Expedition medical care--Army China Expedition 1981.
The planning and execution of medical care is described for a nine-man mountaineering expedition to China.
China↗
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The mental health expediter. A review after two years of the project and one year of the expediter in action.
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Adult↗
[Medical provisions for Bering's first Kamchatka expedition (1725--1730) (on the 250th anniversary of the start of the expedition)].
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Denmark↗
[Calculation of energy losses in the participants of the skiing expedition to the North Pole].
During the expedition to the North Pole, the food consumption rates were calculated on a regular basis. The mean daily energy losses of the participants of the expedition, the energy losses during skiing with a rucksack across the drifting ice were estimated and the energy metabolism curve by days was built up. The body weight of the participants averaged 78 +/- 5 kg. This made it possible to perform an overall calculation per whole group. The total energy supply with food was appraised from the total amount of the food consumed during the expedition. The total body weight loss of the participants was 11.5 kg, the energy consumption being 100.000 kkal. The total (for 7 men) energy consumption during skiing without a rucksack was calculated according to the formula: [(2,770 kkal X 28.5 days)]+ +[(2,385 kkal X 35.5 days)]. It was thus found to be equal to 1.145.300 kkal. The total energy consumption during skiing with a rucksack was calculated according to the formula: (7 men X X 449 h) and was found to be equal to 1.883.200 kkal. The total energy consumption during the expedition amounted to 3.237.500 kkal. During the expedition, the daily energy deficiency per man was 1.300-1.500 kkal. This deficiency was compensated for during rest. The maintenance of such an energy supply pattern made it possible to preserve a high level of work fitness.
Arctic Regions↗
Medical planning for expeditions.
Medical planning requires the expedition physician to draw from many aspects of the knowledge base of wilderness and environmental medicine and to learn and use lessons from those that have gone before. The medical plan is dependent on parameters of the expedition objective, scope, and resources and is developed cooperatively with the overall operational plan. The gathering of medical intelligence is crucial to the planning process and includes data specific to the location of the objective area and the expedition party itself. Medical screening of individual participants should be done for extended- or high-performance ventures. Medical training of both medical and nonmedical expedition party members is the responsibility of the medical planner. The contents, configuration, and deployment of medical kits depends on several variables and must be tailored to the individual venture. Protocols for preventive medicine measures, medical communications, and casualty evacuation are all included in the medical plan. It is hoped that with the focus of attention and effort that appropriate medical planning requires, unnecessary suffering and death will be less frequent as the boundaries of human exploration continue to expand.
Emergency Medicine↗
Changes in plasma lipoprotein levels during a hiking expedition in South America.
Eleven males participated in a hiking expedition over a period of 6 weeks during which they walked an average of 15 km per day, resting days included. The participants completed a seven-day estimated dietary record before and during the expedition. Their habitual dietary intake before the expedition was typical of a Western diet. During the expedition most animal products, with the exception of canned fish, were excluded from the diet. The dietary intake of fat and carbohydrate changed from 36.9% and 40.6% to 14.0% and 76.4% respectively. Cholesterol intake dropped from 557 mg to 92 mg. Mean plasma total cholesterol (TC) decreased from 190.9 mg/100 ml to 142.0 mg/100 ml. These changes were mainly due to changes in low density lipoprotein cholesterol (LDL-C). Although high density lipoprotein cholesterol (HDL-C) did not change, the ratio of HDL-C to TC increased significantly. It can be concluded that drastic dietary changes, together with increased physical activity and weight loss resulted in major plasma lipoprotein changes. The expected fall in HDL-C due to a high carbohydrate diet was counteracted by the increased physical activity and weight loss.
Adult↗
[Andrés Bello and the royal philanthropic vaccine expedition].
In 1803 [corrected], Charles IV King of Spain, sent an expedition to perform widespread ("arm to arm") vaccination against smallpox in the American colonies. The expedition led by Dr Francisco Javier de Belmis visited Puerto Rico, Venezuela, Central America, Colombia, Ecuador, Perú, Bolivia and Chile. A poem to the vaccine was written by Andres Bello, the first rector of the University of Chile, then in Venezuela (1804). The expedition reached Chile in 1807, led by Dr Julián Grajales. This expedition was the most important medical act in the history of the Spanish colonies.
Famous Persons↗
Expedition stress and personality change.
There have been few attempts to investigate the widespread assumption that short-term challenges can have beneficial effects on personality. An expedition to India organized by the British Schools Exploring Society provided such an opportunity. The Gordon Personal Profile Inventory showed that the expedition was associated with increased ascendancy, emotional stability, sociability and responsibility, and decreased cautiousness. Women tended to benefit more than men. The results suggest that the expedition was associated with positive personality changes, though other explanations of the findings cannot be ruled out.
Adolescent↗
Changes in cardiac and respiratory function of Antarctic Research Expedition members--preliminary report.
Cardiac and respiratory functions were estimated in 16 Chinese Antarctic Research Expedition members (Third expedition) before and after spending three months in the Antarctic. No significant changes were found in ECG examination. In cardiac function test, prolonged LVET and abbreviated PEP were found. PEP/LVET decreased significantly. Respiratory ventilation function examination showed an increase in FEV1 and FEV25 and a decrease in ERC. Results showed that cardiac and respiratory functions remained almost unchanged in the Expedition members. It is also suggested that a physiological compensation may have occurred in these members' cardiac functions either in the Antarctic or during the return sea voyage.
Antarctic Regions↗
Assessment of immunological responsiveness in members of International Biomedical Expedition to the Antarctic 1980/81.
Analysis of immune responsiveness was performed in members of the IBEA during a controlled trial of acclimatization with cold baths and during the subsequent 71 day period of Antarctic isolation. Several parameters of humoral and cellular immunity were assessed. No differences were found for those individuals who underwent cold-acclimatization in the first phase of the expedition. On the ice-cap all members showed slight elevation of their immunoglobulins, the increase in IgA reaching significance (p less than 0.05). Values returned to normal on returning to Sydney. Enhanced reactivity to the mycobacterium antigen purified protein derivative (PPD) was found on the ice-cap with 4 individuals becoming positive and remaining so on returning to Sydney. There was no obvious exposure to mycobacterium during the expedition but it is recommended that in future expeditions all PPD negative individuals be vaccinated with BCG.
Adaptation, Physiological↗
The physical characteristics of the members during the International Biomedical Expedition to the Antarctic.
Twelve male medical scientists formed the International Biomedical Expedition to the Antarctic (IBEA). Their physical characteristics and maximum oxygen uptakes (VO2max) were measured in association with three series of thermal tolerance tests in Sydney, twice before and once after going to the Antarctic. In the Antarctic they lived in tents and spent 15 days travelling by motor toboggan. Their body mass (BM) and skinfold thickness (SFT) were measured four times during the 69 days the expedition spent in the field. The characteristics of the group were (ranges): age 26-52 years, height 1680-1889 mm, BM 58.5-103.4 kg, fatness 16-34% BM and VO2max 33-49 ml X kg-1 X min-1. In the Antarctic 9 men lost between 0.7 and 5.5 kg (mean 2.7 kg) of BM with a decrease in SFT, whilst 2 men increased BM by 1.2 and 1.9 kg without change in SFT. One man retired early from the expedition. BM and SFT were regained and physical fitness lost during the return voyage to Australia. Consequently there was no difference in average SFT between the pre- and post-Antarctic laboratory tests, but BM was greater after the Antarctic implying gains in fat free mass. VO2max was lower in the final laboratory tests than in the tests before Antarctica.
Acclimatization↗
University of Edinburgh veterinary expeditions: 1966 to 1986.
Since 1966, teams of new graduates from the Royal (Dick) School of Veterinary Studies have organised eight veterinary research expeditions to Africa, tropical America and the Seychelles. The expeditions are now a regular feature of the school's activities. It is now possible to look back, learn and advise on future expeditions regarding timing, research and funding.
Animals↗
The use of salivary steroids to monitor circadian rhythmicity on expeditions in the arctic.
The circadian variation in salivary cortisol concentration was investigated in four men during a traverse on foot, of the Greenland ice cap and of salivary cortisol and testosterone on a summer expedition to Spitzbergen. In both instances circadian rhythmicity was demonstrated both before leaving the U.K. and throughout the expedition. The acrophase of the rhythms followed the changes in activity patterns on both expeditions although there was a dissociation between the cortisol and testosterone following an acute 8 hr phase shift in Spitzbergen. The mesor of cortisol in both instances tended to be higher than in the U.K. but the difference was never statistically significant. This work demonstrates the feasibility of using salivary steroid concentrations to investigate their circadian rhythmicity in circumstances where frequent blood sampling would be precluded.
Adult↗
High-altitude mountaineering and brain function: neuropsychological testing of members of a Mount Everest expedition.
Concern has been raised regarding the possibility that hypoxic conditions encountered during high-altitude mountaineering may have lasting harmful effects on the human brain. Members of an expedition to Mount Everest completed a series of neuropsychological tests before and after the expedition. Exposure to altitudes above 7,200 m was limited to a maximum of four consecutive nights, separated by rest periods at lower altitudes. No significant decline in performance was observed on any test. The subjects also completed a short series of tests at different altitudes during the expedition. No significant deterioration was observed at altitudes up to 7,500 m. There do not appear to be lasting harmful effects on brain function under these conditions.
Altitude↗
Cardio-respiratory adaptation to physical exercise and hypoxia after a high-altitude expedition.
Seven young, male subjects were tested before and immediately after 6 weeks high-mountain expedition. Cardio-respiratory measurements were performed at rest and during standard physical excercise (10 min, 100 W) when breathing atmospheric air or hypoxic mixture (14% O2 in N2). After the expedition an increased V o2 max (16% an average) and diminished heart rate response to submaximal exercise were found. This was observed during air and hypoxic mixture breathing. There was significant increase in stroke volume and cardiac output during the exercise. No significant differences in ventilatory parameters were found nor at rest or during exercise under condition of breathing atmospheric air or hypoxic mixture. No changes in erythrocyte count or haemoglobin concentration in the blood were found. The physiological changes which developed during high-mountain expedition were more dependent on physical that hypoxic training.
Adaptation, Physiological↗
Birmingham Medical Research Expeditionary Society 1977 Expedition: Psychological aspects of acute mountain sickness.
In order to assess the importance of personality and expectations in the development of Acute Mountain Sickness (AMS), 3 standard personality questionnaires and a Mountain Sickness Anticipation Questionnaire were completed by all of the 17 BMRES expedition members before their departure for the Himalayas. AMS could not be predicted with these tests and its occurrence, when assessed either by clinical interview or by peer review, bore no significant relationship to personality. For comparison daily self-assessment of the signs and symptoms of AMS were also conducted throughout the expedition, using graduated and graphic rating scales. The results were found to be unreliable and dependent upon personality factors. These findings have implications for those assessing others at high altitude.
Adult↗
Physicians on Mount Everest. A clinical account of the 1981 American Medical Research Expedition to Everest.
The American Medical Research Expedition to Everest had a wide variety of medical problems, ranging from leech bites to high-altitude pulmonary edema. Preventive measures, however, such as careful attention to ingesting only pure water and food at the lower elevations and adequate personal hydration, nutrition and rest at extremely high altitude minimized the morbidity suffered by the group. Prophylactic administration of doxycycline was effective in reducing the severity of diarrheal illness in the group. Every member of the expedition suffered upper respiratory tract infections and many other infections, some of which were resistant to all therapy until the patient moved down from high altitude. Despite careful acclimatization, several cases of acute mountain sickness occurred and required descent to a lower altitude for treatment. Frostbite was avoided entirely.
Altitude Sickness↗
Evaluation of sympathoadrenal activity, adrenocortical function and androgenic status in five men during a Himalayan mountaineering expedition (ascent of Mt Pabil, 7,102 m, 23,294 ft).
Sympathoadrenal activity, adrenocortical function and androgenic status were studied in five well-trained mountaineers during the different phases of a mountaineering expedition during the ascent of Mt Pabil (7,102 m) in the Ganesh Himal massif. Sympathoadrenal activity was evaluated by measuring urinary excretion of adrenaline, noradrenaline, metanephrines, and vanillinmandelic acid. Adrenocortical function was assessed by measuring urinary excretion of free cortisol, 17 OHCS (17-hydroxycorticosteroids) and androgenic status by measuring testosterone glucuronide, Adiol (5 alpha-androstane-3 alpha, 17 beta diol) and 17KS (17-ketosteroids). Reference values were obtained at Chamonix at 1,037 m during rest. During trekking noradrenaline increased significantly while Adiol and 17-KS decreased. The fall in the urinary androgenic pool persisted during the next phases of the expedition. At base camp (4,800 m) noradrenaline, its metabolites and free cortisol increased mainly during physical activity. Above 6,000 m, adrenaline, noradrenaline, their metabolites, free cortisol and 17-OHCS reached a maximum value. During the return to sea level, the urinary level of these parameters was still high. The drop in the urinary androgenic pool observed during trekking and exposure to high altitude confirms results obtained in other studies on prolonged efforts. This hypoandrogenicity may play an important role in the metabolic adaptations as well as in the mental state of the climbers. The increase of sympathoadrenal activity and of adrenocortical function may be considered as a regulatory element in the adaptative response to hypoxia and other stressors proper to high altitude.
17-Hydroxycorticosteroids↗