Bispectral index with density spectral array (BIS-DSA) monitoring in a patient with inner ear and cerebral decompression sickness.

Bispectral index with density spectral array (BIS-DSA) monitoring during hyperbaric oxygen therapy of a case with inner ear and cerebral decompression sickness is described. During the initial treatment, a particular DSA pattern was found, which resolved after four treatments. Clinical resolution of the symptoms accompanied this improvement. The particular BIS-DSA pattern described in this case is concordant with a potential hypo-perfusion of the cortex related to decompression stress. This case suggests that BIS-DSA monitoring may be an easy, cost-effective, and viable form of neuro-monitoring during hyperbaric oxygen treatment for decompression sickness.

Efectos biológicos de la exposición a distintas concentraciones de oxígeno: desde la hipoxia hipobárica al oxígeno hiperbárico / Biological effects due to exposure to different concentrations of oxygen from hypo to hyperoxemia

The systemic effects of oxygen deficiency or excess are not thoroughly described. Knowledge is evolving towards the description of beneficial and detrimental effects of both extremes of partial pressure of oxygen (PaO2). The cellular and tissue mediators derived from the modulation of the oxidative tone and the production of reactive oxygen species (ROS) are widely characterized biochemically, but the pathophysiological characterization is lacking. Preclinical models support the use of hypobaric hypoxia preconditioning, based on its beneficial effects on ventricular function or its reduction in infarct size. A very important use of oxygen today is in commercial diving. However, novel clinical indications for oxygen such as the healing of diabetic foot ulcers and bone injury caused by radiotherapy are increasingly used. On the other hand, the modulation of the hypoxic response associated with exposure to high altitude environments (hypobaric), favors Chile and its highlands as a natural laboratory to determine certain cardiovascular, cerebral and metabolic responses in the resident population. Also, the consequences of the intermittent exposure to high altitudes in workers also deserves attention. This review discusses the physiopathological response to hypo and hyperoxemia, associated with environments with different oxygen concentrations, and brings back the concept of oxygen as a pharmacological mediator in extreme environments such as high altitudes and hyperbaric medicine in divers, decompression sickness, osteonecrosis associated with radiotherapy and sudden sensorineural hearing loss.

[Biological effects due to exposure to different concentrations of oxygen from hypo to hyperoxemia]. / Efectos biológicos de la exposición a distintas concentraciones de oxígeno: desde la hipoxia hipobárica al oxígeno hiperbárico.

The systemic effects of oxygen deficiency or excess are not thoroughly described. Knowledge is evolving towards the description of beneficial and detrimental effects of both extremes of partial pressure of oxygen (PaO2). The cellular and tissue mediators derived from the modulation of the oxidative tone and the production of reactive oxygen species (ROS) are widely characterized biochemically, but the pathophysiological characterization is lacking. Preclinical models support the use of hypobaric hypoxia preconditioning, based on its beneficial effects on ventricular function or its reduction in infarct size. A very important use of oxygen today is in commercial diving. However, novel clinical indications for oxygen such as the healing of diabetic foot ulcers and bone injury caused by radiotherapy are increasingly used. On the other hand, the modulation of the hypoxic response associated with exposure to high altitude environments (hypobaric), favors Chile and its highlands as a natural laboratory to determine certain cardiovascular, cerebral and metabolic responses in the resident population. Also, the consequences of the intermittent exposure to high altitudes in workers also deserves attention. This review discusses the physiopathological response to hypo and hyperoxemia, associated with environments with different oxygen concentrations, and brings back the concept of oxygen as a pharmacological mediator in extreme environments such as high altitudes and hyperbaric medicine in divers, decompression sickness, osteonecrosis associated with radiotherapy and sudden sensorineural hearing loss.

Executive Function among Chilean Shellfish Divers: A Cross-Sectional Study Considering Working and Health Conditions in Artisanal Fishing.

Knowledge about professional diving-related risk factors for reduced executive function is limited. We therefore evaluated the association between decompression illness and executive functioning among artisanal divers in southern Chile. The cross-sectional study included 104 male divers and 58 male non-diving fishermen from two fishing communities. Divers self-reported frequency and severity of symptoms of decompression illness. Executive function was evaluated by perseverative responses and perseverative errors in the Wisconsin Card Sorting Test. Age, alcohol consumption, and symptoms of depression were a-priori defined as potential confounders and included in linear regression models. Comparing divers and non-divers, no differences in the executive function were found. Among divers, 75% reported a history of at least mild decompression sickness. Higher frequency and severity of symptoms of decompression illness were associated with reduced executive function. Therefore, intervention strategies for artisanal divers should focus on prevention of decompression illness.

Catching Air: Risk and Embodied Ocean Health among Dominican Diver Fishermen.

This article explores the connections between bodily health and environmental health among diver fishermen in the Dominican Republic, and how these relationships are excluded from broader conversations about marine conservation at the national and global levels. As changing ocean environments refigure marine ecosystems, making fish scarce in the shallows, diver fishermen must dive deeper and stay longer in risky conditions, using a compressor to pump an unlimited supply of air to the diver below. As a result, decompression sickness (the bends) has become a pervasive injury and a way that coastal communities experience changing ocean health. The article analyzes injury narratives from divers who "caught air," the local term for the bends, arguing that decompression sickness is a symptom of failing ecologies and strained human relations with the sea, where environments at risk become embodied through parallel risky practices at sea.

Dysbaric osteonecrosis (DON) among the artisanal diving fishermen of Yucatán, Mexico.

INTRODUCTION: Artisanal diving fishermen in Yucatán, Mexico have high rates of decompression sickness as a result of frequently unsafe diving practices with surface supplied compressed air. In this study, we investigated the prevalence of dysbaric osteonecrosis (DON), a type of avascular necrosis, in the most susceptible joints in a cohort of these fishermen. METHODS: We performed radiographs of bilateral shoulders, hips, and knees of 39 fishermen in Mexico and surveyed them about their medical and diving histories. We performed pairwise correlations to examine if the fishermen's diving behaviours affected the numbers of joints with DON. RESULTS: The radiographs revealed Grade II or higher DON in 30/39 (76.9%) of the fishermen. Twenty-two of 39 fishermen (56.4%) had at least two affected joints. The number of joints with DON positively correlates with the lifetime maximum diving depth and average bottom time. CONCLUSIONS: These findings represent among the highest prevalence rates of DON in divers and reflect the wide-spread scale of decompression sickness among these fishermen. Through this work, we hope to further educate the fishermen on the sequelae of their diving with the aim of improving their diving safety.

A study of decompression sickness using recorded depth-time profiles.

Introduction: 122,129 dives by 10,358 recreational divers were recorded by dive computers from 11 manufacturers in an exploratory study of how dive profile, breathing gas (air or nitrox [N2/O2] mixes), repetitive diving, gender, age, and dive site conditions influenced observed decompression sickness (DCSobs). Thirty-eight reports were judged as DCS. Overall DCSobs was 3.1 cases/104 dives. Methods: Three dive groups were studied: Basic (live-aboard and shore/dayboat), Cozumel Dive Guides, and Scapa Flow wreck divers. A probabilistic decompression model, BVM(3), controlled dive profile variability. Chi-squared test, t-test, logistic regression, and log-rank tests evaluated statistical associations. Results: (a) DCSobs was 0.7/104 (Basic), 7.6/104 (Guides), and 17.3/104 (Scapa) and differed after control for dive variability (p ≺ 0.001). (b) DCSobs was greater for 22%-29% nitrox (12.6/104) than for 30%-50% nitrox (2.04/104) (p ≤ 0.0064) which did not differ from air (2.97/10104). (c) For daily repetitive dives (≺12-hour surface intervals (SI)), DCS occurred only following one or two dives (4.3/10104 DCSobs; p ≺ 0.001) where SIs were shorter than after three or more dives. (d) For multiday repetitive dives (SIs ≺ 48 hours), DCS was associated with high multiday repetitive dive counts only for Guides (p = 0.0018). (e) DCSobs decreased with age at 3%/year (p ≤ 0.0144). (f) Males dived deeper (p ≺ 0.001) but for less time than females (p ≺ 0.001). Conclusion: Collecting dive profiles with dive computers and controlling for profile variability by probabilistic modeling was feasible, but analytical results require independent confirmation due to limited observed DCS. Future studies appear promising if more DCS cases are gathered, stakeholders cooperate, and identified data collection problems are corrected.

Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

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)

The cost of decompression illness: the case of lobster and sea cucumber fishery in Yucatan, Mexico.

Diving fisheries are an important source of income and protein for many coastal communities around the world. However, these fisheries are also the cause of both fatal and non-fatal injuries. The aim of this study is to estimate the costs of decompression sickness (DCS) in the diving small-scale fisheries that target benthic resources in the Yucatan, Mexico. The DCS cases that occurred during three fishing seasons for sea cucumber (Isostichopus badionotus) and one for spiny lobster (Panulirus argus) were used to calculate the direct medical costs. The catch data during the same fishing seasons were used to calculate the potential losses caused by disability as indirect costs. In the three years (from 2013 to 2016) the total number of fishermen treated in the region numbered 282; 116 during lobster fishing and 166 during sea cucumber season. The direct medical costs were estimated to be USD $120,269; the temporary loss of income in USD $724,377; and the permanent loss of income was USD $737,053. Considering the direct and indirect costs, the social costs of diving in both small-scale fisheries was USD $1,614,121. This is a first approach to estimate the cost of the use of diving in fisheries for the health services but for the fishing communities as well. Furthermore, this is an important first step on the road to a full economic evaluation of the benthic fisheries in order to improve their management.

Body mass index in association with decompression sickness events: cross-sectional study among small-scale fishermen-divers in southeast Mexico.

INTRODUCTION: Decompression sickness is endemic to small-scale fishermen-divers from coastal communities in southeast Mexico; overweight and obesity are also highly prevalent in the region. Existing literature suggests it is possible that fat tissue could play a role in decompression sickness pathophysiology. Our aim in this study is to describe the association between the number and severity of DCS events treated at the hyperbaric program and fishermen-diver body mass index. METHODS: In this cross-sectional study, we obtained anthropometric measurements of 105 fishermen-divers and reviewed clinical records of each participant at a hyperbaric program. RESULTS: Average BMI among participants was 34.5 ± 4.7, while 9.5% (n=10) were healthy-weighted, 28.6% (n=30) were overweight and 42.8% (n=65) were obese. Number of DCS events per diver was associated with BMI and severity of DCS in linear regression models. CONCLUSIONS: Overweight and obesity are highly preventable health problems; our results suggest that an association between these conditions and the frequency and the severity of DCS are an important topic to be further considered in longitudinal prospective studies.

Understanding dive behavior of artisanal fishermen divers of the Yucatán Peninsula.

INTRODUCTION/BACKGROUND: Artisanal fishermen dive for sustenance. The lifetime prevalence of decompression sickness (DCS) in this population is alarmingly high. We wanted to understand the level of decompression stress fishermen in this region of the Yucatán experience in their daily fishing effort. We used a mathematical model to quantify nitrogen-loading in a nine-tissue compartment model. MATERIALS AND METHODS: Approved by the UCLA IRB 2 #13-000532, this study was conducted during fishing seasons 2012 through 2017. Diving fishermen were instructed to attach dive recorders to their waists every fishing day during the study period. Sensus Ultra dive recorders (ReefNet Inc.), with an accuracy of ±1 foot of seawater (fsw), 0.304 meters, and an activation depth of 10 fsw, 3.04 meters, were used to record dive parameters. Sampling interval was set to 10 seconds. A program in RStudio was created to extract the dive profiles of each fishing day and curtail into single-line outputs: pressure, time, date, start of dive and end of dive. An exponential decay formula was used to calculate the nitrogen-loading pressures for nine theoretical tissue compartments. Final nitrogen pressure, controlling compartments, decompression stop and time at stop were calculated. RESULTS: Fishermen completed 4,961 dives over 1,758 diving days during the study period. The 40-minute compartment controlled most of the dives. The 80-minute compartment controlled 5%-20% of dives two through five. Decompression stop times for the last dive ranged from one minute to 190 minutes. Most of the required stop time observed was seen at depths of 1-15 fsw.

Spinal decompression sickness in an artisanal diving fisherman in Yucatán, Mexico: a case report.

Artisanal fishermen around the world employ scuba and surface-supplied diving for their livelihoods and often undergo provocative dive profiles due to economic pressures. Consequently, rates of decompression sickness (DCS) are much greater than in recreational scuba divers. Here we present the case of a surface-supplied diving fisherman from the Yucatán Peninsula of Mexico, who suffered a significant episode of spinal DCS and underwent hyperbaric oxygen therapy treatments, with a favorable outcome. Additionally, we review the proposed mechanisms underlying spinal DCS.

Fatal cardiopulmonary decompression sickness in an untrained fisherman diver in Yucatán, Mexico: a clinical case report.

INTRODUCTION: In Yucatán, Mexico, during the sea cucumber season fishermen dive intensely to obtain good catches but are often at risk of decompression sickness (DCS). We present a single case fatality. OBJECTIVE: We analyzed the clinical course, medical assessment and recompression treatment plan of an untrained fisherman. CASE REPORT: A 35-year-old male ascended rapidly using compressed-air diving. Before reaching the coast, he reported dizziness, shortness of breath, and pain in the abdomen and legs. Three hours later, when symptoms worsened, he went to the hospital. He was admitted with increased osteotendinous reflexes and cutis marmorata in the abdomen. The patient was diagnosed with carbon monoxide (CO) poisoning and Type I DCS, receiving the U.S. Navy Treatment Table 5 (USN TT5). Before completing his treatment at depth, he developed myocardial infarction and died. The death certificate indicated Type I DCS, thrombotic pulmonary embolism and cardiac arrest. DISCUSSION: Upon reviewing his medical records, we uncovered no evidence to support the diagnosis of CO poisoning and thrombotic pulmonary embolism. The clinical presentation seems to be compatible with a serious decompression insult, not a Type I hit. Based on the information gathered, it seems likely that the patient died as a result of cardiopulmonary DCS. This case report suggests a need to provide fishermen divers in this region with formal dive training. There also seems to be a need to improve medical education for physicians who work at hyperbaric programs, and to ensure that sufficient and qualified staff is present to supervise patients inside the chambers.

Decompression sickness among diving fishermen in Mexico: observational retrospective analysis of DCS in three sea cucumber fishing seasons.

The probabilities of decompression sickness (DCS) among diving fishermen are higher than in any other group of divers. Diving behavior of artisanal fishermen has been directed mainly to target high-value species. The aim of this study was to learn about the occurrence of DCS derived from sea cucumber harvesting in the Yucatán Peninsula, Mexico. We conducted a retrospective chart review of diving fishermen treated at a multiplace hyperbaric chamber in Tizimín, Mexico. In total, 233 recompression therapies were rendered to 166 diving fishermen from 2014 to 2016. The average age was 36.7 ± 9.2 years (range: 20-59 years); 84.3% had experienced at least one DCS event previously. There was a correlation between age and DCS incidents (F: 8.3; R2: 0.07) and differences in the fishing depth between seasons (H: 9.99; p⟨0.05). Musculoskeletal pain was the most frequently reported symptom. Three divers, respectively, suffered permanent hearing loss, spinal cord injury and fatal outcome. Diving fishermen experience DCS at an alarmingly high rate, probably due to the type of species targeted, given the requirements in each case. Understanding divers' behaviors and their incentives while in pursuit of high-value species such as sea cucumber could help to find ways to mitigate health risks and help enforce regulation.

Social representations of fishermen with spinal cord injury: impacts and life trajectory. / Representações sociais de pescadores com lesão medular: repercussões e trajetória de vida.

OBJECTIVE:: analyze social representations in the life trajectory of artisanal fishermen with spinal cord injury caused by diving on the north coast of Rio Grande do Norte. METHOD:: a descriptive, qualitative study was conducted with 31 fishermen between October 2013 and August 2014, using a semi-structured interview. A lexicographic analysis and descending hierarchical classification of texts were performed (with software ALCESTE), in the perspective of the social representations. RESULTS:: social representations of fishermen with spinal cord injury presented experiences with physical limitations and expectations regarding retirement, which appeared as a distant reality from the requirements in Brazilian labor laws. CONCLUSION:: measures are required for the promotion, prevention and rehabilitation of the health of fishermen with spinal cord injury, as well as safe and decent fishing conditions, with the commitment of health authorities.

Representações sociais de pescadores com lesão medular: repercussões e trajetória de vida / Representaciones sociales de pescadores con lesión medular: repercusiones e historia de vida / Social representations of fishermen with spinal cord injury: impacts and life trajectory

RESUMO Objetivo: analisar as representações sociais da trajetória de vida dos pescadores artesanais com lesão medular vítimas de acidente por mergulho nas praias do litoral Norte do Rio Grande do Norte. Método: estudo descritivo, de natureza qualitativa, desenvolvido com 31 pescadores entre outubro de 2013 e agosto de 2014, mediante entrevista semiestruturada. Empregou-se a análise lexicográfica e classificação hierárquica descendente dos textos (software ALCESTE), sob a ótica das Representações Sociais. Resultados: as representações sociais dos pescadores com lesão medular apresentaram as experiências com as limitações físicas e expectativas de aposentadoria, estas últimas configurando-se como uma realidade distante das exigências impostas por nossas leis trabalhistas. Conclusão: exigem-se medidas de promoção, prevenção e reabilitação da saúde do pescador vítima de lesão medular, além de condições seguras e dignas de trabalho como compromisso das políticas de saúde.

RESUMEN Objetivos: analizar las representaciones sociales de la historia de vida de pescadores artesanales con lesión medular víctimas de accidente de buceo en las playas del litoral Norte de Rio Grande do Norte. Método: estudio descriptivo, de naturaleza cuantitativa, desarrollado con 31 pescadores entre octubre de 2013 y agosto de 2014, mediante entrevista semiestructurada. Se empleó análisis lexicográfico y clasificación jerárquica descendiente en los textos (software ALCESTE), en la visión de las Representaciones Sociales. Resultados: las representaciones sociales de los pescadores con lesión medular expresaron las experiencias de las limitaciones físicas y expectativas de jubilación, configurándose éstas como realidad distante de las exigencias impuestas por la legislación laboral vigente. Conclusión: se requieren medidas de promoción, prevención y rehabilitación de la salud del pescador víctima de lesión medular, además de condiciones laborales seguras y dignas, con compromiso de las políticas de salud.

ABSTRACT Objective: analyze social representations in the life trajectory of artisanal fishermen with spinal cord injury caused by diving on the north coast of Rio Grande do Norte. Method: a descriptive, qualitative study was conducted with 31 fishermen between October 2013 and August 2014, using a semi-structured interview. A lexicographic analysis and descending hierarchical classification of texts were performed (with software ALCESTE), in the perspective of the social representations. Results: social representations of fishermen with spinal cord injury presented experiences with physical limitations and expectations regarding retirement, which appeared as a distant reality from the requirements in Brazilian labor laws. Conclusion: measures are required for the promotion, prevention and rehabilitation of the health of fishermen with spinal cord injury, as well as safe and decent fishing conditions, with the commitment of health authorities.

Spinal cord injury due to diving accidents and stress among artisanal fishers / Lesão medular por mergulho e estresse em pescadores artesanais / Lesion medular por buceo y estrés en pescadores artesanales

ABSTRACT Objective: to analyze the presence and symptoms of stress among artisanal fishers who are victims of spinal cord injury. Method: this descriptive, cross-sectional and quantitative study was conducted with a non-probabilistic sample of 44 fishers, victims of spinal cord injury on the beaches of the northern coast of Rio Grande do Norte, Brazil. Data were collected using an inventory designed for adults addressing the presence and symptoms of stress, and a form addressing the participants' sociodemographic and clinical variables. Descriptive analysis considered the participants' scores. Results: all fishers were male, aged 23.87 ± 20.9 years old on average; time since the accident that caused the injury was 33.3 ± 19.31 years on average; the level of injury most frequently affected was the thoracic spine (41.8%), of which the main sequel was paraplegia (50.0%). The findings reveal stress compatible with the exhaustion phase (25.0%), followed by the resistance phase (13.6%), with the main symptoms including: insomnia, tachycardia, hypertension, and sexual problems, among others. Conclusion: the stress identified among the fishers was in the exhaustion phase and physical symptoms predominated. A spinal cord injury impacts the victim's social, occupational and family context, leading to the emergence of stress.

RESUMO Objetivo: analisar a presença e os sintomas de estresse em pescadores artesanais vítimas de lesão medular. Método: estudo descritivo, seccional e quantitativo, realizado com amostra não probabilística de 44 pescadores vitimados por lesão medular nas praias do litoral norte do Rio Grande do Norte. Os dados foram coletados por meio de aplicação de inventário sobre presença e sintomas de estresse para adultos, conteplando ainda características sociodemográficas e clínicas dos participantes. A etapa de análise considerou o escore e o somatório das respostas obtidas, utilizando-se a estatística descritiva. Resultados: todos os pescadores eram do sexo masculino, com idade média de 23,87 ± 20,9 anos; tempo médio transcorrido após o acidente de mergulho que desencadeou a lesão de 33,3 ±19,31 anos; nível medular mais acometido a coluna torácica (41,8%), tendo como principal sequela a paraplegia (50,0%) e o tempo do acidente por mergulho de 33,3 anos. Os achados remetem ao estresse compatível a fase de exaustão (25,0%), seguida de resistência (13,6%), com destaque para sintomas como insônia, taquicardia, hipertensão, dificuldade sexual, entre outros. Conclusão: constatou-se a presença de estresse entre os pesacadores na fase de exaustão, com predomímio de sintomas físicos. Evidencia-se que a lesão medular por mergulho repercute no contexto social, ocupacional e familiar da vítima, favorecendo o aparecimento de estresse.

RESUMEN Objetivo: analizar la presencia y los síntomas de estrés en pescadores artesanales víctimas de lesión medular. Método: estudio descriptivo, seccional y cuantitativo, realizado con una muestra no probabilístico de 44 pescadores víctimas de lesión medular en las playas del litoral norte de Rio Grande do Norte. Los datos fueron recolectados por medio de la aplicación de inventario sobre presencia y síntomas de estrés para adultos, contemplando aún características sociodemográficas y clínicas de los participantes. La etapa de análisis consideró el score y la suma de las respuestas obtenidas, utilizando la estadística descriptiva. Resultados: todos los pescadores eran del sexo masculino, con edad media de 23,87 ± 20,9 años, tiempo medio transcurrido después del accidente de buceo que desencadenó la lesión de 33,3 ±19,31 años; nivel medular más acometido la columna torácica (41,8%), teniendo como principal secuela la paraplejia (50,0%) y el tiempo del accidente por buceo de 33,3 años. Los hallazgos remeten al estrés compatible a la fase de cansancio (25,0%), seguida de resistencia (13,6%), con destaque para síntomas como insomnio, taquicardia, hipertensión, dificultad sexual, entre otras. Conclusión: se constató la presencia de estrés entre los pescadores en la fase de cansancio, con predominio de síntomas físicos. Se evidencia que la lesión medular por buceo repercute en el contexto social, ocupacional y familiar de la víctima, favoreciendo la aparición de estrés.

Indicação de alcoolismo em pescadores vítimas de lesão medular por mergulho / Indicación del alcoholismo en pescadores víctimas de lesion en la médula espinal por submarinismo / Indication of alcoholism in fishermen victims of spinal cord injury by diving

Examine indication of alcoholism in artisanal fisher folk victims of Spinal Cord Injury (SCI) by diving through the application of the CAGE questionnaire. Method: Sectional study and analytical, with a quantitative approach, carried out between October 2013 and August 2014. The sample was composed of 44 fishermen who suffered SCI for diving. The data were collected by means of a structured script and the analysis was by descriptive statistics. Results: All were male (100.0%), aged 46 to 60 years (63.3%), 54.5% had until elementary school, lived without a mate (63.6%) and 52.3% reported having some type of occupation. As for the questionnaire question 1 CAGE, had the highest percentage of positive responses (90.9%). According to CAGE, it was found that 93.2% of fishermen had indication of alcoholism. Conclusion: The most of the participants had indication of alcoholism...

Analisar a indicação de alcoolismo em pescadores artesanais vítimas de lesão medular (LM) por mergulho por meio da aplicação do questionário CAGE. Método: Estudo seccional e analítico, com abordagem quantitativa, realizado entre outubro de 2013 e agosto de 2014. A amostra foi composta por 44 pescadores que sofreram LM por mergulho. Os dados foram coletados por meio de um roteiro estruturado e a análise foi por estatística descritiva. Resultados: Todos eram do sexo masculino (100,0%), na faixa etária de 46 a 60 anos (63,3%), 54,5% tinham até o ensino fundamental, viviam sem companheira (63,6%) e 52,3% relataram ter algum tipo de ocupação. Quanto ao questionário CAGE, a questão 1 teve o maior percentual de respostas positivas (90,9%). De acordo com o CAGE, constatou-se que 93,2% dos pescadores tinham indicação de alcoolismo. Conclusão: A maioria dos participantes possuíam indicação de alcoolismo...

Analizar la indicación del alcoholismo en los pescadores artesanales víctimas de Lesión Medular Espinal (LME) para el submarinismo por medio de la aplicación del cuestionario CAGE. Método: Estudio transversal y analítico, con un enfoque cuantitativo, realizado entre octubre de 2013 y agosto de 2014. La muestra fue constituida por 44 pescadores que sufrieron LME para el submarinismo. Los datos fueron colectados mediante un guion estructurado y el análisis fue por estadística descriptiva. Resultados: Todos eran varones (100,0%), con edad de 46 a 60 años (63,3%), el 54,5% había completado la escuela primaria, vivían sin pareja (63,6%) y 52,3 % reportó tener algún tipo de ocupación. Cuanto al cuestionario CAGE, la cuestión 1 tuvo el mayor porcentaje de respuestas positivas (90,9%). De acuerdo con lo CAGE, se encontró que el 93,2% de los pescadores tenían indicación de alcoholismo. Conclusión: La mayoría de los participantes tenían indicación de alcoholismo...

Osteonecrosis disbárica de cabeza humeral en buzo pesquero tratado con artroplastia de superficie / Dysbaric osteonecrosis of humeral head in a diver treated with resurfacing arthroplasty

Describir osteonecrosis disbárica (ODB) en buzo pesquero y exponer la experiencia inédita de tratamiento con artroplastia de superficie (AS). Introducción ODB, forma de necrosis avascular secundaria a enfermedad por descompresión (EDC), cuyo tratamiento gold standard para estadios avanzados continúa siendo la artroplastia total (AT). Presentación de caso: Paciente de 49 años, buzo pesquero, antecedentes de EDC tratada el 2008 en cámara hiperbárica, con diagnóstico compatible con ODB de cabeza humeral derecha de 6 años de evolución; Constant score=29. Se realiza AS del hombro derecho, y luego de 18 meses de seguimiento se reporta una adecuada evolución clínica con remisión de la sintomatología; Constant score a 18 meses=72. Discusión: El uso de AT en el paciente joven es limitado, por lo que surge la necesidad de implementar nuevas técnicas quirúrgicas en este grupo de pacientes. Conclusión: La AS constituye una alternativa terapéutica en adultos jóvenes y activos con ODB...

Introduce and describe Dysbaric Osteonecrosis (DON) in a fishing diver patient, emphasising clinical features, use of imaging methods, and present a new experience of treatment with Resurfacing Arthroplasty (RA). Introduction: DON, a form of avascular necrosis secondary to Decompression Sickness (DCS). Total Arthroplasty (AT) remains the reference treatment for advanced stages. Case report: Male, 49 years old, fishing diver, with a history of DCS treated in a hyperbaric chamber (2008). Right humeral head DON Compatible with 6 years of onset. Constant Score=29. RA performed on right shoulder. Clinical remission of symptoms was observed after 18 months of follow-up. Constant Score at 18 months=72. Discussion: TA use in young patients is limited, so there is a need to implement new surgical techniques in this group of patients. Conclusion: RA is a therapeutic alternative in young and active subjects with DON...