Journal of wilderness medicine最新文献_第3页

Continuing medical education — a wilderness of its own 继续医学教育——它本身就是一片荒野

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.248

Paul S. Auerbach MD

引用次数: 1

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.352

引用次数: 0

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.365

引用次数: 0

To breathe or not to breathe 呼吸还是不呼吸

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.251

Robert F. Grover MD

引用次数: 14

Dexamethasone for prophylaxis against acute mountain sickness during rapid ascent to 5334 m 地塞米松预防快速上升至5334米的急性高山病

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.331

William N. Bernhard MD , Lisa Miller Schalick RN, MPH , Alan Gittelsohn PhD

{"title":"Dexamethasone for prophylaxis against acute mountain sickness during rapid ascent to 5334 m","authors":"William N. Bernhard MD , Lisa Miller Schalick RN, MPH , Alan Gittelsohn PhD","doi":"10.1580/0953-9859-5.3.331","DOIUrl":"10.1580/0953-9859-5.3.331","url":null,"abstract":"<div>Twenty-three volunteers participated in a double-blind, randomized trial comparing the steroid dexamethasone 4mg to placebo every 12 h as prophylaxis against acute mountain sickness (AMS) during a rapid ascent to a shelter on Mt Chaclataya, Bolivia. From sea level, subjects were transported by air and land vehicles to 5334 m within a 72-h period. They were evaluated by cerebral scores derived from the Environmental Symptom Questionnaire and confirmed by AMS-C and AMS-R scores. After 6–8 h at high altitude (day 3), the number of ill persons in the dexamethasone group was less than those ill in the placebo group (χ2  =0.01) by chi-square and Fisher's exact tests. After 20 h at high altitude (day 4), the contrast between groups diminished (χ2  =0.214). ANOVA and t-test showed that mean cumulative AMS scores of the dexamethasone group were significantly lower (p  =0.02) than those of the placebo group for both days at high altitude, despite an approximate 82% increase in the mean cumulative score of the dexamethasone group from day 3 to day 4. We conclude that dexamethasone 4 mg every 12 h, though initially effective, was not sufficient to sustain prophylaxis from AMS symptoms at 5334 m.</div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"5 3","pages":"Pages 331-338"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-5.3.331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67124052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Relationship of client attributes and guides’ techniques to client satisfaction at a climbing school 攀岩学校客户属性与导游技术与客户满意度的关系

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.339

E. Michael Kahn MD , Nicholas J. Yardley

{"title":"Relationship of client attributes and guides’ techniques to client satisfaction at a climbing school","authors":"E. Michael Kahn MD , Nicholas J. Yardley","doi":"10.1580/0953-9859-5.3.339","DOIUrl":"10.1580/0953-9859-5.3.339","url":null,"abstract":"<div>Our goals were to (1) conduct a preliminary investigation of the relationships of client characteristics, guide's techniques, and client satisfaction with their guided experience, (2) offer guides practical information about steps they could take to increase client satisfaction, and (3) refine theories, hypotheses, and measurement techniques for further study.Climbing school clients were surveyed regarding their personal attributes, perceptions of guide's actions and performance, and satisfaction with the guided experience. Eighty-seven clients and eight guides were included in the sample.Clients stated that they learned better through supervised practice than through demonstration and explanation. Clients who came with clear objectives felt a greater sense of accomplishment. Key dimensions of guide activity were Technical, Planning, and Support. Key dimensions of client satisfaction were Valuing, Pleasure, Accomplishment, and Comfort. Guides and clients may tend to focus on technical factors; however, indirect measures show the importance of providing emotional support.</div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"5 3","pages":"Pages 339-351"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-5.3.339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67124082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vector-borne infections: a hazard for adventure visitors to Israel 媒介传播感染:以色列探险游客的危险

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.254

Dror Guberman MD, Daniel A. Vardy MD, Laurent Klapholz MD, Sidney N. Klaus MD

{"title":"Vector-borne infections: a hazard for adventure visitors to Israel","authors":"Dror Guberman MD, Daniel A. Vardy MD, Laurent Klapholz MD, Sidney N. Klaus MD","doi":"10.1580/0953-9859-5.3.254","DOIUrl":"10.1580/0953-9859-5.3.254","url":null,"abstract":"<div>Three vector-borne diseases, Mediterranean spotted fever, cave fever, and simple cutaneous leishmaniasis, are endemic to Israel. These diseases may pose a significant health hazard to visitors to this area. The objective of this article is to supply the essential information concerning these diseases to physicians who are unfamiliar with them, with the intention of preventing disease by better traveler education and enabling prompt recognition and treatment outside the endemic areas. Mediterranean spotted fever is a rickettsiosis transmitted by a dog tick and presenting as a high fever with headache and typical rash. Cave fever is a borrelial infection transmitted by a soft tick and presenting as a relapsing febrile disease. Both diseases can be prevented by avoiding endemic areas and ticks, and respond well to treatment with tetracycline. Cutaneous leishmaniasis is a protozoan infection of the skin transmitted by the sandfly and presenting as an indurated erythematous cutaneous nodule. It responds to topical paromomycin and to intralesional or systemic sodium stibogluconate, but the best policy is to take the proper precautions and avoid infection.</div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"5 3","pages":"Pages 254-262"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-5.3.254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67123570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

A transportable hyperbaric chamber with soda lime for the treatment of high-altitude disorders 一种用于治疗高原疾病的可移动的苏打石灰高压氧舱

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.295

Shigeru Saito MD , Hitoshi Shimada MD , Kinichi Yamamori

{"title":"A transportable hyperbaric chamber with soda lime for the treatment of high-altitude disorders","authors":"Shigeru Saito MD , Hitoshi Shimada MD , Kinichi Yamamori","doi":"10.1580/0953-9859-5.3.295","DOIUrl":"10.1580/0953-9859-5.3.295","url":null,"abstract":"<div>A transportable hyperbaric chamber called the Gamow™ bag has been reported to be effective in the treatment of high-altitude disorders in the alpine field. The problem with this device is that the operator has to endure a considerable amount of physical exercise to prevent carbon dioxide accumulation in the bag and to supplement the consumed oxygen. To solve this problem, we have applied soda lime with a respiratory circuit. In preliminary experiments, pumping twice per minute was demonstrated to be sufficient to maintain the appropriate internal conditions of the bag for 90 min. Using this system, the amount of exercise by the operator could be reduced to approximately 10% of the original value. Following the experiments, this system was practically used in the treatment of high-altitude disorders at Mustagata and at Mt. Crown (Xinjang, China). Three patients with acute mountain sickness were successfully treated using this system. Considering further possible applications, this compact system is thought to be worthwhile to carry together with the Gamow bag in alpine expeditions.</div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"5 3","pages":"Pages 295-301"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-5.3.295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67123810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Life-threatening anaphylaxis following envenomation by two different species of Crotalidae 危及生命的过敏反应后，由两种不同种类的蛇爪虫

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.263

Kenneth C. Ryan MD, E. Martin Caravati MD, MPH

引用次数: 14

Relationship of mountain sickness to physical fitness and exercise intensity during ascent 高原病与体能及登山运动强度的关系

Journal of wilderness medicine Pub Date : 1994-08-01 DOI: 10.1580/0953-9859-5.3.302

Hans Peter Bircher MS , U. Eichenberger MS , Marco Maggiorini MD , Oswald Oelz MD , Peter Bärtsch MD

{"title":"Relationship of mountain sickness to physical fitness and exercise intensity during ascent","authors":"Hans Peter Bircher MS , U. Eichenberger MS , Marco Maggiorini MD , Oswald Oelz MD , Peter Bärtsch MD","doi":"10.1580/0953-9859-5.3.302","DOIUrl":"10.1580/0953-9859-5.3.302","url":null,"abstract":"<div>The purpose of the study was to investigate whether susceptibility to acute mountain sickness (AMS) and high-altitude pulmonary edema (HAPE) is related to differences of physical fitness and /or the level of exercise during ascent. Work capacity at a heart rate of 170 min−1 (PWC170) was assessed on a bicycle ergometer prior to high-altitude exposure, and the heart rate was continuously registered during the ascent from 3610 to 4559 m in 41 mountaineers. During the subsequent stay of 3 days at 4559 m, 12 subjects developed AMS, 13 subjects showed radiographic evidence of HAPE, and 16 subjects remained without significant illness. PWC170 (group means between 238 and 247 W) and heart rate during ascent (group means between 134 and 141 min−1) did not significantly differ between these groups. PWC170 correlated negatively with two independent symptoms scores (clinical score, environmental symptom questionnaire) on day 3 at 4559 m, whereas heart rate during ascent correlated positively only with clinical score on days 2 and 3 at 4559 m. Correlations, however, were minor, with correlation coefficients of r  <0.05–0.01). These results indicate that physical fitness or exercise intensity during ascent were of minor importance for the development of AMS and HAPE in our subjects.</div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"5 3","pages":"Pages 302-311"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-5.3.302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67123867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 43