Abstract：
:Recent studies in normal participants have shown that right to left shunt blood vessels in the lung open up during exercise. We describe the first field study to investigate this phenomenon at altitude. This study aimed to assess the effect of altitude and partial acclimatization on inducible right to left shunting at rest and with exercise. A contrast-enhanced transcranial Doppler imaging technique to detect microbubbles after injection of blood and saline agitated with air was used to measure right to left shunting in 10 normal participants at rest and immediately after exercising to maximum oxygen consumption (VO(2max)) at 80 m, on acute exposure to 3450 m, and finally after a week above 3450 m. At 80 m, exercising resulted in right to left shunting via patent foramen ovale in 2 participants, but there was no evidence of shunting in the remaining 8 participants. Cerebral microbubbles were detected at rest in the 2 participants with patent foramen ovale on acute exposure to 3450 m, and the shunting increased on exercise (P = .04). In 5 of the remaining 8 participants without patent foramen ovale, cerebral microbubbles were detected on exercise (P = .04) but not at rest. Partial acclimatization had minimal effect on the prevalence or magnitude of the intrapulmonary or intracardiac shunts. Oxygenation was similar in those with shunts compared with those without shunts. Intrapulmonary shunting occurs on exercise at altitude, but the clinical and physiologic significances have yet to be determined. Despite the occurrence of shunting in most participants, our results suggest that this phenomenon is not a significant factor in altitude and exercise-induced hypoxia.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Imray CH,Pattinson KT,Myers S,Chan CW,Hoar H,Brearey S,Collins P,Wright AD,Birmingham Medical Research Expeditionary Society.doi
10.1580/07-WEME-BR-162.1subject
Has Abstractpub_date
2008-10-01 00:00:00pages
199-204issue
3eissn
1080-6032issn
1545-1534pii
1080-6032-19-3-199journal_volume
19pub_type
杂志文章abstract：OBJECTIVE:Antarctic expeditioners face extremes of environmental conditions along with isolation which affect normal human activity at a polar station. Diets of polar expeditioners consist of products that have been kept in storage for more than a year. Processing and preservation adversely affect the nutritive value o...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-WEME-OR-004R3.1
更新日期：2007-01-01 00:00:00
abstract：:We report a case of survival of a completely buried avalanche victim after being located with the radar-based RECCO Rescue System. In the winter of 2015, 2 off-piste skiers were completely buried in an avalanche near the secured ski area in Baqueira Beret, Spain. The first victim was located with the RECCO Rescue Syst...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2016.02.004
更新日期：2016-06-01 00:00:00
abstract：:Hematotoxic snake bite is a leading cause of mortality in South India. However, it is rare for the emergency physician to encounter a patient with trauma associated with snakebite. Management of such a patient differs substantially from the routine management of either a trauma patient or a snakebite victim. A 59-y-ol...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.08.003
更新日期：2020-12-01 00:00:00
abstract：:A 67-year-old woman presented to a community emergency department in Orange County, CA, after she was stung by a scorpion identified as Centruroides limbatus from Central America. She developed local pain and systemic symptoms, including parasthesias, flushing, hypertension, and wheezing. Envenomation by this genus of...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1999)010[0161:ebtslo]2.3.co;2
更新日期：1999-10-01 00:00:00
abstract：OBJECTIVE:Our intent was to observe the effect of simulated altitude exposure on the intracranial pressure (ICP) of New Zealand white rabbits. It is theorized that the hypoxia of high altitude causes a rise in ICP, which may play a role in the pathogenesis of acute mountain sickness (AMS). Dexamethasone is a medication...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2003)14[183:baeinz]2.0.co;2
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:The incidence of fatal closed head injury (CHI) and nonfatal CHI causing an altered level of consciousness in avalanche victims is unknown. The purpose of this study was to assess the incidence and potential significance of CHI in avalanche-related deaths. METHODS:The records of the state medical examiner an...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2001)012[0244:atachi]2.0.co;2
更新日期：2001-01-01 00:00:00
abstract：:Exposure to and consumption of brackish water are associated with an elevated risk of infection, hypernatremia, and hypothermia. Minimal data exist to support the diagnosis and treatment of patients with long-term brackish water exposure. We present a case of a patient who spent 5 to 10 d semisubmerged in the Elizabet...
journal_title：Wilderness & environmental medicine
pub_type：
doi：10.1016/j.wem.2020.04.003
更新日期：2020-09-01 00:00:00
abstract：:As part of an emergency medical system protocol, national park service rangers certified at the level of an emergency medical technician-basic (EMT-B) are taught to recognize and treat high-altitude pulmonary edema and high-altitude cerebral edema. In Sequoia and Kings Canyon National Parks, this is done with the assi...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2004)15[198:uotgbb]2.0.co;2
更新日期：2004-10-01 00:00:00
abstract：OBJECTIVE:Mountaineers face a variety of health risks at altitude including pulmonary edema; portable ultrasound may be used to diagnose high altitude pulmonary edema. This report tests the functionality of electronic equipment in a hypobaric test environment and the ability of remotely guided nonexperts to use ultraso...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/08-WEME-BR-228R2.1
更新日期：2009-10-01 00:00:00
abstract：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 ex...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.05.003
更新日期：2014-12-01 00:00:00
abstract：OBJECTIVE:Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea). METHODS:An Odor Identification Test was administered before (T0; n = 53), a...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.11.013
更新日期：2016-03-01 00:00:00
abstract：OBJECTIVE:To investigate the demographics, incidence, and symptoms and signs of hydrocarbon poisoning in admitted children from the Negev Desert area of Israel. METHODS:The medical records of all children admitted for hydrocarbon poisoning from 1995 to 1999 were reviewed retrospectively. RESULTS:Of the 274 admitted c...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2003)014[0078:hpicay]2.0.co;2
更新日期：2003-07-01 00:00:00
abstract：:Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Com...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2016.11.008
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:To compare altitude responses of 2 ultraendurance athletes and 2 nonathletes during a 2-week expedition on Denali (Mount McKinley). METHODS:The severity of acute mountain sickness (AMS) symptoms (Lake Louise AMS guidelines) and pulmonary function parameters (forced vital capacity, forced expiratory volume in...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2005)16[198:prouaa]2.0.co;2
更新日期：2005-01-01 00:00:00
abstract：:Teaching emergency procedural skills in a wilderness setting can be logistically challenging. To teach these skills as part of a wilderness medicine elective for medical students, we designed an outdoor simulation session with low-fidelity models. The session involved 6 stations in which procedural skills were taught ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.11.001
更新日期：2014-03-01 00:00:00
abstract：INTRODUCTION:Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we i...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.02.008
更新日期：2018-09-01 00:00:00
abstract：:Families are traveling with their children in increasing frequency. Travel to Asia offers children many opportunities to learn about new cultures and history. It also offers the potential for exposure to numerous infectious agents not commonly encountered in the United States. Families must begin to prepare for travel...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1580/06-WEME-RA-026R2.1
更新日期：2007-10-01 00:00:00
abstract：INTRODUCTION:Depending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.01.006
更新日期：2020-06-01 00:00:00
abstract：:We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.05.001
更新日期：2018-09-01 00:00:00
abstract：: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 duri...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2017.10.003
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:The main goal was to explore the different toxin properties (proteolytic, hemorrhagic, and neurotoxic) of Leptodeira annulata ashmeadii Duvernoy's gland secretion (DGS). METHODS:To separate and characterize the different proteins present in L. annulata ashmeadii DGS, 20% sodium dodecyl sulfate-polyacrylamide...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2004)015[0082:phanac]2.0.co;2
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVE:Planning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documente...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2000)011[0257:pfaaem]2.3.co;2
更新日期：2000-01-01 00:00:00
abstract：OBJECTIVE:Closed-circuit oxygen rebreathers may provide high concentrations of oxygen at extremely low flow rates appropriate for field use with limited oxygen supplies. The performance of the preproduction, second-generation remote emergency medical oxygen (REMO(2)) system developed for Divers Alert Network was evalua...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1580/06-WEME-OR-032R.1
更新日期：2007-07-01 00:00:00
abstract：:Injuries caused by wild boar attacks are rare. A 34-year-old male shepherd sustained injuries caused by a wild boar attack, and was brought to our emergency department. The patient had 2 skin and deep tissue lacerations on the posterior aspect of his thigh. Herein, we discuss the clinical management of a wild boar bit...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2011.06.005
更新日期：2011-09-01 00:00:00
abstract：OBJECTIVES:To determine the incidence of femur fractures in mountain rescue in England and Wales. To investigate the attitudes of rescuers toward the use of femoral traction splints. To review the literature for evidence on the use of traction splints in prehospital medicine and test the hypothesis that femoral tractio...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.01.006
更新日期：2015-09-01 00:00:00
abstract：:A 74-year-old previously healthy woman was bitten by a hump-nosed pit viper (Hypnale hypnale) at dusk causing incoagulable blood lasting for 6 days. Further, she developed ecchymoses over her forearms, upper arms, hands, and lower back on day 4 after the snakebite, and microangiopathic hemolytic anemia (MAHA). Feature...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2017.05.005
更新日期：2017-09-01 00:00:00
abstract：:Stingray envenomation is a common occurrence. X-ray evaluation of stingray wounds is an unnecessarily misunderstood diagnostic concept. We present the case of a patient stung by a stingray with a prolonged and complicated course and permanent disability due to a retained barb. The patient had undergone multiple medica...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.03.006
更新日期：2015-09-01 00:00:00
abstract：INTRODUCTION:Grand Canyon National Park has seen an increase in visitors traversing the canyon from rim to rim (R2R) in a single day. R2R hikers travel over 33.8 km (21 mi) over 3300 m (11,000 ft) of elevation change and endure large temperature changes. Grand Canyon emergency medical service providers provide emergenc...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.08.001
更新日期：2019-03-01 00:00:00
abstract：:A hydatid cyst is a parasitic disease caused by the tapeworm Echinococcus granulosus. It is endemic in many areas, including New Zealand, Australia, and the Mediterranean region. Pulmonary hydatid disease can be diagnosed incidentally in asymptomatic patients or may cause symptoms such as cough, chest pain, dyspnea, f...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/07-WEME-CR-1561.1
更新日期：2008-07-01 00:00:00
abstract：:Two children, ages 2 and 4 years, envenomed by the snake Cerastes vipera are presented. Both children suffered from local pain and swelling of the hand that spread up to the shoulder in the 2-year-old and up to the elbow in the 4-year-old. A hemorrhagic blister was noted on the bitten finger in the younger patient. Ur...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1995)006[0269:sbbcvi]2.3.co;2
更新日期：1995-08-01 00:00:00
