[Hypertension and SCUBA diving]. / Hypertension artérielle et plongée sous-marine.

Hypertension is a major cardiovascular risk factor in our population. This condition is widely recognized as an exacerbating factor for several physiopathological mechanisms, especially under an intense physical effort. In this article we focus on the link between high blood pressure and risk factors in scuba diving. In particular, we illustrate how a hypertensive diver is exposed to an increased risk of acute immersion pulmonary edema, as well as cardiac death.

L'hypertension artérielle est un facteur de risque cardiovasculaire prépondérant dans notre population. Elle est reconnue comme pouvant exacerber de nombreux mécanismes physiopathologiques lors de conditions d'efforts. Dans cet article, nous nous focalisons sur le lien entre l'hypertension artérielle et le risque qu'elle pourrait représenter lors de la pratique de la plongée sous-marine. En particulier, nous illustrerons comment un plongeur hypertendu peut être exposé à un risque augmenté d'œdème pulmonaire aigu d'immersion, ainsi qu'à la mort subite d'origine cardiaque.

[Medical certification for high altitude travel and scuba diving]. / Certificats médicaux pour les séjours en haute montagne et la plongée sous-marine.

People are more and more looking for adventures and discovery of unusual locations. Journeys to high altitude and scuba diving are part of these activities and their access has become easier for a lot of people not necessarily experienced with their dangers. The general practitioner will have to be able to deliver some advices and recommendations to his patients about the risks related to these activities and their ability to practice them. He will also have to deliver some certificates of medical fitness to dive. This paper proposes a brief review of the most important medical aspects to know about high altitude and scuba diving.

Computed tomography colonography imaging of pneumatosis intestinalis after hyperbaric oxygen therapy: a case report.

INTRODUCTION: Pneumatosis intestinalis is a condition characterized by the presence of submucosal or subserosal gas cysts in the wall of digestive tract. Pneumatosis intestinalis often remains asymptomatic in most cases but may clinically present in a benign form or less frequently in fulminant forms. Treatment for such conditions includes antibiotic therapy, diet therapy, oxygen therapy and surgery. CASE PRESENTATION: The present report describes the case of a 56-year-old Swiss-born man with symptomatic pneumatosis intestinalis resistant to all treatment except hyperbaric oxygen therapy, as showed by computed tomography colonography images performed before, during and after treatment. CONCLUSIONS: The current case describes the response to hyperbaric oxygen therapy using virtual colonoscopy technique one month and three months after treatment. Moreover, after six months of follow-up, there has been no recurrence of digestive symptoms.

[Scuba diving and hyperbaric medicine]. / Plongée sous-marine et médecine hyperbare.

Scuba diving is widely practiced in Switzerland. Although rare, decompression sickness may be serious and require specialized treatment. Hyperbaric therapy has been used for a long time with beneficial effects on decompression sickness and gaseous embolism. Conversely, barotrauma does not require recompressive therapy.

[Elective indication for hyperbaric oxygen therapy]. / Indications electives d l'oxygénothérapie hyperbare.

Creation of an hyperbaric medical center in Geneva allows development of elective indications of hyperbaric oxygen therapy. Physiologics effects of hyperbaric oxygen are well known, but credibles clinicals trials lacks. Frequents indications such as diabetic foot ulcer, ischemic ulcer or anaerobic infection will be rewieved here. Others indications will be summarize in a table with actual level of scientific proof. Hyperbaric oxygen therapy is always complementary to usual therapy and need numerous sessions to reach awaited results.