First impressions: Use of the Azoth Systems O'Dive subclavian bubble monitor on a liveaboard dive vessel.

INTRODUCTION: The Azoth Systems O'Dive bubble monitor is marketed at recreational and professional divers as a tool to improve personal diving decompression safety. We report the use of this tool during a 12-day dive trip aboard a liveaboard vessel. METHODS: Six divers were consistently monitored according to the user manual of the O'Dive system. Data were synchronised with the Azoth server whenever possible (depending on cell phone data signal). Information regarding ease of use, diver acceptance and influence on dive behaviour were recorded. RESULTS: In total, 157 dives were completely monitored over 11 diving days. Formal evaluations were only available after six days because of internet connection problems. Sixty-one dives resulted in the detection of bubbles, mostly in one diver, none of which produced any symptoms of decompression illness. CONCLUSIONS: The O'Dive system may contribute to increasing dive safety by making divers immediately aware of the potential consequences of certain types of diving behaviour. It was noted that bubble monitoring either reinforced divers in their safe diving habits or incited them to modify their dive planning. Whether this is a lasting effect is not known.

Recurrence of spontaneous pneumothorax six years after VATS pleurectomy: evidence for formation of neopleura.

BACKGROUND: Primary Spontaneous Pneumothorax (PSP) is considered an absolute and definitive contraindication for scuba diving and professional flying, unless bilateral surgical pleurectomy is performed. Only then is there a sufficiently low risk of recurrence to allow a waiver for flying and/or diving. CASE PRESENTATION: A young fit male patient who suffered a PSP 6 years ago, and underwent an uncomplicated videoscopic surgical pleurectomy, presented with a complete collapse of the lung on the initial PSP side. Microscopic examination of biopsies showed a slightly inflamed tissue but otherwise normal mesothelial cells, compatible with newly formed pleura. CONCLUSIONS: Even with pleurectomy, in this patient, residual mesothelial cells seem to have had the capacity to create a completely new pleura and pleural space. The most appropriate surgical technique for prevention of PSP may still be debated.