Guest Editorial: Rejuvenation Time (p. 1)

It is a great pleasure to welcome Dr. Buddha Basnyat from Kathmandu, Nepal, as the new president of the International Society for Mountain Medicine. The Society badly needs rejuvenation, and Buddha has plenty of good ideas and enthusiasm.

Sightings, Edited by John W. Severinghaus (p. 5)

Clinician's Corner, Edited by Andrew Luks

Frostbite: Prevention and initial management

Cold injury is not limited to high altitude but is a common accompaniment of prolonged exposure particularly if there is some other injury. Ken Zafren (p. 9) brings us up to date with an emphasis on practical issues.

SCIENTIFIC ARTICLES

Efficacy of residence at moderate versus low altitude on reducing acute mountain sickness in men following rapid ascent to 4300 m

The issue of how to prepare for a sudden ascent to high altitude and lessen the likelihood of acute mountain sickness is of interest to many groups. Staab and colleagues (p. 13) describe a study on the value of a period of time at a moderate altitude of about 2000 m prior to an ascent to 4300 m.

Pulmonary vascular reserve and exercise capacity, at sea level and at high altitude

The extent to which changes in pulmonary circulation, including the increase in pulmonary vascular resistance, are responsible for the reduced exercise capacity at high altitude remains unclear. Here Pavelescu and colleagues (p. 19) review previous measurements from four different expeditions to altitudes of approximately 5000 m and conclude that a limited rise in pulmonary vascular resistance and an increase in diffusing capacity for nitric oxide are associated with better aerobic exercise capacity.

Improved glycemic control in moderate high altitude type II diabetic residents

The incidence of type II diabetes is increasing rapidly throughout the world. Hessien (p. 27) provides evidence that a moderate altitude of about 2400 m is associated with improvement of glycemic control compared to sea level. This is an unexpected outcome.

Lung function among 9- to 10-year-old Tibetan and Han Chinese schoolchildren living at different altitudes in Tibet

Yangzong and coworkers (p. 31) point out that although Tibetans have probably lived at high altitude longer than any other population, many aspects of their pulmonary function have been poorly studied. An interesting finding reported here is that spirometry showed significantly better function in Tibetan children at an altitude of 4300 m compared with 3700 m. In addition Tibetans had better lung function than Han Chinese at the same altitude.

Prevalence of metabolic syndrome and common metabolic components in high altitude farmers and herdsman at 3700 meters in Tibet

Metabolic syndrome is increasing in many countries, and in this unusual study Lhamo Sherpa and colleagues (p. 37) describe an extensive survey of metabolic syndrome in 692 Tibetans between the ages of 30 and 80 years. They found that the prevalence of metabolic syndrome in high altitude farmers in Tibet was lower than in other high altitude natives although there was a high prevalence of smoking in the men.

Changes in cardiovascular functions, lipid profile, and body composition at high altitude in two different ethnic groups

Vats and coworkers (p. 45) studied cardiovascular function, lipid profile, and body composition in 20 Indians and 10 Kyrgyz at an altitude of 3200 m. There were significant differences between the two groups including blood pressure, high density lipoprotein, and components of body composition.

Sustained exposure to cytokines and hypoxia enhances excitability of oxygen-sensitive type I cells in rat carotid body: Correlation with the expression of HIF-1α protein and adrenomedullin

Liu and coworkers (p. 53) belong to a group that has carried out extensive studies of the function of the carotid body in rat in response to hypoxia. In this study they report that the changes associated with chronic hypoxia may be mediated by upregulation of HIF-1α, which affects hypoxia-sensitive genes in the type I glomus cells.

Protective effect of Ginkgolide B on high altitude cerebral edema of rats

High altitude cerebral edema is believed by many to be associated with increased oxygen radicals. In this study, Yu and colleagues (p. 61) found that one of the Ginkgolides isolated from Ginkgo Biloba had a protective effect on rats exposed to a simulated altitude of 8000 m in a low-pressure chamber.

Upregulation of cytoprotective defense mechanisms and hypoxia responsive proteins imparts tolerance to acute hypobaric hypoxia

An increase in reactive oxygen species is thought to be a factor in the intolerance of animals to extreme altitude. Jain and colleagues (p. 65) confirmed the increase in oxygen radicals in rats exposed to the extreme altitude of 9754 m in a low-pressure chamber and found genetic and biochemical differences in animals who were able to survive for the longest time. The differences included a higher expression of HIF-1α.

HISTORICAL ARTICLE

Historical vignette: Angelo Mosso's experiments at very low barometric pressures

Angelo Mosso is best known for establishing the Capanna Margherita on Monte Rosa. Here Di Giulio and West (p. 78) briefly describe his experiments in a chamber at extremely low pressures, and how his novelist daughter recorded them.

MEETING REPORTS

Meeting Report: IX ISMM World Congress in Taiwan

The IXth International Congress of High Altitude Medicine and Physiology was held in Taipei, Taiwan, on November 3–6, 2012. George Rodway (p. 80) reports on this successful meeting, which covered a large range of topics having to do with hypoxia.

2nd International Scientific Conference: “High-Altitude Hypoxia and Genome”

This meeting was held in Terskol, Elbrus, Russia, from August 14–17, 2012. Tatiana Serebrovskaya (p. 83) reports on this interesting meeting, which otherwise would probably not have received a great deal of attention.

LETTERS TO THE EDITOR

Acetazolamide for the prevention of acute mountain sickness: Time to move on

Kayser and colleagues reported a meta-analysis on the use of acetazolamide for the prevention of acute mountain sickness in HAMB 13:82–92, 2012. Here Penninga and coworkers (p. 85) discuss possible errors in a meta-analysis. This is a salutary message for those of us who are not familiar with the details of this type of analysis.

Variations in pulse oximetry at high altitude

Pulse oximetry is now extensively used at high altitude by trekkers and climbers who are not familiar with its limitations. In this letter, Kidd and colleagues (p. 87) refer to the article by Luks and Swenson in HAMB 12:109-119, 2011. Kidd et al. point out that they have experience from studies of 1,584 healthy individuals, which is a very large data base. They emphasize the value of pulse oximetry both in the management of patients and as an educational tool.