The use of acetazolamide for the prevention of high-altitude illness

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
David R Shlim
Keyword(s):  
At Risk ◽  
High Risk ◽  
High Altitude ◽  
Sea Level ◽  
Travel Medicine ◽  
Highly Effective ◽  
High Altitude Illness

Abstract Background Modern travel means that many travellers can arrive abruptly to high-altitude destinations without doing any trekking or climbing. Airports in high-altitude cities mean that travellers can go from sea level to over 3350–3960 m (11 000–13 000 feet) in a matter of hours, putting themselves at risk for high-altitude illness (HAI). Methods Acetazolamide has been shown to be an effective way to help prevent HAI on such itineraries. The risk of HAI on rapid arrival to altitudes over 3350 m (11 000 feet) has been shown to range from 35% to nearly 50%. The risk can be higher for high-altitude trekking. This risk is far higher than most travel medicine risks and is on a par with the risk of travellers’ diarrhea in high risk destinations. Result The use of prophylactic acetazolamide in a dosage of 125 mg every 12 h is highly effective at diminishing the risk of HAI. Conclusion Travel medicine practitioners should become comfortable with assessing the risk of HAI and determining when it is appropriate to offer acetazolamide prophylaxis to prevent HAI.

scholarly journals Seasonal and Altitudinal Prevalence of Fascioliasis in Buffalo in Eastern Nepal

2018 ◽  
Vol 4 ◽  
pp. 48-53
Author(s):  
Ramesh Prasad Sah ◽  
Hari Kumar Prasai ◽  
Jiban Shrestha ◽  
Md Hasanuzzaman Talukder ◽  
AKM Anisur Rahman ◽  
...  
Keyword(s):  
High Risk ◽  
High Altitude ◽  
Sea Level ◽  
Rainy Season ◽  
Meat Production ◽  
Parasitic Diseases ◽  
Sedimentation Technique ◽  
Risk Period ◽  
Pasture Contamination ◽  
Low Altitude

Buffalo is the most important livestock commodities for milk, meat production and several other multipurpose uses distributed densely from southern tarai to northern mid-hills in Nepal. Among several internal parasitic diseases fascioliasis is highly economic one caused by Fasciola in buffaloes. However, there are only few studies carried on prevalence of fascioliasis emphasizing buffaloes in relation to seasonal (summer and rainy, and winter) and altitudinal variations. Therefore, we examined prevalence of fascioliasis seasonally and vertically. For the purpose, we selected two districts of eastern Nepal and sampled from low altitude area known as Madhesha ranging from 175-200, Dhankuta from 800-1200 m, and Murtidhunga from 1800-2200 m elevation from the sea level, representing tarai, mid hills and high hills, respectively. Altogether from February 2013 to January 2014 at every two months interval we collected 798 fecal samples from buffaloes; 282 from Murtidhunga, 239 from Dhankuta and 277 from Madhesha. The samples were examined microscopically for the presence of Fasciola eggs using sedimentation technique. Results showed that overall prevalence of fascioliasis in buffaloes was 39.9% (319/798), ranging highest 42.6%in Madhesha followed by 39.7% in Murtidhunga and 37.2% in Dhankuta, respectively. The prevalence of fascioliasis was found to be significantly (p <0.05) high in winter (44.9%) comparing to rainy season (34.4%). The prevalence of fascioliasis in buffaloes was relatively higher in low altitude than high altitude, although it was not statistically significant (p <0.05). In our findings the female buffaloes showed higher prevalence for fascioliasis than in male. Since the fascioliasis in buffaloes is highly endemic, thus strategic deworming in high risk period is recommended along with measure to prevent pasture contamination with buffalo feces.

scholarly journals Validation of a Score for the Detection of Subjects with High Risk for Severe High-Altitude Illness

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jean-Paul Richalet ◽  
Fabien Pillard ◽  
David Le Moal ◽  
Daniel Rivière ◽  
Philippe Oriol ◽  
...  
Keyword(s):  
High Risk ◽  
High Altitude ◽  
High Altitude Illness

scholarly journals Acute Lung Edema as a Presentation of Severe Acute Reentry High-Altitude Illness in a Pediatric Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Alfredo Merino-Luna ◽  
Julio Vizcarra-Anaya
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Edema ◽  
High Altitude ◽  
Sea Level ◽  
Pediatric Patient ◽  
Lung Edema ◽  
High Altitude Pulmonary Edema ◽  
High Altitude Illness ◽  
The City ◽  
Determining Factor

Acute high-altitude pulmonary edema (HAPE) is a pathology involving multifactorial triggers that are associated with ascents to altitudes over 2,500 meters above sea level (m). Here, we report two pediatric cases of reentry HAPE, from the city of Huaraz, Peru, located at 3,052 m. The characteristics of both cases were similar, wherein acclimatization to sea level and a subsequent return to the city of origin occurred, and we speculate that it was caused by activation of predisposing factors to HAPE. The diagnosis and management associated with pulmonary hypertension became a determining factor for therapy.

Acclimatization at high altitude in gradual and acute induction

1995 ◽  
Vol 79 (2) ◽  
pp. 487-492 ◽  
Author(s):  
S. S. Purkayastha ◽  
U. S. Ray ◽  
B. S. Arora ◽  
P. C. Chhabra ◽  
L. Thakur ◽  
...  
Keyword(s):  
High Altitude ◽  
Sea Level ◽  
Time Course ◽  
Physiological Responses ◽  
Acute Mountain Sickness ◽  
Blood Gases ◽  
Blood Gas ◽  
Mountain Sickness ◽  
High Altitude Illness ◽  
In Transit

The study assessed physiological responses to induction to high altitude first to 3,500 m and then to 4,200 m and compared the time course of altitude acclimatization in two groups of male volunteers. The acutely inducted group was transported by aircraft (AI) to 3,500 m in 1 h, whereas the gradually inducted group was transported by road (RI) in 4 days. Baseline recordings of basal cardiovascular, respiratory, and blood gas variables were monitored at sea level as well as at 3,500 m on days 1, 3, 5, and 7. Blood gases were measured on day 10 also. After 15 days at 3,500 m, the subjects were inducted to 4,200 m by road, and measurements were repeated on days 1, 3, and 5, except blood gas variables, which were done on day 10 only. Acute mountain sickness symptoms were recorded throughout. The responses of RI were stable by day 3 of induction at 3,500 m, whereas it took 5 days for AI. Four days in transit for RI appear equivalent to 2 days at 3,500 m for AI. Acclimatization schedules of 3 and 5 days, respectively, for RI and AI are essential to avoid malacclimatization and/or high-altitude illness. Both groups took 3 days at 4,200 m to attain stability for achieving acclimatization.

Effect of intermittent normobaric hypoxia exposure on acclimatization to high altitude by air induction

2021 ◽  
Vol 12 (10) ◽  
pp. 58-63
Author(s):  
Gopinath Bhaumik ◽  
Deepak Dass ◽  
Dishari Ghosh ◽  
Kishan Singh ◽  
Maram Prasanna Kumar Reddy
Keyword(s):  
Oxygen Saturation ◽  
High Altitude ◽  
Sea Level ◽  
Acute Mountain Sickness ◽  
Treated Group ◽  
Physiological Parameters ◽  
Normobaric Hypoxia ◽  
Hypoxia Exposure ◽  
Intermittent Normobaric Hypoxia ◽  
High Altitude Illness

Background: In emergency like condition, defence personnel are deployed to high altitude without proper acclimatization. Maladaption at high altitude leads to high altitude illness like acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE) which hampers the operational capabilities. Aims and Objectives: The aim of the present study was to assess the effect of intermittent normobaric hypoxia exposure (IHE) at sea level on different physiological responses during initial days of acclimatization at 3500m and 4000m altitudes in acute induction. Materials and Methods: The IHE subjects were exposed to 12% FIO2 (equivalent altitude 14500 ft) for 4 hrs/day for 4 consecutive days at sea level and 5th day they were inducted by air to 3500m altitude. Baseline recording of different physiological parameters like cardiovascular, respiratory, oxygen saturation and AMS score were measured at sea level as well as 3500m altitude on daily basis for 6 days to assess acclimatization status. To confirm acclimatization status at 3500m, on fifth day the IHE group subjects were transported by road to 4000m and again measured different basal physiological parameters (like cardiovascular, oxygen saturation and AMS score) for four consecutive days. Results: Different physiological parameters of IHE treated group were stabilized by day 4 of air induction at 3500m altitude. Whereas, at 4000m altitude, these parameters were stabilized by day 2 of induction. Conclusion: Acclimatization schedules of four days at 3500m and two days at 4000m are essential to avoid malacclimatization/or high-altitude illness.

High Altitude Illness

2020 ◽  
Keyword(s):  
At Risk ◽  
High Altitude ◽  
Oxygen Therapy ◽  
High Altitudes ◽  
Key Points ◽  
High Altitude Illness ◽  
Altitude Illnesses

Key Points Individuals traveling to high altitudes (usually to ≥2,500 m) are at risk of developing high altitude illness (HAI), especially if ascending quickly.Acclimatization and slow ascent are the most effective ways to avoid HAI.Acetazolamide is prevention and treatment.High altitude illnesses typically respond to descent, oxygen therapy, or both.

scholarly journals View From Above: Bibliometric and Citation Analysis of Global High Altitude Medicine Research

2020 ◽  
Vol 8 (3) ◽  
pp. 107-115
Author(s):  
Chee Hwui Liew ◽  
Gerard Thomas Flaherty
Keyword(s):  
High Altitude ◽  
Bibliometric Analysis ◽  
Acute Mountain Sickness ◽  
Travel Medicine ◽  
Research Activity ◽  
Medicine Research ◽  
Medicine Journal ◽  
The Usa ◽  
High Altitude Illness ◽  
The Uk

Introduction: High altitude destinations are popular among international travelers. Travel medicine practitioners should be familiar with altitude physiology and high altitude illness recognition, prophylaxis, and management. We performed the first bibliometric analysis of high altitude medicine research. Methods: All articles published in a specialist high altitude medicine journal through April 2020 were mapped against the 34 domains in a theoretical body of knowledge. Citation counts of articles, as well as authors publishing the most articles, were obtained from Scopus. Collaboration analysis was performed using established methods. Results: Mapping of 1150 articles published from 2000 to 2020 identified the leading domains represented by high altitude medicine articles. The top five domains were altitude acclimatization and deterioration (19.4%, n=510); cardiovascular physiology (6.8%, n=180); work at altitude (6.6%, n = 174); acute mountain sickness (6.4%, n=169); respiratory and acid-base physiology (5.9%, n=155). Published articles attracted a total of 13,324 citations, with a mean of 11.6 citations per article. The average number of citations per author was 22.3. The USA was the most productive country with 432 publications (37.6%), followed by the UK (9.5%, n=109) and Switzerland (5.6%, n=64). The collaboration index for multi-authored publications increased from 3.8 in 2002 to 5.4 in 2019. Conclusion: We have performed the first comprehensive bibliometric analysis in high altitude medicine. Efforts to increase the research activity in neglected topics and to promote greater collaboration between high altitude medicine and related fields of study such as travel medicine may be worthwhile.

scholarly journals Rapid Acclimatisation to High Altitude by Intermittent Hypoxia Training at Sea Level Role of Biochemical Markers

2021 ◽  
Vol 6 (2) ◽  
pp. 138-145
Author(s):  
Geetha Suryakumar ◽  
Dishari Ghosh ◽  
Richa Rathor ◽  
Gopinath Bhaumik ◽  
Som Nath Singh ◽  
...  
Keyword(s):  
High Altitude ◽  
Sea Level ◽  
Biochemical Markers ◽  
Intermittent Hypoxia ◽  
Stress Proteins ◽  
Acute Mountain Sickness ◽  
Emergency Situation ◽  
High Altitude Illness ◽  
Army Personnel

Rapid induction of soldiers to high altitude under emergency situation may lead to higher incidence of acute mountain sickness (AMS) and other high altitude illness. Intermittent Hypoxia Training (IHT) at sea level before going to high altitude is an approach for rapid acclimatisation. This approach may be helpful to reduce the occurrence of AMS and leads to better acclimatisation at high altitude in shorter duration. The present study evaluates the role of biochemical markers of acclimatisation after IHT before induction to actual high altitude. The study participants were Indian Army Personnel (n=30) and they were divided into two groups of control (n=16) and IHT exposed (n=14). The intermittent hypoxia training was administered at 12 per cent Oxygen for 4h/day for 4 days at sea level using normobaric hypoxia chamber and within 24 hrs - 48 hrs the subjects were airlifted to Leh, Ladakh, India at 11,700 ft. Preconditioning with IHT may be beneficial in maintaining antioxidant levels and ameliorate oxidative stress at high altitude. The hypoxia responsive proteins like Hemeoxygenase -1 (HO-1) and Vascular endothelial growth factor (VEGF) and the cytoprotective stress proteins, which facilitate the acclimatisation, may also get benefited by IHT exposure.

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