PROGRAMME 18th Capita Selecta Duikgeneeskunde

Capita Selecta Duikgeneeskunde AMC: Mini-Congress Diving Medicine 24 Sept – 1 Okt 2016

PROGRAMME

18th Capita Selecta Duikgeneeskunde Mini-Congress Diving Medicine, Malta

Date: 24 September – 1 October 2016 Venue: Riviera Resort & Spa, Marfa Bay, Mellieha, Malta Aim This course aims to give insight to the dive physician in various aspects of diving (patho-) physiology and medicine and also to present new developments in these fields with respect to research and the practical diving medicine. Hence the mini-congress has a mixed character of a course as well as a scientific congress. It is intended for diving physicians coming from the various disciplines such as occupational-, sports- general medicine as well as clinical specialists, other health workers and high-educated instructors. General: mission of the “AMC Capita Selecta Duikgeneeskunde”. The Capita Selecta Duikgeneeskunde (CSD), refresher courses in dive medicine, are given by the Academic Medical Centre (AMC), a one-board-cooperation of the medical faculty of the University of Amsterdam (UvA) and the academic hospital of the UvA. This hospital has a special position within the Dutch academic hospitals; it is the cradle, both in the Netherlands and in Europe of hyperbaric medicine, performed with the “Boerema Tank”, named after its founder, it was the first clinical hyperbaric tank in Europe In the first place, the AMC Capita Selecta offers extensive and discipline-wise education in dive and caisson medicine. In addition, they also educate in new developments as they occur in academic hospitals and medical faculties. This implies that, in the lectures, the characteristics of disorders are discussed, with their diagnostics and treatment, from the point of view of the academic state of the art. In short, the Capita Selecta are marked by a mix of education in dive medicine of the respective disciplines and related education in the discipline itself. Also, the Capita will pay attention to the requirements of the medical examination. The Capita are aimed at non-specialized physicians, first-line physicians, sport- and occupational physicians, professional diving physicians, clinical doctors and paramedical professionals and diving instructors. In general, the teachers have their affiliation with academic hospitals and medical faculties, and have an international reputation in patient care, academic education and/or medical research as becomes clear from their curriculum vitae. To have lower thresholds for the courses given in the Netherlands (one-day courses with easy to reach venue) and abroad (5-days courses) they are low budget. Recommendation The course is recommended by the expert group of dive medicine of the Vereniging voor Sportgeneeskunde (Soc Sports Med) and by the Nederlandse Vereniging voor Duikgeneeskunde (NVD, Dutch Soc Dive Med). Accreditation In general, the level of the various lectures / subjects of the meeting are (at least) in accordance with that of EDTC and ECHM, level 1 (Medical Examiner) and Level 2D (Diving Physician). The program comprises 18 oral contact hours. The Dutch NVD, NVAB, VSG and NICDA (diving physicians C and D) have been requested to provide 18 accreditation points for the meeting and “outside own specialism” (GAIA) will yield 18 points too. The course members who have registered for accreditation will obtain a certificate after completion of the whole course, including test.


Invited speakers Mattijn Buwalda, anaesthesiologist-intensivist, Odijk, The Netherlands. Chris Jiskoot, occupational physician, occupational diving physician B, ArboUnie, Vlissingen, The

Netherlands. Jean Claude Le Péchon, MSc, MEng, consultant in safety management under hyperbaric conditions,

JCLP Hyperbarie, Paris, France Rienk Rienks, PhD, cardiologist, diving physician, Utrecht Medical Centre, Utrecht, The Netherlands. Jacques Regnard, Prof., PhD, diving an hyperbaric physician, Faculty of Medicine of Besançon, and

University Hospital Minjoz, University of Franche Comté, France. Nico Schellart, PhD MSc, Assoc. Prof, medical physicist, Academisch Medisch Centrum, Amsterdam,

The Netherlands. Adel Taher, diving and hyperbaric physician, director Hyperbaric Medical Centre in Sharm el Sheik,

Egypt. Peter Westerweel, PhD, internist-haematologist, Albert Schweitzer Hospital, Dordrecht, The

Netherlands. Free presentations Attendants of the mini-congress are invited to present an oral lecture of their research, theoreticaly or applied. This can be in every field of diving and caisson medicine. Also case studies are welcome. For participation see the application form “Free oral presentations”. Scientific committee Nico Schellart (chair, medical physicist an diving physiologist), Tjeerd van Rees Vellinga (occupational and hyperbaric physician), Erik van der Sande (family and sport physician) and Marga Schweigmann (hyperbaric & diving physician), Peter Westerweel (internist-haematologist) and ad hoc Jean Claude Le Péchon (diving and hyperbaric consultant), Jacques Regnard (physiologist, sports physician, diving and hyperbaric physician) and Adel Taher (hyperbaric and diving physician). Executive committee Nico Schellart (congress director), Eduard van Riet Paap (administrative manager) and Hans van Dam. Responsibility The Capita Selecta Duikgeneeskunde are given under the responsibility of the Academic Medical Centre, Univ. of Amsterdam (director Nico Schellart). The organization is by the Stichting Duik Research (SDR)1) and Biomedical Engineering & Physics, AMC (chair Prof. Dr. A.G.J.M. van Leeuwen, PhD, MEng). Announcements Ongoing announcements about future courses can be found at www.duikresearch.org, www.diveresearch.org or are communicated by E-mail. 1) SDR is a non-profit organisation aimed to promote dive safety. Work for SDR is done on a voluntary base. © Copyright 2013. All rights reserved. Material of this document may not be reproduced in any form without permission of AMC and the course manager ([email protected]).


Invited speakers

Mattijn Buwalda is an anaesthesiologist-intensivist (DESA EDIC) working as a freelancer in the Netherlands and abroad. After certification as a diving medicine physician by the ECB he worked as a hyperbaric anaesthetist at the London Hyperbaric Medicine Unit Whips Cross Hospital London. He is especially interested in extreme physiology and extreme medicine. He has given many lectures in Holland and the UK on topics related to oxygen and pressure. Examples can be found on his website www.mattijnb.nl. Mattijn is instructor dive medicine for the Advanced Wilderness Life Support Course NL. He has also been instructor and course director in ATLS (Advanced Trauma Life Support) and similar courses. He founded the anaesthetics simulator lab in the University Medical Centre Utrecht and is still involved with the development of the common trunk vital functions for last year medical interns. He is the

author of dive medicine related chapters in the handbook on drowning and the Dutch course book in sport medicine. As a normoxic trimix CCR diver he lives up to the motto: ‘dive docs should dive themselves’. For diving, he has frequently visited Malta, Cyprus, the Red Sea and Bonaire

Chris Jiskoot Chris Jiskoot studied medicine at the University of Amsterdam. In 1981 he started as the occupational health officer of the wrack clearing operation in the Westerscheld and for the fire/ rescue divers in the province of Zeeland. His specialization as a diver-physician he took in the service of the Dutch Royal Navy and as Dive-physician B, the only one at Arbo Unie. He is member of the Expert Centre for Hyperbaric work in Vlissingen, Zeeland with special interest in heart and circulation disorders. He performs examinations for divers and fire/ rescue personnel. At DRDC in Toronto he obtained additional training on saturation diving and Doppler echography. He took part in hyperbaric projects such as the Westerschelde tunnel and the Noord-Zuidlijn of the Amsterdam subway system and he made a risk management analysis for the divers of the fire brigade of Terneuzen, Zeeland. He was

involved with the Sport-Medisch Advies Centrum (sport-medical advisory centre) as expert in diver examinations. With the University of Maastricht he maintains a close relationship in the field of stress and panic disorders in divers. As a member of NVD and EUBS he frequently participates in their meetings and congresses. Diving is mainly in service of his greater passion: sailing on his yacht.

Jean-Claude Le Péchon graduated as biochemical engineer from INSA in Lyon in 1963 and as marine biologist from Nice University. He has been employed at the Musée Océanographique of Monaco as a research engineer and incidentally as scientific diver during the Conshelf III Experiment (the undersea habitat sponsored by Jacques-Yves Cousteau). Later he joined CEMA in Marseilles (J.Y. Cousteau) to do research on breathing gases and to develop procedures for very deep dives (1000 m with animals; 500 m with humans) and was a test diver in the Saturation II simulated dive at 400 msw. From 1973 to 1986, he served with CG DORIS, an offshore and civil engineering commercial diving company. In 1986 he founded JCLP Hyperbarie, a global consultancy agency/ bureau specialized in

matters related to life support and safety under pressure (commercial diving, tunnelling, space and hyperbaric medicine). He has been involved in more than 75 tunneling projects, many with mixed gasses, up to 6.9 bar and as well as in saturation diving technology. Although retired, he is still teaching physiology and technology of diving- and hyperbaric medicine at several universities in France and all over the world. He is a National Instructor for SCUBA diving (Air, Nitrox and Trimix) and holds a deep sea commercial diver certification since 1974. He has published many papers in magazines, books and international congresses etc., and often speaks at international congresses on different topics concerning diving, hyperbaric medicine and compressed gas work.

Rienk Rienks graduated in medicine in 1981 and was confirmed as cardiologist in 1986. He has been trained at the Utrecht University Hospital. Since 1983 working at the Utrecht Medical Centre, UMC, he obtained his doctorate in 1991 on a dissertation on the applications of lasers in cardiology. Detached to the Centraal Militair Hospitaal in Utrecht since 1995, he cares for military personnel. His main interest lies in diving, aeromedical and sports cardiology. Considered a national authority on hypo- and hyperbaric cardiology he fills several consultancies and was member of the board of the Dutch Society for Sports Medicine, VSG, and participates in several committees of the Dutch Society for Cardiology (NVvC) and VSG. He is member of the UHMS. He started to dive in 1982 during his tenure as a resident in Curacao. He is PADI and NAUI certified, advanced open water, rescue, Nitrox.


Jacques Regnard graduated as MD and in Sport Medicine, and later in Diving and Hyperbaric Medicine at the university René Descartes (Paris). He was involved in field and laboratory studies about human physiology during cold exposure and exercising. Conducted pulmonary functional testing in University hospitals. Published research studies about lung function, bronchial reactivity, pulmonary heat exchanges and vascular airway behaviour (PhD in 1990). He then studied autonomic cardiovascular control in health and disease. AS professor of Physiology, University of Franche Comté from 1993, he teaches Physiology, directed PhD degrees, and has set up functional testing of vascular function. Author of original papers of respiratory, cardiovascular, and exercise physiology. The recent publications and current works deal in particular with integrated cardiovascular, renal and

respiratory responses to immersion and diving, with concomitant influences of hyperoxia and autonomic/endocrine stimulations. Member of EUBS, the Société de Médecine Subaquatique et Hyperbare de langue française and of the Société de Physiologie. He was formerly SCUBA diver.

Nico Schellart graduated as biologist and specialized in physiological and biomedical physics. He investigated visual information processing of the retina, resulting in a PhD in 1973 (University of Amsterdam). He is an associate professor with the dept. of Biomedical Engineering and Physics of the AMC and was associate editor of a bioengineering journal. He has investigated information processing of the visual and auditory system in the brain, with animals and with humans by fundamental and clinical EEG and MEG research. His neuroscience studies have been published in some 50 papers, 80 abstracts and 10 contributions in textbooks and published an electronic free textbook in biomedical physics. He has studied the brain and the visual system under hypoxic and hyperoxic conditions both in the lab and in the field, including pre-cordial Doppler studies, and recommends HBO treatment for patients with cerebral radiation damage.

He published these dysbaric and HBOT studies in e.g. Cancer, J Appl Physiol and UHM, and in conference proceedings (like EUBS and UHMS) and is regularly reviewer of journals in applied, sports and environmental medicine. He teaches diving physiology. He is member of UHMS and EUBS and often participated with contributions in their annual meetings. Also, he has tested the technical and physiological performance of dozens of dive computers (www.duikresearch.org), and is a recreational scuba- and formerly a free diver.

Adel Taher, a diving instructor and diving medical specialist at the time, he was the driving force behind the multi-place, multi-lock chamber in Sharm el Sheik as he saw the need for a facility to specialize in diving related accidents. The chamber was built in the USA. He is, in addition to being director of the Hyperbaric Medical Centre in Sharm el Sheik also the founder and director of the diving chamber of Dahab. With over 200 diver-HBO treatments per year, he is without any doubt world leader and trained many physicians in hyperbaric medicine. Dr Adel Taher is member of many international medical diving committees, and lectures about his work at universities, courses, etc. all over the world. He is also the director of DAN-Egypt, a member of the UHMS and of the EUBS. He was the driving force behind the EUBS Annual Scientific Meeting in Sharm el Sheik in 2007 and a recognized invited speaker at their congresses.

Diving still is his passion. He worked intensively on diver education and raising the awareness of dive professionals and divers regarding proper management of dive accidents in remote areas and the proper utilization of normobaric oxygen. The Hyperbaric Medical Centre in Sharm hosts dive medical specialists from all over the world to offer hands-on experience.

Peter Westerweel is internist-hematologist, working at the Albert Schweitzer Hospital in Dordrecht. He has authored several international publications in diving medicine, although the majority if his scientific work has been focused on the role of bone marrow derived progenitor cells in renal and cardiovascular disease. He has obtained his PhD at the University Medical Centre in Utrecht, where he was subsequently employed as a postdoctoral researcher. He worked at the Weill Cornell Medical Centre in New York, USA, as a visiting fellow. He is a diving physician with the Dutch Society for Diving Medicine and member of the board of the society. He also is a consultant for the Diving Medical Centre of the Dutch Navy. He has participated in the development of several national guidelines in diving medicine, including those on diving with diabetes and diving with antiplatelet and anticoagulant drugs. He is the

main investigator of the DIDIH (Diving with Disorders in Hemostasis) study, building a large database of comorbidity and medication used by Dutch and Belgian divers. He is an enthusiastic scuba diver and active PADI Open Water and Specialty Instructor, diving in the Netherlands year-round, while enjoying a tropical underwater excursion when the opportunity arises.


General programme 24 September: Arrival at Riviera Resort. For those coming with the group package from Amsterdam there is free transfer to the resort. Otherwise bus X1 brings you 150 m from the hotel. 25 September: Breakfast from 7:00. Mini-congress lectures 8:00 to 12.00. Lunch from 12:00 (Sunday 12:30). Afternoon leisure time for e.g. diving with Extra Divers. Diner. 26 to 29 September: Same schedule as 25 September.

Program Mini-Congress Diving Medicine

25 September 1. Adel Taher, Acute Dysbaric Diseases, without DCI 2. Jacques Regnard, Fluid balance 1: specific changes during immersion or diving 3. Mattijn Buwalda, Biology and medicine of oxygen, normoxic and hyperoxic 4. Free contributions 26 September 5. Jacques Regnard, Fluid balance 2: Its influence on the cardiovascular system 6. Jean-Claude Le Péchon, The hypobaric environment: diving at altitude and working in 'air' at altitude for tunnelling projects 7. Nico Schellart, Is the lipid surfactant skin of DCI-bubbles a myth? 8. Free contributions 27 September 9. Adel Taher, Non-pressure related diseases and dangerous marine creatures 10. Rienk Rienks, Cardiology, PFO and left-right shunts; development in research and diagnostics. 11. Chris Jiskoot, Medical regulations of professional divers in the Netherlands 12. Free contributions 28 September 13. Peter Westerweel, Diving with diabetes and haematological disorders 14. Jacques Regnard, Warm and cold stress 2: Introduction. Consequences for the cardiopulmonary system. 15. Rienk Rienks, Cardiovascular aspects of the medical exam and the Dutch diving-cardiological guidelines 16. Free contributions 29 September 17. Adel Taher, Differential Diagnosis and First Aid in Diving Accidents. 18. Mattijn Buwalda, Environmental physiology and pathophysiology of hypoxia 19. Jean Claude Hypobaric exposures in aviation and space (EVA environments) and the risk of DCI 20. Test and evaluation of the test (40 min) All invited lectures last 60 min (50+10). Free contribution sessions last 40 min. In total 17h50 contact hours Disclaimer: Capita Selecta Duikgeneeskunde is bound to execute the educational program, but program changes are under reserve.


Information of the accommodation and the dive program Accommodation The Riviera Resort & Spa, Marfa Bay, Mellieha, Malta, is situated in one of the best-preserved and picturesque areas in the north of Malta, in a tranquil sea front location and next to a small beach studded with majestic date palms, facing the Islands of Comino and Gozo across a channel of blue shimmering water, simply idyllic! The hotel is horseshoe shaped with in the centre two spacious outdoor seawater pools. Further it offers an excellent breakfast, lunch and diner, all in buffet style. It has a Thalassa Spa, and one heated indoor seawater swimming pool. The Hotel also has a SSI, CMAS and PADI approved Diving School offering various diving packages to numerous dive wrecks and diving sites found in the vicinity. The Riviera Resort & Spa is ideal for exploring the islands with the Gozo ferry being only two bus stops away. Malta’s largest blue flag sandy beach and the town of Mellieha are also just a few bus stops away. A regular public bus service connects the resort to other towns. Guest rooms have a private balcony and bathroom, are comfortably furnished and offer a range of different views: open sea, country, pool or beach. At night, there are frequently performances in the pool area. Free WI-FI is available. The Hotel also offers an all-inclusive board package (with local wine and beer), but in order to obtain of this service wristbands are to be worn for identification.

The main subscriber is AMC Capita Selecta Duikgeneeskunde, the service provider (dive-tour operator) is Diving World. Diving World is a member of the several Dutch professional guaranty organizations (ANVR (www.ANVR.nl, Calamiteitenfonds (Calamity Fund, www.calamiteitenfonds.nl) and the Garantiefonds (Guarantee fund, www.sgr.nl). The bookings conditions of Diving World and ANVR are applicable (see http://www.divingworld.nl, also for more info). They apply for the flight & accommodation packages and supplements such as the diving package, but not for the congress fees. As usual, this fee and extra charges for the accreditations are non-refundable. In case of questions you are asked to consult Eduard van Riet Paap, NOT Diving World. Costs and flights Please refer to the registration form. It is strongly suggested to book your accommodation-&-flight or accommodation-only package ASAP since Malta is a booming destination. Some flights are already overbooked and soon chairs for direct flight may become scarce. . Dive package When you have a CMAS 2* or PADI Advanced licence, then you can dive 5 days. Shore dives are ca. 30 €. For boat dives and dive-excursions to Gozo there will be additional charges. Dive tank (12 L; DIN and International valves), air and weights are included. Dive equipment rental and nitrox are available. On request one can sign up for a diving course. More info to follow.

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PROGRAMME 18th Capita Selecta Duikgeneeskunde