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Decompression illness

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https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#1
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29081854/toxic-shock-in-children-with-bone-and-joint-infections-a-review-of-seven-years-of-patients-admitted-to-one-intensive-care-unit
#2
D L Kerr, E K Loraas, A C Links, T V Brogan, G A Schmale
PURPOSE: The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A β-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. METHODS: We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29046183/you-re-the-flight-surgeon
#3
(no author information available yet)
Pelligra S. You're the flight surgeon: decompression illness following altitude chamber exposure. Aerosp Med Hum Perform. 2017; 88(11):1052-1055.
November 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28980295/transcatheter-closure-of-patent-foramen-ovale-for-the-secondary-prevention-of-decompression-illness-in-professional-divers-a-single-center-experience-with-long-term-follow-up
#4
Jan Henzel, Piotr Nikodem Rudziński, Mariusz Kłopotowski, Marek Konka, Zofia Dzielińska, Marcin Demkow
BACKGROUND: Patent foramen ovale (PFO) with occasional right-to-left shunting is associated with an increased risk of decompression illness (DCI). Divers with a history of repetitive or severe DCI and diagnosed with PFO should be considered for transcatheter closure if they wish to continue with unrestricted diving. AIM: To summarize our center's experience in transcatheter PFO closure in professional divers with the history of DCI. METHODS: A follow-up of 11 consecutive divers (9 males, 2 females) in whom device PFO closure was performed between 2001-2015 was carried out by phone contact...
October 5, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28975053/extracorporeal-life-support-with-left-ventricular-decompression-improved-survival-in-severe-cardiogenic-shock-results-from-a-retrospective-study
#5
Bastian Schmack, Philipp Seppelt, Alexander Weymann, Christina Alt, Mina Farag, Rawa Arif, Andreas O Doesch, Philip W Raake, Klaus Kallenbach, Ashham Mansur, Aron-Frederik Popov, Matthias Karck, Arjang Ruhparwar
OBJECTIVE: Extracorporeal life support (ECLS) is a life-saving procedure used in the treatment of severe cardiogenic shock. Within this retrospective single centre study, we examined our experience in this critically ill patient cohort to assess outcomes and clinical parameters by comparison of ECLS with or without selective left ventricular decompression. METHODS: Between 2004 and 2014 we evaluated 48 adult patients with INTERMACS level 1 heart failure (age 49...
2017: PeerJ
https://www.readbyqxmd.com/read/28974936/dive-risk-factors-gas-bubble-formation-and-decompression-illness-in-recreational-scuba-diving-analysis-of-dan-europe-dsl-data-base
#6
Danilo Cialoni, Massimo Pieri, Costantino Balestra, Alessandro Marroni
Introduction: The popularity of SCUBA diving is steadily increasing together with the number of dives and correlated diseases per year. The rules that govern correct decompression procedures are considered well known even if the majority of Decompression Sickness (DCS) cases are considered unexpected confirming a bias in the "mathematical ability" to predict DCS by the current algorithms. Furthermore, little is still known about diving risk factors and any individual predisposition to DCS. This study provides an in-depth epidemiological analysis of the diving community, to include additional risk factors correlated with the development of circulating bubbles and DCS...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28965686/factors-influencing-direct-clinical-costs-of-outpatient-arthroscopic-rotator-cuff-repair-surgery
#7
Robert Z Tashjian, Jeffrey Belisle, Sean Baran, Erin K Granger, Richard E Nelson, Robert T Burks, Patrick E Greis
BACKGROUND: Very limited information exists about factors affecting direct clinical costs of rotator cuff repair surgery. The purpose of this study was to determine the direct cost of outpatient arthroscopic rotator cuff repair surgery using a unique value-driven outcomes tool and to identify patient- and treatment-related variables affecting cost. METHODS: Cost data were derived for arthroscopic rotator cuff repairs performed by 3 surgeons from March 2014 to June 2015 using the value-driven outcomes tool...
September 28, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#8
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28880140/-diving-accident-induced-arterial-gas-embolism
#9
P D Nijk, T P van Rees Vellinga, J M van Lieshout, M I Gaakeer
BACKGROUND: During scuba diving, nitrogen dissolves into the body tissues due to elevated pressure under water. During a sudden drop in pressure due to a rapid return to the water surface, arterial gas embolism can arise from pulmonary barotrauma. In a later phase, nitrogen bubbles can also arise in the venous circulation (decompression sickness). Arterial bubbles can incur vascular damage, obstruction, hypoxia and infarction. CASE DESCRIPTION: A 53-year-old healthy sport diver presented at the emergency department in a hypovolemic shock with progressive paresis of all the extremities...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28868599/diving-with-pre-existing-medical-conditions
#10
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/28861003/nanobubbles-form-at-active-hydrophobic-spots-on-the-luminal-aspect-of-blood-vessels-consequences-for-decompression-illness-in-diving-and-possible-implications-for-autoimmune-disease-an-overview
#11
REVIEW
Ran Arieli
Decompression illness (DCI) occurs following a reduction in ambient pressure. Decompression bubbles can expand and develop only from pre-existing gas micronuclei. The different hypotheses hitherto proposed regarding the nucleation and stabilization of gas micronuclei have never been validated. It is known that nanobubbles form spontaneously when a smooth hydrophobic surface is submerged in water containing dissolved gas. These nanobubbles may be the long sought-after gas micronuclei underlying decompression bubbles and DCI...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28828195/critically-ill-patients-and-gut-motility-are-we-addressing-it
#12
REVIEW
Alfredo Vazquez-Sandoval, Shekhar Ghamande, Salim Surani
Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lower GI dysmotility. Upper GI dysmotility manifests by nausea, feeding intolerance and vomiting; its implications include aspiration into the airway of abdominal contents and underfeeding. Several strategies to prevent and treat this condition can be tried and they include prokinetics and post-pyloric feeds...
August 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28783886/cerebrospinal-vascular-diseases-misdiagnosed-as-decompression-illness-the-importance-of-considering-other-neurological-diagnoses
#13
Kiyotaka Kohshi, Yoshitaka Morimatsu, Hideki Tamaki, Yukio Murata, Katsuko Kohshi, Tatsuya Ishitake, Petar J Denoble
The diagnosis of decompression illness (DCI), which is based on a history of decompression and clinical findings, can sometimes be confounded with other vascular events of the central nervous system. The authors report three cases of divers who were urgently transported to a hyperbaric facility for hyperbaric oxygen treatment of DCI which at admission turned out to be something else. The first case, a 45-year-old experienced diver with unconsciousness, was clinically diagnosed as having experienced subarachnoid hemorrhage, which was confirmed by CT scan...
July 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28780148/intraabdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#14
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal compartment syndrome (ACS) is the end point of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion in the abdomen (such as ascites or a hematoma) leads to pathologically increased pressure. This results in so-called intraabdominal hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28777907/elimination-of-ct-detected-gas-bubbles-derived-from-decompression-illness-with-abdominal-symptoms-after-a-short-hyperbaric-oxygen-treatment-in-a-monoplace-chamber-a-case-report
#15
Takuya Oyaizu, Mitsuhiro Enomoto, Toshihide Tsujimoto, Yasushi Kojima, Atsushi Okawa, Kazuyoshi Yagishita
We report the case of a 54-year-old male compressed-air worker with gas bubbles detected by computed tomography (CT). He had complained of strong abdominal pain 30 minutes after decompression after working at a pressure equivalent to 17 meters of sea water for three hours. The initial CT images revealed gas bubbles in the intrahepatic portal vein, pulmonary artery and bilateral femoral vein. After the first hyperbaric oxygen treatment (HBO₂ at 2.5 atmospheres absolute/ATA for 150 minutes), no bubbles were detected on repeat CT examination...
March 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28777522/recurrent-cutaneous-decompression-illness-after-pfo-device-implantation-a-case-report
#16
Martin Vanden EEde
It is well known that patency of the foramen ovale (PFO) is a risk factor for decompression illness (DCI) in scuba divers, even if they adhere to the currently accepted and used decompression tables (termed "an undeserved hit"). The correction of the PFO through percutaneous closure after DCI is an ongoing discussion. We describe a case of a diver who redeveloped a cutaneous DCI due to a recurrent PFO after initial treatment with an occluder device four years earlier.
November 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28759427/negative-pressure-wound-therapy-for-patients-with-complex-abdominal-wounds
#17
Zhi Wang, Ming Bai, Xiao Long, Ru Zhao, Xiaojun Wang
The combination of open abdominal wounds and intra-abdominal infections is challenging to treat and often results in critical illness associated with high mortality. OBJECTIVE: The aim of this study is to evaluate the feasibility of using negative pressure wound therapy (NPWT) to manage complex abdominal wounds and summarize relevant treatment experiences. MATERIALS AND METHODS: A retrospective analysis of records from April 2012 to May 2015 identified 13 hospitalized patients with open abdominal wounds complicated by intra-abdominal infections...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28656350/frequency-of-decompression-illness-among-recent-and-extinct-mammals-and-reptiles-a-review
#18
REVIEW
Agnete Weinreich Carlsen
The frequency of decompression illness was high among the extinct marine "reptiles" and very low among the marine mammals. Signs of decompression illness are still found among turtles but whales and seals are unaffected. In humans, the risk of decompression illness is five times increased in individuals with Patent Foramen Ovale; this condition allows blood shunting from the venous circuit to the systemic circuit. This right-left shunt is characteristic of the "reptile" heart, and it is suggested that this could contribute to the high frequency of decompression illness in the extinct reptiles...
August 2017: Die Naturwissenschaften
https://www.readbyqxmd.com/read/28641324/treatment-preferences-for-decompression-illness-amongst-singapore-dive-physicians
#19
Valerie Huali Tan, Kenneth Chin, Aravin Kumar, Jeremiah Chng, Chai Rick Soh Rick Soh
INTRODUCTION: Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. METHODS: An anonymous web-based questionnaire was sent to known diving physicians in Singapore...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28641322/scuba-diving-and-otology-a-systematic-review-with-recommendations-on-diagnosis-treatment-and-post-operative-care
#20
REVIEW
Devon M Livingstone, Kristine A Smith, Beth Lange
Scuba diving is a popular recreational and professional activity with inherent risks. Complications related to barotrauma and decompression illness can pose significant morbidity to a diver's hearing and balance systems. The majority of dive-related injuries affect the head and neck, particularly the outer, middle and inner ear. Given the high incidence of otologic complications from diving, an evidence-based approach to the diagnosis and treatment of otic pathology is a necessity. We performed a systematic and comprehensive literature review including the pathophysiology, diagnosis, and treatment of otologic pathology related to diving...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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