9 research outputs found
Recompression treatment for decompression illness: 5-year report (2003-2007) from National Centre for Hyperbaric Medicine in Poland
A serious diving accident can occur in recreational diving even in countries where
diving is not very popular due to the fact that diving conditions there are not as great as
in some tropical diving locations. The estimated number of injured divers who need
recompression treatment in European hyperbaric facilities varies between 10 and 100
per year depending on the number of divers in the population, number of dives
performed annually, and number of hyperbaric centres in the country. In 5 years of
retrospective observation in Poland (2003-2007) there were 51 cases of injured
recreational divers recorded. They either dived locally or after returning home by air
from a tropical diving resort. All of them were treated with recompression treatment in
the National Centre for Hyperbaric Medicine in Gdynia which has capability to treat
any patient with decompression illness using all currently available recompression schedules with any breathing mixtures including oxygen, nitrox, heliox or trimix. The
time interval between surfacing and first occurrence of symptoms was significantly
lower in the group of patients with neurological decompression sickness or arterial gas
embolism (median 0.2 hours) than in the group of patients with other types of
decompression sickness (median 2.0 hours). In both groups, there were different types
of recompression tables used for initial treatment and different number of additional
sessions of hyperbaric oxygenation (HBO) prescribed, but the final outcome was
similar. Complete resolution of symptoms after initial recompression treatment was
observed in 24 cases, and this number was increased to 37 cases after additional HBO
sessions (from 1 to 20). In the final outcome, some residual symptoms were observed in
12 cases. In 2 cases initial diagnosis of decompression sickness type I was rejected after
initial recompression treatment and careful re-evaluation of diving profiles, risk factors
and reported symptoms
Implantable cardioverter-defibrillators in patients with long QT syndrome: a multicentre study
Background: Implantable cardioverter-defibrillator (ICD) therapy has been proven effective in the prevention of sudden cardiac death, but data on outcomes of ICD therapy in the young and otherwise healthy patients with long QT syndrome (LQTS) are limited.
Aim: We sought to collect data on appropriate and inappropriate ICD discharges, risk factors, and ICD-related complications.
Methods: All LQTS patients implanted with an ICD in 14 centres were investigated. Demographic, clinical, and ICD therapy data were collected.
Results: The study included 67 patients (88% female). Median age at ICD implantation was 31 years (12–77 years). ICD indication was based on resuscitated cardiac arrest in 46 patients, syncope in 18 patients, and malignant family history in three patients. During a median follow-up of 48 months, 39 (58%) patients received one or more ICD therapies. Time to first appropriate discharge was up to 55 months. Inappropriate therapies were triggered by fast sinus rhythm, atrial fibrillation, and T-wave oversensing. No predictors of inappropriate shocks were identified. Risk factors for appropriate ICD therapy were: (1) recurrent syncope despite b-blocker treatment before ICD implantation, (2) pacemaker therapy before ICD implantation, (3) single-chamber ICD, and (4) noncompliance to b-blockers. In 38 (57%) patients, at least one complication occurred.
Conclusions: ICD therapy is effective in nearly half the patient population; however, the rates of early and late complications are high. Although the number of unnecessary ICD shocks and reimplantation procedures may be lowered by modern programming and increased longevity of newer ICD generators, other adverse events are less likely to be reduced
Primary hypertension is a disease of premature vascular aging associated with neuro-immuno-metabolic abnormalities
Pneumoperitoneum after diving – two clinical cases and literature review
Pneumoperitoneum after diving is a rare symptom. Diagnosis and treatment
strongly depends on the primary source of the air in the abdominal cavity. There are two
main sources of air entering the perineum: perforation of the gastrointestinal tract and
pulmonary barotrauma. The management is different and additionally, in both cases, the
decompression sickness and arterial gas embolism as consequences of inappropriate
decompression phase of the diving should be included in the clinical diagnosis and
treatment. The multidisciplinary team including hyperbaric physicians and surgeons is
necessary for proper management of such cases. In this paper two cases of
pneumoperitoneum of different origins are presented and similar cases reported in the
literature are discussed.
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Altered Genes Profile of Renin–Angiotensin System, Immune System, and Adipokines Receptors in Leukocytes of Children With Primary Hypertension
Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Peripheral Blood Leukocytes and Plasma of Children with Nonalcoholic Fatty Liver Disease
Gene expression profiles of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) were evaluated in peripheral blood leukocytes of children with nonalcoholic fatty liver disease (NAFLD). Gene expression patterns were correlated with their plasma protein counterparts, systemic parameters of liver injury, and selected markers of inflammation. The MMP-2, MMP-9, MMP-12, MMP-14, TIMP-1, TIMP-2, TGF-β, and IL-6 transcripts levels were tested by the real-time PCR. Plasma concentrations of MMP-9, TIMP-1, MMP-9/TIMP-1 ratio, MMP-2/TIMP-2 ratio, sCD14, leptin, resistin, IL-1 beta, and IL-6 and serum markers of liver injury were estimated by ELISA. The MMP-9, TIMP-2 expression levels, plasma amounts of MMP-9, TIMP-1, and the MMP-9/TIMP-1 ratio were increased in children with NAFLD. Concentrations of AST, ALT, GGT, and leptin were elevated in serum patients with NAFLD, while concentration of other inflammatory or liver injury markers was unchanged. The MMP-2 and MMP-9 levels correlated with serum liver injury parameters (ALT and GGT concentrations, respectively); there were no other correlations between MMP/TIMP gene expression profiles, their plasma counterparts, and serum inflammatory markers. Association of MMP-2 and MMP-9 expression with serum liver injury parameters (ALT, GGT) may suggest leukocyte engagement in the early stages of NAFLD development which possibly precedes subsequent systemic inflammatory responses