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Biomedical subjects

F W Rudge

Publications and source records attributed to F W Rudge.

At least 19 recordsLinked to original sources
PubMed1996

Autosomal dominant polycystic kidney disease and hypertension in the aviator.

Autosomal dominant polycystic kidney disease is a relatively common familial disorder which frequently affects multiple organ systems. The condition is associated with hypertension, cardiac valvular abnormalities, cerebral berry aneurysms, and chronic renal failure. We describe an aviator with a long history of hypertension that was found to be due to autosomal dominant polycystic kidney disease. Following an extensive evaluation, he was found capable of continuation of flying duties. The epidemiology, pathogenesis, diagnosis, evaluation, and aeromedical implications of autosomal dominant polycystic kidney disease in an aviator are discussed.

Adult↗
PubMed1996

From the aerospace medicine residents' teaching file.

A pilot presented with a 2-month history of dysgeusia following treatment for sinusitis. This was accompanied by a 30-lb weight loss due to the abnormal taste of most foods. An extensive evaluation failed to demonstrate a cause for the malady. The clinical course and diagnostic evaluation were consistent with a diagnosis of idiopathic dysgeusia. The clinical presentation, evaluation, and diagnosis of a pilot with dysgeusia are discussed.

Adult↗
PubMed1995

Decompression sickness in a private pilot.

Although safe, civil aviation can result in some unique medical problems. Most physicians are not familiar with aviation-related medical problems. One such problem, decompression sickness, is not mentioned in most medical texts, and is not included in most medical school instruction. If not promptly recognized and treated, decompression sickness can result in permanent disability or death. I report a case of altitude-induced decompression sickness after a flight in an unpressurized aircraft.

Aerospace Medicine↗
PubMed1995

A review of articles published in Aviation, Space, and Environmental Medicine, 1975-94.

Aviation, Space, and Environmental Medicine, the official journal of the Aerospace Medical Association, is dedicated to serving and supporting all who work to solve the problems of living and working in hazardous environments on, above, and beneath the earth and sea. This study examines and analyzes the characteristics of authors and their articles published in Aviation, Space, and Environmental Medicine over a 20-y period, from 1975-94. There were 3562 articles meeting inclusion criteria published during this period. Articles were analyzed for article length, number of authors per article, country and institution of origin, main topic, and educational preparation of authors. The majority of articles originated in the United States (68%), followed by England (7%), Canada (5%), France (3%), Israel (2%), and Russia/USSR (2%). The number of different countries contributing articles increased from 26 countries in the first 5 yr to 35 countries in the last 5 yr. The content has remained relatively uniform, with the most frequent topics being aviation medicine, aerospace physiology, environmental medicine, and space medicine. The most infrequent topics were health promotion and wellness, occupational health, and aerospace nursing. Over 85% of articles in which the educational status of authors was known were written by authors with a doctorate degree. Most primary authors possessed a doctor of medicine (38%) degree, doctor of philosophy (37%) degree, or both (5%). This analysis can provide insight into the history and future of aerospace and environmental medicine and physiology, since the contents of the Journal clearly reflect the interests of individuals working in these fields.

Aerospace Medicine↗
PubMed1995

Variations in the presentation of altitude-induced chokes.

Altitude-induced decompression sickness (DCS) remains a potential risk for individuals involved in flying or altitude chamber activities. The pulmonary form of DCS, commonly referred to as chokes, although uncommon, represents the most serious manifestation of the disease. This study reports the Davis Hyperbaric Laboratory experience with altitude-induced chokes from 1 January 1966 to 31 July 1994. Age, gender, type and extent of altitude exposure, time of symptom development, type of initial symptoms, and response to treatment were reviewed for each chokes patient. There were 15 cases of chokes; all were treated with compression therapy with complete resolution. Only 2 of the 15 individuals presented with the classic triad of substernal chest pain, dyspnea, and cough. Substernal chest pain was universally present, and usually occurred very early in the course of the disease. The other classic triad symptoms were frequently absent. The etiology, pathophysiology, and treatment of chokes are discussed.

Adolescent↗
PubMed1994

Ocular barotrauma caused by mask squeeze during a scuba dive.

I describe the case of a 25-year-old man who, after a scuba dive, had ocular barotrauma caused by mask squeeze. As in most cases, the condition occurred because the patient failed to exhale into the mask during descent to equalize the pressure within the mask. Although alarming in appearance, the condition is generally mild and self-limited. Patients should be instructed in the proper technique of mask clearing before they return to diving to prevent a recurrence.

Adult↗
PubMed1993

Carbon monoxide poisoning in infants: treatment with hyperbaric oxygen.

Since 1974 the United States Air Force has treated more than 300 cases of carbon monoxide poisoning with hyperbaric oxygen (HBO). Fourteen of the patients treated were younger than 2 years of age. In all but one case, poisoning resulted from a faulty home heating unit; in all but two cases, more than one family member was affected. There was complete recovery in 13 of the 14 infant patients. The pathophysiology, presentation, and clinical management of carbon monoxide poisoning in infants is discussed.

Carbon Monoxide Poisoning↗
PubMed1993

The role of hyperbaric oxygenation in the treatment of clostridial myonecrosis.

Hyperbaric oxygenation as an adjunct in the treatment of clostridial myonecrosis (gas gangrene) has been used extensively in facilities with hyperbaric chambers. The United States Air Force has had extensive experience in the treatment of clostridial myonecrosis, treating 77 patients since 1965. This study reviews the experience in the treatment of this disease process in military multiplace hyperbaric chambers and provides an in-depth analysis of factors affecting patient survival. A comprehensive review of the literature on the treatment of clostridial myonecrosis with hyperbaric oxygenation is presented in this paper.

Adolescent↗
PubMed1993

Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy.

Radiation necrosis is a major complication of surgery or trauma in a previously irradiated field. Although it may occur in any location, the most common region affected is the head and neck. Osteoradionecrosis (ORN), the involvement of bone with radiation necrosis, occurs most frequently in the mandible, and has been well described. Involvement of the temporal bone, although less frequent, is nonetheless a difficult problem in management. Described herein is a case of ORN of the temporal bone treated with adjunctive hyperbaric oxygen therapy with complete resolution. This is followed by a discussion of the pathophysiology, presentation, and management of osteoradionecrosis of the temporal bone, including the role of adjunctive hyperbaric oxygen in the treatment regimen.

Adult↗
PubMed1992

The role of ground level oxygen in the treatment of altitude chamber decompression sickness.

Most published reports on the treatment of altitude-induced decompression sickness (DCS) deal exclusively with patients treated with hyperbaric oxygenation. Little information exists on the role of normobaric (ground level) oxygenation as a primary treatment modality for altitude-induced DCS. This study reports the U.S. Air Force experience in the treatment of Type 1 altitude chamber DCS with ground level oxygenation (GLO2) during the period 1 January 1989 to 31 December 1991. Data collected included age, sex, time of symptom development, type of initial treatment, and response to GLO2 administration. There were 221 cases of Type 1 DCS, of which 46 were treated with compression therapy without initial use of GLO2. Of the 175 cases treated with GLO2, 40 failed to resolve and were treated with compression therapy. The remaining 135 cases all resolved with GLO2, obviating the need for HBO therapy. Only 8 patients had a recurrence of symptoms after resolution with GLO2, all of which subsequently resolved with compression therapy. Factors associated with a favorable response to GLO2 are discussed.

Adolescent↗
PubMed1992

Altitude-induced arterial gas embolism: a case report.

Following a rapid decompression in an altitude chamber for routine training purposes, a 38-year-old altitude chamber technician developed rapid onset of mental dullness, right arm weakness, and sensory deficits. Immediate treatment with compression therapy in a hyperbaric chamber resulted in complete resolution. Ambient pressure changes great enough to result in arterial air embolism due to an explosive or rapid decompression have been described as a potential hazard in aviation, although no actual cases of such a phenomenon have been previously reported. The aeromedical considerations of this complication are discussed.

Adult↗
PubMed1992

Meckel's stone ileus.

Meckel's diverticulum is the most common congenital abnormality of the small bowel; it occurs in approximately 2% of the population. Complications of Meckel's diverticulum include hemorrhage, usually associated with heterotopic tissue within the diverticulum, intussusception, development of benign or malignant neoplasms, and inflammation. Formation of one or more enteroliths within a diverticulum is rare. An extremely rare complication is mechanical small bowel obstruction secondary to extrusion of an enterolith from a Meckel's diverticulum (Meckel's stone ileus). A case of Meckel's stone ileus is described herein, with a review of the literature of this extremely rare complication.

Aged↗
PubMed1991

The effect of delay on treatment outcome in altitude-induced decompression sickness.

Records at the USAF School of Aerospace Medicine, Hyperbaric Medicine Division, were reviewed to determine whether a relationship exists between the length of time from development of symptoms of altitude chamber decompression sickness (DCS) to start of compression therapy and the outcome of treatment. During the 5-year period from 1 January 1984 to 31 December 1988, 233 cases of altitude chamber DCS were treated in USAF hyperbaric chambers. Information obtained from each record included age, sex, time from exposure to symptom onset, time from symptom onset to start of compression therapy, time required for resolution of symptoms, and number of treatment failures (failure to resolve during the first treatment dive or recurrence of symptoms after the first dive). Analysis of the data obtained from treatment records reveals a direct relationship between length of delay to treatment with compression therapy and outcome of treatment. Patients successfully treated with a single treatment dive had an average delay to treatment of 10.6 h. Patients that failed treatment after one dive (failed to resolve or recurred) had an average delay to treatment of 18.2 h. The difference between these groups is significant (p less than 0.05). Outcome of treatment was not significantly related to patient age, sex, or type of symptoms. A discussion of factors causing delays in treatment of decompression sickness is included.

Adult↗
PubMed1991

Decompression sickness presenting as a viral syndrome.

Decompression sickness (DCS) is a well-known hazard of exposure to significant variations in ambient pressure. The diagnosis and management of DCS is frequently a source of confusion. Although the majority of cases are manifested by joint or limb pains (Type I DCS), patients may present with a wide array of symptoms, such as neurologic deficits, headache, fatigue, nausea, and respiratory difficulty. A thorough knowledge of the differential diagnosis and a strong index of suspicion are crucial to the proper management of DCS. Presented herein are two cases of altitude-related DCS which were confused initially with a viral syndrome. A discussion of the symptoms of DCS is included.

Adult↗
PubMed1991

The use of the pressure cuff test in the diagnosis of decompression sickness.

Records at the Hyperbaric Medicine Division, United States Air Force School of Aerospace Medicine, were reviewed to determine the utility of the pressure cuff test as an aid in the diagnosis of Type I decompression sickness (DCS). Applying local pressure with a blood pressure cuff has been described as a useful test to differentiate the pain of DCS from that of other musculoskeletal conditions. Records were reviewed from January 1985 to December 1989. During this period 179 patients were treated with recompression for extremity pain. Application of a blood pressure cuff to the painful area was used as a diagnostic aid in 87 patients. Only 53 patients (61%) with DCS had a positive test (relief of pain with local pressure). Results did not correlate with the rapidity of relief of symptoms during recompression. We conclude that the failure to respond to the application of local pressure should not be used to rule out the presence of DCS-this must be done with a test of pressure in a hyperbaric chamber.

Adult↗
PubMed1990

Treatment of methylene chloride induced carbon monoxide poisoning with hyperbaric oxygenation.

Methylene chloride is an organic solvent with many industrial uses. Inhalation of methylene chloride fumes can result in toxicity, caused by hepatic biotransformation of methylene chloride to carbon monoxide. A case of acute methylene chloride poisoning is presented, including successful treatment of this patient with the use of hyperbaric oxygenation. The rationale for the use of hyperbaric oxygenation in the treatment of methylene chloride poisoning is discussed.

Adult↗
PubMed1990

A case of decompression sickness at 2,437 meters (8,000 feet).

Among aviators, decompression sickness is a condition that occurs almost exclusively at altitudes above 6,098 m (20,000 ft). Several reports have been published describing the development of decompression sickness after altitude exposures of 3,049 to 4,878 m (10,000-16,000 ft). In most of these cases, the affected individual had a previous history of pain in the involved area due to prior trauma or surgery, or had other risk factors for decompression sickness, such as obesity. Few of these reports have confirmed the presence of decompression sickness by a test of pressure. A case is reported here of multiple joint pains developing after a rapid decompression at 2,439 m (8,000 ft), which improved during descent and rapidly resolved with recompression therapy. There was no prior history of joint pain, trauma, or diving. A brief discussion of decompression sickness is included.

Adult↗