Pisa, Italy
Pisa, Italy

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Cialoni D.,DAN Europe Research Division | Cialoni D.,Apnea Academy Research | Sponsiello N.,DAN Europe Apnea Task Force | Sponsiello N.,Apnea Academy Research | And 8 more authors.
Undersea and Hyperbaric Medicine | Year: 2012

Introduction: After repetitive deep dives, breath-hotd divers are often affected by a syndrome characterized by typical symptoms such as cough, sensation of chest constriction, Mood-striated expectorate (hemoptysis) and, rarely, an overt acute pulmonary edema syndrome, often together with various degrees of dyspnea. The aim of this work is an epidemiological investigation to evatuate the prevatence of acute respiratory symptoms (ARS) in breath-hotd divers (BHDs) in practicing breath-hotd diving. Materials and methods: A retrospective investigation has been performed using specific questionnaires completed by a selected sample of free-divers (212 breathhotd diving instructors - 194 mate, 18 female; mean age 34 ± 6.91 years); affiliated with Apnea Academy, (International School for Education and Research of Free-Diving). We also investigated possible risk factors for post-dive acute respiratory symptoms. Furthermore, the authors report that a severe case of acute pulmonary edema occurred to a healthy and experienced breath-hold diving instructor. We reported a detailed CT scan and follow-up CT scans three days later, with another scan reported 10 days later as well. Result: A total of 56 subjects (26.4%) reported previous events such as cough, thoracic constraint, hemoptysis, associated with various degrees of dyspnea as confirmation of pulmonary involvement. Forty-five of them (82%) reported signs of true hemoptysis and a high degrees of dyspnea. A CT scan revealed the presence of patchy bilateral lung opacities at the level of superior and parahilar zones; follow-up CT scans three days later and 10 days later are also reported. Conclusion: Our data show that this is a common condition among experienced BHDs. In our opinion. this is particularly interesting for the free-diving community. Copyright © 2012 Undersea & Hyperbaric Medical Society, Inc.


Pingitore A.,CNR Institute of Clinical Physiology | Pingitore A.,Extreme Center | Garbella E.,Institute of Life science | Garbella E.,CNR Institute of Neuroscience | And 24 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2011

Early subclinical increase in pulmonary water content in athletes performing sustained heavy exercise at sea level: ultrasound lung comet-tail evidence. Am J Physiol Heart Circ Physiol 301: H2161-H2167, 2011. First published August 26, 2011; doi:10.1152/ajpheart.00388.2011.-Whether prolonged strenuous exercise performed by athletes at sea level can produce interstitial pulmonary edema is under debate. Chest sonography allows to estimate extravascular lung water, creating ultrasound lung comet-tail (ULC) artifacts. The aim of the study was to determine whether pulmonary water content increases in Ironmen (n _ 31) during race at sea level and its correlation with cardiopulmonary function and systemic proinflammatory and cardiac biohumoral markers. A multiple factor analysis approach was used to determine the relations between systemic modifications and ULCs by assessing correlations among variables and groups of variables showing significant pre-post changes. All athletes were asymptomatic for cough and dyspnea at rest and after the race. Immediately after the race, a score of more than five comet tail artifacts, the threshold for a significant detection, was present in 23 athletes (74%; 16.3 _ 11.2; P _ 0.01 ULC after the race vs. rest) but decreased 12 h after the end of the race (13 athletes; 42%; 6.3 _ 8.0; P _ 0.01 vs. soon after the race). Multiple factor analysis showed significant correlations between ULCs and cardiac-related variables and NH2-terminal pro-brain natriuretic peptide. Healthy athletes developed subclinical increase in pulmonary water content immediately after an Ironman race at sea level, as shown by the increased number of ULCs related to cardiac changes occurring during exercise. Hemodynamic changes are one of several potential factors contributing to the mechanisms of ULCs.© 2011 the American Physiological Society.

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