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Environmental Physiology and Medicine: Diving and Hyperbaric Exposure
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Environmental Physiology and Medicine: Diving and Hyperbaric Exposure

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 21312

Special Issue Editors

Dr. Gerardo Bosco

E-Mail Website
Guest Editor
Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
Interests: environmental physiology; hyperbaric oxygen treatment; hyperoxia; oxidative stress; diving physiology; hypoxia
Special Issues, Collections and Topics in MDPI journals
Dr. Matteo Paganini

E-Mail Website
Assistant Guest Editor
Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
Interests: emergency medicine; environmental physiology; carbon monoxide; hyperbaric oxygen treatment; diving physiology
Special Issues, Collections and Topics in MDPI journals
Dr. Danilo Cialoni

E-Mail Website
Assistant Guest Editor
Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy; DAN Europe Research Division, Roseto degli Abruzzi, Italy
Interests: diving and hyperbaric medicine; breath-hold diving; telemedicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Enrico M. Camporesi

E-Mail Website
Assistant Guest Editor
Department of Anesthesiology & Critical Care, University of South Florida, Tampa, FL 33612, USA
Interests: emergency medicine; anesthesia; critical care; environmental physiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The underwater environment poses unique challenges to the human body. The increase in environmental pressure, along with changes in blood gas composition, results in consistent modifications in physiology towards pathology in certain circumstances. Humans have the capability to explore underwater environments in different ways, but time is limited and depends mostly on the duration of air supply to provide adequate oxygenation.

Diving with voluntary breath holding (BHD) has been recorded since ancient times, and nowadays involves not only sport competitions but also recreational activities, fishing, and military operations. Next, scuba diving relies on the duration of air supply from cylinders. Finally, at extremes, commercial diving pushes humans to their limits. They remain for prolonged periods of time, sometimes weeks, at extreme depths. Research in this field has accelerated in the last decades, due to the need to understand the effects of exposure to high pressures and the occupational medicine implications of commercial diving. Given the popularity of scuba diving, research has expanded to clarify the effects of inflammatory cascade, platelet activation, and the prevention and treatment of decompression illness. The rapid adaptations experienced during BHD are of interest as well, due to connections with morbid conditions such as obstructive sleep apnea.

Hyperbaric conditions are easily reproduced in chambers as a way to administer oxygen with therapeutic intent. The value and effects of hyperbaric oxygen therapy (HBOT) on specific diseases are already well-established, but knowledge is continuously evolving towards new applications. In particular, new molecular mechanisms of action have recently been discovered and research to explain the effects of HBOT is ongoing. Moreover, recent studies have clarified the benefits of HBOT in acute diseases and emergencies and highlighted both short- and long-term outcomes. The conundrum of inflammation modulation seems to be at the basis of the HBOT mechanism of action. Therefore, efforts should be made in the future to further investigate this path for the benefit of patients.

Dr. Gerardo Bosco
Dr. Matteo Paganini
Dr. Danilo Cialoni
Prof. Enrico M. Camporesi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly 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 2500 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

  • Breath hold diving
  • Scuba diving
  • Hyperbaric oxygen thearapy
  • Hyperbaric medicine
  • Emergency medicine
  • Decompression illness
  • Hypoxia
  • Inflammation
  • Inflammatory biomarkers

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Published Papers (5 papers)

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Research

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11 pages, 294 KiB  
Article
Scuba Diving as a Form of Rehabilitation for People with Physical Disabilities
by Gabriela Henrykowska, Joanna Soin and Piotr Siermontowski
Int. J. Environ. Res. Public Health 2021, 18(11), 5678; https://doi.org/10.3390/ijerph18115678 - 26 May 2021
Cited by 10 | Viewed by 3950
Abstract
(1) Background: The exploration of the potential therapeutic benefits of scuba diving for the mental and physical health of people with physical disabilities. (2) Methods: The research was conducted on a group of 240 people (men and women) with physical disabilities, using the [...] Read more.
(1) Background: The exploration of the potential therapeutic benefits of scuba diving for the mental and physical health of people with physical disabilities. (2) Methods: The research was conducted on a group of 240 people (men and women) with physical disabilities, using the survey designed by one of the authors. The subjective sense of physical and mental fitness was analyzed in retrospective and real terms. (3) Results: Significant increases in self-esteem, belief in our own abilities (self-confidence) and improvement in the ability to engage in social interactions were observed in the group of scuba divers with disabilities compared to individuals with disabilities not practicing diving. The respondents also declared an improvement in the efficiency of the respiratory system and stressed that a water environment increased their motor skills and relieved pain. (4) Conclusions: Diving can become one of the forms of rehabilitation for people with disabilities. There is a need for further research to expand our understanding of the benefits and possible health problems involved in diving. These activities have a huge impact on improving the quality of life of people with disabilities. Full article
(This article belongs to the Special Issue Environmental Physiology and Medicine: Diving and Hyperbaric Exposure)
9 pages, 1679 KiB  
Article
Hyperbaric Oxygen Exposure Attenuates Circulating Stress Biomarkers: A Pilot Interventional Study
by Jae Seung Chang, Eunha Chang, Yoonsuk Lee, Yong Sung Cha, Seung-Kuy Cha, Won Gil Cho, Yangsik Jeong, Hyun Kim and Kyu-Sang Park
Int. J. Environ. Res. Public Health 2020, 17(21), 7853; https://doi.org/10.3390/ijerph17217853 - 27 Oct 2020
Cited by 6 | Viewed by 2947
Abstract
Hyperbaric oxygen therapy (HBOT) has been used to provide oxygen to underperfused organs following ischemia or carbon monoxide intoxication. Various beneficial consequences of HBOT have been reported, including wound healing, anti-inflammatory action, and cell survival; however, the molecular mechanisms underlying these effects have [...] Read more.
Hyperbaric oxygen therapy (HBOT) has been used to provide oxygen to underperfused organs following ischemia or carbon monoxide intoxication. Various beneficial consequences of HBOT have been reported, including wound healing, anti-inflammatory action, and cell survival; however, the molecular mechanisms underlying these effects have not been elucidated yet. We applied a single HBOT program consisting of administration of 2.8 atmospheres absolute (ATA) for 45 min, followed by 2.0 ATA for 55 min, to 10 male volunteers without any metabolic disease. Within 1 week of HBOT, there was no alteration in serum biochemical variables, except for an increase in triglyceride content. As a mitochondrial stress indicator, the serum concentration of growth differentiation factor 15 was reduced by HBOT. The circulating level of γ–glutamyltransferase was also decreased by HBOT, suggesting an attenuation of oxidative stress. HBOT increased adiponectin and reduced leptin levels in the serum, leading to an elevated adiponectin/leptin ratio. This is the first study to investigate the effect of HBOT on serum levels of metabolic stress-related biomarkers. We suggest that HBOT attenuates mitochondrial and oxidative stresses, and relieves metabolic burdens, indicating its potential for use in therapeutic applications to metabolic diseases. Full article
(This article belongs to the Special Issue Environmental Physiology and Medicine: Diving and Hyperbaric Exposure)
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14 pages, 1546 KiB  
Article
Magnitude and Clinical Predictors of Blood Pressure Changes in Patients Undergoing Hyperbaric Oxygen Therapy: A Retrospective Study
by Simone Schiavo, Carine Djaiani, Julian DeBacker, Lisa Albertini, Daniel Santa Mina, Stephanie Buryk-Iggers, Marcus Vinicius De Moraes, Mohammad Kanj and Rita Katznelson
Int. J. Environ. Res. Public Health 2020, 17(20), 7586; https://doi.org/10.3390/ijerph17207586 - 19 Oct 2020
Cited by 8 | Viewed by 3818
Abstract
Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this [...] Read more.
Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this study was to quantify ABP changes in patients undergoing HBOT and to examine their predictors. This retrospective longitudinal cohort study examined 3291 elective HBOT sessions. Non-invasive ABP was recorded before and after each session. The primary outcome was to quantify the HBOT-induced ABP rise. The secondary outcome was to determine the ABP-rise predictors among demographic and clinical variables. Overall, ABP increased significantly after HBOT; this finding was more evident in the hypertensive subgroup compared to the normotensive one (+6 vs. +16.2 mmHg). Clinical predictors of significant post-HBOT ABP change were history of hypertension and pre-session baseline ABP classification. This study demonstrates an absolute HBOT-induced ABP rise. This change is clinically relevant in patients with history of hypertension. A higher baseline ABP seems a risk factor for clinically relevant ABP change. Pre-session ABP should be used clinically as an indicator for strict ABP monitoring during HBOT; future studies are recommended to explore the ABP optimization before starting an HBO treatment. Full article
(This article belongs to the Special Issue Environmental Physiology and Medicine: Diving and Hyperbaric Exposure)
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Review

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16 pages, 2728 KiB  
Review
Evidence-Supported HBO Therapy in Femoral Head Necrosis: A Systematic Review and Meta-Analysis
by Emma Paderno, Vincenzo Zanon, Giuliano Vezzani, Tommaso Antonio Giacon, Thomas L. Bernasek, Enrico M. Camporesi and Gerardo Bosco
Int. J. Environ. Res. Public Health 2021, 18(6), 2888; https://doi.org/10.3390/ijerph18062888 - 12 Mar 2021
Cited by 13 | Viewed by 5642
Abstract
Although many studies have shown that hyperbaric oxygen (HBO) therapy can significantly improve symptoms and quality of life of patients affected by femoral head necrosis, this therapy is not worldwide approved yet. This meta-analysis was performed to evaluate its clinical effect. Relevant studies [...] Read more.
Although many studies have shown that hyperbaric oxygen (HBO) therapy can significantly improve symptoms and quality of life of patients affected by femoral head necrosis, this therapy is not worldwide approved yet. This meta-analysis was performed to evaluate its clinical effect. Relevant studies published before May 2020 were systematically searched using terms related to HBO and femoral head necrosis. Fixed and random-effects models were used to estimate the odds ratio (OR) with 95% confidence intervals (CI). Subgroup analyses and publication bias tests were carried out to explore potential study heterogeneity and bias. Ten studies involving 353 controls and 368 HBO-treated cases were included, most of which were conducted on Asian population. The clinical effect in the HBO therapy group was 3.84 times higher than in the control group (OR = 3.84, 95% CI (2.10, 7.02), p < 0.00001). Subgroup analyses showed that the clinical effect of HBO therapy was statistically significant in the Asian subpopulation which represented most of the subjects (OR = 3.53, 95% CI (1.87, 6.64), p < 0.00001), but not in the non-Asian subpopulation, probably because of insufficient numerosity (OR = 7.41, 95% CI (0.73, 75.71), p = 0.09). The results of this meta-analysis suggest that patients with femoral head necrosis treated with HBO therapy can achieve a significant clinical improvement. Full article
(This article belongs to the Special Issue Environmental Physiology and Medicine: Diving and Hyperbaric Exposure)
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Other

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9 pages, 1648 KiB  
Case Report
Hyperbaric Oxygen Therapy and A-PRF Pre-Treated Implants in Severe Periodontitis: A Case Report
by Tommaso Antonio Giacon, Franco Giancola, Matteo Paganini, Cesare Tiengo, Enrico M. Camporesi and Gerardo Bosco
Int. J. Environ. Res. Public Health 2021, 18(2), 413; https://doi.org/10.3390/ijerph18020413 - 7 Jan 2021
Cited by 7 | Viewed by 3992
Abstract
Implantation is currently the best option for tooth replacement in periodontitis. Some major contraindications for the immediate implant are acute periodontitis and active infection. We present the case of a 51-year-old female patient with the highest grade and stage periodontitis treated with advanced [...] Read more.
Implantation is currently the best option for tooth replacement in periodontitis. Some major contraindications for the immediate implant are acute periodontitis and active infection. We present the case of a 51-year-old female patient with the highest grade and stage periodontitis treated with advanced platelet-rich fibrin-enriched zirconia implants and with hyperbaric oxygen therapy (HBOT). In particular, HBOT before and after implantation promoted bone regeneration and implant integration, also providing an antiseptic effect. After six months, the implants were well established and fully healed from periodontal disease within 14 months. Further research could confirm a new indication for HBOT in treating periodontitis and dental implantation. Full article
(This article belongs to the Special Issue Environmental Physiology and Medicine: Diving and Hyperbaric Exposure)
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