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  Subjects -> ENVIRONMENTAL STUDIES (Total: 779 journals)
    - ENVIRONMENTAL STUDIES (715 journals)
    - POLLUTION (21 journals)
    - TOXICOLOGY AND ENVIRONMENTAL SAFETY (35 journals)
    - WASTE MANAGEMENT (8 journals)

ENVIRONMENTAL STUDIES (715 journals)            First | 1 2 3 4 5 6 7 8     

Luna Azul     Open Access  
M+A. Revista Electrónica de Medioambiente     Open Access  
Macquarie Journal of International and Comparative Environmental Law     Full-text available via subscription   (Followers: 8)
Madagascar Conservation & Development     Open Access  
Management International Review     Hybrid Journal   (Followers: 5)
Management of Environmental Quality: An International Journal     Hybrid Journal   (Followers: 4)
Marine Ecology     Hybrid Journal   (Followers: 13)
Marine Environmental Research     Hybrid Journal   (Followers: 12)
Marine Pollution Bulletin     Hybrid Journal   (Followers: 12)
Materials for Renewable and Sustainable Energy     Open Access   (Followers: 8)
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: 9)
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: 6)
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: 7)
Natural Areas Journal     Full-text available via subscription   (Followers: 7)
Natural Hazards     Hybrid Journal   (Followers: 257)
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: 7)
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: 28)
Oikos     Hybrid Journal   (Followers: 32)
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: 17)
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: 8)
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: 8)
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: 7)
Postcolonial Studies     Hybrid Journal   (Followers: 8)
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: 5)
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: 5)
Public Works Management & Policy     Hybrid Journal   (Followers: 6)
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: 4)
Regional Studies     Hybrid Journal   (Followers: 6)
Religious Studies     Hybrid Journal   (Followers: 10)
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: 15)
Rendiconti Lincei     Hybrid Journal  
Renewable Energy Focus     Full-text available via subscription   (Followers: 8)
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)

  First | 1 2 3 4 5 6 7 8     

Journal Cover Wilderness & Environmental Medicine
   [5 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1080-6032
     Published by Elsevier Homepage  [2575 journals]
  • Wilderness Medical Society Practice Guidelines for Treatment of
           Exercise-Associated Hyponatremia: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Brad L. Bennett , Tamara Hew-Butler , Martin D. Hoffman , Ian R. Rogers , Mitchell H. Rosner
      Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in austere environments in which medical care is limited and often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to ensure a positive outcome. Failure in this regard is a recognized cause of event-related fatality. In an effort to produce best practice guidelines for EAH in the austere environment, the Wilderness Medical Society convened an expert panel. The panel was charged with the development of evidence-based guidelines for management of EAH. Recommendations are made regarding the situations when sodium concentration can be assessed in the field and when these values are not known. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia published in Wilderness & Environmental Medicine 2013;24(3):228–240.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for Treatment of Eye
           Injuries and Illnesses in the Wilderness: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Ryan Paterson , Brandy Drake , Geoffrey Tabin , Frank K. Butler Jr , Tracy Cushing
      A panel convened to develop an evidence-based set of guidelines for the recognition and treatment of eye injuries and illnesses that may occur in the wilderness. These guidelines are meant to serve as a tool to help wilderness providers accurately identify and subsequently treat or evacuate for a variety of ophthalmologic complaints. Recommendations are graded on the basis of the quality of their supporting evidence and the balance between risks and benefits according to criteria developed by the American College of Chest Physicians. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2012;23(4):325–336.


      PubDate: 2014-12-09T20:42:12Z
       
  • 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: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      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: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Use of Epinephrine
           in Outdoor Education and Wilderness Settings: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Flavio G. Gaudio , Jay Lemery , David E. Johnson
      The Epinephrine Roundtable took place on July 27, 2008, during the 25th Annual Meeting of the Wilderness Medical Society (WMS) in Snowmass, CO. The WMS convened this roundtable to explore areas of consensus and uncertainty in the field treatment of anaphylaxis. Panelists were selected on the basis of their relevant academic or professional experience. There is a paucity of data that address the treatment of anaphylaxis in the wilderness. Anaphylaxis is a rare disease, with a sudden onset and drastic course that does not lend itself to study in randomized, controlled trials. Therefore, the panel endorsed the following position based on the limited available evidence and review of published articles, as well as expert consensus. The position represents the consensus of the panelists and is endorsed by the WMS. In 2014, the authors reviewed relevant articles published since the Epinephrine Roundtable. The following is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2010;21(4):185–187.


      PubDate: 2014-12-09T20:42:12Z
       
  • KevinFedarkoThe Emerald Mile: The Epic Story of the Fastest Ride in
           History Through the Heart of the Grand Canyon2013ScribnerNew YorkUS
           $30.00, 415 pages, hardcover
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Christopher Van Tilburg



      PubDate: 2014-12-09T20:42:12Z
       
  • 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: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Christopher Van Tilburg



      PubDate: 2014-12-09T20:42:12Z
       
  • In Response to WMS Pain Management Guidelines
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Christopher Van Tilburg



      PubDate: 2014-12-09T20:42:12Z
       
  • A Novel Risk Factor for High Altitude Pulmonary Edema?
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Andrew M. Luks



      PubDate: 2014-12-09T20:42:12Z
       
  • Is Drinking to Thirst a Prudent Guideline to Avoid Hyponatremia?
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Bill Aughton



      PubDate: 2014-12-09T20:42:12Z
       
  • Reply to: Is drinking to thirst a prudent guideline to avoid
           hyponatremia?
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Brad L. Bennett , Tamara Hew-Butler , Martin D. Hoffman , Ian R. Rogers , Mitchell H. Rosner



      PubDate: 2014-12-09T20:42:12Z
       
  • Resuscitation
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Canadian Journal Of Surgery
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Case Reports In Medicine
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Amitriptyline Use for Acute Pain in Remote Environments
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      Author(s): Jeremy Joslin , Robert Worthing , Matthew Ladbrook , Joshua Mularella



      PubDate: 2014-12-09T20:42:12Z
       
  • Resuscitation
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Journal Of Korean Medical Science
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for Basic Wound Management
           in the Austere Environment: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Robert H. Quinn , Ian Wedmore , Eric L. Johnson , Arthur A. 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. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2014;25(3):295-310.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Treatment of Acute
           Pain in Remote Environments: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Katie W. Russell , Courtney L. Scaife , David C. Weber , Jeremy S. Windsor , Albert R. Wheeler , William R. Smith , Ian Wedmore , Scott E. McIntosh , James R. Lieberman
      The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded on the basis of the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments published in Wilderness & Environmental Medicine 2014;25(1):41–49.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for Spine Immobilization in
           the Austere Environment: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Robert H. Quinn , Jason Williams , Brad L. Bennett , Gregory Stiller , Arthur A. Islas , Seth McCord
      In an effort to produce best practice guidelines for spine immobilization in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in an austere (dangerous or compromised) environment. Recommendations are made regarding several parameters related to spinal immobilization. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. A treatment algorithm based on the guidelines is presented. This is an updated version of original WMS Practice Guidelines for Spine Immobilization in the Austere Environment published in Wilderness & Environmental Medicine 2013;24(3):241–252.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Prevention and
           Treatment of Lightning Injuries: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Chris Davis , Anna Engeln , Eric L. Johnson , Scott E. McIntosh , Ken Zafren , Arthur A. Islas , Christopher McStay , William R. Smith , Tracy Cushing
      To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the treatment and prevention of lightning injuries. These guidelines include a review of the epidemiology of lightning and recommendations for the prevention of lightning strikes, along with treatment recommendations organized by organ system. Recommendations are graded on the basis of the quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Prevention and Treatment of Lightning Injuries published in Wilderness & Environmental Medicine 2012;23(3):260–269.


      PubDate: 2014-12-09T20:42:12Z
       
  • Human Death Caused by a Giant Anteater (Myrmecophaga tridactyla) in Brazil
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4
      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 tridactyla) 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: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Out-of-Hospital
           Evaluation and Treatment of Accidental Hypothermia: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Ken Zafren , Gordon G. Giesbrecht , Daniel F. Danzl , Hermann Brugger , Emily B. Sagalyn , Beat Walpoth , Eric A. Weiss , Paul S. Auerbach , Scott E. McIntosh , Mária Némethy , Marion McDevitt , Jennifer Dow , Robert B. Schoene , George W. Rodway , Peter H. Hackett , Brad L. Bennett , Colin K. Grissom
      To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia published in Wilderness & Environmental Medicine 2014;25(4):425–445.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Prevention and
           Treatment of Heat-Related Illness: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Grant S. Lipman , Kurt P. Eifling , Mark A. Ellis , Flavio G. Gaudio , Edward M. Otten , Colin K. Grissom
      The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best practice recommendations for both field and hospital-based therapeutic management of heat illness. These recommendations are graded on the basis of the quality of supporting evidence, and balance between the benefits and risks or burdens for each modality. This is an updated version of the original WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness published in Wilderness & Environmental Medicine 2013;24(4):351–361.


      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Prevention and
           Treatment of Frostbite: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Scott E. McIntosh , Matthew Opacic , Luanne Freer , Colin K. Grissom , Paul S. Auerbach , George W. Rodway , Amalia Cochran , Gordon G. Giesbrecht , Marion McDevitt , Christopher H. Imray , Eric L. Johnson , Jennifer Dow , Peter H. Hackett
      The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each modality according to methodology stipulated by the American College of Chest Physicians. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2011;22(2):156–166.


      PubDate: 2014-12-09T20:42:12Z
       
  • Tribute to Jonna Barry
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4




      PubDate: 2014-12-09T20:42:12Z
       
  • Wilderness Medical Society Practice Guidelines for the Prevention and
           Treatment of Acute Altitude Illness: 2014 Update
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Andrew M. Luks , Scott E. McIntosh , Colin K. Grissom , Paul S. Auerbach , George W. Rodway , Robert B. Schoene , Ken Zafren , Peter H. Hackett
      To provide guidance to clinicians about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations about their role in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in Wilderness & Environmental Medicine 2010;21(2):146–155.


      PubDate: 2014-12-09T20:42:12Z
       
  • An Introduction from the Co-Chairs of the WMS Practice Guidelines
           Committee
    • Abstract: Publication date: December 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 4, Supplement
      Author(s): Tracy Cushing , Robert H. Quinn



      PubDate: 2014-12-09T20:42:12Z
       
  • Mt Everest Base Camp Medical Clinic “Everest ER”: Epidemiology
           of Medical Events During the First 10 Years of Operation
    • Abstract: Publication date: Available online 27 November 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Mária Némethy , Andrew B. Pressman , Luanne Freer , Scott E. McIntosh
      Objectives As the highest peak on the planet, Mt Everest provides a truly austere environment in which to practice medicine. We examined records of all visits to the Everest Base Camp Medical Clinic (Everest ER) to characterize the medical problems that occur in these patients. Methods A retrospective analysis of medical records from the first 10 years of operation (2003 to 2012) was performed. Results Medical reasons accounted for 85.3% (3045) of diagnoses, whereas 14.0% (500) were for trauma. The most common medical diagnoses were pulmonary causes such as high altitude cough and upper respiratory infection, comprising more than 38% of medical diagnoses. For traumatic diagnoses, 56% were for dermatologic causes, most commonly for frostbite and lacerations. Pulmonary and dermatologic diagnoses were also the most frequent causes for evacuation from Everest Base Camp, most commonly for high altitude pulmonary edema and frostbite, respectively. Conclusions Medical professionals treating patients at extreme altitude should have a broad scope of practice and be well prepared to deal with serious trauma from falls, cold exposure injuries, and altitude illness.


      PubDate: 2014-11-30T19:37:05Z
       
  • Controlled Hyperventilation After Training May Accelerate Altitude
           Acclimatization
    • Abstract: Publication date: Available online 14 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Geert A. Buijze , Maria T. Hopman



      PubDate: 2014-11-26T19:16:38Z
       
  • Glossopharyngeal Insufflation and Breath-Hold Diving: The More, the
           Worse?
    • Abstract: Publication date: Available online 14 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Alain Boussuges , Olivier Gavarry , Jacques Bessereau , Mathieu Coulange , Morgan Bourc’his , Pascal Rossi
      Objective The glossopharyngeal insufflation maneuver (lung packing) is largely performed by competitive breath-hold divers to improve their performance, despite observational evidence of fainting and loss of consciousness in the first seconds of apnea. Methods We describe here the time course of hemodynamic changes, induced by breath-holding with and without lung packing, in 2 world-class apnea competitors. Results When compared with apnea performed after a deep breath (100% vital capacity), lung packing leads to a decrease in cardiac output, blood pressure, and cerebral blood flow during the first seconds after the beginning of apnea. The major hemodynamic disorders were observed in diver 1, who exhibited the greater increase in pulmonary volume after lung packing (+22% for diver 1 vs +10% for diver 2). After the initial drop in both cardiac output and blood pressure, the time course of hemodynamic alterations became quite similar between the two apneas. Conclusions Some recommendations, such as limiting the number of maneuvers and performing lung packing in the supine position, should be expressed to avoid injuries secondary to the use of glossopharyngeal insufflation.


      PubDate: 2014-11-26T19:16:38Z
       
  • Exercise-Associated Hyponatremic Encephalopathy in an Endurance Open Water
           Swimmer
    • Abstract: Publication date: Available online 14 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ian R. Rogers , Stephen Grainger , Yusuf Nagree
      Exercise-associated hyponatremia and its more serious form, known as exercise-associated hyponatremic encephalopathy, are recognized as some of the most important medical problems seen in a variety of different forms of endurance exercise. We describe a case of exercise-associated hyponatremic encephalopathy presenting as altered conscious state and seizures in a woman who had completed a 20-km open ocean swim. Her serum sodium measured approximately 1 hour after her seizure was 119 mmol/L on point-of-care testing. With ongoing critical care support and the use of hypertonic saline, she was able to be extubated the next day, neurologically intact, and ultimately was discharged from hospital without neurological sequelae. This case emphasizes both the importance of considering exercise-associated hyponatremic encephalopathy as a cause of neurological impairment in all athletes and the pivotal role of hypertonic saline in the treatment of this condition.


      PubDate: 2014-11-26T19:16:38Z
       
  • Regarding the Use of Epinephrine Auto-injectors in Remote Settings
    • Abstract: Publication date: Available online 14 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ray A. Wolf



      PubDate: 2014-11-26T19:16:38Z
       
  • An Itchy Situation
    • Abstract: Publication date: Available online 16 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Pratibha Phuyal , Pranawa Koirala , Buddha Basnyat , Ken Zafren



      PubDate: 2014-11-26T19:16:38Z
       
  • Symptoms and Treatment of Acute Conjunctivitis Caused by Skin Secretions
           of Veined Tree Frog (Trachycephalus Venulosus)
    • Abstract: Publication date: Available online 14 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Levente Tanacs , Etienne Littlefair



      PubDate: 2014-11-26T19:16:38Z
       
  • Waterfall Mortality and Morbidity in North Carolina, 2001–2013
    • Abstract: Publication date: Available online 30 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Aram Attarian



      PubDate: 2014-11-26T19:16:38Z
       
  • A 51-Year-Old Woman Crushed by an Elephant Trunk
    • Abstract: Publication date: Available online 16 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ann H. Tsung , Brandon R. Allen
      Wild and exotic animal attacks are not common in the United States. Animal-related injuries in the United States are usually caused by dog bites, followed by cattle and horse injuries. Exotic animal attacks can occur when the animals are provoked, depressed, or housed improperly by owners. We report the case of a 51-year-old woman who sustained multiple systemic traumatic injuries after she was pinned to a fence by an elephant’s trunk. Upon arrival in the emergency department, she was hypothermic with a temperature of 35.1ºC (95.1ºF), hypotensive to 94/60 mm Hg after 5 L crystalloid, tachycardic at 108 beats/min, and intubated with oxygen saturation of 100%. Tranexamic acid was administered in addition to starting a massive transfusion protocol. Injuries included bilateral multiple rib fractures, left abdominal wall degloving injury, right pneumothorax, right hemothorax, left chest wall puncture wound, grade IV splenic laceration, 3 grade III liver lacerations, retroperitoneal hematoma, and degloving injuries to bilateral posterior thighs requiring more than 30 operations. Why should an emergency physician be aware of this? Several factors need to be considered when evaluating animal-related injuries, including type, age, and sex of the animal. Multisystem traumatic injuries should be assumed when a large animal is involved. Prehospital care and transport time are vital to a patient’s survival in both urban and rural settings. During the initial resuscitation, administering antibiotics tailored to the specific animal can greatly decrease risk of infection and morbidity. Additionally, tetanus immunoglobulin, tetanus toxoid, and rabies immunoglobulin and vaccine may be needed, unless the victim has been previously vaccinated.


      PubDate: 2014-11-26T19:16:38Z
       
  • Search and Rescue Response to a Large-Scale Rockfall Disaster
    • Abstract: Publication date: Available online 30 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Emily Procter , Giacomo Strapazzon , Karla Balkenhol , Ernst Fop , Alessandro Faggionato , Karl Mayr , Markus Falk , Markus Falk , Hermann Brugger
      Objective To describe the prehospital management and safety of search and rescue (SAR) teams involved in a large-scale rockfall disaster and monitor the acute and chronic health effects on personnel with severe dolomitic dust exposure. Methods SAR personnel underwent on-site medical screening and lung function testing 3 months and 3 years after the event. Results The emergency dispatch center was responsible for central coordination of resources. One hundred fifty SAR members from multidisciplinary air- and ground-based teams as well as geotechnical experts were dispatched to a provisionary operation center. Acute exposure to dolomite dust with detectable silicon and magnesium concentrations was not associated with (sub)acute or chronic sequelae or a clinically significant impairment in lung function in exposed personnel. Conclusions The risk for personnel involved in mountain SAR operations is rarely reported and not easily investigated or quantified. This case exemplifies the importance of a multiskilled team and additional considerations for prehospital management during natural hazard events. Safety plans should include compulsory protective measures and medical monitoring of personnel.


      PubDate: 2014-11-26T19:16:38Z
       
  • Wilderness Medical Society Practice Guidelines for the Out-of-Hospital
           Evaluation and Treatment of Accidental Hypothermia
    • Abstract: Publication date: Available online 31 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ken Zafren , Gordon G. Giesbrecht , Daniel F. Danzl , Hermann Brugger , Emily B. Sagalyn , Beat Walpoth , Eric A. Weiss , Paul S. Auerbach , Scott E. McIntosh , Mária Némethy , Marion McDevitt , Jennifer Dow , Robert B. Schoene , George W. Rodway , Peter H. Hackett , Brad L. Bennett , Colin K. Grissom
      To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations.


      PubDate: 2014-11-26T19:16:38Z
       
  • A Prospective Randomized Blister Prevention Trial Assessing Paper Tape in
           Endurance Distances (Pre-TAPED)
    • Abstract: Publication date: Available online 31 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Grant S. Lipman , Mark A. Ellis , Erica J. Lewis , Brandee L. Waite , John Lissoway , Garrett K. Chan , Brian J. Krabak
      Objective Friction foot blisters are a common injury occurring in up to 39% of marathoners, the most common injury in adventure racing, and represent more than 70% of medical visits in multi-stage ultramarathons. The goal of the study was to determine whether paper tape could prevent foot blisters in ultramarathon runners. Methods This prospective randomized trial was undertaken during RacingThePlanet® 155-mile (250-km), 7-day self-supported ultramarathons in China, Australia, Egypt, Chile, and Nepal in 2010 and 2011. Paper tape was applied prerace to one randomly selected foot, with the untreated foot acting as the own control. The study end point was development of a hot spot or blister on any location of either foot. Results One hundred thirty-six participants were enrolled with 90 (66%) having completed data for analysis. There were 36% women, with a mean age of 40 ± 9.4 years (range, 25–40 years) and pack weight of 11 ± 1.8 kg (range, 8–16 kg). All participants developed blisters, with 89% occurring by day 2 and 59% located on the toes. No protective effect was observed by the intervention (47 versus 35; 52% versus 39%; P = .22), with fewer blisters occurring around the tape on the experimental foot than under the tape (23 vs 31; 25.6% versus 34.4%), yet 84% of study participants when queried would choose paper tape for blister prevention in the future. Conclusions Although paper tape was not found to be significantly protective against blisters, the intervention was well tolerated with high user satisfaction.


      PubDate: 2014-11-26T19:16:38Z
       
  • High-Intensity Intermittent Exercise Increases Pulmonary Interstitial
           Edema at Altitude But Not at Simulated Altitude
    • Abstract: Publication date: Available online 7 November 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Mark E. Edsell , Yashvi H. Wimalasena , William L. Malein , Kimberly M. Ashdown , Carla A. Gallagher , Chris H. Imray , Alex D. Wright , Stephen D. Myers
      Objective Ascent to high altitude leads to a reduction in ambient pressure and a subsequent fall in available oxygen. The resulting hypoxia can lead to elevated pulmonary artery (PA) pressure, capillary stress, and an increase in interstitial fluid. This fluid can be assessed on lung ultrasound (LUS) by the presence of B-lines. We undertook a chamber and field study to assess the impact of high-intensity exercise in hypoxia on the development of pulmonary interstitial edema in healthy lowlanders. Methods Thirteen volunteers completed a high-intensity intermittent exercise (HIIE) test at sea level, in acute normobaric hypoxia (12% O2, approximately 4090 m equivalent altitude), and in hypobaric hypoxia during a field study at 4090 m after 6 days of acclimatization. Pulmonary interstitial edema was assessed by the evaluation of LUS B-lines. Results After HIIE, no increase in B-lines was seen in normoxia, and a small increase was seen in acute normobaric hypoxia (2 ± 2; P < .05). During the field study at 4090 m, 12 participants (92%) demonstrated 7 ± 4 B-lines at rest, which increased to 17 ± 5 immediately after the exercise test (P < .001). An increase was evident in all participants. There was a reciprocal fall in peripheral arterial oxygen saturations (Spo 2) after exercise from 88% ± 4% to 80% ± 8% (P < .01). B-lines and Spo 2 in all participants returned to baseline levels within 4 hours. Conclusions HIIE led to an increase in B-lines at altitude after subacute exposure but not during acute exposure at equivalent simulated altitude. This may indicate pulmonary interstitial edema.


      PubDate: 2014-11-26T19:16:38Z
       
  • New Zealand Land Search and Rescue Operations: An Analysis of Medical and
           Traumatic Conditions
    • Abstract: Publication date: Available online 1 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Jenny T. Visser , Adam F.R. Campbell
      Objective The aim of this study was to describe the range and types of medical and traumatic conditions encountered in land search and rescue operations in New Zealand. Methods Twenty months (May 2010 to December 2011) of land search and rescue operations were analyzed. Data on medical and traumatic conditions were extracted from the New Zealand Police search and rescue database. Results During the period audited, New Zealand Police coordinated 1490 land-based search and rescue operations, from which 611 persons fulfilled the study inclusion criteria. Males accounted for 60.5% of the subjects, and a trauma-related injury was the most commonly encountered condition (37.3% of all). The lower limb was the most commonly injured body site, and most injuries occurred as the result of a slip or fall. Medical conditions were recorded in 11.6% of operations and included a wide spread of conditions, with cardiovascular events being seen most frequently. Hypothermia was diagnosed in 9.3% of all operations, and fatalities made up 5.6% of the sample. Thirty percent of all operations were for persons with cognitive impairment who had wandered away from their usual place of residence. These were almost entirely urban searches and concentrated in districts with large populations. Conclusions Search and rescue personnel are exposed to a broad range of medical and traumatic conditions. In New Zealand, they include preexisting cognitive impairment that results in persons lost in urban environments. Notwithstanding this, many subjects will also need to be managed in remote, resource-limited environments for extended periods. First aid training and field equipment should reflect these demands.


      PubDate: 2014-10-04T16:31:21Z
       
  • Evaluation of a Simulation Training Program for Uncomplicated Fishhook
           Removal
    • Abstract: Publication date: Available online 1 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Scott McMaster , David J. Ledrick , Julie M. Stausmire , Kristina Burgard
      Objective The aim of this study was to evaluate the effectiveness of a fishhook removal simulation workshop using investigator-developed diagrams, practice models, and a teaching video. Methods This was a descriptive, prospective educational study with Institutional Review Board approval. The primary outcomes were the learner’s perception of ease of learning, performance ability, and amount of tissue damage for each technique. A 2¾-minute educational video, instructional visual diagrams, and a simulated model were created to teach 4 techniques: simple retrograde, string pull, advance and cut, and needle cover. Learners performed each technique on a model to assess whether they could remove the hook on the first attempt for each technique. They then rank ordered their technique preferences for ease of learning, performance, perceived tissue damage, and overall choice. Results Of a total of 34 participants who completed the study, 71% of learners were emergency medicine residents or faculty, 65% were male, 42% were recreational fishers, and 68% had previous fishhook removal experience. On first attempt, more than 88% of participants demonstrated successful fishhook removal using all techniques except needle cover (47%). Simple retrograde was rated easiest to learn (74%) and perform (59%), was perceived to cause the least tissue damage (44%), and was the overall preferred technique. Needle cover was ranked hardest to learn (88%) and perform (82%), was perceived to cause the worst tissue damage (41%), and was the overall least preferred technique. Conclusions This study is the first to describe a simulation training program for uncomplicated fishhook removal, and to experimentally evaluate physician learning and preferences for fishhook removal techniques. After a brief educational session, physicians could effectively use all techniques except needle cover. Simple retrograde was the overall preferred technique.


      PubDate: 2014-10-04T16:31:21Z
       
  • Utah Ski Patrol: Assessing Training Types and Resources
    • Abstract: Publication date: Available online 3 October 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Emily B. Sagalyn , Marion C. McDevitt , Ryan Ernst
      Background Skiers and snowboarders incur a variety of injuries and medical emergencies each year at ski resorts. The ski patrol is primarily responsible for initial triage, assessment and stabilization of these problems. Objective The purpose of this study was to subjectively evaluate the type of training, resources, and equipment available to local ski patrols within Utah. Methods Ski patrol directors at ski resorts in Utah were asked to complete a voluntary computerized survey. Results Of the 14 ski areas in Utah, ski patrol directors representing 8 resorts responded. The majority of patrols in Utah use Outdoor Emergency Care (OEC) as their primary education and certification source. Most programs also include site-specific training in addition to basic certification. All responding resorts had basic first responder equipment, including splinting devices, basic airway management, and hemorrhage control. Six of 8 responding resorts had affiliated clinics, and all had access to aeromedical transport. All of the responding ski patrol directors believed the current training level was adequate. Conclusions Utah area ski patrollers frequently see trauma-related injuries and have the resources to assess and provide initial immobilization techniques. Many resorts have affiliated clinics with advanced providers, and all have access to aeromedical support to rapidly transfer patients to trauma centers. Medical directors may be of use for training as well as developing extended scope of practice protocols for advanced airway use or medication administration. Patrols may benefit from additional resort-specific training that addresses other frequently seen injuries or illnesses.


      PubDate: 2014-10-04T16:31:21Z
       
  • 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
       
 
 
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