Diving-related disorders in commercial breath-hold divers (Ama) of Japan.

Autor:	Kohshi K; Division of Neurosurgery, Nishinihon Hospital, Kumamoto, Japan.; Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan.; Corresponding author: Dr Kiyotaka Kohshi, Division of Neurosurgery, Nishinihon Hospital, 3-20-1 Hattanda, Kumamotohigashi, Kumamoto 861-8034, Japan, kohshi33@gmail.com., Tamaki H; Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan.; Division of Surgery and General Medicine, Tamaki Hospital, Yamaguchi, Japan., Lemaître F; Faculty of Sport Sciences, University of Rouen, Mont-Saint-Aignan, France.; CRIOBE USR 3278, CNRS-EPHE-UPVD, PSL, France., Morimatsu Y; Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan., Denoble PJ; Divers Alert Network, Durham, NC, USA., Ishitake T; Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan.
Jazyk:	angličtina
Zdroj:	Diving and hyperbaric medicine [Diving Hyperb Med] 2021 Jun 30; Vol. 51 (2), pp. 199-206.
DOI:	10.28920/dhm51.2.199-206
Abstrakt:	Decompression illness (DCI) is well known in compressed-air diving but has been considered anecdotal in breath-hold divers. Nonetheless, reported cases and field studies of the Japanese Ama, commercial or professional breath-hold divers, support DCI as a clinical entity. Clinical characteristics of DCI in Ama divers mainly suggest neurological involvement, especially stroke-like cerebral events with sparing of the spinal cord. Female Ama divers achieving deep depths have rarely experienced a panic-like neurosis from anxiety disorders. Neuroradiological studies of Ama divers have shown symptomatic and/or asymptomatic ischaemic lesions situated in the basal ganglia, brainstem, and deep and superficial cerebral white matter, suggesting arterial insufficiency. The underlying mechanism(s) of brain damage in breath-hold diving remain to be elucidated; one of the plausible mechanisms is arterialization of venous nitrogen bubbles passing through right to left shunts in the heart or lungs. Although the treatment for DCI in Ama divers has not been specifically established, oxygen breathing should be given as soon as possible for injured divers. The strategy for prevention of diving-related disorders includes reducing extreme diving schedules, prolonging surface intervals and avoiding long periods of repetitive diving. This review discusses the clinical manifestations of diving-related disorders in Ama divers and the controversial mechanisms. (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)
Databáze:	MEDLINE
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