Barotrauma y barodontalgia en la aviación / Barotrauma and barodontalgia in Aviation / Barotrauma e barodontalgia na aviação

Introducción: se ha estudiado ampliamente la importancia de los cambios de presión y sus consecuencias en el cuerpo humano. De esto se desprenden dos conceptos importantes: el barotrauma que se define como el daño producido por cambios en la presión atmosférica; y la barodontalgia que se define como el dolor dentario producido por variaciones de presión barométrica, por ejemplo cuando existen gases atrapados en restauraciones o en la cámara pulpar y/o conducto radicular. Estos conceptos se fundamentan en las leyes de los gases: la Ley de Difusión Gaseosa, la Ley de Dalton, la Ley de Boyle, la Ley de Charles y la Ley de Henry. Discusión: el estudio y prevención de la barodontalgia es de suma importancia, ya que aunque no tiene alta prevalencia entre los aviadores, su aparición es súbita y de alta intensidad, lo que puede provocar en el piloto una incapacidad física y mental, que aumenta el riesgo de accidentes. Conclusiones: en esta revisión, se reúnen las estrategias recomendadas para prevenir su aparición.

Introduction: the importance of pressure changes and their consequences on the human body has been widely studied. Two important concepts arise from this: barotrauma, which is defined as the damage produced by changes in atmospheric pressure; and barodontalgia, which is defined as dental pain produced by variations in barometric pressure, for example when gases are trapped in restorations or in the pulp chamber and/or root canal. These concepts are based on the gas laws: the Law of Gaseous Diffusion, Dalton's Law, Boyle's Law, Charles' Law and Henry's Law. Discusion: the study and prevention of barodontalgia is of utmost importance, since although it is not highly prevalent among aviators, its onset is sudden and of high intensity, which can cause physical and mental incapacity in the pilot, increasing the risk of accidents. Conclusions: this review brings together the recommended strategies to prevent its occurrence.

Introducão: a importância das mudanças de pressão e suas conseqüências sobre o corpo humano têm sido amplamente estudadas. Dois conceitos importantes podem ser derivados disto: barotrauma, que é definido como o dano produzido por mudanças na pressão atmosférica; e barodontalgia, que é definida como a dor dental produzida por variações na pressão barométrica, por exemplo, quando os gases estão presos em restaurações ou na câmara de polpa e/ou canal radicular. Estes conceitos são baseados nas leis do gás: a Lei de Difusão Gasosa, a Lei de Dalton, a Lei de Boyle, a Lei de Charles e a Lei de Henry. Discusion: o estudo e prevenção da barodontia é de suma importância, pois embora não seja muito prevalente entre os aviadores, seu início é repentino e de alta intensidade, o que pode causar incapacidade física e mental no piloto, aumentando o risco de acidentes. Conclusões: esta revisão reúne as estratégias recomendadas para evitar sua ocorrência.

Viagem espacial: Um desafio sob o ponto de vista da oftalmologia / Space travel: A challenge from the point of view of ophthalmology

RESUMO No final do século vinte, com o surgimento de novas tecnologias e de novos programas espaciais, a medicina aeroespacial ganhou destaque no meio científico uma vez que os estudos relacionados às alterações da fisiologia humana no espaço tornaram-se cada vez mais necessário para a manutenção da saúde de cosmonautas. Os olhos são considerados uma das estruturas mais sensíveis do corpo às alterações vasculares, estruturais e bioquímicas provocadas pela microgravidade e radiação cósmica. Nesse sentido, essa revisão narrativa busca identificar e explicar as principais alterações morfológicas e funcionais que ocorrem no sistema visual em decorrência de missões espaciais.

ABSTRACT At the end of the twentieth century, with the emergence of new technologies and new space programs, aerospace medicine gained prominence in the scientific community since studies related to changes in human physiology in space have become increasingly necessary for the maintenance of cosmonaut health. The eyes are considered one of the most sensitive structures in the body to vascular, structural and biochemical changes caused by microgravity and cosmic radiation. In this sense, this narrative review seeks to identify and explain the main morphological and functional changes that occur in the visual system as a result of space missions.

Implementation of the protocol of nursing care in trauma in aeromedical service / Implementación del protocolo de la atención de enfermería en el trauma en servicio aeromédico / Implementação do protocolo de cuidados de enfermagem no trauma em serviço aeromédico

ABSTRACT Objective: To analyze the implementation of a nursing care protocol for trauma patients before, during and after the flight. Method: A cross-sectional quantitative study carried out in an aeromedical service, using a checklist with 106 care: 79 before flight, 25 during, and 2 after flight. 97 patients were included in the study. Results: Most care (n = 59; 55.7%) was implemented, totaling 4,435, 1,480 and 192 cares performed before, during and after the flight, respectively. They stood out as unrealized care: protect ears with ear muffler (n = 55) and avoid leaving the pulse oximeter exposed to the sun's rays (n = 22). The main reason for the non-performance was lack of appeal (n = 94). Conclusion: Although most protocol care has been implemented, unrealized care compromises the quality of care, which requires the management of the service to provide more incentive to nurses and adequate resources for its implementation.

RESUMEN Objetivo: Evaluar la implementación de un protocolo de atención de enfermería a pacientes traumatizados antes, durante y después del vuelo. Método: Estudio cuantitativo, transversal, realizado en un servicio aeromédico mediante la aplicación de un checklist con 106 cuidados: 79 antes del vuelo, 25 durante, y 2 después del vuelo. Compusieron la muestra 97 pacientes. Resultados: Se implementó la mayoría (n = 59; 55,7%), y totalizaron 4.435 cuidados realizados antes del vuelo; 1.480 realizados durante; y 192 cuidados realizados después del vuelo. Se destacaron como cuidados no realizados: proteger oídos con orejera (n = 55) y evitar dejar el oxímetro de pulso expuesto a rayos solares (n = 22). El principal motivo de la no ejecución fue la falta de recurso (n = 94). Conclusión: Aunque la mayoría de los cuidados han sido implementados, los cuidados no realizados comprometen la calidad de la asistencia, lo que requiere que la gestión del servicio incentive a los enfermeros y ofrezca recursos adecuados para efectivarla.

RESUMO Objetivo: analisar a implementação de um protocolo de cuidados de enfermagem para pacientes com trauma, antes, durante e após o voo. Método: estudo quantitativo, transversal, realizado em um serviço aeromédico, mediante aplicação de um checklist com 106 cuidados: 79 antes do voo, 25 durante, e dois após o voo. Resultados: a maioria dos cuidados (n = 59; 55,7%) foi implementada, totalizando 4.435, 1.480 e 192 cuidados realizados antes, durante e após o voo. Destacaram-se como cuidados não realizados: proteger ouvidos com abafador de orelha (n = 55) e evitar deixar o oxímetro de pulso exposto a raios solares (n = 22). O principal motivo da inexecução foi falta de recurso (n = 94). Conclusão: embora a maioria dos cuidados do protocolo tenha sido implementada, os cuidados não realizados comprometem a qualidade da assistência, o que requer da gestão do serviço maior incentivo aos enfermeiros e recursos adequados para sua efetivação.

Nurses' responsibilities in the aerospace environment / Atribuciones del enfermero en el medio ambiente aeroespacial / Atribuições do enfermeiro no ambiente aeroespacial

ABSTRACT Objectives: to characterize the nurses who work in the aerospace environment and to identify their most frequent responsibilities during the pre-flight, flight, and post-flight periods. Methods: a quantitative, exploratory-descriptive research, conducted using a survey through Google forms®, from January to April of 2018, with 50 nurses from aerospace services in Brazil. Data were analyzed using descriptive statistics. Results: predominance of male participants (64%), mean age of 37 years, with a mean working time in the aerospace environment of six years, in helicopter (54%), and in the southern region (42%). The main pre-flight, flight, and post-flight activities were, respectively: verification/testing of equipment functionality, nursing care for patients, and replacement of supplies and equipment. Conclusions: In the aerospace environment, nurses' work are primarily organizational and victim care actions, during all phases of the flight.

RESUMEN Objetivos: caracterizar a los enfermeros que actúan en el ambiente aeroespacial e identificar las asignaciones más frecuentes desarrolladas por ellos durante los períodos previos a vuelo, vuelo y post-vuelo. Métodos: investigación exploratoria-descriptiva, con abordaje cuantitativo, desarrollada por medio de una encuesta vía Google forms ®, de enero a abril de 2018, con 50 enfermeros de servicios aeroespaciales de Brasil. Los datos se analizaron por medio de estadística descriptiva. Resultados: predominaron participantes del sexo masculino (64%), con edad media de 37 años, con tiempo promedio de actuación en el ambiente aeroespacial de seis años, en aeronaves de ala rotativa (54%) y provenientes de la Región Sur (42%). Las principales actividades en el pre-vuelo, durante el vuelo y post-vuelo fueron, respectivamente: verificación/prueba de la funcionalidad de equipos, asistencia de enfermería a los pacientes y reposición de insumos y equipamientos. Conclusiones: en la actuación del enfermero en el ambiente aeroespacial predominan acciones organizacionales y de cuidado a la víctima durante todas las etapas del vuelo.

RESUMO Objetivos: caracterizar os enfermeiros que atuam no ambiente aeroespacial e identificar as atribuições mais frequentes desenvolvidas por eles durante os períodos pré-voo, voo e pós-voo. Métodos: pesquisa exploratório-descritiva, com abordagem quantitativa, desenvolvida por meio de um survey via Google forms ®, de janeiro a abril de 2018, com 50 enfermeiros de serviços aeroespaciais do Brasil. Os dados foram analisados por meio de estatística descritiva. Resultados: predominaram participantes do sexo masculino (64%), com idade média de 37 anos, com tempo médio de atuação no ambiente aeroespacial de seis anos, em aeronaves de asa rotativa (54%) e provenientes da região Sul (42%). As principais atividades no pré-voo, durante o voo e pós-voo foram, respectivamente: verificação/teste da funcionalidade de equipamentos, assistência de enfermagem aos pacientes e reposição de insumos e equipamentos. Conclusões: na atuação do enfermeiro no ambiente aeroespacial predominam ações organizacionais e de cuidado à vítima durante todas as etapas do voo.

Profilaxia do tromboembolismo venoso em viagens aéreas / Venous thromboembolism prophylaxis on flights

A aviação civil vem apresentando aumento progressivo do número de voos regulares nos últimos 10 anos e, em função disso, mais passageiros estão sendo transportados em viagens aéreas (VAs). Associado a isso, há um aumento das doenças relacionadas às VAs, especialmente naquelas de longa duração. Uma das complicações mais temidas dos voos é o tromboembolismo venoso (TEV), mas a sua real incidência é de difícil mensuração devido à falta de consenso sobre, por exemplo, quanto tempo após o pouso podemos considerar que o TEV possa estar relacionado à VA realizada ou mesmo quanto tempo de voo pode ser considerado como de longa duração. Muito tem se discutido sobre os mecanismos fisiopatológicos do TEV relacionado às VAs, quais passageiros são os de maior risco e quais medidas profiláticas podemos adotar com segurança e eficácia. O objetivo desta revisão é esclarecer esses pontos e as condutas consensuais atuais

Civil aviation has seen a steady increase in the number of scheduled flights over the last ten years and, as a result, more passengers are traveling by air. This has been associated with an increase in flight-related diseases, especially on long-haul flights. One of the most feared complications during flights is venous thromboembolism (VTE), but its true incidence is difficult to measure because of a lack of consensus on elements such as the definition of how long after landing a VTE can be considered to be related to a flight and even how long a flight must last to be considered of long duration. There has been much discussion of the pathophysiological mechanisms of flight-related VTE, of which passengers are at greatest risk, and of what prophylactic measures can be adopted safely and effectively. The purpose of this review is to clarify these points and describe current consensual conduct

La ergonomía de la persona. la medicina del trabajo en la aviación y en el trabajo médico / Work medicine and the ergonomics of the person

La Organización Internacional de Trabajo (OIT) señala que la magnitud de las lesiones, enfermedades y muertes ocasionadas por el trabajo indica la necesidad imperiosa de los Estados de proseguir la acción para reducirlas. Medicina del trabajo y ergonomía de la persona. Importancia de los exámenes médicos en la prevención de accidentes y enfermedades laborales.

The International Labour Organization (ILO) indicates that the magnitude of work-related injuries, illnesses and deaths caused by work, indicates the imperative need for States to continue to reduce them. Medicine the work and ergonomics of the person, importance of medical examinations in prevention of accidents and labor diseases.

Revisión bibliográfica y propuesta de guía de manejo para la prevención y rehabilitación de pilotos con predisposición a la aparición de cinetosis / Bibliographic review and guide proposal for the prevention and rehabilitation of pilots predisposed to the appearance of motion sickness

Introducción: La aerocinetosis se caracteriza por la aparición de una sintomatología variada que incluye náuseas y vómitos, mareos, palidez, sudoración, malestar gástrico y en casos más graves alteraciones de la conciencia. Dichos síntomas pueden mantenerse a lo largo de los días aun habiendo acabado la exposición, si la misma fue mantenida en el tiempo. Cuando se presenta en tripulantes puede resultar inhabilitante para la actividad. Objetivos: Se trata de una revisión bibliográfica que cuenta con información obtenida de múltiples fuentes siendo la más importante la que se obtuvo a través de la experiencia personal no solo del autor sino de los especialistas consultados. Material y Método: Describir los aspectos generales del equilibrio en los seres humanos. Describir las principales características de la aerocinetosis. Proponer una guía de manejo para la prevención y rehabilitación de pilotos con predisposición a la aparición de cinetosis. Conclusión: Se realizó en este trabajo una revisión exhaustiva del tema y se aborda la actitud preventiva y terapéutica a seguir, la cual está orientada a brindar información, identificar los síntomas y/o signos y llevar a cabo estrategias de entrenamiento y adaptación al movimiento que le permitirá al piloto que se ve afectado continuar con su actividad de forma adecuada

Introduction: Kinetosis is characterized by the appearance of a varied symptomatology including nausea and vomiting, dizziness, paleness, sweating, gastric discomfort and in more severe cases alterations of consciousness. These symptoms can be maintained throughout the days even if the exposure is finished, if the same was maintained in the time. When it occurs in crew members it can be disabling for the activity. Objectives: To describe the general aspects of balance in humans. Describe the main characteristics of aerocinetosis. To propose a management guide for the prevention and rehabilitation of pilots with predisposition to the onset of motion sickness. Material and method: This is a bibliographical review that has information obtained from multiple sources, the most important of which was obtained through the personal experience of the specialists consulted. Conclusions: A comprehensive review of the topic was carried out and the preventive and therapeutic attitude to be followed, which is aimed at providing information, identifying symptoms and signs and carrying out strategies of training and adaptation to the movement will allow the pilot who is affected to continue his activity properly.

El corazón de la Medicina Aeroespacial / The Heart of Aerospace Medicine

Desde mucho antes de que la humanidad tuviera la concepción del cosmos, ya la mitología griega, a través de Ícaro, narraba que habiendo sido apresado en Creta por el Rey Minos junto con su padre Dédalo, usó las alas que este había inventado y fabricado con enormes plumas de aves y pegadas con cera, para escapar de su confinamiento. Pese a las advertencias de su padre de no volar muy alto ni muy bajo, y fascinado por lo maravilloso del acto, el joven Ícaro se elevó por los aires y se sintió dueño del mundo y quiso llegar hasta el sol, derritiéndose la cera de las alas y muriendo al caer al mar. Es quizás desde aquí cuando el hombre intenta volar ­dicen algunos- para huir de los lazos que lo ataban a la Tierra. El primer registro histórico del hombre y el vuelo apareció hacia el año 850 de nuestra era en el emirato de Córdoba; el inventor andalusí Abbas Ibn Firnás construyó un par de alas y al parecer planeó por el aire recorriendo cierta distancia antes de que se precipitara a tierra, y mal herido, fue atendido por un médico (posiblemente el primer médico aeronáutico o aeroespacial, cuyo nombre no trascendió a la historia. Pasaron muchas centurias, hasta que los hermanos Wilbur y Orville Wright, el 13 de diciembre de 1903, rompieron un principio físico que nadie se había atrevido a desafiar: un objeto más pesado que el aire no puede sostenerse debido a la fuerza de la gravedad. Hasta ese entonces no se había pensado en que el empuje ­y esto aplica en todo-, puede vencer cualquier fuerza negativa. Fue así como Orville voló durante 59 segundos una distancia de 260 metros empleando dos motores a gasolina, moviendo las hélices con cadenas de bicicleta. Este hecho solo fue publicado en la prensa meses después. Al poco tiempo - 12 de noviembre de 1906-, en Bois de Boologne en París, un latinoamericano, el brasilero Alberto Santos Dumont se convertía en el primer piloto del mundo al volar a una altura de 6 metros y recorrer una distancia de 220 metros a una velocidad de 42 Km/h, y en ese mismo año Louis Blériot atravesaba el canal de la Mancha. En ese entonces los aviones eran monoplaza (un solo tripulante: el piloto) y el oficio requería cierto entrenamiento, destrezas, habilidades, algunos conocimientos de física, geografía, aerodinámica y mucho de imaginación y arrojo, además de aptitudes psicofísicas.

Progress on space oral medicine research under microgravity environment / 华西口腔医学杂志

As an interdisciplinary of stomatology and space medicine, space oral medicine focuses mainly on oral diseases happened under space environment. With the manned space technology stepping into the new era, space oral medicine has been put under the spotlight. This article will review the historical events on this subject, summarize the newly progress especially on craniomaxillofacial bone, tooth-derived stem cell and oral microbiology researches and still put forward future prospect.

The clinical research of aviatic nasal diseases with medical evaluation prevention and control intervention / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Exploring the clinical features of aviatic nasal diseases to provide references for medical evaluation, prevention and control measures in aircrew.@*METHOD@#To analysis and summary 605 cases with 503 pilots of nasal diseases in aircrew during 1966 to 2013.@*RESULT@#(1) There were 605 cases of aviatic nasal diseases, including 550 cases of general diseases and 55 cases of specific diseases. The general nasal diseases included 140 cases of anatomical abnormalities in nasal cavity type, 290 cases of inflammation in nasal cavity, 73 cases of allergy type, 47 cases of cyst and tumor type, and the specific nasal diseases were 55 cases of sinus barotrauma (SB). (2) The, constituent ratio of SB, which was happened in frontal sinus and /or maxillary sinus, was 95.55%. (3) The constituent ratio of cyst and tumor type in nasal cavity was easier causing to SB than anatomical abnormalities, inflammation, allergy disease in nasal cavity (P < 0.05). (4) The grounded constituent ratio of secondary SB was higher than anatomical abnormalities, inflammation, allergy, cyst and tumor disease in nasal cavity (P < 0.05). (5) The ways of hypobaric chamber tests were different for the kinds of aircrew. The qualified adjustment function of sinuses for barometric pressure was an essential condition for aircrew to continue flying. (6) The key point for the treatment of aviatic nasal diseases was to remove pathological change in nasal cavity and sinus and restore sinus ostium patency. The key point for the medical evaluation was to restore normal sinus pressure balance function.@*CONCLUSION@#The key point of medical evaluation about aviatic nasal diseases is to assess the sinus pressure balance function in hypobaric chamber tests. Normative treatment and medical evaluation can effectively avoid flight accidents and improve the attendance rate for aircrew.

Use of Parabolic Flight for the Research of Aerospace Biomedicine / 대한평형의학회지

As it is difficult to perform biological study in the actual space, several researchers have tried to develop methods that could 'mimic' microgravity condition on Earth. During the free fall of the aircraft, so-called 'parabolic flight', objects in a plane could experience weightlessness during a short period of time (approximately 20 to 30 seconds). We first reviewed former studies using parabolic flight in a variety of research filed including vestibular, neurologic, cardiovascular, musculoskeletal and immune system. We also investigated the actual conditions of biologic research using parabolic flight in Korea, by performing a questionnaire survey for 19 experts in space biology.

Retos para la docencia en medicina aeroespacial en colombia / Challenges in Colombian aerospace medicine teaching / Desafios para o ensino na medicina aeroespacial na Colômbia

La medicina aeroespacial es una especialidad médica de reciente creación de la cual existen pocos programas en el mundo, uno de ellos en Colombia. La incorporación de los egresados de este programa de posgrado al campo laboral aeronáutico no ha sido un proceso fácil, lo cual lleva a revisar si desde la universidad se están generando los profesionales que la sociedad necesita para un campo altamente especializado como el sector aeronáutico. Desde este ensayo se plantea la propuesta de la formación de un profesional integral para la medicina aeroespacial en Colombia y se formulan algunas estrategias que se pueden implementar desde la educación formal en docencia universitaria.

Aerospace medicine is a medical specialty with few programs in the world, one of these carried out in Colombia. The incorporation of these graduates to the aeronautical field has not been an easy process, which leads to review whether the university is producing professionals that society needs for a field as highly specialized as aeronautical industry. This paper presents the proposal of a professional with comprehensive training for aerospace medicine in Colombia and proposes some strategies that can be implemented from formal education in university teaching.

A medicina aeroespacial é uma especialidade médica de recente criação, da qual existem poucos programas no mundo; um destes na Colômbia. A incorporação dos professionais ao campo laboral aeronáutico não tem sido um processo fácil, o qual leva a pesquisar se desde a universidade se estão gerando os professionais que a sociedade precisa em uma área altamente especializada como o setor aeronáutico. O artigo discute a proposta da formação de um profissional integral para a medicina aeroespacial na Colômbia, e sugere algumas estratégias para a implementação desde a educação formal em docência universitária.

Effect of aerospace weightlessness on cognitive functions and the relative dialectical analysis of Chinese medicine / 中国中西医结合杂志

Aerospace medicine has paid more and more attention to abnormal changes of physiological functions induced by weightlessness and studies on their prevention during space flight. In this paper, the effect of space weightlessness on cognitive functions was introduced. We tried to analyze the correlation between the cognitive function changes and relevant Chinese medical syndromes, thus providing a potential available way to prevent and treat weightlessness induced cognitive deficit during space flight.

Comparison of antioxidant status between pilots and non-flight staff of the army force: pilots may need more vitamin C / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the blood antioxidant levels and dietary antioxidant intakes between pilots and non-flight staff of the Army Force in The Islamic Republic of Iran.</p><p><b>METHODS</b>Thirty-seven helicopter pilots and 40 non-flight staff were included in this study. Their general characteristics were recorded and their weight, height, and waist circumference were measured. Their daily intake of energy and nutrients including antioxidants was assessed using a semi-quantitative food frequency questionnaire. Serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), and glutathione reductase (GR), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) in red blood cells were also measured.</p><p><b>RESULTS</b>The median erythrocytes SOD, serum MDA level and the mean serum level of TAC and erythrocytes GPx were significantly higher in pilots than in non-flight staff. The median vitamin C intake was significantly lower in pilots than in non-flight staff. The serum MDA levels were similar in non-flight staff and pilots when their vitamin C intake was ⋜168 mg and significantly lower in non-flight staff than in pilots when their vitamin C intake was >168 mg.</p><p><b>CONCLUSION</b>The serum MDA level is lower in non-flight staff than in pilots when their vitamin C intake level is high, indicating that pilots need more vitamin C than non-flight staff.</p>

[Hypertension and aeromedical considerations]

Hypertension is the most prevalent risk factor for arterial disease in the industrialized world and is a frequently encountered clinical problem in the aircrew population. Arterial systolic and diastolic blood pressures are continuously varying quantities, influenced by a host of extraneous factors. Aviators with hypertension responsive to life-style modifications should have serial BP rechecks quarterly to semi-annually during the first year to assure success of the lifestyle modifications. Failure to achieve blood pressure control with lifestyle modifications, or an initial blood pressure average exceeding 160 mmHg systolic or 100 mmHg diastolic, requires initiation of pharmacotherapy. In this study we evaluate books, magazines, articles, guidelines and reliable websites related to aeromedical concerns and waiver considerations in aircrew with hypertension. Two major "types" of essential hypertension are generally recognized. One is characterized by suppressed renin activity and sensitivity to dietary sodium, the other by high renin activity and a lack of response to sodium intake. Thiazide diuretics are certainly the initial therapy of choice, particularly for older subjects. Aircrew with blood pressure that is controlled adequately with thiazides, with no other uncontrolled cardiovascular risk factors, and with no evidence of end-organ damage, are usually fit to return to unrestricted flying in military and civilian spheres. ACE inhibitors are an alternative initial choice in younger aviators, are positively indicated in patients with type 2 diabetes, and have no adverse effects on serum lipids. Hydrochlorothiazide [hctz], with or without triamterene or potassium replacement, can be used as a first line agent for treatment of hypertension in designated personnel. ACE inhibitors might have an adverse effect on G-tolerance have not been borne out by experience in either the US Air Force or the Royal Air Force [RAF], and the US Navy accepts these agents for unrestricted flying without G-tolerance testing

Aspectos históricos do transporte aeromédico e da medicina aeroespacial - revisão / Historical aspects of aeromedical transportand aerospace medicine – review

A história do transporte aeromédico e da Medicina Aeroespacial consiste em agradável viagem ao passado, com grandes perspectivas. Este trabalho descreve como a Medicina militar e as guerras trouxeram conhecimentos sobre a fisiologia humana, contribuindo para o desenvolvimento de várias áreas médicas. A viagem inicia-se na mitologia grega, com Dédalus e Ícaro, passando pelos balões inicialmente sem direção, depois seus dirigíveis, até chegar às máquinas voadoras mais pesadas que o ar. O homem experimentou ambiente hostil que lhe era desconhecido; a baixa pressão atmosférica, a hipóxia e a hipotermia eram apenas o começo. Paul Bert, médico fisiologista e pai da Medicina Aeroespacial, já realizava estudos em câmara hipobárica, mesmo com toda limitação tecnológica da época. Nascia nova era, em que o homem começava a entender e a dominar as alterações fisiológicas da altitude.A concepção de transporte aeromédico foi introduzida durante as guerras napoleônicas e sedimentada na Guerra Franco-Prussiana (1871), quando 160 feridos foram transportados da Paris sediada, em balões de ar quente. A grande evolução nos cuidados pré-hospitalares e no modelo de remoção de pacientes ocorreu durante as Guerras do Vietnã e da Coreia,palco de estrutura que serviu de molde para os sistemas de atendimento ao trauma da atualidade. As guerras continuam a assolar a humanidade, levando vidas e trazendo sofrimento e dor aos que ficam. Paradoxalmente, é a mesma guerra que fornece condições de pesquisae desenvolvimento de inventos e tecnologia, as quais propulsionaram a conquista de novos universos. O caminho é literal. Vai da imaginação da mitologia grega em possibilitar ao homem voar, até a da atualidade, que faz sonhar em conquistar o espaço, com a mesma personalidade desbravadora que dos antecessores. Aqui o céu não é o limite.

The history of aeromedical transport and Aerospace Medicine consists in a pleasant journey to the past, with great prospects. This article describes how military medicine and wars advanced our understanding of human physiology, contributing to the development of various medical s. The journey begins in Greek mythology, with Daedalus and Icarus, moving on to balloons, then on to airships, until we reach heavier than air flying machines. Man experienced a hostile environment unknown to him, low atmospheric pressure, hypoxia and hypothermia were just the beginning.Paul Bert, medical physiologist and father of Aerospace Medicine, already performed studies in hypobaric chambers, even with all the technological limitations of his time. A new era was born, in which man began to understand and master the physiological changes of altitude. The concept of aeromedical transport was introduced during the Napoleonic wars and consolidated in the Franco-Prussian War (1871), when 160 wounded men were transported from sieged Paris on hot air balloons. A great evolution in pre-hospital care and patient evacuation strategies occurred during thewars in Vietnam and Korea, stages that served as a templates for the structures of trauma care today. Wars continue to ravage humanity, taking lives and bringing pain and suffering to those who remain. Paradoxically,it is the same war that provides conditions for research and development of inventions and technology, which propelled the conquering of new worlds. The path is literal. It goes from the ingenuity of Greek mythologythat enabled man to fly, to today, making us dream of conquering space, with the same adventurous personality of our predecessors. Here, the sky is not the limit.

Characteristics and aeromedical evaluation of Meniere's disease in flight aircrew / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.@*METHOD@#Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.@*RESULT@#Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.@*CONCLUSION@#The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.

[Barodontalgia in military aerospace and diving]

Since aerospace and oceans have been captured, the most important concerns were unfamiliarity with hazards of entering into unknown environments. From anatomical and physiological point of view, human body compatible with living on the earth. Thus human survival at other conditions necessitous specific equipment's. Identification of those hazards and how to prevent and cure was the purpose of this article. This review article is a collection of data and knowledge regard to earth atmosphere from credible and scientific books and articles. Tooth pain following barometric pressure changes, named barodontalgia. Military air and naval forces due to face agile maneuvers and special conditions are high-risk population. Three pathophysiological hypotheses suggested: 1 .Inflamatory, 2.Gas embolism, and 3.Trapped air. Pain often occur suddenly and unpredictable. Patient profile, clinical examination and paraclinical procedures help to make net diagnosis. Oral hygiene and periodical dental examinations of high-risk population are critical prevention methods. Barodontalgia is rather rare but its emersion on complicated [critical] air and naval task forces can lead to human and equipment hazards. Therefore, sufficient attention in prevention and creation optimal conditions for researches will be valuable

Study on fatigue of pilots during simulated flight training based on electroencephalogram / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study EEG during simulated flight training, then to explore the situational character of mental fatigue of the pilots.</p><p><b>METHODS</b>Fifty male pilots were randomly choice to be recorded their EEG including rest,flight and recovery phase. Then the band waves of EEG were analysed among the three phase.</p><p><b>RESULTS</b>(1) During flight, the amplitude of alpha, beta, SMR, theta, gamma waves tended to increase. These changes seemed obviously in SMR, theta waves. (2) After flight, all the amplitude of the waves declined except for beta wave of the right lobe,and most of them were still higher than those before flight (P < 0.05); (3) The right brain showed a higher cerebration than the left, especially in theta wave.</p><p><b>CONCLUSION</b>Mental fatigue is started during the flight training, and the right lobe has a severe mental fatigue than the left. After flight, mental fatigue showed a slow recovery.</p>

Thermal comfort and thermoregulation in manned space flight / 中国应用生理学杂志

Exposure to thermal environment is one of the main concerns for manned space exploration. By focusing on the works performed on thermoregulation at microgravity or simulated microgravity, we endeavored to review the investigation on space thermal environmental physiology. First of all, the application of medical requirements for the crew module design from normal thermal comfort to accidental thermal emergencies in a space craft will be addressed. Then, alterations in the autonomic and behavioral temperature regulation caused by the effect of weightlessness both in space flight and its simulation on the ground are also discussed. Furthermore, countermeasures like exercise training, simulated natural ventilation, encouraged drink, etc., in the protection of thermoregulation during space flight is presented. Finally, the challenge of space thermal environment physiology faced in the future is figured out.