ABSTRACT
A Grumman EA-6B aircraft experienced a rapid pressurization failure at 27,000 feet. All four crew members had removed their oxygen masks and were breathing cabin air pressurized to 8,000 feet before the incident. Although none of the crew members developed signs or symptoms of decompression sickness, the potential for adversity was realized by all. Altitude decompression sickness (DCS) and pulmonary overinflation syndrome (POIS) represent potentially fatal complications of rapid decompression or uncontrolled ascent in aircraft. The signs and symptoms of DCS range from mild joint pain to eventual cardiopulmonary collapse and death. The symptoms of POIS are usually more abrupt and lethal. The medical management of DCS and POIS includes (1) maintenance of airway and cardiopulmonary resuscitation if necessary: (2) administration of 100% oxygen; (3) descent as per Naval Aviation Training and Operating Procedures Standardization guidelines; (4) horizontal body position; (5) maintenance of fluid intake; and (6) early medical evaluation by a flight surgeon or other physician qualified in the management of DCS. Symptoms of DCS may appear up to 24 hours after decompression, and continued monitoring or grounding of exposed individuals during this time is essential. Many controllable factors may predispose to DCS/POIS, and preventive measures should be taken to ensure maximum reduction of risk.
Subject(s)
Aircraft , Decompression Sickness , Decompression , Aerospace Medicine , Decompression Sickness/diagnosis , Decompression Sickness/physiopathology , Decompression Sickness/therapy , Humans , Hyperbaric Oxygenation , United StatesSubject(s)
American Medical Association , Health Personnel , Violence , Abortion, Induced , Female , Humans , Organizational Policy , Pregnancy , United StatesABSTRACT
An executive vice president of the American Medical Association says that while physicians across the United States have mixed reviews of the President's proposal, they are basically looking for stability and predictability in a new system.
Subject(s)
American Medical Association , Attitude of Health Personnel , Health Care Reform/legislation & jurisprudence , Insurance Pools , Physicians/psychology , Referral and Consultation/economics , United StatesABSTRACT
Ecklonialactones A, B, and E, previously isolated from the brown alga Ecklonia stolonifera, have been isolated from the Oregon phaeophyte Egregia menziesii. The structure and relative stereochemistry of ecklonialactone E were independently determined by various nmr techniques. The absolute stereochemistry of ecklonialactone A was deduced by cd analysis of a dibenzoate derivative, which indicated it possessed a 11S, 12R, 13S, 15R, 16S stereochemistry. Similar 1H- and 13C-nmr data and optical rotations for all of the ecklonialactones indicate that B and E have the same stereochemistry as A at comparable stereocenters.
