• Klíčová slova
• DECOMPRESSION SICKNESS/prevention and control *,
• MeSH
• biomedicínský výzkum * MeSH
• dekompresní nemoc prevence a kontrola   MeSH
• lidé MeSH
• Perciformes * MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The aim of this investigation was to study the effect of environmental pressure and surface tension on the size of gas bubbles in tissues and on their inner pressure. Due to the action of surface tension, the pressure inside the bubbles is always greater than the surrounding pressure. This phenomenon is the more marked, the smaller are the bubbles. Therapeutic compression leads to diminution of the volume of gas bubbles and thus to a rise of that portion of their inner pressure which is due to surface tension. In small bubbles the surface tension may cause their dissolution and disappearance. It is therefore correct to implement therapeutic compression in decompression sickness as soon as possible before the fusion of a significant number of small bubbles into larger ones occurs.

• MeSH
• atmosférický tlak MeSH
• dekomprese * MeSH
• dekompresní nemoc terapie   MeSH
• plyny * MeSH
• povrchové napětí MeSH
• teoretické modely MeSH
• teplota MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• plyny * MeSH

OBJECTIVES: This paper sought to evaluate the occurrence of decompression sickness (DCS) after the application of a patent foramen ovale (PFO) screening and risk stratification strategy. BACKGROUND: PFO is associated with an increased risk of DCS. Recently, transcatheter closure was reported to reduce DCS occurrence in divers with a high-grade shunt. However, to date, there are no data regarding the effectiveness of any PFO screening and risk stratification strategy for divers. METHODS: A total of 829 consecutive divers (age 35.4 ± 10.0 years, 81.5% men) were screened for PFO by means of transcranial color-coded sonography in the DIVE-PFO (Decompression Illness Prevention in Divers with a Patent Foramen Ovale) registry. Divers with a high-grade PFO were offered either catheter-based PFO closure (the closure group) or advised conservative diving (high grades). Divers with a low-grade shunt were advised conservative diving (low grades), whereas those with no PFO continued unrestricted diving (controls). A telephone follow-up was performed. To study the effect of the screening and risk stratification strategy, DCS occurrence before enrollment and during the follow-up was compared. RESULTS: Follow-up was available for 748 (90%) divers. Seven hundred and 2 divers continued diving and were included in the analysis (mean follow-up 6.5 ± 3.5 years). The DCS incidence decreased significantly in all groups, except the controls. During follow-up, there were no DCS events in the closure group; DCS incidence was similar to the controls in the low-grade group (HR: 3.965; 95% CI: 0.558-28.18; P = 0.169) but remained higher in the high-grade group (HR: 26.170; 95% CI: 5.797-118.160; P < 0.0001). CONCLUSIONS: The screening and risk stratification strategy using transcranial color-coded sonography was associated with a decrease in DCS occurrence in divers with PFO. Catheter-based PFO closure was associated with a DCS occurrence similar to the controls; the conservative strategy had a similar effect in the low-grade group, but in the high-grade group the DCS incidence remained higher than in all other groups.

• Klíčová slova
• decompression sickness, paradoxical embolism, patent foramen ovale, risk stratification, screening,
• MeSH
• dekompresní nemoc * diagnostické zobrazování   epidemiologie   etiologie   MeSH
• dospělí MeSH
• foramen ovale apertum * komplikace   diagnostické zobrazování   epidemiologie   MeSH
• hodnocení rizik MeSH
• lidé středního věku MeSH
• lidé MeSH
• prediktivní hodnota testů MeSH
• registrace MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Patent foramen ovale (PFO), male sex, age, and body mass index (BMI) were all identified as potential risk factors of decompression sickness (DCS). It has been debated whether PFO might cause unprovoked DCS (i.e. without violation of decompression procedure) due to paradoxical embolization of venous gas emboli. To date, there are no data on the incidence or risk factors of unprovoked DCS. This study sought to evaluate the risk factors of unprovoked DCS in recreational divers. METHODS: A total of 489 consecutive divers were screened for PFO between January 2006 and January 2014 by means of transcranial Doppler. All patients were prospectively included in the study registry. Survival analysis techniques were used to assess for risk factors for unprovoked DCS. Age, sex, BMI, PFO presence, and grade were analyzed. The total sum of dives was used as a measure of time. RESULTS: The group performed a total of 169,411 dives (mean 346±636). Thirty-six (7%) of the divers suffered from an unprovoked DCS. The frequency of PFO was 97.2% in divers with a history of unprovoked DCS and 35.5% in controls (p<0.001). There was no difference in sex, age, BMI, or total number of dives between the respective groups. In the adjusted Cox proportional hazards model, PFO grade 3 was a major risk factor for unprovoked DCS; there was a slight protective effect of increasing age. CONCLUSIONS: We demonstrated that a high-grade PFO was a major risk factor for unprovoked DCS in recreational scuba divers.

• Klíčová slova
• Decompression sickness, Patent foramen ovale, Risk factors,
• MeSH
• dekompresní nemoc etiologie   MeSH
• dospělí MeSH
• foramen ovale apertum komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• potápění škodlivé účinky   MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• registrace MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

Recreational and technical diving in the past twenty years have become extraordinary popular. Until then diving was a priority of police, army and scientists. Today more and more enthusiasts are exposed to abnormally high surrounding pressure. To the severest of all risks associated with diving, decompression sickness is the greatest threat. Even the most advanced scientific approaches yet did not reveal the complex mechanisms of decompression sickness formation. The majority of experiments use a live model for decompression sickness studies. This is associated with high fatality rate. The new approach of this scientific study is in the use of an in vitro working media as a means of visualization of gas bubbles due to decompression. The aim of this study is to bring above new approaches in in vitro gas bubble formation during decompression. Main goals are: development of in vitro inert gas bubble visualization and evaluation techniques after a real decompression dive with air a as the diving gas and EANx50 as a decompression gas. We selected cell cultures derived from human fibroblasts B-HEF-2 and cell cultures of mice N2A neuroblasts. We used two decompression profiles. "Explosive" decompression profile with a linear compression to overpressure of 50 bar with an rapid decompression to atmospheric pressure (1 bar). In simulation of a realistic decompression profile we used compressed air as a mean for compression and isocompression breathing gas and an EANx50 blend as a decompression breathing gas. This dive was planned with the use of a VPM-B decompression profile by V-Planner software v.3.62. Our latest experiments show that DNA fragmentation and apoptosis is activated during decompression shock. Use of culture cells can be of great value in further studies of decompression changes in the cellular and subcellular level.

• MeSH
• dekomprese MeSH
• dekompresní nemoc patofyziologie   MeSH
• kultivované buňky MeSH
• lidé MeSH
• potápění fyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• dekompresní nemoc * MeSH
• lidé MeSH
• neurologické manifestace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• DECOMPRESSION SICKNESS *,
• MeSH
• barotrauma * MeSH
• dekompresní nemoc * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• DECOMPRESSION SICKNESS *,
• MeSH
• dekompresní nemoc * MeSH
• lidé MeSH
• práce * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dekompresní nemoc patofyziologie   MeSH
• dospělí MeSH
• elektroencefalografie * MeSH
• lidé MeSH
• pracovní lékařství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• DECOMPRESSION SICKNESS/case reports *,
• MeSH
• chorobopisy * MeSH
• dekompresní nemoc * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH