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Jiang H, Lu C, Wu H, Ding J, Li J, Ding J, Gao Y, Wang G, Luo Q. Decreased cold-inducible RNA-binding protein (CIRP) binding to GluRl on neuronal membranes mediates memory impairment resulting from prolonged hypobaric hypoxia exposure. CNS Neurosci Ther 2024; 30:e70059. [PMID: 39315498 PMCID: PMC11420629 DOI: 10.1111/cns.70059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/30/2024] [Accepted: 09/08/2024] [Indexed: 09/25/2024] Open
Abstract
AIM To investigate the molecular mechanisms underlying memory impairment induced by high-altitude (HA) hypoxia, specifically focusing on the role of cold-inducible RNA-binding protein (CIRP) in regulating the AMPA receptor subunit GluR1 and its potential as a therapeutic target. METHODS A mouse model was exposed to 14 days of hypobaric hypoxia (HH), simulating conditions at an altitude of 6000 m. Behavioral tests were conducted to evaluate memory function. The expression, distribution, and interaction of CIRP with GluR1 in neuronal cells were analyzed. The binding of CIRP to GluR1 mRNA and its impact on GluR1 protein expression were examined. Additionally, the role of CIRP in GluR1 regulation was assessed using Cirp knockout mice. The efficacy of the Tat-C16 peptide, which consists of the Tat sequence combined with the CIRP 110-125 amino acid sequence, was also tested for its ability to mitigate HH-induced memory decline. RESULTS CIRP was primarily localized in neurons, with its expression significantly reduced following HH exposure. This reduction was associated with decreased GluR1 protein expression on the cell membrane and increased localization in the cytoplasm. The interaction between CIRP and GluR1 was diminished under HH conditions, leading to reduced GluR1 stability on the cell membrane and increased cytoplasmic relocation. These changes resulted in a decreased number of synapses and dendritic spines, impairing learning and memory functions. Administration of the Tat-C16 peptide effectively ameliorated these impairments by modulating GluR1 expression and distribution in HH-exposed mice. CONCLUSION CIRP plays a critical role in maintaining synaptic integrity under hypoxic conditions by regulating GluR1 expression and distribution. The Tat-C16 peptide shows promise as a therapeutic strategy for alleviating cognitive decline associated with HA hypoxia.
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Affiliation(s)
- Hui Jiang
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
- College of High‐Altitude Military MedicineInstitute of Medicine and Hygienic Equipment for High Altitude Region, Army Medical UniversityChongqingChina
| | - Chenyan Lu
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Haoyang Wu
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Jie Ding
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Jiayan Li
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Jianfeng Ding
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Yuqi Gao
- College of High‐Altitude Military MedicineInstitute of Medicine and Hygienic Equipment for High Altitude Region, Army Medical UniversityChongqingChina
- Key Laboratory of Extreme Environmental Medicine and High‐Altitude Medicine, Ministry of Education of ChinaChongqingChina
| | - Guohua Wang
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
| | - Qianqian Luo
- Department of Hypoxic BiomedicineInstitute of Special Environmental Medicine and Co‐innovation Center of Neuroregeneration, Nantong UniversityNantongChina
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白 亚, 孙 晓, 文 巧, 吴 江, 邹 剑, 王 海. [Effects of Extreme Environments on Human Sleep]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:1034-1043. [PMID: 39170010 PMCID: PMC11334294 DOI: 10.12182/20240760402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Indexed: 08/23/2024]
Abstract
Recently, with the rapid growth of the global population and the exhaustion of resources, exploration activities in extreme environments such as the polar regions, the outer space, the deep sea, the deep underground and highlands are becoming increasingly more frequent. This in-depth exploration of the external environment and the consequent dramatic changes in lifestyles impact on sleep, a basic life activity of humans, in ways that cannot be overlooked. the basic life activity of human beings. Sleep, a basic life activity and the result of the evolution of organisms to adapt to their environment, is closely associated with sleep homeostasis and endogenous rhythms. However, external environmental changes and lifestyle shifts in extreme environments have had a significant impact on the patterns and the quality of sleep in humans. Furthermore, this impact can lead to many physiological and psychological problems, posing a great threat to human health. In this review, we delved into the specific effects of different extreme natural environments and enclosed environments on sleep, elaborating on how these environments alter the patterns and the quality of sleep in humans. In addition, we summarized the changes in human sleep under extreme environments to help gain a better understanding of the mechanisms by which these specific environments impact human sleep. It is expected that this review will provide a solid theoretical foundation for optimizing long-term survival strategies in extreme environments and help humans adapt to and overcome the challenges posed by extreme environments more effectively.
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Affiliation(s)
- 亚宁 白
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 晓茹 孙
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学深地医学中心 (成都 610041)Deep Under Ground Medical Center, Sichuan University, Chengdu 610041, China
| | - 巧 文
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学深地医学中心 (成都 610041)Deep Under Ground Medical Center, Sichuan University, Chengdu 610041, China
| | - 江 吴
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学深地医学中心 (成都 610041)Deep Under Ground Medical Center, Sichuan University, Chengdu 610041, China
| | - 剑 邹
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学深地医学中心 (成都 610041)Deep Under Ground Medical Center, Sichuan University, Chengdu 610041, China
| | - 海洋 王
- 四川大学华西医院 耳鼻咽喉头颈外科 (成都 610041)Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学深地医学中心 (成都 610041)Deep Under Ground Medical Center, Sichuan University, Chengdu 610041, China
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Ramchandani R, Florica IT, Zhou Z, Alemi A, Baranchuk A. Review of Athletic Guidelines for High-Altitude Training and Acclimatization. High Alt Med Biol 2024; 25:113-121. [PMID: 38207236 DOI: 10.1089/ham.2023.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Ramchandani, Rashi, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, and Adrian Baranchuk. Review of athletic guidelines for high-altitude training and acclimatization. High Alt Med Biol. 00:000-000, 2024. Introduction: Exposure to high altitude results in hypobaric hypoxia with physiological acclimatization changes that are thought to influence athletic performance. This review summarizes existing literature regarding implications of high-altitude training and altitude-related guidelines from major governing bodies of sports. Methods: A nonsystematic review was performed using PubMed and OVID Medline to identify articles regarding altitude training and guidelines from international governing bodies of various sports. Sports inherently involving training or competing at high altitude were excluded. Results: Important physiological compensatory mechanisms to high-altitude environments include elevations in blood pressure, heart rate, red blood cell mass, tidal volume, and respiratory rate. These responses can have varying effects on athletic performance. Governing sport bodies have limited and differing regulations for training and competition at high altitudes with recommended acclimatization periods ranging from 3 days to 3 weeks. Discussion: Physiological changes in response to high terrestrial altitude exposure can have substantial impacts on athletic performance. Major sport governing bodies have limited regulations and recommendations regarding altitude training and competition. Existing guidelines are variable and lack substantial evidence to support recommendations. Additional studies are needed to clarify the implications of high-altitude exposure on athletic ability to optimize training and competition.
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Affiliation(s)
- Rashi Ramchandani
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ioana Tereza Florica
- Department of Medicine, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Zier Zhou
- Atherosclerosis, Genomics and Vascular Biology Division, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Aziz Alemi
- Department of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Department of Medicine, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
- Department of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
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Kronstein-Wiedemann R, Tausche K, Kolditz M, Teichert M, Thiel J, Koschel D, Tonn T, Künzel SR. Long-COVID is Associated with Impaired Red Blood Cell Function. Horm Metab Res 2024; 56:318-323. [PMID: 37890507 DOI: 10.1055/a-2186-8108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
COVID-19 disease, caused by the severe acute respiratory syndrome virus 2 (SARS-CoV-2), induces a broad spectrum of clinical symptoms ranging from asymptomatic cases to fatal outcomes. About 10-35% of all COVID-19 patients, even those with mild COVID-19 symptoms, continue to show symptoms, i. e., fatigue, shortness of breath, cough, and cognitive dysfunction, after initial recovery. Previously, we and others identified red blood cell precursors as a direct target of SARS-CoV-2 and suggested that SARS-CoV-2 induces dysregulation in hemoglobin- and iron-metabolism contributing to the severe systemic course of COVID-19. Here, we put particular emphasis on differences in parameters of clinical blood gas analysis and hematological parameters of more than 20 healthy and Long-COVID patients, respectively. Long-COVID patients showed impaired oxygen binding to hemoglobin with concomitant increase in carbon monoxide binding. Hand in hand with decreased plasma iron concentration and transferrin saturation, mean corpuscular hemoglobin was elevated in Long-COVID patients compared to healthy donors suggesting a potential compensatory mechanism. Although blood pH was within the physiological range in both groups, base excess- and bicarbonate values were significantly lower in Long-COVID patients. Furthermore, Long-COVID patients displayed reduced lymphocyte levels. The clinical relevance of these findings, e. g., as a cause of chronic immunodeficiency, remains to be investigated in future studies. In conclusion, our data suggest impaired erythrocyte functionality in Long-COVID patients, leading to diminished oxygen supply. This in turn could be an explanation for the CFS, dyspnea and anemia. Further investigations are necessary to identify the underlying pathomechanisms.
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Affiliation(s)
- Romy Kronstein-Wiedemann
- Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
| | - Kristin Tausche
- Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Martin Kolditz
- Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Madeleine Teichert
- German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
| | - Jessica Thiel
- Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Dirk Koschel
- Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany
- Department of Internal Medicine and Pneumology, Fachkrankenhaus Coswig, Lung Center, Coswig, Germany
| | - Torsten Tonn
- Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
| | - Stephan R Künzel
- Laboratory for Experimental Transfusion Medicine, Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- German Red Cross Blood Donation Service North-East, Institute for Transfusion Medicine, Dresden, Germany
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Baur DA, Baur KG, Buchanan BK, Ortiz MJ, Doody AG. Load carriage physiology in normoxia and hypoxia. Eur J Appl Physiol 2024; 124:925-943. [PMID: 37740748 PMCID: PMC10879375 DOI: 10.1007/s00421-023-05320-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE To determine the effects of load carriage in normoxia and normobaric hypoxia on ventilatory responses, hemodynamics, tissue oxygenation, and metabolism. METHODS Healthy males (n = 12) completed 3 randomly ordered baseline graded exercise tests in the following conditions: (1) unloaded normoxic (U: FIO2 = 20.93%), (2) loaded (~ 30 kg) normoxic (LN), and (3) loaded hypoxic simulating ~ 3650 m (LH: FIO2 = ~ 13%). Thereafter, experimental exercise trials were completed in quasi-randomized order (i.e., U completed first) consisting of 3 × 10 min of walking (separated by 5 min seated rest) with stages matched with the U condition (in ascending order) for relative intensity, absolute oxygen consumption ([VO2]; 1.7 L min-1), and walking speed (1.45 ± 0.15 m s-1). RESULTS Load carriage increased perceived exertion and reduced VO2max (LN: - 7%; LH: - 32%; p < 0.05). At matched VO2, stroke volume and tidal volume were reduced and maintained with LN and LH vs. U, respectively (p < 0.05). Increases in cardiac output and minute ventilation at matched VO2 (with LH) and speed (with LN and LH), were primarily accomplished via increases in heart rate and breathing frequency (p < 0.05). Cerebral oxygenated hemoglobin (O2HHb) was increased at all intensities with LN, but deoxygenated hemoglobin and total hemoglobin were increased with LH (p < 0.05). Muscle oxygen kinetics and substrate utilization were similar between LN and U, but LH increased CHO dependence and reduced muscle O2HHb at matched speed (p < 0.05). CONCLUSION Load carriage reduces cardiorespiratory efficiency and increases physiological strain, particularly in hypoxic environments. Potential load carriage-induced alterations in cerebral blood flow may increase the risk for altitude illnesses and requires further study.
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Affiliation(s)
- Daniel A Baur
- Department of Human Performance and Wellness, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA.
| | - Katherine G Baur
- Department of Human Performance and Wellness, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA
| | - Beverley K Buchanan
- Department of Human Performance and Wellness, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA
| | - Miles J Ortiz
- Department of Human Performance and Wellness, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA
| | - Abaigeal G Doody
- Department of Human Performance and Wellness, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA
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Zhang X, Zhang Y, Si Y, Gao N, Zhang H, Yang H. A high altitude respiration and SpO2 dataset for assessing the human response to hypoxia. Sci Data 2024; 11:248. [PMID: 38413602 PMCID: PMC10899206 DOI: 10.1038/s41597-024-03065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
This report presents the Harespod dataset, an open dataset for high altitude hypoxia research, which includes respiration and SpO2 data. The dataset was collected from 15 college students aged 23-31 in a hypobaric oxygen chamber, during simulated altitude changes and induced hypoxia. Real-time physiological data, such as oxygen saturation waveforms, oxygen saturation, respiratory waveforms, heart rate, and pulse rate, were obtained at 100 Hz. Approximately 12 hours of valid data were collected from all participants. Researchers can easily identify the altitude corresponding to physiological signals based on their inherent patterns. Time markers were also recorded during altitude changes to facilitate realistic annotation of physiological signals and analysis of time-difference-of-arrival between various physiological signals for the same altitude change event. In high altitude scenarios, this dataset can be used to enhance the detection of human hypoxia states, predict respiratory waveforms, and develop related hardware devices. It will serve as a valuable and standardized resource for researchers in the field of high altitude hypoxia research, enabling comprehensive analysis and comparison.
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Affiliation(s)
- Xi Zhang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Yu Zhang
- School of Computer Science, Northwestern Polytechnical University, Xi'an, 710129, China.
| | - Yingjun Si
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Nan Gao
- Department of Computer Science and Technology, Tsinghua University, Beijing, 100084, China
| | - Honghao Zhang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Hui Yang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China.
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China.
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Tan L, Li Y, Chen H, Lanzi G, Hu X. Sleep at high altitude: A bibliometric study and visualization analysis from 1992 to 2022. Heliyon 2024; 10:e23041. [PMID: 38163230 PMCID: PMC10755286 DOI: 10.1016/j.heliyon.2023.e23041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Background As an important monitoring index for adaptation to hypoxia, sleep may reflect the adaptive state of the body at high altitudes. The literature has shown a link between altitude and sleep problems, and sleep changes have become a common problem for individuals at high altitudes, negatively impacting their physical and mental health. As research on high-altitude sleep has gained attention in recent years, the publishing volume has increased worldwide, necessitating a more comprehensive understanding of this field. This manuscript evaluates the key themes and emerging trends in high-altitude sleep over the past few decades and predicts future research directions. Methods Articles related to high-altitude sleep published from 1992 to 2022 were retrieved from the Web of Science Core Collection, and the relevant literature characteristics were extracted after the screening. Then, bibliometric analyses and visualizations were performed using Microsoft Excel, CiteSpace, VOSviewer, and an online analysis platform (http://bibliometric.com). Results A total of 1151 articles were retrieved, of which 368 were included in the analysis, indicating a gradually increasing trend. The United States, Switzerland, and China have made significant contributions in this field. Bloch KE from the University of Zurich was determined to be the most productive and academically influential author in this field. The highest-yielding journal was High Altitude Medicine & Biology. Initially, altitude training was the primary research topic. Currently, research focuses on sleep disorders and sleep apnea. In the coming years, keywords such as "sleep quality," "prevalence," and "obstructive sleep apnea" will attract more attention. Conclusion Our findings will assist scholars to better understand the intellectual structure and emerging trends in this field. Future developments in high-altitude sleep research are highly anticipated, particularly in terms of sleep quality at high altitudes and its associated prevalence. This research is also crucial for the improvement and treatment of symptoms during nocturnal sleep in patients with chronic hypoxia due to cardiopulmonary diseases at high altitudes.
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Affiliation(s)
- Lixia Tan
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Medical College, Tibet University, Lhasa, China
| | - Yong Li
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hongxiu Chen
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | | | - Xiuying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Arena A, Miller E. Respiratory Acid-Base Disorders. Emerg Med Clin North Am 2023; 41:863-875. [PMID: 37758429 DOI: 10.1016/j.emc.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Respiratory acid-base disorders are often not thought of as frequently as their metabolic cousins, which occur more frequently in the emergency department. Although most respiratory and acid-base disturbances are driven by lung pathology, central nervous system and other organ systems can and do play a role as well. Although managing the airway and appropriate mechanical ventilation may be necessary, it is akin to placing a band-aid on a large wound. It is crucial for the emergency clinician to discover the etiology of the disturbance as management depends on treating the underlying etiology to prevent worsening acid-base status.
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Affiliation(s)
- Alexander Arena
- Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, TX 78229-3900, USA.
| | - Emily Miller
- Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, TX 78229-3900, USA
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Lv J, Qi P, Yan X, Bai L, Zhang L. Structure and Metabolic Characteristics of Intestinal Microbiota in Tibetan and Han Populations of Qinghai-Tibet Plateau and Associated Influencing Factors. Microorganisms 2023; 11:2655. [PMID: 38004668 PMCID: PMC10672793 DOI: 10.3390/microorganisms11112655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Residents of the Qinghai-Tibet Plateau might experience shifts in their gut microbiota composition as a result of the plateau environment. For example, high altitudes can increase the abundance of obligate anaerobic bacteria, decrease the number of aerobic bacteria and facultative anaerobic bacteria, increase probiotics, and decrease pathogenic bacteria. This study aimed to determine the structure and metabolic differences in intestinal microbial communities among the Tibetan and Han populations on the Qinghai-Xizang Plateau and shed light on the factors that influence the abundance of the microbial communities in the gut. The structural characteristics of intestinal microorganisms were detected from blood and fecal samples using 16S rRNA sequencing. Metabolic characteristics were detected using gas chromatography-time-of-flight mass spectrometry (GC-TOFMS). The influencing factors were analyzed using Spearman's correlation analysis. Bacteroides and Bifidobacterium were dominant in the intestinal tract of the Han population, while Bacteroides and Prevotella were dominant in that of the Tibetan population, with marked differences in Pseudomonas, Prevotella, and other genera. Ferulic acid and 4-methylcatechol were the main differential metabolites between the Tibetan and Han ethnic groups. This may be the reason for the different adaptability of Tibetan and Han nationalities to the plateau. Alanine aminotransferase and uric acid also have a high correlation with different bacteria and metabolites, which may play a role. These results reveal notable disparities in the compositions and metabolic characteristics of gut microbial communities in the Tibetan and Han people residing on the Qinghai-Tibet Plateau and may provide insights regarding the mechanism of plateau adaptability.
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Affiliation(s)
- Jin Lv
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; (J.L.); (P.Q.); (X.Y.); (L.B.)
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Ping Qi
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; (J.L.); (P.Q.); (X.Y.); (L.B.)
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Xiangdong Yan
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; (J.L.); (P.Q.); (X.Y.); (L.B.)
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Liuhui Bai
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; (J.L.); (P.Q.); (X.Y.); (L.B.)
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Lei Zhang
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; (J.L.); (P.Q.); (X.Y.); (L.B.)
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, The First Hospital of Lanzhou University, Lanzhou 730000, China
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Jin Y, Li J, Ye J, Luo X, Wilson A, Mu L, Zhou P, Lv Y, Wang Y. Mapping associations between anxiety and sleep problems among outpatients in high-altitude areas: a network analysis. BMC Psychiatry 2023; 23:341. [PMID: 37189050 PMCID: PMC10184966 DOI: 10.1186/s12888-023-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups. METHODS The data was collected from the Sleep Medicine Center of The First People's Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored. RESULTS Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, "Nervousness", "Trouble relaxing", "Uncontrollable worry" were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05). CONCLUSIONS In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jing Ye
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lanxue Mu
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pinyi Zhou
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yunhui Lv
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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11
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Caravedo MA, Mozo K, Morales ML, Smiley H, Stuart J, Tilley DH, Cabada MM. Risk factors for acute mountain sickness in travellers to Cusco, Peru: coca leaves, obesity and sex. J Travel Med 2022; 29:6316244. [PMID: 34230961 DOI: 10.1093/jtm/taab102] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Acute mountain sickness (AMS) may occur after rapid ascents to altitudes >2500 m. Cusco (3350 m) in Peru is a popular destination for altitude inexperienced travellers. This study aimed at evaluating the incidence and risk factors for AMS among a cohort of foreign Spanish language students in Cusco. METHODS We performed a cohort study among young healthy foreign Spanish language students arriving to Cusco between 2012 and 2016. Consenting students answered an enrollment questionnaire on demographics, travel history and intended AMS preventive behaviour within 48 h of arrival. At 4-5 days after enrollment participants answered a second questionnaire about actual preventive behaviour before symptoms and the development of symptoms compatible with AMS during their first 48 h in Cusco. We used the 2018 Lake Louise Scoring System for AMS diagnosis. Participants with headache and a score ≥ 3 were considered to have AMS. RESULTS We enrolled 142 language students, the median age was 21 years (interquartile range 20-25) and 57% were female. Participants decreased physical activity (38%), increased fluid intake (34%), drank coca leaf tea (34%), took acetazolamide (16%) and acclimatized at a lower altitude (6%) to prevent AMS. Thirty-nine percent had AMS. In the multivariate analysis, obesity [odds ratio (OR) 14.45 (2.33-89.6)] and female sex [OR 4.32 (1.81-10.28)] were associated with increased risk of AMS. Taking acetazolamide [OR 0.13 (0.03-0.56)] was associated with decreased AMS risk. Consumption of coca leaf tea was not associated with decreased risk of AMS. CONCLUSIONS In our cohort, AMS affected two out of five travellers. Obesity and female sex were associated with increased risk. Drinking coca leaf tea for prevention did not decrease the risk of AMS. Acetazolamide prophylaxis was associated with decreased risk of AMS.
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Affiliation(s)
- Maria A Caravedo
- Cusco Branch-Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX, USA
| | - Karen Mozo
- Cusco Branch-Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Maria L Morales
- Cusco Branch-Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Hunter Smiley
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Jared Stuart
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Drake H Tilley
- Bacteriology Department, United States Naval Medical Research Unit Six, Lima, Peru
| | - Miguel M Cabada
- Cusco Branch-Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX, USA
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12
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Gandhi S, Chinnadurai V, Bhadra K, Gupta I, Kanwar RS. Urinary metabolic modulation in human participants residing in Siachen: a 1H NMR metabolomics approach. Sci Rep 2022; 12:9070. [PMID: 35641596 PMCID: PMC9156790 DOI: 10.1038/s41598-022-13031-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022] Open
Abstract
The main physiological challenge in high altitude environment is hypoxia which affects the aerobic metabolism reducing the energy supply. These changes may further progress toward extreme environment-related diseases. These are further reflected in changes in small molecular weight metabolites and metabolic pathways. In the present study, metabolic changes due to chronic environmental hypoxia were assessed using 1H NMR metabolomics by analysing the urinary metabolic profile of 70 people at sea level and 40 people at Siachen camp (3700 m) for 1 year. Multivariate statistical analysis was carried out, and PLSDA detected 15 metabolites based on VIP score > 1. ROC analysis detected cis-aconitate, Nicotinamide Mononucleotide, Tyrosine, Choline and Creatinine metabolites with a high range of sensitivity and specificity. Pathway analysis revealed 16 pathways impact > 0.05, and phenylalanine tyrosine and tryptophan biosynthesis was the most prominent altered pathway indicating metabolic remodelling to meet the energy requirements. TCA cycle, Glycine serine and Threonine metabolism, Glutathione metabolism and Cysteine alterations were other metabolic pathways affected during long-term high-altitude hypoxia exposure. Present findings will help unlock a new dimension for the potential application of NMR metabolomics to address extreme environment-related health problems, early detection and developing strategies to combat high altitude hypoxia.
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Affiliation(s)
- Sonia Gandhi
- Metabolomics Research Facility, Institute of Nuclear Medicine and Allied Sciences (INMAS), Lucknow Road, Timarpur, Delhi, 110054, India.
| | - Vijayakumar Chinnadurai
- Cognitive Control and Machine Learning Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
| | - Kuntal Bhadra
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
| | - Isha Gupta
- Metabolomics Research Facility, Institute of Nuclear Medicine and Allied Sciences (INMAS), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Ratnesh Singh Kanwar
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
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13
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Hennis PJ, Cumpstey AF, O'Doherty AF, Fernandez BO, Gilbert-Kawai ET, Mitchell K, Moyses H, Cobb A, Meale P, Pöhnl H, Mythen MG, Grocott MPW, Levett DZH, Martin DS, Feelisch M. Dietary Nitrate Supplementation Does Not Alter Exercise Efficiency at High Altitude - Further Results From the Xtreme Alps Study. Front Physiol 2022; 13:827235. [PMID: 35295581 PMCID: PMC8918982 DOI: 10.3389/fphys.2022.827235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Nitrate supplementation in the form of beetroot juice (BRJ) ingestion has been shown to improve exercise tolerance during acute hypoxia, but its effect on exercise physiology remains unstudied during sustained terrestrial high altitude exposure. We hypothesized that performing exercise at high altitude would lower circulating nitrate and nitrite levels and that BRJ ingestion would reverse this phenomenon while concomitantly improving key determinants of aerobic exercise performance. Methods Twenty seven healthy volunteers (21 male) underwent a series of exercise tests at sea level (SL, London, 75 m) and again after 5-8 days at high altitude (HA, Capanna Regina Margherita or "Margherita Hut," 4,559 m). Using a double-blind protocol, participants were randomized to consume a beetroot/fruit juice beverage (three doses per day) with high levels of nitrate (∼0.18 mmol/kg/day) or a nitrate-depleted placebo (∼11.5 μmoles/kg/day) control drink, from 3 days prior to the exercise trials until completion. Submaximal constant work rate cycle tests were performed to determine exercise efficiency and a maximal incremental ramp exercise test was undertaken to measure aerobic capacity, using breath-by-breath pulmonary gas exchange measurements throughout. Concentrations of nitrate, nitrite and nitrosation products were quantified in plasma samples collected at 5 timepoints during the constant work rate tests. Linear mixed modeling was used to analyze data. Results At both SL and HA, plasma nitrate concentrations were elevated in the nitrate supplementation group compared to placebo (P < 0.001) but did not change throughout increasing exercise work rate. Delta exercise efficiency was not altered by altitude exposure (P = 0.072) or nitrate supplementation (P = 0.836). V̇O2peak decreased by 24% at high altitude (P < 0.001) and was lower in the nitrate-supplemented group at both sea level and high altitude compared to placebo (P = 0.041). Dietary nitrate supplementation did not alter other peak exercise variables or oxygen consumption at anaerobic threshold. Circulating nitrite and S-nitrosothiol levels unexpectedly rose in a few individuals right after cessation of exercise at high altitude. Conclusion Whilst regularly consumed during an 8 days expedition to terrestrial high altitude, nitrate supplementation did not alter exercise efficiency and other exercise physiological variables, except decreasing V̇O2peak. These results and those of others question the practical utility of BRJ consumption during prolonged altitude exposure.
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Affiliation(s)
- Philip J Hennis
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom.,SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Andrew F Cumpstey
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bernadette O Fernandez
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Edward T Gilbert-Kawai
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Kay Mitchell
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Helen Moyses
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alexandra Cobb
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Paula Meale
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Helmut Pöhnl
- AURAPA Würzungen GmbH, Bietigheim-Bissingen, Germany
| | - Monty G Mythen
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Michael P W Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Denny Z H Levett
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Daniel S Martin
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom.,Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Martin Feelisch
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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14
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Vizcarra-Vizcarra CA, Alcos-Mamani AL. High Altitude Pulmonary Edema in a Chronic Kidney Disease Patient-Is Peritoneal Dialysis A Risk Factor? High Alt Med Biol 2022; 23:96-99. [PMID: 35231183 DOI: 10.1089/ham.2021.0136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Vizcarra-Vizcarra, Cristhian A. and Angélica L. Alcos-Mamani. High-altitude pulmonary edema in a chronic kidney disease patient-Is peritoneal dialysis a risk factor? High Alt Med Biol. 23:96-99, 2022.-High-altitude pulmonary edema is a cause of acute respiratory failure secondary to hypobaric hypoxia, which occurs after ascent above 2,500 m (8,202 feet), in susceptible people or without prior acclimatization. We present the case of a 20-year-old man with chronic kidney disease (CKD) on peritoneal dialysis (PD), living at sea (Mollendo, Peru) who presented with dyspnea and pulmonary congestion, after ascending to a high-altitude city (Juliaca, Peru at 3,827 m or 12,555 feet). The patient required diuretics, nifedipine, PD, tracheal intubation, and mechanical ventilation, but recovered and was discharged without complications. We think that CKD and PD could be risk factors for the development of high-altitude pulmonary edema, secondary to pulmonary hypertension and fluid overload, so this diagnosis should be considered in this group of patients when they ascend to high altitude.
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Affiliation(s)
- Cristhian A Vizcarra-Vizcarra
- Nephrology Division, Goyeneche Hospital, Arequipa, Peru.,Faculty of Medicine, San Agustin National University, Arequipa, Peru
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15
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Viruez-Soto A, Arias S, Casas-Mamani R, Rada-Barrera G, Merino-Luna A, Molano-Franco D, Tinoco-Solorzano A, Marques DA, Zubieta-DeUrioste N, Zubieta-Calleja G, Arias-Reyes C, Soliz J. Oxygen therapy limiting peripheral oxygen saturation to 89-93% is associated with a better survival prognosis for critically ill COVID-19 patients at high altitudes. Respir Physiol Neurobiol 2022; 299:103868. [PMID: 35150939 PMCID: PMC8828373 DOI: 10.1016/j.resp.2022.103868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/06/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
Patients admitted to the Intensive Care Unit (ICU) with acute hypoxemic respiratory failure automatically receive oxygen therapy to improve inspiratory oxygen fraction (FiO2). Supplemental oxygen is the most prescribed drug for critically ill patients regardless of altitude of residence. In high altitude dwellers (i.e. in La Paz [≈3,400 m] and El Alto [≈4,150 m] in Bolivia), a peripheral oxygen saturation (SatpO2) of 89-95% and an arterial partial pressure of oxygen (PaO2) of 50-67 mmHg (lower as altitude rises), are considered normal values for arterial blood. Consequently, it has been suggested that limiting oxygen therapy to maintain SatpO2 around normoxia may help avoid episodes of hypoxemia, hyperoxemia, intermittent hypoxemia, and ultimately, mortality. In this study, we evaluated the impact of oxygen therapy on the mortality of critically ill COVID-19 patients who permanently live at high altitudes. A multicenter cross-sectional descriptive observational study was performed on 100 patients admitted to the ICU at the "Clinica Los Andes" (in La Paz city) and "Agramont" and "Del Norte" Hospitals (in El Alto city). Our results show that: 1) as expected, fatal cases were detected only in patients who required intubation and connection to invasive mechanical ventilation as a last resort to overcome their life-threatening desaturation; 2) among intubated patients, prolonged periods in normoxia are associated with survival, prolonged periods in hypoxemia are associated with death, and time spent in hyperoxemia shows no association with survival or mortality; 3) the oxygenation limits required to effectively support the intubated patients' survival in the ICU are between 89% and 93%; 4) among intubated patients with similar periods of normoxemic oxygenation, those with better SOFA scores survive; and 5) a lower frequency of observable reoxygenation events is not associated with survival. In conclusion, our findings indicate that high-altitude patients entering an ICU at altitudes of 3,400 - 4,150 m should undergo oxygen therapy to maintain oxygenation levels between 89 and 93 %.
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Affiliation(s)
- Antonio Viruez-Soto
- Clínica Los Andes del Grupo Embriovid, La Paz, Bolivia; Hospital Agramont, El Alto, Bolivia; Hospital del Norte, El Alto, Bolivia; High Altitude Intensive Care Medicine International Group, GIMIA, Bolivia
| | | | | | | | | | | | | | - Danuzia A Marques
- Centre de Recherche de l'Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | | | | | - Christian Arias-Reyes
- Centre de Recherche de l'Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Jorge Soliz
- High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA), La Paz, Bolivia; Centre de Recherche de l'Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.
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16
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Vanderhaeghen T, Timmermans S, Watts D, Paakinaho V, Eggermont M, Vandewalle J, Wallaeys C, Van Wyngene L, Van Looveren K, Nuyttens L, Dewaele S, Vanden Berghe J, Lemeire K, De Backer J, Dirkx L, Vanden Berghe W, Caljon G, Ghesquière B, De Bosscher K, Wielockx B, Palvimo JJ, Beyaert R, Libert C. Reprogramming of glucocorticoid receptor function by hypoxia. EMBO Rep 2022; 23:e53083. [PMID: 34699114 PMCID: PMC8728616 DOI: 10.15252/embr.202153083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 01/07/2023] Open
Abstract
Here, we investigate the impact of hypoxia on the hepatic response of glucocorticoid receptor (GR) to dexamethasone (DEX) in mice via RNA-sequencing. Hypoxia causes three types of reprogramming of GR: (i) much weaker induction of classical GR-responsive genes by DEX in hypoxia, (ii) a number of genes is induced by DEX specifically in hypoxia, and (iii) hypoxia induces a group of genes via activation of the hypothalamic-pituitary-adrenal (HPA) axis. Transcriptional profiles are reflected by changed GR DNA-binding as measured by ChIP sequencing. The HPA axis is induced by hypothalamic HIF1α and HIF2α activation and leads to GR-dependent lipolysis and ketogenesis. Acute inflammation, induced by lipopolysaccharide, is prevented by DEX in normoxia but not during hypoxia, and this is attributed to HPA axis activation by hypoxia. We unfold new physiological pathways that have consequences for patients suffering from GC resistance.
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17
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Nguyen KT, Gates CA, Hassell JE, Foxx CL, Salazar SN, Luthens AK, Arnold AL, Elam BL, Elsayed AI, Leblanc M, Adams SC, Lowry CA, Reuter JD. Evaluation of the effects of altitude on biological signatures of inflammation and anxiety- and depressive-like behavioral responses. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110331. [PMID: 33891978 DOI: 10.1016/j.pnpbp.2021.110331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
Over sixteen million people suffer from a depressive episode annually in the United States, with females affected at twice the rate of males. Little is known about the effects of exposure to high altitude on the risk of development of major depressive disorder, despite reports of higher suicide rates at higher altitudes. We hypothesize that exposure to hypobaric hypoxia at high altitude increases endophenotypes of self-directed suicidal violence, including biological signatures of chronic inflammation and vulnerability to anxiety-like and depressive-like behavioral responses in a sex-specific manner. Biological signatures of inflammation, including granulocyte:lymphocyte ratios, monocyte cell counts, and monocyte:lymphocyte ratios were assessed using complete blood count data, anhedonia, and anxiety- and depressive-like behavioral responses were evaluated. We assessed biological signatures of inflammation and behavioral responses in the open-field test, sucrose preference test, and modified Porsolt forced swim test in young adult male and female Long-Evans and Sprague Dawley rats. All tests were conducted near sea level (374 ft [114 m] elevation) and at moderate-high altitude (5430 ft [1655 m] elevation) during acclimation periods of one, two, three, four, and five weeks following shipment from a sea level animal breeding facility (N = 320, n = 8 per group). Exposure to moderate-high altitude induced a biological signature of increased inflammation, as evidenced by main effects of altitude for: 1) increased granulocyte:lymphocyte ratio; 2) increased count and relative abundance of circulating monocytes; and 3) increased monocyte:lymphocyte ratios. Exposure to moderate-high altitude also increased anhedonia as assessed in the sucrose preference test in both male and female rats, when data were collapsed across strain and time. Among male and female Long Evans rats, exposure to moderate-high altitude increased immobility in the forced swim test, without changing anxiety-like behaviors in the open-field test. Finally, granulocyte:lymphocyte ratios were correlated with anhedonia in the sucrose preference test. These data are consistent with the hypothesis that hypobaric hypoxia at moderate-high altitude induces persistent endophenotypes of self-directed suicidal violence including biological signatures of inflammation, anhedonia, and depressive-like behavioral responses.
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Affiliation(s)
- Kadi T Nguyen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Chloé A Gates
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - James E Hassell
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Christine L Foxx
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Stephanie N Salazar
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Amalia K Luthens
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Andrea L Arnold
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Brooke L Elam
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Ahmed I Elsayed
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Mathias Leblanc
- Animal Resources Department, Gene Expression Laboratory, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
| | - Sean C Adams
- Animal Resources Department, Gene Expression Laboratory, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Physical Medicine & Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO 80045, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80045, USA.
| | - Jon D Reuter
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Office of Animal Resources, University of Colorado Boulder, Boulder, CO 80309, USA.
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18
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Fan F, Xu N, Sun Y, Li X, Gao X, Yi X, Zhang Y, Meng X, Lin JM. Uncovering the Metabolic Mechanism of Salidroside Alleviating Microglial Hypoxia Inflammation Based on Microfluidic Chip-Mass Spectrometry. J Proteome Res 2021; 21:921-929. [PMID: 34851127 DOI: 10.1021/acs.jproteome.1c00647] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Microglia are the main immune cells in the brain playing a critical role in neuroinflammation, and numerous pieces of evidence have proved that energy metabolism is closely associated with inflammation in activated microglia. Salidroside (Sal) isolated from Tibetan medicine Rhodiola crenulate can inhibit microglial hypoxia inflammation (HI). However, whether the inhibition is due to the intervening energy metabolic process in microglia is not clear. In this work, the hypoxic microenvironment of BV2 microglial cells was simulated using deferoxamine (DFO) in vitro and the change of cell metabolites (lactate, succinate, malate, and fumarate) was real-time online investigated based on a cell microfluidic chip-mass spectrometry (CM-MS) system. Meanwhile, for confirming the metabolic mechanism of BV2 cells under hypoxia, the level of HI-related factors (LDH, ROS, HIF-1α, NF-κB p65, TNF-α, IL-1β, and IL-6) was detected by molecular biotechnology. Integration of the detected results revealed that DFO-induced BV2 cell HI was associated with the process of energy metabolism, in which cell energy metabolism changed from oxidative phosphorylation to glycolysis. Furthermore, administration of Sal treatment could effectively invert this change, and two metabolites of Sal were identified: tyrosol and 4-hydroxyphenylacetic acid. In general, we illustrated a new mechanism of Sal for reducing BV2 cell HI injury and presented a novel analysis strategy that opened a way for real-time online monitoring of the energy metabolic mechanism of the effect of drugs on cells and further provided a superior strategy to screen natural drug candidates for HI-related brain disease treatment.
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Affiliation(s)
- Fangfang Fan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.,School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.,Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China
| | - Ning Xu
- Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China.,Institute of Quality Standard and Testing Technology for Agro-Products, The Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Yucheng Sun
- Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China
| | - Xuanhao Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xinchang Gao
- Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China
| | - Xizhen Yi
- Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China
| | - Yi Zhang
- School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xianli Meng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.,School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jin-Ming Lin
- Department of Chemistry, Beijing Key Laboratory of Microanalytical Methods and Instrumentation, MOE Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Tsinghua University, Beijing 100084, China
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19
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Kaplan S, Khoury S, Zaidenstein R, Cohen E, Tischler-Aurkin D, Sheffer R, Lewis M, Mor Z. Morbidity among Israeli backpack travelers to tropical areas. Travel Med Infect Dis 2021; 45:102178. [PMID: 34687872 DOI: 10.1016/j.tmaid.2021.102178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 09/21/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Travelers to tropical areas may be susceptible to illness or injuries. This study aims to assess morbidity among travelers during their travel and compare those who became ill or were injured with those who did not. METHODS This prospective study included 400 travelers who were counselled by a physician in pre-travel clinics in central Israel between 2017 and 2018. Participants were interviewed within a month after their return regarding morbidity during travel, including health problems that started one week following their return. RESULTS Most travelers (N = 320, 80%) reported at least one illness or injury. Illnesses/injuries were more common among females than males (84.9% vs. 75.1%, p = 0.01), travel periods longer than 30 days (87.7% vs. 77.2%, p = 0.03), and travelers accompanied by their friends or solo travelers compared with those who traveled with their family/partner (83.8% and 70.0%, respectively, p = 0.002). The most common complaint was diarrhea (N = 159, 49.6%), followed by high-altitude sickness (N = 118, 36.9%) and fever (N = 100, 31.2%). Altitude sickness symptoms were more common in females than in males (58.9% vs. 41.0%, p = 0.006) and in those who ascended rapidly in comparison to those who ascended gradually (58.7% vs. 44.6%, p = 0.04). Animal injury was reported by 30 (7.5%) participants yet only eight (27.0%) received medical care, seven of whom (23.3%) were vaccinated against rabies. CONCLUSIONS Being a female, traveling with friends or alone and longer travel periods were associated with illness/injury. Practitioners at pre-travel clinics should inform travelers of the possible risks including the potential severe consequences of rabies and altitude sickness.
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Affiliation(s)
- Shiran Kaplan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Sobhi Khoury
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Zaidenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Internal Medicine Department A, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Mor Travel Clinics, Israel
| | - Erica Cohen
- Mor Travel Clinics, Israel; Maccabi Healthcare Services, Tel Aviv, Israel
| | | | - Rivka Sheffer
- Tel Aviv Department of Health, Ministry of Health, Tel Aviv, Israel
| | - Matthew Lewis
- Mor Travel Clinics, Israel; Israel District Health Office, Ministry of Health, Israel
| | - Zohar Mor
- Mor Travel Clinics, Israel; Tel Aviv Department of Health, Ministry of Health, Tel Aviv, Israel; School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
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20
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Herberg U, Knies R, Müller N, Breuer J. Altitude exposure in pediatric pulmonary hypertension-are we ready for (flight) recommendations? Cardiovasc Diagn Ther 2021; 11:1122-1136. [PMID: 34527538 DOI: 10.21037/cdt-20-494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/27/2020] [Indexed: 11/06/2022]
Abstract
Patients with congenital heart disease are surviving further into adulthood and want to participate in multiple activities. This includes exposure to high altitude by air travel or recreational activities, such as hiking and skiing. However, at an altitude of about 2,500 m, the barometric environmental pressure is reduced and the partial pressure of inspired oxygen drops from 21% to 15% (hypobaric hypoxia). In physiologic response to high-altitude-related hypoxia, pulmonary vasoconstriction is induced within minutes of exposure followed by compensatory hyperventilation and increased cardiac output. Even in healthy children and adults, desaturation can be profound and lead to a significant rise in pulmonary pressure and resistance. Individuals with already increased pulmonary pressure may be placed at risk during high-altitude exposure, as compensatory mechanisms may be limited. Little is known about the physiological response and risk of developing clinically relevant events on altitude exposure in pediatric pulmonary hypertension (PAH). Current guidelines are, in the absence of clinical studies, mainly based on expert opinion. Today, healthcare professionals are increasingly faced with the question, how best to assess and advise on the safety of individuals with PAH planning air travel or an excursion to mountain areas. To fill the gap, this article summarises the current clinical knowledge on moderate to high altitude exposure in patients with different forms of pediatric PAH.
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Affiliation(s)
- Ulrike Herberg
- Department of Pediatric Cardiology, University Hospital Bonn, Bonn, Germany
| | - Ralf Knies
- Department of Pediatric Cardiology, University Hospital Bonn, Bonn, Germany
| | - Nicole Müller
- Department of Pediatric Cardiology, University Hospital Bonn, Bonn, Germany
| | - Johannes Breuer
- Department of Pediatric Cardiology, University Hospital Bonn, Bonn, Germany
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21
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Wang Z, Lv B, Zhang L, Gao R, Zhao W, Wang L, Min Z, Mi Z, Song Y, Zhang J, Yu Y, Ji X, Li J, Wu L. Repeated remote ischaemic preconditioning can prevent acute mountain sickness after rapid ascent to a high altitude. Eur J Sport Sci 2021; 22:1304-1314. [PMID: 33977839 DOI: 10.1080/17461391.2021.1927197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of the present study was to assess the effectiveness of 4 different remote ischaemic preconditioning (RIPC) protocols varying in duration and frequency for preventing acute mountain sickness (AMS). Methods: The participants in the four RIPC groups received different RIPC treatments in the arms at a low altitude; the control group did not receive a specific sham treatment. The participants were then flown to a High Altitude (3650 m). The primary outcome was the incidence and severity of AMS evaluated by the Lake Louise score (LLS) after arrival; vital signs were collected simultaneously. We performed an intention-to-treat analysis. Results: A total of 250 participants were included with 50 participants in each group. The total AMS incidence in all participants was 26.4%. A total of 20 AMS cases (40%) occurred in the control group, whereas 15 AMS cases (30%) occurred both in the RIPC A and RIPC B groups (relative risk 1.3; 95% confidence interval 0.8 - 2.3; χ2 = 1.099; p = 0.29), and 8 AMS cases (16%) occurred both in the RIPC C and D groups (RR 2.5; 95% CI 1.2 - 5.2; χ2 = 7.143, p < 0.01), with significantly lower LLSs in the RIPC C and D groups (F = 6.51, p <0.001). Conclusion: This study demonstrated that a four-week RIPC intervention but not a one-week regimen reduced AMS incidence and severity; however, a placebo effect might have contributed to the results of this study. METHODS The participants in the four RIPC groups received different RIPC treatments in the arms at a low altitude; the control group did not receive a specific sham treatment. The participants were then flown to a High Altitude (3650 m). The primary outcome was the incidence and severity of AMS evaluated by the Lake Louise score (LLS) after arrival; vital signs were collected simultaneously. We performed an intention-to-treat analysis. RESULTS A total of 250 participants were included with 50 participants in each group. The total AMS incidence in all participants was 26.4%. A total of 20 AMS cases (40%) occurred in the control group after arrival at high altitude, whereas 15 AMS cases (30%) occurred both in the RIPC A and RIPC B groups (relative risk 1.3; 95% confidence interval 0.8 - 2.3; χ2 = 1.099; p = 0.29), and 8 AMS cases (16%) occurred both in the RIPC C and D groups (RR 2.5; 95% CI 1.2 - 5.2; χ2 = 7.143, p < 0.01), with significantly lower LLSs in the RIPC C and D groups (F = 6.51, p <0.001). CONCLUSION This study demonstrated that a four-week RIPC intervention but not a one-week regimen reduced AMS incidence and severity; however, a placebo effect might have contributed to the results of this study.
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Affiliation(s)
- Zhen Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Bo Lv
- Department of Neurology, PKUCare Zibo Hospital, Zibo, People's Republic of China.,Department of Neurology, People's Hospital of Yuncheng County, Heze, People's Republic of China
| | - Lin Zhang
- Department of Emergency, People's Hospital of Rizhao, Rizhao, People's Republic of China
| | - Ran Gao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wenbo Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Lin Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhaojun Min
- Department of Geriatric Medicine, People's Hospital of Lhasa, Lhasa, People's Republic of China
| | - Zhen Mi
- Department of Geriatric Medicine, People's Hospital of Lhasa, Lhasa, People's Republic of China
| | - Yang Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jing Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yabin Yu
- Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Xunming Ji
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Junjie Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Liyong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
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22
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Falla M, Papagno C, Dal Cappello T, Vögele A, Hüfner K, Kim J, Weiss EM, Weber B, Palma M, Mrakic-Sposta S, Brugger H, Strapazzon G. A Prospective Evaluation of the Acute Effects of High Altitude on Cognitive and Physiological Functions in Lowlanders. Front Physiol 2021; 12:670278. [PMID: 33995130 PMCID: PMC8113692 DOI: 10.3389/fphys.2021.670278] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our results may have practical implications, suggesting that individuals should practice prudence with higher ascent when performing risky activities in the first 24–36 h, even at altitudes below 3,500 m, due to an impairment of the cognitive performance that could worsen and lead to accidents.
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Affiliation(s)
- Marika Falla
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,Center for Mind/Brain Sciences CIMeC, University of Trento, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences CIMeC, University of Trento, Rovereto, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Anna Vögele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Jenny Kim
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - Elisabeth M Weiss
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Bernhard Weber
- Department of Psychology, University of Graz, Graz, Austria
| | - Martin Palma
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | | | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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23
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Singh AK, Kolligundla LP, Francis J, Pasupulati AK. Detrimental effects of hypoxia on glomerular podocytes. J Physiol Biochem 2021; 77:193-203. [PMID: 33835424 DOI: 10.1007/s13105-021-00788-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/11/2021] [Indexed: 12/19/2022]
Abstract
Hypoxia-inducible factor1 (HIF1) plays a pivotal role in ensuring cells adapt to low-oxygen conditions. Depletion of oxygen, a co-substrate during hydroxylation of prolyl (P402 and P564) residues of HIF1⍺, evades HIF1⍺ ubiquitination and enables its dimerization with HIF1β to mediate global transcriptional response to hypoxia. Though HIF1 is largely considered eliciting a protective role during physiological or pathological hypoxia or ischemia, elevated HIF1 during chronic hypoxia contributes to glomerular diseases' pathology and proteinuria. The glomerulus is responsible for renal permselectivity and excretion of ultra-filtrated urine. Podocytes are the glomerulus' major cell types and are instrumental for glomerular filtration, permselectivity, and glomerular basement membrane maintenance. Podocyte injury is expected to impair the efficiency of glomerular filtration and manifestation of glomerulosclerosis and proteinuria. Accumulated evidence suggests that podocytes are susceptible to various insults during chronic hypoxia, including podocyte EMT, slit-diaphragm dysfunction, foot process effacement, and cytoskeletal derangement due to accumulation of HIF1. This review discusses how hypoxia/HIF1 signaling regulates various features and function of podocytes during exposure to chronic hypoxia or inducing HIF1 by various chemical modulators.
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Affiliation(s)
- Ashish K Singh
- Department of Biochemistry, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Lakshmi P Kolligundla
- Department of Biochemistry, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Justus Francis
- Department of Biochemistry, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Anil K Pasupulati
- Department of Biochemistry, School of Life Sciences, University of Hyderabad, Hyderabad, India.
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24
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Xu G, Shi YK, Sun BD, Liu L, E GJ, He S, Zhang JY, Liu B, Hu Q, Chen J, Gao YQ, Zhang EL. DL-3-n-butylphthalide improved physical and learning and memory performance of rodents exposed to acute and chronic hypobaric hypoxia. Mil Med Res 2021; 8:23. [PMID: 33766114 PMCID: PMC7993509 DOI: 10.1186/s40779-021-00314-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies have revealed the protective effect of DL-3-n-butylphthalide (NBP) against diseases associated with ischemic hypoxia. However, the role of NBP in animals with hypobaric hypoxia has not been elucidated. This study investigated the effects of NBP on rodents with acute and chronic hypobaric hypoxia. METHODS Sprague-Dwaley rats and Kunming mice administered with NBP (0, 60, 120, and 240 mg/kg for rats and 0, 90, 180, and 360 mg/kg for mice) were placed in a hypobaric hypoxia chamber at 10,000 m and the survival percentages at 30 min were determined. Then, the time and distance to exhaustion of drug-treated rodents were evaluated during treadmill running and motor-driven wheel-track treadmill experiments, conducted at 5800 m for 3 days or 20 days, to evaluate changes in physical functions. The frequency of active escapes and duration of active escapes were also determined for rats in a shuttle-box experiment, conducted at 5800 m for 6 days or 27 days, to evaluate changes in learning and memory function. ATP levels were measured in the gastrocnemius muscle and malonaldehyde (MDA), superoxide dismutase (SOD), hydrogen peroxide (H2O2), glutathione peroxidase (GSH-Px), and lactate were detected in sera of rats, and routine blood tests were also performed. RESULTS Survival analysis at 10,000 m indicated NBP could improve hypoxia tolerance ability. The time and distance to exhaustion for mice (NBP, 90 mg/kg) and time to exhaustion for rats (NBP, 120 and 240 mg/kg) significantly increased under conditions of acute hypoxia compared with control group. NBP treatment also significantly increased the time to exhaustion for rats when exposed to chronic hypoxia. Moreover, 240 mg/kg NBP significantly increased the frequency of active escapes under conditions of acute hypoxia. Furthermore, the levels of MDA and H2O2 decreased but those of SOD and GSH-Px in the sera of rats increased under conditions of acute and chronic hypoxia. Additionally, ATP levels in the gastrocnemius muscle significantly increased, while lactate levels in sera significantly decreased. CONCLUSION NBP improved physical and learning and memory functions in rodents exposed to acute or chronic hypobaric hypoxia by increasing their anti-oxidative capacity and energy supply.
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Affiliation(s)
- Gang Xu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Yi-Kun Shi
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Bin-Da Sun
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Lu Liu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Guo-Ji E
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Shu He
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Jian-Yang Zhang
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Bao Liu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Qiu Hu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Jian Chen
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China.,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China.,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China
| | - Yu-Qi Gao
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China. .,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China. .,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China.
| | - Er-Long Zhang
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Number 30, Gaotanyan Street, District of Shapingba, Chongqing, 400038, China. .,Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, China. .,Key Laboratory of High Altitude Medicine, People's Liberation Army, Chongqing, China.
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25
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Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041692. [PMID: 33578749 PMCID: PMC7916528 DOI: 10.3390/ijerph18041692] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 12/13/2022]
Abstract
Alveolar hypoxia is the most prominent feature of high altitude environment with well-known consequences for the cardio-pulmonary system, including development of pulmonary hypertension. Pulmonary hypertension due to an exaggerated hypoxic pulmonary vasoconstriction contributes to high altitude pulmonary edema (HAPE), a life-threatening disorder, occurring at high altitudes in non-acclimatized healthy individuals. Despite a strong physiologic rationale for using vasodilators for prevention and treatment of HAPE, no systematic studies of their efficacy have been conducted to date. Calcium-channel blockers are currently recommended for drug prophylaxis in high-risk individuals with a clear history of recurrent HAPE based on the extensive clinical experience with nifedipine in HAPE prevention in susceptible individuals. Chronic exposure to hypoxia induces pulmonary vascular remodeling and development of pulmonary hypertension, which places an increased pressure load on the right ventricle leading to right heart failure. Further, pulmonary hypertension along with excessive erythrocytosis may complicate chronic mountain sickness, another high altitude maladaptation disorder. Importantly, other causes than hypoxia may potentially underlie and/or contribute to pulmonary hypertension at high altitude, such as chronic heart and lung diseases, thrombotic or embolic diseases. Extensive clinical experience with drugs in patients with pulmonary arterial hypertension suggests their potential for treatment of high altitude pulmonary hypertension. Small studies have demonstrated their efficacy in reducing pulmonary artery pressure in high altitude residents. However, no drugs have been approved to date for the therapy of chronic high altitude pulmonary hypertension. This work provides a literature review on the role of pulmonary hypertension in the pathogenesis of acute and chronic high altitude maladaptation disorders and summarizes current knowledge regarding potential treatment options.
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26
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Amare YE, Haile D. Evaluation of Pulmonary Function Tests Among Pregnant Women of Different Trimesters in Debre Berhan Referral Hospital, Shoa, Ethiopia. Int J Womens Health 2020; 12:1135-1143. [PMID: 33324115 PMCID: PMC7732161 DOI: 10.2147/ijwh.s275742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Pregnancy is characterized by a sequence of dynamic physiological changes that impact multiple organ system functions and is associated with various changes in pulmonary anatomy and physiology. Precise knowledge of the pulmonary function test parameters helps to understand and manage the course and outcome of pregnancy leading to safe delivery. It also helps to avoid misdiagnosis and unnecessary interventions. The aim of this study was to evaluate the effect of normal pregnancy on pulmonary function tests among pregnant women in Debre Berhan Referral Hospital, Ethiopia. Methods A total of 176 study participants (first, second, and third trimester; and control) were involved under a comparative cross-sectional study design and convenience sampling technique. Anthropometric data, oxygen saturation of arterial blood, and pulmonary function tests were measured. Data were tabulated and statistically analyzed using SPSS version 20.0 statistical software. Means of all parameters were compared using one-way ANOVA followed by Tukey’s post hoc multiple comparison test. Statistical significance was preset at a p-value of less than 0.05. Results Mean of FVC for the controls, first, second, and third trimesters was 2.59 ± 0.26, 2.13 ± 0.15, 1.93 ± 0.27, and 1.90 ± 0.11 liters, respectively. Except for FEV1%, the mean values of FVC, FEV1, PEFR, and FEF 25–75% in the pregnant group (all the three trimesters) were significantly decreased from the controls (P<0.05). Strong negative correlation was seen between SaO2 and RR (r= −0.865; P <0.01). As the pregnancy progressed from first to the third trimester, dynamic pulmonary function tests (FVC, FEV1, FEF25-75%, and PEFR) were dropped and the respiratory rate increased. Conclusion The results had shown the tendency of obstructive pattern while pregnancy becoming advanced. We have observed also a remarkable decline of SaO2 in pregnant women that might be counterbalanced by raised respiratory rate.
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Affiliation(s)
- Yosef Eshetie Amare
- Department of Biomedical Sciences, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Diresibachew Haile
- Department of Physiology, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Toussaint CM, Kenefick RW, Petrassi FA, Muza SR, Charkoudian N. Altitude, Acute Mountain Sickness, and Acetazolamide: Recommendations for Rapid Ascent. High Alt Med Biol 2020; 22:5-13. [PMID: 32975448 DOI: 10.1089/ham.2019.0123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Toussaint, Claudia M., Robert W. Kenefick, Frank A. Petrassi, Stephen R. Muza, and Nisha Charkoudian. Altitude, acute mountain sickness, and acetazolamide: recommendations for rapid ascent. High Alt Med Biol. 22:5-13, 2021. Background: Sea level natives ascending rapidly to altitudes above 1,500 m often develop acute mountain sickness (AMS), including nausea, headaches, fatigue, and lightheadedness. Acetazolamide (AZ), a carbonic anhydrase inhibitor, is a commonly used medication for the prevention and treatment of AMS. However, there is continued debate about appropriate dosing, particularly when considering rapid and physically demanding ascents to elevations above 3,500 m by emergency medical and military personnel. Aims: Our goal in the present analysis was to evaluate and synthesize the current literature regarding the use of AZ to determine the most effective dosing for prophylaxis and treatment of AMS for rapid ascents to elevations >3,500 m. These circumstances are specifically relevant to military and emergency medical personnel who often need to ascend rapidly and perform physically demanding tasks upon arrival at altitude. Methods: We conducted a literature search from April 2018 to February 2020 using PubMed, Google Scholar, and Web of Science to identify randomized controlled trials that compared AZ with placebo or other treatment with the primary endpoint of AMS incidence and severity. We included only research articles/studies that focused on evaluation of AZ use during rapid ascent. Results: Four doses of AZ (125, 250, 500, and 750 mg daily) were identified as efficacious in decreasing the incidence and/or severity of AMS during rapid ascents, with evidence of enhanced effectiveness with higher doses. Conclusions: For military, emergency medical, or other activities involving rapid ascent to altitudes >3,500 m, doses 500-750 mg/day within 24 hours of altitude exposure appear to be the most effective for minimizing symptoms of AMS.
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Affiliation(s)
- Claudia M Toussaint
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA.,Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Robert W Kenefick
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Frank A Petrassi
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Stephen R Muza
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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Goat Genomic Resources: The Search for Genes Associated with Its Economic Traits. Int J Genomics 2020; 2020:5940205. [PMID: 32904540 PMCID: PMC7456479 DOI: 10.1155/2020/5940205] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 11/25/2022] Open
Abstract
Goat plays a crucial role in human livelihoods, being a major source of meat, milk, fiber, and hides, particularly under adverse climatic conditions. The goat genomics related to the candidate gene approach is now being used to recognize molecular mechanisms that have different expressions of growth, reproductive, milk, wool, and disease resistance. The appropriate literature on this topic has been reviewed in this article. Several genetic characterization attempts of different goats have reported the existence of genotypic and morphological variations between different goat populations. As a result, different whole-genome sequences along with annotated gene sequences, gene function, and other genomic information of different goats are available in different databases. The main objective of this review is to search the genes associated with economic traits in goats. More than 271 candidate genes have been discovered in goats. Candidate genes influence the physiological pathway, metabolism, and expression of phenotypes. These genes have different functions on economically important traits. Some genes have pleiotropic effect for expression of phenotypic traits. Hence, recognizing candidate genes and their mutations that cause variations in gene expression and phenotype of an economic trait can help breeders look for genetic markers for specific economic traits. The availability of reference whole-genome assembly of goats, annotated genes, and transcriptomics makes comparative genomics a useful tool for systemic genetic upgradation. Identification and characterization of trait-associated sequence variations and gene will provide powerful means to give positive influences for future goat breeding program.
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Li Z, Li R, Xu Y, Xu Y. Study on the Oxygen Enrichment Effect of Individual Oxygen-Supply Device in a Tunnel of Plateau Mine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165934. [PMID: 32824194 PMCID: PMC7459575 DOI: 10.3390/ijerph17165934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/30/2022]
Abstract
Complex characteristics of the plateau environment such as low oxygen content seriously restrict the exploitation of abundant mineral resources in plateau areas. To regulate the hypoxia environment and improve the comfort of workers engaged in intense physical labor like tunnel excavation operations in plateau mines, an individual oxygen-supply device for tunnel of plateau mine was proposed to create local oxygen enrichment in the area around the human nose. The Computational Fluid Dynamics (CFD) method was used to judge the application’s effect of the individual oxygen-supply device in plateau mine, revealing the oxygen diffusion law under the influence of different oxygen enrichment factors. The orthogonal design and range analysis were used to measure the degree of influence of major factors such as oxygen-supply velocity, oxygen-supply concentration, and tunnel airflow velocity. The results demonstrate that the oxygen mass fraction of the air inhaled by the human had a positive correlation exponential function, a positive correlation linear function, and a negative correlation exponential function, respectively, concerning oxygen-supply velocity, oxygen-supply concentration, and tunnel airflow velocity. The range analysis revealed that the major influencing factors of oxygen enrichment in the tunnel of the plateau mine were, in a descending sequence, as follows: oxygen-supply concentration, tunnel airflow velocity, and oxygen-supply velocity, and the corresponding ranges were 2.86, 2.63, and 1.83, respectively. The individual oxygen-supply device achieved the best oxygen enrichment effect when the oxygen-supply velocity was 5 m/s, the oxygen-supply concentration was 60%, and the tunnel airflow velocity was 0.2 m/s, which increased the oxygen mass fraction of air inhaled by the human to 30.42%. This study has a positive guiding significance for the improvement of the respiration environment in the tunnel of plateau mine.
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Sharma P, Tulsawani R. Ganoderma lucidum aqueous extract prevents hypobaric hypoxia induced memory deficit by modulating neurotransmission, neuroplasticity and maintaining redox homeostasis. Sci Rep 2020; 10:8944. [PMID: 32488040 PMCID: PMC7265456 DOI: 10.1038/s41598-020-65812-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 05/11/2020] [Indexed: 02/04/2023] Open
Abstract
Oxidative stress due to hypobaric hypoxia at extreme altitudes causes severe neuronal damage and irreversible cognitive loss. Owing to contraindications of current drug therapies, the aim of the study was to investigate memory enhancing potential of aqueous extract of Ganoderma lucidum (GLAQ) and underlying neuroprotective mechanism using rat hypobaric hypoxia test model. Rats exposed to hypobaric hypoxia showed deranged spatial memory in morris water maze test with hippocampal damage and vasogenic cerebral edema. All these changes were prevented with GLAQ treatment. Blood and biochemical analysis revealed activation of hypoxic ventilatory response, red blood cells induction, reversal of electrolyte and redox imbalance, and restoration of cellular bioenergetic losses in GLAQ treated animals. Notably, GLAQ treatment ameliorated levels of neurotransmitters (catecholamines, serotonin, glutamate), prevented glucocorticoid and α-synuclein surge, improved neuroplasticity by upregulating CREB/p-CREB/BDNF expression via ERK1/ERK2 induction. Further, restoration of nuclear factor erythroid 2-related factor with stabilization of hypoxia inducible factors and inflammatory markers were evidenced in GLAQ treated rats which was additionally established in gene reporter array using an alternative HT22 cell test model. Conclusively, our studies provide novel insights into systemic to molecular level protective mechanism by GLAQ in combating hypobaric hypoxia induced oxidative stress and memory impairment.
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Affiliation(s)
- Purva Sharma
- Defence Institute of Physiology and Allied Sciences (DIPAS), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Rajkumar Tulsawani
- Defence Institute of Physiology and Allied Sciences (DIPAS), Lucknow Road, Timarpur, Delhi, 110054, India.
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Solaimanzadeh I. Acetazolamide, Nifedipine and Phosphodiesterase Inhibitors: Rationale for Their Utilization as Adjunctive Countermeasures in the Treatment of Coronavirus Disease 2019 (COVID-19). Cureus 2020; 12:e7343. [PMID: 32226695 PMCID: PMC7096066 DOI: 10.7759/cureus.7343] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Effective treatments for Coronavirus Disease 2019 (COVID-19) outbreak are urgently needed. While anti-viral approaches and vaccines are being considered immediate countermeasures are unavailable. The aim of this article is to outline a perspective on the pathophysiology of COVID-19 in the context of the currently available clinical data published in the literature. This article appreciates clinical data published on COVID-19 in the context of another respiratory illness - high altitude pulmonary edema (HAPE). Both conditions have significant similarities that portend pathophysiologic trajectories. Following this potential treatment options emerge. Both COVID-19 and HAPE exhibit a decreased ratio of arterial oxygen partial pressure to fractional inspired oxygen with concomitant hypoxia and tachypnea. There also appears to be a tendency for low carbon dioxide levels in both as well. Radiologic findings of ground glass opacities are present in up to 86% of patients with COVID-19 in addition to patchy infiltrates. Patients with HAPE also exhibit patchy infiltrates throughout the pulmonary fields, often in an asymmetric pattern and CT findings reveal increased lung markings and ground glass-like changes as well. Widespread ground-glass opacities are most commonly a manifestation of hydrostatic pulmonary edema. Similarly, elevated fibrinogen levels in both conditions are likely an epiphenomenon of edema formation rather than coagulation activation. Autopsy results of a COVID-19 fatality revealed bilateral diffuse alveolar damage associated with pulmonary edema, pro-inflammatory concentrates, and indications of early-phase acute respiratory distress syndrome (ARDS). HAPE itself is initially caused by an increase in pulmonary capillary pressure and induces altered alveolar-capillary permeability via high pulmonary artery hydrostatic pressures that lead to a protein-rich and mildly hemorrhagic edema. It appears that COVID-19 and HAPE both discretely converge on ARDS. In light of this, a countermeasure that has been shown to be effective in the analogous condition of HAPE is Acetazolamide. Acetazolamide has a myriad of effects on different organ systems, potently reduces hypoxic pulmonary vasoconstriction, improves minute ventilation and expired vital capacity. Other therapeutics to consider that are also directed towards decreased pulmonary pressure include Nifedipine and Phosphodiesterase inhibitors. This review describes COVID-19 in parallel to HAPE. Deranged respiratory parameters that are present in both conditions are highlighted. The utilization of medications found to be effective in HAPE, for the treatment of COVID-19, is proposed. Given the medical emergency of a growing contagion and the thousands of lives at stake, expedient attempts to improve survival are needed. Acetazolamide, Nifedipine and Phosphodiesterase inhibitors may be potential countermeasures.
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Behera J, Nagarajan S, Saran U, Kumar R, Keshri GK, Suryakumar G, Chatterjee S. Nitric oxide restores peripheral blood mononuclear cell adhesion against hypoxia via NO-cGMP signalling. Cell Biochem Funct 2020; 38:319-329. [PMID: 31989682 DOI: 10.1002/cbf.3502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/01/2019] [Accepted: 12/12/2019] [Indexed: 11/10/2022]
Abstract
Hypoxia is the most detrimental threat to humans residing at high altitudes, affecting multifaceted cellular responses that are crucial for normal homeostasis. Inhalation of nitric oxide has been successfully implemented to combat the hypoxia effect in the high altitude patients. We hypothesize that nitric oxide (NO) restores the peripheral blood mononuclear cell-matrix deadhesion during hypoxia. In the present study, we investigate the cellular action of exogenous NO in the hypoxia-mediated diminution of cell-matrix adhesion of PBMNC and NO bioavailability in vitro. The result showed that NO level and cell-matrix adhesion of PBMNC were significantly reduced in hypoxia as compared with normoxia, as assessed by the DAF-FM and cell adhesion assay, respectively. In contrast, cellular oxidative damage response was indeed upregulated in hypoxic PBMNC. Further, gene expression analysis revealed that mRNA transcripts of cell adhesion molecules (Integrin α5 and β1) and eNOS expressions were significantly downregulated. The mechanistic study revealed that administration of NO and 8-Br-cGMP and overexpression of eNOS-GFP restored the basal NO level and recovers cell-matrix adhesion in PBMNC via cGMP-dependent protein kinase I (PKG I) signalling. In conclusion, NO-cGMP/PKG signalling may constitute a novel target to recover high altitude-afflicted cellular deadhesion. SIGNIFICANCE OF THIS STUDY: Cellular adhesion is a complex multistep process. The ability of cells to adhere to extracellular matrix is an essential physiological process for normal homeostasis and function. Hypoxia exposure in the PBMNC culture has been proposed to induce oxidative damage and cellular deadhesion and is generally believed to be the key factor in the reduction of NO bioavailability. In the present study, we demonstrated that NO donor or overexpression of eNOS-GFP has a protective effect against hypoxia-induced cellular deadhesion and greatly improves the redox balance by inhibiting the oxidative stress. Furthermore, this protective effect of NO is mediated by the NO-cGMP/PKG signal pathway, which may provide a potential strategy against hypoxia.
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Affiliation(s)
- Jyotirmaya Behera
- Vascular Biology Lab, AU-KBC Research Centre, MIT Campus of Anna University, Chennai, India
| | - Shunmugam Nagarajan
- Vascular Biology Lab, AU-KBC Research Centre, MIT Campus of Anna University, Chennai, India
| | - Uttara Saran
- Department of Biotechnology, Anna University, Chennai, India
| | - Ravi Kumar
- Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Gaurav K Keshri
- Defence Institute of Physiology and Allied Sciences, Delhi, India
| | | | - Suvro Chatterjee
- Vascular Biology Lab, AU-KBC Research Centre, MIT Campus of Anna University, Chennai, India.,Department of Biotechnology, Anna University, Chennai, India
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Sharma P, Tulsawani R, Agrawal U. Pharmacological effects of Ganoderma lucidum extract against high-altitude stressors and its subchronic toxicity assessment. J Food Biochem 2019; 43:e13081. [PMID: 31609024 DOI: 10.1111/jfbc.13081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/11/2022]
Abstract
Acclimatization is a major pathophysiological concern during ascent to high altitude and may cause mortality in unacclimatized individuals. Absence of target drugs, especially prophylactics, emphasizes the need for development of herbal agents. Present study revealed that animals pre-administered with aqueous extract of Ganoderma lucidum (GLAQ) dose dependently (50, 100, 200 mg/kg) delayed onset of convulsion following severe hypoxia (SH) and restored rectal temperature post-cold restraint (CR) and hypobaric hypoxia (HBH). The compromised antioxidant status (MDA, GSH, SOD, GPx), biochemical (ALT, AST, glucose, triglycerides, cholesterol, urea), and hematological parameters (red blood cells, white blood cells) were ameliorated with GLAQ treatment. Further, extract modulated inflammatory and thermogenic response by attenuating pro-inflammatory cytokines (NFĸB, TNFα, IL6) and restoring UCP1, SIRT1, respectively. Notably, extract did not produce any noxious effects subchronically in rats of both sexes with GLAQ administered at 100, 500, and 1,000 mg/kg in a single dose/day for 90 days, deeming it fit for therapeutic purpose. PRACTICAL APPLICATIONS: GLAQ exhibited better efficacy compared to internal control (gallic acid) suggest that array of bioactive compounds in extract might contribute toward efficacy. Further, antistress properties of GLAQ against multiple stressors including SH, CR, and HBH demonstrate its therapeutic potential for inducing rapid acclimatization and preventing mountain sickness. Conclusively, the present study based on Ganoderma lucidum extract intents to fill the lacunae behind development of nontoxic therapeutic agent for controlling high altitude-related maladies.
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Affiliation(s)
- Purva Sharma
- Department of Biochemical Sciences, Defence Institute of Physiology and Allied Sciences (DIPAS), Delhi, India
| | - Rajkumar Tulsawani
- Department of Biochemical Sciences, Defence Institute of Physiology and Allied Sciences (DIPAS), Delhi, India
| | - Usha Agrawal
- Department of Histopathology, ICMR-National Institute of Pathology, New Delhi, India
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Urrunaga-Pastor D, Runzer-Colmenares FM, Arones TM, Meza-Cordero R, Taipe-Guizado S, Guralnik JM, Parodi JF. Factors associated with poor physical performance in older adults of 11 Peruvian high Andean communities. F1000Res 2019; 8:59. [PMID: 30906536 PMCID: PMC6415321 DOI: 10.12688/f1000research.17513.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.
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Affiliation(s)
- Diego Urrunaga-Pastor
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, 15024, Peru
| | - Fernando M Runzer-Colmenares
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru.,Bamboo Seniors Health Services, Lima, 15038, Peru.,Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, 15067, Peru
| | - Tania M Arones
- Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Universidad de San Martín de Porres, Lima, 15024, Peru
| | - Rosario Meza-Cordero
- Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Universidad de San Martín de Porres, Lima, 15024, Peru
| | - Silvana Taipe-Guizado
- Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Universidad de San Martín de Porres, Lima, 15024, Peru
| | - Jack M Guralnik
- University of Maryland, School of Medicine, Baltimore, Maryland, 21211, USA
| | - Jose F Parodi
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru.,Bamboo Seniors Health Services, Lima, 15038, Peru
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Salivary proteome patterns of individuals exposed to High Altitude. Arch Oral Biol 2018; 96:104-112. [DOI: 10.1016/j.archoralbio.2018.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/09/2018] [Accepted: 09/05/2018] [Indexed: 11/18/2022]
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Kabel AM, Al Thumali AM, Aldowiala KA, Habib RD, Aljuaid SS, Alharthi HA. Sleep disorders in adolescents and young adults: Insights into types, relationship to obesity and high altitude and possible lines of management. Diabetes Metab Syndr 2018; 12:777-781. [PMID: 29673929 DOI: 10.1016/j.dsx.2018.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023]
Abstract
A sleep disorder is a medical disorder of the sleep pattern of a person that may be serious enough to interfere with normal physical, mental and emotional functioning. Disruptions in sleep can be caused by a variety of causes, from teeth grinding to night terrors. Sleep disorders are usually prevalent among adolescents and young adults, possibly due to factors related to life style, dietary habits, hormonal and emotional disturbances. Other factors that may precipitate sleep disorders include environmental, psychological and genetic factors. Sleep disorders may lead to serious psychological and mood disorders and may even affect the immune system. Management of sleep disorders depends on amelioration of the precipitating factors and the use of certain drugs that may help to restore the normal sleep-wake cycle. This review sheds light on sleep disorders in adolescents and young adults regarding their types, etiology, dangers and possible lines of management.
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Affiliation(s)
- Ahmed M Kabel
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia; Pharmacology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | | | | | - Raghad D Habib
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Shoroq S Aljuaid
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Huda A Alharthi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
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Sultana S, Talegaonkar S, Ray B, Singh H, Ahmad FJ, Mittal G, Bhatnagar A. Formulation development and evaluation of nifedipine as pylorospasm inhibitor. Drug Dev Ind Pharm 2018; 44:1171-1184. [DOI: 10.1080/03639045.2018.1438464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Bhaskar Ray
- Department of Pharmaceutics, Jamia Hamdard, Delhi, India
| | | | - F. J. Ahmad
- Department of Pharmaceutics, Jamia Hamdard, Delhi, India
| | - Gaurav Mittal
- Department of Pharmaceutics, Jamia Hamdard, Delhi, India
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Kabel AM, Al Thumali AM, Aldowiala KA, Habib RD, Aljuaid SS. Sleep disorders in a sample of students in Taif University, Saudi Arabia: The role of obesity, insulin resistance, anemia and high altitude. Diabetes Metab Syndr 2018; 12:549-554. [PMID: 29622472 DOI: 10.1016/j.dsx.2018.03.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to assess the incidence of sleep disorders and excessive daytime sleepiness (EDS) among Taif University students and to explore the precipitating factors of these disorders. METHODS This study was carried out on 1066 students in Taif University of both sexes aging from 18 to 25 years. All included individuals were subjected to full history taking and thorough clinical examination, with special concern on anthropometric measurements (weight, height, waist-to-hip ratio and body mass index). Also, fasting blood glucose, fasting serum insulin, homeostatic model assessment (HOMA) index and blood hemoglobin levels were measured. Sleep disorders were assessed using sleep disturbances scale and the Epworth sleepiness scale. RESULTS The overall incidence of sleep disorders and EDS was 31.33% and 15.29% respectively with statistically significant prevalence in females than males. There was significant positive correlation between sleep disturbances scale and Epworth sleepiness scale on one hand and body weight, body mass index, waist-to-hip ratio, the height of the residence place above the sea level, fasting and post-prandial blood glucose, fasting serum insulin and HOMA index on the other hand. Also, there was significant negative correlation between sleep disturbances scale and Epworth sleepiness scale on one hand and blood hemoglobin levels on the other hand. CONCLUSION Sleep disorders and EDS in Taif University students were precipitated by high altitude, anemia, obesity and glucose intolerance. Control of these factors may have a positive impact on the incidence of sleep disorders and EDS in this age group.
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Affiliation(s)
- Ahmed M Kabel
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia; Pharmacology Department, Faculty of medicine, Tanta University, Tanta, Egypt.
| | | | | | - Raghad D Habib
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Shoroq S Aljuaid
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
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Khanna K, Mishra KP, Ganju L, Kumar B, Singh SB. High-Altitude-Induced alterations in Gut-Immune Axis: A review. Int Rev Immunol 2017; 37:119-126. [PMID: 29231767 DOI: 10.1080/08830185.2017.1407763] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
High-altitude sojourn above 8000 ft is increasing day by day either for pilgrimage, mountaineering, holidaying or for strategic reasons. In India, soldiers are deployed to these high mountains for their duty or pilgrims visit to the holy places, which are located at very high altitude. A large population also resides permanently in high altitude regions. Every year thousands of pilgrims visit Holy cave of Shri Amarnath ji, which is above 15 000 ft. The poor acclimatization to high altitude may cause alteration in immunity. The low oxygen partial pressure may cause alterations in gut microbiota, which may cause changes in gut immunity. Effect of high altitude on gut-associated mucosal system is new area of research. Many studies have been carried out to understand the physiology and immunology behind the high-altitude-induced gut problems. Few interventions have also been discovered to circumvent the problems caused due to high-altitude conditions. In this review, we have discussed the effects of high-altitude-induced changes in gut immunity particularly peyer's patches, NK cells and inflammatory cytokines, secretary immunoglobulins and gut microbiota. The published articles from PubMed and Google scholar from year 1975 to 2017 on high-altitude hypoxia and gut immunity are cited in this review.
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Affiliation(s)
- Kunjan Khanna
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - K P Mishra
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Lilly Ganju
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Bhuvnesh Kumar
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Shashi Bala Singh
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
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Horner A, Soriano JB, Puhan MA, Studnicka M, Kaiser B, Vanfleteren LEGW, Gnatiuc L, Burney P, Miravitlles M, García-Rio F, Ancochea J, Menezes AM, Perez-Padilla R, Montes de Oca M, Torres-Duque CA, Caballero A, González-García M, Buist S, Flamm M, Lamprecht B. Altitude and COPD prevalence: analysis of the PREPOCOL-PLATINO-BOLD-EPI-SCAN study. Respir Res 2017; 18:162. [PMID: 28835234 PMCID: PMC5569455 DOI: 10.1186/s12931-017-0643-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/13/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND COPD prevalence is highly variable and geographical altitude has been linked to it, yet with conflicting results. We aimed to investigate this association, considering well known risk factors. METHODS A pooled analysis of individual data from the PREPOCOL-PLATINO-BOLD-EPI-SCAN studies was used to disentangle the population effect of geographical altitude on COPD prevalence. Post-bronchodilator FEV1/FVC below the lower limit of normal defined airflow limitation consistent with COPD. High altitude was defined as >1500 m above sea level. Undiagnosed COPD was considered when participants had airflow limitation but did not report a prior diagnosis of COPD. RESULTS Among 30,874 participants aged 56.1 ± 11.3 years from 44 sites worldwide, 55.8% were women, 49.6% never-smokers, and 12.9% (3978 subjects) were residing above 1500 m. COPD prevalence was significantly lower in participants living at high altitude with a prevalence of 8.5% compared to 9.9%, respectively (p < 0.005). However, known risk factors were significantly less frequent at high altitude. Hence, in the adjusted multivariate analysis, altitude itself had no significant influence on COPD prevalence. Living at high altitude, however, was associated with a significantly increased risk of undiagnosed COPD. Furthermore, subjects with airflow limitation living at high altitude reported significantly less respiratory symptoms compared to subjects residing at lower altitude. CONCLUSION Living at high altitude is not associated with a difference in COPD prevalence after accounting for individual risk factors. However, high altitude itself was associated with an increased risk of undiagnosed COPD.
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Affiliation(s)
- Andreas Horner
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Joan B. Soriano
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Michael Studnicka
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Kaiser
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
| | - Lowie E. G. W. Vanfleteren
- Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Louisa Gnatiuc
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
| | - Peter Burney
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
| | - Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d’Hebron. Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Francisco García-Rio
- Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ. Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Julio Ancochea
- Servicio de Neumología, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana M. Menezes
- Programa de Pós-Graduacão em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Rogelio Perez-Padilla
- Institute of Respiratory Diseases, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Maria Montes de Oca
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Carlos A. Torres-Duque
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
| | - Andres Caballero
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
- Clínica Reina Sofía, Bogotá, Colombia
| | | | - Sonia Buist
- Oregon Health and Science University, Portland, Oregon USA
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Bernd Lamprecht
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
| | - for the BOLD Collaborative Research Group
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
- Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
- Servicio de Neumología, Hospital Universitari Vall d’Hebron. Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
- Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ. Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Programa de Pós-Graduacão em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
- Institute of Respiratory Diseases, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
- Clínica Reina Sofía, Bogotá, Colombia
- Oregon Health and Science University, Portland, Oregon USA
| | - the EPI-SCAN Team
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
- Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
- Servicio de Neumología, Hospital Universitari Vall d’Hebron. Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
- Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ. Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Programa de Pós-Graduacão em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
- Institute of Respiratory Diseases, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
- Clínica Reina Sofía, Bogotá, Colombia
- Oregon Health and Science University, Portland, Oregon USA
| | - the PLATINO Team
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
- Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
- Servicio de Neumología, Hospital Universitari Vall d’Hebron. Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
- Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ. Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Programa de Pós-Graduacão em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
- Institute of Respiratory Diseases, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
- Clínica Reina Sofía, Bogotá, Colombia
- Oregon Health and Science University, Portland, Oregon USA
| | - the PREPOCOL Study Group
- Department of Pulmonary Medicine, Kepler University Hospital, Krankenhausstrasse 9, A4021 Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
- Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Respiratory Epidemiology and Public Health, Imperial College, London, UK
- Servicio de Neumología, Hospital Universitari Vall d’Hebron. Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
- Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ. Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Programa de Pós-Graduacão em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
- Institute of Respiratory Diseases, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia
- Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia
- Clínica Reina Sofía, Bogotá, Colombia
- Oregon Health and Science University, Portland, Oregon USA
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Akunov AC, Sartmyrzaeva MA, Maripov AM, Muratali Uulu K, Mamazhakypov AT, Sydykov AS, Sarybaev AS. High Altitude Pulmonary Edema in a Mining Worker With an Abnormal Rise in Pulmonary Artery Pressure in Response to Acute Hypoxia Without Prior History of High Altitude Pulmonary Edema. Wilderness Environ Med 2017; 28:234-238. [PMID: 28673745 DOI: 10.1016/j.wem.2017.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/11/2017] [Accepted: 04/01/2017] [Indexed: 12/01/2022]
Abstract
High altitude pulmonary edema (HAPE) is a potentially life-threatening form of noncardiogenic pulmonary edema that may develop in otherwise healthy individuals upon ascent to high altitude. A constitutional susceptibility has been noted in some individuals, whereas others appear not to be susceptible at all. In our report, we present a case of HAPE triggered by concurrent respiratory tract infection and strenuous exercise in a mining worker with an abnormal rise in pulmonary artery pressure in response to acute hypoxia, without a prior history of HAPE during almost a year of commuting between high altitude and lowland areas.
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Affiliation(s)
- Almaz Ch Akunov
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Kyrgyz-Indian Mountain Biomedical Research Center, Bishkek, Kyrgyzstan (Drs Akunov, Sartmyrzaeva, Maripov, Muratali uulu, and Sarybaev)
| | - Meerim A Sartmyrzaeva
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Kyrgyz-Indian Mountain Biomedical Research Center, Bishkek, Kyrgyzstan (Drs Akunov, Sartmyrzaeva, Maripov, Muratali uulu, and Sarybaev)
| | - Abdirashit M Maripov
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Kyrgyz-Indian Mountain Biomedical Research Center, Bishkek, Kyrgyzstan (Drs Akunov, Sartmyrzaeva, Maripov, Muratali uulu, and Sarybaev)
| | - Kubatbek Muratali Uulu
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Kyrgyz-Indian Mountain Biomedical Research Center, Bishkek, Kyrgyzstan (Drs Akunov, Sartmyrzaeva, Maripov, Muratali uulu, and Sarybaev)
| | - Argen T Mamazhakypov
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Department of Internal Medicine, University of Giessen and Marburg Lung Center (UGMLC), Justus Liebig University of Giessen, Giessen, Germany (Drs Mamazhakypov and Sydykov)
| | - Akylbek S Sydykov
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Department of Internal Medicine, University of Giessen and Marburg Lung Center (UGMLC), Justus Liebig University of Giessen, Giessen, Germany (Drs Mamazhakypov and Sydykov)
| | - Akpay Sh Sarybaev
- Department of Mountain and Sleep Medicine and Pulmonary Hypertension, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan (Drs. Akunov, Sartmyrzaeva, Maripov, Muratali uulu, Mamazhakypov, Sydykov, and Sarybaev); Kyrgyz-Indian Mountain Biomedical Research Center, Bishkek, Kyrgyzstan (Drs Akunov, Sartmyrzaeva, Maripov, Muratali uulu, and Sarybaev).
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Liu B, Huang H, Wu G, Xu G, Sun BD, Zhang EL, Chen J, Gao YQ. A Signature of Circulating microRNAs Predicts the Susceptibility of Acute Mountain Sickness. Front Physiol 2017; 8:55. [PMID: 28228730 PMCID: PMC5296306 DOI: 10.3389/fphys.2017.00055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/23/2017] [Indexed: 12/21/2022] Open
Abstract
Background: Acute mountain sickness (AMS) is a common disabling condition in individuals experiencing high altitudes, which may progress to life-threatening high altitude cerebral edema. Today, no established biomarkers are available for prediction the susceptibility of AMS. MicroRNAs emerge as promising sensitive and specific biomarkers for a variety of diseases. Thus, we sought to identify circulating microRNAs suitable for prediction the susceptible of AMS before exposure to high altitude. Methods: We enrolled 109 healthy man adults and collected blood samples before their exposure to high altitude. Then we took them to an elevation of 3648 m for 5 days. Circulating microRNAs expression was measured by microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). AMS was defined as Lake Louise score ≥3 and headache using Lake Louise Acute Mountain Sickness Scoring System. Results: A total of 31 microRNAs were differentially expressed between AMS and Non-AMS groups, 15 up-regulated and 16 down-regulated. Up-regulation of miR-369-3p, miR-449b-3p, miR-136-3p, and miR-4791 in patients with AMS compared with Non-AMS individuals were quantitatively confirmed using qRT-PCR (all, P < 0.001). With multiple logistic regression analysis, a unique signature encompassing miR-369-3p, miR-449b-3p, and miR-136-3p discriminate AMS from Non-AMS (area under the curve 0.986, 95%CI 0.970–1.000, P < 0.001, LR+: 14.21, LR–: 0.08). This signature yielded a 92.68% sensitivity and a 93.48% specificity for AMS vs. Non-AMS. Conclusion: The study here, for the first time, describes a signature of three circulating microRNAs as a robust biomarker to predict the susceptibility of AMS before exposure to high altitude.
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Affiliation(s)
- Bao Liu
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - He Huang
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Gang Wu
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Gang Xu
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Bing-Da Sun
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Er-Long Zhang
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Jian Chen
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
| | - Yu-Qi Gao
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of EducationChongqing, China; Key Laboratory of High Altitude Medicine, PLAChongqing, China
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Bui SBD, Petersen T, Poulsen JN, Gazerani P. Simulated airplane headache: a proxy towards identification of underlying mechanisms. J Headache Pain 2017; 18:9. [PMID: 28130626 PMCID: PMC5272852 DOI: 10.1186/s10194-017-0724-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 01/17/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Airplane Headache (AH) occurs during flights and often appears as an intense, short lasting headache during take-off or landing. Reports are limited on pathological mechanisms underlying the occurrence of this headache. Proper diagnosis and treatments would benefit from identification of potential pathways involved in AH pathogenesis. This study aimed at providing a simulated airplane headache condition as a proxy towards identification of its underlying mechanisms. METHODS Fourteen participants including 7 volunteers suffering from AH and 7 healthy matched controls were recruited after meeting the diagnostic and safety criteria based on an approved study protocol. Simulation of AH was achieved by entering a pressure chamber with similar characteristics of an airplane flight. Selected potential biomarkers including salivary prostaglandin E2 (PGE2), cortisol, facial thermo-images, blood pressure, pulse, and saturation pulse oxygen (SPO) were defined and values were collected before, during and after flight simulation in the pressure chamber. Salivary samples were analyzed with ELISA techniques, while data analysis and statistical tests were handled with SPSS version 22.0. RESULTS All participants in the AH-group experienced a headache attack similar to AH experience during flight. The non-AH-group did not experience any headaches. Our data showed that the values for PGE2, cortisol and SPO were significantly different in the AH-group in comparison with the non-AH-group during the flight simulation in the pressure chamber. CONCLUSION The pressure chamber proved useful not only to provoke AH-like attack but also to study potential biomarkers for AH in this study. PGE2, and cortisol levels together with SPO presented dysregulation during the simulated AH-attack in affected individuals compared with healthy controls. Based on these findings we propose to use pressure chamber as a model to induce AH, and thus assess new potential biomarkers for AH in future studies.
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Affiliation(s)
- Sebastian Bao Dinh Bui
- SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Torben Petersen
- SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Jeppe Nørgaard Poulsen
- SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Parisa Gazerani
- SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
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Li S, Wang Y, Huang X, Cao J, Yang D. Diffuse alveolar hemorrhage from systemic lupus erythematosus misdiagnosed as high altitude pulmonary edema. High Alt Med Biol 2016; 16:67-70. [PMID: 25803143 DOI: 10.1089/ham.2014.1094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
UNLABELLED A 26-year-old woman presented with dyspnea and dry cough soon after arriving on the Qinghai-Tibet Plateau (3650 m). Chest radiograph showed diffuse patchy infiltrates. The initial diagnosis was high altitude pulmonary edema (HAPE). However, the patient had no sputum or moist rales, and supplemental oxygen and intravenous aminophylline produced no improvement. Chest HRCT revealed symmetric and diffuse ground glass opacities. Further examination found anemia, leukopenia, urine abnormalities, and increased erythrocyte sedimentation rate. Antibodies for ds-DNA and ANA were positive. Hemoptysis and arthralgia developed after a few days. Finally the patient was diagnosed with diffuse alveolar hemorrhage secondary to systemic lupus erythemetosus. CONCLUSION When considering a diagnosis of HAPE, careful attention to physical signs, and a clinical course that is atypical for HAPE should prompt evaluation for other disease processes; HRCT can be useful in this setting.
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Affiliation(s)
- Suzhi Li
- Department of High Altitude Disease, Xizang Military General Hospital , Lhasa City, Tibet, China
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Song S, Yao N, Yang M, Liu X, Dong K, Zhao Q, Pu Y, He X, Guan W, Yang N, Ma Y, Jiang L. Exome sequencing reveals genetic differentiation due to high-altitude adaptation in the Tibetan cashmere goat (Capra hircus). BMC Genomics 2016; 17:122. [PMID: 26892324 PMCID: PMC4758086 DOI: 10.1186/s12864-016-2449-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/09/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Tibetan cashmere goat (Capra hircus), one of the most ancient breeds in China, has historically been a critical source of meat and cashmere production for local farmers. To adapt to the high-altitude area, extremely harsh climate, and hypoxic environment that the Tibetan cashmere goat lives in, this goat has developed distinct phenotypic traits compared to lowland breeds. However, the genetic components underlying this phenotypic adaptation remain largely unknown. RESULTS We obtained 118,700 autosomal SNPs through exome sequencing of 330 cashmere goats located at a wide geographic range, including the Tibetan Plateau and low-altitude regions in China. The great majority of SNPs showed low genetic differentiation among populations; however, approximately 2-3% of the loci showed more genetic differentiation than expected under a selectively neutral model. Together with a combined analysis of high- and low-altitude breeds, we revealed 339 genes potentially under high-altitude selection. Genes associated with cardiovascular system development were significantly enriched in our study. Among these genes, the most evident one was endothelial PAS domain protein 1 (EPAS1), which has been previously reported to be involved in complex oxygen sensing and significantly associated with high-altitude adaptation of human, dog, and grey wolf. The missense mutation Q579L that we identified in EPAS1, which occurs next to the Hypoxia-Inducible Factor-1 (HIF-1) domain, was exclusively enriched in the high-altitude populations. CONCLUSIONS Our study provides insights concerning the population variation in six different cashmere goat populations in China. The variants in cardiovascular system-related genes may explain the observed phenotypic adaptation of the Tibetan cashmere goat.
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Affiliation(s)
- Shen Song
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
- Department of Animal Genetics and Breeding, China Agricultural University, Beijing, 100094, China.
| | - Na Yao
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Min Yang
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Xuexue Liu
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Kunzhe Dong
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Qianjun Zhao
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Yabin Pu
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Xiaohong He
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Weijun Guan
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Ning Yang
- Department of Animal Genetics and Breeding, China Agricultural University, Beijing, 100094, China.
| | - Yuehui Ma
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
| | - Lin Jiang
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing, 100193, China.
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Anderson PJ, Wiste HJ, Ostby SA, Miller AD, Ceridon ML, Johnson BD. Sleep disordered breathing and acute mountain sickness in workers rapidly transported to the South Pole (2835 m). Respir Physiol Neurobiol 2015; 210:38-43. [PMID: 25655218 DOI: 10.1016/j.resp.2015.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/13/2015] [Accepted: 01/21/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sleep disordered breathing may be a risk factor for high altitude illness. Past Antarctic sleep studies suggest that rapid transport from sea level (SL) to the Amundsen Scott South Pole Station (SP, 2835 m) increases risk of Acute Mountain Sickness (AMS). We analyzed sleep studies in 38 healthy polar workers to explore the association between sleep disordered breathing and AMS after rapid transport to the South Pole. METHODS Subjects completed a baseline questionnaire, performed basic physiology tests, and were evaluated for AMS and medication use using an extended Lake Louise Questionnaire (LLQ) during their first week at the South Pole. Participants were included in this study if they took no medications and underwent polysomnography on their first nights at Sea Level and the South Pole using the Vivometrics LifeShirt(®). Within group changes were assessed with Wilcoxon signed rank tests and between group differences were assessed with Kruskal-Wallis rank sum tests. RESULTS Overall, 21/38 subjects met criteria for AMS at some time on or prior to the third morning at the South Pole. Subjective poor sleep quality was reported by both AMS (65%) and no AMS (41%) groups. The Apnea Hypopnea Index (AHI) increased significantly in both the AMS and no AMS groups, but the difference in the increase between the two groups was not statistically significant. Increased AHI was not associated with increased AMS symptoms. Previous altitude illness (p=0.06) and residence at low altitudes (p = 0.02) were risk factors for AMS. CONCLUSION AMS was not significantly associated with sleep architecture changes or increased AHI. However, AHI sharply increased at South Pole (19/38 participants) primarily due to central apneas. Those developing AMS were more likely to have experienced previous problems at altitude and reported living at lowland altitudes within the 3 months prior to rapid transport to the South Pole than those without AMS.
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Affiliation(s)
| | - H J Wiste
- Mayo Clinic, Rochester, MN, United States
| | - S A Ostby
- Mayo Clinic, Rochester, MN, United States
| | - A D Miller
- Mayo Clinic, Rochester, MN, United States
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Exogenous sphingosine-1-phosphate boosts acclimatization in rats exposed to acute hypobaric hypoxia: assessment of haematological and metabolic effects. PLoS One 2014; 9:e98025. [PMID: 24887065 PMCID: PMC4041657 DOI: 10.1371/journal.pone.0098025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 04/27/2014] [Indexed: 12/31/2022] Open
Abstract
Background The physiological challenges posed by hypobaric hypoxia warrant exploration of pharmacological entities to improve acclimatization to hypoxia. The present study investigates the preclinical efficacy of sphingosine-1-phosphate (S1P) to improve acclimatization to simulated hypobaric hypoxia. Experimental Approach Efficacy of intravenously administered S1P in improving haematological and metabolic acclimatization was evaluated in rats exposed to simulated acute hypobaric hypoxia (7620m for 6 hours) following S1P pre-treatment for three days. Major Findings Altitude exposure of the control rats caused systemic hypoxia, hypocapnia (plausible sign of hyperventilation) and respiratory alkalosis due to suboptimal renal compensation indicated by an overt alkaline pH of the mixed venous blood. This was associated with pronounced energy deficit in the hepatic tissue along with systemic oxidative stress and inflammation. S1P pre-treatment improved blood oxygen-carrying-capacity by increasing haemoglobin, haematocrit, and RBC count, probably as an outcome of hypoxia inducible factor-1α mediated erythropoiesis and renal S1P receptor 1 mediated haemoconcentation. The improved partial pressure of oxygen in the blood could further restore aerobic respiration and increase ATP content in the hepatic tissue of S1P treated animals. S1P could also protect the animals from hypoxia mediated oxidative stress and inflammation. Conclusion The study findings highlight S1P’s merits as a preconditioning agent for improving acclimatization to acute hypobaric hypoxia exposure. The results may have long term clinical application for improving physiological acclimatization of subjects venturing into high altitude for occupational or recreational purposes.
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Koul PA, Khan UH, Hussain T, Koul AN, Malik S, Shah S, Bazaz SR, Rashid W, Jan RA. High altitude pulmonary edema among "Amarnath Yatris". Lung India 2013; 30:193-8. [PMID: 24049253 PMCID: PMC3775198 DOI: 10.4103/0970-2113.116254] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Annual pilgrimage (Yatra) to the cave shrine of Shri Amarnath Ji' is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft) in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. MATERIALS AND METHODS More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft). The clinical features and the response to treatment were recorded. RESULTS Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41) had presented with acute onset breathlessness of 1-4 days (median 1.9 d) starting within 12-24 h of a rapid ascent; accompanied by cough (68%), headache (8%), dizziness and nausea (65%). Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea (n = 31), tachycardia (n = 23), bilateral chest rales (n = 29), cyanosis (n = 22) and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation (n = 3). Three patients died due to multiorgan dysfunction. CONCLUSIONS Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.
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Affiliation(s)
- Parvaiz A Koul
- Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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