This study did not show a correlation between postexercise oxygen saturation or 6MWTD and summit success on Denali.

Introduction.-Acute mountain sickness (AMS) is a potentially life threatening complication of high altitude trekking. Several ascent profiles of Mount Kilimanjaro have been criticized for rapid ascent allowing little acclimatization time. The 7 day Lemosho route is one of the longest treks, allowing 2 days for acclimatization (day 3 & 4) and more time for rest which should improve the success rate of trekkers reaching the summit as well as decreasing the incidence of potentially fatal complications of AMS such as high altitude cerebral edema (HACE). Objective.-To evaluate symptom profiles of trekkers on Lemosho route to determine whether this route enhances acclimatization. Methods.-Daily measurement of oxygen saturation, heart rate, and Lake Louise Symptom Score (LLSS), plus clinical assessment score (CAS) recorded days 1-4, summit day for 25 subjects. Results.-Median LLSS þ CAS day 1 ¼ 0.56, incidence of AMS 4% ; median LLSS þ CAS day 2 ¼ 2.24, incidence of AMS 40%; median LLSS þ CAS day 3 ¼ 1.72, incidence of AMS 36%; median LLSS þ CAS day 5 ¼ 1.84 incidence of AMS 24%; median LLSS þ CAS summit day ¼ 2.4 incidence of AMS 40%. Incidence of AMS/HAPE in smokers (12%; n ¼ 3) ¼ 0; incidence of AMS/HAPE in non-smokers (88%; n ¼ 24) ¼ 48% (n ¼ 12); incidence of AMS/HAPE without acetazolamide (24%; n ¼ 6) ¼ 8% (n ¼ 2); incidence of AMS/ HAPE with acetazolamide (76%; n ¼ 19) ¼ 10. Conclusions.-Incidence of AMS has been reported to range between 47 and 75% on Mount Kilimanjaro. Our results show a significantly lower rate with symptom scores and heart rate highest at day 2 but improved following the subsequent acclimatization day demonstrating benefits of the longer route and the value of time to acclimatize.

fit athletes training at both lower elevations and elevations greater than 5000 feet. Military population rates of injury have been consistently lower than civilian sectors in previous studies. Nevertheless, no large-scale studies of this type have looked at altitude and the effects of hydration on SCT-related complications. The military uses an aggressive hydration and work/rest protocol for all soldiers. Objective.-The investigators hypothesized that hydration and work/rest protocols may have led to lower rates of injury in soldiers with SCT exposed to altitude. Methods.-We conducted a retrospective review of a 2800 soldier cohort using blinded data of injuries occurring in participants with pre-identified SCT during a series of 28-day Marine Mountain Warfare training events conducted in Bridgeport, CA from May 2010-Feb 2012. All soldiers with SCT enrolled in the course were included in the study and their injury patterns followed. We compared their patterns with those of the non-SCT population. Results.-Out of the 2800 soldiers, 25 had SCT, but only 1 of the SCT group had an altitude-related complication (acute mountain sickness). Surprisingly, despite a reported clear predilection for complications secondary to SCT, altitudespecific illnesses were rare and only occurred once out of 25 participants (4%). The rate of injuries was much lower than previous civilian studies. There were no deaths in either the study group or the control group. Conclusions.-Medical providers must be prepared to recognize possible SCT-related complications at elevations above 5-10,000 feet, but also recognize that it may be far more likely that their soldiers with SCT will more likely have a wide range of routine illnesses and injuries that are not altitude related.