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Flight medic

Alex J Krotulski, Amanda L A Mohr, Donna M Papsun, Barry K Logan
The number of emerging novel stimulants modified based on beta-keto variations of amphetamine-like substances continues to rise. Dibutylone reports described in the medical and toxicological literature are limited, therefore little information is available in terms of quantitative confirmation or metabolism. During this study, authentic human specimens, including blood, urine, vitreous humor, oral fluid and liver were quantitatively and qualitatively analyzed for the presence of dibutylone and butylone, with paired case history and demographic information...
March 15, 2018: Journal of Analytical Toxicology
Derek Wakeman, Max R Langham
The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties...
April 2018: Seminars in Pediatric Surgery
Yangyang Xu, Hao Cai, Gang Cao, Yu Duan, Ke Pei, Sicong Tu, Jia Zhou, Li Xie, Dongdong Sun, Jiayu Zhao, Jing Liu, Xiaoqi Wang, Lin Shen
Baizhu Shaoyao San (BSS) is a famous traditional Chinese medicinal formula widely used for the treatment of painful diarrhea, intestinal inflammation, and diarrhea-predominant irritable bowel syndrome. According to clinical medication, three medicinal herbs (Atractylodis Macrocephalae Rhizoma, Paeoniae Radix Alba, and Citri Reticulatae Pericarpium) included in BSS must be processed using some specific methods of stir-frying. On the basis of the classical theories of traditional Chinese medicine, the therapeutic effects of BSS would be significantly enhanced after processing...
March 3, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Kota Asakura, Takuya Azechi, Hiroshi Sasano, Hidehito Matsui, Hideaki Hanaki, Motoyasu Miyazaki, Tohru Takata, Miwa Sekine, Tomoiku Takaku, Tomonori Ochiai, Norio Komatsu, Keigo Shibayama, Yuki Katayama, Koji Yahara
Vancomycin-intermediately resistant Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) are associated with treatment failure. hVISA contains only a subpopulation of cells with increased minimal inhibitory concentrations, and its detection is problematic because it is classified as vancomycin-susceptible by standard susceptibility testing and the gold-standard method for its detection is impractical in clinical microbiology laboratories. Recently, a research group developed a machine-learning classifier to distinguish VISA and hVISA from vancomycin-susceptible S...
2018: PloS One
Claudia R Gerstle
Aviation and healthcare are complex industries and share many similarities: the cockpit and the operating theater, the captain and the surgeon. While North American commercial aviation currently enjoys a tremendous safety record, it was not always this way. A spike of accidents in 1973 caused 3214 aviation-related fatalities. Over the past 20years, the rate of fatal accidents per million flights fell by a factor of five, while air traffic increased by more than 86%. There have been no fatalities on a U.S. carrier for over 12years...
February 8, 2018: Journal of Pediatric Surgery
Sara Faccidomo, Katarina S Swaim, Briana L Saunders, Taruni S Santanam, Seth M Taylor, Michelle Kim, Grant T Reid, Vallari R Eastman, Clyde W Hodge
RATIONALE: There is a clear need for discovery of effective medications to treat behavioral pathologies associated with alcohol addiction, such as chronic drinking. OBJECTIVE: The goal of this preclinical study was to assess effects of chronic alcohol drinking on the nucleus accumbens (NAcb) proteome to identify and validate novel targets for medications development. MATERIALS AND METHODS: Two-dimensional difference in-gel electrophoresis (2D-DIGE) with matrix-assisted laser desorption ionization tandem time-of-flight (MALDI-TOF/TOF) was used to assess effects of chronic voluntary home-cage (24-h access) alcohol drinking on the NAcb proteome of C57BL/6J mice...
March 3, 2018: Psychopharmacology
Sissel Kramer Aagaard, Agnete Larsen, Mette Findal Andreasen, Iana Lesnikova, Rasmus Telving, Anna Louise Vestergaard, Niels Tørring, Niels Uldbjerg, Pinar Bor
OBJECTIVE: The aim of this study was to investigate the prevalence of xenobiotic substances, such as caffeine, nicotine and illicit drugs (eg, cannabis and cocaine), in blood samples from first-trimester Danish pregnant women unaware of the screening. DESIGN: A cross - sectional study examined 436 anonymised residual blood samples obtained during 2014 as part of the nationwide prenatal first-trimester screening programme. The samples were analysed by ultra performance liquid chromatography with high-resolution time-of-flight mass spectrometry...
March 3, 2018: BMJ Open
Olivier Mortelé, Philippe Vervliet, Celine Gys, Maarten Degreef, Matthias Cuykx, Kristof Maudens, Adrian Covaci, Alexander L N van Nuijs, Foon Yin Lai
Designer benzodiazepines have recently emerged as a class of new psychoactive substances. These substances are used in recreational settings and as alternatives to prescription benzodiazepines as self-medication for patients suffering from anxiety or other mental disorders. Due to the limited information available on the metabolic fate of these new substances, it is challenging to reliably detect their usage in bioanalytical (e.g. clinical and forensic) settings. The objective of this study was to investigate the in vitro Phase I and Phase II metabolism of the new designer benzodiazepine cloniprazepam and identify potential biomarkers for its detection in human biological fluids...
February 21, 2018: Journal of Pharmaceutical and Biomedical Analysis
Philip Pallmann, Alun W Bedding, Babak Choodari-Oskooei, Munyaradzi Dimairo, Laura Flight, Lisa V Hampson, Jane Holmes, Adrian P Mander, Lang'o Odondi, Matthew R Sydes, Sofía S Villar, James M S Wason, Christopher J Weir, Graham M Wheeler, Christina Yap, Thomas Jaki
Adaptive designs can make clinical trials more flexible by utilising results accumulating in the trial to modify the trial's course in accordance with pre-specified rules. Trials with an adaptive design are often more efficient, informative and ethical than trials with a traditional fixed design since they often make better use of resources such as time and money, and might require fewer participants. Adaptive designs can be applied across all phases of clinical research, from early-phase dose escalation to confirmatory trials...
February 28, 2018: BMC Medicine
David Kodama, Bobby Yanagawa, Jim Chung, Ken Fryatt, Alun D Ackery
No abstract text is available yet for this article.
February 26, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Joël Israëls, Ad F Nagelkerke, Dick G Markhorst, Marc van Heerde
The number of children on commercial aircrafts is rising steeply and poses a need for their treating physicians to be aware of the physiologic effects and risks of air travel. The most important risk factors while flying are a decrease in partial oxygen pressure, expansion of trapped air volume, low cabin humidity, immobility, recirculation of air and limited options for medical emergencies. Because on-board medical emergencies mostly concern exacerbations of chronic disease, the medical history, stability of current disease and previous flight experience should be assessed before flight...
February 26, 2018: European Journal of Pediatrics
Marcy Phipps, Virginia Conley, William H Constantine
INTRODUCTION: Despite the prevalence of fixed wing medical flights for specialized care and repatriation, few acuity rating scales exist aimed at the prediction of adverse in-flight medical events. An acuity scoring system can provide information to flight crews, allowing for staffing enhancements, protocol modifications, and flight planning, with the aim of improving patient care, outcomes, and preventing losses to providers because of costly diversions. METHODS: Our medical crew developed an acuity scale, which was applied retrospectively to 296 patients transported between January 2016 and March 2017...
March 2018: Air Medical Journal
Marc P Dotson, Mark L Gustafson, Alfred Tager, Leslie M Peterson
OBJECTIVE: Simulation training is an integral part of the training of medical personnel. However, there are limited data on the use of simulation in the training of helicopter emergency medical services (HEMS). METHODS: In this study, we retrospectively compared the number of orientation flights needed to be released to a full crewmember and the cost of training in an air medical flight academy before and after implementation of a high-fidelity air medical simulator...
March 2018: Air Medical Journal
Youichi Yanagawa, Kouhei Ishikawa, Ikuto Takeuchi, Hiroki Nagasawa, Kei Jitsuiki, Hiromichi Ohsaka, Kazuhiko Omori
The local fire department executed a training simulation for chemical and explosive incidents at a large sports facility. In this training simulation, a physician-staffed helicopter arrived at the request of the fire department and landed just outside the cold zone in the parking area. The doctor and nurse of the helicopter were escorted to a red area in the cold zone, which was selected based on the results of postdecontamination triage. After the patients had been treated, they were air medically evacuated to the base hospital...
March 2018: Air Medical Journal
Brian Wilkinson, James Garwood, Stephen Langford
OBJECTIVE: Patients can be transferred many hundreds of kilometers with acute mental health disturbance for specialist mental health services in Western Australia. METHODS: A retrospective notes review of Royal Flying Doctor Service Western Operations records was undertaken over a 4-month period. Patients were identified from the transfer database by mental health diagnosis. Benzodiazepine and antipsychotic doses were converted into a reference drug per class for comparison...
March 2018: Air Medical Journal
Khader M Hasan, Benson Mwangi, Zafer Keser, Roy Riascos, Ashot E Sargsyan, Larry A Kramer
BACKGROUND AND PURPOSE: As part of its technological sophistication, the International Space Station (ISS) Program operates a robust medical surveillance schedule for its rotating 6-person crew to control the known health risks and to address knowledge gaps related to human health in space flight environment. Recent evidence on visual impairment in a subset of ISS crew has renewed the interest in the effects of long-duration space flight on the central nervous system (CNS). Through retrospective analysis in a sample of 10 healthy astronauts, we demonstrate the utility of multimodal quantitative magnetic resonance imaging (qMRI) with diffusion tensor imaging (DTI)-based customized brain templates to examine the structural attributes of various CNS compartments in this occupational group...
February 20, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Basma El Hamzaoui, Maureen Laroche, Lionel Almeras, Jean Michel Bérenger, Didier Raoult, Philippe Parola
BACKGROUND: Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has recently emerged in the field of entomology as a promising method for the identification of arthropods and the detection of associated pathogens. METHODOLOGY/PRINCIPAL FINDINGS: An experimental model of Ctenocephalides felis (cat fleas) infected with Bartonella quintana and Bartonella henselae was developed to evaluate the efficacy of MALDI-TOF MS in distinguishing infected from uninfected fleas, and its ability to distinguish fleas infected with Bartonella quintana from fleas infected with Bartonella henselae...
February 16, 2018: PLoS Neglected Tropical Diseases
Irene M L W Körver-Keularts, Ping Wang, Huub W A H Waterval, Leo A J Kluijtmans, Ron A Wevers, Claus-Dieter Langhans, Camilla Scott, Daphna D J Habets, Jörgen Bierau
Since organic acid analysis in urine with gaschromatography-mass spectrometry (GC-MS) is a time-consuming technique, we developed a new liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) method to replace the classical analysis for diagnosis of inborn errors of metabolism (IEM). Sample preparation is simple and experimental time short. Targeted mass extraction and automatic calculation of z-scores generated profiles characteristic for the IEMs in our panel consisting of 71 biomarkers for defects in amino acids, neurotransmitters, fatty acids, purine, and pyrimidine metabolism as well as other disorders...
February 12, 2018: Journal of Inherited Metabolic Disease
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Martin Körsgen, Bonnie J Tyler, Marcel Heeger, Moritz Buhl, Heinrich F Arlinghaus
The use of time-of-flight secondary ion mass spectrometry (SIMS) is of increasing interest for biological and medical applications due to its ability to provide chemical information on a submicrometer scale. However, the detection of larger biomolecules such as phospholipids and peptides is often inhibited by high fragmentation rates and low ionization efficiencies. One way to increase the secondary ion molecular yield is to chemically modify the surface using the matrix-enhanced SIMS approach, where an organic matrix is placed upon the surface...
February 8, 2018: Biointerphases
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