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  • Author: Piotr Siermontowski x
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Abstract

The article presents the results of research on the effects of a long-term exposure to non-physiological location of anatomical elements of the masticatory organ in the course of diving. The said exposure is connected with the utilisation of various types of diving mouthpieces.

The study was conducted on 186 professional divers manifesting various conditions occurring immediately upon diving completion and connected with the temporomandibular joints and muscles lifting the mandible. The most frequently reported pain affected the areas of cervical spine and shoulder ring, earache and reflex pain, an exhausting gritting of teeth.

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.

Abstract

The prerequisite of development of pulmonary barotrauma [PB] is retention of the breathing mix in the lungs during a sudden decrease in external pressure or its administration into the airways under increased pressure or in a volume exceeding the maximum lung capacity. In such cases, the pulmonary parenchyma ruptures and air enters both the pleural cavity and/or the lumen of ruptured blood vessels located in the alveolar septa. The result is permanent disruption of the pulmonary parenchyma.

The aim of the study was to assess the influence of post-PB lesions on the heart muscle and the importance of hyperbaric treatment on the exacerbation of such lesions in the heart. The hearts of 35 rabbits were used in the study. In animals of the experimental group, PB was induced in the pressure chamber using the proprietary method described in previous publications. Part of the animals in this group were treated with air hyperbaria. The comparison group consisted of animals, which did not undergo PB during a simulated dive. All animals were weighed, observed for four weeks and then put to death following the experiment. In autopsy, among others, whole hearts were collected and weighed after fixation. Subsequently, the C/S ratio, i.e. the body to heart weight ratio, was calculated. The measurement results were subject to statistical analysis. A statistically significant increase in the C/S ratio was found, indicating an increase in the share of heart weight in the total body weight in the group of animals with PB not treated with air hyperbaria as compared to the control group.

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.

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.

Abstract

Patent foramen ovale (PFO) is a condition present in 25% of the adult population. It is a remnant of fetal foramen ovale which allows blood to pass from the right to the left atrium, bypassing the fetal lungs. In majority adults it does not have any clinical significance, but in some people it may allow shunting of venous blood into the left atrium (right – left – shunt or RLS), circumventing the lung filter, especially during sneezing, cough, lifting heavy equipment. Is such case, PFO may be a route for venous emboli or gas bubbles from veins to the arterial system. It is known as a paradoxical embolism and may be cause of ischaemic stroke or neurologic decompression sickness (DCI), inner-ear DCI and cutis marmorata. Transesophageal echocardiography is considered as a reference standard in detection of intracardial shunts. Its sensitivity and specificity ranges between 94%-100%. However, TEE is an invasive examination with potentially serious side effects. An alternative examination in RLS detection is contrast enhanced Transcranial Doppler (the bubble study or c-TCD). In comparison to TEE, Transcranial Doppler is not invasive, relatively not expensive and save technique. With its high sensitivity and specificity in detection of PFO, 97% and 93% respectively, it may improve detection of RLS and allow to conduct screening examination for PFO in divers.

Abstract

Stress among naval mariners is caused by a new environment in the form of climate, noise, defective food, diseases or injuries, and others. Stress is aggravated by the lack of information, conflicts between mariners, changing decisions of superiors. The strongest stressor military action is the fear of losing life or health.

The stress leads to disturbances in the neuronal transmission and reduction in CNS cells, weakening the processes of neurogenesis. Its complications are a social problem for soldiers returning from humanitarian and military missions and their families.

Mariners cope with stress individually in the area of operations of the armed forces. When difficult situations overwhelm the possibility of compensating psyche, there are algorithms for psychological support. The basis for coping with stress is permanent, social support. The next level concerns support group sessions, involving soldiers after a traumatic event or completing a task. Sessions take place in a quiet place, after the cessation of activities. We are talking about defusing and debriefing technique. The highest level of coping with stress refers to psychotherapy. At first, in the field conditions, and then in the form of hospitalization in the country. Clinical forms of combat stress is post-traumatic stress disorder, acute stress syndrome, personality change as a result of the disaster experience, dissociative disorders, operational fatigue, DESNOS. The treatment of these disorders involves cognitive behavioral oriented trauma therapy and medical therapy with the use of SSRIs, SNRIs, and antipsychotics.

In the twenty-first century a inquiry into combat stress creates a tight prevention of its complications.

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.

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.

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.