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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Winter Issue of High Altitude Medicine & Biology

The Winter 2007 issue of High Altitude Medicine & Biology, the official publication of the International Society for Mountain Medicine, has just been published. This is an excellent journal, entirely devoted to matters associated with physiology and events at high altitude. Here is an overview of some of what one will find in the current issue:

In the lead editorial, there is comment about the fact that the International Federation of Association Football (FIFA) [soccer in the U.S.] had banned international matches at altitudes over 2500 m (8202 ft). It is hypothesized that the rationale for the ban may have been to protect some of the South American football giants, such as Argentina and Brazil, whose teams would be disadvantage if their games were played so high above sea level. Because of protests from countries, like Ecuador and Bolivia, with major cities (and teams) at high altitude, the ban was loosened a bit to allow games up to 3000 m (9842 ft) and in La Paz, Bolivia.

A paper that was the product of the Caudwell Xtreme Everest Research Group identified a specific gene configuration that appeared to have been associated with successful ascent to extreme high altitude. It is interesting to note that this particular gene configuration may also be associated with lowered mortality from acute respiratory distress syndrome and a better response to other medical situations that might in part be related to low oxygen in tissues.

Another investigation measured optic nerve sheath diameter as a surrogate for the presence of increased intracranial pressure (e.g., pressure within the skull, which suggests brain swelling, called high altitude cerebral edema [HACE]), and showed that high altitude pulmonary edema (HAPE, or fluid in the lungs) was associated with increased intracranial pressure. Although HAPE and HACE are currently felt to have different pathophysiological causes, there may be more of a relationship between the two than has previously been appreciated.

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