High altitude medicine & biology最新文献

{"title":"Lung \"Comet Tails\" in Healthy Individuals: Accumulation or Clearance of Extravascular Lung Water?","authors":"Jordan K Parks,&nbsp;Courtney M Wheatley-Guy,&nbsp;Glenn M Stewart,&nbsp;Caitlin C Fermoyle,&nbsp;Bryan J Taylor,&nbsp;Jesse Schwartz,&nbsp;Briana Ziegler,&nbsp;Kay Johnson,&nbsp;Alice Gavet,&nbsp;Loïc Chabridon,&nbsp;Paul Robach,&nbsp;Bruce D Johnson","doi":"10.1089/ham.2022.0114","DOIUrl":"10.1089/ham.2022.0114","url":null,"abstract":"<p><p>Parks, Jordan K, Courtney M. Wheatley-Guy, Glenn M. Stewart, Caitlin C. Fermoyle, Bryan J. Taylor, Jesse Schwartz, Briana Ziegler, Kay Johnson, Alice Gavet, Loïc Chabridon, Paul Robach, and Bruce D. Johnson. Lung \"Comet Tails\" in healthy individuals: accumulation or clearance of extravascular lung water? <i>High Alt Med Biol.</i> 24:230-233, 2023-Ultrasound lung comet tails (or B-lines) tend to be limited in number (<5) or absent under ultrasound examination, and the appearance of diffuse B-lines with lung sliding has been suggested to identify pulmonary edema. Clinical evaluation of B-lines has been utilized as a bedside test to assess pulmonary congestion in patients with heart failure. Exposure to altitude or prolonged exercise can alter fluid regulation and can lead to pulmonary congestion or edema. As such, B-lines have been utilized in the field to monitor for pathological lung fluid accumulation. However, ultrasound lung comet lines might not be as reliable for identifying extravascular lung water (EVLW) as previously thought in healthy individuals exercising at altitude where an increase in the number of ultrasound lung comets would reflect fluid buildup in the interstitial space of the alveoli and pulmonary capillaries. This report will focus on reviewing the literature and our data from a group of ultraendurance runners that completed the Ultra Trail Mont Blanc race that demonstrates that lung comet tails may not always be evidence of pathological fluid accumulation in healthy individuals and as such should be used to assess EVLW in concert with other diagnostic testing.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"230-233"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Prevalence of Body Fat-Defined Obesity at Higher Altitudes in Peruvian Adults.","authors":"Orison O Woolcott,&nbsp;Till Seuring,&nbsp;Oscar A Castillo","doi":"10.1089/ham.2022.0097","DOIUrl":"10.1089/ham.2022.0097","url":null,"abstract":"<p><p>Woolcott, Orison O., Till Seuring, and Oscar A. Castillo. Lower prevalence of body fat-defined obesity at higher altitudes in Peruvian adults. <i>High Alt Med Biol</i>. 24:214-222, 2023. <b><i>Background:</i></b> Previous studies have reported a lower prevalence of obesity (defined as a body mass index [BMI] ≥30 kg/m²) in populations from higher altitudes. Since BMI does not distinguish fat mass and fat-free mass, it is unclear whether there is an inverse association between altitude and body fat-defined obesity. <b><i>Methods:</i></b> We performed an analysis of cross-sectional data to examine the association between altitude and body fat-defined obesity (as opposed to BMI-defined obesity) using individual-level data from a nationally representative sample of the Peruvian adult population living between 0 and 5,400 m altitude. Body fat-defined obesity was diagnosed using the relative fat mass (RFM), an anthropometric index validated to estimate whole-body fat percentage. RFM cutoffs for obesity diagnosis were ≥40% for women and ≥30% for men. We utilized Poisson regression to estimate the prevalence ratio and confidence intervals (CIs) as the measure of the association, adjusting for age, cigarette use, and diabetes. <b><i>Results:</i></b> Analysis comprised 36,727 individuals (median age, 39 years; 50.1% women). In rural areas, for a one-km increase in altitude, the prevalence of body fat-defined obesity decreased by 12% among women (adjusted prevalence ratio: 0.88; 95% CI, 0.86 - 0.90; <i>p</i> < 0.001) and 19% among men (adjusted prevalence ratio: 0.81; 95% CI, 0.77 - 0.86; <i>p</i> < 0.001), on average, when all the other variables were held constant. The inverse association between altitude and obesity was less strong in urban areas than in rural areas but remained significant among women (<i>p</i> = 0.001) and men (<i>p</i> < 0.001). However, the relationship between altitude and obesity in women who live in urban areas appears to be nonlinear. <b><i>Conclusions:</i></b> In Peruvian adults, the prevalence of body fat-defined obesity was inversely associated with altitude. Whether this inverse association is explained by altitude <i>per se</i> or confounded by socioeconomic or other environmental factors, or differences in race/ethnicity or lifestyle, warrants further investigation.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"214-222"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Ultrahigh Altitude on the Mental Health of Civil Servants in Western China Based on Propensity Score Matching.","authors":"Luyao Wang,&nbsp;Bo Zhou,&nbsp;Chenghui Yang,&nbsp;Shuya Pan,&nbsp;Yulan Huang,&nbsp;Jinyu Wang","doi":"10.1089/ham.2020.0086","DOIUrl":"10.1089/ham.2020.0086","url":null,"abstract":"<p><p>Wang, Luyao, Bo Zhou, Chenghui Yang, Shuya Pan, Yulan Huang, and Jinyu Wang. The effect of ultrahigh altitude on the mental health of civil servants in western China based on propensity score matching. <i>High Alt Med Biol</i>. 24:193-200, 2023. <b><i>Objective:</i></b> This study aims to analyze the net effect of ultrahigh altitude on the mental health of civil servants in western China after adjusting for sociodemographic factors. <b><i>Methods:</i></b> A cross-sectional study was performed to survey the mental health of 2,939 civil servants working at an altitude of more than 1,500 m in 13 areas of the Tibetan Qiang Autonomous Prefecture of Ngawa using the Insomnia Severity Index Questionnaire, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9. Ultrahigh altitude refers to an area above 3,500 m above sea level, which may have an impact on the sleep and mood of residents. Therefore, our research was divided into two groups based on altitude (ultrahigh altitude >3,500 m; high altitude = 1,500-3,400 m). Propensity score matching (PSM) was used to control for sociodemographic factors and compare the differences in mental health between the two groups. <b><i>Results:</i></b> After kernel matching, the mean bias of the covariates was reduced from 21.6 to 1.8. The severity of insomnia, depression, and anxiety in civil servants at ultrahigh altitudes was still significantly greater than that in civil servants at high altitudes after controlling for sociodemographic factors, and the average treatment effects on the treated were 1.39, 1.35, and 0.80, respectively; the results were significant (<i>α</i> < 0.01). PSM regression analysis further showed that for every 100 m increase in altitude, the severity of anxiety, depression, and insomnia increased by 0.042 points (<i>p</i> < 0.001), 0.063 points (<i>p</i> < 0.001), and 0.070 points (<i>p</i> < 0.001), respectively, all of which were higher than those obtained with ordinary least squares regression. <b><i>Conclusion:</i></b> Ultrahigh altitude significantly increases the severity of insomnia, depression, and anxiety after adjusting for sociodemographic factors.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"193-200"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10285977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior Ambulatory Mild Coronavirus Disease 2019 Does Not Increase Risk of Acute Mountain Sickness.","authors":"Elan Small,&nbsp;Caleb Phillips,&nbsp;William Bunzel,&nbsp;Lakota Cleaver,&nbsp;Nishant Joshi,&nbsp;Laurel Gardner,&nbsp;Rony Maharjan,&nbsp;James Marvel","doi":"10.1089/ham.2022.0150","DOIUrl":"10.1089/ham.2022.0150","url":null,"abstract":"<p><p>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. <i>High Alt Med Biol</i>. 24:201-208, 2023. <b><i>Background:</i></b> 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. <b><i>Materials and Methods:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> = 0.6) or moderate AMS (<i>p</i> = 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 (<i>p</i> = 0.3) or moderate AMS (<i>p</i> = 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. <b><i>Conclusions:</i></b> Prior ambulatory mild COVID-19 was not associated with increased risk of AMS and should not preclude high-altitude travel.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"201-208"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10663644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global REACH 2018: High Altitude-Related Circulating Extracellular Microvesicles Promote a Proinflammatory Endothelial Phenotype <i>In Vitro</i>.","authors":"L Madden Brewster,&nbsp;Anthony R Bain,&nbsp;Vinicius P Garcia,&nbsp;Noah M DeSouza,&nbsp;Michael M Tymko,&nbsp;Jared J Greiner,&nbsp;Philip N Ainslie","doi":"10.1089/ham.2023.0013","DOIUrl":"10.1089/ham.2023.0013","url":null,"abstract":"<p><p>Brewster, L. Madden, Anthony R. Bain, Vinicius P. Garcia, Noah M. DeSouza, Michael M. Tymko, Jared J. Greiner, and Philip N. Ainslie. Global REACH 2018: high altitude-related circulating extracellular microvesicles promote a proinflammatory endothelial phenotype <i>in vitro</i>. <i>High Alt Med Biol</i>. 24:223-229, 2023. <b><i>Introduction:</i></b> Ascent to high altitude (HA) can induce vascular dysfunction by promoting a proinflammatory endothelial phenotype. Circulating microvesicles (MVs) can mediate the vascular endothelium and inflammation. It is unclear whether HA-related MVs are associated with endothelial inflammation. <b><i>Objectives:</i></b> We tested the hypothesis that MVs derived from ascent to HA induce a proinflammatory endothelial phenotype. <b><i>Methods:</i></b> Ten healthy adults (8 M/2 F; age: 28 ± 2 years) residing at sea level (SL) were studied before and 4-6 days after rapid ascent to HA (4,300 m). MVs were isolated and enumerated from plasma by centrifugation and flow cytometry. Human umbilical vein endothelial cells were treated with MVs collected from each subject at SL (MV-SL) and at HA (MV-HA). <b><i>Results:</i></b> Circulating MV number significantly increased at HA (26,637 ± 3,315 vs. 19,388 ± 1,699). Although intracellular expression of total nuclear factor kappa beta (NF-κB; 83.4 ± 6.7 arbitrary units [AU] vs. 90.2 ± 6.9 AU) was not affected, MV-HA resulted in ∼55% higher (<i>p</i> < 0.05) active NF-κB (129.6 ± 19.8 AU vs. 90.7 ± 10.5 AU) expression compared with MV-SL. In addition, MV-HA induced higher interleukin (IL)-6 (63.9 ± 3.9 pg/ml vs. 53.3 ± 3.6 pg/ml) and IL-8 (140.2 ± 3.6 pg/ml vs. 120.7 ± 3.8 pg/ml) release compared with MV-SL, which was blunted with NF-κB blockade. <b><i>Conclusions:</i></b> Circulating extracellular MVs increase at HA and induce endothelial inflammation, potentially contributing to altitude-related vascular dysfunction.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"223-229"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter to the Editor:</i> SpO₂ Reading at an Altitude of 2,300 Meters Above Sea Level.","authors":"Ugyen Tshering,&nbsp;Cheku Dorji","doi":"10.1089/ham.2023.0059","DOIUrl":"10.1089/ham.2023.0059","url":null,"abstract":"","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"240-242"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin Levels in Peruvian Patients with Chronic Kidney Disease at Different Altitudes.","authors":"Abdías Hurtado-Aréstegui,&nbsp;Karina Rosales-Mendoza,&nbsp;Yanissa Venegas-Justiniano,&nbsp;José Gonzales-Polar,&nbsp;Rina Barreto-Jara,&nbsp;Alaciel Melissa Palacios-Guillén","doi":"10.1089/ham.2023.0046","DOIUrl":"10.1089/ham.2023.0046","url":null,"abstract":"<p><p>Hurtado-Aréstegui, Abdías, Karina Rosales-Mendoza, Yanissa Venegas-Justiniano, José Gonzales-Polar, Rina Barreto-Jara, and Alaciel Melissa Palacios-Guillén. Hemoglobin levels in Peruvian patients with chronic kidney disease at different altitudes. <i>High Alt Med Biol</i>. 24:209-213, 2023. <b><i>Background:</i></b> Decreased hemoglobin is a manifestation of chronic kidney disease (CKD), and people who reside at high altitude adapt to hypoxia by increasing their hemoglobin. The study's objective was to determine the influence of altitude and the associated factors on the hemoglobin levels of patients with CKD who were not on dialysis (ND). <b><i>Methods:</i></b> This exploratory and cross-sectional study was carried out in three Peruvian cities, located at different altitudes: (1) \"sea level\" (161 m), (2) \"moderate altitude\" (2,335 m), and \"high altitude\" (3,399 m). The study included female and male individuals between 20 and 90 years old, with CKD stage 3a, through stage 5. <b><i>Results:</i></b> Of the 256 volunteers evaluated, 92 lived at sea level, 82 at moderate altitude, and 82 at high altitude. The three groups were similar in age, number of volunteers in each CKD stage, systolic blood pressure, and diastolic blood pressure. Hemoglobin levels were statistically different according to gender (<i>p</i> = 0.024), CKD stage, and altitude (<i>p</i> < 0.001). High-altitude dwellers had higher hemoglobin by 2.5 g/dl (95% confidence interval: 1.8-3.1, <i>p</i> < 0.001) than those living at lower altitudes (adjusted for gender, age, nutritional status, and smoking habit). For all CKD stages, the high-altitude population had higher hemoglobin levels than population at moderate altitude and at sea level. <b><i>Conclusion:</i></b> Subjects living at high altitude with CKD stages 3 to 5 who are yet ND have higher hemoglobin levels than those who live at moderate altitude and at sea level.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"209-213"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Altitude Exposure and Cerebral Venous Thrombosis: An Updated Systematic Review.","authors":"Sanjeev Kharel,&nbsp;Suraj Shrestha,&nbsp;Samriddha Raj Pant,&nbsp;Suman Acharya,&nbsp;Amit Sharma,&nbsp;Santosh Baniya,&nbsp;Sanjeeb S Bhandari","doi":"10.1089/ham.2022.0106","DOIUrl":"10.1089/ham.2022.0106","url":null,"abstract":"<p><p>Kharel, Sanjeev, Suraj Shrestha, Samriddha Raj Pant, Suman Acharya, Amit Sharma, Santosh Baniya, and Sanjeeb S. Bhandari. High-altitude exposure and cerebral venous thrombosis: an updated systematic review. <i>High Alt Med Biol</i>. 24:167-174, 2023. <b><i>Background:</i></b> High altitude (HA) may increase the risk of cerebral venous thrombosis (CVT). Differentiating it from other HA illnesses is crucial for prompt treatment and better outcomes. We aimed to summarize the clinical data, etiology, and risk factors of this poorly understood entity at an HA. <b><i>Materials and Methods:</i></b> A systematic literature search of various databases, including PubMed, Embase, and Google Scholar, was done using relevant keywords; cerebral venous thrombosis; HA, up to May 1, 2022. <b><i>Results:</i></b> A total of nine studies, including 75 cases of CVT at HA (3,000-8,848 m), with 66 males and 9 females, were included in this review. Headache and seizure were the most common clinical presentations. Smoking, drinking habits, and the use of oral contraceptive pills (OCP) were the most common risk factors for the development of CVT. Similarly, various underlying hypercoagulable states were also present among cases of CVT associated with HA exposure. <b><i>Conclusion:</i></b> Our review concludes that HA exposure can predispose individuals with risk factors such as preexisting hypercoagulable states, smoking, drinking habits, and use of OCP to an increased risk of CVT.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"167-174"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising Natural Medicines for the Treatment of High-Altitude Illness.","authors":"Li Li,&nbsp;Lin Lin,&nbsp;Bo Wen,&nbsp;Peng-Cheng Zhao,&nbsp;Da-Sheng Liu,&nbsp;Guo-Ming Pang,&nbsp;Zi-Rong Wang,&nbsp;Yong Tan,&nbsp;Cheng Lu","doi":"10.1089/ham.2022.0139","DOIUrl":"10.1089/ham.2022.0139","url":null,"abstract":"<p><p>Li Li, Lin Lin, Bo Wen, Peng-cheng Zhao, Da-sheng Liu, Guo-ming Pang, Zi-rong Wang, Yong Tan, and Cheng Lu. Promising natural medicines for the treatment of high-altitude illness. <i>High Alt Med Biol</i>. 24:175-185, 2023.-High-altitude illness (HAI) is a dangerous disease characterized by oxidative stress, inflammatory damage and hemodynamic changes in the body that can lead to severe damage to the lungs, heart, and brain. Natural medicines are widely known for their multiple active ingredients and pharmacological effects, which may be important in the treatment of HAI. In this review, we outline the specific types of HAI and the underlying pathological mechanisms and summarize the currently documented natural medicines applied in the treatment of acute mountain sickness and high-altitude cerebral edema, high-altitude pulmonary edema, chronic mountain sickness, and high-altitude pulmonary hypertension. Their sources, types, and medicinal sites are summarized, and their active ingredients, pharmacological effects, related mechanisms, and potential toxicity are discussed. In conclusion, natural medicines, as an acceptable complementary and alternative strategy with fewer side effects and more long-term application, can provide a reference for developing more natural antialtitude sickness medicines in the future and have good application prospects in HAI treatment.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"175-185"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counseling Patients with Chronic Obstructive Pulmonary Disease Traveling to High Altitude.","authors":"Konrad E Bloch, Talant M Sooronbaev, Silvia Ulrich, Mona Lichtblau, Michael Furian","doi":"10.1089/ham.2023.0053","DOIUrl":"10.1089/ham.2023.0053","url":null,"abstract":"<p><p>Bloch, Konrad E., Talant M. Sooronbaev, Silvia Ulrich, Mona Lichtblau, and Michael Furian. Clinician's corner: counseling patients with chronic obstructive pulmonary disease traveling to high altitude. <i>High Alt Med Biol</i>. 24:158-166, 2023.-Mountain travel is increasingly popular also among patients with chronic obstructive pulmonary disease (COPD), a highly prevalent condition often associated with cardiovascular and systemic manifestations. Recent studies have shown that nonhypercapnic and only mildly hypoxemic lowlanders with moderate to severe airflow obstruction owing to COPD experience dyspnea, exercise limitation, and sleep disturbances when traveling up to 3,100 m. Altitude-related adverse health effects (ARAHE) in patients with COPD include severe hypoxemia, which may be asymptomatic but expose patients to the risk of excessive systemic and pulmonary hypertension, cardiac arrhythmia, and even myocardial or cerebral ischemia. In addition, hypobaric hypoxia may impair postural control, psycho-motor, and cognitive performance in patients with COPD during altitude sojourns. Randomized, placebo-controlled trials have shown that preventive treatment with oxygen at night or with acetazolamide reduces the risk of ARAHE in patients with COPD while preventive dexamethasone treatment improves oxygenation and altitude-induced excessive sleep apnea, and lowers systemic and pulmonary artery pressure. This clinical review provides suggestions for pretravel assessment and preparations and measures during travel that may reduce the risk of ARAHE and contribute to pleasant mountain journeys of patients with COPD.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":"24 3","pages":"158-166"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10296866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}