A unique case of a 70-hour decompression sickness latency.

We report a unique and well-documented case of a type II decompression sickness (DCS) with a latency interval of 70 hours. It may raise divers' awareness and help medical practitioners to keep suspect divers under close observation longer than before and identify and treat DCS accordingly.

Change of occurance of type 1 and type 2 decompression sickness of divers treated at the Croatian Naval Medical Institute in the period from 1967 to 2000.

A significant change of occurrence (p=0.0343) of type 1 and type 2 decompression sickness (DCS) of divers in Croatia was observed in the period from 1991 to 2002 (type 1: n=26, 37.68% and type 2: n=43, 62.32%) compared with the period from 1967 to 1990 (type 1: n=93, 52.84% and type 2: n=83, 47.16%). The change was attributed to the extensive usage of diving computers and artificial gas mixtures which enable extended bottom times and deeper dives, thus putting divers at an increased decompression risk. The importance of the results of this report is in the fact that permanent neurological deficit occurs only after type 2 DCS. Injured divers with permanent loss after type 2 DCS are not fit for diving and require a long term medical care, thus becoming a significant public health problem.

[Gas gangrene and hyperbaric oxygenation--a lesson forgotten or never learned?]. / Plinska gangrena i hiperbaricna oksigenacija--zaboravljena ili nikad naucena lekcija?

Gas gangrene develops in devitalized hypoxic tissue. It spreads rapidly under strong influence of enzymes produced by the causing bacteria and often results in fatal outcome. It is of utmost importance to stop toxin production as soon as possible, which is most effectively achieved by early application of hyperbaric oxygenation (HBO2), as the first measure in a "trident" (HBO2, antibiotics, surgical measures). The paper reviews the most important data from microbiology, pathophysiology and epidemiology of gas gangrene, current clinical practice, scientific basis for application of HBO2 in the treatment of this disease, and data from the archives of the Naval Medical Institute of the Croatian Navy in Split (NMI). At the NMI, in the period from 1982 to 2000, HBO2 was administered in the treatment of 21 patients with gas gangrene, of average age 41.6 +/- 16.3 years. The average treatment consisted of 6.8 +/- 3.8 sessions. 13 (76%) patients were cured.

Recompression therapy of mountain sickness.

This paper describes the treatment of a severe case of acute mountain sickness with a portable hyperbaric chamber. A 37-year old climber was treated for acute high altitude pulmonary oedema, which developed on the North Col of Mount Everest, at an altitude of 7,060 m. The treatment in the portable Gamow bag hyperbaric chamber lasted two hours, with a bag pressure of 103 mm Hg (0.136 kg/cm2 or 2 psig) using ambient air, without the addition of oxygen. With this pressure increase, the hyperbaric chamber lowered the patient's effective ambient altitude from 6,050 to 4,400 m. The treatment was successful and the pulmonary oedema disappeared. Outside the hyperbaric chamber, the patient recovered fully when he reached the altitude of 2,000 m. Portable hyperbaric chamber is recommended for the treatment of severe cases of acute mountain sickness, as well as for risky descent to lower altitudes.