Air Evacuation of Citizens During the COVID-19 Epidemic.

BACKGROUND: The coronavirus epidemic originated in China, having its epicenter in Wuhan. This was the first place in the world to adopt social distancing measures to contain the disease on January 23rd, 2020. After the initial isolation, several countries started making diplomatic plans to evacuate and repatriate their citizens, with the permission of the Chinese authorities. Due to the high risk of exposure of the transported passengers, evacuations were conducted with preventive measures against contamination by biological agents.CASE REPORT: We report the air evacuation of 39 passengers from China to Brazil. Five passengers were transported to Poland and the remaining 34 went to Brazil, where they remained in quarantine for 14 d. The mission was triggered on February 4th, named "Operation Return to Brazil" (Operação Regresso à Pátria Amada Brasil), and conducted by military personnel of the Brazilian Air Force. The mission was accomplished in 6 days; the flight from Wuhan lasted 25 h 20 min; and, additionally, there were on-ground preparations.DISCUSSION: Only with adequate isolation and protective measures was it possible to air evacuate the potentially contaminated passengers in the initial phase of the pandemic. Specific protective equipment (Personal Protective Equipment - PPE) is mandatory for missions in which the properties of the potentially contagious biological agent are not fully known, as was the case. Due to the risk of contamination of passengers and the likely evolution of the transport into an aeromedical evacuation, protocols stating the minimum safety conditions for this kind of patient transport must be followed, with consideration for the patient as well as the crew.Gomes ED, Ronconi MABR, Santos MB, Júnior PP, Franco AZP, Haberland DF, Borges LL. Air evacuation of citizens during the COVID-19 epidemic. Aerosp Med Hum Perform 2022; 93(2):94-98.

Lipid Subhyaloid Maculopathy and Exposure to High Altitude.

BACKGROUND: High altitude retinopathy (HAR) includes a number of diseases related to high altitude such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). High altitude retinopathy is mainly characterized by retinal hemorrhages, usually sparing the macular region, a condition specifically known as high altitude retinal hemorrhages (HARH). The pathogenesis of HARH is unclear. Many studies show that lack of oxygen causes an inadequate autoregulation of retinal circulation, causing vascular incompetence. Other retinal changes described in HAR have been reported, such as optical disk edema, optic disc hyperemia, cotton wool exudates, venous occlusions, and macular edema. CASE REPORT: In this paper we present a case of an aviator who developed a unilateral maculopathy through subhyaloid lipid accumulation on a climb to the top of Mt. Everest. The clinical findings are suggestive of an apparent case of temporary altitude-induced visual disruption maybe by the same presumable pathogenesis of HARH. Right eye visual loss was perceived at 5150 m when he was trying to take a photograph 40 d into the expedition. DISCUSSION: The maculopathy developed by this patient adds to the discussion on the pathogenesis of HARH, especially the aspect of this maculopathy and its complete resolution. It seems that autoregulation failure could lead to exudation and lipid deposits in the foveal area. Although macular damage is not a common signal in HARH, checking visual acuity during high altitude expeditions remains an important procedure to avoid late diagnosis as unilateral blindness may not be detected early. Rosas Petrocinio R, Gomes ED. Lipid subhyaloid maculopathy and exposure to high altitude. Aerosp Med Hum Perform. 2016; 87(10):898-900.

Avaliação da perda auditiva induzida pelo ruído ocupcional (PAIRO): uma proposta metodológica / Evaluation of hearing loss induced by noise ocupcional (PAIR): a methodological proposal

O ruído é o mais comum dos riscos laborativos e a PAIRO, uma das frequentes doenças ocupacionais. Todavia, inexistem no Brasil estatísticas oficiais sobre sua incidência e gravidade, restando avaliar o tema através de dados indiretos da literatura, visto que os casos oficialmente notificados são muito inferiores à realidade. O diagnóstico e o controle médico da PAIRO são temas de extrema relevância no âmbito da Medicina Ocupacional, exigindo avaliação criteriosa e detalhada. O presente estudo pretende coligir os principais aspectos reacionados ao tema, de modo a fornecer subsídios para a implementação de uma rotina eficiente em relação a esta doença.