DCS or DCI? The difference and why it matters.
Authors: Mitchell SJ Abstract There are few issues that generate as much confusion in diving medicine as the nomenclature of bubble-induced dysbaric disease. Prior to the late 1980s, the diagnosis 'decompression sickness' (DCS) was invoked for symptoms presumed to arise as a consequence of bubble formation from dissolved inert gas during or after decompression. These bubbles were known to form within tissues, and also to appear in the venous blood (presumably after forming in tissue capillaries). A second diagnosis, 'arterial gas embolism' (AGE) was invoked for symptoms presumed to arise when bubbles were introduce...
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Calculated risk of pulmonary and central nervous system oxygen toxicity: a toxicity index derived from the power equation.
CONCLUSION: The limited use of this toxicity index in the diving community, after more than a decade since its publication in the literature, establishes the need for a handy, user-friendly implementation of the power equation. PMID: 31523789 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Increasing prevalence of vestibulo-cochlear decompression illness in Malta - an analysis of hyperbaric treatment data from 1987-2017.
CONCLUSION: The increasing prevalence of vestibulo-cochlear DCI may be due to a change in diving practices in Malta. PMID: 31523790 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Seizure frequency in more than 180,000 treatment sessions with hyperbaric oxygen therapy - a single centre 20-year analysis.
This study aimed to determine the seizure frequency and assess the clinical benefit of a 5-minute air-break (5´-AIRBK). METHODS: Twenty-year (1999-2018) retrospective analysis of all consecutive treatments with HBOT. Medical records were reviewed to determine patient demographics, comorbidities, HBOT indications, and seizure characteristics and timing. Seizure frequency was compared before and after incorporating a 5´-AIRBK in the treatment protocol. Chi-square testing was performed using SPSS (version 24.0); P
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Only minor stem cell mobilization in head and neck irradiated patients treated with hyperbaric oxygen.
CONCLUSION: We found a minor statistically significant mobilizing effect of HBO treatment on the bone marrow derived stem/progenitor cell content in peripheral blood after 15 treatments (n = 10 patients), but no effect after 30 treatments (n = 6 patients). However, because of the low number of patients we cannot confidentially prove or disprove the null hypothesis. The possibility that HBO treatment reduces the number of activated platelets could not be demonstrated nor excluded. PMID: 31523792 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Assessment of sensory sensitivity through critical flicker fusion frequency thresholds after a maximum voluntary apnoea.
Authors: de Asís Fernández F, González-Mohino F, González-Ravé JM Abstract INTRODUCTION: The influence of acute exercise on sensory sensitivity (SS) differs according to the type and duration of exercise performed. In the present study, we assessed changes on SS soon after a maximal dynamic apnoea. METHODS: Thirty-nine experienced male breath-hold divers were recruited. Critical flicker fusion frequency (CFFF) thresholds were used to measure SS. Thresholds were determined before and after a maximal dynamic apnoea. Immediately after surfacing, heart rate and oxygen saturation (...
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Snorkelling and breath-hold diving fatalities in Australia, 2001 to 2013. Demographics, characteristics and chain of events.
CONCLUSION: Human factors, such as chronic health conditions, poor skills and inexperience and poor planning can play a substantial role throughout the chain of events leading to a snorkelling fatality. It is important to educate the community, doctors and dive industry professionals about potential problems associated with the interaction between certain health-related conditions, especially cardiovascular conditions, and snorkelling. Close supervision is strongly recommended for inexperienced snorkellers due to their likely poor skills, as well as for experienced breath-hold divers due to the potential for apnoeic hypoxi...
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Descriptive study of diving injuries in the Canary Islands from 2008 to 2017.
CONCLUSIONS: Over half of the injured divers did not receive any on-site first aid. The majority (94%) of treated injured divers were discharged without sequelae. Based on these data, several public health recommendations for the Canary Islands are made. PMID: 31523795 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Evidence for simulation-based education in hyperbaric medicine: A systematic review.
CONCLUSIONS: More research is needed to determine how the hyperbaric medicine community and their patients may benefit from simulation-based education to optimize both practice and patient care. PMID: 31523796 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Is there a role for hyperbaric oxygen therapy in the treatment of refractory wounds of rare etiology?
CONCLUSION: We recommend the establishment of comprehensive and detailed wound care registries to rapidly collect prospective data on the use of HBOT for these problem wounds. There is a strong case for appropriately powered, multi-centre randomized trials to establish the true efficacy and cost-effectiveness of HBOT especially for vasculitis ulcers that have not improved following immunosuppressive therapy. PMID: 31523797 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A diver's guide to subaquatic envenomation in the Mediterranean.
CONCLUSION: Envenomation by subaquatic species is common and preventable yet the dissemination of the appropriate knowledge is limited. This knowledge summary provides pertinent information aimed at divers in preventing and managing such injuries. PMID: 31523798 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A case report of cerebral arterial gas embolism (CAGE) associated with Takotsubo cardiomyopathy.
Authors: McCool D, Butler C, Evans J, Aase C Abstract A 43-year-old female scuba diver was retrieved and treated following a rapid ascent and presumed cerebral arterial gas embolism (CAGE). She subsequently developed respiratory distress and was found to have Takotsubo cardiomyopathy, with transient left ventricular dysfunction, elevated cardiac enzymes, and normal CT coronary angiography. We believe this to be the first report of CAGE associated with Takotsubo cardiomyopathy. PMID: 31523799 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 18, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Risk mitigation in divers with persistent (patent) foramen ovale.
Authors: Wilmshurst P Abstract In this issue, Anderson and colleagues report follow-up of divers who were found to have a persistent (patent) foramen ovale (PFO) or, in eleven cases, an atrial septal defect (ASD). In most divers diagnosis followed an episode of decompression illness (DCI). The efficacy of closure of the PFO/ASD in preventing future DCI was compared with conservative diving. They reported that in the closure group the occurrence of confirmed DCI decreased significantly compared with pre-closure, but in the conservative group this reduction was not significant. It is believed there are three requ...
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The effectiveness of risk mitigation interventions in divers with persistent (patent) foramen ovale.
CONCLUSIONS: PFO closure should be considered on an individual basis. In particular, individuals who are healthy, have a significant DCS burden, a large PFO or seek to pursue advanced diving may benefit from closure. PMID: 31177513 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Serum tau concentration after diving - an observational pilot study.
CONCLUSION: Repeated diving to between 52-90 msw is associated with a statistically significant increase in serum tau protein concentration, which could indicate neuronal stress. PMID: 31177514 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A survey of scuba diving-related injuries and outcomes among French recreational divers.
CONCLUSION: Based on these results, diving injury rates may be higher than previously reported. However, the most frequent symptoms appear to be of only a modest nature. PMID: 31177515 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The impact of health on professional diver attrition.
CONCLUSIONS: The key determinant of early attrition from the New Zealand professional diver workforce is industry-related rather than health-related. The current New Zealand diver health surveillance system detects the medical problems that cause divers to quit the industry. PMID: 31177516 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The utility and safety of hypoxia experiences for rebreather divers.
CONCLUSION: An hypoxic experience did not improve cognitive performance or subject insight into performance in a second exposure five weeks later. Hypoxia imposes a significant physiological stress which may be hazardous in unscreened, non-medically supervised subjects. Hypoxia experience training is not recommended for rebreather divers at this time. PMID: 31177517 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Early detection of diving-related cognitive impairment of different nitrogen-oxygen gas mixtures using critical flicker fusion frequency.
Authors: Lafère P, Hemelryck W, Germonpré P, Matity L, Guerrero F, Balestra C Abstract INTRODUCTION: Cognitive impairment related to inert gas narcosis (IGN) is a threat to diving safety and operations at depth that might be reduced by using enriched air nitrox (EANx) mixtures. Using critical flicker fusion frequency (CFFF), a possible early detection of cognitive abilities/cerebral arousal impairment when breathing different oxygen (O2) fractions was investigated. METHODS: Eight male volunteers performed, in random order, two dry chamber dives breathing either air or EANx40 (40% O₂-60% nitrogen...
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Systematic review on the effects of medication under hyperbaric conditions: consequences for the diver.
CONCLUSIONS: Animal studies revealed that psycho-pharmaceuticals can limit the onset of neurologic symptoms and cardiovascular protective drugs might add a potential protective effect against decompression sickness. No evidence of significant risks due to changes in pharmacologic mechanisms were revealed and most medication is not a contraindication to diving. For improving decision making in prescribing medicine for recreational and occupational divers and to enhance safety by increasing our understanding of pharmacology in hyperbaric conditions, future research should focus on controlled human studies. PMID: 31177519...
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The Hyperbaric Protective Tube: A housing for a left ventricular assist device (LVAD) in a multiplace hyperbaric chamber.
CONCLUSION: An isolation housing that vents into the dumping system of the hyperbaric chamber allows for the safe use of critical medical devices without prior testing for their compatibility with the hyperbaric environment. PMID: 31177520 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Cerebral arterial gas embolism in a scuba diver with a primary lung bulla.
We present the case of a healthy 27-year-old Caucasian male who presented following the second of two introductory resort dives with neurological symptoms attributable to CAGE. Investigations revealed a previously undiagnosed large primary lung bulla. This case highlights the clinical sequelae of primary lung bullae in the context of pulmonary barotrauma related to recreational diving activity. PMID: 31177521 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - June 11, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The impact of diving on hearing: a 10-25 year audit of New Zealand professional divers.
CONCLUSION: Audiological changes over 10 to 25 years of occupational diving were not found to be significantly different from age-related changes. Routine annual audiological testing of professional divers does not appear to be justifiable. PMID: 30856661 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Eustachian tube balloon dilation in treatment of equalization problems of freediving spearfishermen.
CONCLUSION: Balloon dilation of the Eustachian tube is an effective therapy in the treatment of equalization problems with a good success rate. PMID: 30856662 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The effects of pressure in vitro on three methods of root canal obturation.
CONCLUSIONS: Vertical condensation may be the best technique, based on sealing ability, for people who frequently experience pressure alterations. PMID: 30856663 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A 20-year analysis of compressed gas diving-related deaths in Tasmania, Australia.
CONCLUSIONS: This 20-year study highlighted regional variations for Tasmanian deaths and presents opportunities for strategies to prevent diving deaths in the future. Of particular concern was the diving practice of 'hookah' diving, which has no governing regulations. The study highlighted the importance of applying a structured methodology such as chain of events analysis to scrutinise diving deaths. PMID: 30856664 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Immersion pulmonary oedema: a cardiological perspective.
Authors: Wilmshurst PT Abstract It is postulated that immersion pulmonary oedema (IPE) occurs because of combinations of factors that each increase the hydrostatic pressure gradient between the pulmonary capillaries and the alveoli. The factors, by definition, include the effects of immersion, particularly raised central blood volume and hence cardiac filling pressures. Breathing against a negative pressure is important but the magnitude of the effect depends on the relation of the diver's lung centroid to the source of the breathing gas and the breathing characteristics of diving equipment. Other factors are cold-...
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Diving and attention deficit hyperactivity disorder.
This article presents guidelines for recreational diving in combination with ADHD and psychostimulants. These guidelines are based solely on 'expert' opinion and were adopted at a meeting of the Dutch Association for Diving Medicine in 2017. PMID: 30856666 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The performance of 'temperature stick' carbon dioxide absorbent monitors in diving rebreathers.
CONCLUSION: When operated at even shallow depth, temperature sticks provided timely warning of significant CO₂ breakthrough in the scenarios examined. They are much less accurate during simulated exercise at surface pressure. PMID: 30856667 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Lion's mane jellyfish (Cyanea capillata) envenoming presenting as suspected decompression sickness.
We describe five divers presenting with suspected decompression sickness, where the probable diagnosis was jellyfish envenoming. PMID: 30856668 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Massive portal venous gas embolism after scuba diving.
CONCLUSION: The role of portal venous gas in DCS is not obvious. Isolated portal venous gas seems to cause no obvious harm. Medical imaging should be considered for differential diagnosis and to prevent some complications, especially in divers presenting with abdominal pain. PMID: 30856669 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Gas micronuclei that underlie decompression bubbles and decompression sickness have not been identified.
Authors: Doolette DJ Abstract Gas micronuclei are gas-filled voids in liquids from which bubbles can form at low gas supersaturation. If water is depleted of gas micronuclei, high gas supersaturation is required for bubble formation. This high gas supersaturation is required in part to overcome the Laplace pressure at the point of transition from dissolved gas to a bubble of perhaps nanometer-scale radius. The sum of gas and vapour partial pressures inside a spherical bubble (Pbub) of radius r exceeds the ambient barometric pressure (Pamb) and is given by the Young-LaPlace equation: Pbub = Pamb + 2γ/r for a b...
Source: Diving and Hyperbaric Medicine - March 13, 2019 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Malnutrition screening in outpatients receiving hyperbaric oxygen therapy: an opportunity for improvement?
Authors: Tatucu-Babet OA, Ridley EJ Abstract Outpatients who receive hyperbaric oxygen treatment (HBOT) may represent a group at significant risk of malnutrition owing to the underlying conditions that are often treated with HBOT (e.g., non-healing diabetic wounds and radiation-induced skin injury). In this issue, See and colleagues provide new, preliminary evidence of the prevalence of malnutrition in a small group of HBOT outpatients treated in an Australian hospital, reporting that approximately one-third of patients receiving HBOT were at risk of malnutrition. To our knowledge, routine malnutrition screening is...
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Comparison of tissue oxygenation achieved breathing oxygen from a demand valve with four different mask configurations.
CONCLUSION: Of the commonly available O₂ masks for use with a demand valve, the IOM with NC achieved the highest PtcO₂ values. PtcO₂ and nasopharyngeal FIO₂ values were similar between the IOM with and without NC. Given the reported discomfort of the NC, the IOM without NC may be the best option. PMID: 30517952 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Decompression illness and other injuries in a recreational dive charter operation.
CONCLUSIONS: DCI requiring recompression was relatively rare in this supervised recreational diving operation. Minor non-diving injuries were the most common adverse event. Compared to other adventure sports, the prevalence of injury in recreational scuba diving is low. PMID: 30517953 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Fatal shark attacks on divers in Australia, 1960-2017.
CONCLUSION: Spearfishing and other seafood collection, as well as diving near fishing activities and/or seals, were identified as major risk factors. However, shark attacks on divers are relatively rare and represent only 3% of diving-related fatalities in Australia over this 57-year period. PMID: 30517954 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Assessment of hyperbaric patients at risk of malnutrition using the Malnutrition Screening Tool - a pilot study.
CONCLUSION: The prevalence of patients being at risk of malnutrition in our hyperbaric medical service was about one in three. Malnutrition screening should be part of routine patient assessment in order to ensure patients receive timely nutritional intervention. This may improve wound healing. PMID: 30517955 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Preventive effects of ketone ester BD-AcAc2 on central nervous system oxygen toxicity and concomitant acute lung injury.
This study aimed to further investigate the protective effects of BD-AcAc2 against CNS-OT and concomitant acute lung injury (ALI) in mice. METHODS: Mice were treated with BD-AcAc2 in peanut oil vehicle (2.5, 5.0 or 10.0 g·kg⁻² body weight) by gavage 20 minutes before 600 kPa HBO exposure. Control mice received the vehicle only. Seizure latency was recorded. Malondialdehyde content in brain and lung tissues, total protein level in bronchoalveolar lavage fluid (BLF) and lung water content were measured 60 minutes after the hyperbaric exposure. Histopathology of lung tissue was undertaken. RESULTS: Compa...
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Vibration and bubbles: a systematic review of the effects of helicopter retrieval on injured divers.
CONCLUSION: There is some physical evidence that vibration leads to bubble formation although there is a paucity of research on the specific effects of helicopter vibration and VGE in divers. Technological advances have led to improved assessment of VGE in divers and will aid in further research. PMID: 30517957 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Validation of algorithms used in commercial off-the-shelf dive computers.
CONCLUSIONS: Man-trial data on PDCS is available to the non-US Navy scientific community for testing of commercial decompression algorithms. This type of validation testing can be very informative on how to best use available commercial dive computers to improve diver safety. PMID: 30517958 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A diver with immersion pulmonary oedema and prolonged respiratory symptoms.
Authors: Morishima R, Nakashima K, Suzuki S, Yamami N, Aoshima M Abstract Immersion pulmonary oedema (IPE) is particularly associated with an excessive reaction to exercise and/or cold stress. IPE usually resolves without recompression therapy within a day or two. Herein we report a diver diagnosed with IPE, in whom symptoms persisted for five days. A 58-year-old man presented with sudden onset of dyspnoea, cough and haemoptysis after surfacing. He was an experienced diving instructor with a history of moderate mitral valve regurgitation. While IPE was diagnosed and oxygen administered, respiratory symptoms deterio...
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

The on-site differential diagnosis of decompression sickness from endogenous cerebral ischaemia in an elderly Ama diver using ultrasound.
This report suggests the usefulness of on-site ultrasound for making a differential diagnosis of DCS from endogenous cerebral ischaemia. Further clinical studies of this management approach are warranted. PMID: 30517960 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - December 7, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Decompression sickness, fatness and active hydrophobic spots.
Authors: van Ooij PJA Abstract Since decompression sickness (DCS) in humans was first described, mankind has embarked on an odyssey to prevent it. The demonstration that decompression releases bubbles, which mainly contain inert gas (nitrogen, helium), into the circulation and that the slower the decompression rate the lesser the incidence of DCS, resulted in 1908 in the publication of the first, reasonably safe diving tables. Besides the development of proper diving tables, the selection of divers is also of importance. A relationship between body composition and DCS was observed in dogs as long ago as the ninetee...
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Reliability of venous gas embolism detection in the subclavian area for decompression stress assessment following scuba diving.
Authors: Hugon J, Metelkina A, Barbaud A, Nishi R, Bouak F, Blatteau JE, Gempp E Abstract INTRODUCTION: Ultrasonic detection of venous gas emboli (VGE) in the precordial (PRE) region is commonly used in evaluation of decompression stress. While subclavian (SC) VGE detection can also be used to augment and improve the evaluation, no study has rigorously compared VGE grades from both sites as decompression stress indicators. METHODS: This retrospective study examined 1,016 man-dives breathing air extracted from the Defence Research and Development Canada dataset. Data for each man-dive included dive parameters (d...
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Provisional report on diving-related fatalities in Australian waters in 2012.
CONCLUSIONS: Pre-existing medical conditions; poor organisation, planning and supervision; equipment-related problems; snorkelling or diving alone or with loose buddy oversight and apnoeic hypoxia were features in several deaths in this series. PMID: 30199888 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Impact of various pressures on fracture resistance and microleakage of amalgam and composite restorations.
CONCLUSIONS: Composite restorations showed better fracture resistance compared to the amalgam group. However, diving pressure cycles demonstrated adverse effects on the fracture resistance values of both restorative materials. PMID: 30199889 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Meta-analysis on the effect of hyperbaric oxygen as adjunctive therapy in the outcome of anastomotic healing of experimental colorectal resections in rats.
CONCLUSION: Postoperative HBOT has a positive effect on colorectal anastomoses in rats. Further research should focus on a larger systematic animal study. PMID: 30199890 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Inner ear barotrauma in divers: an evidence-based tool for evaluation and treatment.
CONCLUSION: The diagnosis of IEBt remains difficult to define short of visualization through surgical exploration. Early treatment is defined by conservative management with a subsequent observational period to determine symptomatic resolution and need for surgery. However, a similar differential diagnosis is inner ear DCS which requires early recompression. The HOOYAH tool provides a method for assisting the provider in forming a more confident decision regarding the underlying pathology and facilitation of the appropriate treatment. PMID: 30199891 [PubMed - in process] (Source: Diving and Hyperbaric Medicine)
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

A recurrent, ischaemic ileocolonic anastomosis ulcer refractory to surgery treated with hyperbaric oxygen.
Authors: Pateria P, Chong A Abstract A 54-year-old male had undergone right hemicolectomy and ileo-colonic anastomosis for carcinoma-in-situ found at colonoscopy. Eighteen months later, he presented with a lower gastrointestinal bleed from an anastomotic ulcer, treated with resection of the anastomotic site and ileo-sigmoid anastomosis. In the ensuing 12 months, he had three episodes of haematochezia. Colonoscopy revealed a 12 mm anastomotic ulcer necessitating a further colonic resection and re-anastomosis. Two-years later, he presented with iron deficiency anaemia. He preferred expectant management and received t...
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Fatty diet, active hydrophobic spots, and decompression sickness.
Authors: Arieli R Abstract In a study of the effect of a fatty diet on decompression bubbles, based on the responses to a questionnaire regarding daily food consumption, the approximate fat intake for each diver was calculated, taking into account the maximum recommended intake for a person doing his type of work. Following hyperbaric exposure, divers were divided into two groups: 'bubblers' (a minimum of the second level on the Kisman-Masurel scale) and 'non-bubblers'. Bubblers had higher fat consumption than non-bubblers (146 ± 39% versus 92 ± 18%). There was only a small difference in body mass ind...
Source: Diving and Hyperbaric Medicine - September 12, 2018 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research