Selected scientific publications on diving medicine and physiology.

2017 Sep 19
Dive Risk Factors, gas bubble formation, and decompression illness in recreational SCUBA diving: Analysis of DAN Europe DSL Data Base
Cialoni D, Pieri M, Balestra C & Marroni A.

Introduction: The popularity of SCUBA diving is steadily increasing together with the number of dives and correlated diseases per year. The rules that govern correct decompression procedures are considered well known even if the majority of Decompression Sickness (DCS) cases are considered unexpected confirming a bias in the "mathematical ability" to predict DCS by the current algorithms. Furthermore, little is still known about diving risk factors and any individual predisposition to DCS. This study provides an in-depth epidemiological analysis of the diving community, to include additional risk factors correlated with the development of circulating bubbles and DCS.

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2017 Apr 1
Diving deeper into SCUBA Science
Balestra C.

The editors of and authors of this book are a cadre of scientists and physicians with broad experience and knowledge of diving physiology and decompression theory. As is often the case, it requires a group effort to succeed in advancing practical knowledge. The colloquialism "the whole is greater than the sum of its parts" is often true and the PHYPODE Reasearch Group epitomizes this concept. By logically grouping the various elements of diving science and medicine with provocative "food for thought" sections, the text offers valuable lessons to those interested in the current state of diving. Despite nearly 170 years of reasearch, the fundamenal nature of decompression stress remains elusive. As is well outlined in this book, great advances have been made to the practical elements allowing for safe diving. Nonetheless, there are glaring voids of knowledge related to the nature of bubble nucleation, its consequences and methods to ameliorate risk. The synergy exhibited in this text not only provides a foundation for what is known, it offers a glimpse of where research is taking us. - Professor Stephen R. Thom, Dept. of Emergency Medicine, University of Maryland School of Medicine.

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2019 Oct 1
Diving physiopathology: the end of certainties? Food for thought
Balestra C, Germonpre P, Rocco M, Biancofiore G & Kot J.

Our understanding of decompression physiopathology has slowly improved during this last decade and some uncertainties have disappeared. A better understanding of anatomy and functional aspects of patent foramen ovale (PFO) have slowly resulted in a more liberal approach toward the medical fitness to dive for those bearing a PFO. Circulating vascular gas emboli (VGE) are considered the key actors in development of decompression sickness and can be considered as markers of decompression stress indicating induction of pathophysiological processes not necessarily leading to occurrence of disease symptoms.

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2019 Nov 27
Doppler ultrasound dataset for the development of automatic emboli detection algorithms
Paola Pierleoni, Marco Mercuri Alberto Belli, Massimo Pieri, Alessandro Marroni, Lorenzo Palma

The article describes a dataset of doppler ultrasound audio tracks taken on a sample of 30 divers according to the acquisition protocol defined by the Divers Alert Network. The audio tracks are accompanied by a medical evaluation for the decompression sickness risk according to the Spencer's scale levels. During the acquisition campaign, each diver in the post-dive phase was subjected to a double doppler ultrasound examination of approximately 45 seconds each one in the precordial area using a Huntleigh FD1 Fetal doppler probe. The two measurements were separated by a time of 8-10 seconds necessary for carrying out specific physical exercises designed to free the bubbles trapped in the tissues.

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2020 Apr 17
Early Endothelial Dysfunction in Type 1 Diabetes Is Accompanied by an Impairment of Vascular Smooth Muscle
Elodie Lespagnol, Luc Dauchet, Mehdi Pawlak-Chaouch, Costantino Balestra, Serge Berthoin, Martin Feelisch, Matthieu Roustit, Julien Boissière, Pierre Fontaine, Elsa Heyman

Background: A large yet heterogeneous body of literature exists suggesting that endothelial dysfunction appears early in type 1 diabetes, due to hyperglycemia-induced oxidative stress. The latter may also affect vascular smooth muscles (VSM) function, a layer albeit less frequently considered in that pathology. This meta-analysis aims at evaluating the extent, and the contributing risk factors, of early endothelial dysfunction, and of the possible concomitant VSM dysfunction, in type 1 diabetes. Methods: PubMed, Web of Sciences, Cochrane Library databases were screened from their respective inceptions until October 2019. We included studies comparing vasodilatory capacity depending or not on endothelium (i.e., endothelial function or VSM function, respectively) in patients with uncomplicated type 1 diabetes and healthy controls.

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