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Jakub Szyller, Mariusz Kozakiewicz and Piotr Siermontowski

Abstract

Any stay in an environment with an increased oxygen content (a higher oxygen partial pressure, pO2) and an increased pressure (hyperbaric conditions) leads to an intensification of oxidative stress. Reactive oxygen species (ROS) damage the molecules of proteins, nucleic acids, cause lipid oxidation and are engaged in the development of numerous diseases, including diseases of the circulatory system, neurodegenerative diseases, etc. There are certain mechanisms of protection against unfavourable effects of oxidative stress. Enzymatic and non-enzymatic systems belong to them. The latter include, among others, heat shock proteins (HSP). Their precise role and mechanism of action have been a subject of intensive research conducted in recent years. Hyperoxia and hyperbaria also have an effect on the expression and activity of nitrogen oxide synthase (NOS). Its product - nitrogen oxide (NO) can react with reactive oxygen species and contribute to the development of nitrosative stress. NOS occurs as isoforms in various tissues and exhibit different reactions to the discussed factors. The authors have prepared a brief review of research determining the effect of hyperoxia and hyperbaria on HSP expression and NOS activity.

Open access

Michał Żychliński, Piotr Siermontowski and Romuald Olszański

Abstract

Service on a submarine is the most stressful and psychologically challenging form of military service. It is characterised by specific living and sanitaryepidemiological conditions which are far from typical. This work is based on the analyses of reports formulated from research conducted by a working environment laboratory, and on the control protocols of the sanitary supervision and control team (WOMP) Gdynia, from the Kobben submersible vessels in the years 2014 and 2015. Military Centres of Preventive Medicine hold supervision over Military Units pursuant to generally applicable regulations in the civil environment and standardised NATO norms. Measurements concern the level of noise, mechanical vibrations, chemical agents, electromagnetic radiation, physiochemical and biological water and kitchenware tests. The objective of the research is to evaluate the service conditions on a submersible vessel with regard to sanitary-epidemiological aspects such as exposure to infectious and occupational diseases. In selected stations, the conducted measurements indicate an increased level of noise, electromagnetic radiation and excess quantities of bacteria colonies on kitchenware.

Open access

Ewa Zieliński, Anna Lipińska, Kinga Grobelska and Piotr Siermontowski

Abstract

This article presents a description of a case of a patient diagnosed with complicated inflammation of the tibia bone, who was treated hyperbarically, in order to underline the advantages of this method of treatment used not as an alternative to antibiotics and surgery, but as a supportive method.

Open access

Romuald Olszański, Maciej Konarski and Piotr Siermontowski

Abstract

The paper discusses the treatment results of ten patients with severe atopic dermatitis (AD) who did not respond to standard pharmacotherapy and underwent hyperbaric oxygen therapy (HBOT). Each patient was subject to 10 oxygen exposures at pO2 2.5 ATA (~ 250 kPa) with the duration time of 60 minutes. In the period of implementation of the hyperbaric procedures the general treatment plan was suspended for all patients while maintaining typical local treatment. Clinical evaluation was performed in the study group as well as determination of levels of immunoglobulins: IgA, IgG, IgM and IgE and C3 and C4 complement. All patients indicated clinical improvement and a decreased IgE immunoglobulin and complement C3 level upon the completion of the exposure cycle. Taking into account the authors’ own observations and data from literature, an overall improvement in the clinical status and a decrease in the level of immunoglobulin E and C3 complement following a cycle of exposures may be indicative of an immunomodulating HBOT effect on AD, whereas hyperbaric oxygenation may constitute a therapeutic option for some patients with AD, especially those exhibiting a poor response to standard treatment.

Open access

Piotr Siermontowski, Beata Janas and Romuald Olszański

Abstract

This two-part article reviews the current legal situation of specialist staff performing hyperbaric procedures for purposes not related to diving. Numerous discrepancies between the applicable legal acts and the lack of legal regulations concerning procedures not financed from the state budget have been noted. The first significant problem consisted in the lack of a correlation between various Regulations of the Minister of Health concerning hyperbaric oxygenation, as well as inconsistencies with the programmes of medical specialisation effective in Poland. The second problem is the lack of determination requirements of medical personnel other than doctors and nurses in the documents of the Ministry of Health. It was also found that medical hyperbaric centres which do not apply for funding from the budget (National Health Fund), do not even meet the minimum requirements defined as to the qualifications of the staff working there. Moreover, there is a lack of knowledge of the requirements set out in legal acts other than those concerning medicine.

Open access

Romuald Olszański, Piotr Siermontowski and Zbigniew Dąbrowiecki

Abstract

The article presents a dermatosis that occurs in tropical and subtropical countries. Though the definitive hosts of the cutaneous larva migrans parasite are animals, humans can become accidental hosts and they are infected when their skin comes into contact with damp soil, most frequently sand. The disease is only present in the epidermis where an itch is brought about by the mining activity of the larva. Sunbathers and divers who put on their gear on a beach, on account of the epidermis maceration caused by a prolonged exposure to water, are particularly susceptible to the penetrative activities of the larva. In Poland the cutaneous larva migrans is in most cases mistaken for nettle rash or eczema.

Open access

Adam Olejnik and Piotr Siermontowski

Abstract

The article deals with the subject matter related to the development of underwater works technologies. Nearly 15 years ago one of the authors of this study published a material in the monthly magazine of “Podwodny Świat” (The Underwater World) entitled “The Future of Underwater Technologies – the diver or the robot?” where he noted that the time of great changes in technologies aimed at researching the depths and conducting works under water has arrived. This new era mainly consists in the fact that on an increasing number of occasions the diver is replaced by an underwater robot. The presented material constitutes an attempt to provide an answer to the question whether the then posed thesis is still valid. In the article the authors discuss issues concerned with the development of techniques and technologies applied in the conquest of depths that leads them to the conclusion that the previously observed tendency of a double-tracked development of underwater technologies is gaining in strength, which causes that the works and exploration of bodies of water at great depths will be possible only with the use of unmanned techniques.

Open access

Piotr Radziwon, Romuald Olszański, Jolanta Korsak and Piotr Siermontowski

Abstract

The lack of evidence for the tissue-factor dependent activation of the coagulation system and the release of thrombin on one hand, and a decreased concentration of factor XII after short term air, saturated air and heliox exposures, as well as an increased concentration of the plasmin-antiplasmin complex (PAP) after short dives indicate that diving and decompression possibly affect fibrinolysis. The aim of our research was to verify the assumption that diving and decompression activate the system of fibrinolysis and the clarification of the pathomechanism of this activation.

The study involved 50 healthy volunteers who were subjected to short-term, air hyperbaric exposures at 400 kPa and 700 kPa, which correspond to 30m and 60m dives. Decompression was applied in accordance with Naval tables of decompression. Before hyperbaric exposition and after decompression the following factors were determined: activity of factor XII, concentration and activity of t-PA, concentration and activity of PAI-1, concentration of alpha2- antiplasmin, concentration of PAP, concentration of neutrophil elastase.

The following observations have been made: a statistically significant increase in the factor XII activity, increase in the PAP complex concentration and a simultaneous significant decline in the α2-AP activity. No measurable t-PA activity or significant changes in t-PA concentration have been observed. In addition, a statistically significant decline in both the activity and concentration of PAI-1 has been observed, which was more pronounced after the expositions that corresponded to 60 m dives. The concentrations of granulocyte elastase did not differ significantly before and after decompression.

Conclusions: People qualified for diving should have the following risk factors examined: risk factors of increased fibrynolytic activity - haemostasis abnormalities that increase the risk of haemorrhage, possibility of parietal blood clots/thrombi.

Open access

Małgorzata Remlein, Romuald Olszański, Piotr Siermontowski, Zdzisław Kobos, Jacek Buczyński and Andrzej Buczyński

Abstract

Strong wind, low temperature, intense current and poor visibility under water are the most common stress inducing factors in individuals practising water sports. Stress is a state of agitation, which can be caused both by external and internal factors. Its objective is to mobilise one’s physical and psychological capabilities, thus it is a favourable reaction especially in crisis situations when such full mobilisation enables one to cope. Psychological stress is usually evoked by the occurrence of an atypical situation, exceeding one’s handling capacity. It can be induced by seeing real or imagined danger in the surroundings, as well as by external pressure related to a task interpreted as too difficult or exceeding one’s capabilities. Internal pressure appears when a person feels insecure in a given situation, when they cannot solve a problem or they feel discomfort due to their inability to meet the expectations of others, for instance, to perform a particular dive, or because of the money spent on this purpose or the invested time. Physical stress is usually an organism’s response to the environmental impacts. This article presents and discusses factors which have an effect on stress intensification, as well as providing a characterisation of selected psychological and medical theories of stress.

Open access

Krzysztof Gadomski, Piotr Siermontowski, Zbigniew Dąbrowiecki and Romuald Olszaski

Abstract

Allergic contact eczema is the most common occupational skin disease caused by allergens. Thus far, no research has been conducted in Poland in relation to the development of contact allergies amongst divers resulting from particular diving suit components. A group of 86 divers were examined using allergy patch tests. Standard products of contact allergy diagnostics were used containing 40 allergens.