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PubMed2004

Identification of professional scuba divers with patent foramen ovale at risk for decompression illness.

Functional and anatomic characteristics of patent foramen ovale (PFO) were investigated in 66 professional scuba divers (41 with and 25 without decompression illness) using transthoracic and transesophageal echocardiography. PFO with right-to-left shunting at rest is associated with decompression illness, particularly the neurologic type. A wider patency diameter together with a higher membrane mobility are associated with the risk of developing the disease in divers with PFO.

Adult↗
PubMed2005

Patent foramen ovale and diving.

Patency of the foramen ovale is a risk factor for DCS in SCUBA divers, even if they adhere to the currently accepted and used decompression tables. The primary cause of DCS, however, is the nitrogen bubble, not the PFO. There are a number of techniques any diver can use to minimize the occurrence of nitrogen bubbles after a dive. The authors current practice is to inform civilian sports divers of the increased risk and to advise them to adopt conservative dive profiles. This can be achieved by selecting a more conservative dive computer, performing only dives that do not require obligatory decompression stops, or using oxygen-enriched breathing gas mixtures("nitrox") while still diving on "air profiles" [56].Dive-safety organizations are currently under-taking studies aimed at proposing changes in the decompression algorithms to produce low-bubble dive tables [12]. In the meantime, PFO remains a reason for caution. Whether all divers should be screened for PFOis an ongoing discussion [50] in view of methodologic and practical issues outlined in this article. Any definitive recommendations can be made only after a careful, prospective evaluation of the real relative risk for DCS and long-term cerebral damage.

Decompression Sickness↗
PubMed2004

Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale.

BACKGROUND: The risk of developing decompression illness (DCI) in divers with a patent foramen ovale (PFO) has not been directly determined so far; neither has it been assessed in relation to the PFO's size. METHODS: In 230 scuba divers (age 39+/-8 years), contrast trans-oesophageal echocardiography (TEE) was performed for the detection and size grading (0-3) of PFO. Prior to TEE, the study individuals answered a detailed questionnaire about their health status and about their diving habits and accidents. For inclusion into the study, > or =200 dives and strict adherence to decompression tables were required. RESULTS: Sixty-three divers (27%) had a PFO. Overall, the absolute risk of suffering a DCI event was 2.5 per 10(4) dives. There were 18 divers (29%) with, and 10 divers (6%) without, PFO who had experienced > or =1 major DCI events P=0.016. In the group with PFO, the incidence per 10(4) dives of a major DCI, a DCI lasting longer than 24 h and of being treated in a decompression chamber amounted to 5.1 (median 0, interquartile range [IQR] 0-10.0), 1.9 (median 0, IQR 0-4.0) and 3.6 (median 0, IQR 0-9.8), respectively and was 4.8-12.9-fold higher than in the group without PFO (P<0.001). The risk of suffering a major DCI, of a DCI lasting longer than 24 h and of being treated by recompression increased with rising PFO size. CONCLUSION: The presence of a PFO is related to a low absolute risk of suffering five major DCI events per 10(4) dives, the odds of which is five times as high as in divers without PFO. The risk of suffering a major DCI parallels PFO size.

Decompression Sickness↗
PubMed2004

Diving emergencies.

Explore the source record for details and available documents.

Cardiopulmonary Resuscitation↗
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↗
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↗
PubMed2005

The persistent foramen ovale and migraine.

There is association between migraine, particularly migraine with aura, and large persistent foramen ovale (PFO) and other right-to-left shunts. Migraine is often improved by closure of a PFO in patients who have a large shunt. Inheritance of migraine is linked to the inheritance of large atrial shunts in some families. The data indicate that in some patients PFOs play a causal role in migraine with aura. These observations may also improve understanding of the etiology of migraine in patients who do not have a shunt.

Decompression Sickness↗
PubMedDate not supplied

Ensuring of long operation life of the orbiting station EVA space suit.

Russia has gained a lot of experience in operating the space suits (SS) during the extravehicular activities (EVA) by the crews of SALYUT-6, SALYUT-7 and MIR orbiting stations. A total of 21 Orlan-type space suits of various models were operated onboard the orbiting stations (OS) during almost 20 years period. Some of these space suits served up to 3 years in orbit. The paper reviews special features of long SS operation (without return to the Earth) onboard an orbiting station as well as the problems associated with SS repeated use by several crews. An analysis of measures to support solving of the problems of SS long stay and reliable operation onboard the orbiting station is made: selection of a corresponding SS type and separate elements design; selection of the materials; routine and preventive maintenance; development tests. The advantages of the space suit of a semi-rigid type for solving the above problems are shown. The paper includes a short analysis of space suits' operation onboard the Russian orbiting station MIR, and some restuts of inspection of the Orlan-DMA space suit returned to the Earth from orbit by STS-79 alter long operation in orbit. Recommendations on further improvement of the space suits for EVA operations in the International Space Station (ISS) are given.

Decompression Sickness↗