Wilderness & Environmental Medicine最新文献

Introduction: Rock climbing has recently gained popularity, particularly among females. There are no current studies evaluating pelvic floor dysfunction among female climbers. This cross-sectional study seeks to investigate the prevalence of incontinence and pelvic floor disorders among female rock climbers in the United States.

Methods: This study utilized an online survey distributed via social media platforms to assess the prevalence of pelvic floor disorders. Participants were queried about demographic information, climbing habits, pregnancy history, and pelvic floor symptoms. Data analysis involved descriptive statistics and inferential analysis where applicable.

Results: A total of 343 participants completed the study, with a median age of 34 years, lean body mass, and the majority identifying as White or Caucasian. The most common pelvic floor disorder was overactive bladder (n = 314, 91.5%), and the least common was pelvic organ prolapse (n = 6, 1.7%). Rope climbers were significantly more bothered by pelvic organ prolapse and anal incontinence symptoms than boulderers (4, p < .01 and 1.44, p < .01, respectively). Parous climbers reported significantly higher bothersome symptoms of OAB and SUI (1.43, p = .01 and 2.71, p < .01, respectively) than their nulliparous counterparts.

Conclusions: Although rock climbing represents a relatively low-impact sport and our sample was largely comprised of young, healthy, nulliparous women, female rock climbers demonstrated higher rates of pelvic floor disorders than a normative population, with rope climbers at higher risk than boulderers. Clinicians should be aware of the need for more frequent pelvic floor disorder screening in active women.

Introduction: Vital sign acquisition is a key component of modern medical care. In wilderness and space medical settings, vital sign acquisition can be a difficult process because of limitations on available personnel or lack of access to the patient. Camera-acquired vital signs could address each of these difficulties.

Methods: Healthy volunteers used software designed by Presage Technologies to acquire heart rate and respiratory rate at the HI-SEAS space-analog site in Mauna Loa, Hawai'i. Camera-acquired vital signs were compared to more conventionally acquired vital signs.

Results: Camera-acquired heart rate showed high correlation to conventionally acquired heart rate (R ∼ 0.95). Camera-acquired respiratory rate showed moderate correlation (R ∼ 0.65).

Conclusions: These results show that camera acquisition of vital signs is theoretically feasible in wilderness and space-analog environments. HR may be highly accurate even using current technology. Additional studies will be needed to further validate other types of camera sensors and other potential environments such as partial gravity and microgravity.

Long-duration spaceflights beyond low-Earth orbit, including missions to the Moon and Mars, pose significant health risks. Although biomedical approaches commonly appear in the literature, considering psychological and social factors alongside physiologic health offers a more holistic approach to astronaut care. Integrating the biopsychosocial (BPS) framework into medical planning addresses complex spaceflight challenges and aids in developing mitigation strategies. This review examined health risks associated with long-duration spaceflight within a BPS framework. Sources included governmental space agencies, academic textbooks, and relevant publications from multiple databases. Considering the National Aeronautics and Space Administration's Human Research Program's 5 main hazards, a conceptual model was developed to highlight the multifactorial BPS effects of spaceflight. In space, astronauts face unique environments and biological adaptations, including fluid shift, plasma volume loss, bone density loss, and muscle atrophy. Noise and the absence of natural light disrupt circadian rhythms, causing sleep disturbances and fatigue, which affect physical and mental health. Studies on crews in isolated and confined extreme environments reveal psychosocial challenges, including impaired mood and cognition, interpersonal tension, and miscommunication. International collaboration in spaceflight introduces differences in communication, problem solving, and social customs due to diverse cultural backgrounds. Upcoming long-distance missions likely will amplify these challenges. This review emphasizes BPS health considerations in long-duration spaceflight. It highlights the interplay among psychological, social, and biological factors, advocating for multidisciplinary teams and a holistic approach to astronaut health and mission planning and the potential added value of BPS perspectives in considering countermeasures.

Introduction: Wilderness medicine (WM) is the study of medicine in austere environments. There are several US multidisciplinary courses that teach WM to people from varying medical backgrounds. However, WM topics are covered to different extents. This study's purpose was to compare WM components among US multidisciplinary training courses.

Methods: The American College of Emergency Physicians WM fellowship curriculum's 19 components and the Fellowship of the Academy of Wilderness Medicine's 12 core and 16 elective competencies and their credits were used as two control lists. Curricula from 10 US multidisciplinary courses were analyzed for WM components. Using descriptive analysis, each course curriculum was compared with the controls.

Results: This study examines WM components in 10 courses. The greatest number of American College of Emergency Physicians WM fellowship topics (14 of 19) was covered by the Paramedic course and the fewest number (4 of 19) by the Tactical Combat Casualty Care-Combat Lifesaver course. The greatest number of Fellowship of the Academy of Wilderness Medicine core credits (56) was offered by the Paramedic course and the fewest number (24) by the Tactical Combat Casualty Care-Medical Personnel course. The greatest number of Fellowship of the Academy of Wilderness Medicine elective credits (83) was offered by the Paramedic course and the fewest number (25) by the Tactical Combat Casualty Care-Combat Lifesaver course.

Conclusion: This research analyzed WM components in US multidisciplinary courses and demonstrated that each covers WM topics to varying extents. This shows an opportunity for these courses to expand their WM education within their scope. It also demonstrates competencies offered by different courses for interested trainees.

Space medicine is a multidisciplinary field that requires the integration of medical imaging techniques and expertise in diagnosing and treating a wide range of acute and chronic conditions to maintain astronaut health. Medical imaging within this domain has been viewed historically through the lens of inflight point-of-care ultrasound and predominantly research uses of cross-sectional imaging before and after flight. However, space radiology, a subfield defined here as the applications of imaging before, during, and after spaceflight, will grow to necessitate the involvement of more advanced imaging techniques and subspecialist expertise as missions increase in length and complexity. While the performance of imaging in spaceflight is limited by equipment mass and volume, power supply, radiation exposure, communication delays, and personnel training, recent developments in nonsonographic modalities have opened the door to their potential for in-mission use. Additionally, improved exam protocols and scanner technology in combination with artificial intelligence algorithms have greatly advanced the utility of possible pre- and postflight studies. This article reviews the past and present of space radiology and discusses possible use cases, knowledge gaps, and future research directions for radiography, fluoroscopy, computed tomography, and magnetic resonance imaging within space medicine, including both the performance of new exam types for new indications and the increased extraction of information from exams already routinely obtained. Through thoughtfully augmenting the use of these tools, medical mission risk may be reduced substantially through preflight screening, inflight diagnosis and management, and inflight and postflight surveillance.

In 1911, Mabel Purefoy FitzGerald (1872-1973) conducted a study in the mountains of Colorado that offered invaluable insights into how the body responds to chronic hypoxia. Researchers awarded the Nobel Prize for Physiology or Medicine 2019 cited her work as critical in unravelling the hypoxia sensing system. The astounding career situation in which FitzGerald found herself while conducting this study offers important insights into the challenges faced by women in science at the turn of the twentieth century. Like Ginger Rogers dancing with Fred Astaire, FitzGerald did the equivalent of everything her male colleagues did, only backward and in high heels. Although it is tempting to believe that such inequities for women are relegated to history, the career challenges faced by 2023 Nobel Laureate Katalin Karikó highlight evidence that the struggle for equality of women in science remains a significant problem.

Introduction: Buthus species, including B paris, are classified as one of the most dangerous scorpion genera in Morocco, implicated in several cases of human death. Our objective is to characterize, for the first time, the toxicity and histopathologic and biochemical impacts of B paris venom.

Methods: We investigated the experimental pathophysiology of B paris venom by examining histologic changes in vital organs (heart, kidneys, liver, and lungs) and assessing biochemical enzymatic markers (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, urea, and creatinine) in mice injected subcutaneously with 2 doses of 400 and 450 mg·kg^-1.

Results: Our results showed that the subcutaneous median lethal dose of B paris venom was around 0.52 mg·kg^-1. Histologic findings revealed significant tissue damage in the previously mentioned vital organs, confirmed through biochemical analysis indicating impaired heart and liver functions. Additionally, an increase in urea, creatinine, and glucose levels occurred following B paris venom injection.

Conclusion: Our findings show that B paris venom exhibits a high level of experimental toxicity. These results highlight the potentially lethal nature of this venom and emphasize the potential medical importance of this species.