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Reduced Acetazolamide Dosing in Countering Altitude Illness: A Comparison of 62.5 vs 125 mg (the RADICAL Trial)
ConclusionsThe reduced dose of acetazolamide at 62.5 mg twice daily was noninferior to the currently recommended dose of 125 mg twice daily for the prevention of AMS. Low incidence of AMS in the study population may have limited the ability to differentiate the treatment effects. Further research with more participants with greater rates of AMS would further elucidate this reduced dosage for preventing altitude illness. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 9, 2019 Category: Environmental Health Source Type: research

In Response to Cold Card by Giesbrecht
Publication date: Available online 4 January 2019Source: Wilderness & Environmental MedicineAuthor(s): Paweł Podsiadło, Mathieu Pasquier, Sylweriusz Kosiński, Tomasz Sanak, Robert Gałązkowski, Tomasz Darocha (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 5, 2019 Category: Environmental Health Source Type: research

Rock Climber Self-Rescue Skills
ConclusionsSelf-rescue skills were generally lacking in our study population. Climber confidence, experience, training, and climbing frequency did not appear to be associated with a higher level of rescue skills. Self-rescue skills should be emphasized in climbing instruction and courses to increase overall safety. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 5, 2019 Category: Environmental Health Source Type: research

Pedicled Abdominal Flaps for Enhanced Digital Salvage After Severe Frostbite Injury
Publication date: Available online 24 December 2018Source: Wilderness & Environmental MedicineAuthor(s): Owain L. Fisher, Ruth A. Benson, Matthew R. Venus, Christopher H.E. ImrayExtremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Reconstruction of affected digits is limited by bone...
Source: Wilderness and Environmental Medicine - December 25, 2018 Category: Environmental Health Source Type: research

In Response to Bite Wounds Caused by a Wild Boar by Nagasawa et al
Publication date: Available online 21 December 2018Source: Wilderness & Environmental MedicineAuthor(s): Beuy Joob, Viroj Wiwanitkit (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - December 22, 2018 Category: Environmental Health Source Type: research

Fatal Pulmonary Edema in a Child After Jellyfish Stings in Korea
Publication date: December 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 4Author(s): Ji Hye Kim, Seung Baik Han, Areum DureyJellyfish have been increasing at a global scale in recent years. These blooms not only have deleterious effects on marine ecosystems, they also increase the risk of jellyfish stings and accompanying envenomation. Here, we report a fatal case of pulmonary edema caused by jellyfish envenomation in a child in Korea. The patient died 4 h after envenomation despite cardiopulmonary resuscitation. Nemopilema nomurai was the suspected species of jellyfish encountered by the patient, altho...
Source: Wilderness and Environmental Medicine - November 15, 2018 Category: Environmental Health Source Type: research

Observational Study of Grand Canyon Rim-to-Rim Day Hikers: Determining Behavior Patterns to Aid in Preventive Search and Rescue Efforts
ConclusionsCrossing R2R in a day is hazardous and associated with risk of injury and illness. The results of this study can be used by Preventive Search and Rescue to reduce these risks by educating hikers. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 2, 2018 Category: Environmental Health Source Type: research

Severe Systemic Envenomation Following Vipera berus Bite Managed with ViperaTAb Antivenom
We present a case demonstrating both severe systemic and local effects necessitating out of hospital resuscitation, vasopressor support, and prolonged rehabilitation. Hemodynamic stability was restored promptly after administration of ViperaTAb antivenom, the first published case of its use in the UK. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 30, 2018 Category: Environmental Health Source Type: research

In Response to AVReCh—Avalanche Resuscitation Checklist by Strapazzon et al
Publication date: Available online 24 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Lorenzati Bartolomeo, Sciolla Andrea, Tortore Andrea, Lauria Giuseppe (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 25, 2018 Category: Environmental Health Source Type: research

Poisoning with Tasty and Sweet Seed Pods of Bird of Paradise Plant Caesalpinia gilliessii
Publication date: Available online 25 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Seyed Mostafa Mirakbari, Mohammad Hadi Shirazi (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 25, 2018 Category: Environmental Health Source Type: research

Don't Stand So Close to Me: A Stinging Rash
Publication date: Available online 25 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Kyle J. Halle, Victoria S. Klovenski, Andrew Juergens (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 25, 2018 Category: Environmental Health Source Type: research

The Golden Jellyfish of Ongeim'l Tketau During an Afternoon Rain
Publication date: Available online 22 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Rombod Rahimian (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 24, 2018 Category: Environmental Health Source Type: research

Blinding and Peer Review
Publication date: Available online 14 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 14, 2018 Category: Environmental Health Source Type: research

The Effects of Acetazolamide on Exercise Performance at Sea Level and in Hypoxic Environments: A Review
Publication date: Available online 9 October 2018Source: Wilderness & Environmental MedicineAuthor(s): Alexander M. Posch, Stewart Dandorf, David C. HileLowlanders rapidly ascending to high altitude (>2500 m) often develop acute mountain sickness (AMS). While acclimatization is the most effective method of reducing symptoms of AMS (ie, headache, fatigue, nausea, gastrointestinal distress, etc.), it may take several days to become fully acclimated. Prophylactic use of acetazolamide (AZ), a carbonic anhydrase inhibitor, has become a popular alternative to staged acclimatization because it can be a less time-consuming method ...
Source: Wilderness and Environmental Medicine - October 10, 2018 Category: Environmental Health Source Type: research

Russell's Viper Envenomation-Associated Addisonian Crisis
We report a case of bilateral adrenal hemorrhage in a 28-y-old man with Russell's viper bite that occurred in the Sathyamangalam forest range in the Indian state of Tamil Nadu. In this case, a combination of early bite recognition, hospital-based supportive care, corticosteroid therapy, and timely administration of polyvalent antivenom resulted in a favorable clinical outcome. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 9, 2018 Category: Environmental Health Source Type: research