El buceo recreativo y la otorrinolaringología: ¿qué sabemos y deberíamos saber? / Recreational diving and otolaryngology: what do we know and should we know?

El buceo recreativo es una práctica cada vez más popular en la población mundial, sin embargo, no está exenta de riesgos. A medida que transcurre una inmersión, el buzo es susceptible a una serie de cambios de presión que afectan las distintas cavidades que contienen aire dentro del cuerpo humano, tales como el oído, cavidades paranasales y los pulmones. Existe un gran espectro de patologías asociadas al buceo, explicándose la mayoría de ellas por el barotrauma asociado, cuya gravedad depende de la magnitud del daño asociado, pudiendo presentar desde manifestaciones a nivel local, así como también a nivel sistémico. Las patologías otológicas suelen ser las más frecuentes y el principal motivo de consulta en este tipo de pacientes. Sin embargo, las afecciones otoneurológicas, rinosinusales, de vía aérea y sistémicas pueden ser comunes dependiendo de cada perfil de buceo. Actualmente no existen recomendaciones locales sobre esta práctica, por lo que el conocimiento de la fisiología, fisiopatología y el tratamiento de las patologías otorrinolaringológicas asociadas deben ser conocidas a medida que este deporte se vuelve cada vez más popular. Se realizó una revisión de la literatura sobre las distintas afecciones otorrinolaringológicas con el fin de sistematizarlas y elaborar recomendaciones para establecer una práctica segura.

Recreational diving is an increasingly popular practice in the world; however, it is not without risks. As a dive progresses, the diver is susceptible to a series of pressure changes that affect the air-containing cavities, such as the ear, paranasal cavities, and lungs. There is a large spectrum of pathologies associated with diving, most of them being explained by associated barotrauma, the severity of which depends on the magnitude of the associated damage, could present local manifestations, as well as at systemic level. Otological pathologies are usually the most frequent and the main reason for consultation in this type of patients, however, otoneurological, rhinosinusal, airway and systemic conditions can be common depending on each diving profile. Currently there are no local recommendations on this practice, therefore, knowledge of the physiology, pathophysiology and treatment of associated otorhinolaryngological pathologies should be known as this sport becomes increasingly popular. A review of the literature on the different ear, nose and throat conditions was carried out in order to systematize them and develop recommendations to establish a safe practice.

Research progression on safety verification of diving decompression procedures / 中国职业医学

@#A diving decompression procedure is a specific rule that divers should follow when they ascend and get out of water. It comes from the decompression theory and algorithm and is designed for the prevention of decompression sickness. With the ， ， development of diving technology and diving medicine the decompression procedures are constantly innovated and the new ， decompression procedure can be used in diving practice after safety verification. In principle the safety verification of ， decompression procedures should be conducted on animal experiments before human experiments and the risks of ， decompression sickness and oxygen toxicity should be systematically assessed. However the assessment methods used in ， ， ， different studies differ greatly thus it is urgent to establish a standard and universal verification system. Traditionally the risk ， ， assessment of decompression sickness and oxygen toxicity is mainly carried out by observing the incidence detecting bubbles ， theoretical calculation and lung functional test. Furthermore biochemical indicators are increasingly becoming important ， ， supplements. Due to the special underwater environment the diving operation is prone to accidents. Therefore in addition to ， verifying the safety of the new decompression procedure exploring its safety decompression limit is of great significance for the formulation of emergency decompression procedures in emergency situations. The specific approach is to shorten the decompression time and assess the safety until the critical time for detecting bubbles without the occurrence of decompression ， ， sickness is found. Future studies should continue to optimize safety assessment methods explore sensitive biochemical markers ， clarify species associations and improve verification efficiency and reliability of results.

Research on scientific sports training of students majoring in physical education / Pesquisa científica sobre o treinamento esportivo de alunos do curso de educação física / Investigación sobre la formación científico-deportiva de estudiantes de la carrera de educación física

ABSTRACT Introduction: The organization of high-level sports teams in colleges and universities is an important measure for my country's competitive sports to break the traditional monopoly and monopoly pattern and go to the market and society in an all-around way. It helps to improve the cultural quality of Chinese athletes and cultivate new sports talents for comprehensive development. It can make full use of universities' multidisciplinary and high-tech advantages, increase the technological content of competitive training, and accelerate the improvement of sports level. Objective: This article intends to take the diving team as an example to explain the role and significance of scientific training in developing competitive sports in my country's ordinary colleges and universities and put forward suggestions for the establishment, organization, and implementation of scientific training. Methods: The scientific research support system used in the thesis includes: physiological and biochemical monitoring, health and sports injury monitoring, nutrition and weight monitoring, psychological consultation and monitoring, technical training support system, training quality management system, physical training support system, and athlete training database. Results: The in-depth research on diving training focuses on: (1) the detection and evaluation of diving technique training; (2) the training of divers' specific strength qualities; (3) the monitoring of nutrition and weight of female athletes; (4) Pre-match psychological training for outstanding diving athletes. Conclusions: The diving team's training shows that scientific and systematic training is an important guarantee for high-level student-athletes training in ordinary universities in my country. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A organização de equipes esportivas de alto nível em faculdades e universidades é uma medida importante para que os esportes competitivos em meu país quebrem o padrão tradicional de monopólio e entrem no mercado e na sociedade de maneira abrangente. Ajuda a melhorar a qualidade cultural dos atletas chineses e a cultivar novos talentos esportivos para um desenvolvimento integral. Pode tirar o máximo proveito das vantagens multidisciplinares e de alta tecnologia das universidades, aumentar o conteúdo tecnológico do treinamento competitivo e acelerar a melhoria do nível esportivo. Objetivo: Este artigo visa tomar a equipe de mergulho como exemplo para explicar o papel e a importância da formação científica no desenvolvimento dos esportes competitivos em faculdades e universidades comuns do meu país e apresentar sugestões para o estabelecimento, organização e implementação da formação científica. Métodos: O sistema de apoio à investigação científica utilizado na tese inclui: monitorização fisiológica e bioquímica, monitorização de lesões na saúde e desportivas, monitorização da nutrição e peso, consulta e monitorização psicológica, sistema de apoio técnico à formação, sistema de gestão da qualidade da formação, apoio à formação física sistema e banco de dados de treinamento de atletas. Resultados: A pesquisa aprofundada sobre o treinamento em mergulho concentra-se em: (1) detecção e avaliação do treinamento em técnicas de mergulho; (2) treinar as qualidades específicas de força dos mergulhadores; (3) monitorar a nutrição e o peso dos atletas; (4) Treinamento psicológico pré-jogo para atletas de mergulho de destaque. Conclusões: O treinamento da equipe de mergulho mostra que o treinamento científico e sistemático é uma garantia importante para a formação de alunos-atletas de alto nível em universidades comuns de meu país. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción: La organización de equipos deportivos de alto nivel en colegios y universidades es una medida importante para que el deporte competitivo de mi país rompa el patrón tradicional de monopolio e ingrese al mercado y a la sociedad de manera integral. Ayuda a mejorar la calidad cultural de los atletas chinos y a cultivar nuevos talentos deportivos para un desarrollo integral. Puede aprovechar al máximo las ventajas multidisciplinarias y de alta tecnología de las universidades, aumentar el contenido tecnológico de la formación competitiva y acelerar la mejora del nivel deportivo. Objetivo: Este artículo pretende tomar al equipo de buceo como ejemplo para explicar el papel y la importancia de la formación científica en el desarrollo de deportes competitivos en los colegios y universidades ordinarios de mi país y presentar sugerencias para el establecimiento, organización e implementación de la formación científica. Métodos: El sistema de apoyo a la investigación científica utilizado en la tesis incluye: seguimiento fisiológico y bioquímico, seguimiento de la salud y lesiones deportivas, seguimiento de la nutrición y el peso, consulta y seguimiento psicológico, sistema de apoyo al entrenamiento técnico, sistema de gestión de la calidad del entrenamiento, sistema de apoyo al entrenamiento físico, y base de datos de entrenamiento de atletas. Resultados: La investigación en profundidad sobre el entrenamiento de buceo se enfoca en: (1) la detección y evaluación del entrenamiento de técnicas de buceo; (2) el entrenamiento de las cualidades de fuerza específicas de los buzos; (3) el seguimiento de la nutrición y el peso de las atletas; (4) Entrenamiento psicológico previo al partido para atletas de buceo destacados. Conclusiones: La formación del equipo de buceo muestra que la formación científica y sistemática es una garantía importante para la formación de estudiantes-deportistas de alto nivel en las universidades ordinarias de mi país. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Um estado da arte sobre o mergulho autônomo recreativo no Brasil / A state of the art about recreational scuba diving in brazila state of the art about recreational scuba diving in Brazil

O mergulho autônomo recreativo é uma atividade de lazer realizada junto à natureza. Consiste em submergir, em água doce ou salgada, aberta ou confinada, usando o equipamento autônomo de respiração. A pesquisa analisou o que é discutido sobre o mergulho nas produções acadêmicas do País, por meio de um estado da arte nas principais plataformas de periódicos. Foram encontrados 12 textos. A aplicação manual do método de análise temática de conteúdo permitiu a compreensão de que o mergulho é uma atividade pouco estudada, sendo um fenômeno importante para ser compreendido pela perspectiva do lazer, uma vez que é bastante abordado pelas áreas do turismo e administração. É necessário maior aprofundamento na compreensão das relações que se estabelecem entre lazer, corpo e natureza na perspectiva do mergulho recreativo brasileiro.

Recreational scuba diving is a leisure activity carried out close to nature. It consists of submerging, in fresh or salt water, open or confined, using self-contained breathing apparatus. The research analyzed what has been discussed regarding diving in the academic productions of the country through a "state of the art" in the main journals platforms. 12 texts were identified. The manual application of the Thematic Content Analysis method allowed the understanding that diving is a poorly studied activity, being an important phenomenon to be understood from the perspective of leisure, since it is widely addressed by the areas of tourism and administration. It is necessary to deepen the understanding of the relationships established between leisure, body and nature in the perspective of Brazilian recreational diving.

Uso de máscaras de buceo modificadas para aplicación segura de ventilación no invasiva. Estudio piloto / Modified snorkeling facemasks for safe application of non-invasive ventilation. A pilot study / Uso de máscaras de mergulho modificadas para aplicação segura de ventilação não invasiva. Estudo piloto

Resumen: Introducción: en el contexto de la pandemia de SARS-CoV-2, diferentes autores propusieron adaptaciones a máscaras de buceo comerciales (máscaras modificadas, MM) para proporcionar oxigenoterapia a pacientes con o sin presión positiva. Hasta la fecha, ninguno ha evaluado su desempeño como interfaz para la ventilación no invasiva (VNI) en el modo de soporte de presión inspiratoria (PSI). Objetivos: desarrollar una interfaz de VNI utilizando MM y evaluar su rendimiento en comparación con una máscara oronasal (MC) convencional. Métodos: las MM se adaptaron como interfaces VNI utilizando dos piezas creadas mediante impresión 3D. Se comparó su desempeño contra una MC en 10 voluntarios sanos en modo PSI (3 cmH2O) con dos niveles de presión positiva al final de la espiración (PEEP 4 y 8 cmH2O). Se compararon: fugas del sistema, frecuencia respiratoria, volumen corriente, oximetría de pulso, CO2 transcutáneo y comodidad. Resultados: con 4 cmH2O de PEEP no hubo diferencias significativas entre las máscaras en ninguna de las variables estudiadas. Con 8 cmH2O de PEEP, el uso de MM se asoció con un menor nivel de CO2tc (41,0±5,7 vs 43,5±8,1 mmHg; p=0,03) y un mayor confort (8,3±1,1 vs 6,5±1,4; p<0,01) que las MC. Conclusiones: el uso de MM para realizar VNI presenta, en voluntarios sanos, un rendimiento similar a las mascarillas oronasales estándar, con la ventaja de mayor comodidad y menor costo. Si bien restan estudios para avalar su utilización, en la emergencia sanitaria provocada por la pandemia SARS-CoV-2, la adaptación de máscaras de buceo podría representar una opción válida frente a la escasez de interfaces comerciales.

Abstract: Introduction: within the context of the SARS-CoV-2 pandemic, different authors proposed adaptations to snorkeling masks available in the market (modified masks: MM) to provide oxygen therapy with positive pressure ventilation or not. Until today, none of them has assessed its performance as an interface for non-invasive ventilation (NIV) in the inspiratory pressure support mode. Objective: to develop an interface of NIV using MM and assess its performance with a conventional full mask. Method: the MM were adapted as NIV interfaces using two pieces created by 3D printing. Their performance was compared to a that of a conventional mask in 10 healthy volunteers in inspiratory pressure support (3 cmH2O) mode with two levels of positive pressure towards the end of expiration (PEEP 4 and 8 cmH2O). The following were compared: system leaks, respiratory rate, normal volume, pulse oximetry, transcutaneous car bon dioxide and comfort. Results: with 4 cmH2O of PEEP, no significant differences were found between masks in none of the variables studied. With 8 cmH2O de PEEP, the use of MM were associated to a lower level of CO2tc (41.0±5.7 vs 43.5±8.1 mmHg; p=0.03) and greater comfort (8.3±1.1 vs 6.5±1.4; p<0.01) than conventional masks (CM). Conclusions: in healthy volunteers, MM for NIV evidence a similar performance than that of standard oronasal masks, and have a further advantage, as they are more comfortable and cheaper. Even if further studies are needed to support its use, modified snorkeling masks could represent a valid option during the health emergency caused by the SARS-CoV-2 pandemic in consideration of the scarce interfaces available in the market.

Resumo: Introdução: no contexto da pandemia de SARS-CoV2, diferentes autores propuseram adaptações às máscaras de mergulho comerciais (máscaras modificadas, MM) para fornecer oxigenoterapia a pacientes com ou sem pressão positiva. Até o momento, nenhum avaliou seu desempenho como interface para ventilação não invasiva (VNI) no modo de suporte de pressão inspiratória (PSI). Objetivos: desenvolver uma interface de VNI usando MM e avaliar seu desempenho em comparação com uma máscara oronasal convencional (MC). Métodos: as MMs foram adaptadas como interfaces VNI usando duas peças criadas por impressão 3D. Seu desempenho contra uma MC foi comparado em 10 voluntários saudáveis no modo PSI (3 cmH2O) com dois níveis de pressão positiva no final da expiração (PEEP 4 e 8 cmH2O). Vazamentos do sistema, frequência respiratória, volume corrente, oximetria de pulso, CO2 transcutâneo e conforto foram comparados. Resultados: com 4 cmH2O de PEEP, não se observaram diferenças significativas entre as máscaras em nenhuma das variáveis estudadas. Com PEEP de 8 cmH2O, o uso de MM foi associado a um menor nível de CO2tc (41,0 ± 5,7 vs 43,5 ± 8,1 mmHg; p = 0,03) e maior conforto (8,3 ± 1,1 vs 6,5 ± 1,4; p <0,01) do que a MC. Conclusões: o uso do MM para a realização da VNI apresenta, em voluntários saudáveis, desempenho semelhante às máscaras oronasais padrão, com a vantagem de maior conforto e menor custo. Embora ainda sejam necessários mais estudos que embasem seu uso, na emergência sanitária ocasionada pela pandemia do SARS-CoV-2, a adaptação de máscaras de mergulho pode representar uma opção válida diante da escassez de interfaces comerciais.

Predictors associated with inappropriate transport of near shore spinal injuries / 中华创伤杂志(英文版)

PURPOSE@#Spinal injuries resulting in neurological damage cause significant morbidity. Swift neurosurgical intervention can mitigate negative outcomes. However, variable mechanisms of injury may be associated with inappropriate transport (IAT), which may delay necessary surgical interventions. Patients with near shore spinal injuries (NSSI) presented with unique mechanisms, so we investigated factors associated with IAT in patients with NSSI.@*METHODS@#We performed a multicenter retrospective study of all adult patients transported from a beach resort to 3 hospitals for suspected NSSI between 2006 - 2017. We excluded patients transferred to other facilities, and those not injured in the water. Primary outcome was IAT, defined as patients with NSSI requiring transfer to another trauma center. To avoid heterogeneity in our analysis, we further excluded patients without NSSI who were inappropriately transported to a level I trauma center. We used multivariable logistic regression to assess association of independent variables (such as demographic, environmental, and clinical factors) with outcome.@*RESULTS@#We analyzed 278 patients with suspected NSSI, and found 14 (5.0%) had IAT. Compared to appropriately transported patients, diving was associated with higher percentages of IAT (28.6% vs. 3.9%, p = 0.014) and more were transported by air (50.0% vs. 20.6%, p = 0.01). In multivariable regression, patients' oxygenation saturation (odds ratio [OR] = 0.8, 95% confidence intervals [CI]: 077-0.98) and diving (OR = 7.5, 95% CI: 1.2-46) were significantly associated with IAT.@*CONCLUSION@#Rate of IAT for patients with NSSI was low. However, first responders and emergency medicine providers should be aware that diving is associated with a higher likelihood of IAT.

A case of pulmonary barotrauma complicated with cerebral arterial air embolism in a diver / 中华劳动卫生职业病杂志

Pulmonary barotrauma is a kind of disease caused by the injury of lung tissue or blood vessel when the gas pressure of lung is too high or too lower than the external pressure of the body, which causes the air to enter the blood vessel and adjacent tissue. It could be happened in the escape of the divers with the light diving equipment or the sailors from submarine. Generally, the decompression chamber was used to treating the disease, and the minimum air pressure of 0.5 MPa recompression therapeutic schedule was used to selecting. In November 2019, a patient with pulmonary barotrauma combined with cerebral arterial gas embolism caused by improper underwater escape with light diving equipment was admitted to the General Hospital of Eastern War Zone. He was treated with 0.12 MPa oxygen inhalation recompression scheme in the oxygen chamber pressurized with air. 7 days later, the patient recovered and discharged.

Doppler grading for decompression bubbles / 中国职业医学

Ultrasonic bubble detection has been widely used in predicting the risk of decompression sickness and evaluating the efficiency and safety of decompression procedures. Currently, the widely used SPENCER scale is conducted by using Doppler ultrasound to monitor the bubble signal in the precordial region of subjects. KM grading system is a computerized system based on Doppler ultrasound. The grading score can be converted into SPENCER bubble grading scale score and the bubble grading is precise and suitable for the motion status. On the basis of the above two methods, the KISMAN integrated severity score, extended SPENCER bubble grading and simplified Doppler bubble grading system were established. They not only coordinated analysis of Doppler ultrasound bubble detection results with other risk factors of decompression disease, but also convenient to use computer for processing detection results. With the in-depth application of Fourier technique and empirical mode decomposition in Doppler audio bubble signal detection, methods such as three-parameter fuzzy analysis and energy operator method are playing an important role in automatic bubble analysis. Optimization of detection technology and improvement of sensitivity and accuracy of automatic analysis are important development directions in the field of decompression bubble Doppler grating technology.

Lung macrophages are involved in lung injury secondary to repetitive diving / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

This study aimed to establish an animal model of decompression-induced lung injury (DILI) secondary to repetitive diving in mice and explore the role of macrophages in DILI and the protective effects of high-concentration hydrogen (HCH) on DILI. Mice were divided into three groups: control group, DILI group, and HCH group. Mice were exposed to hyperbaric air at 600 kPa for 60 min once daily for consecutive 3 d and then experienced decompression. In HCH group, mice were administered with HCH (66.7% hydrogen and 33.3% oxygen) for 60 min after each hyperbaric exposure. Pulmonary function tests were done 6 h after decompression; the blood was harvested for cell counting; the lung tissues were harvested for the detection of inflammatory cytokines, hematoxylin and eosin (HE) staining, and immunohistochemistry; western blotting and polymerase chain reaction (PCR) were done for the detection of markers for M1 and M2 macrophages. Our results showed that bubbles formed after decompression and repeated hyperbaric exposures significantly reduced the total lung volume and functional residual volume. Moreover, repetitive diving dramatically increased proinflammatory factors and increased the markers of both M1 and M2 macrophages. HCH inhalation improved lung function to a certain extent, and significantly reduced the pro-inflammatory factors. These effects were related to the reduction of M1 macrophages as well as the increase in M2 macrophages. This study indicates that repetitive diving damages lung function and activates lung macrophages, resulting in lung inflammation. HCH inhalation after each diving may be a promising strategy for the prevention of DILI.

Enfermedad descompresiva grave en buzo aficionado / Severe decompressive illness in amateur diver

RESUMEN Paciente masculino de 23 años de edad, buzo aficionado, que ingresó en el Hospital Militar "Dr. Joaquín Castillo Duany", con historia de haber realizado inmersiones profundas, dos días consecutivos, con escape a superficie sin realizar las paradas de descompresión establecidas, a la salida de la segunda inmersión. Comenzó a presentar de forma brusca calambres, pérdida total de la fuerza muscular en miembros inferiores y disminución de la fuerza muscular en miembros superiores, así como falta de aire, opresión torácica, relajación de esfínter anal y vesical e intranquilidad. Se diagnosticó enfermedad descompresiva grave o tipo II y barotrauma pulmonar. Fue reportado grave e ingresado en sala de terapia intensiva. Se realizó tratamiento recompresivo de urgencia. La evolución clínica resultó favorable sin peligro para la vida; aunque con secuelas neurológicas invalidantes(AU)

ABSTRACT We present a 23-year-old male patient, amateur diver, who came to Dr. Joaquín Castillo Duany Militar Hospital complaining of sudden cramps, total loss of muscle strength in lower limbs, decreased muscle strength in upper limbs, shortness of breath, chest tightness, anal and bladder sphincter relaxation and restlessness. He had done deep-sea dives in two consecutive days, with escape to the surface but not performing required decompression stops at the exit of the second dive. His diagnosis was severe decompression sickness or type II and pulmonary barotrauma. He is reported as severe and admitted to the intensive care unit. Urgent recompression treatment was performed. The clinical evolution was favorable without danger to life although with disabling neurological sequelae(AU)

Real-time 3D echocardiography and 2D speckle tracking imaging in evaluation on right ventricular shape and systolic function changes in divers after scuba diving / 中国医学影像技术

Objective:To observe changes of right ventricular shape and systolic function in divers after scuba diving with real-time 3D echocardiography and 2D speckle tracking imaging. Methods: Recording of heart rate (HR) and conventional echocardiography were performed in 60 healthy divers before and immediately, 1 day, 3 days after scuba diving (wearing self-contained underwater respirator, constant temperature diving 11 m and 60 min), respectively, then 2D apical four-chamber heart and 3D right ventricular volumes dynamic images were stored. The right ventricle diameters and volume, right ventricle index of myocardial performance (RIMP), 2D global longitudinal strain of right ventricle free wall (2DGLS[F]), tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC), 3D right ventricular ejection fraction (3DRVEF) and 3D global longitudinal strain of right ventricle free wall (3DGLS[F]) were obtained before and immediately, 1 day, 3 days after scuba diving. All the parameters were compared before and after scuba diving. Results: There was no significant difference of right ventricle middle transverse diameter, RIMP, right ventricular systolic volume, stroke volume, TAPSE nor 3DRVEF before and immediately, 1 day, 3 days after scuba diving (P>0.05). Compared with the results before scuba diving, HR, 2DGLS(F), FAC and 3DGLS(F) decreased, while right ventricular end diastolic volume, right ventricular base transverse diameter and right ventricular long axis diameter increased immediately after scuba diving (all P0.05). Three days later, there was no significant difference of the above parameters (P>0.05). Conclusion: After scuba diving, right ventricular shape and systolic function of divers can slightly change in a short term, which can be sensitively observed with real-time 3D echocardiography of RV volume quantification analysis and 2D speckle tracking imaging technique.

SCUBA Diving Fatality by Overweighted Belt: An Autopsy Case / 대한법의학회지

Scuba diving is a popular sports activity, even though it is associated with potential hazards. When a diver enters the water for an underwater expedition, he/she needs a series of diving gear, including a regulator, buoyancy compensator, diving suit, and weight belt, among others. Here, the author encountered a fatal diving accident wherein autopsy showed the evidence of death by drowning. The witness stated that the diver requested more weight to descend into the water, and the diver wore one more weight belt, totalling 26 kg. After a second trial of diving, he did not grab the regulator and disappeared into the water suddenly, and bubbles did not appear at the surface. Based on the witness statement and autopsy findings, the original cause of accident was concluded as an overweighted belt for descent into the water.

Vulnerabilidad de las especies de Dytiscidae (Coleoptera) en Cuba / Vulnerability of Dytiscidae species (Coleoptera) in Cuba

Resumen La diversidad de coleópteros acuáticos de Cuba se encuentra entre las más elevadas en el Caribe insular. Sin embargo, existe escasa información sobre los ditíscidos cubanos para identificar las especies y hábitats que requieren urgentes acciones de conservación. El objetivo de este estudio fue identificar los taxa amenazados de la familia Dytiscidae en Cuba según su grado de vulnerabilidad. Para ello se recopiló información sobre la distribución de todos los ditíscidos cubanos, incluyendo datos de la literatura, de colecciones y de muestreos realizados en el período comprendido entre los años 2000 y 2014. Además, fue evaluada la vulnerabilidad de las especies a partir de una metodología que combina seis criterios referentes a las características de las especies y los hábitats que ocupan. El análisis de vulnerabilidad fue posible realizarlo a 50 de las 53 especies de ditíscidos (94 %) presentes en Cuba. Un total de cinco especies (9 %) presentan vulnerabilidad alta, 20 (38 %) media y 25 (48 %) baja. Las cinco especies más amenazadas son Laccodytes cobrinae, Laccophilus alariei, Copelatus barbouri, C. darlingtoni, and Desmopachria glabella. Estas son endémicas de Cuba y se caracterizan por presentar poblaciones muy localizadas, poco abundantes, así como por una alta especificidad de hábitat. Por ello, se propone su inclusión en lista roja de la fauna de Cuba, así como en la Lista Roja de la UICN bajo la categoría de "Vulnerable". Además, no todas las áreas donde se encuentran estas especies pertenecen al Sistema Nacional de Áreas Protegidas de Cuba, por lo que recomendamos la inclusión de la Laguna Base Julio A. Mella y el Norte de Imías en este sistema. Así mismo, sugerimos la implementación de medidas de gestión efectivas que eviten o mitiguen la alteración de los ecosistemas acuáticos en los que aparecen las especies vulnerables.

Abstract Cuba has one of the richest diving beetles species diversity in the Caribbean islands. However, Cuban Dytiscidae remain scarcely studied, and there is need to identify those species and habitats that urgently require effective conservation actions. Here we aim to identify the threatened taxa of the family Dytiscidae in Cuba according to their degree of vulnerability. For that, we compiled distributional data on the Cuban fauna, including data from literature, collections and own samplings carried out between the period 2000 and 2014. In addition, the vulnerability of the species was evaluated using a methodology that combines six criteria regarding both species and habitat attributes. This analysis of vulnerability was completed to 50 (94 %) out of 53 Cuban species. Five species (9 %) were identified as highly vulnerable, 20 (38 %) moderately and 25 (48 %) as having low conservation status. The five most threatened species were Laccodytes cobrinae, Laccophilus alariei, Copelatus barbouri, C. darlingtoni, and Desmopachria glabella. These species are endemic to Cuba and characterized by highly localized populations and low abundance as well as high habitat specificity. Thus, we propose the inclusion of these five species in both the red list of Cuban fauna and the IUCN Red List (under the category of "Vulnerable"). In addition, not all areas where these species were found belong to the National System of Protected Areas of Cuba. Thus, we suggest the inclusion of the Laguna Base Julio A. Mella and the North of Imías, and to develop effective management measures to prevent the alteration of these aquatic ecosystems. Rev. Biol. Trop. 66(2): 709-721. Epub 2018 June 01.

Enfermedad descompresiva espinal: mielopatía isquémica secundaria a un accidente de buceo / Spinal cord decompression sickness: Ischemic myelopathy secondary to a diving accident

Se reporta el caso de un paciente de 34 años, buzo de profesión, hospitalizado por presentar de forma súbita confusión, debilidad generalizada, dolor intenso seguido de paraplejía y retención urinaria luego de emerger rápidamente desde una profundidad aproximada de 42 metros. El paciente fue admitido 48 horas después del evento habiendo completado dos sesiones de terapia de descompresión. Al examen se evidenció paraplejía flácida arrefléxica con nivel sensitivo a nivel de D5 global, reflejo plantar extensor bilateral y retención urinaria. En la resonancia magnética se evidenció incremento del calibre medular con alteración de señal en su diámetro anteroposterior, el cual es visto como hiperintensidad heterogénea en la secuencia T2 y STIR desde D2 hasta D11, sin dilatación del canal medular, compatible con lesión isquémica secundaria a enfermedad descompresiva. Recibió tratamiento con sesiones de cámara hiperbárica y corticoterapia (metilprednisolona 1g EV por 5días) con respuesta parcial.Se comenta la baja incidencia de esta patología enfermedad descompresiva secundaria a un accidente de buceo) y las peculiaridades de su presentación clínica.

We report the case of a 34-year-old male patient, a professional diver hospitalized in connection with a clinical picture characterized by sudden onset of disorientation, generalized weakness, intense body pain followed by sudden paraplegia and urinary retention. These manifestations occurred after a rapid ascent (10 minutes) from a depth of about 42 meters. He was admitted after having received two sessions of decompression therapy. Physical examination revealed flaccid paraplegia, bilateral extensor plantar reflex, a D5 sensitive level. Magnetic resonance imaging showed an increase in the medullar gauge with alteration of its signal, both in anterior and posterior areas, seen as a heterogeneous hyperintensity in the sequence T2 and STIR from D2 to D11, without dilatation of the spinal canal, compatible with ischemic injury. The diagnosis of ischemic myelopathy secondary to decompressive disease was made, and the patient received treatment with a hyperbaric chamber and a short course of steroids (Methylprednisolone 1g EV for 5 days) with partial response.The case is presented, and comments are made regarding the low incidence of this pathology and the variety of clinical peculiarities in its presentation.

Subjective Health and Factors of Health-related Quality of Life in Elderly Haenyo

PURPOSE: To investigate the subjective health and health-related quality of life (HRQoL) in Haenyo. METHODS: Subjects were 100 elderly Haenyo in Jeju island who belonged to a fishing-village society. Main variables were activities of daily living (ADL), instrumental ADL (IADL), the HRQoL, subjective health, and depression. Subjective health and differences of HRQoL by variables were analyzed by t-test or ANOVA using IBM SPSS Statistics 23. Hierarchical multiple regression was executed to examine the effects of the major factors on the quality of life. RESULTS: The mean age was 69.9 years, the mean period for diving career was 51.5 years, and work hours per month were 37.8. Comorbidity of diseases was 2.74, and the common health problems were osteoporosis and headache/dizziness. HRQoL was significantly different by age (F=4.52, p=.013), education (F=6.10, p=.003), muljil work years (F=3.93, p=.050), depression (t=-3.04, p=.030), subjective health state (F=30.62, p < .01), and degenerative arthritis (F=-2.38, p=.019). In the final model by hierarchical multiple regression, ADL/IADL (β=.41, p < .001), depression (β=-.29, p < .001), and subjective health (β=.43~.51, p < .001) were significant and explained 63.5% of the total variance of HRQoL. CONCLUSION: Haenyo have specific health problems different from those of elderly women in general. ADL/IADL, depression and subjective health affected their HRQoL. It is clear that Haenyos' health problems need further study to improve their health.

Reef fishes of the Anchieta Island State Park, Southwestern Atlantic, Brazil / Peixes recifais do Parque Estadual da Ilha Anchieta, Sudoeste do Atlântico, Brasil

Abstract This paper presents a checklist of the reef fish fauna of the Anchieta Island State Park, a no-take zone in which no extractive activities are allowed, in Ubatuba, Southeastern Brazil. Data was obtained between 2011 and 2013, mainly through underwater observations with snorkelling and SCUBA, and secondarily using scientific fishing (trawling). Published and unpublished data were also verified and compiled. A total of 103 reef fish species, distributed in 78 genus and 50 families was recorded. Haemulidae was the richest family (n=7 species), followed by Epinephelidae (n=6), Pomacentridae, Carangidae and Tetraodontidae (n= 4 each). Haemulon was also the most speciose genera (n=5), followed by Stegastes, Acanthurus and Mycteroperca (n=3 each). Sixty-nine species (67%) are included in global and regional Red Lists. Twenty-five species (24.2%) are within the categories Critically Endangered (CR), Endangered (EN), Vulnerable (VU) and Near-Threathened (NT). The network of Marine Protected Areas in Southeastern Brazil is still incipient, and the considerable number of threatened species in the Anchieta Island State Park clearly indicates the importance of the study area for the conservation of coastal and reef fishes.

Resumo Este artigo apresenta uma lista de espécies de peixes recifais do Parque Estadual da Ilha Anchieta, uma área na qual nenhuma atividade extrativista é permitida, em Ubatuba, Sudeste do Brasil. Os dados foram coletados entre 2011 e 2013, principalmente por observações subaquáticas com o uso de mergulhos livres e autônomos e, secundariamente, através de pescaria científica (arrasto). Dados publicados e não publicados também foram verificados e compilados. Foram registradas 103 espécies de peixes recifais distribuídas em 78 gêneros e 50 famílias. Haemulidae foi a família com maior número de espécies (n=7 espécies), seguida por Epinephelidae (n=6), Pomacentridae, Carangidae e Tetraodontidae (n=4 cada). Os gêneros com maior número de espécies foram Haemulon (n=5) e Stegastes¸ Acanthurus e Mycteroperca (n=3 cada). Sessenta e nove espécies (67%) estão inclusas em listas vermelhas de espécies ameaçadas globais e regionais. Vinte e cinco espécies (24,2%) são classificadas nas categorias Criticamente em Perigo (CR), Em Perigo (EN), Vulnerável (VU) e Quase Ameaçadas (NT). A rede de Áreas Marinhas Protegidas no Sudeste do Brasil ainda é incipiente e o considerável número de espécies ameaçadas no Parque Estadual da Ilha Anchieta indica claramente a importância da área de estudo para a conservação de peixes recifais e costeiros.

Professor GUO Lizhong's Experience of Treating Depression with Strengthening Yang-Qi / 浙江中医药大学学报

[Objective]Summarize the Professor GUO Lizhong's experience of treating depression with strengthening Yang-Qi, providing a new perspective for the treatment of depression. [ Methods]Through observing and recording the clinical work with Professor GUO, organizing medical records, prescriptions and collecting lecture materials, theses and writings, analyzing its dialectical ideas, prescription and medication; by retriving ancient TCM books and analyzing famous TCM doctors' academic thoughts, to summarize Professor GUO's point of treating depression academic ideas and prescription drugs by strengthening Yang-Qi. That choosing Sini soup combined with Guipi soup and Tianjing soup receives good effect. [Results]Professor GUO Lizhong's thought mainly originates from classical works, such as "Internal Classics", who thinks that Yang-Qi deficiency is the root cause of depression, the essence and blood deficiency are the key links, frivolous virtual fire is its incentive, treatment of wanning or diving Yang-Qi is the first, then support essence and Yang-Qi. Two cases of depression returned to normal work and life after treatment of warning and diving Yang-Qi and supporting essence and Yang-Qi. [ Conclusion ]lt's unique of Professor GUO's experience in the treatment of depression, it is worthy of further study and experience of the dialectical ideas and election of prescription clinical value. To take GUO's experience for treating depression from the "Yang weakness, essence and blood deficiency, Yin fire up", and apply his rule can markedly relieve depression patients' clinical symptoms and obviously improve patients' life quality.

Effects of simulated 100 m Trimix conventional diving on oxidative stress and inflammatory reaction in rabbits / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of simulated 100 m Trimix conventional diving on tissue inflammatory cytokines in rabbits.@*METHODS@#Eight New Zealand rabbits were performed a simulated 100 m Trimix conventional diving program which was established according to the Haldane theory. The expression levels of interferon-gamma(IFN-), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), myeloperoxidase(MPO) and matrix metallo proteinase-9 (MMP-9) in rabbits lung and brain tissues were detected by Elisa after diving decompression. The tissue wet/dry ratio was calculated. The serum levels of superoxide dismutase (SOD),glutathione(GSH), catalase(CAT), malondiadehyde(MDA) and lipid peroxide(LPO) were detected by Elisa method in rabbits before and after diving.@*RESULTS@#The expressions of IFN-, TNF-α, IL-6, IL-8, MPO and MMP-9 in simulated diving group rabbits were significantly increased compared with the intact group(<0.05, <0.01); the simulated diving rabbits tissues wet/dry ratio had no significant changes compared with the intact group. After diving, the activities of SOD and GSH were decreased significantly (<0.01), while the contents of CAT, MDA and LPO were increased significantly (<0.01).@*CONCLUSIONS@#The simulated 100 m Trimix conventional diving had significant impact on oxidative stress and inflammatory reaction in rabbits, the results of wet/dry ratio showed that the diving rabbits had no tissue edema after decompression.

Fracaso implantario derivado de la práctica del submarinismo: a propósito de un caso / Implant failure secondary to Scuba diving: report of a case

En las últimas décadas, el buceo con equipo de respiración subacuático autónomo (SCUBA) ha experimentado un gran auge, lo que conlleva la necesidad por parte del odontólogo de conocer las posibles complicacionesasociadas. Durante su práctica, se producen cambios en la presión inducida, así como micromovimientos derivados de sostener la boquilla del tubo de oxígeno con la boca, que pueden conducir al fracaso temprano del implante. El tiempo mínimo recomendado antes de volvera practicar el submarinismo tras la inserción de implantes dentales depende del criterio del cirujano; sin embargo, no se recomienda que seaantes de las primeras cinco semanas a dos meses postquirúrgicos. Encirugías con procedimientos asociados más complejos, se recomiendan periodos de reposo más largos.

In the last decades, the number of people who practice self-contained underwater breathing apparatus (SCUBA) diving has increased,which makes it important for dentists to be prepared to address andtreat complications resulting from its practice. While performing the sport, pressure may change and induced micro-motion derived from holding the tube of oxygen can lead to an early implant failure. Divingis not recommended during the fi rst fi ve weeks to two months after the implant placement. In surgeries where the associated procedures aremore complex, a greater recovery period is recommended.