Abstract
Editorial: The spectrum of readership of the Journal (p. 293)
The topics of high altitude medicine and biology represent a small segment of medical sciences. However the readership of the Journal is very broad ranging from high altitude climbers to biologists interested in hypoxia. Maintaining a balance in the Journal for this broad spectrum of readers can be a challenge.
How to treat patients with the obstructive sleep apnea syndrome during an altitude sojourn
Sleep is very frequently disturbed at high altitude, and if somebody has the common syndrome of obstructive sleep apnea at sea level, the problems can be accentuated. Latshang and Bloch (p. 303) bring us up to date on this clinical problem.
Pro and Con, Edited by Erik R. Swenson
The issue of whether hypoxic pulmonary vasoconstriction limits exercise at high altitude is a topical one, partly because of the availability of drugs such as sildenafil that reduce pulmonary vascular resistance. Robert Naeije (p. 309) and James Anholm and Gary Foster (p. 313) discuss the evidence.
Scientific Articles
No correlation between plasma levels of vascular endothelial growth factor or its soluble receptor and acute mountain sickness
The pathogenesis of acute mountain sickness is still something of a mystery although of course hypoxia must be a factor. Here Schommer et al. (p. 323) look at the possible relationship between VEGF and AMS.
Visual analogue scores in assessment of acute mountain sickness
The assessment of the severity of acute mountain sickness continues to be an issue partly because it is so subjective. Here Hext et al. (p. 329) discuss the value of visual analogue scoring.
Medical standards for mountain rescue operations using helicopters: official consensus recommendations of the international commission for mountain emergency medicine (ICAR MEDCOM)
Our Journal has provided an international outlet for a number of studies by the ICAR MEDCOM group having to do with mountain rescue. Here we have an authoritative document by Tomazin et al. (p. 335) on rescue operations using helicopters.
Equipment of medical backpacks in mountain rescue
Elsensohn and colleagues (p. 343) update us on what may be a rather mundane issue but is very important in mountain rescue.
Preparation and medical outcomes of Nepalese staff and porters compared with foreign nationals, on the Annapurna trekking circuit
The medical problems of Nepalese porters during Himalayan expeditions raise many difficult issues. In this in-depth analysis, Drew and others (p. 349) discuss the issue.
Cardiopulmonary response and body composition changes after prolonged high altitude exposure in women
Most of the physiological studies carried out at high altitude are on men, and so it is refreshing to find one on body composition and cardiorespiratory responses to exercise in women. Ermolao et al. (p. 357) studied 12 females before and after 21 days of residence at an altitude of 5050 m in the Pyramid Laboratory.
The effects of altitude training on the AMPK-related glucose transport pathway in the red skeletal muscle of both lean and obese Zucker rats
Chen and colleagues (p. 371) studied aspects of glucose metabolism in lean and obese rats exposed to 14% oxygen at sea level. They conclude that altitude training may be useful for treating and preventing insulin resistance.
Brief Reports
The headache of high altitude and microgravity—insights from clinical syndromes of cerebral venous hypertension
Wilson and colleagues (p. 379) provide new insights on the poorly explained problem of high altitude headache. They use the experience of microgravity to offer an unusual interdisciplinary approach.
Prior altitude experience of climbers attempting to summit Aconcagua
Increasingly, inexperienced climbers are attempting to reach the summits of some of the world's highest mountains, and the results are sometimes disastrous. One such mountain is Aconcagua and Borm and colleagues (p. 387) discuss some of the issues.
Case Report
Retinal vein occlusion in high altitude
Gupta et al. (p. 393) describe three cases of retinal vein occlusion.
Meeting Report
The quest for evidence-based practice in mountain emergency medicine
Obtaining sound evidence-based data in mountain medicine has always been a challenge. Strapazzon and others (p. 399) report on a meeting of knowledgeable high altitude physicians on this topic.
Book Review
Prelude to Everest: Alexander Kellas, Himalayan Mountaineer
Alexander Kellas was one of the greatest early Himalayan climbers, and he also made important contributions to high altitude medicine and physiology. However Mitchell and Rodway now provide the first full-length biography of the man (p. 401), and it is very welcome.
Letters To The Editor
Is depression the link between suicide and high altitude?
In the 12:1 issue of the Journal, Brenner and colleagues presented strong evidence for an association between suicide and high altitude which gained a good deal of national attention. Here Gamboa and colleagues (p. 403) suggest that depression may be the link and Brenner (p. 405) also responds.
At what altitude does inspired hypoxia become significant?
In a previous issue Cabrera de León and colleagues argued that even very moderate altitudes above 600 m reduce the risk of cardiovascular disease while increasing the risk of some metabolic diseases such as diabetes. This provocative article has resulted in a letter from Swenson (p. 407) and a response from the authors (409).
Response to, “Dexamethasone improves maximal exercise capacity of individual's susceptible to high altitude pulmonary edema at 4559m”
Siebenmann and colleagues (HAMB 12:2, pp. 169-177) described the improved maximal exercise capacity of subjects using dexamethasone at high altitude. However, Windsor et al (p. 411) emphasize the dangers of using these drugs. Siebenmann and Maggiorini (p. 413) respond.