Aviat Space Envir Md
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Aviat Space Envir Md · Nov 2003
Case ReportsPulmonary edema following closed-circuit oxygen diving and strenuous swimming.
Acute pulmonary edema may be induced by diving and strenuous swimming. We report the case of a diver using closed-circuit, scuba equipment who developed acute dyspnea, hemoptysis, and hypoxemia following a dive in 18 degreesC (64.4 degrees F) water and physical exertion during the swim back to shore. With the growing popularity of recreational scuba diving, emergency physicians are liable to be faced with increasing numbers of diving-related medical problems. Diving-induced pulmonary edema should be included in the differential diagnosis of acute hypoxemia, sometimes accompanied by acid-base abnormalities, when this is seen in a diver.
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Aviat Space Envir Md · Nov 2003
Selective serotonin reuptake inhibitors in pilot fatalities of civil aviation accidents, 1990-2001.
Selective serotonin reuptake inhibitors (SSRIs) are popularly prescribed for treating depression. With a few exceptions, these psychotropic medications are not approved by aeromedical regulatory authorities for use by aviators. Since SSRIs have the potential for impairing performance and causing drug-drug interactions, the prevalence of SSRIs in pilot fatalities of civil aviation accidents was evaluated. ⋯ Numbers of SSRI-involved accidents were low, and blood SSRI concentrations in the associated pilot fatalities ranged from subtherapeutic to toxic levels. However, the interactive effects of other drug(s), ethanol, and/or even altitude hypoxia in producing adverse effects in the pilots cannot be ruled out. Findings from this study should be useful in investigating SSRI and other substance-involved accidents and in making decisions concerning the use of SSRIs in aviation.
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Aviat Space Envir Md · Nov 2003
CommentAnti-depressant use by aircrew: modulation of higher nervous function and the sleep-wake continuum.
The use of anti-depressants by aircrew raises clinical and operational issues. In this commentary the importance of a multi-disciplinary approach to the decision-making process is emphasized.
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Aviat Space Envir Md · Oct 2003
Association between right-to-left shunts and brain lesions in sport divers.
Recent studies suggest that healthy sport divers may develop clinically silent brain damage, based on the association between a finding of multiple brain lesions on MRI and the presence of right-to-left shunt, a pathway for venous gas bubbles to enter the arterial system. ⋯ Our data support the theory that right-to-left shunts can serve as a pathway for venous gas bubbles into the arterial circulation. However, we could not confirm an association between brain lesions and the presence of a right-to-left shunt in sport divers.
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Aviat Space Envir Md · Sep 2003
Clinical TrialSuppression of sickness by controlled breathing during mildly nauseogenic motion.
Anecdotal reports from aviators indicate that controlled breathing is used as a countermeasure for motion sickness. We report a trial on the effectiveness of focused, regular breathing on motion sickness. ⋯ Controlled breathing may be effective for controlling nausea.