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[Bonaparte's expedition in Egypt].

Bonaparte's expedition in Egypt was not only a military operation. It was also a tentative colonial move which was used as a model for over a century as well as a cultural and scientific adventure, quite unique for its time. The evacuation of the Oriental Army stands as a milestone in the history of civilisations because the protocols which marked its achievement - to which Desgenettes and Larrey contributed-displayed outstanding humanitarian and medical dimensions. The humanitarian dimension is highlighted by the remarkable contribution of the British Authorities in taking care of the wounded, sick and disabled as well as in ensuring that the French troops safely got home or dealing with the various civilian people not following the army back to France. These agreements between belligerents clearly anticipated what became, 63 years later, the cornerstone of the Red Cross. The medical dimension is illustrated with all the sanitary measures which were taken in order to keep away from any risk of plague epidemics which were rightly feared at the time. Scurvy was also an issue. Although Lind had stated its "deficiency" characteristic 50 years earlier scurvy was still considered as an infectious and contagious disease. Not surprisingly the remarkable 3000 case study made by Larrey, which undoubtedly led up to the conclusion that the disease stemmed exclusively from nutritional deficiencies, had been almost neglected.

Altruism↗

[Metabolism in cosmonauts: the results of biochemical research on the blood of the crew members of the 7 prime expeditions on the Mir orbital space complex].

The pre- and postflight biochemical analyses of the blood of 16 cosmonauts flown aboard Mir orbital station over 125-366 days revealed the changes in carbohydrate, lipid and protein metabolism being in line with the present-day ideas about the space flight effects on the human metabolism. A particular individual pattern of the responses and the absence of correlation with flight duration of space expeditions ranging from 4 months to a 1 year, are noted.

Blood↗

[Problems of radiation safety of a Martian expedition crew].

Analysis of the radiation conditions during a piloted expedition to Mars made it evident that the radiation safety system will be one of the most critical components of life support aboard the future Martian vehicle. The concept and main functions of the system have been considered. The authors give their vision of the radiation monitoring system based on the present-day radiation safety postulates, comparison and contrasting methods and equipment applied for the purpose in current orbital and projected interplanetary flights.

Cosmic Radiation↗

[The concept of microbiological safety of a piloted Martian expedition].

It is the peculiar evolution of the microbial association aboard long-operating space vehicles that lends additional medical, technical and technological risks that may impact crew safety and orbital systems performance. Based on the experience of the Russian space stations, a concept of microbiological safety of a piloted expedition to Mars has been proposed comprising preventive measures, methods, means and technologies to control the microbiological environment in transport vehicles, lander and Martian habitation module.

Environmental Microbiology↗

Medicare program; expedited determination procedures for provider service terminations. Final rule with comment period.

This final rule with comment period responds to comments on one discrete aspect of the proposed rule published in the Federal Register on November 15, 2002. The portion of that proposed rule addressed here involves the expedited determination and reconsideration procedures available to beneficiaries when a provider informs them of a decision that Medicare coverage of their provider services is about to end.

Centers for Medicare and Medicaid Services, U.S.↗

Monitoring of expiratory flow rates and lung volumes during a high altitude expedition.

BACKGROUND: Data on lung volumes and changes in flow-volume spirometry at high altitude are few and do not provide comprehensive assessment of the occurring changes. This study characterizes alterations of the forced expiratory flow-volume curve (FEFV-curve) and lung volumes at increasing altitude. METHODS: FEFV-curve and lung volumes at increasing altitude were characterized by daily assessment of peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and maximal expiratory flow rates (MEF 25, 50, 75) at 25%, 50% and 75% of the FEFV-curve with a portable spirometer (turbinometric method) three times a day during an expedition to Mustagh Ata (7545m) in 15 healthy mountaineers. RESULTS: With increasing altitude FVC and FEV1 were reduced by up to 25% (74.8% / 74.6% of baseline) and MEF25 was reduced to 81.5% of baseline values. PEF initially increased up to 4451m and returned to baseline values above 5000m. After descent below 2000m, all values normalized within one day. There were weak negative correlations between AMSS and FEV1, FVC and PEF (r = -0.23, p<0.001). CONCLUSIONS: We found increasing pulmonary restriction at high altitude without a marked reduction of PEF. Assessment of the FEFV-curve at high altitudes with a portable spirometer is a practical method reflecting the true field situation and may provide clinically relevant information (impending pulmonary edema).

Adult↗

[Diseases of the cardiovascular system and the function of the endocrine glands in veterans of Soviet Antarctic expeditions].

The authors examined 58 men who had repeatedly participated in the Antarctic expeditions. In addition to a profound study of the cardiovascular system, the insulin tolerance test (0.1 U/kg simple insulin injected by intravenous drip for 90 minutes) was made, permitting the degree of tissue insulin resistance to be quantitatively estimated with measurements of the content of cyclic nucleotides in blood leukocytes and of immunoreactive insulin, C-peptide and counterinsular hormones in the blood before and after the functional test. It was established that with the increase of the number of Antarctic winterings tissue insulin resistance naturally grows regardless of the age of the examinees, manifesting itself in an increase of basal insulinemia, the content of cyclic adenosine monophosphate in blood leukocytes, appreciable increment of insulinemia after infusion of exogenous insulin. Analogous changes were detected in polar researchers suffering from coronary disease, essential hypertension irrespective of the number of winterings. It is concluded that the rise of tissue insulin resistance occurring under the influence of multiple exposures to natural and social factors of high latitudes is a predisposing factor of the formation of cardiovascular pathology.

Adaptation, Physiological↗

[Immunological reactivity and the prognosis for allergic complications in the crew of the 2d Saliut-4 expedition].

Immunological reactivity of P. I. Klimuk and V. I. Sevastyanov was studied before and after their 63-day flight aboard the orbital station Salyut-4. The study used the methods to assay reactivity of T- and B-lymphocytes (PHA-blast-transformation, nonspecific formation of rosettes with sheep red blood cells, immunofluorescence to identify cells carrying immunoglobulin receptors on their surface, serum level of immunoglobulins as a function of Becells). Sensitization of the human body to allergenes of representatives of normal automicroflora of Staphylococcus, Streptococcus, Proteus and E. coli was examined. Specific immunological reactivity which was marked on the 2nd day and tended to return to normal on the 7th day postflight as well as a significant decrease of IgA were noted. Postflight P. I. Klimuk showed sensitization to allergens of Staphylococcus and Streptococcus. Results of immunological examinations of the first and second expeditions aboard the orbital station Salyut-4 were compared.

Adult↗

[Preliminary results of studies of the cardiovascular system in members of the 2d expedition in the Mir orbital station].

Three crewmembers of the second expedition onboard Mir were examined. Their physiological data (bioelectric activity of the heart, phasic structure of the cardiac cycle, circulation parameters at rest and circulation responses to exercise ergometry tests and LBNP tests) were monitored and transmitted to the Earth. This paper presents the physiological data obtained, their interpretation and conclusion that the Commander during his longest-term flight remained in best shape. Individual responses of each cosmonaut in terms of adaptation to flight conditions are discussed.

Adaptation, Physiological↗

[Longitudinal study on circadian rhythms of plasma hormone levels during Japanese Antarctic Research Expedition].

Circadian rhythms of plasma cortisol, aldosterone and testosterone levels were studied longitudinally in a member of the 21st Japanese Antarctic Research Expedition during periods of one year both in Antarctica and in Hokkaido, Japan. Results were as follows. Plasma cortisol, aldosterone and testosterone levels of man both in Antarctica and in Hokkaido showed average patterns of rhythmicity which were similar to respective Aschoff's standard curves with an exception of testosterone rhythm pattern in Hokkaido. Monthly mean plasma cortisol level diminished markedly in June, the month of darkness throughout the day, but normal circadian rhythm of cortisol level was maintained even during this period. However in Japan the seasonal fluctuation of monthly mean plasma cortisol level was small and had no correlation with the environmental temperature and solar rhythm. Monthly mean plasma aldosterone level increased markedly in July, dark winter month and also in December, the month of midnight sun in Antarctica. In Japan also the same kind of seasonal fluctuation which showed peaks in winter and summer was observed. Monthly mean plasma testosterone level increased markedly in June, the month of darkness in Antarctica. However little seasonal fluctuation was observed in Japan. These findings suggest that social factors rather than light-dark cycle act as a Zeitgeber effective for the maintenance of circadian rhythms of human circulating hormone levels.

Adult↗

[Action on water-salt metabolism as a prophylactic method in orthostatic intolerance in crew members of the 2d expedition of the Saliut-1 station].

The water-salt supplement developed in ground-based experiments in order to increase human tolerance to LBNP and orthostatic tests was recommended to be given to the crewmembers at the final stage of the second expedition of Salyut-4. On the 53rd flight day, concomitantly with an intake of 4.0 g sodium chloride and 900-1200 ml water, an LBNP test was carried out to assess the effectiveness of this supplement, to select its optimal doses and to clarify individual responses. After the intake both cosmonauts showed a better tolerance of the LBNP test. They also displayed individual variations in their responses, viz. the commander in arterial circulation, and the flightengineer in venous circulation. As suggested by the ground-based experiments and the inflight provocative test, both cosmonauts were requested to take 9.0 g sodium chloride and 1000--1200 ml water on the last flight day. The postflight examinations demonstrated that the countermeasures applied (physical exercises, LBNP) in combination with the direct action on the fluid-electrolyte metabolism gave a pronounced positive effect.

Adult↗

[Free amino acids in the blood of the "Salyut-5" crew members before and after a 21-day space flight (2d expedition)].

This paper presents the measurements of free amino acids in the plasma of the Salyut-5 crewmembers (the second expedition) before and after their 21-day space flight. The measurements were performed in a Hitachi KLA-3B automatic amino acid analyzer. The changes in amino acid metabolism were associated with the chemical composition of the space diet, actual food intake and space flight effects. The conclusion is made that the dietary content of cystine and methionine, as well as phenylalanine, tyrosine, glycine, glutamic acid and serine should be increased. No signs of hepatic or renal dysfunction were detected. It is recommended to control strictly food consumption inflight.

Amino Acids↗

Peculiar characteristics of crewmembers' metabolism on the second expedition aboard orbital station Salyut-4.

This paper presents the results of metabolic studies of crew members on the second expedition aboard orbital station Salyut-4. Pre- and postflight medical examinations included measurements of a wide range of biochemical parameters characterising protein and carbohydrate metabolism, enzyme activity, energy exchange in red blood cells, hormone concentration, etc. It was shown that, during the 63-d flight and 7-d recovery period, crew-members developed no metabolic changes which could suggest pathologies. The changes were functional and seemed to be manifestations of adaptive reactions to space flight and return to 1 G. Elucidation of mechanisms of the reactions requires further study.

Adult↗

[Ballistocardiographic studies during the 4th expedition on the Saliut-6 orbital station].

This paper presents ballistocardiographic examinations of the Salyut-6 fourth expedition crew members who showed variations in both the shape and the amplitude of ballistocardiographic complexes. Ballistocardiograms (BCG) were recorded by means of a piezoelectric sensor with a sensitivity of 3 mV/cm x s-2. The sensor weight was 30 g. The sensor was attached to the upper part of the iliac bone, near the body mass center. During ballistocardiography the ballistic forces in the head-to-feet direction were recorded. The examinations were performed preflight and on mission days 46, 71, 98, 133, and 175. Hemodynamic specificities of the right and left heart were determined with the aid of the breath holding test. Measurements of BCG amplitudes were used to determine the kinetic effect of heart rate. The largest amplitude of BCG waves was seen on mission day 133. At this time period the systolic wave amplitude decreased during inhalation holding.

Ballistocardiography↗

[Etiology of hypertensive states in workers engaged in expedition shifted-duty brigades].

The state of peripheral and central hemodynamics was examined in 603 workers engaged into shifted duty expeditions in West Siberia, considering the length of service in the shifted duty cycle. The examination revealed high occurrence of cardiovascular diseases with prevalent hypertension. Rheographic findings proved that in 5 years of the shifted duty work high blood pressure develops with increased peripheral vascular tone (especially in brain) and enhanced contractility of left ventricle. Important role in the high blood pressure formation is played by changes of hemodynamics in first days after the duty shift.

Adult↗

["Doctors and soldiers during the expedition to Egypt" (1798-1799)].

About two centuries ago, an uncommon military campaign commanded by General BONAPARTE aged of 29 led the French Army to Egypt. The history did not, up till now, underline the role of the Military Health Service. But it was tremendous, in spite of its poor facilities because its strong subordination to the omnipotent Supply Services Through the description of the conditions of the daily life of soldiers, the author reviews the measures which aimed at the protection of the troops against the usual troubles faced at by an army in the field at the end of the 18th Century: thirst and hunger, long marches with heavy equipment, affective isolation increased by the roughness of battles, diseases among with plague that caused heavy casualties. So, are reviewed in this framework many problems peculiar to that period of time: recruitment, uniforms, food, cantonments, spirits of the troops, personal hygiene as well as collective one; and consequently the measures taken by the French Military officers attached to that expedition to prevent some diseases and epidemics.

Communicable Disease Control↗

[Results of a study of metabolic processes in members of the crew of the 2d expedition of the "Sliut-4" orbital station].

A detailed biochemical analysis of the venous blood and daily urine samples of the crewmembers of the Salyut-4 second expedition after their 63-day space flight showed metabolic changes as compared with the preflight level. The changes were more marked immediately postflight. On the 7th postflight day most parameters studied tended to return to the preflight values. This study did not demonstrate any adverse biochemical changes that may prevent long-duration manned space flights.

Adaptation, Physiological↗