Costantino Balestra | Haute Ecole Paul-Henri Spaak (original) (raw)
Papers by Costantino Balestra
Undersea & Hyperbaric Medicine, 2023
During deep-sea freediving, many freedivers describe symptoms fairly similar to what has been rel... more During deep-sea freediving, many freedivers describe symptoms fairly similar to what has been related to inert gas narcosis in scuba divers. This manuscript aims to present the potential mechanisms underlying these symptoms. First, known mechanisms of narcosis are summarized while scuba diving. Then, potential underlying mechanisms involving the toxicity of gases (nitrogen, carbon dioxide and oxygen) are presented in freedivers. As the symptoms are felt during ascent, nitrogen is likely not the only gas involved. Since freedivers are frequently exposed to hypercapnic hypoxia toward the end of the dive, it is proposed that carbon dioxide and oxygen gases both play a major role. Finally, a new “hemodynamic hypothesis” based on the diving reflex is proposed in freedivers. The underlying mechanisms are undoubtedly multifactorial and therefore require further research and a new descriptive name. We propose a new term for these types of symptoms: freediving transient cognitive impairment.
European Heart Journal, Dec 1, 2004
Diving and Hyperbaric Medicine, Dec 20, 2020
PubMed, Mar 1, 2015
In my December 2014 EUBS President&am... more In my December 2014 EUBS President's column, entitled "Hydrophobicity: the link between bubbles, bubblers and autoimmunity?" (Diving Hyperb Med. 2014;44:185), the text in the first two paragraphs under the subheading "Surfactants act against proteins and cause autoimmune diseases" should have been attributed to: Arieli R. Was the appearance of surfactants in air breathing vertebrates ultimately the cause of decompression sickness and autoimmune disease? Resp Physiol Neurobiol. 2015;206:15-18. This paper was available on-line from November 2014. Dr Arieli accepts that this omission was unintentional on my part and that the promulgation of his theories was done from the best of motives.
Journal of Applied Physiology, Sep 1, 2020
Diving and Hyperbaric Medicine, 2013
Frontiers in Psychology, Apr 19, 2023
Diving and Hyperbaric Medicine, 2013
International Journal of Molecular Sciences, Mar 22, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Editions universitaires europeennes eBooks, Nov 20, 2019
Les redacteurs et les auteurs de ce livre sont un groupe de scientifiques et de medecins possedan... more Les redacteurs et les auteurs de ce livre sont un groupe de scientifiques et de medecins possedant une vaste experience et des connaissances approfondies de la physiologie de la plongee et de la theorie de la decompression. Comme c'est souvent le cas, il faut un effort collectif pour reussir a faire progresser les connaissances pratiques. Le familier "le tout est plus grand que la somme de ses parties" est souvent vrai et le Groupe de recherche PHYPODE incarne ce concept. En regroupant logiquement les differents elements de la science et de la medecine de la plongee avec des sections provocantes et " matiere a reflexion ", le texte offre des lecons precieuses a ceux qui s'interessent a l'etat actuel de la plongee. Malgre pres de 170 ans de recherche, la nature fondamentale du stress de decompression demeure insaisissable. Comme il est bien decrit dans ce livre, de grands progres ont ete realises en ce qui concerne les elements pratiques permettant de plonger en toute securite. Ce travail est une traduction realisee avec l'intelligence artificielle.
info:eu-repo/semantics/published
IntroductIon D ecompression Illness (DCI) is a complex condition that can appear with a wide vari... more IntroductIon D ecompression Illness (DCI) is a complex condition that can appear with a wide variety of signs and symptoms. Any significant organic or functional decrement in individuals who have been exposed to a reduction in environmental pressure must be considered as possibly being DCI until proven otherwise. This applies to acute, sub-acute and chronic changes related to decompression and may be related to acute clinical symptoms or to situations that may develop subclinically and insidiously. It is in fact generally accepted that subclinical forms of DCI, with little or no reported symptoms, may cause changes in the bones, the central nervous system and the lungs (Kelemen, 1983; Shinoda et al., 1997; Wilmshurst and Ross, 1998). Generally, a disorder is a physical derangement, frequently slight and transitory in nature. A disease is considered a condition of an organ, part, structure, or system of the body in which there is abnormal function resulting from genetic predisposition, diet, or environmental factors. A disease is typically a more serious, active, prolonged and deep-rooted condition. DCI should be considered a disorder due to a physical primary cause that can transform into a disease unless adequate and timely action is undertaken to abort or to minimize the pathophysiological effects of bubbles on the body tissues. The predominant physical cause of DCI is the separation of gas in the body's tissues, due to inadequate decompression, leading to an excessive degree of gas supersaturation (Kumar et al., 1990). Rapid decompression (rate of ascent or omission of decompression stops) is a primary cause of gas separation in tissues (Figure 1). The most obvious prevention strategy for DCI is, therefore, determining and observing appropriate ascent and decompression procedures (Marroni and Zannini, 1981; ABSTRACT. Decompression Illness (DCI), Decompression Sickness (DCS), Dysbaric Illness (DI), disorder, syndrome are terms associated with the clinical signs or symptoms originally generated by a reduction of absolute pressure surrounding the patient. For 100 years the definition of the "disease" is a matter of "disputes" or "consensi". We understand nowadays that it is not enough to know how to cure evident clinical manifestations, but also to reduce or virtually eliminate the primary physical cause for the physiological damages: the gas separation phase from saturated tissues-stationary or circulating bubbles. To achieve this goal, research is more oriented on the decompression procedures or the diver pre-conditioning (heat exposure, physical activity, whole body vibration, antioxidant medication, oxygen breathing, hyperbaric oxygen therapy, hydration or dehydration) and post-conditioning (different decompression procedures or models, deep stops, shallow stop followed by a deeper one, post exposure hydration, speed of ascent, exercise during decompression). Some factors that were believed to be crucial, such as patency of the cardiac Foramen Ovale or gender, are considered less important than modified decompression procedures that are studied today with sharper technology.
Doctorat en kinésithérapie et réadaptationinfo:eu-repo/semantics/nonPublishe
Frontiers in Physiology, Sep 29, 2022
Excessive fluid loss triggered by hyperbaric pressure, water immersion and hot water suits causes... more Excessive fluid loss triggered by hyperbaric pressure, water immersion and hot water suits causes saturation divers to be at risk of dehydration. Dehydration is associated with reductions in mental and physical performance, resulting in less effective work and an increased risk of work-related accidents. In this study we examined the hydration status of 11 male divers over 19 days of a commercial saturation diving campaign to a working depth of 74 m, using two non-invasive methods: Bioelectrical impedance analysis (BIA) and urine specific gravity (USG). Measurements were made daily before and after bell runs, and the BIA data was used to calculated total body water (TBW). We found that BIA and USG were weakly negatively correlated, probably reflecting differences in what they measure. TBW was significantly increased after bell runs for all divers, but more so for bellmen than for in-water divers. There were no progressing changes in TBW over the 19-day study period, indicating that the divers' routines were sufficient for maintaining their hydration levels on short and long term.
International Journal of Molecular Sciences
Exposure to acute normobaric hypoxia (NH) elicits reactive oxygen species (ROS) accumulation, who... more Exposure to acute normobaric hypoxia (NH) elicits reactive oxygen species (ROS) accumulation, whose production kinetics and oxidative damage were here investigated. Nine subjects were monitored while breathing an NH mixture (0.125 FIO2 in air, about 4100 m) and during recovery with room air. ROS production was assessed by Electron Paramagnetic Resonance in capillary blood. Total antioxidant capacity, lipid peroxidation (TBARS and 8-iso-PFG2α), protein oxidation (PC) and DNA oxidation (8-OH-dG) were measured in plasma and/or urine. The ROS production rate (μmol·min−1) was monitored (5, 15, 30, 60, 120, 240 and 300 min). A production peak (+50%) was reached at 4 h. The on-transient kinetics, exponentially fitted (t1/2 = 30 min r2 = 0.995), were ascribable to the low O2 tension transition and the mirror-like related SpO2 decrease: 15 min: −12%; 60 min: −18%. The exposure did not seem to affect the prooxidant/antioxidant balance. Significant increases in PC (+88%) and 8-OH-dG (+67%) at ...
Canadian Journal of Diabetes
What is already known about this subject? • Physical activity (PA) induces glucose fluctuations t... more What is already known about this subject? • Physical activity (PA) induces glucose fluctuations that are difficult to manage in everyday-life and fear of hypoglycemia is a main perceived barrier to PA. What is the new information? • Children/adolescents who spend more time in hypoglycemia on nights following PA see more hypoglycemia as a barrier while in their parents this link does not appear. • Surprisingly, adults with type diabetes having more exercise events associated with a drop in glycemia were less afraid of exercise-related hypoglycemia.
Undersea & Hyperbaric Medicine, 2023
During deep-sea freediving, many freedivers describe symptoms fairly similar to what has been rel... more During deep-sea freediving, many freedivers describe symptoms fairly similar to what has been related to inert gas narcosis in scuba divers. This manuscript aims to present the potential mechanisms underlying these symptoms. First, known mechanisms of narcosis are summarized while scuba diving. Then, potential underlying mechanisms involving the toxicity of gases (nitrogen, carbon dioxide and oxygen) are presented in freedivers. As the symptoms are felt during ascent, nitrogen is likely not the only gas involved. Since freedivers are frequently exposed to hypercapnic hypoxia toward the end of the dive, it is proposed that carbon dioxide and oxygen gases both play a major role. Finally, a new “hemodynamic hypothesis” based on the diving reflex is proposed in freedivers. The underlying mechanisms are undoubtedly multifactorial and therefore require further research and a new descriptive name. We propose a new term for these types of symptoms: freediving transient cognitive impairment.
European Heart Journal, Dec 1, 2004
Diving and Hyperbaric Medicine, Dec 20, 2020
PubMed, Mar 1, 2015
In my December 2014 EUBS President&am... more In my December 2014 EUBS President's column, entitled "Hydrophobicity: the link between bubbles, bubblers and autoimmunity?" (Diving Hyperb Med. 2014;44:185), the text in the first two paragraphs under the subheading "Surfactants act against proteins and cause autoimmune diseases" should have been attributed to: Arieli R. Was the appearance of surfactants in air breathing vertebrates ultimately the cause of decompression sickness and autoimmune disease? Resp Physiol Neurobiol. 2015;206:15-18. This paper was available on-line from November 2014. Dr Arieli accepts that this omission was unintentional on my part and that the promulgation of his theories was done from the best of motives.
Journal of Applied Physiology, Sep 1, 2020
Diving and Hyperbaric Medicine, 2013
Frontiers in Psychology, Apr 19, 2023
Diving and Hyperbaric Medicine, 2013
International Journal of Molecular Sciences, Mar 22, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Editions universitaires europeennes eBooks, Nov 20, 2019
Les redacteurs et les auteurs de ce livre sont un groupe de scientifiques et de medecins possedan... more Les redacteurs et les auteurs de ce livre sont un groupe de scientifiques et de medecins possedant une vaste experience et des connaissances approfondies de la physiologie de la plongee et de la theorie de la decompression. Comme c'est souvent le cas, il faut un effort collectif pour reussir a faire progresser les connaissances pratiques. Le familier "le tout est plus grand que la somme de ses parties" est souvent vrai et le Groupe de recherche PHYPODE incarne ce concept. En regroupant logiquement les differents elements de la science et de la medecine de la plongee avec des sections provocantes et " matiere a reflexion ", le texte offre des lecons precieuses a ceux qui s'interessent a l'etat actuel de la plongee. Malgre pres de 170 ans de recherche, la nature fondamentale du stress de decompression demeure insaisissable. Comme il est bien decrit dans ce livre, de grands progres ont ete realises en ce qui concerne les elements pratiques permettant de plonger en toute securite. Ce travail est une traduction realisee avec l'intelligence artificielle.
info:eu-repo/semantics/published
IntroductIon D ecompression Illness (DCI) is a complex condition that can appear with a wide vari... more IntroductIon D ecompression Illness (DCI) is a complex condition that can appear with a wide variety of signs and symptoms. Any significant organic or functional decrement in individuals who have been exposed to a reduction in environmental pressure must be considered as possibly being DCI until proven otherwise. This applies to acute, sub-acute and chronic changes related to decompression and may be related to acute clinical symptoms or to situations that may develop subclinically and insidiously. It is in fact generally accepted that subclinical forms of DCI, with little or no reported symptoms, may cause changes in the bones, the central nervous system and the lungs (Kelemen, 1983; Shinoda et al., 1997; Wilmshurst and Ross, 1998). Generally, a disorder is a physical derangement, frequently slight and transitory in nature. A disease is considered a condition of an organ, part, structure, or system of the body in which there is abnormal function resulting from genetic predisposition, diet, or environmental factors. A disease is typically a more serious, active, prolonged and deep-rooted condition. DCI should be considered a disorder due to a physical primary cause that can transform into a disease unless adequate and timely action is undertaken to abort or to minimize the pathophysiological effects of bubbles on the body tissues. The predominant physical cause of DCI is the separation of gas in the body's tissues, due to inadequate decompression, leading to an excessive degree of gas supersaturation (Kumar et al., 1990). Rapid decompression (rate of ascent or omission of decompression stops) is a primary cause of gas separation in tissues (Figure 1). The most obvious prevention strategy for DCI is, therefore, determining and observing appropriate ascent and decompression procedures (Marroni and Zannini, 1981; ABSTRACT. Decompression Illness (DCI), Decompression Sickness (DCS), Dysbaric Illness (DI), disorder, syndrome are terms associated with the clinical signs or symptoms originally generated by a reduction of absolute pressure surrounding the patient. For 100 years the definition of the "disease" is a matter of "disputes" or "consensi". We understand nowadays that it is not enough to know how to cure evident clinical manifestations, but also to reduce or virtually eliminate the primary physical cause for the physiological damages: the gas separation phase from saturated tissues-stationary or circulating bubbles. To achieve this goal, research is more oriented on the decompression procedures or the diver pre-conditioning (heat exposure, physical activity, whole body vibration, antioxidant medication, oxygen breathing, hyperbaric oxygen therapy, hydration or dehydration) and post-conditioning (different decompression procedures or models, deep stops, shallow stop followed by a deeper one, post exposure hydration, speed of ascent, exercise during decompression). Some factors that were believed to be crucial, such as patency of the cardiac Foramen Ovale or gender, are considered less important than modified decompression procedures that are studied today with sharper technology.
Doctorat en kinésithérapie et réadaptationinfo:eu-repo/semantics/nonPublishe
Frontiers in Physiology, Sep 29, 2022
Excessive fluid loss triggered by hyperbaric pressure, water immersion and hot water suits causes... more Excessive fluid loss triggered by hyperbaric pressure, water immersion and hot water suits causes saturation divers to be at risk of dehydration. Dehydration is associated with reductions in mental and physical performance, resulting in less effective work and an increased risk of work-related accidents. In this study we examined the hydration status of 11 male divers over 19 days of a commercial saturation diving campaign to a working depth of 74 m, using two non-invasive methods: Bioelectrical impedance analysis (BIA) and urine specific gravity (USG). Measurements were made daily before and after bell runs, and the BIA data was used to calculated total body water (TBW). We found that BIA and USG were weakly negatively correlated, probably reflecting differences in what they measure. TBW was significantly increased after bell runs for all divers, but more so for bellmen than for in-water divers. There were no progressing changes in TBW over the 19-day study period, indicating that the divers' routines were sufficient for maintaining their hydration levels on short and long term.
International Journal of Molecular Sciences
Exposure to acute normobaric hypoxia (NH) elicits reactive oxygen species (ROS) accumulation, who... more Exposure to acute normobaric hypoxia (NH) elicits reactive oxygen species (ROS) accumulation, whose production kinetics and oxidative damage were here investigated. Nine subjects were monitored while breathing an NH mixture (0.125 FIO2 in air, about 4100 m) and during recovery with room air. ROS production was assessed by Electron Paramagnetic Resonance in capillary blood. Total antioxidant capacity, lipid peroxidation (TBARS and 8-iso-PFG2α), protein oxidation (PC) and DNA oxidation (8-OH-dG) were measured in plasma and/or urine. The ROS production rate (μmol·min−1) was monitored (5, 15, 30, 60, 120, 240 and 300 min). A production peak (+50%) was reached at 4 h. The on-transient kinetics, exponentially fitted (t1/2 = 30 min r2 = 0.995), were ascribable to the low O2 tension transition and the mirror-like related SpO2 decrease: 15 min: −12%; 60 min: −18%. The exposure did not seem to affect the prooxidant/antioxidant balance. Significant increases in PC (+88%) and 8-OH-dG (+67%) at ...
Canadian Journal of Diabetes
What is already known about this subject? • Physical activity (PA) induces glucose fluctuations t... more What is already known about this subject? • Physical activity (PA) induces glucose fluctuations that are difficult to manage in everyday-life and fear of hypoglycemia is a main perceived barrier to PA. What is the new information? • Children/adolescents who spend more time in hypoglycemia on nights following PA see more hypoglycemia as a barrier while in their parents this link does not appear. • Surprisingly, adults with type diabetes having more exercise events associated with a drop in glycemia were less afraid of exercise-related hypoglycemia.