Undersea and Hyperbaric Medicine最新文献

{"title":"Vascular occlusion following hyaluronic acid injection: A case report.","authors":"Recep Özkan, Buyçe Kaya, Güven Kaya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This case presentation discusses vascular occlusion following hyaluronic acid (HA) injection and the subsequent treatment.</p><p><strong>Case report: </strong>A 52-year-old female underwent a 0.2 ml HA filler injection for aesthetic purposes in the forehead area, followed by the development of discoloration and severe pain extending from the glabellar region to the forehead.</p><p><strong>Discussion: </strong>The diagnosis was determined as vascular occlusion due to the injection, and the patient received 300 IU of hyaluronidase immediately. Additionally, hyperbaric oxygen treatment (HBO₂) was initiated. The patient received seven HBO₂ treatments and healed without developing post-treatment necrosis. No scar formation was observed at the three-month follow-up. This case highlights the potential benefits of HBO₂ in managing complications arising from HA fillers. It underscores the importance of physicians performing aesthetic procedures, being attentive to facial anatomy and injection techniques to prevent such complications. Furthermore, having knowledge about the effectiveness of HBO₂ in potential complication scenarios and collaboration with hyperbaric clinics when necessary are recommended.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"47-50"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678095","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}

{"title":"Maximal fat oxidation in navy divers.","authors":"Clara Sjöblom, Lars Ekman, Oscar Plogmark, Mirko Mandić, Lara Rodríguez-Zamora, Anna K Melin, Magnus Ekström, Oskar Frånberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Oxidating fat as an energy substrate requires more oxygen than utilizing carbohydrates and can be acutely increased by hyperoxia. Therefore, substrate utilization may affect endurance performance and gas consumption in divers, but previous research is limited. This study aimed to evaluate changes in maximal fat oxidation (MFO) in navy divers during training.</p><p><strong>Methods: </strong>Seven explosive ordnance disposal (EOD) divers (age 20.0±1.4, BMI 23.5±1.6), five combat divers (age 23.6±3.0, BMI 26.2±1.2), and seven amphibious rangers (controls) (age 23.0±2.9, BMI 26.2±1.7) were recruited. MFO was measured with indirect calorimetry using an incremental test before and after diver training of 15 weeks (EOD divers) or 16 weeks spaced over nine months (combat divers and controls). EOD divers performed a treadmill protocol in normoxia and hyperoxia, and combat divers and controls performed a bicycle ergometer protocol in normoxia.</p><p><strong>Results: </strong>Combat divers increased their MFO with 0.14 g/minute ([95 % CI] 0.04 to 0.23) while no difference was observed in EOD divers (-0.05 g/minute; -0.19 to 0.08) or controls (0.00 g/minute; -0.14 to 0.14).</p><p><strong>Discussion: </strong>Combat diver training can increase fat oxidation, potentially affecting oxygen consumption and carbon dioxide production. A combination of training stressors, including hyperoxia, training load, and negative energy balance, may cause these changes.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"19-30"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678022","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}

{"title":"Risk Factors of Dysbaric Osteonecrosis in Saturation Diving Identified through Magnetic Resonance Imaging Surveillance.","authors":"Yuka Miyoshi, Shun Watanabe, Satoshi Tsukazaki, Takao Sugiura, Fumitaka Ikomi, Teppei Tanaka, Hitoshi Ogawa, Takehito Sawamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Only a few cohort studies have investigated dysbaric osteonecrosis (DON) in saturation diving (SD) divers using magnetic resonance imaging (MRI) to detect early-stage DON. We aimed to investigate DON in the Japan Maritime Self-Defense Force (JMSDF) deep SD divers using MRI and examined the relationship between DON and the risk factors.</p><p><strong>Methods: </strong>This study included 62 JMSDF SD divers. DON was diagnosed in the subjects' shoulders, hips, and knee joints using MRI and their clinical information. We analyzed subjects' diving records, including pre- and post-diving medical check information such as decompression sickness (DCS) and pain +/-. Data from the annual JMSDF health checks were analyzed to identify risk factors for DON based on divers' predispositions, lifestyles, and diving profiles.</p><p><strong>Results: </strong>Of the 62 saturation divers (mean age: 40.61±6.93 years), three (4.8%) showed evidence of DON. MRI showed a geographic lesion with symptoms or a history of DCS. Two divers with DON had knee pain and a history of DCS. Furthermore, one asymptomatic diver and another diver with pain were heavy drinkers. Regarding physical and biochemical examination, diastolic blood pressure and high-density lipoprotein-cholesterol were identified as significant risk factors in an unpaired t-test (DON+ vs. DON-).</p><p><strong>Discussion: </strong>Our findings suggest that SD is associated with a higher risk of DON, the early stage of which can be detected using MRI. The possible risk factors for DON were a previous history of DCS, diastolic BP, and HDL cholesterol, suggesting that ischemia could be involved in DON pathogenesis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"35-46"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678153","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}

{"title":"Hyperbaric Oxygen Therapy in Traumatic Brain Injury: A Comprehensive Structure Review.","authors":"Azizul Fadzli Jusoh, Ismawati Ismail, Rosliza Yahaya, Azlie Hassan, Harmy Mohamed Yusoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen (HBO₂) treatment has sparked increasing attention as a potential therapeutic intervention for traumatic brain injury (TBI), but the variability in findings necessitates a comprehensive analysis of recent literature. This review aims to evaluate the latest empirical evidence on the effectiveness of HBO₂ treatment for TBI, focusing on its impact on neurological recovery, cognitive function, and physiological markers.</p><p><strong>Methods: </strong>To achieve this, we extensively searched scholarly articles in reputable databases such as Scopus and Web of Science (WoS), focusing on studies published between 2015 and 2024, and followed the PRISMA framework for study selection. The final dataset comprised 74 cases (n=74) and was analyzed using both quantitative methods (descriptive statistics) and qualitative techniques (thematic analysis). The findings were divided into three themes: (1) clinical efficacy of HBO₂ treatment for TBI, (2) mechanisms of action and biological pathways in HBO₂ treatment, and (3) evolving therapeutic applications of HBO₂ in TBI.</p><p><strong>Results: </strong>Mixed outcomes; while some studies reported significant cognitive, physiological, and clinical improvements, others raised concerns about methodological variability and limited reproducibility. Mechanistic studies highlighted HBO₂'s role in modulating pathways such as TLR4/NF-κB and VEGF/ERK, facilitating neuroprotection, angiogenesis, and synaptogenesis. Emerging therapies combining HBO₂ with regenerative approaches, such as stem cell treatments, showed promise in enhancing recovery.</p><p><strong>Discussion: </strong>In conclusion, HBO₂ treatment demonstrates clinical efficacy in improving memory, executive function, and neuroprotection, particularly in the treatment of post-concussive symptoms. Mechanistic studies highlight its role in reducing neuroinflammation and oxidative stress while promoting neurogenesis and angiogenesis. However, standardized protocols and long-term follow-up are needed to confirm its full therapeutic potential in TBI management.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"65-82"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677990","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}

{"title":"Dysbaric osteonecrosis: Case series osteonecrosis in divers.","authors":"Ayatoulah Amamri, Abdelghani Miliani, Rym Boudour, Youçef Mellal, Mahmoud Dib, Mohamed Medaouar, Ali Bedjaoui","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This is the first published study examining decompression illness (DCI) among divers in Algeria. DCI is a complex syndrome caused by bubbles of inert gas that form in the body due to an improper decompression process, following exposure to increased pressure underwater. Algerian diving conditions pose significant challenges to divers. The study focuses on red coral diving, a popular and long-standing practice in eastern Algeria. We present three case reports describing dysbaric osteonecrosis of the humeral head with varying degrees of severity and presentation. Dysbaric osteonecrosis (DON), a rare complication in professional divers and compressed-air workers, presents a controversial link to previous decompression sickness (DCS) with musculoskeletal pain (type 1 DCS). The potential for these ischemic lesions to progress to osteonecrosis after DCS remains unclear.</p><p><strong>Case report: </strong>This report describes a professional diver declared permanently unfit for diving due to advanced dysbaric osteonecrosis of the shoulder, following type 1 DCS in the same region treated with hyperbaric oxygen therapy. This case highlights the potential association between these events and emphasizes the importance of close monitoring after acute type 1 DCS.</p><p><strong>Discussion: </strong>Early magnetic resonance imaging (MRI) evaluation of all DCS cases with musculoskeletal pain is recommended to detect potential osteo-medullary damage. Such damage could worsen with continued diving and potentially transition into bone necrosis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"83-89"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678013","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}

{"title":"Case of Broca's Aphasia as an expression of cerebral decompression sickness with advanced non-invasive monitoring during HBO₂ treatment.","authors":"Gerald Schmitz, Sharon Aguero, Luis Carlos Huertas Gabert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case of severe CNS decompression sickness (DCS) that included Broca's aphasia in a recreational diver, offering insights into the application of advanced non-invasive monitoring during hyperbaric oxygen treatment (HBO₂).</p><p><strong>Case report: </strong>This 64-year-old male diver experienced the onset of expressive aphasia, vertigo, and right-sided hemiparesis about 30-120 minutes after surfacing following a rapid ascent after a deep dive.</p><p><strong>Discussion: </strong>Initial monitoring with bispectral index (BIS) and density spectral array (DSA) revealed significant asymmetry between cerebral hemispheres, particularly in spectral edge frequency (SEF) values, with the left hemisphere showing a marked reduction during air breaks at HBO₂ pressures. This pattern resolved progressively over three HBO₂ sessions, with full clinical recovery after four sessions, coinciding with the resolution of this DSA hemispheric asymmetry. The case indirectly supports the theoretical roles of microparticles and endothelial dysfunction in contributing to cerebral hypoperfusion in DCS, beyond the conventional focus on gas bubbles, as reflected in the clinical findings and the clinical gradient. This novel application of BIS-DSA in hyperbaric medicine offers promising potential for real-time monitoring of cerebral involvement. It could enhance patient outcomes by guiding individualized treatment in neurologically compromised DCS cases.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"91-97"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678038","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}

{"title":"Multifactorial determinants of diving-associated deaths in Turkey: autopsy-based insights and the imperative of integrated forensic assessment.","authors":"Mehmet Doğan, Yusuf Atan, Mehmet Ali Dağ, İbrahim Üzün","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This autopsy-based study aims to investigate the underlying causes and forensic characteristics of fatal diving incidents in Turkey, emphasizing the autopsy-based strategies employed to distinguish drowning from other diving-related pathologies such as decompression illness and arterial gas embolism.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 11 fatal diving cases evaluated by the First Forensic Medicine Specialization Board between 2002 and 2023. Data were retrieved from judicial records, including detailed autopsy reports, histopathological findings, toxicological analyses, and scene investigations.</p><p><strong>Results: </strong>The decedents consisted of ten males and one female (median age: 45), reflecting the male-dominant profile of diving activity. Diving modalities included SCUBA (n=7), breath-hold (n=2), and surface-supplied compressor diving (n=2). The leading cause of death was drowning (n=5), followed by arterial gas embolism (AGE; n=2), sudden cardiac death (n=2), subarachnoid hemorrhage (n=1), and asphyxia due to mechanical entrapment (n=1). AGE cases demonstrated intravascular gas via specialized autopsy techniques. Cardiovascular comorbidities were identified in four cases, while medications- primarily prescribed-were detected in five. Alcohol and illicit drugs were absent in all cases.</p><p><strong>Discussion: </strong>Diving fatalities pose complex medicolegal challenges that require a multidisciplinary approach. Drowning and AGE were the most frequent causes, often accompanied by cardiovascular pathology. Proper autopsy techniques, scene correlation, and pre-dive medical screening remain critical for accurate diagnosis and prevention. The findings underscore the need for standardized forensic protocols, especially in regions with limited access to postmortem imaging.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"1-14"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677984","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}

{"title":"The amount of the settled surfactant dipalmitoylphosphatidylcholine (DPPC) in the heart of rats does not correlate with decompression illness.","authors":"Uri Wolkowski, Soliman Khatib, Ran Arieli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The lung surfactant dipalmitoylphosphatidylcholine (DPPC) settles on the luminal aspect of blood vessels to form active hydrophobic spots (AHS). The nanobubbles that develop at these spots are gas micronuclei from which decompression bubbles expand upon decompression. Variability between \"bubblers\" and \"non-bubblers\" is derived from the variability in the AHS. We expected that the level of DPPC in the heart would correlate with the severity of decompression illness (DCI).</p><p><strong>Methods: </strong>Thirty-six rats were exposed to 8 bar for 32 minutes.</p><p><strong>Results: </strong>After decompression, they were examined for DCI and defined as non-DCI rats (ND, n=18), DCI-inflicted rats (DCI, n=13), and dead rats (DEATH, n=5). The DPPC concentration in the hearts (mg/g) was 2.97 ± 0.56 SD for ND, 2.87 ± 0.62 SD for DCI, and 2.81 ± 0.46 SD for DEATH.</p><p><strong>Discussion: </strong>There was no significant difference between the three groups. The results are discussed, and a further study to explore the correlation between bubbling and heart DPPC is suggested.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"15-18"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678101","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}

{"title":"Hyperbaric oxygen therapy for selected problem wounds.","authors":"Enoch T Huang, Marvin Heyboer, Davut J Savaser","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The field of Undersea and Hyperbaric Medicine has been segregated into those indications related to undersea medicine and those related to wound healing. Historically, though, hyperbaric medicine's role in wound healing owes a debt to Jacques Cousteau's divers working 35 feet under the surface of the Red Sea who claimed that their wounds healed significantly better when living in an underwater habitat than when they lived on dry land. In 1964, Dr. TK Hunt was asked by the National Science Foundation (NSF) to investigate these divers' claims. Dr. Hunt's work, along with that of his peers and colleagues, provide the scientific evidence and rationale that wound healing is dependent on tissue oxygenation [1].</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"111-154"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678015","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}

{"title":"Case report of auricular avulsion injury, repair, and adjunctive treatment.","authors":"Gerard A Fischer, Donna Hangan, Jessica G Li, Brandon Saxe, Cameron Christiansen, Kenneth Paticoff, Oren Richman, Homayoun Sasson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this case report is to present an 11-year-old male patient who sustained a partial avulsion injury of the left ear involving the helix, anti-helix, and scapha, along with initial management and adjunctive treatments throughout the patient's course in the hospital.</p><p><strong>Case report: </strong>Traumatic ear avulsion is an uncommon injury that poses unique surgical challenges, as there is no standard of care for its management. The viability of the avulsed tissue is of paramount concern given its small vasculature and limited perfusion. Some techniques used in ear avulsion injuries include microvascular reconstruction, the pocket technique, and direct reattachment. Ear avulsion injuries require a multidisciplinary approach to achieve optimal patient outcomes.</p><p><strong>Discussion: </strong>This case report demonstrates the effectiveness of multiple adjunctive treatments in optimizing revascularization and viability of previously avulsed tissue, resulting in better short-term outcomes and a more favorable long-term prognosis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"105-109"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678024","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}