Selected scientific publications on diving medicine and physiology.
2018 Aug 1
European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism
Pristipino C, Sievert H, D'Ascenzo F, Mas JL, Meier B, Scacciatella P, Hildick-Smith D, Gaita F, Toni D, Kyrle P, Thomson J, Derumeaux G, Onorato E, Sibbing D, Germonpre P, Berti S, Chessa M, Bedogni F, Dudek D, Hornung M, Zamorano J, European Association of Percutaneous Cardiovascular I, European Stroke O, European Heart Rhythm A, European Association for Cardiovascular I, Association for European P, Congenital C, GUCH ESCWgo, Thrombosis ESCWgo & European Haematological S.
The presence of a patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions; however, the subject remains controversial and no official statements have been published. This interdisciplinary paper, prepared with involvement of eight European scientific societies, aims to review the available trial evidence and to define the principles needed to guide decision making in patients with PFO. In order to guarantee a strict process, position statements were developed with the use of a modified grading of recommendations assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio.
Variability in circulating gas emboli after a same scuba diving exposure
Papadopoulou V., Germonpré P., Cosgrove D., Eckersley RJ., Dayton PA., Obeid G., Boutros A., Tang MX., Theunissen S., Balestra C.
A reduction in ambient pressure or decompression from scuba diving can result in ultrasound-detectable venous gas emboli (VGE). These environmental exposures carry a risk of decompression sickness (DCS) which is mitigated by adherence to decompression schedules; however, bubbles are routinely observed for dives well within these limits and significant inter-personal variability in DCS risk exists. Here, we assess the variability and evolution of VGE for 2 h post-dive using echocardiography, following a standardized pool dive in calm warm conditions.
Spirometry and oxidative stress after rebreather diving in warm water
Bosco G., Rizzato A., Quartesan S., Camporesi E., Mrakic-Sposta S., Moretti S., Balestra C., Rubini A.
Hyperbaric oxygen (HBO₂) therapy and use of enriched air can result in oxidative injury affecting the brain, lungs and eyes. HBO₂ exposure during diving can lead to a decrease in respiratory parameters. However, the possible effects of acute exposure to oxygen-enriched diving on subsequent spirometric performance and oxidative state in humans have not been recently described recently. We aim to investigate possible effects of acute (i) hyperbaric and (ii) hyperbaric hyperoxic exposure using scuba or closed-circuit rebreather (CCR) on subsequent spirometry and to assess the role of oxidative state after hyperoxic diving.
Cellular Glucose Uptake During Breath-Hold Diving in Experienced Male Breath-Hold Divers
Sponsiello N., Cialoni D., Pieri M., Marroni A.
Background: The physiological and pathophysiological mechanisms that govern diving, both self-contained underwater breathing apparatus (SCUBA) and breath-hold diving (BH-diving), are in large part well known, even if there are still many unknown aspects, in particular about cell metabolism during BH-diving.
The scope of this study was to investigate changes in glycemia, insulinemia, and the catecholamine response to BH-diving, to better understand if the insulin-stimulated glucose uptake mechanism is involved in cellular metabolism in this sport.
Methods: Twenty male experienced healthy breath-hold divers were studied. Anthropometric information was obtained. Glycemia, insulinemia, and catecholamine response were investigated before and after the series of BH-diving.
Echocardiography is able to detect morphological and functional changes of the right heart in sport Scuba Divers
Pudil R, Horakova L, Rozloznik M & Balestra C.
Introduction: Scuba diving represents stressful event for cardiovascular system. Breathing with compressed air, hyperbaric environment and microbubbles formation are the main factors are the most influencing factors for pulmonary circulation.
Hypothesis: The aim of the study was to evaluate the change in morphology and function of the right heart after scuba dive with compressed air.
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