Selected scientific publications on diving medicine and physiology.

2009 Jan 1
Discussion: Diving Researcher Recruitment
Molvaer O.I., Gennser M., Brubakk A., Ellingsen O., Gardiner B., Hope A., Moon R., Richardson R., Dujic Z., Doolette D., Perdrizet G., Lindholm P., Ross J., Eftedal O., Angelini S., Kayar S., Gutvik C., Gaustad S., Thorsen E., Balestra C., Jacobsen J.E., Pontier J., Fahlman A., Mollerlokken A., Skjerven L., Masoy S., Knaus D, Buckey J., Blatteau J., Arnfinsen A., Havnes M.

This publication of the proceedings of “The Future of Diving: 100 Years of Haldane and Beyond” is co-sponsored by the Smithsonian Institution and Trondheim University. The symposium was convened by the Baromedical and Environmental Physiology Group of the Norwegian University of Science and Technology in Trondheim, Norway, on 18–19 December 2008.

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2007 Nov 30
Effect of varying deep stop times and shallow stop times on precordial bubbles after dives to 25 msw (82 fsw)
Bennett PB1, Marroni A, Cronje FJ, Cali-Corleo R, Germonpre P, Pieri M, Bonuccelli C, Leonardi MG, Balestra C.

In our previous research, a deep 5-min stop at 15 msw (50 fsw), in addition to the typical 3-5 min shallow stop, significantly reduced precordial Doppler detectable bubbles (PDDB) and "fast" tissue compartment gas tensions during decompression from a 25 msw (82 fsw) dive; the optimal ascent rate was 10 msw (30 fsw/min). Since publication of these results, several recreational diving agencies have recommended empirical stop times shorter than the 5 min stops that we used, stops of as little as 1 min (deep) and 2 min (shallow). In our present study, we clarified the optimal time for stops by measuring PDDB with several combinations of deep and shallow stop times following single and repetitive open-water dives to 25 msw (82 fsw) for 25 mins and 20 minutes respectively; ascent rate was 10 msw/min (33 fsw). Among 15 profiles, stop time ranged from 1 to 10 min for both the deep stops (15 msw/50 fsw) and the shallow stops (6 msw/20 fsw). Dives with 2 1/2 min deep stops yielded the lowest PDDB scores--shorter or longer deep stops were less effective in reducing PDDB. The results confirm that a deep stop of 1 min is too short--it produced the highest PDDB scores of all the dives. We also evaluated shallow stop times of 5, 4, 3, 2 and 1 min while keeping a fixed time of 2.5 min for the deep stop; increased times up to 10 min at the shallow stop did not further reduce PDDB. While our findings cannot be extrapolated beyond these dive profiles without further study, we recommend a deep stop of at least 2 1/2 mins at 15 msw (50 fsw) in addition to the customary 6 msw (20 fsw) for 3-5 mins for 25 meter dives of 20 to 25 minutes to reduce PDDB.

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2005 Apr 4
Evidence for increasing patency of the foramen ovale in divers
Germonpre P, Hastir F, Dendale P, Marroni A, Nguyen AF, Balestra C.

Using a standardized contrast-enhanced transesophageal echocardiographic technique, a group of divers was reexamined for the presence and size of patent foramen ovale (PFO) 7 years after their initial examinations. Unexpected but significant increases in the prevalence and size of PFO were found, suggesting a possible increasing risk for decompression sickness in these divers over time.

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2005 Mar 6
Pulpal and periodontal temperature rise during KTP laser use as a root planing complement in vitro
Nammour, Rocca JP, Keiani K, Balestra C, Snoeck T, Powell L, Reck JV.

The purpose of this study was to define the optimal irradiation conditions of a KTP laser during root planing treatment. METHODS: The surfaces of 60 single-root human teeth were scaled with conventional instruments before lasing. The pulpal temperature increase was measured by means of one thermocouple placed in the pulp chamber and a second one placed on the root surface at 1 mm from the irradiation site. The influence of variables of coloration by Acid Red 52 (photosensitizer), scanning speed, dentin thickness, and probe position was analyzed for a constant exposure time of 15 sec and 500 mw (spot size diameter, 0.5 mm). The pulpal temperature was below 3 degrees C for the adjustments.

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2004 Jul 1
A deep stop during decompression from 82 fsw (25m) significantly reduces bubbles and fast tissue gas tensions
Marroni A., Bennett P.B., Cronjè F.J., Cali-Corleo R., Germonprè P., Pieri M., Bonuccelli C., Balestra C.

In spite of many modifications to decompression algorithms, the incidence of decompression sickness (DCS) in scuba divers has changed very little. The success of stage, compared to linear ascents, is well described yet theoretical changes in decompression ratios have diminished the importance of fast tissue gas tensions as critical for bubble generation. The most serious signs and symptoms of DCS involve the spinal cord, with a tissue half time of only 12.5 minutes. It is proposed that present decompression schedules do not permit sufficient gas elimination from such fast tissues, resulting in bubble formation. Further, it is hypothesized that introduction of a deep stop will significantly reduce fast tissue bubble formation and neurological DCS risk. A total of 181 dives were made to 82 fsw (25 m) by 22 volunteers. Two dives of 25 min and 20 min were made, with a 3 hr 30 min surface interval and according to 8 different ascent protocols. Ascent rates of 10, 33 or 60 fsw/min (3, 10, 18 m/min) were combined with no stops or a shallow stop at 20 fsw (6 m) or a deep stop at 50 fsw (15 m) and a shallow at 20 fsw (6 m). The highest bubbles scores (8.78/9.97), using the Spencer Scale (SS) and Extended Spencer Scale (ESS) respectively, were with the slowest ascent rate. This also showed the highest 5 min and 10 min tissue loads of 48% and 75%. The lowest bubble scores (1.79/2.50) were with an ascent rate of 33 fsw (10 m/min) and stops for 5 min at 50 fsw (15 m) and 20 fsw (6 m). This also showed the lowest 5 and 10 min tissue loads at 25% and 52% respectively. Thus, introduction of a deep stop significantly reduced Doppler detected bubbles together with tissue gas tensions in the 5 and 10 min tissues, which has implications for reducing the incidence of neurological DCS in divers.

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