Publications by authors named "Pearlly Ng"

5 Publications

  • Page 1 of 1

Paper Tape Prevents Foot Blisters: A Randomized Prevention Trial Assessing Paper Tape in Endurance Distances II (Pre-TAPED II).

Clin J Sport Med 2016 Sep;26(5):362-8

*Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California; †Department of Emergency Medicine, Presence Resurrection Medical Center, Chicago, Illinois; ‡Computational Science, University of Colorado, Boulder, Colorado; §Department of Surgery, University of Utah, Salt Lake City, Utah; ¶Department of Emergency Medicine, New York University, New York, New York; and ‖Department of Orthopedics and Sports Medicine, University of Washington, Seattle, Washington.

Objective: To determine whether paper tape prevents foot blisters in multistage ultramarathon runners.

Design: Multisite prospective randomized trial.

Setting: The 2014 250-km (155-mile) 6-stage RacingThePlanet ultramarathons in Jordan, Gobi, Madagascar, and Atacama Deserts.

Participants: One hundred twenty-eight participants were enrolled: 19 (15%) from the Jordan, 35 (27%) from Gobi, 21 (16%) from Madagascar, and 53 (41%) from the Atacama Desert. The mean age was 39.3 years (22-63) and body mass index was 24.2 kg/m (17.4-35.1), with 31 (22.5%) females.

Interventions: Paper tape was applied to a randomly selected foot before the race, either to participants' blister-prone areas or randomly selected location if there was no blister history, with untaped areas of the same foot used as the control.

Main Outcome Measures: Development of a blister anywhere on the study foot.

Results: One hundred six (83%) participants developed 117 blisters, with treatment success in 98 (77%) runners. Paper tape reduced blisters by 40% (P < 0.01, 95% confidence interval, 28-52) with a number needed to treat of 1.31. Most of the study participants had 1 blister (78%), with most common locations on the toes (n = 58, 50%) and heel (n = 27, 23%), with 94 (80%) blisters occurring by the end of stage 2. Treatment success was associated with earlier stages [odds ratio (OR), 74.9, P < 0.01] and time spent running (OR, 0.66, P = 0.01).

Conclusion: Paper tape was found to prevent both the incidence and frequency of foot blisters in runners.
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http://dx.doi.org/10.1097/JSM.0000000000000319DOI Listing
September 2016

Preparticipation Evaluation for Climbing Sports.

Wilderness Environ Med 2015 Dec;26(4 Suppl):S40-6

Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, Utah (Drs Ng and McIntosh).

Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs.
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http://dx.doi.org/10.1016/j.wem.2015.09.014DOI Listing
December 2015

Preparticipation Evaluation for Climbing Sports.

Clin J Sport Med 2015 Sep;25(5):412-7

*Family and Sports Medicine, University of Utah Health Care, Salt Lake City, Utah; †Department of Emergency Medicine, University of Colorado School of Medicine; ‡Kaiser Permanente, Department of Emergency Medicine, University of Colorado; §Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, Utah; ¶Arizona Sports Medicine Center, Mesa, Arizona; and ‖Central Maine Sports Medicine (a Clinical Division of CMMC), Evergreen Sports Medicine Fellowship, Lewiston, Maine.

Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs.
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http://dx.doi.org/10.1097/JSM.0000000000000247DOI Listing
September 2015

The Impact of Freeze-Thaw Cycles on Epinephrine.

Wilderness Environ Med 2015 Dec 19;26(4):514-9. Epub 2015 May 19.

Division of Emergency Medicine (Drs Ng and McIntosh), University of Utah Health Care, Salt Lake City, UT.

Objectives: Epinephrine is the first-line medical treatment for anaphylaxis, a life-threatening allergic syndrome. To treat anaphylaxis, backcountry recreationalists and guides commonly carry epinephrine autoinjectors. Epinephrine may be exposed to cold temperatures and freezing during expeditions. An epinephrine solution must contain 90% to 115% of the labeled epinephrine amount to meet United States Pharmacopeia standards. The purpose of this study was to determine whether freeze-thaw cycles alter epinephrine concentrations in autoinjectors labeled to contain 1.0 mg/mL epinephrine. A further objective was to determine whether samples continued to meet United States Pharmacopeia concentration standards after freeze-thaw cycles.

Methods: Epinephrine from 6 autoinjectors was extracted and divided into experimental and control samples. The experimental samples underwent 7 consecutive 12-hour freeze cycles followed by 7 12-hour thaw cycles. The control samples remained at an average temperature of 23.1°C for the duration of the study. After the seventh thaw cycle, epinephrine concentrations were measured using a high-performance liquid chromatography assay with mass spectrometry detection.

Results: The mean epinephrine concentration of the freeze-thaw samples demonstrated a statistically significant increase compared with the control samples: 1.07 mg/mL (SD ± 8.78; 95% CI, 1.04 to 1.11) versus 0.96 mg/mL (SD ± 6.81; 95% CI, 0.94 to 0.99), respectively. The maximal mean epinephrine concentration in the experimental freeze-thaw group was 1.12 mg/mL, which still fell within the range of United States Pharmacopeia standards for injectables (0.90 to 1.15 mg/mL).

Conclusions: Although every attempt should be made to prevent freezing of autoinjectors, this preliminary study demonstrates that epinephrine concentrations remain within 90% to 115% of 1.0 mg/mL after multiple freeze-thaw cycles.
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http://dx.doi.org/10.1016/j.wem.2015.04.001DOI Listing
December 2015

Advanced Avalanche Safety Equipment of Backcountry Users: Current Trends and Perceptions.

Wilderness Environ Med 2015 Sep 30;26(3):417-21. Epub 2015 Apr 30.

Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs Ng and McIntosh).

Objective: Backcountry travelers should carry a standard set of safety gear (transceiver, shovel, and probe) to improve rescue chances and reduce mortality risk. Many backcountry enthusiasts are using other advanced equipment such as an artificial air pocket (eg, the AvaLung) or an avalanche air bag. Our goal was to determine the numbers of backcountry users carrying advanced equipment and their perceptions of mortality and morbidity benefit while carrying this gear.

Methods: A convenience sample of backcountry skiers, snowboarders, snowshoers, and snowmobilers was surveyed between February and April 2014. Participants of this study were backcountry mountain users recruited at trailheads in the Wasatch and Teton mountain ranges of Utah and Wyoming, respectively. Questions included prior avalanche education, equipment carried, and perceived safety benefit derived from advanced equipment.

Results: In all, 193 surveys were collected. Skiers and snowboarders were likely to have taken an avalanche safety course, whereas snowshoers and snowmobilers were less likely to have taken a course. Most backcountry users (149, 77.2%), predominantly skiers and snowboarders, carried standard safety equipment. The AvaLung was carried more often (47 users) than an avalanche air bag (10 users). The avalanche air bag had a more favorable perceived safety benefit. A majority of participants reported cost as the barrier to obtaining advanced equipment.

Conclusions: Standard avalanche safety practices, including taking an avalanche safety course and carrying standard equipment, remain the most common safety practices among backcountry users in the Wasatch and Tetons. Snowshoers remain an ideal target for outreach to increase avalanche awareness and safety.
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http://dx.doi.org/10.1016/j.wem.2015.03.029DOI Listing
September 2015
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