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  Subjects -> ENVIRONMENTAL STUDIES (Total: 763 journals)
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ENVIRONMENTAL STUDIES (689 journals)

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Journal Cover Wilderness & Environmental Medicine
  [SJR: 0.49]   [H-I: 29]   [3 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1080-6032
   Published by Elsevier Homepage  [3043 journals]
  • Media and Mountain Medicine: A Commitment: Role and Impact of Media on
           Society and with Special Reference to Newspapers’ Role in Public
           Awareness
    • Authors: Rajashekar Nanjappa
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Rajashekar Nanjappa


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.022
       
  • Cerebrovascular CO2 Reactivity: A Potential Tool for Prevention of High
           Altitude Brain Edema
    • Authors: Jose Antonio Carmona Suazo
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Jose Antonio Carmona Suazo


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.020
       
  • Prospective Validation of Framingham Criteria for Congestive Heart Failure
           Diagnosis in a High-Altitude Population
    • Authors: Z. Sovero; E. Capcha; W. Calderón-Gerstein
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Z. Sovero, E. Capcha, W. Calderón-Gerstein


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.018
       
  • Neural Mechanisms Involved in Autonomic and Respiratory Changes in Rats,
           Submitted to Short-Term Sustained Hypoxia
    • Authors: Daniela Accorsi-Mendonça; Carlos E.L. Almado; Leni G.H. Bonagamba; Kauê M. Costa; Jaci A. Castania; João Henrique Costa-Silva; Daniel B. Zoccal; Davi J.A. Moraes; Benedito H. Machado
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Daniela Accorsi-Mendonça, Carlos E.L. Almado, Leni G.H. Bonagamba, Kauê M. Costa, Jaci A. Castania, João Henrique Costa-Silva, Daniel B. Zoccal, Davi J.A. Moraes, Benedito H. Machado


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.017
       
  • Modification and Further Applications of the Adaptation to High Altitude
           Formula
    • Authors: Gustavo Zubieta-Calleja; Natalia Zubieta-DeUrioste
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Gustavo Zubieta-Calleja, Natalia Zubieta-DeUrioste


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.016
       
  • Rebuilding of Carbohydrate and Lipid Metabolism Under Hypoxia:
           Regularities and Therapeutic Possibilities
    • Authors: A. Portnychenko; V. Portnichenko; T. Lapikova-Bryhinska; V. Nosar; M. Vasylenko; H. Portnichenko
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): A. Portnychenko, V. Portnichenko, T. Lapikova-Bryhinska, V. Nosar, M. Vasylenko, H. Portnichenko


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.015
       
  • Low Altitude Peripheral Edema (LAPE): The Opposite of HAPE or HACE
    • Authors: Gustavo Zubieta-Calleja; Natalia Zubieta-DeUrioste
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Gustavo Zubieta-Calleja, Natalia Zubieta-DeUrioste


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.014
       
  • Why is it Not Possible to Predict, Through Tests at Sea Level, Who Will
           Have AMS?
    • Authors: Gustavo Zubieta-Calleja; Natalia Zubieta DeUrioste
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Gustavo Zubieta-Calleja, Natalia Zubieta DeUrioste


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.013
       
  • Rearrangement of Neuroendocrine Systems in the Mountains
    • Authors: Sadykova Gulnura; Dzhunusova Gulnara
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Sadykova Gulnura, Dzhunusova Gulnara


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.012
       
  • Life in High-Altitude Conditions
    • Authors: Thuppil Venkatesh
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Thuppil Venkatesh


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.011
       
  • Potential Application of Cerium Dioxide Nanoparticles for Acute Pneumonia
           Treatment
    • Authors: Z. Serebrovska; V. Dosenko; A. Shysh; S. Pavlovich; A. Dorovskych; V. Lysenko; V. Tertykh; J. Bolbuckh; V. Portnichenko
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Z. Serebrovska, V. Dosenko, A. Shysh, S. Pavlovich, A. Dorovskych, V. Lysenko, V. Tertykh, J. Bolbuckh, V. Portnichenko


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.010
       
  • Interindividual Differences Concerning the Oxygen Diffusion-Transport
           Function in the Lung
    • Authors: Giuseppe Miserocchi
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Giuseppe Miserocchi


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.009
       
  • Interindividual Differences in the Adaptive Response of the Lung to
           Hypoxia
    • Authors: Giuseppe Miserocchi
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Giuseppe Miserocchi


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.008
       
  • The Road to “Defeating Hypoxia” is a Timely Exposure to
           Chronic Hypoxia
    • Authors: Gustavo Zubieta-Calleja
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Gustavo Zubieta-Calleja


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.007
       
  • Abstracts from the 6th Chronic Hypoxia Symposium, October 8–15,
           2016, La Paz, Bolivia
    • Authors: Dedicated to the late Prof. Dr. Gustavo Zubieta-Castillo
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Dedicated to the late Prof. Dr. Gustavo Zubieta-Castillo


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.006
       
  • An Assessment of Diarrhea Among Long-Distance Backpackers in the Sierra
           Nevada
    • Authors: Derek J. Meyer; Amber Costantino; Susanne Spano
      Pages: 4 - 9
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Derek J. Meyer, Amber Costantino, Susanne Spano
      Introduction Diarrhea is a common problem among long-distance backpackers, ranging in overall incidence from 11–56% as reported by previous studies on the Appalachian Trail and Long Trail. Differences in age, sex, and regularity of standard backcountry hygiene recommendations and practices have been shown to significantly affect the incidence of diarrhea. No study to date has investigated these trends among long-distance backpackers on the John Muir Trail (JMT) in the Sierra Nevada mountain range of California. Methods Retrospective analysis of online survey data gathered from long-distance backpackers who attempted a JMT trek in 2014. Data were assessed for the significance of variables that might contribute to the incidence and severity of on-trail diarrhea. Results Of 737 valid responders, 16.4% reported experiencing diarrhea (82% with minimal/mild severity; 18% with significant severity). Regular hand sanitizer use was significantly correlated with more severe diarrhea (P < .05), but had no effect on incidence. Regular hand sanitizer users followed all other recommended hygiene practices as frequently as or better than those not using hand sanitizer regularly. Of all backpackers, 88% filtered or treated their drinking water regularly, with 18% of those reporting diarrhea of any severity. Conclusions JMT backpackers have a comparatively lower incidence of diarrhea than backpackers on other major long-distance backpacking routes in the United States. Most JMT backpackers follow standard backcountry hygiene recommendations, including regular filtration or treatment of drinking water. No statistical significance was found between the incidence of diarrhea and compliance with standard hygiene recommendations. Regular hand sanitizer use was significantly correlated with more severe diarrhea but was not associated with incidence. There was no significant difference in compliance with standard backcountry hygiene practices between regular and infrequent hand sanitizer users.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.12.002
       
  • The Effects of a 36-Hour Mixed Task Ultraendurance Race on Mucosal
           Immunity Markers and Pulmonary Function
    • Authors: David Bellar; Kellie A. Murphy; Ritvik Aithal; Greggory R. Davis; Tim Piper
      Pages: 10 - 16
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): David Bellar, Kellie A. Murphy, Ritvik Aithal, Greggory R. Davis, Tim Piper
      Objective The present study was conducted to assess the changes in mucosal immunity and pulmonary function among participants in a 36-hour mixed task ultraendurance race. Methods Thirteen of the 20 race participants volunteered for the investigation (age 34±5 y). The event consisted of a mixture of aerobic, strong man, and military-style exercise. Participants had a pulmonary function test and gave a finger stick capillary blood sample and unstimulated saliva samples both before the event and upon dropout or completion. The blood sample was analyzed for hematocrit, and the saliva sample was analyzed for salivary flow rate, salivary alpha amylase, salivary immunoglobulin A (IgA), and IgA type 1. Results Significant differences were noted among the finishers and those who dropped out in salivary flow rate (P = .026), salivary IgA (P = .017), and peak expiratory flow (P = .05) measurements. Salivary flow rate and IgA for the race finishers were reduced from pre- to postrace, whereas the nonfinishers showed no change or small increases. No significant differences emerged for other variables. Conclusions Based on the results of the present investigation, finishing a 36-hour mixed task ultra-endurance event results in a decline in both pulmonary function and mucosal immunity compared with competitors who do not finish.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.12.001
       
  • HMOX1 Promoter Microsatellite Polymorphism Is Not Associated With High
           Altitude Pulmonary Edema in Han Chinese
    • Authors: Xue-Feng Cao; Lan Ma; Shang Ma; Jin Xu; Ri-Li Ge
      Pages: 17 - 22
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Xue-Feng Cao, Lan Ma, Shang Ma, Jin Xu, Ri-Li Ge
      Objective To investigate the relationship between microsatellite polymorphism in the Heme oxygenase-1 (HMOX1) gene promoter and high-altitude pulmonary edema (HAPE) in Han Chinese. Methods Eighty-three construction workers who developed HAPE 2 to 7 days after arrival at Yushu (3800 m) in Qinghai, China, and 145 matched healthy subjects were included in this study. The amplification and labeling of the polymerase chain reaction products for capillary electrophoresis were performed to identify HMOX1 genotype frequency. The alleles were classified as short (S: <25 [GT]n repeats) and long (L: ≥25 [GT]n repeats) alleles. Results Patients with HAPE have significantly higher white blood cell count, heart rate, and mean pulmonary artery pressure, but lower hemoglobin and arterial oxygen saturation than healthy subjects without HAPE. The numbers of (GT)n repeats in the HMOX1 gene promoter show a bimodal distribution. However, there is no significant difference in the genotype frequency and allele frequency between patients with HAPE and healthy subjects without HAPE. Chi-square test analysis reveals that the genotype frequency of (GT)n repeats is not associated with HAPE. Conclusion The microsatellite polymorphism in the HMOX1 gene promoter is not associated with HAPE in Han Chinese in Qinghai, China.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.12.003
       
  • Wilderness Medical Society Practice Guidelines for Prevention and
           Management of Avalanche and Nonavalanche Snow Burial Accidents
    • Authors: Christopher Van Tilburg; Colin K. Grissom; Ken Zafren; Scott McIntosh; Martin I. Radwin; Peter Paal; Pascal Haegeli; William “Will” R. Smith; Albert R. Wheeler; David Weber; Bruce Tremper; Hermann Brugger
      Pages: 23 - 42
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Christopher Van Tilburg, Colin K. Grissom, Ken Zafren, Scott McIntosh, Martin I. Radwin, Peter Paal, Pascal Haegeli, William “Will” R. Smith, Albert R. Wheeler, David Weber, Bruce Tremper, Hermann Brugger
      To provide guidance to clinicians and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention, rescue, and medical management of avalanche and nonavalanche snow burial victims. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.10.004
       
  • Bleeding Control Using Hemostatic Dressings: Lessons Learned
    • Authors: Brad L. Bennett
      Abstract: Publication date: Available online 17 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Brad L. Bennett
      Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting. It is concluded that there is adequate evidence of hemorrhage control effectiveness in both military and civilian preclinical studies and clinical case series. The Committee on Tactical Combat Casualty Care recommends implementing approved hemostatic dressings as one part of a comprehensive hemorrhage control training and clinical management program. These recommendations for hemostatic dressings use by public safety and laypersons should be applied in acute transport urban settings or during prolonged care in austere environments.

      PubDate: 2017-03-17T11:20:17Z
      DOI: 10.1016/j.wem.2016.12.005
       
  • First Report of Using Portable Unmanned Aircraft Systems (Drones) for
           Search and Rescue
    • Authors: Christopher Van Tilburg
      Abstract: Publication date: Available online 17 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Christopher Van Tilburg
      Unmanned aircraft systems (UAS), colloquially called drones, are used commonly for military, government, and civilian purposes, including both commercial and consumer applications. During a search and rescue mission in Oregon, a UAS was used to confirm a fatality in a slot canyon; this eliminated the need for a dangerous rappel at night by rescue personnel. A second search mission in Oregon used several UAS to clear terrain. This allowed search of areas that were not accessible or were difficult to clear by ground personnel. UAS with cameras may be useful for searching, observing, and documenting missions. It is possible that UAS might be useful for delivering equipment in difficult areas and in communication.

      PubDate: 2017-03-17T11:20:17Z
      DOI: 10.1016/j.wem.2016.12.010
       
  • Junctional Hemorrhage Control for Tactical Combat Casualty Care
    • Authors: Russ S. Kotwal; Frank K. Butler
      Abstract: Publication date: Available online 17 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Russ S. Kotwal, Frank K. Butler
      During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable, the majority are truncal, junctional, and extremity hemorrhage. Novel and effective approaches directed toward prehospital hemorrhage control have emerged in recent years, some of which can prove useful in the management of junctional hemorrhage whether in a military or civilian setting. An initial comprehensive review of junctional tourniquets was conducted by the Department of Defense Committee on Tactical Combat Casualty Care in 2013. The objective of this article is to provide an updated review of junctional hemorrhage control efforts and devices as they apply primarily to military prehospital trauma management and Tactical Combat Casualty Care and to prompt further consideration and application of these devices in nonmilitary prehospital, austere, and wilderness environments. Four junctional tourniquets are currently cleared by the Food and Drug Administration (FDA) for junctional hemorrhage control, and 1 junctional tourniquet is also FDA-cleared for pelvic stabilization. As junctional hemorrhage control efforts progress, scientists need to continue to conduct research and clinicians need to continue to monitor the performance of junctional tourniquets, especially in conjunction with morbidity and mortality outcomes, for both military and civilian trauma patients.

      PubDate: 2017-03-17T11:20:17Z
      DOI: 10.1016/j.wem.2016.11.007
       
  • Tactical Combat Casualty Care: Transitioning Battlefield Lessons Learned
           to Other Austere Environments
    • Authors: Brad Bennett; Ian Wedmore; Frank Butler
      Abstract: Publication date: Available online 9 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Brad Bennett, Ian Wedmore, Frank Butler


      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2017.01.003
       
  • Tactical Combat Casualty Care: Beginnings
    • Authors: Frank K. Butler
      Abstract: Publication date: Available online 9 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Frank K. Butler
      Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. The origins of TCCC were nontraditional. The TCCC program began as a Naval Special Warfare biomedical research effort launched after the realization that extremity hemorrhage, a leading cause of preventable death on the battlefield, was not being treated with a readily available and highly effective intervention: the tourniquet. This insight prompted a systematic reevaluation of all aspects of battlefield trauma care that was conducted from 1993 to 1996 as a joint effort by special operations medical personnel and the Uniformed Services University of the Health Sciences. The product of that 3-year research project was TCCC, the first-ever set of battlefield trauma care guidelines designed to combine good medicine with good small-unit tactics.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.12.004
       
  • The Transition to the Committee on Tactical Combat Casualty Care
    • Authors: Stephen D. Giebner
      Abstract: Publication date: Available online 6 March 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Stephen D. Giebner
      The original Tactical Combat Casualty Care (TCCC) guidelines were published in a special supplement to Military Medicine in 1996 as the terminal deliverable of a 2-year development project funded by the United States Special Operations Command (USSOCOM). Two years later, the USSOCOM Biomedical Initiatives Steering Committee (BISC) promulgated its Task Statement 5-98, in which it called for the formation of a panel of subject matter experts to update the TCCC guidelines. This article discusses the formation of the Committee on Tactical Combat Casualty Care (CoTCCC) and the changes to the original guidelines that constituted the first update.

      PubDate: 2017-03-10T08:53:03Z
      DOI: 10.1016/j.wem.2016.11.005
       
  • Mountains—Law—Ethics
    • Authors: KVR Tagore
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): KVR Tagore


      PubDate: 2017-03-10T08:53:03Z
       
  • Vihangam Yoga Helps in High Altitude Chronic Hypoxia
    • Authors: Nam Deo
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Nam Deo


      PubDate: 2017-03-10T08:53:03Z
       
  • Development and Validation of New Sepsis Criteria at High-Altitude
    • Authors: Walter
      Abstract: Publication date: March 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 1
      Author(s): Walter Calderón-Gerstein


      PubDate: 2017-03-10T08:53:03Z
       
  • 2016 Wilderness &amp; Environmental Medicine Peer Reviewers
    • Authors: Alicia Byrne
      Abstract: Publication date: Available online 30 January 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Alicia Byrne


      PubDate: 2017-02-18T01:26:44Z
      DOI: 10.1016/j.wem.2017.01.001
       
  • Turning Submissions Into a Journal
    • Authors: Neal W. Pollock
      Abstract: Publication date: Available online 2 February 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Neal W. Pollock


      PubDate: 2017-02-05T23:19:28Z
      DOI: 10.1016/j.wem.2017.01.002
       
  • In reply to Drs Sikri, Bhattachar, and Thapa
    • Authors: James S. Lawrence; Stephen A. Reid
      Abstract: Publication date: Available online 1 February 2017
      Source:Wilderness & Environmental Medicine
      Author(s): James S. Lawrence, Stephen A. Reid


      PubDate: 2017-02-05T23:19:28Z
      DOI: 10.1016/j.wem.2016.11.004
       
  • Lymphangitis from Scolopendra heros Envenomation: The Texas Redheaded
           Centipede
    • Authors: Shannon E. Essler; Maneesha Julakanti; Andrew L. Juergens
      Abstract: Publication date: Available online 11 January 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Shannon E. Essler, Maneesha Julakanti, Andrew L. Juergens
      Envenomation by Scolopendra heros, the Texas redheaded centipede, can present variably. Although transient pain and erythema are often treated conservatively, complications may include cellulitis, necrosis, myocardial infarction, and rhabdomyolysis. We present a case of an elderly man who came to the emergency department with lymphangitis and dermatitis secondary to a centipede sting that awoke him from sleep. It is important to recognize the potential of centipede envenomation to have severe local and systemic manifestations.

      PubDate: 2017-01-15T21:24:29Z
      DOI: 10.1016/j.wem.2016.11.003
       
  • Severe Hemorrhagic Syndrome After Lonomia Caterpillar Envenomation in the
           Western Brazilian Amazon: How Many More Cases Are There?
    • Authors: João Hugo A. Santos; Sâmella S. Oliveira; Eliane C. Alves; Iran Mendonça-da-Silva; Jacqueline A.G. Sachett; Antonio Tavares; Luiz Carlos Ferreira; Hui Wen Fan; Marcus V.G. Lacerda; Wuelton M. Monteiro
      Abstract: Publication date: Available online 10 January 2017
      Source:Wilderness & Environmental Medicine
      Author(s): João Hugo A. Santos, Sâmella S. Oliveira, Eliane C. Alves, Iran Mendonça-da-Silva, Jacqueline A.G. Sachett, Antonio Tavares, Luiz Carlos Ferreira, Hui Wen Fan, Marcus V.G. Lacerda, Wuelton M. Monteiro
      Contact with Lonomia caterpillars can cause a hemorrhagic syndrome. In Brazil, Lonomia obliqua and Lonomia achelous are known to cause this venom-induced disease. In the Brazilian Amazon, descriptions of this kind of envenomation are scarce. Herein, we report a severe hemorrhagic syndrome caused by Lonomia envenomation in the Amazonas state, Western Brazilian Amazon. The patient showed signs of hemorrhage lasting 8 days and required Lonomia antivenom administration, which resulted in resolution of hemorrhagic syndrome. Thus, availability of Lonomia antivenom as well as early antivenom therapy administration should be addressed across remote areas in the Amazon.

      PubDate: 2017-01-15T21:24:29Z
      DOI: 10.1016/j.wem.2016.11.001
       
  • On Rope Looking Up
    • Authors: Joshua E. Lane
      Abstract: Publication date: Available online 10 January 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Joshua E. Lane


      PubDate: 2017-01-15T21:24:29Z
      DOI: 10.1016/j.wem.2016.10.003
       
  • On Trails: An Exploration, Robert Moor. Simon &amp; Schuster, New
           York, NY (2016)
    • Authors: Cindy Bitter
      Abstract: Publication date: Available online 28 December 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Cindy Bitter


      PubDate: 2017-01-06T20:22:19Z
       
  • Ethics and Oversight in Publication
    • Authors: Neal W. Pollock
      First page: 449
      Abstract: Publication date: December 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 4
      Author(s): Neal W. Pollock


      PubDate: 2016-12-06T08:56:06Z
      DOI: 10.1016/j.wem.2016.10.001
       
  • Circadian Rhythm and Sleep During Prolonged Antarctic Residence at Chinese
           Zhongshan Station
    • Authors: Nan Chen; Quan Wu; Yanlei Xiong; Guang Chen; Dandan Song; Chengli Xu
      Pages: 458 - 467
      Abstract: Publication date: December 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 4
      Author(s): Nan Chen, Quan Wu, Yanlei Xiong, Guang Chen, Dandan Song, Chengli Xu
      Objective Residence at Zhongshan Station (69°22′24″S, 76°22′40″E) for over 1 year exposes winter-over members to marked changes of light−dark cycle, ranging from the constant daylight of polar days to the constant darkness of polar nights, in addition to geographic and social isolation. This extreme photoperiodic environment may increase the risk of sleep disturbances and circadian desynchrony. The aim of this study was to investigate the circadian rhythm and sleep phase of Chinese winter-over expeditioners at Zhongshan Station. Methods This study was conducted on 17 healthy male participants before departure from Shanghai and during residence at Zhongshan Station for 1 year (before winter, mid-winter, and end of winter). Sequential urine samples over 48 hours were obtained, 6-sulphatoxymelatonin in urine was assessed, and the circadian rhythm was analyzed by a cosine curve-fitting method. Participants’ sleep parameters were obtained from wrist actigraphy and sleep logs. Morningness-Eveningness Questionnaire and Seasonal Pattern Assessment Questionnaire were completed. Results The acrophase of 6-sulphatoxymelatonin rhythm, sleep onset, sleep offset, and mid-sleep time were delayed significantly (P < .05) in Antarctica relative to departure values. The subjects had greater eveningness preference (P < .05) in mid-winter in Antarctica. The Global Seasonality Score and the prevalence of subsyndromal seasonal affective disorder increased (P < .05) during winter. Conclusions Our results indicate that during polar nights Chinese expeditioners experienced the following problems: delayed circadian rhythm and sleep phase, later chronotype, and incidence of subsyndromal seasonal affective disorder. An appropriate combination of artificial bright light during dark winter months and a strict social schedule are recommended in a winter-over station in Antarctica.

      PubDate: 2016-12-06T08:56:06Z
      DOI: 10.1016/j.wem.2016.07.004
       
  • Clinical and Epidemiological Aspects of Scorpionism in the World: A
           Systematic Review
    • Authors: Maria S.V. Santos; Cláudio G.L. Silva; Basílio Silva Neto; Cícero R.P. Grangeiro Júnior; Victor H.G. Lopes; Antônio G. Teixeira Júnior; Deryk A. Bezerra; João V.C.P. Luna; Josué B. Cordeiro; Jucier Gonçalves Júnior; Marcos A.P. Lima
      Pages: 504 - 518
      Abstract: Publication date: December 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 4
      Author(s): Maria S.V. Santos, Cláudio G.L. Silva, Basílio Silva Neto, Cícero R.P. Grangeiro Júnior, Victor H.G. Lopes, Antônio G. Teixeira Júnior, Deryk A. Bezerra, João V.C.P. Luna, Josué B. Cordeiro, Jucier Gonçalves Júnior, Marcos A.P. Lima
      Objective Scorpion stings are registered worldwide, but the incidence and the features of the envenomations vary depending on the region. The aim of this review was to summarize the epidemiological, clinical, diagnostic, and therapeutic data worldwide regarding humans stung by scorpions. Methods A systematic review of the literature was conducted through the online databases of the Virtual Health Library (VHL), which hosts Medline and the Latin American and Caribbean Center on Health Sciences Informational (LILACS) database. We selected articles published between January 1, 2002 and July 31, 2014. Results Scorpion envenomation reports were found throughout the world, mainly in subtropical and tropical regions. The clinical manifestations were sympathetically and parasympathetically mediated, depending on the species of scorpion. Some of the most common severe complications of scorpionism included respiratory distress syndrome, pulmonary edema, cardiac dysfunction, impaired hemostasis, pancreatitis, and multiple organ failure. Scorpion envenomation could be classified as mild, moderate, and severe, and the therapeutic approach was based on the case severity. The treatment comprised 3 components: symptomatic measures, vital functions support, and injection of antivenom. Moreover, the time that elapsed between the sting and administration of the appropriate medical care was extremely important to the patient’s prognosis. Conclusions The large number of scorpion stings worldwide is concerning and reaffirms the need for new prevention measures and policies to reduce the incidence, prevalence, morbidity, and mortality rates from these poisonous arachnids.

      PubDate: 2016-12-06T08:56:06Z
      DOI: 10.1016/j.wem.2016.08.003
       
  • Littered Cans—Death Trap of Snakes
    • Authors: Subhendu Mallik; Sudipta Ranjan Singh; Indramani Nath
      Abstract: Publication date: Available online 15 December 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Subhendu Mallik, Sudipta Ranjan Singh, Indramani Nath


      PubDate: 2016-12-20T13:41:56Z
      DOI: 10.1016/j.wem.2016.10.002
       
  • In Response to Risk Determinants of Acute Mountain Sickness by Lawrence
           and Reid
    • Authors: Gaurav Sikri; Srinivasa Bhattachar; Bikalp Thapa
      Abstract: Publication date: Available online 6 December 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Gaurav Sikri, Srinivasa Bhattachar, Bikalp Thapa


      PubDate: 2016-12-12T12:24:03Z
      DOI: 10.1016/j.wem.2016.10.005
       
  • Clinically Significant Envenomation From Postmortem Copperhead
           (Agkistrodon contortrix)
    • Authors: Michael P. Emswiler; F. Phillip Griffith; Kirk L. Cumpston
      Abstract: Publication date: Available online 18 November 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Michael P. Emswiler, F. Phillip Griffith, Kirk L. Cumpston
      Over 14,000 copperhead (Agkistrodon contortrix) bites were reported to United States poison centers between 1983 and 2008, and 1809 cases were reported to poison centers in 2014. The copperhead is primarily found in the southeastern United States and belongs to the pit viper subfamily Crotalinae, which also includes the water moccasin (Agkistrodon piscivorus) and rattlesnakes (Crotalus and Sistrurus genera). Postmortem rattlesnakes have been reported to cause clinically significant envenomation; we report a case of a postmortem copperhead causing clinically significant envenomation after inadvertent puncture with the deceased copperhead fang. The copperhead was transected twice, leaving the snake in 3 separate pieces. While handling the snake head, an inadvertent puncture occurred on the right index finger followed by pain and swelling in the affected extremity necessitating antivenom administration. Care should be taken when handling deceased pit vipers due to the continued risk of envenomation.

      PubDate: 2016-11-21T21:30:34Z
      DOI: 10.1016/j.wem.2016.09.007
       
  • Inclined Wind Tunnel for the Study of Human and Large Animal Flight
    • Authors: Anton Westman; Peter Georén; Johan Strömberg
      Abstract: Publication date: Available online 18 November 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Anton Westman, Peter Georén, Johan Strömberg


      PubDate: 2016-11-21T21:30:34Z
      DOI: 10.1016/j.wem.2016.08.004
       
  • Health Supply Utilization at a Boy Scout Summer Camp: An Evaluation for
           Improvement and Preparedness
    • Authors: Ross T. Miller; Bradley E. Barth
      Abstract: Publication date: Available online 3 November 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Ross T. Miller, Bradley E. Barth
      Objective To describe the health conditions treated by a health services center at a Boy Scout summer camp and make recommendations for appropriate resources and supplies. Methods We conducted a retrospective review of health center utilization at a Boy Scout camp in central Missouri during the summers of 2012 and 2013. Health logbook data were compiled and analyzed using descriptive and comparative statistics. Results During the study period 19,771 camp participants made 1586 visits to the health care center. The overall incidence rate of health center visits was 6.20 visits per 1000 camp days. Two-thirds of visits were for illness and the remainder for injury. Over 90% of patients were returned to camp, 7.3% were transferred to another health facility, and 1.6% were advised to leave camp and return home. The most common treatments were rehydration (17.8 %) and administration of analgesics (13.4%) and topical creams (12.3%). Conclusions Summer camps need to be prepared for a wide range of conditions and injuries in youth campers, leaders, and staff members. Over 90% of presenting complaints were managed on site, and the majority of conditions were easily treatable minor injuries and illnesses. We provide recommendations for appropriate medical supplies and suggest opportunities for improvement to aid health centers in planning and treatment.

      PubDate: 2016-11-07T20:01:26Z
      DOI: 10.1016/j.wem.2016.09.004
       
  • Dull Brains and Frozen Feet: A Historical Essay on Cold
    • Authors: Harvey V. Lankford
      Abstract: Publication date: Available online 3 November 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Harvey V. Lankford
      This essay will review historical and medical aspects of cold exposure, hypothermia, and frostbite during the Napoleonic era. The 19th century writings of Dominique Jean Larrey, Pierre Jean Moricheau-Beaupré, and others are used to provide an evocative supporting narrative to illustrate some of the cold illnesses, physiology, and theory of both an earlier era and the present time. Medical care for over a century followed the how but not the why of treating frostbite and hypothermia slowly with snow or cold water rather than heat. There were 2 main reasons: First was a practical attempt to limit gangrene. Less known, and long forgotten, is a major rationale based on the erroneous theory of heat called “the caloric.” Because of these 2 reasons, the slow method of “cold warming” remained standard medical practice well into the 20th century. Although these recommendations are now known to be flawed, some of the reasons behind them will be discussed, along with early but correct observations on afterdrop and circumrescue collapse. There is a long backstory of treatment from 1812 to the present.

      PubDate: 2016-11-07T20:01:26Z
      DOI: 10.1016/j.wem.2016.09.005
       
  • Management of Burn Injuries in the Wilderness: Lessons from Low-Resource
           Settings
    • Authors: Cindy C. Bitter; Timothy B. Erickson
      Abstract: Publication date: Available online 28 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Cindy C. Bitter, Timothy B. Erickson
      Burns are a common source of injuries worldwide, with a high burden of disease in low- and middle-income countries. Burns also account for 2%−8% of wilderness injuries. Although many are minor, the potential for serious morbidity and mortality exists, and standard treatments used in high-resource settings are not readily available in the backcountry. A literature review was performed to find evidence from low-resource settings that supports alternative or improvised therapies that may be adapted to care of burns in the wilderness. There is good evidence for use of oral rehydration to support volume status in burn patients. There is moderate evidence to support cold therapy as first aid and adjunct for pain control. Some evidence supports use of alternative dressings such as boiled potato peel, banana leaf, aloe vera, honey, sugar paste, and papaya when standard therapies are not available.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.09.001
       
  • Preparing the United States for Zika Virus: Pre-emptive Vector Control and
           Personal Protection
    • Authors: James H. Diaz
      Abstract: Publication date: Available online 27 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): James H. Diaz
      Discovered in 1947 in a monkey in the Zika forest of Uganda, Zika virus was dismissed as a cause of a mild illness that was confined to Africa and Southeast Asia and transmitted by Aedes mosquitoes. In 2007, Zika virus appeared outside of its endemic borders in an outbreak on the South Pacific Island of Yap. In 2013, Zika virus was associated with a major neurological complication, Guillain-Barré syndrome, in a larger outbreak in the French Polynesian Islands. From the South Pacific, Zika invaded Brazil in 2015 and caused another severe neurological complication, fetal microcephaly. The mosquito-borne transmission of Zika virus can be propagated by sexual transmission and, possibly, by blood transfusions, close personal contacts, and organ transplants, like other flaviviruses. Since these combined mechanisms of infectious disease transmission could result in catastrophic incidences of severe neurological diseases in adults and children, the public should know what to expect from Zika virus, how to prevent infection, and what the most likely failures in preventive measures will be. With federal research funding stalled, a Zika vaccine is far away. The only national strategies to prepare the United States for Zika virus invasion now are effective vector control measures and personal protection from mosquito bites. In addition to a basic knowledge of Aedes mosquito vectors and their biting behaviors, an understanding of simple household vector control measures, and the selection of the best chemical and physical mosquito repellents will be required to repel the Zika threat.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.07.006
       
  • Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do
           They Compare?
    • Authors: John B. Luck; Danielle Campagne; Roberto Falcón-Banchs; Jason Montoya; Susanne J. Spano
      Abstract: Publication date: Available online 26 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): John B. Luck, Danielle Campagne, Roberto Falcón-Banchs, Jason Montoya, Susanne J. Spano
      Objective Compare the pressures measured by improvised irrigation techniques to a commercial device and to prior reports. Methods Devices tested included a commercial 500-mL compressible plastic bottle with splash guard, a 10-mL syringe, a 10-mL syringe with a 14-ga angiocatheter (with needle removed), a 50-mL Sawyer syringe, a plastic bag punctured with a 14-ga needle, a plastic bottle with cap punctured by a 14-ga needle, a plastic bottle with sports top, and a bladder-style hydration system. Each device was leveled on a support, manually compressed, and aimed toward a piece of glass. A high-speed camera placed behind the glass recorded the height of the stream upon impact at its highest and lowest point. Measurements were recorded 5 times for each device. Pressures in pounds per square inch (psi) were calculated. Results The syringe and angiocatheter pressures measured the highest pressures (16–49 psi). The 50-mL syringe (7–11 psi), 14-ga punctured water bottle (7–25 psi), and water bottle with sports top (3–7 psi) all measured at or above the commercial device (4–5 psi). Only the bladder-style hydration system (1–2 psi) and plastic bag with 14-ga needle puncture (2–3 psi) did not reach pressures generated by the commercial device. Conclusions Pressures are consistent with those previously reported. All systems using compressible water bottles and all syringe-based systems provided pressures at or exceeding a commercial wound irrigation device. A 14-ga punctured plastic bag and bladder-style hydration pack failed to generate similar irrigation pressures.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.09.002
       
  • Pulling Harder than the Hamate Tolerates: Evaluation of Hamate Injuries in
           Rock Climbing and Bouldering
    • Authors: Christoph Lutter; Andreas Schweizer; Thomas Hochholzer; Thomas Bayer; Volker Schöffl
      Abstract: Publication date: Available online 26 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Christoph Lutter, Andreas Schweizer, Thomas Hochholzer, Thomas Bayer, Volker Schöffl
      Objective Hamate hook fractures are rare injuries, comprising 2% to 4% of all carpal fractures. Climbing athletes seem to be affected more frequently than others, as they strain the passive and active anatomical structures of their hands and fingers to maximum capacity during training or competing. This stress is transmitted to the hook of the hamate by tightened flexor tendons, which creates high contact pressure to the ulnar margin of the carpal tunnel. Injuries of the hamate hook, caused by contact pressure of the anatomical structures, are rare and occur nearly exclusively during climbing. Methods We diagnosed 12 athletes with hamate hook fractures who presented with diffuse pain in the wrist joint, which occurred either during or after climbing. Radiographs or computed tomography revealed fractures in the hamate bones in most of the patients; therapy consisted of consequent stress reduction. Results Follow-up investigations found that all athletes were free of symptoms after 10.7 ± 5.1 (6–24) (mean ± standard deviation with range) weeks. Resection of the hamate hook was necessary in 3 patients. All patients regained their preinjury climbing level. Conclusion Climbers with an unspecific, diffuse pain in the wrist need to be examined by radiograph and, if radiograph is unclear, computed tomography or magnetic resonance imaging to detect or exclude the diagnosis of hamate fracture in order to avoid severe complications.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.09.003
       
  • Medical Pathologies and Hut Guardians’ Ability to Provide First Aid in
           Mountain Huts: A Prospective Observational Study
    • Authors: Marc Blancher; Jérôme Colonna d’Istria; Amandine Coste; Philippine Saint Guilhem; Antoine Pierre; Flora Clausier; Guillaume Debaty; Jean Luc Bosson; Raphaël Briot; Pierre Bouzat
      Abstract: Publication date: Available online 24 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Marc Blancher, Jérôme Colonna d’Istria, Amandine Coste, Philippine Saint Guilhem, Antoine Pierre, Flora Clausier, Guillaume Debaty, Jean Luc Bosson, Raphaël Briot, Pierre Bouzat
      Objective To describe the resources for medical condition management in mountain huts and the epidemiology of such events. Methods We conducted a 3-step study from April 2013 to August 2014 in French mountain huts. The first step consisted of collecting data regarding the first aid equipment available in mountain huts. The second step consisted of a qualitative evaluation of the mountain hut guardian’s role in medical situations through semistructured interviews. Finally, a prospective observational study was conducted in the summer season to collect all medical events (MEs) that occurred during that period. Results Out of 164 hut guardians, 141 (86%) had a basic life support diploma. An automatic external defibrillator was available in 41 (26%) huts, and 148 huts (98%) were equipped with a first aid kit. According to semistructured interviews, hut guardians played a valuable role in first aid assistance. Regarding the observational study, 306 people requested the hut guardian’s help for medical reasons in 87 of the 126 huts included. A total of 501 MEs for approximately 56,000 hikers (0.85%) were reported, with 280 MEs (56%) involving medical pathologies and 221 (44%) MEs involving trauma-related injuries. Conclusions MEs had low prevalence, but the hut guardian played a valuable role as a first aid responder.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.08.002
       
  • Improvised Cricothyrotomy on a Mountain Using Hiking Gear
    • Authors: Clare A. Johnson; Diana S. Goodwine; Ingrid Passier
      Abstract: Publication date: Available online 18 October 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Clare A. Johnson, Diana S. Goodwine, Ingrid Passier
      We present a case of a 57-year-old man who fell while climbing a mountain in California and sustained severe facial trauma. Three firefighters and 2 emergency physicians witnessed the fall and resuscitated the patient. The patient ultimately required a surgical cricothyrotomy performed with a pocket knife and Platypus hydration pack. The physicians made a makeshift positive pressure airway device using the Platypus hydration pack. We believe this is the first case report describing an improvised cricothyrotomy performed in the wilderness using only hiking gear. This report also discusses indications for cricothyrotomy, the challenges of resuscitation in a low-resource environment, and special considerations in a high-altitude setting.

      PubDate: 2016-10-31T18:05:04Z
      DOI: 10.1016/j.wem.2016.08.001
       
 
 
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