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https://www.readbyqxmd.com/read/28870508/inappropriate-dexamethasone-use-by-a-trekker-in-nepal-a-case-report
#1
Nicholas R Haslam, Rachel Garth, Nicola Kelly
We present a case of inappropriate dexamethasone use in a trekker in the Everest region of Nepal. We aim to increase awareness among health professionals of the possible use of this medication by trekkers and promote knowledge of potential complications. In this case, a previously altitude-naive trekker was prescribed prophylactic dexamethasone by physicians in a Western travel clinic before high-altitude trekking in Nepal. There were no indications for prophylactic medication nor for the use of dexamethasone...
September 1, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28860167/measuring-high-altitude-adaptation
#2
Lorna G Moore
High altitudes (>8000 ft or 2500 m) provide an experiment of nature for measuring adaptation and the physiological processes involved. Studies conducted over the past ~25 years in Andeans, Tibetans, and less often Ethiopians show varied but distinct O2 transport traits from those of acclimatized newcomers, providing indirect evidence for genetic adaptation to high altitude. Short-term (acclimatization, developmental) and long-term (genetic) responses to high altitude exhibit a temporal gradient such that, while all influence O2 content, the latter also improve O2 delivery and metabolism...
August 31, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28857147/safety-and-ergogenic-properties-of-combined-aminophylline-and-ambrisentan-in-hypoxia
#3
Thies Schroeder, Claude A Piantadosi, Michael J Natoli, Julie Autmizguine, Michael Cohen-Wolkowieczs, Karyn L Hamilton, Christopher Bell, Jelena Klawitter, Uwe Christians, David C Irwin, Robert J Noveck
We hypothesized that concomitant pharmacological inhibition of the endothelin and adenosine pathway is safe and improves exercise performance in hypoxic humans, via a mechanism that does not involve augmentation of blood oxygenation. To test this hypothesis, we established safety and drug interactions for aminophylline (500mg) plus ambrisentan (5mg) in normoxic volunteers. Subsequently, a placebo-controlled study was employed to test the combination in healthy resting and exercising volunteers at simulated altitude (4,267m)...
August 31, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28832689/incidence-and-severity-of-acute-mountain-sickness-and-associated-symptoms-in-children-trekking-on-xue-mountain-taiwan
#4
Fei-Ying Cheng, Mei-Jy Jeng, Yin-Chou Lin, Shih-Hao Wang, Shih-Hao Wu, Wen-Cheng Li, Kuo-Feng Huang, Te-Fa Chiu
BACKGROUND: Acute mountain sickness (AMS) occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher. The aim of this study was to examine the incidence and severity of AMS and associated symptoms in children. METHODS: The prospective observational study included 197 healthy, non-acclimatized 11 and 12-year-old children trekking the round-trip from the trailhead to the summit of Xue Mountain, Taiwan (2,179 m to 3,886 m) over 3 days...
2017: PloS One
https://www.readbyqxmd.com/read/28828048/initial-evaluation-and-key-principles-of-critically-ill-pediatric-patient-aerial-transport
#5
Constanta Pick
Recent advances in more efficient communications, modern telemedicine systems, medical progress, better training of the medical professionals with the possibility of sub-specialisation has led to shorter transfer times in safer conditions of this and overall affording a better chance of survival. High altitude air transport has considerable implications on the respiratory system's efficiency. Caregiver selection is key in avoiding the dangers of debilitating altitude sickness on the medical team. Minimizing physiological or anatomical derangements and minimizing potential complications in the very small critically ill patients while achieving short transfer times are major objectives...
December 2016: Mædica
https://www.readbyqxmd.com/read/28810963/treating-decompression-sickness-military-flight-simulation-site-community-hospital-partnership
#6
Whitney C Rhodes, George Hertner, Robert Price, Lani Finck, Claudia Temmer, Tracy Cushing, Kathleen Flarity
BACKGROUND: High-altitude flight simulation familiarizes military trainees with the symptoms of hypoxia to prepare them for emergency situations. Decompression sickness (DCS) can occur as a result of these simulations. In cases when ground-level supplemental oxygen does not resolve symptoms, hyperbaric oxygen (HBO) therapy is indicated. Many military hyperbaric chambers have been closed because of cost reductions, necessitating partnerships with community hospitals to ensure access to treatment...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810235/obesity-as-a-conditioning-factor-for-high-altitude-diseases
#7
Rocío San Martin, Julio Brito, Patricia Siques, Fabiola León-Velarde
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...
2017: Obesity Facts
https://www.readbyqxmd.com/read/28798201/remote-ischemic-preconditioning-does-not-prevent-acute-mountain-sickness-after-rapid-ascent-to-3450-m
#8
Marc M Berger, Franziska Macholz, Lukas Lehmann, Daniel Dankl, Marcel Hochreiter, Bernhard Bacher, Peter Bärtsch, Heimo Mairbäurl
Remote ischemic preconditioning (RIPC) has been shown to protect remote organs, such as the brain and the lung, from damage induced by subsequent hypoxia or ischemia. Acute mountain sickness (AMS) is a syndrome of non-specific neurologic symptoms and in high altitude pulmonary edema excessive hypoxic pulmonary vasoconstriction (HPV) plays a pivotal role. We hypothesized that RIPC protects the brain from AMS and attenuates the magnitude of HPV after rapid ascent to 3450 m. Forty non-acclimatized volunteers were randomized into 2 groups...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28781177/impact-of-a-newly-constructed-motor-vehicle-road-on-altitude-illness-in-the-nepal-himalayas
#9
Jonathan Reisman, Dinesh Deonarain, Buddha Basnyat
OBJECTIVE: This study investigated the impact that motor vehicle travel along a newly constructed road has on altitude illness (including acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema). The new road from Besisahar (760 m) to Manang (3540 m) in Nepal was completed in December 2014. METHODS: We enrolled all patients diagnosed with altitude illness at the Himalayan Rescue Association Manang clinic in fall 2016. Phi coefficients were calculated to test for an association between Nepali ethnicity and rapid ascent by motor vehicle...
August 3, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28731986/the-effect-of-sex-on-heart-rate-variability-at-high-altitude
#10
Christopher John Boos, Emma Vincent, Adrian Mellor, John O'Hara, Caroline Newman, Richard Cruttenden, Phylip Scott, Mark Cooke, Jamie Matu, David Richard Woods
There is evidence to suggest that high altitude (HA) exposure leads to a fall in heart rate variability (HRV) that is linked to the development of acute mountain sickness (AMS). The effects of sex on changes in HRV at HA and its relationship to AMS are unknown. METHODS: HRV (5-minute single lead ECG) was measured in 63 healthy adults (41 men and 22 women) aged 18-56 years at sea level (SL) and during a HA trek at 3619m, 4600m and 5140m respectively. The main effects of altitude (SL, 3619, 4600 and 5140m) and sex (men vs women) and their potential interaction were assessed using a Factorial Repeated Measures ANOVA...
July 20, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28716290/yarsagumba-fungus-health-problems-in-the-himalayan-gold-rush
#11
Pranawa Koirala, Bidur Pandit, Pratibha Phuyal, Ken Zafren
INTRODUCTION: Seasonal migration of people in search of Yarsagumba fungus creates a population of collectors that faces hardship and health risks in austere high-altitude settings. METHODS: In 2016, our 4-person team performed a 2-day health-needs survey of people collecting Yarsagumba fungus near the village of Yak Kharka (4020 m) in the Manang District of Nepal. RESULTS: There were approximately 800 people, both male and female, from age 10 to over 60, collecting Yarsagumba fungus...
July 14, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28705998/is-normobaric-hypoxia-an-effective-treatment-for-sustaining-previously-acquired-altitude-acclimatization
#12
Beth A Beidleman, Charles S Fulco, Bruce S Cadarette, Allen Cymerman, Mark J Buller, Roy M Salgado, Alexander M Posch, Janet E Staab, Ingrid V Sils, Beau R Yurkevicius, Adam J Luippold, Alexander P Welles, Stephen R Muza
This study examined whether normobaric hypoxia (NH) treatment is more efficacious for sustaining high altitude (HA) acclimatization during re-introduction to altitude (RA) than no treatment at all. Seventeen sea level (SL) residents (age=23±6yrs; mean±SE) completed in the following order: 1)4d of SL testing, 2)12d of high altitude (HA) acclimatization at 4300m, 3)12d at SL post HA acclimatization (Post) where each received either NH (n=9;FiO2=0.122) or Sham (n=8;FiO2=0.207) treatment, and 4)24-h re-introduction to 4300m altitude (RA) in a hypobaric chamber...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28705997/evidence-from-high-altitude-acclimatization-for-an-integrated-cerebrovascular-and-ventilatory-hypercapnic-response-but-different-responses-to-hypoxia
#13
Zachary M Smith, Erin Krizay, Rui Carlos Sa, Ethan T Li, Miriam Scadeng, Frank L Powell, David J Dubowitz
Ventilation and cerebral blood flow (CBF) are both sensitive to hypoxia and hypercapnia. To compare chemosensitivity in these two systems, we made simultaneous measurements of ventilatory and cerebrovascular responses to hypoxia and hypercapnia in 35 normal human subjects before and after acclimatization to hypoxia. Ventilation and CBF were measured during stepwise changes in isocapnic hypoxia and iso-oxic hypercapnia. We used MRI to quantify actual cerebral perfusion. Measurements were repeated after 2-days of acclimatization to hypoxia at 3,800m altitude (PiO2 = 90 Torr) to compare plasticity in the chemosensitivity of these two systems...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28704259/systemic-blood-pressure-at-exercise-in-hypoxia-in-hypertensive-and-normotensive-patients
#14
Laurent Winkler, François J Lhuissier, Jean-Paul Richalet
OBJECTIVES: The current study aimed to determine whether acute hypoxia exposure in laboratory conditions associated with exercise induces an increase in systemic blood pressure (BP) in normotensive and hypertensive patients, and whether hypertensive patients are more prone to develop severe acute mountain sickness (sAMS). Finally, to determine if BP changes at exercise in acute hypoxia in hypertensive patients are predictive factors for sAMS. METHODS: From 2012 to 2015, 852 normotensive and 106 hypertensive patients went through an acute hypoxia exercise test before a sojourn at high altitude...
July 12, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28698346/acute-mountain-sickness-arterial-oxygen-saturation-and-heart-rate-among-tibetan-students-who-reascend-to-lhasa-after-7-years-at-low-altitude-a-prospective-cohort-study
#15
Gonggalanzi, Labasangzhu, Espen Bjertness, Tianyi Wu, Hein Stigum, Per Nafstad
OBJECTIVES: The aim of the present study was to estimate the incidence of acute mountain sickness (AMS) and address the changes in arterial oxygen saturation (SaO2) and heart rate (HR) in native Tibetans who reascend to the high-altitude city of Lhasa (3658 m) after a 7-year stay at low altitude. METHODS: We followed two cohorts of students aged 17-21 years (859 Native Tibetan and 801 Han Chinese), travelling from lowland China until 3 days after their arrival in highland city of Lhasa...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695835/the-concept-of-travel-medicine-and-the-actual-situation-of-travel-related-illnesses
#16
Varol Tunalı, Nevin Turgay
Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels...
June 2017: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/28694388/annexin-a2-supports-pulmonary-microvascular-integrity-by-linking-vascular-endothelial-cadherin-and-protein-tyrosine-phosphatases
#17
Min Luo, Elle C Flood, Dena Almeida, LunBiao Yan, David A Berlin, Paul M Heerdt, Katherine A Hajjar
Relative or absolute hypoxia activates signaling pathways that alter gene expression and stabilize the pulmonary microvasculature. Alveolar hypoxia occurs in disorders ranging from altitude sickness to airway obstruction, apnea, and atelectasis. Here, we report that the phospholipid-binding protein, annexin A2 (ANXA2) functions to maintain vascular integrity in the face of alveolar hypoxia. We demonstrate that microvascular endothelial cells (ECs) from Anxa2(-/-) mice display reduced barrier function and excessive Src-related tyrosine phosphorylation of the adherens junction protein vascular endothelial cadherin (VEC)...
September 4, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28684588/dietary-nitrate-supplementation-increases-acute-mountain-sickness-severity-and-sense-of-effort-during-hypoxic-exercise
#18
Gabriella M K Rossetti, Jamie Hugo Macdonald, Lee J Wylie, Samuel J Little, Victoria Newton, Benjamin Wood, Kieran A Hawkins, Rhys Beddoe, Hannah E Davies, Samuel James Oliver
Dietary nitrate supplementation enhances sea level performance and may ameliorate hypoxemia at high altitude. However, nitrate may exacerbate acute mountain sickness (AMS), specifically headache. This study investigated the effect of nitrate supplementation on AMS symptoms and exercise responses with 6h hypoxia. Twenty recreationally-active men (mean(SD): age 22(4) years, V̇O2max 51(6) mL·min-1·kg-1) completed this randomized double-blinded placebo-controlled crossover study. Twelve participants were classified as AMS- based on Environmental Symptom Questionnaire (AMS-C) score <0...
July 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28665150/association-between-plasma-n-acylethanolamides-and-high-hemoglobin-concentration-in-southern-peruvian-highlanders
#19
Dulce E Alarcón-Yaquetto, Lidia Caballero, Gustavo F Gonzales
Alarcón-Yaquetto, Dulce E., Lidia Caballero, and Gustavo F. Gonzales. Association between plasma N-acylethanolamides and high hemoglobin concentration in Southern Peruvian highlanders. High Alt Med Biol 00:000-000, 2017.-High-altitude (HA) hypoxia is a stressful condition endured by organisms through different mechanisms. Failing to adapt to chronic HA exposure leads to a disease called chronic mountain sickness (CMS) characterized by excessive erythrocytosis (hemoglobin [Hb] ≥19 g/dL for women and ≥21 g/dL for men)...
June 30, 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28661230/circle-co2-reabsorbing-breathing-systems-human-applications
#20
Patrick Magee
Artificial breathing systems to help humans survive extreme environments are used over a range of ambient pressures, using various gases of different volumetric concentrations. These activities include anaesthesia and intensive care activity, high-altitude mountaineering, firefighting, aerospace extravehicular space activity and underwater diving operations. A circle breathing system is one in which the exhaled carbon dioxide is absorbed by an alkali substance and the remaining unused gases are recirculated, usually for the sake of economy and environment...
July 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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