Aviat Space Envir Md
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Aviat Space Envir Md · May 2002
ReviewPharmacologic considerations for serotonin reuptake inhibitor use by aviators.
Physicians frequently use serotonin reuptake inhibitors (SRIs) to treat a variety of psychiatric and medical conditions, many of which occur in aviators. SRIs are efficacious for treating acute conditions and may also prove useful for prophylaxis against recurrence through maintenance dosage. ⋯ This article reviews the particular threats that serotonergic agents pose to aviation safety. Some SRIs may prove safer than others to use in the aviation environment, but such medications will require appropriate ground testing, and must provide aeromedically safe control of the symptoms for which they are prescribed.
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Aviat Space Envir Md · Apr 2002
Case ReportsDelayed treatment of frostbite injury with hyperbaric oxygen therapy: a case report.
The effects of hyperbaric oxygen therapy on skin microcirculation were evaluated by laser-Doppler flowmetry and vital capillary microscopy in a frostbite victim 2 wk after the injury. Laser-Doppler skin blood flow, measured in intact skin on the dorsum of the foot, decreased from 52 to 31 perfusion units during hyperbaric oxygen therapy. The number of visible nutritive capillaries in frostbitten areas on the toes increased from 2 to 12 per mm2, as measured immediately after the hyperbaric oxygen therapy. We conclude that hyperbaric oxygen therapy is capable of improving nutritive skin blood flow in frostbitten areas more than 2 wk after the injury.
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Aviat Space Envir Md · Apr 2002
Voluntary hyperventilation into a simple mixing chamber relieves high altitude hypoxia.
Involuntary hyperventilation is a critical factor in acclimatization to a high altitude. Unacclimatized subjects do poorly when acutely exposed to high altitude. This may not be due to hypocapnia itself, but rather an associated symptom which inhibits hypoxic respiratory stimulation. ⋯ However, subjects voluntarily hyperventilating may overventilate and become disabled from severe hypocapnia. A simple mixing chamber is described which makes voluntary hyperventilation easier, safer, and possibly more effective. A subject breathing into a mixing chamber was able to maintain an SaO2 of 90% at 20,000 ft.
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Aviat Space Envir Md · Apr 2002
The role of the central nervous system in heatstroke: reversible profound depression of cerebral activity in a primate model.
The neurological manifestations of heatstroke victims vary. The exact sequence of the central nervous system (CNS) changes during lethal hyperthermia has only been partially explored, and the data covering the post-resuscitation CNS changes, which in most cases lead to secondary cardiac arrest, are insufficient. ⋯ The acute cerebral derangements during and after lethal hyperthermia are reversible. The cause of death is probably not CNS damage, but systemic hemodynamic deterioration.
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In recent years, there have been increasing complaints from cockpit crew, cabin crew, and passengers that the cabin air quality of commercial aircraft is deficient. A myriad of complaints including headache, fatigue, fever, and respiratory difficulties among many others have been registered, particularly by flight attendants on long-haul routes. ⋯ This paper will review some aspects relevant to cabin air quality such as volatile organic compounds (VOCs), carbon dioxide (CO2), carbon monoxide (CO), ozone (O3), particulates, and microorganisms, as well as the cabin ventilation system, to discern possible causes and effects of illness contracted inflight. The paper will conclude with recommendations on how the issue of cabin air quality may be resolved.