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Number 5

UHM Journal Number 44-5 - September-October 2017 - full issue

  09-28-2017

An open letter to the American Diabetes Association board of directors: Special commentary

These organizations have been made aware of the following position statement from the ADA that is to be released in the upcoming year. . . . We take issue with the conclusions of the statement. . . DOI: 10.22462/9.10.2017.1

  09-01-2017

Hyperbaric oxygen in patients with ischemic stroke following cardiac surgery: a retrospective observational trial

Background: Hyperbaric oxygenation (HBO2) involves breathing 100% oxygen under elevated ambient pressure in a hyperbaric chamber, thereby dissolving oxygen in the plasma. This results in an increase of arterial partial pressure of oxygen (pO2). Though well established in experimental studies, HBO2 treatment for ischemic stroke is still under discussion. Methods: From 2002-2014 HBO2 (2.2 bar, 90 minutes one/day; average number per patient: 4.7) was applied in 49 consecutive patients (32 males, 17 females, mean age: 68.8 years, range 31.2 – 83.9) with acute neurological deficit following cardiac surgery (CABG 15; combined surgery 14; valve surgery 11; aneurysm repair 8; malformation 1). Patients’ history ..

  09-01-2017

A pilot study evaluating knowledge of indications for hyperbaric oxygen therapy

A pilot study was conducted in mid-Michigan to evaluate know-ledge of appropriate hyperbaric oxygen therapy referrals in “first contact” physicians who did not have additional hyperbaric training.  The hypothesis for this study is that many first-contact physicians have little or no exposure to hyperbaric oxygen (HBO2) therapy and its indications. A survey was distributed regarding accepted indications combined with conditions not currently approved or contraindicated for HBO2. Answers were tallied for correct identification of approved indications, missed approved indications, and inappropriate identification of unapproved indications.  Ninety surveys were distributed and 62 physicians of various specialties responded. There were notably high percentages of missed indications, as ..

  09-01-2017

Efficacy of the U.S. Navy Treatment Tables in treating DCS in 103 recreational scuba divers

Despite the fact that current decompression schedules reduce the risk of decompression sickness (DCS), recreational scuba divers continue to experience DCS. Therapy outcomes in these divers are difficult to track. Our study aims to understand the efficacy of the United States Navy (USN) Treatment Tables (5, 6, 6A, 9) in providing symptomatic relief among recreational scuba divers. We conducted a single-center retrospective review of recreational divers treated from 2003 to 2013. A total of 187 divers were identified: 84 divers were excluded, and the charts of the remaining 103 divers were independently reviewed by three clinicians. For these 103 divers, the response variable, therapy outcome, ..

  09-01-2017

Cost effectiveness of residential carbon monoxide alarms

Background: While residential carbon monoxide (CO) alarms are now required in a majority of states, the cost effectiveness of the devices is unknown. This analysis was performed to determine the degree of prevention efficacy necessary from home carbon monoxide alarms for their expense to be cost-effective.  Methods: Data regarding numbers of individuals affected in the United States annually from accidental, non-fire, residential non-fatal and fatal carbon monoxide poisoning were obtained from published literature. Federal governmental estimates of societal costs associated with medical care, lost wages and earnings, value of pain and suffering, and value of a statistical life were applied. The cost of uniform residential ..

  09-01-2017

Repetitive freshwater diving: risk factors and prevalence of barotrauma

Objective: The aim was to investigate the influence of repetitive scuba diving in fresh water on the middle ear mucosa. The prevalence of middle ear barotrauma (MEB) and risk factors for MEB were evaluated.  Study design: Prospective cohort study, Level of evidence 1b. Methods: During three days, 23 divers made 144 repetitive dives in a freshwater lake. Participants underwent otoscopic examinations and were questioned about ENT-related complaints in the morning before the first dive, in between the dives and after the last dive. Otoscopic findings were documented and classified according to the TEED scale (0 = normal eardrum to 4 = perforation), for the right and ..

  09-01-2017

Spinal decompression sickness in an artisanal diving fisherman in Yucatán, Mexico: a case report

Artisanal fishermen around the world employ scuba and surface- supplied diving for their livelihoods and often undergo provocative dive profiles due to economic pressures. Consequently, rates of decompression sickness (DCS) are much greater than in recreational scuba divers. Here we present the case of a surface-supplied diving fisherman from the Yucatán Peninsula of Mexico who suffered a significant episode of spinal DCS and underwent hyperbaric oxygen therapy treatments, with a favorable outcome. Additionally, we review the proposed mechanisms underlying spinal DCS. DOI: 10.22462/9.10.2017.7

  09-01-2017

Hyperbaric oxygen therapy in the treatment of ischemia-reperfusion injury following dialysis access-steal syndrome: case report

We report the case of a 49-year-old patient who presented with ischemia-reperfusion injury (IRI) of her right hand following a dialysis access-steal syndrome treated by arteriovenous fistula ligation. Subsequently, she was treated with three daily 90-minute hyperbaric oxygen treatments and had remarkable improvement in her symptoms of pain, numbness and swelling. The patient demonstrated regain of function at three-weeks post-treatment, with full recovery of function at six months post-treatment. The non-invasive and relatively safe nature of hyperbaric oxygen therapy supports its use as a potential treatment for IRI. DOI: 10.22462/9.10.2017.8

  09-01-2017

ASM 2017 Session A: DIVING/DECOMPRESSION ILLNESS: THEORY & MECHANISMS

  DOI: 10.22462/9.10.2017.9

  09-01-2017

ASM 2017 Session B: HBO2 THERAPY MECHANISMS

 DOI: 10.22462/9.10.2017.10

  09-01-2017

ASM 2017 Session C: Clinical HBO2 THERAPY

  DOI: 10.22462/9.10.2017.11

  09-01-2017

ASM 2017 Session D: DIVING AND DECOMPRESSION ILLNESS

  DOI: 10.22462/9.10.2017.12

  09-01-2017

ASM 2017 Session E: HBO2 THERAPY, CHAMBERS AND EQUIPMENT

  DOI: 10.22462/9.10.2017.13

  09-01-2017

ASM 2017 Session F: CLINICAL AND DIVING-RELATED HBO2 THERAPY

  DOI: 10.22462/9.10.2017.14

  09-01-2017

ASM 2017: Author abstract list

  DOI: 10.22462/9.10.2017.15

  09-01-2017

Letter: Car wrecks and caution: a lament on getting the facts straight in scientific reporting – I. Eftedal - A discussion on incident reporting during a study

  DOI: 10.22462/9.10.2017.16

  09-01-2017

Letter: Response - Response: Car wrecks and caution: a lament on getting the facts straight in scientific reporting – S.L. Blogg, et al. - A discussion on incident reporting during a study

  DOI: 10.22462/9.10.2017.17

  09-01-2017

Letter: Final word - A FINAL WORD: Car wrecks and caution: a lament on getting the facts straight in scientific reporting – E. Camporesi - A discussion on incident reporting during a study

  DOI: 10.22462/9.10.2017.18

  09-01-2017