ABSTRACT
INTRODUCTION: The treatment of divers for decompression illness (DCI) in Auckland, New Zealand, has not been described since 1996, and subsequent trends in patient numbers and demographics are unmeasured. METHODS: This was a retrospective audit of DCI cases requiring recompression in Auckland between 01 January 1996 and 31 December 2012. Data describing patient demographics, dive characteristics, presentation of DCI and outcomes were extracted from case notes and facility databases. Trends in annual case numbers were evaluated using Spearman's correlation coefficients (ρ) and compared with trends in entry-level diver certifications. Trends in patient demographics and delay between diving and recompression were evaluated using regression analyses. RESULTS: There were 520 DCI cases. Annual caseload decreased over the study period (ρ = 0.813, P < 0.0001) as did entry level diving certifications in New Zealand (ρ = 0.962, P < 0.0001). Mean diver age was 33.6 (95% confidence limits (CI) 32.7 to 34.5) years and age increased (P < 0.0001) over the study period. Median (range) delay to recompression was 2.06 (95% CI 0.02 to 23.6) days, and delay declined over the study period (P = 0.005). CONCLUSIONS: Numbers of DCI cases recompressed in Auckland have declined significantly over the last 17 years. The most plausible explanation is declining diving activity but improvements in diving safety cannot be excluded. The delay between diving and recompression has reduced.
Subject(s)
Decompression Sickness/therapy , Adolescent , Adult , Aged , Certification/classification , Certification/statistics & numerical data , Decompression Sickness/diagnosis , Decompression Sickness/epidemiology , Diving/statistics & numerical data , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Retrospective Studies , Risk Factors , Time-to-Treatment , Treatment Outcome , Young AdultABSTRACT
El material particulado es uno de los contaminantes atmosféricos más estudiados en el mundo, este se define como el conjunto de partículas sólidas y/o líquidas (a excepción del agua pura) presentes en suspensión en la atmósfera (Mészáros, 1999), que se originan a partir de una gran variedad de fuentes naturales o antropogénicas y poseen un amplio rango de propiedades morfológicas, físicas, químicas y termodinámicas. La presencia en la atmósfera de este contaminante ocasiona variedad de impactos a la vegetación, materiales y el hombre, entre ellos, la disminución visual en la atmósfera, causada por la absorción y dispersión de la luz (Chen,Ying &Kleeman,2009).Además, la presencia del material particulado está asociada con el incremento del riesgo de muerte por causas cardiopulmonares en muestras de adultos (Pope, 2004) Es necesario, además de realizar mediciones de la concentración de este contaminante, evaluar su comportamiento en el espacio y el tiempo, asociándolo con los fenómenos meteorológicos, composición química y origen, los cuales permitan orientar estrategias de control y realizar seguimiento por parte de las autoridades ambientales interesadas. Este artículo presenta una revisión bibliográfica de los impactos asociados con partículas presentes en la atmósfera, los equipos para su monitoreo, aplicaciones tecnológicas complementarias y tecnologías de control.
Particulate matter is one of the most studied atmospheric pollutants around the world. It is defined as the set of solid or liquid particles (except plain water) which are present in suspension in the atmosphere (Mészáros, 1999), and that originate from a variety of natural or anthropogenic sources and have a wide range of morphological, physical, chemical and thermodynamic properties. The presence of this pollutant in the atmosphere causes a variety of impacts on vegetation, materials and human beings, including a visual decrease in the atmosphere caused by the absorption and diffusion of light (Chen, Ying & Kleeman, 2009). Furthermore, the presence of particulate matter is associated with increased risk of death from cardiopulmonary causes in samples of adults (Pope, 2004) Besides measuring this pollutant concentrations, it is necessary to assess its behavior in space and time associating it with meteorological phenomena, chemical composition, and origin of which allows the orientation of control strategies and the performance of follow-up activities by the environmental authorities concerned. This article presents a literature review of the impacts associated with particles present in the atmosphere, the equipment for monitoring them, complementary technological applications and control technologies.
Subject(s)
Humans , Air Pollution , Pollutants Dispersion , Particulate MatterABSTRACT
Air embolism is rare and potentially fatal. Its early recognition and prompt treatment can help to prevent life-threatening sequelae. Herein, we report the case of a 75-year-old man who underwent a computed tomographic-guided lung biopsy of a left-lower-lobe pulmonary nodule. A few minutes after the procedure, he experienced numbness and weakness in his right hand; this lasted for approximately 10 minutes and resolved on its own. Similar symptoms developed in his left hand and subsided in 5 minutes. His speech then became garbled. An urgent computed tomographic scan of the head showed no acute abnormality. Review of the chest computed tomographic scans that were performed during the biopsy revealed 10 cc of air in the left ventricular cavity. The patient was placed on 100% forced inspiratory oxygen and was kept in the Trendelenburg position on his left side. After 4 hours, computed tomography revealed that the air had been absorbed into the circulation. The patient had no residual neurologic deficits. In addition to reporting this case, we discuss possible causes of air embolism and the management of the condition after percutaneous lung biopsy.
