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High Altitude Edema

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41. Is High Altitude Pulmonary Edema Relevant to Hawai‘i? (Full text)

Is High Altitude Pulmonary Edema Relevant to Hawai‘i? High altitude clinical syndromes have been described in the medical literature but may be under recognized in the state of Hawai'i. As tourism increases, high altitude injuries may follow given the easy access to high altitude attractions. Visitors and clinicians should be aware of the dangers associated with the rapid ascent to high altitudes in the perceived comfort of a vehicle. This paper will review the basic pathophysiology (...) , prevention, and treatment of the most serious of the high altitude clinical syndromes, high altitude pulmonary edema.

2014 Hawai'i Journal of Medicine & Public Health PubMed

42. High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition (Full text)

High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid. This case describes a patient with no prior history of HAPE and extensive experience hiking above 2,500 meters who developed progressive dyspnea (...) and cough while ascending to 3,200 meters. His risk factors included rapid ascent, high altitude, male sex, and a possible genetic predisposition for HAPE.

2014 Western Journal of Emergency Medicine PubMed

43. Pulmonary Edema, High-Altitude (Treatment)

Pulmonary Edema, High-Altitude (Treatment) High-Altitude Pulmonary Edema Treatment & Management: Medical Care, Diet, Prevention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwNzE2LXRyZWF0bWVudA== processing (...) > High-Altitude Pulmonary Edema Treatment & Management Updated: Dec 31, 2015 Author: Rohit Goyal, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP Share Email Print Feedback Close Sections Sections High-Altitude Pulmonary Edema Treatment Medical Care The treatment of high-altitude pulmonary edema (HAPE) includes rest, administration of oxygen, and descent to a lower altitude. If diagnosed early, recovery is rapid with a descent of only 500-1000 m. A portable hyperbaric chamber or supplemental oxygen

2014 eMedicine.com

44. Pulmonary Edema, High-Altitude (Overview)

Pulmonary Edema, High-Altitude (Overview) High-Altitude Pulmonary Edema: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwNzE2LW92ZXJ2aWV3 processing > High-Altitude (...) Pulmonary Edema Updated: Dec 31, 2015 Author: Rohit Goyal, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP Share Email Print Feedback Close Sections Sections High-Altitude Pulmonary Edema Overview Background High-altitude illness may result from short-term exposures to altitudes in excess of 2000 m (6560 ft). This illness comprises a spectrum of clinical entities that are probably the manifestations of the same disease process. High-altitude pulmonary edema (HAPE) and cerebral edema are the most ominous

2014 eMedicine.com

45. Pulmonary Edema, High-Altitude (Follow-up)

Pulmonary Edema, High-Altitude (Follow-up) High-Altitude Pulmonary Edema Treatment & Management: Medical Care, Diet, Prevention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwNzE2LXRyZWF0bWVudA== processing (...) > High-Altitude Pulmonary Edema Treatment & Management Updated: Dec 31, 2015 Author: Rohit Goyal, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP Share Email Print Feedback Close Sections Sections High-Altitude Pulmonary Edema Treatment Medical Care The treatment of high-altitude pulmonary edema (HAPE) includes rest, administration of oxygen, and descent to a lower altitude. If diagnosed early, recovery is rapid with a descent of only 500-1000 m. A portable hyperbaric chamber or supplemental oxygen

2014 eMedicine.com

46. Pulmonary Edema, High-Altitude (Diagnosis)

Pulmonary Edema, High-Altitude (Diagnosis) High-Altitude Pulmonary Edema: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwNzE2LW92ZXJ2aWV3 processing > High-Altitude (...) Pulmonary Edema Updated: Dec 31, 2015 Author: Rohit Goyal, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP Share Email Print Feedback Close Sections Sections High-Altitude Pulmonary Edema Overview Background High-altitude illness may result from short-term exposures to altitudes in excess of 2000 m (6560 ft). This illness comprises a spectrum of clinical entities that are probably the manifestations of the same disease process. High-altitude pulmonary edema (HAPE) and cerebral edema are the most ominous

2014 eMedicine.com

47. Beneficial Role of Erythrocyte Adenosine A2B Receptor-Mediated AMP-Activated Protein Kinase Activation in High-Altitude Hypoxia. (Full text)

Beneficial Role of Erythrocyte Adenosine A2B Receptor-Mediated AMP-Activated Protein Kinase Activation in High-Altitude Hypoxia. High altitude is a challenging condition caused by insufficient oxygen supply. Inability to adjust to hypoxia may lead to pulmonary edema, stroke, cardiovascular dysfunction, and even death. Thus, understanding the molecular basis of adaptation to high altitude may reveal novel therapeutics to counteract the detrimental consequences of hypoxia.Using high-throughput (...) , unbiased metabolomic profiling, we report that the metabolic pathway responsible for production of erythrocyte 2,3-bisphosphoglycerate (2,3-BPG), a negative allosteric regulator of hemoglobin-O2 binding affinity, was significantly induced in 21 healthy humans within 2 hours of arrival at 5260 m and further increased after 16 days at 5260 m.This finding led us to discover that plasma adenosine concentrations and soluble CD73 activity rapidly increased at high altitude and were associated with elevated

2016 Circulation PubMed

48. Athletes at High Altitude (Full text)

for competitive and recreational athletes.A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar.Clinical review.Level 3.AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent (...) Athletes at High Altitude Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance

2016 Sports health PubMed

49. Polymorphisms of angiotensin converting enzyme and nitric oxide synthase 3 genes as risk factors of high-altitude pulmonary edema: a case-control study and meta-analysis. (PubMed)

Polymorphisms of angiotensin converting enzyme and nitric oxide synthase 3 genes as risk factors of high-altitude pulmonary edema: a case-control study and meta-analysis. High-altitude pulmonary edema (HAPE) is a non-cardiogenic type of pulmonary edema developing altitudes > 2,500 m. Angiotensin converting enzyme (ACE) and nitric oxide synthase 3 (NOS3) play important roles in regulating pulmonary vascular tone. To assess associations between genetic variants in the ACE and NOS3 genes and HAPE

2013 The Tohoku journal of experimental medicine

50. Hemosiderin deposition in the brain as footprint of high-altitude cerebral edema. (PubMed)

Hemosiderin deposition in the brain as footprint of high-altitude cerebral edema. Based on recent findings of microhemorrhages (MHs) in the corpus callosum (CC) in 3 individuals after nonfatal high-altitude cerebral edema (HACE), we hypothesized that hemosiderin depositions in the brain after high-altitude exposure are specific for HACE and remain detectable over many years.This was a cross-sectional study involving 37 mountaineers in 4 groups: 10 had experienced HACE, 8 high-altitude pulmonary (...) edema, 11 severe acute mountain sickness, and 8 had climbed to altitudes ≥6,962 m without developing any high-altitude illness. HACE was defined as ataxia necessitating assistance with walking and/or decreased consciousness. Within <1 to 38 months after the qualifying incident, MRI of the brain was performed using a 3-tesla scanner and high-resolution susceptibility-weighted magnetic resonance sequences for detection of hemosiderin depositions, which were quantified by a score.Unequivocal MHs

2013 Neurology

51. The Athlete and High Altitude. (Full text)

The Athlete and High Altitude. Expanding athlete participation in high-altitude environments highlights the importance for a sports physician to have a good understanding of the high-altitude illness (HAI) syndromes: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). All may occur in the setting of acute altitude exposure higher than 2500 m; incidence and severity increases as altitudes or ascent rates increase. Once HAI is recognized (...) , proven therapies should be instituted to alleviate symptoms and avert the possibility of critical illness. Allowing for acclimatization is the best strategy for preventing HAI. Acetazolamide and dexamethasone are additional preventive measures for AMS/HACE; nifedipine, salmeterol, and phosphodiesterase inhibitors are useful in preventing HAPE. Along with the immediate hazards of HAI with altitude exposure, the sport physician also should be familiar with altitude/hypoxic training practices used

2017 Current Sports Medicine Reports PubMed

52. 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

2015 FP Notebook

53. 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

2015 FP Notebook

54. 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

2015 FP Notebook

55. Association of endothelial nitric oxide synthase (eNOS) G894T polymorphism with high altitude pulmonary edema susceptibility: a meta-analysis. (PubMed)

Association of endothelial nitric oxide synthase (eNOS) G894T polymorphism with high altitude pulmonary edema susceptibility: a meta-analysis. High altitude pulmonary edema (HAPE) is a potentially deadly disease associated with exposure to altitudes greater than 3000 m. Individuals who have previously experienced HAPE are at a significantly higher risk of recurrence, suggesting an underlying genetic component to HAPE pathogenesis. In a previous nuclear genomic study of individual variation

2012 Wilderness & environmental medicine

56. MRI evidence: acute mountain sickness is not associated with cerebral edema formation during simulated high altitude. (Full text)

MRI evidence: acute mountain sickness is not associated with cerebral edema formation during simulated high altitude. Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. However, the underlying mechanisms causing the symptoms of AMS are still unknown. It has been suggested that AMS is a mild form of high-altitude cerebral edema both sharing a common pathophysiological mechanism. We hypothesized that brain swelling and consequently (...) AMS development is more pronounced when subjects exercise in hypoxia compared to resting conditions. Twenty males were studied before and after an eight hour passive (PHE) and active (plus exercise) hypoxic exposure (AHE) (F(i)O(2) = 11.0%, P(i)O(2)∼80 mmHg). Cerebral edema formation was investigated with a 1.5 Tesla magnetic resonance scanner and analyzed by voxel based morphometry (VBM), AMS was assessed using the Lake Louise Score. During PHE and AHE AMS was diagnosed in 50% and 70

2012 PloS one PubMed

57. Sleep and breathing in high altitude pulmonary edema susceptible subjects at 4,559 meters. (Full text)

Sleep and breathing in high altitude pulmonary edema susceptible subjects at 4,559 meters. Susceptible subjects ascending rapidly to high altitude develop pulmonary edema (HAPE). We evaluated whether HAPE leads to sleep and breathing disturbances that are alleviated by dexamethasone.Double-blind, randomized, placebo-controlled trial with open-label extension.One night in sleep laboratory at 490 m, 2 nights in mountain hut at 4,559 m.21 HAPE susceptibles.Dexamethasone 2 × 8 mg/d, either 24 h (...) ), sleep efficiency decreased from 91% to 65%, slow wave sleep from 20% to 8% (P < 0.05, both instances). In dex-early, corresponding sleep efficiencies were 96% and 95%, slow wave sleep 18% and 9% (P < 0.05). From night 1 to 3, sleep efficiency remained unchanged in both groups while slow wave sleep increased to 20% in dex-late (P < 0.01). Compared to dex-early, initial AMS scores in dex-late were higher but improved during stay at altitude.HAPE susceptibles ascending rapidly to high altitude

2012 Sleep PubMed

58. Bosentan effects in hypoxic pulmonary vasoconstriction: Preliminary study in subjects with or without high altitude pulmonary edema-history. (Full text)

Bosentan effects in hypoxic pulmonary vasoconstriction: Preliminary study in subjects with or without high altitude pulmonary edema-history. Hypoxia-induced pulmonary vasoconstriction in patients with a medical history of high-altitude pulmonary edema (HAPE) may involve activation of the endothelin-1 (ET-1) pathway. We, therefore, compared the effect of the ETA/ETB receptor antagonist, bosentan, on pulmonary artery systolic pressure (PASP) in healthy subjects with (HS: HAPE subjects, n=5

2012 Pulmonary circulation PubMed

59. Inhaled Budesonide Does Not Affect Hypoxic Pulmonary Vasoconstriction at 4559 Meters of Altitude. (PubMed)

) and to prevent high-altitude pulmonary edema. This study tested whether inhalation of the corticosteroid budesonide attenuates PAP and right ventricular (RV) function after rapid ascent to 4559 m. In this prospective, randomized, double-blind, and placebo-controlled trial, 50 subjects were randomized into three groups to receive budesonide at 200 or 800 μg twice/day (n = 16 and 17, respectively) or placebo (n = 17). Inhalation was started 1 day before ascending from 1130 to 4559 m within 20 hours. Systolic (...) Inhaled Budesonide Does Not Affect Hypoxic Pulmonary Vasoconstriction at 4559 Meters of Altitude. Berger, Marc Moritz, Franziska Macholz, Peter Schmidt, Sebastian Fried, Tabea Perz, Daniel Dankl, Josef Niebauer, Peter Bärtsch, Heimo Mairbäurl, and Mahdi Sareban. Inhaled budesonide does not affect hypoxic pulmonary vasoconstriction at 4559 meters of altitude. High Alt Med Biol 19:52-59, 2018.-Oral intake of the corticosteroid dexamethasone has been shown to lower pulmonary artery pressure (PAP

2018 High altitude medicine & biology

60. Acetazolamide and Exercise Performance at Altitude

Hct Males = 37.5-51.0%; Females = 34.0-46.6%) levels, presence of abnormal blood chemicals (hemoglobin S or sickle cell traits) Prior HAPE (high altitude pulmonary edema) or HACE (high altitude cerebral edema) diagnosis Smokers or tobacco/nicotine users (unless have quit more than 4 months prior) Presence of asthma or respiratory tract infections (unless more than 1 month prior or approved by OMSO). Allergy to sulfa drugs (Acetazolamide) Evidence of apnea or other sleeping disorders History (...) represents a serious challenge to the health and performance of the Warfighter who may need to rapidly deploy to high altitude. However, there have been concerns that AZ might alter or impair endurance exercise performance, and possibly fine motor skills. These would represent major limitations to the use of this drug in a Warfighter who has a specific timeframe in which to accomplish mission tasks. In the present project, we will use exposure to simulated altitude in the USARIEM hypobaric chamber

2018 Clinical Trials

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