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At least 379 records · Page 21Linked to original sources
PubMed2000

Cerebral autoregulation in subjects adapted and not adapted to high altitude.

BACKGROUND AND PURPOSE: Impaired cerebral autoregulation (CA) from high-altitude hypoxia may cause high-altitude cerebral edema in newcomers to a higher altitude. Furthermore, it is assumed that high-altitude natives have preserved CA. However, cerebral autoregulation has not been studied at altitude. METHODS: We studied CA in 10 subjects at sea level and in 9 Sherpas and 10 newcomers at an altitude of 4243 m by evaluating the effect of an increase of mean arterial blood pressure (MABP) with phenylephrine infusion on the blood flow velocity in the middle cerebral artery (Vmca), using transcranial Doppler. Theoretically, no change of Vmca in response to an increase in MABP would imply perfect autoregulation. Complete loss of autoregulation is present if Vmca changes proportionally with changes of MABP. RESULTS: In the sea-level group, at a relative MABP increase of 23+/-4% during phenylephrine infusion, relative Vmca did not change essentially from baseline Vmca (2+/-7%, P=0.36), which indicated intact autoregulation. In the Sherpa group, at a relative MABP increase of 29+/-7%, there was a uniform and significant increase of Vmca of 24+/-9% (P<0.0001) from baseline Vmca, which indicated loss of autoregulation. The newcomers showed large variations of Vmca in response to a relative MABP increase of 21+/-6%. Five subjects showed increases of Vmca of 22% to 35%, and 2 subjects showed decreases of Vmca of 21% and 23%. CONCLUSIONS: All Sherpas and the majority of the newcomers showed impaired CA. It indicates that an intact autoregulatory response to changes in blood pressure is probably not a hallmark of the normal human cerebral vasculature at altitude and that impaired CA does not play a major role in the occurrence of cerebral edema in newcomers to the altitude.

Adaptation, Physiological↗
PubMed2003

Psychological adaptation and distress among HIV+ Latina women: adaptation to HIV in a Mexican American cultural context.

In order to examine the relative importance of general individual orientations (mastery and self-esteem) and specific coping styles with regard to psychological distress among women with HIV, data are examined from a pilot study involving in-depth face-to-face interviews with 32 HIV+ Latinas receiving care at 4 clinics serving the South Texas population. Interviews were conducted to provide preliminary psychometric information on coping and distress instruments in this predominantly Mexican American population as well as to examine psychosocial factors related to individual adjustment to HIV among Latina females. Refusal rates were low in this study (approximately 10%) and measurement instruments generally had acceptable internal consistency reliability. Results of exploratory multiple regression analyses suggest that self-esteem and mastery may be more salient predictors of depression and anxiety symptoms than are specific coping strategies.

Adaptation, Psychological↗