Health and wellbeing of recently active United States scuba divers.

INTRODUCTION: This study aimed to describe recently active adult scuba divers in the United States (US) and compare their characteristics with other active adults. The research question was: do active scuba divers have different health and wellbeing characteristics, compared with adults active in other pursuits? METHODS: The Behavioural Risk Factor Surveillance System (BRFSS) is a proportionally representative annual survey of adults in the US. It is the largest continuous population health survey in the world. Since 2011, data on scuba diving is collected biannually. A comparison group were matched on age, sex, being physically active and state of residence. RESULTS: The dataset comprised 103,686,087 person-years of monthly behavioural data, including 14,360 person years of monthly scuba data. The median weekly frequency of recent scuba diving was 1.0 times per week and the median weekly duration was equivalent to two dives each of one hour. Compared with the comparison group, divers more often earned > USD$50,000 per year, were less frequently married, with fewer children in the house, which they more often owned. They reported being able to afford a doctor if needed within the previous year, but more often reported excellent/good health and excellent/good mental health, despite the divers being 16% more frequently overweight. CONCLUSIONS: The results demonstrate a relatively healthy cohort of active scuba divers, confirming previous survey results that active divers are commonly college-educated, unmarried, without children, home owning, often overweight, they often currently drink alcohol, and smoked tobacco in the past, but commonly gave up smoking ten years or more ago.

Prognostic indicators for naïve canine non-indolent T-cell lymphoma treated with combination lomustine, vincristine, procarbazine and prednisolone chemotherapy.

Lomustine, vincristine, procarbazine and prednisolone (LOPP) chemotherapy has been suggested to be an effective treatment for dogs with naïve non-indolent T-cell lymphoma (TCL). Studies evaluating prognostic factors for dogs with TCL treated with LOPP chemotherapy are lacking. The aim of this retrospective study was to assess potential prognostic factors for canine naïve non-indolent TCL treated with the LOPP protocol. This was a retrospective cohort study of naïve non-indolent TCL treated with the LOPP chemotherapy protocol at a single specialty veterinary oncology clinic. Sixty-seven dogs met the inclusion criteria. The outcomes assessed included progression free survival (PFS), overall survival time (OST) and duration of complete response (DCR). The overall median PFS was 118 days (range 7-2302 days). The median OST was 202 days (range 8-2302 days). The overall median DCR was 316 days (range 38-2261 days). Number of treatments administered (p < .0001), multicentric disease (p = .044) and the presence of hypercalcaemia (p = .006) were prognostic indicators for PFS. Increasing number of treatments (p < .0001) and age (p = .0088) were prognostic indicators for OST. To our knowledge, this is the first study to describe hypercalcaemia as a positive prognostic indicator of PFS for TCL treated with LOPP chemotherapy. LOPP chemotherapy can be considered as a first-line treatment protocol against naïve hypercalcaemic non-indolent TCL.

Risk factors for cardiovascular disease among active adult US scuba divers.

Cardiovascular factors among uninjured active adult recreational scuba divers in the USA are described. Scuba diving as an activity was included in 2011, 2013, and 2015 Behavioral Risk Factor Surveillance System data. One-third of active US scuba divers were aged ≥50 years and/or reported prior high cholesterol, around half were overweight, more than half reported having smoked cigarettes, and 32% reported hypertension or borderline hypertension. High cholesterol, hypertension, high body mass index, and smoking status should all be addressed during routine diving fitness physician assessments, to reduce the risk of mortality while diving.

Dispersed oil decreases the ability of a model fish (Dicentrarchus labrax) to cope with hydrostatic pressure.

Data on the biological impact of oil dispersion in deep-sea environment are scarce. Hence, the aim of this study was to evaluate the potential interest of a pressure challenge as a new experimental approach for the assessment of consequences of chemically dispersed oil, followed by a high hydrostatic pressure challenge. This work was conducted on a model fish: juvenile Dicentrarchus labrax. Seabass were exposed for 48 h to dispersant alone (nominal concentration (NC) = 4 mg L-1), mechanically dispersed oil (NC = 80 mg L-1), two chemically dispersed types of oil (NC = 50 and 80 mg L-1 with a dispersant/oil ratio of 1/20), or kept in clean seawater. Fish were then exposed for 30 min at a simulated depth of 1350 m, corresponding to pressure of 136 absolute atmospheres (ATA). The probability of fish exhibiting normal activity after the pressure challenge significantly increased from 0.40 to 0.55 when they were exposed to the dispersant but decreased to 0.26 and 0.11 in the case of chemical dispersion of oil (at 50 and 80 mg L-1, respectively). The chemical dispersion at 80 mg L-1 also induced an increase in probability of death after the pressure challenge (from 0.08 to 0.26). This study clearly demonstrates the ability of a pressure challenge test to give evidence of the effects of a contaminant on the capacity of fish to face hydrostatic pressure. It opens new perspectives on the analysis of the biological impact of chemical dispersion of oil at depth, especially on marine species performing vertical migrations.

Antioxidants, endothelial dysfunction, and DCS: in vitro and in vivo study.

Reactive oxygen species (ROS) production is a well-known effect in individuals after an undersea dive. This study aimed to delineate the links between ROS, endothelial dysfunction, and decompression sickness (DCS) through the use of antioxidants in vitro and in vivo. The effect of N-acetylcysteine (NAC) on superoxide and peroxynitrite, nitric oxide (NO) generation, and cell viability during in vitro diving simulation were analyzed. Also analyzed was the effect of vitamin C and NAC on plasma glutathione thiol and thiobarbituric acid reactive substances (TBARS), plasma angiotensin-converting enzyme (ACE) activity, and angiotensin-II and DCS morbidity during in vivo diving simulation. During an in vitro diving simulation, vascular endothelial cells showed overproduction of superoxide and peroxynitrite, obvious attenuation of NO generation, and promotion of cell death, all of which were reversed by NAC treatment. After in vivo diving simulation, plasma ACE activity and angiotensin-II level were not affected. The plasma level of glutathione thiol was downregulated after the dive, which was attenuated partially by NAC treatment. Plasma TBARS level was upregulated; however, either NAC or vitamin C treatment failed to prevent DCS morbidity. During in vitro simulation, endothelial superoxide and peroxynitrite-mediated oxidative stress were involved in the attenuation of NO availability and cell death. This study is the first attempt to link oxidative stress and DCS occurrence, and the link could not be confirmed in vivo. Even in the presence of antioxidants, ROS and bubbles generated during diving and/or decompression might lead to embolic or biochemical stress and DCS. Diving-induced oxidative stress might not be the only trigger of DCS morbidity.

Theoretical tissue compartment inert gas pressures during a deep dive with and without deep decompression stops: a case analysis.

BACKGROUND: Deep decompression stops are increasingly common in recreational technical diving. Concerns exist that they shift decompression stress back into slower tissues. A diver recorded an exceptional exposure dive, with deeps stops, on a commercially available dive computer. MATERIAL AND METHODS: Using the R package SCUBA tissue inert gas pressures in 17 Bühlmann (ZH-L16A) compartments were estimated from the dive computer recorded profile. The RGBM dive plan generated by the diver's software was similarly interrogated, as was a third profile with reduced deep stops generated using the VPM-B/E model. RESULTS: In this dive the combination of 5 gas switches appeared to ameliorate the effect of deep stops from 76 m depth. CONCLUSIONS: A higher-than-anticipated inert gas content in a decompression mixture, coupled with climbing 200 stairs post-decompression, appear possible risk factors for decompression sickness. Nonetheless, the physiological effect of deep decompression stops during exceptional exposure, even when diving with gas switches, remains urgently to be determined to improve safe decompression following exceptional exposures. Until algorithms utilising deep decompression stops are validated with human data, dive profiles incorporating deep decompression stops should be considered experimental.

Reactive Oxygen Species, Mitochondria, and Endothelial Cell Death during In Vitro Simulated Dives.

PURPOSE: Excessive reactive oxygen species (ROS) is considered a consequence of hyperoxia and a major contributor to diving-derived vascular endothelial damage and decompression sickness. The aims of this work were: 1) to directly observe endothelial ROS production during simulated air dives as well as its relation with both mitochondrial activity and cell survival; and 2) to determine which ambient factor during air diving (hydrostatic pressure or oxygen and/or nitrogen partial pressure) is responsible for the observed modifications. METHODS: In vitro diving simulation was performed with bovine arterial endothelial cells under real-time observation. The effects of air diving, hydrostatic, oxygen and nitrogen pressures, and N-acetylcysteine (NAC) treatment on mitochondrial ROS generation, mitochondrial membrane potential and cellular survival during simulation were investigated. RESULTS: Vascular endothelial cells performing air diving simulation suffered excessive mitochondrial ROS, mitochondrial depolarization, and cell death. These effects were prevented by NAC: after NAC treatment, the cells presented no difference in damage from nondiving cells. Oxygen diving showed a higher effect on ROS generation but lower impacts on mitochondrial depolarization and cell death than hydrostatic or nitrogen diving. Nitrogen diving had no effect on the inductions of ROS, mito-depolarization, or cell death. CONCLUSION: This study is the first direct observation of mitochondrial ROS production, mitochondrial membrane potential and cell survival during diving. Simulated air SCUBA diving induces excessive ROS production, which leads to mitochondrial depolarization and endothelial cell death. Oxygen partial pressure plays a crucial role in the production of ROS. Deleterious effects of hyperoxia-induced ROS are potentiated by hydrostatic pressure. These findings hold new implications for the pathogenesis of diving-derived endothelial dysfunction.

Risk factors for running low on gas in recreational divers in Western Australia.

INTRODUCTION: The aim of this study was to investigate risk factors associated with running low on gas among certified recreational divers. METHODS: Dive and diver information were collected from divers joining organised recreational dives in Western Australia and depth/time loggers were attached to each diver. Case dives ending with < 50 bar in the cylinder were compared with control dives made at the same dive site and time by divers with > or = 50 bar remaining. A conditional logistic regression model identified factors significantly associated with running low on gas. RESULTS: In total, 1,032 dive profiles were collected. Case dives (n = 183) returning with < 50 bar were compared with 510 control dives ending with > or = 50 bar. Perceived workload was associated with rate of consumption of gas. Factors associated with a dive ending low on gas included: younger age; males; lower number of lifetime dives; a longer period since last dive; deeper maximum depth and breathing at a heavier rate. Eleven per cent of case divers, compared with 1% of control dives, reported surprise at the low remaining level of gas. CONCLUSIONS: Dive organisers are recommended to select dive sites based on the recent experience of the group and to encourage divers to monitor their remaining gas frequently, relative to the depth of the site. Divers are reminded that, if they perceive a strenuous workload, they should pay even closer attention to monitoring their gas reserves. That 89% of low-on-gas dives were reported to be no surprise to the divers making them warrants further investigation.