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Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society

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https://www.readbyqxmd.com/read/28357828/cerebral-arterial-gas-embolism-ingestion-of-hydrogen-peroxide-and-flight
#1
LETTER
Beuy Joob, Viroj Wiwanitkit
We read with interest the recent report by Smedley et al. on an interesting case of cerebral arterial gas embolism (CAGE) after pre-flight ingestion of hydrogen peroxide (H₂O₂). The authors discuss the safety of aero-medical transfer following H₂O₂ ingestion. We agree with the possible problems but the concern on the other side of the coin needs to be mentioned; can transfer be delayed is the big question? Indeed, as reported by others, ingestion of even a small amount of concentrated H₂O₂ can result in CAGE...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357827/usn-treatment-table-9
#2
LETTER
Dick Clarke
The United States Navy (USN) introduced Treatment Table 9 (USN TT9) in 1999. Its purpose is to provide a dosing protocol for cases of incomplete resolution of decompression sickness (DCS) and arterial gas embolism following initial provision of USN Treatment Table 6 (USN TT6). It also can be used for several non-diving-related acute toxicities. Prior to USN TT9, it was and remains common to use USN Treatment Table 5 (USN TT5) for 'follow-up' therapy. An exception might be cases of severe residual neurologic injury, where some prefer to repeat USN TT6...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357826/anton-s-syndrome-as-a-presentation-of-decompression-illness
#3
Charles Paul Azzopardi, Lyubisa Matity, Stephen Muscat
We present a case of a patient with Anton's syndrome due to decompression illness (DCI) after recreational scuba diving. Visual anosognosia, or denial of loss of vision, which is associated with lack of awareness regarding visual loss in the setting of cortical blindness, is known as Anton's syndrome (also termed Anton-Babinski syndrome). Our patient presented with progressive neurological DCI treated with repeated recompression. The anosogosia resolved after 48 h. Subsequent echocardiography revealed a persistent (patent) foramen ovale...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357825/the-prevalence-of-electrocardiogram-abnormalities-in-professional-divers
#4
Ali Erdal Gunes, Maide Cimsit
BACKGROUND: The underwater environment presents physiological challenges for the cardiovascular, renal and pulmonary systems. Increases in external hydrostatic pressure reduce the capacity of the venous compartment and cause blood to move toward the lung. The aim of this study was to evaluate retrospectively electrocardiographic (ECG) changes in a cohort of professional divers. METHODS: Between January 2009 and January 2012, 225 randomly selected professional divers, 204 male (91%) and 21 female (9%) attended our clinic for their biannual diving medical assessment...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357824/identifying-and-acting-on-inappropriate-metadata-a-critique-of-the-grattan-institute-report-on-questionable-care-in-australian-hospitals
#5
P David Cooper, David R Smart
INTRODUCTION: In an era of ever-increasing medical costs, the identification and prohibition of ineffective medical therapies is of considerable economic interest to healthcare funding bodies. Likewise, the avoidance of interventions with an unduly elevated clinical risk/benefit ratio would be similarly advantageous for patients. Regrettably, the identification of such therapies has proven problematic. A recent paper from the Grattan Institute in Australia (identifying five hospital procedures as having the potential for disinvestment on these grounds) serves as a timely illustration of the difficulties inherent in non-clinicians attempting to accurately recognize such interventions using non-clinical, indirect or poorly validated datasets...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357823/performance-of-the-bbraun-perfusor-space-syringe-driver-under-hyperbaric-conditions
#6
Lachlan Frawley, Bridget Devaney, Theo Tsouras, Geoff Frawley
BACKGROUND: The BBraun Perfusor Space™ syringe driver is already in use by ambulance services and retrieval teams but has not previously been assessed for hyperbaric chamber use. METHODS: Pump flow accuracy was tested at rates between 1 and 40 ml· h⁻¹ using three different brands of 50 ml syringe. Function of the occlusion alarms was assessed using the same syringes. The hyperbaric profile involved pressurisation to 284 kPa at 30 kPa· min⁻¹, 30 min at 284 kPa and decompression at 30 kPa· min⁻¹...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357822/an-assessment-of-the-performance-of-the-baxter-elastomeric-lv10-infusor%C3%A2-pump-under-hyperbaric-conditions
#7
Stephen Perks, Denise F Blake, Derelle A Young, John Hardman, Lawrence H Brown, Iestyn Lewis, Tilley Pain
INTRODUCTION: There are limited data on the use of elastomeric infusion pumps during hyperbaric oxygen treatment. AIM: This study evaluated the flow rate of the Baxter elastomeric LV10 Infusor™ pump under normobaric (101.3 kPa) and three hyperbaric conditions of 203 kPa, 243 kPa and 284 kPa. METHODS: Elastomeric pumps were secured to participants in the same manner as for a typical patient, except that a container collected the delivered antibiotic solution...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357821/tenth-european-consensus-conference-on-hyperbaric-medicine-recommendations-for-accepted-and-non-accepted-clinical-indications-and-practice-of-hyperbaric-oxygen-treatment
#8
Daniel Mathieu, Alessandro Marroni, Jacek Kot
The tenth European Consensus Conference on Hyperbaric Medicine took place in April 2016, attended by a large delegation of experts from Europe and elsewhere. The focus of the meeting was the revision of the European Committee on Hyperbaric Medicine (ECHM) list of accepted indications for hyperbaric oxygen treatment (HBOT), based on a thorough review of the best available research and evidence-based medicine (EBM). For this scope, the modified GRADE system for evidence analysis, together with the DELPHI system for consensus evaluation, were adopted...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357820/preventive-effect-of-rosiglitazone-on-liver-injury-in-a-mouse-model-of-decompression-sickness
#9
Bin Peng, Miao-Miao Chen, Zheng-Lin Jiang, Xia Li, Guo-Hua Wang, Li-Hua Xu
BACKGROUND AND AIMS: Severe decompression sickness (DCS) is a multi-organ injury. This study investigated the preventive effects of rosiglitazone on liver injury following rapid decompression in mice and examined the underlying mechanisms. METHODS: Mice were randomly divided into four groups: a control group, vehicle group, and rosiglitazone (5 and 10 mg·kg⁻¹) groups, the latter three being exposed to a pressure of 911 kPa. Haematoxylin and eosin staining, plasma levels of alanine transaminase (ALT), aspartate transaminase (AST) and lactate dehydrogenase and blood cell counts were used to evaluate liver injury at 30 min after rapid decompression...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357819/a-comparative-evaluation-of-two-decompression-procedures-for-technical-diving-using-inflammatory-responses-compartmental-versus-ratio-deco
#10
COMPARATIVE STUDY
Enzo Spisni, Claudio Marabotti, Luigia De Fazio, Maria Chiara Valerii, Elena Cavazza, Stefano Brambilla, Klarida Hoxha, Antonio L'Abbate, Pasquale Longobardi
INTRODUCTION: The aim of this study was to compare two decompression procedures commonly adopted by technical divers: the ZH-L16 algorithm modified by 30/85 gradient factors (compartmental decompression model, CDM) versus the 'ratio decompression strategy' (RDS). The comparison was based on an analysis of changes in diver circulating inflammatory profiles caused by decompression from a single dive. METHODS: Fifty-one technical divers performed a single trimix dive to 50 metres' sea water (msw) for 25 minutes followed by enriched air (EAN50) and oxygen decompression...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28357818/otitis-externa-in-military-divers-more-frequent-and-less-harmful-than-reported
#11
Thijs T Wingelaar, Pieter-Jan Am van Ooij, Rob A van Hulst
INTRODUCTION: Although otitis externa (OE) is a common disease, data related to (military) divers are limited. This study aimed to determine the incidence of OE in military divers during their initial training. We also wished to consider seasonal influences on incidence and whether early detection increases completion of the diving course. METHODS: From January 2011 to October 2016 the Royal Netherlands Navy Diving School trained 189 divers. Up to December 2015 we used the training records for the analyses...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966207/partial-retraction-of-lawrence-chd-chen-iyd-the-effect-of-scuba-diving-on-airflow-obstruction-in-divers-with-asthma-diving-and-hyperbaric-medicine-2016-march-46-1-11-14
#12
Christopher Hd Lawrence, Isobel Yd Chen
Consistent with the Committee on Publication Ethics guidelines, we the above authors are initiating a partial retraction of our paper: Lawrence CHD, Chen IYD. The effect of scuba diving on airflow obstruction in divers with asthma. Diving and Hyperbaric Medicine. 2016 March;46(1):11-14. We wish to make the following statement: "Following independent statistical review of our paper we would like to withdraw the following: all subgroup statistical analysis including Table 1 and the statement "∗ P 〈 0.05, non-asthmatic controls vs Group A3 asthmatics" in the legend of Figure 2; the discussion statement: "We hope that these data will provide practitioners assessing and risk stratifying people with asthma prior to diving with a modest evidence basis on which to advise them of their relative risk of airflow obstruction compared to the normal population...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966206/middle-ear-barotrauma-causing-transient-facial-nerve-paralysis-after-scuba-diving
#13
Matthew Lee Carmichael, K Paul Boyev
Middle ear barotrauma is a well known entity with typical injury occurring when diving or ascending in a commercial jetliner. Patients often present with symptoms of acute onset otalgia, hearing loss and sometimes haemotympanum (with or without tympanic membrane perforation). On rare occasions, facial nerve paralysis can occur when the tympanic segment of the facial nerve is dehiscent within the middle ear. We present a case of spontaneously resolving facial nerve palsy associated with middle ear barotrauma following a brief, shallow dive...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966205/increasing-the-probability-of-surviving-loss-of-consciousness-underwater-when-using-a-rebreather
#14
REVIEW
Paul Haynes
Re-circulating underwater breathing apparatus (rebreathers) have become increasingly popular amongst sport divers. In comparison to open-circuit scuba, rebreathers are complex life support equipment that incorporates many inherent failure modes and potential for human error. This individually or in combination can lead to an inappropriate breathing gas. Analysis of rebreather diving incidents suggests that inappropriate breathing gas is the most prevalent disabling agent. This can result in spontaneous loss of consciousness (LoC), water aspiration and drowning...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966204/the-influence-of-pressure-changes-on-the-retentive-force-and-coronal-microleakage-of-different-types-of-posts-in-endodontically-treated-teeth-during-simulated-dives
#15
Gergo Mitov, Florian Draenert, Paul Schumann, Marcus Stötzer, Constantin von See
OBJECTIVES: We assessed the influence of a simulated diving environment on the interfacial microleakage and retentive forces of different post types in root-canal-filled teeth. MATERIALS AND METHODS: One-hundred-and-twenty extracted, single-rooted teeth were endodontically treated and were randomly divided into three groups according to the post and cement used: ER Post/Harvard cement (Titanium), CeraPost/DentinBuild Evo (Zirconia), DT Light Post/Calibra (FRC). Each group was randomly divided into two equal subgroups, a control group, and an experimental group, subjected to simulated dives to 456 kPa in a diving chamber...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966203/estimating-the-risk-of-a-scuba-diving-fatality-in-australia
#16
John Lippmann, Christopher Stevenson, David McD Taylor, Jo Williams
INTRODUCTION: There are few data available on which to estimate the risk of death for Australian divers. This report estimates the risk of a scuba diving fatality for Australian residents, international tourists diving in Queensland, and clients of a large Victorian dive operator. METHODOLOGY: Numerators for the estimates were obtained from the Divers Alert Network Asia-Pacific dive fatality database. Denominators were derived from three sources: Participation in Exercise, Recreation and Sport Surveys, 2001-2010 (Australian resident diving activity data); Tourism Research Australia surveys of international visitors to Queensland 2006-2014 and a dive operator in Victoria 2007-2014...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966202/provisional-report-on-diving-related-fatalities-in-australian-waters-in-2011
#17
John Lippmann, Christopher Lawrence, Andrew Fock, Scott Jamieson, Richard Harris
INTRODUCTION: An individual case review of diving-related deaths reported as occurring in Australia in 2011 was conducted as part of the DAN Asia-Pacific dive fatality reporting project. METHOD: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and, where available, details from the post-mortem examination are provided. A chain of events analysis was conducted for each case...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27966201/the-demographics-and-diving-behaviour-of-dan-asia-pacific-members-with-and-without-pre-existing-medical-conditions
#18
John Lippmann, David McD Taylor, Christopher Stevenson, Simon Mitchell
INTRODUCTION: This report examines Diver Alert Network Asia-Pacific (DAN AP) members with and without cardiac or respiratory conditions, diabetes or hypertension and compares their demographics, health and diving activities. METHODOLOGY: Two online cross-sectional surveys of DAN AP members were conducted. The first sought information from 833 divers who applied for membership between July 2009 and August 2013 and who had declared the targeted medical conditions...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27723024/hypothesis-the-influence-of-cavitation-or-vacuum-phenomenon-for-decompression-sickness
#19
LETTER
Costantino Balestra
Dr Yanagawa and his colleagues present an interesting hypothesis, and our group has had some discussions around this vacuum phenomenon and decompression sickness (DCS). I am aware of at least one diver in whom symptoms appeared after a 'self-manipulation' of his lower lumbar spine. The diver exited the water symptom-free and approximately 1.5 hours after the dive went to the hotel swimming pool. Before getting into the water, he self manipulated his lumbar spine as he was in the habit of doing, provoking the familiar cracking sound...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27723023/hypothesis-the-influence-of-cavitation-or-vacuum-phenomenon-for-decompression-sickness
#20
LETTER
Youichi Yanagawa, Kazuhiko Omori, Kouhei Ishikawa, Kei Jitsuiki, Toshihiko Yoshizawa, Ikuto Takeuchi, Hiromichi Ohsaka
Attention has recently been focused on the vacuum phenomenon detected by computed tomography (CT), where gas in the human body is incidentally detected by CT. We introduce our hypothesis that the vacuum phenomenon increases the risk of decompression sickness (DCS) in subjects who engage in post-diving exercise. When the screw propeller of a ship operates underwater, a swirling effect called cavitation occurs. This swirling effect is closely related to the ship's propulsive efficiency as well as propeller cracking and damage...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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