[Sarcoidosis in flying personnel]. / Sarkoisoz u letnogo sostava.

The 10-year database of the Central military clinical aviation hospital was used to analyze protocols of medical discharge of military flyers with sarcoidosis in comparison to other respiratory pathologies. Consideration was given to the pathology incipience, age specifics, and diagnostic pitfalls. Self-descriptiveness of the diagnostic methods was compared and effectiveness of various therapeutic courses was evaluated. Conclusions of the analysis were embodied in a clinical-therapeutic-certification algorithm for dynamic sarcoidosis prediction in flying personnel.

[Analysis of the causes of loss of tolerance to standard G-loads by fighter pilots]. / Analiz prichin ponizheniia ustoichiivosti k ékspertnym peregruzkam letchikov istrebitel'noi aviatsii.

Analytical treatment has been given to causes for the loss of tolerance to radial accelerations by fighter pilots subjected to clinical tests during flight medical certification in recent years. The diagnostic necessity of implementation of additional tests by this cohort of pilots has been demonstrated and methods to improve pilots' cardiovascular adaptability to g-loads during the inpatient medical examination have been proposed.

[Objective diagnosis of cardiac ischemic disease in pilots]. / Ob"ektivizatsiia ishemicheskoi bolezni serdtsa u letchikov.

Reviewed was specifics of diagnostics of the cardiac ischemic disease (CID) in pilots. It was stated that pilots develop CID at an earlier age and incidence of the disease rises with the period of employment. Frequently, CID proceeds asymptomatically posing problems to diagnostics and a thread to flight safety. In this context, the medical flight cetification should largely rely on verifying the diagnostic methods, coronary angiography in the first place. Indications and contraindications to the clinical and flight certification applications have been determined and made the core of a rational plan for early CID detection in flying personnel.

[A method increasing G-tolerance of fighters' pilots with symptoms of the partial cardiovascular deficiency]. / Metod povysheniia ustoichivosti k peregruzkam letchikov istrebitel'noi aviatsii s iavleniiami partsial'noi nedostatochnosti serdechno-sosudistoi sistemy.

Training on the static ergometer was shown to increase tolerance of fighters' pilots for radial accelerations. Proposed is a program of training on the static ergometer consisting of two incremental loads in the interval between 120 and 240 kgf. In persons with cardiac pathologies this training program noticeably improved parameters of the cardiovascular adaptive reaction to static loads. Effectiveness, technical simplicity and low cost of the training are the attributes that can insure it a proper place in the rehabilitative treatment of pilots prior to or during the institutional examination as a part of the medical flight certification.

[Prognostic evaluation of the flying longevity of pilots with idiopathic mitral valve prolapse]. / Prognosticheskaia otsenka letnogo dolgoletiia u letchikov s idiopaticheskim prolapsom mitral'nogo klapana.

In the period of 1995-2001, 576 17- to 49-yr. old pilots of fighters and fighter-bombers with the idiopathic mitral valve prolapse (IMVP) were investigated at the Seventh Central military aviation clinical hospital. In this group, a very feebly marked mitral valve prolapse was found in 98.7% of cases. In 96.7% class-1 IMVP was accompanied by a mitral reguragitation, most often the first-degree one. Based on results of comprehensive examination, medically qualified to fly were 560 out of 576 pilots from the main group (97.0%) and 144 out of 150 pilots from the group of control (97.2%). In the next 5 years the flying career was continued by 76.3% and 78.7% of the pilots, respectively. A clinical-diagnostic and expert algorithm for medical certification of pilots of highly maneuverable aircraft with IMVP was developed which will reduce time of in-hospital medical certification and facilitate more accurately determination of the criteria for immediate and long-range estimation of the flying longevity.

[Classification of myocardial dystrophies in aviation medical certification]. / Klassifikatsiia miokardiodistrofii v praktike vrachebno-letnoi ékspertizy.

Myocardial dystrophy is one of the most common noncoronary lesions of the myocardium in pilots. However, the abundance of proposed classifications of myocardial dystrophies poses certain problems to medical experts. The authors attempt to consider the existing classifications from the standpoint of aviation medical certification and advocate the most acceptable, to their thinking, systematics by N.P. Paleev and L.I.Levitina (1991). Examples of establishing diagnoses of myocardial dystrophy are included. The best suited program for the aviation medical certification board to work out the final statement regarding the occupational fitness of pilots with myocardial dystrophy is proposed.

[Myocardiodystrophy in flight personnel]. / Miokardiodistrofiia u lits letnogo sostava.

Presented are results of the review of 150 case records of pilots with myocardial dystrophies of various geneses. Analysis of the most informative clinical instrumental techniques for diagnosing myocardial dystrophy pointed out electrocardiography (the most typical ECG indications of this nosologic form are exemplified). The outgrowth of this analysis is an algorithm for diagnosing myocardial dystrophy in pilots.

[Characteristics of clinical course of myocardial infarct in pilots]. / Osobennosti klinicheskogo techeniia infarkta miokarda u letchikov.

Review of case histories of 10 pilots treated for extensive myocardial infarction revealed that before manifestation of the disease each of them had been qualified by Flight Certification Boards. When compared with the control group, more often than not the clinical progress of disease was characterized by absence of anginal anamnesis in the past. Moreover, spurious negative results of the veloergometer test were also a matter of fact. This circumstance must be considered in the practice of flight certification examination and upgrading the procedures of functional testing the flight personnel.

[Diagnosis of cardiac rhythm disorders in pilots using 24-hour ECG monitoring]. / Diagnostika narushenii ritma serdtsa u lits letnogo sostava s ispol'zovaniem 24-chasovogo monitorirovaniia elektro-kardiogrammy.

As a result of comprehensive examinations of 57 pilots, aged 31 to 50 years, which included multi-step bicycle ergometry, specific tests simulating flight effects (e.g., positive pressure breathing, moderate hypoxia, radial acceleration) and 24-hour Holter monitoring, various cardiac arrhythmias were identified in 37 subjects (64.9%). They included supraventricular ectopic beats and ventricular ectopic beats of different grades. It was demonstrated that Holter monitoring was very reliable in comparison with conventional methods such as ECG at rest, bicycle ergometry or specific tests. In 5 cases, transient cardiac arrhythmias were associated with ischemic heart disease manifestations. The method of Holter monitoring is recommended to be used in medical expertise of the aircraft personnel.