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Mateikaitė-Pipirienė K, Jean D, Paal P, Horakova L, Kriemler S, Rosier AJ, Andjelkovic M, Beidleman BA, Derstine M, Hefti JP, Hillebrandt D, Keyes LE. Menopause and High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2024; 25:1-8. [PMID: 37922458 DOI: 10.1089/ham.2023.0039] [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: 11/05/2023] Open
Abstract
Mateikaitė-Pipirienė, Kastė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J. Rosier, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, and Linda E. Keyes for the UIAA MedCom writing group on Women's Health in the Mountains. Menopause and high altitude: A scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 25:1-8, 2024. Background: Older people are an important fraction of mountain travelers and climbers, many of them postmenopausal women. The aim of this work was to review health issues that older and postmenopausal women may experience at high altitude, including susceptibility to high-altitude illness. Methods: We performed a scoping review for the UIAA Medical Commission series on Women's Health in the mountains. We searched PubMed and Cochrane libraries and performed an additional manual search. The primary search focused on articles assessing lowland women sojourning at high altitude. Results: We screened 7,165 potential articles. The search revealed three relevant articles, and the manual search another seven articles and one abstract. Seven assessed menopausal low-altitude residents during a high-altitude sojourn or performing hypoxic tests. Four assessed high-altitude residents. We summarize the results of these 11 studies. Conclusions: Data are limited on the effects of high altitude on postmenopausal women. The effects of short-term, high-altitude exposure on menopause symptoms are unknown. Menopause has minimal effect on the physiological responses to hypoxia in physically fit women and does not increase the risk of acute mountain sickness. Postmenopausal women have an increased risk of urinary tract infections, which may be exacerbated during mountain travel. More research is needed on the physiology and performance of older women at high altitude.
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Affiliation(s)
- Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Clinics, Elektrėnai Division, Lithuania
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelesus Medical University, Salzburg, Austria
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alison J Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- US Army Research Institute of Environmental Medicine, Military Performance Division, Natick MA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Derstine M, Jean D, Beidleman BA, Pichler Hefti J, Hillebrandt D, Horakova L, Kriemler S, Mateikaitė-Pipirienė K, Paal P, Rosier AJ, Andjelkovic M, Keyes LE. Acute Mountain Sickness and High Altitude Cerebral Edema in Women: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2023; 24:259-267. [PMID: 37870579 DOI: 10.1089/ham.2023.0043] [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: 10/24/2023] Open
Abstract
Derstine, Mia, Dominique Jean, Beth A. Beidleman, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, Susi Kriemler, Kasté Mateikaité-Pipiriené, Peter Paal, Alison Rosier, Marija Andjelkovic, and Linda E. Keyes. Acute mountain sickness and high altitude cerebral edema in women: A scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:259-267, 2023. Background: Acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) are illnesses associated with rapid ascent to altitudes over 2,500 m in unacclimatized lowlanders. The aim of this scoping review is to summarize the current knowledge on sex differences in the epidemiology, pathophysiology, symptomatology, and treatment of AMS and HACE, especially in women. Methods and Results: The UIAA Medical Commission convened an international author team to review women's health issues at high altitude and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including AMS, HACE, and high altitude), with additional publications found by hand search. The primary search focus was for articles assessing lowland women sojourning at high altitude. Results: The literature search yielded 7,165 articles, 37 of which were ultimately included. The majority of publications included did not find women at increased risk for AMS or HACE. There was extremely limited sex-specific data on risk factors or treatment. Conclusions: There is a limited amount of data on female-specific findings regarding AMS and HACE, with most publications addressing only prevalence or incidence with regard to sex. As such, general prevention and treatment strategies for AMS and HACE should be used regardless of sex.
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Affiliation(s)
- Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Beth A Beidleman
- US Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massachusetts, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, United Kingdom
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Clinics, Elektrėnai Division, Lithuania
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelesus Medical University, Salzburg, Austria
| | - Alison J Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Garrido E, Hüfner K. An Episode of "Third Person" Phenomenon Involving Somesthetic and Visual Hallucinations in a World-Class Extreme Altitude Climber. Wilderness Environ Med 2023; 34:549-552. [PMID: 37620238 DOI: 10.1016/j.wem.2023.07.004] [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: 05/10/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/26/2023]
Abstract
Psychotic symptoms can occur at high altitude. However, most reports are in the mountaineering literature and lack a clear medical assessment and interpretation. Here we report an episode of isolated high-altitude psychosis. It consisted of a "third person" phenomenon involving 2 sensory modalities: somesthetic (felt presence) and visual (the light of 2 flashlights) hallucinations. This episode occurred in a highly experienced climber when he was at an altitude of approximately 7500 m while descending at dusk from the summit of Gasherbrum I (8068 m). The symptoms lasted approximately 3 h and had fully resolved on reaching high camp (7150 m). No other physical or mental symptoms were reported. In addition to hypoxia, a number of other risk factors could have contributed to the occurrence of psychosis in this climber. These included sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, feeling of isolation, and perceived danger. The climber has participated in many extreme altitude expeditions, and neither before nor since this episode has the climber experienced psychotic symptoms.
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Affiliation(s)
- Eduardo Garrido
- Hypobaria and Biomedical Physiology Service, Department of Physiological Sciences II, University of Barcelona-Bellvitge University Campus, Barcelona, Spain.
| | - Katharina Hüfner
- Department for Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II (Psychosomatic Medicine), Medical University Innsbruck, Innsbruck, Austria
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Tu B, Wei X, Shang H, Liu Z, Wang Y, Gao Y. [Application of quantitative proteomics in the study of acute mountain sickness]. Sheng Wu Gong Cheng Xue Bao 2023; 39:3594-3604. [PMID: 37805840 DOI: 10.13345/j.cjb.220865] [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] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Acute mountain sickness (AMS) is a clinical syndrome of multi-system physiological disorder after acute exposure to low pressure and low oxygen at high altitude. Quantitative proteomics can systematically quantify and describe protein composition and dynamic changes. In recent years, quantitative proteomics has been widely used in the prevention, diagnosis, treatment and pathogenesis of many diseases. This review summarizes the progress of quantitative proteomics techniques and its application in the prevention, diagnosis, treatment of AMS and mechanisms of rapidly acclimatizing to plateau, in order to provide a reference for the pathogenesis, early intervention, clinical treatment and proteomic research of AMS.
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Affiliation(s)
- Bodan Tu
- School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, Jiangxi, China
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
| | - Xue Wei
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
| | - Huiying Shang
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
| | - Zuoxu Liu
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
| | - Yihao Wang
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
| | - Yue Gao
- School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, Jiangxi, China
- Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
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5
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Small E, Phillips C, Bunzel W, Cleaver L, Joshi N, Gardner L, Maharjan R, Marvel J. Prior Ambulatory Mild Coronavirus Disease 2019 Does Not Increase Risk of Acute Mountain Sickness. High Alt Med Biol 2023; 24:201-208. [PMID: 37306966 DOI: 10.1089/ham.2022.0150] [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: 06/13/2023] Open
Abstract
Small, Elan, Caleb Phillips, William Bunzel, Lakota Cleaver, Nishant Joshi, Laurel Gardner, Rony Maharjan, and James Marvel. Prior ambulatory mild coronavirus disease 2019 does not increase risk of acute mountain sickness. High Alt Med Biol. 24:201-208, 2023. Background: Given its long-term morbidity, understanding how prior coronavirus disease 2019 (COVID-19) may affect acute mountain sickness (AMS) susceptibility is important for preascent risk stratification. The objective of this study was to examine if prior COVID-19 impacts risk of AMS. Materials and Methods: This was a prospective observational study conducted in Lobuje (4,940 m) and Manang (3,519 m), Nepal, from April to May 2022. AMS was defined by the 2018 Lake Louise Questionnaire criteria. COVID-19 severity was defined using the World Health Organization-developed criteria. Results: In the Lobuje cohort of 2,027, 46.2% of surveyed individuals reported history of COVID-19, with 25.7% AMS point-prevalence. There was no significant relationship between prior ambulatory mild COVID-19 and AMS (p = 0.6) or moderate AMS (p = 1.0). In the Manang cohort of 908, 42.8% reported history of COVID-19, with 14.7% AMS point-prevalence. There was no significant relationship between prior ambulatory mild COVID-19 and AMS (p = 0.3) or moderate AMS (p = 0.4). Average months since COVID-19 was 7.4 (interquartile range [IQR] 3-10) for Lobuje, 6.2 (IQR 3-6) for Manang. Both cohorts rarely exhibited moderate COVID-19 history. Conclusions: Prior ambulatory mild COVID-19 was not associated with increased risk of AMS and should not preclude high-altitude travel.
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Affiliation(s)
- Elan Small
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Caleb Phillips
- Department of Computational Science, University of Colorado, Boulder, Colorado, USA
| | - William Bunzel
- Department of Emergency Medicine, University of California San Francisco Fresno, Fresno, California, USA
| | - Lakota Cleaver
- Department of Emergency Medicine, Yale New Haven Health, New Haven, Connecticut, USA
| | - Nishant Joshi
- Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Laurel Gardner
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rony Maharjan
- Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - James Marvel
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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Miyatake H, Onishi T, Kaneda Y, Ozaki A, Tanimoto T, Beniya H. Possibility for Children with Medical Complexities to Reach a 3000-m Peak: A Report of 2 Cases. Wilderness Environ Med 2023; 34:383-387. [PMID: 37438154 DOI: 10.1016/j.wem.2023.05.008] [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: 01/02/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 07/14/2023]
Abstract
With the recent development of neonatal medicine, the number of children with medical complexities (CMCs) is increasing. Outdoor activities are important for their psychosocial development, and the principles of accessibility should be addressed. We report the experience of 2 CMCs' high-altitude mountaineering with the necessary support. The participants were a 3-y-old girl with cerebral palsy, symptomatic epilepsy, and a ventriculoperitoneal shunt (Child A) and a 6-y-old girl who underwent bilateral Glenn operations at 11 mo for hypoplastic left heart syndrome (Child B). The support staff consisted of 4 doctors, 1 nurse, 5 nonmedical staff , 3 members from a mountaineering association, and 2 people from an oxygen company. The climbing schedule was 2 days. On the first day, we took a bus to a hut at an altitude of 2450 m and stayed overnight to acclimatize to the altitude. On the second day, we took the beginner's route, which took 3 h to climb 500 m, and our team made an attempt on the summit. During the attempt, Child B panicked. Although her lung sounds did not raise suspicions of pulmonary edema, we decided to leave the mountain with her because her transcutaneous oxygen saturation decreased. Child A had no apparent health problems and made it to the summit. Although CMCs' alpine climbing requires careful planning and staffing considering the risk of high-altitude sickness, our case suggests the feasibility of such activities with CMCs as part of accessibility.
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Affiliation(s)
| | - Toya Onishi
- School of Medicine, Shiga University of Medical Science, Otsu City, Shiga Prefecture, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima Prefecture, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato City, Tokyo, Japan
| | - Hiroyuki Beniya
- Orange Home-Care Clinic, Fukui City, Fukui Prefecture, Japan
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Song Z, Zhang A, Luo J, Xiong G, Peng H, Zhou R, Li Y, Xu H, Li Z, Zhao W, Zhang H. Prevalence of High-Altitude Polycythemia and Hyperuricemia and Risk Factors for Hyperuricemia in High-Altitude Immigrants. High Alt Med Biol 2023; 24:132-138. [PMID: 37015076 DOI: 10.1089/ham.2022.0133] [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] [Indexed: 04/06/2023] Open
Abstract
Song Zhen, Anxin Zhang, Jie Luo, Guanghai Xiong, Haibo Peng, Rang Zhou, Yuanfeng Li, Hongqiang Xu, Zhen Li, Wei Zhao, and Haoxiang Zhang. Prevalence of high-altitude polycythemia and hyperuricemia and risk factors for hyperuricemia in high-altitude immigrants. High Alt Med Biol. 24:132-138, 2023. Background: Few studies have investigated the epidemiology of chronic mountain sickness (CMS) in high-altitude immigrants. This study evaluated the prevalence of polycythemia and hyperuricemia (HUA) and risk factors for HUA in high-altitude immigrants. Methods: A cross-sectional study was conducted with 7,070 immigrants 15-45 years of age living on the Tibetan Plateau between January and December 2021. Information from routine physical examinations was obtained from each participant. Binary logistic regression analysis was performed to determine the correlation of several risk factors for HUA. Results: The prevalence of high-altitude polycythemia (HAPC) and HUA was 25.8% (28.7% in males and 9.4% in females) and 54.2% (59.9% in males and 22.5% in females), respectively. The highest prevalence of HAPC in males and females was observed in participants 26-30 and 21-25 years of age, respectively. The highest prevalence of HUA in both males and females was observed in participants 26-30 years of age. Binary logistic regression analysis showed that age, sex, and hemoglobin (Hb) concentration were risk factors for HUA, among which age was a negative factor and male sex and Hb concentration were positive factors. Conclusions: Immigrants are more susceptible to HAPC and HUA. The high prevalence of CMS of immigrants may be associated with Hb concentration, age, and sex.
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Affiliation(s)
- Zhen Song
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Anxin Zhang
- Department of Ultrasonography, The 954th Army Hospital, Shannan, P.R. China
| | - Jie Luo
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Guanghai Xiong
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Haibo Peng
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Rang Zhou
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Yuanfeng Li
- State Key Laboratory of Proteomics, National Center for Protein Sciences, Beijing Institute of Radiation Medicine, Beijing, P.R. China
| | - Hongqiang Xu
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Zhen Li
- Department of Clinical Laboratory, The 954th Army Hospital, Shannan, P.R. China
| | - Wei Zhao
- Department of Gastroenterology, The 954th Army Hospital, Shannan, P.R. China
| | - Haoxiang Zhang
- Department of Gastroenterology, The 954th Army Hospital, Shannan, P.R. China
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8
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Pérez-Padilla R. Impact of moderate altitude on lung diseases and risk of high altitude illnesses. Rev Invest Clin 2022; 74:232-243. [PMID: 36170185 DOI: 10.24875/ric.22000088] [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: 04/04/2022] [Accepted: 08/06/2022] [Indexed: 06/16/2023]
Abstract
A large world population resides at moderate altitudes. In the Valley of Mexico (2240 m above sea level) and for patients with respiratory diseases implies more hypoxemia and clinical deterioration, unless supplementary oxygen is prescribed or patients move to sea level. A group of individuals residing at 2500 or more meters above sea level may develop acute or chronic mountain disease but those conditions may develop at moderate altitudes although less frequently and in predisposed individuals. In the valley of México, at 2200 m above sea level, re-entry pulmonary edema has been reported. The frequency of other altituderelated diseases at moderate altitude, described in skiing resorts, remains to be known in visitors to Mexico City and other cities at similar or higher altitudes. Residents of moderate altitudes inhale deeply the city's air with all pollutants and require more often supplementary oxygen.
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Affiliation(s)
- Rogelio Pérez-Padilla
- Department of Research on Smoking and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
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Affiliation(s)
- Andrew M Luks
- From the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle (A.M.L.); and the Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (P.H.H.)
| | - Peter H Hackett
- From the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle (A.M.L.); and the Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (P.H.H.)
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10
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Yang T, Zhou J, Fang L, Wang M, Dilinuer M, Ainiwaer A. Protection function of 18β-glycyrrhetinic acid on rats with high-altitude pulmonary hypertension based on 1H NMR metabonomics technology. Anal Biochem 2021; 631:114342. [PMID: 34419454 DOI: 10.1016/j.ab.2021.114342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/14/2021] [Revised: 08/02/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023]
Abstract
18β-Glycyrrhetinic acid (GA) is the triterpenoid aglycone component of glycyrrhizic acid, a natural product of traditional Chinese medicine, and has been proven to possess a variety of pharmacological effects. The protection function and the mechanism of GA on rats with high-altitude pulmonary hypertension (HAPH) are studied using proton nuclear magnetic resonance (1H NMR) metabonomics technology and biochemical analysis. An HAPH model is established, and 60 male rats are randomly divided into the following groups: Control(normal saline, 0.4 mL/100 g), model (normal saline, 0.4 mL/100 g), Nifedipine (nifedipine, 2.7 mg/kg), and high-, medium-, and low-dose GA groups (100, 50, and 25 mg/kg GA designated as GA.H, GA.M, and GA.L, respectively). Serum biochemical indicators of rats in each group are measured, and pathological changes in the pulmonary artery are observed. 1H NMR metabonomics technology is used for serum analysis. Results show that GA can significantly reduce pulmonary arterial pressure and malondialdehyde levels and increase the glutathione peroxidase and superoxide dismutase activities in HAPH rats. Pathological results show that GA can alleviate pulmonary artery injuries of HAPH rats. Metabolomics analytical findings show that GA can alleviate the metabolic disorder of HAPH rats through anti-oxidation and anti-inflammatory effects, improve their bodies' ability to resist hypoxia, and restore various metabolic pathways (energy metabolism, amino acid metabolism, and lipid metabolism). GA has potential therapeutic effects on HAPH rats, but its target needs to be further studied.
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Affiliation(s)
- Tao Yang
- Central Laboratory, Xinjiang Medical University, Urumqi, 830011, China
| | - Jing Zhou
- Department of Human Resources, General Hospital of Xinjiang Military, Urumqi, 830011, China
| | - Lei Fang
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Minmin Wang
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Maimaitiyiming Dilinuer
- Heart Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Aikemu Ainiwaer
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China; Key Laboratory of Active Components of Xinjiang Natural Medicine and Drug Release Technology, Xinjiang Medical University, Urumqi, 830011, China.
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11
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Alcantara-Zapata DE, Bangdiwala SI, Jiménez D, Kogevinas M, Marchetti N, Nazzal C. Effects of chronic intermittent hypobaric hypoxia on prostate-specific antigen (PSA) in Chilean miners. Occup Environ Med 2021; 78:753-760. [PMID: 33980699 PMCID: PMC8448907 DOI: 10.1136/oemed-2020-107232] [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: 11/19/2020] [Revised: 02/15/2021] [Accepted: 03/24/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim was to determine the effects of chronic intermittent hypobaric hypoxia (CIHH) on prostate-specific antigen (PSA) levels in Chilean miners who work at different altitudes. METHODS A cross-sectional study was conducted between April and July 2019. Miners from five mines (N=338) at different altitudes were evaluated. We recorded sociodemographic, working and altitude information. Haemoglobin oxygen saturation (SaO2) and haemoglobin (Hb) were measured in situ, while PSA and testosterone were analysed at a low level. Linear mixed-effect models were used to evaluate the association between PSA level and two CIHH exposures: composite CIHH (with four descriptors) and ChileStd-CIHH (CIHH Chilean standard; based on the Chilean technical guide for occupational exposure to CIHH). All models were adjusted by age, body mass index and day of the work the samples were taken. RESULTS Highest and lowest PSA levels were found in mines ≥3000 m above sea level (mine 3: median=0.75, IQR=-0.45; mine 4: median=0.46, IQR=-0.35). In the multilevel models, the wider altitude difference between mining operation and camp showed lower PSA levels (model D: βPSA=-0.93 ng/mL, βlogPSA=-0.07, p<0001), adjusted for other CIHH descriptors, SaO2, Hb and testosterone. The descriptors of composite CIHH explained better PSA variations than ChileStd-CIHH (model D: marginal R2=0.090 vs model A: marginal R2=0.016). CONCLUSIONS Occupational health regulations and high altitude medicine should consider these results as initial evidence on the inclusion of new descriptors for CIHH and the possible effect of this exposure on PSA levels in this male-dominated occupational sector.
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Affiliation(s)
- Diana Elizabeth Alcantara-Zapata
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
- Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Daniel Jiménez
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Manolis Kogevinas
- Barcelona Institute for Global Health - Campus MAR, Barcelona, Spain
| | - Nella Marchetti
- Occupational Health Department, School of Public Health. University of Chile, Santiago, Chile
| | - Carolina Nazzal
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
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Abstract
BACKGROUND: Gradual ascent is impractical for personnel deploying to the South Pole due to logistical challenges. Prevention of altitude illness relies on prophylactic medications such as acetazolamide and behavioral modifications including hydration and avoidance of overexertion. We present three recent cases of altitude illness that occurred in previously healthy individuals at the South Pole.CASE REPORTS: 1) A 52-yr-old woman not on prophylactics presented with headache and intractable vomiting 7 h after arriving and hiking around the station. She was treated with acetazolamide, dexamethasone, oxygen, and supportive care. Her symptoms resolved during the evacuation flight. 2) A 23-yr-old man presented with dyspnea at rest 3 d after arriving without prophylactic treatments. He had a Sao₂ of 49%, wheezes and crackles on lung exam, and interstitial infiltrates on chest X-ray. His treatment included oxygen, nifedipine, acetazolamide, and dexamethasone. His symptoms resolved during the evacuation flight. 3) A 40-yr-old man presented with dyspnea after a series of strenuous workouts since his arrival 5 d prior. He had a Sao₂ of 41%, and his chest X-ray was consistent with high altitude pulmonary edema. He was treated with oxygen, nifedipine, and fluids before descent to sea level, where his symptoms fully resolved 4 d later.DISCUSSION: These patients illustrate that altitude illness may develop despite medical screening, participant education, and availability of prophylactic medications based on published guidelines. These cases could be attributed to noncompliance and misinformation, bringing to light some of the challenges with managing more diverse populations that deploy to remote environments.Rose JS, Law J, Scheuring R, Ramage MH, McKeith JJ. Serious altitude illness at the South Pole. Aerosp Med Hum Perform. 2020; 91(1):46-50.
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Zhang W, Zhou C, Huang Z, Yang S, Chen J, Ma C, Zhu Y, Ni C. Effect of Continuous Monitoring of Oxygen Saturation to Counter Acute Mountain Sickness in Physician Climbers: A Pilot Study. High Alt Med Biol 2019; 20:204-205. [PMID: 31180237 DOI: 10.1089/ham.2019.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Weidai Zhang
- 1 Department of Cardiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chunbin Zhou
- 2 Department of Orthopedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhuangcheng Huang
- 3 Department of surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Senyuan Yang
- 3 Department of surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Junheng Chen
- 4 Department of Anesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chuangxin Ma
- 5 Department of Intervention, Shantou Central Hospital, Shantou, Guangdong, China
| | - Yilin Zhu
- 2 Department of Orthopedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Chumin Ni
- 1 Department of Cardiology, Shantou Central Hospital, Shantou, Guangdong, China
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Affiliation(s)
| | - Pippa Oakeshott
- Population Health Research Institute, St George's Hospital, University of London, UK
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Sierra Quintana E, Martínez Caballero CM, Batista Pardo SA, Abella Barraca S, de la Vieja Soriano M. [Nontraumatic medical emergencies in mountain rescues]. Emergencias 2017; 29:339-342. [PMID: 29077294] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the clinical and epidemiologic characteristics of patients with nontraumatic medical problems rescued by a Spanish mountain emergency response service (061 Aragon). MATERIAL AND METHODS Retrospective observational analysis of records of mountain rescues completed between July 2010 and December 2016. RESULTS A total of 164 patients with nontraumatic medical emergencies were rescued; 82.3% were males. Most patients were between the ages of 50 and 59 years. Environmentally related problems, most often hypothermia, accounted for 36.6% of the emergencies. Cardiac problems led to 20.7% and digestive problems to 12.8%. Eighty-two percent of the patients were hiking or engaged in general mountain activities (other than rock climbing, canyoning, hunting, or skiing). CONCLUSION Recent years have seen a rise in the number of patients requiring rescue from mountains for nontraumatic medical emergencies, particularly heart problems. The typical patient to expect would be a man between the ages of 50 and 59 years who is hiking in the summer.
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Affiliation(s)
| | | | | | | | - María de la Vieja Soriano
- Servicio de Urgencias y Emergencias, Althaia Xarxa Assistencial Universitaria de Manresa, Barcelona España
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Abstract
OBJECTIVES The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.
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Affiliation(s)
- Alba Sánchez-Mascuñano
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Cristina Masuet-Aumatell
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Sergio Morchón-Ramos
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Josep M Ramon
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
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Lüneburg N, Siques P, Brito J, De La Cruz JJ, León-Velarde F, Hannemann J, Ibanez C, Böger RH. Long-Term Intermittent Exposure to High Altitude Elevates Asymmetric Dimethylarginine in First Exposed Young Adults. High Alt Med Biol 2017; 18:226-233. [PMID: 28453332 PMCID: PMC5649417 DOI: 10.1089/ham.2016.0123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Lüneburg, Nicole, Patricia Siques, Julio Brito, Juan José De La Cruz, Fabiola León-Velarde, Juliane Hannemann, Cristian Ibanez, and Rainer Böger. Long-term intermittent exposure to high altitude elevates asymmetric dimethylarginine in first exposed young adults. High Alt Med Biol. 18:226–233, 2017.—Hypoxia-induced dysregulation of pulmonary and cerebral circulation may be related to an impaired nitric oxide (NO) pathway. We investigated the effect of chronic intermittent hypobaric hypoxia (CIH) on metabolites of the NO pathway. We measured asymmetric and symmetric dimethylarginine (ADMA and SDMA) and monomethyl-L-arginine (L-NMMA) and assessed their associations with acclimatization in male draftees (n = 72) undergoing CIH shifts at altitude (3550 m) during 3 months. Sixteen Andean natives living at altitude (3675 m) (chronic hypobaric hypoxia [CH]) were included for comparison. In CIH, ADMA and L-NMMA plasma concentrations increased from 1.14 ± 0.04 to 1.95 ± 0.09 μmol/L (mean ± SE) and from 0.22 ± 0.07 to 0.39 ± 0.03 μmol/L, respectively, (p < 0.001 for both) after 3 months, whereas SDMA did not change. The concentrations of ADMA and L-NMMA were higher in CH (3.48 ± 0.07, 0.53 ± 0.08 μmol/L; p < 0.001) as compared with CIH. In both CIH and CH, ADMA correlated with hematocrit (r2 = 0.07, p < 0.05; r2 = 0.26; p < 0.01). In CIH, an association of ADMA levels with poor acclimatization status was observed. We conclude that the endogenous NO synthase inhibitors, ADMA and L-NMMA, are elevated in hypoxia. This may contribute to impaired NO production at altitude and may also be predictive of altitude-associated health impairment.
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Affiliation(s)
- Nicole Lüneburg
- Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Patricia Siques
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Julio Brito
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Juan José De La Cruz
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Fabiola León-Velarde
- Department of Biological and Physiological Sciences, Facultad de Ciencias y Filosofía/IIA, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Juliane Hannemann
- Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Cristian Ibanez
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Rainer H. Böger
- Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract
Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.
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Affiliation(s)
| | - Matthew Gavin
- 2 University of Leeds School of Biomedical Sciences , Leeds, United Kingdom
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Lawrence JS, Reid SA. Risk Determinants of Acute Mountain Sickness and Summit Success on a 6-Day Ascent of Mount Kilimanjaro (5895 m). Wilderness Environ Med 2017; 27:78-84. [PMID: 26948557 DOI: 10.1016/j.wem.2015.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 04/12/2015] [Revised: 11/22/2015] [Accepted: 11/23/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aims of this study were to assess incidence of acute mountain sickness (AMS) and summit success on a 6-day ascent profile of Mt. Kilimanjaro and evaluate potential risk factors for these outcomes. METHODS All trekkers through a single Australian tour company between August 2012 and July 2014 were included. Participants ascended via the Rongai route and attempted the summit on day 6. Daily assessments were made using the self-reported Lake Louise score (LLS) questionnaire. Two different AMS diagnostic criteria (LLS ≥ 3 and LLS ≥ 5) were used for data analysis. Risk factors for development of AMS and summit success were analyzed. RESULTS Over the 24-month period a total of 175 participants undertook the trek. Incidence of AMS was 52.6% (LLS ≥ 3) and 22.9% (LLS ≥ 5). Summit success was 88%. Age, sex, body mass index, and acetazolamide use were not associated with risk of AMS development. Age ≥ 40 years (P = .0002) and female sex (P = .0004) were both significantly associated with reduced summit success rate. CONCLUSIONS Our cohort found a lower incidence of AMS and better summit success on a 6-day ascent of Mt Kilimanjaro than previously described in other groups on 4- and 5-day ascents. Female sex and age ≥ 40 years both predicted failure to summit, but did not increase risk of developing AMS. AMS is a common cause of morbidity on Mt. Kilimanjaro, and although the risk can be mitigated by a slower ascent, there is an ongoing need for education of individual trekkers, tour companies, and local authorities.
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Affiliation(s)
- James S Lawrence
- North Sydney Sports Medicine Centre, St. Leonards, Australia (Dr Lawrence).
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Abstract
Obesity, a worldwide epidemic, has become a major health burden because it is usually accompanied by an increased risk for insulin resistance, diabetes, hypertension, cardiovascular diseases, and even some kinds of cancer. It also results in associated increases in healthcare expenditures and labor and economic consequences. There are also other fields of medicine and biology where obesity or being overweight play a major role, such as high-altitude illnesses (acute mountain sickness, hypoxic pulmonary hypertension, and chronic mountain sickness), where an increasing relationship among these two morbid statuses has been demonstrated. This association could be rooted in the interactions between obesity-related metabolic alterations and critical ventilation impairments due to obesity, which would aggravate hypobaric hypoxia at high altitudes, leading to hypoxemia, which is a trigger for developing high-altitude diseases. This review examines the current literature to support the idea that obesity or overweight could be major conditioning factors at high altitude.
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Affiliation(s)
- Rocío San Martin
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Julio Brito
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
- *Julio Brito, Institute of Health Studies, Universidad Arturo Prat, Avda. Arturo Prat 2120, Iquique, 1110939, Chile,
| | - Patricia Siques
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Fabiola León-Velarde
- Department of Biological and Physiological Sciences. Facultad de Ciencias y Filosofía/ IIA, Universidad Peruana Cayetano Heredia, Lima, Perú
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21
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Abstract
CONTEXT Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes. EVIDENCE ACQUISITION A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 3. RESULTS AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks. CONCLUSION Individualized and appropriate acclimatization is an essential component of injury and illness prevention.
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Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
- Morteza Khodaee, MD, MPH, Department of Family Medicine, University of Colorado School of Medicine, AFW Clinic, 3055 Roslyn Street, Denver, CO 80238 ()
| | - Heather L. Grothe
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Jonathan H. Seyfert
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Karin VanBaak
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
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Sorokina TS. "The Great Silk Road" and the First Description of Hypoxia. Vesalius 2016; 22:53-58. [PMID: 29297216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The first written reports about the effect of high-altitude air on the human organism in Ancient China (the 30s BC) and in South America during the conquest (late XVI century) are discussed in this paper.
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Shi QH, Ge D, Zhao W, Ma X, Hu KY, Lu Y, Liu ZX, Ran JH, Li XL, Zhou Y, Fu JF. A Computerized Evaluation of Sensory Memory and Short-term Memory Impairment After Rapid Ascent to 4280 m. Biomed Environ Sci 2016; 29:457-460. [PMID: 27470108 DOI: 10.3967/bes2016.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/30/2016] [Indexed: 06/06/2023]
Abstract
To evaluate the effect of acute high-altitude exposure on sensory and short-term memory using interactive software, we transported 30 volunteers in a sport utility vehicle to a 4280 m plateau within 3 h. We measured their memory performance on the plain (initial arrival) and 3 h after arrival on the plateau using six measures. Memory performance was significantly poorer on the plateau by four of the six measures. Furthermore, memory performance was significantly poorer in the acute mountain sickness (AMS) group than in the non-AMS group by five of the six measures. These findings indicate that rapid ascent to 4280 m and remaining at this altitude for 3 h resulted in decreased sensory and short-term memory, particularly among participants who developed AMS.
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Affiliation(s)
- Qing Hai Shi
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Di Ge
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Wei Zhao
- Clinical Laboratory Center, The First People's Hospital of Akesu Prefecture, Akesu 843000, Xinjiang, China
| | - Xue Ma
- Xinjiang Medical University, Urumqi 830000, Xinjiang, China
| | - Ke Yan Hu
- Xinjiang Medical University, Urumqi 830000, Xinjiang, China
| | - Yao Lu
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Zheng Xiang Liu
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Ji Hua Ran
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Xiao Ling Li
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Yu Zhou
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
| | - Jian Feng Fu
- Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, Xinjiang, China
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Bakker-Dyos J, Vanstone S, Mellor AJ. High altitude adaptation and illness: military implications. J R Nav Med Serv 2016; 102:33-39. [PMID: 29984977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
British military personnel are frequently exposed to high altitude (HA) (>1500m). Operations in Afghanistan have occurred at altitudes of up to 3000m and there remains the possibility of rapid deployment of non-acclimatised troops to HA areas. British military personnel also deploy to HA frequently on Adventurous Training (AT) and there are numerous expeditions every year to the Greater Ranges. As such, there remains a reasonable likelihood of the development of high altitude illness (HAI) with potentially life-threatening consequences. This article aims to provide an overview of the adaptive (acclimatisation) and pathological (acute HAI) responses to HA exposure, with particular reference to military deployments.
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Sikri G, Srinivasa AB, Chawla A. Acute mountain sickness and obesity. Eur Rev Med Pharmacol Sci 2015; 19:4086. [PMID: 26592831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- G Sikri
- Department of Physiology, Armed Forces Medical College, Pune, India.
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Yang B, Sun ZJ, Cao F, Zhao H, Li CW, Zhang J. Obesity is a risk factor for acute mountain sickness: a prospective study in Tibet railway construction workers on Tibetan plateau. Eur Rev Med Pharmacol Sci 2015; 19:119-122. [PMID: 25635984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Although few retrospective studies of high altitude have reported that obesity might be associated with the development of acute mountain sickness (AMS), this association has not been fully studied prospectively. The aim of this study was to investigate the effect of obesity on subjects with acute high-altitude exposure. PATIENTS AND METHODS Totally 262 male subjects aged 25-43 (mean 33.2 ± 9.3) years with acute high-altitude exposure were involved in this study. Among them, there are 120 obese and 142 non-obese young-middle aged male subjects. Each subject completed an AMS (acute mountain sickness) self-report questionnaire at sea level and after ascending high-altitude (3658 meters) 12 hours and 24 hours. Weight and height were measured and BMI was calculated. Vital capacity of lungs was measured. Venous blood was sampled for measuring hemoglobin at baseline. Arterial blood was taken for evaluating arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. RESULTS No statistical differences were found between groups at age (p = 0.1488), hemoglobin (p = 0.5807) and vital capacity (p = 0.1806). BMI in the two groups was significantly different (p < 0.001) because it is the cut-off point of grouping. At sea level, no statistical differences were found between groups at SO2 (p = 0.1806), PaO2 (p = 0.0949), PaCO2 (p = 0.1960). But 24 hours after ascending high-altitude, SO2 (p = 0.0002), PaO2 (p < 0.001) were much lower and PaCO2 (p < 0.001) was significantly higher in obese group than in non-obese group. Comparison of AMS score: No symptom was reported at sea level in all participants (scored 0). But 12-hour and 24-hour after ascending high-altitude, the AMS scores in obese group were significantly higher than those in non-obese group (p < 0.001). CONCLUSIONS Obesity is an important risk factor in the development of acute mountain sickness.
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Affiliation(s)
- B Yang
- Cardiovascular Department, Chinese PLA General Hospital, Beijing, China.
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Shin T. High altitude illnesses in Hawai'i. Hawaii J Med Public Health 2014; 73:4-6. [PMID: 25478293 PMCID: PMC4244895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
High Altitude Headache (HAH), Acute Mountain Sickness (AMS), and High Altitude Cerebral Edema (HACE) are all high altitude related illnesses in order of severity from the mildly symptomatic to the potentially life-threatening. High altitude illnesses occur when travelers ascend to high altitudes too rapidly, which does not allow enough time for the body to adjust. Slow graded ascent to the desired altitude and termination of ascent if AMS symptoms present are keys to illness prevention. Early recognition and rapid intervention of AMS can halt progression to HACE. Pharmacologic prophylaxis with acetazolamide is a proven method of prevention and treatment of high altitude illness. If prevention fails then treatment modalities include supplemental oxygen, supportive therapy, hyperbaric treatment, and dexamethasone. Given the multitude of visitors to the mountains of Hawai'i, high altitude illness will continue to persist as a prevalent local condition. This paper will emphasize the prevention and early diagnosis of AMS so that the illness does not progress to HACE.
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Affiliation(s)
- Terry Shin
- Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859
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Abstract
BACKGROUND Workers coming from lowland regions are at risk of developing acute mountain sickness (AMS) when working in low oxygen high-altitude areas. OBJECTIVES The aim of this study was to improve the conditions that lead to hypoxia and ensure the safety of the high-altitude workers. We analyzed the influence of low atmospheric pressure on the oxygen enrichment process in high-altitude areas using an engineering method called low-pressure swing adsorption (LPSA). METHODS Fourteen male subjects were screened and divided into three groups by type of oxygen supply system used: (1) oxygen cylinder group; (2) LPSA oxygen dispersal group; and (3) control group. These tests included arterial oxygen saturation (SaO2), pulse rate (PR), breaths per minute (BPM), and blood pressure (BP). RESULTS The results showed that after supplying oxygen using the LPSA method at the tunnel face, the SaO2 of workers increased; the incidence of acute mountain sickness, PR, and BPM significantly decreased. CONCLUSIONS The LPSA life support system was found to be a simple, convenient, efficient, reliable, and applicable approach to ensure proper working conditions at construction sites in high-altitude areas.
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Abstract
For people unaccustomed to high altitude, exposure to height often leads to Acute Mountain Sickness, with headaches, difficulty breathing and gastrointestinal symptoms. Nausea and loss of appetite may result in less calorie intake and weight loss. At altitudes greater than 4000 m about 50-80% of people are affected. After only short exposure, gastrointestinal mucosal lesions can occur, potentially leading to gastrointestinal bleeding and lessened hunger. Patients with inflammatory bowel disorders may develop an acute exacerbation. At high altitude, an induction of numerous metabolic processes can be observed, including increased iron absorption. While the pathophysiology of hypobaric hypoxia has been well documented for the respiratory and cardiovascular system, this Mini-Review summarizes the current literature concerning the gastrointestinal function in high altitude.
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Affiliation(s)
- Heiko Frühauf
- Departement Innere Medizin und Spezialdisziplinen, Abteilung für Gastroenterologie und Hepatologie, Stadtspital Triemli; Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich
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Oztürk C, Balta S, Metin S, Cakmak T. Should obese people be allowed to rise to high altitude? Anadolu Kardiyol Derg 2014; 14:407-408. [PMID: 24818977 DOI: 10.5152/akd.2014.5404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Cengiz Oztürk
- Department of Cardiology, Eskişehir Military Hospital; Eskişehir-Turkey.
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Yang B, Li N, Sun ZJ, Chen B, Li X, Chen YD. Obesity is a risk factor for acute mountain sickness: a prospective study in Tibet railway construction workers on Tibetan plateau. Anadolu Kardiyol Derg 2013; 13:806-808. [PMID: 24287355 DOI: 10.5152/akd.2013.4585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Bo Yang
- Department of Cardiovascular, Chinese PLA General Hospital, Beijing-China.
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Zhao SY, Wu XM, Guo YM, Zhang SS, An YM, Li B, Wang H. [Study of blood oxygen saturation, heart rate changes and plateau reaction of the Antarctic Kunlun station investigation team in different plateau environments]. Zhonghua Yi Xue Za Zhi 2013; 93:1743-1745. [PMID: 24124685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To explore the blood oxygen saturation and heart rate changes of the Antarctic explorers. METHODS During August 2010 to April 2011, the changes in blood oxygen saturation, heart rate and plateau reaction of 16 Antarctic expedition team in different plateau environments (Tibetan plateau versus Antarctic plateau) were monitored with the noninvasive pulse oximeter MD300-C. The extent of acute mountain sickness was determined according to the Lake Louise Consensus acute mountain reaction symptom scores and judgment method. RESULTS The changes of blood oxygen saturation, heart rate at different altitudes of 110, 3650, 4300 m (96.8% ± 1.2%,89.1% ± 1.2%, 86.1% ± 2.0%, (75.0 ± 5.4) times/min, (104.0 ± 4.3) times/min, (113.0 ± 5.2) times/min,F = 214.155, 240.088,both P < 0.05). With rising latitude and elevation gradient in Antarctic plateau, the changes of blood oxygen saturation, heart rate at different altitudes of 2000, 2500, 3000, 3500 and 4087 m(91.9% ± 1.3%,90.5% ± 1.3%,87.6% ± 1.4%,85.0% ± 1.8%,81.5% ± 2.2%, (85.9 ± 3.2) times/min, (90.6 ± 2.8) times/min, (97.8 ± 4.1) times/min, (102.0 ± 3.4) times/min, (106.3 ± 3.9) times/min, F = 105.418, 90.174, both P < 0.05). Levels of blood oxygen saturation and heart rate were both correlated with the risk of altitude sickness (r = -0.446 and 0.565, both P < 0.05). CONCLUSIONS As the increases of altitude, there are significant changes in oxygen saturation, heart rate of the Antarctic explorers. And with the increases of altitude, the risk of altitude sickness gradually increases.
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Affiliation(s)
- Shun-yun Zhao
- Department of Surgery, Qinghai Provincial People's Hospital, Xining 810007, China
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Kedzierewicz R, Cabane D. [Acute mountain sickness and high altitude cerebral and pulmonary edema]. Rev Prat 2013; 63:18-26. [PMID: 23457822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Altitude hypoxia is responsible for acute mountain sickness. It can worsen and generate a high altitude cerebral edema, which can be fatal. After reminding the reader clinical and epidemiological facts, this review aims to present new insights of the physiopathological continuity between these two illnesses and the current preventive and treatment tools. Have new medications, as sumatriptans, kept their promises? Have recent studies provide evidence of empirical use of old drugs as aspirin or ibuprofen? What are acetazolamide and dexamethasone places? This wide range of medication doesn't replace non-pharmacological tools.
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Affiliation(s)
- Romain Kedzierewicz
- Antenne médicale des armées de Barby, 13e bataillon de chasseurs alpins, centre médical des armées des Alpes, 73230 Barby, France.
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Klein F. [Altitude sickness. Too quickly too high]. MMW Fortschr Med 2012; 154:22. [PMID: 22838123 DOI: 10.1007/s15006-012-0725-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Wu TY, Ding SQ, Liu JL, Jia JH, Chai ZC, Dai RC. Who are more at risk for acute mountain sickness: a prospective study in Qinghai-Tibet railroad construction workers on Mt. Tanggula. Chin Med J (Engl) 2012; 125:1393-1400. [PMID: 22613641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND It is important to determine the incidence of acute mountain sickness (AMS) among workers at altitudes between 3500 m and 5000 m on Mt. Tanggula during the construction of the Qinghai-Tibet railroad. This study explored the risk factors predisposing workers to developing AMS and attempted to develop more effective ways of preventing and treating AMS. METHODS A total of 11,182 workers were surveyed by completing twice daily a Lake Louise questionnaire, and a score ≥ 3 indicated AMS. The contributing risk factors were assessed for at least 2 months for the duration of the study in the years from 2001 to 2003. A risk model was developed by multiple Logistic regression. Standard statistical methods were used to analyze data. RESULTS AMS occurred in 56% of workers working at high altitudes on Mt. Tanggula. The incidence of AMS increased with increasing altitude. Rapid ascent to an altitude above 3500 m, sea-level or lowland newcomers, young people under 25 years of age, heavy physical exertion, obese person, and arterial oxygen saturation (SaO2) below 80% were independent AMS risk factors. No significant association was found between AMS and sex or taking Rhodiola. Medical education contributed to an early diagnosis of AMS. CONCLUSIONS This study used the Lake Louise scoring system suggesting that it is a well-validated standard for field evaluation of AMS and for making an early diagnosis. These studies have described many variables regarding risk factors for the development of AMS. Risk factors which can be modified should be attended to, and the physicians should carry out check-ups and tests to identify subjects who are more at risk. Prevention consists in continuous gradual ascent, medical education, and prompt descent to avoid progression in patients with serious AMS. It is most important to effectively control the risk factors of AMS.
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Affiliation(s)
- Tian-yi Wu
- Physiological Research Group of the Ministry of Railway, High Altitude Medical Research Institute, Xining, Qinghai 810012, China.
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Kovaleva IO, Artem'eva MM, Ilatovskaia ME, Medvedev OS, Medvedeva NA. [Role of estradiol in hypoxia-induced pulmonary hypertension in female rats]. Eksp Klin Farmakol 2012; 75:19-21. [PMID: 23700662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Gender differences play role in pathogenesis and treatment of many cardiovascular diseases. One of these diseases is hypoxia-induced pulmonary hypertension (PHT). The aim of this study was to analyze the involvement of female hormone estradiol in development of hypoxia-induced PHT in female Wistar rats. PHT was induced by exposure to hypobaric hypoxia in an altitude chamber at a simulated altitude of 5000 m (02 concentration reduced to 10 %), 10 h per day for 2 weeks. The development of PHT leads to a twofold increase in the level of estradiol. Ovariectomy decreases by half the level of estradiol and causes significant decrease in hypoxia-induced PHT symptoms.
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Donegani E. [Nitrates at high altitude, that is the inappropriate use of a drug]. G Ital Cardiol (Rome) 2011; 12:824-828. [PMID: 22158453 DOI: 10.1714/996.10827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Willmann G, Fischer MD, Schatz A, Schommer K, Messias A, Zrenner E, Bartz-Schmidt KU, Gekeler F. Quantification of optic disc edema during exposure to high altitude shows no correlation to acute mountain sickness. PLoS One 2011; 6:e27022. [PMID: 22069483 PMCID: PMC3206056 DOI: 10.1371/journal.pone.0027022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 10/07/2011] [Indexed: 02/07/2023] Open
Abstract
Background The study aimed to quantify changes of the optic nerve head (ONH) during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS). This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3®) was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m). Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL) and AMS-cerebral (AMS-c) scores; oxygen saturation (SpO2) and heart rate (HR) were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE) 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation) changed significantly at high altitude compared to baseline (p<0.05) and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO2 or HR. Conclusions/Significance Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO2 and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS.
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Affiliation(s)
- Gabriel Willmann
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
| | - M. Dominik Fischer
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
- * E-mail:
| | - Andreas Schatz
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
| | - Kai Schommer
- Department of Sports Medicine, Medical Clinic, University Hospital Heidelberg, Heidelberg, Germany
| | - Andre Messias
- Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Eberhart Zrenner
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
| | - Karl U. Bartz-Schmidt
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
| | - Florian Gekeler
- Centre for Ophthalmology, University of Tuebingen, Tübingen, Baden-Württemberg, Germany
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Ma HP, Fan PC, Jing LL, Yao J, He XR, Yang Y, Chen KM, Jia ZP. Anti-hypoxic activity at simulated high altitude was isolated in petroleum ether extract of Saussurea involucrata. J Ethnopharmacol 2011; 137:1510-1515. [PMID: 21893186 DOI: 10.1016/j.jep.2011.08.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 08/15/2011] [Accepted: 08/16/2011] [Indexed: 05/27/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Rhodiola algida, Saussurea involucrata, and other herbs grown in Qinghai-Tibetan plateau have long been used to prevent and treat acute mountain sickness. AIM OF THE STUDY To screen and identify the anti-hypoxic constituents in the herbs grown in Qinghai-Tibetan plateau of Northwestern China. MATERIALS AND METHODS The anti-hypoxic activities of 20 selected plateau herbs were examined against two positive controls, Rhodiola algida and acetazolamide, using the normobaric hypoxia model of mice. The herb with the highest activity was successively extracted with 70% ethanol, petroleum ether, chloroform, ethyl acetate and n-butanol. The extract with the highest activity was identified by comparing the survival time of mice under normobaric hypoxia condition after being subjected to different extracts. The identified extract was further tested by simulating high altitudes through an acute decompression model and a chronic decompression model for mice. RESULTS The herb found to have the highest anti-hypoxic activity was Saussurea involucrate (Kar. et Kir.) Sch.-Bip, and the most effective fraction was in the petroleum ether extract. Administration of petroleum ether extract of Saussurea involucrata (PESI) to mice at 50mg/kg significantly decreased the mortality of animals under acute decompression conditions. Changes in biochemical indicators for glycometabolism and energy metabolism, including adenosine triphosphate (ATP) content and adenosine triphosphatase (ATPase) activity in brain and cardiac muscle, lactic acid (LAC) and lactate dehydrogenase (LDH) in blood and cardiac muscles, blood sugar, and glycogen content in liver and skeletal muscle were reversed under chronic decompression conditions. CONCLUSIONS Saussurea involucrata (Kar. et Kir.) Sch.-Bip exhibits high anti-hypoxic activity that may be effective in preventing acute mountain sickness, and the active constituents are mainly in the petroleum ether extract.
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Affiliation(s)
- Hui-Ping Ma
- Department of Pharmacology, School of Pharmacy, Fourth Military Medical University, Xi'an 710032, PR China
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Ugalde D, Conte G, Ugalde H, Figueroa G, Cuneo M, Muñoz M, Mayor J. [Sub capsular splenic hematoma in a sickle cell trait carrier. Case report]. Rev Med Chil 2011; 139:1192-1195. [PMID: 22215399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Drepanocytic anemia is an uncommon hereditary disease in Chile. The heterozygous state of drepanocytic anemia or "sickle trait" has a frequency of 8% among Afro-Americans. A small number of patients carrying hemoglobin S are homozygous, with clinical manifestations of hemolytic anemia and thrombotic disease. Sickle trait is usually asymptomatic. We report a 59-year-old male who presented an acute abdominal pain and dyspnea while staying at high altitude. Six days later, an angio CAT scan showed the presence of a subcapsular splenic hematoma that was managed conservatively. Sickle cell induction with sodium metabisulphite was positive. Hemoglobin electrophoresis confirmed the sickle trait.
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Affiliation(s)
- Diego Ugalde
- Servicio de Hematología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Chile
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Affiliation(s)
- Chris Imray
- Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK.
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Grissom CK. Ataxia is Still an Important Clinical Finding in Severe High Altitude Illness. Wilderness Environ Med 2011; 22:105-6. [PMID: 21664557 DOI: 10.1016/j.wem.2011.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 03/17/2011] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE A recent study concerning high-altitude pulmonary edema (HAPE), a non-cardiogenic pulmonary edema, suggested that it is initially a hydrostatic-type pulmonary edema. We suspect that some extent of cardiac insufficiency may likely relate to the mechanism of the development of this disease. METHODS By Doppler echocardiography, the Tei index (a new quantitative index proposed for the evaluation of global myocardial performance) and the systolic pulmonary artery pressure (sPAP) were measured before and after 30 minutes of hypoxic breathing. PATIENTS Eleven HAPE-susceptible subjects (HAPE-s) and nine HAPE-resistant subjects (HAPE-r). RESULTS The results of Tei index indicated an enhanced left myocardial performance but an impaired right performance in HAPE-s during hypoxic breathing. The sPAP of HAPE-s was significantly increased after hypoxic breathing, which was not correlated with the heart functions such as right ventricular (RV) Tei index, cardiac index (CI), percent ejection fraction (EF%) and percent fractional shortening (FS%) under hypoxic condition. Comparatively, the HAPE-r subjects did not show such significant changes of Tei index after hypoxic breathing. The results suggested that a paradoxical myocardial performance, in a format of an augmented left ventricular (LV) in contrast to an attenuated RV, was observed in the HAPE-s exposed to acute hypoxia. CONCLUSION The responses of the left and right myocardial performances to hypoxia may be involved in the pathogenesis of HAPE.
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Affiliation(s)
- Masayuki Hanaoka
- The First Department of Medicine, Shinshu University School of Medicine, Japan.
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Okumiya K, Sakamoto R, Kimura Y, Ishimoto Y, Wada T, Ishine M, Ishikawa M, Nakajima S, Hozo R, Ge RL, Norboo T, Otsuka K, Matsubayashi K. Strong association between polycythemia and glucose intolerance in elderly high-altitude dwellers in Asia. J Am Geriatr Soc 2010; 58:609-11. [PMID: 20398132 DOI: 10.1111/j.1532-5415.2010.02753.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Harris NS. Ask the doctor. Some friends invited me to accompany them to Rocky Mountain National Park. I would love to go, but I have high blood pressure and worry that high altitudes are dangerous for people with this condition. Is this the case? Harv Heart Lett 2010; 20:8. [PMID: 20590011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Garófoli A, Montoya P, Elías C, Benzo R. [Exercise and the detection of severe acute mountain sickness]. Medicina (B Aires) 2010; 70:3-7. [PMID: 20228017 PMCID: PMC3402082] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Acute mountain sickness (AMS) is a group of non-specific symptoms, seen in subjects that ascend from low to high altitude too quickly, without allowing sufficient time to acclimatize. Usually it is self-limiting, but the severe forms (pulmonary and cerebral edema) can be fatal. Exaggerated hypoxemia at rest is related to later development of AMS but its predictive value is limited. Since exercise at altitude induces greater hypoxemia and symptoms, we postulated the predictive value of a simple exercise test to prognosticate severe AMS. We studied the predictive value of the oxygen saturation during rest and sub-maximum exercise at 2.700 m and 4.300 m in 63 subjects that intended the ascent to Mount Aconcagua (6.962 m). We considered exercise oxygen desaturation to a drop of 5% respect to the resting value. Lake-Louise Score was used to quantify the presence of severe AMS. Six subjects developed severe AMS (9.5%) and required evacuation. Resting oxygen saturation at 2.700 m was not significant to classify subjects that then developed severe AMS. The association of oxygen desaturation during exercise at 2.700 m plus inappropriate resting oxygen saturation at 4.300 m was significant to classify the subjects that then developed severe AMS with a positive predictive value of 80% and a negative predictive value of 97%. Our results are relevant for mountaineering and suggest the use of a simple exercise test in the prediction of severe AMS.
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Affiliation(s)
- Adrian Garófoli
- Departamento de Neumonología, Hospital Militar Mendoza, Argentina.
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Bailey DM, Bärtsch P, Knauth M, Baumgartner RW. Emerging concepts in acute mountain sickness and high-altitude cerebral edema: from the molecular to the morphological. Cell Mol Life Sci 2009; 66:3583-94. [PMID: 19763397 PMCID: PMC3085779 DOI: 10.1007/s00018-009-0145-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Accepted: 08/20/2009] [Indexed: 01/09/2023]
Abstract
Acute mountain sickness (AMS) is a neurological disorder that typically affects mountaineers who ascend to high altitude. The symptoms have traditionally been ascribed to intracranial hypertension caused by extracellular vasogenic edematous brain swelling subsequent to mechanical disruption of the blood-brain barrier in hypoxia. However, recent diffusion-weighted magnetic resonance imaging studies have identified mild astrocytic swelling caused by a net redistribution of fluid from the "hypoxia-primed" extracellular space to the intracellular space without any evidence for further barrier disruption or additional increment in brain edema, swelling or pressure. These findings and the observation of minor vasogenic edema present in individuals with and without AMS suggest that the symptoms are not explained by cerebral edema. This has led to a re-evaluation of the relevant pathogenic events with a specific focus on free radicals and their interaction with the trigeminovascular system.
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Affiliation(s)
- Damian Miles Bailey
- Neurovascular Research Laboratory, Faculty of Health, Science and Sport, University of Glamorgan, Pontypridd, CF37 1DL, South Wales, UK.
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Gonzales GF, Gasco M, Tapia V, Gonzales-Castañeda C. High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men. Am J Physiol Endocrinol Metab 2009; 296:E1319-25. [PMID: 19318512 PMCID: PMC2692401 DOI: 10.1152/ajpendo.90940.2008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis (EE) secondary to hypoventilation. Erythropoietin (Epo) and testosterone regulate erythrocyte production. Low thyroid hormone levels are also associated to hypoventilation. Hence, these hormones can play a role in etiopathogeny of EE. The purpose of this study was to elucidate the effect of sexual and thyroid hormones and Epo in residents from Lima (150 m) and Cerro de Pasco (4,340 m), Peru, and the response to human chorionic gonadotrophin stimulation (hCG). Three groups, one at low altitude and two at high altitude [1 with hemoglobin values >16-21 g/dl and the second with Hb >or=21 g/dl (EE)], were studied. hCG was administered intramuscularly in a single dose (1,000 IU), and blood samples were obtained at 0, 6, 12, 24, 48, and 72 h after injection. High-altitude natives present similar levels of gonadotropins and thyroid hormones but lower dehydroepiandrosterone sulphate (DHEAS) levels (P < 0.01) and greater Epo (P < 0.01), 17alpha-hydroxyprogesterone (P < 0.01), and testosterone levels (P < 0.01) than those at 150 m. Serum testosterone levels (524.13 +/- 55.91 microg/dl vs. 328.14 +/- 53.23 ng/dl, means +/- SE; P < 0.05) and testosterone/DHEAS ratios are higher (7.98 +/- 1.1 vs. 3.65 +/- 1.1; P < 0.01) and DHEAS levels lower in the EE group (83.85 +/- 14.60 microg/dl vs. 148.95 +/- 19.11 ug/dl; P < 0.05), whereas Epo was not further affected. Testosterone levels were highest and DHEAS levels lowest in the EE group at all times after hCG stimulation. In conclusion, high androgen activity could be involved in the etiopathogeny of CMS. This evidence provides an opportunity to develop new therapeutic strategies.
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Affiliation(s)
- Gustavo F Gonzales
- Laboratory of Endocrinology and Reproduction, Faculty of Sciences and Philosophy, "Alberto Cazorla Tálleri" Universidad Peruana Cayetano Heredia, Ave. Honorio Delgado 430, Lima 31, Peru.
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Gudmundsson G, Gudbjartsson T. [High altitude sickness - review]. LAEKNABLADID 2009; 95:441-447. [PMID: 19491409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
High altitude sickness is a common name for illnesses that can occur at high altitude, usually above 3000 meters from sea level. The cause is hypoxia but the pathophysiology of the diseases is a complex mixture of multiple factors, involving the human response to hypoxia. The most common symptom is headache, but loss of appetite, nausea and sleep disturbances are also common complaints. With rapid or high ascent there is increased risk of acute mountain sickness, with severe headache that responds poorly to pain medications, nausea, vomiting and extreme fatigue as the most common symptoms. The most severe forms of high-altitude sickness are high altitude cerebral edema and high altitude pulmonary edema. High altitude sickness can be prevented by slow ascent and avoiding overexertion. Medications can also be used to reduce symptoms. In this overview high altitude physiology and acclimatisation are reviewed. The main types of high altitude sickness are described with special emphasis on symptoms and diagnosis, but treatment and prevention are also reviewed.
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