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SPACE MEDICINE

Good evening ladies and gentlemen .The subject of my

assignment is space medicine . First of all I would like to give
you a definition of that term: Space Medicine is that field of
medicine concerned with the maintenance of health, safety,
and performance of those involved space activity . I strongly
believe that space medicine is an extremely interesting science
field because not only helps humans explore ,and maybe later,
inhabit space, but also contributes to medicine on the ground.
At the beginning we are going to talk about the problems that
astronauts face during their mission due to weightlessness and
other hazardous factors of space environment. Later we are
going to see how space medicine solves some of these and at
last how this benefits patients on the earth.

Human body is not build for space conditions. The adaptation

process involves a variety of physiological changes.

 Firstly cardiovascular system is significantly affected by

weightlessness:
human body is affected by gravity in all activities and that’s why
it is equipped with various mechanisms to maintain sufficient
blood flow to the brain. In microgravity though astronauts have
to deal with “fluid shift’’ because the distribution of body fluid
alters . In early stage of spaceflight facial edema appears,
especially around the eyes, and the cranial veins dilate. Other
more subjective symptoms are stuffy nose ,headache and puffy
face. Fluid shift makes thick veins to dilate which is interpreted
by the body as an overall increment of the circulating volume
and this activates mechanisms that counteract hypervolemia
and finally leads to significant loss of water.

Despite all these the cardiovascular system adapts to

microgravity environment but also occurs cardiovascular
deconditioning. As result , on return to Earth astronauts suffer
from orthostatic intolerance, the tendency to develop
orthostatic hypotension and syncope.

To encounter orthostatic intolerance Lower Body Negative

Pressure(LBNP) is applied and provides a physiologic stress on
the lower body as a substitute for Earth gravity. Also
astronauts have injection of isotonic saline just before their
reentry as it thought to be effective.

Musculoskeletal system is also affected by microgravity

environment:

Bones are useful in locomotion and posture maintenance and

also stock calcium and phosphorus , thus the 99% of calcium
and the 85% of phosphorous exists in bones. But without
gravitational stress these elements are excreted in urine and
feces. Especially loss of calcium in urine may produce urinary
stone, decrease of bone density which will lead to bone
fracture.
On the other hand muscles rapidly atrophy due to the lack of
use and transform from muscles composed of slow-twitch
muscle fibers to fast-twitch muscle fibers. The loss of bone and
muscle makes it very difficult for humans to move and even
breathe under the weight of Earth's pull upon their return.

The solution to these problems is exercise. Astronauts work out

about two hours a day, using treadmills, exercise bikes, and an
IRED--a device specially developed to allow astronauts to do
resistive or strength training.

Another problem that astronauts have to to face is motion

sickness which is characterized by headaches, malaise, nausea
and eventually vomiting. The basic mechanisms responsible for
developing space motion sickness is that the otolith organs in
the middle ear sensitive to linear accelerations no longer
perceive a downwards bias, muscles are no longer required to
contract to maintain posture and pressure receptors in the feet
and ankles no longer signal the direction of down. It has also
been proposed that fluid-shift theory should be involved in the
development of space motion sickness.

Rotating chair used to be one countermeasure, but without any

significant effect and it is no longer used. Today Biofeedback
training, adaptation training using virtual reality, and water
immersion training are used combined with medicines such as
promethazine hydrochloride, which is about 30 times as
effective as commonly-used travelmine. Though astronauts
continue to suffer from motion sickness for about 2-3 days until
the human body adapts to the new microgravity environment.

Hematologic and immunologic system is affected too. In

weightlessness, some erythrocytes transform from biconcave
discoid shape into spherical shapes. The number of red blood
cells decreases by approximately 15% after a three-month
spaceflight and so astronauts suffer from anemia. In space, T-
cells do not reproduce properly and those that do exist are less
able to fight off infection. This increases vulnerability to new
exposures, viruses already present in the body—which would
normally be suppressed—are now becoming active.

The various types of space radiation existing in space

environment such as galactic radiation coming from outside our
solar system, solar-particle radiation originating from the Sun,
geomagnetically trapped radiation surrounding the Earth in the
plane of the geomagnetic equator threat astronauts health.

Right now, the countermeasure for radiation is limiting

astronauts exposure--which means limiting the amount of time
they're allowed to be in space. Also an exploration class
spaceship includes shielding that can absorb cosmic rays made
of materials that have high hydrogen content like polyethylene,
a common plastic. Although the polyethylene shield, still a
great amount of radiation affects the astronauts. Antioxidants
like vitamins C and A can help by sopping up radiation-
produced particles before they can do any harm. NASA
scientists are also looking for ways to help the body after the
damage has been done.

The long-term confined environment may also induce severe

psychological stress on international crew members. The
enormous stress on the crew, coupled with the body adapting
to other environmental changes, can result in anxiety, insomnia
sleeping disorders and depression. Psychological considerations
must therefore be introduced into the selection criteria for
astronauts. Psychological supports, such as private
psychological counseling and periodic spouse and family
conferences with two-way voice and video communication, are
provided as countermeasures. In addition there is significant
demand for effective crew organization of high-level team
performance based on psychological compatibility.

Main role for astronauts health play the Flight Surgeons (FS).
Their work is mainly composed of selecting astronauts, periodic
medical examinations, health monitoring of the astronauts
before and during spaceflight, and post flight rehabilitation. The
health care for astronauts is composed of the thorough medical
examinations before, during and after space flight.

Preflight medical care includes physical examinations

performed by the FS, clinical laboratory tests (analyses of
blood, urine and feces), electrocardiography, pulmonary
function test, audio and visual examinations, and dental
examinations. In addition astronauts are isolated from all but a
few key persons about one week before launch to protect them
from infectious diseases.

Because, as healthy and fit as astronauts are, the possibility

exists that some medical problem could arise during long
missions using smart medical equipment. This means
developing expert systems that can work effectively regardless
of the training of the people who are operating them. many of
these devices are already being developed on Earth, external
defibrillators, for example. Robotically assisted surgery and
Telemedicine might also play a role.
At post-flight health care astronauts receive simple medical
examinations by the FS immediately after space fight and more
detailed later at a clinic.

The technologies needed for long term exploration of the solar

system are the same that are needed to provide quality
medical care to an isolated rural community, to treat soldiers in
the field or have a beneficial impact in our daily medical use

Firstly we have the blood analyzer. For the Skylab manned

orbital laboratory, a toaster-sized centrifugal analyzing device
was developed with funding provided by NASA. It is an epoch-
making system which can perform 80 to 100 chemical blood
tests using a single drop of whole blood. Secondly did you know
that The Food Service System, which is now widely used in
hospitals, is originated in space technology developed by NASA
in 1966-67 for meal service aboard the Apollo lunar spacecraft.
In addition to these space medicine helped fight against cancer
with radiation therapy In conjunction with Cleveland Clinic, the
cyclotron at NASA’s center in Cleveland, Ohio—which had been
utilized for testing nuclear propulsion systems for air and space
craft—was used in the first clinical trials for the treatment and
evaluation of neutron radiation therapy for cancer patients.
Spinoffs from space medicine don’t seem to have an and. CAT
scans and MRIs development would not have been possible
without the technology provided by NASA after it found a way
to take better pictures of the Earth’s moon. Surgically
implantable heart pacemaker, orthopedic evaluation tools,
muscle stimulator device, implantable heart defibrillator are
only a fraction of what space medicine has offered to ground
medicine
Space medicine continues to develop every day as the will to
explore the universe grows. Space is a tremendous driver for
the development of new technologies, Williams says "and the
technologies that we develop to move beyond low earth orbit
are truly going to change the way we practice medicine here on
Earth’’. Thank you for your attention . I would be glad to
answer at any of your questions.