Scientific papers 2021 - Part B
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Authors:
Kurt Magri, Ingrid Eftedal, Vanessa Petroni Magri, Lyubisa
Matity, Charles Paul Azzopardi, Stephen Muscat, and
Nikolai Paul Pace.
Abstract:
Decompression sickness (DCS) develops due to inert gas
bubble formation in bodily tissues and the circulation,
leading to a wide range of potentially serious clinical
manifestations. Its pathophysiology remains incompletely
understood. In this study, the authors explore changes in
the human leukocyte transcriptome in divers with DCS
compared to closely matched unaffected controls after
uneventful diving.
Authors:
Anna B. Marcinkowska, Natalia D. Mankowska, Jacek Kot,
Pawel J. Winklewski.
Hyperbaric oxygen therapy (HBOT) is a modality of
treatment in which patients inhale 100% oxygen inside a
hyperbaric chamber pressurised to greater than 1
atmosphere. The aim of this review is to discuss
neuropsychological findings in various neurological
disorders treated with HBOT and to open new
perspectives for therapeutic improvement.
Authors:
Roxane Monnoyer, Kjersti Haugum, Jacky Lautridou,
Arnar Flatberg, Astrid Hjelde, and Ingrid Eftedal.
During commercial saturation diving, divers live and work
under hyperbaric and hyperoxic conditions. The myriads
of bacteria that live in and on the human body must
adjust to the resultant hyperbaric stress. In this study, the
authors examined the shifts in bacterial content in the oral
cavity of saturation divers, using a metagenomic approach
to determine the diversity in the composition of bacterial
phyla and genera in saliva from 23 male divers before,
during, and immediately after four weeks of commercial
heliox saturation diving to a working depth of circa 200 m
Authors:
Richard V. Lundell, Laura Tuominen,Tommi Ojanen, Kai
Parkkola, & Anne Räisänen-Sokolowski
Technical diving is popular in Finland year-round, despite
tough conditions like cold water and low visibility. Factors
such as cold temperatures and stress impact the
autonomic nervous system (ANS). To study divers' ANS
responses, heart rate variability (HRV) was measured
during dives in 2–4 degrees C water. Twenty-six
experienced CCR divers took part in a 45-meter
decompression dive while focusing on a non-physical task.
Authors:
Eric Mulder, Arne Sieber, Erika Schagatay
Deep freediving exposes humans to hypoxia and
dramatic changes in pressure. The effect of depth on gas
exchange may enhance the risk of hypoxic blackout (BO)
during the last part of the ascent. The purpose of this
study was to investigate arterial oxygen saturation (SpO 2
) and heart rate (HR) in shallow and deep freedives,
central variables, which have rarely been studied
underwater in deep freediving.
Authors:
Matteo Paganini, Giulia Mormando, Sandro Savino,
Giacomo Garetto, Giulia Tiozzo, Enrico M. Camporesi,
Fabrizio Fabris, and Gerardo Bosco
Hyperbaric chambers and underwater environments are
challenging and at risk of serious accidents. Personnel
aiming to assist patients and subjects should be
appropriately trained, and several courses have been
established all over the world. In healthcare, simulation is
an effective learning technique. However, there have
been few peer-reviewed articles published in the medical
literature describing its use in diving and hyperbaric
medicine.
Authors:
Sanjoy K. Deb, Eimear Dolan, Catherine Hambly, John R.
Speakman, Olav Eftedal, Mohammed Gulrez Zariwala,
and Ingrid Eftedal
Commercial saturation divers are exposed to unique
environmental conditions and are required to conduct
work activity underwater. Consequently, divers’
physiological status is shown to be perturbed, and
therefore, appropriate strategies and guidance are
required to manage the stress and adaptive response. This
study aimed to evaluate the daily energy expenditure
(DEE) of commercial saturation divers during a 21-day
diving operation in the North Sea.
Authors:
Kurt Magri, Ingrid Eftedal, Vanessa Petroni Magri, Lyubisa
Matity, Charles Paul Azzopardi, Stephen Muscat, and
Nikolai Paul Pace.
This study investigates changes in the human leukocyte
transcriptome in divers with decompression sickness (DCS)
compared to unaffected controls. Seven divers with DCS
symptoms were studied alongside six healthy divers. Blood
samples were taken at two times: within 8 hours of diving
and again 40-44 hours later. RNA-Sequencing was used
for transcriptome analysis.
Authors
Eric Mulder, Arne Sieber, & Erika Schagatay
Deep freediving exposes humans to hypoxia and
dramatic changes in pressure. The effect of depth on the
gas exchange may enhance the risk of hypoxic blackout
(BO) during the last part of the ascent. This study
investigated arterial oxygen saturation (SpO2) and heart
rate (HR) in shallow and deep freedivers, central variables
which have rarely been studied underwater in deep
freediving.
Authors:
Fabian Möller, Elena Jacobi, Uwe Hoffmann, Thomas
Muth, Jochen D. Schipke.
Oxygen-enriched air is commonly used in diving and
might affect ventilation and heart rate, but little work exists
for applied diving settings. This study hypothesized that
ventilation is decreased, especially during strenuous
underwater fin-swimming when using oxygen-enriched
air as breathing gas.
Author: Alexander Patrician, Željko Dujic, Boris Spajic, Ivan
Drviš, and Philip N. Ainslie.
Breath-hold diving involves highly integrative physiology
and extreme responses to both exercise and asphyxia
during progressive elevations in hydrostatic pressure. With
astonishing depth records exceeding 100 m, and up to
214 m on a single breath, the human capacity for deep
breath-hold diving continues to refute expectations. The
physiological challenges and responses occurring during
a deep dive highlight the coordinated interplay of
oxygen conservation, exercise economy, and
hyperbaric management. In this review, the physiology of
deep diving is portrayed as it occurs across the phases of a
dive.
Authors:
Xiao-Chen Bao, Yi-Qun Fang, Tao Yang, Yong-jun Sun, Jun
Ma, Ji Xu, Nan Wang, Fang-Fang Wang
The authors of this paper tested the changes in pulmonary
function of divers after 80m, 100m, and 120m heliox dive.
They found that single deep heliox diving can cause
temporary expiratory and minor airway dysfunction,
which can be recovered 24h after diving. This result
increases our knowledge of the impact of the diving
environment on the body, and corresponding preventive
measures should be taken in this regard.
Authors:
Michael R. Kahn, Richard L. Watson, Jay T.
Thetford, Joseph Isaac Wong, and Nader Kamangar
21% of patients with severe COVID-19 sustained
barotrauma (33% of patients receiving Intermittent
mandatory ventilation (IMV), 8% of patients receiving
Non-invasive ventilation (NIV). There were no differences
between the barotrauma and non-barotrauma groups
regarding demographics, illness severity, or medications
received, nor tidal volume or average/peak airway
pressures in those receiving IMV.
Authors:
Amit Chopra, Ali Hani Al-Tarbsheh , Nidhi J. Shah, Hamid
Yaqoob, Kurt Hu, Paul J. Feustel g, Ronaldo Ortiz-Pacheco,
Kinner M. Patel, Jozef Oweis, Natalya Kozlova, Spyridon
Zouridis, Sahar Ahmad, Oleg Epelbaum, Woon H. Chong,
John T. Huggins, Biplab K. Saha i, Edward Conuel, Hau
Chieng, Jeannette Mullins, Divyansh Bajaj, Boris Shkolnik,
Rachel Vancavage, Nagendra Madisi, Marc A. Judson
The authors of this study compared mechanically
ventilated patients who developed a pneumothorax with
those who did not to determine the incidence, clinical
features, and outcomes of critically ill patients with COVID-
19 infection who developed pneumothorax.
Authors:
Kiyotaka Kohshi, Hideki Tamaki, Frédéric Lemaître,
Yoshitaka Morimatsu, Petar J Denoble, Tatsuya Ishitake
Clinical characteristics of DCI in Ama divers mainly suggest
neurological involvement, especially stroke-like
cerebraleventswith sparing of the spinal cord. FemaleAma
divers achieving deep depths haver arely experienced
apanic-like neurosisfrom anxiety disorders.
Neuroradiological studies of Ama divers have shown
symptomatic
and/or asymptomatic ischaemic lesions situated in the
basal ganglia, brainstem, and deepand superfi cial
cerebral white matter, suggesting arterial insufficiency.
Authors:
Gabriel-Petric Bala, Ruxandra-Mioara Râjnoveanu,
Emanuela Tudorache, Radu Motisan, & Cristian Oancea
The goal of this review was to summarize the most
important air pollutants and their impact on the main
respiratory diseases, including chronic obstructive
pulmonary disease and asthma, lung cancer, idiopathic
pulmonary fibrosis, respiratory infections, bronchiectasis,
and tuberculosis, to reduce both short- and long-term
exposure consequences. We considered the most
important air pollutants, including sulfur dioxide, nitrogen
dioxide, carbon monoxide, volatile organic compounds,
ozone, particulate matter, and biomass smoke, and
observed their impact on pulmonary pathologies.
Authors: Oskari H Lindfors, Anne K Räisänen-Sokolowski,
Jari Suvilehto, Saku T Sinkkonen
Middle ear barotrauma (MEBt) is the most common
medical complication in diving, posing a serious risk to
dive safety. This was a survey study. An anonymous
electronic questionnaire was distributed to 7,060
recipients, including professional divers from the Finnish
Border Guard, the Finnish Rescue Services, and the
Finnish Heritage Agency; and recreational divers
registered as members of the Finnish Divers’ Association
and reachable by email.
Authors
Antonio Barajas-Martínez, Geraldine Tello-Santoyo, Pablo
Berumen-Cano, Adriana Robles-Cabrera, Juan Antonio
López-Rivera, Ruben Fossion, Juan Claudio Toledo-Roy,
Alejandro Frank, Bruno Estañol, and Ana Leonor Rivera
Young men have high cardiorespiratory variability,
reflecting the balance between robustness and
adaptability to environmental and internal changes that
characterize good health. However, there are few
biomarkers of this variability. Thus, it is important to
determine the ranges for healthy men. Moreover, the
health condition of women has considerable correlation
with their menstrual cycle.
Authors: Suman Sen, Sheuli Sen
This review indicates the action of hyperbaric oxygen on
biochemical and various physiological changes in cellular
level. Narrative review covers the current indications and
contraindications of hyperbaric oxygen therapy. The
review also focuses on the therapeutic effects of
hyperbaric oxygen pretreatment and precondition in
different pathological conditions. The complications and
side effects of hyperbaric oxygen therapy are discussed.
Authors:
Ethar Mohamedalfatih Fadol, Hayat Mohamed Suliman,
Bashier Osman, Safa A. Abdalla, Wadah J.A. Osman,
Elwasila M. Mohamed, Iman Hassan Abdoon.
Diabetic foot ulcers (DFUs) are a common complication of
diabetes that often leads to amputation and disability.
Despite some promising results in using hyperbaric
oxygen therapy (HBOT) for DFUs treatment, its efficacy is
still debatable. The aim of this study was to evaluate the
therapeutic outcomes of adjuvant HBOT in non-healing
DFUs treatment.
Authors: Richard Lundell, Vesa Järvinen, Harri Mäkitalo, Kai
Parkkola, Tomi Wuorimaa
There is limited knowledge of the cumulative effect of
repetitive cold-water diving on cardiac function. Single
cold dives cause some known cardiological risks, such as
malignant arrhythmia, due to a concurrent activation of
the sympathetic and parasympathetic autonomic nervous
system. A previous study from warmer water dives has
shown that successive dives cause a decrease in vagal
tone and a less responsive cardiovascular system. The aim
of this study was to evaluate changes in cardiac function
with 2D echocardiography during 4 days of diving in
near-freezing water.
Authors: Julien D. Periard, Thijs M. H. Eijsvogels, and Hein
A. M. Daanen
This paper reviews how the human body responds to
exercise under heat stress and discusses countermeasures
to enhance aerobic performance. The authors describe
fundamental concepts and physiological processes related
to thermoregulation and fluid balance, methods to
determine thermal strain and hydration status, and the
impact of heat stress on human performance. They also
explore strategies to mitigate the effects of hyperthermia
and hypohydration, such as heat acclimation, cooling
strategies, and hyperhydration, while summarizing
contemporary controversies and suggesting future
research directions.
Authors:
Jianping Liu, Miaomiao Wu, Run Zhang, Zhi Ping Xu
This document aims to comprehensively review oxygen-
derived free radicals (ODFRs), their biological significance,
and the development of responsive nanoprobes for their
detection and bioimaging. It introduces the production
and biological importance of ODFRs, summarizes the
development of nanoprobes for detecting and imaging
superoxide anion and hydroxyl radicals, discusses the
specific oxidation mechanisms of these radicals, highlights
challenges, and proposes future research directions in this
field.
Authors: Yang Saeng Park, John R. Claybaugh, Keizo
Shiraki, and Motohiko Mohri
This study explains the physiological changes in urine flow
and solute excretion that occur during mixed-gas
saturation diving under hyperbaric conditions. It describes
the mechanisms behind increased diuresis, changes in
urine osmolality, and the excretion of various solutes such
as urea, potassium (K+), sodium (Na+), calcium (Ca2+),
and inorganic phosphate (Pi). It also discusses the roles of
hormones like antidiuretic hormone (ADH) and
aldosterone in these processes and highlights the need
for further research to understand the mechanisms of
impaired solute transport in the proximal tubule under
these conditions.
Authors: Fang Liang, Nan Kang, Pinpin, Xuehua Liu, Ge Li,
Jing Yang
This study investigates the effectiveness of hyperbaric
oxygen therapy (HBOT) in promoting neural functional
recovery after traumatic brain injury (TBI) by encouraging
the polarization of microglia (MG) from the pro-
inflammatory M1 phenotype to the anti-inflammatory M2
phenotype. The authors compare the expression levels of
specific biomarkers associated with M1 and M2 microglia
in both control and experimental animal models subjected
to HBOT. They conclude that HBOT can suppress pro-
inflammatory markers and enhance anti-inflammatory
markers, suggesting its potential therapeutic benefits in
managing TBI.
Authors: Ran Arieli
This document describes findings related to the role of
lung surfactants, particularly
dipalmitoylphosphatidylcholine (DPPC), in the formation
of gas micronuclei that can lead to decompression illness
(DCI) in divers. It discusses the mechanisms by which
DPPC leaks into the bloodstream and forms active
hydrophobic spots (AHS) that contribute to bubble
formation during decompression and explores
adaptations in deep-diving marine mammals, such as the
elephant seal, which have evolved to reduce the risk of
DCI by altering the composition of their lung surfactants.
08 - The Chemistry of Reactive Oxygen Species (ROS) Revisited:
Outlining Their Role in Biological Macromolecules (DNA, Lipids
and Proteins) and Induced Pathologies
- Published by Molecular Science - MDPI
Author: Celia Andrés Juan, José Manuel Pérez de la
Lastra, Francisco J. Plou, and Eduardo Pérez-
Lebeña
Living species constantly face reactive oxidants from
outside sources and those made inside their bodies. There
is much research on reactive oxygen species (ROS), their
production, effects, and roles in cellular processes. Cells
generate ROS normally, but excess levels can cause
oxidative stress and disease. Oxidative stress happens
when there's a mismatch between radical species
production and antioxidant defenses, damaging lipids,
proteins, and DNA. This review explores the chemical
reactions of ROS and oxidative stress..
09 - Oxygen-derived free radicals: Production, biological importance,
bioimaging, and analytical detection with responsive
luminescent nanoprobes
- Published by Diving and Hyperbaric Medicine.
Author: Jianping Liu, Miaomiao Wu, Run Zhang, Zhi
Ping Xu
Oxygen-derived free radicals (ODFRs) are reactive
intermediates formed in living organisms during biological
processes. Superoxide anion and hydroxyl radicals are
highly reactive and can damage biomolecules. Elevated
levels of these radicals are linked to diseases like
neurodegenerative disorders and cancers. This review
covers the production of ODFRs, their role in diseases, and
responsive nanoprobes developed for detecting them. It
also discusses challenges and future research directions.
29 - Diving-related disorders in commercial breath-hold divers (Ama)
of Japan
- Published by Diving and Hyperbaric Medicine
Author: Kiyotaka Kohshi, Hideki Tamaki, Frédéric
Lemaître, Yoshitaka Morimatsu, Petar J Denoble,
Tatsuya Ishitake
Decompression illness (DCI) is recognized in compressed-
air diving and also reported in breath-hold divers like the
Japanese Ama. It often shows neurological symptoms,
particularly stroke-like events. Treatment with oxygen is
recommended, and prevention strategies include
reducing extreme diving.
07 - Reply: Commentary on using critical flicker fusion frequency to
measure gas narcosis
- Published by Diving and Hyperbaric Medicine
Author: Xavier CE Vrijdag, Hanna van Waart, Jamie W
Sleigh, Simon J Mitchell
Research has shown that many gases that could cause a
narcotic effect due to their lipid solubility do not actually
do so because they do not fit receptor sites. Dopamine
changes are just one of many pathways affected by
oxygen around seizures, but these pathways are not
related to narcotic effects. Oxygen may increase NMDA-
receptor activity, while gases like nitrous oxide and
ketamine inhibit this receptor. Thus, oxygen's narcotic
effect seems unlikely. The study concludes that critical
flicker fusion frequency (CFFF) is not a useful measure for
monitoring gas narcosis due to its sensitivity to
confounding factors.
27 - Commentary on using critical flicker fusion frequency to
measure gas narcosis
- Published by Diving and Hyperbaric Medicine
Authors: Jacek Kot, Pawel J Winklewski
This paper discusses the use of critical flicker fusion
frequency (CFFF) for monitoring gas narcosis in divers.
However, the authors argue that the method has
limitations, such as a five-minute acclimatization period,
which may not capture other mechanisms influencing
gas narcosis. They also note that oxygen seizures rarely
occur before 20 minutes of breathing oxygen, and that
the narcotic effect of oxygen is 3 to 4 times more potent
than nitrogen. Despite these limitations, the CFFF remains
a recognized method for assessing neuronal excitability
influencing attention and alertness.
28 - Fatalities involving divers using surface-supplied breathing
apparatus in Australia, 1965 to 2019
- Published by Diving and Hyperbaric Medicine
Author: John Lippmann
This study identifies characteristics and diving practices of
victims of fatal surface-supplied breathing apparatus
(SSBA) incidents in Australia from 1965 to 2019. The
majority were young, healthy males, with 50%
undertaking work-related diving and 37% being
recreational diving. Equipment issues, mainly compressor-
related, were the main contributor in 48% of incidents
and triggers in 24%. Preventable surface-supplied diving
deaths still occur in both occupational and recreational
diving, often due to poor equipment maintenance and
oversight. Improved education and regulatory oversight
could help control the increase in health-related incidents
in older participants.
06 - Database selection and data gathering methods in systematic
reviews of qualitative research regarding diabetes mellitus - an
explorative study
- Published by BMC - Medical Research Methodology
Author: Tobias Justesen, Josefine Freyberg & Anders N. Ø.
Schult
This article investigates the effectiveness of various
academic literature databases in maximizing recall rates
for systematic reviews (SRs) of qualitative research
concerning diabetes mellitus. The study analyzes 26 SRs
published between 2010 and 2020, focusing on the
combination of databases used and the additional
sources employed for data collection. Findings reveal that
MEDLINE/PubMed is the most utilized database, and
hand searches of reference lists significantly enhance the
recall rate. Combinations of certain databases yield the
best results in reference retrieval, highlighting the
importance of methodological rigor in conducting
systematic reviews.
Authors: Samantha Bonnington, Neil Banham, Kevin
Foley, Ian Gawthrope
This study investigated the safety of using monoplace
chambers for hyperbaric oxygen treatment (HBOT) and
the United States Navy Treatment Table 6 for the
treatment of decompression illness (DCI). While other
Australian units avoid monoplace chambers for USN Table
6 due to the perceived risk of oxygen toxicity seizures, this
research aimed to assess this risk. A retrospective review of
1000 USN Table 6 treatments (331 monoplace, 669
multiplace) conducted between 1989 and 2020 revealed
a seizure rate of 0.59% in multiplace chambers and zero
seizures in monoplace chambers, indicating no statistically
significant difference in seizure occurrence between the
two chamber types.
Authors: Peter Buzzacott, George Anderson, Frauke
Tillmans, James W Grier, Petar J Denoble
This study investigated the impact of age, sex, and body
mass index (BMI) on arrhythmias in divers aged 40 and
over, both before and after diving, and the prevalence of
left ventricular hypertrophy (LVH). Seventy-seven divers
participated in 84 trips. Among those without pre-trip
arrhythmias, 12% developed post-trip arrhythmias, with a
median increase of one. For those with pre-trip
arrhythmias, outcomes varied, with some experiencing
fewer, no change, or significantly more arrhythmias post-
dive. Age, but not sex or BMI, was linked to changes in
arrhythmia frequency (P = 0.02). Specifically, the risk of
arrhythmia change increased by 2.1 for every decade of
age. Of 60 divers with cardiac imaging, five exhibited LVH.
Authors: Peter Buzzacott, Al Hornsby, Karl Shreeves
This study reassessed mortality in PADI's Discover Scuba
Diving (DSD) programme from 1992 to 2019. Analyzing
7,118,731 registrations and 79 fatalities, it compared two
14-year periods: 1992–2005 (‘early’) and 2006–2019
(‘late’). Using Monte Carlo simulations to stabilize annual
variation, the mean mortality rate dropped significantly
from 2.55 to 0.87 deaths per 100,000 registrations (P <
0.0001), indicating improved safety in the later period.
Authors: Tsz-Ki Cheung, Willem AJ Meintjes
In Hong Kong, recreational divers must fill out a self-
declared medical statement (RSTC form) before diving.
There is no research on how useful the Chinese version of
this form is. In a study, 117 participants completed the
Chinese RSTC form and were interviewed. About 15.4%
found it difficult to complete, and only 28.2% answered ‘all
negative’ to the questions. Some health risks weren’t
identified by the form. While there was generally good
effectiveness in the form, discrepancies between the
English and Chinese versions were noted, along with
implementation issues concerning user attitudes and
reliability of responses.
Authors: Kevin Foley, Neil Banham, Samantha
Bonnington, Ian Gawthrope
Oxygen toxicity seizures (OTS) can occur during
hyperbaric oxygen treatment (HBOT) and are typically
assumed to stem from central nervous system oxygen
toxicity (CNS-OT). This study reports four cases where
other causes, referred to as "OTS mimics," led to seizures
instead. A review of patient records from Fiona Stanley
Hospital and Fremantle Hospital identified these mimics:
posterior reversible encephalopathy syndrome, pethidine
toxicity, prior subarachnoid hemorrhage with epilepsy,
and severe hypoglycemia.
Authors: Stevan E. Hobfoll, Patricia Watson, Carl C. Bell,
Richard A. Bryant, Melissa J. Brymer, Matthew J.
Friedman, Merle Friedman, Berthold P.R. Gersons,
Joop T.V.M de Jong, Christopher M. Layne, Shira
Maguen, Yuval Neria, Ann E. Norwood, Robert S.
Pynoos, Dori Reissman, Josef I. Ruzek, Arieh Y.
Shalev, Zahava Solomon, Alan M. Steinberg, and
Robert J. Ursano
Existing intervention policies for mass trauma lack an
evidence-based consensus. To address this, a global expert
panel extrapolated from related research to establish five
core intervention principles for the early to mid-term post-
trauma phases: promoting safety, calming, self and
community efficacy, connectedness, and hope.
Authors: Sinem Kara, Ender Inci, E Deniz Gözen, K Cenk
Gülgün, H Murat Yener
A 20-year-old male presented with a traumatic nasal glass
cut, complicated by a haematoma and skin necrosis within
24 hours. With only the columellar artery intact, blood
supply was severely compromised, classifying the wound
as difficult to heal. The patient received 30 HBOT sessions
(253.3 kPa, twice daily for four days, then daily) alongside
antibiotics and conservative wound care. Complete
healing was achieved without further surgery, suggesting
HBOT may effectively support conservative management
in sharp nasal trauma.
Authors: Ulrika Lindblom, Carl Tosterud
A fit 26-year-old soldier suffered pulmonary barotrauma
with cerebral arterial gas embolism during underwater
vehicle escape training with compressed air, after
surfacing from a shallow depth of 0.75–1.2 metres of
freshwater. She presented with altered consciousness,
slurred speech, sensory deficit, and right hemiparesis.
Hyperbaric oxygen treatment, initiated 11 hours post-
incident using US Navy Treatment Table 6, led to near-
complete recovery after repeated sessions. This case is
unusual due to the very shallow depth, with only two
similar cases previously reported.
Authors: Bengusu Mirasoglu, Hande Cetin, Sevgi Ozdemir
Akgun, Samil Aktas
Intrauterine limb ischaemia is rare and can have
devastating outcomes; despite various treatments,
amputation may be required. Post-natal hyperbaric
oxygen therapy (HBOT) has emerged as a salvage option.
This report describes a newborn with total brachial artery
occlusion who began HBOT at 48 hours of life. The
patient completed 47 HBOT sessions at 2.4 atm abs for
115 minutes each, including four within the first 24 hours,
with brief compression, three 25-minute oxygen periods
and decompression. Full recovery was achieved with this
regimen plus anticoagulation, fasciotomy and supportive
care; the infant tolerated therapy well with no
complications.
Authors: David PM Monnot, Jocelyn Boisvert, Dominique
Buteau, Neal W Pollock
The Centre de Médecine de Plongée du Québec (CMPQ)
launched a bilingual, 24/7 dive emergency and
information service in 2004, accessible toll-free across
Canada. Over 15 years , it received 3,232 contacts,
followed by requests for medical opinion (28%), post-
urgent issues (13%), non-life-threatening urgencies (7%),
and only 0.1% were immediate life or health-threatening.
Top concerns included emergency planning (20%),
technical diving questions (16%), ear/nose/throat issues
(12%), and decompression sickness (7%). Among
identified cases (67%), diving activity was predominantly
professional (48%) or recreational (46%), with minimal
breath-hold diving (1%).
Authors: Monica Rocco, Luigi Maggi, Chiara Loffredo,
Massimiliano Pelli, Pia Di Benedetto, Silvia Fiorelli,
Maurizio Simmaco, Roberto Alberto De Blasi
Decompression sickness (DCS) is linked to intravascular
bubbles triggering inflammatory responses. This study
examined whether breathing gas composition (air vs.
helium-rich trimix) influences inflammation in divers after a
50-meter dive. Thirty-three advanced divers were split into
air (n=17) and trimix (21% O2, 35% He, 44% N2; n=16)
groups, following identical dive profiles. Blood samples
analyzed before and after diving showed minor changes
in inflammatory markers: IL-6 increased slightly, while IL-8
and EGF decreased in both groups, with no significant
differences between gas compositions.
Author: Jochen D Schipke
This document discusses how statistical practices in
biomedical research have changed over the last 50 years.
Initially, research focused on basic statistics and simple
designs, but as studies became more complex, reliance on
advanced statistical methods increased, leading to strict
publication requirements. The author criticizes the
overemphasis on p-values, which can misrepresent clinical
relevance. He encourages researchers to lead inquiry and
highlights the American Statistical Association’s call for
better interpretation of statistics, noting some journals
have banned p-values.
Authors: Juan M Valdivia-Valdivia, Anne Räisänen-
Sokolowski, Peter Lindholm
Competitive breath-hold divers sometimes use dry apnoea
training (hyperventilating then exhaling to residual lung
volume) to increase hypoxia and hypercapnia tolerance.
This method rapidly induces cerebral hypoxia and risk of
loss of consciousness (LOC) with minimal respiratory
discomfort. In an unsupervised case, a diver using a nose
clip failed to resume breathing after LOC, leading to
prolonged severe hypoxia and poor recovery. Breath-
holding on empty lungs generated intrathoracic sub-
atmospheric pressure upon attempted inhalation, resulting
in severe intralobular pulmonary oedema, resembling
immersion pulmonary oedema or descent-related
barotrauma.
Authors: Xavier CE Vrijdag, Hanna van Waart, Jamie W
Sleigh, Simon J Mitchell
This text is the authors' response to doctors Kot and
Winklewski, who critiqued their previous article and their
position regarding the use of critical flicker fusion
frequency (CFFF) for detecting nitrogen narcosis and
therefore standing by their conclusion that research on
CFFF as a measure of the narcotic effect exerted by
hyperbaric gases has generated conflicting results, typically
explained in each paper by invoking various confounding
factors. However, they agree with Kot and Winlewski's
conclusion that CFFF is poorly suited to monitoring
hyperbaric gas narcosis. It is too sensitive to confounding
effects that may obfuscate the cognitive impairment
caused by gas narcosis.
Authors: Zhen-Biao Guan, Yan-Yan Zhou, Yi Cen, Han-De
Feng, Wen-Wu Liu, Hong-Jie Yi, Hui Chen
Exposure to high oxygen pressure can cause central
nervous system oxygen toxicity (CNS-OT), though the role
of necroptosis in its development remains unclear. In mice
studies, the necroptosis inhibitor necrostatin-1 (Nec-1)
delayed seizure onset under high oxygen conditions and
reduced brain inflammation and necroptosis, but did not
significantly affect oxidative stress.
Authors: Costantino Balestra, Kate Lambrechts, Simona
Mrakic-Sposta, Alessandra Vezzoli, Morgan
Levenez, Peter Germonpré, Fabio Virgili, Gerardo
Bosco, and Pierre Lafère
This study tested whether a five-week, low-intensity, non-
training program with modified oxygen could elicit a
hormetic metabolic load akin to that of higher-intensity
exercise. Young adults underwent sessions under
hyperoxia or mild hypoxia, with Hb, redox state, NOx,
iNOS, cytokines, and renal biomarkers measured. The
results showed that intermittent hyperoxia triggers the
normobaric oxygen paradox and, with hypoxia exposure,
modulates inflammatory and immune markers.
Authors: Xiao-Chen Bao, Quan Shen, Yi-Qun Fang, and
Jian-guo Wu
This study investigated the physiological effects of a single
deep helium-oxygen (heliox) dive to 80 meters seawater
(msw) on 40 male divers. Blood and saliva samples
collected before and after the dive revealed significant
changes in immune and hematological markers:
granulocyte percentage increased while lymphocytes,
intermediate cells, red blood cells, hematocrit, and platelets
decreased. Biochemical analysis indicated elevated serum
creatine kinase (CK), CK-MB, and salivary amylase (AMY1),
alongside increased testosterone and glutathione (GSH)
levels, with reduced vascular cell adhesion molecule-1
(VCAM-1) and salivary IgA. No changes were observed in
malondialdehyde (MDA) or endothelin-1 (ET-1) levels.
