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https://www.readbyqxmd.com/read/28919307/a-journey-between-high-altitude-hypoxia-and-critical-patient-hypoxia-what-can-it-teach-us-about-compression-and-the-management-of-critical-disease
#1
M L Avellanas Chavala
High altitude sickness (hypobaric hypoxia) is a form of cellular hypoxia similar to that suffered by critically ill patients. The study of mountaineers exposed to extreme hypoxia offers the advantage of involving a relatively homogeneous and healthy population compared to those typically found in Intensive Care Units (ICUs), which are heterogeneous and generally less healthy. Knowledge of altitude physiology and pathology allows us to understanding how hypoxia affects critical patients. Comparable changes in mitochondrial biogenesis between both groups may reflect similar adaptive responses and suggest therapeutic interventions based on the protection or stimulation of such mitochondrial biogenesis...
September 14, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28890440/inhaled-budesonide-for-acute-mountain-sickness
#2
EDITORIAL
Robert Naeije, Erik R Swenson
No abstract text is available yet for this article.
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28870508/inappropriate-dexamethasone-use-by-a-trekker-in-nepal-a-case-report
#3
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
#4
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
#5
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
#6
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/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/28770234/snps-linkage-disequilibrium-and-chronic-mountain-sickness-in-tibetan-chinese
#10
Norman E Buroker, Xue-Han Ning, Zhao-Nian Zhou, Kui Li, Wei-Jun Cen, Xiu-Feng Wu, Wei-Zhong Zhu, C Ronald Scott, Shi-Han Chen
Chronic mountain sickness (CMS) is estimated at 1.2% in Tibetans living at the Qinghai-Tibetan Plateau. Eighteen single-nucleotide polymorphisms (SNPs) from nine nuclear genes that have an association with CMS in Tibetans have been analyzed by using pairwise linkage disequilibrium (LD). The SNPs included are the angiotensin-converting enzyme (rs4340), the angiotensinogen (rs699), and the angiotensin II type 1 receptor (AGTR1) (rs5186) from the renin-angiotensin system. A low-density lipoprotein apolipoprotein B (rs693) SNP was also included...
2017: Hypoxia
https://www.readbyqxmd.com/read/28731986/the-effect-of-sex-on-heart-rate-variability-at-high-altitude
#11
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/28720395/acetazolamide-and-n-acetylcysteine-in-the-treatment-of-chronic-mountain-sickness-monge-s-disease
#12
Shailendra Sharma, Jane Gralla, Joyce Gonzalez Ordonez, Maria-Elena Hurtado, Erik R Swenson, Robert B Schoene, Jackeline Pando Kelly, David Callacondo, Christopher Rivard, Carlos Roncal-Jimenez, Jeffrey Sirota, Richard Fuquay, Brian P Jackson, Kai E Swenson, Richard J Johnson, Abdias Hurtado, Elizabeth Escudero
Patients suffering from chronic mountain sickness (CMS) have excessive erythrocytosis. Low -level cobalt toxicity as a likely contributor has been demonstrated in some subjects. We performed a randomized, placebo controlled clinical trial in Cerro de Pasco, Peru (4380m), where 84 participants with a hematocrit (HCT) ≥65% and CMS score>6, were assigned to four treatment groups of placebo, acetazolamide (ACZ, which stimulates respiration), N-acetylcysteine (NAC, an antioxidant that chelates cobalt) and combination of ACZ and NAC for 6 weeks...
July 15, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28716290/yarsagumba-fungus-health-problems-in-the-himalayan-gold-rush
#13
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
#14
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
#15
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
#16
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
#17
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/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/28668540/budesonide-versus-acetazolamide-for-prevention-of-acute-mountain-sickness
#19
Grant S Lipman, David Pomeranz, Patrick Burns, Caleb Phillips, Mary Cheffers, Kristina Evans, Carrie Jurkiewicz, Nick Juul, Peter Hackett
BACKGROUND: Inhaled budesonide has been suggested as a novel prevention for acute mountain sickness. However, efficacy has not been compared with the standard acute mountain sickness prevention medication acetazolamide. METHODS: This double-blind, randomized, placebo-controlled trial compared inhaled budesonide versus oral acetazolamide versus placebo, starting the morning of ascent from 1240 m (4100 ft) to 3810 m (12,570 ft) over 4 hours. The primary outcome was acute mountain sickness incidence (headache and Lake Louise Questionnaire ≥3 and another symptom)...
June 28, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28665150/association-between-plasma-n-acylethanolamides-and-high-hemoglobin-concentration-in-southern-peruvian-highlanders
#20
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
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