Effect of Dynamic Workstation Use on Radiologist Detection of Pulmonary Nodules on CT.

PURPOSE: The aim of this study was to determine the effects of using a treadmill workstation during CT interpretation on radiologists' sensitivity for lung nodule detection, accuracy and adherence to accepted management recommendations, and examination interpretation time. METHODS: This HIPAA-compliant study was approved by the institutional review board. Three radiologists performed a retrospective review of 55 CT examinations of the chest originally performed for lung cancer screening. These studies were reviewed both while sitting at a conventional workstation and while walking at a treadmill workstation. A separate thoracic radiologist reviewed the examinations at a conventional workstation only to serve as a control. The number of pulmonary nodules detected, accuracy of or adherence to follow-up recommendations, and time required for examination interpretation were recorded and compared between each condition. RESULTS: There was no statistically significant difference in the total number of nodules detected while walking versus seated. Intraobserver follow-up recommendations were consistent to highly consistent between sitting and walking. There was moderate interobserver agreement between the radiologists' recommendation for seated versus walking conditions. There was a statistically significant difference in time taken to complete each examination, with interpretation during walking taking less time than during sitting. CONCLUSIONS: Use of a treadmill workstation does not significantly affect the detection of lung nodules on CT or lead to changes in management recommendations but does decrease examination interpretation time.

Proteinuria in aviation personnel: waiver policy in the U.S. Navy.

BACKGROUND: Proteinuria is a condition occasionally detected both in applicants for military pilot training and in experienced pilots. Medical personnel involved in the care of either group require a standardized policy for the evaluation and aeromedical disposition of proteinuria for these personnel. METHODS: A literature search was conducted to obtain current information and prognostic data on proteinuria in the general medical literature. Generally accepted waiver principles were then examined to determine if proteinuria should be waivered in aviation personnel. Other agency policies regarding proteinuria in aviation personnel were examined. The biomedical database records at the Naval Aerospace Medical Institute (NAMI) were searched to discover the U.S. Navy's experience in the evaluation and disposition of aviation personnel with proteinuria. RESULTS: A review of the general medical literature revealed general categories of proteinuria (dependent on protein excretion amount and symptomatology) and the presence or absence of systemic disease that correlated well with prognostic data. These categories provided useful criteria to develop an aeromedical policy that was consistent with previous (informal) NAMI policies, generally accepted waiver principles, and the existing policies of other agencies. Using the above results, a recommended policy for aviation personnel with proteinuria was presented. CONCLUSIONS: A recommended policy for the evaluation and aeromedical disposition of aviation personnel with proteinuria was developed for both applicants for U.S. Navy aviation duty as well as in those already serving within the U.S. Navy aviation community.

Cases from the aerospace medicine residents' teaching file. The oxygen paradox.

A student aviator experiences a transient loss of consciousness following a hypoxia demonstration after being placed on 100% oxygen. Presentation, diagnosis, treatment, and aeromedical implications surrounding the oxygen paradox phenomenon are discussed.