Compressed gas diving fatalities in Australian waters 2014 to 2018.

Introduction: This study aimed to investigate compressed gas diving deaths in Australia from 2014-2018 and make comparison to those from 2001-2013 to identify ongoing problems and assess countermeasures.

Methods: Media reports and the National Coronial Information System were searched to identify scuba diving deaths for 2014-2018, inclusive. Data were extracted from the witness and police reports, medical histories, and autopsies.

A review of diving practices and outcomes following the diagnosis of a persistent (patent) foramen ovale in compressed air divers with a documented episode of decompression sickness.

Introduction: The presence of a persistent (patent) foramen ovale (PFO) increases the risk of decompression sickness (DCS) whilst diving with pressurised air. After the diagnosis of a PFO, divers will be offered a number of options for risk mitigation. The aim of this study was to review the management choices and modifications to diving practices following PFO diagnosis in the era preceding the 2015 joint position statement (JPS) on PFO and diving.

Biallelic loss of function variants in SYT2 cause a treatable congenital onset presynaptic myasthenic syndrome.

Synaptotagmins are integral synaptic vesicle membrane proteins that function as calcium sensors and regulate neurotransmitter release at the presynaptic nerve terminal. Synaptotagmin-2 (SYT2), is the major isoform expressed at the neuromuscular junction. Recently, dominant missense variants in SYT2 have been reported as a rare cause of distal motor neuropathy and myasthenic syndrome, manifesting with stable or slowly progressive distal weakness of variable severity along with presynaptic NMJ impairment.

Immersion pulmonary edema: case reports from Oceania.

Introduction: We aimed to document identified cases of immersion pulmonary edema (IPE) in divers from Oceania (the Indo-Pacific region) from January 2002 to May 2018, inclusive.

Method: Cases were identified using various sources, including searches of the Divers Alert Network Asia-Pacific (DAN AP) Fatality Database, published case reports, and interviews with survivors who had reported their incident to DAN AP. Where available, investigations, pathology and autopsy results were obtained.

Autosomal recessive limb-girdle and Miyoshi muscular dystrophies in the Netherlands: The clinical and molecular spectrum of 244 patients.

In this retrospective study, we conducted a clinico-genetic analysis of patients with autosomal recessive limb-girdle muscular dystrophy (LGMD) and Miyoshi muscular dystrophy (MMD). Patients were identified at the tertiary referral centre for DNA diagnosis in the Netherlands and included if they carried two mutations in CAPN3, DYSF, SGCG, SGCA, SGCB, SGCD, TRIM32, FKRP or ANO5 gene. DNA was screened by direct sequencing and multiplex ligand-dependent probe amplification (MLPA) analysis.

Hyperbaric Oxygen as an Adjunctive Therapy Postfasciotomy for Unilateral Supraspinatus Rhabdomyolysis and Compartment Syndrome.

We present a case of severe supraspinatus muscle rhabdomyolysis following overexertion in a young male. Preexisting risk factors included illicit drug use. Even single muscle rhabdomyolysis can cause significant renal failure, and in our case the use of intravenous flushing was used in conjunction with hyperbaric oxygen after muscle compartment fasciotomy to maximize muscle recovery and renal protection in a manual worker (musician).

Provisional report on diving-related fatalities in Australian waters in 2012.

Introduction: An individual case review of known diving-related deaths that occurred in Australia in 2012 was conducted.

Method: The case studies were compiled using statements from witnesses and reports of the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.

A pleural vacuum relief device for pleural drain unit use in the hyperbaric environment.

Introduction: When a standard water-seal pleural drain unit (PDU) is used under hyperbaric conditions there are scenarios where excessive negative intrapleural pressure (IPP) and/or fluid reflux can be induced, risking significant morbidity. We developed and tested a pleural vacuum relief (PVR) device which automatically manages these risks, whilst allowing more rapid hyperbaric pressure change rates.

Methods: The custom-made PVR device consists of a one-way pressure relief valve connected in line with a sterile micro filter selected for its specific flow capacity.

Decompressing recompression chamber attendants during Australian submarine rescue operations.

Introduction: Inside chamber attendants rescuing survivors from a pressurised, distressed submarine may themselves accumulate a decompression obligation which may exceed the limits of Defense and Civil Institute of Environmental Medicine tables presently used by the Royal Australian Navy. This study assessed the probability of decompression sickness (P) for medical attendants supervising survivors undergoing oxygen-accelerated saturation decompression according to the National Oceanic and Atmospheric Administration (NOAA) 17.11 table.

Decompressing rescue personnel during Australian submarine rescue operations.

Introduction: Personnel rescuing survivors from a pressurized, distressed Royal Australian Navy (RAN) submarine may themselves accumulate a decompression obligation, which may exceed the bottom time limits of the Defense and Civil Institute of Environmental Medicine (DCIEM) Air and In-Water Oxygen Decompression tables (DCIEM Table 1 and 2) presently used by the RAN. This study compared DCIEM Table 2 with alternative decompression tables with longer bottom times: United States Navy XVALSS_DISSUB 7, VVAL-18M and Royal Navy 14 Modified tables.

Methods: Estimated probability of decompression sickness (P), the units pulmonary oxygen toxicity dose (UPTD), the volume of oxygen required and the total decompression time were calculated for hypothetical single and repetitive exposures to 253 kPa air pressure for various bottom times and prescribed decompression schedules.

Provisional report on diving-related fatalities in Australian waters in 2011.

Introduction: An individual case review of diving-related deaths reported as occurring in Australia in 2011 was conducted as part of the DAN Asia-Pacific dive fatality reporting project.

Method: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and, where available, details from the post-mortem examination are provided.

Neurofibromatosis type 1 associated low grade gliomas: A comparison with sporadic low grade gliomas.

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder, associated with a variable clinical phenotype including café-au-lait spots, intertriginous freckling, Lisch nodules, neurofibromas, optic pathway gliomas and distinctive bony lesions. NF1 is caused by a mutation in the NF1 gene, which codes for neurofibromin, a large protein involved in the MAPK- and the mTOR-pathway through RAS-RAF signalling. NF1 is a known tumour predisposition syndrome, associated with different tumours of the nervous system including low grade gliomas (LGGs) in the paediatric population.

Provisional report on diving-related fatalities in Australian waters 2010.

Introduction: An individual case review was conducted of known diving-related deaths that occurred in Australia in 2010.

Method: The case studies were compiled using statements from witnesses and reports of the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.

A 10-year estimate of the incidence of decompression illness in a discrete group of recreational cave divers in Australia.

Introduction: The vast majority of freshwater cave diving in Australia occurs within the limestone caves of the Gambier karst in the south-east of South Australia. The incidence of decompression illness (DCI) in cave divers is presumed to be higher than open-water recreational divers because of the greater depths involved, but has not previously been reported. Our aim was to determine the incidence of DCI in cave divers, the patterns of diving and the outcome of hyperbaric treatment.

Provisional report on diving-related fatalities in Australian waters 2009.

Introduction: An individual case review of diving-related deaths reported as occurring in Australia in 2009 was conducted as part of the DAN Asia-Pacific Dive Fatality Reporting Project.

Method: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.

Analysis of recreational closed-circuit rebreather deaths 1998-2010.

Introduction: Since the introduction of recreational closed-circuit rebreathers (CCRs) in 1998, there have been many recorded deaths. Rebreather deaths have been quoted to be as high as 1 in 100 users.

Methods: Rebreather fatalities between 1998 and 2010 were extracted from the Deeplife rebreather mortality database, and inaccuracies were corrected where known.

Oxygen exposure and toxicity in recreational technical divers.

Introduction: Central nervous system oxygen toxicity is a recognised risk in recreational open-circuit scuba diving with the use of nitrox (oxygen-enriched air mixtures), but other forms of oxygen toxicity in other diving settings are poorly understood. However, divers using constant partial pressure of oxygen closed-circuit rebreathers (CCRs) for multi-day, multi-dive expeditions could potentially experience cumulative oxygen exposures above the current recommended limits.

Methods: We followed a number of technical recreational diving expeditions using CCRs and recorded the cumulative oxygen exposures of the individual divers.

Clinical and mutational characteristics of spinal muscular atrophy with respiratory distress type 1 in The Netherlands.

Spinal muscular atrophy with respiratory distress type 1 is an autosomal recessive disorder with early respiratory difficulties, distal muscle weakness, and contractures leading to foot deformities as the most striking clinical symptoms. Mutations of the gene encoding the immunoglobulin heavy chain μ-binding protein 2, mapped on chromosome 11q13, are the cause of the disease. We present the clinical and mutational characteristics of ten patients in the Netherlands who showed considerable clinical variability; they carried six novel mutations, including a deletion of exon 2.

Provisional report on diving-related fatalities in Australian waters 2008.

Introduction: An individual case review of diving-related deaths, reported as occurring in Australia in 2008, was conducted as part of the DAN Asia-Pacific dive fatality reporting project.

Method: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.

Provisional report on diving-related fatalities in Australian waters 2007.

Introduction: An individual case review of diving-related deaths reported as occurring in Australia in 2007 was conducted as part of the on-going Divers Alert Network (DAN) Asia-Pacific dive fatality reporting project.

Method: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.

Pediatric hyperbaric oxygen therapy in Victoria, 1998-2010.

Objectives: The aim of this review is to identify clinical conditions currently treated in a pediatric population referred to the Alfred hyperbaric unit, to describe outcomes, and detail any complications occurring during treatment or transfer between units.

Design: Retrospective, noncontrolled, clinical study.

Setting: Adult hyperbaric unit in a university hospital.

Provisional report on diving-related fatalities in Australian waters 2006.

Introduction: An individual case review of diving-related deaths reported as occurring in Australia in 2006 was conducted as part of the Divers Alert Network Asia-Pacific (DAN AP) dive fatality reporting project.

Method: The case studies were compiled using reports from witnesses, the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided.