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Klass S, Burton A, Price C. SCUBA Diver's Knee: A Case Report. Curr Sports Med Rep 2022; 21:109-111. [PMID: 35394950 DOI: 10.1249/jsr.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT With more than 9 million recreational certified self-contained underwater breathing apparatus divers in the United States, clinicians should be aware of the unique diving-related injuries. One of the most common diving-related injuries is type 1 decompression sickness, or "the bends." The bends commonly manifest as localized joint pain, most often occurring within 24 h of surfacing and resolving over the following 1 to 2 d. We report a unique case of a patient who experienced an exacerbation of musculoskeletal joint pain following initial recovery. This 35-year-old man had nearly complete resolution of his joint pain following the bends, then developed severe right knee pain with swelling after a high-volume lower body workout. Following unremarkable imaging and unsuccessful conservative treatment, ultrasound-guided aspiration of his right knee was performed, which resolved the patient's symptoms. This case highlights a unique presentation of the bends and demonstrates a potentially beneficial treatment if recurrence of the bends is suspected.
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Affiliation(s)
- Scott Klass
- University of Miami Miller School of Medicine, University of Miami Hospitals and Clinics, Miami, FL
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Ostrovska K. Features of diving headache. PAIN MEDICINE 2022. [DOI: 10.31636/pmjua.v6i4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
WHO estimates that the prevalence of headaches worldwide in the adult population is approximately 50 %. Globally, half to threequarters of people aged 18 to 65 have complained of headaches in the past year, and more than 30 percent have suffered from migraines. At the same time, 1.7 to 4 % of the adult population suffers from headaches that last 15 or more days a month. Undoubtedly, cephalgia constitutes a global problem.However, it is worrying that the causes of headaches are not always correctly diagnosed. The main clinical barrier pointed out by WHO is the lack of knowledge of health professionals about headache management. Thus, the broad coverage of issues related to the management of patients with cephalgia does not lose its relevance, and even more: it needs to be supplemented with current data. In particular, the mechanisms of headache can be associated with several pathophysiological processes that are triggered by the influence of professional activities, specific physical activity, active leisure, or amateur sports.Recreational diving has become a popular form of active leisure for the past 20 years. It is noteworthy that headache is a common symptom in divers and, although it is usually benign, it can sometimes signal the serious consequences of high pressure. Proper diagnostic tactics require specialists to carefully collect the anamnesis and examine the patient, as well as to understand the unique physiological changes in the human body that occur under the influence of underwater environmental factors.
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Seyithanoğlu MH, Abdallah A, Dündar TT, Kitiş S, Aralaşmak A, Gündağ Papaker M, Sasani H. Investigation of Brain Impairment Using Diffusion-Weighted and Diffusion Tensor Magnetic Resonance Imaging in Experienced Healthy Divers. Med Sci Monit 2018; 24:8279-8289. [PMID: 30447152 PMCID: PMC6252049 DOI: 10.12659/msm.911475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to understand the changes of decompression illness in healthy divers by comparing diffusion-weighted (DWI) and diffusion tensor MRI findings among healthy professional divers and healthy non-divers with no history of diving. Material/Methods A total of 26 people were recruited in this prospective study: 11 experienced divers with no history of neurological decompression disease (cohort) and 15 healthy non-divers (control). In all study subjects, we evaluated apparent diffusion coefficient (ADC) and type of diffusion tensor metric fractional anisotropy (FA) values of different brain locations (e.g., frontal and parieto-occipital white matter, hippocampus, globus pallidus, putamen, internal capsule, thalamus, cerebral peduncle, pons, cerebellum, and corpus callosum). Results ADC values of hippocampus were high in divers but low in the control group; FA values of globus pallidus and putamen were lower in divers compared to the control group. DWI depicted possible changes due to hypoxia in different regions of the brain. Statistically significant differences in ADC values were found in hypoxia, particularly in the hippocampus (p=0.0002), while FA values in the globus pallidus and putamen were statistically significant (p=0.015 and p=0.031, respectively). We detected forgetfulness in 6 divers and deterioration in fine-motor skills in 2 divers (p=0.002 and p=0.17, respectively). All of them were examined using neuro-psychometric tests. Conclusions Repeated hyperbaric exposure increases the risk of white matter damage in experienced healthy divers without neurological decompression illness. The hippocampus, globus pallidus, and putamen are the brain areas responsible for memory, learning, navigation, and fine-motor skills and are sensitive to repeated hyperbaric exposure.
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Affiliation(s)
| | - Anas Abdallah
- Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Tolga Turan Dündar
- Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Serkan Kitiş
- Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Ayşe Aralaşmak
- Department of Radiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Hadi Sasani
- Department of Radiology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
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A Systematic Review of the Causes and Management of Ischaemic Stroke Caused by Nontissue Emboli. Stroke Res Treat 2017; 2017:7565702. [PMID: 29123937 PMCID: PMC5662829 DOI: 10.1155/2017/7565702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction The inadvertent or purposeful introduction of foreign bodies or substances can lead to cerebral infarction if they embolize to the brain. Individual reports of these events are uncommon but may increase with the increased occurrences of their risk factors, for example, intra-arterial procedures. Method We searched EMBASE and MEDLINE for articles on embolic stroke of nontissue origin. 1889 articles were identified and screened and 216 articles were ultimately reviewed in full text and included in qualitative analysis. Articles deemed relevant were assessed by a second reviewer to confirm compatibility with the inclusion criteria. References of included articles were reviewed for relevant publications. We categorized the pathology of the emboli into the following groups: air embolism (141 reports), other arterial gas embolisms (49 reports), missiles and foreign bodies (16 reports), and others, including drug embolism, cotton wool, and vascular sclerosant agents. Conclusion Air and gaseous embolism are becoming more common with increased use of interventional medical procedures and increased popularity of sports such as diving. There is increasing evidence for the use of hyperbaric oxygen for such events. Causes of solid emboli are diverse. More commonly reported causes include bullets, missiles, and substances used in medical procedures.
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Ergen M, Uslu A, Caglar O, Akca-Kalem S, Cimsit M, Gurvit H. Evaluation of cognitive performance in professional divers by means of event-related potentials and neuropsychology. Clin Neurophysiol 2017; 128:579-588. [PMID: 28231476 DOI: 10.1016/j.clinph.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 12/14/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We investigated whether professional air diving with no decompression illness causes any long-term changes in cognitive functions. METHODS The all-male participants consisted of 18 healthy control (HC) volunteers and 32 divers. Divers were divided into two subgroups as moderate exposure group, Divers-I (DI) and extensive exposure group, Divers-II (DII). Participants were administered a comprehensive neuropsychological battery and event-related potentials (ERPs) were recorded while they performed auditory oddball task and visual continuous performance test (CPT). RESULTS P3 waves in oddball and CPT were significantly attenuated and peak latencies were prolonged in both diver groups compared with HC. Amplitude decrements in CPT P3 were graded with respect to level of diving exposure. Neuropsychologically, DII group displayed significantly poorer performance than HC and DI groups in measures of visuo-constructional and visual long-term memory tests. DI group performed better than HC group in some measures of planning ability. CONCLUSIONS Most of the changes in neurophysiological measures and poorer neuropsychological performance were found in DII group, and this might be interpreted as a red flag for the reflection of the slowly progressing deleterious effects of silent bubbles in brain function. SIGNIFICANCE This study reports impairments in certain neuropsychological measures and apparent neurophysiological markers pointing to slow cognitive decline referring to long-term effects of diving.
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Affiliation(s)
- Mehmet Ergen
- Department of Physiology, School of Medicine, Acibadem University, Atasehir 34752, Istanbul, Turkey
| | - Atilla Uslu
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey
| | - Ozlem Caglar
- Department of Underwater and Hyperbaric Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey
| | - Sukriye Akca-Kalem
- Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey
| | - Maide Cimsit
- Department of Underwater and Hyperbaric Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey
| | - Hakan Gurvit
- Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey.
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Découverte fortuite d’une aéroportie chez un plongeur victime d’accident de décompression. ANNALES FRANCAISES DE MEDECINE D URGENCE 2016. [DOI: 10.1007/s13341-016-0617-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rosińska J, Łukasik M, Kozubski W. Neurological complications of underwater diving. Neurol Neurochir Pol 2014; 49:45-51. [PMID: 25666773 DOI: 10.1016/j.pjnns.2014.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 11/29/2022]
Abstract
The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.
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Affiliation(s)
- Justyna Rosińska
- Chair & Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Maria Łukasik
- Chair & Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Kozubski
- Chair & Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
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Sphenoid sinus barotrauma after scuba diving. Am J Otolaryngol 2012; 33:477-80. [PMID: 22133966 DOI: 10.1016/j.amjoto.2011.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 10/15/2011] [Indexed: 11/22/2022]
Abstract
We report the case of an 18-year-old male patient operated on for sphenoid sinus barotrauma after scuba diving. The patient attended our emergency department because of intractable headache but did not improve with conservative treatment. After computed tomography and magnetic resonance imaging examination, he was diagnosed with sphenoid sinusitis that extended to the nasal septum. He therefore underwent surgery for sinus ventilation and abscess drainage.
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Clinical Presentation and Conservative Management of Tympanic Membrane Perforation during Intrapartum Valsalva Maneuver. Case Rep Med 2010; 2010:856045. [PMID: 20204134 PMCID: PMC2831512 DOI: 10.1155/2010/856045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 01/29/2010] [Indexed: 11/17/2022] Open
Abstract
Background. Tympanic membrane perforation may occur when ear pressures are excessive, including valsalva maneuver associated with active labor and vaginal delivery. A pressure differential across the eardrum of about 5 psi can cause rupture; the increased intraabdominal pressure spikes repeatedly manifested by "pushing" during second-stage labor easily approach (and may exceed) this level. Material and Method. We describe a healthy 21-year old nulliparous patient admitted in active labor at 39-weeks' gestational age. Results. Blood appeared asymptomatically in the left ear canal at delivery during active, closed-glottis pushing. Otoscopic examination confirmed perforation of the left tympanic membrane. Complete resolution of the eardrum rupture was noted at postpartum check-up six weeks later. Conclusion. While the precise incidence of intrapartum tympanic membrane rupture is not known, it may be unrecognized without gross blood in the ear canal or subjective hearing loss following delivery. Only one prior published report on tympanic membrane perforation during delivery currently appears in the medical literature; this is the first English language description of the event. Since a vigorous and repetitive valsalva effort is common in normal vaginal delivery, clinicians should be aware of the potential for otic complications associated with the increased intraabdominal pressure characteristic of this technique.
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Jeoung SM, Kim SG, Kwon JD. The Changes of Intraocular Pressure, Optic Nerve and Visual Field in SCUBA Diving. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.12.1598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Moon Jeoung
- Department of Ophthalmology, Wallace Memorial Baptist Hospital1, Busan, Korea
| | - Sung Gil Kim
- Department of Ocean Physical Education, Korea Maritime University, Busan, Korea
| | - Jeong Do Kwon
- Department of Ophthalmology, Wallace Memorial Baptist Hospital1, Busan, Korea
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Affiliation(s)
- Ki-Jun Kim
- Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Yoshiyama M, Asamoto S, Kobayashi N, Sugiyama H, Doi H, Sakagawa H, Ida M. Spinal cord decompression sickness associated with scuba diving: correlation of immediate and delayed magnetic resonance imaging findings with severity of neurologic impairment—a report on 3 cases. ACTA ACUST UNITED AC 2007; 67:283-7. [PMID: 17320639 DOI: 10.1016/j.surneu.2006.06.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Accepted: 06/19/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND There are few reports detailing an association between immediate and delayed changes in MR imaging findings and severity of neurologic impairment in patients with spinal cord DCS. We report on the cases of 3 patients diagnosed with spinal cord DCS presenting with severe neurologic symptoms after scuba diving. CASE DESCRIPTION Of 175 patients with DCS referred to the Tokyo Metropolitan Ebara Hospital Department of Neurosurgery, 3 were determined by MR imaging and neurologic examination to have a spinal cord injury. Hyperbaric oxygen, methylprednisolone, and rehabilitation therapies were applied to these patients. We examined whether the severity of the patients' neurologic dysfunction, classified according to Fränkel's grade, was associated with the extent of abnormal signals depicted by spinal MR imaging in these patients at the acute phase and monthly follow-up points. T2-weighted MR imaging performed within 24 hours of the onset of the patients' neurologic symptoms revealed signals of increased intensity located predominantly in the dorsolateral regions, involving spinal segments 1 through 4, and a neurologic examination upon admission revealed severe sensory and motor dysfunction (Fränkel's grade A) in all 3 patients. The abnormal signals on MR images at 1 month postinjury were markedly decreased in size as compared with those at the acute phase. However, neurologic function showed minimal or no improvement (Fränkel's grade A or B). CONCLUSION In patients with spinal cord DCS, the improvement in MR imaging findings was not associated with improved clinical status. This discrepancy suggests that intricate pathophysiologic changes, reversible and persistent damage subsequent to initial cord injuries (ie, edematous and neurotoxic lesions), underlie the disease and affect the clinical course.
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Dillard TA, Khosla S, Ewald FW, Kaleem MA. Pulmonary function testing and extreme environments. Clin Chest Med 2005; 26:485-507, vii. [PMID: 16140140 DOI: 10.1016/j.ccm.2005.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Millions of people worldwide engage in leisure or occupational activities in extreme environments. These environments entail health risks even for normal subjects. The presence of lung disease, or other conditions, further predisposes to illness or injury. Patients who have lung conditions should, but often do not, consult with their pulmonary clinicians before traveling. Normal subjects, including elderly or deconditioned adults, may be referred to pulmonologists for evaluation of risk prior to exposure. Other patients may present for consultations after complications occur. Pulmonary function testing before or after exposure can assist physicians counseling patients about the likelihood of complications.
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Affiliation(s)
- Thomas A Dillard
- Division of Pulmonary/Critical Care, Medical College of Georgia, BBR 5513, 1120 15th Street, Augusta, GA 30912-3135, USA.
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Abstract
Barotrauma is pressure-induced injury. The application of direct pressure to the body may cause trauma, including positive pressure from artificial ventilation. Trauma may also be caused by the effects of pressure changes on gas-containing body spaces, not in communication with the environment. This can include the external ear, the middle ear (and, indirectly, the inner ear), the para-nasal sinuses, the lungs, the gut, and abscess cavities (for example, in the teeth). Gas may penetrate tissues adjoining the affected space (such as the anterior cranial fossa, via the ethmoid sinus), or may embolise via the blood stream. The most severe expression of this is cerebral arterial gas embolism, which may present as a stroke. The management of these problems includes prevention, the use of pressure-equalizing techniques, vasoconstrictor drugs, surgery, and hyperbaric oxygen therapy.
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Affiliation(s)
- Martin Hamilton-Farrell
- Department of Hyperbaric Medicine, Whipps Cross University Hospital, Leytonstone, London E11 1NR, UK.
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Abstract
Self-Contained Underwater Breathing Apparatus (SCUBA) diving popularity is increasing tremendously, reaching a total of 9 million people in the US during 2001, and 50,000 in the UK in 1985. Over the past 10 years, new advances, equipment improvements, and improved diver education have made SCUBA diving safer and more enjoyable. Most diving injuries are related to the behaviour of the gases and pressure changes during descent and ascent. The four main pathologies in diving medicine include: barotrauma (sinus, otic, and pulmonary); decompression illness (DCI); pulmonary edema and pharmacological; and toxic effects of increased partial pressures of gases. The clinical manifestations of a diving injury may be seen during a dive or up to 24 h after it. Physicians living far away from diving places are not excluded from the possibility of encountering diver-injured patients and therefore need to be aware of these injuries. This article reviews some of the principles of diving and pathophysiology of diving injuries as well as the acute treatment, and further management of these patients.
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Affiliation(s)
- Paul D Hess
- Moncreif Army Community Hospital, Fort Jackson, SC, USA
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Abbott AV. Selected Injuries. Fam Med 2003. [DOI: 10.1007/978-0-387-21744-4_50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
During the past 20 yrs, as burn care has evolved as a specialty of surgery, survival and outcome quality have soared. Public expectations for survival and long-term outcomes are at previously unprecedented levels. These changes are the result of a number of advances in aspects of burn care that have occurred in parallel and have fostered increasing regionalization of this resource-intensive activity into fewer specialized centers. These are complex hospitalizations and can be divided into four phases: initial evaluation and resuscitation, initial wound excision and biological closure, definitive wound closure, and rehabilitation and reconstruction.
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Affiliation(s)
- Robert L Sheridan
- Burn Surgery Service, Shriners Burns Hospital, Sumner Redstone Burn Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Augoustides J, Mancini DJ, Marchilinski F. An unusual cause of intraoperative confusion in the electrophysiology laboratory. J Cardiothorac Vasc Anesth 2002; 16:351-3. [PMID: 12073210 DOI: 10.1053/jcan.2002.124147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- John Augoustides
- Departments of Anesthesiology and Cardiology, University of Pennsylvania Medical School, Philadelphia, PA 19104-4283, USA.
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Abstract
BACKGROUND Neurologists may be consulted to diagnose and treat the severe neurologic injuries that can occur in divers with decompression illness (DCI). REVIEW SUMMARY Subclinical bubbles form during normal diving activity. DCI, a diffuse and multifocal process, results when bubbles cause symptoms by exerting mass effect in tissues, or obstructing venous or arterial flow. The lower thoracic spinal cord is a commonly affected area of the central nervous system. The most commonly described form of brain DCI is cerebral arterial gas embolism with middle cerebral artery or vertebrobasilar distribution involvement. Bubbles exert secondary damage to the vascular endothelium, causing activation of numerous biochemical cascades. CONCLUSIONS Divers can develop DCI on very short dives or in shallow water, even when adhering to protocols. DCI should be strongly considered when divers experience pain after diving. Any neurologic symptoms after a dive are abnormal and should be attributed to DCI. Even doubtful cases should be treated immediately with hyperbaric oxygen (HBO), after a chest x-ray to rule out pneumothorax. The Divers Alert Network should be contacted for emergency consultation. Delay to treatment can worsen outcome; however, the overwhelming majority of divers respond to HBO even days to weeks after injury. Although DCI is a clinical diagnosis, magnetic resonance imaging, somatosensory evoked potentials, single-photon emission tomography, and neuropsychologic testing help to document disease and monitor response to therapy. Divers should be treated with HBO until they reach a clinical plateau. Complete relief of symptoms occurs in 50% to 70% of divers; 30% have partial relief.
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Abstract
Even if scuba diving is not a local enthusiasm, someone with life-threatening dive-related problems could turn up in the emergency department at any time. This article describes how to respond.
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Dillard TA, Ewald FW. The use of pulmonary function testing in piloting, air travel, mountain climbing, and diving. Clin Chest Med 2001; 22:795-816, x. [PMID: 11787666 DOI: 10.1016/s0272-5231(05)70067-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Millions of people engage in occupational or leisure activities at high altitude or at variable depths below sea level. This article presents an overview of the utility of pulmonary function testing in evaluating complications and other consequences of exposure to high and low pressure environments. The authors review recent literature concerning expected changes in pulmonary function with hyperbaric and hypobaric exposures. The article provides guidance for clinicians evaluating mountain climbers, pilots, aircrew members, airline passengers and deep sea divers.
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Affiliation(s)
- T A Dillard
- Medical College of Georgia and the Veteran's Administration Medical Center, Augusta, USA
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