The latest medical research on Undersea & Hyperbaric Medicine
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about undersea & hyperbaric medicine gathered by our medical AI research bot.
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A diving physician's experience of dental barotrauma during hyperbaric chamber exposure: case report.Diving and Hyperbaric Medicine
Previous cases of dental barotrauma have been reported in pilots and divers. We report a case of dental barotrauma and barodontalgia in a diving ph...
A neoprene vest hastens dyspnoea and leg fatigue during exercise testing: entangled breathing and cardiac hindrance?Diving and Hyperbaric Medicine
Symptoms and contributing factors of immersion pulmonary oedema (IPO) are not observed during non-immersed heart and lung function assessments. We ...
Mortality rate during professionally guided scuba diving experiences for uncertified divers, 1992-2019.Diving and Hyperbaric Medicine
The aim of this study was to re-examine the mortality rate among participants in the Professional Association of Diving Instructors' (PADI)'s Discover Scuba Diving (DSD) programme.
Fatalities reported to PADI as having occurred during DSD scuba dives were counted for each year between 1992 and 2019. DSD participant registrations were also counted for each year. The data were conveniently divided into two equal 14-year periods, 1992-2005 ('early') and 2006-2019 ('late'). To smooth out the year-to-year variation in raw rates, Monte Carlo simulations were performed on the mean rate per 100,000 participants per year during each period.
There were a total of 7,118,731 DSD participant registrations and 79 fatalities during the study period. The estimated overall mean mortality rate in the early period was 2.55 per 100,000 DSD registrations whereas the estimated rate of 0.87 per 100,000 DSD registrations was significantly lower in the late period (P < 0.0001).
PADI's contemporary Discover Scuba Diving introductory scuba experiences, at 0.87 fatalities per 100,000 participants, have a calculated mortality rate that is less than half that calculated for 1992-2008. The late period's rate improvement appears due either to significant under-registration in the early period, or to significant safety-performance improvement in the late period or, more likely, some combination of the two.
Pulmonary barotrauma with cerebral arterial gas embolism from a depth of 0.75-1.2 metres of fresh water or less: A case report.Diving and Hyperbaric Medicine
During underwater vehicle escape training with compressed air, a fit 26-year-old soldier suffered pulmonary barotrauma with cerebral arterial gas e...
An insight to tympanic membrane perforation pressure through morphometry: A cadaver study.Diving and Hyperbaric Medicine
A cadaveric experimental investigation aimed to show the rupture pressure of the tympanic membrane (TM) for otologists to evaluate its tensile strength.
Twenty adult ears in 10 fresh frozen whole cadaveric heads (four males, six females) mean age 72.8 (SD 13.8) years (range 40-86) were studied. The tensile strength of the TM was evaluated with bursting pressure of the membrane. The dimensions of the membranes and perforations were measured with digital imaging software.
The mean bursting pressure of the TM was 97.71 (SD 36.20) kPa. The mean area, vertical and horizontal diameters of the TM were 57.46 (16.23) mm2, 9.54 (1.27) mm, 7.99 (1.08) mm respectively. The mean area, length and width of the perforations were 0.55 (0.25) mm2, 1.37 (0.50) mm, and 0.52 (0.22) mm, respectively. Comparisons of TM dimension, bursting pressure, and perforation size by laterality and gender showed no significant differences. The bursting pressure did not correlate (positively or negatively) with the TM or perforation sizes.
The TM can rupture during activities such as freediving or scuba diving, potentially leading to serious problems including brain injuries. Studying such events via cadaveric studies and data from case studies is of fundamental importance. The minimum experimental bursting pressures might better be taken into consideration rather than average values as the danger threshold for prevention of TM damage (and complications thereof) by barotrauma.
Assessment of insulin sensitivity during hyperbaric oxygen treatment.Diving and Hyperbaric Medicine
Previous studies using a hyperinsulinaemic, euglycaemic glucose clamp have demonstrated an increase in peripheral insulin sensitivity in men with and without Type-2 diabetes mellitus on the third and thirtieth hyperbaric oxygen treatment (HBOT) session. In two studies using different techniques for assessment of insulin sensitivity, we investigated the onset and duration of this insulin-sensitising effect of HBOT.
Men who were obese or overweight but without diabetes were recruited. One study performed a hyperinsulinaemic euglycaemic glucose clamp (80 mU.m-2.min-1) at baseline and during the first HBOT exposure (n = 9) at a pressure of 203 kPa. Data were analysed by paired t-test. The other study assessed insulin sensitivity by a frequently sampled intravenous glucose tolerance test (FSIGT) at three time points: baseline, during the third HBOT and 24-hours post-HBOT (n = 9). Results were analysed by repeated-measures ANOVA.
There was a significant 23% increase in insulin sensitivity by clamp measured during the first HBOT exposure. The FSIGT showed no significant changes in insulin sensitivity.
The hyperinsulinaemic, euglycaemic glucose clamp demonstrated a significant increase in peripheral insulin sensitivity during a single, 2-hour HBOT session in a group of men who were obese or overweight but without diabetes. As an alternate technique for assessing insulin sensitivity during HBOT, the FSIGT failed to show any changes during the third HBOT and 24-hours later, however modification of the study protocol should be considered.
Sudden death after oxygen toxicity seizure during hyperbaric oxygen treatment: Case report.Diving and Hyperbaric Medicine
Acute cerebral oxygen toxicity (ACOT) is a known side effect of hyperbaric oxygen treatment (HBOT), which can cause generalised seizures. Fortunate...
Symptoms of central nervous system oxygen toxicity during 100% oxygen breathing at normobaric pressure with increasing inspired levels of carbon dioxide: a case report.Diving and Hyperbaric Medicine
The greatest danger faced by divers who use oxygen-enriched gas mixtures is central nervous system oxygen toxicity (CNS-OT). CNS-OT is characterise...
The myopic shift associated with hyperbaric oxygen administration is reduced when using a mask delivery system compared to a hood - a randomised controlled trial.Diving and Hyperbaric Medicine
A temporary myopic shift is a well-recognized complication of hyperbaric oxygen treatment (HBOT). Oxidation of proteins in the crystalline lens is the likely cause. Direct exposure of the eye to hyperbaric oxygen may exacerbate the effect. Our aim was to measure the magnitude of the myopic shift over a course of HBOT when using two different methods of oxygen delivery.
We conducted a randomised trial of oxygen delivery via hood versus oronasal mask during a course of 20 and 30 HBOT sessions. Subjective refraction was performed at baseline and after 20 and 30 sessions. We repeated these measurements at four and 12 weeks after completion of the course in those available for assessment.
We enrolled 120 patients (mean age 57.6 (SD 11.2) years; 81% male). The myopic shift was significantly greater after both 20 and 30 sessions in those patients using the hood. At 20 treatments: refractory change was -0.92 D with hood versus -0.52 D with mask, difference 0.40 D (95% CI 0.22 to 0.57, P < 0.0001); at 30 treatments: -1.25 D with hood versus -0.63 with mask, difference 0.62 D (95% CI 0.39 to 0.84, P < 0.0001). Recovery was slower and less complete in the hood group at both four and 12 weeks.
Myopic shift is common following HBOT and more pronounced using a hood system than an oronasal mask. Recovery may be slower and less complete using a hood. Our data support the use of an oronasal mask in an air environment when possible.
A case of Löfgren's syndrome confused with decompression sickness.Diving and Hyperbaric Medicine
A broad differential diagnosis is important to provide appropriate care. This may be challenging for conditions like decompression sickness (DCS) w...
A case report of cerebral arterial gas embolism (CAGE) associated with Takotsubo cardiomyopathy.Diving and Hyperbaric Medicine
A 43-year-old female scuba diver was retrieved and treated following a rapid ascent and presumed cerebral arterial gas embolism (CAGE). She subsequ...
Cerebral arterial gas embolism in a scuba diver with a primary lung bulla.Diving and Hyperbaric Medicine
Primary lung bullae have been reported to cause pulmonary barotrauma and lead to cerebral arterial gas embolism (CAGE) in the context of diving; ho...