Wild at Heart


Mt. Adams, in the Cascades. Photo by Pugetopolis, Wikimedia

September is here, and the first of the month is when we would normally be publishing the fifth edition of CJSM for 2015.  But ‘things’ are a little special this time around.

We’re publishing on 9/9/15 this year, after the Labor Day weekend in the USA has passed.  And we’re not just ‘publishing,’ we are ‘co-publishing’:  along with Wilderness and Environmental Medicine (WEM), the official journal of the Wilderness Medical Society (WMS), we are producing a themed issue on the pre-participation evaluation of adventure and wilderness athletes.

And so, while President Obama is making his own mountain news with the change of a name, we’ll be looking to make a mark in the media and social media with this special wilderness issue (perhaps not as big — @POTUS has almost 4 million followers on Twitter).

We publish research relevant to this world of adventure/wilderness medicine frequently.  In the blog, in the last year, I have written about ‘High Altitude Medicine,’ risk factors for Acute Mountain Sickness (AMS) , and the Badwater 135, the ultra-marathon run through Death Valley in the summer time. In the journal, we have recently published the Canadian Academy of Sport and Exercise Medicine (CASEM) Position Statement on High Altitude Medicine; original research on the renal function of runners participating in an Ultra-Distance Mountain run; and multiple case studies involving adventure athletes, including this interesting one on the ‘heel-hook’ rock climbing maneuver, creating a specific pattern of knee injury.

What is so special about the September 2015 issue is that members of the American Medical Society for Sports Medicine (AMSSM) and the WMS collaborated on the project–the editors and individual authors were members of either or both AMSSM and WMS.  And the final product–a series of articles focused on primary injury prevention and pre-participation evaluation of this special type of athlete–is being co-published by WEM and CJSM.  It’s the culmination of a process nearly two years old, and took the effort of a great many people to put into production.

We have planned several posts and a podcast to highlight various aspects of the new issue.  You’ll be hearing a lot about it, here on the blog and on our social media feeds. You’ll here about it in this podcast too!   And, most importantly, we hope you visit cjsportmed.com to read the issue itself.

Let the adventure begin……

Going Higher: Risk Factors for Acute Mountain Sickness

In a recent post on this blog, we looked at the Canadian Academy of Sport and Exercise Medicine Position Statement:  Athletes at High Altitude.

Turns out, we’re not ready to get out of the mountains quite yet.


3310 meters high in Taiwan: Jiaming Lake

Among the many features of CJSM I have come to appreciate as a reader, a reviewer, an author, and now as an editor is our ‘Published Ahead of Print’  (PAP) section.  Articles that CJSM publishes ahead of print have gone through peer review and been accepted for publication; there may still be some final changes to the paper prior to full print publication.  PAP represents just one of the initiatives we make in keeping with our commitment to getting high-quality, peer-reviewed, clinically relevant publications disseminated as quickly as possible.

One of our most recent PAP offerings comes to you from a group primarily comprised of emergency medicine physicians from Taiwan:  Hsu T, Weng Y, Chiu Y, et al. have published an interesting study on the Rate of Ascent and Acute Mountain Sickness at High Altitude.

The authors share their results from a study conducted during an ascent in Yushan National Park, Taiwan.  In a prospective, non-randomized study design, the authors followed two groups of trekkers up to Jiaming Lake to ascertain whether rate of ascent, as they hypothesized, was related to onset of acute mountain sickness (AMS).  91 young adults chose one of two routes up and down a mountain:  43 chose a ‘fast ascent’ approach (going 8.4 km from 2370m to 3350m in one day) and 48 chose a ‘slow ascent’ approach (covering this distance in two days).  Significantly, given the groups were non-randomized, the authors looked at possible confounders which were not equally distributed among the participants and found statistically significant differences in history of alcohol consumption (more common in ‘fast ascent’–maybe higher rates of risk taking?!) and climbing experience above 3000 m (more common in the fast ascent group).  Otherwise, the groups were well matched by BMI, age, gender, smoking status, etc.

An a posteriori power analysis was done and demonstrated that there was a 5% chance of Type II error given the numbers studied. Read more of this post

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