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[PMID]:29376589
[Au] Autor:Alyaev YG; Sirota ES; Bezrukov EA; Fiev DN; Bukatov MD; Letunovskii AV; Byadretdinov IS
[Ad] Endereço:I.M. Sechenov First MSMU of Minzdrav of Russia, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia.
[Ti] Título:[Application of 3D soft print models of the kidney for treatment of patients with localized cancer of the kidney (a pilot study)].
[So] Source:Urologiia;(6):12-19, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To evaluate the possibility of using 3D-printing in the management of patients with localized kidney cancer. MATERIALS AND METHODS: The study comprised five patients with localized kidney cancer who were treated at the Urology Clinic of the I.M. Sechenov First Moscow State Medical University from January 2016 to April 2017. Along with the standard examination, the patients underwent multispiral computed tomography (MSCT) to produce patient-specific 3D-printed models of the kidney tumors using 3D modeling and 3D printing. To evaluate the effectiveness of using 3D-printed models, two-stage preoperative planning was conducted, and five surgeons were surveyed using a four-question multiple choice questionnaire. At the first stage, the planning of operations was carried out based on MSCT findings. At the second stage, the surgeons were given patient-specific soft 3D models of the kidney with a tumor for preoperative training. After preoperative training, patients underwent laparoscopic resection of the kidney with a tumor. RESULTS: According to the survey results, each of the participating surgeons at least once changed surgical plan based on data obtained with 3D printed models of the kidney with the tumor. The implementation of preoperative training using 3D printed models of the kidney turned out to be effective. All patients underwent laparoscopic surgery performed by a single surgeon with extensive experience in this type of surgery. The mean operative time was 187 minutes. All operations were performed with main renal artery occlusion. The men warm ischemia time was 19.5 minutes and the mean blood loss was 170 ml. There were no conversions to open surgery and organ-removing operations. There were no postoperative complications or deaths. All surgical margins were negative. Morphological examination showed that four patients had renal cell carcinoma one patient had the oncocytoma. CONCLUSION: The study demonstrated the promise of using 3D printing for preoperative planning and surgical performance due to a high-precision three-dimensional soft patient-specific model of the localized kidney.
[Mh] Termos MeSH primário: Imagem Tridimensional
Neoplasias Renais/patologia
Rim/patologia
Modelos Anatômicos
Impressão Tridimensional
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Rim/cirurgia
Neoplasias Renais/cirurgia
Masculino
Pilotos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


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[PMID]:29390512
[Au] Autor:Kelkar AH; Jacob KS; Yousif EB; Farrell JJ
[Ad] Endereço:Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL.
[Ti] Título:Venous thromboembolism related to cytomegalovirus infection: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9336, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job. DIAGNOSES: Computed tomography of the abdomen revealed PVT, which was managed initially by heparin infusion. Cefepime was ordered for broad-spectrum antibiotic management of sepsis and possible septic thrombosis. Further workup exposed elevated transaminases consistent with mild hepatitis without synthetic dysfunction and colonoscopy revealed colitis. A comprehensive evaluation for liver disease was notable for a markedly elevated ferritin level. Spiking fevers and neutrophilia persisted for several days despite empiric antimicrobial treatment, but eventually resolved. The remainder of the workup was negative except for positive CMV IgM titer and viral load. This raised suspicion for a hypercoagulable state caused by CMV hepatitis with CMV-induced PVT. Heparin was transitioned to warfarin at the time of discharge. INTERVENTIONS: Given the patient's immunocompetent state and resolution of fevers, antiviral therapy for CMV infection was not initiated. OUTCOMES: The patient continued to improve with a normalization of the serum ferritin level and anticoagulation therapy was stopped after 6 months. LESSONS: There is mounting support for infectious causes of venous thromboembolism (VTE) based on existing molecular biology and clinical research. Meta-analysis of existing data showed that between 1.9% and 9.1% of patients hospitalized with VTE had concurrent acute CMV infection. Theoretical mechanisms for this association include transient formation of antiphospholipid antibodies, transient formation of antibodies targeting CMV capsule phospholipids with procoagulant properties, and direct infection of the endothelial cells. We hope this case will serve as a reminder to consider CMV as a transient cause of PVT and VTE, particularly in light of 2016 guidelines for unprovoked VTE recommending lifelong anticoagulation. We also plan to prospectively study the association of unprovoked VTE and acute CMV infection in our own hospital system.
[Mh] Termos MeSH primário: Infecções por Citomegalovirus/complicações
Veia Porta
Tromboembolia Venosa/virologia
[Mh] Termos MeSH secundário: Anticoagulantes/uso terapêutico
Fadiga/etiologia
Hepatite Viral Humana/complicações
Hepatite Viral Humana/virologia
Seres Humanos
Masculino
Meia-Idade
Pilotos
Tromboembolia Venosa/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009336


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[PMID]:28818147
[Au] Autor:Laukkala T; Bor R; Budowle B; Sajantila A; Navathe P; Sainio M; Vuorio A
[Ti] Título:Attention-Deficit/Hyperactivity Disorder and Fatal Accidents in Aviation Medicine.
[So] Source:Aerosp Med Hum Perform;88(9):871-875, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms of inattention and/or hyperactivity-impulsivity that interfere with functioning and/or development. ADHD occurs in about 2.5% of adults. ADHD can be an excluding medical condition among pilots due to the risk of attentional degradation and therefore impact on flight safety. Diagnosis of ADHD is complex, which complicates aeromedical assessment. This study highlights fatal accident cases among pilots with ADHD and discusses protocols to detect its presence to help to assess its importance to flight safety. METHODS: To identify fatal accidents in aviation (including airplanes, helicopters, balloons, and gliders) in the United States between the years 2000 to 2015, the National Transportation Safety Board (NTSB) database was searched with the terms ADHD, attention deficit hyperactivity disorder, and attention deficit disorder (ADD). RESULTS: The NTSB database search for fatal aviation accidents possibly associated with ADHD yielded four accident cases of interest in the United States [4/4894 (0.08%)]. Two of the pilots had ADHD diagnosed by a doctor, one was reported by a family member, and one by a flight instructor. An additional five cases were identified searching for ADD [5/4894 (0.1%)]. Altogether, combined ADHD and ADD cases yielded nine accident cases of interest (0.18%). DISCUSSION: It is generally accepted by aviation regulatory authorities that ADHD is a disqualifying neurological condition. Yet FAA and CASA provide specific protocols for tailor-made pilot assessment. Accurate evaluation of ADHD is essential because of its potential negative impact on aviation safety.Laukkala T, Bor R, Budowle B, Sajantila A, Navathe P, Sainio M, Vuorio A. Attention-deficit/hyperactivity disorder and fatal accidents in aviation medicine. Aerosp Med Hum Perform. 2017; 88(9):871-875.
[Mh] Termos MeSH primário: Acidentes Aeronáuticos/mortalidade
Acidentes Aeronáuticos/estatística & dados numéricos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
Pilotos/psicologia
[Mh] Termos MeSH secundário: Medicina Aeroespacial
Feminino
Seres Humanos
Masculino
Fatores de Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4919.2017


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[PMID]:28818149
[Au] Autor:Hesselbrock RR
[Ti] Título:Cerebellar Infarction Presenting with Acute Vestibular Syndrome in Two U.S. Air Force Pilots.
[So] Source:Aerosp Med Hum Perform;88(9):880-883, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cerebellar infarction is an uncommon but serious cause of isolated acute vestibular symptoms, particularly in young, healthy individuals, and can easily be overlooked. We present two cases of cerebellar infarction in U.S. Air Force pilots, one of which occurred during flight. CASE REPORTS: A 41-yr-old man developed acute vertigo, disequilibrium, nausea, and headache, with progressive slow symptomatic improvement, and presented to medical attention 4 d after symptom onset. Brain magnetic resonance imaging showed right inferomedial cerebellar infarction. Echocardiography discovered patent foramen ovale and atrial septal aneurysm. A 40-yr-old man developed severe vertigo, nausea, and vomiting during initial aircraft descent. Head computed tomography scan was performed acutely and was normal. Initial assessment was benign paroxysmal positional vertigo. Brain magnetic resonance imaging 1 mo after symptom onset showed a small right inferior cerebellar infarction. Patent foramen ovale and bilateral atrial enlargement were seen on echocardiography. Both pilots made full neurological recoveries and were eventually returned to flight status. DISCUSSION: Central causes of isolated acute vestibular symptoms are uncommon and are often not considered in otherwise healthy individuals. Cerebellar infarction is one of these uncommon but increasingly recognized causes of acute vestibular symptoms. As evaluation and management of central causes are much different from peripheral conditions, prompt localization confirmation is paramount. Accurate evidence-based bedside screening methods are available for rapid localization. Awareness of the possibility of central etiologies and careful clinical evaluation with application of bedside screening methods in patients with acute vestibular symptoms will reduce the number of inaccurate diagnoses.Hesselbrock RR. Cerebellar infarction presenting with acute vestibular syndrome in two U.S. Air Force pilots. Aerosp Med Hum Perform. 2017; 88(9):880-883.
[Mh] Termos MeSH primário: Doenças Cerebelares/diagnóstico por imagem
Forame Oval Patente/diagnóstico por imagem
Infarto da Artéria Cerebral Média/diagnóstico por imagem
Militares
Pilotos
Doenças Vestibulares/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Doenças Cerebelares/tratamento farmacológico
Diagnóstico Diferencial
Seres Humanos
Infarto da Artéria Cerebral Média/tratamento farmacológico
Imagem por Ressonância Magnética
Masculino
Inibidores da Agregação de Plaquetas/uso terapêutico
Síndrome
Doenças Vestibulares/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4897.2017


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[PMID]:28818146
[Au] Autor:Kim MB; Kim HJ; Kim SH; Lee SH; Lee SH; Park WJ
[Ti] Título:Metabolic Syndrome and Cardio-Cerebrovascular Risk Disparities Between Pilots and Aircraft Mechanics.
[So] Source:Aerosp Med Hum Perform;88(9):866-870, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In the Republic of Korea Air Force, the health of pilots is strictly supervised, but there is comparatively not enough interest in aircraft mechanics' health. Among mechanics, who are heavily involved in military aircraft maintenance, the occurrence of sudden cardio-cerebrovascular diseases (CCVDs) is a possible risk factor during the maintenance process, which should be performed perfectly. METHODS: We performed health examinations on 2123 male aircraft pilots and 1271 aircraft mechanics over 30 yr of age and determined the prevalence of metabolic syndrome (MetS), an important risk factor for CCVDs. RESULTS: The prevalence of MetS in the aircraft mechanics (21.3%) was significantly higher than in the pilots (12.6%), and the gap in prevalence tended to grow as age increased. Among aircraft mechanics in their 30s and 40s, the prevalence of MetS was lower than in the general population. However, the prevalence of MetS among aircraft mechanics in their 50s (36.0%) was similar to that in the general population (35.7%). CONCLUSIONS: Systematic health management is needed for aircraft mechanics for aviation safety and for the maintenance of military strength via the prevention of CCVDs.Kim M-B, Kim H-J, Kim S-H, Lee S-H, Lee S-H, Park W-J. Metabolic syndrome and cardio-cerebrovascular risk disparities between pilots and aircraft mechanics. Aerosp Med Hum Perform. 2017; 88(9):866-870.
[Mh] Termos MeSH primário: Síndrome Metabólica/epidemiologia
Militares
Pilotos
[Mh] Termos MeSH secundário: Adulto
Medicina Aeroespacial
Doenças Cardiovasculares/epidemiologia
Transtornos Cerebrovasculares/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Prevalência
República da Coreia/epidemiologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4859.2017


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[PMID]:28818145
[Au] Autor:Guo Y; Ji M; You X; Huang J
[Ti] Título:Protective Effects of Emotional Intelligence and Proactive Coping on Civil Pilots' Mental Health.
[So] Source:Aerosp Med Hum Perform;88(9):858-865, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Pilots' mental health is an issue of crucial importance that may endanger flight safety. As such, it is of profound significance to address the question of what characteristics are protective of mental health among pilots. The present study aimed to explore the indirect effects of emotional intelligence (EI) on depression and anxiety via proactive coping, and examine the moderating role of previous flight experience (PFE) in the conditional indirect effect of EI on depression through proactive coping. METHODS: A cross-sectional regression design was used to measure EI (Trait Meta Mood Scale), proactive coping (Proactive Coping Scale), depression (The PHQ-9), and anxiety (The GAD-7) among 319 Chinese civil pilots from China Southern Airlines. Mediation and moderated mediation effects were explored using regression analyses and were confirmed by the bootstrapping approach. RESULTS: Pilots reported relatively low levels of depression (M = 0.39, SD = 0.24) and anxiety (M = 0.22, SD = 0.23). Married pilots had higher levels of depression (t = 2.46) and anxiety (t = 3.07) than single pilots. Proactive coping mediated the association between EI and depression (B = -0.25), as well as the relationship between EI and anxiety (B = -0.23). Moreover, conditional process analysis showed that PFE moderated the indirect effect of EI on depression through proactive coping (b3 = 0.005), in which simple slope analysis showed a stronger mediating effect for pilots with more PFE (simple slope = -0.14). DISCUSSION: The results showed that EI and proactive coping had protective potential in the prevention of depression and anxiety. Implications for the promotion of mental health and diminishing depression and anxiety among pilots are discussed.Guo Y, Ji M, You X, Huang J. Protective effects of emotional intelligence and proactive coping on civil pilots' mental health. Aerosp Med Hum Perform. 2017; 88(9):858-865.
[Mh] Termos MeSH primário: Adaptação Psicológica
Inteligência Emocional
Saúde Mental
Pilotos/psicologia
[Mh] Termos MeSH secundário: Adulto
Ansiedade/epidemiologia
China/epidemiologia
Estudos Transversais
Demografia
Depressão/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4799.2017


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[PMID]:28818142
[Au] Autor:Johannes B; Rothe S; Gens A; Westphal S; Birkenfeld K; Mulder E; Rittweger J; Ledderhos C
[Ti] Título:Psychophysiological Assessment in Pilots Performing Challenging Simulated and Real Flight Maneuvers.
[So] Source:Aerosp Med Hum Perform;88(9):834-840, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The objective assessment of psychophysiological arousal during challenging flight maneuvers is of great interest to aerospace medicine, but remains a challenging task. In the study presented here, a vector-methodological approach was used which integrates different psychophysiological variables, yielding an integral arousal index called the Psychophysiological Arousal Value (PAV). METHODS: The arousal levels of 15 male pilots were assessed during predetermined, well-defined flight maneuvers performed under simulated and real flight conditions. RESULTS: The physiological data, as expected, revealed inter- and intra-individual differences for the various measurement conditions. As indicated by the PAV, air-to-air refueling (AAR) turned out to be the most challenging task. In general, arousal levels were comparable between simulator and real flight conditions. However, a distinct difference was observed when the pilots were divided by instructors into two groups based on their proficiency in AAR with AWACS (AAR-Novices vs. AAR-Professionals). AAR-Novices had on average more than 2000 flight hours on other aircrafts. They showed higher arousal reactions to AAR in real flight (contact: PAV score 8.4 ± 0.37) than under simulator conditions (7.1 ± 0.30), whereas AAR-Professionals did not (8.5 ± 0.46 vs. 8.8 ± 0.80). DISCUSSION: The psychophysiological arousal value assessment was tested in field measurements, yielding quantifiable arousal differences between proficiency groups of pilots during simulated and real flight conditions. The method used in this study allows an evaluation of the psychophysiological cost during a certain flying performance and thus is possibly a valuable tool for objectively evaluating the actual skill status of pilots.Johannes B, Rothe S, Gens A, Westphal S, Birkenfeld K, Mulder E, Rittweger J, Ledderhos C. Psychophysiological assessment in pilots performing challenging simulated and real flight maneuvers. Aerosp Med Hum Perform. 2017; 88(9):834-840.
[Mh] Termos MeSH primário: Pilotos
Desempenho Psicomotor/fisiologia
Análise e Desempenho de Tarefas
[Mh] Termos MeSH secundário: Adulto
Medicina Aeroespacial
Nível de Alerta/fisiologia
Simulação por Computador
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4782.2017


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[PMID]:28814301
[Au] Autor:Gudmundsdottir EM; Hrafnkelsson J; Rafnsson V
[Ad] Endereço:Faculty of Medicine, University of Iceland, Reykjavik, Iceland. emg5@hi.is.
[Ti] Título:Incidence of cancer among licenced commercial pilots flying North Atlantic routes.
[So] Source:Environ Health;16(1):86, 2017 Aug 16.
[Is] ISSN:1476-069X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To evaluate cancer incidence among licenced commercial pilots in association with cosmic radiation. METHODS: Cohort study where ionizing radiation dose of cosmic radiation was estimated from airline data and software program and cancer incidence was obtained by record linkage with nation-wide cancer registry. All licenced commercial male airline pilots were followed from 1955 to 2015, ever or never employed at airline with international routes. Standardized incidence ratios were calculated and relative risk by Poisson regression, to examine exposure-response relation. RESULTS: Eighty three cancers were registered compared with 92 expected; standardized incidence ratios were 0.90 (95% CI 0.71 to 1.11) for all cancers, 3.31 (95% CI 1.33 to 6.81) for malignant melanoma, and 2.49 (95% CI 1.69 to 3.54), for basal cell carcinoma of skin. The risk for all cancers, malignant melanoma, prostate cancer, basal cell carcinoma of skin, and basal cell carcinoma of trunk increased with an increase in number of employment years, cumulative air hours, total cumulative radiation dose, and cumulative radiation dose sustained up to age of 40 years. The relative risk for the highest exposure categories of cumulative radiation dose were 2.42 (95% CI 1.50 to 3.92) for all cancers, 2.57 (95% CI 1.18 to 5.56) for prostate cancer, 9.88 (95% CI 1.57 to 190.78) for malignant melanoma, 3.61 (95% CI 1.64 to 8.48) for all basal cell carcinoma, and 6.65 (95% CI 1.61 to 44.64) for basal cell carcinoma of trunk. CONCLUSIONS: This study was underpowered to study brain cancer and leukaemia risk. Basal cell carcinoma of skin is radiation-related cancer, and may be attributed to cosmic radiation. Further studies are needed to clarify the risk of cancers in association with cosmic radiation, other workplace exposure, host factors, and leisure sun-exposure, as clothes, and glass in cockpit windows shield pilots from the most potent ultraviolet-radiation.
[Mh] Termos MeSH primário: Neoplasias/epidemiologia
Pilotos/estatística & dados numéricos
Radiação Ionizante
[Mh] Termos MeSH secundário: Adulto
Aeronaves
Oceano Atlântico
Estudos de Coortes
Seres Humanos
Islândia/epidemiologia
Incidência
Masculino
Meia-Idade
Neoplasias/etiologia
Risco
Raios Ultravioleta/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1186/s12940-017-0295-4


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[PMID]:28772091
[Au] Autor:Linakis MW; Job KM; Liu X; Collingwood SC; Pangburn HA; Ott DK; Sherwin CMT
[Ad] Endereço:a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA.
[Ti] Título:Riding (High) into the danger zone: a review of potential differences in chemical exposures in fighter pilots resulting from high altitude and G-forces.
[So] Source:Expert Opin Drug Metab Toxicol;13(9):925-934, 2017 Sep.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: When in flight, pilots of high performance aircraft experience conditions unique to their profession. Training flights, performed as often as several times a week, can expose these pilots to altitudes in excess of 15 km (~50,000 ft, with a cabin pressurized to an altitude of ~20,000 ft), and the maneuvers performed in flight can exacerbate the G-forces felt by the pilot. While the pilots specifically train to withstand these extreme conditions, the physiologic stress could very likely lead to differences in the disposition of chemicals in the body, and consequently, dangerously high exposures. Unfortunately, very little is known about how the conditions experienced by fighter pilots affects chemical disposition. Areas covered: The purpose of this review is to present information about the effects of high altitude, G-forces, and other conditions experienced by fighter pilots on chemical disposition. Using this information, the expected changes in chemical exposure will be discussed, using isopropyl alcohol as an example. Expert opinion: There is a severe lack of information concerning the effects of the fighter pilot environment on the pharmacokinetics and pharmacodynamics of chemicals. Given the possibility of exposure prior to or during flight, it is important that these potential effects be investigated further.
[Mh] Termos MeSH primário: Altitude
Doenças Profissionais/fisiopatologia
Pilotos
[Mh] Termos MeSH secundário: 2-Propanol/envenenamento
Aeronaves
Animais
Gravitação
Seres Humanos
Exposição Ocupacional/efeitos adversos
Estresse Fisiológico/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
ND2M416302 (2-Propanol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2017.1360867


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[PMID]:28720186
[Au] Autor:Steinman Y; van den Oord MHAH; Frings-Dresen MHW; Sluiter JK
[Ti] Título:Flight Performance During Exposure to Acute Hypobaric Hypoxia.
[So] Source:Aerosp Med Hum Perform;88(8):760-767, 2017 Aug 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The purpose of the present study was to examine the influence of hypobaric hypoxia (HH) on a pilot's flight performance during exposure to simulated altitudes of 91, 3048, and 4572 m (300, 10,000, and 15,000 ft) and to monitor the pilot's physiological reactions. METHOD: In a single-blinded counter-balanced design, 12 male pilots were exposed to HH while flying in a flight simulator that had been placed in a hypobaric chamber. Flight performance of the pilots, pilot's alertness level, Spo2, heart rate (HR), minute ventilation (VE), and breathing frequency (BF) were measured. RESULTS: A significant difference was found in Flight Profile Accuracy (FPA) between the three altitudes. Post hoc analysis showed no significant difference in performance between 91 m and 3048 m. A trend was observed at 4572 m, suggesting a decrease in flight performance at that altitude. Significantly lower alertness levels were observed at the start of the flight at 4572 m compared to 91 m, and at the end of the flight at 4572 m compared to the start at that altitude. Spo2 and BF decreased, and HR increased significantly with altitude. DISCUSSION: The present study did not provide decisive evidence for a decrease in flight performance during exposure to simulated altitudes of 3048 and 4572 m. However, large interindividual variation in pilots' flight performance combined with a gradual decrease in alertness levels observed in the present study puts into question the ability of pilots to safely fly an aircraft while exposed to these altitudes without supplemental oxygen.Steinman Y, van den Oord MHAH, Frings-Dresen MHW, Sluiter JK. Flight performance during exposure to acute hypobaric hypoxia. Aerosp Med Hum Perform. 2017; 88(8):760-767.
[Mh] Termos MeSH primário: Altitude
Pressão Atmosférica
Frequência Cardíaca
Hipóxia/fisiopatologia
Pilotos
Ventilação Pulmonar
Taxa Respiratória
Análise e Desempenho de Tarefas
Vigília
[Mh] Termos MeSH secundário: Adulto
Medicina Aeroespacial
Aeronaves
Seres Humanos
Hipóxia/psicologia
Masculino
Treinamento por Simulação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4789.2017



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