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Wilderness & Environmental Medicine

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https://read.qxmd.com/read/30737155/retrospective-documentation-of-a-confirmed-white-lipped-green-pit-viper-trimeresurus-albolabris-gray-1842-bite-in-the-south-central-hills-of-nepal
#1
Deb P Pandey, Amod Ghimire, Bhola R Shrestha
This case report documents envenomation by an arboreal white-lipped green pit viper (Trimeresurus albolabris), a species found in South and Southeast Asia that causes the majority of venomous snakebites among Southeast Asian pit vipers. Clinical features vary from asymptomatic to serious coagulopathy that may progress into life-threatening or fatal hemorrhage. The proven life-threatening cases described in published literature, however, are sparse. Practically, no specific antivenom targeted to pit viper bites is available in Nepal...
February 5, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30737154/epidemiology-of-cardiac-events-during-prehospital-care-in-mountain-rescues-conducted-in-arag%C3%A3-n
#2
Carmen M Martínez-Caballero, Eva Sierra Quintana
INTRODUCTION: Cardiac events are one of the leading causes of death in the Spanish population. Given the increase in the nontraumatic medical conditions found in mountain rescues, the objective of this study was to report on the heart conditions of patients rescued in the mountains of Aragón in the Spanish Pyrenees. METHODS: We conducted a retrospective observational study based on data collected from patients' medical histories for rescues undertaken in from 2010 to 2016 (at altitudes between 500 m [1640 ft] and 3404 m [11,168 ft])...
February 5, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30737153/efficacy-of-head-and-torso-rewarming-using-a-human-model-for-severe-hypothermia
#3
Kartik Kulkarni, Erik Hildahl, Ramesh Dutta, Sandra C Webber, Steven Passmore, Gerren K McDonald, Gordon G Giesbrecht
INTRODUCTION: To evaluate the rewarming effectiveness of a similar amount of heat (from a charcoal heater) applied to either the head or torso in a human model for severe hypothermia in which shivering is pharmacologically inhibited in mildly hypothermic subjects. METHODS: Six male subjects were cooled on 3 different occasions, each in 8°C water for 60 min, or to a lowest core temperature of 35°C. Shivering was inhibited by intravenous meperidine (1.5 mg·kg-1 ), administered during the last 10 min of the cold-water immersion...
February 5, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30733084/in-response-to-metabolic-demand-of-hiking-in-wildland-firefighting-by-sol-et-al
#4
LETTER
Cara McAnaney, Arun Ganti
No abstract text is available yet for this article.
February 4, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30733083/camp-fire-smoke-sunset
#5
(no author information available yet)
No abstract text is available yet for this article.
February 4, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30733082/sea-ice-floes-in-the-weddell-sea
#6
(no author information available yet)
No abstract text is available yet for this article.
February 4, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30718138/expired-drugs-in-the-remote-environment
#7
Emma Browne, Frank Peeters, Melanie Priston, P T Marquis
INTRODUCTION: The British Antarctic Survey Medical Unit works in a very remote area of the world, with several Antarctic bases receiving only a single annual resupply of consumable goods. Pharmaceuticals supplied in this manner will often be approaching or past the end of their nominal shelf life before the following year's resupply. Drugs are transported from the UK via ship; the hold is not temperature controlled, and the ship crosses through the tropics (air temperature 25-30°C for approximately 3 wk)...
February 1, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30718137/one-foot-after-another-fungal-foot-issues-in-expedition-adventure-racing
#8
Thomas M Reynolds, Mathew W P Morreau, Lynne John, Matthew S Jeans
Skin infections are an important issue among participants in expedition-length adventure races. Prolonged stress, scant sleep, and water exposure mean that competitors are at risk of uncommon manifestations of infections. Ulcerative tinea pedis is an example of this. We present a case with characteristic clinical manifestations, including the "sandpaper symptom." There is limited literature exploring infectious foot complaints in expedition adventure racers. Beyond this case report, more research is needed to better understand incidence rates, risk factors, diagnostic measures, treatment, and prevention options...
February 1, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30712825/rejection-under-peer-review
#9
EDITORIAL
Neal W Pollock
No abstract text is available yet for this article.
January 31, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30711421/thrombotic-microangiopathy-hemolytic-uremic-syndrome-and-thrombotic-thrombocytopenic-purpura-following-hump-nosed-pit-viper-genus-hypnale-envenoming-in-sri-lanka
#10
Rmmk Namal Rathnayaka, Pe Anusha Nishanthi Ranathunga, Senanayake Am Kularatne
Thrombotic microangiopathy (TMA), which includes the spectrum of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, is an uncommon complication of hump-nosed pit viper envenomation. We describe 4 cases of TMA following hump-nosed pit viper (Hypnale spp) bites in Sri Lanka. The first case is a typical TMA that spontaneously resolved with supportive treatments. The second and third cases are related to hemolytic uremic syndrome complicated with acute kidney injury that required hemodialysis. The fourth case is thrombotic thrombocytopenic purpura associated with acute kidney injury that required hemodialysis and therapeutic plasma exchange...
January 30, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30711420/success-rates-with-digital-intubation-comparing-unassisted-stylet-and-gum-elastic-bougie-techniques
#11
Andrew L Juergens, Brandon W Odom, Christine E Ren, Kirk E Meyers
INTRODUCTION: The utility of digital intubation, especially in an austere environment with limited equipment, has been previously described. However, evidence supporting best practices for its technique is limited. We seek to quantify the time to intubation and the rate of successful placement of the tube for digital intubation using different approaches and assistance devices. METHODS: Using a manikin, digital intubation was performed with an endotracheal tube alone, with an endotracheal tube and a 14-French stylet, or with a gum-elastic bougie...
January 30, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30661825/in-reply-to-drs-joob-and-wiwanitkit
#12
LETTER
Hiroki Nagasawa, Youichi Yanagawa
No abstract text is available yet for this article.
January 18, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30660431/in-reply-to-dr-podsiad%C3%A5-o-et-al
#13
LETTER
Gordon G Giesbrecht
No abstract text is available yet for this article.
January 16, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30660430/2018-wilderness-environmental-medicine-peer-reviewers
#14
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
January 16, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30642713/delayed-onset-high-altitude-pulmonary-edema-a-case-report
#15
Anjan Bhattarai, Suman Acharya, Jayant Kumar Yadav, Matt Wilkes
High altitude pulmonary edema (HAPE) is a life-threatening altitude illness that usually occurs in insufficiently acclimatized climbers in the first few days at altitudes above 2500 m. Acetazolamide is recommended for prophylaxis of acute mountain sickness, but a role for acetazolamide in the prevention of HAPE has not been established. We report a case of a trekker with previous high altitude experience who developed HAPE 8 d after arrival to altitude despite what was believed to be a conservative ascent profile...
January 11, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30642712/ethnicity-based-inequality-in-heat-related-illness-is-on-the-rise-in-california
#16
LETTER
Rana Abualsaud, Grigory Ostrovskiy, Ziyad R Mahfoud
No abstract text is available yet for this article.
January 11, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30642711/neko-harbor-andvord-bay-antarctic-peninsula-on-a-beautiful-sunny-day
#17
(no author information available yet)
No abstract text is available yet for this article.
January 11, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30642710/improvised-hydration-bladder-air-splint-a-wilderness-case-report
#18
Hans F Hurt, Aaron J Reilly
This case report describes the use of a hydration bladder as an improvised air splint for a left forearm fracture in an austere environment. The literature regarding the use of air splints in the prehospital and wilderness environments is scarce, and it does not appear that this technique has been previously described in the literature. Given the widespread use of hydration bladders, the adjustable nature and overall comfort of the splint, and the anecdotal success of this technique without any complications or harm to the patient, the authors believe this is an important improvised splinting option to add to the quiver of any outdoor enthusiast or wilderness medical professional...
January 11, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30642709/in-reply-to-lorenzati-et-al
#19
LETTER
Giacomo Strapazzon, Mario Milani, Hermann Brugger
No abstract text is available yet for this article.
January 11, 2019: Wilderness & Environmental Medicine
https://read.qxmd.com/read/30638665/bite-caused-by-the-assassin-bug-zelus-fabricius-1803-hemiptera-heteroptera-reduviidae-in-a-human
#20
Carlos Eduardo Pereira Dos Santos, José Ricardo de Souza, Régis Adriel Zanette, Felipe Jorge da Silva, Christine Strussmann
A 47-y-old man was bitten by a reduviid bug from the Zelus Fabricius, 1803 genus, which was hidden inside a rubber-coated boot. The bite caused immediate and sharp pain, followed by local edema and constant pruritus for 15 d. Pain and fever within the first 24 h were managed with analgesics as needed, and resolution was complete and without sequelae after 21 d.
January 9, 2019: Wilderness & Environmental Medicine
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