Altitude Sickness: Multiple symptoms associated with reduced oxygen at high ALTITUDE.Motion Sickness: Disorder caused by motion, as sea sickness, train sickness, car sickness, air sickness, or SPACE MOTION SICKNESS. It may include nausea, vomiting and dizziness.Mountaineering: A sport involving mountain climbing techniques.Serum Sickness: Immune complex disease caused by the administration of foreign serum or serum proteins and characterized by fever, lymphadenopathy, arthralgia, and urticaria. When they are complexed to protein carriers, some drugs can also cause serum sickness when they act as haptens inducing antibody responses.Sick Leave: An absence from work permitted because of illness or the number of days per year for which an employer agrees to pay employees who are sick. (Webster's New Collegiate Dictionary, 1981)Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death.Absenteeism: Chronic absence from work or other duty.Acclimatization: Adaptation to a new environment or to a change in the old.African Horse Sickness: An insect-borne reovirus infection of horses, mules and donkeys in Africa and the Middle East; characterized by pulmonary edema, cardiac involvement, and edema of the head and neck.Trypanosomiasis, African: A disease endemic among people and animals in Central Africa. It is caused by various species of trypanosomes, particularly T. gambiense and T. rhodesiense. Its second host is the TSETSE FLY. Involvement of the central nervous system produces "African sleeping sickness." Nagana is a rapidly fatal trypanosomiasis of horses and other animals.Tibet: An autonomous region located in central Asia, within China.Anoxia: Relatively complete absence of oxygen in one or more tissues.Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned.Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent DECOMPRESSION SICKNESS. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings.Trypanosoma brucei gambiense: A hemoflagellate subspecies of parasitic protozoa that causes Gambian or West African sleeping sickness in humans. The vector host is usually the tsetse fly (Glossina).Atmosphere Exposure Chambers: Experimental devices used in inhalation studies in which a person or animal is either partially or completely immersed in a chemically controlled atmosphere.Work Capacity Evaluation: Assessment of physiological capacities in relation to job requirements. It is usually done by measuring certain physiological (e.g., circulatory and respiratory) variables during a gradually increasing workload until specific limitations occur with respect to those variables.Morning Sickness: Symptoms of NAUSEA and VOMITING in pregnant women that usually occur in the morning during the first 2 to 3 months of PREGNANCY. Severe persistent vomiting during pregnancy is called HYPEREMESIS GRAVIDARUM.Certification: Compliance with a set of standards defined by non-governmental organizations. Certification is applied for by individuals on a voluntary basis and represents a professional status when achieved, e.g., certification for a medical specialty.Athletic Performance: Carrying out of specific physical routines or procedures by one who is trained or skilled in physical activity. Performance is influenced by a combination of physiological, psychological, and socio-cultural factors.Sweating Sickness: A clinical condition characterized by fever and profuse sweating and associated with high mortality. It occurred in epidemic form five times in the fifteenth and sixteenth centuries in England, first in 1485 and last in 1551, specially during the summer and early autumn, attacking the relatively affluent adult male population. The etiology was unknown.Trypanosoma brucei rhodesiense: A hemoflagellate subspecies of parasitic protozoa that causes Rhodesian sleeping sickness in humans. It is carried by Glossina pallidipes, G. morsitans and occasionally other species of game-attacking tsetse flies.BoliviaOccupational Health: The promotion and maintenance of physical and mental health in the work environment.NepalPensions: Fixed sums paid regularly to individuals.Aircraft: A weight-carrying structure for navigation of the air that is supported either by its own buoyancy or by the dynamic action of the air against its surfaces. (Webster, 1973)Tsetse Flies: Bloodsucking flies of the genus Glossina, found primarily in equatorial Africa. Several species are intermediate hosts of trypanosomes.Acetazolamide: One of the CARBONIC ANHYDRASE INHIBITORS that is sometimes effective against absence seizures. It is sometimes useful also as an adjunct in the treatment of tonic-clonic, myoclonic, and atonic seizures, particularly in women whose seizures occur or are exacerbated at specific times in the menstrual cycle. However, its usefulness is transient often because of rapid development of tolerance. Its antiepileptic effect may be due to its inhibitory effect on brain carbonic anhydrase, which leads to an increased transneuronal chloride gradient, increased chloride current, and increased inhibition. (From Smith and Reynard, Textbook of Pharmacology, 1991, p337)Pulmonary Edema: Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.Altitude: A vertical distance measured from a known level on the surface of a planet or other celestial body.Oxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Adaptation, Physiological: The non-genetic biological changes of an organism in response to challenges in its ENVIRONMENT.Diving: An activity in which the organism plunges into water. It includes scuba and bell diving. Diving as natural behavior of animals goes here, as well as diving in decompression experiments with humans or animals.Melarsoprol: Arsenical used in trypanosomiases. It may cause fatal encephalopathy and other undesirable side effects.Return to Work: Resumption of normal work routine following a hiatus or period of absence due to injury, disability, or other reasons.Workplace: Place or physical location of work or employment.Occupational Diseases: Diseases caused by factors involved in one's employment.Trypanocidal Agents: Agents destructive to the protozoal organisms belonging to the suborder TRYPANOSOMATINA.Trypanosoma brucei brucei: A hemoflagellate subspecies of parasitic protozoa that causes nagana in domestic and game animals in Africa. It apparently does not infect humans. It is transmitted by bites of tsetse flies (Glossina).Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Air Pressure: The force per unit area that the air exerts on any surface in contact with it. Primarily used for articles pertaining to air pressure within a closed environment.Musculoskeletal Diseases: Diseases of the muscles and their associated ligaments and other connective tissue and of the bones and cartilage viewed collectively.Aerospace Medicine: That branch of medicine dealing with the studies and effects of flight through the atmosphere or in space upon the human body and with the prevention or cure of physiological or psychological malfunctions arising from these effects. (from NASA Thesaurus)Insurance, Disability: Insurance designed to compensate persons who lose wages because of illness or injury; insurance providing periodic payments that partially replace lost wages, salary, or other income when the insured is unable to work because of illness, injury, or disease. Individual and group disability insurance are two types of such coverage. (From Facts on File Dictionary of Health Care Management, 1988, p207)PeruSwedenMilk Sickness: An acute, often fatal disease caused by the ingestion of milk, milk products, or the flesh of cattle or sheep which have a disease known as trembles. It is marked by weakness, anorexia, vomiting, constipation, and sometimes muscular tremors. It is caused by poisoning by white snakeroot (Eupatorium rugosum) and the rayless goldenrod (Haplopappus heterophyllus). (From Dorland, 27th ed)Oxygen Consumption: The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Personnel Downsizing: Reducing staff to cut costs or to achieve greater efficiency.Carbonic Anhydrase Inhibitors: A class of compounds that reduces the secretion of H+ ions by the proximal kidney tubule through inhibition of CARBONIC ANHYDRASES.Polycythemia: An increase in the total red cell mass of the blood. (Dorland, 27th ed)Social Security: Government sponsored social insurance programs.Employment: The state of being engaged in an activity or service for wages or salary.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Indians, South American: Individual members of South American ethnic groups with historic ancestral origins in Asia.Hemoglobins: The oxygen-carrying proteins of ERYTHROCYTES. They are found in all vertebrates and some invertebrates. The number of globin subunits in the hemoglobin quaternary structure differs between species. Structures range from monomeric to a variety of multimeric arrangements.Occupational Health Physicians: Physicians employed in a company or corporate setting that is generally not in the health care industry.Hematocrit: The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value.Personnel Management: Planning, organizing, and administering all activities related to personnel.Blood Gas Analysis: Measurement of oxygen and carbon dioxide in the blood.

Barometric pressures on Mt. Everest: new data and physiological significance. (1/315)

Barometric pressures (PB) near the summit of Mt. Everest (altitude 8, 848 m) are of great physiological interest because the partial pressure of oxygen is very near the limit for human survival. Until recently, the only direct measurement on the summit was 253 Torr, which was obtained in October 1981, but, despite being only one data point, this value has been used by several investigators. Recently, two new studies were carried out. In May 1997, another direct measurement on the summit was within approximately 1 Torr of 253 Torr, and meteorologic data recorded at the same time from weather balloons also agreed closely. In the summer of 1998, over 2,000 measurements were transmitted from a barometer placed on the South Col (altitude 7,986 m). The mean PB values during May, June, July, and August were 284, 285, 286, and 287 Torr, respectively, and there was close agreement with the PB-altitude (h) relationship determined from the 1981 data. The PB values are well predicted from the equation PB = exp (6.63268 - 0.1112 h - 0.00149 h2), where h is in kilometers. The conclusion is that on days when the mountain is usually climbed, during May and October, the summit pressure is 251-253 Torr.  (+info)

Effects of acute prolonged exposure to high-altitude hypoxia on exercise-induced breathlessness. (2/315)

The direct effects of hypoxia on exercise-induced breathlessness are unclear. Increased breathlessness on exercise is known to occur at high altitude, but it is not known whether this is related to the hypoxia per se, or to other ventilatory parameters. To examine the role of high-altitude hypoxia in exercise-induced breathlessness, studies were performed in 10 healthy, normal subjects at sea level and after acute exposure to an altitude of 4450 m. Although the perception of hand weights did not alter between sea level and high altitude, the intensity of exercise-induced breathlessness increased significantly at high altitude. This was associated with a higher minute ventilation and respiratory frequency for any given exercise level, whereas tidal volume was not significantly altered from sea level values. The increased intensity of breathlessness with exercise did not change significantly over the 5 days at high altitude. These results suggest that the increased intensity of exercise-induced breathlessness at high altitude is not related to peripheral mechanisms or the pattern of ventilation, or to the level of hypoxia per se, but to the level of reflexly increased ventilation.  (+info)

Acute mountain sickness is not related to cerebral blood flow: a decompression chamber study. (3/315)

To evaluate the pathogenetic role of cerebral blood flow (CBF) changes occurring before and during the development of acute mountain sickness (AMS), peak mean middle cerebral artery flow velocities () were assessed by transcranial Doppler sonography in 10 subjects at 490-m altitude, and during three 12-min periods immediately (SA1), 3 (SA2), and 6 (SA3) h after decompression to a simulated altitude of 4,559 m. AMS cerebral scores increased from 0. 16 +/- 0.14 at baseline to 0.44 +/- 0.31 at SA1, 1.11 +/- 0.88 at SA2 (P < 0.05), and 1.43 +/- 1.03 at SA3 (P < 0.01); correspondingly, three, seven, and eight subjects had AMS. Absolute and relative at simulated altitude, expressed as percentages of low-altitude values (%), did not correlate with AMS cerebral scores. Average % remained unchanged, because % increased in three and remained unchanged or decreased in seven subjects at SA2 and SA3. These results suggest that CBF is not important in the pathogenesis of AMS and shows substantial interindividual differences during the first hours at simulated altitude.  (+info)

Appetite at "high altitude" [Operation Everest III (Comex-'97)]: a simulated ascent of Mount Everest. (4/315)

We hypothesized that progressive loss of body mass during high-altitude sojourns is largely caused by decreased food intake, possibly due to hypobaric hypoxia. Therefore we assessed the effect of long-term hypobaric hypoxia per se on appetite in eight men who were exposed to a 31-day simulated stay at several altitudes up to the peak of Mt. Everest (8,848 m). Palatable food was provided ad libitum, and stresses such as cold exposure and exercise were avoided. At each altitude, body mass, energy, and macronutrient intake were measured; attitude toward eating and appetite profiles during and between meals were assessed by using questionnaires. Body mass reduction of an average of 5 +/- 2 kg was mainly due to a reduction in energy intake of 4.2 +/- 2 MJ/day (P < 0.01). At 5,000- and 6,000-m altitudes, subjects had hardly any acute mountain sickness symptoms and meal size reductions (P < 0.01) were related to a more rapid increase in satiety (P < 0.01). Meal frequency was increased from 4 +/- 1 to 7 +/- 1 eating occasions per day (P < 0. 01). At 7,000 m, when acute mountain sickness symptoms were present, uncoupling between hunger and desire to eat occurred and prevented a food intake necessary to meet energy balance requirements. On recovery, body mass was restored up to 63% after 4 days; this suggests physiological fluid retention with the return to sea level. We conclude that exposure to hypobaric hypoxia per se appears to be associated with a change in the attitude toward eating and with a decreased appetite and food intake.  (+info)

Effects of high altitude and hypophagia on mineral metabolism of rats. (5/315)

Electrolyte excretion and balance were compared in meal-eating, adlibitum-fed rats maintained in Denver (1,600 m) and on Pikes Peak (4,300 m) and in meal-eating rats maintained in Denver but pair-fed to the Pikes Peak animals. Most of the changes in excretion and balance at Pikes Peak were attributable to hypophagia. At both elevations, equivalent decrements in mineral intake led to nearly equivalent decrements in mineral excretion. Comparisons of the Pikes Peak and Denver pair-fed animals, however, revealed certain changes that were unique to high altitude. These included a marked and sustained reduction in ammonia excretion over the 13-day period of exposure. The higher elevation also produced an enhanced sodium excretion on day 1 of exposure and a reduced sodium balance over the first 6 days. Potassium balance showed no changes unique to high altitude during the first 6 days on Pikes Peak but was significantly reduced during week 2 of exposure. The urinary sodium:potassium ratio was elevated during the first 4 days at 4,300 m, but this effect was attributable to altitude on day 1 only. Enhanced calcium and magnesium excretions, relative to those observed in the pair-fed rats, were observed over the middle and latter portions of the exposure period. The balance of these two minerals showed no altitude-dependent effects. Chloride and phosphate excretions showed an altitude-dependent reduction during day 1 and week 1 of exposure, respectively. These changes were associated with more positive balances. It is concluded that the altitude-dependent effects on mineral metabolism are largely, if not entirely, attributable to hypocapnia and associated alkalosis.  (+info)

Role of the spleen in the exaggerated polycythemic response to hypoxia in chronic mountain sickness in rats. (6/315)

In a rat model of chronic mountain sickness, the excessive polycythemic response to hypoxic exposure is associated with profound splenic erythropoiesis. We studied the uptake and distribution of radioactive iron and red blood cell (RBC) morphology in intact and splenectomized rats over a 30-day hypoxic exposure. Retention of (59)Fe in the plasma was correlated with (59)Fe uptake by both spleen and marrow and the appearance of (59)Fe-labeled RBCs in the blood. (59)Fe uptake in both the spleen and the marrow paralleled the production of nucleated RBCs. Splenic (59)Fe uptake was approximately 10% of the total marrow uptake under normoxic conditions but increased to 60% of the total marrow uptake during hypoxic exposure. Peak splenic (59)Fe uptake and splenomegaly occurred at the most intense phase of erythropoiesis and coincided with the rapid appearance of (59)Fe-labeled RBCs in the blood. The bone marrow remains the most important erythropoietic organ under both resting and stimulated states, but inordinate splenic erythropoiesis in this rat strain accounts in large measure for the excessive polycythemia during the development of chronic mountain sickness in chronic hypoxia.  (+info)

Hypoxia reduces airway epithelial sodium transport in rats. (7/315)

Ascent to high altitude leads to pulmonary edema formation in some individuals. Recent laboratory evidence supports the hypothesis that hypoxia may impair the function of the alveolar epithelium and thus augment edema accumulation via reduced clearance of lung liquid. We investigated the effect of hypobaric hypoxia on epithelial sodium transport in adult Sprague-Dawley rats by measuring the nasal transepithelial potential difference (PD) as an index of airway sodium transport. Baseline PDs were similar to those previously reported in other species. Administration of amiloride resulted in a significant fall in nasal PD, as did ouabain administration for 24 h (-27.8 vs. -18.8 mV; P = 0.001; n = 5 rats). Exposure to hypobaric hypoxia (0.5 atm) for 24 h caused a significant fall in nasal PD (-23.7 vs. -18.8 mV; P = 0.002; n = 15 rats), which was not additive to the changes in nasal PD produced by amiloride or ouabain. We conclude that subacute exposure to moderate hypobaric hypoxia can inhibit sodium transport by the airway epithelium in rats.  (+info)

Blood pressure and plasma catecholamines in acute and prolonged hypoxia: effects of local hypothermia. (8/315)

This study measured the pressor and plasma catecholamine response to local hypothermia during adaptation to hypobaric hypoxia. Eight healthy men were studied at rest and after 10 and 45 min of local cooling of one hand and forearm as well as after 30 min of rewarming at sea level and again 24 h and 5 days after rapid, passive transport to high altitude (4,559 m). Acute mountain sickness scores ranged from 5 to 16 (maximal attainable score: 20) on the first day but were reduced to 0-8 by the fifth day. Systolic blood pressure, heart rate, and plasma epinephrine increased on day 1 at altitude compared with sea level but declined again on day 5, whereas diastolic and mean blood pressures continued to rise in parallel with plasma norepinephrine. With local cooling, an increased vasoactive response was seen on the fifth day at altitude. Very high pressures were obtained, and the pressure elevation was prolonged. Heart rate increased twice as much on day 5 compared with the other two occasions. Thoracic fluid index increased with cooling on day 5, suggesting an increase in pulmonary vascular resistance. In conclusion, prolonged hypoxia seems to elicit an augmented pressor response to local cooling in the systemic and most likely also the pulmonary circulation.  (+info)

BACKGROUND AND PURPOSE High-altitude headache is the primary symptom associated with acute mountain sickness, which may be caused by nitric oxide-mediated activation of the trigeminovascular system. Therefore, the present study examined the effects of inspiratory hypoxia on the transcerebral exchange kinetics of the vasoactive molecules, nitrite (NO(2)(*)), and calcitonin gene-related peptide (CGRP). METHODS Ten males were examined in normoxia and after 9-hour exposure to hypoxia (12.9% O(2)). Global cerebral blood flow was measured by the Kety-Schmidt technique with paired samples obtained from the radial artery and jugular venous bulb. Plasma CGRP and NO(2)(*) were analyzed via radioimmunoassay and ozone-based chemiluminescence. Net cerebral exchange was calculated by the Fick principle and acute mountain sickness/headache scores assessed via clinically validated questionnaires. RESULTS Hypoxia increased cerebral blood flow with a corresponding increase in acute mountain sickness and headache
Another name for Altitude Pulmonary Edema is High Altitude Pulmonary Edema. Initial symptoms of high altitude pulmonary edema may include: * Dry cough ...
A healthy, nonacclimatized 56-year-old woman developed mood changes and general weakness followed by vomiting, sensory disturbances, and ultimately unconsciousness within hours during an ascent from 1,600 to 2,800 meters in the Himalayas, Nepal. She reported no headache, ataxia, or visual disturbances during and following the hike, as confirmed by fellow travelers. As high-altitude cerebral edema (HACE) was suspected, she received 8 mg of dexamethasone and was transferred to a hospital specializing in acute mountain sickness (AMS) located at 1,300 meters. During the transfer, she had a generalized seizure. The next morning, her consciousness was still clouded. She exhibited subtle, brief, involuntary muscle twitching in both arms and neck. Because she responded properly to stimuli, this was interpreted as myoclonus. Laboratory testing revealed serum hyponatremia (117 mmol/L), hyposmolarity, and urine hyperosmolality. These disturbances were associated with decreased urine volume, high positive ...
Gradual ascent reduces symptoms and can save lives.. Cerebral forms of altitude illness occur as a continuum, from common and benign acute mountain sickness (AMS), to rare, but potentially lethal high-altitude cerebral edema (HACE) and High altitude pulmonary edema (HAPE). For the sake of comparison - AMS occurs very commonly with rapid ascents , 2500 meters (a rapid ascent (1 or 2 days) to 4400 meters feet on Mt. Rainier has rates as high as 67%; or 50% for those who fly to the Khumbu region vs. 25% in those who walk up). HACE is much less common , 1% with rapid ascents , 4300 meters. High-altitude pulmonary edema (HAPE) is the primary lung syndrome. HAPE is the leading cause of death from altitude illness.. ...
Increasing number of Hindu pilgrims visit the Himalayas where some of them suffer from high altitude illness including the life threatening forms, high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema. Compared to tourists and trekkers, pilgrims are usually ignorant about altitude illness. This is a case of a pilgrim who suffered from HAPE on his trip to Kailash-Mansarovar and is brought to a tertiary level hospital in Kathmandu. This report emphasises on how to treat a patient with HAPE, a disease which is increasingly being seen in the high altitude pilgrim population.
Results from this review do not support those of the original review on the topic published in 2000,12 which concluded that doses of acetazolamide lower than 750 mg were not effective in preventing acute mountain sickness. The results of the current review show the effectiveness of lower doses of acetazolamide (250 mg and 500 mg daily) in preventing acute mountain sickness and confirm the efficacy of acetazolamide 750 mg as previously reported.12. An important difference between this review and the original review lies in the number of participants. In this review we analysed 1512 participants in three dose specific subgroup analyses, whereas in the original review 295 participants were analysed in the acetazolamide arm of the meta-analysis and the reviewers did not carry out a subgroup analysis for acetazolamide 250 mg daily.12 Also, we included randomised placebo controlled trials only, whereas the original review included trials that were not placebo controlled.12. Our findings are in line ...
Cerebral blood flow is thought to increase at high altitude and in subjects suffering from acute mountain sickness (AMS); however, data from the literature are contentious. Blood flow velocity in the middle cerebral artery (MCAv) may be used as a proxy measure of cerebral blood flow. Using transcranial Doppler sonography, MCAv was measured during normo- and hyper-ventilation in subjects who participated in a trial that tested the effect of magnesium supplementation on the prevention of AMS. First, MCAv was recorded at 353 m (baseline). Subjects were then randomized to receive oral magnesium citrate and matching placebo. A second measurement was taken after a 24±2 h ascent from 1130 m to 4559 m (altitude I), and a third after a 20-24 h stay at 4559 m (altitude II). Using multivariate linear regression, an association was sought between MCAv and magnesium supplementation, subjects′ age and gender, altitude itself, a temporary stay at altitude, and the presence of AMS (Lake Louise Score ,6 with ...
Obesity: associations with acute mountain sickness. Obesity and mountain sickness. Excess body weight is not independently associated with outcome in mechanically ventilated patients with acute lung injury
Acute mountain sickness (AMS) is a potentially lethal condition caused by acute hypoxia after ascending to altitudes higher than 2500 m in a short time. The main symptom of AMS is headache. Numerous risk factors of AMS have been examined, including gender, obesity, ascent rate, age and individual susceptibility. In previous studies, age was considered a predisposing factor for AMS. However, different opinions have been raised in recent years. To clarify the association between AMS and age, we conducted this meta-analysis. We obtained observational studies that explored risk factors for AMS by searching PubMed, Embase, China National Knowledge Internet (CNKI), the Wanfang database and CQVIP for articles published before March 2017. The studies included were required to provide the mean age and its standard deviation for subjects with and without AMS, the maximum altitude attained and the mode of ascent. The Lake Louse Score (LLS) or the Chinese AMS score (CAS) was used to judge the severity of AMS
References. By 37 BC, the ancient Chinese recognized a peculiar illness when they hiked the passes of what they later named the Little Headache and Great Headache mountains. The first westerner to describe mountain sickness was the Jesuit priest, Jose de Acosta, who accompanied the Spanish Conquistadors in Peru. Since then researchers have described the consequences of travel to high altitudes and named the syndrome acute mountain sickness (AMS). Acute mountain sickness is characterized by a constellation of symptoms. Headache is the main symptom. Nausea, vomiting, dyspnea (shortness of breath), and insomnia are other common symptoms. The traveler at altitude can also experience impaired cognition and balance. Onset of symptoms typically occurs within hours to three days after arrival at altitude. These symptoms tend to resolve after several days but can persist for up to two weeks. They can be the harbinger of the fatal conditions, high-altitude cerebral edema and high-altitude pulmonary ...
Istanbul, Turkey - 12 December 2013: The first test to identify acute mountain sickness has been developed by a team of researchers in Italy and France and is presented today at EuroEcho-Imaging 2013. The test could revolutionise trekking and climbing by predicting who will develop the potentially deadly condition so they can avoid high altitudes, ascend more gradually or take preventative medication.. EuroEcho-Imaging 2013 is the official annual meeting of the European Association of Cardiovascular Imaging (EACVI), a registered branch of the European Society of Cardiology (ESC). It takes place during 11-14 December in Istanbul, Turkey, at the Istanbul Lutfi Kırdar Convention & Exhibition Centre (ICEC).. Dr Rosa Maria Bruno, first author of the study, said: "It is well known that when ascending to high altitude the quantity of oxygen (O2) in the air becomes lower and lower. Thus people going to high altitude, above 2500m, develop hypoxia, which is a reduced content of O2 in the blood and ...
Acute Mountain Sickness (AMS) is a well described disease process that occurs as a result of rapid exposure to high altitude. High altitude headache (HAH) is defined as the presence of headache in the setting of a recent increase in altitude. When HAH is associated with nausea, vomiting, fatigue, weakness, dizziness, lightheadedness or poor sleeping, AMS is diagnosed. While benign, AMS is very common, afflicting up to 80 % of travelers who ascend rapidly to 14,000 ft, and can be debilitating. AMS is thought to occur secondary to hypoxia-induced cerebral vasodilation. The antiemetic metoclopramide has been well studied and is commonly administered for treatment of migraine headaches in emergency departments across the U.S. The symptoms of migraine headaches are often similar to those of AMS. The mechanism of metoclopramide‟s beneficial effect in this indication appear to be a result of its antagonism of central and peripheral dopamine receptors,most notably by blocking stimulation of the ...
SM. Morrissey, AR Bradwell; Auditory Brain Stem Evoked Potentials in Acute Mountain Sickness. Clin Sci (Lond) 1 January 1990; 78 (s22): 33P. doi: https://doi.org/10.1042/cs078033Pc. Download citation file:. ...
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Before going trekking to the Himalayas make sure you familiarize yourself with the common symptoms of mountain sickness so that you may be better able to help yourself and others. AMS (acute mountain sickness) causes headache and nausea at high altitude (,2700 m). So if you are going to Lahsa, Tibet or Kailash/Mana sarover please take diamox (125 mg two times per day) for 4 days, starting on day before your trip. Make sure you have no sulpha allergy before taking this drug expect tingling of your fingers and toes. The life-threatening problems at altitude are HACE (High Altitude Cerebral Edema) and HAPE (High Altitude Pulmonary Edema) For further info, please check our website: www.nepalinternationalclinic.com. ...
Steve House called in this morning with the latest news from his Makalu expedition. Its hard to imagine drowning when youre 22,000 feet above
Most people who travel to high altitudes acclimatize. Acclimatization precludes the development of HACE by maintaining adequate levels of cerebral oxygen.[9] The primary cause of HACE is hypoxia (oxygen deprivation).[10] This occurs after the body is exposed to a low-oxygen environment and before it acclimatizes. The rate of change from a normal oxygen environment and how little oxygen is in the new environment can be used to predict the chance of developing HACE.[11] Prolonged exertion in low oxygen also causes serious hypocapnia, lower carbon dioxide in the bloodstream,[12] which may play a role in HACE.[13] These factors cause the brain to swell with fluid, resulting in severe impairment.[14] If the swelling is untreated, it causes death by brain herniation.[3] The brain swelling is likely a result of vasogenic edema, the penetration of the blood-brain barrier by fluids.[15] This process has been observed in MRI studies. Hypoxia increases extracellular fluid, which passes through the ...
Most people who travel to high altitudes acclimatize. Acclimatization precludes the development of HACE by maintaining adequate levels of cerebral oxygen.[9] The primary cause of HACE is hypoxia (oxygen deprivation).[10] This occurs after the body is exposed to a low-oxygen environment and before it acclimatizes. The rate of change from a normal oxygen environment and how little oxygen is in the new environment can be used to predict the chance of developing HACE.[11] Prolonged exertion in low oxygen also causes serious hypocapnia, lower carbon dioxide in the bloodstream,[12] which may play a role in HACE.[13] These factors cause the brain to swell with fluid, resulting in severe impairment.[14] If the swelling is untreated, it causes death by brain herniation.[3]. The brain swelling is likely a result of vasogenic edema, the penetration of the blood-brain barrier by fluids.[15] This process has been observed in MRI studies. Hypoxia increases extracellular fluid, which passes through the ...
Ginkgo was not effective in reducing the incidence or severity of acute mountain sickness when compared with placebo and failed to show a protective benefit for any outcome measure. Furthermore, the addition of ginkgo to acetazolamide caused a marginally significant decrease in the efficacy of acetazolamide against headache (the most common symptom at altitude); this was unexpected considering the different proposed mechanisms of action for the two substances. Research has shown ginkgo to have some vasodilatory properties.15 This may theoretically increase cerebral blood flow, which in turn could worsen the symptoms of acute mountain sickness such as headache. Regardless of the mechanism, clinicians should avoid recommending ginkgo as prophylaxis for acute mountain sickness either alone or combined with acetazolamide.. This is the first study in which ginkgo prophylaxis was given when the participants were enrolled at a high baseline altitude (as opposed to starting the drug at sea level before ...
Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28 4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9) and during ...
Altitude Sickness (aka Acute Mountain Sickness or AMS), is caused by traveling to elevation (above 5000 ft.), and has symptoms ranging from a mild headache and fatigue to nausea/indigestion, vomiting, rapid pulse, difficulty sleeping, shortness of breath and even death due from accumulation of fluid in the lungs or brain. It affects roughly one in four Colorado mountain vacationers. Altitude sickness can affect persons of any age and fitness level. Altitude sickness can be mild to life threatening. Here are six helpful tips to help reduce your risk of AMS. Early diagnosis and preventive measures are critical as it is much easier to treat altitude sickness in its early stages.. ...
Altitude Sickness Global Clinical Trials Review, H2, 2015BriefGlobalDatas clinical trial report, Altitude Sickness Global Clinical Trials Review, H2, 2015 offers ...
High-altitude illness, or sickness, can occur when your body doesnt get enough oxygen. Learn how to recognize, prevent, and treat the illness.
Three hospitals participated (4779 masl, barometric pressure (Pb) ∼417 mm Hg; 4505 masl, Pb ∼440 mm Hg; 4292 masl, Pb ∼447 mm Hg). The highest work site was at 4905 masl. The study was approved by the China National Science Foundation and the Qinghai High Altitude Medical Research Institute Committee on Human Research. In 2003, a first group of 4683 workers was recruited. All prospective workers filled out a questionnaire providing information on age, sex, ethnicity, occupation, place of birth, altitude exposure, personal and family medical history, smoking and drinking behaviour. Subjects were interviewed and underwent a physical exam. Subjects in good health and physical condition were offered a job. The subjects were then asked to participate in a study on the health effects of altitude exposure. Subjects were kept unaware of the study objective, were not given information on smoking, received no incentives, were informed about procedures, knew they could withdraw at any time and gave ...
Three hospitals participated (4779 masl, barometric pressure (Pb) ∼417 mm Hg; 4505 masl, Pb ∼440 mm Hg; 4292 masl, Pb ∼447 mm Hg). The highest work site was at 4905 masl. The study was approved by the China National Science Foundation and the Qinghai High Altitude Medical Research Institute Committee on Human Research. In 2003, a first group of 4683 workers was recruited. All prospective workers filled out a questionnaire providing information on age, sex, ethnicity, occupation, place of birth, altitude exposure, personal and family medical history, smoking and drinking behaviour. Subjects were interviewed and underwent a physical exam. Subjects in good health and physical condition were offered a job. The subjects were then asked to participate in a study on the health effects of altitude exposure. Subjects were kept unaware of the study objective, were not given information on smoking, received no incentives, were informed about procedures, knew they could withdraw at any time and gave ...
Usual Adult Dose for Edema 250 to 375 mg oral or IV once a day. When continued acetazolamide therapy for edema is desired, it is recommended that every second or third dose be skipped to allow the kidney to recover. Usual Adult Dose for Acute Mountain Sickness Oral tablet: 125 to 250 mg orally every 6 to 12 hours. -or- SR capsule: 500 mg orally every 12 to 24 hours. The maximum recommended dose is 1 gram/day. For rapid ascent, higher doses are beneficial for preventing acute mountain sickness beginning 24 to 48 hours before ascent and continuing for 48 hours while at high altitude. Usual Adult Dose for Glaucoma Open-angle Glaucoma: tablet or IV injection: 250 mg 1 to 4 times a day. - or- SR capsule: 500 mg once or twice a day. Closed-angle glaucoma: 250 to 500 mg IV, may repeat in 2 to 4 hours to a maximum of I gram/day. Usual Adult Dose for Seizure Prophylaxis 8 to 30 mg/kg/day in 1 to 4 divided doses. Do not exceed 1 gram per day. If this patient is already taking other anticonvulsants, the ...
Information about high altitude illness and physiology, and the home of the International HAPE Database - a registry of sufferers of high altitude pulmonary edema. ...
Methods A total of 39 obese and 43 non-obese young-middle aged male subjects were enrolled in this study. Each subject completed an AMS (acute mountain sickness) self-report questionnaire at sea level and after ascending high-altitude 12 hours and 24 hours. Weight and height were measured and BM1 was calculated. Vital capacity of lungs was measured. Venous blood was sampled for measuring haemoglobin at baseline. Arterial blood was taken for evaluating arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCOz) at baseline and 24 hours after ascending high-altitude.. ...
Altitude Sickness The available amount of oxygen to sustain mental and physical alertness decreases with altitude. Available oxygen drops as the air density drops. Dehydration due to the higher rate of water vapor lost from the lungs at higher altitudes may contribute to the symptoms of altitude sickness. The rate of ascent, altitude attained, amount of physical activity at high altitude, as well as individual susceptibility, are contributing factors to the onset and severity of high- altitude illness.Dehydration Altitude sickness-also known as acute mountain sickness (AMS): is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude. It commonly occurs above 2,400 meters (8,000 feet). It presents as a collection of nonspecific symptoms, acquired at high altitude or in low air pressure, resembling a case of
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Most climbers must use oxygen and will have difficulty sleeping. A Bodys Reactions At high elevation, the body will compensate by producing more red blood cells and functions should return to normal. At extremely high elevations, the brain can actually swell and blood vessels begin to leak, resulting in High Altitude Cerebral Edema, or HACE. High Altitude Pulmonary Edema, or HAPE, occurs when fluid accumulates in the lungs. How Climbers Avoid These Conditions Everest climbers typically make several trips up and down the mountain ...
The underlying main issue in high altitude as mentioned before is due to the lack of oxygen in the air, a condition known as hypoxia. It is well known that hypoxia will lead to an elevated brain volume and this brain volume is due to an increase at least in part by swelling of the brain as a result of water retention, a term called brain edema. Brain edema may occur as a result of brain cells damage or death due to lack of oxygen and also may be related to the vascular supply to the brain which again is related to a lack of oxygen at a high altitude. The brain edema if not controlled will lead to the compression of the brain, raised/elevated intracranial pressure and lead to change in the mental status and further deterioration into coma and brain death.. With regards to high altitude pulmonary edema (HAPE), the underlying mechanism is due to exaggerated hypoxic pulmonary hypertension i.e. the arterial pressure of the lungs are increased dramatically as a result of the lack of oxygen and ...
High altitude cerebral edema (or HACE) is a severe (usually fatal) form of altitude sickness. HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include headache, loss of coordination (ataxia), weakness, and decreasing levels of consciousness including disorientation, loss of memory, hallucinations, psychotic behavior, and coma. It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent is a necessary life-saving measure (2,000 - 4,000 feet). There are some medications (e.g. dexamethasone) that may be prescribed for treatment in the field, but these require proper medical training in their use. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment. A gamow bag can sometimes be used to stabilize the sufferer before transport or descending. Climbers may also suffer high altitude pulmonary edema (HAPE), which affects the lungs. While not as life ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
Patient Presentation A 15-year-old male came to clinic for travel advice. He was traveling to the Andes Mountains for most of his trip. He was going to ~3000m altitude and would be acclimatizing there for a couple of days before going to ~3500 m hiking over 4 days. He then would be returning to sea…
Military models indicate at least 25% of unacclimatized troops parachuting into a battlefield at 10,000 feet-and more than 80% of troops fighting at 13,200 feet-will get altitude sickness. One military study of a prolonged operation in the high mountains of Afghanistan found 14% of troops evacuated for medical treatment didnt have combat injuries-they had altitude sickness. Uncounted others, not sick enough to merit rescue by helicopter, were huddled in base camps while their units went out fighting, said Dr. Muza, the Army research physiologist. In most cases, acute mountain sickness dissipates within three days as the body adjusts to the elevation, though in severe cases, it can linger or lead to fatal complications ...
Acute Mountain Sickness. Unacclimatized person , 8200ft (2500m). 1-2 days onset for AMS and 3-4d onset for HAPE. Headache + Additional symptom (loss of appetite, nausea, vomiting, dizziness, sleep disturbance, peripheral edema). "Do you feel sick? Do you have a headache? Do you feel hung-over?". HACE. Unusual below 1000m (3050ft). Progression of CNS symptoms in someone with AMS or HAPE. Ataxia or acting drunk. HAPE. Dypsnea at rest and weakness. Crackles first develop in right upper axilla. CXR shows R,L consolidations easily confused with PNA. Prophylaxis. For h/o AMS and ascent to ,2800m in 1d. ascent , 2800m in 1d. ascent , 1600m/d over 10 000ft without acclimatization. ,11 500ft in 1 day. For h/o HACE and HAPE. Acetazolamide 125mg - 250mg BID starting day before travel until d2-3 at altitude.. Dexamethasone 4mg BID or QID starting on ascent. Inhaled budesonide ...
In conclusion, a predictive index combining clinical and hematological parameters measured at an intermediate step on the way to the top may provide information on impending AMS.
Not many of you know that Viagra contains Sildenafil Citrate: this substance is primarily used to treat erectile dysfunctions, but its also useful in many other ways. For instance, did you know that Sildenafil is also used to treat pulmonary hypertension and- hold on! - altitude sickness? Well, its true and scientifically proven: the substance contained by Generic Viagra is quite effective in pulmonary arterial hypertension because and it also works in cases of high altitude pulmonary edema, which usually causes altitude sickness.. Of course the thing Viagra is most renowned for is that it improves the ability to have sex in cases where sexual desire exists but erectile dysfunctions have interfered for one reason or the other. Most ED problems are associated with age, but nowadays there is no reason why elderly gentlemen should not continue enjoying the great pleasures of life. As a matter of fact, its been proven that a healthy sexual life leads to prolonged life expectancy. Still, elderly ...
to increase, so does the incidence of altitude-related diseases. Shlim (1992) stated that 77% of deaths that were caused by high altitude pulmonary oedema(HAPE) or cerebral oedema (HACE) occurred in organized trekking groups - but only 40% of all trekkers were part of an organized tour [1]. In other words in 1992: an individuals risk of dying from an altitude-related problem was increased by 5.0 times at the moment of booking! As recent data suggest the situation is still the same (ADEMED Expedition 2008 and 2011 (data not yet publishes), www.ademed.de). Technically simple high altitude treks and peaks with easy access such as Kilimanjaro, Aconcagua, or the Everest trek (with fly-in to Lukla) are still potentially dangerous because of the rapid ascent profile undertaken by many trekkers and offered by many trekking companies [2 ...
Research interests include the study of cardiorespiratory function in humans exposed to environmental conditions ranging from 200 feet of seawater depth to high altitude, gas exchange during diving, the pathophysiology of high altitude pulmonary edema, the effect of anesthesia and postoperative analgesia on pulmonary function and monitoring of tissue oxygenation.
I thought you might want to read this account. I would recommend going to the end and read his February reflections first. You will appreciate his insights that Covid may be more of a HAPE ( high altitude pulmonary edema ) like issue rather than Acute Respiratory distress ( ARDS ). 40 TRIBES FOUNDER/DIRECTORS ACCOUNT…
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Ascent to high altitude leads to a number of changes in lung function. We studied 55 subjects at sea level and as they ascended from 2600m to 5300m over 8 to 14 days to investigate the possible time course of these changes. Using a turbine spirometer, previously validated at simulated altitude, subjects recorded their peak expiratory flow (PEF), forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC) on arrival at each new attitude and again the next morning. Compared to sea level, PEF rose by 4.7% (95% confidence intervals (CI) 4.4-5.0, p=0.007), and FVC fell by 0.54% (95% CI 0.4-0.7, p=0.034), for every 1000m gain in altitude. FEV1 was unaffected by altitude change. These observations are in line with our previous findings (Pollard et al, Thorax, 1996;51:175-8). There was no significant change in lung function or acute mountain sickness (AMS) scores between arrival at each altitude and the next morning. Subjects with a greater fall in FVC on arrival at each attitude had higher
The new finding of the present study is that AMS symptoms in subjects acutely exposed to high altitude appear to be related to an altered dynamic autoregulation of the cerebral circulation.. Transcranial Doppler was used for the noninvasive and beat-by-beat estimation of CBF. This approach is based on the reasonable assumption that hypoxia or acute hypotension would not alter the diameter of the middle cerebral artery.16,17 Finger plethysmography was used for the noninvasive beat-by-beat estimation of cerebral arterial pressure. This approach is validated for the measurement of instantaneous relative changes, and as such, has been used previously for cerebral autoregulation studies and ARI computing.11,12. Previous studies in normal subjects using the same methodology as in the present study reported a normal ARI of ≈5, range from 3 to 7, for an average BP drop ranging from 15 to 28 mm Hg.12 Our normal subjects presented with a baseline ARI of 4.44 for an average cuff release-induced drop in ...
Acute Mountain Sickness (AMS) The percentage of oxygen in the atmosphere at sea level is about 21%. As altitude increases, the percentage remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,600 m) there are roughly 40% fewer oxygen molecules per breath so the body must adjust to having less oxygen. AMS is caused by the failure of the body to adapt quickly enough to the reduced oxygen at increased altitudes. Altitude sickness can occur in some people as low as 8,000 feet, but serious symptoms do not usually occur until over 12,000 feet. It is not the height that is most troublesome, but the rate of ascension. It is difficult to determine who may be affected by altitude sickness since there are no specific factors such as age, sex, or physical condition that correlate with susceptibility. At over 10,000 feet (3,000 m), more than 75% of climbers will experience at least some form of mild AMS. There are four factors related to AMS:. ...
If you think your travelmate is behaving (more) strangely than usual, there maybe a reason. A small percentage of travellers to high altitudes (ie in excess of 4000m) will develop the symptoms of acute mountain sickness. This may vary from mild headache, lassitude and altered sleep through to altered conscious state and severe illness requiring emergency treatment. The altered conscious state can occasionally make people stagger, say or do silly things and may be an early sign.. ...
Vonn partially tore one of the reconstructed ligaments in her surgically repaired knee. She will continue to go through therapy on her knee and hasnt ruled out Lake Louise. Her good friend and rival, Maria Hoefl-Riesch of Germany, visited with Vonn the other day just to lift her spirits. She fully expects to see Vonn back sooner rather than later. "Shes of course sad she cant be here," said Hoefl-Riesch, who turned in the eighth-fastest training time on Tuesday, 1.01 seconds behind Gut. "But she was positive because shes not out for the season and that she maybe can come back next week already. If anybody is strong enough in the head, its her." This new course-the site of the 2015 world championships-appears well suited for Vonn given all the terrain changes. Heres some of the feedback on the hill from the fastest skiers on the circuit: - "Its quick. A lot of switches are quick and a lot of technical turns-intimidating sections. Its got a little bit of everything. Its pretty awesome," ...
The Canadian mens alpine team received a big boost on Thursday after learning injured veteran skier Erik Guay should be ready for the seasons second World Cup event in Lake Louise, Alta. The competition is set for Nov. 24-25.
Altitude[edit]. Main article: Altitude sickness. Atmospheric pressure reduces with altitude and with it, the amount of oxygen.[ ... Generalized hypoxia occurs in healthy people when they ascend to high altitude, where it causes altitude sickness leading to ... In the case of altitude sickness, where hypoxia develops gradually, the symptoms include fatigue, numbness / tingling of ... "Altitude oxygen calculator". Apex (Altitude Physiology Expeditions). Archived from the original on 2017-06-11. Retrieved 2006- ...
the benefits of acetazolamide prophylaxis to reduce the incidence of altitude sickness, as part of the Birmingham Medical ... Coote, JH (December 1991). "Pharmacological control of altitude sickness". Trends in Pharmacological Sciences. 12 (12): 450-5. ... West, John B. (1998). High Life a History of High-Altitude Physiology and Medicine. New York, NY: Springer New York. p. 385. ... to study the effects of high altitude on human performance. Substantive posts include: Lecturer in Department of Physiology, ...
Sources Altitude Decompression Sickness Susceptibility, MacPherson, G; Aviation, Space, and Environmental Medicine, Volume 78, ... Decompression sickness is the injury to the tissues of the body resulting from the presence of nitrogen bubbles in the tissues ... Leaving and returning to Earth's gravity causes "space sickness," dizziness, and loss of balance in astronauts. By studying how ... 434-443(10) Incidence of Adverse Reactions from 23,000 Exposures to Simulated Terrestrial Altitudes up to 8900 m, DeGroot, D; ...
This is one contributor to high altitude sickness. On the other hand, if the switch to oxygen homeostasis is incomplete, then ... "Online high altitude oxygen calculator". altitude.org. Archived from the original on 29 July 2012. Retrieved 15 August 2007.. ... At altitude this variation in the ventilation/perfusion ratio of alveoli from the tops of the lungs to the bottoms is ... At a body core temperature of 37 °C it is 6.3 kPa (47.0 mmHg), irrespective of any other influences, including altitude.[26] ...
Acute mountain sickness (AMS) may develop into high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE), ... Altitude sickness results from climbing rapidly to elevations beyond 2,500 metres (approximately 8,000 feet). The process of ... Roach, Robert; Stepanek, Jan; Hackett, Peter (2002). "Acute Mountain Sickness and High-Altitude Cerebral Edema". Medical ... both of which are life-threatening and require immediate transportation to a lower altitude. Carbon monoxide poisoning may ...
Session 2 Altitude decompression sickness - A. A. Pilmanis; Treatment of altitude decompression sickness - P. N Kimbrell; ... Gerth, WA; Vann, RD (1996). "A statistical bubble dynamics model of decompression sickness risk for diving and altitude ... Van Liew; Survival Models for Altitude Decompression Sickness - N Kannan; Multinomial Bubble Score Model - P Tikuisis, KA. ... Wachholtz, CJ; Dovenbarger, JA; Bond, BG; Bennett, PB (1989); Altitude exposure in decompression sickness reported to the ...
In 1941, altitude decompression sickness was first treated with hyperbaric oxygen. and the revised US Navy Decompression Tables ... Gribble, M. de G. (1960); "A Comparison of the High-Altitude and High-Pressure Syndromes of Decompression Sickness", Brit. J. ... Brown, J. R.; Antuñano, Melchor J. "Altitude-induced Decompression Sickness" (PDF). AM-400-95/2 Medical Facts for Pilots. ... "Altitude decompression sickness: hyperbaric therapy results in 145 cases". Aviation, Space, and Environmental Medicine. 48 (8 ...
It is considered particularly effective against altitude sickness. It also is used as an anesthetic and analgesic to alleviate ... Coca is traditionally cultivated in the lower altitudes of the eastern slopes of the Andes (the Yungas), or the highlands ...
This is one contributor to high altitude sickness. On the other hand, if the switch to oxygen homeostasis is incomplete, then ... ISBN 81-7450-496-6. "Online high altitude oxygen calculator". altitude.org. Archived from the original on 29 July 2012. ... the pressure in the lungs also decreases at the same rate with altitude. At altitude, a pressure differential is still required ... The lower viscosity of air at altitude allows air to flow more easily and this also helps compensate for any loss of pressure ...
Gribble, M. de G. (1960); A comparison of the High-Altitude and High-Pressure syndromes of decompression sickness, Brit. J. ... Retrieved 26 November 2015 "Altitude-induced Decompression Sickness" (PDF). Federal Aviation Administration. Retrieved 21 ... Doolette and Mitchell's study of Inner Ear Decompression Sickness (IEDCS) shows that the inner ear may not be well-modelled by ... 1965) Decompression Sickness. A thermodynamic approach arising from a study on Torres Strait diving techniques. Hvalradets ...
"Tragedy of brilliant student who competed at Commonwealth Games killed by altitude sickness on gap year in Peru". Daily Mail. ... "Doctors daughter dies from 'altitude sickness' on gap year". Daily Telegraph. 2010-06-01. Retrieved 2010-06-01. Katie Cassidy ( ... Jacks died of an apparent dose of altitude sickness, which affects human beings above 2,400 metres (7,900 ft), on May 16, 2010 ... Richard Smith (2010-06-01). "Commonwealth Games medallist Katrina Jacks killed by altitude while on holiday in Peru". Daily ...
At this pressure, many people suffer from altitude sickness. The climate on the summit of Mount Evans can be extreme. The mean ... In 1940, for example, it was the site of a significant study of high-altitude physiology. Pioneering studies on the effects of ... Mount Evans Road is also noteworthy as a high-altitude vehicle testing venue for auto manufacturers. With full visibility on a ... Battling the unusual problems that come with high-altitude construction (steam shovels performing only half as effective at ...
Altitude sickness.. *Frostbite or hypothermia from exposure to freezing cold air at high altitude. ... This measure of altitude is known as the Armstrong limit, which is the practical limit to survivable altitude without ... Decompression sickness.[22][23][26][27]. *Physical trauma caused by the violence of explosive decompression, which can turn ... "AC 61-107A - Operations of aircraft at altitudes above 25,000 feet msl and/or mach numbers (MMO) greater than .75" (PDF). ...
"Mount Everest: Altitude sickness claims third death in three days". BBC.com. 23 May 2016. "Mount Everest: total of six dead as ...
It has also been alleged to help with altitude sickness. However, no long-term, well-controlled scientific studies have ...
Cholayna's altitude sickness gets worse, as do the travel conditions. High in the Hellers, they meet Kyntha, who explains that ... The Terran women suffer frostbite and altitude sickness, but continue despite their troubles. After about a week, they continue ...
They also consumed garlics and onions, to prevent altitude sickness. Only 4,300 mules and 511 horses survived, less than half ...
Without pressurization, one could suffer from altitude sickness including hypoxia. If a pressurized aircraft suffers a ... At cruising altitudes of modern commercial aircraft the surrounding atmosphere is too thin for passengers and crew to breathe ... It becomes necessary when the aircraft reaches a certain altitude, because the natural atmospheric pressure would be too low to ... without an oxygen mask, so cabins are pressurized at a higher pressure than ambient pressure at altitude. In commercial air ...
For me, it has nothing to do with altitude sickness." Late in the day of 10 May, as bad weather closed in, Scott Fischer ... Boukreev, Anatoli; Wylie, Linda (2002), Above the Clouds: The Diaries of a High Altitude Mountaineer, p. 146, ISBN 0-312-29137- ... suffering from a severe case of high altitude pulmonary edema (HAPE). Hospitalised, Ngawang remained incapacitated in Kathmandu ...
There is a medical centre, which specializes in high-altitude sickness. Main street of Manang with yaks A view of Gangapurna ... It is located at 28°40'0N 84°1'0E with an altitude of 3,519 metres (11,545 ft). According to the preliminary result of the 2011 ... Most groups trekking around the Annapurna range will take resting days in Manang to acclimatize to the high altitude, before ...
The rail cars have personal oxygen supplies to prevent altitude sickness. For a satellite image showing the separate highway ...
Encounters with passing yaks, and hypothermia and altitude sickness, are common. Trekking to Manaslu is thus a test of ... These are categorised on the basis of the altitude as Low hill, Middle mountain and High mountain types with its exclusive ... The zones coalesce with the variation of the altitude from about 600 metres (2,000 ft) in the tropical zone to the 8,156 metres ...
Judd traveled between the summit and the Recruiting Station to tend the many who suffered from altitude sickness or had worn ... A snowstorm was in progress and several suffered from altitude sickness. That night (December 23), the snow on the canvas roof ... The next morning they were unable to start a fire using friction due to the thin air at that altitude, and sent for matches. By ...
Takashi Ozaki, 58, dies of altitude sickness while attempting his third ascent.[36] ... "Altitude Junkies. 22 May 2013. Retrieved 11 April 2016.. *^ Kobler, Kari (22 May 2013). "Summit success on Mt. Everest!". ... Air at that altitude already contains only one third as much oxygen as sea-level air.. ... In late November, the team was stopped by bad weather after reaching an altitude of 8100 metres.[19] ...
Chronic mountain sickness. In: High Altitude. An Exploration of Human Adaptation. Series: Lung Biology in Health and Disease. ... She is also author of chapters in several books about altitude sickness and related topics particularly in the Andes. She is a ... Modulation of autonomic cardiovascular function in Andean high-altitude natives with and without chronic mountain sickness. J. ... Genetic association analysis of chronic mountain sickness in an Andean high altitude population. [Haematologica][17]. 90(1):13- ...
Most of these systems have not been cleared for medical applications by the FDA and are used by athletes for altitude training ... minimising the risk of succumbing to acute mountain sickness on a subsequent ascent. The hypoxia challenge of IHT is normally ... 2007). "Effects of simulated altitude (normobaric hypoxia) on cardiorespiratory parameters and circulating endothelial ... an emerging drug-free treatment for a wide range of degenerative disorders and for simulated altitude training used to achieve ...
High Altitude Sickness Find everything you need to know about high altitude sickness including causes, acclimatization,symptoms ... medication and treatment, altitude sickness in children and the most important, how to avoid it.... ... 2.Its more likely to suffer from AMS for your body couldnt get used to the dramatic altitude rise.. 3.And if you still want ... What to eat and drink in Tibet are quite different from mainland China for such a high altitude and harsh climate. Daily diets ...
... morning sickness for mothers, expecting mothers, and soon to be expecting mothers. Morning sickness is also known as Nausea ... Hyperemesis gravidarum, on the other hand, is a more severe form of morning sickness/nausea and vomiting of pregnancy and often ... Traveling Pregnant: How Changes in Altitude and Temperature May Affect You. The winter holidays are upon us. Tis the season ... Morning Sickness Symptoms. More than one-half of all pregnant women will suffer morning sickness symptoms. Morning sickness ...
Altitude Concerns. Maps & Routes. Scenery Album. Tour Guide. Tibet Permit. Pre-tour Must Know. Altitude Sickness. What to pack ...
Altitude Sickness. *Trekking Equipments. *Trekking Seasons. Inquiry/ Reservation Form. Please fill up the form given below and ...
... motion sickness medicine, motion sickness cure, motion sickness remedy, motion sickness patch, motion sickness remedy and sea ... Cruise Sickness. Sea Sickness. Car Sickness. Air Sick. Morning Sickness. Altitude Sickness ... Other Motion Sickness Links. Related Pages for Motion Sickness ...
... motion sickness medicine, motion sickness cure, motion sickness remedy, motion sickness patch, motion sickness remedy and sea ... Sea Sickness Site ~ Motion Sick Facts ~ Cruise Sickness Sea Sickness Car Sickness Air Sick Altitude Sickness Morning Sickness ... Motion Sickness Relief Products - Motion Sickness Facts, Motion Sickness Links. Sea Sickness Relief Products - Sea Sickness ... Relief Band - Motion Sickness, Sea Sickness, Seasickness, seasickness. Humminbird Fishin Buddy - Humminbird Fishin Buddy fish ...
43% of those on the drug had symptoms of altitude sickness.. 69% of those on the placebo had similar issues, showing the drug ... Kilimanjaro Climbers Underestimate The Risks Of Potentially Fatal Altitude Sickness Researchers from UKs Edinburgh University ... New Medicated Chewing Gum Can Prevent Motion Sickness Individuals with motion sickness may receive more benefits from a newly ... much like the altitude sickness itself.. Lipman says : "We suggest that availability alone makes ibuprofen an appealing drug ...
Altitude sickness, acute reaction to a change from sea level or other low-altitude environments to altitudes above 8,000 feet ( ... In 1878 French physiologist Paul Bert demonstrated that the symptoms of altitude sickness are ... 2,400 metres). Altitude sickness was recognized as early as the 16th century. ... Altitude sickness, also called mountain sickness, acute reaction to a change from sea level or other low-altitude environments ...
found that small groups of men exposed to simulated altitudes of up to 4,500 meters did not exhibit significantly different ... Though my colleague Jim Ledbetter suggests a massive data-mining project to measure voting patterns as a function of altitude ... recently pondered the possibility that flying at high altitudes makes one more likely to cry at cheesy movies. ( ... More direct attempts to measure the effect of altitude on emotions have not found strong correlations; a ...
Some people are more susceptible to altitude sickness, a condition caused by exposure to low oxygen levels at high altitude. ... leisure and sport to making permanent homes at altitude. ... There are many reasons why people ascend to high altitudes, ... Forms of Altitude Sickness. The most dangerous consequences of altitude sickness are coma and death, but not all forms of ... Acute Mountain Sickness (AMS). Acute mountain sickness is typically the least life-threatening form of altitude sickness. The ...
The US Air Force recently fired (discharged) 30 junior personnel for using or selling synthetic drugs, in this case a marijuana-like item called Spice All the airmen were based at Tinker Air Force Base This is part of a trend Earlier this year, th
... acute mountain sickness (ams) is the mildest form and its very common. the symptoms can feel like a hangover - dizziness, ... High Altitude Cerebral Edema (HACE) is the most severe form of altitude sickness and happens when theres fluid in the brain. ... There are three kinds of altitude sickness:. Acute Mountain Sickness (AMS) is the mildest form and its very common. The ... What are the different types of altitude sickness?. ANSWER ... What can you do to prevent altitude sickness?. *What is iron ...
Adjust for altitude. Regardless of your physical condition, altitude sickness can strike anyone. Give yourself a couple of days ... The results speak for themselves - a 26 percent drop in the likelihood of suffering the effects of altitude sickness. ... Can Ibuprofen Fend Off Altitude Sickness?. by Kraig Becker on Mar 29, 2012. ... the over-the-counter medication ibuprofen could be an effective agent in staving off the effects of altitude sickness such as ...
Altitude sickness occurs because the oxygen levels in the air decreases with progressive increase in high elevations. This quiz ... Quiz on Altitude Sickness (Advance). Quiz on Altitude Sickness (Advance). Developed by Medindia Content Team , Health Quiz ... Ibuprofen Reduces Altitude Sickness. Ibuprofen - an anti-inflammatory drug can reduce acute altitude sickness, shows study. ... Altitude Sickness. Travellers and adventure seekers who climb or fly to high altitudes often experience severe headaches, ...
Altitude sickness includes: acute mountain sickness (AMS), high altitude cerebral edema (HACE) and high altitude pulmonary ... Acute mountain sickness is a common form of altitude illness affecting around 60% of the trekkers travelling to high altitude ... Altitude sickness is a common pathological condition in high altitude because of our bodys inability to acclimatize properly. ... "The number of patients with severe form of altitude illnesses, that is high altitude cerebral edema and high altitude pulmonary ...
The best treatment for altitude sickness is to descend to a lower altitude as quickly as possible. Getting to a lower altitude ... Extreme Altitude: above 5500 m. People facing the risk of altitude sickness would include mountain climbers, hikers, skiers, or ... Altitude (or mountain) sickness refers to the symptoms that affect people at an altitude level, usually above 8,000 feet or ... If you feel unwell at a high altitude, it is better to assume that it is altitude sickness and stop the ascent. If you only ...
... altitude sickness medicine for 4 days in the Bernese Oberland area. We will be taking trips to the Top of ... Altitude sickness medicine Id like some input on the need for (or not) altitude sickness medicine for 4 days in the Bernese ... The medicines for altitude sickness have to be tailored to your medical condition. Ask your doctor, as there can be side ... It was prescribed to me here in the States years ago for altitude sickness while skiing in CO. Only side effect was mild ...
Altitude sickness, the mildest form being acute mountain sickness (AMS), is the negative health effect of high altitude, caused ... However, in extreme cases, altitude sickness can be fatal. High altitudeEdit. At high altitude, 1,500 to 3,500 metres (4,900 to ... Acute mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, chronic mountain sickness[2]. ... People have different susceptibilities to altitude sickness; for some otherwise healthy people, acute altitude sickness can ...
Altitude Sickness - an easy to understand guide covering causes, diagnosis, symptoms, treatment and prevention plus additional ... Altitude sickness is more likely to occur in people who have a previous history of altitude sickness. It is more likely if you ... Symptoms of altitude sickness can disappear in just a few days at lower altitudes. In many cases, activities at high altitude ... The outlook for altitude sickness depends on how quickly the person can be moved to a lower altitude, and how serious their ...
A new test may help show which people are the most vulnerable to suffering sickness related to a lack of blood oxygen at ... This could help show which people may need medicinal help to enable them to operate at altitude. ... by identifying which people are the most vulnerable to contracting acute mountain sickness (AMS). ... may help Britons who travel overseas to high altitude for leisure or work reasons. ...
Can you get altitude sickness from air travel? We explain the symptoms to watch for after a flight, and risk factors that may ... What are the symptoms of altitude sickness?. Altitude sickness symptoms vary based upon the type of altitude sickness that you ... What causes altitude sickness? Altitude sickness is caused by a too-fast escalation in altitude. Thats because it takes ... Altitude sickness can vary in severity. The mildest form of altitude sickness (acute mountain sickness) can occur from flying. ...
Altitude sickness is range of related conditions that can affect you when riding on a plane as well as hiking up a mountain. ... Altitude Sickness. Altitude decompression sickness is a type of altitude sickness that affects climbers, scuba divers and ... Chronic Mountain Sickness. Another type of altitude sickness that can cause joint ache is chronic mountain sickness, or Monges ... Altitude sickness is treatable; consult your physician immediately if you are experiencing a severe form of altitude sickness. ...
... researchers have determined that high-altitude psychosis is a stand-alone medical illness, rather ... In a new study of psychotic episodes at extreme altitudes, ... rather than a condition stemming from acute altitude sickness ... In a new study of psychotic episodes at extreme altitudes, researchers have determined that high-altitude psychosis is a stand- ... that although they are indeed linked to altitude, they cannot be ascribed to a high-altitude cerebral edema, nor to other ...
... it is important to know how to prepare and for and if possible prevent altitude sickness. ... If you are planning to go away to a destination with high altitude, ... Preventing Altitude Sickness. Altitude sickness occurs when you cannot get enough oxygen from the air at high altitudes. More ... Altitude sickness is most common among those who spend time at high altitudes such as mountaineers or skiers. Thus those who ...
New tests could spare soldiers from debilitating sickness at high altitudes--and mitigate cattle deaths in the Rockies ... In many cases, the symptoms of altitude sickness are mild and dissipate after a few days. But for some people altitude sickness ... Genetic Screening Susses Out Susceptibility to Altitude Sickness. New tests could spare soldiers from debilitating sickness at ... Altitude sickness is also the scourge of entirely different population of mountain-dwellers: cows. By the time a rancher spots ...
  • Morning sickness is such an expected symptom of pregnancy that nausea and vomiting are used in movies, on television, and in books to hint at a woman's condition. (babymed.com)
  • Morning sickness is a classic symptom of early pregnancy, often unpleasant but mild and clearing up on its own by the end of the first trimester. (babymed.com)
  • Lipman's study took 86 men and women and used double-blind and placebos to look into the effects of Ibuprofen on altitude sickness. (medicalnewstoday.com)
  • Ibuprofen could be a way to prevent AMS in a significant number of the tens of millions of people who travel to high altitudes each year. (medicalnewstoday.com)
  • We suggest that availability alone makes ibuprofen an appealing drug for individuals who travel to high altitudes. (medicalnewstoday.com)
  • Can Ibuprofen Fend Off Altitude Sickness? (gadling.com)
  • Ibuprofen - an anti-inflammatory drug can reduce acute altitude sickness, shows study. (medindia.net)
  • Packing ibuprofen is an also an asset for aches and pains brought on by high altitudes. (trails.com)
  • Ibuprofen, an anti-inflammatory medication often used as a painkiller, was found to significantly reduce the incidence of altitude sickness in a double-blind, placebo-controlled trial of 86 men and women, according to the study, published online March 20 in Annals of Emergency Medicine . (stanford.edu)
  • Of the 44 participants who received ibuprofen, 19 (43 percent) suffered symptoms of altitude sickness, whereas 29 of the 42 participants (69 percent) receiving placebo had symptoms, according to the study. (stanford.edu)
  • In terms of the medicines available to treat altitude sickness, it's advisable that you are given some ibuprofen and plenty of liquids to keep you hydrated. (harcourthealth.com)
  • Taking Ibuprofen to Avoid Altitude Sickness? (healthworkscollective.com)
  • The study showed that of the group taking prophylactic ibuprofen ( and remember that statistically, only 25% of individuals at altitude are taken ill with AMS ) significantly lowered the instances of altitude sickness by nearly 30% ! (healthworkscollective.com)
  • Those taking ibuprofen prophylactically not only had a significantly lower occurrence of altitude sickness, but the symptoms of those who did get sick were also less severe than those taking the placebo. (healthworkscollective.com)
  • Ibuprofen is both fast and effective, and is much cheaper than most well-known prescription medications used to avoid altitude sickness. (healthworkscollective.com)
  • Altitude sickness can be prevented by taking Ibuprofen according to research published in the Annals of Emergency Medicine. (z6mag.com)
  • A small study of 86 men and women was conducted in California's White Mountains for two nights and found that people who took four 600-milligram doses of ibuprofen over a 24-hour period in which they went up to 12,570 feet above sea level were less likely to get altitude sickness compared to those taking a placebo. (z6mag.com)
  • Ibuprofen can increase the amount of space above you by increasing the altitude at which your body is now tolerant to your environment," Dr Grant Lipman said. (z6mag.com)
  • i) The best treatment for altitude sickness is to descend to a lower altitude as quickly as possible. (infobarrel.com)
  • The mainstay of treatment for altitude sickness is descent. (theuiaa.org)
  • The main treatment for altitude sickness is simple: Get to lower elevation. (vaildaily.com)
  • The best treatment for altitude sickness is to go to a lower altitude. (johnstonhealth.org)
  • For more than a decade, medical professionals have debated the efficacy of Viagra as a treatment for altitude sickness as well as its potential role - if any - in enhancing athletic performance at higher elevations. (accessrx.com)
  • It's normal to be a bit apprehensive, but once you've learned our expert tips on how to avoid altitude sickness, we hope you'll feel a bit better about planning a trip to Peru. (southamerica.travel)
  • To enjoy your trip to its fullest, follow these simple tips to avoid altitude sickness. (southamerica.travel)
  • See the post on How to Avoid Altitude Sickness for more detail. (yowangdu.com)
  • If preventative measures fail, you'll need to know how to treat altitude sickness. (howstuffworks.com)
  • However, studies have shown that generic Viagra can also be used to successfully treat altitude sickness. (iservepharmacy.com)
  • To understand how this medication can treat altitude sickness, it's important to see what causes this condition. (iservepharmacy.com)
  • I discovered that since my last article on natural ways to treat altitude sickness, the published medical literature has remained confusing. (denvernaturopathic.com)
  • There are several pharmacological and non-pharmacological measures that can be taken to prevent acute altitude sickness. (news-medical.net)
  • for some otherwise healthy people, acute altitude sickness can begin to appear at around 2,000 metres (6,600 ft) above sea level, such as at many mountain ski resorts, equivalent to a pressure of 80 kilopascals (0.79 atm). (wikipedia.org)
  • GLENWOOD SPRINGS - A 20-year-old woman from Pennsylvania died almost two weeks ago on her way to Conundrum Hot Springs near Aspen after suffering from acute altitude sickness, according to her mother. (vaildaily.com)
  • You are more likely to suffer from altitude sickness if you have had it before. (trails.com)
  • Why do some people from a similar age and background suffer from altitude sickness while others do not even while ascending at the same rate to high altitude? (theuiaa.org)
  • Even though getting Viagra could be the answer to high-altitude athletes that suffer from altitude sickness, other safe measures should be practiced, such as slow ascending, avoiding any activity that requires physical effort, not drinking alcohol 24 hours after reaching high altitudes. (iservepharmacy.com)
  • Not all dogs suffer from altitude sickness, and this problem is only an issue if the dog needs to climb mountains or fly. (k99.com)
  • that is to say, that although they are indeed linked to altitude, they cannot be ascribed to a high-altitude cerebral edema, nor to other organic factors such as fluid loss, infections or organic diseases," said researcher Hermann Brugger, head of the Institute of Mountain Emergency Medicine at Eurac Research. (psychcentral.com)
  • Decrease salt because salt causes your body to retain fluid which increases the severity of altitude sickness. (takingthekids.com)
  • Interestingly, young people are somewhat more predisposed to the development of AMS especially when they scale high altitudes with more rapid ascent and have greater exertional levels on reaching the altitude as they are fit and are able to perform greater physical activities upon reaching the altitude. (ezyhealth.com)
  • Moreover, the brain can also swell (know as high altitude cerebral oedema (HACO), making it difficult for the individual to coordinate his physical movements. (infobarrel.com)
  • This sickness affects close to half of all people who begin near to sea level and climb to 14,000 feet of elevation without scheduling enough rest time. (drugs.com)
  • It is more likely if you climb quickly, if you exercise vigorously during your first few days of altitude exposure, and if you have been living at low elevation prior to your climb. (drugs.com)
  • Usually after 2700m, not to climb more than 400m from the previous night's sleeping altitude would be a reasonable recommendation. (theuiaa.org)
  • If you climb slowly and give your body time to adapt you should feel fine and not get altitude sickness. (howstuffworks.com)
  • It is fine to climb higher during the day and then reduce altitude to sleep (the preferred acclimatization method), but don't go so high that AMS symptoms appear. (backpacking.net)
  • Both groups took their tablets (600mg) before, during and as well as after the study, which had them climb from an altitude of 4,100 feet to 12,570 feet over the course of two days and one night. (healthworkscollective.com)
  • Precisely because of this, researchers believe that generic Viagra can significantly help with altitude sickness. (iservepharmacy.com)
  • People often wonder, what can I drink to help with altitude sickness in Peru? (southamerica.travel)
  • Greetings, all, Does anyone know of herbs or home remedies that help with altitude sickness? (healingwiseforum.com)
  • The most dangerous consequences of altitude sickness are coma and death, but not all forms of altitude sickness are equally dangerous. (news-medical.net)
  • Descent, descent and descent is the only treatment of these severe forms of altitude illnesses. (thehimalayantimes.com)
  • While AMS can certainly ruin a vacation in the mountains, there are more serious forms of altitude sickness that can be life-threatening. (life-enhancement.com)
  • While the effects of AMS are similar to a hangover and typically do not require medical treatment, AMS is a warning sign that you are at a heightened risk of experiencing more serious forms of altitude sickness. (internal-medicine-centers.com)