Tricyclic Antidepressants Found in Pilots Fatally Injured in Civil Aviation Accidents.

Prevalence of tricyclic antidepressants (TCAs) has not been explored in pilots. The National Transportation Safety Board (NTSB) aviation accident and the Federal Aviation Administration's Civil Aerospace Medical Institute (CAMI) toxicology and medical certification databases were searched for pilots fatally injured in aviation accidents. During 1990-2012, CAMI received bio-samples of pilots from 7037 aviation accidents. Of these, 2644 cases were positive for drugs. TCAs were present in 31. TCA blood concentrations ranged from therapeutic to toxic levels. The NTSB determined that the use of drugs and ethanol as the probable cause or contributing factor in 35% (11 of 31) of the accidents. None of the 31 pilots reported the use of TCAs during their aviation medical examination. The prevalence of TCAs in aviators was less than 0.5% (31 of 7037 cases). There is a need for aviators to fully disclose the use of medications at the time of their medical examination.

Potential benefits of hyperbaric oxygen therapy on atherosclerosis and glycaemic control in patients with diabetic foot.

INTRODUCTION: The aim of this study was to investigate the effects of hyperbaric oxygen therapy (HBOT) on glycaemic control, atherosclerosis, inflammatory markers, and other clinical and laboratory parameters in patients undergoing systemic HBOT for diabetic foot ulcerations. MATERIAL AND METHODS: Twenty-eight patients with Wagner grade 2-4 diabetic foot ulcerations were included. All patients were given 100% oxygen at 2.4 absolute atmosphere (ATA) for about 105 minutes, five times a week for a total of 30 sessions. Fasting blood glucose (FBG), haemoglobin A1c (HbA1c), homeostasis model measurement-insulin resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP), uric acid, mean platelet volume (MPV), complete blood count, and lipid profile were tested. RESULTS: Upon completion of treatment, a statistically significant improvement was observed in the mean values of all assessed parameters. CONCLUSIONS: HBOT was shown to have beneficial effects on atherosclerosis and glycaemic control in diabetic patients. Further large-scale randomized studies are needed to study the systemic effects of HBOT.