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Objective.—To evaluate the Sharpened Romberg Test (SRT) as a measure of ataxia in subjects with mild acute mountain sickness in order to determine its sensitivity and specificity.
Methods.—The SRT was performed in 23 subjects during ascent to 5260 m.
Results.—The SRT was more often abnormal than the traditional heel-to-toe test, and at the highest altitude it was related to higher median Lake Louise symptom scores with predictive values of 60% sensitivity and 89% specificity. Our evaluation of the SRT appears to agree with similar studies on ataxia showing a lack of correlation between ataxia and symptoms of acute mountain sickness at altitudes below 5260 m.
Conclusion.—The SRT was easy to perform and provided a quantitative assessment of truncal ataxia in the field without the need for specialized equipment.
Objective.—To evaluate the causes of human fatalities in the United States from 1991 to 2001 that were caused by venomous and nonvenomous animal encounters exclusive of zoonotic infections or animal-vehicle collisions.
Methods.—An inquiry of CDC Wonder, a database for epidemiologic research, was used to provide information on animal-related fatalities on the basis of ICD-9 and ICD-10 codes.
Results.—From 1991 to 2001, 1943 persons died in the United States after venomous and nonvenomous animal encounters. An average of 177 fatalities per year were recorded. Venomous animal encounters were responsible for 39% of the fatalities. White males appear to be the group most likely to die from an encounter. Most fatalities occurred in the southern United States.
Conclusions.—Although the average number of fatalities from animal encounters has increased compared with the previous decade, the death rate has remained essentially unchanged. The medical and financial costs from both fatal and nonfatal animal encounters have a significant impact on public health.
Objective.—To examine the use of protective headgear by surfers, their perceptions of its usefulness, and barriers to its use.
Methods.—A researcher-administered questionnaire was used to undertake a cross-sectional survey of 646 surfboard riders at 8 popular surfing beaches in Victoria, Australia. The main outcome measures were rate of use of headgear, perceptions of head injury risk relative to a range of other activities, perceptions regarding headgear, and the reasons for not wearing headgear.
Results.—Most surfers were men (90.2%), young (mean age 28.2 years), and experienced (mean years of surfing 11.6). Only 245 (38.0%, 95% CI 34.2–41.9) surfers considered the risk of head injury while surfing as moderate or high, and only 12 (1.9%, 95% CI 1.0–3.3) reported routine use of headgear. The surfers were more likely to believe that there was a higher risk of head injury in other sports and physical activities (P < .001). Although 475 surfers (73.8%, 95% CI 70.2–77.1) thought that surfers who wear headgear are less likely to become injured, 400 (62.1%, 95% CI 58.2–65.9) reported that headgear restricted surfing performance and that they would rather surf without it. The main reasons for not wearing headgear were “no need,” discomfort, claustrophobia, and effects upon the senses and balance.
Conclusions.—Although most surfers acknowledge some risk of head injury, headgear is rarely used and barriers to its use are apparent. Research is required to clarify the risk of head injury among surfers and the effectiveness of headgear in reducing injury risk. Until this evidence is available, educational initiatives, improved headgear design, and profile within the surfing culture would be required to increase rates of wearing headgear.
Objective.—To evaluate the role of the autonomic nervous system and adrenal system in acclimatization to cold in tropical men during short or prolonged sojourns at Antarctica.
Methods.—The study was carried out on volunteers of the 18th winter over team (WOT) and 19th summer team (ST) of an Indian Antarctic Expedition. The ST members were evaluated at Delhi; during voyage; and on days 7, 30, and 60 of their stay at Antarctica. Identical studies were performed in WOT members who had stayed at Antarctica for 14 months. The parameters examined included heart rate, blood pressure, oral temperature, index finger skin temperature, heart rate variability, urinary epinephrine and norepinephrine, and salivary cortisol.
Results.—The resting heart rate and blood pressure in ST members significantly increased (P < .05) on days 7 and 30 of their stay at Antarctica and returned to baseline Delhi values by day 60. The index finger temperature declined (P < .05) on day 7 at Antarctica and remained at lower levels during the entire period of observations. Heart rate variability showed an imbalance of autonomic nervous system effects with predominance of low-frequency band on day 7 of stay and returned to Delhi values by day 60. The urinary excretion of epinephrine and norepinephrine and salivary cortisol were also increased on day 7 and declined to baseline Delhi values after 2 months of stay. Compared with the ST group, the WOT group showed a significantly higher (P < .05) resting heart rate, blood pressure, and low-frequency power and urinary excretion of norepinephrine.
Conclusions.—These observations suggest that Antarctic residency during austral summer results in gradual attenuation of sympathetic tone and a shift of autonomic balance toward the parasympathetic side. However, WOT members showed a predominance of sympathetic and adrenal activity compared with initial responses of ST members, suggesting deconditioning or possible resetting of the autonomic nervous system.
Objective.—To determine the burden of and risk factors for diarrheal illness among mountaineers climbing Denali during the spring of 2002.
Methods.—We conducted a retrospective cohort study of all willing and available climbers who returned to base camp from June 11 to 14, 2002. We used a questionnaire that addressed illness status, demographics, and potential risk factors for illness. A case of diarrhea was defined as self-reported diarrhea (loose stool) in a Denali climber who did not have diarrhea before arrival at base camp.
Results.—Thirty-eight (29%) of the 132 climbers who were interviewed reported experiencing diarrhea at some point on the mountain. Spending 8 or more days at the 17 200-foot high camp; being a member of a climbing party in which at least 1 other person also had diarrhea, especially if tent occupancy was 3 or more; and not receiving education about disease risk-reduction techniques among climbers who were on a guided expedition were associated with increased risk of illness.
Conclusions.—To prevent infectious diarrheal outbreaks among mountaineers climbing Denali (and other highly trafficked alpine routes), we recommend that park staff provide climbers with detailed information related to minimizing disease risk and develop more effective strategies for preventing climbers from depositing fecal material directly into snow along the route, such as establishing and enforcing firmer penalties for noncompliance with existing human waste disposal regulations and requiring the use of personal stool-hauling devices.
A 55-year-old man was attacked by a Brazilian tapir (Tapirus terrestris) after surprising and stabbing the animal in his corn plantation. The victim received deep bites in the thighs, neck, and cervical areas, resulting in severe hemorrhage and death. This is the first report of a tapir incident resulting in death and is of interest because of the severity of the contusions and lacerations caused by the provoked animal.
We describe a case report of a subject suffering high-altitude cerebral and pulmonary edema successfully treated with low flow rates of supplemental oxygen administered with a breathing system designed to conserve oxygen supplies at high altitude.