Abstract
Guest Editorial: Will blood Tell? Three Recent Papers Demonstrate Genetic Selection in Tibetans
One of the most important advances in high altitude biology in the last year or so has been the evidence for genetic selection of Tibetans. This was the subject of three key papers published in the summer of 2010. Rupert (p. 307) discusses the evidence for genetic changes in Tibetans as a result of the natural selection in response to the hypoxia of high altitude. This is a major breakthrough.
Sightings Edited by John W. Severinghaus (p. 311)
High Altitude Web Edited by Thomas E. Dietz (p. 315)
Clinician's Corner Edited by Andrew Luks
Acetazolamide and sulfonamide allergy: a not so simple story
Kelly and Hackett (p. 319) address the problem of the person who would like to take acetazolamide to reduce the likelihood of AMS but who is allergic to the drug.
Scientific Papers
Prediction of AMS by monitoring SpO2 during ascent
Karinen and colleagues (p. 325) studied the arterial oxygen saturation by pulse oximetry in 83 subjects during 6 expeditions. The measurements were made both at rest and after moderate exercise during ascents at altitudes of 2400 to 5300 m. AMS was assessed using the Lake Louise questionairre. The SpO
Peripheral blood lymphocytes: a model for monitoring physiological adaptation to high altitude
Mariggiò and co-workers (p. 333) tested whether the function of peripheral lymphocytes gave information about the degree of oxidative stress at high altitude. Blood was removed from 7 climbers before and after a 21 day exposure to a simulated altitude of 5000 m. High altitude exposure increased intracellular calcium ion concentration, resulted in a decrease in mitochondrial membrane potential, but did not significantly change the antioxidant status of either the lymphocytes or the serum. This is a novel way of assessing oxidative stress at high altitude.
The prevalence and risk factors of acute mountain sickness in the Eastern and the Western Alps
Mairer et al., (p. 343) studied the prevalence of acute mountain sickness in mountaineers in the eastern and western European Alps using the Lake Louise score. The measurements were made in the morning after the first night at high altitude. There was a significantly higher prevalence in the eastern as opposed to the western Alps. The authors concluded that the lower mountaineering experience in climbers from the east was responsible.
The evidence for a genetic basis for altitude illness: the 2010 update
MacInnis and coworkers (p. 349) provide an update on the evidence that the genetic make-up of people contributes to high altitude illness. This follows a previous article by two of these same authors on this topic in this Journal in 2006. Some 56 genes have now been studied for their role in altitude illness, and about 16 have shown an association with the susceptibility to, or the severity of, the condition. This is a difficult area of research where at the present time it is often impossible to make absolute statements, but the subject is important and rapid advances are being made.
17° Celsius body temperature - resuscitation successful?
Hungerer and associates (p. 369) report an extraordinary case of profound hypothermia in a 17-year-old man who became lost and spent the night outside in the foothills of the Alps after a New Year's Eve party. When found, his body temperature was below 20°C and after transport to a hospital, his temperature as measured by a urinary bladder thermometer was 17°C. The patient was gradually re-warmed and after six weeks was able to walk and communicate at a basic level. However, 54 days after the hypothermic incident, the patient developed septic shock and a laparotomy revealed total necrosis of the small bowel and colon. Death followed quickly.
Experience with helicopter rescue missions for crevasse accidents
Hohlrieder and colleagues (p. 375) describe their experience with helicopter rescue missions following crevasse accidents of 95 people. Trauma and asphyxia were the most common causes of mortality in this series. Sudden cardiac death from hypothermia was a serious problem.
Report on the VIII World Congress on High Altitude Medicine and Physiology, Arequipa, Peru, August 8–12, 2010
Anholm (p. 381) reports on this very successful Congress in the lovely city of Arequipa in southern Peru. Of the many memorable sessions, one of the best was that devoted to genetic selection in Tibetans as described in the guest editorial in this issue. However, as this report indicates, high altitude medicine and biology is making rapid strides in many areas at the present time.