for Journals by Title or ISSN
for Articles by Keywords
help
  Subjects -> ENVIRONMENTAL STUDIES (Total: 797 journals)
    - ENVIRONMENTAL STUDIES (726 journals)
    - POLLUTION (22 journals)
    - TOXICOLOGY AND ENVIRONMENTAL SAFETY (39 journals)
    - WASTE MANAGEMENT (10 journals)

ENVIRONMENTAL STUDIES (726 journals)

The end of the list has been reached or no journals were found for your choice.
Journal Cover Wilderness & Environmental Medicine
  [SJR: 0.49]   [H-I: 29]   [2 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1080-6032
   Published by Elsevier Homepage  [3175 journals]
  • Journal Shopping and Pruning the Literature
    • Authors: Neal W. Pollock
      Pages: 1 - 2
      Abstract: Publication date: Available online 19 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Neal W. Pollock


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.12.001
      Issue No: Vol. 29, No. 1 (2018)
       
  • 2017 Wilderness & Environmental Medicine Peer Reviewers
    • Authors: Alicia Byrne
      Pages: 3 - 4
      Abstract: Publication date: Available online 19 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Alicia Byrne


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.12.003
      Issue No: Vol. 29, No. 1 (2018)
       
  • Use of a Parabolic Microphone to Detect Hidden Subjects in Search and
           Rescue
    • Authors: Nathaniel L. Bowditch; Stanley K. Searing; Jeffrey A. Thomas; Peggy K. Thompson; Jacqueline N. Tubis; Sylvia P. Bowditch
      Pages: 11 - 17
      Abstract: Publication date: Available online 6 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Nathaniel L. Bowditch, Stanley K. Searing, Jeffrey A. Thomas, Peggy K. Thompson, Jacqueline N. Tubis, Sylvia P. Bowditch
      Introduction This study compares a parabolic microphone to unaided hearing in detecting and comprehending hidden callers at ranges of 322 to 2510 m. Methods Eight subjects were placed 322 to 2510 m away from a central listening point. The subjects were concealed, and their calling volume was calibrated. In random order, subjects were asked to call the name of a state for 5 minutes. Listeners with parabolic microphones and others with unaided hearing recorded the direction of the call (detection) and name of the state (comprehension). Results The parabolic microphone was superior to unaided hearing in both detecting subjects and comprehending their calls, with an effect size (Cohen’s d) of 1.58 for detection and 1.55 for comprehension. For each of the 8 hidden subjects, there were 24 detection attempts with the parabolic microphone and 54 to 60 attempts by unaided listeners. At the longer distances (1529–2510 m), the parabolic microphone was better at detecting callers (83% vs 51%; P<0.00001 by χ2) and comprehension (57% vs 12%; P<0.00001). At the shorter distances (322–1190 m), the parabolic microphone offered advantages in detection (100% vs 83%; P=0.000023) and comprehension (86% vs 51%; P<0.00001), although not as pronounced as at the longer distances. Conclusions Use of a 66-cm (26-inch) parabolic microphone significantly improved detection and comprehension of hidden calling subjects at distances between 322 and 2510 m when compared with unaided hearing. This study supports the use of a parabolic microphone in search and rescue to locate responsive subjects in favorable weather and terrain.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.002
      Issue No: Vol. 29, No. 1 (2018)
       
  • Frequency of Polycythemia and Other Abnormalities in a Tibetan Herdsmen
           Population Residing in the Kham Area of Sichuan Province, China
    • Authors: Jian-bo Zhang; Lin Wang; Jie Chen; Zhi-ying Wang; Mei Cao; Shang-mian Yie; Hua Yang; Xiao-qin Yao; Yi Zeng; Yong-chang Yang; Chun-bao Xie; Tai-qiang Zhao
      Pages: 18 - 28
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Jian-bo Zhang, Lin Wang, Jie Chen, Zhi-ying Wang, Mei Cao, Shang-mian Yie, Hua Yang, Xiao-qin Yao, Yi Zeng, Yong-chang Yang, Chun-bao Xie, Tai-qiang Zhao
      Introduction The Kham Tibetans are one of several Tibetan ethnic subgroups living in the Kham area of China. Because studies on the high-altitude adaptation of the Kham people are scant, the main aim of this study is to investigate whether the response to hypoxia, especially polycythemia status, in the Kham Tibetans is different from other Tibetan ethnic subgroups. Methods The primary investigation was conducted on 346 native Kham Tibetan adults (268 men and 78 women) from 3 herdsmen villages located in Hongyuan County situated at an altitude of greater than 3600 m. The participants were aged 46.2+/-14.1 (21–82; mean+/-SD with range) years. Anthropometric measurements such as weight, height, waist circumference, body mass index, and blood pressure, as well as laboratory blood tests such as glycosylated hemoglobin, hemoglobin, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and uric acid were analyzed. Results The concentrations of hemoglobin were 171.3±12.9 (66–229) mg·L-1 and 151.4±16.4 (86–190) mg·L-1 in men and women, respectively. The frequency of polycythemia was found to be 25.5 and 21.8% in men and women, respectively. Polycythemia was found to be significantly associated with glycosylated hemoglobin concentrations, hypertension, and hyperuricemia (P=0.002, 0.023, and 0.009, respectively). Conclusions There is a higher frequency of polycythemia in the Kham Tibetans when compared with reported studies from other Tibetan ethnic subgroups living on the Qinghai-Tibet plateau.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.010
      Issue No: Vol. 29, No. 1 (2018)
       
  • Cutaneous Vascular Responses of the Hands and Feet to Cooling, Rewarming,
           and Hypoxia in Humans
    • Authors: Heather C. Massey; James R. House; Michael J. Tipton
      Pages: 45 - 55
      Abstract: Publication date: Available online 17 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Heather C. Massey, James R. House, Michael J. Tipton
      Introduction This study investigated skin vasomotor responses in the fingers and toes during cooling and rewarming with and without normobaric hypoxia. Methods Fourteen volunteers (8 males and 6 females) were exposed to gradual air cooling (mean±SD: −0.4±0.1oC·min−1) followed by rewarming (+0.5±0.1oC·min−1) while breathing normoxic air (FIO2 0.21 at 761±3 mm Hg) or hypoxic gas (FIO2 0.12, at 761±3 mm Hg, equivalent to ~5000 m above sea level). Throughout the gradual cooling and rewarming phases, rectal temperature was measured, and skin temperatures and laser Doppler skin blood flow were measured on the thumb, little finger, and great and little toe pads. Results During gradual cooling, skin temperature but not deep body temperature decreased. No differences in cutaneous vascular conductance were found for the toes or thumb (P=0.169 great toe; P=0.289 little toe; P=0.422 thumb). Cutaneous vascular conductance was reduced in the little finger to a greater extent at the same mean skin temperatures (34.5–33.5oC) in the hypoxic compared with normoxic conditions (P=0.047). The onset of vasoconstriction and release of vasoconstriction in the thumb and little finger occurred at higher mean skin temperatures in hypoxia compared with normoxia (P<0.05). The onset of vasoconstriction and release of vasoconstriction in the toes occurred at similar skin temperatures (P=0.181 and P=0.132, respectively). Conclusion The earlier vasoconstrictor response and later release of vasoconstriction in the finger during hypoxic conditions may result in a greater dose of cold to that digit, taking longer to rewarm following the release of vasoconstriction.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.006
      Issue No: Vol. 29, No. 1 (2018)
       
  • Relations Between Self-Reported and Linguistic Monitoring Assessments of
           Affective Experience in an Extreme Environment
    • Authors: Nathan Smith
      Pages: 61 - 65
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Nathan Smith
      Introduction Approaches for monitoring psychosocial health in challenging environments are needed to maintain the performance and safety of personnel. The purpose of the present research was to examine the relationship between 2 candidate methods (self-reported and linguistics) for monitoring affective experience during extreme environment activities. Methods A single-subject repeated-measures design was used in the present work. The participant was a 46-year-old individual scheduled to complete a self-supported ski expedition across Arctic Greenland. The expedition lasted 28 days, and conditions included severe cold, low stimulation, whiteouts, limited habitability, and threats to life and limb. During the expedition, the participant completed a daily self-report log including assessment of psychological health (perceptions of control and affect) and a video diary (emotion). Video diary entries were subjected to linguistic inquiry and word count analyses before the links between self-report and linguistic data across the expedition period were tested. Results Similarities in the pattern of self-reported and linguistic assessments emerged across the expedition period. A number of predictable correlations were identified between self-reported and linguistic assessments of affective/emotional experience. Overall, there was better agreement between self-reports and linguistic analytics for indicators of negative affect/emotion. Conclusions Future research should build on this initial study to further test the links between self-reported affect and emotional states monitored via linguistics. This could help develop methods for monitoring psychological health in extreme environments and support organizational decision making.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.08.023
      Issue No: Vol. 29, No. 1 (2018)
       
  • Psychological Attributes of Ultramarathoners
    • Authors: Katherine Buck; Jack Spittler; Alex Reed; Morteza Khodaee
      Pages: 66 - 71
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Katherine Buck, Jack Spittler, Alex Reed, Morteza Khodaee
      Introduction As the popularity of ultramarathon participation increases, there still exists a lack of understanding of the unique psychological characteristics of ultramarathon runners. The current study sought to investigate some of the psychological and behavioral factors that are involved in ultramarathon running. Methods We obtained information from participants of the Bear Chase Trail Race via an online survey. This race is a single-day, multidistance race consisting of a 10 k, half marathon, 50 k, 50 mi, and 100 k run in Lakewood, Colorado, at a base altitude of 1680 m with total altitude in climbs ranging from 663 to 2591 m. We correlated information from the Exercise Addiction Inventory and the Patient Health Questionnaire-2 and demographic information with race finish times. Results Out of 200 runners who started the race, 98 (48%) completed the survey. Over half of the runners were men (61.2%), and the average age was 39.0 years (SD±8.9; range 21–64 years). A number of respondents (20%) screened positive for exercise addiction concerns. Approximately 20% of our sample screened positive for depressive symptoms (Patient Health Questionnaire-2 score >3). The majority of participants reported receiving strong social support from current partners with regard to their ultramarathon running training time and goals. Conclusions Although only a screening, the number of positive screens on the Exercise Addiction Inventory suggests use of screening measures with an ultramarathon running population. Athletes with positive screening tests should be fully evaluated for depression and exercise addiction because this would enable appropriate athlete support and treatment referral.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.003
      Issue No: Vol. 29, No. 1 (2018)
       
  • Prehospital Emergencies in Illegal Gold Mining Sites in French Guiana
    • Authors: Gérald Egmann; Pierre Tattevin; Renaud Palancade; Matthieu Nacher
      Pages: 72 - 77
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Gérald Egmann, Pierre Tattevin, Renaud Palancade, Matthieu Nacher
      Introduction Illegal gold mining is flourishing in French Guiana, existing outside the law due to both the high cost of gold mining permits and the challenges of law enforcement within the Amazon forest. We report the characteristics of, and the medical responses to, medical emergencies in illegal gold mining sites. Methods We performed a retrospective study of all medical emergencies reported from illegal gold mining sites to the centralized call office of SAMU 973 from 1998 through 2000 and from 2008 through 2010. According to the national health care system, any medical emergency within the territory is handled by the prehospital emergency medical service (SAMU 973), irrespective of the patients’ legal status. Data were extracted from the SAMU 973 notebook registry (1998–2000) or the SAMU 973 computerized database (2008–2010) and werre collected using a standardized questionnaire. Results Of 71,932 calls for medical emergencies in French Guiana during the study periods, 340 (0.5%) originated from illegal gold mining sites. Of these, 196 (58%) led to medical evacuation by helicopter, whereas the overall rate of evacuation by helicopter after placing a call to SAMU 973 was only 4% (3020/71,932; P<0.0001 for comparison with illegal gold mining sites). Medical emergencies were classified as illness (48%, mostly infectious), trauma (44%, mostly weapon wounds), and miscellaneous (8%). Conclusions Medical emergencies at illegal gold mining sites in the Amazon forest mostly include infectious diseases, followed by trauma, and often require medical evacuation by helicopter. Our study suggests that implementation of preventive medicine within gold mining sites, irrespective of their legal status, could be cost-effective and reduce morbidity.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.008
      Issue No: Vol. 29, No. 1 (2018)
       
  • Core Content for Wilderness Medicine Training: Development of a Wilderness
           Medicine Track Within an Emergency Medicine Residency
    • Authors: Walter A. Schrading; Nicole Battaglioli; Jonathan Drew; Sarah Frances McClure
      Pages: 78 - 84
      Abstract: Publication date: Available online 17 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Walter A. Schrading, Nicole Battaglioli, Jonathan Drew, Sarah Frances McClure
      Wilderness medicine training has become increasingly popular among medical professionals with numerous educational opportunities nationwide. Curricula for fellowship programs and for medical student education have previously been developed and published, but a specific curriculum for wilderness medicine education during emergency medicine (EM) residency has not. The objective of this study is to create a longitudinal wilderness medicine curriculum that can be incorporated into an EM residency program. Interest-specific tracks are becoming increasingly common in EM training. We chose this model to develop our curriculum specific to wilderness medicine. Outlined in the article is a 3-year longitudinal course of study that includes a core didactic curriculum and a plan for graduated level of responsibility. The core content is specifically related to the required EM core content for residency training with additions specific to wilderness medicine for the residents who pursue the track. The wilderness medicine curriculum would give residencies a framework that can be used to foster learning for residents interested in wilderness medicine. It would enhance the coverage of wilderness and environmental core content education for all EM residents in the program. It would provide wilderness-specific education and experience for interested residents, allowing them to align their residency program requirements through a focused area of study and enhancing their curriculum vitae at graduation. Finally, given the popularity of wilderness medicine, the presence of a wilderness medicine track may improve recruitment for the residency program.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.10.003
      Issue No: Vol. 29, No. 1 (2018)
       
  • A Case of Autosplenectomy in Sickle Cell Trait Following an Exposure to
           High Altitude
    • Authors: Uday Yanamandra; Reena Das; Pankaj Malhotra; Subhash Varma
      Pages: 85 - 89
      Abstract: Publication date: Available online 10 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Uday Yanamandra, Reena Das, Pankaj Malhotra, Subhash Varma
      A 24-year-old man presented with acute abdominal pain upon ascent to moderate altitude (3500 m). An immediate evaluation revealed a splenic infarct, and he was evacuated to sea level. Upon recovery, he was sent back to 3500 m without detailed etiological evaluation, whereupon he experienced recurrent episodes of left-side subcostal pain. Imaging suggested autosplenectomy, and workup revealed a negative thrombophilia profile but was positive for sickle cell trait (SCT). Individuals with SCT can be asymptomatic until exposure to severe hypoxia, upon which they can manifest clinically as sickle cell syndrome. We discuss the rare presentation of autosplenectomy in a patient with previously undiagnosed SCT on exposure to high altitude.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.08.021
      Issue No: Vol. 29, No. 1 (2018)
       
  • Pott’s Disease Resulting in Complete Cervical Vertebral Destruction
    • Authors: Jeffrey H. Walden; Jeremy Schmitz
      Pages: 90 - 93
      Abstract: Publication date: Available online 1 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Jeffrey H. Walden, Jeremy Schmitz
      Skeletal tuberculosis, otherwise known as Pott’s disease, has been recognized for centuries. Although typically diagnosed in citizens from countries with endemic tuberculosis, long-term workers in these regions, such as military deployees, can also acquire the disease. We present a case report of a military veteran presenting with neck pain and initially diagnosed with cervical disc disease. The patient’s pain progressed to the point of developing paresthesias in his bilateral upper extremities. Eventually, cervical spine radiographs were obtained that revealed complete cervical vertebral body destruction from spinal tuberculosis. Epidemiology, diagnosis, and treatment of the disorder are discussed.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.004
      Issue No: Vol. 29, No. 1 (2018)
       
  • Microangiopathic Hemolytic Anemia Following Three Different Species of
           Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka
    • Authors: Rathnayaka Mudiyanselage M.K. Namal Rathnayaka; Anusha Nishanthi Ranathunga; Senanayake A.M. Kularatne; Jayanthe Rajapakse; Shirani Ranasinghe; Radha Jayathunga
      Pages: 94 - 101
      Abstract: Publication date: Available online 1 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Rathnayaka Mudiyanselage M.K. Namal Rathnayaka, Anusha Nishanthi Ranathunga, Senanayake A.M. Kularatne, Jayanthe Rajapakse, Shirani Ranasinghe, Radha Jayathunga
      There are 3 species of hump-nosed pit vipers in Sri Lanka: Hypnale hypnale, Hypnale zara, and Hypnale nepa. The latter 2 are endemic to the country. Microangiopathic hemolytic anemia (MAHA) is a known complication of hump-nosed pit viper bites. It was previously documented as a complication of general viper bites and not species specific. We report a series of 3 patients who developed MAHA after being bitten by each species of hump-nosed pit viper. The first patient was bitten by H hypnale and developed a severe form of MAHA associated with acute kidney injury and thrombocytopenia falling into the category of thrombotic microangiopathy. The other 2 developed MAHA that resolved without any complications.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.003
      Issue No: Vol. 29, No. 1 (2018)
       
  • An Effective Treatment in the Austere Environment' A Critical
           Appraisal into the Use of Intra-Articular Local Anesthetic to Facilitate
           Reduction in Acute Shoulder Dislocation
    • Authors: Fraser John Gould
      Pages: 102 - 110
      Abstract: Publication date: Available online 17 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Fraser John Gould
      Acute shoulder dislocation is a common injury in the outdoor environment. The objective of this systematic review of the literature was to determine if intra-articular local anesthetic (IAL) is an effective treatment that could have prehospital application. A methodical search of MEDLINE, PubMed, and EMBASE databases targeted publications from January 1, 1990 until January 1, 2017. Eligible articles compared IAL with other analgesic techniques in patients 16 years or older experiencing acute glenohumeral dislocation. Reduction success, complications, and patient-reported outcome measures underwent comparison. All identified publications originated from the hospital setting. Procedural success rates ranged widely among randomized control trials comparing IAL with intravenous analgesia and sedation (IAL 48–100%, intravenous analgesia and sedation 44–100%). A pooled risk ratio [RR] favored intravenous analgesia and sedation (RR 0.91, 95% confidence interval [CI] 0.84–0.98), but there was significant inconsistency within the analysis (I2 = 75%). IAL provided lower complication rates (4/170, 2%) than intravenous analgesia and sedation (20/150, 13%) (RR 1.11, 95% CI 1.04–1.19, I2 = 63%). One trial found a clinically relevant reduction in visual analogue pain scores when comparing IAL against no additional analgesia in the first minute (IAL 21±13 mm; control 49±15 mm; P<0.001) and fifth minute (IAL 10±10 mm; control 40±14 mm, P<0.001) after reduction. The results suggest that IAL is an effective intervention for acute anterior shoulder dislocation that would have a place in the repertoire of the remote physician. Further research might be beneficial in determining the outcomes of performing IAL in the prehospital setting.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.013
      Issue No: Vol. 29, No. 1 (2018)
       
  • Amatoxin-Containing Mushroom Poisonings: Species, Toxidromes, Treatments,
           and Outcomes
    • Authors: James H. Diaz
      Pages: 111 - 118
      Abstract: Publication date: Available online 8 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): James H. Diaz
      Amatoxins are produced primarily by 3 species of mushrooms: Amanita, Lepiota, and Galerina. Because amatoxin poisonings are increasing, the objective of this review was to identify all amatoxin-containing mushroom species, present a toxidromic approach to earlier diagnoses, and compare the efficacies and outcomes of therapies. To meet these objectives, Internet search engines were queried with keywords to select peer-reviewed scientific articles on amatoxin-containing mushroom poisoning and management. Descriptive epidemiological analyses have documented that most mushroom poisonings are caused by unknown mushrooms, and most fatal mushroom poisonings are caused by amatoxin-containing mushrooms. Amanita species cause more fatal mushroom poisonings than other amatoxin-containing species, such as Galerina and Lepiota. Amanita phalloides is responsible for most fatalities, followed by Amanita virosa and Amanita verna. The most frequently reported fatal Lepiota ingestions are due to Lepiota brunneoincarnata, and the most frequently reported fatal Galerina species ingestions are due to Galerina marginata. With the exception of liver transplantation, the current treatment strategies for amatoxin poisoning are all supportive and have not been subjected to rigorous efficacy testing in randomized controlled trials. All patients with symptoms of late-appearing gastrointestinal toxicity with or without false recovery or quiescent periods preceding acute liver insufficiency should be referred to centers providing liver transplantation. Patients with amatoxin-induced acute liver insufficiency that does not progress to liver failure will have a more favorable survival profile with supportive care than patients with amatoxin-induced acute liver failure, about half of whom will require liver transplantation.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.10.002
      Issue No: Vol. 29, No. 1 (2018)
       
  • Common Bite—Bizarre Rash
    • Authors: Simant Singh Thapa; Buddha Basnyat
      Pages: 123 - 124
      Abstract: Publication date: Available online 5 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Simant Singh Thapa, Buddha Basnyat


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.001
      Issue No: Vol. 29, No. 1 (2018)
       
  • Elevation 3 mm: A Case of a Cardiac Emergency and Rescue on Mount
           Monadnock
    • Authors: Benjamin J. Church; Nicholas J. Daniel
      Pages: 125 - 131
      Abstract: Publication date: Available online 10 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Benjamin J. Church, Nicholas J. Daniel


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.08.022
      Issue No: Vol. 29, No. 1 (2018)
       
  • Wilderness First Responder: Are Skills Soon Forgotten'
    • Authors: Alexandra L. Rhue; Beth VanDerveer
      Pages: 132 - 137
      Abstract: Publication date: Available online 1 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Alexandra L. Rhue, Beth VanDerveer
      Wilderness first responders are trained to provide competent medical care in wilderness settings or until evacuation for more advanced treatment can be obtained. In light of the isolated environments in which they are called upon to respond to illnesses and injuries, their ability to effectively apply their training is crucial. Despite the responsibility assigned to them, there is an absence of research assessing the skill and knowledge retention of wilderness first responders, creating a gap in understanding whether a deficit in their ability to perform exists between certifications. Without such research, it is important to review knowledge and skill retention in related responder groups. The literature over the past 4 decades documents the loss over time of skills and knowledge across an array of trained responders, both professional and laypeople. Although the findings reviewed suggest that WFRs will exhibit a similar pattern of increasing skill loss beginning shortly after certification and a slower, but concurrent, decrease in knowledge, research is needed to document or refute this assumption.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.005
      Issue No: Vol. 29, No. 1 (2018)
       
  • Human–Snake Encounters and Folk Remedies in Nepal
    • Authors: Alok Atreya; Tanuj Kanchan
      Pages: 138 - 140
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Alok Atreya, Tanuj Kanchan


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.08.006
      Issue No: Vol. 29, No. 1 (2018)
       
  • Mismanagement of Severe Altitude Illness in a Tertiary Hospital in Nepal:
           A Cautionary Tale
    • Authors: Santosh Baniya; Buddha Basnyat
      Pages: 140 - 142
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Santosh Baniya, Buddha Basnyat


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.10.001
      Issue No: Vol. 29, No. 1 (2018)
       
  • Acetazolamide Use in Ultrarunners at Altitude: Issues with Doping
    • Authors: Suvash Dawadi
      First page: 140
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Suvash Dawadi


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.009
      Issue No: Vol. 29, No. 1 (2018)
       
  • Jellyfish Blooms Causing Mass Envenomations in Aquatic Marathonists:
           Report of Cases in S and SE Brazil (SW Atlantic Ocean)
    • Authors: Vidal Haddad; André C. Morandini; Lucia E. Rodrigues
      Pages: 142 - 145
      Abstract: Publication date: Available online 12 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Vidal Haddad, André C. Morandini, Lucia E. Rodrigues


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.09.012
      Issue No: Vol. 29, No. 1 (2018)
       
  • An Iconic Pit Viper of the Central American Rainforests
    • Authors: Pablo Deschepper; Raf Aerts
      Pages: 146 - 147
      Abstract: Publication date: Available online 17 January 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Pablo Deschepper, Raf Aerts


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.001
      Issue No: Vol. 29, No. 1 (2018)
       
  • International Commission for Mountain Emergency Medicine Consensus
           Guidelines for On-Site Management and Transport of Patients in Canyoning
           Incidents
    • Authors: Giacomo Strapazzon; Oliver Reisten; Fabien Argenone; Ken Zafren; Greg Zen-Ruffinen; Gordon L. Larsen; Inigo Soteras
      Abstract: Publication date: Available online 13 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Giacomo Strapazzon, Oliver Reisten, Fabien Argenone, Ken Zafren, Greg Zen-Ruffinen, Gordon L. Larsen, Inigo Soteras
      Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.12.002
       
  • HMOX1 Promoter Microsatellite Polymorphism and High Altitude Pulmonary
           Edema in Han Chinese Men
    • Authors: Gaurav Sikri; Srinivasa Bhattachar
      Abstract: Publication date: Available online 3 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Gaurav Sikri, Srinivasa Bhattachar


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.008
       
  • Mount Meru
    • Authors: Jon Conard
      Abstract: Publication date: Available online 1 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Jon Conard


      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.002
       
  • Potential Environmental and Ecological Effects of Global Climate Change on
           Venomous Terrestrial Species in the Wilderness
    • Authors: Robert K. Needleman; Isabelle P. Neylan; Timothy Erickson
      Abstract: Publication date: Available online 1 February 2018
      Source:Wilderness & Environmental Medicine
      Author(s): Robert K. Needleman, Isabelle P. Neylan, Timothy Erickson
      Introduction Climate change has been scientifically documented, and its effects on wildlife have been prognosticated. We sought to predict the overall impact of climate change on venomous terrestrial species. We hypothesize that given the close relationship between terrestrial venomous species and climate, a changing global environment may result in increased species migration, geographical redistribution, and longer seasons for envenomation, which would have repercussions on human health. Methods A retrospective analysis of environmental, ecological, and medical literature was performed with a focus on climate change, toxinology, and future modeling specific to venomous terrestrial creatures. Species included venomous reptiles, snakes, arthropods, spiders, and Hymenoptera (ants and bees). Animals that are vectors of hemorrhagic infectious disease (eg, mosquitos, ticks) were excluded. Results Our review of the literature indicates that changes to climatic norms will have a potentially dramatic effect on terrestrial venomous creatures. Empirical evidence demonstrates that geographic distributions of many species have already shifted due to changing climatic conditions. Given that most terrestrial venomous species are ectotherms closely tied to ambient temperature, and that climate change is shifting temperature zones away from the equator, further significant distribution and population changes should be anticipated. For those species able to migrate to match the changing temperatures, new geographical locations may open. For those species with limited distribution capabilities, the rate of climate change may accelerate faster than species can adapt, causing population declines. Specifically, poisonous snakes and spiders will likely maintain their population numbers but will shift their geographic distribution to traditionally temperate zones more often inhabited by humans. Fire ants and Africanized honey bees are expected to have an expanded range distribution due to predicted warming trends. Human encounters with these types of creatures are likely to increase, resulting in potential human morbidity and mortality. Conclusions Temperature extremes and changes to climatic norms may have a dramatic effect on venomous terrestrial species. As climate change affects the distribution, populations, and life histories of these organisms, the chance of encounters could be altered, thus affecting human health and the survivability of these creatures.

      PubDate: 2018-02-26T09:22:53Z
      DOI: 10.1016/j.wem.2017.11.004
       
  • Effect of Simulated Tree-well vs Avalanche Snow Burial on Core Temperature
           Cooling Rate
    • Authors: Nicholas Kanaan; Joseph Krakker; Heather Beasley; Jeffrey Sorensen; Scott McIntosh; Colin Grissom
      First page: 365
      Abstract: Publication date: December 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 4
      Author(s): Nicholas Kanaan, Joseph Krakker, Heather Beasley, Jeffrey Sorensen, Scott McIntosh, Colin Grissom


      PubDate: 2017-12-26T16:48:47Z
      DOI: 10.1016/j.wem.2017.08.009
       
  • Reduced Acetazolamide Dosing for Acute Mountain Sickness Prevention Study:
           A Comparison of 62.5 vs 125 mg BID (the RAD AMS prevention study)
    • Authors: Scott McIntosh; Mika Hemphill; Marion McDevitt; Tsering Yangzom Gurung; Mukhiya Ghale; Jonathan Knott; Ghan Bahadur Thapa; Buddha Basnyat; Jennifer Dow; David Weber; Colin Grissom
      Pages: 365 - 366
      Abstract: Publication date: December 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 4
      Author(s): Scott McIntosh, Mika Hemphill, Marion McDevitt, Tsering Yangzom Gurung, Mukhiya Ghale, Jonathan Knott, Ghan Bahadur Thapa, Buddha Basnyat, Jennifer Dow, David Weber, Colin Grissom


      PubDate: 2017-12-26T16:48:47Z
      DOI: 10.1016/j.wem.2017.08.010
       
  • Sleep Characterization at High Altitude
    • Authors: Nicholas Kanaan; Caleb Phillips; Becky Higbee; David Pomeranz; Michael Shaheen; Kristin Fontes; Patrick Cain; Sean Wentworth; Carolyn Meyer; Grant Lipman
      First page: 366
      Abstract: Publication date: December 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 4
      Author(s): Nicholas Kanaan, Caleb Phillips, Becky Higbee, David Pomeranz, Michael Shaheen, Kristin Fontes, Patrick Cain, Sean Wentworth, Carolyn Meyer, Grant Lipman


      PubDate: 2017-12-26T16:48:47Z
      DOI: 10.1016/j.wem.2017.08.011
       
  • Oral L-Tyrosine Supplementation Improved Core Temperature Maintenance to
           Whole-Body Cold Exposure in Older Adults
    • Authors: James Lang; Jahyun Kim; Alex Krajek; Joel Rand
      First page: 366
      Abstract: Publication date: December 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 4
      Author(s): James Lang, Jahyun Kim, Alex Krajek, Joel Rand


      PubDate: 2017-12-26T16:48:47Z
      DOI: 10.1016/j.wem.2017.08.012
       
  • Prevalence of the “Screaming Barfies” Among North American Ice
           Climbers
    • Authors: Alexander Beyer; Arun Ganti; Brendan Byrne
      First page: 367
      Abstract: Publication date: December 2017
      Source:Wilderness & Environmental Medicine, Volume 28, Issue 4
      Author(s): Alexander Beyer, Arun Ganti, Brendan Byrne


      PubDate: 2017-12-26T16:48:47Z
      DOI: 10.1016/j.wem.2017.08.013
       
  • Scientific Writing
    • Authors: Neal Pollock
      Abstract: Publication date: Available online 31 October 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Neal W. Pollock


      PubDate: 2017-11-03T05:12:03Z
       
  • A Comprehensive Review of Hirudiniasis: From Historic Uses of Leeches to
           Modern Treatments of Their Bites
    • Authors: Jeremy Joslin; Amy Biondich; Kara Walker; Nicole Zanghi
      Abstract: Publication date: Available online 10 October 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Jeremy Joslin, Amy Biondich, Kara Walker, Nicole Zanghi
      Exposure to leeches in the wilderness setting is common. Leeches may attach themselves to exposed skin or pass through one of the body’s orifices and attach internally. The condition of leech attachment is known as hirudiniasis, which can result in serious morbidity and, rarely, mortality. A comprehensive review of the literature was performed to detail the prevention of leech attachment, as well as both anecdotal and studied methods of removal. Complications from leech attachments include ongoing bleeding, wound infection, and poor wound healing. Although medicinal leeches are the most well-studied variety, this review examines all aspects of leech attachment, prevention, and management.

      PubDate: 2017-10-12T23:14:53Z
      DOI: 10.1016/j.wem.2017.08.002
       
  • Recreational and Commercial Catfishing Injuries: A Review of the
           Literature
    • Authors: Courtney R.J. Kaar; Albert K. Nakanishi
      Abstract: Publication date: Available online 28 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Courtney R.J. Kaar, Albert K. Nakanishi
      Catfish injuries are increasingly common from the recreational activities of hobbyists, fishermen, and “noodling” enthusiasts as well as in the commercial catfish industry, most commonly in Brazil. Injuries can range from mild skin abrasions to life-threatening infections and tissue damage requiring urgent treatment. Most injuries and subsequent morbidity associated with catfish encounters involve the dorsal and pectoral fins. These injuries are most often lacerations involving the upper extremities. Deep, penetrating catfish spine injuries can lead to serious injuries, including arterial and nerve lacerations. Catfish venom is released when a spine is torn. The venom may cause reactions that include erythema, edema, local hemorrhage, tissue necrosis, and muscle contractions. When “finned” by a catfish, the fish’s spine may separate from the fish, which can cause a foreign body embedment. Some injuries are not thought to be severe enough at the time of injury to require medical care, although symptoms may arise years later. In this literature review of catfishing injuries, references were obtained through a PubMed search of the following terms: catfish injuries, fishing, envenomation, spine, and aquatic infection. Articles were chosen for citation based on pertinence to the topic of catfishing.

      PubDate: 2017-09-28T06:13:09Z
      DOI: 10.1016/j.wem.2017.07.007
       
  • Colorful Mushroom Ingestion
    • Authors: James H. Diaz
      Abstract: Publication date: Available online 22 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): James H. Diaz


      PubDate: 2017-09-28T06:13:09Z
      DOI: 10.1016/j.wem.2017.07.006
       
  • Functional and Sports-Specific Outcome After Surgical Repair of Rotator
           Cuff Tears in Rock Climbers
    • Authors: Michael Simon; Dominik Popp; Christoph Lutter; Volker Schöffl
      Abstract: Publication date: Available online 20 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Michael Simon, Dominik Popp, Christoph Lutter, Volker Schöffl
      Objective The purpose of this study was to analyze the general (Constant Murley score) and sports-specific (change in International Climbing and Mountaineering Federation [UIAA] grade) outcome after surgical repair of rotator cuff injuries in rock climbers. Methods In a retrospective study, 12 rock climbers (10 men, 2 women; age 55 years; SD±9; range 28–66 years [mean±SD with range] with rotator cuff lesions were re-evaluated 27±16 (12–72) months after arthroscopic surgical repair of the rotator cuff of the shoulder. The etiology of the rotator cuff pathology was equally chronic (age 61±12 [28–66] years) and acute (age 53±5 [51–65] years). The postoperative general outcome, including the Constant Murley score, was assessed with a standardized questionnaire and clinical examination. The postoperative sports-specific outcome was analyzed using the UIAA metric scale. Results The postoperative Constant Murley score was 92±7 (80–98). All participants had already started climbing again; 11 of 12 climbers regained a climbing level within ±1.33 UIAA metric grades of their initial capability. Conclusion Arthroscopic repair of acute and chronic rotator cuff tears shows a good functional outcome, enabling most patients to regain a high level of rock climbing ability.

      PubDate: 2017-09-21T03:08:32Z
      DOI: 10.1016/j.wem.2017.07.003
       
  • Pulmonary Injury from Waterproofing Spray During a Hike
    • Authors: Tomonori Harada; Yukio Hirabayashi; Yuriko Takayama-Isagawa; Hiroto Sakamoto; Makoto Kawaishi; Hiroyuki Hara; Shin Aizawa
      Abstract: Publication date: Available online 15 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Tomonori Harada, Yukio Hirabayashi, Yuriko Takayama-Isagawa, Hiroto Sakamoto, Makoto Kawaishi, Hiroyuki Hara, Shin Aizawa
      A 48-year-old man developed general fatigue, dyspnea, and fever at an altitude of 1562 m from the morning of the first day of a 3-day hike. Despite pharyngeal discomfort and mild general fatigue, he felt that the symptoms were not sufficient to abandon his plan. He usually required 1.5 hours to reach Tokusawa (6.4 km from the starting point at an altitude of 1500 m), but this time he required 2.5 hours and slept briefly upon arrival at Tokusawa due to extreme fatigue and respiratory discomfort. His symptoms became aggravated, so he presented at a mountain clinic with oxygen saturation at 80% and body temperature of 37.6ºC. He was diagnosed with hypoxemia due to pneumonia and/or other disease(s) and was evacuated to a hospital where a chest computed tomography scan revealed ground glass opacity and infiltrative shadows. He was treated for pneumonia, but another doctor discovered during follow-up that the patient had sprayed 300 mL of a waterproofing aerosol on mountain equipment in a nonventilated, enclosed area of his home on the night before starting out on the hike. Therefore, waterproofing spray was considered to have caused pulmonary damage. Self-reporting or appropriate questionnaires are the only means of identifying this type of injury. The differential diagnosis of pulmonary problems in an outdoor setting should include toxic aerosol exposure from waterproofing spray.

      PubDate: 2017-09-16T01:06:52Z
      DOI: 10.1016/j.wem.2017.07.002
       
  • Improvised Hand Injury Treatment Using Traditional Veterinary Medicine in
           Ethiopia
    • Authors: Raf Aerts; Eva J.J. November; Maissa Rayyan
      Abstract: Publication date: Available online 14 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Raf Aerts, Eva J.J. November, Maissa Rayyan
      In remote wilderness environments, local people with traditional knowledge of medicinal plants are potentially important first-line health care providers. We present a case of a 31-year-old man who fell off a horse while trekking through a remote mountain landscape in Ethiopia and sustained blunt force trauma to the hand. A local mountain hut keeper examined the patient’s hand and used heated leaves of the succulent plant Kalanchoe petitiana to treat a suspected metacarpal fracture. As first responder in a low-resource setting, the hut keeper relied on his traditional knowledge of ethnoveterinary medicine to improvise a treatment for a human injury in a remote mountain environment. Although in this case the outcome of the traditional intervention was positive, our analysis shows that the massage component of the intervention could have led to complications. Conversely, reports from the use of related Kalanchoe species suggest that heated Kalanchoe leaves could be useful in the compression component of traditional care for hand injuries. Validation of traditional remedies and their therapeutic potential are needed if they are to complement wilderness wound care safely and reliably. The documentation and validation of these remedies are urgently needed, as many medicinal plants and indigenous knowledge of how to use these valuable natural resources are being lost.

      PubDate: 2017-09-16T01:06:52Z
      DOI: 10.1016/j.wem.2017.06.012
       
  • Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness
           Expeditions from 1984 to 2012
    • Authors: Kimberly A. Stanford; Lara Phillips; Yuchiao Chang; Drew Leemon; Tod Schimelpfenig; N. Stuart Harris
      Abstract: Publication date: Available online 4 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Kimberly A. Stanford, Lara Phillips, Yuchiao Chang, Drew Leemon, Tod Schimelpfenig, N. Stuart Harris
      Objective Wilderness expeditions inevitably involve risk to participants. Understanding of expedition-related illnesses and injuries allows institutions and individuals to develop strategies to mitigate risk. We describe findings and trends in soft tissue injuries, the second-most common type of injury, among participants in the National Outdoor Leadership School expeditions from 1984 to 2012. Methods Injuries and illnesses sustained by students and staff have been recorded continuously since 1984 in the extensive National Outdoor Leadership School database. We performed a retrospective analysis of incidence of soft tissue injuries in this population. Data before 1996 were standardized in order to make use of the entire dataset. Results Of 9734 total reported incidents, 2151 (22%) were soft tissue related, 707 (33%) of which required evacuation. The sex distribution of incidents was similar to the sex distribution of participants. The largest incidence of soft tissue injuries occurred independent of activity (711 incidents, 33%). The most commonly associated activities were hiking (528 incidents, 25%), camping (301 incidents, 14%), and cooking (205 incidents, 10%). Over the study period, rates of injury declined overall and in every individual category except cooking. Conclusions Over this 28-year period, the incidence of soft tissue injuries associated with the most common activities decreased. Incidence of activity-independent injuries did not change significantly, but reported severity decreased. These data provide unique insights to help improve wilderness risk management for institutions and individuals and suggest areas in which educational efforts may further reduce risk.

      PubDate: 2017-09-09T23:44:38Z
      DOI: 10.1016/j.wem.2017.06.005
       
  • Bite Wounds Caused by a Wild Boar: A Case Report
    • Authors: Hiroki Nagasawa; Kazuhiko Omori; Hiroyuki Maeda; Ikuto Takeuchi; Suguru Kato; Takashi Iso; Kei Jitsuiki; Toshihiko Yoshizawa; Kouhei Ishikawa; Hiromichi Ohsaka; Youichi Yanagawa
      Abstract: Publication date: Available online 1 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Hiroki Nagasawa, Kazuhiko Omori, Hiroyuki Maeda, Ikuto Takeuchi, Suguru Kato, Takashi Iso, Kei Jitsuiki, Toshihiko Yoshizawa, Kouhei Ishikawa, Hiromichi Ohsaka, Youichi Yanagawa
      A 74-year-old man was attacked by a wild boar while on his way home from his farm in the daytime in winter 2017 on the rural Izu peninsula. He did not provoke the boar; however, hunters were hunting animals in the mountains near the farm around the same time. The boar bit his left leg, and the man fell to the ground. The boar continued biting the man’s left leg, and the man delivered a few kicks to the boar’s face with his right leg. The boar then bit his right foot and ran away. The man was taken to a hospital, and a physical examination revealed 3 bite wounds on his left leg and right foot. The wounds were irrigated with sterilized saline and closed with sutures under local anesthesia. He received antibiotics and a tetanus toxoid booster. The next day, his wounds were found to be infected, and pus was drained from them. After these treatments, his wounds healed successfully. Animal bite wounds are frequently contaminated. Accordingly, in addition to early proper wound treatment, close observation of the wound is required for both the early detection of any signs of infection and early medical intervention, including appropriate drainage of pus and irrigation as necessary.

      PubDate: 2017-09-03T22:07:33Z
      DOI: 10.1016/j.wem.2017.06.004
       
  • Inappropriate Dexamethasone Use by a Trekker in Nepal: A Case Report
    • Authors: Nicholas R. Haslam; Rachel Garth; Nicola Kelly
      Abstract: Publication date: Available online 1 September 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Nicholas R. Haslam, Rachel Garth, Nicola Kelly
      We present a case of inappropriate dexamethasone use in a trekker in the Everest region of Nepal. We aim to increase awareness among health professionals of the possible use of this medication by trekkers and promote knowledge of potential complications. In this case, a previously altitude-naive trekker was prescribed prophylactic dexamethasone by physicians in a Western travel clinic before high-altitude trekking in Nepal. There were no indications for prophylactic medication nor for the use of dexamethasone. The trekker reported that no discussion regarding risks and benefits, alternatives, side effects, contraindications, or dose tapering on completion of the course had occurred before travel. Side effects were temporary, but serious complications may have ensued if it not for timely interventions by doctors at the International Porter Protection Group rescue post. The events leading to inappropriate dexamethasone use in this case cannot be known for certain. However, it is clear that the trekker lacked the knowledge to use the medication safely. Although the efficacy of dexamethasone in the prevention of acute mountain sickness is undisputed, associated side effects and other limitations make acetazolamide the prophylactic drug of choice. Inappropriate use of dexamethasone can lead to severe complications, and such a case has been reported from Mount Everest. Clinicians prescribing dexamethasone must understand the indications and risks, and health professionals at altitude should be aware of its use by trekkers and the potential complications.

      PubDate: 2017-09-03T22:07:33Z
      DOI: 10.1016/j.wem.2017.06.007
       
  • Exercise-Associated Hyponatremia, Hypernatremia, and Hydration Status in
           Multistage Ultramarathons
    • Authors: Brian J. Krabak; Grant S. Lipman; Brandee L. Waite; Sean D. Rundell
      Abstract: Publication date: Available online 7 August 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Brian J. Krabak, Grant S. Lipman, Brandee L. Waite, Sean D. Rundell
      Objective Dysnatremia and altered hydration status are potentially serious conditions that have not been well studied in multistage ultramarathons. The purpose of this study was to assess the incidence and prevalence of exercise-associated hyponatremia (EAH) (Na+ <135 mmol·L-1) and hypernatremia (Na+ >145 mmol·L-1) and hydration status during a multistage ultramarathon. Methods This study involved a prospective observational cohort study of runners competing in a 250-km (155-mile) multistage ultramarathon (in the Jordan, Atacama, or Gobi Desert). Prerace body weight and poststage (stage [S] 1 [42 km], S3 [126 km], and S5 [250 km]) body weight and serum sodium concentration levels were obtained from 128 runners. Results The prevalence of EAH per stage was 1.6% (S1), 4.8% (S3), and 10.1% (S5) with a cumulative incidence of 14.8%. Per-stage prevalence of hypernatremia was 35.2% (S1), 20.2% (S3), and 19.3% (S5) with a cumulative incidence of 52.3%. Runners became more dehydrated (weight change <–3%) throughout the race (S1=22.1%; S3=51.2%; S5=53.5%). Body weight gain correlated with EAH (r=–0.21, P = .02). Nonfinishers of S3 were significantly more likely to have EAH compared with finishers (75% vs 5%, P = .001), but there was no difference in either EAH or hypernatremia between nonfinishers and finishers of S5. Conclusions The incidence of EAH in multistage ultramarathons was similar to marathons and single-stage ultramarathons, but the cumulative incidence of hypernatremia was 3 times greater than that of EAH. EAH was associated with increased weight gain (overhydration) in early stage nonfinishers and postrace finishers.

      PubDate: 2017-09-03T22:07:33Z
      DOI: 10.1016/j.wem.2017.05.008
       
  • L-arginine Attenuates Hypobaric Hypoxia-Induced Increase in Ornithine
           Decarboxylase 1
    • Authors: Li Yuhong; Bai Zhengzhong; Tang Feng; Yang Quanyu; Ri-Li Ge
      Abstract: Publication date: Available online 21 July 2017
      Source:Wilderness & Environmental Medicine
      Author(s): Li Yuhong, Bai Zhengzhong, Tang Feng, Yang Quanyu, Ri-Li Ge
      Background Chronic hypoxia-induced pulmonary hypertension and vascular remodeling have been shown to be associated with ornithine decarboxylase 1 (ODC1). However, few animal studies have investigated the role of ODC1 in acute hypoxia. Objectives We investigated ODC1 gene expression, morphologic and functional changes, and the effect of L-arginine as an attenuator in lung tissues of rats exposed to acute hypobaric hypoxia at a simulated altitude of 6000 m. Methods Sprague-Dawley rats exposed to simulated hypobaric hypoxia (6000 m) for 24, 48, or 72 hours were treated with L-arginine (L-arginine group, 20 mg/100 g intraperitoneal; n=15) or untreated (non–L-arginine group, n=15). Control rats (n=5) were maintained at 2260 m in a normal environment for the same amount of time but were treated without L-arginine. The mean pulmonary artery pressure was measured by PowerLab system. The morphologic and immunohistochemical changes in lung tissue were observed under a microscope. The mRNA and protein levels of ODC1 were measured by real-time polymerase chain reaction and Western-blot, respectively. Results Hypobaric hypoxia induced pulmonary interstitial hyperemia and capillary expansion in the lungs of rats exposed to acute hypoxia at 6000 m. The mean pulmonary artery pressure and the mRNA and protein levels of ODC1 were significantly increased, which could be attenuated by treatment with L-arginine. Conclusions L-arginine attenuates acute hypobaric hypoxia-induced increase in mean pulmonary artery pressure and ODC1 gene expression in lung tissues of rats. ODC1 gene contributes to the development of hypoxic pulmonary hypertension.

      PubDate: 2017-07-26T11:33:51Z
      DOI: 10.1016/j.wem.2017.05.009
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.81.166.196
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-