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At least 1,063 records · Page 59Linked to original sources
PubMed1997

High altitude may be synergistic with pulmonary hazards of appetite control medications fenfluramine and dexfenfluramine.

Clinical observations over the past 15 years incriminated first fenfluramine and recently dexfenfluramine in the provocation of primary pulmonary hypertension. Limited animal toxicology data tend to support this inference. The basis for respiratory pathology of high-altitude pulmonary malfunction, which reaches its maximal level in high-altitude pulmonary edema, evolves from and depends upon the occurrence of pulmonary hypertension. For this reason we hypothesize that high altitude and these two anorexic medications constitute a potentially synergistic combination, of which physicians treating patients for high-altitude illness, as well as those prescribing the drugs, should be aware.

Altitude↗
PubMed1996

Pulmonary, vascular responses in rats exposed to chronic hypobaric hypoxia at two different altitude levels.

High altitude hypoxia is known to cause pulmonary hypertension in humans. Altitudes of 5500 m and 4000 m above sea level are considered to be the upper limits for short-term human survival and long-term human residence, respectively. To study the effects of hypobaric-hypoxic environments on pulmonary vascular beds, the physiologic and morphometric differences occurring in the pulmonary arteries of rats at the equivalent of these two altitude levels were compared. One hundred and ninety male rats were housed in a double-roomed mechanical chamber and subjected for 12 weeks to hypobaric-hypoxic environments equivalent to an altitude level of 5500 m or 4000 m. After 6-8 weeks, mean pulmonary arterial pressure (PAPm) was significantly higher in rats at the 5500 m level than in those at 4000 m. The external diameter of muscular arteries (M) and of partially muscular arteries (PM) in the lungs of rats at 8 and 12 weeks, and those of nonmuscular arteries (NM) around the alveolar sacs at 2 and 8 weeks were each significantly less in rats exposed to the 5500 m level than in those at 4000 m. At 4 weeks, the ratio of medial thickness to external diameter for M and PM around the alveolar ducts and alveolar sacs were greater in rats exposed to the 5500 m level than in those at 4000 m. Erythrocyte count, hemoglobin and hematocrit tests showed polycythemic patterns during the initial hypobaric period in both 5500 m-, and 4000 m-level rats. However, from 4 to 12 weeks, the hematologic values of the 4000 m-level rats declined progressively toward the upper end of the normal range. This study suggests (i) that elevated PAPm in rats exposed to hypobaric-hypoxic environments results from structural remodeling of all M, PM and NM within the lobule, and (ii) that an environment equivalent to the 5500 m level causes more severe pulmonary vascular changes than one equivalent to the 4000 m level. The hematologic results suggest that rats exposed to the equivalent of the upper limit for long-term human residence can acquire acclimatization, but not those exposed to the equivalent of the upper limit for short-term human survival.

Altitude Sickness↗
PubMed2003

[High altitude cerebral oedema].

Acute mountain sickness and high altitude cerebral edema are specific pathologies of high altitude exposure. The usual symptoms of acute mountain sickness are headache, nausea, vomiting, insomnia, lassitude, dizziness and ataxia. High altitude cerebral oedema is a severe state of acute mountain sickness with, in addition, alteration of mental status and consciousness. The pathophysiology of these 2 diseases are essentially due to an increase of intracranial pressure directly dependent of an increase of cerebral volume. Molecular and cellular mechanisms underlying acute mountain sickness and high altitude cerebral oedema are still poorly understood. The regulation of cerebral blood flow by nitric oxide seems to play a major role.

Altitude Sickness↗
PubMed1997

High altitude training increases reactive carbonyl derivatives but not lipid peroxidation in skeletal muscle of rats.

The oxidative stress related consequences of physical training at high altitude are not known. The hypothesis was tested that physical training and exposure to high altitude have adverse effects on free radical generation and activities of antioxidant enzymes. The present results showed that 4 weeks of exercise at an altitude of 4000 m increased the activity of Mn-SOD in both white and red types of skeletal muscle. The activities of Cu,Zn-SOD, catalase, and glutathione peroxidase, as well as the level of lipid peroxidation measured by TBARS and lipid hydroperoxides, did not change significantly. In contrast, the level of reactive carbonyl derivatives measured by anti-2,4-dinitrophenylhydrazone antibodies and spectrophotometry showed an increase in both types of muscle of altitude trained rats compared with sea level trained and control groups. It was suggested that the oxidative modification of certain amino acids is due to the increasing gap between activity of SOD and peroxide scavenging enzymes, which results in increases in the number of hydrogen peroxide molecules. Thus, since the mechanism of generation and/or the mode of action of radicals resulting in lipid peroxidation and protein oxidation appears to be different in vivo, both processes should be studied during oxidative stress.

Altitude↗
PubMed1999

Cosmic rays and dosimetry at aviation altitudes.

Recent concerns regarding the effects of the cosmic radiation field at aircraft altitudes on aircrew have resulted in a renewed interest in detailed measurements of the neutral and charged particle components in the atmosphere. CR-39 nuclear track detectors have been employed on a number of subsonic and supersonic aircraft to measure charge spectra and LET spectra at aircraft altitudes. These detectors are ideal for long term exposures required for these studies and their passive nature makes them suitable for an environment where interference with flight instrumentation could be a problem. We report here on measurements and analysis of short range tracks which were produced by high LET particles generated mainly by neutron interactions at aviation altitudes. In order to test the overall validity of the technique measurements were also carried out at the CERN-CEC field which simulates the radiation field at aviation altitudes and good agreement was found with dose values obtained using mainly heavy ion calibration.

Aircraft↗
PubMed2003

Pulmonary diffusing capacity in pregnancy at sea level and at high altitude.

The impact of pregnancy on respiratory function and whether this is influenced by living conditions, such as altitude of residence, must be determined if the management of pregnant women, particularly those with pulmonary disease is to be optimized. Pulmonary diffusing capacity, corrected for haemoglobin concentration (DL(COc)), therefore, was measured in 112 healthy Peruvian women with singleton pregnancies living at sea level and 192 living at 4300 m. At each location, 19 non-pregnant women were studied. The mean DL(COc)s of the pregnant and non-pregnant women studied at sea level were similar but lower than those of their high altitude counterparts (P<0.001, P<0.001). At high altitude, the mean DL(COc)s of women studied in the first and second trimester were similar to that of non-pregnant women, but the mean DL(COc) of pregnant women studied in the third trimester was lower than that of the non-pregnant women (P<0.01). Our results demonstrate that the effect of pregnancy on pulmonary diffusing capacity is influenced by altitude of residence.

Altitude↗
PubMed2004

[Altitude, the ratio of PaO2 to fraction of inspired oxygen, and shunt: impact on the assessment of acute lung injury].

The ratio of PaO2 to the fraction of inspired oxygen (PaO2/FIO2) is commonly used to determine the severity of acute lung injury and acute respiratory distress syndrome (ARDS). The research presented here used computational models of the lung to analyze the effect of altitude on the PaO2/FIO2 ratio and pulmonary shunt. At a given shunt, the PaO2/FIO2 ratio is lower at higher altitudes. Therefore, when evaluating for ARDS based on a PaO2/FIO2 ratio of <200 mm Hg, patients residing at high altitudes will have less shunt and, presumably, less severe lung injury than patients at sea level. This should be taken into consideration when comparing patients from different altitudes. Shunt should more often be measured directly or be estimated assuming a constant arteriovenous oxygen content difference.

Altitude↗
PubMed1993

Studies of linkage in populations. X. Altitude and autosomal gene arrangements in Drosophila robusta.

Data are presented concerning the gene arrangements in the second and third chromosomes of Drosophila robusta in eight altitudinal transects. A consistent change is the increase in the arrangement 2L-3, particularly in the linkage combination 2L-3.2R, with increasing altitude. The reciprocal decrease with increasing altitude affects several different 2-left arrangements, most consistently 2L-1. The arrangements of 2-right show no significant variation with altitude, and those of 3-right do so only in a few samples of the two northern transects studied, none in any of the southern ones. These results confirm previous evidence for the significant role of the arrangements of the left arm of the second chromosome in the adaptations of this species to altitude and suggest further that interactions of linked arrangements are involved in these adaptations. The data also indicate that the factors responsible for the altitudinal adaptations of this species are in many cases not the same ones that are responsible for variations in its gene arrangements with latitude.

Altitude↗
PubMed2002

Birth seasonality in Jujeño (north-west Argentina) altitude populations.

Seasonality of births has been related to multiple factors, including environmental, biological and sociocultural ones, in populations of diverse geographic and cultural origin. However, the relationship between this variable of bioanthropologic interest and geographic altitude has not been adequately explored. The aim of this study was to analyse the monthly distribution pattern of birth rates in Jujeño (north-west Argentina) populations located at different geographic altitude levels. Data were provided by the Statistical Reports on Liveborns (n = 110,404) in the province of Jujuy, 1985-1992. Records were grouped by birthplace into the four geographic regions of the province: Ramal (350 m.a.s.l.), Valle (1200 m.a.s.l.), Quebrada (2500 m.a.s.l.) and Puna (3500 m.a.s.l.). Henry's coefficients of seasonality were estimated. A chi-square test for goodness of fit (chi2) was used to identify statistically significant seasonal variations. Edwards' test was used to detect simple harmonic cycles in birth distribution. Statistically significant seasonal patterns were found in the four geographic regions and they respond to a cyclic model of simple harmonic variation. The greatest Henry coefficients were observed in spring and summer in the higher regions (Puna and Quebrada). whereas they were seen in autumn and winter in the lowlands (Valle and Ramal). It is suggested that these patterns reflect the influence of environmental and socioeconomic altitude-related factors and inter-regional cultural diversity, rather than the influence of geographical altitude per se.

Altitude↗
PubMed2005

Protein composition, plasmin activity and cheesemaking properties of cows' milk produced at two altitudes from hay of lowland and high-alpine origins.

The influence of high altitude, alpine origin of the forage and roughage-only diets on milk protein content and composition, plasmin activity and cheesemaking properties was investigated. There were four treatment groups, each consisting of six dairy cows in early to mid-lactation. Two groups were fed only with hay ad libitum either at 2000 m or at 400 m a.s.l. One group, kept in the lowlands, was pair-fed to the alpine-site group and another group received a mixed diet of silages, hay and concentrates. Two hay types, harvested either at the alpine site or in the lowlands, were offered to all cows fed with hay alone, following a change-over design in three periods each of 3 weeks. In the respective third week, milk was sampled at every milking. Hay of alpine origin significantly reduced milk protein, in particular whey proteins, which is why the casein number increased. kappa-Casein proportion in total casein was reduced and its glycosylation was increased by the alpine hay. The apparent plasminogen-derived activity was reduced when alpine hay was given, but apparent plasmin activity and rennet coagulation properties of the milk were not affected by hay type. Independent of hay type, the high altitude group showed a significantly reduced milk protein content, lower glycosylation of kappa-casein and impaired rennet coagulation properties. For several of the traits, the trend was the same in the pair-fed group. There was no effect of altitude on apparent plasmin activity. Hay-alone v. the mixed diet resulted initially in marked declines in milk protein content but did not impair cheesemaking properties. Thus the extensive diet without concentrates, typical of high-alpine conditions, contributed less to the overall effect of extensive alpine v. intensive lowland feeding systems than hay quality and altitude did. In conclusion, certain positive influences of the alpine sojourn of cows on cheese processing quality are overruled by the major adverse impact of lower milk protein content.

Altitude↗
PubMed2001

Fasciola hepatica and lymnaeid snails occurring at very high altitude in South America.

Fascioliasis due to the digenean species Fasciola hepatica has recently proved to be an important public health problem, with human cases reported in countries of the five continents, including severe symptoms and pathology, with singular epidemiological characteristics, and presenting human endemic areas ranging from hypo- to hyperendemic. One of the singular epidemiological characteristics of human fascioliasis is the link of the hyperendemic areas to very high altitude regions, at least in South America. The Northern Bolivian Altiplano, located at very high altitude (3800-4100 m), presents the highest prevalences and intensities of human fascioliasis known. Sequences of the internal transcribed spacers ITS-1 and ITS-2 of the nuclear ribosomal DNA of Altiplanic Fasciola hepatica and the intermediate snail host Lymnaea truncatula suggest that both were recently introduced from Europe. Studies were undertaken to understand how the liver fluke and its lymnaeid snail host adapted to the extreme environmental conditions of the high altitude and succeeded in giving rise to high infection rates. In experimental infections of Altiplanic lymnaeids carried out with liver fluke isolates from Altiplanic sheep and cattle, the following aspects were studied: miracidium development inside the egg, infectivity of miracidia, prepatent period, shedding period, chronobiology of cercarial emergence, number of cercariae shed by individual snails, survival of molluscs at the beginning of the shedding process, survival of infected snails after the end of the shedding period and longevity of shedding and non-shedding snails. When comparing the development characteristics of European F. hepatica and L. truncatula, a longer cercarial shedding period and a higher cercarial production were observed, both aspects related to a greater survival capacity of the infected lymnaeid snails from the Altiplano. These differences would appear to favour transmission and may be interpreted as strategies associated with adaptation to high altitude conditions.

Altitude↗
PubMed2000

High-altitude retinopathy and retinal vascular dysregulation.

PURPOSE: (a) To show that high-altitude retinopathy (HAR) is common at high altitudes even in well-acclimatised climbers and that it should not be regarded as part of the spectrum of benign mountain sickness but rather as a clinical sign with a separate aetiology. (b) To test the hypothesis that HAR could be interpreted as a clinical expression of 'ocular vascular dysregulation'. METHODS: Both eyes of the 8 mountaineers of the First Vienna Himalayan Expedition in May/June 1996 were examined 2 weeks before departure to and 2 weeks after descent from a high altitude. Retinal blood flow was measured in the right eyes of 7 climbers, using the Heidelberg Retina Flowmeter (HRF). RESULTS: Two of the 8 climbers had bilateral retinal haemorrhage after the expedition. In 5 climbers chronic hypoxic exposure caused an increase in retinal blood flow between +18% and +96%, and in 2 climbers a decrease in retinal blood flow between -21% and -31%. The 2 climbers (climbers 1 and 2) with bilateral retinal haemorrhage showed a significant increase in HRF parameters. CONCLUSIONS: HAR may be a clinical sign of mountaineers with a tendency towards ocular vascular dysregulation. The pronounced increase in all haemodynamic parameters in the 2 climbers with retinal haemorrhage combined with a dilated epipapillary network 2 weeks after the exposure reflects a retinal vessel configuration, as might be expected at high altitudes under acute hypoxic stress. An inadequate autoregulatory response of the retinal circulation under conditions of chronic hypoxia may play an important part in the pathogenesis of HAR.

Adult↗
PubMed1997

Cough frequency and cough-receptor sensitivity are increased in man at altitude.

1. Travellers to high altitude often complain of paroxysmal cough, which has not been previously investigated. We recorded overnight cough frequency and cough-receptor sensitivity to inhaled citric acid in a group of climbers travelling to 5300 m or higher. 2. Cough frequency, monitored in ten subjects, increased from a median of 0 coughs at sea level (range 0-1) to 5 coughs at 5000 m (range 0-13) and to over 60 coughs in subjects ascending to 7000 m. Citric acid cough threshold, measured in 42 subjects, was unchanged on arrival at 5300 m compared with sea level (geometric mean difference 1.26, 95% confidence intervals 0.84-1.89, P = 0.25), but was significantly reduced after 6 days, or more, at altitude compared with sea level (geometric mean difference 2.2, 95% confidence intervals 1.54-3.15, P = 0.0002). Cough threshold was not related to symptoms of acute mountain sickness, oxygen saturation, carbon dioxide tension or lung function. 3. These results indicate an increase in cough and cough-receptor sensitivity after some days at altitude. This may be due to respiratory tract damage from breathing cold dry air at increased ventilatory rates. Other explanations, such as sub-clinical pulmonary oedema or an effect on the cough centre of acclimatization to altitude, cannot be excluded.

Altitude↗
PubMed2002

Pressure in the cuffs of tracheal tubes at altitude.

Pressures in the cuffs of three commonly used tracheal tubes (Portex Profile Softseal, Mallinckrodt Lo-Contour and Mallinckrodt Hi-Contour, size 8.0 mm and 9.0 mm internal diameter), inflated with air, were measured during simulated ascents in an altitude chamber to 10 000 ft. There was no detectable difference in performance between sizes for each type of tracheal tube. When averaged over the two sizes for each type of tube, cuff pressure reached the critical perfusion pressure 50 cmH2O (37 mmHg) for tracheal mucosa at a higher altitude in the Portex Profile Softseal (2837 ft, 95% CI 2488-3186 ft) than in the Mallinckrodt Lo-Contour (2128 ft, 95% CI 1779-2476 ft; p = 0.02) and Mallinckrodt Hi-Contour (1820 ft; 95% CI 1471-2168 ft; p = 0.002) tracheal tubes. When the cuffs of the 9.0-mm tracheal tubes were inflated with saline, much smaller increases in pressure were measured with increasing altitude, although inflation of the cuffs with saline was technically difficult. Commonly used tracheal tubes with air-inflated cuffs can be used for aeromedical retrieval, but air should be evacuated from the cuffs after increases in altitude of as little as 2000-3000 ft.

Aerospace Medicine↗
PubMed2003

Remodelling of uteroplacental arteries is decreased in high altitude placentae.

Uterine blood flow and birth weight are reduced and the risk of pre-eclampsia is increased in high-altitude pregnancies. Since IUGR and pre-eclampsia are associated with reduced invasion and remodelling of maternal spiral arteries we asked whether the terminal ends of uteroplacental arteries located at the maternal-foetal decidual interface evidenced less remodelling in 19 high (3100 m) compared with 13 moderate (1600 m) altitude placentae from normal pregnancies. Previous work has demonstrated marked villous angiogenesis in high altitude placentae. We asked whether such changes are compensatory for reduced modelling and/or whether they contribute to increased birth weight. Placentae were randomly sampled and examined with immunohistochemistry to evaluate vessel remodelling and foetal capillary density. The decidual ends of uteroplacental arteries were 8-fold more likely to be remodelled at 1600 vs. 3100 m (OR=8.1; CI 2.4, 27.0,P< 0.001). There were more than twice as many uteroplacental arteries observed in the high vs. moderate altitude placentae (OR=2.1; CI: 1.3, 3.5, P=0.006). Foetal capillary density was greater at 3100 vs. 1600 m (P< 0.001), but did not relate to remodelling nor to birth weight. In this in vivo model for chronic hypoxia, remodelling is reduced, and villous angiogenesis is not fully compensatory for reduced PO(2).

Adaptation, Physiological↗
PubMed2000

High-altitude cerebral edema (HACE): the Denver/Front Range experience.

High-altitude cerebral edema (HACE) is a potentially fatal metabolic encephalopathy associated with a time-dependent exposure to the hypobaric hypoxia of altitude. Symptoms commonly are headache, ataxia, and confusion progressing to stupor and coma. HACE is often preceded by symptoms of acute mountain sickness and coupled, in its severe form, with high-altitude pulmonary edema. Although HACE is mostly seen at altitudes above that of the Denver/Front Range visitor-skier locations, we report our observations over a 13-year period of skier-visitor HACE patients. It is believed that this is a form of vasogenic edema, and it is responsive to expeditious treatment with a successful outcome.

Adolescent↗
PubMed1994

The nutritional intake of Bolivian boys. The relation between altitude and socioeconomic status.

The nutrition of 57 native Bolivian boys living at high altitude (HA) in La Paz (+/- 4000 m) and of 63 boys living at low altitude (LA) in St. Cruz (+/- 400 m) is described. The dietary information was obtained with a 24-h recall method, by interviewing the child and mother. The food items are listed in household measures and weight if possible. All food items were converted into grams, and nutrients were calculated by using food composition tables of Latin America. The results show that the energy and nutrient intake of the HSES boys was significantly higher (p < 0.05) than the intake of the LSES boys, at both altitudes. At HA the mean energy intake of the HSES boys was about 9.8 MJ per day (+/- 0.7); for the LSES boys an intake was found of 8.4 MJ per day (+/- 0.4). At LA the HSES boys had an energy intake of 10.7 MJ per day (+/- 0.6) and the LSES boys 7.7 MJ per day (+/- 0.3). The daily protein intake was in HAHSES boys 85 g (+/- 8), LAHSES 100 g (+/- 8), HALSES 60 g (+/- 4), and LALSES 52 g (+/- 3). In comparison with the recommended daily requirements the dietary intakes of the HSES boys seem too "rich," and of the LSES boys to some extent too "poor." These results are reflected in smaller body height and body weight of LSES boys and a higher fat mass in HSES boys irrespective of altitude.

Adult↗
PubMed1994

Habitual physical activity in 10- to 12-year-old Bolivian boys. The relation between altitude and socioeconomic status.

This study describes habitual physical activity (HPA) of Bolivian boys living at different altitudes and from different socioeconomic status. The boys were living at high altitude (HA) in La Paz (4000 m) and at low altitude (LA) in Santa Cruz (400 m). At both altitudes samples of 10- to 12-year-old boys were chosen from a relatively low socioeconomic status (LSES) and a relatively high socioeconomic status (HSES). At HA 19 boys from LSES and 10 boys from HSES were measured and at LA 14 boys from LSES and 13 boys from HSES. HPA was measured by 24-h heart rate (HR) monitoring. Also an interview was completed to recall the HPA. By comparing the registered HR data with the time they were asleep the mean HR during sleep was calculated (HRsleep). The maximal HR (HRmax) was measured from a maximal exercise test on a bicycle ergometer. Heart rate reserve (HRR = HRmax-HRsleep) was used to measure the mean level of physical activity of the subjects. The results show that HRsleep (= HRrest) in HA boys with 70 (+/- 6) beats/min was significantly lower (p < 0.05) than in LA boys with 77 (+/- 10) beats/min. HRmax was also significantly lower (p < 0.05) in HA boys (187 +/- 12 beats/min) compared to LA boys (195 +/- 8 beats/min). Because HA influences HRsleep and HRmax in the same way, HRR is not significantly different between boys of HA and LA. The mean heart rate over 24 h (HRmean) in HA boys (87 +/- 7 beats/min) was significantly lower than in LA boys (93 +/- 8 beats/min).(ABSTRACT TRUNCATED AT 250 WORDS)

Altitude↗