Risk factors for pilot fatalities in general aviation airplane crash landings.

CONTEXT: Most pilots survive airplane crash landings in small airplanes. Factors associated with pilot death have not been well studied. OBJECTIVE: To identify factors associated with fatalities in general aviation airplane crash landings. DESIGN: Case-control study. SETTING: The United States. SUBJECTS: All pilots in general aviation crash landings of airplanes with 10 seats or fewer, from 1983 through 1992. MAIN OUTCOME MEASURE: Pilot death. RESULTS: Pilots died in 437 (5.2%) of 8411 crash landings. A fire or explosion on the ground was strongly associated with pilot death (relative risk [RR], 20.4; 95% confidence interval [CI], 15.5-26.9), adjusted for pilot age, pilot flight hours, type of landing gear, and the filing of an instrument flight plan. Pilots who failed to use both lap belt and shoulder harness were more likely to die (adjusted RR, 6.8; 95% CI, 1.8-25.5), as were those who used only the lap belt (adjusted RR, 1.7; 95% CI, 1.3-2.2), compared with pilots who used both restraints. CONCLUSION: Pilots may be able to reduce their risk of death in a crash landing by using lap and shoulder restraints.

[Otorhinolaryngologic manifestation of chronic atrophic polychondritis. Apropos of a case]. / Les manifestations ORL de la polychondrite chronique atrophiante. A propos d'une observation.

Approximately 300 cases of relapsing polychondritis have been reported. The etiology of the disease is still unknown. The pathologist finds a fibrous degeneration of the cartilage of the body. A case relapsing polychondritis is presented and the otolaryngological disorders of the disease are reviewed.

Upper intestinal endoscopy induces hypoxemia in patients with obstructive pulmonary disease.

We studied the effects of fiberoptic upper intestinal endoscopy on blood oxygenation and cardiac rhythm in 13 patients. Six patients had normal pulmonary function or mild obstruction to air flow. None of these developed arterial oxygen desaturation during endoscopy. Seven patients had moderate to severe airflow obstruction. Six of these desaturated to less than 90%; the mean +/- SEM arterial oxygen tension changed from a baseline of 75 +/- 2 mm Hg to 54 +/- 2 mm Hg during endoscopy (P less than 0.01). Electrocardiographic changes during endoscopy occurred in 5 patients, 4 of whom had moderate to severe airflow obstruction. In 3 of these patients, the ECG changes were concurrent with desaturation. Patients with moderate to severe airflow obstruction frequently become hypoxemic and may develop cardiac arrhythmias during upper gastrointestinal endoscopy.