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Duenas-Meza E, Severiche-Bueno DF, Santos Quintero C, Talani Ochoa J, Ronderos Dummit M, Stapper C, Granados G C. Prevalence of pulmonary hypertension in children with obstructive sleep apnea living at high altitude. Sleep Med X 2024; 7:100106. [PMID: 38356659 PMCID: PMC10864626 DOI: 10.1016/j.sleepx.2024.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction The prevalence of obstructive sleep apnea (OSA) is 1-4 %. Some reports describe its association with pulmonary hypertension (PH), but its prevalence is unknown. No studies at high altitude have determined the relationship between OSA and PH. The aim of this study was to establish the prevalence of PH in children diagnosed with OSA living in a high-altitude city at 2640 m above sea level. Methods Children between 2 and 16 years of age referred to the Sleep Laboratory of the Fundación Neumológica Colombiana in Bogotá with a positive polysomnogram for OSA were included, and a two-dimensional transthoracic echocardiogram (TTE) was performed to evaluate PH. Statistical analysis was performed using median, interquartile range, chi-squared test, and Kruskall-Wallis test. Results Of the 55 patients (n: 55), 63.6 % were male, with a median age of 6 years, 14 children (25.5 %) were overweight; 12 children (21.8 %) had mild OSA, 12 (21.8 %) had moderate OSA and 31 (56.4 %) severe OSA. In patients with severe OSA, the minimum saturation during events was 78 % with a desaturation index (DI) of 33.8/hour (p < 0.01). T90 and T85 increased proportionally with OSA severity (p < 0.05). Of the 55 patients with OSA, none had PH according to echocardiography; 4 patients (7.2 %) had pulmonary artery systolic pressure (PASP) at the upper limit of normal (ULN), and it was not related to a higher body mass index (BMI). Conclusions We found no association between OSA and PH in children with OSA at high altitude.
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Affiliation(s)
| | | | | | - Jenny Talani Ochoa
- Departamento de Pediatría, Universidad de La Sabana, Chía, Cundinamarca, Colombia
| | | | | | - Carlos Granados G
- Departamento de Pediatría, Universidad de La Sabana, Chía, Cundinamarca, Colombia
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Lagman-Bartolome AM, Im J, Gladstone J. Headaches Attributed to Disorders of Homeostasis. Neurol Clin 2024; 42:521-542. [PMID: 38575264 DOI: 10.1016/j.ncl.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Headaches attributed to disorders of homeostasis include those different headache types associated with metabolic and systemic diseases. These are headache disorders occurring in temporal relation to a disorder of homeostasis including hypoxia, high altitude, airplane travel, diving, sleep apnea, dialysis, autonomic dysreflexia, hypothyroidism, fasting, cardiac cephalalgia, hypertension and other hypertensive disorders like pheochromocytoma, hypertensive crisis, and encephalopathy, as well as preeclampsia or eclampsia. The proposed mechanism behind the causation of these headache subtypes including diagnostic criteria, evaluation, treatment, and overall management will be discussed.
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Affiliation(s)
- Ana Marissa Lagman-Bartolome
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto; Department of Pediatrics, Division of Neurology, Children's Hospital, London Health Sciences Center, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioner's Road East, London, Ontario N6A5W9, Canada.
| | - James Im
- Department of Medicine, Division of Adult Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B1W8, Canada
| | - Jonathan Gladstone
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto; Gladstone Headache Clinic, 1333 Sheppard Avenue E, Suite 122, North York, Ontario M2J1V1, Canada
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Wang C, Huang X, Tang Z, Zhang Y, Wei M, Du S, Song X, Wu Y, Chi Q, Zhuang X, Lina D, Jin Y. Dissolving microneedles loaded with nimodipine for prevention of sleep disorders at a high altitude. Pharm Dev Technol 2024:1-42. [PMID: 38626316 DOI: 10.1080/10837450.2024.2342965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
Sleep disorders are one of the most common acute reactions on the plateau, which can cause serious complications. However, there is no effective and safe treatment currently available. Nimodipine (NMD) is a dihydropyridine calcium channel blocker with neuroprotective and vasodilating activity, mainly used for the treatment of ischemic brain injury. Commercial oral or injectable NMD formulations are not a good option for central neuron diseases due to their poor brain delivery. In this study, nimodipine dissolving microneedles (NDMNs) were prepared for the prevention of sleep disorders caused by hypoxia. NDMNs were composed of NMD and polyvinyl pyrrolidone (PVP) K90 with a conical morphology and high rigidity. After administration of NDMNs on the back neck of mice, the concentration of NMD in the brain was significantly higher than that of oral medication as was confirmed by the fluorescent imaging on mouse models. NDMNs enhanced cognitive function, alleviated oxidative stress, and improved the sleep quality of mice with high-altitude sleep disorders. The blockage of calcium ion overloading may be an important modulation mechanism. NDMNs are a promising and user-friendly formulation for the prevention of high-altitude sleep disorders.
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Affiliation(s)
- Chunqing Wang
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Xin Huang
- Department of Cognitive Sciences, Institute of Military Cognition and Brain Sciences, Beijing 100850, China
| | - Ziyan Tang
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Yizhi Zhang
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Meng Wei
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Shumin Du
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Xingshuang Song
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yanping Wu
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Qiang Chi
- The 967th Hospital of Joint Logistic Support Force, Dalian 116011, China
| | - Xiaomei Zhuang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Du Lina
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yiguan Jin
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
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Liu Z, Yang J, Yang B, Sun M, Ye X, Yu S, Tan H, Hu M, Lv H, Wu B, Gao X, Huang L. Effect of ubiquinol on electrophysiology during high-altitude acclimatization and de-acclimatization: A substudy of the Shigatse CARdiorespiratory fitness (SCARF) randomized clinical trial. Int J Cardiol 2024; 401:131817. [PMID: 38307422 DOI: 10.1016/j.ijcard.2024.131817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND High-altitude exposure changes the electrical conduction of the heart. However, reports on electrocardiogram (ECG) characteristics and potent prophylactic agents during high-altitude acclimatization and de-acclimatization are inadequate. This study aimed to investigate the effects of ubiquinol on electrophysiology after high-altitude hypoxia and reoxygenation. METHODS The study was a prospective, randomized, double-blind, placebo-controlled trial. Forty-one participants were randomly divided into two groups receiving ubiquinol 200 mg daily or placebo orally 14 days before flying to high altitude (3900 m) until the end of the study. Cardiopulmonary exercise testing was performed at baseline (300 m), on the third day after reaching high altitude, and on the seventh day after returning to baseline. RESULTS Acute high-altitude exposure prolonged resting ventricular repolarization, represented by increased corrected QT interval (455.9 ± 23.4 vs. 427.1 ± 19.1 ms, P < 0.001) and corrected Tpeak-Tend interval (155.5 ± 27.4 vs. 125.3 ± 21.1 ms, P < 0.001), which recovered after returning to low altitude. Ubiquinol supplementation shortened the hypoxia-induced extended Tpeak-Tend interval (-7.7 ms, [95% confidence interval (CI), -13.8 to -1.6], P = 0.014), Tpeak-Tend /QT interval (-0.014 [95% CI, -0.027 to -0.002], P = 0.028), and reserved maximal heart rate (11.9 bpm [95% CI, 3.2 to 20.6], P = 0.013) during exercise at high altitude. Furthermore, the decreased resting amplitude of the ST-segment in the V3 lead was correlated with decreased peak oxygen pulse (R = 0.713, P < 0.001) and maximum oxygen consumption (R = 0.595, P < 0.001). CONCLUSIONS Our results illustrated the electrophysiology changes during high-altitude acclimatization and de-acclimatization. Similarly, ubiquinol supplementation shortened the prolonged Tpeak-Tend interval and reserved maximal heart rate during exercise at high altitude. REGISTRATION URL: www.chictr.org.cn; Unique identifier: ChiCTR2200059900.
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Affiliation(s)
- Zhen Liu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Jie Yang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Bingjie Yang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Xiaowei Ye
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Shiyong Yu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Hu Tan
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Mingdong Hu
- Department of Physical Examination, the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hailin Lv
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Boji Wu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Xubin Gao
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Lan Huang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China.
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Chen Y, Tang X, Zeng X, Han B, Xie H, Wang W, Sun L, Hu M, Gao Y, Xiao W. Gastrointestinal syndrome encountered during a train voyage to high altitudes: A 14-day survey of 69 passengers in China. Travel Med Infect Dis 2024; 59:102718. [PMID: 38582488 DOI: 10.1016/j.tmaid.2024.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The diagnosis and evaluation of the severity of acute mountain sickness (AMS) continue to be problematic due to a lack of consensus on the inclusion of symptoms in a scoring system. Recent investigations highlight the significance of gastrointestinal symptoms in identifying this condition. However, the specific gastrointestinal symptoms associated with AMS have not been thoroughly elucidated in previous studies, and the underlying risk factors remain inadequately comprehended. METHODS This study aimed to investigate the characteristics, trends, and risk factors related to gastrointestinal symptoms encountered during train travel to high altitude. A total of 69 passengers, specifically all with medical backgrounds, were surveyed 6 times over a period of 14 days. RESULTS The daily incidence of abdominal discomfort was higher than non-gastrointestinal symptoms within 14 days. Gastrointestinal symptoms demonstrated a greater prevalence, longer duration, and increased risk compared to non-gastrointestinal symptoms, such as headaches. The symptoms of abdominal distension and bowel sound hyperaction were found to be prevalent and persistent among patients diagnosed with AMS, exhibiting a high incidence rate. Gender, age, body mass index (BMI), smoking habits, and alcohol consumption were identified as risk factors associated with the occurrence and duration of gastrointestinal symptoms. CONCLUSION This study suggests that gastrointestinal symptoms are more common and persistent when traveling to the plateau by train. These symptoms should be taken into consideration in the further diagnosis and prevention of AMS. Therefore, this study provides a significant theoretical foundation for the prevention and treatment of AMS.
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Affiliation(s)
- Yihui Chen
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Xiaoqi Tang
- Department of Clinical Laboratory Medicine, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Xiong Zeng
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Ben Han
- Department of Nutrition, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Huichao Xie
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Wei Wang
- Department of Nutrition, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Lihua Sun
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Mingdong Hu
- Department of Geriatrics and Special Services Medicine, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
| | - Yuqi Gao
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University, Chongqing, 400038, China.
| | - Weidong Xiao
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
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Tonellato MH, Cates VC, Dickenson JA, Day TA, Strzalkowski NDJ. The effects of acute normobaric hypoxia on standing balance while dual-tasking with and without visual input. Eur J Appl Physiol 2024:10.1007/s00421-024-05469-4. [PMID: 38573534 DOI: 10.1007/s00421-024-05469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/09/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To investigate the influence of acute normobaric hypoxia on standing balance under single and dual-task conditions, both with and without visual input. METHODS 20 participants (7 female, 20-31 years old) stood on a force plate for 16, 90-s trials across four balance conditions: single-task (quiet stance) or dual-task (auditory Stroop test), with eyes open or closed. Trials were divided into four oxygen conditions where the fraction of inspired oxygen (FIO2) was manipulated (normoxia: 0.21 and normobaric hypoxia: 0.16, 0.145 and 0.13 FIO2) to simulate altitudes of 1100, 3,400, 4300, and 5200 m. Participants breathed each FIO2 for ~ 3 min before testing, which lasted an additional 7-8 min per oxygen condition. Cardiorespiratory measures included heart rate, peripheral blood oxygen saturation, and pressure of end tidal (PET) CO2 and O2. Center of pressure measures included total path length, 95% ellipse area, and anteroposterior and mediolateral velocity. Auditory Stroop test performance was measured as response accuracy and latency. RESULTS Significant decreases in oxygen saturation and PETO2, and increased heart rate were observed between normoxia and normobaric hypoxia (P < 0.0001). Total path length was higher at 0.13 compared to 0.21 FIO2 for the eyes closed no Stoop test condition (P = 0.0197). No other significant differences were observed. CONCLUSION These findings suggest that acute normobaric hypoxia has a minimal impact on standing balance and does not influence auditory Stroop test or dual-task performance. Further investigation with longer exposure is required to understand the impact and time course of normobaric hypoxia on standing balance.
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Affiliation(s)
- Marshall H Tonellato
- Department of Biology, Faculty of Science and Technology, Mount Royal University, 4826Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
| | - Valerie C Cates
- Department of Biology, Faculty of Science and Technology, Mount Royal University, 4826Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
| | - Jessica A Dickenson
- Department of Biology, Faculty of Science and Technology, Mount Royal University, 4826Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
| | - Trevor A Day
- Department of Biology, Faculty of Science and Technology, Mount Royal University, 4826Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
| | - Nicholas D J Strzalkowski
- Department of Biology, Faculty of Science and Technology, Mount Royal University, 4826Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada.
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Quispe G, Loza C, Limaco L, Gallegos R, Palomino C, Cruz I, Miranda J, Rodriguez L, Husøy A, Steiner TJ. The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study. J Headache Pain 2024; 25:48. [PMID: 38566009 PMCID: PMC10988909 DOI: 10.1186/s10194-024-01759-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains. METHODS The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18-65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question ("Have you had headache in the last year?") was followed by diagnostic questions based on ICHD-3 and demographic enquiry. RESULTS The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5-66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8-41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8-1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1-3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m). CONCLUSION The Global Campaign's first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.
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Affiliation(s)
| | - Cesar Loza
- Department of Nephrology, Peruvian University Cayetano Heredia, Lima, Peru
| | - Luis Limaco
- National Institute of Statistics and Informatics, Tacna, Peru
| | - Ruth Gallegos
- Neurology Service, Hospital Daniel Alcides Carrion, Callao, Peru
| | - Carlos Palomino
- Neurology Service, Hospital Luis Negreiros Vega, Callao, Peru
| | - Ivett Cruz
- Neurology Service, Hospital Luis Negreiros Vega, Callao, Peru
| | | | - Liliana Rodriguez
- Neurology Service, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Andreas Husøy
- NorHEAD, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Edvard Griegs gate, Trondheim, Norway
| | - Timothy J Steiner
- NorHEAD, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Edvard Griegs gate, Trondheim, Norway.
- Department of Neurology, University of Copenhagen, Copenhagen, Denmark.
- Division of Brain Sciences, Imperial College London, London, UK.
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Wang Z, Du Y, Li J, Zheng W, Gong B, Jin X, Zhou X, Yang H, Yang F, Guo J, Liu H, Wang M, Yan L, Zhu Y, Li X, Xu J, Wang J, Ma Z. Changes in health-promoting metabolites associated with high-altitude adaptation in honey. Food Chem 2024; 449:139246. [PMID: 38604035 DOI: 10.1016/j.foodchem.2024.139246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
The levels of metabolites in honey are influenced by floral origin, production region, and bee species. However, how environmental factors affect honey quality remains unclear. Based on untargeted metabolomics and using UPLC Q-Orbitrap MS, we analyzed 3596 metabolites in 51 honey samples from Yunnan and Shennongjia. Comparative analysis revealed that geniposidic acid, kynurenic acid and caffieine accumulated at significantly different levels between Shennongjia and Yunnan honey. Based on cluster structure analysis, 36 Yunnan honey samples were divided into two distinct groups by altitude. Notably, quercetin, hyperoside, taxifolin, rutin, tryptophan, astragalin and phenylalanine were higher levels in high-altitude honey (>1700 m), whereas abscisic acid was higher levels in low-altitude honey (≤1700 m). Among these, significantly elevated levels of hyperoside, taxfolin, astragalin, and tryptophan were observed in honey collected from high-altitude areas in Shennongjia. Our findings highlight the effect of altitude on honey health-promoting components, providing valuable insights into honey quality.
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Affiliation(s)
- Ziyuan Wang
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Yuxia Du
- Tropical and Subtropical Cash Crops Research Institute; Yunnan Academy of Agricultural Sciences, Baoshan 678000, China
| | - Jingjing Li
- Hubei Provincial Institute of Veterinary Drug Control, Wuhan 430064, China
| | - Weikang Zheng
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Bo Gong
- Hubei Provincial Institute of Veterinary Drug Control, Wuhan 430064, China
| | - Xiue Jin
- Hubei Provincial Institute of Veterinary Drug Control, Wuhan 430064, China
| | - Xianyan Zhou
- Tropical and Subtropical Cash Crops Research Institute; Yunnan Academy of Agricultural Sciences, Baoshan 678000, China
| | - Hongxia Yang
- Tropical and Subtropical Cash Crops Research Institute; Yunnan Academy of Agricultural Sciences, Baoshan 678000, China
| | - Fan Yang
- Tropical and Subtropical Cash Crops Research Institute; Yunnan Academy of Agricultural Sciences, Baoshan 678000, China
| | - Jun Guo
- Tropical and Subtropical Cash Crops Research Institute; Yunnan Academy of Agricultural Sciences, Baoshan 678000, China
| | - Hangxiu Liu
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China; National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100010, China
| | - Meng Wang
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Lu Yan
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Yi Zhu
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Xinxin Li
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Jiahao Xu
- National Key Laboratory for Germplasm Innovation & Utilization of Horticultural Crops, Huazhong Agricultural University, Wuhan 430070, China
| | - Jun Wang
- Hubei Provincial Institute of Veterinary Drug Control, Wuhan 430064, China
| | - Zhaocheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China.
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Jiang Z, Wu L, Niu H, Jia Z, Qi Z, Liu Y, Zhang Q, Wang T, Peng J, Mao H. Investigating the impact of high-altitude on vehicle carbon emissions: A comprehensive on-road driving study. Sci Total Environ 2024; 918:170671. [PMID: 38316305 DOI: 10.1016/j.scitotenv.2024.170671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
This study addresses the literature gap concerning accurately identifying vehicle carbon emission characteristics in high-altitude areas. Utilizing a portable emission measurement system (PEMS) for real-world testing, we quantified the influence of altitude on carbon emissions from light-duty gasoline (LDGV) and diesel vehicles (LDDV). The Random Forest (RF) algorithm was employed to analyze the complex nonlinear relationships between altitude, meteorological conditions, driving patterns, and carbon dioxide (CO2) emissions, enabling predictions across different altitudes. The results showed that CO2 emissions progressively increase with elevation. Furthermore, as altitude increases, combustion efficiency declines, and the overall impact of driving conditions on emission rates diminishes. Altitude and meteorological factors significantly contributed to CO2 emissions, whereas driving conditions and road grades contributed less. Compared with the COPERT model, the RF model demonstrates strong accuracy in predicting carbon emissions at different altitudes. Specifically, the CO2 emission rate nearly triples as altitude increases from 2.0 km to 4.5 km. This research bridges a critical gap in the understanding carbon emissions from high-altitude vehicles, offering insights into policy development for emission reduction strategies in such regions. Future studies should integrate diverse testing methodologies and comprehensive surveys to validate and extend the findings.
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Affiliation(s)
- Zhiwen Jiang
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Lin Wu
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Haomiao Niu
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Zhenyu Jia
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Zhaoyu Qi
- Key Laboratory of Environmental Protection in Water Transport Engineering Ministry of Transport, Tianjin Research Institute for Water Transport Engineering, No. 2618 Xingang Erhao Road, Binhai New District, Tianjin 300456, China
| | - Yan Liu
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Qijun Zhang
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Ting Wang
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Jianfei Peng
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
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Chen F, Li Y, Gong Y, Wei L, Wang J, Li Y. Evaluation of functional and electrical features of automatic external defibrillators in extreme altitude and temperature environments. Resusc Plus 2024; 17:100562. [PMID: 38323138 PMCID: PMC10846406 DOI: 10.1016/j.resplu.2024.100562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 02/08/2024] Open
Abstract
Aims Human exposure to high-altitude and/or low-temperature areas is increasing and cardiac arrest in these circumstances represents an increasing proportion of all treated cardiac arrests. However, little is known about the performance of automated external defibrillators (AED) in these circumstances. The objective of this study is to assess the functional and electrical features of 6 commercially available AEDs in extreme environments. Methods Accuracy of shockable rhythm detection, the time required for self-test, rhythm analysis, and capacitor charging, together with total energy, peak voltage, peak current, and phasic duration of defibrillation waveform measured after placing the AEDs in simulated high-altitude, simulated low-temperature, and natural composite high-altitude and low-temperature environment for 30 min, were compared to those measured in the standard environment. Results All of the shockable rhythms were correctly detected and all of the defibrillation shocks were successfully delivered by the AEDs. However, the time required for self-test, rhythm detection, and capacitor charging was shortened by 1.2% (3 AEDs, maximum 12.4%) in the simulated high-altitude environment, was prolonged by 3.6% (4 AEDs, maximum 40.8%) in the simulated low-temperature environment, and was prolonged by 4.1% (5 AEDs, maximum 52.1%) in the natural environment. Additionally, the total delivered energy was decreased by 2.5% (2 AEDs, maximum 6.8%) in the natural environment. Conclusion All of the investigated AEDs functioned properly in simulated and natural environments, but a large variation in the functional and electrical feature change was observed. When performing cardiopulmonary resuscitation in extreme environments, the impact of environmental factors may need consideration.
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Affiliation(s)
- Fangxiao Chen
- Department of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China
- Department of High Altitude Military Medicine, Army Medical University, Chongqing 400038, China
| | - Yunchi Li
- Department of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China
| | - Yushun Gong
- Department of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China
| | - Liang Wei
- Department of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China
| | - Juan Wang
- Emergency Department, Southwest Hospital, Army Medical University, Chongqing 400038, China
| | - Yongqin Li
- Department of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China
- Department of High Altitude Military Medicine, Army Medical University, Chongqing 400038, China
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Jing L, Da Q, Zhang S, Zhang J, Ma H, Luo H. Nitronyl Nitroxide Ameliorates Hypobaric Hypoxia-Induced Cognitive Impairment in Mice by Suppressing the Oxidative Stress, Inflammatory Response and Apoptosis. Neurochem Res 2024; 49:785-799. [PMID: 38103103 DOI: 10.1007/s11064-023-04080-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
Abundant investigations have shown that hypobaric hypoxia (HH) causes cognitive impairment, mostly attributed to oxidative stress, inflammation, and apoptosis. HPN (4'-hydroxyl-2-subsitiuted phenylnitronyl nitroxide) is an excellent free radical scavenger with anti-inflammatory and anti-apoptotic activities. Our previous study has found that HPN exhibited neuroprotective effect on HH induced brain injury. In the present study, we examined the protective effect and potential mechanism of HPN on HH-induced cognitive impairment. Male mice were exposed to HH at 8000 m for 3 days with and without HPN treatment. Cognitive performance was assessed by the eight-arm radical maze. The histological changes were assayed by Nissle staining. The hippocampus cell apoptosis was detected by Tunnel staining. The levels of inflammatory cytokines and oxidative stress markers were detected. The expression of oxidative stress, inflammation-related and apoptosis-related proteins was determined by western blot. HPN administration significantly and mitigated HH induced histological damages and spatial memory loss with the evidence of decreased working memory error (WME), reference memory error (RME), total errors (TE) and total time (TT). In addition, HPN treatment significantly decreased the content of H2O2 and MDA, increased the levels of SOD, CAT, GSH-Px and GSH, and inhibited the synthesis of TNF-α, IL-1β and IL-6. Moreover, HPN administration could down-regulate the expression of NF-κB, TNF-α, Bax, and cleaved caspase-3 and up-regulate the expression of Nrf2, HO-1 and Bcl-2. The number of apoptotic cells was also significantly decreased in the hippocampus of mice in the HPN group. There results indicate that HPN improve HH-induced cognitive impairment by alleviating oxidative stress damage, suppressing inflammatory response and apoptosis and may be a powerful candidate compound for alleviating memory loss induced by HH.
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Affiliation(s)
- Linlin Jing
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, NO.277 Yanta West Road, Yanta District, Xi'an, 710061, Shaanxi, People's Republic of China.
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support force of PLA, Lanzhou, 730050, Gansu, People's Republic of China.
| | - Qingyue Da
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, NO.277 Yanta West Road, Yanta District, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support force of PLA, Lanzhou, 730050, Gansu, People's Republic of China
| | - Shuyu Zhang
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, NO.277 Yanta West Road, Yanta District, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support force of PLA, Lanzhou, 730050, Gansu, People's Republic of China
| | - Jie Zhang
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support force of PLA, Lanzhou, 730050, Gansu, People's Republic of China
| | - Huiping Ma
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support force of PLA, Lanzhou, 730050, Gansu, People's Republic of China
| | - Hongbo Luo
- Department of Neurology, The Fifth Affiliated Hospital of Zunyi Medical University, NO.1439 Zhufeng Road, Doumen District, Zhuhai, 519000, Guangdong, People's Republic of China.
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Zhong Y, Liu F, Zhang X, Guo Q, Wang Z, Wang R. Research progress on reproductive system damage caused by high altitude hypoxia. Endocrine 2024; 83:559-570. [PMID: 38170433 DOI: 10.1007/s12020-023-03643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The high altitude area is characterized by low pressure and hypoxia, and rapidly entering the high altitude area will cause a series of damage to the body. Some studies have shown that hypoxia can cause damage to the reproductive system. In recent years, researchers have been paying attention to the effects of hypoxia on hormone level, ovarian reserve, embryonic development, testicular development, sperm motility level, and have begun to explore its injury mechanism, but its mechanism is not clear. In this paper, the mechanism of hypoxia on the reproductive system is reviewed, which is expected to provide a new idea for solving the problem of the low fertility rate of humans and animals at high altitudes. METHODS A comprehensive PubMed search was conducted, selecting all relevant peer-reviewed English papers published before January 2022. Other relevant papers were selected from the list of references. RESULTS Studies have shown that the complete fertility rate of people living at low altitudes is 7.7, and the complete fertility rate of people living at high altitudes is 4.77, and the hypoxic environment at high altitudes reduces fertility. At the same time, high-altitude, low-oxygen environments are associated with increased infant mortality and post-neonatal mortality. To date, most studies seem to point to a correlation between anoxic exposure at high altitudes and low fertility in humans and animals. CONCLUSION Although the molecular mechanisms are not fully understood, the effects of hypoxia at high altitude on hormonal level, ovarian reserve, embryonic development, testicular development, and sperm motility and levels require further research to investigate this complex topic.
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Affiliation(s)
- Yan Zhong
- School of Pharmacy, Gansu University of Traditional Chinese Medicine, Lanzhou, China.
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
| | - Feifei Liu
- School of Pharmacy, Gansu University of Traditional Chinese Medicine, Lanzhou, China
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Xiaojing Zhang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
| | - Qianwen Guo
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Zihan Wang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Rong Wang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
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13
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Sanchez-Macedo L, Vidal-Espinoza R, Minango-Negrete J, Ronque EV, Campos LFCCD, Fuentes-López J, Vargas-Ramos E, Rivera-Portugal M, Cossio-Bolaños M, Gomez-Campos R. Parameters of pubertal growth spurt in children and adolescents living at high altitude in Peru. J Pediatr (Rio J) 2024; 100:189-195. [PMID: 37944907 PMCID: PMC10943288 DOI: 10.1016/j.jped.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES The aim was to estimate the pubertal growth height of children and adolescents living in a high-altitude region of Peru using the Preece-Baines model 1 (1 PB). METHODS A cross-sectional study was conducted in schoolchildren from the department of Puno (Peru) between 3841 and 3874 masl. The age range was between 4 and 17 years. Standing height was evaluated. 1 PB was used to infer the mathematical and biological parameters of stature. RESULTS Mathematical parameters estimated by the 1 PB model reflected small residual standard error (RSE) values in both sexes (0.25 in boys and 0.27 in girls). In boys, the age at which peak velocity was reached (APHV) was estimated at 13.21 ± 0.33years. While in girls it was 9.96 ± 0.26years (p < 0.05). In general, girls reached APHV (y) 3.25 years earlier than boys. On the other hand, the growth velocity of maximum height [APHV (cm/y)] of boys was higher (6.33 ± 6.06 cm/y) relative to girls (6.06 ± 0.32 cm/y). Estimated final adult height (EFAH) in boys was reached at 166.020 ± 0.99 cm and height at maximum growth velocity (HPHV) was 153.07 ± 0.67 cm, while in girls they were significantly lower (EFAH; 153.74 ± 0.44 cm and HPHV: 139.73 ± 0.84 cm). CONCLUSIONS This study showed that girls living in Puno at a high altitude in Peru reached APHV 3 years earlier than boys and at the same time reflected slower PHV. These results suggest that pubertal growth at high altitudes is slower in both sexes and especially in girls. Thus, modeling physical growth may be an important step in understanding the onset of puberty at different latitudes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marco Cossio-Bolaños
- Carrera de Ciencias de la Actividad Física y del Deporte, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - Rossana Gomez-Campos
- Carrera de Ciencias de la Actividad Física y del Deporte, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Perú.
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Luks AM, Beidleman BA, Freer L, Grissom CK, Keyes LE, McIntosh SE, Rodway GW, Schoene RB, Zafren K, Hackett PH. Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update. Wilderness Environ Med 2024; 35:2S-19S. [PMID: 37833187 DOI: 10.1016/j.wem.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/14/2023] [Accepted: 05/17/2023] [Indexed: 10/15/2023]
Abstract
To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention, diagnosis, and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches for managing each form of acute altitude illness that incorporate these recommendations as well as recommendations on how to approach high altitude travel following COVID-19 infection. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in Wilderness & Environmental Medicine in 2010 and the subsequently updated WMS Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness published in 2014 and 2019.
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Affiliation(s)
- Andrew M Luks
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA
| | - Beth A Beidleman
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Luanne Freer
- Everest ER, Himalayan Rescue Association, Kathmandu, Nepal
| | - Colin K Grissom
- Pulmonary and Critical Care Medicine, Intermountain Healthcare and the University of Utah, Salt Lake City, UT
| | - Linda E Keyes
- Department of Emergency Medicine, Section of Wilderness Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Scott E McIntosh
- Department of Emergency Medicine, University of Utah Health, Salt Lake City, UT
| | - George W Rodway
- Department of Family Medicine-Sports Medicine, University of Nevada, Reno School of Medicine, Reno, NV
| | - Robert B Schoene
- Division of Pulmonary and Critical Care Medicine, Sound Physicians, St. Mary's Medical Center and Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA
| | - Ken Zafren
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
- Himalayan Rescue Association, Kathmandu, Nepal
| | - Peter H Hackett
- Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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Ríos-Méndez RE, Araúz-Martínez ME, Oliveros-Rivero JA, Crespo-Gutiérrez YJ, Pérez-Vite YW. [Closure of patent ductus arteriosus with Occlutech TM device, experience in an andean country]. Arch Cardiol Mex 2024. [PMID: 38359430 DOI: 10.24875/acm.23000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/26/2023] [Indexed: 02/17/2024] Open
Abstract
Background and Objective To communicate the experience in an Andean country with the OcclutechTM Duct Occluder device for the closure of patent ductus arteriosus. Method observational, retrospective, cross-sectional study with basic statistical analysis. Period: December/2014 to December/2022. Data: medical chart, reports of catheterization. Results Forty-six patients, female 71.3%, male 28.7%; age: 0.6-38 years-old (median [Me]: 5.2); weight: 6.3-60 kg (Me: 16.5). Origin: Andean 91.3%, coast 8.7%. Types of patent ductus arteriosus: E 54.4%, A 32.6%, D 13%. Minimum ductal diameter: 1.8-11.8 mm (Me: 3.5). Mean pulmonary artery pressure prior to occlusion: 14-67 mmHg (Me: 27). Pulmonary vascular resistance index prior to occlusion: 0.28-4.9 WU/m2 (Me: 1.3). Six of them were classified as hypertensive patent ductus arteriosus. Occlusion rate: 47.8% immediate, 81% at 24 hours, 100% after six months. Fluoroscopy time: 2-13.8 minutes (Me: 4). Complications: a migrated device. Follow-up: 1-6.5 years. Conclusions OcclutechTM Duct Occluder device was effective and safe for the closure of patent ductus arteriosus type E, A and D in low-altitude and high-altitude dwellers, whether they were children or adults, even when these ductus arteriosus were hypertensive.
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Affiliation(s)
- Raúl E Ríos-Méndez
- Servicio de Hemodinamia, Hospital Clínica Kennedy, Guayaquil, Guayas, Ecuador
- Servicio de Consulta Externa, Clínica Especialidades Médicas Santa Lucía. Quito, Pichincha, Ecuador
| | - María E Araúz-Martínez
- Servicio de Consulta Externa, Clínica Especialidades Médicas Santa Lucía. Quito, Pichincha, Ecuador
| | | | | | - Yesenia W Pérez-Vite
- Servicio de Anestesiología, Hospital Clínica Kennedy; Guayaquil, Guayas, Ecuador
- Servicio de Anestesiología Hospital SOLCA, Guayaquil, Guayas, Ecuador
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16
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Huang Z, Huang DX, Wang YY, Jiang LJ, Wang YH, Dai J, Kang X, Wen Y, He SY. Features of thromboelastogram in populations exposed to or transferring from high altitude. Heliyon 2024; 10:e25223. [PMID: 38322976 PMCID: PMC10845907 DOI: 10.1016/j.heliyon.2024.e25223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Background Thromboelastogram (TEG) is an effective indicator that monitors the dynamic changes of blood coagulation in real-time. It still remains controversial about the performance and influence of coagulation at high altitude. The present study intends to describe comprehensively the clinical features of TEG in populations exposed to or transferring from high altitude. Methods Two groups were recruited in the present study. Group A included young males who worked at high-altitude (4888 m or 5418 m) areas for some time, while Group B included young males who had recently returned from high-altitude (4888 m or 5418 m) areas. Medical examinations were performed using portable devices. Spearman's test was used to evaluate the correlations between thromboelastogram (TEG) variables and other variables. Logistic regression analysis was used to analyze the factors affecting various abnormal TEG variables. Results A total of 51 adult males were included in the two groups. Significantly increased reaction time (R) and decreased maximum amplitude (MA) were found in group B (P < 0.05). No significant differences were observed in the comparisons of K and angle between the two groups. Various TEG variables were identified to be correlated with different coagulation and biochemical variables. Logistic regression analysis demonstrated that abnormal R was independently associated with direct bilirubin, and abnormal K was independently associated with the platelet count in Group A (P < 0.05). However, none of the factors were independently associated with abnormal TEG variables in Group B. Conclusion Populations exposed to or transferring from high altitudes are characterized by different TEG characteristics. Our findings give a comprehensive description of the complex interaction between TEG indexes, coagulation dynamics, and hematological parameters, which can help guide the development of appropriate medical approaches tailored to the unique needs of these populations.
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Affiliation(s)
- Zhu Huang
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
- Department of General Surgery, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Dong-xin Huang
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
- Department of General Surgery, The General Hospital of Western Theater Command, Chengdu, 610000, China
- College of Medicine, Southwest Jiaotong University, Chengdu, 610000, China
| | - Yan-yan Wang
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
- Department of Clinical Laboratory, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Li-juan Jiang
- Department of General Surgery, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Yong-hua Wang
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Jing Dai
- Laboratory of Basic Medicine, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Xia Kang
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Yi Wen
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
- Department of General Surgery, The General Hospital of Western Theater Command, Chengdu, 610000, China
| | - Si-yi He
- Pancreatic Injury and Repair Key Laboratory of Sichuan Province, The General Hospital of Western Theater Command, Chengdu, 610000, China
- Department of Cardiac Surgery, The General Hospital of Western Theater Command, Chengdu, 610000, China
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Błażejczyk K, Havenith G, Szymczak RK. Simulations of the human heat balance during Mount Everest summit attempts in spring and winter. Int J Biometeorol 2024; 68:351-366. [PMID: 38114844 PMCID: PMC10794380 DOI: 10.1007/s00484-023-02594-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/15/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
The majority of research dealing with the impacts of the Himalayan climate on human physiology focuses on low air temperature, high wind speed, and low air pressure and oxygen content, potentially leading to hypothermia and hypoxia. Only a few studies describe the influence of the weather conditions in the Himalayas on the body's ability to maintain thermal balance. The aim of the present research is to trace the heat exchange between humans and their surroundings during a typical, 6-day summit attempt of Mount Everest in the spring and winter seasons. Additionally, an emergency night outdoors without tent protection is considered. Daily variation of the heat balance components were calculated by the MENEX_HA model using meteorological data collected at automatic weather stations installed during a National Geographic expedition in 2019-2020. The data represent the hourly values of the measured meteorological parameters. The research shows that in spite of extreme environmental conditions in the sub-summit zone of Mount Everest during the spring weather window, it is possible to keep heat equilibrium of the climbers' body. This can be achieved by the use of appropriate clothing and by regulating activity level. In winter, extreme environmental conditions in the sub-summit zone make it impossible to maintain heat equilibrium and lead to hypothermia. The emergency night in the sub-peak zone leads to gradual cooling of the body which in winter can cause severe hypothermia of the climber's body. At altitudes < 7000 m, climbers should consider using clothing that allows variation of insulation and active regulation of their fit around the body.
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Affiliation(s)
- Krzysztof Błażejczyk
- Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 02-818, Warszawa, Poland.
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough School of Design & Creative Arts, Loughborough University, Loughborough, UK
| | - Robert K Szymczak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
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Schneider SR, Müller J, Bauer M, Mayer L, Lüönd L, Ulrich T, Furian M, Forrer A, Carta A, Schwarz EI, Bloch KE, Lichtblau M, Ulrich S. Overnight exposure to high altitude in pulmonary hypertension: adverse events and effect of oxygen therapy. Eur Heart J 2024; 45:309-311. [PMID: 38079468 PMCID: PMC10821358 DOI: 10.1093/eurheartj/ehad789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/19/2023] [Accepted: 11/17/2023] [Indexed: 01/28/2024] Open
Affiliation(s)
- Simon R Schneider
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Julian Müller
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Meret Bauer
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Laura Mayer
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Lea Lüönd
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Tanja Ulrich
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Michael Furian
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Aglaia Forrer
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Arcangelo Carta
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Esther I Schwarz
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Konrad E Bloch
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Mona Lichtblau
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
| | - Silvia Ulrich
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
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Lili L, Meydan C, Rickard N, Zhang B. The importance of personalization in high altitude protocols for hematologic and metabolic benefits in sports: A multi-dimensional N-of-1 case study. Heliyon 2024; 10:e23159. [PMID: 38170057 PMCID: PMC10758776 DOI: 10.1016/j.heliyon.2023.e23159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
The hematologic and metabolic benefits of high altitude exposure have been extensively studied in athletes due to their promising performance enhancing effects. However, despite the increased research and development of various high altitude protocols for achieving peak performance, the reproducibility of the results at the individual level remains sparse. To systematically address this limitation and establish a more effective method to achieve consistent results at the individual level, we conducted a multi-dimensional study of one elite endurance athlete in two Phases. In Phase 1, we applied the standard protocol of LHTH (Live-High-Train-High) using a commercially available, at-home, normobaric, high altitude simulation tent under the SHTL (Sleep-High-Train-Low) model. Then, we developed the athlete's personalized protocol for peak hematologic parameters during their off-season. This protocol determined the exact total high altitude exposure time required to achieve peak hematologic parameters, which in the case of this athlete, amounted to 45 nights with approximately 8hrs per night. In Phase 2, we replicated the Phase 1 protocol during the athlete's in-season and observed the same or even higher hematologic and metabolic benefits compared to Phase 1. During both phases, we collected thousands of multi-dimensional data points to ensure that the athlete's lifestyle and environmental factors remained stable, and to increase the likelihood that physiological changes resulted primarily from the high altitude exposure. The data trends in both Phases validated that, for this athlete, hematologic measures such as red blood cell count, hematocrit, and hemoglobin, as well as electrolyte content, body weight and gut microbiome composition improved to their personal best values after a total of approximately 15 days of high altitude exposure (45 nights with roughly 8hrs per night totaling 360hrs or 15days). These improvements did not occur after the 21 days recommended by the LHTH protocol highlighting the significance of personalization in high altitude protocols that are designed for peak performance parameters. Therefore, to maximize the benefits in hematologic and other metabolic values and thus increase muscle oxygen supply and peak aerobic capacity through high altitude exposure, each athlete may require a unique total duration of high altitude exposure tailored to their individual physiology. This duration must be determined by their specific response in hematologic peaking. Therefore, initially establishing a personalized protocol for an athlete by determining their required total duration of high altitude exposure for peak hematologic values during their off-season and applying this protocol during their in-season phase may lead to more successful and reproducible benefits compared to following a generalized protocol alone.
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Affiliation(s)
- Loukia Lili
- Thorne HealthTech, Inc., 152W 57th st, New York, NY 10019, USA
| | - Cem Meydan
- Thorne HealthTech, Inc., 152W 57th st, New York, NY 10019, USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10021, USA
| | - Nate Rickard
- Thorne HealthTech, Inc., 152W 57th st, New York, NY 10019, USA
| | - Bodi Zhang
- Thorne HealthTech, Inc., 152W 57th st, New York, NY 10019, USA
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Gong B, Wang Y, Zhang JA, Zhang Q, Zhao J, Li J, Wang X, Han Y, Yu Z, Zhang C, Peng B, Xing Y, Li Q, Wang P, Li Y, Teng W, Shan Z. Effects of altitude on thyroid disorders according to Chinese three-rung, ladder-like topography: national cross-sectional study. BMC Public Health 2024; 24:26. [PMID: 38167020 PMCID: PMC10762831 DOI: 10.1186/s12889-023-17569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chinese topography appears a three-rung ladder-like distribution of decreasing elevation from northwest to southeast, which is divided by two sloping edges. Previous studies have reported that prevalence of thyroid diseases differed by altitude, and geographical factors were associated with thyroid disorders. To explore the association between three-rung ladder-like regions and thyroid disorders according to unique Chinese topographic features, we conducted an epidemiological cross-sectional study from 2015-2017 that covered all 31 mainland Chinese provinces. METHODS A total of 78,470 participants aged ≥ 18 years from a nationally representative cross-sectional study were included. Serum thyroid peroxidase antibody, thyroglobulin antibody, and thyroid-stimulating hormone levels; urine iodine concentration; and thyroid volume were measured. The three-rung ladder-like distribution of decreasing elevation from northwest to southeast in China was categorized into three topographic groups according to elevation: first ladder, > 3000 m above sea level; second ladder, descending from 3000-500 m; and third ladder, descending from 500 m to sea level. The third ladder was further divided into groups A (500-100 m) and B (< 100 m). Associations between geographic factors and thyroid disorders were assessed using linear and binary logistic regression analyses. RESULTS Participants in the first ladder group were associated with lower thyroid peroxidase (β = -4.69; P = 0.00), thyroglobulin antibody levels (β = -11.08; P = 0.01), and the largest thyroid volume (β = 1.74; P = 0.00), compared with the other groups. The second ladder group was associated with autoimmune thyroiditis (odds ratio = 1.30, 95% confidence interval [1.18-1.43]) and subclinical hypothyroidism (odds ratio = 0.61, 95%confidence interval [0.57-0.66]) (P < 0.05) compared with the first ladder group. Group A (third ladder) (500-100 m) was associated with thyroid nodules and subclinical hypothyroidism (P < 0.05). Furthermore, group B (< 100 m) was positively associated with autoimmune thyroiditis, thyroid peroxidase and thyroglobulin antibody positivity, and negatively associated with overt hypothyroidism, subclinical hypothyroidism, and goiter compared with the first ladder group(P < 0.05). CONCLUSION We are the first to investigate the association between different ladder regions and thyroid disorders according to unique Chinese topographic features. The prevalence of thyroid disorders varied among the three-rung ladder-like topography groups in China, with the exception of overt hyperthyroidism.
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Affiliation(s)
- Boshen Gong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Youmin Wang
- Department of Endocrinology, The First People's Hospital of An-Hui Medical University, Hefei, Anhui, 230000, P. R. China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hospital, Shanghai, 201318, P. R. China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Guiqian International General Hospital, Guiyang, Guizhou, 550004, P. R. China
| | - Jiajun Zhao
- Department of Endocrinology, Hospital Affiliated With Shandong University, Jinan, Shandong, 250012, P. R. China
| | - Jiashu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ziwei Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Bingcong Peng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yumin Xing
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Qiuxian Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ping Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
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Li W, Wang Y, Xu L, Yuan F. High-Altitude Pulmonary Edema Combined with Spontaneous Pneumomediastinum: A Case Report. Curr Med Imaging 2024; 20:e15734056234694. [PMID: 38087298 DOI: 10.2174/0115734056234694230922101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 08/06/2023] [Accepted: 08/28/2023] [Indexed: 12/18/2023]
Abstract
Background High-altitude pulmonary edema (HAPE) is a serious life-threatening disease that occurs after rapid ascent to high altitude; its main early-stage presentations include fatigue, headache, low-grade fever, dyspnea, and cough. X-ray and computed tomography (CT) images show pulmonary shadows and patches, which may be localized (initial right lung field predomination) or generalized to the bilateral lung base. Case Presentation In this report, we present a case of a 25-year-old man diagnosed with HAPE combined with spontaneous pneumomediastinum. After a quick descent and effective medical treatment, this patient made a full recovery. The case may provide helpful information for the prevention and treatment of this disease since an increased number of people, especially young men, currently travel and work at high altitudes. Conclusion After accurate clinical diagnosis with the help of CT or X-ray, immediate descent and appropriate oxygen supplementation are the most effective treatments for HAPE at high altitude.
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Affiliation(s)
- Wenzhe Li
- Department of Radiotherapy, General Hospital of Xinjiang Military Command, Wulumuqi, China
| | - Yajing Wang
- Department of Chemistry, No.54 Senior High School, Wulumuqi, China
| | - Li Xu
- Department of Radiotherapy, General Hospital of Xinjiang Military Command, Wulumuqi, China
| | - Fang Yuan
- Department of Radiotherapy, General Hospital of Xinjiang Military Command, Wulumuqi, China
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22
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Li X, Zhang J, Liu G, Wu G, Wang R, Zhang J. High altitude hypoxia and oxidative stress: The new hope brought by free radical scavengers. Life Sci 2024; 336:122319. [PMID: 38035993 DOI: 10.1016/j.lfs.2023.122319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/05/2023] [Accepted: 11/27/2023] [Indexed: 12/02/2023]
Abstract
Various strategies can be employed to prevent and manage altitude illnesses, including habituation, oxygenation, nutritional support, and medication. Nevertheless, the utilization of drugs for the prevention and treatment of hypoxia is accompanied by certain adverse effects. Consequently, the quest for medications that exhibit minimal side effects while demonstrating high efficacy remains a prominent area of research. In this context, it is noteworthy that free radical scavengers exhibit remarkable anti-hypoxia activity. These scavengers effectively eliminate excessive free radicals and mitigate the production of reactive oxygen species (ROS), thereby safeguarding the body against oxidative damage induced by plateau hypoxia. In this review, we aim to elucidate the pathogenesis of plateau diseases that are triggered by hypoxia-induced oxidative stress at high altitudes. Additionally, we present a range of free radical scavengers as potential therapeutic and preventive approaches to mitigate the occurrence of common diseases associated with hypoxia at high altitudes.
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Affiliation(s)
- Xuefeng Li
- College of Life Science, Northwest Normal University, Lanzhou 730070, China
| | - Juanhong Zhang
- College of Life Science, Northwest Normal University, Lanzhou 730070, China; School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, China.
| | - Guoan Liu
- College of Life Science, Northwest Normal University, Lanzhou 730070, China
| | - Guofan Wu
- College of Life Science, Northwest Normal University, Lanzhou 730070, China.
| | - Rong Wang
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, China; Key Laboratory for Prevention and Remediation of Plateau Environmental Damage, 940th Hospital of Joint Logistics Support Force of CPLA, Lanzhou 730050, China.
| | - Junmin Zhang
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, China.
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Gong H, Zhou Q, Gama Z, Lan Y. High-Altitude Exposure and Diabetic Retinopathy: Unveiling the Impact and Mechanisms of Alleviation. Ophthalmic Res 2023; 67:76-84. [PMID: 38104543 DOI: 10.1159/000535429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND High altitude (HA) is an extremely challenging environment for millions of people who either travel to HA regions or inhabit there permanently. SUMMARY Significant progress has been made over the past decades in the understanding of physiological adaptations in HA conditions, and recently, more studies regarding its influence on metabolic disease have been published. However, the effect of HA on diabetic retinopathy (DR), the leading cause of blindness, remains unclear. KEY MESSAGES The present article provides an overview of the changes in the principal physiology and clinical characteristics related to DR after HA exposure. Despite conflicting evidence, this review synthesizes the available studies and explores the potential mechanisms, such as genetic adaptations, glucose homeostasis, and related physiological changes, by which long-term exposure to HA may alleviate the progression of DR. By shedding light on this complex relationship, it also provides insights into the interplay between HA and DR, offering valuable implications for clinical practice and further research.
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Affiliation(s)
- Haijun Gong
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China,
| | - Qihang Zhou
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhujue Gama
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yuqing Lan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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24
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Babu LK, Shaw S, Ghosh D. Bone mineral metabolism and different indices of skeletal health of Ladakhi women living at high altitude. Osteoporos Sarcopenia 2023; 9:131-136. [PMID: 38374823 PMCID: PMC10874723 DOI: 10.1016/j.afos.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 02/21/2024] Open
Abstract
Objectives High altitude possesses a great challenge for human survival owing to low oxygen tension and has been reported to cause bone deterioration among sojourns of high altitude. The bone health of Ladakhi women is investigated for the first time in this study. Methods Dual energy X-ray absorptiometry of Ladakhi women and sea level women was done at the radius and calcaneus using EXA-3000 (Osteosys, Korea), followed by colorimetric and Enzyme Linked Immunosorbent Assay analysis of parameters regulating bone health. Results There was no statistically significant difference between bone mineral density of Ladakhi women and sea level women at radius (P = 0.287) or calcaneus (P = 0.839). Almost similar cases of osteopenia were reported at both sites measured in the study among both groups. Two post-menopausal Ladakhi women however, had osteoporosis at the radius while 4 had osteoporosis at calcaneus. Significant increase in calcium levels with a decrease in intact parathyroid hormone and an increase in calcitonin levels were observed in Ladakhi women as compared to sea level women. Though there was no significant difference in 25-hydroxy vitamin D levels of both groups, a higher percentage of 25-hydroxy vitamin D deficiency (77% vs 23%) was observed in Ladakhi women as compared to sea level women. Estradiol levels were similar in both groups. Conclusions The present study suggest that there is no significant relationship between high altitude living and bone mineral density among Ladakhi women.
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Affiliation(s)
- Lijy K. Babu
- Applied Physiology Lab, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Snigdha Shaw
- Applied Physiology Lab, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Dishari Ghosh
- Applied Physiology Lab, Defence Institute of Physiology and Allied Sciences, Delhi, India
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Song C, Ren Y, Liu Y, Cao R, Duan G. Oxygen comfort evaluation method based on symptom index for short-term internal migrants to Tibet. Sci Total Environ 2023; 902:166418. [PMID: 37607633 DOI: 10.1016/j.scitotenv.2023.166418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
In Tibet, the hypobaric-hypoxic environment found at high altitudes leads to dysfunction in short-term internal migrants and has noticeable effects on physiology, psychological health, and comfort level. Therefore, it is essential to accurately determine the degree of hypoxia and improve the hypoxic environment of plateaus. Despite advances in the medical diagnosis and treatment of pathological hypoxic injuries, there are some limitations in the oxygenic evaluation of internal migrants with mild hypoxia. An oxygen comfort evaluation method (OCEM) based on typical anoxic symptomatology and physiological indices is proposed in this study. Experiments with different oxygen concentrations were conducted to measure anoxic symptomatology and physiological indices. Using item and exploratory factor analyses, 19 symptom indices were screened to predict oxygen sensation in humans. Finally, the OCEM was established using an artificial neural network and fuzzy mathematics method and its accuracy was verified through a field survey. The results showed that the artificial neural network model using symptomatologic indices could predict human oxygen sensation, with an area under the receiver operating characteristic curve of 0.630-0.913 and prediction accuracy of 93 %. Oxygen comfort can be predicted from the oxygen sensation and typical physiological indices using the fuzzy mathematics method; the weighted kappa coefficient was 0.825, indicating a strong correlation between the predicted and actual values. The proposed OCEM can help determine the oxygen comfort conditions of high-altitude internal migrants and provide a basis for indoor oxygen environment regulation in high-altitude buildings.
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Affiliation(s)
- Cong Song
- State Key Laboratory of Green Building in Western China, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China; School of Building Services Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China.
| | - Yushu Ren
- School of Building Services Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China
| | - Yanfeng Liu
- State Key Laboratory of Green Building in Western China, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China; School of Building Services Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China
| | - Ruixuan Cao
- School of Building Services Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China
| | - Guannan Duan
- School of Building Services Science and Engineering, Xi'an University of Architecture and Technology, Xi'an, Shaanxi 710055, China
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Yan C, Tian D, Zhang C, Zhang Q, Sun Y. Evaluation of blood cellular and biochemical parameters in rats under a chronic hypoxic environment at high altitude. Ann Med 2023; 55:898-907. [PMID: 36896573 PMCID: PMC10796155 DOI: 10.1080/07853890.2023.2184859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The purpose of this study was to explore the changes in blood cellular and biochemical parameters of rats in a natural environment of low pressure and low oxygen on the plateau. METHODS Male Sprague-Dawley rats in two groups were raised in different environments from 4 weeks of age for a period of 24 weeks. They were raised to 28 weeks of age and then transported to the plateau medical laboratory of Qinghai University. Blood cellular and biochemical parameters were measured and the data of the two groups were statistically analyzed. RESULTS 1. RBC in the HA group was higher than that in the Control group, but there was no significant difference between the two groups (p > 0.05), Compared with the Control group, HGB, MCV, MCH, MCHC and RDW in the HA group were significantly higher (p < 0.05). 2. Compared with the Control group, WBC, LYMP, EO, LYMP% and EO% in the HA group decreased significantly (p < 0.05), and ANC% increased significantly (p < 0.05). 3. In the platelet index, compared with the Control group, PLT in the HA group was significantly reduced (p < 0.05), PDW, MRV, P-LCR were significantly increased (p < 0.05). 4. In blood biochemical indicators, compared with the Control group, AST, TBIL, IBIL, LDH in the HA group decreased significantly (p < 0.05), CK in the HA group increased significantly (p < 0.05). CONCLUSIONS 1. The indexes related to red blood cells, white blood cells, platelets and some biochemical indexes in the blood of rats at high altitude have changed. 2. Under the high altitude environment, the oxygen carrying capacity of SD rats is improved, the resistance to disease may be reduced, the coagulation and hemostasis functions may be affected, and there is a risk of bleeding. The liver function, renal function, heart function and skeletal muscle energy metabolism may be affected. 3. This study can provide an experimental basis for the research on the pathogenesis of high-altitude diseases from the perspective of blood.KEY MESSAGESIn this study, red blood cells, white blood cells, platelets and blood biochemical indicators were included in the real plateau environment to comprehensively analyze the changes of blood cellular and biochemical parameters in rats under the chronic plateau hypobaric hypoxia environment.From the perspective of blood, this study can provide an experimental basis for research on the pathogenesis of high-altitude diseases.Explore the data support of oxygen-carrying capacity, disease resistance and energy metabolism of the body in the natural environment at high altitude.
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Affiliation(s)
- Chunlong Yan
- Suzhou Medical College of Soochow University, suzhou, China
- Department of Radiology, Jining No.1 People’s Hospital, Jining, China
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, China
| | - Dengfeng Tian
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, China
| | - Chenhong Zhang
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, China
| | - Qiang Zhang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Yanqiu Sun
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, China
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Shushanyan R, Grigoryan A, Abgaryan T, Karapetyan A. Histological and cytochemical analysis of the brain under conditions of hypobaric hypoxia-induced oxygen deficiency in albino rats. Acta Histochem 2023; 125:152114. [PMID: 37980852 DOI: 10.1016/j.acthis.2023.152114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/21/2023]
Abstract
High altitude sickness is a life-threatening disease that occurs among acclimatized individuals working or living at a high altitude accompanied by hypobaric hypoxia exposure. The prolonged influence of hypobaric hypoxia on the brain may trigger neuronal damage and cell death due to an oxygen deficiency. The purpose of the current study was to investigate the histomorphological changes in the hippocampus, cerebral cortex, cerebellar cortex, and striatum of the rat's brain following chronic hypobaric hypoxia. Fourteen albino rats were used for this investigation. The animals were exposed to chronic hypobaric hypoxia in the special decompression chamber at an altitude of 7000 m for 7 days. The histological analysis was conducted via toluidine staining and silver impregnation. DNA damage and cell apoptosis were assessed via Feulgen staining. The histochemical assessment revealed increased dark neurons in the hippocampus with cell swelling. Silver impregnation showed increased argyrophilic neurons in the cerebellar cortex, striatum, CA1 subfield of the hippocampus, and cerebral cortex. The cytochemical analysis determined the increased apoptotic cells with hyperchromatic condensation and pyknosis in the hippocampus subfields and cerebral cortex. In addition, it has been observed that hypoxia has resulted in small hemorrhages and perivascular edema within the cerebellar and cerebral cortex. The results indicate brain injury observed in the various parts of the brain towards hypobaric hypoxia, however, the hippocampus showed greater vulnerability against hypoxic exposure in comparison to the striatum, cerebellum, and cerebral cortex. These changes support our insights regarding brain intolerance under conditions of hypoxia-induced oxygen deficiency and its histomorphological manifestations.
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Affiliation(s)
- Ruzanna Shushanyan
- Department of Human and Animal Physiology, Yerevan State University, Yerevan, Armenia.
| | - Anna Grigoryan
- Department of Human and Animal Physiology, Yerevan State University, Yerevan, Armenia.
| | - Tamara Abgaryan
- Department of Human and Animal Physiology, Yerevan State University, Yerevan, Armenia.
| | - Anna Karapetyan
- Department of Human and Animal Physiology, Yerevan State University, Yerevan, Armenia.
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Li J, Zhang G, Wang X, Qiangba C, Song X, Lin R, Huang C, Yang X, Ning S, Zhang J, Liao H, Xie S, Suo Z, Qi H, Yu Z, Shi R, Yao Y. Characteristics of neonatal hypoxic-ischemic encephalopathy at high altitude and early results of therapeutic hypothermia. BMC Pediatr 2023; 23:609. [PMID: 38037071 PMCID: PMC10691051 DOI: 10.1186/s12887-023-04421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Altitude hypoxia and limited socioeconomic conditions may result in distinctive features of neonatal hypoxic-ischemic encephalopathy (HIE). Therapeutic hypothermia (TH) has not been used at altitude. We examined characteristics of HIE and early outcomes of TH in 3 centers at two high altitudes, 2 at 2,261 m and 1 at 3,650 m. METHODS The incidence of HIE at NICUs was noted. TH was conducted when personnel and devices were available in 2019~2020. Standard inclusion criteria were used, with the addition of admission age >6 hours and mild HIE. Demographic and clinical data included gestational age, gender, weight, Apgar score, ethnics, age on admission, age at TH and clinical degree of HIE. EEG was monitored for 96 hours during hypothermia and rewarming. MRI was performed before discharge. RESULTS There was significant difference in ethnics, HIE degree, age at TH across 3 centers. The overall NICU incidence of HIE was 4.0%. Among 566 HIE patients, 114 (20.1%) received TH. 63 (55.3%) patients had moderate/severe HIE. Age at TH >6 hours occurred in 34 (29.8%) patients. EEG discharges showed seizures in 7~11% of patients, whereas spikes/sharp waves in 94~100%, delta brushes in 50~100%. After TH, MRI showed moderate to severe brain injury in 77% of patients, and correlated with center, demographic and clinical variables (Ps≤0.0003). Mortality was 5% during hospitalization and 11% after discharge until 1 year. CONCLUSIONS At altitude, the incidence of HIE was high and brain injury was severe. TH was limited and often late >6 hours. EEG showed distinct patterns attributable to altitude hypoxia. TH was relatively safe. TRIAL REGISTRATION The study was registered on February 23, 2019 in Chinese Clinical Trial Register (ChiCTR1900021481).
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Affiliation(s)
- Jia Li
- Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
- Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China.
| | - Guofei Zhang
- NICU, Qinghai Red Cross Hospital, Xining, Qinghai, China
| | - Xiaorong Wang
- NICU, Qinghai Women's and Children's Hospital, Xining, Qinghai, China
| | | | - Xiaoyan Song
- NICU, Nanfang Hospital, Guangzhou, Guangdong, China
| | - Rouyi Lin
- Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Chantao Huang
- Department of Radiology, Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xiaoying Yang
- NICU, Qinghai Women's and Children's Hospital, Xining, Qinghai, China
| | - Shuyao Ning
- Department of Electroneurophysiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jian Zhang
- Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Haiyan Liao
- Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Siyuan Xie
- Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Zhen Suo
- Department of Echocardiography, Lhasa People's Hospital, Lhasa, Tibet, China
| | - Haiying Qi
- Department of Echocardiography, Qinghai Women's and Children' Hospital, Xining, Qinghai, China
| | - Zhen Yu
- NICU, Lhasa People's Hospital, Lhasa, Tibet, China
| | - Runling Shi
- NICU, Qinghai Women's and Children's Hospital, Xining, Qinghai, China
| | - Yanli Yao
- Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China
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Zhang X, Men S, Jia L, Tang X, Storey KB, Niu Y, Chen Q. Comparative metabolomics analysis reveals high-altitude adaptations in a toad-headed viviparous lizard, Phrynocephalus vlangalii. Front Zool 2023; 20:35. [PMID: 37919723 PMCID: PMC10621141 DOI: 10.1186/s12983-023-00513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023] Open
Abstract
Extreme environmental conditions at high altitude, such as hypobaric hypoxia, low temperature, and strong UV radiation, pose a great challenge to the survival of animals. Although the mechanisms of adaptation to high-altitude environments have attracted much attention for native plateau species, the underlying metabolic regulation remains unclear. Here, we used a multi-platform metabolomic analysis to compare metabolic profiles of liver between high- and low-altitude populations of toad-headed lizards, Phrynocephalus vlangalii, from the Qinghai-Tibet Plateau. A total of 191 differential metabolites were identified, consisting of 108 up-regulated and 83 down-regulated metabolites in high-altitude lizards as compared with values for low-altitude lizards. Pathway analysis revealed that the significantly different metabolites were associated with carbohydrate metabolism, amino acid metabolism, purine metabolism, and glycerolipid metabolism. Most intermediary metabolites of glycolysis and the tricarboxylic acid cycle were not significantly altered between the two altitudes, but most free fatty acids as well as β-hydroxybutyric acid were significantly lower in the high-altitude population. This may suggest that high-altitude lizards rely more on carbohydrates as their main energy fuel rather than lipids. Higher levels of phospholipids occurred in the liver of high-altitude populations, suggesting that membrane lipids may undergo adaptive remodeling in response to low-temperature stress at high altitude. In summary, this study demonstrates that metabolic profiles differ substantially between high- and low-altitude lizard populations, and that these differential metabolites and metabolic pathways can provide new insights to reveal mechanisms of adaptation to extreme environments at high altitude.
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Affiliation(s)
- Xuejing Zhang
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Shengkang Men
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Lun Jia
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiaolong Tang
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Kenneth B Storey
- Department of Biology, Carleton University, Ottawa, ON, K1S 5B6, Canada
| | - Yonggang Niu
- Department of Life Sciences, Dezhou University, Dezhou, 253023, Shandong, China.
| | - Qiang Chen
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China.
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Liu Y, Hong J, Yin X, Zhang F, Guo Y, Sun P. Relationship between cardiorespiratory fitness and executive function of Chinese Tibetan adolescents aged 13-18. J Sci Med Sport 2023; 26:610-615. [PMID: 37739853 DOI: 10.1016/j.jsams.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/05/2023] [Accepted: 09/02/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVES Explore the correlation between cardiorespiratory fitness (CRF) and execution function (EF) of Chinese Tibetan adolescents at high altitude (HA) areas. DESIGN A cross-sectional survey was used to study 1138 participants aged 13-18 (47.72% boys) at baseline. METHODS Lhasa (3650 m), Nagqu (4500 m), Qamdo (3500 m), and Nyingchi (3100 m) in China were chosen. CRF was measured by the 20 m shuttle run test (20mSRT) and a subsequent estimation of their maximal oxygen consumption (V̇O2max) was calculated using the Léger equations. The three core EFs (inhibition, working memory, and cognitive flexibility) were tested by a modified Eriksen flanker, N-back, and a more-odd shifting. The association between CRF and EF was explored by Pearson correlation, one-way ANOVA, and stratified regression. RESULTS The reaction time (RT) of 1-back, cognitive flexibility with V̇O2max showed a declining trend, (F = 34.475, 27.498, P < 0.01). Interestingly, 2-back RT went up and then went down with V̇O2max. (F = 29.55, P < 0.01). After increasing V̇O2max as a variable, a stratified regression analysis with the RT for 1-back, 2-back, and cognitive flexibility showed that ΔR2 equaled 0.107 ms, 0.071 ms, and 0.091 ms, respectively (P < 0.01). With V̇O2max increased by 1 mL/kg/min, the RT of 1-back, 2-back, and cognitive flexibility shortened 14.697 ms, 15.689 ms, and 11.771 ms, respectively. CONCLUSIONS CRF was positively associated with working memory, and cognitive flexibility development among Chinese Tibetan adolescents living at HA areas, respectively.
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Affiliation(s)
- Yuan Liu
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China
| | - Jun Hong
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China
| | - Xiaojian Yin
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China; College of Economics and Management, Shanghai Institute of Technology, China.
| | - Feng Zhang
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China
| | - Yaru Guo
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China
| | - Pengwei Sun
- College of Physical Education and Health, East China Normal University, China; Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, China
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Chen H, Chen C, Qin Y, Wang L, Zheng J, Gao F. Protective effects of epigallocatechin-3-gallate counteracting the chronic hypobaric hypoxia-induced myocardial injury in plain-grown rats at high altitude. Cell Stress Chaperones 2023; 28:921-933. [PMID: 37875765 PMCID: PMC10746658 DOI: 10.1007/s12192-023-01386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/11/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023] Open
Abstract
Exposure to hypobaric hypoxia (HH) environment causes stress to the body, especially the oxygen-consuming organs. Chronic HH conditions have adverse effects on the myocardium. Thus, we conducted this experiment and aim to evaluate such adverse effects and explore the therapeutic role of epigallocatechin-3-gallate (EGCG) in rats' heart under chronic HH conditions. For that purpose, we transported rats from plain to a real HH environment at high altitude for establishing the HH model. At high altitude, animals were treated with EGCG while the salidroside was used as the positive control. General physiological data were collected, and routine blood test results were analyzed. Cardiac magnetic resonance (CMR) was examined to assess the structural and functional changes of the heart. Serum levels of cardiac enzymes and pro-inflammatory cytokines were examined. Oxidative markers in the left ventricle (LV) were detected. Additionally, ultrastructural and histopathological changes and apoptosis of the LV were assessed. Furthermore, the antioxidant stress-relevant proteins nuclear factor E2-related factor 2 (Nrf2) and the heme oxygenase-1 (HO-1) were detected. The experiment revealed that EGCG treatment decreased HH-induced elevation of cardiac enzymes and relieved mitochondrial damage of the LV. Notably, EGCG treatment significantly alleviated oxidative stress in the LV and inflammatory response in the blood. Western blot confirmed that EGCG significantly upregulated Nrf2 and HO-1. Therefore, EGCG may be considered a promising natural compound for treating the HH-induced myocardial injuries.
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Affiliation(s)
- Haotian Chen
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China
| | - Chen Chen
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China
| | - Yuhui Qin
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China
| | - Lei Wang
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Fabao Gao
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China.
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Niederer M, Tscherny K, Burger J, Wandl B, Fuhrmann V, Kienbacher CL, Schreiber W, Herkner H, Roth D, Egger A. Influence of high altitude after a prior ascent on physical exhaustion during cardiopulmonary resuscitation: a randomised crossover alpine field experiment. Scand J Trauma Resusc Emerg Med 2023; 31:59. [PMID: 37875893 PMCID: PMC10599065 DOI: 10.1186/s13049-023-01132-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Performing cardiopulmonary resuscitation (CPR) inevitably causes significant physical, as well as psychological stress for rescuers. Physical activity at high altitude, a hypobaric and hypoxic environment, similarly adds to the level of stress and causes multiple physiological changes. Continuous measurement of pulse rate serves as an objective measure of fatigue during CPR. We therefore aimed to investigate rescuers' heart rates as a measure of physical strain during CPR in a high-altitude alpine environment to provide a better understanding of the physiological changes under these very special conditions. METHODS Twenty experienced mountaineers performed basic life support (BLS) on a manikin for 16 min, both at baseline altitude and at high altitude (3454 m) following a quick and exhausting ascent over 1200 m. Sequence of scenarios was randomised for analysis. Heart rate was continuously measured and compared between baseline and high altitude by absolute differences and robust confidence intervals. RESULTS During CPR at baseline, the average heart rate increased from 87 bpm (SD 16 bpm) to 104 bpm [increase 17 bpm (95% CI 8.24-24.76)], compared to an increase from 119 bpm (SD 12 bpm) to 124 bpm [increase 5 bpm (95% CI - 1.59 to 12.19)] at high altitude [difference between two groups 32 bpm (95% CI 25-39)]. Differences between periods of chest compressions and ventilations were very similar at baseline [19 bpm (95%CI 16.98-20.27)] and at high altitude [20 bpm 95% CI 18.56-21.44)], despite starting from a much higher level at high altitude. The average heart rates of rescuers at high altitude at any point were higher than those at baseline at any other point. CONCLUSION Performing BLS CPR causes exhaustion both at base level and at a high altitude. A further increase during CPR might imply a physiological reserve for adapting to additional physical exertion at high altitude. Phases of ventilation are much needed recovery-periods, but heart rates remain very high. Subjective measures of exhaustion, such as the BORG-scale, might lead to rescuers' overestimation of their own performance.
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Affiliation(s)
- Maximilian Niederer
- Department of Anaesthesiology and Intensive Care Medicine, Hospital Scheibbs, Eisenwurzenstraße 26, 3270, Scheibbs, Austria
- Mountain Rescue Service Austria, Baumgasse 129, 1030, Vienna, Austria
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Katharina Tscherny
- Department of Anaesthesiology and Intensive Care Medicine, Hospital Scheibbs, Eisenwurzenstraße 26, 3270, Scheibbs, Austria
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Josef Burger
- Mountain Rescue Service Austria, Baumgasse 129, 1030, Vienna, Austria
- Department of Paediatrics, Hospital Lienz, Emanuel von Hibler-Straße 5 A, 9900, Lienz, Austria
| | - Bettina Wandl
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
- Institute of Nursing Science, Department of Nursing Science and Gerontology, UMIT TIROL - Private University for Health Sciences and Health Technology, Hall in Tyrol, Austria
| | - Verena Fuhrmann
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Calvin L Kienbacher
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Alexander Egger
- Department of Anaesthesiology and Intensive Care Medicine, Hospital Scheibbs, Eisenwurzenstraße 26, 3270, Scheibbs, Austria
- Mountain Rescue Service Austria, Baumgasse 129, 1030, Vienna, Austria
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Vélez-Páez JL, Baldeón-Rojas L, Cañadas Herrera C, Montalvo MP, Jara FE, Aguayo-Moscoso S, Tercero-Martínez W, Saltos L, Jiménez-Alulima G, Guerrero V, Pérez-Galarza J. Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude. BMC Pulm Med 2023; 23:393. [PMID: 37848858 PMCID: PMC10583315 DOI: 10.1186/s12890-023-02691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND In 2020, Ecuador had one of the highest death rates because of COVID-19. The role of clinical and biomolecular markers in COVID disease prognosis, is still not well supported by available data. In order for these markers to have practical application in clinical decision-making regarding patient treatment and prognosis, it is necessary to know an optimal cut-off point, taking into consideration ethnic differences and geographic conditions. AIM To determine the value of clinical and biomolecular markers, to predict mortality of patients with severe COVID-19 living at high altitude. METHODS In this study, receiver operating characteristic (ROC) curves, area under the curve (AUC) of ROC, sensitivity, specificity and likelihood ratios were calculated to determine levels of clinical and biomolecular markers that best differentiate survivors versus non-survivors in severe COVID subjects that live at a high altitude setting. RESULTS Selected cut-off values for ferritin (≥ 1225 ng/dl, p = 0.026), IL-6 (≥ 11 pg/ml, p = 0.005) and NLR (≥ 22, p = 0.008) at 24 h, as well as PaFiO2 (≤ 164 mmHg, p = 0.015), NLR (≥ 16, p = p = 0.013) and SOFA (≥ 6, p = 0.031) at 72 h, appear to have good discriminating power to differentiate survivors versus non-survivors. Additionally, odds ratios for ferritin (OR = 3.38); IL-6 (OR = 17.07); PaFiO2 (OR = 4.61); NLR 24 h (OR = 4.95); NLR 72 h (OR = 4.46), and SOFA (OR = 3.77) indicate increased risk of mortality when cut-off points were taken into consideration. CONCLUSIONS We proposed a straightforward and understandable method to identify dichotomized levels of clinical and biomolecular markers that can discriminate between survivors and non-survivors patients with severe COVID-19 living at high altitudes.
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Affiliation(s)
- Jorge Luis Vélez-Páez
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
- Faculty of Medical Sciences, Central University of Ecuador, Quito, Ecuador
| | - Lucy Baldeón-Rojas
- Faculty of Medical Sciences, Central University of Ecuador, Quito, Ecuador
- Research Institute of Biomedicine, Central University of Ecuador, Quito, Ecuador
| | | | | | - Fernando Esteban Jara
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
| | | | - Wendy Tercero-Martínez
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
| | - Lenin Saltos
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
| | - Glenda Jiménez-Alulima
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
| | - Verónica Guerrero
- Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research Center, Quito, Ecuador
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Vignati C, Contini M, Salvioni E, Lombardi C, Caravita S, Bilo G, Swenson ER, Parati G, Agostoni P. Exercise in hypoxia: a model from laboratory to on-field studies. Eur J Prev Cardiol 2023; 30:ii40-ii46. [PMID: 37819224 DOI: 10.1093/eurjpc/zwad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 10/13/2023]
Abstract
Clinical outcome and quality of life of patients with chronic heart failure (HF) have greatly improved over the last two decades. These results and the availability of modern lifts allow many cardiac patients to spend leisure time at altitude. Heart failure per se does not impede a safe stay at altitude, but exercise at both simulated and real altitudes is associated with a reduction in performance, which is inversely proportional to HF severity. For example, in normal subjects, the reduction in functional capacity is ∼2% every 1000 m altitude increase, whereas it is 4 and 10% in HF patients with normal or slightly diminished exercise capacity and in HF patients with markedly diminished exercise capacity, respectively. Also, the on-field experience with HF patients at altitude confirms safety and shows overall similar data to that reported at simulated altitude. Even 'optimal' HF treatment in patients spending time at altitude or at hypoxic conditions is likely different from optimal treatment at sea level, particularly with regard to the selectivity of β-blockers. Furthermore, high altitude, both simulated and on-field, represents a stimulating model of hypoxia in HF patients and healthy subjects. Our data suggest that spending time at altitude (<3500 m) can be safe even for HF patients, provided that subjects are free from comorbidities that may directly interfere with the adaptation to altitude and are stable. However, HF patients experience a reduction of exercise capacity directly proportional to HF severity and altitude. Finally, HF patients should be tested for functional capacity and must undergo a specific 'hypoxic-tailored treatment' to avoid pharmacological interference with altitude adaptation mechanisms, particularly with regard to the selectivity of β-blockers.
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Affiliation(s)
- Carlo Vignati
- Centro Cardiologico Monzino, IRCCS, Via Parea, Milano 20138, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Via Parea, Milano 20138, Italy
| | - Mauro Contini
- Centro Cardiologico Monzino, IRCCS, Via Parea, Milano 20138, Italy
| | | | - Carolina Lombardi
- Sleep Medicine Center, Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Sergio Caravita
- Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Grzegorz Bilo
- Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Erik R Swenson
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Via Parea, Milano 20138, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Via Parea, Milano 20138, Italy
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Liu G, Li Y, Liao N, Shang X, Xu F, Yin D, Shao D, Jiang C, Shi J. Energy metabolic mechanisms for high altitude sickness: Downregulation of glycolysis and upregulation of the lactic acid/amino acid-pyruvate-TCA pathways and fatty acid oxidation. Sci Total Environ 2023; 894:164998. [PMID: 37353011 DOI: 10.1016/j.scitotenv.2023.164998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
Hypobaric hypoxia is often associated with the plateau environment and can lead to altitude sickness or death. The underlying cause is a lack of oxygen, which limits energy metabolism and leads to a compensatory stress response. Although glycolysis is commonly accepted as the primary energy source during clinical hypoxia, our preliminary experiments suggest that hypobaric hypoxia may depress glycolysis. To provide a more comprehensive understanding of energy metabolism under short-term hypobaric hypoxia, we exposed mice to a simulated altitude of 5000 m for 6 or 12 h. After the exposure, we collected blood and liver tissues to quantify the substrates, enzymes, and metabolites involved in glycolysis, lactic acid metabolism, the tricarboxylic acid cycle (TCA), and fatty acid β-oxidation. We also performed transcriptome and enzymatic activity analyses of the liver. Our results show that 6 h of hypoxic exposure significantly increased blood glucose, decreased lactic acid and triglyceride concentrations, and altered liver enzyme activities of mice exposed to hypoxia. The key enzymes in the glycolytic, TCA, and fatty acid β-oxidation pathways were primarily affected. Specifically, the activities of key glycolytic enzymes, such as glucokinase, decreased significantly, while the activities of enzymes in the TCA cycle, such as isocitrate dehydrogenase, increased significantly. Lactate dehydrogenase, pyruvate carboxylase, and alanine aminotransferase were upregulated. These changes were partially restored when the exposure time was extended to 12 h, except for further downregulation of phosphofructokinase and glucokinase. This study demonstrates that acute high altitude hypoxia upregulated the lactic acid/amino acid-pyruvate-TCA pathways and fatty acid oxidation, but downregulated glycolysis in the liver of mice. The results obtained in this study provide a theoretical framework for understanding the mechanisms underlying the pathogenesis of high-altitude sickness in humans. Additionally, these findings have potential implications for the development of prevention and treatment strategies for altitude sickness.
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Affiliation(s)
- Guanwen Liu
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
| | - Yinghui Li
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China
| | - Ning Liao
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
| | - Xinzhe Shang
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China
| | - Fengqin Xu
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China
| | - Dachuan Yin
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
| | - Dongyan Shao
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
| | - Chunmei Jiang
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
| | - Junling Shi
- School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi'an, Shaanxi Province 710072, China.
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Xue L, Zhou B, Ding L, Feng H, Nie J, Zhang Q. Effects of simulated high altitude on body temperature and heart rate in pilot reserves during the hot-dry exposure. J Therm Biol 2023; 117:103685. [PMID: 37597448 DOI: 10.1016/j.jtherbio.2023.103685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 08/21/2023]
Abstract
Recent research has primarily focused on human thermoregulatory responses at high altitudes, but investigations involving extremely high-temperature and hypobaric compound environments are currently lacking. To address this gap in knowledge, this study aimed to enhance the prediction of human heat sensation for pilot reserves while operating in extremely hot cabins with decompression. To achieve this, an improved Predicted Heat Strain (PHS) model was developed by incorporating the influence of air pressure on metabolic rate. The model's validity was assessed through experiments conducted at different altitudes (0m, 5000m, and 8000m) and varying environmental conditions (26°C and 45 °C, 10% RH and 40% RH) within an environmental simulation cabin. During these experiments, local skin temperature, core temperature, heart rate, and blood oxygen saturation were measured. The findings revealed distinct variations in the skin temperature of the hand and foot segments across different experimental stages, and significant correlations were observed between heart rate, core temperature, and local skin temperatures. Furthermore, regression models were established to explore the relationship between heart rate and local skin temperatures. By comparing simulated and experimental core and local skin temperatures, the enhanced PHS model was successfully validated. The conclusions drawn from this study provide valuable insights for predicting thermal physiological indices accurately and conveniently in hot-dry and hypobaric environments.
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Affiliation(s)
- Lihao Xue
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Biyun Zhou
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Li Ding
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Hetian Feng
- Institute of Artificial Intelligence, Beihang University, Beijing, 100083, China
| | - Jiachen Nie
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Qing Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
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Grimm M, Seglias A, Ziegler L, Mademilov M, Isaeva E, Tynybekov K, Tilebalieva A, Osmonbaeva N, Furian M, Sooronbaev TM, Ulrich S, Bloch KE. Sleep apnea in school-age children living at high altitude. Pulmonology 2023; 29:385-391. [PMID: 36964122 DOI: 10.1016/j.pulmoe.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 03/26/2023] Open
Abstract
INTRODUCTION Among adults, sleep apnea is more common in highlanders than in lowlanders. We evaluated the sleep apnea prevalence in children living at high altitude compared to age-matched low-altitude controls. METHODS Healthy children, 7-14 y of age, living at 2500-3800m in the Tien Shan mountains, Kyrgyzstan, were prospectively studied in a health post at 3250m. Healthy controls of similar age living at 700-800m were studied in a University Hospital at 760m in Bishkek. Assessments included respiratory sleep studies scored according to pediatric standards, clinical examination, medical history, and the pediatric sleep questionnaire (PSQ, range 0 to 1 with increasing symptoms). RESULTS In children living at high altitude (n = 37, 17 girls, median [quartiles] age 10.8y [9.6;13.0]), sleep studies revealed: mean nocturnal pulse oximetry 90% (89;91), oxygen desaturation index (ODI, >3% dips in pulse oximetry) 4.3/h (2.5;6.7), apnea/hypopnea index (AHI) total 1.7/h (1.0;3.6), central 1.6/h (1.0;3.3), PSQ 0.27 (0.18;0.45). In low-altitude controls (n=41, 17 girls, age 11.6y [9.5;13.0], between-groups comparison of age P=0.69) sleep studies revealed: pulse oximetry 97% (96;97), ODI 0.7/h (0.2;1.2), AHI total 0.4/h (0.1;1.0), central 0.3/h (0.1;0.7), PSQ 0.18 (0.14;0.31); P<0.05, all corresponding between-group comparisons. CONCLUSIONS In school-age children living at high altitude, nocturnal oxygen saturation was lower, and the total and central AHI were higher compared to children living at low altitude. The greater score of sleep symptoms in children residing at high altitude suggests a potential clinical relevance of the nocturnal hypoxemia and subtle sleep-related breathing disturbances.
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Affiliation(s)
- M Grimm
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - A Seglias
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - L Ziegler
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - M Mademilov
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - E Isaeva
- National Center of Maternity and Childhood Care, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - K Tynybekov
- National Center of Maternity and Childhood Care, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - A Tilebalieva
- National Center of Maternity and Childhood Care, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - N Osmonbaeva
- National Center of Maternity and Childhood Care, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - M Furian
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - T M Sooronbaev
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - S Ulrich
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic
| | - K E Bloch
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland; Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyz Republic.
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kandel K, Regmi PR, Poudel S. Susceptibility - weighted imaging: A valuable diagnostic tool for early detection of high-altitude cerebral edema: A case report. Radiol Case Rep 2023; 18:3089-3092. [PMID: 37434613 PMCID: PMC10331005 DOI: 10.1016/j.radcr.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/03/2023] [Indexed: 07/13/2023] Open
Abstract
High altitude cerebral edema (HACE) is a clinical spectrum of high-altitude illness. The working diagnosis of HACE should be based on the history of rapid ascent with signs of encephalopathy. Magnetic resonance imaging (MRI) can be crucial in the timely diagnosis of the condition. A 38-year-old female was airlifted from Everest base camp due to sudden onset of vertigo and dizziness. She had no significant medical or surgical history, and routine laboratory tests showed normal results. MRI was performed, which showed no abnormalities except for the detection of subcortical white matter and corpus callosum hemorrhages on susceptibility-weighted imaging (SWI). The patient was hospitalized for 2 days and treated with dexamethasone and oxygen, and had a smooth recovery during follow-up. HACE is a serious and potentially life-threatening condition that can occur in individuals who rapidly ascend to high altitudes. MRI is a valuable diagnostic tool in the evaluation of early HACE, and can detect various abnormalities in the brain that may indicate the presence of HACE, including micro-hemorrhages. Micro-hemorrhages are tiny areas of bleeding in the brain that may not be visible on other MRI sequences but can be detected on SWI. Clinicians especially radiologists, should be aware of the importance of SWI in the diagnosis of HACE, and ensure that it is included in the standard MRI protocol for evaluating individuals with high altitude-related illnesses for early diagnosis and appropriate treatment to prevent further neurological damage and improve patient outcomes.
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Affiliation(s)
- Kamal kandel
- Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
| | - Pradeep Raj Regmi
- Department of Radiology, Maharajgunj Medical Campus/Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Saroj Poudel
- Chitwan Medical College, Bharatpur, Chitwan, Nepal
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Thejaswi SG, Koirala P, Pradhan U, Papanaik H, Bhuyan S. Severe Vitamin D Deficiency as a Risk Factor in Newly Diagnosed Tuberculosis Patients: Comparative Study on Inhabitants of High Altitude Region. Int J Prev Med 2023; 14:106. [PMID: 37854998 PMCID: PMC10580179 DOI: 10.4103/ijpvm.ijpvm_180_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/27/2022] [Indexed: 10/20/2023] Open
Abstract
Background The present study was conducted to find the association between tuberculosis and vitamin D levels and assess severe vitamin D deficiency (VDD) as a risk factor for developing tuberculosis at high-altitude regions. Methods This cross-sectional study was carried out at a tertiary care hospital situated at an average altitude of 5,412 feet above sea level. Newly diagnosed active cases of tuberculosis (Group A) and unmatched healthy individuals (Group B) were recruited in the study. Serum samples were analyzed for Vitamin 25(OH) D levels and correlated between the groups. Results The study included 54 newly diagnosed tuberculosis patients (Group A) (47 pulmonary and 7 extrapulmonary tuberculosis) and 87 healthy controls (Group B). Of the total 141 participants, 69 (49%) had severe VDD and 44 (31%) had VDD. The mean (SD) vitamin D level was significantly lower in patients having tuberculosis (12.6 ± 7 ng/mL) as compared to Group B (15.9 ± 7 ng/mL). The risk of tuberculosis infection was 2.13 times higher among those who had VDD (odds ratio = 2.13) (P-0.106), whereas those with severe VDD were at 3.2 times higher risk of developing tuberculosis (crude odds ratio = 3.2) (P = 0.001) and severe VDD independently contributed to being diagnosed with tuberculosis (adjusted odds ratio = 3.1) (P = 0.002). Conclusions Vitamin D levels are significantly low in tuberculosis patients and severe VDD independently contributes to developing tuberculosis infection.
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Affiliation(s)
- S G Thejaswi
- Department of Orthopaedics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Prakash Koirala
- Department of Orthopaedics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Ujjawal Pradhan
- Department of Orthopaedics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - H Papanaik
- Department of Orthopaedics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - Shreyasmita Bhuyan
- Department of Orthopaedics, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
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He Y, Cui C, Guo Y, Zheng W, Yue T, Zhang H, Ouzhuluobu, Wu T, Qi X, Su B. High Arterial Oxygen Saturation in the Acclimatized Lowlanders Living at High Altitude. Phenomics 2023; 3:329-332. [PMID: 37589023 PMCID: PMC10425305 DOI: 10.1007/s43657-023-00117-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 08/18/2023]
Abstract
Blood oxygen saturation (SpO2) is a key indicator of oxygen availability in the body. It is known that a low SpO2 at high altitude is associated with morbidity and mortality risks due to physiological hypoxemia. Previously, it was proposed that the lowlander immigrants living at high altitude should have a lower SpO2 level compared to the highlander natives, but this proposal has not been rigorously tested due to the lack of data from the lowlander immigrants living at high altitude. In this study, we compared arterial oxygen saturation of 5929 Tibetan natives and 1034 Han Chinese immigrants living at altitudes ranging from 1120 m to 5020 m. Unexpectedly, the Han immigrants had a higher SpO2 than the Tibetan natives at the same high altitudes. At the same time, there is a higher prevalence of chronic mountain sickness in Han than in Tibetans at the same altitude. This result suggests that the relatively higher SpO2 level of the acclimatized Han is associated with a physiological cost, and the SpO2 level of Tibetans tends to be sub-optimal. Consequently, SpO2 alone is not a robust indicator of physiological performance at high altitude. Supplementary Information The online version contains supplementary material available at 10.1007/s43657-023-00117-x.
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Affiliation(s)
- Yaoxi He
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Chaoying Cui
- High Altitude Medical Research Center, School of Medicine, Tibetan University, Lhasa, 850000 China
| | - Yongbo Guo
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Wangshan Zheng
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Tian Yue
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Hui Zhang
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Ouzhuluobu
- High Altitude Medical Research Center, School of Medicine, Tibetan University, Lhasa, 850000 China
| | - Tianyi Wu
- National Key Laboratory of High Altitude Medicine, High Altitude Medical Research Institute, Xining, 810012 China
| | - Xuebin Qi
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
| | - Bing Su
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223 China
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Huppertz B. Placental physioxia is based on spatial and temporal variations of placental oxygenation throughout pregnancy. J Reprod Immunol 2023; 158:103985. [PMID: 37406413 DOI: 10.1016/j.jri.2023.103985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
For obvious reasons, in vivo measurements of placental oxygenation are extremely rare and hence, scientists need to focus on the few studies that revealed at least some data on the topic. The scarcity of real in vivo data resulted in the development of hypotheses on placental oxygenation that blocked an objective view on the topic for decades. Only now, new hypotheses are emerging adding new views and ideas on the topic. Especially in the field of preeclampsia, hypotheses on placental oxygenation have mislead a whole generation of scientists. This review article displays the available in vivo placental oxygen data from 8 to 40 weeks of gestation. It also compares these physiological oxygen concentrations, called physioxia, with the situation in pre-placental hypoxia, i.e. pregnancies at high altitude. Finally, it summarizes what we know today about oxygen measurements in cases with preeclampsia. In early-onset preeclampsia cases, all in vivo data available today point to increased oxygen values in the intervillous space of the placenta. This is due to a reduced oxygen transfer of the placental barrier from maternal to fetal blood, resulting in hypoxia of fetal blood and the fetus.
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Affiliation(s)
- Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria.
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Al-Emam AMA, Dajam A, Alrajhi M, Alfaifi W, Al-Shraim M, Helaly AM. Sudden death in the southern region of Saudi Arabia: A retrospective study. World J Clin Cases 2023; 11:4843-4851. [PMID: 37583982 PMCID: PMC10424041 DOI: 10.12998/wjcc.v11.i20.4843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Sudden death is unanticipated, non-violent death taking place within the first 24 h after the onset of symptoms. It is a major public health problem worldwide. Moreover, the effects of living at moderate altitude on mortality are poorly understood. AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital, 2255 m above sea level, in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016. METHODS The medical records of 1821 deaths were examined and showed 353 cases (19.4%) of sudden death. RESULTS The highest incidence of sudden death was among the elderly (51%), whereas, the lowest was among children and adolescents (6.5%). With regard to gender, the incidence of sudden death was higher in males (54.4%) compared to 45.6% in females. In this study, we found that the most common direct causes of sudden death were cardiovascular diseases (29.2%), respiratory disease (22.7%), infectious disease (12.2%), cancer (9.4%) and hematological diseases (6.2%). With respect to seasonal variation, the highest incidence was during winter (31.32%) followed by summer (25.8%). CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.
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Affiliation(s)
- Ahmed Mohamed Ahmed Al-Emam
- Department of Pathology, College of Medicine, King Khalid University, Asir 61421, Saudi Arabia
- Forensic Medicine and Clinical Toxicology, Mansoura University, Mansoura 35516, Egypt
| | | | - Mohammed Alrajhi
- Medical School, King Khalid University, Asir 61421, Saudi Arabia
| | - Waleed Alfaifi
- Medical School, King Khalid University, Asir 61421, Saudi Arabia
| | - Mubarak Al-Shraim
- Department of Pathology, College of Medicine, King Khalid University, Asir 61421, Saudi Arabia
| | - Ahmed Mohamed Helaly
- Forensic Medicine and Clinical Toxicology, Mansoura University, Mansoura 35516, Egypt
- Clinical Science, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
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Al-Emam AMA, Dajam A, Alrajhi M, Alfaifi W, Al-Shraim M, Helaly AM. Sudden death in the southern region of Saudi Arabia: A retrospective study. World J Clin Cases 2023; 11:4839-4847. [DOI: 10.12998/wjcc.v11.i20.4839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Sudden death is unanticipated, non-violent death taking place within the first 24 h after the onset of symptoms. It is a major public health problem worldwide. Moreover, the effects of living at moderate altitude on mortality are poorly understood.
AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital, 2255 m above sea level, in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.
METHODS The medical records of 1821 deaths were examined and showed 353 cases (19.4%) of sudden death.
RESULTS The highest incidence of sudden death was among the elderly (51%), whereas, the lowest was among children and adolescents (6.5%). With regard to gender, the incidence of sudden death was higher in males (54.4%) compared to 45.6% in females. In this study, we found that the most common direct causes of sudden death were cardiovascular diseases (29.2%), respiratory disease (22.7%), infectious disease (12.2%), cancer (9.4%) and hematological diseases (6.2%). With respect to seasonal variation, the highest incidence was during winter (31.32%) followed by summer (25.8%).
CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.
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Affiliation(s)
- Ahmed Mohamed Ahmed Al-Emam
- Department of Pathology, College of Medicine, King Khalid University, Asir 61421, Saudi Arabia
- Forensic Medicine and Clinical Toxicology, Mansoura University, Mansoura 35516, Egypt
| | | | - Mohammed Alrajhi
- Medical School, King Khalid University, Asir 61421, Saudi Arabia
| | - Waleed Alfaifi
- Medical School, King Khalid University, Asir 61421, Saudi Arabia
| | - Mubarak Al-Shraim
- Department of Pathology, College of Medicine, King Khalid University, Asir 61421, Saudi Arabia
| | - Ahmed Mohamed Helaly
- Forensic Medicine and Clinical Toxicology, Mansoura University, Mansoura 35516, Egypt
- Clinical Science, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
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Prosperi P, Verratti V, Bondi D, Spacone A. On pulse oximetry and hypoxia. Respir Physiol Neurobiol 2023; 315:104111. [PMID: 37406841 DOI: 10.1016/j.resp.2023.104111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Pierpaolo Prosperi
- Department of Pneumology and Respiratory Physiopathology, S. Spirito Hospital, 66020 Pescara, Italy.
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" Chieti - Pescara, 66100 Chieti, Italy.
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti - Pescara, 66100 Chieti, Italy.
| | - Antonella Spacone
- Department of Pneumology and Respiratory Physiopathology, S. Spirito Hospital, 66020 Pescara, Italy.
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Xing Z, Yang T, Shi S, Meng X, Chen R, Long H, Hu Y, Chai D, Liu W, Tong Y, Wang Y, Ma Y, Pan M, Cui J, Sun T, Guo Y. Ambient particulate matter associates with asthma in high altitude region: A population-based study. World Allergy Organ J 2023; 16:100774. [PMID: 37214170 PMCID: PMC10193005 DOI: 10.1016/j.waojou.2023.100774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/14/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Background Exposure to particulate matter (PM) has been a major public health threat, but the potentially differential effects on asthma of PM remain largely unknown in high altitude settings. We evaluated the effects of ambient PM on asthma in high altitude settings. Methods The study recruited a representative sample from high altitude settings using a multistage stratified sampling procedure. Asthma was defined by a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. The annual mean PM2.5 and PM10 concentrations were calculated for each grid cell at 1-km spatial resolution based on the geographical coordinates. Results We analyzed data for participants (mean age 39.1 years, 51.4% female) and 183 (3.7%, 95% confidence interval (CI): 3.2-4.2) of the participants had asthma. Prevalence was higher in women (4.3%, 95% CI 3.5-5.1) than in men (3.1%, 2.4-3.8) and increasing with higher concentration of PM exposures. For an interquartile range (IQR) difference (8.77 μg/m3) in PM2.5 exposure, the adjusted odds ratio (OR) was 1.64 (95% CI 1.46-1.83, P < 0.001) for risk of asthma. For PM10, there was evidence for an association with risk of asthma (OR 2.34, 95% CI: 1.75-3.15, P < 0.001 per IQR of 43.26 μg/m3). Further analyses showed that household mold or damp exposure may aggravate PM exposure associated risks of asthma. Conclusions This study identified that PM exposure could be a dominate environmental risk factor for asthma but largely unconsidered in the high-altitude areas. The association between PM exposure and asthma should be of interest for planners of national policies and encourage programs for prevention of asthma in residents living at high altitudes.
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Affiliation(s)
- ZhenZhen Xing
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, China
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China
- Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Huanyu Long
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanlu Hu
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Di Chai
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - WeiMing Liu
- Department of Intensive Care Medicine, Beijing Boai Hospital, Rehabilitation Research Center, Beijing, China
| | - YaQi Tong
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - YuXia Wang
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - YaLi Ma
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - MingMing Pan
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Cui
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - TieYing Sun
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - YanFei Guo
- Peking University Fifth School of Clinical Medicine, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Wang L, Wang F, Tuo Y, Wan H, Luo F. Clinical characteristics and predictors of pulmonary hypertension in chronic obstructive pulmonary disease at different altitudes. BMC Pulm Med 2023; 23:127. [PMID: 37072815 PMCID: PMC10111800 DOI: 10.1186/s12890-023-02405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) is a common complication in patients with chronic obstructive pulmonary disease (COPD) and is closely associated with poor prognosis. However, studies on the predictors of PH in COPD patients are limited, especially in populations living at high altitude (HA). OBJECTIVES To investigate the differences in the clinical characteristics and predictors of patients with COPD/COPD and PH (COPD-PH) from low altitude (LA, 600 m) and HA (2200 m). METHODS We performed a cross-sectional survey of 228 COPD patients of Han nationality admitted to the respiratory department of Qinghai People's Hospital (N = 113) and West China Hospital of Sichuan University (N = 115) between March 2019 and June 2021. PH was defined as a pulmonary arterial systolic pressure (PASP) > 36 mmHg measured using transthoracic echocardiography (TTE). RESULTS The proportion of PH in COPD patients living at HA was higher than that in patients living at LA (60.2% vs. 31.3%). COPD-PH patients from HA showed significantly different in baseline characteristics, laboratory tests and pulmonary function test. Multivariate logistic regression analysis indicated that the predictors of PH in COPD patients were different between the HA and LA groups. CONCLUSIONS The COPD patients living at HA had a higher proportion of PH than those living at LA. At LA, increased B-type natriuretic peptide (BNP) and direct bilirubin (DB) were predictors for PH in COPD patients. However, at HA, increased DB was a predictor of PH in COPD patients.
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Affiliation(s)
- Lixia Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Faping Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yajun Tuo
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Xining, China
| | - Huajing Wan
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fengming Luo
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Macotela L, Naya DE, González-Morales JC, Anaya M, Fajardo V, Manjarrez J. Altitudinal variation in organ mass from three mountain systems: The case of mesquite lizard Sceloporus grammicus. Comp Biochem Physiol A Mol Integr Physiol 2023; 281:111426. [PMID: 37059292 DOI: 10.1016/j.cbpa.2023.111426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
High altitude environments provide a fertile ground for investigating the benefits of phenotypic adjustments at several levels of biological organization. Low oxygen partial pressure and low environmental temperature are the main limiting factors that promote phenotypic variation in different organs, such as the lung and heart. Although high-altitude environments act like natural laboratories, most morphological studies conducted to date lack replication. Here, we evaluated organ mass variation in nine populations of Sceloporus grammicus, throughout three altitudinal gradients (mountains) from the Trans-Mexican volcanic belt. A total of 84 individuals from three different altitudes at three different mountains were collected. Then, we used generalized linear models to analyze the pattern of variation in internal organs mass as a function of altitude and temperature. We observed a striking pattern of altitudinal variation in the size of cardiorespiratory organs: while heart mass increased with altitude and decreased with temperature, the lung showed a significant statistical interaction between mountain transect and temperature. Overall, our results support the hypothesis that cardiorespiratory organs should be bigger in populations occurring at higher altitudes. Moreover, the study of different mountain systems allowed us to observe some differences in one mountain in relation to the other two.
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Affiliation(s)
- Luis Macotela
- Doctorado en Ciencias Agropecuarias y Recursos Naturales, Universidad Autónoma del Estado de México, Instituto Literario No. 100, Col. Centro, C. P. 5000 Toluca, Estado de Mexico, Mexico; Instituto para la Conservación de la Cordillera Neovolcánica ante el Cambio Climático, A.C. Calle Lago de Atitlán No. 502, C. P. 50100 Toluca, Estado de México, Mexico
| | - Daniel E Naya
- Departamento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; Museum of Vertebrate Zoology, University of California, Berkeley, CA 94720, USA
| | - Juan C González-Morales
- Centro Universitario Amecameca, Universidad Autónoma del Estado de México, Instituto Literario 100, Col. Centro, CP 50000 Toluca, Estado de México, Mexico
| | - Mariluz Anaya
- Instituto para la Conservación de la Cordillera Neovolcánica ante el Cambio Climático, A.C. Calle Lago de Atitlán No. 502, C. P. 50100 Toluca, Estado de México, Mexico; Maestría en Ciencias Biológicas, Facultad de Ciencias, Universidad Autónoma del Estado de Mexico, Mexico
| | - Víctor Fajardo
- Instituto para la Conservación de la Cordillera Neovolcánica ante el Cambio Climático, A.C. Calle Lago de Atitlán No. 502, C. P. 50100 Toluca, Estado de México, Mexico
| | - Javier Manjarrez
- Facultad de Ciencias, Universidad Autónoma del Estado de México, Campus El Cerrillo, Carretera Toluca - Ixtlahuaca Km 15.5, Piedras Blancas, 50200 Toluca de Lerdo, Mexico.
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Shaikh AA, He T, Deng F, Luo Z, Zhao J, Zhang Z, Liu H. Altitude-dependent gaseous emissions from freight trucks along the China-Pakistan Economic Corridor in Pakistan. Environ Sci Ecotechnol 2023; 14:100226. [PMID: 36479160 PMCID: PMC9720242 DOI: 10.1016/j.ese.2022.100226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
Recent increases in emissions from freight transport have caused strong concerns about air quality in Pakistan, following the rapid development of projects related to the China-Pakistan Economic Corridor (CPEC). This study reported the first measurements of on-road truck emissions in Pakistan and investigated their dependence on altitude along CPEC routes. Emissions from 70 trucks were measured on CPEC highways located in Islamabad (540 m above sea level), Sost (2800 m above sea level), and at the Khunjerab Pass (4693 m above sea level). Calculated emission factors for carbon monoxide, hydrocarbons, and nitrogen oxides from heavy-duty trucks in Islamabad were 12.94 ± 1.46, 15.21 ± 1.67, and 10.69 ± 1.34 g km-1 (95% confidence level), respectively, for pre-Pak-II trucks, and 12.75 ± 2.80, 14.24 ± 3.53, and 10.24 ± 2.34 g km-1 (95% confidence level), respectively, for Pak-II trucks, representing 2-20 times higher values than the emission standards in Pakistan and India. An altitude increase of approximately 4000 m, with the associated changes in meteorology and fleet characteristics, induced an average increase of 103.6%, 86.3%, 124.5%, and 133.6% in the emission factors of carbon monoxide, hydrocarbons, nitrogen oxides, and carbon dioxide, respectively. Moreover, on-road emissions along the CPEC were mainly influenced by truck types. This study will support the budget evaluation of transport emissions from the CPEC trade fleet.
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Gao C, Yang B, Li Y, Pei W. Monocarboxylate transporter-dependent mechanism is involved in the adaptability of the body to exercise-induced fatigue under high-altitude hypoxia environment. Brain Res Bull 2023; 195:78-85. [PMID: 36804772 DOI: 10.1016/j.brainresbull.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
Under high-altitude hypoxia environment, the body is more prone to fatigue, which occurs in both peripheral muscles and the central nervous system (CNS). The key factor determining the latter is the imbalance of brain energy metabolism, which makes it difficult to maintain the central nervous system to send peripheral nerve impulse continuously. During strenuous exercise, lactate released from astrocytes is taken up by neurons stored for energy to maintain synaptic transmission, a process mediated by monocarboxylate transporters (MCTs) in CNS. The present study investigated the correlation among the adaptability to exercise-induced fatigue, brain lactate metabolism and neuronal hypoxia injury under high-altitude hypoxia environment. Rats were subjected to exhaustive incremental load treadmill exercise under either normal pressure and normoxic conditions or simulated high-altitude low pressure and hypoxic conditions, with subsequent evaluation of the average exhaustive time as well as the expression of monocarboxylate transporters 2 (MCT2), MCT4, the average neuronal density in the cerebral motor cortex, and the lactate content in rat brain. At the early stage of simulated high-altitude environment, the average exhaustive time and neuronal density of rats decreased rapidly, then gradually recovered to some extent with the extension of altitude acclimatization time. The expression of MCT2, MCT4 and the lactate content in rat brain also increased gradually with the extension of altitude acclimatization time. After the application of lactate transport inhibitor, the recovery of exercise capacity of rats after altitude acclimatization was quickly blocked, and the neuronal injury in the cerebral motor cortex of rats was also significantly aggravated. These findings demonstrate that MCT-dependent mechanism is involved in the adaptability of the body to central fatigue, and provide a potential basis for medical intervention for exercise-induced fatigue under high-altitude hypoxia environment.
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Affiliation(s)
- Chen Gao
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China.
| | - Binni Yang
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
| | - Yurong Li
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
| | - Wenjuan Pei
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
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Sharma P, Mohanty S, Ahmad Y. A study of survival strategies for improving acclimatization of lowlanders at high-altitude. Heliyon 2023; 9:e14929. [PMID: 37025911 PMCID: PMC10070159 DOI: 10.1016/j.heliyon.2023.e14929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Human Acclimatization and therapeutic approaches are the core components for conquering the physiological variations at high altitude (≥2500 m) exposure. The declined atmospheric pressure and reduced partial pressure of oxygen at high altitudes tend to decrease the temperature by several folds. Hypobaric hypoxia is a major threat to humanity at high altitudes, and its potential effects include altitude mountain sickness. On severity, it may lead to the development of conditions like high-altitude cerebral edema (HACE) or high-altitude pulmonary edema (HAPE) and cause unexpected physiological changes in the healthy population of travelers, athletes, soldiers, and low landers while sojourning at high altitude. Previous investigations have been done on long-drawn-out acclimatization strategies such as the staging method to prevent the damage caused by high-altitude hypobaric Hypoxia. Inherent Limitations of this strategy hamper the daily lifestyle and time consuming for people. It is not suitable for the rapid mobilization of people at high altitudes. There is a need to recalibrate acclimatization strategies for improving health protection and adapting to the environmental variations at high altitudes. This narrative review details the geographical changes and physiological changes at high altitudes and presents a framework of acclimatization, pre-acclimatization, and pharmacological aspects of high-altitude survival to enhance the government efficacy and capacity for the strategic planning of acclimatization, use of therapeutics, and safe de-induction from high altitude for minimizing the life loss. It's simply too ambitious for the importance of the present review to reduce life loss, and it can be proved as the most essential aspect of the preparatory phase of high-altitude acclimatization in plateau regions without hampering the daily lifestyle. The application of pre-acclimatization techniques can be a boon for people serving at high altitudes, and it can be a short bridge for the rapid translocation of people at high altitudes by minimizing the acclimatization time.
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Affiliation(s)
- Poornima Sharma
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
| | - Swaraj Mohanty
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
| | - Yasmin Ahmad
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
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