Aviat Space Envir Md
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Optimum treatment for aircrew who have developed anxiety associated with flight includes a flying phase for desensitization. However, standardized flight profiles are not found in the literature. In this study, a method of desensitization flying, which may increase the probability of a return to productive flying, was devised and assessed. ⋯ In all referred aircrewmen, anxiety was controllable in flight at IAM. Somatic signs diminished and no sortie was terminated early. All returned to operational flying. Anxiety recurred in one fast jet pilot while flying solo, and in one navigator, both of whom requested a change to transports. A transport pilot had recurrent uncontrollable anxiety at high altitude and is grounded. At 9-24 months follow-up, 5/7 were flying comfortably with rare, controllable anxiety. We conclude that actual exposure to flying is usually necessary for aircrew to recover from anxiety associated with flight.
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Aviat Space Envir Md · Dec 1995
Review Comparative StudyConvulsive syncope in the aviation environment.
Syncope in the aviation environment can be a very difficult problem to assess. Even more difficult is the differential diagnosis between convulsive syncope and epilepsy after the first event. This paper discusses syncope in general and the differential diagnosis between vasovagal syncope and other forms of syncope. ⋯ The other 35% are due to a variety of causes. We found no good algorithm to differentiate convulsive syncope from epilepsy. We reviewed the literature to develop a differential diagnostic table, focusing on: age, awake status, position, emotional/physiologic stressors, onset, aura, appearance, injury on falling, seizure characteristics, automatism, length of unconsciousness and subsequent confusion, pulse characteristics, blood pressure, urinary incontinence, seizure duration, recovery time post-event, post-seizure sequelae, amnesia, posture vs. recovery, EEG characteristics, and the value of sophisticated diagnostic procedures.
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Aviat Space Envir Md · Dec 1995
Influence of body composition on rewarming from immersion hypothermia.
This study was conducted to determine if the differences between efficacies of three treatments for immersion hypothermia are affected by body composition. ⋯ The inter-treatment differences between these techniques are accentuated in the HF, and attenuated (afterdrop) or even eliminated (rewarming rate) in the LF subgroup.
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Aviat Space Envir Md · Nov 1995
Randomized Controlled Trial Clinical TrialOcular effects of hyoscine in double dose transdermal administration and its reversal by low dose pyridostigmine.
The potential of low dose (30 mg t.i.d) pyridostigmine to reduce the ocular side effects of double dose transdermal controlled release hyoscine was evaluated by the study of near visual acuity, accommodation amplitude and pupil diameter in a placebo controlled, double masked study. We studied 47 healthy men (age 18-21 yr) in 3 groups: 16 assigned to placebo hyoscine and placebo pyridostigmine, 15 assigned to double dose hyoscine and placebo pyridostigmine, and 16 to double dose hyoscine and pyridostigmine. Subjects were tested during 48 h of treatment and 48 h of washout period. ⋯ This decrease was significant when compared to the placebo group (p < 0.05) and to the pyridostigmine-protected group (p < 0.05). Pyridostigmine, however, did not significantly change the hyoscine-induced mydriasis of 1.47 + 0.15 mm change from baseline (p < 0.05). These results suggest that pyridostigmine administration may be beneficial in shortening recovery time when near vision impairment is experienced following single and double dose transdermal hyoscine administration.
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Aviat Space Envir Md · Nov 1995
U.S. Air Force aeromedical evacuation of obstetric patients in Europe.
U. S. Air Force (USAF) regulations do not recommend the routine movement of obstetrical patients greater than 34 weeks gestation. ⋯ By contrast, the USAF operates a high-volume, long-range aeromedical evacuation system with large fixed-wing aircraft. Of the 13,095 patients reported for military aeromedical movement within the study time frame, 329 patients were uneventfully airlifted for obstetrical reasons. This study suggests that long distance movement by fixed-wing aircraft of obstetric patients at any gestational age can be done safely in the USAF military aeromedical system.