Costantino Balestra

Costantino Balestra
HE2B - Haute Ecole Bruxelles-Brabant · HE2B - ISEK

Prof. PhD

About

238
Publications
79,959
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
4,380
Citations
Introduction
Dr. Costantino Balestra started to study neurophysiology of fatigue then started studies on environmental physiology issues. He teaches physiology, biostatistics, research methodology, as well as other subjects. He Is the Director of the Integrative Physiology Laboratory and a full time professor at the Haute Ecole Bruxelles-Brabant (Brussels). He is VP of DAN Europe for research and education, Immediate past President of the European Underwater and Baromedical Society.
Additional affiliations
September 2010 - present
Vrije Universiteit Brussel
Position
  • Senior Researcher
March 1994 - present
DAN Europe
Position
  • Vice President
September 1989 - present
Haute Ecole Bruxelles-Brabant, Brussels, Belgium
Position
  • Principal Investigator

Publications

Publications (238)
Article
Full-text available
Background Anemia is common among hospitalized critically ill and surgical oncological patients. The rising incidence of cancer and aggressive treatments has increased the demand for blood products, further strained by a dwindling donor pool. The normobaric oxygen paradox (NOP) has emerged as a potential avenue to increase EPO levels. While some st...
Article
Full-text available
Introduction: Diving decompression theory hypothesizes inflammatory processes as a source of micronuclei which could increase related risks. Therefore, we tested 10 healthy, male divers. They performed 6–8 dives with a maximum of two dives per day at depths ranging from 21 to 122 msw with CCR mixed gas diving. Methods: Post-dive VGE were counted by...
Article
Purpose: Ultrasound imaging is commonly used in decompression research to assess venous gas emboli (VGE) post-dive, with higher loads associated with increased decompression sickness risk. This work examines, for the first time in humans, the performance of a novel electrical impedance spectroscopy technology (I-VED), on possible detection of post-...
Article
Full-text available
Underwater activities are characterized by an imbalance between reactive oxygen/nitrogen species (RONS) and antioxidant mechanisms, which can be associated with an inflammatory response, depending on O2 availability. This review explores the oxidative stress mechanisms and related inflammation status (Oxy-Inflammation) in underwater activities such...
Article
Full-text available
The brain's unique characteristics make it exceptionally susceptible to oxidative stress, which arises from an imbalance between reactive oxygen species (ROS) production, reactive nitrogen species (RNS) production, and antioxidant defense mechanisms. This review explores the factors contributing to the brain's vascular tone's vulnerability in the p...
Article
Full-text available
The "normobaric oxygen paradox" (NOP) describes the response to the return to normoxia after a hyperoxic event, sensed by tissues as an oxygen shortage, up-regulating redox-sensitive transcription factors. We have previously characterized the time trend of oxygen-sensitive transcription factors in human PBMCs, in which the return to normoxia after...
Article
Full-text available
Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are critical neurological conditions that necessitate specialized care in the Intensive Care Unit (ICU). Managing cerebral perfusion pressure (CPP) and mean arterial pressure (MAP) is of primary importance in these patients. To maintain targeted MAP and CPP, vasopressors and/or inotrope...
Preprint
Full-text available
The brain's unique characteristics make it exceptionally susceptible to oxidative stress, which arises from an imbalance between reactive oxygen species (ROS) production, reactive nitrogen species (RNS) production, and antioxidant defense mechanisms. This review explores the factors contributing to the brain vascular tone vulnerability in the prese...
Preprint
Full-text available
Diving decompression theory hypothesizes inflammatory processes as a source of micronuclei which could increase related risks. Therefore, we tested 10 healthy, male divers. They performed 6-8 dives with a maximum of two dives per day at depths ranging from 21 to 122 msw with CCR mixed gas diving. Post-dive VGE were counted by echocardiography. Sali...
Article
Full-text available
Intense, long exercise can increase oxidative stress, leading to higher levels of inflammatory mediators and muscle damage. At the same time, fatigue has been suggested as one of the factors giving rise to delayed-onset muscle soreness (DOMS). The aim of this study was to investigate the efficacy of a specific electrical stimulation (ES) treatment...
Article
Full-text available
Molecular oxygen (O2) is one of the four most important elements on Earth (alongside carbon, nitrogen and hydrogen); aerobic organisms depend on it to release energy from carbon-based molecules [...]
Article
Full-text available
Hyperbaric oxygen therapy (HBOT) is a therapeutical approach based on exposure to pure oxygen in an augmented atmospheric pressure. Although it has been used for years, the exact kinetics of the reactive oxygen species (ROS) between different pressures of hyperbaric oxygen exposure are still not clearly evidenced. In this study, the metabolic respo...
Article
Full-text available
In this study, the metabolic responses of hypoxic breathing for 1 h to inspired fractions of 10% and 15% oxygen were investigated. To this end, 14 healthy nonsmoking subjects (6 females and 8 males, age: 32.2 ± 13.3 years old (mean ± SD), height: 169.1 ± 9.9 cm, and weight: 61.6 ± 16.2 kg) volunteered for the study. Blood samples were taken before,...
Article
Full-text available
We investigated the effects of intermittent long-term stretch training (5 weeks) on the architectural and mechanical properties of the muscle–tendon unit (MTU) in healthy humans. MTU’s viscoelastic and architectural properties in the human medial gastrocnemius (MG) muscle and the contribution of muscle and tendon structures to the MTU lengthening w...
Article
Full-text available
Blood-borne extracellular vesicles and inflammatory mediators were evaluated in divers using a closed circuit rebreathing apparatus and custom-mixed gases to diminish some diving risks. “Deep” divers (n = 8) dove once to mean (±SD) 102.5 ± 1.2 m of sea water (msw) for 167.3 ± 11.5 min. “Shallow” divers (n = 6) dove 3 times on day 1, and then repeti...
Article
Full-text available
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 Reso...
Article
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 to...
Article
Full-text available
Background and Objectives: The use of closed-circuit rebreathers (CCRs) in recreational diving is gaining interest. However, data regarding its physiological effects are still scarce. Immersion, cold water, hyperoxia, exercise or the equipment itself could challenge the cardiopulmonary system. The purpose of this study was to examine the impact of...
Article
Full-text available
Oxygen is a powerful trigger for cellular reactions and is used in many pathologies, including oxidative stress. However, the effects of oxygen over time and at different partial pressures remain poorly understood. In this study, the metabolic responses of normobaric oxygen intake for 1 h to mild (30%) and high (100%) inspired fractions were invest...
Article
Full-text available
Hypoxia, even at non-lethal levels, is one of the most stressful events for all aerobic organisms as it significantly affects a wide spectrum of physiological functions and energy production. Aerobic organisms activate countless molecular responses directed to respond at cellular, tissue, organ, and whole-body levels to cope with oxygen shortage al...
Article
Full-text available
Background and Objectives: Saturation diving is a technique used in commercial diving. Decompression sickness (DCS) was the main concern of saturation safety, but procedures have evolved over the last 50 years and DCS has become a rare event. New needs have evolved to evaluate the diving and decompression stress to improve the flexibility of the op...
Article
Objective Ever since the first research on barriers to physical activity (PA) highlighting fear of hypoglycemia as a major barrier, many studies have attempted to understand their demographic and behavioral determinants. However, no research has been conducted on whether these perceived barriers towards PA are based on real life-experienced adverse...
Article
Full-text available
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 stat...
Article
Full-text available
Oxygen is a powerful trigger for cellular reactions, but there are few comparative investigations assessing the effects over a large range of partial pressures. We investigated a metabolic response to single exposures to either normobaric (10%, 15%, 30%, 100%) or hyperbaric (1.4 ATA, 2.5 ATA) oxygen. Forty-eight healthy subjects (32 males/16 female...
Article
Full-text available
Objective We aimed to evaluate the feasibility of an online High-Intensity Interval Training (HIIT) program on clinical psychological symptoms in higher education students in the context of the COVID-19 pandemic lockdown. Materials and Methods During the lockdown, 30 students aged 18–25 years, who had been screened previously with a cut-off score...
Article
Full-text available
Background: Despite evolution in decompression algorithms, decompression illness is still an issue nowadays. Reducing vascular gas emboli (VGE) production or preserving endothelial function by other means such as diving preconditioning is of great interest. Several methods have been tried, either mechanical, cardiovascular, desaturation aimed or bi...
Article
Full-text available
Background: This study aimed to observe the effects of a fast acute ascent to simulated high altitudes on cardiovascular function both in the main arteries and in peripheral circulation. Methods: We examined 17 healthy volunteers, between 18 and 50 years old, at sea level, at 3842 m of hypobaric hypoxia and after return to sea level. Cardiac output...
Article
Full-text available
Background and Objective: Several cases of central serous chorioretinopathy (CSC) in divers have been reported in our medical retina center over the past few years. This study was designed to evaluate possible changes induced by SCUBA diving in ophthalmic parameters and especially subfoveal choroidal thickness (SFCT), since the choroid seems to pla...
Article
Full-text available
PurposeData regarding decompression stress after deep closed-circuit rebreather (CCR) dives are scarce. This study aimed to monitor technical divers during a wreck diving expedition and provide an insight in venous gas emboli (VGE) dynamics.Methods Diving practices of ten technical divers were observed. They performed a series of three consecutive...
Article
Full-text available
Impaired flow mediated dilation (FMD), an index of vascular stress, is known after SCUBA diving. This is related to a dysfunction of nitric oxide (NO) availability and a disturbance of the redox status, possibly induced by hyperoxic/hyperbaric gas breathing. SCUBA diving is usually performed with a mask only covering “half face” (HF) and therefore...
Article
Full-text available
PurposeDeep diving using mixed gas with closed-circuit rebreathers (CCRs) is increasingly common. However, data regarding the effects of these dives are still scarce. This preliminary field study aimed at evaluating the acute effects of deep (90–120 msw) mixed-gas CCR bounce dives on lung function in relation with other physiological parameters.Met...
Article
Full-text available
Introduction: Divers with a patent Foramen Ovale (PFO) have an increased risk for decompression sickness (DCS) when diving with compressed breathing gas. The relative risk increase, however, is difficult to establish as the PFO status of divers is usually only determined after a DCS occurrence. Methods: This prospective, single-blinded, observation...
Article
Full-text available
Depending on the oxygen partial pressure in a tissue, the therapeutic effect of oxygenation can vary from simple substance substitution up to hyperbaric oxygenation when breathing hyperbaric oxygen at 2.5–3.0 ATA. Surprisingly, new data showed that it is not only the oxygen supply that matters as even a minimal increase in the partial pressure of o...
Article
Full-text available
Background: Divers thermal status influences susceptibility to decompression sickness hence the need for proper insulation during immersion in cold water. However, there is a lack of data on thermal protection provided by diving suits, hence this study. Materials and methods: Two different groups of divers wearing either a wetsuit (n = 15) or a...
Article
Full-text available
The “Normobaric Oxygen Paradox” (NOP) is a physiologic mechanism that induces an increase of endogenous erythropoietin (EPO) production by creating a state of relative hypoxia in subjects previously exposed to hyperoxia, followed by a rapid return to normoxia. Oxygen exposure duration and inspired oxygen fraction required to observe a significant i...
Article
Full-text available
Exercise generates reactive oxygen species (ROS), creating a redox imbalance towards oxidation when inadequately intense. Normobaric and hyperbaric oxygen (HBO) breathed while not exercising induces antioxidant enzymes expression, but literature is still poor. Twenty-two athletes were assigned to five groups: controls; 30%, or 50% O2; 100% O2 (HBO)...
Article
Full-text available
Inflammation is an adaptive response to both external and internal stimuli including infection, trauma, surgery, ischemia-reperfusion, or malignancy. A number of studies indicate that physical activity is an effective means of reducing acute systemic and low-level inflammation occurring in different pathological conditions and in the recovery phase...
Article
Full-text available
Introduction: Heart rate variability (HRV) during underwater diving has been infrequently investigated because of environment limitations and technical challenges. This study aims to analyze HRV changes while diving at variable hyperoxia when using open circuit (OC) air diving apparatus or at constant hyperoxia using a closed-circuit rebreather (CC...
Article
Full-text available
Previous studies suggest that altered gravity levels during parabolic flight maneuvers affect spatial updating. Little is known about the impact of the experimental setting and psychological stressors associated with parabolic flight experiments on attentional processes. To address this gap, we investigated the level of alertness, selective and sus...
Article
Full-text available
We report Blood Oxygen Level Dependent (BOLD) signal changes recorded in the brain of an elite breath-hold diver during voluntary dry long breath-hold by means of fMRI. An independent component analysis (ICA) method was applied to extract brain areas that are putatively involved in the apnea process network. We discuss the hypothesis that these BOL...
Article
Full-text available
The term “normobaric oxygen paradox” (NOP), describes the response to the return to normoxia after a hyperoxic event, sensed by tissues as oxygen shortage, and resulting in up-regulation of the Hypoxia-inducible factor 1α (HIF-1α) transcription factor activity. The molecular characteristics of this response have not been yet fully characterized. He...
Article
Venous gas emboli (VGE) are often quantified as a marker of decompression stress on echocardiograms. Bubble-counting has been proposed as an easy to learn method, but remains time-consuming, rendering large dataset analysis impractical. Computer automation of VGE counting following this method has therefore been suggested as a means to eliminate ra...
Article
Full-text available
Introduction: The Azoth Systems O'Dive bubble monitor is marketed at recreational and professional divers as a tool to improve personal diving decompression safety. We report the use of this tool during a 12-day dive trip aboard a liveaboard vessel. Methods: Six divers were consistently monitored according to the user manual of the O'Dive system...
Article
Full-text available
Introduction: Critical flicker fusion frequency (CFFF) has been used in various studies to measure the cognitive effects of gas mixtures at depth, sometimes with conflicting or apparently paradoxical results. This study aimed to evaluate a novel automatic CFFF method and investigate whether CFFF can be used to monitor gas-induced narcosis in diver...
Article
Full-text available
Decompression sickness (DCS) is a complex and poorly understood systemic disease with wide inter-individual resistance variability. We selectively bred rats with a 3-fold greater resistance to DCS than standard ones. To investigate possible physiological mechanisms underlying the resistance to DCS, including sex-related differences in these mechani...
Preprint
Full-text available
Introduction: The SARS-CoV2 pandemic has led to an worldwide shortage of Personal Protection Devices (PPD) for medical and paramedical personnel. Adaptation of commercially available snorkel masks to serve as full face masks has been proposed. Even not formally approved as PPD, they are publicized on social media as suitable for this use. Concerns...
Article
Full-text available
Introduction: The “Severe Acute Respiratory Syndrome Coronavirus 2″ (SARS-CoV2) pandemic has led to a worldwide shortage of personal protection devices (PPD) for medical and paramedical personnel. Adaptation of commercially available snorkel masks to serve as full face masks has been proposed. Even not formally approved as PPD, they are publicized...
Article
Full-text available
Introduction: The SARS-CoV2 pandemic has led to an worldwide shortage of Personal Protection Devices (PPD) for medical and paramedical personnel. Adaptation of commercially available snorkel masks to serve as full face masks has been proposed. Even not formally approved as PPD, they are publicized on social media as suitable for this use. Concerns...
Article
Full-text available
Background: A large yet heterogeneous body of literature exists suggesting that endothelial dysfunction appears early in type 1 diabetes, due to hyperglycemia-induced oxidative stress. The latter may also affect vascular smooth muscles (VSM) function, a layer albeit less frequently considered in that pathology. This meta-analysis aims at evaluating...
Article
Full-text available
Background: Ocean racing has become increasingly demanding, both physically and psychologically. The aim of the study was to assess global changes after a transoceanic race. Materials and methods: Eight male sailors were evaluated pre- and post-race through anthropometric measurements (weight, skinfold, girth at different level and estimated bod...
Article
Full-text available
Oxygenation conditions are crucial for growth and tumor progression. Recent data suggests a decrease in cancer cell proliferation occurring after exposure to normobaric hyperoxia. Those changes are associated with fractal dimension. The purpose of this research was to study the impact of hyperoxia on apoptosis and morphology of leukemia cell lines....
Poster
BACKGROUND : Results on the estimations of intra and inter-raters reliabilities of knee angles done with different goniometers have shown promising results (1)(2)(3).Those encouraging results were confirmed by the few studies that stratified reliabilities through examiners' experience , with small numbers of experimenters (n=3 to 6) without samplin...
Article
Full-text available
Introduction: When divers are compressed to water depths deeper than 150 meter sea water (msw), symptoms of high-pressure neurological syndrome (HPNS) might appear due to rapid increase in pressure on the central nervous system during compression. The aim of this study was to first operate a new computerized tool, designed to monitor divers’ wellbe...
Article
Our understanding of decompression physiopathology has slowly improved during this last decade and some uncertainties have disappeared. A better understanding of anatomy and functional aspects of patent foramen ovale (PFO) have slowly resulted in a more liberal approach toward the medical fitness to dive for those bearing a PFO. Circulating vascula...
Article
Full-text available
Introduction: The risk for decompression sickness (DCS) after hyperbaric exposures (such as SCUBA diving) has been linked to the presence and quantity of vascular gas emboli (VGE) after surfacing from the dive. These VGE can be semi-quantified by ultrasound Doppler and quantified via precordial echocardiography. However, for an identical dive, VGE...
Book
Full-text available
If we want to simply depict what extreme environments are, we can consider them as majorly depending on two parameters: Temperature and Pressure. Both can also be submitted to gravitational changes. As a matter of fact, both dimensions are also well linked together. Depending on those two parameters, hydration, gas partial pressures, effort, work o...
Article
Full-text available
Introduction: Cognitive impairment related to inert gas narcosis (IGN) is a threat to diving safety and operations at depth that might be reduced by using enriched air nitrox (EANx) mixtures. Using critical flicker fusion frequency (CFFF), a possible early detection of cognitive abilities/cerebral arousal impairment when breathing different oxygen...
Article
Full-text available
Objective: To observe the effects of a fast-acute ascent to high altitude on brain cognitive function and transcranial doppler parameters in order to understand the physiological countermeasures of hypoxia. Methods: 17 high-altitude-naïve male subjects (mean age was 26.3 � 8.1 years) participated in the study. We measured Critical Flicker Fusion Fr...
Article
Full-text available
The original version of this article unfortunately contained a mistake.
Article
Divers Alert Network Europe has created a database with a large amount of dive-related data that has been collected since 1993 within the scope of the Diving Safety Laboratory citizen science project. The main objectives of this study are the grouping divers by their health information and revealing significant differences in diving parameters usin...
Article
Full-text available
Commercial saturation diving involves divers living and working in an enclosed atmosphere with elevated partial pressure of oxygen (ppO2) for weeks. The divers must acclimatize to these conditions during compression, and for up to 28 days until decompression is completed. During decompression, the ppO2 and ambient pressure are gradually decreased;...
Article
Full-text available
Purpose Underwater divers face several potential neurological hazards when breathing compressed gas mixtures including nitrogen narcosis which can impact diver’s safety. Various human studies have clearly demonstrated brain impairment due to nitrogen narcosis in divers at 4 ATA using critical flicker fusion frequency (CFFF) as a cortical performanc...
Article
Full-text available
In situ evaluation of human brain performance and arousal remains challenging during operational circumstances, hence the need for a rapid, reliable and reproducible tool. Here we hypothesized that the Critical flicker fusion frequency (CFFF) reflecting/requiring visual integration, visuo-motor skills and decision-taking process might be a powerful...
Article
Full-text available
Introduction: Because a significant association between training to perform emergency free ascent (EFA) and the occurrence of pulmonary barotrauma (PBT) was demonstrated in 2006, the Belgian Underwater Federation (BUF) decided to discontinue this procedure. An evaluation was needed 10 yr after the implementation of this change. Methods: All medi...