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PubMed1995

The sigma-selective ligand NE-100 attenuates the effect of phencyclidine in a rat diving model.

1. Phencyclidine (PCP) reduces the latency of rats diving into a water-filled pool from a hidden platform, without stereotyped behavior. 2. The sigma-selective ligand, NE-100 (N,N-dipropyl-2-[4-methoxy-3-(2-phenylethoxy)phenyl]-ethyl-amine monohydrochloride), attenuates the effects of PCP in this procedure. 3. The serotonin2 (5-HT2) antagonist, ritanserin, and the sigma receptor ligands, 1-(cyclopropylmethyl)-4-[2'(4"-fluorophenyl)-2'-oxoethyl]- piperidine HBr (Dup734), 4-[2'-(4"-cyanophenyl)-2'-oxoethyl]-1- (cyclopropylmethyl)piperidine (XJ448), alpha-(4-fluorophenyl)-4-(5-fluoro-2-pyrimidinyl)-1-piperazine butanol (BMY14802) and rimcazole similarly attenuate the effects of PCP. 4. The dopamine D2/sigma ligands, haloperidol and cis-N-(1-benzyl-2-methyl-pyrrolidin-3-yl)-2-methoxy-5-chloro-4- methylaminobenzamide (YM-09151-2) completely reverse the effects of PCP, whereas the same dose ranges of these drugs produce sedation. 5. The dopamine D2-selective antagonist, sulpiride, has no apparent effect on the PCP latency to the rat dive. 6. Thus, PCP-induced diving behavior was improved by sigma ligands and the 5-HT2 antagonist. This model of negative symptoms in an experimental animal will facilitate experiments on drug treatments for schizophrenia.

Animals↗
PubMed1984

Diving injuries.

This is a collective review about the pathophysiology, diagnosis, and management of SCUBA and diving injuries by the emergency physician. These injuries can be classified into those resulting from the toxic effects of the inhaled gas, from the pressure changes in the water and gas mixture while diving, and from decompression sickness. With the increasing popularity of SCUBA diving, it is hoped that this discussion will enable a recognition of these injuries and therefore minimize the morbidity and mortality from them.

Athletic Injuries↗
PubMed2005

Antioxidant enzymes in ringed seal tissues: potential protection against dive-associated ischemia/reperfusion.

Diving seals experience heart rate reduction and preferential distribution of the oxygenated blood flow to the heart and brain, widespread peripheral vasoconstriction, and selective ischemia in the most hypoxia-tolerant tissues. The first breath after the dive restores the oxygenated blood flow to all tissues and raises the potential for the production of reactive oxygen species (ROS). We hypothesized that in order to counteract the damaging effects of ROS and to tolerate repetitive cycles of ischemia/reperfusion associated with diving, ringed seal (Phoca hispida) tissues have elevated activities of antioxidant enzymes. Activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were measured by spectrophotometric techniques in heart, kidney, liver, lung, and muscle extracts of ringed seals and domestic pigs (Sus scrofa). The results suggest that in ringed seal heart SOD, GPx and GST activities are an efficient protective mechanism for counteracting ROS production and its deleterious effects. Apparently CAT activity in seal liver and GPx activity in seal muscle participate in the removal of hydroperoxides, while seal lung appears to be protected from oxidative damage by SOD and GPx activities.

Animals↗
PubMed2004

Fabrication of a custom diving mouthpiece using a thermoforming material.

Scuba divers may suffer from temporomandibular joint dysfunction and related problems associated with the use of commercially available diving mouthpieces. Several authors have recommended that custom diving mouthpieces be fabricated for relieving the symptoms of diver's mouth syndrome. The lost wax technique is commonly used for this purpose but may be time-consuming and is technically complicated. This article describes a simplified technique using thermoforming material for fabricating a custom diving mouthpiece.

Diving↗
PubMed2005

Diving medicine.

Recreational diving developed in the late 1940s when self-contained underwater breathing apparatus (SCUBA) first became available for civilian use. At the same time the development of the commercial airliner, in particular the jet airliner, made possible the concept of international travel for pleasure as opposed to business. Over the past 50 years the number of international tourists has increased by over 2500% from a mere 25 million in 1950 to over 700 million in 2002 (Treadwell TL. Trends in travel. In: Zuckerman JN, editor. Principles and practice of travel medicine, 2001; p. 2-6). The popularity of recreational diving has also increased over the same period from an activity experienced by a small number of individuals in the early 1950s to an activity today enjoyed by many millions. The combination of increased international travel and the means by which to enter and explore the underwater world has led to diving becoming increasingly popular as a tourist activity.

Adolescent↗
PubMed1999

Electrical stimulation of the anterior ethmoidal nerve produces the diving response.

Stimulation of the upper respiratory tract usually produces apnea, but it can also produce a vagally mediated bradycardia and a sympathetically mediated increase in peripheral vascular resistance. This cardiorespiratory response, often called the diving response, is usually initiated by nasal stimulation. The purpose of this research was to investigate the anterior ethmoidal nerve (AEN) that innervates the nasal mucosa of muskrats (Ondatra zibethicus). Electrical stimulation of the AEN (typically 50 Hz, 100 micros and 500 microA) produced immediate and sustained bradycardia and cessation of respiration similar to that of the diving response. Heart rate (HR) significantly decreased from 264+/-18 to 121+/-8 bpm, with a concurrent 4.2+/-0.9 s apnea, during the 5 s stimulation period. BP decreased from 97.9+/-4.8 to 91.2+/-6.4 mmHg. Using estimations from (1) cross-sectional areas of AEN trigeminal ganglion cells labeled with WGA-HRP, and (2) electron microscopic analysis of the AEN, we found that approximately 65% of the AEN is composed of unmyelinated C-fibers. In addition, 72.4% of myelinated fibers from the nerves that innervate the nasal passages were of small diameter (<6 microm, presumably Adelta fibers). Thus, the AEN of the muskrat contains a high concentration of small diameter fibers (89.8%). We conclude that electrical stimulation of small diameter fibers within the AEN of muskrats can produce the cardiovascular and respiratory responses similar to that of the diving response.

Animals↗
PubMed2000

Neurological accidents caused by repetitive breath-hold dives: two case reports.

We report two Japanese male professional breath-hold divers (33 and 39 years of age) who experienced neurological disorders during repetitive dives to over 20 m of seawater. One patient had right homonymous hemianopsia, and the other presented with right hemiparesis with facial involvement and sensory deficit. In addition, they each had a history of neurological problems following such dives. Magnetic resonance images of their brains disclosed multiple T2-weighted hyperintensities corresponding to their neurological symptoms. Their brain lesions suggest a multiple cerebral infarction caused by occlusion of the cerebral arteries. We conclude that the repetitive deep breath-hold dives induced the brain involvement.

Adult↗
PubMedDate not supplied

Differential diagnostic problems of decompression sickness--examples from specialist physicians' practices in diving medicine.

It can be expected that the differential diagnosis problem of decompression sickness will increase in the future due to the increasing number of divers. During the last 30 years, 232 divers were treated for decompression sickness (DCS) at the Naval Medical Institute (NMI) in Split, Croatia. In 66 cases (28%), physicians at various diving sites reached diagnosis with difficulty, and 86 divers (37%) came directly to the NMI without seeing a physician first. Physicians at remote diving locations frequently have only basic knowledge of diving medicine and are often inexperienced. The language barrier was a major obstacle in obtaining a medical history and examination of foreign divers. Consultations at the NMI proved a major contribution to correct diagnosis and treatment. We present six illustrative cases from NMI Archives that demonstrate how prejudices, panic, and inexperience could create problems in establishing DCS diagnosis.

Adult↗
PubMed1997

Diving-related emergencies.

The proliferation of sport or recreational divers over the last several decades has resulted in significant increases in the number of patients treated for diving-related emergencies. The treatment of these individuals is no longer confined to a small group of physicians with special training or experience. Rather, community emergency physicians and physicians engaged in the practice of travel medicine are increasingly called on to treat such patients. This article discusses general physical principles relating to diving medicine and common presentations and treatment of diving-related emergencies.

Barotrauma↗
PubMed2003

Diversity in and adaptation to breath-hold diving in humans.

Several features of potential adaptation to breath-hold diving in diving populations and extreme divers are reviewed. Thermal adaptation consists of an improvement in cold tolerance, as witnessed by a decrease in critical water temperature, and implies an elevation of the shivering threshold associated with a greater body insulation. This is indicative of either a strong peripheral vasoconstriction or a more effective countercurrent heat exchange. Respiratory adaptation consists of a blunted ventilatory response to carbon dioxide and an enlargement of lung volumes. Finally, the occurrence of a diving response has been demonstrated. An extreme peripheral vasoconstriction is associated with a dramatic increase in arterial blood pressure. The consequent stimulation of arterial baroreceptors causes an extreme drop of heart rate. Bradycardia is not compensated by a higher stroke volume, with consequent decrease in cardiac output. This decrease, however, is not such as to undermine perfusion to vital organs. Redistribution of blood flow occurs, and some organs such as skeletal muscle may become unperfused, as indicated by the high blood lactate concentrations at low metabolic rate. It is not possible to state, however, whether these changes reflect genetic adaptations or an adaptive response to a prolonged environmental stress.

Adaptation, Physiological↗
PubMedDate not supplied

A review of the forensic investigation of scuba diving deaths.

With more people engaging in recreational scuba diving, fatalities from this sport are encountered by forensic investigators. There is a plethora of factors contributing to death and the investigator must be acquainted with how to elucidate them. The emphasis is on a multi-disciplinary approach that involves co-divers and instructors, the rescue team, the police, forensic scientists, diving equipment suppliers, underwater physiologists and physicians, decompression chamber personnel, general practitioners, relatives and the forensic pathologist. This report presents the various factors contributing to scuba diving deaths and suggests how to conduct such investigations.

Athletic Injuries↗
PubMed2005

Spinal cord injuries due to diving accidents.

STUDY DESIGN: Retrospective study and data analysis. OBJECTIVE: To investigate and analyse the main features of spinal cord injuries due to diving accidents accepted in our Centre from June 1978 to December 2002. SETTING: Regional Spinal Unit of Florence, Italy. INTRODUCTION: Diving accidents mostly occur in a young and healthy population and most of the patients develop tetraplegia with a severe lifelong disability. From 1978 to 2002, 65 patients with spinal injuries due to diving accidents were admitted to the Regional Spinal Unit of Florence. MATERIAL AND METHODS: A retrospective study was conducted by analysing data stored in our local computerized database. We considered the vertebral injury, ASIA-ISCOS neurological classification on admission and discharge, gender, age at the time of injury, month of injury, treatment of vertebral lesion, length of stay in the Spinal Unit, neurological outcome, and complications. Data were analysed statistically by using the Fisher's exact test and logistic regression. RESULTS: In all, 62/65 patients were males (95%). Mean age at injury time: 22 years. On admission, 35/65 were neurologically complete ASIA A (54%), while 16 were classified ASIA B, 7 ASIA C and 7 ASIA D, according to the ASIA-ISCOS neurological standard of classification. C6 was the most common neurological motor level (40%) and C5 the most common vertebral injury level. In all, 36/65 (55%) patients underwent surgical treatment. Mean hospitalization time was 5 months. No neurological deterioration was recorded. In all, 20/65 (31%) patients improved neurologically and 16/20 (80%) of those had received surgical treatment. In all, 15/65 (23%) patients had complications and one patient died during the hospitalization period. CONCLUSIONS AND DISCUSSION: Patients whose vertebral lesions were surgically treated had a better neurological outcome than conservatively treated ones. Teardrop fractures showed worse neurological outcome as compared with burst fractures. Neurological improvement was more present in initially incomplete lesions. Treatment with high dose methylprednisolone during the first 8 h after trauma seemed to influence the neurological outcome positively. Age was also an important factor in influencing the neurological outcome.

Accidents↗
PubMed2000

[Medical aspects of diving in otorhinolaryngology. I. Barotrauma and decompression sickness].

Recreational scuba diving has become immensely popular in recent years and is no longer restricted to individualists or adventurers. During a dive, the human body with its gas-filled cavities is exposed to an increased ambient pressure. In the present review article, aspects of diving and hyperbaric medicine related to the otolaryngology field are presented. The basics of physics, physiology and pathophysiology that are essential to understand the effects of an increased and varying ambient pressure are reviewed. Barotrauma of the outer, middle and inner ear, the paranasal sinuses, face, teeth and larynx are explained and classified in those during the compression and decompression phase. This is followed by a discussion of inner ear decompression sickness. The present article will provide a background and foundation for both, an adequate treatment of these diseases and a critical and responsible health education of the diver.

Athletic Injuries↗
PubMed2001

[Simultaneous transthoracic echocardiography and transcranial doppler ultrasonography with ultrasound contrast agents for the detection of a patent foramen ovale in diving medicine].

OBJECTIVE: Presentation of a non-invasive method for the identification of a patent foramen ovale (PFO) in screening of diving-candidates or for the investigation of diving accidents. METHOD: Simultaneous transthoracic echocardiography and transcranial Doppler sonography of the middle cerebral artery using ultrasound contrast media. RESULTS: In an unselected collective of amateur and professional divers a PFO was identified according to statistical prediction. CONCLUSION: This method can be used in diving medicine for PFO detection as an alternative procedure to transesophageal echocardiography.

Adult↗
PubMed2001

The impact of environmental Pseudomonas aeruginosa genotypes on skin infections in occupational saturation diving systems.

Skin infection caused by Pseudomonas aeruginosa is the most frequent health problem associated with occupational saturation diving on the Norwegian continental shelf. In the course of 14-y surveillance of infection and environmental control in occupational offshore saturation diving systems, a collection of approximately 1000 P. aeruginosa isolates has been amassed. Retrospective genomic analyses using restriction enzyme fragmentation and pulsed-field gel electrophoresis have identified 24 of 76 environmental P. aeruginosa genotypes as being of significance for single infections, outbreaks of infections and recurrent skin infections in occupational diving systems. In addition, these genomic analyses have made it possible to separate outbreaks of infection into outbreaks with 1 single genotype and clusters of infections where different genotypes are involved. We conclude that the established, assumed diver-to-diver contagion vector ought to be replaced by a environmental contagion vector as the most likely vector within these specific occupational environments. Furthermore, consecutive presence of the frequent environmental/infectious genotypes demands specific improvement of infection prevention and control in these systems.

Cluster Analysis↗
PubMed2004

Technique and timing in women's and men's reverse one and one half somersault with two and one half twists (5335D) and men's reverse one and one half somersault with three and one half twists (5337D) 3 m springboard dives.

The purpose of this study was to compare timing and technique of males and females performing reverse twisting dives in elite international competition. Video data of the dives performed at the 1999 FINA World Diving Cup were captured and digitised to obtain times and postures of the divers at specific events including takeoff and entry. Estimates of flight height and mass-normalised work done on the springboard were obtained from flight times. The data indicated that many males are able to complete an additional twist rotation because they attain more height, and therefore more time in the air, than females.

Diving↗
PubMed2002

A review of asthma and scuba diving.

An increasing number of asthmatics participate in recreational scuba diving. This activity presents unique physical and physiological challenges to the respiratory system. This review addresses the susceptibility of divers with asthma to diving accidents, acute asthmatic attacks, and long-term exacerbation of their disease. Recommendations on fitness to dive with asthma and airway hyperresponsiveness are provided.

Asthma↗
PubMed1968

Onset of and recovery from diving bradycardia in ducks.

1. No evidence was found of a ;postural reflex' in ducks. Neither the position of the head nor the water temperature affected the cardiac response to diving.2. In ducks with access to air through a tracheal cannula, submersion did not invariably cause apnoea until the water level reached the glottis. Heart rate was closely related to respiratory frequency, and bradycardia did not occur during submersion unless there was a reduction in respiratory frequency or a cessation of ventilation altogether.3. When apnoea and bradycardia did occur during submersion, the first inspiration upon surfacing was 2-3 times larger than normal and was accompanied by an instantaneous rise in heart rate.4. Atropinization or cold block of the vagus abolished diving bradycardia. Only one vagal trunk was involved in cardiac chronotropic control at any one time. This vagal trunk also appeared to be more important in control of respiratory frequency.5. beta-adrenergic receptor blockade did not affect either diving bradycardia or post-dive tachycardia.6. The results show that the cardiac chronotropic response both during and after submergence is controlled solely by changes in parasympathetic vagal activity.

Anesthesia, Conduction↗