Undersea and Hyperbaric Medicine最新文献_第2页

Technical Suitability of Implantable Cardiac Devices for Recreational Diving. 娱乐性潜水植入式心脏装置的技术适用性。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Matteo Paganini, Luigi Tarsia, Gerardo Bosco, Enrico M Camporesi, Mauro Biffi, Cristian Martignani, Matteo Ziacchi, Giuseppe Boriani, Marco Vitolo, Igor Diemberger

{"title":"Technical Suitability of Implantable Cardiac Devices for Recreational Diving.","authors":"Matteo Paganini, Luigi Tarsia, Gerardo Bosco, Enrico M Camporesi, Mauro Biffi, Cristian Martignani, Matteo Ziacchi, Giuseppe Boriani, Marco Vitolo, Igor Diemberger","doi":"","DOIUrl":"","url":null,"abstract":"Background: Diving is a diffused recreational activity, and the number of divers carrying cardiac implanted devices is similarly growing. Due to the lack of guidelines or technical indications, the suitability of such devices for diving or the fitness to dive for these patients still needs to be determined.Objective: This work summarizes implantable cardiac devices' suitability for recreational diving, technical vulnerability factors, and recommendations to improve implanted divers' safety.Methods: Between May 1, 2021, and March 20, 2022, three interventional cardiologists retrieved the technical documentation of selected implantable cardiac devices. In particular, any suitability and tests conducted in hyperbaric environments were tracked.Results: Technical documentation was recovered for four companies. Most devices were tested in hyperbaric conditions in single, prolonged, or repeated exposures to pressurized air; underwater tests were not mentioned. No company expressly disclosed the suitability of the devices for underwater activities.Conclusion: In the absence of technical indications or guidelines, a multidisciplinary evaluation between cardiology, diving medicine, and sports medicine is essential to establish the suitability for underwater sports in implanted patients. Before each diving trip, device control is advisable, and underwater physiological adaptations should be considered, especially in the cardiovascular domain. Stressors other than water and pressure must be considered during diving, such as lead strain caused by arm movements and pressure exerted by suits or buoyancy control devices on the chest. Future directions point towards a follow-up of implanted, active divers and developing leadless devices and underwater telemonitoring.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"169-177"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862607","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

EEG-based brain biomarker supports hyperbaric oxygen therapy for acute concussions. 基于脑电图的脑生物标志物支持急性脑震荡高压氧治疗。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Daphne Watkins Denham, Menley A Denham

{"title":"EEG-based brain biomarker supports hyperbaric oxygen therapy for acute concussions.","authors":"Daphne Watkins Denham, Menley A Denham","doi":"","DOIUrl":"","url":null,"abstract":"Acute concussion is a significant health issue among youth athletes, affecting their quality of life and performance. However, the standard of care, rest, has been questioned, while treatments are lacking. This pilot case series used an FDA-cleared electroencephalogram-based brain biomarker (EEGBB) to demonstrate hyperbaric oxygen therapy (HBO₂) improvement for treating concussion. From December 31, 2021, through May 27, 2022, school-aged patients presenting at two HBO₂ clinics within ten days of injury with an acute concussion confirmed by an initial EEGBB assessment were evaluated. The EEGBB diagnoses concussions using artificial intelligence to yield a score between 0-100, with scores ≤70 considered concussed. HBO₂ using 1.5-2.0 ATA, progressing stepwise per patient tolerance, was administered in ≥4-hour intervals until sustained symptom-free. EEGBB assessment was performed before and after each treatment. Eleven patients [mean age: 16±2.2; six male (55%)] participated. Patients presented one to nine days (median: three) after injury. Their median baseline EEGBB score was 18 (range: 1 to 35). The median first and last post-treatment scores available were 84 (range: 32-90) and 85 (range: 75-89), respectively. The median number of HBO₂ treatments was three (range: 2-8) administered over a median of two days (range: two to five). All patients except one (due to a technical error) received a post-treatment follow-up score 2- 22 days after treatment completion. The median final score was 85 (range: 64-90). There were no adverse events. Preliminary data demonstrate that the EEGBB objectively supports the use of HBO₂ to treat acute concussions. Further research should confirm the appropriate HBO₂ regimen to treat concussions.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"81-92"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862598","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

Clostridial Myonecrosis (Gas Gangrene). 梭状菌性肌坏死（气性坏疽）。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Robert P Weenink, Georgios F Giannakopoulos, Robert A van Hulst

{"title":"Clostridial Myonecrosis (Gas Gangrene).","authors":"Robert P Weenink, Georgios F Giannakopoulos, Robert A van Hulst","doi":"","DOIUrl":"","url":null,"abstract":"Clostridial myositis and myonecrosis, or gas gangrene, is an acute, rapidly progressive, non-pyogenic, invasive clostridial infection of the muscle tissue characterized by profound toxemia, extensive edema, massive death of tissue, and a variable degree of gas production [1-2]. Gas gangrene is either an endogenous infection caused by contamination from a clostridial focus in the body (spontaneous, atraumatic) or an exogenous infection found mostly in patients with compound and/or complicated fractures with extensive soft tissue injuries after trauma (non-spontaneous, traumatic). The onset of gas gangrene may occur between one to six hours after injury or operation and begins with severe and sudden pain in the infected area before the clinical signs appear. In atraumatic clostridial myonecrosis there are certain predisposing risks such as colonic and gynecologic malignancy, radiation, chemotherapy, and neutropenia. Seemingly disproportionate pain in a clinically still-normal area must make the clinician highly suspicious for developing gas gangrene, especially after trauma or operation. In the early phases, the skin overlying the infected area appears shiny and tense. In the next phase it becomes dusky and progresses to a bronze discoloration. The infection can advance very rapidly, and the patient may become moribund within 12 hours [3]. Hemorrhagic bullae or vesicles may be noted. A thin, serosanguinolent exudate with a sickly, sweet odor is present. Swelling and edema of the infected area is pronounced. The muscles appear dark red to black or greenish. They are noncontractile and do not bleed when cut. The tissue gas seen on radiographs appears as featherlike figures between muscle fibers and is an early and highly characteristic sign of clostridial myonecrosis. Crepitus is usually present as well. Systemic toxicity presents as high fever and tachycardia, followed by shock and multiorgan failure [3].","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"203-209"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862596","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

Definition of delayed-onset neurologic sequelae: A review article. 迟发性神经系统后遗症的定义：综述文章。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Alik Dakessian, Zachary Hagen, Eugenio R Rocksmith, Kinjal N Sethuraman

{"title":"Definition of delayed-onset neurologic sequelae: A review article.","authors":"Alik Dakessian, Zachary Hagen, Eugenio R Rocksmith, Kinjal N Sethuraman","doi":"","DOIUrl":"","url":null,"abstract":"Background: Delayed-onset neurologic sequelae (DNS) is a devastating complication of carbon monoxide poisoning. Despite abundant research studies on DNS, the definition remains unclear, with a wide range of symptoms. This review aims to identify the different symptoms and definitions that have been associated with DNS in available research.Methods: For this review, searches were conducted in PubMed and Scopus. Two authors screened research studies by abstract and title, and a third resolved conflicts. After the full-text review, one author extracted the data. Only original full-text research studies in English with a clear definition of DNS were included.Results: This review included 127 studies. Signs and symptoms associated with DNS were categorized into twelve groups. The most used symptom categories to define DNS were general neurological and cognitive/learning dysfunctions. Imaging studies, clinical testing, and neuropsychiatric testing used to define DNS were also documented.Conclusions: The literature did not consistently define DNS attributed to CO toxicity. Standardizing the definition and diagnostic criteria would benefit clinical research.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"121-131"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862597","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

Position change during hyperbaric oxygen therapy for arterial gas embolism. 动脉气体栓塞高压氧治疗时体位改变。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Naoto Jingami, Takayuki Nitta, Yoshitaka Ishiguro, Yudai Takatani, Tomoyuki Yunoki, Shigeru Ohtsuru

{"title":"Position change during hyperbaric oxygen therapy for arterial gas embolism.","authors":"Naoto Jingami, Takayuki Nitta, Yoshitaka Ishiguro, Yudai Takatani, Tomoyuki Yunoki, Shigeru Ohtsuru","doi":"","DOIUrl":"","url":null,"abstract":"Arterial gas embolism can be fatal and should be treated with care. Typically, the patient is placed in the supine position during treatment. However, we present a case where the patient's position was changed to facilitate treatment. A 78-year-old man with severely reduced heart function underwent cryoablation for chronic atrial fibrillation. During the procedure, he accidentally inhaled rapidly. Subsequently, he presented with stroke symptoms. Computed tomography (CT) revealed air in the brain and left ventricle, leading to a diagnosis of arterial gas embolism. He underwent hyperbaric oxygen (HBO₂) therapy as per the US NAVY Table 6 protocol. The air embolism in the brain reduced but that in the apex of the left ventricle persisted. Subsequently, HBO₂, as per the US NAVY Table 5 protocol, was performed along with a position change to the right lateral and manual vibration. The position change was based on the three-dimensional structures of the left ventricle, aortic arch, and descending aorta. Subsequently, no air was observed on CT, and rehabilitation was initiated. Safe body positions for arterial and venous gas embolisms differ. Therefore, understanding the vascular anatomy is imperative for treating gas embolism.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"157-161"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862603","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

Visualization and Bibliometric Analysis of the Research Progress and Trends of Air Embolism. 空气栓塞研究进展与趋势的可视化与文献计量学分析。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-02-01

Yuehong Ma, Wenying Lv, Shuyi Pan, Dazhi Guo

{"title":"Visualization and Bibliometric Analysis of the Research Progress and Trends of Air Embolism.","authors":"Yuehong Ma, Wenying Lv, Shuyi Pan, Dazhi Guo","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The etiology and diagnosis of air embolism (AE), including approaches for prevention and management based on experimental and clinical data, have been presented. However, these publications may not reach all the intended audience (e.g., surgeons), and thus, the use of bibliometric analyses is encouraged.Methods: We queried the Web of Science database using bibliometric analysis to identify publications related to AE from 1995 to 2022.Results: The literature search retrieved 2463 publications that met the inclusion criteria. In AE research, the total number of articles published every year was 80±16, and it increased gradually in recent years. Many published articles and most of the top ten research institutions (8/10) were from the USA (n = 826, 33.5%). The USA also has the highest citations and the most extensive cooperation with most countries. However, the proportion of the top ten journals is not too high, and the quality of these papers is not sufficiently good. The mean number of citations for the top ten articles was 105.8 (range: 68-298). Moreover, ten authors contributed to 146 manuscripts from eight countries. A total of 7926 keywords were found. Among these, 135 were hotspot keywords that appeared at least 20 times. The keywords with strong citation bursts changed from dog to risk factors of AE (7.66 versus 9.81).Conclusions: We explore the citation relevance and collaboration map and their hotspots in AE and provide a foundational understanding of the research progress and trends of AE.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 2","pages":"133-147"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862609","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

Decompression Sickness: Current Recommendations. 减压病：目前的建议。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-01-01

Richard E Moon, Simon J Mitchell

引用次数: 0

Risk at work under pressure with medication- what do we know? 在压力下服药的工作风险——我们知道什么？

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-01-01

Anne Räisänen-Sokolowski, Roland Vanden Eede, Martin Vanden Eede

引用次数: 0

Hyperbaric Treatment of Air or Gas Embolism: Current Recommendations. 空气或气体栓塞的高压氧治疗：目前的建议。

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-01-01

Richard E Moon, Simon J Mitchell

{"title":"Hyperbaric Treatment of Air or Gas Embolism: Current Recommendations.","authors":"Richard E Moon, Simon J Mitchell","doi":"","DOIUrl":"","url":null,"abstract":"Gas can enter arteries (arterial gas embolism) due to alveolar-capillary disruption (caused by pulmonary overpressurization, e.g. breath-hold ascent by divers), veins (venous gas embolism, VGE) as a result of tissue bubble formation due to decompression (diving, altitude exposure), or during certain surgical procedures where capillary hydrostatic pressure at the incision site is subatmospheric. Both AGE and VGE can be caused by iatrogenic gas injection. AGE usually produces stroke-like manifestations, such as impaired consciousness, confusion, seizures, and focal neurological deficits. Small amounts of VGE are often tolerated due to filtration by pulmonary capillaries; however, VGE can cause pulmonary edema, cardiac \"vapor lock,\" and AGE due to transpulmonary passage or right-to-left shunt through a patent foramen ovale. Intravascular gas can cause arterial obstruction or endothelial damage and secondary vasospasm and capillary leak. Vascular gas is frequently not visible with radiographic imaging, which should not be used to exclude the diagnosis of AGE. Isolated VGE usually requires no treatment. AGE treatment is similar to decompression sickness (DCS), with first aid oxygen followed by hyperbaric oxygen. Although cerebral AGE (CAGE) often causes intracranial hypertension, animal studies have failed to demonstrate a benefit of induced hypocapnia. An evidence-based review of adjunctive therapies is presented.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"52 1","pages":"41-53"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036385","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

Respiratory fitness for occupational diving, what is new? 职业潜水呼吸健康有什么新进展？

IF 0.7 4区医学

Undersea and Hyperbaric Medicine Pub Date : 2025-01-01

Pieter-Jan van Ooij, Robert A van Hulst

引用次数: 0