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Extreme Physiology & Medicine

Ned Gilbert-Kawai
Whilst attending a conference in the not too distant past, I was fortunate enough to be seated at lunch next to a very eminent octogenarian academic. Conversation ensued, and I was instantly captivated by his stories. These were not narratives filled with scientific facts, but rather anecdotes of his life and the pathways he had taken to get where he was today. Fascinated by such accounts, I set about the task of interviewing persons of scientific acclaim, to learn more about their life stories and unwritten tales...
2016: Extreme Physiology & Medicine
Mitsuhiro Denda
It has long been suggested that climate, especially atmospheric pressure change, can cause health problems ranging from migraine to myocardial infarction. Here, I hypothesize that the sensory system of epidermal keratinocytes mediates the influence of atmospheric pressure change on the human physiological condition. We previously demonstrated that even subtle changes of atmospheric pressure (5-20 hPa) induce elevation of intracellular calcium level in cultured human keratinocytes (excitation of keratinocytes)...
2016: Extreme Physiology & Medicine
Edward Gilbert-Kawai, Daniel Martin, Michael Grocott, Denny Levett
BACKGROUND: High-altitude exposure causes a mild to moderate rise in systolic and diastolic blood pressure. This case report describes the first documented case of a hypertensive crisis at altitude, as well as the first report of the occurrence of acute kidney injury in the context of altitude-related hypertension. CASE PRESENTATION: A healthy, previously normotensive 30-year old, embarked on a trek to Everest Base Camp (5300 m). During his 11-day ascent the subject developed increasingly worsening hypertension...
2016: Extreme Physiology & Medicine
Nora Petersen, Patrick Jaekel, Andre Rosenberger, Tobias Weber, Jonathan Scott, Filippo Castrucci, Gunda Lambrecht, Lori Ploutz-Snyder, Volker Damann, Inessa Kozlovskaya, Joachim Mester
BACKGROUND: To counteract microgravity (µG)-induced adaptation, European Space Agency (ESA) astronauts on long-duration missions (LDMs) to the International Space Station (ISS) perform a daily physical exercise countermeasure program. Since the first ESA crewmember completed an LDM in 2006, the ESA countermeasure program has strived to provide efficient protection against decreases in body mass, muscle strength, bone mass, and aerobic capacity within the operational constraints of the ISS environment and the changing availability of on-board exercise devices...
2016: Extreme Physiology & Medicine
Anthony Walker, Andrew McKune, Sally Ferguson, David B Pyne, Ben Rattray
BACKGROUND: First responders and military personnel experience rates of post-traumatic stress disorder (PTSD) far in excess of the general population. Although exposure to acute traumatic events plays a role in the genesis of these disorders, in this review, we present an argument that the occupational and environmental conditions where these workers operate are also likely contributors. PRESENTATION OF THE HYPOTHESIS: First responders and military personnel face occupational exposures that have been associated with altered immune and inflammatory activity...
2016: Extreme Physiology & Medicine
John Leach
Our cognitive system has adapted to support goal-directed behaviour within a normal environment. An abnormal environment is one to which we are not optimally adapted but can accommodate through the development of coping strategies. These abnormal environments can be 'exceptional', e.g., polar base, space station, submarine, prison, intensive care unit, isolation ward etc.; 'extreme', marked by more intense environmental stimuli and a real or perceived lack of control over the situation, e.g., surviving at sea in a life-raft, harsh prison camp etc...
2016: Extreme Physiology & Medicine
Samuel J E Lucas, Jørn W Helge, Uwe H W Schütz, Ralph F Goldman, James D Cotter
This review addresses human capacity for movement in the context of extreme loading and with it the combined effects of metabolic, biomechanical and gravitational stress on the human body. This topic encompasses extreme duration, as occurs in ultra-endurance competitions (e.g. adventure racing and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may be at least as problematic, and are therefore included as a reference, e...
2016: Extreme Physiology & Medicine
James O M Plumb, James M Otto, Michael P W Grocott
Haemoglobin is the blood's oxygen carrying pigment and is encapsulated in red blood corpuscles. The concentration of haemoglobin in blood is dependent on both its total mass in the circulation (tHb-mass) and the total plasma volume in which it is suspended. Aerobic capacity is defined as the maximum amount of oxygen that can be consumed by the body per unit time and is one measure of physical fitness. Observations in athletes who have undergone blood doping or manipulation have revealed a closer relationship between physical fitness (aerobic capacity) and total haemoglobin mass (tHb-mass) than with haemoglobin concentration ([Hb])...
2016: Extreme Physiology & Medicine
Tara Diversi, Vanessa Franks-Kardum, Mike Climstein
[This corrects the article DOI: 10.1186/s13728-016-0044-2.].
2016: Extreme Physiology & Medicine
Tara Diversi, Vanessa Franks-Kardum, Mike Climstein
BACKGROUND: The purpose of this study was to determine if cold water swimmers (CWS) developed hypothermia over a 6-h cold water endurance swim and whether body composition, stroke rate (SR) or personal characteristics correlated with core temperature (TC) change. Nine experienced male and female CWS who were aspiring English Channel (EC) swimmers volunteered to participate. Subjects aimed to complete their 6-h EC qualifying swim (water 15-15.8 °C/air 15-25 °C) while researchers intermittently monitored TC and SR...
2016: Extreme Physiology & Medicine
John P Florian, Friedhelm J Baisch, Martina Heer, James A Pawelczyk
BACKGROUND: Astronauts in space consume fewer calories and return to earth predisposed to orthostatic intolerance. The role that caloric deficit plays in the modulation of autonomic control of the cardiovascular system is unknown. Therefore, the purpose of this study was to determine the effects of 6° head-down bedrest (an analog of spaceflight) with a hypocaloric diet (25 % caloric restriction) (CR) on autonomic neural control during static handgrip (HG) and cold pressor (CP) tests...
2016: Extreme Physiology & Medicine
S K Deb, P A Swinton, E Dolan
Saturation diving is an occupation that involves prolonged exposure to a confined, hyperoxic, hyperbaric environment. The unique and extreme environment is thought to result in disruption to physiological and metabolic homeostasis, which may impact human health and performance. Appropriate nutritional intake has the potential to alleviate and/or support many of these physiological and metabolic concerns, whilst enhancing health and performance in saturation divers. Therefore, the purpose of this review is to identify the physiological and practical challenges of saturation diving and consequently provide evidence-based nutritional recommendations for saturation divers to promote health and performance within this challenging environment...
2016: Extreme Physiology & Medicine
Adrian Mellor, Naomi Dodds, Raj Joshi, John Hall, Sundeep Dhillon, Sarah Hollis, Pete Davis, David Hillebrandt, Eva Howard, Matthew Wilkes, Burjor Langdana, David Lee, Nigel Hinson, Thomas Harcourt Williams, Joe Rowles, Harvey Pynn
To support leaders and those involved in providing medical care on expeditions in wilderness environments, the Faculty of Pre-Hospital Care (FPHC) of The Royal College of Surgeons of Edinburgh convened an expert panel of leading healthcare professionals and expedition providers. The aims of this panel were to: (1) provide guidance to ensure the best possible medical care for patients within the geographical, logistical and human factor constraints of an expedition environment. (2) Give aspiring and established expedition medics a 'benchmark' of skills they should meet...
2015: Extreme Physiology & Medicine
Victor A Convertino
This review focuses on a career of unique opportunities to participate in various areas of research related to extreme physiology and medicine. My experience as a volunteer subject in exercise experiments conducted at NASA included the study of acute and chronic physiological responses and adaptations to exercise in environments of hypoxia, heat stress, and simulated microgravity (bed rest), and eventually to my doctoral work on mechanisms underlying expansion of plasma and blood volume with acute and repeated exercise and heat exposure...
2015: Extreme Physiology & Medicine
Matthieu Komorowski, Sarah Fleming
BACKGROUND: The question of the safety of anaesthetic procedures performed by non anaesthetists or even by non physicians has long been debated. We explore here this question in the hypothetical context of an exploration mission to Mars. During future interplanetary space missions, the risk of medical conditions requiring surgery and anaesthetic techniques will be significant. On Earth, anaesthesia is generally performed by well accustomed personnel. During exploration missions, onboard medical expertise might be lacking, or the crew doctor could become ill or injured...
2015: Extreme Physiology & Medicine
Damien Vitiello, Francis Degache, Jonas J Saugy, Nicolas Place, Federico Schena, Grégoire P Millet
BACKGROUND: Studies have recently focused on the effect of running a mountain ultra-marathon (MUM) and their results show muscular inflammation, damage and force loss. However, the link between peripheral oedema and muscle force loss is not really established. We tested the hypothesis that, after a MUM, lower leg muscles' swelling could be associated with muscle force loss. The knee extensor (KE) and the plantar flexor (PF) muscles' contractile function was measured by supramaximal electrical stimulations, potentiated low- and high-frequency doublets (PS10 and PS100) of the KE and the PF were measured by transcutaneous electrical nerve stimulation and bioimpedance was used to assess body composition in the runners (n = 11) before (Pre) and after (Post) the MUM and compared with the controls (n = 8)...
2015: Extreme Physiology & Medicine
Andrew Murray, Marco Cardinale
Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e...
2015: Extreme Physiology & Medicine
Selina M Parry, Zudin A Puthucheary
Prolonged immobility is harmful with rapid reductions in muscle mass, bone mineral density and impairment in other body systems evident within the first week of bed rest which is further exacerbated in individuals with critical illness. Our understanding of the aetiology and secondary consequences of prolonged immobilization in the critically ill is improving with recent and ongoing research to establish the cause, effect, and best treatment options. This review aims to describe the current literature on bed rest models for examining immobilization-induced changes in the musculoskeletal system and pathophysiology of immobilisation in critical illness including examination of intracellular signalling processes involved...
2015: Extreme Physiology & Medicine
Matt Brearley, Anthony Walker
Rapidly cooling firefighters post emergency response is likely to increase the operational effectiveness of fire services during prolonged incidents. A variety of techniques have therefore been examined to return firefighters core body temperature to safe levels prior to fire scene re-entry or redeployment. The recommendation of forearm immersion (HFI) in cold water by the National Fire and Protection Association preceded implementation of this active cooling modality by a number of fire services in North America, South East Asia and Australia...
2015: Extreme Physiology & Medicine
Michael P W Grocott, Hugh M Montgomery
No abstract text is available yet for this article.
2015: Extreme Physiology & Medicine
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