Katharine Foster, James D Anholm, Gary Foster, Suman Thapamagar, Prajan Subedi
Foster, Katharine, James D. Anholm, Gary Foster, Suman Thapamagar, and Prajan Subedi. Effects of naltrexone on sleep quality and periodic breathing at high altitude. High Alt Med Biol. 00:000-000, 2024. Objective: This study examined the effects of naltrexone on breathing and sleep at high altitude. Mu-opioid receptor (MOR) agonists have a depressive effect on respiration. Naltrexone is known to block the MOR. We hypothesized that MOR blockade with naltrexone would result in higher nocturnal oxygen saturations, fewer apneas, and improved sleep at high altitude. Methods: This double-blind, placebo-controlled, crossover study included nine healthy volunteers (four females, five males) aged 27.9 (4.6) (mean [standard deviation]) years. Two overnight trips spaced at least 2 weeks apart took participants from Loma Linda, CA (355 m) to the Barcroft Laboratory, CA (3,810 m) for each arm. Participants ingested either 50 mg naltrexone or matching placebo at bedtime. Sleep metrics were recorded using an ambulatory physiological sleep monitor (APSM). Subjective data were measured with the Groningen Sleep Quality Scale, Stanford Sleepiness Scale, and the 2018 Lake Louise Score (LLS) for acute mountain sickness (AMS). Results: Mean overnight SpO2 was lower after taking naltrexone, 81% (6) versus 83% (4) (mean difference 1.9% [2.1, 95% confidence interval or CI = 0.1-3.6, p = 0.040]). The lowest overnight SpO2 (nadir) was lower on naltrexone 70% (6) versus 74% (4) (dif. 4.6% [4.3], CI = 1.0-8.2, p = 0.020). Total sleep time and total apnea-hypopnea index were unchanged. Subjective sleep quality was significantly worse on naltrexone measured via the Groningen Sleep Quality Scale (p = 0.033) and Stanford Sleepiness Scale (p = 0.038). AMS measured via LLS was significantly worse while taking naltrexone (p = 0.025). Conclusion: Contrary to our hypothesis, this study demonstrated a significant decrease in nocturnal oxygen saturation, worse sleep quality, and AMS scores. Further characterization of the MOR's effects on sleep and AMS is needed to evaluate potential exacerbating mechanisms for AMS and poor sleep quality at altitude.
Foster, Katharine, James D. Anholm, Gary Foster, Suman Thapamagar, and Prajan Subedi.纳曲酮对高海拔地区睡眠质量和周期性呼吸的影响。00:000-000, 2024.目的:本研究探讨了纳曲酮对高海拔地区呼吸和睡眠的影响。缪阿片受体(MOR)激动剂对呼吸有抑制作用。已知纳曲酮能阻断 MOR。我们假设,使用纳曲酮阻断 MOR 会提高夜间血氧饱和度,减少呼吸暂停,并改善高海拔地区的睡眠。研究方法这项双盲、安慰剂对照、交叉研究包括九名健康志愿者(四名女性,五名男性),年龄为 27.9(4.6)(平均值[标准差])岁。每组参与者从加利福尼亚州洛马林达(海拔 355 米)到加利福尼亚州巴克罗夫特实验室(海拔 3810 米)进行了两次隔夜旅行,每次旅行间隔至少 2 周。参与者在睡前服用 50 毫克纳曲酮或相应的安慰剂。使用动态生理睡眠监测仪(APSM)记录睡眠指标。主观数据采用格罗宁根睡眠质量量表、斯坦福嗜睡量表和 2018 年急性登山病(AMS)路易斯湖评分(LLS)进行测量。结果显示服用纳曲酮后的平均过夜SpO2较低,为81%(6人)对83%(4人)(平均差异为1.9% [2.1,95%置信区间或CI = 0.1-3.6,P = 0.040])。纳曲酮的最低夜间 SpO2(最低点)较低,为 70%(6 人)对 74%(4 人)(差异为 4.6% [4.3],CI = 1.0-8.2,P = 0.020)。总睡眠时间和总呼吸暂停-低通气指数保持不变。通过格罗宁根睡眠质量量表(p = 0.033)和斯坦福嗜睡量表(p = 0.038)测量,服用纳曲酮后主观睡眠质量明显降低。通过 LLS 测量的 AMS 在服用纳曲酮后明显降低(p = 0.025)。结论与我们的假设相反,这项研究表明,夜间血氧饱和度明显降低,睡眠质量和急性嗜睡量表评分均有所下降。需要进一步确定 MOR 对睡眠和高山反应的影响,以评估高山反应和睡眠质量差的潜在加剧机制。
{"title":"Effects of Naltrexone on Sleep Quality and Periodic Breathing at High Altitude.","authors":"Katharine Foster, James D Anholm, Gary Foster, Suman Thapamagar, Prajan Subedi","doi":"10.1089/ham.2024.0023","DOIUrl":"https://doi.org/10.1089/ham.2024.0023","url":null,"abstract":"<p><p>Foster, Katharine, James D. Anholm, Gary Foster, Suman Thapamagar, and Prajan Subedi. Effects of naltrexone on sleep quality and periodic breathing at high altitude. <i>High Alt Med Biol.</i> 00:000-000, 2024. <b><i>Objective:</i></b> This study examined the effects of naltrexone on breathing and sleep at high altitude. Mu-opioid receptor (MOR) agonists have a depressive effect on respiration. Naltrexone is known to block the MOR. We hypothesized that MOR blockade with naltrexone would result in higher nocturnal oxygen saturations, fewer apneas, and improved sleep at high altitude. <b><i>Methods:</i></b> This double-blind, placebo-controlled, crossover study included nine healthy volunteers (four females, five males) aged 27.9 (4.6) (mean [standard deviation]) years. Two overnight trips spaced at least 2 weeks apart took participants from Loma Linda, CA (355 m) to the Barcroft Laboratory, CA (3,810 m) for each arm. Participants ingested either 50 mg naltrexone or matching placebo at bedtime. Sleep metrics were recorded using an ambulatory physiological sleep monitor (APSM). Subjective data were measured with the Groningen Sleep Quality Scale, Stanford Sleepiness Scale, and the 2018 Lake Louise Score (LLS) for acute mountain sickness (AMS). <b><i>Results:</i></b> Mean overnight SpO<sub>2</sub> was lower after taking naltrexone, 81% (6) versus 83% (4) (mean difference 1.9% [2.1, 95% confidence interval or CI = 0.1-3.6, <i>p</i> = 0.040]). The lowest overnight SpO<sub>2</sub> (nadir) was lower on naltrexone 70% (6) versus 74% (4) (dif. 4.6% [4.3], CI = 1.0-8.2, <i>p</i> = 0.020). Total sleep time and total apnea-hypopnea index were unchanged. Subjective sleep quality was significantly worse on naltrexone measured via the Groningen Sleep Quality Scale (<i>p</i> = 0.033) and Stanford Sleepiness Scale (<i>p</i> = 0.038). AMS measured via LLS was significantly worse while taking naltrexone (<i>p</i> = 0.025). <b><i>Conclusion:</i></b> Contrary to our hypothesis, this study demonstrated a significant decrease in nocturnal oxygen saturation, worse sleep quality, and AMS scores. Further characterization of the MOR's effects on sleep and AMS is needed to evaluate potential exacerbating mechanisms for AMS and poor sleep quality at altitude.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534275","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}
Andrew M Luks, Thomas G DeLoughery, Jeffrey H Gertsch, Suzy Stokes
Luks, Andrew M., Thomas G. DeLoughery, Jeffrey H. Gertsch, and Suzy Stokes. Clinical conundrum: return to high altitude after cerebral venous sinus thrombosis. High Alt Med Biol. 00:00-00, 2024.
Luks, Andrew M., Thomas G. DeLoughery, Jeffrey H. Gertsch, and Suzy Stokes.临床难题:脑静脉窦血栓形成后重返高海拔地区。00:00-00, 2024.
{"title":"Clinical Conundrum: Return to High Altitude After Cerebral Venous Sinus Thrombosis.","authors":"Andrew M Luks, Thomas G DeLoughery, Jeffrey H Gertsch, Suzy Stokes","doi":"10.1089/ham.2024.0079","DOIUrl":"https://doi.org/10.1089/ham.2024.0079","url":null,"abstract":"<p><p>Luks, Andrew M., Thomas G. DeLoughery, Jeffrey H. Gertsch, and Suzy Stokes. Clinical conundrum: return to high altitude after cerebral venous sinus thrombosis. <i>High Alt Med Biol.</i> 00:00-00, 2024.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534274","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}
Autoimmune myasthenia gravis (MG) is a condition commonly caused by the production of antibodies that block acetylcholine receptors. Until recently, gastrointestinal (GI) symptoms were considered rare in myasthenia gravis, but are now being proposed as an early identification tool. Presented here is a case study that exemplifies GI symptoms in MG, exacerbated by low barometric pressure at altitude. This illustrates the need to identify GI symptoms earlier in MG patients, as well as the need for providers at high altitude to be aware of these manifestations of MG.
{"title":"Ileus at Altitude.","authors":"Christine Ebert-Santos, Ana Campos","doi":"10.1089/ham.2023.0132","DOIUrl":"https://doi.org/10.1089/ham.2023.0132","url":null,"abstract":"<p><p>Autoimmune myasthenia gravis (MG) is a condition commonly caused by the production of antibodies that block acetylcholine receptors. Until recently, gastrointestinal (GI) symptoms were considered rare in myasthenia gravis, but are now being proposed as an early identification tool. Presented here is a case study that exemplifies GI symptoms in MG, exacerbated by low barometric pressure at altitude. This illustrates the need to identify GI symptoms earlier in MG patients, as well as the need for providers at high altitude to be aware of these manifestations of MG.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491646","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}
Xu-Gang Tang, Zheng-Dao Wei, Xiao Wang, Rui Zhang, Jing Wen, De Li
{"title":"<i>Letter to the Editor</i>: T-Wave Inversion in Leads V1-V3 as a Crucial Indicator of High-Altitude Pulmonary Hypertension among Young Chinese Males at 4,820 m: A Report of Two Cases.","authors":"Xu-Gang Tang, Zheng-Dao Wei, Xiao Wang, Rui Zhang, Jing Wen, De Li","doi":"10.1089/ham.2024.0093","DOIUrl":"https://doi.org/10.1089/ham.2024.0093","url":null,"abstract":"","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491645","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}
Esteban Ortiz-Prado, Juan Sebastian Izquierdo-Condoy, María G Dávila-Rosero, Jorge Vásconez-González, Ana M Diaz, Carla E Moyano, Vanessa Arcos-Valle, Ginés Viscor, Joshua H West
Esteban Ortiz-Prado, Juan Sebastian Izquierdo-Condoy, María G. Dávila-Rosero, Jorge Vásconez-González, Ana M. Diaz, Carla E. Moyano, Vanessa Arcos-Valle, Ginés Viscor, and Joshua H. West. Reduced Violence-Related Burden and Mortality at Higher Altitudes: Examining the Association between High Altitude Living and Homicide Rates in Ecuador. High Alt Med Biol. 00:000-000, 0000.Background: Homicides are a major public health concern and a leading cause of preventable deaths worldwide. The relationship between altitude and homicides remains unclear, and evidence of the possible effects of living at high altitudes on homicide rates is limited. This research aimed to investigate the mortality rates resulting from various types of aggression that culminated in homicides in Ecuador and to explore potential differences associated with altitude. Methods: An ecological analysis of homicide rates in Ecuador was conducted from 2001 to 2022. Homicide cases and the population at risk were categorized based on their place of residence according to two altitude classifications: a binary classification of low (<2,500 m) and high altitude (>2,500 m), and a detailed classification according to criteria by the International Society for Mountain Medicine, which includes low (<1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m), and very high altitude (3,500-5,500 m) categories. Both crude and directly age-sex standardized mortality rates were calculated for each altitude category. Results: We analyzed a total of 40,708 deaths attributed to aggressions (ICD-10 codes X85-Y09). The total homicide rate for men was 21.29 per 100,000 (95% confidence interval [CI]: 9.55-32.37), whereas for women, it was 2.46 per 100,000 (95% CI: 1.44-3.27). Average rates across the 22 analyzed years were higher at low altitudes (men: 13.2/100,000 and women: 1.33/100,000) as compared with high altitudes (men: 5.79/100,000 and women: 1.05/100,000). Notably, the male-to-female rate difference was more pronounced at low altitudes (898%) than at high altitudes (451%). Conclusions: Our study revealed a higher prevalence of homicides in certain provinces and significant disparities in mortality rates between men and women. Although we cannot establish a direct relationship between altitude and homicide rates, further research is needed to explore potential confounding factors and a better understanding of the underlying causes for these variations.
Esteban Ortiz-Prado、Juan Sebastian Izquierdo-Condoy、María G. Dávila-Rosero、Jorge Vásconez-González、Ana M. Diaz、Carla E. Moyano、Vanessa Arcos-Valle、Ginés Viscor 和 Joshua H. West。高海拔地区与暴力相关的负担和死亡率降低:厄瓜多尔高海拔生活与凶杀率之间的关联研究》。00:000-000, 0000.背景:凶杀案是一个重大的公共卫生问题,也是全球可预防死亡的主要原因。海拔高度与凶杀案之间的关系仍不清楚,生活在高海拔地区对凶杀案发生率可能产生影响的证据也很有限。本研究旨在调查厄瓜多尔因各种类型的侵犯行为而导致的凶杀案死亡率,并探讨与海拔高度相关的潜在差异。研究方法对厄瓜多尔 2001 年至 2022 年的凶杀率进行了生态分析。凶杀案和高危人群根据其居住地按照两种海拔高度分类:低海拔(2,500 米)二元分类,以及根据国际山地医学协会标准进行的详细分类,其中包括低海拔(结果:我们共分析了 40 708 例因侵害致死的案例(ICD-10 代码 X85-Y09)。男性的凶杀总发生率为每 10 万人 21.29 例(95% 置信区间 [CI]:9.55-32.37),女性为每 10 万人 2.46 例(95% 置信区间 [CI]:1.44-3.27)。与高海拔地区(男性:5.79/100,000,女性:1.05/100,000)相比,低海拔地区 22 个分析年份的平均发病率更高(男性:13.2/100,000,女性:1.33/100,000)。值得注意的是,低海拔地区的男女发病率差异(898%)比高海拔地区(451%)更为明显。结论:我们的研究显示,某些省份的凶杀案发生率较高,而且男女之间的死亡率存在显著差异。虽然我们无法确定海拔高度与凶杀案发生率之间的直接关系,但仍需开展进一步研究,探索潜在的干扰因素,并更好地了解造成这些差异的根本原因。
{"title":"Reduced Violence-Related Burden and Mortality at Higher Altitudes: Examining the Association between High Altitude Living and Homicide Rates in Ecuador.","authors":"Esteban Ortiz-Prado, Juan Sebastian Izquierdo-Condoy, María G Dávila-Rosero, Jorge Vásconez-González, Ana M Diaz, Carla E Moyano, Vanessa Arcos-Valle, Ginés Viscor, Joshua H West","doi":"10.1089/ham.2024.0005","DOIUrl":"https://doi.org/10.1089/ham.2024.0005","url":null,"abstract":"<p><p>Esteban Ortiz-Prado, Juan Sebastian Izquierdo-Condoy, María G. Dávila-Rosero, Jorge Vásconez-González, Ana M. Diaz, Carla E. Moyano, Vanessa Arcos-Valle, Ginés Viscor, and Joshua H. West. Reduced Violence-Related Burden and Mortality at Higher Altitudes: Examining the Association between High Altitude Living and Homicide Rates in Ecuador. <i>High Alt Med Biol. 00:000-000, 0000.</i> <b><i>Background:</i></b> Homicides are a major public health concern and a leading cause of preventable deaths worldwide. The relationship between altitude and homicides remains unclear, and evidence of the possible effects of living at high altitudes on homicide rates is limited. This research aimed to investigate the mortality rates resulting from various types of aggression that culminated in homicides in Ecuador and to explore potential differences associated with altitude. <b><i>Methods:</i></b> An ecological analysis of homicide rates in Ecuador was conducted from 2001 to 2022. Homicide cases and the population at risk were categorized based on their place of residence according to two altitude classifications: a binary classification of low (<2,500 m) and high altitude (>2,500 m), and a detailed classification according to criteria by the International Society for Mountain Medicine, which includes low (<1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m), and very high altitude (3,500-5,500 m) categories. Both crude and directly age-sex standardized mortality rates were calculated for each altitude category. <b><i>Results:</i></b> We analyzed a total of 40,708 deaths attributed to aggressions (ICD-10 codes X85-Y09). The total homicide rate for men was 21.29 per 100,000 (95% confidence interval [CI]: 9.55-32.37), whereas for women, it was 2.46 per 100,000 (95% CI: 1.44-3.27). Average rates across the 22 analyzed years were higher at low altitudes (men: 13.2/100,000 and women: 1.33/100,000) as compared with high altitudes (men: 5.79/100,000 and women: 1.05/100,000). Notably, the male-to-female rate difference was more pronounced at low altitudes (898%) than at high altitudes (451%). <b><i>Conclusions:</i></b> Our study revealed a higher prevalence of homicides in certain provinces and significant disparities in mortality rates between men and women. Although we cannot establish a direct relationship between altitude and homicide rates, further research is needed to explore potential confounding factors and a better understanding of the underlying causes for these variations.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283558","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}
Robert K Szymczak, Magdalena Sawicka, Małgorzata Jelitto
Szymczak, Robert K., Magdalena Sawicka, and Małgorzata Jelitto. Recurrent pulmonary embolism at high altitude in a mountaineer with hereditary thrombophilia. High Alt Med Biol. 00:000-000, 2024.-It is speculated that high-altitude travel is an independent risk factor for thrombosis. Mountaineering-specific factors, such as hypoxia, cold, and immobilization, may interact with patient-specific risk factors and contribute to thrombus formation. We present the case of a mountaineer with hereditary thrombophilia who experienced recurrent pulmonary embolism during high-altitude expeditions.
Szymczak, Robert K., Magdalena Sawicka, and Małgorzata Jelitto.一名患有遗传性血栓性疾病的登山者在高海拔地区复发性肺栓塞。00:000-000, 2024.据推测,高海拔旅行是血栓形成的一个独立危险因素。登山运动特有的因素,如缺氧、寒冷和固定,可能与患者特有的风险因素相互作用,导致血栓形成。我们介绍了一名患有遗传性血栓性疾病的登山者在高海拔探险期间反复出现肺栓塞的病例。
{"title":"Recurrent Pulmonary Embolism at High Altitude in a Mountaineer with Hereditary Thrombophilia.","authors":"Robert K Szymczak, Magdalena Sawicka, Małgorzata Jelitto","doi":"10.1089/ham.2023.0110","DOIUrl":"https://doi.org/10.1089/ham.2023.0110","url":null,"abstract":"<p><p>Szymczak, Robert K., Magdalena Sawicka, and Małgorzata Jelitto. Recurrent pulmonary embolism at high altitude in a mountaineer with hereditary thrombophilia. <i>High Alt Med Biol.</i> 00:000-000, 2024.-It is speculated that high-altitude travel is an independent risk factor for thrombosis. Mountaineering-specific factors, such as hypoxia, cold, and immobilization, may interact with patient-specific risk factors and contribute to thrombus formation. We present the case of a mountaineer with hereditary thrombophilia who experienced recurrent pulmonary embolism during high-altitude expeditions.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199630","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":"Mismanagement of Patients with High Altitude Illness Evacuated from the Mount Everest Region in Nepal.","authors":"Samriddha Raj Pant, Suraj Shrestha, Suman Acharya, Ghan Bahadur Thapa, Buddha Basnyat","doi":"10.1089/ham.2024.0034","DOIUrl":"https://doi.org/10.1089/ham.2024.0034","url":null,"abstract":"","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199627","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}
Pub Date : 2024-06-01Epub Date: 2024-01-12DOI: 10.1089/ham.2023.0042
Rashi Ramchandani, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, Adrian Baranchuk
Ramchandani, Rashi, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, and Adrian Baranchuk. Review of athletic guidelines for high-altitude training and acclimatization. High Alt Med Biol. 00:000-000, 2024. Introduction: Exposure to high altitude results in hypobaric hypoxia with physiological acclimatization changes that are thought to influence athletic performance. This review summarizes existing literature regarding implications of high-altitude training and altitude-related guidelines from major governing bodies of sports. Methods: A nonsystematic review was performed using PubMed and OVID Medline to identify articles regarding altitude training and guidelines from international governing bodies of various sports. Sports inherently involving training or competing at high altitude were excluded. Results: Important physiological compensatory mechanisms to high-altitude environments include elevations in blood pressure, heart rate, red blood cell mass, tidal volume, and respiratory rate. These responses can have varying effects on athletic performance. Governing sport bodies have limited and differing regulations for training and competition at high altitudes with recommended acclimatization periods ranging from 3 days to 3 weeks. Discussion: Physiological changes in response to high terrestrial altitude exposure can have substantial impacts on athletic performance. Major sport governing bodies have limited regulations and recommendations regarding altitude training and competition. Existing guidelines are variable and lack substantial evidence to support recommendations. Additional studies are needed to clarify the implications of high-altitude exposure on athletic ability to optimize training and competition.
{"title":"Review of Athletic Guidelines for High-Altitude Training and Acclimatization.","authors":"Rashi Ramchandani, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, Adrian Baranchuk","doi":"10.1089/ham.2023.0042","DOIUrl":"10.1089/ham.2023.0042","url":null,"abstract":"<p><p>Ramchandani, Rashi, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, and Adrian Baranchuk. Review of athletic guidelines for high-altitude training and acclimatization. <i>High Alt Med Biol.</i> 00:000-000, 2024. <b><i>Introduction:</i></b> Exposure to high altitude results in hypobaric hypoxia with physiological acclimatization changes that are thought to influence athletic performance. This review summarizes existing literature regarding implications of high-altitude training and altitude-related guidelines from major governing bodies of sports. <b><i>Methods:</i></b> A nonsystematic review was performed using PubMed and OVID Medline to identify articles regarding altitude training and guidelines from international governing bodies of various sports. Sports inherently involving training or competing at high altitude were excluded. <b><i>Results:</i></b> Important physiological compensatory mechanisms to high-altitude environments include elevations in blood pressure, heart rate, red blood cell mass, tidal volume, and respiratory rate. These responses can have varying effects on athletic performance. Governing sport bodies have limited and differing regulations for training and competition at high altitudes with recommended acclimatization periods ranging from 3 days to 3 weeks. <b><i>Discussion:</i></b> Physiological changes in response to high terrestrial altitude exposure can have substantial impacts on athletic performance. Major sport governing bodies have limited regulations and recommendations regarding altitude training and competition. Existing guidelines are variable and lack substantial evidence to support recommendations. Additional studies are needed to clarify the implications of high-altitude exposure on athletic ability to optimize training and competition.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139424650","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}
Pub Date : 2024-06-01Epub Date: 2024-03-01DOI: 10.1089/ham.2023.0101
Vipin Rana, Pradeep Kumar, Sandeepan Bandopadhyay, Vijay K Sharma, Meenu Dangi, Dattakiran Joshi, Sanjay Kumar Mishra, Satyabrat Srikumar, V A Arun
Rana, Vipin, Pradeep Kumar, Sandeepan Bandopadhyay, Vijay K. Sharma, Meenu Dangi, Dattakiran Joshi, Sanjay Kumar Mishra, Satyabrat Srikumar, and V.A. Arun. Central retinal artery occlusion in young adults at high altitude: thin air, high stakes. High Alt Med Biol. 00:000-000, 2024.-We present five cases of young security personnel who were posted at high altitude (HA) for a duration of at least 6 months and presented with a sudden decrease of vision in one eye. The diagnosis of central retinal artery occlusion (CRAO) was made in all patients. Fundus fluorescein angiography and optical coherence tomography of the macula supported the diagnosis. None of these cases had any preexisting comorbidities. Erythrocytosis was noticed in all patients, and two of them had hyperhomocysteinemia. Four out of five patients showed either middle cerebral artery or internal carotid artery (ICA) thrombosis on computed tomography angiography. The patients were managed by a team of ophthalmologist, hematologist, vascular surgeon, and neurologist. In cases of incomplete ICA occlusion, patients were managed surgically. However, in the case of complete ICA occlusion, management was conservative with antiplatelet drugs. This case series highlights HA-associated erythrocytosis and hyperhomocysteinemia as important risk factors for CRAO in young individuals stationed at HA.
{"title":"Central Retinal Artery Occlusion in Young Adults at High Altitude: Thin Air, High Stakes.","authors":"Vipin Rana, Pradeep Kumar, Sandeepan Bandopadhyay, Vijay K Sharma, Meenu Dangi, Dattakiran Joshi, Sanjay Kumar Mishra, Satyabrat Srikumar, V A Arun","doi":"10.1089/ham.2023.0101","DOIUrl":"10.1089/ham.2023.0101","url":null,"abstract":"<p><p>Rana, Vipin, Pradeep Kumar, Sandeepan Bandopadhyay, Vijay K. Sharma, Meenu Dangi, Dattakiran Joshi, Sanjay Kumar Mishra, Satyabrat Srikumar, and V.A. Arun. Central retinal artery occlusion in young adults at high altitude: thin air, high stakes. <i>High Alt Med Biol.</i> 00:000-000, 2024.-We present five cases of young security personnel who were posted at high altitude (HA) for a duration of at least 6 months and presented with a sudden decrease of vision in one eye. The diagnosis of central retinal artery occlusion (CRAO) was made in all patients. Fundus fluorescein angiography and optical coherence tomography of the macula supported the diagnosis. None of these cases had any preexisting comorbidities. Erythrocytosis was noticed in all patients, and two of them had hyperhomocysteinemia. Four out of five patients showed either middle cerebral artery or internal carotid artery (ICA) thrombosis on computed tomography angiography. The patients were managed by a team of ophthalmologist, hematologist, vascular surgeon, and neurologist. In cases of incomplete ICA occlusion, patients were managed surgically. However, in the case of complete ICA occlusion, management was conservative with antiplatelet drugs. This case series highlights HA-associated erythrocytosis and hyperhomocysteinemia as important risk factors for CRAO in young individuals stationed at HA.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021582","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}
Pub Date : 2024-06-01Epub Date: 2024-03-22DOI: 10.1089/ham.2023.0100
Laurel Gardner, Linda E Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, James Marvel
Gardner, Laurel, Linda E. Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, and James Marvel. Women at altitude: Menstrual-cycle phase, menopause, and exogenous progesterone are not associated with acute mountain sickness. High Alt Med Biol. 00:000-000, 2024. Background: Elevated progesterone levels in women may protect against acute mountain sickness (AMS). The impact of hormonal contraception (HC) on AMS is unknown. We examined the effect of natural and exogenous progesterone on the occurrence of AMS. Methods: We conducted a prospective observational convenience study of female trekkers in Lobuche (4,940 m) and Manang (3,519 m). We collected data on last menstrual period, use of exogenous hormones, and development of AMS. Results: There were 1,161 trekkers who met inclusion criteria, of whom 307 (26%) had AMS. There was no significant difference in occurrence of AMS between women in the follicular (28%) and the luteal (25%) phases of menstruation (p = 0.48). The proportion of premenopausal (25%) versus postmenopausal women (30%) with AMS did not differ (p = 0.33). The use of HC did not influence the occurrence of AMS (HC 23% vs. no HC 26%, p = 0.47), nor did hormonal replacement therapy (HRT) (HRT 11% vs. no HRT 31%, p = 0.13). Conclusion: We found no relationship between menstrual-cycle phase, menopausal status, or use of exogenous progesterone and the occurrence of AMS in trekkers and conclude that hormonal status is not a risk factor for AMS. Furthermore, women should not be excluded from future AMS studies based on hormonal status.
Gardner, Laurel, Linda E. Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, and James Marvel.高海拔地区的女性:月经周期阶段、绝经期和外源性孕酮与急性高山反应无关。00:000-000, 2024.背景:女性体内孕酮水平升高可预防急性登山病(AMS)。荷尔蒙避孕(HC)对急性登山病的影响尚不清楚。我们研究了天然和外源性孕酮对急性登山病发生的影响。研究方法我们对罗布泊(海拔 4940 米)和芒康(海拔 3519 米)的女性徒步旅行者进行了一项前瞻性方便观察研究。我们收集了有关末次月经、使用外源性激素和发生 AMS 的数据。结果共有 1,161 名徒步旅行者符合纳入标准,其中 307 人(26%)患有急性髓系白血病。月经卵泡期(28%)和黄体期(25%)的女性在发生急性膀胱炎方面没有明显差异(P = 0.48)。绝经前(25%)和绝经后(30%)妇女发生急性盆腔炎的比例没有差异(p = 0.33)。使用 HC 不会影响 AMS 的发生(使用 HC 23% 与不使用 HC 26%,p = 0.47),激素替代疗法(HRT)也不会影响 AMS 的发生(使用 HRT 11% 与不使用 HRT 31%,p = 0.13)。结论我们发现月经周期阶段、绝经状态或使用外源性黄体酮与徒步旅行者发生 AMS 之间没有关系,并得出结论:荷尔蒙状态不是发生 AMS 的风险因素。此外,今后的 AMS 研究不应根据荷尔蒙状况将女性排除在外。
{"title":"Women at Altitude: Menstrual-Cycle Phase, Menopause, and Exogenous Progesterone Are Not Associated with Acute Mountain Sickness.","authors":"Laurel Gardner, Linda E Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, James Marvel","doi":"10.1089/ham.2023.0100","DOIUrl":"10.1089/ham.2023.0100","url":null,"abstract":"<p><p>Gardner, Laurel, Linda E. Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, and James Marvel. Women at altitude: Menstrual-cycle phase, menopause, and exogenous progesterone are not associated with acute mountain sickness. <i>High Alt Med Biol.</i> 00:000-000, 2024. <b><i>Background:</i></b> Elevated progesterone levels in women may protect against acute mountain sickness (AMS). The impact of hormonal contraception (HC) on AMS is unknown. We examined the effect of natural and exogenous progesterone on the occurrence of AMS. <b><i>Methods:</i></b> We conducted a prospective observational convenience study of female trekkers in Lobuche (4,940 m) and Manang (3,519 m). We collected data on last menstrual period, use of exogenous hormones, and development of AMS. <b><i>Results:</i></b> There were 1,161 trekkers who met inclusion criteria, of whom 307 (26%) had AMS. There was no significant difference in occurrence of AMS between women in the follicular (28%) and the luteal (25%) phases of menstruation (<i>p</i> = 0.48). The proportion of premenopausal (25%) versus postmenopausal women (30%) with AMS did not differ (<i>p</i> = 0.33). The use of HC did not influence the occurrence of AMS (HC 23% vs. no HC 26%, <i>p</i> = 0.47), nor did hormonal replacement therapy (HRT) (HRT 11% vs. no HRT 31%, <i>p</i> = 0.13). <b><i>Conclusion:</i></b> We found no relationship between menstrual-cycle phase, menopausal status, or use of exogenous progesterone and the occurrence of AMS in trekkers and conclude that hormonal status is not a risk factor for AMS. Furthermore, women should not be excluded from future AMS studies based on hormonal status.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184263","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}