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Decompression illness

I R F da Silva, J A Frontera
Environmental injuries can result in serious neurologic morbidity. This chapter reviews neurologic complications of thermal burns, smoke inhalation, lightning strikes, electric injury, near drowning, decompression illness, as well as heat stroke and accidental hypothermia. Knowing the pathophysiology and clinical presentation of such injuries is essential to proper management of primary and secondary medical complications. This chapter highlights the most frequently encountered neurologic injuries secondary to common environmental hazards, divided into the topics: injuries related to fire, electricity, water, and the extremes of temperature...
2017: Handbook of Clinical Neurology
Rebecca J Crawford, Quentin J Malone, Roger I Price
BACKGROUND: Interspinous spacer/implants like the Device for Intervertebral Assisted Motion (DIAM™) are controversially yet commonly used in the surgical treatment of lumbar degenerative pathologies. Criticism is based on ill-defined indications, lack of superiority over decompression, and a poorly understood mechanical effect. Yet, continued use by surgeons implies their perceived clinical merit. We examined radiographic spinal alignment for 12 months, and pain and function for 24 months, after DIAM-augmented surgery to improve the understanding of the mechanical effect relating to clinical outcomes in patients...
2017: Scoliosis and Spinal Disorders
Alessandro Di Rienzo, Pier Paol Pangrazi, Michele Riccio, Roberto Colasanti, Ilaria Ghetti, Maurizio Iacoangeli
BACKGROUND: The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS: In a 10-year time, we treated by DC 450 patients, 344 of whom underwent cranioplasty, either with autologous bone or artificial implants (hydroxyapatite, polyetheretherketone, titanium, polymethylmethacrylate)...
2016: Surgical Neurology International
Joseph F Baker, Thomas J Errico, Yong Kim, Afshin Razi
Degenerative spondylolisthesis is a common presentation, yet the best surgical treatment continues to be a matter of debate. Interbody fusion is one of a number of options, but its exact role remains ill defined. The aim of this study was to provide a contemporary review of the literature to help determine the role, if any, of interbody fusion in the surgical treatment of degenerative spondylolisthesis. A systematic review of the literature since 2005 was performed. Details on study size, patient age, surgical treatments, levels of slip, patient reported outcome measures, radiographic outcomes, complications and selected utility measures were recorded...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Joe X Zhang, Jacob R Berry, Devin P Beckstrand
BACKGROUND: Arterial gas embolism (AGE) is a rare condition in the flying community most often only ever seen in flight while operating at high altitude or incidents involving hypobaric chambers. This article describes a severe case of AGE that occurred in a pilot of a fourth generation fighter aircraft at ground level. The environmental control system (ECS) malfunctioned, causing an overpressurized cockpit and a subsequent explosive decompression when the pilot opened the canopy to egress...
2016: Aerospace Medicine and Human Performance
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Victoria A McCredie, Simone Piva, Marlene Santos, Wei Xiong, Airton Leonardo de Oliveira Manoel, Andrea Rigamonti, Gregory M T Hare, Martin G Chapman, Andrew J Baker
BACKGROUND: There are a range of opinions on the benefits and thresholds for the transfusion of red blood cells in critically ill patients with traumatic brain injury (TBI) and an urgent need to understand the neurophysiologic effects. The aim of this study was to examine the influence of red blood cell transfusions on cerebral tissue oxygenation (SctO2) in critically ill TBI patients. METHODS: This prospective observational study enrolled consecutive TBI patients with anemia requiring transfusion...
October 18, 2016: Neurocritical Care
Ezekiel Toh Yoon, Kazuki Nishihara, Hirohiko Murata
For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy...
2016: Internal Medicine
(no author information available yet)
Lenz CR, Shields JL, Morgan AO. You're the flight surgeon: an unusual case of ground-level F-15 decompression illness. Aerosp Med Hum Perform. 2016; 87(10):906-909.
2016: Aerospace Medicine and Human Performance
Tom Robinson, Jose S Evangelista, Emi Latham, Samir T Mukherjee, Andrew Pilmanis
INTRODUCTION: Supersonic, high altitude aviation places its pilots and aircrew in complex environments, which may lead to injury that is not easily diagnosed or simply treated. Decompression illness (either venous or arterial) and environmental conditions (e.g., abnormal gases and pressure) are the most likely adverse effects aircrew often face. Though symptomatic aircrew personnel may occasionally require hyperbaric oxygen treatment, it is rare to require more than one treatment before returning to baseline function...
August 2016: Aerospace Medicine and Human Performance
Changsin Kim, Jeong Eun Shin, Soon Min Lee, Ho Seon Eun, Min Soo Park, Kook In Park, Ran Namgung, Sungsoo Lee, Choon Sik Yoon
The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely...
November 2016: Yonsei Medical Journal
Dror Ofir, Yoav Yanir, Michael Mullokandov, Ben Aviner, Yehuda Arieli
"Yo-yo" diving may place divers at a greater risk of neurologic decompression illness (DCI). Using a rat model, we previously demonstrated that "yo-yo" diving has a protective effect against DCI. In the current study, we evaluated the risk of neurologic DCI following "yo-yo" dives in a pig model. Pigs were divided into four groups. The Control group (A) made a square dive, without excursions to the surface ("peeps"). Group B performed 2 "peeps", Group C performed 4 "peeps", and Group D did not dive at all. All dives were conducted on air to 5 atmospheres absolute, for 30 min bottom time...
August 18, 2016: Journal of Applied Physiology
Ran Arieli, Soliman Khatib, Jacob Vaya
Most severe cases of decompression illness (DCI) are caused by vascular bubbles. We showed that there are active hydrophobic spots (AHS) on the luminal aspect of ovine blood vessels where bubbles are produced after decompression. It has been suggested that AHS may be composed of lung surfactant. Dipalmitoylphosphatidylcholine (DPPC) is the main component of lung surfactants. Blood samples and four blood vessels, the aorta, superior vena cava, pulmonary vein and pulmonary artery, were obtained from 11 slaughtered sheep...
August 11, 2016: Journal of Applied Physiology
Dong-Hyun Lee, Kyoung-Tae Kim, Jeong-Ill Park, Ki-Su Park, Dae-Chul Cho, Joo-Kyung Sung
We propose a double layered (intradural and epidural patch) duraplasty that utilizes Lyoplant and Duraseal. We examined a 47-year-old woman after decompression for thoracic ossification of posterior longitudinal ligament was performed in another hospital. On postoperative day 7, she complained of weakness in both legs. Postoperative magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) collection with cord compression. In the operative field, we found 2 large dural defects on the ventral dura mater...
June 2016: Korean Journal of Spine
Rebekah M Mack, Benjamin Staiger, Daniel K Langlois, Stephen J Mehler, Nathaniel Lam, Trevor Moore, Andrew Brown, Matthew W Beal
OBJECTIVE: To develop and describe a technique for percutaneous radiologic gastrojejunostomy tube placement in the dog. DESIGN: Prospective technique development study. SETTING: University teaching hospital. ANIMALS: Six healthy adult male Beagles. INTERVENTIONS: Following anesthetic induction, fluoroscopic and ultrasound guidance were used to identify an appropriate gastropexy site on the left lateral abdomen...
September 2016: Journal of Veterinary Emergency and Critical Care
Pierre Louge, Mathieu Coulange, Frederic Beneton, Emmanuel Gempp, Olivier Le Pennetier, Maxime Algoud, Lorene Dubourg, Pierre Naibo, Marion Marlinge, Pierre Michelet, Donato Vairo, Nathalie Kipson, François Kerbaul, Yves Jammes, Ian M Jones, Jean-Guillaume Steinberg, Jean Ruf, Régis Guieu, Alain Boussuges, Emmanuel Fenouillet
Immersion pulmonary edema (IPE) is a misdiagnosed environmental illness caused by water immersion, cold, and exertion. IPE occurs typically during SCUBA diving, snorkeling, and swimming. IPE is sometimes associated with myocardial injury and/or loss of consciousness in water, which may be fatal. IPE is thought to involve hemodynamic and cardiovascular disturbances, but its pathophysiology remains largely unclear, which makes IPE prevention difficult. This observational study aimed to document IPE pathogenesis and improve diagnostic reliability, including distinguishing in some conditions IPE from decompression sickness (DCS), another diving-related disorder...
June 2016: Medicine (Baltimore)
Christian Svendsen Juhl, Morten Hedetoft, Daniel Bidstrup, Erik Christian Jansen, Ole Hyldegaard
INTRODUCTION: The incidence, diver characteristics and symptomatology of decompression illness (DCI) in Denmark has not been assessed since 1982, and the presence of long-term residual symptoms among divers receiving hyperbaric oxygen therapy in Denmark has never been estimated to our knowledge. METHODS: We undertook a retrospective study of the incidence and characteristics of DCI cases in Denmark for the period of 1999 to 2013. Medical records and voluntary questionnaires were reviewed, extracting data on age, gender, weight, height, diver certification level, diving experience, number of previous dives, type of diving, initial type of hyperbaric treatment and DCI symptoms...
June 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
J Dituri, R Sadler, F Siddiqi, C Sadler, N Javeed, H Annis, H Whelan
Decompression sickness is a potentially fatal illness. Optimal treatment is dry recompression with hyperbaric oxygen. In-water recompression (IWR) offers expedited treatment but has insufficient evidence to recommend it as a treatment option. This trial compares IWR to standard surface oxygen treatment using 2D echocardiography as the semi-quantitative measurement for inert gas loading. Divers were randomly assigned to either IWR or normobaric oxygen (NBO2). A provocative dive profile to 33.5 meters for 25 minutes was used to stimulate bubble formation...
March 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Peter Wilmshurst
Right-to-left shunts can result in decompression illness in divers and lead to a number of other conditions. Transthoracic echocardiography with intravenous injection of bubble contrast, when performed according to a well-tested protocol by trained personnel, enables the safe, simple, rapid and inexpensive detection of right-to-left shunts, the assessment of the size of the shunts and the differentiation of atrial shunts from pulmonary shunts. This article summarises the author's views on the techniques available and his preferred protocol for transthoracic echocardiography...
March 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Helen Razmjou, Patrick Henry, Giuseppe Costa, Tim Dwyer, Richard Holtby
BACKGROUND: The purpose of this study was to examine the impact of rotator cuff (RC) decompression and/or repair on post-operative ROM in patients with pre-operative restricted passive motion who had undergone arthroscopic subacromial debridement and/or rotator cuff repair. Potential predictors of ROM recovery such as age, sex, mechanism of injury, type of surgery, presence of an endocrine illness and having an active Worker Compensation claim related to the shoulder were explored. METHODS: A retrospective analysis of prospectively collected data was performed...
February 24, 2016: BMC Musculoskeletal Disorders
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