Selected scientific publications on diving medicine and physiology.
2004 Jan 1
The Fractal approach as a tool to understand asymptomatic brain hyperintense MRI signals
Balestra C., Germonprè P., Marroni A., Farkas B., Peetrons P., Vanderschueren F., Duboc E., Snoeck T.
The prevalence of a Patent Foramen Ovale is described in merely 30% of the asymptomatic population. This patency has been shown to be an increasing risk factor for paradoxical cerebral embolization. Some desaturation or decompression situations in human activities such as scuba diving or altitude flight are prone to provoke embolisations.
Intrathoracic pressure changes after Valsalva strain and other maneuvers: implications for divers with patent foramen ovale
Balestra C., Germonpré P., Marroni A.
Scuba divers with patent foramen ovale (PFO) may be at risk for paradoxical nitrogen gas emboli when performing maneuvers that cause a rebound blood loading to the right atrium. We measured the rise and fall in intrathoracic pressure (ITP) during various maneuvers in 15 divers. The tests were standard isometric exercises (control), forceful coughing, knee bend (with and without respiration blocked), and Valsalva maneuver (maximal, gradually increased to reach control ITP, and as performed by divers to equalize middle ear pressure). All the maneuvers, as well as the downward slope of ITP at the release phase, were related to the control value.
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.
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