Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Mountain & Wilderness Medicine World Congress Abstracts Part 4

As I noted in my first post about the Mountain & Wilderness Medicine World Congress, sponsored by the Wilderness Medical Society and the International Society for Mountain Medicine in Aviemore, Scotland from October 3-7, 2008, there were many excellent abstracts presented. The following is the fourth installment of some of the more interesting of these:

It is axiom in high altitude medicine that altitude-related illnesses do not spare the fit; that is, that fit persons are just as likely to be victims as persons who are out of shape. I have often heard the perhaps counterintuitive observation that perhaps fit persons are more prone to altitude-related illnesses, perhaps because they ascend more rapidly and do not take the proper time to achieve acclimatization. To the best of my knowledge, no one has definitively proved one way or the other either the demographics or causation related to these notions. In “The relationship between a subject’s fitness level and the development of acute mountain sickness,” M. Ranney and colleagues of the TeamEverest Expedition 2007 evaluated fitness in 25 young trekkers using measured maximal oxygen consumption while exercising, and simultaneously recorded AMS symptoms during ascent to Everest Base Camp, which is at an approximate altitude of meters (17,500 feet). Fitter subjects did less well at altitude and had higher daily AMS scores than did their less fit colleagues. The results were more pronounced in males as compared to females. The authors did not propose an explanation for their observations.

Determining predisposition to disease, and then guiding therapy, according to the genetic profile of individuals is in the future of wilderness and mountain medicine. In “Nitric oxide pathway and high altitude pulmonary hypertension,” Almaz Aldashev and colleagues look at nitric oxide synthesis in the lungs, which is related to high-altitude pulmonary hypertension (HAPH, or increased pressure in the circulation of the lungs, which is felt to be a significant cause of high altitude pulmonary edema). They note that a certain genetic profile is associated development of HAPH in resident highlanders of Kyrgyzstan. In “Genetic adaptation to hypobaric hypoxia in sherpas,” Corrado Angelini and colleagues obtained DNA from nine Sherpa porters from different villages in the Solu-Khumbu area of Nepal. They commented that the Himalayan population has a long-standing genetic adaptation to hypoxia and that this contributes to their ability to display a better prolonged maximal physical performance compared to lowlanders.

More abstracts to follow…

photo of the traditional haggis courtesy of

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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.