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PubMed1976

Study of space perception functioning during simulation of certain space flight factors.

The results are reported of spatial perception function studies in 130 healthy males of 17-35 years of age and in 33 people with complete or partial inhibition of the function of the labyrinth (deaf-mutes). The comparative magnitudes of gravitational vertical perception impairments were studied during vestibular stimulation (Coriolis and linear acceleration), as well as during clino-orthostatic and antiorthostatic hypokinesia. Hypokinesia to a certain extent permitted the simulation of the blood redistribution in weightlessness. The ability of the subjects to determine the subjective visual vertical was used as the test criterion. The experiments have shown that the magnitude of the observed changes in the human sensory area depends on the physical properties of the vestibular stimulus, on the angle of inclination of the head of the bed during hypokinesia and on the duration of bed rest, but not necessarily on the level of vestibular tolerance. Possible mechanisms of impairment of perception in the space flight environment are discussed. Examinations of spatial perception function are useful during selection procedures for astronauts and airmen.

Acceleration↗

PubMed2005

Diabetes mellitus type 1 in five military aviators: flying with insulin.

OVERVIEW: Diagnosis of diabetes mellitus (DM) type 1 results in medical disqualification for all military aviation duties all over the world. The main concern is hypoglycemia, which can cause sudden incapacitation. Efforts to reduce the glucose levels and long-term complications increase the frequency of hypoglycemia. PURPOSE: This paper reviews five newly diagnosed cases of DM type 1 in Israeli Air Force aviators that presented over the last 15 yr. Four of the aviators were allowed to continue on active duty with limitations and one was disqualified. METHODS: The records of all five diabetic aircrew were reviewed. Aircrews are tested every 3 mo for HbA1c levels. Every year they receive dilated fundoscopic eye examination. They have lipid levels drawn annually and are seen by both an endocrinologist and a flight surgeon for general medical examinations. RESULTS: Four of the aviators continued on active duty for years. No symptomatic hypoglycemia or sudden incapacitation occurred. Three of the four airmen experienced undesirable HbA1c levels. CONCLUSIONS: Our experience indicates that safely flying with newly diagnosed DM type 1 is possible. The cost of the demanding lifestyle of military aircrew members and the fear of hypoglycemic episodes can result in periods of sub-optimal glucose control.

Adult↗

PubMed2006

Pre-diabetes.

Pre-diabetes is the situation of having chronically high blood sugars but not meeting diagnostic criteria for diabetes. Many steps can be taken to delay or prevent the onset of diabetes in people with this condition. In general, the aviation medical examiner can issue a certificate to these airmen, but HbA1c readings greater than 6.0 should prompt further workup. The use of medications for pre-diabetes (such as metformin or acarbose) will require the submission of clinical information to the Aerospace Medical Certification Division.

Aviation↗

PubMedDate not supplied

[Longitudinal study of health status of pilots: changes in body weight].

On the basis of medical monitoring of the flying personnel, their body weight variations as a function of age and disease were studied (trauma complications, malformations, refraction, color perception, obesity without concomitant diseases were ignored). The subjects were subdivided into two groups with respect to the age when the first chronic disease was detected. It was demonstrated that the airmen who remained healthy for a long period of time had body weight values close to the group mean and age-related body weight gain within normal limits. The subjects who fell ill when younger than 28 years had a high body weight and those who fell ill at the age of 28-32 years had a low body weight which increased drastically at the age of 30-35 years.

Adult↗

PubMed1991

[Medical Ischl. Brine bath, imperial summer residence, military city].

In 1823 Josef Goetz and Franz Wirer v. Rettenbach established the first brine bath at Ischl. Having finished a cure there, Archduchess Sophie, who had been childless, gave birth to a son, who subsequently became Emperor Franz Joseph. For 65 years (as from 1849) Ischl was his summer residence. Wirer, Josef Brenner-Felsach and Max Mayer founded the first hospitals for the inhabitants of Ischl. Another medical institution was the Emperor Franz Joseph Children's Hospital of the City of Vienna at Ischl/Sulzbach. In 1943 the military hospital of the German Air Force for treatment of airmen with injuries of the brain, spinal cord and nerves was transferred to Ischl from Berlin. Under Dietrich Wolfgang Krüger it became the cradle of Austrian neurosurgery after the war (till 1968). The neurologist Karl Theodor Dussik, head of the neurological ward of the Military Hospital at Ischl was the first to use ultrasound for the diagnosis of diseases of the central nervous system. He is internationally regarded to be the father of ultrasonic diagnosis.

Austria↗

PubMed1990

Left anterior hemiblock in South African aircrew.

Serial ECGs and clinical records were examined to determine the prevalence, associated ECG abnormalities and outcome of left anterior hemiblock (LAH) in 13,037 airmen. The prevalence of LAH was 0.72% and it was not related to underlying cardiac disease. LAH should be regarded as a benign finding in healthy individuals.

Adolescent↗

PubMed1987

Characteristics of medically disqualified airman applicants in calendar years 1982 and 1983.

This study presents comprehensive data reflecting pertinent denial rates regarding the medical and general attributes of those airmen denied medical certification in the calendar years 1982 and 1983, and updates previously reported data with respect to medical certification denials. The annual denial rate based on airman applicants is 6.2 per 1,000. By class of certificate applied for, the annual rate per 1,000 applicants is 3.3 for first class, 3.8 for second class, and 8.6 for third class. As anticipated, general aviation and new applicants contribute greatly to total denials. The most significant causes for denial are cardiovascular, the miscellaneous pathology category (endocrinopathies, disqualifying medications, and administrative), neuropsychiatric and, at a substantially lower level, eye pathology. These updated data on medically disqualified applicants are consistent with expectations and previous findings, with cardiovascular diseases still the number 1 cause for denial.

Adult↗

PubMed1987

Apical hypertrophic nonobstructive cardiomyopathy in a pilot.

Apical hypertrophic cardiomyopathy is a form of nonobstructive hypertrophic cardiomyopathy characterized by disproportionate hypertrophy of the left ventricular apical region. With increasing reports of apical hypertrophic cardiomyopathy appearing in the literature, this condition is certain to be diagnosed amongst airmen. The question of flying status in these pilots may create a problem for the flight surgeon. We present a pilot with clinical and morphological features typical of apical hypertrophic cardiomyopathy who has remained asymptomatic over a 15-year follow-up period. There appears to be a spectrum of severity in apical hypertrophic cardiomyopathy ranging from mild to severe. Those having the mild form of the disease may be considered for restricted licensing subject to having a normal exercise test and no significant arrhythmias on 24-h ambulatory electro-cardiogram. If licensed, review by a cardiologist should be required every 6 months.

Adult↗

PubMed1986

Cockpit resource management: exploring the attitude-performance linkage.

Measured attitudes regarding cockpit management were contrasted for pilots whose line flying performance was independently evaluated by Check Airmen as above or below average. A highly significant discriminant function was obtained indicating that these attitudes are significant predictors of behavior. The performance of 95.7% of the pilots was correctly classified by the analysis. Implications of the results for cockpit resource management training and pilot selection are discussed.

Aerospace Medicine↗

PubMed1985

Polycystic kidney disease and the flyer.

Polycystic kidney disease (PKD) is a disorder occasionally detected in aircrew members. Complications associated with PKD include hypertension, urinary tract infections and calculi, and cerebral or abdominal aneurysms with the most frequent cause of death, uremia and renal failure. The prognosis for PKD is variable in that it is a benign disorder for some patients whereas others are fraught with these complications. Many airmen with PKD can continue with cockpit duties as long as there are no potentially incapacitating symptoms. Of particular importance is good blood pressure control for those with hypertension.

Adult↗

PubMed1983

Decompression sickness: USAF experience 1970-80.

During the period 1970-80, there were 58 cases of decompression sickness in one of its forms reported in USAF aircrewmen. These cases occurred in a number of different types of aircraft in which cabin/cockpit depressurization occurred either intentionally (because of operational requirements) or because of mechanical malfunction. The most common manifestation of decompression sickness was bends, although some airmen experienced various degrees of neurological dysfunction. Even though none of the aircraft was lost or damaged due to crew incapacitation, the threat was clearly there. The authors briefly review decompression sickness including prevention, treatment, and aeromedical disposition.

Adult↗

PubMed1982

Limitations of the exercise stress test in the detection of coronary artery disease in apparently healthy men.

During a 1-year period, the United States Air Force School of Aerospace Medicine reviewed routine exercise tests by 771 completely asymptomatic male flying personnel aged 35-54 years, who underwent the stress test as the sole screening procedure to detect latent coronary artery disease. All of the aviators had a normal baseline 12-lead electrocardiogram, which would not have required a stress test in accordance with current policies of the USAF Central Electrocardiographic Library. Of these 771 exercise tests, 153 were maximal treadmill tests without a previous Double Master's Step test, and 618 were Double Master's tests. Borderline abnormal or abnormal Double Master's tests were followed by treadmill testing. Airmen with abnormal treadmill tests were offered coronary angiography for clarification of the aeromedical significance of the test result. The predictive value of a routine abnormal treadmill test in a population of aircrew members with a borderline abnormal or abnormal Double Master's test ranged from 17-55%. Thus, mass screening for coronary artery disease with exercise stress tests in apparently asymptomatic individuals is hampered by a low yield of true positive test in an unacceptably high proportion of false positive results.

Adult↗

PubMed1980

Exposure to radio-frequency radiation from an aircraft radar unit.

Two airmen exposed to radio-frequency radiation 38 times above the Air Force permissible exposure level were medically evaluated for physical effects from exposure. Initial anxiety and hypertension were found, but these problems resolved with therapy. This case is reported with the hope that further research will be undertaken to understand the behavioral effects of radar beams on exposed aircrew or ground personnel.

Aerospace Medicine↗

PubMed1981

Postmortem coronary atherosclerosis findings in general aviation accident pilot fatalities: 1975-77.

The autopsies of 764 pilots involved in fatal general aviation accidents during the years 1975-77 were reviewed to appraise the age specific prevalence of coronary atherosclerosis among the autopsied group. Of the pilots killed in aircraft accidents and autopsied during 1975-77, 51% were found to have some degree of coronary atherosclerosis ranging from minimal to severe. However, only about 5% of the autopsied group were categorized as having severe coronary atherosclerosis. The rate per 1,000 of severe coronary atherosclerosis increased with age from 14.5 for ages less than 30, to 89.9 for ages 50 years and above; the rate nearly tripled from ages 30-39 to 40-49 (22.1 to 63.6). The prevalence of coronary atherosclerosis among this group of autopsied airmen is less than would have been expected based on the results of other recent studies.

Accidents, Aviation↗

PubMed1994

The Guinea Pig Club.

The "Guinea Pig Club" was formed in 1941 by a group of airmen who had sustained grievous injuries--mostly serious burns of the hands and face--and been treated by a team of plastic surgeons led by a remarkable New Zealander, Archibald McIndoe, at the Queen Victoria Hospital at East Grinstead in England. The most senior "Guinea Pig" was Tom Gleave, a fighter pilot who had been shot down during the Battle of Britain, and who carried out his duties as "Chief Guinea Pig" until his death in June 1993. This paper describes Tom Gleave's arrival at the Queen Victoria Hospital, and the formation and development of The Guinea Pig Club.

Burns↗

PubMed1994

Designing a standardized oral health survey for the tri-services.

To address a Congressional directive for a comprehensive study of the military medical care system (including dental care), the Tri-Service Dental Chiefs convened a panel of dental epidemiologists to develop a standardized protocol for assessing the oral health of soldiers, sailors, and airmen. This paper discusses previous military and civilian oral health surveys and outlines key design features of the common military protocol that evolved from this critical review of the literature.

Adolescent↗

PubMed1993

Flight leads and crisis decision-making.

Flight leads of fighter aircraft are typically considered to be superior airmen. However, little research has explicitly studied the decision-making ability of flight leads. In this study, the crisis decision-making of pilots in the role of flight lead is examined. Data from 156 fighter aircraft mechanical breakdown mishaps are used to compare the decision-making of flight leads to that of wingmen. The results suggest decision-making performance of flight leads is significantly inferior to wingmen. Further, we demonstrate this effect of flight leadership only affects experienced pilots, not inexperienced pilots. Explanations for this counter-intuitive finding include stress, training practices, and communication limitations.

Accidents, Aviation↗

PubMed1996

Prevalence of tobacco use among first-term Air Force personnel before and after basic military training.

To support the goal of a tobacco-free Air Force, a longitudinal study of 3,531 first-term airmen was conducted during basic military training (BMT) at Lackland Air Force Base, Texas. Tobacco use is currently prohibited during the 6-week period of BMT. Three self-reported surveys to determine tobacco use prevalence and behaviors were administered at the beginning, end, and 90 days post-BMT. Results indicate that 36% of men and 29% of women used some form of tobacco prior to BMT. Within 90 days after completing BMT, 74% of matched males and females resumed tobacco use and 6% of matched males and females initiated tobacco use. Regression analysis found that several survey questions could predict 85% of tobacco use and 88% of non-tobacco use after BMT. We conclude that tobacco prohibition during BMT has a small, beneficial effect on post-BMT tobacco use. Further efforts, however, are needed to meet the goal of a tobacco-free Air Force.

Adult↗