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High Altitude Edema

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161. Treatment of Hypertension in Patients With Coronary Artery Disease

Receptor Blockers 1394 6.7.4. β-Blockers 1394 6.7.5. Nitrates and Hydralazine 1395 6.7.6. Aldosterone Receptor Antagonists 1395 6.8. Renal Denervation 1395 6.9. Goal BP 1395 6.10. Drugs to Avoid 1395 6.11. Recommendations 1396 This is an update of the American Heart Association (AHA) scientific statement “Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research (...) groups. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure uses the traditional definition of hypertension as an SBP of ≥140 mm Hg or a DBP of ≥90 mm Hg and/or the current use of antihypertensive medication. With this definition, an estimated 65 million adult Americans, or nearly one fourth of the adult population of the United States, have hypertension. Another quarter of the population have prehypertension, defined as an SBP

2015 American Heart Association

162. Physical Activity and Exercise During Pregnancy and the Postpartum Period

of recreational activities is safe. Activities with high risk of abdominal trauma should be avoided (Box 3). Scuba diving should be avoided in pregnancy because of the inability of the fetal pulmonary circulation to filter bubble formation ( ). For lowlanders, physical activity up to 6,000 feet altitude is safe in pregnancy ( ). Special Populations Several reviews have determined that there is no credible evidence to prescribe bed rest in pregnancy, which is most commonly prescribed for the prevention (...) training in pregnancy has been shown to increase aerobic capacity in normal weight and overweight pregnant women ( ). Temperature regulation is highly dependent on hydration and environmental conditions. During exercise, pregnant women should stay well-hydrated, wear loose-fitting clothing, and avoid high heat and humidity to protect against heat stress, particularly during the first trimester ( ). Although exposure to heat from sources like hot tubs, saunas, or fever has been associated

2015 American College of Obstetricians and Gynecologists

163. Does This Patient Have Acute Mountain Sickness?: The Rational Clinical Examination Systematic Review. Full Text available with Trip Pro

Does This Patient Have Acute Mountain Sickness?: The Rational Clinical Examination Systematic Review. Acute mountain sickness (AMS) affects more than 25% of individuals ascending to 3500 m (11 500 ft) and more than 50% of those above 6000 m (19 700 ft). AMS may progress from nonspecific symptoms to life-threatening high-altitude cerebral edema in less than 1% of patients. It is not clear how to best diagnose AMS.To systematically review studies assessing the accuracy of AMS diagnostic (...) at altitude, Acute Mountain Sickness-Cerebral, and clinical functional score perform similarly to the Lake Louise Questionnaire Score using a score of 5 or greater as a reference standard. In clinical and travel settings, the clinical functional score is the simplest instrument to use. Clinicians evaluating high-altitude travelers who report moderate to severe limitations in activities of daily living (clinical functional score ≥2) should use the Lake Louise Questionnaire Score to assess the severity

2017 JAMA

164. Diabetes, Pre-Diabetes and Cardiovascular Diseases

Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes ALTITUDE Aliskiren Trial in Type 2 Diabetes Using Cardio- Renal Endpoints Apo apolipoprotein ARB angiotensin receptor blocker ARIC Atherosclerosis Risk In Communities ARISTOTLE Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation ASCOT Anglo-Scandinavian Cardiac Outcomes Trial ATLAS Assessment of Treatment with Lisinopril And Survival AVERROES Apixaban VERsus (...) for prevention of Vascular Events Aspirin ACTIVE W Atrial ?brillation Clopidogrel Trial with Irbesar- tan for prevention of Vascular Events Warfarin ADA American Diabetes Association ADDITION Anglo-Danish-Dutch Study of Intensive Treat- ment in People with Screen Detected Diabetes in Primary Care ADP adenosine diphosphate ADVANCE Action in Diabetes and Vascular Disease: Pre- terax and Diamicron Modi?ed Release Con- trolled Evaluation AF atrial ?brillation AGEs advanced glycation end-products AIM-HIGH

2013 European Society of Cardiology

165. Effects of Pneumatic Vitreolysis on Macular Hole

inclusion criteria must be met: Age ≥ 18 years • Participants < 18 years old are not being included because the condition is so rare in this age group that the diagnosis may be questionable. At least one eye meets the study eye criteria Able and willing to provide informed consent Able and willing to avoid high altitude travel, including airline travel, until gas resolution (approximately 6 to 8 weeks) For phakic patients, able and willing to avoid supine position until gas resolution (approximately 6 (...) ) Exclusion Other ocular condition that might affect visual acuity during the course of the study or require intraocular treatment (e.g., retinal vein occlusion, substantial age-related macular degeneration, or macular edema induced by a condition other than VMT) If diabetic retinopathy is present, severity level must be microaneurysms only or better (≤ diabetic retinopathy severity level 20). Presence of drusen is acceptable; however, eyes with geographic atrophy or neovascular age-related macular

2018 Clinical Trials

166. Effects of Pneumatic Vitreolysis on Vitreomacular Traction

one eye meets the study eye criteria listed below. Able and willing to provide informed consent. Able and willing to avoid high altitude travel, including airline travel, until gas resolution (approximately 6 to 8 weeks). For phakic patients, able and willing to avoid supine position until gas resolution (approximately 6 to 8 weeks). Able and willing to wear wristband that informs any medical personnel that the patient has a gas bubble in the eye Exclusion A potential participant is not eligible (...) visual acuity remains stable • An eye that requires prompt treatment for VMT should not be enrolled Exclusion e. Other ocular condition that might affect visual acuity during the course of the study or require intraocular treatment (e.g., retinal vein occlusion, substantial age-related macular degeneration, or macular edema induced by a condition other than VMT) • If diabetic retinopathy is present, severity level must be microaneurysms only or better (≤ diabetic retinopathy severity level 20

2018 Clinical Trials

167. Acute Exposure of Simulated Hypoxia on Cardiac Output

at an altitude < 1000m asl. Exclusion Criteria: Resting partial oxygen pressure (PaO2) ≤7.3 kiloPascal (kPA) corresponding to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, High Altitude Pulmonary Edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study (...) by (Responsible Party): University of Zurich Study Details Study Description Go to Brief Summary: Randomized crossover trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FIO2: 15.1% = equivalent to 2500m above sea level) on non-invasive cardiac output assessments by Finapres® "NOVA" Technology at rest and under exercise. Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude (FiO2: 15.1) Device: Shamed

2018 Clinical Trials

168. Acute Exposure of Simulated Hypoxia on ECG and Non-invasive Blood Pressure

> 6.5 kPa) Susceptibility to high altitude related diseases (AMS, High Altitude Pulmonary Edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation Residence > 1000m above sea level Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic problems with walking disability Women who are pregnant or breast feeding (...) Party): University of Zurich Study Details Study Description Go to Brief Summary: Randomized crossover trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FIO2: 15.1% = equivalent to 2500m above sea level) on ECG repolarizations and non-invasive blood pressure measurements by Finapres® NOVA Technology. Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude: (FiO2: 15.1) Device: Shamed Hypoxia

2018 Clinical Trials

169. T89 in Prevention and Treatment of Acute Mountain Sickness (AMS) During Rapid Ascent

Drug: T89 225 mg group Drug: Placebo Drug: T89 300 mg group Phase 2 Detailed Description: Acute mountain sickness (AMS) is a common ailment in people venturing over 2500 meters altitude. It is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude. It presents as a collection of nonspecific symptoms, acquired at high altitude or in low air pressure, including headache and one of the following: gastrointestinal symptoms, fatigue (...) and/or weakness, dizziness/ lightheadedness or difficulty sleeping. Severity and incidence of these conditions depend on the rate of ascent, elevation obtained, duration of altitude exposure, physical exertion, and inherent genetic susceptibility. Pilgrims to high altitudes are at an added risk since they are unaware and they gain height faster than the recommendations. The underlying pathophysiology of AMS remains poorly defined, but some data support the role of increased fluid retention, which may

2018 Clinical Trials

170. Acute Exposure to Simulated Hypoxia on Exercise Capacity

to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, High Altitude Pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation Residence > 1000m above sea level Inability to follow the procedures of the study, e.g. due to language problems (...) Description Go to Brief Summary: Randomized crossover trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FiO2:15.1, equivalent to 2500m above sea level) in constant loaded exercise capacity. Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude (FiO2: 15.1%) Device: Shamed Hypoxia (FiO2: 20.9) Not Applicable Detailed Description: Low altitude baseline measurements will be performed in Zurich (460m asl

2018 Clinical Trials

171. Acute Exposure of Simulated Hypoxia on Heart Rate and Ventilation During Exercise

for > 4 weeks Patient live permanently at an altitude < 1000m asl. Exclusion Criteria: Resting partial oxygen pressure (PaO2) ≤7.3 kilopascal (kPA) corresponding to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 (...) provided by (Responsible Party): University of Zurich Study Details Study Description Go to Brief Summary: Randomized crossover trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FIO2: 15.1% = equivalent to 2500m above sea level) on heart rate and Ventilation changes under exercise. Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude: (FiO2: 15.1) Device: Shamed Hypoxia (FiO2: 20.9

2018 Clinical Trials

172. Acute Exposure of Simulated Hypoxia on Pulmonary Artery Pressure and Right Heart Function (Echo) Under Exercise

related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation Residence > 1000m above sea level Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic problems with Walking disability Women who are pregnant or breast feeding Contacts and Locations Go to Information (...) (PAWP) ≤15 mmHg during right heart catheterization at the time of Initial diagnosis PH class 1 (PAH) or 4 (CTEPH) Stable condition, on the same medication for > 4 weeks Patient live permanently at an altitude < 1000m asl. Exclusion Criteria: Resting partial oxygen pressure (PaO2) ≤7.3 kilopascal (kPA) corresponding to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude

2018 Clinical Trials

173. Acute Exposure of Simulated Hypoxia on Cognitive Function

(nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation Residence > 1000m above sea level Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic (...) Description Go to Brief Summary: Randomized crossover Trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FiO2:15.1, equivalent to 2500m above sea level) on cognitive functions. Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude (FiO2: 15.1%) Device: Shamed Hypoxia (FiO2: 20.9) Not Applicable Detailed Description: Low altitude baseline measurements will be performed in Zurich (460m asl) including

2018 Clinical Trials

174. Acute Exposure of Simulated Hypoxia on Blood and Tissue Oxygenation (aBGA, NIRS)

daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation Residence > 1000m above sea level Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic problems with walking disability Women who (...) provided by (Responsible Party): University of Zurich Study Details Study Description Go to Brief Summary: Randomized crossover trial in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary Hypertension (CTEPH) to assess the acute response to simulated altitude (FiO2:15.1, equivalent to 2500m above sea level) on blood and tissue oxygenation (ABGA, near infrared spectroscopy) Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated

2018 Clinical Trials

175. Acute Exposure of Simulated Hypoxia on Pulmonary Artery Pressure and Right Heart Function (Echo)

condition, on the same medication for > 4 weeks Patient live permanently at an altitude < 1000m asl. Exclusion Criteria: Resting partial Oxygen pressure (PaO2) ≤7.3 kilopascal (kPA) corresponding to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) Severe daytime hypercapnia (pCO2 > 6.5 kPa) Susceptibility to high altitude related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. Exposure (...) Sponsor: University of Zurich Information provided by (Responsible Party): University of Zurich Study Details Study Description Go to Brief Summary: Randomized crossover trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to simulated altitude (FiO2:15.1, equivalent to 2500m above sea level) on pulmonary artery pressure and right heart function (Echo). Condition or disease Intervention/treatment Phase Pulmonary Hypertension Device: Simulated Altitude (FiO2: 15.1

2018 Clinical Trials

176. Remote ischemic preconditioning does not prevent acute mountain sickness after rapid ascent to 3,450 m. Full Text available with Trip Pro

Remote ischemic preconditioning does not prevent acute mountain sickness after rapid ascent to 3,450 m. Remote ischemic preconditioning (RIPC) has been shown to protect remote organs, such as the brain and the lung, from damage induced by subsequent hypoxia or ischemia. Acute mountain sickness (AMS) is a syndrome of nonspecific neurologic symptoms and in high-altitude pulmonary edema excessive hypoxic pulmonary vasoconstriction (HPV) plays a pivotal role. We hypothesized that RIPC protects (...) h and stayed there for 48 h. AMS was evaluated by the Lake Louise score (LLS) and the AMS-C score. Systolic pulmonary artery pressure (SPAP) was assessed by transthoracic Doppler echocardiography. RIPC had no effect on the overall incidence (RIPC: 35%, control: 35%, P = 1.0) and severity (RIPC vs.P = 0.496 for LLS; P = 0.320 for AMS-C score) of AMS. RIPC also had no significant effect on SPAP [maximum after 10 h at high altitude; RIPC: 33 (SD 8) mmHg; controls: 37 (SD 7) mmHg; P = 0.19

2018 Journal of applied physiology (Bethesda, Md. : 1985) Controlled trial quality: uncertain

177. Substrate stiffness-dependent exacerbation of endothelial permeability and inflammation: mechanisms and potential implications in ALI and PH (2017 Grover Conference Series) Full Text available with Trip Pro

Substrate stiffness-dependent exacerbation of endothelial permeability and inflammation: mechanisms and potential implications in ALI and PH (2017 Grover Conference Series) The maintenance of endothelial barrier integrity is absolutely essential to prevent the vascular leak associated with pneumonia, pulmonary edema resulting from inhalation of toxins, acute elevation to high altitude, traumatic and septic lung injury, acute lung injury (ALI), and its life-threatening complication, acute

2018 Pulmonary circulation

178. Comparison of Optic Nerve Sheath Diameter between both eyes: A Bedside Ultrasonography Approach Full Text available with Trip Pro

by bedside ocular ultrasonography (USG) in Indian adults.This was a prospective study conducted from September 2012 to March 2013 in the Department of Internal Medicine of a tertiary care hospital situated at moderate high altitude (11,500 ft) in India.Patients admitted with high altitude pulmonary edema (HAPE) were recruited by convenience sampling. The ONSD of both eyes were measured 3 mm behind the globe using a 7.5 MHz linear probe on the closed eyelids of supine subjects.Analysis was done using SPSS

2018 Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

179. The effects of respiratory inhaled drugs on the prevention of acute mountain sickness. Full Text available with Trip Pro

The effects of respiratory inhaled drugs on the prevention of acute mountain sickness. Acute mountain sickness (AMS) is common in high-altitude travelers, and may lead to life-threatening high-altitude cerebral edema (HACE) or high-altitude pulmonary edema (HAPE). The inhaled drugs have a much lower peak serum concentrations and a shorter half-life period than oral drugs, which give them a special character, greater local effects in the lung. Meanwhile, short-term administration of inhaled (...)  ± 0.89 vs 1.91 ± 1.23, P < .05) and BUD (1.35 ± 0.94 vs 1.91 ± 1.23, P < .05) groups were both significantly lower than the placebo group at 72 hours. There were no significant differences in LLS scores among the 4 groups at 120 hours. The incidence of AMS in the COM group was significantly reduced at 72 hours (16.7% in COM group vs 43.4% in placebo group, P < .05) after exposure to high-altitude. There were no significant differences in AMS incidences at 120 hours among the 4 groups.The prophylactic

2018 Medicine

180. Going to altitude? Bring your vitamins! Full Text available with Trip Pro

Ascorbic Acid Pulmonary edema of mountaineers IM Altitude Sickness metabolism pathology Ascorbic Acid metabolism Endothelin-1 Humans Hypertension, Pulmonary metabolism pathology Nitric Oxide metabolism Oxidative Stress Vitamin E metabolism 2010 12 3 6 0 2010 12 3 6 0 2011 4 13 6 0 ppublish 21123200 588/23/4603 10.1113/jphysiol.2010.200899 PMC3010123 High Alt Med Biol. 2009 Spring;10(1):17-24 19326597 Am J Physiol Regul Integr Comp Physiol. 2009 Nov;297(5):R1283-92 19726713 J Appl Physiol (1985). 2005 (...) Going to altitude? Bring your vitamins! 21123200 2011 04 11 2018 11 13 1469-7793 588 Pt 23 2010 Dec 01 The Journal of physiology J. Physiol. (Lond.) Going to altitude? Bring your vitamins! 4603-4 10.1113/jphysiol.2010.200899 Lundby Carsten C Institute of Physiology, University of Zurich, Winterthurerstrasse 190, Zurich 8057, Switzerland. carsten.lundby@access.uzh.ch eng Journal Article England J Physiol 0266262 0022-3751 0 Endothelin-1 1406-18-4 Vitamin E 31C4KY9ESH Nitric Oxide PQ6CK8PD0R

2010 The Journal of physiology

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