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  Subjects -> ENVIRONMENTAL STUDIES (Total: 767 journals)
    - ENVIRONMENTAL STUDIES (704 journals)
    - POLLUTION (21 journals)
    - TOXICOLOGY AND ENVIRONMENTAL SAFETY (34 journals)
    - WASTE MANAGEMENT (8 journals)

ENVIRONMENTAL STUDIES (704 journals)            First | 1 2 3 4 5 6 7 8     

Marine Ecology     Hybrid Journal   (Followers: 13)
Marine Environmental Research     Hybrid Journal   (Followers: 12)
Marine Pollution Bulletin     Hybrid Journal   (Followers: 11)
Materials for Renewable and Sustainable Energy     Open Access   (Followers: 7)
Mathematical and Computational Forestry & Natural-Resource Sciences     Free  
Mathematical Population Studies: An International Journal of Mathematical Demography     Hybrid Journal   (Followers: 2)
Medio Ambiente y Urbanizacion     Full-text available via subscription  
Membranes     Open Access   (Followers: 4)
Michigan Journal of Sustainability     Open Access  
Midwest Studies In Philosophy     Hybrid Journal   (Followers: 10)
Mine Water and the Environment     Hybrid Journal   (Followers: 6)
Mitigation and Adaptation Strategies for Global Change     Hybrid Journal   (Followers: 12)
Modern Asian Studies     Hybrid Journal   (Followers: 5)
Modern Cartography Series     Full-text available via subscription   (Followers: 6)
Mountain Research and Development     Open Access   (Followers: 3)
Multequina     Open Access  
Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis     Hybrid Journal   (Followers: 2)
Mutation Research/Genetic Toxicology and Environmental Mutagenesis     Hybrid Journal   (Followers: 8)
Nativa     Open Access  
Natur und Recht     Hybrid Journal   (Followers: 6)
Natural Areas Journal     Full-text available via subscription   (Followers: 7)
Natural Hazards     Hybrid Journal   (Followers: 214)
Natural Resources     Open Access  
Natural Resources and Environmental Issues     Open Access   (Followers: 5)
Nature and Culture     Full-text available via subscription   (Followers: 9)
NeuroToxicology     Hybrid Journal   (Followers: 1)
Neurotoxicology and Teratology     Hybrid Journal   (Followers: 2)
NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy     Full-text available via subscription   (Followers: 6)
New Zealand Journal of Environmental Law     Full-text available via subscription   (Followers: 3)
NJAS - Wageningen Journal of Life Sciences     Full-text available via subscription   (Followers: 1)
Noise Notes     Full-text available via subscription   (Followers: 3)
Novos Cadernos NAEA     Open Access  
Observatorio Medioambiental     Open Access  
Occupational and Environmental Medicine     Full-text available via subscription   (Followers: 8)
Ocean Acidification     Open Access  
Oecologia     Hybrid Journal   (Followers: 25)
Oikos     Hybrid Journal   (Followers: 31)
Open Journal of Ecology     Open Access   (Followers: 10)
Open Journal of Marine Science     Open Access   (Followers: 6)
Open Journal of Modern Hydrology     Open Access   (Followers: 1)
Our Nature     Open Access   (Followers: 2)
Oxford Journal of Legal Studies     Hybrid Journal   (Followers: 16)
Pace Environmental Law Review     Open Access   (Followers: 4)
Palaeobiodiversity and Palaeoenvironments     Hybrid Journal   (Followers: 3)
Papers on Global Change IGBP     Open Access   (Followers: 1)
Particle and Fibre Toxicology     Open Access   (Followers: 3)
Pastos y Forrajes     Open Access  
Pesquisa em Educação Ambiental     Open Access  
Pharmacology & Therapeutics     Hybrid Journal   (Followers: 5)
Pharmacology Biochemistry and Behavior     Hybrid Journal   (Followers: 1)
Philosophical Studies     Hybrid Journal   (Followers: 7)
Physio-Géo     Open Access   (Followers: 2)
Pittsburgh Journal of Environmental and Public Health Law     Open Access   (Followers: 1)
Planet     Open Access   (Followers: 1)
Planning & Environmental Law: Issues and decisions that impact the built and natural environments     Hybrid Journal   (Followers: 6)
Plant Ecology & Diversity     Partially Free   (Followers: 11)
Plant Knowledge Journal     Open Access   (Followers: 2)
Plant, Cell & Environment     Hybrid Journal   (Followers: 4)
Polar Journal     Hybrid Journal   (Followers: 1)
Policy Studies     Hybrid Journal   (Followers: 7)
Policy Studies Journal     Hybrid Journal   (Followers: 5)
Polish Polar Research     Open Access   (Followers: 4)
Political Studies     Hybrid Journal   (Followers: 22)
Political Studies Review     Hybrid Journal   (Followers: 14)
Population and Environment     Hybrid Journal   (Followers: 6)
Population Ecology     Hybrid Journal   (Followers: 9)
Population Studies: A Journal of Demography     Hybrid Journal   (Followers: 6)
Postcolonial Studies     Hybrid Journal   (Followers: 6)
Practice Periodical of Hazardous, Toxic, and Radioactive Waste Management     Full-text available via subscription   (Followers: 3)
Presence Teleoperators & Virtual Environments     Hybrid Journal   (Followers: 1)
Presidential Studies Quarterly     Hybrid Journal   (Followers: 4)
Procedia Environmental Sciences     Open Access   (Followers: 2)
Proceedings of ICE, Waste and Resource Management     Hybrid Journal   (Followers: 3)
Proceedings of the Institution of Mechanical Engineers Part M: Journal of Engineering for the Maritime Environment     Hybrid Journal   (Followers: 1)
Proceedings of the International Academy of Ecology and Environmental Sciences     Open Access   (Followers: 4)
Process Safety and Environmental Protection     Hybrid Journal   (Followers: 3)
Progress in Industrial Ecology, An International Journal     Hybrid Journal   (Followers: 4)
Psychological Assessment     Full-text available via subscription   (Followers: 5)
Public Money & Management     Hybrid Journal   (Followers: 4)
Public Works Management & Policy     Hybrid Journal   (Followers: 5)
Qatar Foundation Annual Research Forum Proceedings     Open Access   (Followers: 3)
Radioactivity in the Environment     Full-text available via subscription   (Followers: 4)
Regional Environmental Change     Hybrid Journal   (Followers: 3)
Regional Studies     Hybrid Journal   (Followers: 6)
Religious Studies     Hybrid Journal   (Followers: 11)
RELP - Renewable Energy Law and Policy     Full-text available via subscription   (Followers: 4)
Remediation Journal     Hybrid Journal   (Followers: 5)
Remote Sensing Letters     Hybrid Journal   (Followers: 9)
Renaissance Studies     Hybrid Journal   (Followers: 13)
Rendiconti Lincei     Hybrid Journal  
Renewable Energy Focus     Full-text available via subscription   (Followers: 7)
Research & Reviews : Journal of Ecology     Full-text available via subscription  
Research and Practice for Persons with Severe Disabilities     Full-text available via subscription   (Followers: 4)
Research Journal of Environmental Sciences     Open Access   (Followers: 1)
Research Journal of Environmental Toxicology     Open Access   (Followers: 2)
ReSource     Full-text available via subscription  
Resources     Open Access  
Resources, Conservation and Recycling     Hybrid Journal   (Followers: 9)
Reuse/Recycle Newsletter     Hybrid Journal   (Followers: 1)
Review of English Studies     Hybrid Journal   (Followers: 7)

  First | 1 2 3 4 5 6 7 8     

Journal Cover Wilderness & Environmental Medicine
   Journal TOC RSS feeds Export to Zotero [5 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1080-6032
     Published by Elsevier Homepage  [2566 journals]
  • An EPAS1 Haplotype Is Associated With High Altitude Polycythemia in Male
           Han Chinese at the Qinghai-Tibetan Plateau
    • Abstract: Publication date: Available online 16 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Yu Chen , Chunhua Jiang , Yongjun Luo , Fuyu Liu , Yuqi Gao
      Background Hemoglobin concentration at high altitude is considered an important marker of high altitude adaptation, and native Tibetans in the Qinghai-Tibetan plateau show lower hemoglobin concentrations than Han people who have emigrated from plains areas. Genetic studies revealed that EPAS1 plays a key role in high altitude adaptation and is associated with the low hemoglobin concentration in Tibetans. Three single nucleotide polymorphisms (rs13419896, rs4953354, rs1868092) of noncoding regions in EPAS1 exhibited significantly different allele frequencies in the Tibetan and Han populations and were associated with low hemoglobin concentrations in Tibetans. Methods To explore the hereditary basis of high altitude polycythemia (HAPC) and investigate the association between EPAS1 and HAPC in the Han population, these 3 single nucleotide polymorphisms were assessed in 318 male Han Chinese HAPC patients and 316 control subjects. Genotyping was performed by high resolution melting curve analysis. Results The G-G-G haplotype of rs13419896, rs4953354, and rs1868092 was significantly more frequent in HAPC patients than in control subjects, whereas no differences in the allele or genotype frequencies of the 3 single nucleotide polymorphisms were found between HAPC patients and control subjects. Moreover, genotypes of rs1868092 (AA) and rs4953354 (GG) that were not observed in the Chinese Han in the Beijing population were found at frequencies of 1.6% and 0.9%, respectively, in our study population of HAPC patients and control subjects. Conclusions Carriers of this EPAS1 haplotype (G-G-G, rs13419896, rs4953354, and rs1868092) may have a higher risk for HAPC. These results may contribute to a better understanding of the pathogenesis of HAPC in the Han population.


      PubDate: 2014-09-19T12:02:59Z
       
  • Summer Climbing Incidents Occurring on Fujisan’s North Face from
           1989 to 2008
    • Abstract: Publication date: Available online 16 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Thomas E. Jones , Kiyotatsu Yamamoto , Uichi Hayashi , Nicholas R. Jones
      Objective Few studies exist on climbing-related incidents at Fujisan, although it is Japan’s highest peak at 3776 m, and attracts dense crowds of summer climbers. A retrospective review was thus conducted to analyze the types of incidents and the demographics of climbers involved. Methods Police reports of summer climbing incidents occurring along the Yoshida trail on Fujisan’s north face from 1989 to 2008 were reviewed. Variables assessed included climber age, sex, experience, gear, altitude of incident, and whether the incident occurred during ascent or descent, as well as the cause and severity of any associated injury. Results A total of 155 incident reports were assessed, including 28 deaths mostly attributable to cardiac events occurring among male climbers during ascent. The majority of nonfatal incidents occurred during descent and most involved tripping. More than half of all incidents were reported at the 8th step (approximately 3000 m). The frequent appearance of male climbers without experience or adequate footwear reflects Fujisan’s summer demographics, yet the injury rate appears higher among older climbers more than 50 years of age. There were also 28 noninjury incidents attributed to acute mountain sickness or fatigue. Conclusions This retrospective review describes the demographics of summer climbing incidents on Fujisan’s north face. Additionally, limitations to the current method of incident reporting were identified. More comprehensive recordkeeping would increase understanding of injuries and illness, which could improve resource allocation and reduce the risk of fatalities from out-of-hospital cardiac events.


      PubDate: 2014-09-19T12:02:59Z
       
  • Stand-Up Paddleboarding, Artibonite River, Verettes, Haiti
    • Abstract: Publication date: Available online 17 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christopher Van Tilburg , Jennifer Donnelly



      PubDate: 2014-09-19T12:02:59Z
       
  • Human Skeletal Muscle mRNA Response to a Single Hypoxic Exercise Bout
    • Abstract: Publication date: Available online 16 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Dustin R. Slivka , Matthew W.S. Heesch , Charles L. Dumke , John S. Cuddy , Walter S. Hailes , Brent C. Ruby
      Background The ability to physically perform at high altitude may require unique strategies to acclimatize before exposure. The effect of acute hypoxic exposure on the metabolic response of the skeletal muscle may provide insight into the value of short-term preacclimatization strategies. Objective To determine the human skeletal muscle response to a single acute bout of exercise in a hypoxic environment on metabolic gene expression. Methods Eleven recreationally active male participants (24 ± 4 years, 173 ± 20 cm, 82 ± 12 kg, 15.2 ± 7.1% fat, 4.0 ± 0.6 L/min maximal oxygen consumption) completed two 1-hour cycling exercise trials at 60% of peak power followed by 4 hours of recovery in ambient environmental conditions (975 m) and at normobaric hypoxic conditions simulating 3000 m in a randomized counterbalanced order. Muscle biopsies were obtained from the vastus lateralis before exercise and 4 hours after exercise for real-time polymerase chain reaction analysis of select metabolic genes. Results Gene expression of hypoxia-inducible factor 1 alpha, cytochrome c oxidase subunit 4, peroxisome proliferator-activated receptor gamma coactivator 1 alpha, hexokinase, phosphofructokinase, mitochondrial fission 1, and mitofusin-2 increased with exercise (P < .05) but did not differ with hypoxic exposure (P > .05). Optic atrophy 1 did not increase with exercise or differ between environmental conditions (P > .05). Conclusions The improvements in mitochondrial function reported with intermittent hypoxic training may not be explained by a single acute hypoxic exposure, and thus it appears that a longer period of preacclimatization than a single exposure may be required.


      PubDate: 2014-09-19T12:02:59Z
       
  • Medical Student Electives in Wilderness Medicine: Curriculum Guidelines
    • Abstract: Publication date: Available online 12 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Stephanie A. Lareau , Michael J. Caudell , Kiran B. Pandit , Brian C. Hiestand
      Wilderness medicine has been a part of medical student education for many years and is becoming more popular. To help standardize and improve the student experience, we surveyed current elective directors to gain an understanding of what experts in the field thought were priority elements in a wilderness medicine elective. Although there is a diversity of opinion among leaders in the field, there are multiple topics on which there is concordance on inclusion or exclusion.


      PubDate: 2014-09-14T09:22:49Z
       
  • David OliverRelinSecond Suns: Two Doctors and Their Amazing Quest to
           Restore Sight and Save Lives2013Random House, IncNew York, NYUS $27.00,
           415 pages
    • Abstract: Publication date: Available online 12 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Buddha Basnyat



      PubDate: 2014-09-14T09:22:49Z
       
  • Student Electives in Wilderness Medicine: Curriculum Guidelines—An
           Introduction
    • Abstract: Publication date: Available online 12 September 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Steve Donelan



      PubDate: 2014-09-14T09:22:49Z
       
  • Concussion Management in the Wilderness
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Justin M. Wright , Arthur A. Islas
      Head trauma accounts for a significant number of injuries in the wilderness setting. Concussions are possible sequelae of falls or encounters with unforeseen obstacles. Although not immediately life-threatening, concussions can be a source of significant short- and long-term morbidity. Diagnosis of a concussion in the wilderness may be challenging as symptoms can often be confused with other conditions, such as altitude illness and hyponatremia. Successful management depends on accurate diagnosis and determination of the severity of symptoms so that appropriate decisions regarding treatment and need for evacuation can be made.


      PubDate: 2014-09-04T06:06:55Z
       
  • Incidence and Characteristics of Snakebite Envenomations in the New York
           State Between 2000 and 2010
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Jeremy D. Joslin , Jeanna M. Marraffa , Harinder Singh , Joshua Mularella
      Objective We sought to evaluate the incidence of reported venomous snakebites in the state of New York between 2000 and 2010. Methods Data were collected retrospectively from the National Poison Data System (NPDS) and then reviewed for species identification and clinical outcome while using proxy measures to determine incidence of envenomation. Results From 2000 to 2010 there were 473 snakebites reported to the 5 Poison Control Centers in the state of New York. Venomous snakes accounted for 14.2% (67 of 473) of these bites. Only 35 bites (7%) required antivenom. The median age of those bitten by a venomous snake was 33. Most victims were male. Conclusions Although not rare, venomous snakebites do not occur commonly in New York State, with a mean of just 7 bites per year; fortunately most snakebites reported are from nonvenomous snakes. Yet even nonvenomous bites have the potential to cause moderately severe outcomes. Medical providers in the state should be aware of their management.


      PubDate: 2014-09-04T06:06:55Z
       
  • The Incidence of Acute Mountain Sickness Among Passengers Traveling Across
           the Tibetan Plateau by Train
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Yong Wang , Hong Jiang , Xinying Xue , Lei Pan , Lina Jia , Yongjie Huang , Jin Qian , Xiaoyong Ma



      PubDate: 2014-09-04T06:06:55Z
       
  • Grant S.LipmanMDThe Wilderness First Aid Handbook2013Sky Horse
           PublishingNew York, NYUS $14.95, 120 pages, soft cover
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Gabriel Cade



      PubDate: 2014-09-04T06:06:55Z
       
  • Diana L.De StefanoEncounters in Avalanche Country: A History of Survival
           in the Mountain West, 1820–19202013University of Washington
           PressSeattle, WA, USAUS$34.95, 171 pages, hardcover
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Christopher Van Tilburg



      PubDate: 2014-09-04T06:06:55Z
       
  • Novel Anticoagulants Should NOT Be Recommended for High-Risk Activity
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Michael A. Darracq , Megann Young



      PubDate: 2014-09-04T06:06:55Z
       
  • Symptomatic Hypotonic Hyponatremia Presenting at High Altitude
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Martin D. Hoffman , Robert H. Weiss



      PubDate: 2014-09-04T06:06:55Z
       
  • In Reply to Symptomatic Hypotonic Hyponatremia Presenting at High Altitude
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Susanne J. Spano , Zacharia Reagle , Timothy Evans



      PubDate: 2014-09-04T06:06:55Z
       
  • Effectiveness of Preventive Search and Rescue: Illness and Injury
           Prevention and Fiscal Impact
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Christian Malcolm , Heinrich Hannah , Emily Pearce



      PubDate: 2014-09-04T06:06:55Z
       
  • Physiological Temperature Thresholds and Heat-Related Hiker Assists:
           Preventive Search and Rescue in Grand Canyon National Park
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Christian Malcolm , Hannah Heinrich , Emily Pearce



      PubDate: 2014-09-04T06:06:55Z
       
  • Chaos in the Wilderness: Lifesaving Performance of Medical Teams in
           Austere Environments
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Lancer A. Scott , Julie Teuber , Jamal Jones , Judy Staub , Andrew Seymore



      PubDate: 2014-09-04T06:06:55Z
       
  • Hydration Status as Predictor of Summit Success on Mount McKinley
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Eric R. Ladd , Katherine M. Shea , Grant S. Lipman , Patrick Bagley , Elizabeth Pirrotta , Hurnan Vongsachang , N. Ewen Wang , Paul S. Auerbach



      PubDate: 2014-09-04T06:06:55Z
       
  • Incidence of Illness and Sickle-Cell Trait at Altitude: Data from the
           Marine Mountain Warfare Training Center
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Ian C. May , Garrett Ripoll , Ian Wedmore , Carl Skinner , Darren Thomas , Owen McGrane



      PubDate: 2014-09-04T06:06:55Z
       
  • 6-Minute Walk Test as a Predictor of Summit Success on Denali
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Katherine M. Shea , Eric R. Ladd , Grant S. Lipman , Patrick Bagley , Elizabeth Pirrotta , Hurnan Vongsachang , N Ewen Wang , Paul S. Auerbach



      PubDate: 2014-09-04T06:06:55Z
       
  • Scientific Reports
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Matthew Stewart



      PubDate: 2014-09-04T06:06:55Z
       
  • World Journal of Orthopedics
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Pearlly Ng



      PubDate: 2014-09-04T06:06:55Z
       
  • Walk High, Sleep Low: An Observational Cohort Study of Altitude Symptoms
           and Physiological Profiles Over a 6 Day Ascent of Mount Kilimanjaro
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Laura G. Nicol , Hannah E. Evans



      PubDate: 2014-09-04T06:06:55Z
       
  • Australasian Medical Journal
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Matthew Stewart



      PubDate: 2014-09-04T06:06:55Z
       
  • Hawai’i Journal of Medicine and Public Health
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Heather Beasley



      PubDate: 2014-09-04T06:06:55Z
       
  • Journal of Sports Science and Medicine
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Matthew Stewart



      PubDate: 2014-09-04T06:06:55Z
       
  • A Pilot Study of Solar Water Disinfection in the Wilderness Setting
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Christopher M. Tedeschi , Christopher Barsi , Shane E. Peterson , Kevin M. Carey
      Objective Solar disinfection of water has been shown to be an effective treatment method in the developing world, but not specifically in a wilderness or survival setting. The current study sought to evaluate the technique using materials typically available in a wilderness or backcountry environment. Methods Untreated surface water from a stream in rural Costa Rica was disinfected using the solar disinfection (SODIS) method, using both standard containers as well as containers and materials more readily available to a wilderness traveler. Results Posttreatment samples using polyethylene terephthalate (PET) bottles, as well as Nalgene and Platypus water containers, showed similarly decreased levels of Escherichia coli and total coliforms. Conclusions The SODIS technique may be applicable in the wilderness setting using tools commonly available in the backcountry. In this limited trial, specific types of containers common in wilderness settings demonstrated similar performance to the standard containers. With further study, solar disinfection in appropriate conditions may be included as a viable treatment option for wilderness water disinfection.


      PubDate: 2014-09-04T06:06:55Z
       
  • Effect of Ski Mountaineering Track on Foot Sole Loading Pattern
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Matthias Haselbacher , Katharina Mader , Maximiliane Werner , Michael Nogler
      Objective Ski mountaineering is becoming a popular sport. The ascending techniques (tracks) can be divided into 3 different groups: flat field, direct ascent, and traversing. This study examines the relationship between different mechanical loads on the foot and the 4 different mountaineering ascending techniques. Methods All subjects used the same pair of ski boots and the same skis while performing the 4 different ascending techniques. An in-shoe dynamic pressure measuring system was used to measure the mechanical load on the foot soles of each ski mountaineer. The foot sole was divided into 6 anatomic sections to measure the different loads in each section. Results Thirteen men with an average age of 29 years were enrolled in the study. The results showed small, not significant differences in the mechanical foot load in the flat field or in the direct ascent. The average mechanical foot load was highest on the valley side foot while traversing (179 kPa to 117 kPa). The higher load forces were in the medial ball of the foot and the longitudinal aspect of the foot side closer to the hill. Conclusions The higher impact placed on the valley side foot and the concentration of force placed on the medial ball of the valley side foot suggested the influence of the track on the load pattern of the foot sole. This higher impact may result in upward forces that affect the force distribution in the ankle and knee joints.


      PubDate: 2014-09-04T06:06:55Z
       
  • Atraumatic Splenic Rupture After Coagulopathy Owing to a Snakebite
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Changwoo Kang , Dong Hoon Kim , Seong Chun Kim , Dong Seob Kim , Chi-Young Jeong
      Among the many complications that may follow envenomation by some species of venomous snakes, coagulopathy is common and well known. However, hemoperitoneum induced by coagulopathy after a snakebite is rare. Atraumatic spontaneous splenic rupture is also an uncommon and life-threatening condition. Here, we report a case of presumptive envenomation by Gloydius spp. that resulted in atraumatic splenic rupture as a probable manifestation of coagulopathy, which has not been previously reported.


      PubDate: 2014-09-04T06:06:55Z
       
  • Effects of Hiking at Moderate and Low Altitude on Cardiovascular
           Parameters in Male Patients With Metabolic Syndrome: Austrian Moderate
           Altitude Study
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Günther Neumayr , Dietmar Fries , Markus Mittermayer , Egon Humpeler , Anton Klingler , Wolfgang Schobersberger , Reinhard Spiesberger , Rochus Pokan , Peter Schmid , Robert Berent
      Objective Physical activity is a cornerstone in therapy for patients with metabolic syndrome. Walking and hiking in a mountain scenery represents an ideal approach to make them move. The Austrian Moderate Altitude Study (AMAS) 2000 main study is a randomized controlled trial to investigate the cardiovascular effects of hiking at moderate altitude on patients with metabolic syndrome compared with a control group at low altitude, to assess a potential altitude-specific effect. Methods Seventy-one male patients with metabolic syndrome were randomly assigned to a moderate altitude group (at 1700 m), with 36 participants, or to a low altitude group (at 200 m), with 35 participants. The 3-week vacation program included 12 hiking tours (4 per week, average duration 2.5 hours, intensity 55% to 65% of heart rate maximum). Physical parameters, performance capacity, 24-hour blood pressure, and heart rate profiles were obtained before, during, and after the stay. Results In both groups, we found a significant mean weight loss of −3.13 kg; changes in performance capacity were minor. Systolic, diastolic, and mean arterial pressures and circadian heart rate profiles were significantly reduced in both groups, with no differences between them. Consequently, the pressure-rate product was reduced as well. All study participants tolerated the vacation well without any adverse events. Conclusions A 3-week hiking vacation at moderate or low altitude is safe for patients with metabolic syndrome and provides several improvements in their cardiovascular parameters. The cardiovascular benefits achieved are more likely to be the result of regular physical activity than the altitude-specific effect of a mountain environment.


      PubDate: 2014-09-04T06:06:55Z
       
  • Hypoxia – high, low, and far
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Scott E. McIntosh , Tracy Cushing , Linda Keyes



      PubDate: 2014-09-04T06:06:55Z
       
  • Doppler Detection in Ama Divers of Japan
    • Abstract: Publication date: September 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 3
      Author(s): Frédéric Lemaître , Kiyotaka Kohshi , Hideki Tamaki , Kasuo Nakayasu , Mesanori Harada , Masanobu Okayama , Yuka Satou , Michiko Hoshiko , Tatsuya Ishitake , Guillaume Costalat , Bernard Gardette
      Objective Symptoms consistent with neurological decompression sickness (DCS) in commercial breath-hold (Ama) divers has been reported from a few districts of Japan. The aim of this study was to detect circulating intravascular bubbles after repetitive breath-hold diving in a local area where DCS has been reported in Ama divers. Methods The participants were 12 partially assisted (descent using weights) male Ama divers. The equipment (AQUALAB system) consisted of continuous-wave Doppler with a 5-MHz frequency, and the Doppler probe was placed in the precordial site with the ultrasonic wave directed into the pulmonary infundibulum. We carried out continuous monitoring for 10 minutes at the end of the series of repetitive dives, and the recordings were made on numerical tracks and graded in a blind manner by 2 experienced investigators, according to the Spencer Doppler code. Results Depths and number of dives were 8 to 20 m and 75 to 131 times. Mean diving duration and surface interval were 64 ± 12 seconds and 48 ± 8 seconds, respectively (mean ± SD). We detected the lowest grade of intravascular bubbles (Spencer’s grade I) in an Ama diver whose mean surface interval was only 35.2 ± 6.2 seconds. His mean descending, bottom, and ascending times were 10.4 ± 1.6 seconds, 39.2 ± 8 seconds, and 18.2 ± 3.0 seconds, respectively, over the course of 99 dives. Conclusions Intravascular bubbles may be formed after repetitive breath-hold dives with short surface intervals or after a long breath-holding session in Ama divers. Symptoms consistent with neurological accidents in repetitive breath-hold diving may be caused in part by the intravascular presence of bubbles, indicating the need for safety procedures.


      PubDate: 2014-09-04T06:06:55Z
       
  • Deep: The Story of Skiing and the Future of Snow, Porter Fox Jackson, WY,
           USA: Rink House, 2013 US $24.95, 286 pages, hardcover
    • Abstract: Publication date: Available online 25 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christopher Van Tilburg



      PubDate: 2014-07-29T04:37:31Z
       
  • Implementing an Emergency Medical Services System in Kathmandu, Nepal: A
           Model for “White Coat Diplomacy”
    • Abstract: Publication date: Available online 19 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Rebecca Walker , Paul S. Auerbach , Benjamin V. Kelley , Rajesh Gongal , David Amsalem , Swaminatha Mahadevan
      Wilderness medicine providers often visit foreign lands, where they come in contact with medical situations that are representative of the prevailing healthcare issues in the host countries. The standards of care for matters of acute and chronic care, public health, and crisis intervention are often below those we consider to be modern and essential. Emergency medical services (EMS) is an essential public medical service that is often found to be underdeveloped. We describe our efforts to support development of an EMS system in the Kathmandu Valley of Nepal, including training the first-ever class of emergency medical technicians in that country. The purpose of this description is to assist others who might attempt similar efforts in other countries and to support the notion that an effective approach to improving foreign relations is assistance such as this, which may be considered a form of “white coat diplomacy.”


      PubDate: 2014-07-29T04:37:31Z
       
  • Extreme Altitude: Words From on High
    • Abstract: Publication date: Available online 19 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Harvey V. Lankford
      Medical science has its own objective language for describing the effects of high altitude. Mountaineers’ words and metaphors tell the story with subjectivity and feeling. This essay will include only limited physiology about lowlanders and high altitude. Instead, the focus will be literary, using the quotations of 20th-century mountaineers and mountaineer physicians to provide color commentary about the hardship. These are Words From on High.


      PubDate: 2014-07-29T04:37:31Z
       
  • A Novel Risk Factor for High Altitude Pulmonary Edema?
    • Abstract: Publication date: Available online 25 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Andrew M. Luks



      PubDate: 2014-07-29T04:37:31Z
       
  • Is Drinking to Thirst a Prudent Guideline to Avoid Hyponatremia?
    • Abstract: Publication date: Available online 30 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Bill Aughton



      PubDate: 2014-07-29T04:37:31Z
       
  • Long-Term Monitoring of Oxygen Saturation at Altitude Can Be Useful in
           Predicting the Subsequent Development of Moderate-to-Severe Acute Mountain
           Sickness
    • Abstract: Publication date: Available online 11 July 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Gaia Mandolesi , Giovanni Avancini , Manuela Bartesaghi , Eva Bernardi , Luca Pomidori , Annalisa Cogo
      Objective The use of pulse oximetry (Spo 2) to identify subjects susceptible to acute mountain sickness (AMS) is the subject of debate. To obtain more reliable data, we monitored Spo 2 for 24 hours at altitude to investigate the ability to predict impending AMS. Methods The study was conducted during the climb from Alagna (1154 m) to Capanna Regina Margherita (4559 m), with an overnight stay in Capanna Gnifetti (3647 m). Sixty subjects (11 women) were recruited. Each subject was fitted with a 24-hour recording finger pulse oximeter. The subjects rode a cable car to 3275 m and climbed to 3647 m, where they spent the night. Results In the morning, 24 subjects (6 women) had a Lake Louise Questionnaire score (LLS) ≥ 3 (AMS+), and 15 subjects (4 women) exhibited moderate-to-severe disease (LLS ≥5 = AMS++). At Alagna, Spo 2 did not differ between the AMS– and AMS+ subjects. At higher stations, all AMS+ subjects exhibited a significantly lower Spo 2 than did the AMS– subjects: at 3275 m, 85.4% vs 87.7%; resting at 3647 m, 84.5% vs 86.4%. The receiver operating characteristics curve analysis resulted in a rather poor discrimination between the AMS– subjects and all of the AMS+ subjects. With the cutoff LLS ≥ 5, the sensitivity was 86.67%, the specificity was 82.25%, and the area under the curve was 0.88 (P < .0001) for Spo 2 ≤ 84% at 3647 m. Conclusions We conclude that AMS+ subjects exhibit a more severe and prolonged oxygen desaturation than do AMS– subjects starting from the beginning of altitude exposure, but the predictive power of Spo 2 is accurate only for AMS++.


      PubDate: 2014-07-29T04:37:31Z
       
  • Human Death Caused by a Giant Anteater (Myrmecophaga trydactila) in Brazil
    • Abstract: Publication date: Available online 11 July 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Vidal Haddad Jr , Guilherme C. Reckziegel , Domingos G. Neto , Fábio L. Pimentel
      The fatal outcome of a defensive attack by a giant anteater (Myrmecophaga trydactila) is reported. The attack occurred while the victim was hunting, and his dogs cornered the adult anteater, which assumed an erect, threatening position. The hunter did not fire his rifle because of concern about accidentally shooting his dogs. He approached the animal armed with a knife, but was grabbed by its forelimbs. When his sons freed him, he had puncture wounds and severe bleeding in the left inguinal region; he died at the scene. Necroscopic examination showed femoral artery lesions and a large hematoma in the left thigh, with death caused by hypovolemic shock. A similar case is cited, and recommendations are made that boundaries between wildlife and humans be respected, especially when they coinhabit a given area.


      PubDate: 2014-07-29T04:37:31Z
       
  • Spine Immobilization Algorithm Revisited
    • Abstract: Publication date: Available online 6 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Paul Nicolazzo



      PubDate: 2014-06-18T22:46:29Z
       
  • Novel Method for Reducing Temperature of i-STAT1 Analyzer in Extreme
           Environments
    • Abstract: Publication date: Available online 3 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Jeremy Joslin , Joshua Mularella , Susan Schreffler , DO Jennifer Kruse



      PubDate: 2014-06-18T22:46:29Z
       
  • Reply to: Novel Anticoagulants Should NOT Be Recommended for High-Risk
           Activity
    • Abstract: Publication date: Available online 2 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Seth C. Hawkins , Michael J. Caudell , Thomas Deloughery , William Murray



      PubDate: 2014-06-18T22:46:29Z
       
  • The Impact of an Ultramarathon on Hormonal and Biochemical Parameters in
           Men
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Brian R. Kupchak , William J. Kraemer , Martin D. Hoffman , Stephen D. Phinney , Jeff S. Volek
      Objective To examine circulating hormonal responses in men competing in the Western States Endurance Run (WSER, June 23 to 24, 2012): a 161-km trail run that starts in Squaw Valley, CA, and concludes in Auburn, CA. Methods We examined 12 men who completed the WSER. Blood samples were obtained the morning before the race, immediately postrace (IP), and 1 (D1) and 2 (D2) days after the conclusion of the WSER. The hypothalamic-pituitary-testicular (HPT) axis was assessed by measuring testosterone and luteinizing hormone (LH). We also examined sex hormone-binding globulin (SHBG) and cortisol. Biochemical and muscle damage markers were also measured. Results Relative to prerace, there were significant (P ≤ .05) decreases in testosterone, LH, and SHBG, whereas cortisol showed a significantly marked elevation at IP. Testosterone, LH, SHBG, and cortisol remained significantly different from prerace at D1. Additionally, the testosterone to cortisol (T:C) ratio, a marker of anabolism, was decreased at IP and D1. Serum total protein, albumin, and globulin significantly decreased at IP, and remained decreased at D1 and D2. Bilirubin increased significantly IP and D1, whereas alkaline phosphatase decreased at D1 and D2. Creatine kinase, myoglobin, aspartate aminotransferase, and alanine aminotransferase increased at IP, and continued to be significantly elevated at D1 and D2. Conclusions Training for and completing the WSER produced a significant suppression in the HPT axis as seen by decreased levels of testosterone and LH. Additionally, running the WSER continued to influence endocrine function until 2 days after the race. Furthermore, the stress caused by the WSER produced severe muscle damage.


      PubDate: 2014-06-18T22:46:29Z
       
  • In Reply to Spine Protection in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Robert Quinn , Jason Williams , Brad Bennett , Gregory Stiller , Arthur Islas , Seth McCord



      PubDate: 2014-06-18T22:46:29Z
       
  • Exercise Limitation of Acetazolamide at Altitude (3459 m)
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Arthur R. Bradwell , Stephen D. Myers , Maggie Beazley , Kimberly Ashdown , Nick G. Harris , Susie B. Bradwell , Jamie Goodhart , Chris H. Imray , Yashvi Wimalasena , Mark E. Edsell , Kyle T.S. Pattinson , Alex D. Wright , Stephen J. Harris
      Objective To assess the effect of acetazolamide (Az) on exercise performance during early acclimatization to altitude. Methods Az (250 mg twice daily) or placebo was administered for 3 days in a double-blind, randomized manner followed by a rapid ascent to 3459 m in the Italian Alps. Twenty healthy adults (age range, 18–67 years) were tested at 60% of sea-level peak power output for 15 minutes on a bicycle ergometer after 16 to 27 hours of altitude exposure. Exercise performance was measured in relation to peripheral oxygen saturations measured from pulse oximetry (Spo 2), Lake Louise acute mountain sickness (AMS) score, and perceived difficulty. Results At altitude, resting Spo 2 was higher in the Az group compared with placebo (P < .001). The highest AMS scores were in 4 of the placebo individuals with the lowest resting Spo 2 (P < .05). During the exercise test, Spo 2 fell in all but 1 subject (P < .001) and was reduced more in the Az group (P < .01). Four Az and 1 placebo subject were unable to complete the exercise test; 4 of these 5 had the largest fall in Spo 2. The perception of exercise difficulty was higher in the Az subjects compared with those taking the placebo (P < .01). There was an age relationship with exercise limitation; 4 of the 9 older than 50 years failed to complete the test whereas only 1 of 11 younger than 50 years failed, and there were no failures in the 6 younger than 30 years (P < .05). Conclusions In this study group, and despite higher resting Spo 2, Az may have compromised exercise at 3459 m altitude during early acclimatization, particularly in older subjects.


      PubDate: 2014-06-18T22:46:29Z
       
  • An Unprovoked Attack by a Blue Shark Prionace glauca (Chondrichthyes:
           Carcharhinidae) on a Spear Fisherman in Terceira Island, Azores, Northeast
           Atlantic
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): João Pedro Barreiros , Otto B.F. Gadig , Vidal Haddad Jr.



      PubDate: 2014-06-18T22:46:29Z
       
  • Wilderness Medical Society Practice Guidelines for Basic Wound Management
           in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Robert H. Quinn , Ian Wedmore , Eric Johnson , Arthur Islas , Anne Anglim , Ken Zafren , Cindy Bitter , Vicki Mazzorana
      In an effort to produce best-practice guidelines for wound management in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for the management of wounds sustained in an austere (dangerous or compromised) environment. Recommendations are made about several parameters related to wound management. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians.


      PubDate: 2014-06-18T22:46:29Z
       
  • Spine Protection in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ken Zafren , William R. Smith , David E. Johnson , Tim Kovacs



      PubDate: 2014-06-18T22:46:29Z
       
  • Sleeping in Moderate Hypoxia at Home for Prevention of Acute Mountain
           Sickness (AMS): A Placebo-Controlled, Randomized Double-Blind Study
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christoph Dehnert , Astrid Böhm , Igor Grigoriev , Elmar Menold , Peter Bärtsch
      Objective Acclimatization at natural altitude effectively prevents acute mountain sickness (AMS). It is, however, unknown whether prevention of AMS is also possible by only sleeping in normobaric hypoxia. Methods In a placebo-controlled, double-blind study 76 healthy unacclimatized male subjects, aged 18 to 50 years, slept for 14 consecutive nights at either a fractional inspired oxygen (Fio 2) of 0.14 to 0.15 (average target altitude 3043 m; treatment group) or 0.209 (control group). Four days later, AMS scores and incidence of AMS were assessed during a 20-hour exposure in normobaric hypoxia at Fio 2 = 0.12 (equivalent to 4500 m). Results Because of technical problems with the nitrogen generators, target altitude was not achieved in the tents and only 21 of 37 subjects slept at an average altitude considered sufficient for acclimatization (>2200 m; average, 2600 m). Therefore, in a subgroup analysis these subjects were compared with the 21 subjects of the control group with the lowest sleeping altitude. This analysis showed a significantly lower AMS-C score (0.38; 95% CI, 0.21 to 0.54) vs 1.10; 95% CI, 0.57 to 1.62; P = .04) and lower Lake Louise Score (3.1; 95% CI, 2.2 to 4.1 vs 5.1; 95% CI, 3.6 to 6.6; P = .07) for the treatment subgroup. The incidence of AMS defined as an AMS-C score greater than 0.70 was also significantly lower (14% vs 52%; P < .01). Conclusions Sleeping 14 consecutive nights in normobaric hypoxia (equivalent to 2600 m) reduced symptoms and incidence of AMS 4 days later on exposure to 4500 m.


      PubDate: 2014-06-18T22:46:29Z
       
 
 
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