Scientific papers 2012
Authors: W. Gerth & D. Doolette
This article discusses the Thalmann Algorithm, specifically
focusing on its parameterization with VVal-18 and VVal-
18M, which are foundational to U.S. Navy dive
decompression procedures. The VVal-18 models provide
longer air no-stop limits at various depths compared to
the standards established in 1957. However, due to
unacceptable cases of Decompression Sickness (DCS)
observed in trials using these extended limits, the U.S.
Navy decided to retain the original no-stop limits in its
Revision 6 decompression tables. The report introduces
VVal-79, a modified version of VVal-18M that allows for
more reliable air diving no-stop limits without the need for
arbitrary adjustments.
Authors:
Megan Brenner, Deborah Stein, Peter Hu, MS, Joseph
Kufera, MA; Matthew Wooford, Thomas Scalea.
The objective of this paper is to investigate the relationship
between oxygenation and short-term outcomes in
patients with traumatic brain injury (TBI).
Authors:
Nicolas Vallee, Cédric Meckler, Jean-Jacques Risso, and
Jean-Eric Blatteau.
This article discusses the effects of nitrogen
supersaturation and bubble formation in the vascular
system after diving, leading to decompression sickness
(DCS). It focuses on the role of the TREK-1 potassium ion
channel in neuroprotection against DCS. The study
involved experiments on wild type (WT) and TREK-1
knockout (KO) mice subjected to decompression from a
simulated dive. The results indicated that the presence of
TREK-1 provides significant neuroprotection against DCS,
as demonstrated by the higher survival and better grip
test performances of WT mice compared to KO mice.
Authors:
Emmanuel Gempp, Jean Morin, Pierre Louge, and Jean
Eric Blatteau.
A low-grade process of coagulation activation in
association with severe neurological decompression
sickness (DCS) in divers has been anecdotally observed.
The authors aimed to investigate whether measurement
of plasma D-dimers and other hemostatic parameters in
injured scuba divers were effective as prognostic
biomarkers of neurological DCS, and they compared the
diagnostic accuracy of a combination of D-dimers test and
initial clinical assessment with either one alone.
Authors:
Jean-Eric Blatteau, Sandrine Barre, Aurelie Pascual, Olivier
Castagna, Jacques H. Abraini, Jean-Jacques Risso, &
Nicolas Vallee.
Massive bubble formation after diving can lead to
decompression sickness (DCS) that can result in central
nervous system disorders or even death. Bubbles alter the
vascular endothelium and activate blood cells and
inflammatory pathways, leading to a systemic
pathophysiological process that promotes ischemic
damage. Fluoxetine, a well-known antidepressant, is
recognized as having anti-inflammatory properties at the
systemic level, as well as in the setting of cerebral
ischemia. The authors report a beneficial clinical effect
associated with fluoxetine in experimental DCS.
Authors:
Taiki Miyazawa, Masahiro Horiuchi, Daisuke Ichikawa,
Andrew W. Subudhi, Jun Sugawara, & Shigehiko Ogoh.
Facial cooling (FC) increases cerebral blood flow (CBF) at
rest and during exercise; however, the mechanism of this
response remains unclear. The purpose of the present
study was to test the author's hypothesis that FC causes
facial vasoconstriction that diverts skin blood flow
(SkBFface) toward the middle cerebral artery (MCA
Vmean) at rest and to a greater extent during exercise.
Authors: R. Arieli & A Marmur
It is a long-standing hypothesis that the bubbles which
evolve as a result of decompression have their origin in
stable gas micronuclei. In a previous study (Arieli and
Marmur, 2011), the authors used hydrophilic and
monolayer-covered hydrophobic smooth silicon wafers to
show that nanobubbles formed on a flat hydrophobic
surface may be the gas micronuclei responsible for the
bubbles that evolve to cause decompression sickness. On
decompression, bubbles appeared only on the
hydrophobic wafers. The purpose of the present study
was to examine the dynamics of bubble evolution.
Authors:
Sema Yilmaz, Kenan Daglioglu, Dincer Yildizdas, Ibrahim
Bayram, Derya Gumurdulu, Sait Polat
Current treatment modalities and new therapeutic
approaches in acute repiratory distress syndrome primarily
focused on the resolution of alveolar edema. These
treatments include glucocorticoids, surfactants, inhaled
nitric oxide, antioxidants and various anti-inflammatory
treatments. Unfortunately, to date, none of these
pharmacologic treatments has proven to be effective. The
authors hypothesized that helium gas might have a
beneficial role in the treatment of ARDS.
Authors:
Masaki Fujioka, Daisuke Niino, Masahiro Ito, and Yohjiro
Matsuoka
Patent Foramen ovale is a well know decease that affects
many divers and can lead to decompression accidents.
This document is the report of an autopsy that revealed a
patent foramen ovale of the heart that resulted in the
patient dying of paradoxical air embolization of the
coronary and cerebral arteries through a patent foramen
ovale because of right-to-left shunting.
Authors: Barbara E. Shykoff & Dan E. Warkander
Combined effects on respiratory minute ventilation (VE )
and, thus, on end-tidal carbon dioxide partial pressure of
breathing resistance and elevated inspired carbon dioxide
had not been determined during heavy exercise. In this
Institutional Review Board-approved, dry, sea-level study,
12 subjects in each of three phases exercised to
exhaustion at 85% peak oxygen uptake while VE and P ET
CO2 were measured. Participants inhaled 0%, 1%, 2%, or
3% CO2 in air, or 0% or 2% CO2 in oxygen, with or
without breathing resistance, mimicking the U.S. Navy’s
MK 16 rebreather underwater breathing apparatus (UBA).
Authors: Paul Schaffer and Reginald F. Baugh
Acute otitis externa is a common condition involving
inflammation of the ear canal. The acute form is caused
primarily by bacterial infection, with Pseudomonas
aeruginosa and Staphylococcus aureus the most
common pathogens. Acute otitis externa presents with
the rapid onset ofear canal inflammation, resulting in
otalgia, itching, canal edema, canal erythema, and
otorrhea, and often occurs following swimming or minor
trauma from inappropriate cleaning. Tenderness with
movement of the tragus or pinna is a classic finding.
Authors: Jacek Kot
Clear differences between professional and recreational
deep diving are disappearing, at least when taking into
account the types of breathing mixtures (oxygen, nitrox,
heliox, and trimix) and range of dive parameters (depth
and time). Training of recreational deep divers is
conducted at depths of 120–150 metres and some divers
dive to 180–200 metres using the same diving
techniques. Extremely deep recreational divers go to
depths of more than 200 metres, at which depths the
physical and chemical properties of breathing gases
create some physiological restrictions already known from
professional deep diving.
Authors:
Marc Dalecki, Otmar Bock, and Benjamin Schulze
Clear differences between professional and recreational
deep diving are disappearing, at least when taking into
account the types of breathing mixtures (oxygen, nitrox,
heliox, and trimix) and range of dive parameters (depth
and time). Training of recreational deep divers is
conducted at depths of 120–150 metres and some divers
dive to 180–200 metres using the same diving
techniques. Extremely deep recreational divers go to
depths of more than 200 metres, at which depths the
physical and chemical properties of breathing gases
create some physiological restrictions already known from
professional deep diving.
Authors: N.A.M. Schellart , & W. Sterk
Decompression tables indicate that a repetitive dive to the
same depth as the first dive should be shortened to obtain
the same probability of occurrence of decompression
sickness (pDCS). Repetition protocols are based on small
numbers, a reason for re-examination. Since venous gas
embolism (VGE) and pDCS are related, one would expect
a higher bubble grade (BG) of VGE after the repetitive
dive without reducing bottom time.
Authors: Ingrid Eftedal, Arve Jørgensen, Ragnhild
Røsbjørgen, Arnar Flatberg, and Alf O. Brubakk
The aim of this study was to analyze genetic reactions that
may be involved in acute changes in vascular function in
divers. Rats were exposed to 709 kPa of hyperbaric air
(149 kPa PO2 ) for 50 minutes, followed by post-dive
monitoring of vascular bubble formation and full genome
microarray analysis of the aorta from diving rats and
unexposed controls.
Authors: Christoph Klingmann, Nils Rathmann, Daniel
Hausmann, Thomas Bruckner and Rolf Kern
Divers with a history of decompression sickness (DCS)
who adopted more conservative diving profiles (CDP)
showed a significant reduction in the recurrence of DCS,
regardless of the presence or size of a right-to-left shunt.
This study involved 27 divers who, after experiencing DCS,
changed their diving practices upon recommendation.
They performed a total of 9,236 dives post-
recommendation with only four instances of DCS,
compared to 34 instances during 17,851 pre-
recommendation dives. This suggests that conservative
diving effectively lowers the risk of subsequent DCS.
Authors: Michael H Bennett, Simon J Mitchell, Derelle
Young and David King
In August 2011, the South Pacific Underwater Medicine
Society and the Hyperbaric Technicians and Nurses
Association held a one-day workshop to discuss the use of
deep recompression treatment tables for decompression
illness in Australia and New Zealand. The goal was to
create consensus statements to guide regional practices,
focusing on 405 kPa (30 msw) depth tables with helium-
oxygen mixes, covering indications, staffing, and technical
requirements. This report summarizes the evidence and
consensus statements from the workshop.
Authors: Mayuree Sampanthavivat, Wararat Singkhwa,
Thanasawat Chaiyakul, Sangdaw
Karoonyawanich and Haruthai Ajpru
This study evaluated the effectiveness of hyperbaric
oxygen therapy (HBOT) on 60 Thai children with autism
aged three to nine years. Participants underwent 20 one-
hour sessions of either HBOT at 153 kPa or sham air at
116 kPa. The results indicated significant behavioral
improvements in both groups, but no significant
differences were found between the HBOT and sham
groups. Overall, no definitive clinical benefit from HBOT
was observed, although both treatments were safe and
well-tolerated.
Authors: Nada Bilopavlovic, Jasna Marinovic, Marko
Ljubkovic, Ante Obad , Jaksa Zanchi, Neal W.
Pollock, Petar Denoble, Zeljko Dujic
The study investigated changes in markers of endothelial
and brain damage after repetitive SCUBA diving, while
also assessing venous gas bubble production and
arterialization. Despite significant bubble production and
occasional arterialization, no changes were observed in
the levels of endothelin-1 and neuron-specific enolase.
However, the levels of the S100 calcium-binding protein B
(S100B) were significantly elevated after the 18-meter and
control dives, suggesting its release from skeletal muscles
rather than indicating brain or endothelial damage.
Authors: Marianne B. Havnes, Catrine Ahlen, Alf O.
Brubakk, and Ole-Jan Iversen.
This document discusses the findings of a scientific study
that investigated the production of autoantibodies against
Heat Shock Protein 60 (HSP60) in rats immunized with
Pseudomonas aeruginosa and the influence of diving on
the levels of these autoantibodies. The study aims to
understand the relationship between P. aeruginosa
infections, common in saturation divers and cystic fibrosis
patients, and the immune response involving HSP60. The
results indicate that immunization with P. aeruginosa
increases autoantibodies against HSP60, but this increase
is not observed in rats that were both immunized and
subjected to simulated diving conditions.
Authors:
Lisette B. Soegaard, Marie N. Hansen, Cornelis van Elk,
Jesper Brahm, and Frank B. Jensen.
The study of sea mammals is a path to better
understanding physiological phenomena linked to diving.
This document explains a scientific investigation into the
physiological traits of harbor porpoises that are adaptive
for their diving behavior. The study focuses on various
aspects such as blood oxygen-transporting properties,
buffer characteristics, chloride transport via the erythrocyte
anion exchanger (AE1), circulating nitric oxide
metabolites, and hemoglobin nitrite reduction.
Authors:
Helene N. David, Benoıt Haelewyn, Mickael Degoulet,
Denis G. Colomb, , Jean-Jacques Risso, Jacques H. Abraini
Argon is known for its high Narcosis properties and is not
used in diving breathing mixes for these reasons.
However, it can have other applications. This study
investigates whether this gas can provide neuroprotection
after excitotoxic or ischemic events. The results indicate
that while argon has beneficial effects at the cortical level,
it may increase subcortical brain damage if administered
post-ischemia. The authors suggest that argon should be
administered during ischemia, before reperfusion, to
maximize its neuroprotective benefits and minimize
potential harm.
Authors:
Sara R. Zwart, J. Milburn Jessup, Jiuping Ji, Scott M. Smith
This study investigated the effects of an oxygen-rich
environment on oxidative damage, iron stores, and
vitamin status, particularly folate, in humans. It involved
participants undergoing a saturation dive in a hyperoxic
environment, and it aimed to assess the biochemical
markers of iron status, oxidative damage, and vitamin
status before, during, and after the dive. The results
indicated that increased body iron stores and oxidative
stress were associated with decreased folate status and an
elevated DNA damage repair response. The study
suggests that folate requirements may be higher in such
environments.
Authors:
Stephen R. Thom, Tatyana N. Milovanova, Marina Bogush,
Veena M. Bhopale, Ming Yang, Kim Bushmann, Neal W.
Pollock, Marko Ljubkovic, Petar Denoble, and Zeljko Dujic
This study evaluated the presence of annexin V-positive
microparticles (MPs) and neutrophil activation in humans
following decompression from open-water SCUBA diving.
It was hypothesized that these changes are related to
intravascular bubble formation. The document details the
methodology, including the profile of the dives, the timing
of blood sample collection, and the techniques used to
quantify intravascular bubbles and assess neutrophil
activation. It also summarizes the key findings, such as the
increase in MPs, neutrophil activation, and the interactions
between platelets and neutrophils.
Authors:
Ivan. T. Demchenko, Alexander N. Moskvin, Alexander I.
Krivchenko, Claude A. Piantadosi, & Barry W. Allen
This study evaluated the presence of annexin V-positive
microparticles (MPs) and neutrophil activation in humans
following decompression from open-water SCUBA diving.
It was hypothesized that these changes are related to
intravascular bubble formation. The document details the
methodology, including the profile of the dives, the timing
of blood sample collection, and the techniques used to
quantify intravascular bubbles and assess neutrophil
activation. It also summarizes the key findings, such as the
increase in MPs, neutrophil activation, and the interactions
between platelets and neutrophil.
Authors: Sermin Sengun, Atilla Uslu, Salih Aydin
This study investigates the level and source of dehydration
in divers who use heliox. Using multifrequency
bioelectrical impedance analysis (MF-BIA), it aims to
determine whether the dehydration is intracellular,
extracellular, or both. The text outlines the study's
background, objective, methodology, results, and
conclusions.
Authors: Assim A. Alfadda, and Reem M. Sallam
This document provides an overview and summary of the
roles of reactive oxygen species (ROS) in health and
disease. It aims to highlight the biological effects of ROS,
their production, and metabolism in cellular organelles
like the endoplasmic reticulum and mitochondria, as well
as recent research findings that have advanced the
understanding of ROS in redox regulation. It also offers a
brief perspective on research to enhance the knowledge
of ROS actions in various health and disease conditions.
Authors:
Yara Bernaldo de Quirós, Oscar González-Diaz, Manuel
Arbelo, Eva Sierra, Simona Sacchini, Antonio Fernández
As previously mentioned, studies on sea mammals help to
understand phenomena linked to diving. This document
presents the findings from a survey of gas embolic lesions
in stranded cetaceans, particularly in relation to military
sonar. It aims to analyze the prevalence, amount,
distribution, and composition of gas bubbles in marine
mammal tissues, taking into account species-specific
variability and the impact of decomposition. It also
provides recommendations for necropsy procedures to
minimize the masking effects of putrefaction gases and
highlights the significance of gas bubble amounts in
pathological assessments.
Authors:
Manav V Vyas, Amit X Garg, Arthur V Iansavichus, John
Costella, Allan Donner, Lars E Laugsand, Imre Janszky,
Marko Mrkobrada, Grace Parraga, Daniel G Hackam
This study is a systematic review and meta-analysis of
observational studies to determine the association
between shift work and major vascular events, such as
myocardial infarction, ischemic stroke, and coronary
events. It outlines the methodology used for data
collection and analysis, the results of the studies reviewed,
and the implications of these findings for public policy and
occupational medicine.
Authors:
Mikulas Chavko, Usmah Kawoos, Saleena Adeeb, Jason
Lankasky, Charles R. Auker, Richard M. McCarron
The authors of this study investigate the protective effects
of intermittent hyperbaric oxygen (HBO2) exposure
against the central nervous system (CNS) and pulmonary
toxicity. The study aims to optimize the duration of HBO2
cycles to enhance protective outcomes. It describes the
methods used, including the exposure of rats to different
HBO2 cycles and the assessment of lung inflammation
and respiratory changes. The results indicate that
intermittent HBO2 exposure is more effective in reducing
lung inflammation and respiratory changes compared to
continuous exposure.
Authors: Christopher J. Morris; Jessica N. Yang; and Frank
A. J. L. Scheer
This paper intends to convey scientific findings regarding
the relationship between the circadian timing system, shift
work, and the increased risk of cardiovascular and
metabolic diseases. The research explains how the body's
internal clock influences cardiovascular risk markers and
how misalignment between the circadian rhythm and
external factors, such as shift work, can lead to adverse
health outcomes.
Authors: Earl S Ford, & Carl J Caspersen
This study summarizes research on the relationship
between sedentary behavior, specifically screen time and
sitting time, and the risk of cardiovascular disease (CVD).
Based on prospective studies that primarily used self-
reported data, it highlights the association between
increased sedentary time and higher risks of both fatal and
non-fatal CVD. Additionally, it suggests that future
research using more objective measures of sedentary
behavior could provide more accurate risk assessments
and inform public health guidelines and interventions to
reduce sedentary behavior.
Authors: C. Balestra, P. Lafere, P. Germonpre
This study investigated the effects of inert gas narcosis
(IGN) on divers. The report provides insights into the
mechanisms of IGN by measuring critical flicker fusion
frequency (CFFF) at various stages of a dive and indicates
that IGN may involve gas-protein interactions and that its
effects on cerebral function can persist for at least 30
minutes after surfacing. It also highlights the importance
of understanding these effects, especially in situations
requiring precise judgment or actions.
Authors:
Wenbing Xu, Wenwu Liu, Guoyang Huang, ZiJiao Zou,
Zhiyu Cai, Weigang Xu
This study aims to provide a detailed report on the
occurrence, treatment, and outcomes of decompression
illness (DCI) cases in a fishery area in northern China. It
aims to share findings from a study conducted over a
decade, highlighting the effectiveness of recompression
treatment schedules and emphasizing the importance of
timely intervention.
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Authors: Robert P. Weenink, Markus W. Hollmann,
Robert A. van Hulst
Cerebral arterial gas embolism is a serious issue from
diving and medical procedures. This review covers key
features of various animal models used in research,
including species, anatomy, air embolization methods, air
amount, bubble size, outcome measures, anesthesia,
blood glucose, body temperature, and blood pressure.
02 - Animal models of cerebral arterial gas embolism.
- Published by the Journal of Neuroscience Methods - Elsevier
18 - Severe capillary leak syndrome after inner ear decompression
sickness in a recreational scuba diver.
- Published by the Journal of Emergency Medicine
Authors: Emmanuel Gempp, Guillaume Lacroix, Jean-
Marie Cournac, and Pierre Louge
Post-decompression shock with plasma volume deficit is
rare, seen in extreme diving conditions. A case of shock
from plasma extravasation in a diver with inner ear
decompression sickness is reported. Endothelial damage
may cause capillary leak and hypotension. Accurate
diagnosis in the Emergency Department is vital, and
elevated hematocrit in divers may indicate capillary leak
syndrome needing albumin infusion.
39 - Abdominal compartment syndrome caused by tension
pneumoperitoneum in a scuba diver.
- Published by the Royal college of Surgeons of England
Authors: J Bunni , PJ Bryson, SM Higgs
Abdominal compartment syndrome is a serious
emergency due to increased pressure in the abdomen,
causing issues with breathing, heart, and kidneys. It's
mostly found in post-operative and trauma patients. This
case involves a 52-year-old diver who developed tension
pneumoperitoneum after a dive, resulting in severe
abdominal pain. She was treated successfully with needle
decompression, avoiding surgery. Prompt treatment is
crucial to prevent complications.
40 - Decompression calculations for trimix dives with PC software:
variations in the time-to-surface: where do they come from?
- Published by the International Journal of the Society for Underwater Technology
Author: Albrecht Salm
This paper examines how gradient factors influence
decompression time calculations and the impact of
different dive profile data. It analyzed 480 dive profiles
using various software, revealing differences in
decompression times with trimix gases based on helium
levels. These variations arise from how numerical methods
are implemented, not from the algorithms themselves.
Users should be aware of these differences.
44 - Intramicroparticle nitrogen dioxide is a bubble nucleation site
leading to decompression-induced neutrophil activation and
vascular injury
- Published by the American Physiological society
Author: Stephen R. Thom, Ming Yang, Veena M.
Bhopale, Tatyana N. Milovanova, Marina Bogush,
and Donald G. Buerk
Intramicroparticle nitrogen dioxide acts as a site for bubble
formation, leading to neutrophil activation and vascular
damage during decompression. In studies, a specific type
of microparticle increases in size under pressure in wild-
type mice but not in iNOS knockout mice. This indicates
nitrogen dioxide's role in causing inflammation after
decompression.
36 - Pressure-selective modulation of NMDA receptor subtypes may
reflect 3D structural differences
- Published by Frontiers
Authors: Amir Mor, Yosef Y. Kuttner, Shiri Levy, Merav
Mor, Michael Hollmann, and Yoram Grossman
High Pressure (HP) exposure in professional deep-water
divers can lead to High Pressure Neurological Syndrome
(HPNS), causing hyperexcitability and potentially
irreversible neuronal damage. HP affects eight specific
glutamate N-methyl-D-aspartate receptor (NMDAR)
subtypes, increasing ionic currents in one subtype and
reducing in four others. This suggests selective HP effects
on different brain regions and calls for further
investigation and re-evaluation of deep-diving safety
guidelines.
38 - Psychomotor function during mild narcosis induced by
subanesthetic level of nitrous oxide: individual susceptibility
beyond gender effect
- Published by Undersea & Hyperbaric Medical Society (Author-released)
Authors: Miroljub Jakovljevic, Gaj Vidmar, Igor B.
Mekjavic
This study examined the impact of nitrous oxide (N2O)
on psychomotor performance in undergraduate
students. Participants were 12 female and 12 male.
Psychomotor assessments were conducted using a
computerized Visual Simple Reaction Time (VSRT) test
and Trail Making Tests Part A and Part B. Results showed
that males had shorter VSRT in air trials, and mean
performance in N2O trials degraded significantly only in
VSRT.
45 - The Undersea and Hyperbaric Medical Society. A report on the
annual scientific meeting 2012, Phoenix, AZ, USA June 21 – 23
- Published by BioMed Central Ltd
Author: Michael H Bennett
This is a report on the content of the 45th annual scientific
meeting of the Undersea and Hyperbaric Medical Society
(UHMS) in Phoenix AZ, USA last June 21-23, 2012.
Authors: Glenn Courtenay, Derek R Smith, and William
Gladstone
Marine and freshwater scientists face numerous
occupational hazards, including animal attacks, exposure
to toxins, and dangerous environmental conditions. While
hazards have been studied in the general population,
specific occupational risks remain under-researched.
Incidents involving sharks and crocodiles, while notable,
are less common than other dangers like jellyfish stings or
dog bites. Moreover, many SCUBA-related accidents
involve inexperienced divers rather than seasoned
professionals. The overall risks associated with marine and
freshwater research are significant, necessitating serious
consideration of the potential for injury, death, and long-
term health effects in this field.
Author: Peter L. Buzzacott
This article reviews the epidemiology of injuries associated
with recreational scuba diving, highlighting the
prevalence and types of injuries, including barotrauma,
decompression sickness, and drowning. It notes the
incidence rates of injuries per divers and dives, along with
fatalities primarily arising from drowning. Factors
contributing to dive injuries include diver-specific
characteristics and environmental conditions. In addition,
recommendations for safer diving practices are proposed,
alongside the need for further research on risk factors and
health economics related to dive injuries
Authors: Chen Ruiyong, Xiao Weibing, Li Jun, He Jia,
Chen Haiting
High-pressure nervous syndrome (HPNS) is a response of
the nervous system to increased pressure. In this study, in
which 63 mice were exposed to pressures up to 4.0 MPa,
the authors recorded changes in brainstem auditory-
evoked potentials (BAEPs). Interpeak latencies showed a
biphasic response, shortening then prolonging under
pressure. Results suggest that CNS functions are sensitive
to small-to-moderate pressures, with an "optimum"
pressure around 0.7 MPa. Individual responses vary with
biological condition, highlighting the need for further
research into barotolerant candidates for deep diving.
