Selected scientific publications on diving medicine and physiology.

2014 Mar 1
Association of digital vascular function with cardiovascular risk factors: a population study.
Kuznetsova T, Van Vlierberghe E, Knez J, Szczesny G, Thijs L, Jozeau D, Balestra C, D'hooge J, Staessen JA.

OBJECTIVES: Vasodilation of the peripheral arteries during reactive hyperaemia depends in part on release of nitric oxide from endothelial cells. Previous studies mainly employed a fingertip tonometric device to derive pulse wave amplitude (PWA) and PWA hyperaemic changes. An alternative approach is based on photoplethysmography (PPG). We sought to evaluate the correlates of digital PPG PWA hyperaemic responses as a measure of peripheral vascular function...

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2014 Mar 1
The use of portable 2D echocardiography and 'frame-based' bubble counting as a tool to evaluate diving decompression stress
Germonpré P, Papadopoulou V, Hemelryck W, Obeid G, Lafère P, Eckersley RJ, Tang MX, Balestra C.

INTRODUCTION: 'Decompression stress' is commonly evaluated by scoring circulating bubble numbers post dive using Doppler or cardiac echography. This information may be used to develop safer decompression algorithms, assuming that the lower the numbers of venous gas emboli (VGE) observed post dive, the lower the statistical risk of decompression sickness (DCS). Current echocardiographic evaluation of VGE, using the Eftedal and Brubakk method, has some disadvantages as it is less well suited for large-scale evaluation of recreational diving profiles. We propose and validate a new 'frame-based' VGE-counting method which offers a continuous scale of measurement...

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2014 Oct 1
Flying after diving: in-flight echocardiography after a scuba diving week
Cialoni D, Pieri M, Balestra C, Marroni A.

INTRODUCTION: Flying after diving may increase decompression sickness risk (DCS), but strong evidence indicating minimum preflight surface intervals (PFSI) is missing. METHODS: On return flights after a diving week on a live-aboard, 32 divers were examined by in-flight echocardiography with the following protocol: 1) outgoing flight, no previous dive; 2) during the diving week; 3) before the return flight after a 24-h PFSI; and 4) during the return flight. RESULTS: All divers completed similar multiple repetitive dives during the diving week. All dives were equivalent as to inert gas load and gradient factor upon surfacing. No bubbles in the right heart were found in any diver during the outgoing flight or at the preflight control after a 24-h PFSI following the diving week. A significant increase in the number and grade of bubbles was observed during the return flight. However, bubbles were only observed in 6 of the 32 divers. These six divers were the same ones who developed bubbles after every dive. CONCLUSIONS: Having observed a 24-h preflight interval, the majority of divers did not develop bubbles during altitude exposure; however, it is intriguing to note that the same subjects who developed significant amounts of bubbles after every dive showed equally significant bubble grades during in-flight echocardiography notwithstanding a correct PFSI. This indicates a possible higher susceptibility to bubble formation in certain individuals, who may need longer PFSI before altitude exposure after scuba diving.

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2014 Dec 1
A ternary model of decompression sickness in rats
Buzzacott P, Lambrechts K, Mazur A, Wang Q, Papadopoulou V, Theron M, Balestra C, Guerrero F.

Decompression sickness (DCS) in rats is commonly modelled as a binary outcome. The present study aimed to develop a ternary model of predicting probability of DCS in rats, (as no-DCS, survivable-DCS or death), based upon the compression/decompression profile and physiological characteristics of each rat...

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2016 May 15
Continuous real-time monitoring and recording of glycemia during scuba diving: pilot study
Pieri M, Cialoni D, Marroni A.

Insulin-dependent diabetes has been considered a scuba diving contraindication. This is currently being reconsidered for well-controlled diabetes. We developed a real-time continuous glucose monitor (CGM) to check glycemia, or blood glucose (BG), during diving, both for prospective studies and to increase diabetic diver safety, allowing for real-time control of glycemia and hypoglycemia prevention. To ensure CGM measurement accuracy we tested the method under hyperbaric conditions...

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