Decompression illness reported in a survey of 429 recreational divers.

BACKGROUND: The purpose of this study was to investigate the influence of diving experience and diving techniques on the lifetime incidence of decompression illness (DCI). METHODS: Attendants of three diving medical symposia voluntarily answered a questionnaire about their age, gender, medical history, diving experience, diving habits, diving certification levels, and diving associated incidents (cross-sectional survey). RESULTS: Out of 650 divers, 429 completed the questionnaire. The study population consisted of experienced divers with an average of 670 dives. The majority of the divers were certified diving instructors (43%). There were 37 participants (8.7%) who were classified as technical divers with an average of 1193 logged dives. There was an overall lifetime incidence of DCI of 1 per 5463 dives. The complete study group showed an increased lifetime incidence of DCI with decreased diving experience (1.97-fold to 8.17-fold higher). Of the divers, 27% reported severe DCI with neurological symptoms. The lifetime incidence for severe DCI was 1 in 20,291 dives. Again, lifetime incidence for severe DCI was increased with decreased diving certification level (1.1-fold to 13.7-fold higher). Technical divers showed a DCI lifetime incidence of 1 to 8591 dives compared to the non-technical divers with a lifetime incidence of 1 to 5077 dives (not significant). CONCLUSION: In our study population, the lifetime incidence of DCI was increased in divers with less diving experience. If further studies confirm this finding, diving federations should be encouraged to intensify their efforts of educating divers and should limit diving time and depth in inexperienced divers.

Carbohydrate antigen 19-9 in saliva: possible preoperative marker of malignancy in parotid tumors.

OBJECTIVE: Facial nerve preservation and oncological safety are crucial in surgery of parotid tumors. An unexpected histopathologic diagnosis of a malignant parotid tumor, however, may unfavorably require a second, more radical surgery. The aim of this study was to find out whether the assessment of serological tumor markers in parotid saliva might have some diagnostic significance in the preoperative differentiation between benign and malignant parotid lesions. STUDY DESIGN, SETTING, PATIENTS, AND METHODS: In a prospective pilot study performed at a university medical center in 28 patients with a unilateral parotid tumor, 7 serological tumor markers established in the clinical routine were quantitatively assessed in parotid saliva collected simultaneously on both sides after stimulation. The results were correlated with the histopathological diagnosis. RESULTS: Of the 4 investigated tumors that were malignant neoplasms, 3 had a sufficient quantity of saliva available for tumor marker measurements. Carbohydrate antigen 19-9 (CA 19-9) consistently revealed high levels compared with the unaffected side in all malignant tumors, thus allowing malignant tumors to be differentiated from benign lesions. CONCLUSION: The results of this pilot study are encouraging, showing that preoperative tumor marker investigation in saliva from parotid glands is feasible and merits further investigation. CA 19-9 might be a valuable new diagnostic tool in the preoperative differentiation between malignant and benign parotid tumors and should be investigated in a larger number of patients.