ABSTRACT
OBJECTIVE: To study the effect of percutaneous patent foramen ovale (PFO) closure in divers with a history of decompression sickness (DCS). STUDY DESIGN: (1) Retrospective study of patient records and (2) telephonic follow-up. Patients with unexplained decompression sickness, who were referred to a cardiologist with a focus on diving medicine between 2000 and 2017, were included in the study RESULTS: A total of 62 divers with DCS were included. In all cases transoesophageal echocardiography (TEE) was performed, showing 29 PFOs and 6 atrial septum defects (ASDs) in total nâ¯= 35 (56%). The highest prevalence was found in divers with cutaneous and vestibular DCS. At follow-up (mean follow-up duration 6.8 years), 21 PFOs/ASDs were closed using a percutaneous procedure. One diver was lost to follow-up. One diver quit diving. The remaining divers were able to resume unrestricted diving; there was no recurrence of major DCS. Of the divers with an open PFO or ASD, 14 were included of whom 7 are currently diving. All (except one diver with a small PFO) divers are using a conservative diving profile to reduce nitrogen load and the appearance of venous nitrogen bubbles. There was no recurrence of major DCS in this group. CONCLUSION: Percutaneous PFO closure may be an effective and safe treatment for divers who have suffered a major DCS to return to unrestricted diving. Alternatively, conservative treatment seems safe when divers refrain from unrestricted diving and use a conservative technique in order to reduce nitrogen load.
ABSTRACT
BACKGROUND: The European Youth Olympic Festival (EYOF) is a biennial sporting event of nine Olympic Summer Sports for talented athletes, aged 13-18â years, from all over Europe. OBJECTIVE: To analyse the injuries and illnesses that occurred during the multisport event (14-19 July 2013), with the long-term aim of enabling international sports federations, the National Olympic Committees, and the European Olympic Committee to improve protection of athletes' health in youth. METHODS: Daily occurrence or non-occurrence of injuries and illnesses was recorded by using the IOC injury and illness surveillance system for multisport events. All National Olympic Committee physicians and healthcare providers and physicians of the Local Organizing Committee were invited to participate. RESULTS: In total, 2272 athletes from 49 countries took part in the EYOF 2013. During the five competition days of EYOF, 207 injuries and 46 illnesses were reported, resulting in an incidence of 91.1 injuries and 20.2 illnesses per 1000 athletes. Almost 10% of the athletes sustained at least one injury or illness. CONCLUSIONS: This study is the first multisport surveillance study on injuries and illnesses during the EYOF or any other summer Games organised for youth elite athletes. The data form the basis for further research on risk factors and injury mechanisms for this cohort. This research is needed to gain more knowledge and finally to implement effective injury and illness prevention measures.
