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Volume 25, Number 12c
March 23, 2018
 
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SMO Reports Fewer Jets, More Helicopters
 
Mary Grady
 
 

The operators of Santa Monica Airport shortened the sole runway in December, but the airport’s data for February shows that while jet operations were down 80 percent compared to the 2016-17 average, helicopter and turboprop operations both increased by about 40 percent. Piston operations remained about the same, with a slight 2 percent drop. Overall, the total takeoffs and landings were down just over 1 percent for the month, compared to the 2016-17 average. “Perhaps jet setters are choosing other ways to beat the traffic over the 405,” noted the local Malibu Times. The runway was shortened from 5,000 to 3,500 feet.

The city has said it plans to close the airport by the end of 2028. NBAA is challenging that decision in the courts. Oral arguments in that case are set for May 14 in the D.C. Circuit Court of Appeals. NBAA has said it hopes ultimately the courts will force the city to restore the runway to its original length.

Diamond Updates Future Plans
 
Mary Grady
 
 

Diamond Aircraft, based in Austria, was sold to new owners in China last December, and this week the company released details about how the new owners plan to manage the company. Wanfeng Aviation Industry will focus on continued growth and maintain the site in Austria as “global headquarters,” according to the statement. The company will continue to develop new technologies and new products, including the Dart turboprop aerobatic trainer and the DA50 single-engine models. Some products pursued by the former management are “currently under evaluation,” including the Dart-280 helicopter and a tiltrotor concept. The company will add to the 600 workers now at its Austria headquarters, mainly in R&D, sales and marketing, production, and support. Diamond Canada added about 100 new staff over the last year.

Christian Dries, who founded the company more than 25 years ago, said he decided to sell the company after he turned 60, and no one in his family was interested in taking over. “Diamond is my life’s work,” he said. “In the interest of a successful long-term future, we needed to find the right partner to continue our good work. Wanfeng and specifically Mr. Bin Chen [president of Wanfeng] share my vision of the future of general aviation and are investing for the right reasons, with a long-term strategy and the resources to see their vision through. I look forward to seeing Diamond develop further, and based on our successful year-long partnership in Diamond Canada, I am fully satisfied that I leave Diamond in very good hands.” Dries will maintain an advisory function to help guide the new ownership and ensure the continued development of Diamond Aircraft Group.

Aspen, Sensurion To Develop UAV Avionics
 
Mary Grady
 
 

Aspen Avionics and Sensurion Aerospace said this week they have entered a partnership to work together to create certified avionics for unmanned aerial vehicles. The partners said they plan to create FAA-certified autopilots, communications, navigation and surveillance systems, for small, medium and large aircraft. Aspen CEO John Uczekaj told AVweb on Wednesday the partnership is still in its early stages and no particular partners or products have been identified yet. “It’s anticipated that drones that operate beyond line of sight will need certified avionics for that mission, and the demand for that will occur,” he said. “For us this is a major growth market, with great opportunities for companies like ours.”

The companies also hope to develop products that can be used in autonomous VTOL aircraft. “That market is just developing,” Uczekaj said. “There’s a lot of things going on … we see a need for sophisticated avionics in that market.” The timeline is still unknown for that, he said, but he hopes to be working in that direction, and perhaps will be developing products within the next five years or so. “Any kind of innovation that occurs creates possibilities to feed that technology back into the GA market,” he said. “We’d all like to see that, and I think this will facilitate that.” Sensurion Aerospace, based in Bloomington, Minnesota, manufactures and sells small drones, and offers support services and training to drone operators. Aspen Avionics, based in Albuquerque, develops products for the general aviation market.

Regulation vs. Common Sense
 
Paul Bertorelli
 

Aviation regulation theory couldn’t be simpler. The freckle-necked masses aren’t expert enough to assess the relative risks in boarding a flying machine so we, as a society, allow the government to establish certain standards and rules designed to eliminate the most egregious practices that people trying to make money in the flying game will, quite naturally, engage in. Then, as predictably as the sun rising tomorrow, we bitch and moan about government interference.

Yet regulation is why, in part, modern aviation—even the relatively wild west of general aviation—is as safe as it is. The worst practices are kept at bay by the long arm of the FAA. Except, sometimes not. That’s why the NTSB issued an urgent safety recommendation Monday urging the FAA to prohibit commercial flights in aircraft where passengers aren’t equipped with quick-release restraints. This seems intuitively obvious, but it apparently wasn’t to FlyNYON, the operator of doors-off helicopter tours around New York city. Five people drowned last week when the helicopter they were riding autorotated into the East River after an engine failure and non-quick release harnesses kept them from egressing after the helo inverted.

The NTSB’s investigation soon revealed that the aircraft was equipped with harnesses of the tour operator’s own design that had not been inspected by the FAA. This raises some sticky regulatory issues. Did that constitute an unauthorized modification of the aircraft or will the attorney for the IA who signed off the annual argue that it was some kind of supplemental restraint not subject to FAR 27.785, which requires restraints with a single-point release? Technically, the harnesses had a single-point release, it just happened to be inoperable by the passenger without a knife. I won't wade into the swamp of TSOs.

How could this slip through the regulatory cracks? One reason is that tour companies operate under Part 91, in a netherworld somewhere south of Part 135. For-hire tour operators are required to have pilot drug testing programs, but they don’t need defined op specs like other for-hire businesses. They operate under specific Letters of Agreement, the FAA’s all-purpose catchall strategy when both the industry and agency agree that more forceful regulation isn’t needed.

So far, so good. But this means the tour operators are on their own to exercise good judgment and common sense in a relatively unfettered commercial air business. One unavoidable question is this: Would an FAA inspector examining that harness rig put the kibosh on it? I’m gonna go with yes.

And thus the regulatory gap and the basis of the NTSB’s urgent safety recommendation. Here we reach a philosophical divide. On Monday, we put up a Question of the Week asking if more regulation is needed, specifically banning doors-off flights. Neither the FAA nor the NTSB have gone quite that far. Yet. More than a third of readers said such flights shouldn’t be banned and that passengers are on their own to assess risk based on informed consent.

I agree they shouldn’t be banned, but given what I view as a serious safety breach, either the LOAs should be hardened to require inspections or tour operators need to be held to a higher basic regulatory standard. There’s always a danger in knee-jerking toward new regulation on the basis of a single occurrence and regulation has to balance the public interest against chilling commercial vitality. But as I mentioned in last week’s blog, it’s unrealistic to think those passengers could have reasonably assessed the risk they were about to take. So how Darwinian do you want to be?

Every Saturday morning in the U.S., thousands of unsuspecting passengers sign up for tandem skydives. The perceived risk is so high that they sign multi-page waivers and the FAA allows the industry to exist in its own laissez-faire bubble. The demonstrated risk is rather lower. Still, inspectors do show up to have a look at these operations, examine the airplanes and look over the maintenance logs. Even though minimal, these inspections are sometimes capricious and intrusive because FAA inspectors can do that if they want. It appears to me that air tour operators don’t even get that much attention. If they did, maybe someone would have squawked those harnesses. 

Navy Shells Out More To Retain Pilots
 
Paul Bertorelli
 
 

Struggling with worsening pilot retention in a hot civil hiring market, the Navy is offering its aviators substantial bonuses to stay in the service. For the second year in a row, the Navy has boosted its incentive pay up to $175,000 for pilots who sign on for a five-year term.

Vice Admiral Robert Burke told Congress last month that the Navy isn’t retaining sufficient pilots in the strike fighter, electronic attack and helicopter mine countermeasure specialties as airlines continue to draw away experienced pilots for higher-paying civil jobs.  

The Air Force is having similar retention problems. That service expects to retain about 65 percent of its pilots with retention bonuses, but recently, that rate has plummeted. The Air Force said it finished 2017 with 2000 fewer pilots than it needed, up from a 1500-pilot shortage the previous year.

The Navy Times reported that pilots who sign on for five years quality for up to $35,000 a year in typical bonuses. To entice pilots not willing to sign on for five years, the Navy is also offering three-year extensions.

Fly SAM STC Approved
FAA OKs Drones On Airport
 
Mary Grady
 
 

Drone flights are restricted within 5 miles of an airport, unless the FAA gives advance permission, but now the FAA is beginning to approve flights within the airport boundaries for professional operators. Last week, the FAA said it will allow first responders to operate drones at Dallas/Fort Worth International Airport — one of the busiest airports in the world. The airport’s police and fire department can fly drones, but they must remain lower than 50 feet above the ground and the operators must maintain contact with ATC at all times. The drones can be equipped with infrared cameras and zoom capabilities to help responders detect various kinds of threats and hazards.

The first FAA approval for such operations went to Hartsfield-Jackson Atlanta International Airport — the world’s busiest airport — last March. ATL hired a drone operator to help with runway inspections. The contractor said the drone could inspect the runway in less than half the time it would take for the traditional method of manually photographing the runway surface. In a recent report, the FAA said it estimates there are now about 1.1 million drones being flown by amateur operators in the U.S., and it expects that fleet to double in size over the next five years. The number of drones operated for commercial purposes also is growing. About 110,000 commercial operators had registered by the end of 2017, and the FAA projects about 450,000 operators by 2022.

FAA Forecast: Turbines Up, Pistons Down
 
Paul Bertorelli
 
 

The FAA’s latest Aerospace Forecast offers a mixed bag for GA for the next two decades, with modest growth in the turbine sector offsetting continued erosion in the piston fleet. The agency says the long-term outlook is “stable to optimistic” for GA and related industries.

The latest report, which the FAA compiles annually, predicts continued shrinkage in the largest portion of the fleet numerically—that’s piston aircraft—but a tepid increase of 0.8 percent in total hours flown through 2038, the outer edge of the report’s timeline. Increases in rotorcraft, turbine and experimental hours are expected to more than offset the decline in fixed-wing piston hours flown, according to the agency’s estimates.

In contrast, the FAA is downright bullish on airline growth, activity and profitability. Citing the trends customers love to hate—unbundling of baggage, boarding priority, legroom upcharges—the agency notes that the airlines achieved the eighth year of profitability in 2017 and it expects more of the same going forward. “Looking forward,” gushes the report, “there is confidence that U.S. airlines have finally transformed from a capital intensive, highly cyclical industry to an industry that generates solid returns on capital and sustained profits.”

The forecast calls for U.S. air carrier passenger growth to average 1.9 percent during the next two decades, down a bit from the 2017 forecast. Economic trends for this growth are favorable, including low and stable oil prices and diminishing headwinds for the world economy. Although the U.S. economy has had lukewarm growth since the 2008 recession, the report says there are signs that growth is heating up.

As revenue passenger miles increase—at 2.3 percent during the forecast period—available seat miles will also grow with the rising demand. And there are more seats per aircraft, too. The forecast predicts that the number of 50-seat airplanes will decline to just a handful, replaced by fewer total aircraft but in the 70- to 90-seat range.

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Healthy Pilot #7: Sensitive Gut
 
Tim Cole
 
 

The stomach is often called a second brain—connected, as it were, to the first brain by the vagus nerve. Although your stomach may play second fiddle, when it comes to your personal domain, it’s often supreme ruler. That’s why dealing with dyspepsia can be the first order of business prior to any flight. Matters of the gut are so important the FAA has placed “Stomach, liver or intestinal trouble” as item 18i on the Basic Med checklist.

For this installment of Healthy Pilot, we’ve once again turned to our friends at sister site University Health News, the health information mother lode sourced by America’s leading medical schools and hospitals.

UHN offers a free guide called Abdominal Pain that covers the major ailments of the alimentary canal, that wondrous collection of connected organs that transfers nutrients from food to the brain and other organs. From mastication at the top, to waste removal at the bottom, your gastrointestinal machinery processes the materials that sustain life. It offers pleasure when you tuck into a good steak, and pain when things go awry.

Dreamstime

Here are just some of the issues we humans have to contend with. The disorders listed may be merely annoying, or persistent, painful conditions that need medical attention.  A quick review may offer talking points for you and your doctor.

Acid Stomach

Gastro-esophageal reflux disorder, or GERD, is very often the first telltale signs of a sensitive gut. The sphincter at the bottom of the esophagus gets a little loose over time and stomach acid backs up into the plumbing above it. You’ll notice this heavy, burning sensation, particularly at night. Often, relieving symptoms is nothing more complicated than elevating your head with a second pillow.  If GERD makes an infrequent visitation, tamping it down with an antacid might resolve the issue.

More persistent cases of GERD may need an over-the-counter omeprazole (trade name Prilosec; others). But there are side effects to these so-called proton pump inhibitors (ppi), so be advised. GERD that’s not easy to resolve requires a doctor’s attention, and the prospect of a closer inspection using an endoscope (think bore scope for the gut).

The stomach is the gut’s epicenter, the tool that quietly breaks down masticated food into the gruel that gets further processed downstream. The classic “stomach ache” can be any number of things—a microbial infection from tainted food, gas or bloating from overconsumption, or, more seriously, gastritis, an inflammation of the stomach lining. UHN advocates placing limitations on caffeine, alcohol, and salty foods if gastritis is suspected. The most common symptoms of gastritis are upset stomach, indigestion, and pain in the upper abdomen that can radiate to the back. Other symptoms are belching, nausea, vomiting, loss of appetite, a feeling of fullness, or burning sensations in the upper abdomen.

Treatment for gastritis will depend on the cause. If H.pylori is the culprit, antibiotic drugs will be prescribed. For most types of gastritis, drugs to reduce stomach acid are also prescribed to promote healing.

Ulcers

Stomach ulcers are not uncommon from middle age and beyond. A peptic ulcer is a sore that forms in the lining of the stomach (gastric ulcer) or the first section of the small intestine (duodenal ulcer). Gastric ulcers can occur anywhere in the stomach but are most common in the lower part of the stomach (called the antrum). Duodenal ulcers occur in the first few inches of the small intestine (the duodenum).

Ulcer symptoms usually begin with a burning sensation in the upper to middle abdomen within one to two hours after a meal. Other symptoms of an ulcer may include:

  • Pain that feels like a dull, gnawing ache
  • Pain that is intermittent or constant, lasting for days to weeks at a time before subsiding
  • Pain that strikes in the middle of the night, or any other time the stomach is empty
  • Pain that decreases after meals

Ulcer treatment can be highly effective. The three goals to treat ulcers caused by bacteria are to reduce stomach acid, protect the stomach lining, and kill the bacteria. This triple therapy allows the ulcer to heal and lowers the chance that it will come back. Antibiotics are used to destroy the bacteria. Reducing stomach acid is generally accomplished with short-term use of a proton pump inhibitor (see above), plus sucralfate or bismuth, typical medications to protect the stomach lining.

Liver, Pancreas, Spleen – the Mid-Gut

The liver, pancreas, spleen normally cause very little trouble, quietly cooperating to deliver fluids to aid in digestion, emulsify fat or cleanse the blood.

If there is a glitch in this well-operating system, the culprit is usually the gallbladder. The gallbladder is a small, pear-shaped pouch beneath the liver. The liver produces bile (a combination of water, acid, cholesterol, bilirubin, and lecithin), to digest fats in the small intestine. As the bile is produced, the gallbladder stores it until needed. When you eat fat, the gallbladder sends bile through a system of tubes (called ducts) leading into the small intestine, where it breaks up fat.

Dreamstime

If there is too much cholesterol or bilirubin in bile, it can form crystals that clump together into gallstones. A problem arises when a gallstone gets caught in a duct and blocks the normal flow of bile. This causes inflammation of the gallbladder, a condition called cholecystitis.

Symptoms of gallstones

  • Severe pain in the upper-right side of the abdomen (called biliary colic) that waxes and wanes and lasts from 30 minutes to several hours
  • Pain that radiates to the back, between the shoulder blades, and under the right shoulder
  • Nausea or vomiting
  • Sweating, fever and chills
  • Clay-colored stools
  • Dark-colored urine

Common Pancreatic Problems

Pancreatitis is an inflammation of the pancreas that can be either short-lived (acute) or long lasting (chronic). While chronic pancreatitis tends to be more serious, either type can cause dangerous complications. Excessive alcohol is known to cause pancreatitis. Or a gallstone from the gallbladder may lodge in the bile duct in such a way that it blocks the pancreatic duct, trapping digestive enzymes inside. The enzymes may begin to digest pancreatic tissue, leading to inflammation.

In addition to gallstones and alcohol, acute pancreatitis can also result from certain types of prescription drugs, which raise the risk of pancreatitis.

Symptoms of acute pancreatitis include pain in the upper abdomen that comes on gradually or suddenly and lasts a few days. The pain may radiate to the back. Sometimes pain worsens after eating. Other symptoms are nausea, vomiting, fever, and rapid pulse. Severe cases may impact the heart, lungs, or kidneys. With a chronic condition, symptoms include nausea, vomiting, weight loss, and greasy or oily stools.

Common Liver Problems

When liver tissue becomes inflamed, thickened, and scarred, it cannot preform its essential function. The body cannot survive without the liver processes.

Alcoholism damages the liver by impeding the metabolism of protein, fats, and carbohydrates. It is the leading cause of cirrhosis followed by hepatitis C in the U.S. and hepatitis B worldwide. Other causes for cirrhosis are rare.

In the early stages there are few symptoms. As it advances, symptoms of fatigue, weakness, weight loss, abdominal pain, and spider-like veins on the skin appear. Eventually, edema (swelling) affects the legs and trunk, and the skin and eyes take on a yellow tone from jaundice.

Hepatitis is an inflammation of the liver generally caused by viral infection. Certain medications, such as acetaminophen (Tylenol), can cause drug-induced hepatitis. An inflamed liver becomes swollen and tender, which can impair or permanently damage the organ.

The hepatitis viruses are identified as A, B, C, D, and E. Any of these viruses can cause short-term (less than six months) inflammation of the liver. Hepatitis A, B, and C may cause no symptoms or just flu-like symptoms (fatigue, nausea, fever, loss of appetite, stomachache, and diarrhea). Some people have dark-yellow urine, light-colored stools, or yellowish eyes and skin. Hepatitis A, B, and C can be detected with a blood test.

Hepatitis A is spread by personal contact or consuming food or water contaminated with human saliva or feces from someone infected with the virus. This is a problem in parts of the world with poor sanitary conditions so travelers in such regions are at risk. Hepatitis A can be prevented with a vaccine.

Hepatitis B can be contracted through contact with the blood, semen, or other body fluid of an infected person. People who travel to countries where hepatitis B is common are at risk of infection but there is a vaccine to prevent infection. Hepatitis B infection can resolve on its own without any treatment. However, sometimes the infection is chronic, and leads to serious liver damage, like cirrhosis.

Hepatitis C is transmitted through contact with the blood of an infected person. This generally occurs when drug users share needles. Hepatitis C is not spread by casual contact. People who had blood transfusions before 1992 are at risk because prior to that there was no test to check blood for the virus. The infection may resolve itself within a few months, but about 75 percent of patients become chronic.

Small Intestine Problems

The small intestine is approximately 20 feet long and connects the stomach to the large intestine. It does most of the digestive work, breaking down food matter and absorbing the majority of available nutrients. Issues involving the small intestine can include the following:

Lactose intolerance: During normal digestion, lactose, the predominant sugar in dairy products, is broken down in the small intestine into glucose to be used by the body. An enzyme called lactase, produced in the small intestine, is responsible for breaking down lactose. In lactose intolerance, there is a shortage of the lactase enzyme.

Lactose intolerance is not dangerous, but it can cause great discomfort. Undigested lactose ferments in the small intestine or colon and can cause such symptoms as nausea, cramps, bloating, gas, and diarrhea. The symptoms usually occur about 30 minutes to two hours after eating or drinking foods containing lactose.

Lactose intolerance can’t be cured, but avoiding or limiting milk products manages it. Lactase enzymes are also available to prevent the symptoms for people who react to even small amounts of lactose and wish to continue eating dairy. These are available without a prescription.

Celiac Disease: An essential process in digestion is the absorption of nutrients from the small intestine into the bloodstream. Disorders that interfere with this are called malabsorption disorders, and one of the most common is celiac disease. This condition, also called sprue, is where damage to the small intestine impedes absorption. The damage occurs when the immune systems mistakes the protein gluten for a dangerous intruder and attacks it. This causes inflammation that irritates and damages the small intestine.

Symptoms of celiac disease

  • Chronic diarrhea
  • Anemia (iron deficiency)
  • Recurring abdominal bloating, gas, and pain
  • Weight loss
  • Bone and joint pain
  • Muscle cramps
  • Pale, foul-smelling stool
  • Behavior changes
  • Tingling and/or numbness in the legs
  • Fatigue
  • Mouth sores
  • Itchy skin rash (called dermatitis herpetiformis)
  • Seizures

If celiac disease is suspected, your physician can make the diagnosis with a blood test and possibly an endoscopic biopsy. The blood test can show whether the body’s immune system is making antibodies against gluten or other enzymes involved in the disease process. Antibodies are substances that are produced by the body to attack threatening invaders. Gene testing to help identify a genetic predisposition to the disease is also available.

The treatment for celiac disease is to avoid all gluten. Once gluten is removed from the diet, immune reaction to gluten is reduced and the inflammation resolves. The small intestine begins to heal, and absorption of nutrients goes back to normal. For older adults, the small intestine should be completely healed after two years on a gluten-free diet.

Large Intestine Problems

The large intestine, also known as the colon, is a multi-layered tube approximately 5 feet long that absorbs liquid from the waste material passed down from the small intestine. The bacteria that live in the large intestine take in any remaining nutrients in the stool before it moves into the rectum to be expelled through the anus.

Constipation: As undigested food passes through the colon, water is absorbed to form the solid waste (stool). If not enough water is removed diarrhea will result. If too much water is removed, the stool becomes hard, dry, and difficult to pass out of the body—constipation.

Many people believe they are constipated if they don’t have a bowel movement every day. In fact, the frequency of bowel movements considered normal ranges from three times a day to three times a week.

Constipation means passing small amounts of hard, dry stool, usually less than three times a week, and straining to have a bowel movement. Other symptoms are bloating, general discomfort, and sluggishness. Like diarrhea, constipation is very common and usually lasts only a short time. Even so, constipation accounts for about 2 million doctor visits each year in the United States.

Common laxative treatments

  • Bulk or fiber laxatives (Metamucil, Citrucel, Fibercon, and Benefiber) serve to hold water in the intestines and soften stool. Patients using these must drink at least eight glasses of fluid (water, juice, milk, coffee or tea) per day to avoid side effects.
  • Osmotic laxatives (Milk of Magnesia and MiraLax,) cause the intestines to secrete water into the colon to make stool soft. These also require adequate fluid intake.
  • Stool softeners (Colace and Surfak) provide moisture to the stool.
  • Stimulants (Correctol, Dulcolax, and Senokot) cause intestinal muscle contractions to help move the stool more quickly. Long-term use is not recommended.

A low-fiber diet, not drinking enough fluids, and lack of exercise are common causes of constipation. Many medications can cause constipation, including pain medications (opioids), antacids that contain aluminum and calcium, calcium channel blockers (for lowering blood pressure), anti-Parkinson’s drugs, antispasmodics, antidepressants, iron supplements, diuretics, and anticonvulsants.

Irritable Bowel Syndrome (IBS): About 10 to 15 percent of Americans suffer with irritable bowel syndrome (IBS). Characterized by symptoms such as cramp-like abdominal pain, bloating, diarrhea, and constipation, IBS can be uncomfortable and distressing. However, it does not cause permanent harm to the intestines, nor does it lead to intestinal bleeding or serious disease such as cancer.

What makes IBS worse?

  • Large meals
  • Wheat, rye, barley, chocolate, milk products, alcohol
  • Caffeine
  • High levels of fructose
  • Carbohydrates in foods like wheat, beer, garlic, onions, artichokes, asparagus
  • Sugar alcohols such as sorbitol, fruits, cabbage, beans, lentils, and soy
  • Insoluble fiber found in wheat and bran
  • Large amounts of fat
  • Women with IBS may experience more symptoms during their menstrual periods, suggesting that reproductive hormones can exacerbate IBS.

Inflammatory Bowel Disease (IBD): Inflammatory bowel disease (IBD) is a collective term for abnormal immune system activity in the intestines that leads to inflammation. The two major diseases are ulcerative colitis and Crohn’s disease.

Dreamstime

Ulcerative colitis causes inflammation and ulcers in the inside lining of the large intestine (rectum and colon). It affects just the top layer of the intestinal lining (called the mucosa). Crohn’s disease also causes inflammation, usually in the small intestine, but it can affect all areas of the gastrointestinal tract (mouth to anus). Crohn’s disease affects all four layers of the intestinal wall.

The exact cause of IBD is unknown, but some interaction between hereditary factors, environment, and the immune system is probably at work. It’s theorized that the body’s immune system reacts inappropriately to viruses or bacteria in the intestines. The immune system mistakes these for foreign invaders and launches an attack by sending white blood cells to the intestinal lining. This produces inflammation that becomes chronic, damaging the intestine. This reaction is thought to occur in people genetically predisposed to IBD.

The main symptoms of ulcerative colitis are cramp-like abdominal pain on the lower-left side and bloody diarrhea. Loss of appetite, weight loss, nausea, anemia, and fatigue also are common.

Crohn’s symptoms vary depending upon severity and which part of the intestine is affected, but generally include abdominal pain, diarrhea, and bloating. People with either type of IBD also can have symptoms outside the digestive system, such as joint inflammation (arthritis), eye inflammation, or skin, liver, or kidney problems. These symptoms are probably caused by the abnormal immune system response in these patients.

Diverticulosis and Diverticulitis: Diverticulosis is a condition where pockets form in the lining of the colon. Diverticulitis occurs when those pockets become infected and enflamed.

Half of Americans older than age 60 have diverticulosis, a condition where small pouches (about the size of large peas), called diverticula, bulge outward from the colon. Diverticulosis is not a disease in itself, but if the diverticula become inflamed or infected, it becomes diverticulitis and requires treatment. From 10 to 25 percent of people with diverticulosis develop diverticulitis.

Although the exact cause is unknown, it’s thought that diverticulosis results from a low-fiber diet. It is more common in industrialized countries, such as the United States, England, and Australia. It is uncommon in Asia and Africa, where people eat diets higher in vegetable fiber.

If diverticula become inflamed or infected, it can cause fever, pain or tenderness in the lower left abdomen, and a change in bowel function or blood in the stool. It is unknown why diverticula become infected, but it may stem from stool or bacteria getting caught in the pouches.

As diverticulitis symptoms can also mimic inflammatory bowel disease or infectious gastroenteritis, the doctor will likely perform a CT scan with contrast, to diagnosis the disease.

Diverticulitis is treated with antibiotics and pain relievers. A short stay in the hospital is sometimes required. In a few cases, diverticula burst and require surgery. Surgery may also be necessary if an infection is persistent or very severe.

Hemorrhoids: The word “hemorrhoid” is a medical term for the tissue cushions surrounding blood vessels in the anal area. What most consider a hemorrhoid when anal tissue prolapses through the sphincter muscle, exposing the delicate lining of the rectum. This can lead to bleeding, itching, and irritation.

Hemorrhoids can either be inside the anus (internal) or under the skin around the anus (external). The chief symptom of internal hemorrhoids is bright-red blood on your toilet tissue or in the toilet bowl. If the hemorrhoid protrudes through the anus, it may become irritated and painful. External hemorrhoids may not produce any symptoms unless a blood clot forms within the tissue. In this case, there may be painful swelling or a hard lump may form around the anus.

Increasing hemorrhoid risk

  • Straining to expel stools
  • Extended time spent standing or sitting
  • Chronic constipation
  • Passing hard, dry, small stools
  • Diarrhea symptoms
  • Laxative abuse

A diagnosis will require an examination of the anus and rectum and the doctor may need to use an anoscope (a lighted tube useful for viewing internal hemorrhoids), a proctoscope (which can be used to examine the entire rectum), or a sigmoidoscope (to view both the rectum and lower colon).

Careful cleansing of the anal area is also important, daily and after each bowel movement, while sitz baths (warm-water baths that cover only the hips and buttocks) may be soothing. Using cold compresses and topical creams on the area can ease pain. Procedures in the doctor’s office include tying off the hemorrhoid so it will fall off on its own or sclerotherapy, an injection that will shrink the hemorrhoid. Only about 10 percent of patients need more invasive surgery.

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Video: Top Flightbag Picks
 
Larry Anglisano
 
 

The pilot's flight bag has gotten smaller over the years and in a market flooded with compact flight totes, four bags—all with different styling—survived our long-term evaluation and earned our critical praise. In this video, Aviation Consumer Editor Larry Anglisano offers a close look at four favorites on the Aviation Consumer evaluation bench.

Navy Pier, Chicago, Illinois
 
 
This gorgeous photo was taken on a night flight over Lake Michigan, a half mile off shore from Navy Pier.

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Short Final

Going One Direction or the Other

 

While flying one day in Northern California, I heard the following:

Center: “Cessna 1234 are you planning to pass east or west of Mt. Diablo?

Cessna: “We’re currently heading south.

Center: (with a chuckle) “I understand that you’re heading south. But when you pass that mountain ahead, will it be on your left or right side?”

Phil Verghese

Santa Clara, CA

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Industry News Briefs: March 22, 2018
 
AVweb Staff
 
 

Sandel Avionics announced that longtime avionics executive Larry Riddle has joined the company as VP of marketing and sales. Previously, Riddle was with L3 for 16 years. Sandel has an extensive line of specialty avionics including primary attitude displays, AHRS and TAWS systems.

Aviation apps for the iPhone and iPad continue to proliferate and the latest comes from Jet Express Technology Limited. It’s called Pilot Assist Pro and is designed to declutter the cockpit with easy access to checklists, weather and flight logs.

Swift Fuels continues to gain modest market traction with its UL94 unleaded aircraft fuel. Dublin Municipal  Airport recently announced it’s the first Texas airport to offer this new fuel. Price per gallon is listed at $4.10.

Want to see famed hero-of-the-Hudson Chesley B. Sullenberger? He’ll be speaking at a special anniversary luncheon on May 25, 2018, in Denver, Colorado, in conjunction with the 50th anniversary of the Arapahoe County Public Airport Authority. He’ll share his credo of "leadership by personal example" as well as the life lessons that prepared him to handle the unprecedented crisis of US Airways Flight 1549’s ditching in the Hudson River in 2009.

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