Selected scientific publications on diving medicine and physiology.
1996 Jan 1
Cost Benefit and Cost-Efficiency Evaluation of Hyperbaric Oxygen Therapy
Marroni A, Oriani G, Wattel F.
Hyperbaric oxygen therapy, apart from some acute and very specialized indications regarding the treatment of decompression disorders and arterial air/gas embolism, is generally aimed at treating serious and complex disorders, generally reluctant to standard treatment and requires prolonged and reiterated hospitalization/rehabilitation periods as well as elevated technical, social and human costs.
The clinical application of Hyperbaric Oxygen Therapy (HBOT), although based on sound physiological principles as well as on a logical rationale, has often been characterized by empirical procedures, and the choice of the treatment schedules has been more fortuitous than rational. The indication for HBOT and the treatment protocol are originated by the general and often acritical assumption that a given lesion or malfunction is caused, facilitated or worsened by hypoxia. Furthermore, the increasingly common use of multiplace hyperbaric chambers, where many patients can be treated at the same time, although maximizing the cost benefit ration of HBOT and the performance of the chamber technical and nursing personnel justified the commonly adopted routine of using average treatment pressures and schedules without considering the differences between indications, patients, disease conditions and the evolving physiopathological stages of the healing process in the individual patients. As a consequence, it is quite frequent to witness the very strange paradox that a treatment based on extremely solid physiological grounds is often applied empirically and nonrationally.
Acupuncture effect on thermal tolerance and electrical pain threshold: a randomised controlled trial
Amand M, Nguyen-Huu F, Balestra C.
OBJECTIVE: The aim of this study was to test whether acupuncture could modify the threshold of tolerance to thermal and electrical stimuli.
METHODS: A randomised placebo-controlled single-blind trial was conducted in 36 healthy volunteers randomly distributed to control (no treatment), conventional acupuncture and sham acupuncture groups. The subjects were blind to the group allocation. The authors measured before and after treatment the pain threshold with the Painmatcher (Cefar Medical AB, Lund, Sweden) and the cold tolerance with the cold pressor test, together with the Visual Analogue Scale pain score.
Correlation between Patent Foramen Ovale, Cerebral "Lesions" and Neuropsychometric Testing in Experienced Sports Divers: Does Diving Damage the Brain?
Balestra C, Germonpré P.
SCUBA diving exposes divers to decompression sickness (DCS). There has been considerable debate whether divers with a Patent Foramen Ovale of the heart have a higher risk of DCS because of the possible right-to-left shunt of venous decompression bubbles into the arterial circulation. Symptomatic neurological DCS has been shown to cause permanent damage to brain and spinal cord tissue; it has been suggested that divers with PFO may be at higher risk of developing subclinical brain lesions because of repeated asymptomatic embolization of decompression-induced nitrogen bubbles...
Prevalence of acute respiratory symptoms in breath-hold divers
Cialoni D, Sponsiello N, Marabotti C, Marroni A, Pieri M, Maggiorelli F, Tonerini M, Frammartino B.
INTRODUCTION: After repetitive deep dives, breath-hold divers are often affected by a syndrome characterized by typical symptoms such as cough, sensation of chest constriction, blood-striated expectorate (hemoptysis) and, rarely, an overt acute pulmonary edema syndrome, often together with various degrees of dyspnea. The aim of this work is an epidemiological investigation to evaluate the prevalence of acute respiratory symptoms (ARS) in breath-hold divers (BHDs) in practicing breath-hold diving.
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