1/99. Three cases of spinal decompression sickness treated by U.S. Navy Treatment Table 7.For patients of type 2 decompression sickness, recompression therapy using U.S. Navy Treatment Table 6 (TT6) and its extensions is the most common means of treatment. However, some cases are resistant to the recompression therapy, and the outcome of TT6 is not always satisfactory. Although a new table, the U.S. Navy Treatment Table 7 (TT7) was described in 1985 in the U.S. Navy diving Manual, to date few cases who were treated using TT7 have been reported. Here, we report three cases of spinal decompression sickness who received treatment according to TT7. Two were sports scuba divers, and the other a commercial diver. TT7 was applied later than 4 d after onset in all three cases; two patients were remarkably improved during the recompression therapy, while the other improved to a certain extent after additional repetitive TT6. Mild impairment of lung function, probably due to pulmonary oxygen toxicity, was observed on lung function testing in one case. In all cases, after additional TT6 and/or rehabilitation, patients were able to return to active daily living.- - - - - - - - - - ranking = 1keywords = sickness (Clic here for more details about this article) |
2/99. Inner ear decompression sickness following altitude chamber operation.decompression sickness (DCS) is a known hazard of altitude chamber operation. The musculoskeletal, dermal, neurological and pulmonary manifestations of DCS are well recognized, but inner ear injury has not been reported. We present the unusual case of a medical corpsman suffering from vestibular DCS after an altitude chamber exposure to 25,000 ft. The patient had a good clinical response to hyperbaric treatment, but there was laboratory evidence of mild residual vestibular damage with full compensation. This case suggests that aviation medical personnel should be more aware of the possible occurrence of inner ear DCS among subjects exposed to altitude.- - - - - - - - - - ranking = 0.83333333333333keywords = sickness (Clic here for more details about this article) |
3/99. Infraorbital hypesthesia after maxillary sinus barotrauma.We report a case of a diver who suffered an episode of maxillary sinus barotrauma that presented with decreased sensation over the cutaneous distribution of the infraorbital nerve after an ascent which produced facial pain and crepitus. This case illustrates a potential confusion between a decompression sickness etiology and a barotraumatic etiology for the observed sensory deficit. The clinical features of this case were most consistent with a barotraumatic etiology for the findings noted. The anatomy of the trigeminal nerve and previous reports of cranial nerve deficits following barotrauma are reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
4/99. A trial to determine the risk of decompression sickness after a 40 feet of sea water for 200 minute no-stop air dive.BACKGROUND: The USN93 probabilistic model of decompression sickness (DCS) predicts a DCS risk of 3.9% after a 40 ft of seawater (fsw) for 200 min no-stop air dive, although little data is available to evaluate the accuracy of this prediction. Based on an analysis of Navy safety Center data from diving on U.S. Navy standard air decompression tables, the observed incidence of DCS for this type of dive is 0.11%. Knowing the true incidence of the dive is important for deciding whether or not to adopt proposed probability based decompression procedures for U.S. Navy diving. HYPOTHESIS: The risk of DCS after a 40 fsw for 200 min no-stop air dive is 3.9%. methods: We conducted a closed sequential trial to determine the DCS incidence on this dive. RESULTS: Of 30 military divers who completed 91 dives, there were 2 cases of DCS (2.2%, 95% CI: 0.27 7.7%). The study was terminated early after the second DCS case because of the presence of neurological symptoms and signs. CONCLUSIONS: This study demonstrates that the incidence of DCS in a laboratory setting is higher than observed in fleet diving. Use of the 40 fsw for 200 min schedule in a decompression computer is likely to result in DCS incidence 2.5- to 70-fold greater than that observed in U.S. Navy diving using table-based procedures.- - - - - - - - - - ranking = 0.83333333333333keywords = sickness (Clic here for more details about this article) |
5/99. Test and evaluation of exercise-enhanced preoxygenation in U-2 operations.BACKGROUND: Preoxygenation to prevent decompression sickness (DCS) during U-2 reconnaissance flights requires considerable time and occasionally does not provide adequate protection. Increasing preoxygenation within a practical period of time provides marginally increased protection and is not always operationally feasible. Including exercise during preoxygenation to increase muscle tissue perfusion, cardiac output, and ventilation can improve the quality of the denitrogenation. methods: A pilot, who reported two cases of DCS during his first 25 U-2 high flights involving cabin altitudes of 29,000-30,000 ft, volunteered to test exercise-enhanced preoxygenation. He performed 10 min of strenuous upper and lower body exercise at the beginning of preoxygenation prior to subsequent high flights without increasing total preoxygenation time. RESULTS: The exercise was performed at 75% of maximal oxygen uptake based on the estimated maximal oxygen uptake determined during an air Force aerobic fitness test and heart rate. The pilot's next 36 high flights, using exercise-enhanced preoxygenation, were completed with no reports of DCS. CONCLUSIONS: This statistically significant operational test reinforced the laboratory studies. Implementation of this procedure for reducing DCS in susceptible U-2 pilots and collecting additional data from the U-2 pilot population is recommended.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
6/99. Delayed onset pulmonary barotrauma or decompression sickness? A case report of decompression-related disorder.A-24-yr-old male professional diver began to complain of substernal pain 3 h after a controlled ascent from a dive of less than 40 ft of sea water (fsw). The diving master who supervised his dive and the physicians who examined him on presentation suspected pulmonary barotrauma rather than decompression sickness (DCS) because he had only descended to a depth of 32 fsw. Hyperbaric oxygen therapy (HBO) by U.S. Navy treatment Table VI was implemented because of his progressively worsening pain. HBO was apparently effective and a relapse was not seen. The author cannot label his condition based on the conventional classification categories, such as decompression sickness (DCS), barotrauma or even decompression illness. This case report is offered as a topic for consideration in the controversy over decompression-related disorders.- - - - - - - - - - ranking = 1keywords = sickness (Clic here for more details about this article) |
7/99. Cases from the aerospace medicine Resident's teaching File: unsuspected pulmonary barotrauma.A USAF pararescue specialist developed chest pain during scuba diving duty. Initial evaluations considered decompression sickness and musculoskeletal etiologies. Pulmonary barotrauma was not contemplated because of the relatively mild presentation. Later, a very significant pneumothorax was discovered and successfully treated without sequelae. decompression sickness is briefly discussed followed by a more in-depth examination of the presentation, diagnosis, treatment, and aeromedical aspects of spontaneous and "deserved" pneumothoraces.- - - - - - - - - - ranking = 0.33333333333333keywords = sickness (Clic here for more details about this article) |
8/99. The "bends" and neurogenic bladder dysfunction.decompression sickness (the "bends") is a well-known risk of scuba diving. The pathophysiology and treatment is well documented. In the urologic data, no reference to the development of a neurogenic bladder as a result of an episode of the bends was found. We present the evaluation and management of a previously asymptomatic man who developed detrusor hyperreflexia after an episode of decompression sickness. Urologists in coastal communities should be aware of the potential risk of the development of neurogenic bladder.- - - - - - - - - - ranking = 0.33333333333333keywords = sickness (Clic here for more details about this article) |
9/99. Radionuclide lung imaging in respiratory decompression sickness: potential role in the diagnosis and evaluation of hyperbaric therapy.Of the more than 3.5 million trained divers in the united states, many will experience various illnesses specific to divers. Most of these illnesses are related to the changes in absolute pressure that divers experience while diving. During and after ascent, a diver is at risk for decompression sickness and pulmonary barotrauma. A very rare casualty is pulmonary decompression sickness from immersion. This is a literature review and case report of a young woman with acute respiratory decompression sickness who had defects on perfusion lung imaging after a diving accident and after hyperbaric oxygen therapy. However, the perfusion defects reverted to normal in less than 24 hours. Possible explanations for the changes in the appearances of the scans are offered and discussed. This case report shows the potential utility of lung scanning in the diagnostic examination of these patients and the evaluation of the adequacy of treatment with hyperbaric oxygen therapy. A greater use of ventilation-perfusion lung scans in the treatment of such patients may establish its role more definitely.- - - - - - - - - - ranking = 1.1666666666667keywords = sickness (Clic here for more details about this article) |
10/99. Diver with decompression injury, elevation of serum transaminase levels, and rhabdomyolysis.A 43-year-old female recreational scuba diver presented to the emergency department 1 hour after a rapid, uncontrolled ascent. Her presentation included progressing confusion, slow and slurred speech, and complaints of headache and hypesthesia over her forearms and anterior thighs bilaterally. Differential diagnosis included arterial gas embolism and decompression sickness. She underwent recompression therapy with US Navy Table 6 within 120 minutes of her ascent. After recompression therapy, the patient had signs and symptoms consistent with severe rhabdomyolysis, including creatine kinase levels of 36,000 U/L and myoglobinuria.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
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