Diving and hyperbaric medicine最新文献

Five consecutive cases of sensorineural hearing loss associated with inner ear barotrauma due to diving, successfully treated with hyperbaric oxygen.

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-12-20 DOI: 10.28920/dhm54.4.360-367

David Smart

{"title":"Five consecutive cases of sensorineural hearing loss associated with inner ear barotrauma due to diving, successfully treated with hyperbaric oxygen.","authors":"David Smart","doi":"10.28920/dhm54.4.360-367","DOIUrl":"10.28920/dhm54.4.360-367","url":null,"abstract":"Introduction: This report describes the outcomes of sensorineural hearing loss (SNHL) due to cochlear inner ear barotrauma (IEBt) in five divers treated with hyperbaric oxygen (HBOT).Methods: The case histories of five consecutive divers presenting with SNHL from IEBt due to diving, were reviewed. All divers provided written consent for their data to be included in the study. All had reference pre-injury audiograms. All noted ear problems during or post-dive. Independent audiologists confirmed SNHL in all divers prior to HBOT, then assessed outcomes after HBOT.Results: Three divers breathed compressed air on low risk dives, and two were breath-hold. None had symptoms or signs other than hearing loss, and none had vestibular symptoms. All could equalise their middle ears. Inner ear decompression sickness was considered unlikely for all cases. All were treated with HBOT 24 hours to 12 days after diving. Two divers received no steroid treatment, one was treated with HBOT after an unsuccessful 10-day course of steroids, and two divers received steroids two days after commencing HBOT. All divers responded positively to HBOT with substantial improvements in hearing across multiple frequencies and PTA4 measurements. Median improvement across all frequencies (for all divers) was 28 dB, and for PTA4 it was 38 dB.Conclusions: This is the first case series describing use of HBOT for IEBt-induced SNHL. The variable treatment latency and use/timing of steroids affects data quality, but also reflects pragmatic reality, where steroids have minimal evidence of benefit for IEBt. HBOT may benefit diving related SNHL from IEBt with no evidence of perilymph fistula, and provided the divers can clear their ears effectively. A plausible mechanism is via correction of ischaemia within the cochlear apparatus. More study is required including data collection via national or international datasets, due to the rarity of IEBt.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"360-367"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Economic analysis of hyperbaric oxygen therapy for the treatment of ischaemic diabetic foot ulcers. 高压氧疗法治疗缺血性糖尿病足溃疡的经济分析。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-12-20 DOI: 10.28920/dhm54.4.265-274

Robin J Brouwer, Nick S van Reijen, Marcel G Dijkgraaf, Rigo Hoencamp, Mark Jw Koelemay, Robert A van Hulst, Dirk T Ubbink

{"title":"Economic analysis of hyperbaric oxygen therapy for the treatment of ischaemic diabetic foot ulcers.","authors":"Robin J Brouwer, Nick S van Reijen, Marcel G Dijkgraaf, Rigo Hoencamp, Mark Jw Koelemay, Robert A van Hulst, Dirk T Ubbink","doi":"10.28920/dhm54.4.265-274","DOIUrl":"10.28920/dhm54.4.265-274","url":null,"abstract":"Introduction: The aim was to determine the cost-effectiveness and cost-utility of additional hyperbaric oxygen therapy (HBOT) compared to standard care (SC) for ischaemic diabetic foot ulcers (DFUs) regarding limb salvage and health status.Methods: An economic analysis was conducted, comprising cost-effectiveness and cost-utility analyses, with a 12-month time horizon, using data from the DAMO₂CLES multicentre randomised clinical trial. Cost-effectiveness was defined as cost per limb saved and cost-utility as cost per quality-adjusted life year (QALY). The difference in cost effectiveness between HBOT+SC and SC alone was determined via an incremental cost-effectiveness ratio (ICER).Results: One-hundred and twenty patients were included, with 60 allocated to HBOT+SC and 60 to SC. No significant cost difference was found in the intention-to-treat analysis: €3,791 (bias corrected and accelerated [BCA] 95% CI, €3,556 - €-11,138). Cost per limb saved showed an ICER of €37,912 (BCA 95% CI €-112,188 - €1,063,561) for HBOT+SC vs. SC. There was no significant difference in mean QALYs: 0.54 for HBOT+SC vs. 0.56 for SC alone (-0.02; BCA 95% CI -0.11-0.08). This resulted in a cost-utility of minus €227,035 (BCA 95% CI €-361,569,550 - €-52,588) per QALY. Subgroup analysis for Wagner stages III/IV showed an ICER of €19,005 (BCA 95%CI, -€18,487 - €264,334) while HBOT did not show any benefit for Wagner stage II.Conclusions: HBOT as an adjunct to SC showed no significant differences in costs and effectiveness for patients with DFUs regarding limb salvage and health status. However, for patients with Wagner stage III/IV ischaemic DFUs there was a trend towards better effectiveness and cost-effectiveness.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"265-274"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Joint position statement on immersion pulmonary oedema and diving from the South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Diving Medical Committee (UKDMC) 2024.

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-12-20 DOI: 10.28920/dhm54.4.344-349

Neil Banham, David Smart, Peter Wilmshurst, Simon J Mitchell, Mark S Turner, Philip Bryson

{"title":"Joint position statement on immersion pulmonary oedema and diving from the South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Diving Medical Committee (UKDMC) 2024.","authors":"Neil Banham, David Smart, Peter Wilmshurst, Simon J Mitchell, Mark S Turner, Philip Bryson","doi":"10.28920/dhm54.4.344-349","DOIUrl":"10.28920/dhm54.4.344-349","url":null,"abstract":"This joint position statement (JPS) on immersion pulmonary oedema (IPO) and diving is the product of a workshop held at the 52nd Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) from 12-17 May 2024, and consultation with the United Kingdom Diving Medical Committee (UKDMC), three members of which attended the meeting. The JPS is a consensus of experts with relevant evidence cited where available. The statement reviews the nomenclature, pathophysiology, risk factors, clinical features, prehospital treatment, investigation of and the fitness for future compressed gas diving following an episode of IPO. Immersion pulmonary oedema is a life-threatening illness that requires emergency management as described in this statement. A diver with previous suspected or confirmed IPO should consult a medical practitioner experienced in diving medicine. The SPUMS and the UKDMC strongly advise against further compressed gas diving if an individual has experienced an episode of IPO.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"344-349"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of myopia in scuba diving and hyperbaric oxygen treatment: a case report and systematic review.

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-12-20 DOI: 10.28920/dhm54.4.328-337

Sofia A Sokolowski, Anne K Räisänen-Sokolowski, Richard V Lundell

{"title":"Development of myopia in scuba diving and hyperbaric oxygen treatment: a case report and systematic review.","authors":"Sofia A Sokolowski, Anne K Räisänen-Sokolowski, Richard V Lundell","doi":"10.28920/dhm54.4.328-337","DOIUrl":"10.28920/dhm54.4.328-337","url":null,"abstract":"Introduction: A 54-year-old, previously healthy Caucasian male diver was on a 22-day liveaboard diving holiday. During this time, he performed 75 open-circuit dives, of which 72 were with enriched air nitrox. All dives were within recreational length and depth. After the trip he noticed a worsening of vision and his refraction had changed from the previous -3.75/-5.75 to -5.5/-7.75 dioptres. Hyperoxic myopia is a well-known phenomenon after hyperbaric oxygen treatment (HBOT), but related literature in recreational divers is scarce.Methods: A systematic literature review on the effect of a hyperoxic environment on the development of myopia was done according to the PRISMA guidelines. Three databases were searched: Ovid MEDLINE, Scopus, and the Cochrane Library. A risk of bias analysis was done on all articles, and the GRADE approach was used to evaluate the quality of evidence. Articles that had sufficient data were used to synthesise a visualisation of oxygen exposure and changes in refraction.Results: Twenty-two articles were included in this review. These included five case reports, two case series, nine cohort studies, one randomised controlled trial and five reviews, of which one was systematic. Most articles described HBOT patients' ocular complications, although four articles were diver centric. The synthesis of results suggests that divers tend to get a greater myopic shift with a smaller exposure. However, the data were too heterogeneous to perform meaningful statistical analyses. This review is the first to focus on divers instead of HBOT patients.Conclusions: The case presented led to a systematic literature review on the effects of hyperbaric oxygen on refractive changes in both HBOT patients and divers. The data were too heterogeneous to make meaningful suggestions on a safety limit to prevent myopisation in diving.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"328-337"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

South Pacific Underwater Medicine Society (SPUMS) position statement regarding paediatric and adolescent diving.

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-12-20 DOI: 10.28920/dhm54.4.338-343

Elizabeth Elliott, David Smart, John Lippmann, Neil Banham, Matias Nochetto, Stephan Roehr

{"title":"South Pacific Underwater Medicine Society (SPUMS) position statement regarding paediatric and adolescent diving.","authors":"Elizabeth Elliott, David Smart, John Lippmann, Neil Banham, Matias Nochetto, Stephan Roehr","doi":"10.28920/dhm54.4.338-343","DOIUrl":"10.28920/dhm54.4.338-343","url":null,"abstract":"This paediatric diving position statement was developed from a targeted workshop at the 51st Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) on 8 June 2023. It highlights the factors that SPUMS regards as important when undertaking health risk assessments for diving by children and adolescents (defined as aged 10 to 15 years). Health risk assessments for diving should be performed by doctors who are trained in diving medicine and who are familiar with the specific risks which result from breathing compressed gas in the aquatic environment. Undertaking a diver health risk assessment of children and adolescents requires a detailed history (including medical, mental health, psychological maturity), a comprehensive diver medical physical examination and evaluation of all relevant investigations to exclude unacceptable risks. In addition, assessment of the individual's motivation to dive and reported in-water capability should occur, whilst engaging with their parent /guardian and instructor, where appropriate, to ensure that safety for the child is optimised. The guideline applies to all compressed air diving including scuba and surface supply diving provided in open and contained bodies of water.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"338-343"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of necrotising infection clinical composite endpoint in a retrospective cohort of patients with necrotising soft tissue infections. 在坏死性软组织感染患者回顾性队列中验证坏死性感染临床综合终点。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-09-30 DOI: 10.28920/dhm54.3.155-161

Victoria Bion, Dylan Jape, Rachel Niesen, Margaret Angliss, Frank Bruscino-Raiola, Biswadev Mitra, Bridget Devaney

{"title":"Validation of necrotising infection clinical composite endpoint in a retrospective cohort of patients with necrotising soft tissue infections.","authors":"Victoria Bion, Dylan Jape, Rachel Niesen, Margaret Angliss, Frank Bruscino-Raiola, Biswadev Mitra, Bridget Devaney","doi":"10.28920/dhm54.3.155-161","DOIUrl":"10.28920/dhm54.3.155-161","url":null,"abstract":"Introduction: Rapidly progressive necrotising soft tissue infections (NSTIs) are associated with high mortality and morbidity. Low incidence and disease heterogeneity contribute to low event rates and inadequately powered studies. The Necrotising Infections Clinical Composite Endpoint (NICCE) provides a binary outcome with which to assess interventions for NSTIs. Partly with a view towards studies of hyperbaric oxygen treatment in NSTIs we aimed to validate NICCE in a retrospective cohort of NSTI patients.Methods: Eligible patients were admitted between 2012 and 2021 to an adult major referral hospital in Victoria, Australia with surgically confirmed NSTI. The NICCE and its constituents were assessed in the whole cohort (n = 235). The cohort was divided into two groups using the modified sequential organ failure assessment (mSOFA) score, with an admission mSOFA score ≥ 3 defined as high acuity.Results: Baseline characteristics of the whole (n = 235), the high (n = 188) and the low acuity cohorts (n = 47) were similar. Survival rates were high (91.1%). Patients with an admission mSOFA ≥ 3 were less likely to meet NICCE criteria for 'success' compared to the lower acuity cohort (34.1% and 64.7% respectively). Meeting NICCE criteria was significantly associated with lower resource utilisation, measured by intensive care unit days, ventilator days, and hospital length of stay for all patients and for those with high acuity on presentation.Conclusions: The NICCE provides greater discriminative ability than mortality alone. It accurately selects patients at high risk of adverse outcomes, thereby enhancing feasibility of trials. Adaptation of NICCE to include patient-centred outcomes could strengthen its clinical relevance.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 3","pages":"155-161"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Errata: Formulating policies and procedures for managing diving related deaths: a whole of state engagement from frontline and hospital services in Tasmania. 勘误表：制定管理潜水相关死亡的政策和程序：塔斯马尼亚州前线和医院服务的全州参与。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-09-30 DOI: 10.28920/dhm54.3.253

Elizabeth J Elliot, Karl Price, Bernard Peters

引用次数: 0

Bispectral index with density spectral array (BIS-DSA) monitoring in a patient with inner ear and cerebral decompression sickness. 对一名内耳和大脑减压病患者进行密度谱阵列双谱指数（BIS-DSA）监测。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-09-30 DOI: 10.28920/dhm54.3.237-241

Gerald Schmitz, Sharon Aguero

引用次数: 0

Maxillary sinus barotrauma with infraorbital nerve paraesthesia after breath-hold diving. 憋气潜水后上颌窦气压创伤伴眶下神经麻痹。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-09-30 DOI: 10.28920/dhm54.3.230-232

Kubra Canarslan Demir, Zeliha Yücel

{"title":"Maxillary sinus barotrauma with infraorbital nerve paraesthesia after breath-hold diving.","authors":"Kubra Canarslan Demir, Zeliha Yücel","doi":"10.28920/dhm54.3.230-232","DOIUrl":"10.28920/dhm54.3.230-232","url":null,"abstract":"Barosinusitis, or sinus barotrauma, is a sinonasal injury and/or inflammation that results when the aerated spaces of the nose and sinuses are exposed to an uncompensated change in ambient pressure. We describe a 19-year-old male diver who presented to our clinic on the fourth day following a breath-hold diving session. During descent on a constant weight monofin dive at the South Cyprus World Championship he began to experience symptoms due to the inability to equalise the pressure, particularly in the Eustachian tubes and middle ear cavities. He felt pain and pressure in the upper left half of his face, left upper molars, and under his left eye at 60 metres, and he continued diving down to 74 metres. At presentation to our clinic, he still had ecchymosis under his right eye and pain in his upper right teeth, half of his face, and ear. He also described tingling in the lower left half of his nose and the left half of his upper lip. He received decongestants, B vitamins, and underwent endoscopic sinus drainage which alleviated his symptoms alleviated over time. The diver reported complete resolution of tingling, numbness, and pain after three months. It should not be forgotten that if appropriate treatment is delayed, permanent changes may occur as a result of long-term compression of the nerve, and therefore patients should be monitored closely.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 3","pages":"230-232"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retrospective analysis of challenging cases for medical examiners of diving. 对潜水法医挑战性案例的回顾性分析。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-09-30 DOI: 10.28920/dhm54.3.184-187

Inge Reus, Erik van de Sande, Rienk Rienks, Thijs Wingelaar

{"title":"Retrospective analysis of challenging cases for medical examiners of diving.","authors":"Inge Reus, Erik van de Sande, Rienk Rienks, Thijs Wingelaar","doi":"10.28920/dhm54.3.184-187","DOIUrl":"10.28920/dhm54.3.184-187","url":null,"abstract":"Introduction: Assessing a diver's fitness to dive enhances diving safety, with medical examiners of diving (MED) being entrusted with this responsibility. However, the effectiveness of MED training in preparing physicians for this task remains underexplored. In the Netherlands, where any physician can pursue MED qualification, challenging cases can be presented to a board of experts.Methods: This retrospective analysis included all cases presented to a board of experts in the period 2013-2023. Aside from baseline information, cases were coded using the International Classification of Diseases 11th Revision (ICD-11). Additionally, the type of advice given by the board was also recorded.Results: A total of 291 cases could be included, 62.5% were male divers with a median age of 47 years old (interquartile range 29-55). Circulatory (20.9%), respiratory (16.2%), neurologic (14.4%), psychiatric (9.6%) and endocrine (6.5%) disease comprised more than two-thirds of all presented cases. Problems for the MED included multimorbidity, knowledge of guidelines and interpretation of diagnostic data.Conclusions: These results could be used to improve MED courses or serve as a topic for continuing medical education for MEDs, however, further research into generalisability is required.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 3","pages":"184-187"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0