[Arrhythmias and heart blocks in flying personnel with mitral valve prolapses]. / Aritmii i blokady serdtsa pri prolapse mitral'nogo klapana u letnogo sostava.

Investigated were 76 pilots with ECG-verified mitral valve prolapses (MVP) of the 1st and 2nd degree (w/o profound regurgitation). There were various heart blocks and ECG repolarization changes in 35 cases. Comparison of results of the cardiovascular functional investigations of flyers with MVP displayed non-specific cardiac rhythm and conductance disturbances that were registered more often during ECG-monitoring or test loading. According to the data of this study, bicycle and treadmill ergometry revealed "pseudoischemic" shifts in ECG. Literary indications of a significant loss in human endurance of physical loads due to MVP combined with the strain-induced arrhythmia received the experimental confirmation. Probably, arrhythmias in flyers with diagnosed MVP are predominantly associated with electric instability of the myocardium against the autonomous dysfunction with prevailing adrenergic effects.

[Adaptational disorders of the cardiovascular regulation during brief exposure to hypobaric hypoxia]. / Disadaptatsionnye rasstroistva serdechno-sosudistoi reguliatsii pri kratkosrochnom vozdeistvii gipobaricheskoi gipoksii.

Responses of the cardiovascular system to brief exposure to hypobaric hypoxia were the focus of this investigation. Impairment of adaptive reactions of the body was found to depend on the level of physical loading. "Critical" time of exposure to a simulated altitude of 5000 m came to 7-10 minutes. The deadaptive disorders have a non-specific character, e.g. hypotonia, dysrhythmias, etc. Probability of their emergence hinges on the physical state of subject. Low tolerance of chamber tests was a distinguishing feature of subjects with cardiovascular abnormalities.

[Prediction of G-load (Gz) tolerance based on various functional tests]. / Prognosirovanie ustoichivosti k pilotazhnym peregruzkam +Gz c pomoshchiu razlichykh funktsionalnykh prob.

The purpose of the present study was to analyze and sum up the data on the methods of predicting g-tolerance (+Gz) utilizing various functional tests within the program of medical flight certification. The study involved 478 fighter pilots who were examined at the Central Military Scientific/Research Aviation Hospital. The age of examinates varied from 25 to 50 years (35 yr. on the average). Along with healthy subjects there were also pilots with the history of vascular-autonomous instability, anamnesis of syncope, myocardiodystrophy, myocardiac and atherosclerotic cardiosclerosis, and some other disorders. As a result, a correlation was established between the tolerance of lower body negative pressure at -50 mm Hg and standing tests. No link was noted between tolerance of the subjects to moderate hypoxia (H = 5,000 m for 30 minutes) and +Gz-loads at 3 and 5 units for 30 seconds. Neither was there evidence of correlation between tolerance of standing tests including their modifications and g-loads. Pearson association coefficient ra = 0.01. Comparison of the tolerance to +Gz at 3, 5, and 6 units without the anti-gravity suit and static loads at 120, 160, 200, and 240 kg/s during 30 seconds each gave an agreement of 67%. However, the statoergometry test revealed a poor tolerance of static loads only in 17.2% out of 29 pilots with low g-loads tolerance. Hence, the association coefficient appeared to be equal to 0.06 denying any predictive link. This absence of reliable predictive correlation between the tests in use was extenuated by different physiological mechanisms of adaptation.

[Making of the clinicophysiological diagnosis within the system of medical flight certification]. / Kliniko-fiziologicheskii diagnoz v sisteme vrachebno-letnoi ekspertizy.

Adaptation responses were evaluated in flying personnel during medical examination with the use of simulators of the main dynamic factors of flight. Utility of assessing the adaptive reactions of the cardiovascular system by their physiological "cost" has been demonstrated. Parameters of the normal cardiovascular response to moderate hypoxia in altitude chamber have been established. On the basis of accumulated data, more sensitive and informative criteria for assessment of the functional state of the human organism are proposed for clinicophysiological diagnostics within the system of medical certification of flying personnel.

[Theoretical aspects of rehabilitation and occupational health of pilots]. / Teoreticheskie aspekty reabilitatsii i professional'noe zdorov'e letchika.

Some theoretical aspects of the rehabilitation problem and its interaction with the problem of professional health of pilot have been discussed in this paper. The authors have proposed methodologic approaches to the essence of medical and professional rehabilitation; classification of the main directions and types of rehabilitation, the principles of its application in flying practice as well as the question about economic advisability have been studied. As the main lines of medical rehabilitation there suggests the nosologic, psychologic and physiologic, professional (singly) rehabilitation with consideration of the labile and base components of professional health of pilot. As the base principle of rehabilitation there advances an etiopathogenic approach to the use of different means and methods of rehabilitation treatment and correction of a changed functional state. General requirements upon provision of multilevel, differential, individual, accessible and adequate rehabilitation are formulated. The method to calculate the economic effect of rehabilitation measures at the expense of savings in costs of pilot personnel by increasing the flight longevity and decreasing the number of flights necessary for maintaining the given level of combat effectiveness is proposed. The classifier of the main directions and types of rehabilitation is presented.

[New methodological approaches in assessing adaptive body reactions in the system of flight medicine expertise]. / O novykh metodologicheskikh podkhodakh v otsenke prisposobitel'nykh reaktsii organizma v sisteme vrachebno-letnoi ékspertizy.

The "cost" of adjustable systemic and cellular reactions in the human body in extreme environments have been assessed from the standpoint of their potentialities for upgrading special methods of evaluating and predicting functional status practiced in flight certification examination. As was stated, the functional reserves of blood circulation should be assessed by chronotropic activity of cardiac regulation in response to hypoxic exposure. The adequacy of adaptive processes on the cellular level can be drawn from the dynamics of malon-dialdehide (the by-product of lipid peroxidation) and plasma monoaminoxidase. The biochemical investigations of peripheral blood and saliva also show promise.

[The nature of the changes in the indices of intracerebral blood circulation in flight personnel performing functional tests]. / Kharakter izmenenii pokazatelei intratserebral'noi gemotsirkuliatsii u letnogo sostava pri provedenii nekotorykh funktsional'nykh prob.

The state of intracerebral hemocirculation in the pilots during expert examinations to determine the tolerance for special exercise tests was studied. The cerebral circulation reactions were evaluated with the use of ultrasonic transcranial Doppler vasography. It is found that exercise tests depending on an intensity of exposure and directionality result in different degree of changes in the cerebral circulation parameters. In an effect of the flight-surgeon's appraisal the use of transcranial Doppler vasography during LBNP test to identify the persons susceptible to the syncopal states is advisable.