Inside vitro degradation haemolysis and also cytotoxicity study regarding Mg04CeZnO2 nanocomposites
The mortality rate of patients with Guillain-Barré syndrome (GBS) who develop respiratory muscle paralysis and need mechanical ventilation is increased. Though an unestablished indication, hyperbaric oxygen treatment (HBOT) has been used to treat patients with mild GBS who do not have respiratory muscle paralysis. The use of HBOT in severe cases has not been reported. We present a patient with severe GBS who received HBOT while ventilated in a multiplace hyperbaric chamber. #link# Three courses of HBOT (one session per day, 10 sessions per course) were administered with a 2-day rest period between each course. The HBOT protocol was 40 minutes at 220 kPa with 25 minutes of compression and decompression. Following weeks of gradual deterioration, motor function improved after the first HBOT session. After eight HBOT sessions, the patient was successfully discontinued from mechanical ventilation and after 10 sessions the patient's muscle strength was significantly improved. After 30 HBOT sessions, the patient had normal breathing and speech, and did not cough when eating. Upper limb muscle strength was graded as 4 on the Medical Research Council (MRC) scale, lower limb muscle strength was graded as MRC 3. The patient was successfully discharged. Mechanically ventilated GBS patients may benefit from HBOT but studies are required to separate spontaneous recovery rates from treatment benefit.A 75 year-old male developed features of an acute stroke following bubble contrast echocardiography, which was shown on emergent computed tomography scanning to be a result of cerebral arterial gas embolism (CAGE) to the left middle cerebral artery. Ischaemic stroke symptoms have previously been reported as a rare complication of bubble contrast echocardiography. Radiologically proven find more from bubble contrast echocardiography had not been reported at the time this case occurred. Immediate provision of 100% oxygen and administration of hyperbaric oxygen are recommended treatments for CAGE and were associated with a substantial recovery for this patient.
Dysbaric osteonecrosis (DON) in people working under increased atmospheric pressure is well documented. It is generally less common in military and commercial divers than in caisson workers, except in some high-risk groups, such as in many indigenous diving industries where workers have little or no understanding of decompression principles. With the increasing popularity within the recreational diving community of deep air and mixed-gas decompression diving ('technical diving'), it is likely that diving physicians may see an increase in the prevalence of DON in this group in the future.
The case report is presented of a technical diving instructor, with a 30-year history of deep diving, who developed bilateral humeral head DON and required a right shoulder hemi-arthroplasty. A focused literature search was also undertaken to identify published cases of DON in recreational divers.
The frequency, duration and depth of exposure to pressure, inadequate decompression, the occurrence of DCS and increasing age have been common features associated with DON in both divers and caisson workers. Many of these features were present in this technical diver.
Whilst DON is uncommon in recreational air scuba divers, all the above risk factors are present to a greater degree in technical diving. It is suggested that medical review for DON is merited from time to time in this potentially high-risk group of recreational divers.
Whilst DON is uncommon in recreational air scuba divers, all the above risk factors are present to a greater degree in technical diving. It is suggested that medical review for DON is merited from time to time in this potentially high-risk group of recreational divers.Arterial gas embolism (AGE) may result when diving while breathing compressed gas and ascending rapidly or with a closed glottis. Pulmonary over-pressurisation can result in lung stretch injury with entry of bubbles into the pulmonary venous circulation and subsequently the systemic arterial circulation. We present the case of an individual who suffered AGE while breathing compressed air at 1.2 metres' fresh water (mfw) in a swimming pool and discuss the factors determining the depth at which this form of injury may occur. This case serves to underscore the fact that risk of AGE exists at shallow depths.
Hydration status is considered a parameter likely to influence the risk of decompression sickness (DCS), but scientific evidence is scarce and conflicting. This experiment aimed to analyse the influence of pre-hydration on DCS occurrence in a rat model.
Intra-peritoneal injections of saline solution were administered to rats (NaCl 0.9% 0 ml (Control), 0.1 ml (Group 1), or 1 ml·100g
body mass (Group 2) at each of 24 h, 12 h, and 30 min prior to simulated air dives (45 min at 1,010 kPa; compression and decompression rates 101 kPa·min
; stops 5 min at 202 kPa, 5 min at 160 kPa, 10 min at 130 kPa). Evaluation of DCS occurrence and severity was made after decompression.
Pre-dive hydration reduced severe DCS from 47% (Control) to 29% (Group 1) and 0% (Group 2), and increased the proportion of animals without any signs of DCS from 40 (Control) to 57% (Group 1) and 93% (Group 2); Chi
P = 0.041.
This experiment demonstrated that pre-hydration can drastically reduce the DCS occurrence in an animal model. In the context of scuba diving, this result highlights the importance of elucidating the mechanisms linking hydration status and DCS risk.
This experiment demonstrated that pre-hydration can drastically reduce the DCS occurrence in an animal model. In the context of scuba diving, this result highlights the importance of elucidating the mechanisms linking hydration status and DCS risk.Scuba diving is a critical activity for commercial industry, military activities, research, and public safety, as well as a passion for many recreational divers. Physicians are expected to provide return-to-diving recommendations after SARS-CoV-2 (COVID-19) infection based upon the best available evidence, often drawn from experience with other, similar diseases. Scuba diving presents unique physiologic challenges to the body secondary to immersion, increased pressure and increased work of breathing. The long-term sequelae of COVID-19 are still unknown, but if they are proven to be similar to other coronaviruses (such as Middle East respiratory syndrome or SARS-CoV-1) they may result in long-term pulmonary and cardiac sequelae that impact divers' ability to safely return to scuba diving. This review considers available literature and the pathophysiology of COVID-19 as it relates to diving fitness, including current recommendations for similar illnesses, and proposes guidelines for evaluation of divers after COVID-19.