Altitude Sickness in Climbers and Efficacy of NSAIDs Trial (ASCENT): randomized, controlled trial of ibuprofen versus placebo for prevention of altitude illness.

Objective: To study the effectiveness of ibuprofen versus placebo in preventing acute mountain sickness (AMS) and high altitude headache (HAH).

Methods: Double-blind, randomized, placebo-controlled trial.

Results: Two hundred ninety-four healthy Western trekkers were recruited on the Everest approach at 4280 m or 4358 m and randomly assigned to receive either 600 mg of ibuprofen or placebo 3 times daily before and during ascent to 4928 m.

"Spontaneous" rupture of the healthy oesophagus.

The clinical features of four cases of ‘spontaneous’ rupture of the oesophagus are described together with the radiological changes. It is emphasized that the diagnosis often may be made from simple penetrated views of the heart shadow with the patient in the erect position.