[Health of the pilots and flight safety]. / Helse hos flygere og flysikkerhet.

Pilots and other aviation personnel meet physicians on different terms depending on the purpose of the medical consultation: Whether it is a periodical medical examination by an appointed medical examiner required for renewal of flight licence, or whether the pilot consults the physician on a health problem. The physician has different roles in these two types of consultation. This article is a short introduction to physicians outside the aviation community on health problems among pilots with regard to flight safety.

[The risk of exposure to hepatitis B and human immunodeficiency virus among employees at Norwegian hospitals]. / Smitterisiko for hepatitt B og humant immunsviktvirus blant ansatte ved norske sykehus.

During the period from 1986 to 1989 a study was carried out to determine the risk of occupational exposure to hepatitis B virus and human immunodeficiency virus among approximately 5,500 employees at Aker hospital, Ullevål hospital and "Sentralsykehuset" in Akershus. Four hundred and fourteen injuries were reported during the study period of approximately 16,800 man-years, corresponding to an injury rate of 2.4/100 man-years. The majority of injuries occurred during direct patient contact in the wards. Of the known sources 8.2% were HBsAg positive and 16.8% HIV-antibody positive. One attendant contracted hepatitis B during the observation period. No HIV-seroconversion has been observed as yet.

[Non-invasive detection of asymptomatic coronary disease]. / Ikke-invasiv påvisning av asymptomatisk koronarsykdom.

The prevalence of silent ischemia is reported to be 1.5-2.5% in middle-aged men. We have calculated the incidence of silent ischemia in a low-risk population consisting of all Norwegian male pilots. During the period from January 1983 to May 1988 54 pathological exercise-ECG were found among 3,430 recordings made on 3,800 individuals. The risk estimate for coronary artery disease was calculated on the basis of clinical history and findings, exercise-ECG, tallium myocardial scintigraphy and measure of the ejection fraction by technetium scintigraphy by means of conditional probability analysis. 30 persons had a low probability estimate, whereas 24 had a high probability estimate. The findings show that non-invasive criteria for coronary artery disease are observed infrequently in a male low-risk population. In our material the annual incidence was 0.10%.

Diffuse pulmonary ossification and spontaneous pneumothorax in a pilot: a case report.

A 51-year-old pilot with spontaneous pneumothorax, emphysema, and multiple horny ossification in the lung is reported. The literature concerning diffuse pulmonary ossification is reviewed and aeromedical implications are discussed.

Training of prescreening cytotechnicians. A report on 10-year experience.

Institutional training of prescreening cytotechnicians started in 1972 in the Research Institute of Oncopathology, Budapest. Up to 1983 ten classes, i.e. 230 students have been trained. Authors acknowledge the good achievements of their students and state that the diagnostic reliability of the qualified cytotechnicians has been recognized by professionals. Their activity resulted in a considerably increased number of screenings and recognized cervical cancers. In 1964 merely 25 600 examinations, whereas in 1982 altogether 1 030 000 examinations were performed. Cervical cancers announced in 1978 were 597, but in 1982 this number rose to 1022, being 661 (66%) in stage 0. A so-called Cervix Program based on the activity of cytotechnicians has been initiated by the Hungarian Ministry of Health. In view of the authors' ten-year experience the execution of this enormous enterprise seems possible.

Comparative study of cimetidine and trimipramine in the short-term treatment of duodenal and gastric ulcer.

Sixty-nine outpatients with endoscopically confirmed duodenal and prepyloric (DU) or gastric ulcers (GU) completed a 4-week double-blind trial with either cimetidine, 1 g/day, or trimipramine, 50 mg/day. Ulcer healing was assessed by endoscopy at 4 weeks. At the end of the study 14 of 23 patients with DU treated with cimetidine and 13 of 25 treated with trimipramine had healed ulcers. In the patients with GU 7 of 11 ulcers (cimetidine) and 4 of 10 (trimipramine) healed. The differences in healing rates between the two treatment groups were not statistically significant, either in DU and GU groups separately or in the total material. The number of pain attacks per week decreased and the symptoms improved significantly in both treatment groups in DU, GU, and totally. Both drugs were well tolerated, but two patients in each treatment group developed a slight increase in serum transaminases. No serious side effects occurred. The study suggests trimipramine as an alternative drug to the well-established drug cimetidine in the treatment of duodenal and possibly also of gastric ulcer.

Enzymatic characteristics of tubular adenomas and carcinomas of the large intestine.

Enzymes activities in homogenates of the large intestine were measured in biopsies from 11 tubular adenomas and six carcinomas and from the corresponding normal mucosa of each individual. A similar and significant increase was found in the total activities of glucose-6-phosphate dehydrogenase (G 6 PD), pyruvate kinase, and lactate dehydrogenase in adenomas and carcinomas as compared with the levels of normal mucosa. The lactate dehydrogenase isoenzyme patterns showed also a marked and similar change in the adenomas and carcinomas with a significant increase of lactate dehydrogenase M-monomers. Most of the adenomas showed slight to moderate dysplasia. The results indicate that the measurement of total G 6 PD, pyruvate kinase and lactate dehydrogenase activities for screening purposes has no predictive value in separating non-premalignant from premalignant adenomas. Moreover, it seems that the enzymatic characteristics of malignancy are present even in tubular adenomas. This is in agreement with the theory of a polyp-cancer sequence.