Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.862
Filtrar
1.
Wilderness Environ Med ; 31(1): 110-115, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32734896

RESUMO

We developed an elective course titled Medicine in Extreme Environments (MEE) at the University of Texas Southwestern Medical Center for first- and second-year medical students. This course covered physiology, research, clinical practice, and career guidance regarding the fields of wilderness, space, hyperbaric, combat, and exercise medicine. The primary aim was to generate interest in and awareness of these seldom covered fields of medicine by exposing medical students to these disciplines during their preclinical years. A postcourse questionnaire was implemented to investigate whether the MEE course increased awareness of, interest in, and knowledge in the fields of medicine included in the curriculum. Through 2 iterations of the class, a total of 67 students enrolled in the course, and 38 students completed the questionnaire. After course completion, 95% felt they better understood the work and lifestyle of the fields covered, 100% learned more about concepts of each field, and 74% agreed that the elective influenced the direction of their future careers to include some part of the fields emphasized. Although only a limited number of students enrolled in this course, these initial findings suggest that the MEE curriculum may have some utility in promoting awareness of and interest in these medical disciplines among students who attend the course. With continued student and faculty support, this course will likely be continued annually at our institution. We believe that certain aspects of this course may be useful in helping develop similar courses at other medical schools.


Assuntos
Medicina Aeroespacial/educação , Educação Médica/organização & administração , Terapia por Exercício/educação , Ambientes Extremos , Oxigenação Hiperbárica , Medicina Militar/educação , Medicina Selvagem/educação , Conflitos Armados , Humanos , Meio Selvagem
2.
Air Med J ; 39(4): 251-256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32690299

RESUMO

Recent coronavirus disease 2019 (COVID-19) events have presented challenges to health care systems worldwide. Air medical movement of individuals with potential infectious disease poses unique challenges and threats to crews and receiving personnel. The US Department of Health and Human Services air medical evacuation teams of the National Disaster Medical System directly supported 39 flights, moving over 2,000 individuals. Infection control precautions focused on source and engineering controls, personal protective equipment, safe work practices to limit contamination, and containment of the area of potential contamination. Source control to limit transmission distance was used by requiring all passengers to wear masks (surgical masks for persons under investigation and N95 for known positives). Engineering controls used plastic sheeting to segregate and treat patients who developed symptoms while airborne. Crews used Tyvek (Dupont Richmond, VA) suits with booties and a hood, a double layer of gloves, and either a powered air-purifying respirator or an N95 mask with a face shield. For those outside the 6-ft range, an N95 mask and gloves were worn. Safe work practices were used, which included mandatory aircraft surface decontamination, airflow exchanges, and designated lavatories. Although most patients transported were stable, to the best of our knowledge, this represents the largest repatriation of potentially contagious patients in history without infection of any transporting US Department of Health and Human Services air medical evacuation crews.


Assuntos
Medicina Aeroespacial , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Transporte de Pacientes/métodos , Betacoronavirus , China , Infecções por Coronavirus/terapia , Medicina de Desastres , Desinfecção , Equipamentos e Provisões , Governo Federal , Pessoal de Saúde , Humanos , Eliminação de Resíduos de Serviços de Saúde , Isolamento de Pacientes/métodos , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Pneumonia Viral/terapia , Quarentena/métodos , Navios , Estados Unidos , United States Dept. of Health and Human Services
9.
PLoS One ; 15(6): e0234361, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32525946

RESUMO

Artificial gravity elicited through short-arm human centrifugation combined with physical exercise, such as jumping, is promising in maintaining health and performance during space travel. However, motion sickness symptoms could limit the tolerability of the approach. Therefore, we determined the feasibility and tolerability, particularly occurrence of motion sickness symptoms, during reactive jumping exercises on a short-arm centrifuge. In 15 healthy men, we assessed motion sickness induced by jumping exercises during short-arm centrifugation at constant +1Gz or randomized variable +0.5, +0.75, +1, +1.25 and +1.5 Gz along the body axis referenced to center of mass. Jumping in the upright position served as control intervention. Test sessions were conducted on separate days in a randomized and cross-over fashion. All participants tolerated jumping exercises against terrestrial gravity and on the short-arm centrifuge during 1 Gz or variable Gz at the center of mass without disabling motion sickness symptoms. While head movements markedly differed, motion sickness scores were only modestly increased with jumping on the short-arm centrifuge compared with vertical jumps. Our study demonstrates that repetitive jumping exercises are feasible and tolerable during short-arm centrifugation. Since jumping exercises maintain muscle and bone mass, our study enables further development of exercise countermeasures in artificial gravity.


Assuntos
Centrifugação/efeitos adversos , Gravidade Alterada/efeitos adversos , Enjoo devido ao Movimento/etiologia , Voo Espacial , Adaptação Fisiológica , Adulto , Medicina Aeroespacial , Centrifugação/instrumentação , Exercício Físico/fisiologia , Gravitação , Movimentos da Cabeça/fisiologia , Voluntários Saudáveis , Humanos , Masculino , Enjoo devido ao Movimento/fisiopatologia , Enjoo devido ao Movimento/prevenção & controle , Contramedidas de Ausência de Peso , Adulto Jovem
11.
Urology ; 137: 12, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32115062
15.
Ergonomics ; 63(4): 399-406, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31957600

RESUMO

Instrument and night flights are sources of mishaps: they produce stressful contexts to aircrews in which operability can be affected. This study aimed to analyse the effect of night and instrument flights in cortical arousal, autonomic modulation, muscle strength, and stress perception. 23 people were analysed (8 helicopter pilots, 4 helicopter mechanics - Spanish Air Forces - and 11 controls) before and after instrument and night flight exposition. Lactate and perceived exertion rose after flights. Anxiety was higher in instrument than in night flights. Pilots had a higher sense of anxiety before a flight compared to mechanics, although mechanics experienced a higher raise of heart rate during flight, with lower heart rate variability. Breath capacity was affected in pilots. Cortical arousal was more affected in unexperienced than in experienced aircrew during flights. These data suggest differences in their previous training. Practitioner summary: Night and instrument helicopter flights produced a different psychophysiological response of aircrew. These results could help to design specific training for aircrew that usually face instrument and night manoeuvres. Specific training based on high-intensity interval training integrated with reverse periodisation could improve their preparation. Abbreviations: BMI: body mass index; BOS: blood oxygen saturation; BT: body temperature; CA: cognitive anxiety; CFFT: critical flicker fusion threshold; ES: effect size; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; HF: high frequency; HR: heart rate; HRV: heart rate variability; HIS: isometric handgrip strength; LF: low frequency; NVG: night vision googles; PEF: peak expiratory flow; pNN50: proportion of differences between R-R intervals higher than 50 ms; RMSSD: square root of the mean of the sum of the squared differences between adjacent normal R-R intervals; RPE: rated of perceived exertion; SA: somatic anxiety; SC: self confidence; STAI: state trait anxiety inventory.


Assuntos
Aeronaves , Ansiedade , Nível de Alerta , Militares/psicologia , Força Muscular , Estresse Psicológico , Adulto , Medicina Aeroespacial , Aviação , Escuridão , Humanos , Masculino , Oximetria , Testes de Função Respiratória , Inquéritos e Questionários , Sinais Vitais
16.
J Urol ; 203(5): 991-995, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31821067

RESUMO

PURPOSE: In-flight medical events are rare but may cause significant distress as access to care is limited. There is a paucity of data on in-flight urological medical events. We describe urological in-flight medical emergencies and report clinical and flight outcomes. MATERIALS AND METHODS: We reviewed all in-flight urological medical emergencies between 2015 and 2017 from MedAire®, a ground based medical support center that provides remote medical advisory services to approximately 35% of commercial airline passenger traffic worldwide. Our primary end point was the incidence rates of in-flight urological medical events. We also characterized the types of in-flight medical emergencies, in-flight management and their impact on flight status. Statistical analyses included Student's t-tests, chi-square analysis and analysis of variance. RESULTS: We identified 1,368 (1%) urological in-flight medical emergencies from a total of 138,612 in-flight medical emergencies, with an incidence of 0.5 per million passengers. The most common in-flight medical emergencies were lower urinary tract symptoms (35%), urinary retention (30%) and flank pain (21%). Among in-flight medical emergencies 883 (60%) resolved in flight, 273 (28%) required on-arrival medical evaluation and 21 (1.5%) resulted in flight diversions. Of the flight diversions the majority were due to urinary retention (12, 57%) and less commonly flank pain (6, 28%) and testicular/abdominal pain (3, 15%). CONCLUSIONS: The most common causes of urological in-flight medical emergencies are lower urinary tract symptoms, urinary retention and renal colic, the majority of which resolved in flight. These data are useful for informing flight personnel and emergency kit equipment needs to minimize the impact of these events when they occur.


Assuntos
Medicina Aeroespacial/estatística & dados numéricos , Aeronaves , Emergências/epidemiologia , Viagem , Triagem/organização & administração , Doenças Urológicas/epidemiologia , Adulto , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças Urológicas/diagnóstico
20.
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA