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Background: This study sought to investigate therapeutic effects of hydrogen-rich saline (HRS) combined with hyperbaric oxygen (HBO2) in an experimental rat model of acute lung injury (ALI).  Methods: Forty male Sprague-Dawley rats were randomly divided into sham, LPS, LPS + HBO2, LPS + HRS, and LPS + HBO2 + HRS groups. After an intratracheal injection of LPS-induced ALI, the rats were given a single-agent HBO2 or HRS or HBO2 + HRS treatment. The treatments were continued for three days in this experimental rat model of ALI. At the end of experiment, the lung pathological, inflammatory factors, and cell apoptosis in the pulmonary tissue were detected by Tunel method and cell apoptosis rate was calculated accordingly.  Results: In the groups treated with HBO2 + HRS, pulmonary pathological data, wet-dry weight ratio, and inflammatory factors of pulmonary tissues and alveolar lavage fluid were significantly superior to those of the sham group (p<0.05). Cell apoptosis detection revealed that no single agent treatment of HRS or HBO2, or combination treatment , could alleviate all cell apoptosis. HRS combined with HBO2 treatment was superior to single treatment (p<0.05).  Conclusion: HRS or HBO2 single treatment could decrease inflammatory cytokines release in lung tissue, reduce the accumulation of oxidative products ..

Purpose: Sudden sensorineural hearing loss (SSNHL) is a time-sensitive urgent condition. The aim of this study was to evaluate the frequency of hearing improvement in patients with idiopathic SSNHL who only received hyperbaric oxygen (HBO2) therapy within three days of symptom onset, instead of conventional corticosteroid treatment. Methods: The medical charts of patients who experienced SSNHL between January 1, 2012, and December 31, 2021, were reviewed. The present study included all adult patients who were diagnosed with idiopathic SSNHL and started HBO2 therapy within 72 hours of symptom onset. These subjects did not take corticosteroids due to contraindications or because they were concerned about possible side effects. The HBO2 therapy protocol consisted of at least 10 sessions of 85 minutes each with pure oxygen inhalation at 2.5 atmospheres absolute pressure. Results: Overall, 49 subjects (26 males and 23 females) met the inclusion criteria, with a mean age of 47 (+/- 20.4) years. The mean initial hearing threshold was 69.8 dB (+/- 18.0). After HBO2 therapy, complete hearing recovery was observed in 35 patients (71.4%), and the mean hearing threshold improved significantly (p<0.001) to 31.4 dB (+/- 24.5). In patients with complete hearing recovery, no significant differences were found between males and females (p=0.79), right and left ears (p=0.72) or initial grades of hearing loss (p=0.90). Conclusion: ..

On November 9, 1963, during the afternoon shift change at the Miike coal mine, eight rail cars filled with coal broke free and fell 360 meters [1]. The impact ignited coal dust in the mine and set off two explosions, killing 20 people immediately and trapping nearly 1,400 other workers up to 450 meters below the surface and 8 kilometers from the mine entrance.  The explosion damaged electrical and telephone lines, but the ventilation fan continued to operate and spread carbon monoxide throughout the mine [1].  This paper is the result is a study 33 years after the event. DOI: 10.22462/01.01.2023.40

Introduction: In fatal accidents during scuba diving, it is necessary to differentiate a death from primary drowning from a secondary drowning death that is primarily due to other etiopathogenetic factors. The inhalation of water can only be the end point of a series of events capable of causing the diver’s exitus. This study aims to demonstrate that even low-risk heart disease in daily life become potentially fatal during scuba diving. Methods: In this case series, we describe all cases of deaths in the course of diving that came to the observation of the Forensic Institute of the University Bari over 20 years (2000-2020). A judicial autopsy was performed on all subjects, with ancillary execution of histological and toxicological investigations. Results: The results of the medicolegal investigations carried out in the complex identified heart failure with acute myocardial infarction as the cause of death in four cases characterized by severe myocardiocoronarosclerosis, a primary drowning in a subject without previous pathological substrate in one case, and a terminal atrial fibrillation induced by acute dynamic heart failure due to functional overload of the right ventricle in one case. Conclusion: Our study demonstrates that lethal events during diving are often related to the presence of unrecognized or ..

Introduction: In this study, we aimed to examine dental barotrauma and temporomandibular joint (TMJ) complaints in a large group of divers. Method: This survey study included scuba divers older than 18. The questionnaire contained 25 questions about the demographic characteristics of divers, dental health behaviors, and diving-related dental, sinus and/or temporomandibular joint pain Results: The study group consisted of 287 instructors, recreational and commercial divers (mean age 38.96 years) (79.1% males). A total of 46% of divers reported a frequency of tooth brushing less than twice a day; 28% never receive a routine dental examination; 22.6% experienced dental pain after and/or during diving, mostly in the upper posterior teeth (40%); 17% required dental treatment; 77% of these cases are restoration fracture. TMJ symptoms after diving were statistically significantly higher in women (p=0.04). Jaw and masticatory muscle pain in the morning (p<0.001) limitation of mouth opening (p=0.04) and joint sounds in daily life (p<0.001) were recorded as exacerbated after diving; the results were found to be statistically significant. Conclusion: In our study, the localization of barodontalgia was consistent with the distribution of caries and restored tooth areas in the literature. Dive-related TMJ pain was also more common in those with pre-dive problems such as bruxism and ..

During deep-sea freediving, many freedivers describe symptoms fairly similar to what has been related to inert gas narcosis in scuba divers. This manuscript aims to present the potential mechanisms underlying these symptoms. First, known mechanisms of narcosis are summarized while scuba diving. Then, potential underlying mechanisms involving the toxicity of gases (nitrogen, carbon dioxide and oxygen) are presented in freedivers. As the symptoms are felt during ascent, nitrogen is likely not the only gas involved. Since freedivers are frequently exposed to hypercapnic hypoxia toward the end of the dive, it is proposed that carbon dioxide and oxygen gases both play a major role. Finally, a new “hemodynamic hypothesis” based on the diving reflex is proposed in freedivers. The underlying mechanisms are undoubtedly multifactorial and therefore require further research and a new descriptive name. We propose a new term for these types of symptoms: freediving transient cognitive impairment.  DOI: 10.22462/01.01.2023.38

The Swedish Armed Forces (SwAF) air dive tables are under revision. Currently, the air dive table from the U.S. Navy (USN) Diving Manual (DM) Rev. 6 is used with an msw-to-fsw conversion. Since 2017, the USN has been diving according to USN DM rev. 7, which incorporates updated air dive tables derived from the Thalmann Exponential Linear Decompression Algorithm (EL-DCM) with VVAL79 parameters.  The SwAF decided to replicate and analyze the USN table development methodology before revising their current tables. The ambition was to potentially find a table that correlates with the desired risk of decompression sickness.   New compartmental parameters for the EL-DCM algorithm, called SWEN21B, were developed by applying maximum likelihood methods on 2,953 scientifically controlled direct ascent air dives with known outcomes of decompression sickness (DCS). The targeted probability of DCS for direct ascent air dives was ≤1% overall and ≤1‰ for neurological DCS (CNS-DCS).  One hundred fifty-four wet validation dives were performed with air between 18 to 57 msw. Both direct ascent and decompression stop dives were conducted, resulting in incidences of two joint pain DCS (18 msw/59 minutes), one leg numbness CNS-DCS (51 msw/10 minutes with deco-stop), and nine marginal DCS cases, such as rashes and itching.  A total of three ..