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Diving Physiology and Medical Healthcare
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Diving Physiology and Medical Healthcare

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (28 April 2022) | Viewed by 17794

Special Issue Editors

Prof. Dr. Alessandro Marroni

E-Mail Website
Guest Editor
Research Department, DAN Europe Foundation, 64026 Roseto, Italy
Interests: prevention of DCI in recreational and professional diving; hyperbaric medicine (ECHM); baromedicine; hyperbaric medicine; underwater and baromedical society; decompression sickness; diving; air embolism; remote emergency medical assistance; telemedicine in underwater and extreme environments
Special Issues, Collections and Topics in MDPI journals
Dr. Danilo Cialoni

E-Mail Website
Guest Editor
Research Department, DAN Europe Foundation, 64026 Roseto, Italy
Interests: diving pathophysiology; decompression illnesses; decompression algorithms; breath hold diving; extreme environments; telemedicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is focused on the role of advanced real-time field research in the definition of human adaptation to the underwater environment and to extreme environments in general, through the use of advanced, virtual augmented reality, AI and machine learning-assisted, real time physiological monitoring techniques, the definition of physio-pathological patterns and best safety standards for decompression after underwater immersion, and mechanisms of human adaptation to underwater immersion.

Prof. Dr. Alessandro Marroni
Dr. Danilo Cialoni
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diving pathophysiology
  • decompression illnesses
  • decompression algorithms
  • breath hold diving
  • extreme environments
  • telemedicine

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Published Papers (5 papers)

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Research

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12 pages, 493 KiB  
Article
Influence of Scuba Diving on the Quality of Life of People with Physical Disabilities
by Gabriela Henrykowska, Joanna Soin, Katarzyna Pleskacz and Piotr Siermontowski
Healthcare 2022, 10(5), 761; https://doi.org/10.3390/healthcare10050761 - 20 Apr 2022
Cited by 2 | Viewed by 3395
Abstract
The aim of the study was to assess quality of life related to mental and physical health among divers and non-divers with physical disabilities. The examined group consisted of 240 disabled people (both genders). The SF-36 questionnaire (Short-Form Health Survey) was used to [...] Read more.
The aim of the study was to assess quality of life related to mental and physical health among divers and non-divers with physical disabilities. The examined group consisted of 240 disabled people (both genders). The SF-36 questionnaire (Short-Form Health Survey) was used to measure the overall sense of health-related quality of life. Moreover, the authors’ survey was also used in the study. There was a significant difference (p < 0.05) in the self-assessment of the quality of life (physical functioning, social functioning, mental health, and vitality) between the examined diving and non-diving groups. In other areas evaluated with the use of the SF-36 questionnaire, i.e., limitation in performing roles due to emotional problems and pain, limitations in performing roles due to physical health, a tendency to a higher rating was noticed in the group of divers. Scuba diving can improve various components of the life-quality of people with disabilities, and in general can be seen as a form of physical activity and rehabilitation for people with disabilities. However, it is necessary to conduct extensive research in this area. Full article
(This article belongs to the Special Issue Diving Physiology and Medical Healthcare)
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11 pages, 2645 KiB  
Article
White Blood Cells, Platelets, Red Blood Cells and Gas Bubbles in SCUBA Diving: Is There a Relationship?
by Danilo Cialoni, Andrea Brizzolari, Alessandra Barassi, Gerardo Bosco, Massimo Pieri, Valentina Lancellotti and Alessandro Marroni
Healthcare 2022, 10(2), 182; https://doi.org/10.3390/healthcare10020182 - 18 Jan 2022
Cited by 3 | Viewed by 2450
Abstract
(1) Background: SCUBA diving can influence changes of several hematological parameters (HP) but the changes of HP in the decompression phases are still unclear. The aim of this study was to investigate any possible relationship between HP and predisposition to inert gas bubble [...] Read more.
(1) Background: SCUBA diving can influence changes of several hematological parameters (HP) but the changes of HP in the decompression phases are still unclear. The aim of this study was to investigate any possible relationship between HP and predisposition to inert gas bubble formation after a single recreational dive. (2) Methods: Blood, obtained from 32 expert SCUBA divers, was tested for differences in white blood cells (WBC), granulocytes (GRAN), lymphocytes (LYM), and monocytes (MONO), red blood cells (RBC), and platelets (PLT) between bubblers (B) and non-bubblers (NB). (3) Results: We found inter-subject differences in bubble formation (considering the same diving profile performed by the divers) and a statistically significant higher number of total WBC, GRAN and LYM in NB as compared to the B divers in the pre and in the post diving sample, while no statistical differences were found for MONO and PLT. In addition, we did not find any statistically significant difference between NB and B in RBC. (4) Conclusions: Our results, even if in absence of investigated anti-inflammatory markers, could indicate a relationship between low WBC numbers and bubble formation. This aspect may explain a possible cause of inter-subject differences in bubble formation in divers performing the same dive profile. Full article
(This article belongs to the Special Issue Diving Physiology and Medical Healthcare)
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9 pages, 855 KiB  
Article
The Effect of Scuba Diving on Microleakage of a Class II Composite Restoration: An In-Vitro Study
by Maryam Shahnavazi, Behzad Salari and Reza Fekrazad
Healthcare 2021, 9(6), 768; https://doi.org/10.3390/healthcare9060768 - 19 Jun 2021
Cited by 3 | Viewed by 3817
Abstract
Persistent pressure change is a common phenomenon within scuba diving with various medical and dental sign side effects. This study evaluates the effect of simulated pressure change due to scuba diving on the microleakage of class II composite restoration. In our methodology, a [...] Read more.
Persistent pressure change is a common phenomenon within scuba diving with various medical and dental sign side effects. This study evaluates the effect of simulated pressure change due to scuba diving on the microleakage of class II composite restoration. In our methodology, a total number of 150 intact bicuspids are divided into two main groups (A and B), and prepared for a class II composite restoration. The samples of each main group are divided into five subgroups to be prepared with different liners. Then samples are restored with the same resin composite material. The teeth in group A are thermocycled under the normal atmospheric pressure, while group B are thermocycled under simulated scuba diving conditions. The gingival microleakage is assessed based on dye penetration. The group B teeth show a significantly higher microleakage score than their equivalents in group A (p < 0.05). The subgroups without a liner have a higher microleakage score than the other subgroups (p < 0.05). The flowable composite shows the leased leakage scores followed by Nano ionomer, Resin Modified Glass Iononomer, GIOMER, and linerless groups (p < 0.05). Scuba diving could increase the risk of microleakage development beneath class II, a composite restoration. Full article
(This article belongs to the Special Issue Diving Physiology and Medical Healthcare)
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Review

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8 pages, 243 KiB  
Review
An Updated Narrative Review on Ergometric Systems Applied to Date in Assessing Divers’ Fitness
by Sven Dreyer, Johannes Schneppendahl, Fabian Moeller, Andreas Koch, Thomas Muth and Jochen D. Schipke
Healthcare 2021, 9(8), 1044; https://doi.org/10.3390/healthcare9081044 - 13 Aug 2021
Cited by 2 | Viewed by 2477
Abstract
Many recreational divers suffer medical conditions, potentially jeopardizing their safety. To scale down risks, medical examinations are mandatory and overwhelmingly performed using bicycle ergometry, which overlooks some important aspects of diving. Searching ergometric systems that better address the underwater environment, a systematic literature [...] Read more.
Many recreational divers suffer medical conditions, potentially jeopardizing their safety. To scale down risks, medical examinations are mandatory and overwhelmingly performed using bicycle ergometry, which overlooks some important aspects of diving. Searching ergometric systems that better address the underwater environment, a systematic literature search was conducted using the keywords ‘diving’, ‘fitness’, ‘ergometry’, and ‘exertion’. All presented alternative systems found convincingly describe a greatly reduced underwater physical performance. Thus, if a diver’s workload in air should already be limited, he/she will suffer early from fatigue, risking a diving incident. How to assess fitness? Performance diagnostics in sports is always specific for a modality or movement. Therefore, professional scuba divers should be tested when fin-swimming underwater. For the vast number of recreational divers, the current screening can likely not be replaced. However, to prevent accidents, divers need to understand and be able to improve factors that limit their physical performance underwater. Other systems, presented here, will continue to be important tools in underwater research. Full article
(This article belongs to the Special Issue Diving Physiology and Medical Healthcare)

Other

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17 pages, 4691 KiB  
Case Report
How to Survive 33 min after the Umbilical of a Saturation Diver Severed at a Depth of 90 msw?
by Sven Dreyer, Andreas Deussen, Dietmar Berndt and Jochen D. Schipke
Healthcare 2022, 10(3), 453; https://doi.org/10.3390/healthcare10030453 - 28 Feb 2022
Cited by 1 | Viewed by 4508
Abstract
In 2012, a severe accident happened during the mission of a professional saturation diver working at a depth of 90 m in the North Sea. The dynamic positioning system of the diver support vessel crashed, and the ship drifted away from the working [...] Read more.
In 2012, a severe accident happened during the mission of a professional saturation diver working at a depth of 90 m in the North Sea. The dynamic positioning system of the diver support vessel crashed, and the ship drifted away from the working place, while one diver’s umbilical became snagged on a steel platform and was severed. After 33 min, he was rescued into the diving bell, without exhibiting any obvious neurological injury. In 2019, the media and a later ‘documentary’ film suggested that a miracle had happened to permit survival of the diver once his breathing gas supply was limited to only 5 min. Based on the existing data and phone calls with the diver concerned (Dc), the present case report tries to reconstruct, on rational grounds, how Dc could have survived after he was cut off from breathing gas, hot water, light and communication while 90 m deep at the bottom of the sea. Dc carried bail-out heliox (86/14) within two bottles (2 × 12 L × 300 bar: 7200 L). Calculating Dc’s varying per-minute breathing gas consumption over time, both the decreased viscosity of the helium mix and the pressure-related increase in viscosity did not exhibit a breathing gas gap. Based on the considerable respiratory heat loss, the core temperature was calculated to be as low as 28.8 °C to 27.2 °C after recovery in the diving bell. In accordance with the literature, such values would be associated with impaired or lost consciousness, respectively. Relocating Dc on the drilling template by using a remotely operated vehicle (ROV), the transport of the victim to the bell and subsequent care in the hyperbaric chamber must be regarded as exemplary. We conclude that, based on rational arguments and available literature data, Dc’s healthy survival is not a miracle, as it can be convincingly explained by means of reliable data. Remaining with a breathing gas supply sufficient for five minutes only would not have ended in a miracle but would have ended in death by suffocation. Nevertheless, survival of such an accident may appear surprising, and probably the limit for a healthy outcome was very close. We conclude, in addition, that highly effective occupational safety measures, in particular the considerable bail-out heliox reserve, secured the healthy survival. Nevertheless, the victim’s survival is likely to be due to his excellent diving training, together with many years of diving routine. The rescue action of the second diver and Dc’s retrieval by the ROV operator are also suggestive of the behavior of carefully selected crew members with the high degree of professional qualification needed to correctly function in a hostile environment. Full article
(This article belongs to the Special Issue Diving Physiology and Medical Healthcare)
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