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Objective: To evaluate the prevalence and characteristics of acute kidney injury (AKI) in 100-km ultramarathon runners. Design: Prospective observational study. Setting: The 2011 Soochow University ultramarathon, in which each athlete ran for 100 km. Participants: All Taiwanese entrants who participated in the 100-km race and lived in the northern part of Taiwan were invited to participate in the study. Main Outcome Measures: Acute kidney injury was defined using the Acute Kidney Injury Network criteria. Blood and urine samples were collected 1 week before, immediately after, and 1 day after the race. Results: Immediately after the race, 85% (22) of the 26 subjects were diagnosed with AKI, 65% (16) with moderate dehydration, 23% (6) with muscle cramps, and 12% (3) with hematuria. Body weight was significantly decreased from prerace to all postrace measurements. Plasma levels of potassium ion, creatinine, renin, and aldosterone were significantly elevated immediately after the race and then significantly reduced 1 day after the race. Changes in plasma levels of sodium, creatine kinase, and creatine kinase–MB, as well as urine potassium and creatinine, were indicative of AKI. Conclusions: Transient AKI and muscle cramps are very common in 100-km ultramarathon runners. All transient ultra-runners who developed AKI in this study recovered their renal function 1 day later. Clinical Relevance: Ultramarathon running is associated with a wide range of significant changes in hematological parameters, several of which can be associated with potentially serious renal and physiological abnormalities. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the correlation between serial weight changes and athletic performance in 52 race participants during 12- and 24-hour international ultramarathons held by the Soochow University in 2003. The researchers found that the majority of weight decrease and dehydration in both the 12- and 24-hour races occurred during the first eight hours, with the most rapid decreases apparent over the first four hours. They recommend the optimization of fluid intake in the first eight hours for both 12- and 24-hours runners and in 16 to 20 hours for 24-hour marathon runners.

PURPOSE: To examine the efficacy and safety of administration of calcium and magnesium orally and intraperitoneally to treat severe sodium fluoride intoxication. MATERIALS AND METHODS: Mice were initially gavaged a lethal dose of sodium fluoride (NaF) or water. Then, mice were treated with water or varying concentrations of calcium chloride (CaCl2) or magnesium sulfate (MgSO4) via intraperitoneal (IP) route or via oral route. Mice were monitored for 24h, and the time of death was recorded. RESULTS: IP injections of large amounts of CaCl2 or MgSO4 were dangerous. All mice gavaged with water and then treated with oral CaCl2 or MgSO4 survived and displayed normal activity during the experiment. The survival rate of mice gavaged with a lethal dose of NaF and then treated with a high dose of oral CaCl2 or MgSO4 was significantly higher than those of using low dose. CONCLUSION: Oral administration of a high dose of CaCl2 or MgSO4 is a simple, safe, and effective adjunctive method for treating severe oral fluoride poisoning. [ABSTRACT FROM AUTHOR]

Blood testing for endogenous small metabolites to determine physiological and biochemical states is routine for laboratory analysis. Here we demonstrate that by combining the commercial direct analysis in real time (DART) ion source with an ion trap mass spectrometer, native cholesterol in its free alcohol form is readily detected from a few hundred nanoliters of human serum loaded onto chromatography paper. Deuterium-labeled cholesterol was used as the internal standard to obtain the absolute quantity of the endogenous cholesterol. The amount of the cholesterol measured by this paper-loaded DART mass spectrometry (pDART-MS) is statistically comparable with that obtained by using commercially available fluorometric-enzymatic assay and liquid chromatography/mass spectrometry. Furthermore, sera from 21 participants at three different time points in an ultramarathon were collected to obtain their cholesterol levels. The test requires only very minimal sample preparation, and the concentrations of cholesterol in each sample were acquired within a minute. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of ascent rate on the induction of acute mountain sickness (AMS) in young adults during a climb to Jiaming Lake (3350 m) in Taiwan. Design: Prospective, nonrandomized. Setting: Climb from 2370 to 3350 m. Participants: Young adults (aged 18 to 26 years) (N = 91) chose to participate in either the fast ascent (3 days; n = 43) or slow ascent (4 days; n = 48) group (1 and 2). Assessment of Risk Factors: Two criteria were used to define AMS. A Lake Louise score ≥3 and Lake Louise criteria [in the setting of a recent gain in altitude, the presence of headache and at least 1 of gastrointestinal discomfort (anorexia, nausea, or vomiting), fatigue or weakness, dizziness or lightheadedness, or difficulty sleeping]. Main Outcome Measures: Heart rate, blood oxygen saturation (SaO2), and symptoms of AMS were monitored each morning and evening. Results: Baseline characteristics were similar between groups, except for significant differences in history of alcohol consumption (P = 0.009) and climbing experience above 3000 m (P < 0.001). The incidence of AMS was not associated with the rate of ascent. Acute mountain sickness was most prevalent in group 1 on day 2 in the evening and in group 2 on day 3 in the evening. In both groups, AMS correlated with the initial reduction in SaO2. Body mass index (BMI) .24 kg/m2 was identified as a significant risk factor for AMS. Conclusions: The development of AMS was closely associated with an initial reduction in SaO2. A BMI .24 kg/m2 also contributed to the occurrence of AMS. Clinical Relevance: These findings indicate that factors other than ascent rate should be considered when trying to ameliorate the risk of AMS. [ABSTRACT FROM AUTHOR]

Objective: To determine the change and relationship of spectral components of heart rate variability (HRV) measurements in subjects with or without acute mountain sickness (AMS) at both low and high altitude. Design: A prospective study. Setting: A 12-day itinerary by trekking to the Namche Bazaar, 3440 m in Nepal. Participants: A total of 32 subjects were recruited. Interventions: The alternations were measured by heart rate (HR), arterial oxygen saturation (SpO2), and spectral analysis of HRV at sea level, 1317 m, 3440 m, 1317 m, and sea level, respectively. Main Outcome Measures: Spectral analysis of HRV. Results: There were statistically significant increases in HR and decreases in SpO2 in all subjects at high altitude. In HRV, the values of R-R interval, total variance, high frequency (HF), low frequency (LF), and HF% were significantly lower at 3440 m than at sea level, respectively (P < 0.05). The subjects with AMS had significantly lower total variance, HF, and HF%, respectively, but higher LF:HF ratio (P < 0.05) at 3440 m. Subjects with both HF% < 20% (nu) and LF:HF ratio > 1.3 measured at 1317 m had odds ratios of 7.00 (95% confidence interval, 1.11 to 44.06; P = 0.047) to get AMS at 3440 m. Conclusions: The HRV measurements in total variances, HF, and HF% in trekkers with AMS were statistically significantly lower at high altitude. HF% < 20% (nu) or LF:HF ratio > 1.3 at lower altitudes could be an important predication parameter of trekkers with AMS at higher altitudes. [ABSTRACT FROM AUTHOR]

AbstractWang, Shih-Hao1,2Tai-Yi Hsu,1,2Jen-Tse Kuan,1,2Jih-Chang Chen,1,2Wei-Fong Kao,3Te-Fa Chiu,1,2Yu-Cheng Chen,1,2and Hang-Cheng Chen.1,2Medical problems requiring mountain rescues from 1985 to 2007 in Yu-Shan National Park, Taiwan. High Alt. Med Biol. 10:77–82, 2009.—Medical problems requiring mountain rescue in densely populated and low-latitude locations like Taiwan have rarely been studied or discussed. The purpose of this research was to examine mountain-rescue operations that occurred in Yu-Shan National Park Taiwan from 1985 to 2007. Of 186 mountain-rescue operations, 128 involved medical problems (illnesses or injuries). Of the medical problems, 62 involved trauma and 41 involved illness. Ninety-nine ground rescues, 14 helicopter rescues, 38 combination ground and helicopter rescues, and 20 rescues using unclear methods were conducted, and the remaining 15 rescue operations did not involve visitors. In the 186 rescue operations, 330 visitors were rescued, 240 of them survived, 66 were dead, and 24 had an unclear outcome. Factors that affected the type of injury or the probability of survival included the activity, altitude, composition of the visitor group, weather, and occurrence of natural disasters. Mountain-rescue operations in which both ground and helicopter rescue were utilized were more successful. Our retrospective findings indicate that wilderness emergency services should have the capability of performing rescues in rugged terrain and be flexible in their approach to any situation arising in mountainous regions; proper training of onboard helicopter medical personnel is also necessary. In conclusion, we recommend setting up a standard system for reporting mountain- rescue operations, with statistics compiled annually. [ABSTRACT FROM AUTHOR]

The article discusses a study which aims to determine the relationship between urine output and performance of runners in a 12-hour ultramarathon and to understand the urination pattern. The study found that runners with less urination performed better during the first 11 hours of competition than runners with significant urination. The study assessed that runners with fastest tertile had lower prerace body weight than runners with slowest and intermediate tertiles, however, the differences were not statistically significant.

The support systems for the Emergency Medical Services (EMS) at mass gatherings, such as the local marathon or large international baseball games, are underdeveloped. The purposes of this study were to extend well-developed, triage-based, EMS Personal Digital Assistant (PDA) support systems to cover pre-hospital emergency medical services and onsite evaluation forms for the mass gatherings, and to evaluate users' perceived ease of use and usefulness of the systems in terms of Davis' Technology Acceptance Model (TAM). The systems were developed based on an established intelligent triage PDA support system and two other forms -- the general EMS form from the Taipei EMT and the customer-made Mass Gathering Medical form used by a medical center. Twenty-three nurses and six physicians in the medical center, who had served at mass gatherings, were invited to examine the new systems and answer the TAM questionnaire. The PDA systems were composed of 450 information items within 42 screens in 6 categories. The results supported the potential for using triage-based PDA systems at mass gatherings. Overall, most of the subjects agreed that the systems were easy to use and useful for mass gatherings, and they were willing to accept the systems. [ABSTRACT FROM AUTHOR]