Publicaciones
Publicaciones científicas seleccionadas, sobre medicina y fisiología del buceo
2020 sep 30
Endothelial function may be enhanced in the cutaneous microcirculation after a single air dive
François Guerrero, Kate Lambrechts, Qiong Wang, Aleksandra Mazur, Michael Théron, Alessandro Marroni

ntroduction: The effects of scuba diving on the vessel wall have been studied mainly at the level of large conduit arteries. Data regarding the microcirculation are scarce and indicate that these two vascular beds are affected differently by diving. Methods: We assessed the changes in cutaneous microcirculation before an air scuba dive, then 30 min and 24 h after surfacing. Endothelium-dependent and independent vasomotion were successively elicited by iontophoretic administration of acetylcholine and sodium nitroprusside respectively, and cutaneous blood flux was monitored by laser Doppler flowmetry.

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2021 jul 9
Endothelial Nitric Oxide Production and Antioxidant Response in Breath-Hold Diving: Genetic Predisposition or Environment Related?
Cialoni D, Brizzolari A, Samaja M, Bosco G, Paganini M, Sponsiello N, Lancellotti V & Marroni A.

Introduction: Nitric oxide (NO) is an essential signaling molecule modulating the endothelial adaptation during breath-hold diving (BH-diving). This study aimed to investigate changes in NO derivatives (NOx) and total antioxidant capacity (TAC), searching for correlations with different environmental and hyperbaric exposure. Materials and methods: Blood samples were obtained from 50 breath-hold divers (BH-divers) before, and 30 and 60 min after the end of training sessions performed both in a swimming pool or the sea. Samples were tested for NOx and TAC differences in different groups related to their hyperbaric exposure, experience, and additional genetic polymorphism.

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2017 feb 23
Environment-induced pulmonary oedema in healthy individuals
Marabotti C., Cialoni D., Pingitore A.

Infrequently, healthy individuals can develop acute pulmonary oedema when exposed to an extreme or unusual environment (ie, deep dives or high altitudes), especially during physical exertion. High-altitude pulmonary oedema (HAPO) has been reported in 0·5–7·0% of individuals who climb to altitudes higher than 4000 m (according to ascent speed), whereas swimming-induced pulmonary oedema (SIPO) has been reported in a different proportion of individuals engaged in aquatic activities.

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2013 oct 10
EPO modulation in a 14-days undersea scuba dive
Revelli L, Vagnoni S, D'Amore A, Di Stasio E, Lombardi CP, Storti G, Proietti R, Balestra C, Ricerca BM

Erythropoiesis is affected during deep saturation dives. The mechanism should be related to a downregulation of serum Erythropoietin (s-EPO) concentration or to a toxic effect of the hyperbaric hyperoxia. We evaluated s-EPO and other haematological parameters in 6 scuba divers before, during and after a 14-days guinness saturation dive (8-10 m). Athletes were breathing air at 1.8-2 ATA, under the control of a team of physicians. Serum parameters were measured before diving (T0) and: 7 days (T1), 14 days (T2) after the beginning of the dive and 2 h (T3) and 24 h (T4) after resurfacing. Hgb, and many other haematological parameters did not change whereas Ht, s-EPO, the ratio between s-EPO predicted and that observed and reticulocytes (absolute, percent) declined progressively from T0 to T3. At T4 a significant rise in s-EPO was observed. Hgb did not vary but erythropoiesis seemed to be affected as s-EPO and reticulocyte counts showed. All these changes were statistically significant. The experiment, conducted in realistic conditions of dive length, oxygen concentration and pressure, allows us to formulate some hypotheses about the role of prolonged hyperbarism on erythropoiesis. The s-EPO rise, 24 h after resurfacing, is clearly documented and related to the "Normobaric Oxygen Paradox". This evidence suggests interesting hypotheses for new clinical applications such as modulation of s-EPO production and Hgb content triggered by appropriate O₂ administration in pre-surgical patients or in some anemic disease.

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2018 ago 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.

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