Diving Medical Literature

[Gene_Hobbs]

I saw a thread in another forum recently asking for decompression papers and articles. I am not a member of that forum. Since I don't give enough time to any of the forums I am a member of (this one included), I elected not to join one more. As most of the parties in that thread are also members here, so I am posting my comments here.

My presentation on "Diving Medical Literature" at the 2006 Global Underwater Explorers (gue.com/) Conference was supported by DAN (DAN Divers Alert Network - Scuba Diving and Dive Safety Association). This presentation was to point out locations of available literature and resources. The location information is followed up with examples of the free content available through those sites. We added notes to the slides and the presentation is now available for download: The Rubicon Foundation: GUE (no log-in required). We do have a newer version of this talk that I am preparing now and it should be posted in about a week.

A summary of the work we have done is available on the main page of our "Rubicon Research Repository" (Rubicon Research Repository). The goal of this project is to make the available information more accessible. Currently, we contain the only online collection of Undersea and Hyperbaric Medical Society (UHMS) journal articles and abstracts online. This project is still young and with many divers offering both time and donations, we are starting to grow even faster. If you are interested in why we are doing this, follow this link: The Rubicon Foundation: Archive .

Today we added two new collections:
The first collection contains technical reports published by Defence R&D Canada (Defence Research and Development Canada / Recherche et développement pour la défense Canada), formerly Defence and Civil Institute of Environmental Medicine. The second collection of workshops held by the Smithsonian Institution Scientific Diving Program (Smithsonian Scientific Diving Program - Science diving information and authorization forms).

UHMS members are entitled to almost all of the same resources that I am as a member of the Duke Medical Center staff. If you plan to do a lot of research and don't have access to an academic library, it is worth joining UHMS (Undersea & Hyperbaric Medicine Society).

I hope you all find this resource as valuable as we have and I hope this post fills in some of the blanks.

Take care,
Gene

[GLOC]

Thanks very much Gene for this. I saw the thread on YD and will point the people to your site, creditting your organisation for a fantastic job.

Regards.

[Gene_Hobbs]

Quote: (Originally Posted by GLOC)

Thanks very much Gene for this. I saw the thread on YD and will point the people to your site, creditting your organisation for a fantastic job.

Thanks Gareth,

It has been fun but a ton of work. My list of things to do grows daily so keep watching it.

For the record, MD's (DO, MB, etc...) and PhD's are 'Regular' Members of UHMS at $US 200.00 /year. Most of us fall under 'Associate' and it is only $US 40.00 /year.

Please let me know if you guys find something you need. At the moment, I am concentrating my time on the NEDU collection (I have about 500 more sitting in my office at home I need to get out of my wife's way ) and one of our volunteers is working on UHMS abstracts too complete that collection. We want this to be useful so please ask, if I can find it, we will get permission and put it in there (if permission is not already granted).

Take care,
G

[GLOC]

Quote: (Originally Posted by Gene_Hobbs)

For the record, MD's (DO, MB, etc...) and PhD's are 'Regular' Members of UHMS at $US 200.00 /year. Most of us fall under 'Associate' and it is only $US 40.00 /year.

Thanks Gene, I will update the other post accordingly when I get home and don't have to fight with the work firewall uploading large posts!!

[Gene_Hobbs]

Quote: (Originally Posted by Gene_Hobbs)

My presentation on "Diving Medical Literature" at the 2006 Global Underwater Explorers (gue.com/) Conference was supported by DAN (DAN Divers Alert Network - Scuba Diving and Dive Safety Association). This presentation was to point out locations of available literature and resources. The location information is followed up with examples of the free content available through those sites. We added notes to the slides and the presentation is now available for download: The Rubicon Foundation: GUE (no log-in required). We do have a newer version of this talk that I am preparing now and it should be posted in about a week.

UPDATE...

Here is the updated "Diving Medical Literature" presentation. (http://rubicon-foundation.org/download/Dive_Med_Lit.pdf) This file will be updated periodically so please check back.

We added the 2002 UHM articles over the weekend.

The Rubicon Research Repository (RRR) is also now up to 3224 references now including more NEDU reports and some reports from Defence R&D Canada (DRDC - formerly DCIEM).

We also added the presentation Jim Caruso, MD (USN) gave to the American Society for Clinical Pathology (ASCP) to the RRR yesterday. This is a unique opportunity to learn.

*** Be aware that this presentation was intended for Clinical Pathologists. Some of the images my not be suitable for meals.

Rubicon Research Repository
The Pathologist's Approach to SCUBA Diving Deaths.
Caruso, 2006
RRR ID: 3933 (enter this number in the search box)
If you need help getting started with the repository, please visit: The Rubicon Foundation: FAQ

[GLOC]

Quote: (Originally Posted by Gene_Hobbs)

We also added the presentation Jim Caruso, MD (USN) gave to the American Society for Clinical Pathology (ASCP) to the RRR yesterday. This is a unique opportunity to learn.

*** Be aware that this presentation was intended for Clinical Pathologists. Some of the images my not be suitable for meals.

Thanks for the last one Gene. I can attest that they aren't too kind on the stomach but then again autopsies normally aren't.

Notwithstanding this, the presentation was very good and provides an insight into the cause of deaths whilst people have been SCUBA diving. In the UK, BSAC collate stats into scuba related deaths but not to this level.

Thanks again for providing the link again.

[Gene_Hobbs]

UPDATE...

We added the 2003 UHM articles over the weekend.

Some of these that may be of interest to folks here:
Health outcome following multi-day occupational air diving. RRR ID: 3965
The effect of breathing hyperoxic gas during simulated submarine escape on venous gas emboli and decompression illness. RRR ID: 3969
Adjunctive treatment of decompression illness with a non-steroidal anti-inflammatory drug (tenoxicam) reduces compression requirement. RRR ID: 3971
Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox. RRR ID: 3975
Change in strategy of solving psychological tests: evidence of nitrogen narcosis in shallow air-diving. RRR ID: 3976

Also, don't forget our "Diving Medical Literature" presentation. (http://rubicon-foundation.org/download/Dive_Med_Lit.pdf) This file will be updated periodically so please check back. Feedback is also appreciated.

[Janos]

Gene,

Do you know any papers that investigate the effects of the "Oxygen Window" [1] on divers. I know of a few papers that show there is a difference between veinous and arterial ppO2. However I haven't seen anything that suggests that this gap will improve decompression.

Can you think of anything?

Cheers,
Janos


[1] - The term O2 window is bandied about a fair bit. In this context I use it refer to the claim that you will decompress quicker at elevated ppO2s. Ie that you will decompress quicker at 6m, breathing pure O2, than you will at 3m, again breathing ppO2.

[Gene_Hobbs]

Quote: (Originally Posted by Janos)

Do you know any papers that investigate the effects of the "Oxygen Window" [1] on divers. I know of a few papers that show there is a difference between veinous and arterial ppO2. However I haven't seen anything that suggests that this gap will improve decompression.

Can you think of anything?

Cheers,
Janos


[1] - The term O2 window is bandied about a fair bit. In this context I use it refer to the claim that you will decompress quicker at elevated ppO2s. Ie that you will decompress quicker at 6m, breathing pure O2, than you will at 3m, again breathing ppO2.

Good question... I did add this paper to the repository about a week ago. There are 13 early refs here. As I scan and add more, I'll keep my eyes open.

The Synergistic Effect of Pressure and Oxygen and Its Relationship to Decompression Sickness in Mice.
Berghage et. al., 1973
RRR ID: 3946, NEDU and NMRI: AD0774104

Happy New Year!

[Gene_Hobbs]

So, a quick look for other terms that would have been used, include 'partial pressure vacancy' and 'isobaric inert gas transport'. The first use I can find of the term 'oxygen window' is by Albert Behnke [1]. He also refers to early work by Momsen on 'partial pressure vacancy' (PPV) where he used partial pressures of O2 and He as high as 2-3 ATA to create a maximal PPV [2]. Behnke then goes on to describe 'Isobaric inert gas transport' was described by LeMessurier and Hills [3] and Hills [4] in actual diving operations [2].

1. Behnke. (1967) The isobaric (oxygen window) principle of decompression. In: The New Thrust Seaward. Trans. Third Marine Tech. Soc. Conf. 5-7 June, San Diego. Washington, DC: Marine Tech. Soc.
2. Behnke. (1969) Early Decompression Studies. In: The Physiology and Medicine of Diving and Compressed Air Work, Bennett and Elliott. First Edition. p234
3. LeMessurier and Hills. (1965) Decompression Sickness. A thermodynamic approach arising from a study on Torres Strait diving techniques. Hvalradets Skrifter, Nr. 48, 54-84.
4. Hills. (1966) A thermodynamic and kinetic approach to decompression sickness. Thesis

I think the Momsen work referenced is:
Report on Use of Helium Oxygen Mixtures for Diving.
Momsen, 1942
RRR ID: 3312, NEDU: AD0728758

Two others worth a read are:

Reinertsen, R. E., V. Flook, S. Koteng, and A. O. Brubakk.Effect of oxygen tension and rate of pressure reduction during decompression on central gas bubbles. J. Appl. Physiol. 84(1): 351-356, 1998.
Effect of oxygen tension and rate of pressure reduction during decompression on central gas bubbles -- Reinertsen et al. 84 (1): 351 -- Journal of Applied Physiology

The oxygen window and decompression bubbles: estimates and significance.Entrez PubMed