Wilderness & Environmental Medicine最新文献_第4页

Establishment of Ultrasound Evaluation of Bubble Load in Rabbit Model with Decompression Sickness. 兔减压病模型气泡负荷超声评价方法的建立。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-16 DOI: 10.1177/10806032251320081

Qunyan Wu, Jiaxin Chen, Qing Ye, Yongquan Huang, Shuqing Wang, Yuhong Lin, Shushan Zhang, Zhongzhen Su

{"title":"Establishment of Ultrasound Evaluation of Bubble Load in Rabbit Model with Decompression Sickness.","authors":"Qunyan Wu, Jiaxin Chen, Qing Ye, Yongquan Huang, Shuqing Wang, Yuhong Lin, Shushan Zhang, Zhongzhen Su","doi":"10.1177/10806032251320081","DOIUrl":"10.1177/10806032251320081","url":null,"abstract":"IntroductionTo establish a decompression sickness (DCS) model in New Zealand white rabbits and a quantitative method for assessing bubble load in DCS by ultrasound.MethodsFifteen male New Zealand white rabbits were exposed in a hyperbaric chamber for 60 min with air compressed to 500 kPa (absolute pressure) at 100 kPa/min, followed by decompression at a rate of 200 kPa/min back to normal pressure. Behavioral changes were observed 10 min after removing the rabbits from the chamber to assess whether a model with DCS was successfully established. Bubbles in the inferior vena cava (IVC) and right ventricle (RV) were detected by ultrasound and semi-quantitatively graded using the Eftedal-Brubakk (EB) grade. One hour after exiting the chamber, the rabbits underwent autopsy to observe macroscopic bubbles in vessels and tissues for postmortem (PM) scoring. Correlations between EB grading by ultrasound and PM bubble scores were analyzed.ResultsThe decompression protocol yielded a 100% DCS incidence (15/15) with 13.3% mortality (2/15) within 1 h after the rabbits were removed from the chamber. Ultrasound revealed bubble-like hyperechoic foci in the IVC and RV after decompression, with significantly higher EB grades in the IVC (p < 0.05). IVC's EB grades exhibited a stronger correlation with its PM bubble scores (r = 0.921, p < 0.01) compared to RV grades (r = 0.573, p < 0.05).ConclusionA reliable DCS model was established in New Zealand white rabbits. EB grading of the IVC and RV by ultrasound demonstrated a robust correlation with their PM bubble scores, suggesting potential for clinical translation in assessing bubble loads in DCS.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"201-208"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Evacuations of Climbers on Mount Aconcagua, 2022-2024. 2022-2024年阿空加瓜山登山者的医疗后送。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-18 DOI: 10.1177/10806032251323504

Aaron Brillhart, Javier Seufferheld, Bernabé Abramor, Rodrigo Duplessis, Roxana Pronce, Sameer Sethi

{"title":"Medical Evacuations of Climbers on Mount Aconcagua, 2022-2024.","authors":"Aaron Brillhart, Javier Seufferheld, Bernabé Abramor, Rodrigo Duplessis, Roxana Pronce, Sameer Sethi","doi":"10.1177/10806032251323504","DOIUrl":"10.1177/10806032251323504","url":null,"abstract":"IntroductionMount Aconcagua (6961 m) is the highest peak in the Western Hemisphere and attempted by over 3000 climbers annually. Aconcagua Provincial Park (APP) and the APP medical service oversee all rescues and medical care. This study aims to describe patients and conditions requiring rescue medical evacuation on Aconcagua.MethodsDemographic, medical, and logistics data provided by APP on all park evacuations were retrospectively reviewed from the 2022-23 and 2023-24 climbing seasons.ResultsOf 6494 total Aconcagua climbers over the study period, 302 required an evacuation response from APP (mean 151 per year), yielding an evacuation rate of 4.7%. Mean age was 43.0. Male climbers had twice the risk of requiring rescue than female climbers (OR 2.01). Most evacuees were European (40%) or North American (33%), though climbers from Africa, Asia, and Australia had over twice the incidence of rescue (OR 2.26). Most frequent reasons for evacuation included altitude illness of all types (62%), high-altitude pulmonary edema (HAPE) (49%), trauma/musculoskeletal (15%), general medical (11%), and acute mountain sickness (11%). Most were flown by helicopter (95%), with flight location primarily from 4200 to 4300 m base camps (77%) and between 5300 and 5970 m (16%).ConclusionsOn Aconcagua, 4.7% of climbers required medical evacuation. Altitude illness frequently required rescue, with HAPE representing the single most common reason for evacuation. Male sex and certain continents of origin showed increased risks. Helicopter evacuation and medical oversight by APP appear to contribute to climber safety on Aconcagua. Opportunities exist for future study and climber education of risks.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"209-215"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemoptysis During Swimming. 游泳时咯血。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-02-28 DOI: 10.1177/10806032251318579

Nefeli Mouratidou, Dimitrios Papadopoulos, Lydia Prantalou, Iro Vrouvaki, Zoi Tsilogianni, Anthoula Psara, Stamatis Katsenos

引用次数: 0

Looking Back, Moving Forward. 回顾过去，向前迈进。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-17 DOI: 10.1177/10806032251327851

George W Rodway

引用次数: 0

Oropharyngeal Bee, Hornet, Yellow Jacket, and Wasp Stings: A National Electronic Injury Surveillance System Analysis and Scoping Review. 口咽蜜蜂、大黄蜂、黄蜂和黄蜂蜇伤：全国电子伤害监测系统分析和范围界定审查》。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-28 DOI: 10.1177/10806032251323507

Andrew Huff, Lara Phillips, Scott W Keith

{"title":"Oropharyngeal Bee, Hornet, Yellow Jacket, and Wasp Stings: A National Electronic Injury Surveillance System Analysis and Scoping Review.","authors":"Andrew Huff, Lara Phillips, Scott W Keith","doi":"10.1177/10806032251323507","DOIUrl":"10.1177/10806032251323507","url":null,"abstract":"IntroductionIt is estimated that up to 94.5% of the adult population has received at least 1 Hymenoptera sting in their lifetime, which includes stings from bees, hornets, yellow jackets, or wasps. This study describes the epidemiology of oropharyngeal stings due to bees, hornets, yellow jackets, and wasps in the United States between 2004 and 2023.MethodsThis study used data from the National Electronic Injury Surveillance System to describe patients with stings who presented to US hospitals for treatment. It then contextualized these findings through a scoping review of case reports of oropharyngeal stings published on Scopus and PubMed, with particular attention to the hospital disposition of cases.ResultsThe National Electronic Injury Surveillance System analysis found that an estimated 5% of all stings involved the oropharyngeal region. The rate of oropharyngeal stings has varied over time, and an estimated 2% of victims were admitted to the hospital for any reason. This finding stands in contrast to the review of case reports, in which 64% of victims were hospitalized.ConclusionsOropharyngeal stings present a unique risk of airway compromise and merit conservative treatment, which may include hospitalization.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"216-222"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012-2022. 黑寡妇蜘蛛暴露：2012-2022年国家毒物数据系统回顾。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2024-12-13 DOI: 10.1177/10806032241300134

Abigail F Kerns, Emily T Scheffel, Rita Farah, Christopher P Holstege

{"title":"Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012-2022.","authors":"Abigail F Kerns, Emily T Scheffel, Rita Farah, Christopher P Holstege","doi":"10.1177/10806032241300134","DOIUrl":"10.1177/10806032241300134","url":null,"abstract":"IntroductionThe black widow spider, Latrodectus mactans, stands out as one of the most medically significant arachnids due to its extensive geographic distribution in the United States and its ability to produce a potent neurotoxin, α-latrotoxin. This study aimed to describe the epidemiology of black widow spider exposures by month of exposure, geographic distribution, demographics, symptoms, treatment, and health system resource utilization between 2012 and 2022.MethodsThis was a retrospective observational study using the US National Poison Data System, the data warehouse of the 55 US poison centers. A descriptive analysis of patient demographic data, month of exposure, clinical effects, level of healthcare received, and medical outcome was performed.ResultsDuring the studied period, a total of 15,299 cases of Latrodectus spp exposures were reported to US poison centers. Exposures occurred with higher frequency in warm-weather states and during summer months. Almost half the cases were managed outside a healthcare facility (48.6%). Hospital admission was required for 10.0% of exposures. The most common therapies received were wound care (43.7%) and benzodiazepines (18.6%). Antivenom was administered in 3.4% (n=521) of exposures.ConclusionsPoison center data indicate that most black widow spider exposures result in minor consequences. Supportive care is the primary approach for black widow spider bites. Although antivenom use is infrequent, providers may seek administration guidance from toxicologists through local poison centers. This study underscores the pivotal role of poison centers in mitigating unnecessary healthcare visits and subsequent hospitalizations.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"154-158"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Attacks on Humans by Neotropical Otters. 新热带水獭对人类的攻击

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-01-20 DOI: 10.1177/10806032241304736

D Nataly Castelblanco-Martínez, Alex A González-Vargas, Gustavo González, M Fabiola Corona-Figueroa, Carlos A Lasso

引用次数: 0

2024 Wilderness & Environmental Medicine Peer Reviewers. 2024荒野与环境医学同行评审。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1177/10806032251325908

引用次数: 0

Mohave Rattlesnake Envenomation Causing Allergic Myocardial Infarction (Kounis Syndrome) and Neurotoxic Respiratory Failure. 莫哈维响尾蛇中毒引起过敏性心肌梗死（库尼斯综合征）和神经毒性呼吸衰竭。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-02-13 DOI: 10.1177/10806032251316792

Martina Mookadam, Damir Vukomanovic, Siamac Yazdchi, Samuel Unzek, Farouk Mookadam

{"title":"Mohave Rattlesnake Envenomation Causing Allergic Myocardial Infarction (Kounis Syndrome) and Neurotoxic Respiratory Failure.","authors":"Martina Mookadam, Damir Vukomanovic, Siamac Yazdchi, Samuel Unzek, Farouk Mookadam","doi":"10.1177/10806032251316792","DOIUrl":"10.1177/10806032251316792","url":null,"abstract":"Mohave rattlesnakes (Crotalus scutulatus) are known to inhabit the deserts of southwestern United States, with their territory extending into southern Mexico. Envenomation can impart dramatic local and systemic effects on the body, ranging from local skin necrosis to neurotoxicity, depending on the protein complex in the venom. Kounis syndrome, or allergic angina, is an allergic response to a specific insult that results in myocardial injury often in the form of coronary artery vasospasm but can include myocardial infarction and coronary stent thrombosis. To our knowledge, there have not been any reports associating C scutulatus envenomation with Kounis syndrome. We describe a patient who developed Kounis syndrome presenting as an allergic myocardial infarction following envenomation by a Mohave rattlesnake. A second unique feature of this patient's envenomation is that he experienced respiratory failure secondary to right hemidiaphragmatic paralysis. Severe neurotoxicity from Mohave rattlesnake bites in humans has been reported rarely in the literature.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"272-277"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case Report of a Traumatic Arthrotomy of the Knee Diagnosed by Ultrasound. 外伤性膝关节切开术超声诊断一例报告。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-01-20 DOI: 10.1177/10806032241310385

Marc Heronemus, Spencer Tomberg

{"title":"Case Report of a Traumatic Arthrotomy of the Knee Diagnosed by Ultrasound.","authors":"Marc Heronemus, Spencer Tomberg","doi":"10.1177/10806032241310385","DOIUrl":"10.1177/10806032241310385","url":null,"abstract":"In this case report we describe evaluating a patient for a traumatic knee arthrotomy using ultrasound in a resource-limited medical clinic at the base of a ski area. A 23-y-old female presented with a laceration superior to the patella of the left leg. On examination, the wound tracked deep, and providers had concern for traumatic arthrotomy. Lacerations around the knee have the highest risk for traumatic arthrotomy of any joint. This risk is due to the joint capsule of the knee extending up to 12 cm proximally from the joint line of the knee, making suprapatellar lacerations a risk. Although surgical evaluation is the gold standard for diagnosing a traumatic arthrotomy, computed tomography scan has been shown to be more sensitive than the saline-load test for identifying open traumatic arthrotomies. However, computed tomography scan was not available at the ski area clinic, and the authors have found the saline-load test to be extremely painful for patients. In this case, a novel technique using ultrasound to visualize a sterile cotton swab being inserted into the wound until it contacted the knee's joint line successfully identified a traumatic arthrotomy in a proximal knee laceration. The patient was transferred to a trauma center, where she had a surgical washout of her left knee joint. In conclusion, providers should be aware of the risk of traumatic arthrotomy in wounds that are proximal/superior to the patella. In this case, an ultrasound was used to confirm that the wound entered the proximal knee joint.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"267-271"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0