Aviat Space Envir Md
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Aviat Space Envir Md · Mar 1998
Historical ArticleThe history of the United States Navy flight surgeon/naval aviator program.
Early in the history of aviation the need for a special kind of physician who could understand the physical and psychological problems encountered by flyers was well recognized. These physicians were called flight surgeons. In 1922, RADM W. ⋯ Moffett, USN, the first Chief of the Bureau of Aeronautics and the "Father of Naval Aviation," called for a group of Navy medical officers to be trained as flight surgeons. He believed that all Navy flight surgeons should be trained as pilots "primarily in order that they may experience the emergencies and conditions that arise in flying." This article traces the history of the Navy flight surgeon/naval aviator. It chronicles the evolution of the Navy's flight surgeon/naval aviator program from the World War I doctor who flew seaplanes at a Naval Air Station in Italy to the present day flight surgeon/naval aviator who flys operational and test aircraft as a research pilot.
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Aviat Space Envir Md · Mar 1998
Case ReportsCarotid artery dissection presenting as a painless Horner's syndrome in a pilot: fit to fly?
We describe a case of a middle-aged Caucasian pilot who presented to us with a painless left Horner's syndrome due to a focal dissection of the infra-petrous portion of the ipsilateral internal carotid artery. He did not suffer symptoms of cerebral ischemia at the time of onset, or during the following 2 yr. ⋯ The literature suggests that the risk of stroke after onset of dissection is usually in the first month, and the risk of recurrence of dissection is about 1% per year after the first year. Our patient was prescribed aspirin 300 mg.d-1, and certified to fly as or with a co-pilot commencing 1 yr after onset of his symptoms.
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Aviat Space Envir Md · Jan 1998
The convective afterdrop component during hypothermic exercise decreases with delayed exercise onset.
Following cold water immersion, the post-cooling decrease in esophageal temperature (Tes) (i.e., afterdrop) is 3 times greater during exercise than during shivering, presumably due to increased muscular blood flow and convective core-to-periphery heat loss with exercise (J. Appl. Physiol. 63:2375, 1987). We felt that if exercise were to commence once the afterdrop period during shivering is complete, the threat of a further decrease in Tes (i.e., a second afterdrop) during the subsequent exercise would be minimized because much of the convective capacity for core cooling would already be dissipated. ⋯ It is likely that during the Shivering-Exercise protocol, continued blood flow to shivering muscles: a) contributes to the initial afterdrop, and thus b) diminishes the convective capacity (or heat sink) available for further cooling during subsequent exercise.
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Aviat Space Envir Md · Jan 1998
Partial renal resistance to arginine vasopressin as an adaptation to high altitude living.
The normal physiological response to high altitude (HA) is a decrease in total body water (TBW) and plasma and extracellular volume. The present investigation was designed to determine the mechanisms of the decrease in TBW with HA adaptation. ⋯ Present data demonstrate the following adaptations to HA: decrease in TBW, better ability to handle a water load despite high levels of AVP, a significant decrease in the circulation of vessel dilator, and diminished excretion of AQP2 water channel. These findings indicate an insensitivity of the collecting duct of HA subjects to the actions AVP. However, exogenous administration of AVP caused a marked excretion of AQP2.
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Aviat Space Envir Md · Nov 1997
Case ReportsNeurological manifestation of arterial gas embolism following standard altitude chamber flight: a case report.
In the course of a decompression at flight level 280 (28,000 ft) in an altitude chamber flight, a 45-yr-old cabin air traffic controller developed sudden numbness in his left upper and lower extremities and, soon after, complete paralysis in the left side, dysarthria and left facial palsy. A presumptive diagnosis of arterial gas embolism (AGE) was made and hyperbaric oxygen therapy (HBO) was given after airevac of the patient to the closest compression facility. ⋯ AGE is a rare event in the course of regular altitude chamber flight and diagnosis should be done in the context of the barometric pressure changes and an acute cerebral vascular injury. Risk factors and follow-up diagnostic procedures are discussed.