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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/29241238/hyperbaric-oxygen-associated-seizure-leading-to-stroke
#1
Jordan M Warchol, Jeffrey S Cooper, Thomas S Diesing
Oxygen toxicity seizures are a well-known complication of hyperbaric oxygen treatment (HBOT). Until now, there have not been any reported cases of an acute ischaemic event (stroke) as the result of a HBOT-associated oxygen toxicity seizure. We report an event in which a seizure and stroke occurred together and consider that the stroke may have been caused by seizure-induced demand ischaemia. This challenges the generally held view that oxygen toxicity seizures in the clinical hyperbaric setting are benign. A discussion of the literature on the subject of seizure-induced brain injury is included...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241237/delayed-hyperbaric-intervention-in-life-threatening-decompression-illness
#2
Michael Fm Perez, Janet V Ongkeko Perez, April R Serrano, Maravic P Andal, Maria Cc Aldover
Arterial gas embolism is a catastrophic event. Bubbles in the arterial circulation may lodge in the brain and cause infarction in the affected area and/or in a coronary vessel causing acute myocardial ischaemia. There is no well-defined window of time beyond which a response to hyperbaric oxygen is not expected. Major improvement may occur if the patient is treated as soon as possible, but is less likely in divers with severe decompression illness who have delayed intervention. We report on a 51-year-old, male rebreather diver who suffered loss of consciousness and cardiovascular collapse within minutes of a 30-metre deep dive at a remote Micronesian dive site...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241236/diving-and-antidepressants
#3
Abraham L Querido
Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241235/personality-and-behavioural-outcomes-in-diving-current-status-and-recommendations-for-future-research
#4
Charles H van Wijk
This paper provides a brief overview of the shift from studies describing the personality profiles of divers to studies exploring associations between personality variables and diving performance in terms of behavioural outcomes. The personality associations that were investigated include performance during training, panic proneness, diving injuries, susceptibility to inert gas narcosis, and the behaviour of tourist divers. The paper concludes with a number of suggested directions for further research on personality and diving that may provide tangible benefits in terms of both enhanced safety and improved performance underwater...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241234/lost-at-sea-the-medicine-physiology-and-psychology-of-prolonged-immersion
#5
Heather Massey, John Leach, Michael Davis, Vicki Vertongen
In most countries, immersion represents the second most common cause of accidental death in children and the third in adults. Between 2010 and 2013, 561 deaths worldwide involving recreational divers were recorded by the Divers Alert Network. Consequently, there is no room for complacency when diving. Being lost at sea is a diver's worst nightmare. In 2006, a diver was lost at sea off the coast of New Zealand for 75 hours. It is unprecedented that, after such a long time immersed in temperate (16-17°C) waters, he was found and survived...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241233/hyperbaric-oxygen-in-the-treatment-of-acute-retinal-artery-occlusion
#6
Mark J Elder, John A Rawstron, Michael Davis
INTRODUCTION: Acute retinal artery occlusion (ARAO) is a major cause of sudden, painless visual loss, often leaving no useful vision in the affected eye. Its incidence is cited at 0.85 per 100,000 persons per year but may be higher because of under-reporting. The natural history is difficult to study, but a spontaneous resolution rate of < 1-8% for acute, non-arteritic ARAO has been cited. Occurrence in an only eye is devastating for the patient. There is currently no consensus regarding management of ARAO and little evidence to support any treatment modality...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241232/thromboelastographic-assessment-of-the-impact-of-mexiletine-on-coagulation-abnormalities-induced-by-air-or-normal-saline-intravenous-injections-in-conscious-rats
#7
Joseph L Nates, Davide Cattano, Fernanda S Costa, Jacques E Chelly, Marie-Francoise Doursout
BACKGROUND: Thromboelastography (TEG) in venous air embolism (VAE) has been poorly studied. We induced coagulation abnormalities by VAE in a rat model, assessed by TEG with and without mexiletine, a lidocaine analogue local anesthetic. METHODS: Twenty-three Sprague Dawley rats instrumented under isoflurane anesthesia and allowed to recover five days prior to the experiments were randomized into three experimental groups: 1) VAE (n = 6); 2) VAE and mexiletine (n = 9); and 3) normal saline (NS) alone (control group, n = 8)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241231/influence-of-repetitive-diving-in-freshwater-on-pressure-equalization-and-eustachian-tube-function-in-recreational-scuba-divers
#8
Stefanie Jansen, Manuela Boor, Moritz F Meyer, Eberhard D Pracht, Ruth Volland, Heinz D Klünter, Karl-Bernd Hüttenbrink, Dirk Beutner, Maria Grosheva
INTRODUCTION: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). METHODS: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241230/influence-of-repetitive-diving-in-saltwater-on-pressure-equalization-and-eustachian-tube-function-in-recreational-scuba-divers
#9
Moritz F Meyer, Manuela Boor, Stefanie Jansen, Eberhard D Pracht, Moritz Felsch, Heinz D Klünter, Karl-Bernd Hüttenbrink, Dirk Beutner, Maria Grosheva
INTRODUCTION: We investigated in a prospective, observational trial the feasibility of using the Eustachian tube function test (ETFT) to measure the effect of repetitive pressure exposure during open seawater dives on Eustachian tube function. METHODS: The study included 28 adult divers during six consecutive days of diving in the Red Sea. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241229/back-to-the-future-occupational-diver-training-in-australia
#10
EDITORIAL
David Smart
The Australian Diver Accreditation Scheme (ADAS) had its genesis in the 1990s in response to a need to produce occupational divers who were trained to international standards with the necessary skills to safely undertake complex work in high-risk environments. Well-trained dive teams who are 'fit-for-purpose' can be regarded as the highest level of risk control in preventing accidents and workplace morbidity. Without such training, work site risks are not detected, with potentially disastrous consequences. In September 2017, the only civilian ADAS level 3 and 4 training facility in Australia, The Underwater Centre Tasmania (TUCT), closed its doors...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868603/proliferative-retinopathy-during-hyperbaric-oxygen-treatment
#11
REVIEW
Viet Tran, David Smart
A 43-year-old male with type 2 diabetes mellitus, treated with insulin for 28 years and with an HbA1c of 7.9% six months prior, suffered from bilateral plantar ulcers refractory to specialised wound care. He underwent a planned 40 sessions of hyperbaric oxygen treatment (HBOT) at 243 kPa for 90 minutes. Consent was given for this report. The patient's ophthalmic history included bilateral proliferative diabetic retinopathy (PDR) identified on routine diabetic eye screening three years previously. This was treated with pan-retinal photocoagulation (PRP)...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868602/ruptured-tympanic-membrane-from-underwater-impact-with-an-atlantic-salmon-salmo-salar
#12
David Smart
An unusual case of tympanic membrane rupture in a diver due to impact from an Atlantic salmon, Salmo salar is described. The diver was treated conservatively and the injury fully healed by eight weeks after which the diver successfully returned to diving. The author contends that the appearances of such traumatic perforations differ from barotrauma in divers secondary to ear clearing problems on descent.
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868601/periorbital-emphysema-after-a-wet-chamber-dive
#13
Wei-Shih Tseng, Hui-Chieh Lee, Bor-Hwang Kang
Although periorbital emphysema (PE) is commonly associated with orbital fractures, it may develop without any fracture or significant trauma in circumstances such as post-surgery, infection, forceful nose blowing, sneezing, and weight lifting. We report on a healthy military diver who developed PE following a wet chamber dive. A diagnosis of PE secondary to sinus barotrauma was reached. He was treated conservatively without medication and his symptoms recovered completely within 10 days. To the best of our knowledge, only five cases of diving-related PE have been reported in the literature...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868600/a-pleural-vacuum-relief-device-for-pleural-drain-unit-use-in-the-hyperbaric-environment
#14
Marco Gelsomino, Theo Tsouras, Ian Millar, Andrew Fock
INTRODUCTION: When a standard water-seal pleural drain unit (PDU) is used under hyperbaric conditions there are scenarios where excessive negative intrapleural pressure (IPP) and/or fluid reflux can be induced, risking significant morbidity. We developed and tested a pleural vacuum relief (PVR) device which automatically manages these risks, whilst allowing more rapid hyperbaric pressure change rates. METHODS: The custom-made PVR device consists of a one-way pressure relief valve connected in line with a sterile micro filter selected for its specific flow capacity...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868599/diving-with-pre-existing-medical-conditions
#15
John Lippmann, David McD Taylor, Christopher Stevenson, Jo Williams, Simon J Mitchell
INTRODUCTION: This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any diving modifications used to mitigate the risk and outcomes. METHODOLOGY: An online cross-sectional survey was sent to 833 divers who had declared a targeted medical condition when applying for DAN AP membership between July 2009 and August 2013...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868598/turkish-recreational-divers-a-comparative-study-of-their-demographics-diving-habits-health-and-attitudes-towards-safety
#16
COMPARATIVE STUDY
Bengusu Mirasoglu, Samil Aktas
INTRODUCTION: In Turkey, scuba diving has become more popular and accessible in the past decade and there has been a commensurate rise in the number of certified divers. This new generation of recreational divers has not been described in detail previously. The aim of this study was to profile this group, while investigating any gender differences and making comparisons with the global diving community. METHODS: Turkish dive club members and diving forum⁄blog readers were invited to complete an online questionnaire investigating their demography, medical issues and diving history and habits...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868597/decompressing-recompression-chamber-attendants-during-australian-submarine-rescue-operations
#17
Michael P Reid, Andrew Fock, David J Doolette
INTRODUCTION: Inside chamber attendants rescuing survivors from a pressurised, distressed submarine may themselves accumulate a decompression obligation which may exceed the limits of Defense and Civil Institute of Environmental Medicine tables presently used by the Royal Australian Navy. This study assessed the probability of decompression sickness (PDCS) for medical attendants supervising survivors undergoing oxygen-accelerated saturation decompression according to the National Oceanic and Atmospheric Administration (NOAA) 17...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868596/decompressing-rescue-personnel-during-australian-submarine-rescue-operations
#18
Michael P Reid, Andrew Fock, David J Doolette
INTRODUCTION: Personnel rescuing survivors from a pressurized, distressed Royal Australian Navy (RAN) submarine may themselves accumulate a decompression obligation, which may exceed the bottom time limits of the Defense and Civil Institute of Environmental Medicine (DCIEM) Air and In-Water Oxygen Decompression tables (DCIEM Table 1 and 2) presently used by the RAN. This study compared DCIEM Table 2 with alternative decompression tables with longer bottom times: United States Navy XVALSS_DISSUB 7, VVAL-18M and Royal Navy 14 Modified tables...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868595/heat-deactivation-of-the-stonefish-synanceia-horrida-venom-implications-for-first-aid-management
#19
Samantha Barnett, Silvia Saggiomo, Michael Smout, Jamie Seymour
OBJECTIVES: To investigate the effects of temperature and hot water immersion time on neutralising venom lethality of the Australian estuarine stonefish (Synanceia horrida). DESIGN: Depths of the spines were measured while venom was extracted from S. horrida individuals. The venom was then exposed to temperatures of 4°C, 37.0°C, 40.1°C, 42.3°C, 45.0°C, 47.7°C, 55.2°C, and 60.0°C for either five or 20 minutes incubation periods. Venom samples were added to cultured human cardiomyocytes and cell viability curves were produced using the ACEA's xCELLigence real-time cell monitoring system...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868594/chain-of-events-analysis-for-a-scuba-diving-fatality
#20
John Lippmann, Christopher Stevenson, David McD Taylor, Jo Williams, Mohammadreza Mohebbi
INTRODUCTION: A scuba diving fatality usually involves a series of related events culminating in death. Several studies have utilised a chain of events-type analysis (CEA) to isolate and better understand the accident sequence in order to facilitate the creation of relevant countermeasures. The aim of this research was to further develop and better define a process for performing a CEA to reduce potential subjectivity and increase consistency between analysts. METHODOLOGY: To develop more comprehensive and better-defined criteria, existing criteria were modified and a template was created and tested using a CEA...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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