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https://www.readbyqxmd.com/read/27903670/oxygen-the-lung-and-the-diver-friends-and-foes
#1
Pieter-Jan A M van Ooij, Peter J Sterk, Robert A van Hulst
Worldwide, the number of professional and sports divers is increasing. Most of them breathe diving gases with a raised partial pressure of oxygen (PO2 ). However, if the PO2 is between 50 and 300 kPa (375-2250 mmHg) (hyperoxia), pathological pulmonary changes can develop, known as pulmonary oxygen toxicity (POT). Although in its acute phase, POT is reversible, it can ultimately lead to non-reversible pathological changes. Therefore, it is important to monitor these divers to prevent them from sustaining irreversible lesions...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27723022/insulin-dependent-diabetes-mellitus-and-recreational-scuba-diving-in-australia
#2
Rebecca Johnson
Dive medicine bodies worldwide recognise that, with comprehensive screening and careful management, people with insulin-dependent diabetes (IDDM) can dive safely. Despite this, people with IDDM in Australia are generally denied access to dive training, an out-dated status quo that is not acceptable to the Australian diabetes community. This paper reflects upon the important advocacy work that has been done to progress this issue, and what is still required to open up access and bring Australia into line with more flexible and supportive international standards...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27502704/distinct-subclonal-tumour-responses-to-therapy-revealed-by-circulating-cell-free-dna
#3
G Gremel, R J Lee, M R Girotti, A K Mandal, S Valpione, G Garner, M Ayub, S Wood, D G Rothwell, A Fusi, A Wallace, G Brady, C Dive, N Dhomen, P Lorigan, R Marais
BACKGROUND: The application of precision medicine in oncology requires in-depth characterisation of a patient's tumours and the dynamics of their responses to treatment. PATIENTS AND METHODS: We used next-generation sequencing of circulating cell-free DNA (cfDNA) to monitor the response of a KIT p.L576P-mutant metastatic vaginal mucosal melanoma to sequential targeted, immuno- and chemotherapy. RESULTS: Despite a KIT mutation, the response to imatinib was mixed...
October 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27368044/pathophysiological-and-diagnostic-implications-of-cardiac-biomarkers-and-antidiuretic-hormone-release-in-distinguishing-immersion-pulmonary-edema-from-decompression-sickness
#4
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)
https://www.readbyqxmd.com/read/27174117/patent-foramen-ovale-indications-for-closure-and-techniques
#5
Maurizio Taramasso, Fabian Nietlispach, Francesco Maisano, Bernhard Meier
Non-surgical closure of the patent foramen ovale (PFO) has been possible for 40 years and proved safe in probably a million cases performed worldwide. Nonetheless, indications are still restricted as only a few are supported by randomised data. Paradoxical embolism through a PFO causes stroke, myocardial infarction, and visceral or peripheral ischaemia. The PFO is a likely mediator of migraine, diving or high altitude sickness, dyspnoea, and sleep apnoea problems. As untoward effects of a PFO are rare and spaced widely timewise, large cohorts and long follow-ups are required to prove unequivocally that PFO closure is bene-ficial and appropriate in comparison to no treatment or medical therapy...
May 17, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27143638/consensus-on-precision-medicine-for-metastatic-cancers-a-report-from-the-map-conference
#6
C Swanton, J-C Soria, A Bardelli, A Biankin, C Caldas, S Chandarlapaty, L de Koning, C Dive, J Feunteun, S-Y Leung, R Marais, E R Mardis, N McGranahan, G Middleton, S A Quezada, J Rodón, N Rosenfeld, C Sotiriou, F André
Recent advances in biotechnologies have led to the development of multiplex genomic and proteomic analyses for clinical use. Nevertheless, guidelines are currently lacking to determine which molecular assays should be implemented in metastatic cancers. The first MAP conference was dedicated to exploring the use of genomics to better select therapies in the treatment of metastatic cancers. Sixteen consensus items were covered. There was a consensus that new technologies like next-generation sequencing of tumors and ddPCR on circulating free DNA have convincing analytical validity...
August 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/26957817/performing-cpr-on-a-commercial-diver-inside-the-diving-bell
#7
Sourabh Bhutani, Rohit Verma, Dipak Kumar Ghosh
CPR in a diving bell is difficult. It is taught by diving companies and training institutes but has not been subjected to the tenets of evidence based medicine. The diving bell lacks space as well as a flat hard surface to lay the patient on and therefore conventional methods of administering CPR are not possible. The diver is hung from a pulley tied to the diver's harness, and the bell flooded with water to reduce pooling of blood. Airway is established using a cervical collar to hyperextend the neck and inserting an appropriate oropharyngeal airway...
September 2015: Indian Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/26857731/otologic-hazards-related-to-scuba-diving
#8
Tiffany A Glazer, Steven A Telian
CONTEXT: As of 2015, more than 23 million scuba diver certifications have been issued across the globe. Given the popularity of scuba diving, it is incumbent on every physician to know and understand the specific medical hazards and conditions associated with scuba diving. EVIDENCE ACQUISITION: Sources were obtained from PubMed, MEDLINE, and EBSCO databases from 1956 onward and ranged from diverse fields including otologic reviews and wilderness medicine book chapters...
March 2016: Sports Health
https://www.readbyqxmd.com/read/26793915/genomics-this-time-it-s-personal
#9
Marty Stempniak
An Illinois health system is diving into personalized medicine, using an individual's unique genetic traits to tailor care. Leaders there say it is the future for all of health care.
July 2015: Hospitals & Health Networks
https://www.readbyqxmd.com/read/26736233/psycho-physiological-tele-monitoring-of-human-operators-in-commercial-diving-the-life-support-system-in-the-suono-project
#10
Marco Laurino, Lorenzo Guerriero, Paolo Allegrini, Danilo Menicucci, Francesca Mastorci, Daniele Magrin, Benedetto Allotta, Remo Bedini, Angelo Gemignani
Sea-diving operations for monitoring or intervention are carried out by highly-specialized divers called Certified Commercial Divers (CCD). CCDs operate under highly demanding working conditions in extreme and hazardous environments. Every day consists of an 8 hours' shift. To avoid decompression problems the remaining 16 hours are spent in a hyperbaric environment located aboard the surface vessel or on the platform. These operating conditions require the design of a technologically-advanced device for tele-monitoring, to maximize CCDs' safety...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26715644/application-of-sequencing-liquid-biopsies-and-patient-derived-xenografts-for-personalized-medicine-in-melanoma
#11
Maria Romina Girotti, Gabriela Gremel, Rebecca Lee, Elena Galvani, Dominic Rothwell, Amaya Viros, Amit Kumar Mandal, Kok Haw Jonathan Lim, Grazia Saturno, Simon J Furney, Franziska Baenke, Malin Pedersen, Jane Rogan, Jacqueline Swan, Matthew Smith, Alberto Fusi, Deemesh Oudit, Nathalie Dhomen, Ged Brady, Paul Lorigan, Caroline Dive, Richard Marais
UNLABELLED: Targeted therapies and immunotherapies have transformed melanoma care, extending median survival from ∼9 to over 25 months, but nevertheless most patients still die of their disease. The aim of precision medicine is to tailor care for individual patients and improve outcomes. To this end, we developed protocols to facilitate individualized treatment decisions for patients with advanced melanoma, analyzing 364 samples from 214 patients. Whole exome sequencing (WES) and targeted sequencing of circulating tumor DNA (ctDNA) allowed us to monitor responses to therapy and to identify and then follow mechanisms of resistance...
March 2016: Cancer Discovery
https://www.readbyqxmd.com/read/26523604/-hyperbaric-therapy-and-diving-medicine-hyperbaric-therapy-part-1-evidence-based-emergency-care
#12
REVIEW
Björn Jüttner, Kay Tetzlaff
Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. To evaluate the evidence of clinical efficacy of HBOT we performed a systematic literature review. Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion...
October 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/26510110/-hyperbaric-therapy-and-diving-medicine-hyperbaric-chambers-in-use
#13
REVIEW
Clemens Henze, Christian Heß
Hyperbaric oxygen therapy (HBOT) is a scientifically justified and internationally established therapy, which is however not well-known thus rarely used in Germany. During a HBOT, the ambient pressure is raised while the patient breathes 100% O2, causing tissue partial oxygen pressure (ptO2) to increase distinctly. Through that, various pressure- and O2-associated processes are initiated. Herein 3 case studies are described that illustrate the mechanism of action and the range of applications of HBOT.
October 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/26510109/-hyperbaric-therapy-and-diving-medicine-diving-medicine-present-state-and-prospects
#14
REVIEW
Bernd Winkler, Claus-Martin Muth, Tim Piepho
The diving accident (decompression incident, DCI) occurs in the decompression phase of dives. The DCI can either be caused by an arterial gas embolism (AGE) subsequent to a pulmonary barotrauma or by the formation of inert gas bubbles subsequent to a reduction of ambient pressure during the ascent from depth. In contrast to the traditional assumption that decompression incidents only occur if decompression rules are neglected, recent data indicate that a vast amount of diving accidents occur even though divers adhered to the rules...
October 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/26510108/-hyperbaric-therapy-and-diving-medicine-hyperbaric-therapy-part-2-adjuvant-therapy
#15
REVIEW
Kay Tetzlaff, Björn Jüttner
Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. To evaluate the evidence of clinical efficacy of HBOT we performed a systematic literature review. Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion...
October 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/26448836/stroke-in-a-young-swimmer
#16
Shahram Mohaghegh, Maryam Hajian
INTRODUCTION: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of the cervical arterial dissection in a young swimmer. CASE PRESENTATION: A 30-year-old male professional swimmer with no history of any major disease suddenly complained of severe ataxia, moderate headache, neck pain, unilateral left facial weakness, and feelings of tingling and paresthesia on the left side of his body and face a few minutes following head and body stretching exercises in land...
June 2015: Asian Journal of Sports Medicine
https://www.readbyqxmd.com/read/26371977/accuracy-of-a-set-of-screening-parameters-developed-for-the-diagnosis-of-arterial-gas-embolism-the-sandhog-criteria
#17
Stephen R Hayden, Kevin C Buford, Edward M Castillo
BACKGROUND: Arterial gas embolism (AGE) is a major cause of morbidity and mortality in self-contained underwater breathing apparatus (SCUBA) diving and certain medical procedures. There are currently no well-defined criteria to diagnose AGE. Emergency physicians often find themselves facing a decision whether or not a patient with dive-related symptoms has an AGE and needs to be transferred to a hyperbaric facility. OBJECTIVES: The objective of this study was to test the accuracy of diagnostic criteria developed by the San Diego Hyperbaric Oxygen Group (SANDHOG) for the diagnosis of AGE...
November 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26360691/the-hidden-dangers-of-beaches-cardiorespiratory-arrest-induced-by-thermal-shock
#18
H M Café, S Santos, V Pereira, S Chaves, P Faria, M Câmara, J Nóbrega
Thermal shock is widely recognized by modern medicine. Its pathophysiological mechanisms are known, as are its possible consequences, but scientific reports in the literature about clinical cases with severe consequences are sparse. The authors present a case of cardiorespiratory arrest after prolonged sun exposure followed by a dive in the ocean. Other aetiological causes were ruled out, by exclusion, leading to the diagnosis of cardiorespiratory arrest caused by thermal shock. It is important to inform the public in general of the risks of negligent behaviour on the beach...
March 2015: West Indian Medical Journal
https://www.readbyqxmd.com/read/26271135/assessing-potential-divers-with-a-history-of-congenital-heart-disease
#19
REVIEW
Mark S Turner
This article describes a structured approach to assessing the medical fitness of potential divers who have a history of congenital heart disease. The importance of a complete and accurate cardiac history, including details of surgery and other interventions is emphasized. Specific assessment of intracardiac shunts, exercise capacity and ability to deal with the physical challenge of diving, risk of diving-included pulmonary oedema, of arrhythmia and of incapacity in case of arrhythmia and the consequences of surgical and catheter treatment are discussed, including the risks associated with lung injury and the pressure limitations of implanted devices like pacemakers...
June 2015: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/26207174/all-the-right-moves-the-need-for-the-timely-use-of-hyperbaric-oxygen-therapy-for-treating-tbi-cte-ptsd
#20
Kenneth P Stoller
BACKGROUND: The modern age of hyperbaric medicine began in 1937; however, today few know about hyperbaric oxygen's effects on the body and medical conditions outside of diving medicine and wound care centers - a serious ethical issue as there are 20 US military veterans committing suicide every day directly related to Traumatic Brain Injury/Post Traumatic Stress Disorder. The problem is not whether hyperbaric oxygen is effective for treating brain injuries, but why the interference in offering this therapy to those who need it...
2015: Medical Gas Research
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