohibits those younger than 18 years from patronizing tanning salons. CONCLUSIONS: Youth access laws governing indoor tanning display remarkable variety. Uniform indoor tanning youth access laws modeled on the example of tobacco youth access laws merit consideration.