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High Altitude Edema

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1. Interstitial Pulmonary Edema Assessed by Lung Ultrasound on Ascent to High Altitude and Slight Association with Acute Mountain Sickness: A Prospective Observational Study. (Abstract)

Interstitial Pulmonary Edema Assessed by Lung Ultrasound on Ascent to High Altitude and Slight Association with Acute Mountain Sickness: A Prospective Observational Study. Background: Acute mountain sickness (AMS) is a common disease that may have a pulmonary component, as suggested by interstitial pulmonary edema quantified by the B-line score (BLS) on ultrasound (US). This subclinical pulmonary edema has been shown to increase with ascent to high altitude and AMS severity, but has not been (...) % total incidence of AMS. The mean (±standard deviation) BLS increased from baseline (1.15 ± 1.80) to high altitude (2.56 ± 2.86), a difference of 1.37 (±2.48) (p = 0.04). Overall BLS was found, on average, to be higher among those diagnosed with AMS than without (2.97 vs. 2.0, p = 0.04, 95% confidence interval [CI] -∞ to -0.04). The change in BLS (ΔBLS) from low altitude baseline was significantly associated with AMS (0.88 vs. 1.72, r2 = 0.023, 95% CI -∞ to -0.01, p = 0.048). Conclusions

2019 High altitude medicine & biology Controlled trial quality: predicted high

2. High Altitude Pulmonary Edema in Children: A Single Referral Center Evaluation. (Abstract)

High Altitude Pulmonary Edema in Children: A Single Referral Center Evaluation. To describe the clinical features of children who presented to Children's Hospital Colorado (CHCO) with high-altitude pulmonary edema (HAPE).We performed a retrospective chart review in children discharged from CHCO (an elevation of 1668 m) with a clinical diagnosis of HAPE and a chest radiograph consistent with noncardiogenic pulmonary edema. Descriptive statistics were used to describe the demographics (...) , presentations, and treatment strategies.From 2004 to 2014, 50 children presented to CHCO who were found to have a clinical diagnosis of HAPE and a chest radiograph consistent with noncardiogenic pulmonary edema. Most (72%) patients were male, and most (60%) of the children in the study were diagnosed with classic HAPE, 38% with re-entry HAPE, and 2% with high altitude resident pulmonary edema. Elevation at symptom presentation ranged from 1840 to 3536 m. Patients were treated with a variety of medications

2019 Journal of Pediatrics

3. Effect of Acetazolamide on Subclinical High-Altitude Pulmonary Edema Detected by Lung Ultrasonography

Effect of Acetazolamide on Subclinical High-Altitude Pulmonary Edema Detected by Lung Ultrasonography Effect of Acetazolamide on Subclinical High-Altitude Pulmonary Edema Detected by Lung Ultrasonography - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Effect of Acetazolamide on Subclinical High-Altitude Pulmonary Edema Detected by Lung Ultrasonography The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03490916 Recruitment Status : Terminated (PI was unable to continue to gather data during the trip during

2018 Clinical Trials

4. Higher ascent, trouble breathing: High altitude pulmonary edema (HAPE) Full Text available with Trip Pro

Higher ascent, trouble breathing: High altitude pulmonary edema (HAPE) 30167070 2018 10 01 2018 10 01 1937-8688 30 2018 The Pan African medical journal Pan Afr Med J Higher ascent, trouble breathing: High altitude pulmonary edema (HAPE). 43 10.11604/pamj.2018.30.43.15181 Thapa Simant Singh SS Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA. Basnyat Buddha B Nepal International Clinic, Kathmandu, Nepal, Oxford University Clinical Research Unit-Nepal, Center (...) for Tropical Medicine and Global Health, University of Oxford, UK. eng Case Reports Journal Article 2018 05 18 Uganda Pan Afr Med J 101517926 Pulmonary edema of mountaineers IM Adult Altitude Sickness diagnosis physiopathology Dyspnea etiology Fatigue etiology Humans Hypertension, Pulmonary diagnosis physiopathology Male Hypoxia USA high altitude pulmonary edema travelers´ 2018 02 14 2018 05 01 2018 9 1 6 0 2018 9 1 6 0 2018 10 3 6 0 epublish 30167070 10.11604/pamj.2018.30.43.15181 PAMJ-30-43 PMC6110567

2018 The Pan African medical journal

5. Exendin-4 inhibits high-altitude cerebral edema by protecting against neurobiological dysfunction Full Text available with Trip Pro

Exendin-4 inhibits high-altitude cerebral edema by protecting against neurobiological dysfunction The anti-inflammatory and antioxidant effects of exendin-4 (Ex-4) have been reported previously. However, whether (Ex-4) has anti-inflammatory and antioxidant effects on high-altitude cerebral edema (HACE) remains poorly understood. In this study, two rat models of HACE were established by placing rats in a hypoxic environment with a simulated altitude of either 6000- or 7000-m above sea level (...) (MASL) for 72 hours. An altitude of 7000 MASL with 72-hours of hypoxia was found to be the optimized experimental paradigm for establishing HACE models. Then, in rats where a model of HACE was established by introducing them to a 7000 MASL environment with 72-hours of hypoxia treatment, 2, 10 and, 100 μg of Ex-4 was intraperitoneally administrated. The open field test and tail suspension test were used to test animal behavior. Routine methods were used to detect change in inflammatory cells

2018 Neural Regeneration Research

6. Sequencing the exons of human glucocorticoid receptor (NR3C1) gene in Han Chinese with high-altitude pulmonary edema Full Text available with Trip Pro

Sequencing the exons of human glucocorticoid receptor (NR3C1) gene in Han Chinese with high-altitude pulmonary edema High-altitude pulmonary edema (HAPE) is a serious acute mountain sickness that mainly occurs in non-acclimatized individuals after rapid ascent to high altitude. The precise etiology of HAPE remains unclear. This study aimed to investigate whether NR3C1 gene polymorphism is associated with the susceptibility to HAPE.The exons of NR3C1 gene were sequenced by a ABI 3730 DNA (...) analyzer in 133 HAPE patients and matched 135 healthy Han Chinese controls from the Yushu area in Qinghai (the altitude greater than 3500 m).DNA sequencing showed the heterozygous substitutions at codon 588 (rs6194) in exon 6 and 766 (rs6196) in exon 9 of NR3C1 gene. The genotypic distributions and allelic frequencies of NR3C1 SNP rs6194 showed significant differences in two groups (P < 0.05). The frequencies of the C allele were significantly higher in the HAPE group than in the control group (P

2018 Journal of physiological anthropology

7. Lung Ultrasound Is Accurate for the Diagnosis of High-Altitude Pulmonary Edema: A Prospective Study Full Text available with Trip Pro

Lung Ultrasound Is Accurate for the Diagnosis of High-Altitude Pulmonary Edema: A Prospective Study The aim of this study was to assess the diagnostic accuracy of lung ultrasonography (LUS) for high-altitude pulmonary edema (HAPE).LUS has proven to be a reliable tool for the diagnosis of pulmonary diseases, including pneumonia, acute respiratory distress syndrome (ARDS), and pneumothorax. LUS also has potential for the diagnosis of HAPE. However, the actual diagnostic value of LUS for HAPE (...) CXR (0.98 vs. 0.93, P < 0.05 using the McNemar test). After treatment, LUS was consistent with CXR in 96.55% of HAPE patients, and the concordance between LUS and CXR was high (k statistic = 0.483 P ≤ 0.001; 95% CI -0.021 to -0.853).The results indicate that LUS is a reliable method for the diagnosis and surveillance of HAPE. This trial is registered with Chinese Clinical Trial Registry (No. ChiCTR-DDD-16009841).

2018 Canadian respiratory journal

8. Changes in corneal thickness in patients with high-altitude pulmonary edema after systemic oxygen therapy Full Text available with Trip Pro

Changes in corneal thickness in patients with high-altitude pulmonary edema after systemic oxygen therapy High-altitude pulmonary edema (HAPO) is an acute medical emergency occurring typically in lowlanders, who ascend rapidly to heights of 3000 m or more. It presents with marked dyspnea on exertion, fatigue with minimal-to-moderate effort, prolonged recovery time, and dry cough with manifestations of cyanosis, tachycardia, tachypnea, and temperature which generally does not increase beyond (...) 38.5°C. The condition may be fatal if not treated in time with supplemental oxygen or hyperbaric oxygen or rapid descent to lower altitude. There is paucity in literature on changes in corneal thickness in HAPO. The effect of continued oxygen therapy on corneal thickness has also not been studied in detail. Hence, this study was conducted at high altitude among physician-confirmed HAPO cases.A case-control study was conducted at an altitude of 11,400 feet. Cases were patients suffering from HAPO

2018 Indian journal of ophthalmology

9. CRACKCast E144 – High Altitude Medicine

save lives. Cerebral forms of altitude illness occur as a continuum, from common and benign acute mountain sickness (AMS ), to rare, but potentially lethal high-altitude cerebral edema (HACE) and High altitude pulmonary edema (HAPE) For the sake of comparison – AMS occurs very commonly with rapid ascents > 2500 meters (a rapid ascent (1 or 2 days) to 4400 meters feet on Mt. Rainier has rates as high as 67%; or 50% for those who fly to the Khumbu region vs. 25% in those who walk up). HACE is much (...) less common < 1% with rapid ascents > 4300 meters. High-altitude pulmonary edema (HAPE) is the primary lung syndrome. HAPE is the leading cause of death from altitude illness . It’s incidence ranges from 0.01% to 15% with rapid ascents (as cited in Rosen’s from Auerbach 2012) The pathophysiologic effects of high altitude begin when the oxygen saturation of the arterial blood begins to fall below the 90% level. The sigmoidal shape of the oxyhemoglobin dissociation curve prevents a significant fall

2018 CandiEM

10. Lung Ultrasound in High Altitude Lung Edema

Lung Ultrasound in High Altitude Lung Edema Lung Ultrasound in High Altitude Lung Edema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Lung Ultrasound in High Altitude Lung Edema The safety and scientific (...) Summary: High altitude pulmonary edema is a life-threatening condition that remains a concern for climbers and clinicians alike. It is defined as a non-cardiac pulmonary edema occurring at altitudes exceeding 3000m in non-acclimatised individuals. Recently, studies conducted in remote areas have demonstrated that ultrasound lung comets (B lines) can be used as a measure of sub-acute pulmonary edema and high altitude pulmonary edema in climbers ascending to altitude. the investigators want to assess

2017 Clinical Trials

11. Susceptibility to high-altitude pulmonary edema is associated with a more uniform distribution of regional specific ventilation Full Text available with Trip Pro

Susceptibility to high-altitude pulmonary edema is associated with a more uniform distribution of regional specific ventilation High-altitude pulmonary edema (HAPE) is a potentially fatal condition affecting high-altitude sojourners. The biggest predictor of HAPE development is a history of prior HAPE. Magnetic resonance imaging (MRI) shows that HAPE-susceptible (with a history of HAPE), but not HAPE-resistant (with a history of repeated ascents without illness) individuals develop greater (...) rather than greater ventilation heterogeneity is observed in HAPE-susceptible subjects. This suggests that the basis for uneven HPV in HAPE involves vascular phenomena.NEW & NOTEWORTHY Uneven hypoxic pulmonary vasoconstriction (HPV) is thought to incite high-altitude pulmonary edema (HAPE). We evaluated whether greater heterogeneity of ventilation is also a feature of HAPE-susceptible subjects compared with HAPE-resistant subjects. Contrary to our hypothesis, ventilation heterogeneity was less

2017 Journal of Applied Physiology

12. Association between single nucleotide polymorphisms in ADRB2, GNB3 and GSTP1 genes and high-altitude pulmonary edema (HAPE) in the Chinese Han population Full Text available with Trip Pro

Association between single nucleotide polymorphisms in ADRB2, GNB3 and GSTP1 genes and high-altitude pulmonary edema (HAPE) in the Chinese Han population High altitude pulmonary edema (HAPE) occurs mainly under conditions such as high altitude, rapid ascent, or hypoxia. Previous studies suggest that ADRB2, GNB3, TH, and GSTP1 polymorphisms are associated with various lung diseases. We evaluated whether those polymorphisms are associated with the risk of HAPE in a Chinese Han population. ADRB2

2017 Oncotarget

13. Subclinical pulmonary dysfunction contributes to high altitude pulmonary edema susceptibility in healthy non-mountaineers Full Text available with Trip Pro

Subclinical pulmonary dysfunction contributes to high altitude pulmonary edema susceptibility in healthy non-mountaineers HAPE susceptible (HAPE-S, had HAPE episode in past) subjects may have subclinical cardio-pulmonary dysfunction. We compared the results of pulmonary function tests in 25 healthy HAPE-S non-mountaineers and 19 matched HAPE resistant (HAPE-R, no HAPE episode in past). Acute normobaric hypoxia (FIo2 0.12) was administered at sea level to confirm hypoxia intolerance in HAPE-S

2017 Scientific reports

14. Genome-wide association study of high-altitude pulmonary edema in a Han Chinese population Full Text available with Trip Pro

Genome-wide association study of high-altitude pulmonary edema in a Han Chinese population A two-stage genome-wide association study (GWAS) was performed to identify and analyze genes and single nucleotide polymorphisms (SNPs) associated with high-altitude pulmonary edema (HAPE) in a Han Chinese patient population. In the first stage, DNA samples from 68 patients with recurrent HAPE were scanned using Affymetrix SNP Array 6.0 Chips, and allele frequencies were compared to those of 84 HapMap CHB

2017 Oncotarget

15. Hypoxia augments LPS-induced inflammation and triggers high altitude cerebral edema in mice. Full Text available with Trip Pro

Hypoxia augments LPS-induced inflammation and triggers high altitude cerebral edema in mice. High altitude cerebral edema (HACE) is a life-threatening illness that develops during the rapid ascent to high altitudes, but its underlying mechanisms remain unclear. Growing evidence has implicated inflammation in the susceptibility to and development of brain edema. In the present study, we investigated the inflammatory response and its roles in HACE in mice following high altitude hypoxic injury (...) that hypoxia augments LPS-induced inflammation and induces the occurrence and development of cerebral edema in mice at high altitude. Here, we provide new information on the impact of systemic inflammation on the susceptibility to and outcomes of HACE.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Brain, behavior, and immunity

16. Reply: Unilateral Pulmonary Edema after Visiting High Altitude. (Abstract)

Reply: Unilateral Pulmonary Edema after Visiting High Altitude. 28837781 2017 09 01 2325-6621 14 9 2017 Sep Annals of the American Thoracic Society Ann Am Thorac Soc Reply: Unilateral Pulmonary Edema after Visiting High Altitude. 1492-1493 10.1513/AnnalsATS.201707-538LE Cherian Sujith V SV 1 University of Texas Health Science Center at Houston, McGovern Medical School Houston, Texas. Estrada-Y-Martin Rosa M RM 1 University of Texas Health Science Center at Houston, McGovern Medical School

2017 Annals of the American Thoracic Society

17. High Altitude Pulmonary Edema

High Altitude Pulmonary Edema High Altitude Pulmonary Edema Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 High Altitude Pulmonary (...) Edema High Altitude Pulmonary Edema Aka: High Altitude Pulmonary Edema , HAPE From Related Chapters II. Epidemiology : 4% in travel above 15000 feet (4600 meters) Most common cause of death from high altitude illness Onset: 1-4 days after rapid ascent above 8000 feet (2400 meters) III. Pathophysiology Hypoxic pulmonary striction results in increased pulmonary capillary pressure Results in non-inflammatory fluid extravasation into alveoli May occur in the absence of IV. Risk Factors Same as with V

2018 FP Notebook

18. High Altitude Cerebral Edema

High Altitude Cerebral Edema High Altitude Cerebral Edema Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 High Altitude Cerebral Edema (...) High Altitude Cerebral Edema Aka: High Altitude Cerebral Edema , HACE From Related Chapters II. Pathophysiology End-stage Course from mild to death can occur within hours III. Symptoms See IV. Signs Screening: Heal-toe walking in a straight line V. Diagnosis Criteria 1 Mental status changes OR and criteria Criteria 2 Mental status changes AND Without criteria VI. Management See Descend Immediately Initial: 4-8 mg IM/IV/PO Later: 4 mg q6h IM/IV/PO High flow Intubation and if patient comatose VII

2018 FP Notebook

19. High Altitude Edema

High Altitude Edema High Altitude Edema Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 High Altitude Edema High Altitude Edema Aka (...) : High Altitude Edema From Related Chapters II. Definition on ascending to altitudes over 2400 meters III. Related Conditions ( ) ( ) IV. Epidemiology More common in women V. Signs Facial and Provoked by high salt diet Resolves with diuresis on altitude descent Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "High Altitude Edema." Click on the image (or right click) to open the source website in a new browser window. Related

2018 FP Notebook

20. Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude Full Text available with Trip Pro

Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 17:353-358, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent (...) , other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE. Upon further evaluation, five had deep vein thrombosis (DVT). One woman had a contraceptive ring and seven patients had no known thrombotic risks. PE can coexist with or mimic HAPE and should be considered in patients presenting with shortness of breath from high altitude regardless of thrombotic risk.

2016 High altitude medicine & biology

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