Composición corporal, parámetros bioeléctricos y fuerza de prensión manual en escaladores chilenos federados y recreativos / Body composition, bioelectrical parameters, and handgrip strength in federated and recreational Chilean climbers

RESUMEN: El objetivo del siguiente estudio fue determinar y comparar los valores de composición corporal, parámetros bioeléctricos y fuerza de prensión manual de escaladores chilenos federados y recreativos. Participaron voluntariamente 13 escaladores chilenos, de los cuales 4 eran federados (25,75 ± 2,87 años) y 9 recreativos (22,33 ± 1,41 años). La composición corporal se evaluó por medio de un impedanciómetro bioeléctrico octopolar multifrecuencia, mientras que la fuerza de prensión manual se determinó con un dinamómetro manual. Si bien no hubo diferencias en las variables de composición corporal entre ambos grupos, el ángulo de fase del tronco fue superior en los federados en comparación a los recreativos (p = 0,011 [95 % IC = 1,10; 5,20]). Respecto a la fuerza de prensión manual, la fuerza relativa fue superior para los federados (p = 0,025 [95 % IC = 0,10; 0,22]), mientras que la diferencia de la fuerza entre la mano dominante y no dominante fue mayor para los recreativos (p = 0,012 [95 % IC = 1,60; 10,05]). Este es uno de los primeros estudios que explora las diferencias entre escaladores chilenos federados y recreativos. Los resultados sugieren una diferenciación a nivel de ángulo de fase y fuerza de prensión manual, lo cual debería corroborarse con futuros estudios.

SUMMARY: This study aimed to determine and compare the body composition, bioelectric parameters, and handgrip strength in federated and recreational Chilean climbers. Thirteen Chilean climbers voluntarily participated, being 4 federated (25.75 ± 2.87 years) and 9 recreational (22.33 ± 1.41 years). Body composition was measured using a multifrequency octopolar bioelectrical impedance meter, while handgrip strength was determined with a dynamometer. Although there were no statistical differences in the body composition variables between groups, the trunk phase angle was statistically higher in the federated compared to the recreational climbers (p = 0,011 [95 % CI = 1,10; 5,20]). Regarding handgrip strength, the relative strength was higher for federated (p = 0,025 [95 % CI = 0,10; 0,22]), while the difference in strength between dominant and non-dominant hand was higher for recreational climbers (p = 0,012 [95 % CI = 1,60; 10,05]). This study is one of the first that explore the differences between federated and recreational Chilean climbers. These results suggest a differentiation at the level of phase angle and handgrip strength, which should be corroborated in future studies.

Profiling and predicting performance of indoor rock climbers / Perfil e predição do desempenho de escaladores indoor

Abstract The aim of this study is to establish somatotype and profile the anthropometric and biomotor characteristics of indoor rock climbers. Fourteen elite level male and ten recreational female Iranian indoor rock climbers completed a battery of tests. All anthropometric measurements were performed according to the recommendations of international standards for anthropometric assessment. Upper body strength and endurance were assessed by isometric tests. Explosive power and balance were also evaluated by Sargent jump and Star Excursion Balance Test (SEBT), respectively. Samples' somatotypes were calculated by the method of Heath and Carter. Pearson's correlation coefficient and partial correlations were calculated and stepwise multiple regression analyses were implemented to determine a set of best predictors of elite male climbers' ability. Shoulder width, body fat content, upper-body strength and endurance for females, showed the most correlation with the climbing ability (range: r = 0.46-0.7, p ≤ 0.05), while among the male samples, these correlations with the climbing ability were mostly between WHR, absolute and relative to body mass handgrip strength, SEBT performance and the left-hand digit ratio. The results of stepwise multiple regression revealed that the SEBT performance in the posterior direction of right foot stance and Upper Extremity Girth Index are able to explain 62% of the variance of climbing ability. It is likely that decreasing the fat mass has no direct impact on the climbers' performance. Also, SEBT performance is able to predict 35% of climbing performance. Hence, it seems balance exercises could be effective in improvement of climbing performance.

Resumo O objetivo do estudo foi estabelecer o somatotipo, o perfil antropométrico e neuromotor de escaladores indoor. Quatorze atletas do sexo masculino de elite e 10 atletas recreacionais do sexo feminino do Irã da modalidade escalada indoor participaram da pesquisa. Todas as medidas antropométricas foram coletas conforme padronizações internacionais. Força e resistência dos membros superiores foram avaliadas por teste isométrico. Força explosiva e equilíbrio foram avaliados pelos testes Sargent jump e Star Excursion Balance (SEBT), respectivamente. O somatotipo foi calculado pelo método Heath e Carter. O coeficiente de correlação de Pearson, correlações parciais e a análise de regressão múltipla foram utilizados. Largura do ombro, percentual de gordura corporal, força e resistência dos membros superiores para as mulheres apresentaram correlação positiva com a capacidade de escalar (ranque: r = 0,46-0,70, p ? 0,05). Para os homens, a habilidade de escalar foi associada com a razão cintura estatura, força de preensão manual absoluta e relativa à massa corporal, ao equilíbrio e a proporção digital da mão esquerda. O desempenho no SEBT e o índice de circunferência dos membros superiores tiveram o poder de explicar 62% na variação da capacidade de escalar. É provável que diminuir a massa de gordura não tenha impacto direto no desempenho dos escaladores. Além disso, o desempenho do SEBT é capaz de prever 35% do desempenho de escalada. Portanto, parece que os exercícios de equilíbrio podem ser eficazes na melhoria do desempenho de escalada.

Montanhismo e impacto ambiental: investigando os praticantes ocasionais do Rio de Janeiro / Mountaineering and environmental impact: researching the occasional practitioners of Rio de Janeiro

O objetivo deste estudo foi investigar a relação entre o montanhismo e a conservação ambiental na cidade do RJ, mais especificamente, no complexo do Pão-de-Açúcar. A metodologia utilizada na pesquisa foi a observação participante e a análise de conteúdo, por meio de entrevistas com os interlocutores. O que se pode perceber, por meio dos discursos dos montanhistas ocasionais, foi uma busca pelo mínimo impacto e uma acusação da massificação dos usos dos espaços como responsável pelos impactos ambientais. Estes discursos foram relacionados, como modos de legitimização da prática, através da categoria "estilo de vida" que é extensão das preocupações ambientais para outras esferas da vida dos montanhistas.

The objective of this study was to investigate the relationship between mountaineering and environmental impact in the city of Rio de Janeiro, more specifically, in the Sugar Loaf complex. The methodology applied in the research was the participant observation and the content analysis, through interviews with the interlocutors. What can be perceived in the speeches of the occasional mountaineers was the search for minimum impact and the accusation that the mass use is responsible for the environmental impacts. These speeches are related as kinds of practice legitimation, through the category "lifestyle", a extension of environmental concern to other spheres of life of the climbers.

Physiological transition threshold in mountain runners: a systematic review / Limiares de transição fisiológica em corredores de montanhas: uma revisão sistemática

Abstract The identification of physiological transition thresholds (TT) is commonly used for prescribing and evaluating the performance of endurance athletes; however, the methods need further investigation in mountain runner athletes. The aim of the present review was to analyze the different methods used to determine TT in mountain runners. After analyzing 1,176 articles found in different databases, 4 articles that presented a relationship with the theme were selected. Varied proposals were observed, in which the surveys searched for physical and/or cardiorespiratory performance, as well as the effect of acclimatization and training at different altitudes in mountain runners. All studies used spirometry to identify the anaerobic threshold through visual methods and a relative mean intensity in thresholds occurred at 80 - 90% of VO2max. The results of studies analyzed evidenced the limited use of methodologies in the identification of exercises for training evaluation and prescription, as well as the use of effective and low-cost alternative methods to determine these thresholds in mountain runners.

Resumo A identificação dos limiares de transição fisiológica (LT) é comumente utilizada para prescrição e avaliação do desempenho de atletas de endurance, no entanto, os métodos precisam de maiores investigações em atletas corredores de montanhas. O objetivo da presente revisão foi analisar os diferentes métodos utilizados para a determinação dos LT em corredores de montanhas. Após a análise de 1176 artigos encontrados em diferentes bases de dados, foram selecionados 4 artigos que apresentaram relação com o tema. Pode-se observar propostas variadas, nas quais as pesquisas buscaram investigar o desempenho físico e/ou cardiorrespiratório, bem como o efeito da aclimatização e treinamento em diferentes altitudes nos corredores de montanhas. Todos os artigos utilizaram a espirometria para a identificação do limiar anaeróbio, através de métodos visuais e a intensidade média relativa nos limiares ocorreu próxima a valores de 80 - 90% VO2máx. Os resultados dos estudos analisados evidenciam o uso limitado de metodologias na identificação dos LT para a avaliação e prescrição de treinamento, bem como a utilização de métodos alternativos eficazes e de baixo custo para a determinação destes limares em atletas corredores de montanhas.

La técnica en la escalada deportiva: una revisión / The technique in the sport climbing: a review

La escalada puede ser definida como una serie de movimientos acíclicos que buscan un desplazamiento del centro de gravedad, manteniendo el equilibrio tanto de forma estática como dinámica. Considerando esta premisa, la técnica deportiva se vuelve fundamental para el logro de este objetivo. La siguiente revisión busca mostrar los avances en los últimos diez años respecto a la técnica y la escalada deportiva. Fueron consultadas cinco bases de datos online considerando los términos “Escalda deportiva”, “Técnica” y “Biomecánica”.Como resultados de la búsqueda fueron encontrados tan solo nueve artículos originales, los cuales a pesar de incluir la técnica de escalada como una variable a considerar en relación a otros parámetros de diversa índole, no logran entregar una descripción adecuada de técnica en escalada deportiva, limitándose a posicionamientos corporales o formas de tomar agarres específicos, sin describir fases u objetivos de las mismas. Queda como tarea hacia el futuro, establecer bases en cuanto a la técnica en la escalada deportiva, considerando comenzar por definir un modelo técnico a nivel nacional que entregue la posibilidad de avanzar de forma estructurada y secuencial en el desarrollo de la técnica deportiva para la escalada y todas las variables implicadas para la mejora de los rendimientos en nuestros deportistas de la mano de la ciencia y la experiencia.

Climbing may be defined as a series of acyclic movements reaching for displacement of the center of gravity, keeping the balance when being both, static and dynamic. Given this premise, sport technique becomes critical to achieving this goal. The following review seeks to show the progress in the last ten regard the sport climbing. Five online databases were consulted including on the words “Sport climbing”, “Technique” and “Biomechanics”. As search results were found only nine original articles, which despite consider climbing technique as a variable to be considered in relation to other parameters of many types, fail to provide an adequate description of technique in sport climbing, limiting just to body positions or ways of taking specific grips, regardless stages or targets. It is the task ahead, to establish bases in terms of technique in sport climbing, considering to start by defining a national technical model that gives the chance to develop in a structured and sequentially way in the sport climbing technique and all the variables involved for improving yields in our athletes with the science and experience as guides.

El trekking en el trayecto formativo de profesores de educación física: integrando el enseñar, aprender y enseñar a enseñar en la formación profesional / The trekking during physical education in the way the training of teachers: integrating the teaching, learning and teaching to teach professional formation

El presente artículo se enmarca en el proyecto de investigación “El andinismo en la Educación Física: seguridad, enseñanza y formación docente” (B169) desarrollado en el Centro Regional Universitario Bariloche dependiente de la Universidad Nacional del Comahue. Dicho proyecto toma como principal foco de estudio las asignaturas del Profesorado de Educación Física vinculadas con la Orientación Actividades de montañismo y escalada a fin de indagar sobre los procesos de enseñanza y aprendizaje que en ellas se llevan a cabo. En esta oportunidad se comparten avances relacionados con el trekking y su enseñanza en la formación de Profesores de Educación Física. Se analizan programas de cátedra y entrevistas realizadas a profesores, asistentes y ayudantes con el objetivo de identificar propósitos, estrategias de enseñanza, secuencia de contenidos y selección de itinerarios que promuevan en el estudiante la apropiación de la actividad, el conocimiento del medio en el cual se realiza y la transferencia de contenidos a otros contextos educativos.A partir de la revisión de marcos teóricos se define conceptualmente al trekking e identifican variables que otorgan rasgos particulares al desarrollo de la actividad. Se establecen categorías que denotan grados de complejidad a fin de visualizar y establecer criterios para la elección de opciones posibles de ser implementadas de manera segura y responsable en distintos ámbitos de la educación formal y no formal.

This article is part of the research project "The andinism in Physical Education: safety, education and teacher training" (B169) developed at the Centro Regional Universitario Bariloche dependant of the Universidad Nacional del Comahue. The project has its main focus of study on the subjects in the Faculty of Physical Education related to climbing and mountaineering orientation, to investigate the processes of teaching and learning that take place. On this opportunity, advances related to trekking and its teaching in the training of physical education teachers are shared. Academic programs and interviews with teachers, assistants and aides are analyzed with the objective of identifying purposes, teaching strategies, contents sequences and choice of itineraries that promote in the student the appropriation of the activity, the knowledge of the environment in which is performed and the transference of contents to other educational contexts. From the review of theoretical frameworks “the trekking” is conceptually defined and variables that give particular features to the development of the activity are identified. Categories indicating degrees of complexity to visualize and establish criteria for the choice of possible options to be implemented safely and responsibly in different areas of formal and non-formal education are established.

Muscular Injury of Iliacus and Gluteus Maximus after Mountain Climbing / 대한스포츠의학회지

Iliacus muscle is the strongest hip flexor of gluteal region that acts with psoas muscle, whereas gluteus maximus muscle is the largest muscle engaged in extension and external rotation of the hip. Mountaineering requires strong contractile force of both flexor and extensor around the hip. A 57-year-old man presented to our hospital with severe pain in left groin after mountaineering for 5 hours without a break. Magnetic resonance imaging revealed incomplete rupture of iliacus muscle and strain of gluteus maximus muscle. Conservative treatment was done. At 3 months of follow-up, he returned to normal life. If we are going to climb mountain, it is important to start warming up with some stretches, take a break while climbing, and use climbing sticks. There have been no report about athletic injury of both iliacus and gluteus maximus after mountaineering. So we report this case with a review of the literature.

Multi-domain cognitive screening test for neuropsychological assessment for cognitive decline in acclimatized lowlanders staying at high altitude.

Background & objectives: Ascent to high altitude has been reported to cause hippocampal atrophy and cognitive impairment in mountaineers. We assessed the cognitive performance and probable occurrence of mild cognitive impairment (MCI) in acclimatized lowlanders (ALL) staying at altitudes above 4,300 m for duration above 12 months and validated a multi-domain cognitive screening test (MDCST) for future demographic studies on MCI. Methods: Following evaluation of sensitivity and correlation of the newly developed MDCST battery with Mini Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) scores on a group of 28 individuals, the MDCST battery was validated on a population of 843 ALL staying at high altitude MSL >4,300 m and 862 subjects staying at MSL <230 m. EEG recordings were performed on 840 ALL staying at altitudes above 4,300 m and 743 control subjects staying at MSL <230 m. Results: Percentage prevalence of MCI was 4.18 per cent in the ALL population as assessed by MMSE while that of the LL population was <0.42 per cent. The percentage prevalence of MCI based on calculations from the MDCST scores was 12.4 per cent in the ALL population as compared to 1.19 per cent in the LL population. Decrease in alpha wave amplitude at the T3 and T4 sources in MCI subjects was observed in LL group while there was an increase in amplitude for alpha wave in these regions in the ALL groups. Domain specific MDCST showed decline in immediate recall, procedural memory and mind body co-ordination which was negligible in the LL population. Interpretation & conclusions: MDCST exhibited excellent psychometric properties in terms of sensitivity, and test-retest reliability qualifying it to be used as a more effective cognitive measure for assessment of MCI in demographic studies in comparison to traditional measures. Our findings also showed increased prevalence of MCI in ALL population staying for longer durations at high altitude which is neurophysiologically distinct from MCI leading to Alzheimer's disease.

Somatotipo, masa grasa y muscular del escalador deportivo Español de elite / Somatotype, fat and muscle mass of elite Spanish climbers

Una adecuada morfología y composición corporal es una condición necesaria para obtener buenos resultados en el deporte de competición y una variable fundamental en el control del rendimiento deportivo. El objetivo del presente trabajo fue describir la masa grasa, la masa muscular y la morfología corporal de 11 escaladores deportivos de elite españoles, en base a métodos antropométricos para la composición corporal (ecuaciones de Faulkner, Carter y Durnin & Womersley) y el somatotipo (Heath & Carter) y de bioimpedancia eléctrica para la masa muscular (ecuaciones de Janssen & Kyle). Un análisis de la varianza (ANOVA) fue aplicado para determinar las diferencias entre las diferentes fórmulas de cálculo del porcentaje de grasa. El porcentaje de grasa obtenido a partir de las ecuación de Durnin & Womersley fue significativamente superior respecto al obtenido con la ecuación de Carter en hombres (7,51 por ciento v/s 5,42 por ciento) y al de Faulkner en mujeres (14,4 por ciento v/s 12,58 por ciento; p<0,05). La masa muscular esquelética fue superior en los hombres (45,52 por ciento) que en las mujeres (34,28 por ciento). Del somatotipo destacó el alto componente mesomórfico y la baja endomorfia en varones (1,34 - 5,22 - 3,05) y el morfotipo ectomesomorfo en mujeres (1,65 - 3,35 - 3,71). Los resultados del presente estudio pueden considerarse como valores de referencia en base al alto nivel deportivo de los sujetos estudiados.

Somatotype and body composition is a necessary assessment in sports competition and training control. The purpose of this work was to determine the fat mass, the muscle mass and anthropometric somatotype of 11 sport climbers by means of anthropometric methods for body composition (Faulkner, Carter and Durnin & Womersley algorithms), anthropometric somatotype (Heath-Carter), and bioelectrical impedance analysis for muscle mass (Janssen and Kyle formulae). Analysis of variance (ANOVA) was performed to determine differences among fat percentages. Fat percentage obtained via Durnin & Womersley's equation was different versus Carter's equation in males (7.51 percent v/s 5.42 percent) meanwhile in females this percentage was different respect to Faulkner's equation (14.4 percent versus 12.58 percent; p<0.05). Muscle mass percentage in males (45.52 percent) was higher than in females (34.28 percent). In males the somatotype was endo-mesomorphic (1.34 - 5.22 - 3.05), whereas females were best described as mesoectomorphic (1.65 - 3.35 - 3.71). These results can be considered as a reference values in body composition and somatotype in elite climbers.

Representações sociais e instituição da realidade no subcampo esportivo do montanhismo: uma possibilidade de leitura sociológica a partir da obra "Sobre homens e montanhas" de Jon Krakauer / Social representations and reality's institucion on sporting subfield of mountaineering: a possibility of sociologic reading from the composition

Os objetivos nos quais se pautou a construção do presente artigo conduzem, de um lado, a identificar algumas representações sociais presentes no universo do montanhismo e, de outro, entender a forma como essas mesmas representações, em meio à luta e à concorrência, contribuem para a construção da realidade social nesse universo empírico delimitado. Para o desenvolvimento dessa proposta buscou-se suporte teórico-metodológico na sociologia reflexiva de Pierre Bourdieu, sobretudo em sua forma adquirida e explicitada na construção da teoria das representações sociais, da economia dos bens simbólicos e dos lucros de distinção no campo esportivo. Por fim, substanciou-se ainda nas considerações empíricas tecidas pelo alpinista e escritor Jon Krakauer em seu best-seller "Sobre homens e montanhas".

The objectives in which the construction of the present article were based lead, from a side, to identify some social representations present in the mountaineering universe and, on the other, to understand the form like the same representations, in the struggle and the competition contribute to the construction of social reality in this delimited empirical universe. For the development of this proposal it was sough metodological support in the reflexive sociology of Pierre Bourdieu, especially in his acquired and explicated form in the construction of the social representations theory, of the economy of the symbolic goods and of the profits of distinction in the sporting field. Finally, it was still nourished in the empirical considerations woven by the mountaineer and writer Jon Krakauer in his best seller "On men and mountains".

Seres Humanos e Natureza: o lazer como mediação / Human Beings and the nature: leisure as mediation

Este estudo objetivou responder a seguinte questão: os aspectos do mundo do trabalho se transferem para o mundo do lazer? Para tanto, analisamos a relação entre seres humanos e natureza, especialmente por meio de uma prática corporal de aventura na natureza específica - o montanhismo. O estudo constituiu-se de caráter qualitativo: buscou compreender e descrever uma realidade social concreta. Para coleta de dados foi utilizada a entrevista semiestruturada. Observamos que relações estabelecidas no mundo do trabalho se disseminam para o mundo do lazer no grupo estudado, ampliando a alienação típica do trabalho nas sociedades de ordem capitalista para outras dimensões da vida humana; mas também observamos que, dialeticamente, as experiências realizadas no montanhismo, geram novos significados e valores para a vida, os quais se disseminam e "contaminam" positivamente o mundo do trabalho.

is study aimed at answering the following question: do aspects from the world of work transfer to the world of leisure? In order do so, the relation between nature and human beings was analyzed, especially through a specific adventurous body practice in nature - the mountaineering. This study has a qualitative character: its main purpose was to comprehend and describe a concrete social reality. The data collection was based on semi-structured interview. We could realize that the relations established in the work world disseminate to the leisure world in the group studied, which amplifies the typical work alienation in capitalist societies to other dimensions of human life; on the other hand, we also observed that, dialectically, the experiences performed in mountaineering generate new meanings and values to life, which disseminate themselves and positively "contaminate" the world of work.

Efeitos da exposição à altitude sobre os aspectos neuropsicológicos: uma revisão da literatura / Effects of exposure to altitude on neuropsychology aspects: a literature review

OBJETIVO: Discutir os efeitos da exposição à altitude sobre as funções neuropsicológicas. MÉTODO: Foi realizada uma revisão de literatura usando como fonte de pesquisa artigos indexados no Pubmed, no período de 1921 a 2008, utilizando as palavras-chave "cognition and hypoxia", "hypoxia and neuropsychology", "acute hypoxia", "chronic hypoxia" e "acclimatization and hypoxia", além de livros específicos do assunto. DISCUSSÃO: Os efeitos agudos e crônicos da hipóxia podem alterar inúmeras funções neuropsicológicas em diferentes altitudes, decorrentes de alterações fisiológicas que resultam da diminuição parcial de oxigênio (O2), que podem levar as alterações neuropsicológicas, como atenção, memória, tomada de decisão e demais funções executivas, em indivíduos expostos a grandes altitudes. CONCLUSÃO: Indivíduos que se expõem às grandes altitudes devem utilizar suplementação de O2 e prática de aclimatização, entre outras estratégias para minimizar os efeitos negativos da hipóxia nos aspectos neuropsicológicos.

OBJECTIVE: Discuss the effects of altitude exposure on neuropsychological functions. METHOD: We have conducted a literature review using as source indexed articles at Pubmed in the period from 1921 to 2008, using the following key words: "cognition and hypoxia", "hypoxia and neuropsychology", "acute hypoxia", "chronic hypoxia", and "acclimatization and hypoxia", as well as specific books on the subject. DISCUSSION: Acute and chronic effects of Hypoxia can alter many of the neuropsychological functions in different altitudes due to physiological changes resulted by the oxygen (O2) partial decrease that can lead to neuropsychological alterations in individuals exposed to high altitudes. CONCLUSION: Individuals exposed to high altitudes must use an O2 supplementation and the practice of acclimatization, among other strategy ways that can be used in order to minimize the negative effects of hypoxia on neuropsychological aspects.

Ejercicio y la detección del mal agudo de montaña grave / Exercise and the detection of severe acute mountain sickness

El mal agudo de montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2.700 m y 4 300 m en 63 sujetos que ascendían al cerro Aconcagua (6 962 m). Se consideró desaturación de oxígeno con ejercicio a una disminución = 5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. Seis sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2.700 m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2.700 m más la saturación inapropiada en reposo a 4.300 m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave.

Acute mountain sickness (AMS) is a group of non-specific symptoms, seen in subjects that ascend from low to high altitude too quickly, without allowing sufficient time to acclimatize. Usually it is self-limiting, but the severe forms (pulmonary and cerebral edema) can be fatal. Exaggerated hypoxemia at rest is related to later development of AMS but its predictive value is limited. Since exercise at altitude induces greater hypoxemia and symptoms, we postulated the predictive value of a simple exercise test to prognosticate severe AMS. We studied the predictive value of the oxygen saturation during rest and sub-maximum exercise at 2.700 m and 4.300 m in 63 subjects that intended the ascent to Mount Aconcagua (6.962 m). We considered exercise oxygen desaturation to a drop of = 5% respect to the resting value. Lake-Louise Score was used to quantify the presence of severe AMS. Six subjects developed severe AMS (9.5%) and required evacuation. Resting oxygen saturation at 2.700 m was not significant to classify subjects that then developed severe AMS. The association of oxygen desaturation during exercise at 2.700 m plus inappropriate resting oxygen saturation at 4.300 m was significant to classify the subjects that then developed severe AMS with a positive predictive value of 80% and a negative predictive value of 97%. Our results are relevant for mountaineering and suggest the use of a simple exercise test in the prediction of severe AMS.

Profile of non traumatic surgical disorders found in the pilgrims/trekkers travelling to Shri Amarnath Ji cave.

BACKGROUND & OBJECTIVES: The "Shri Amarnath Ji Yatra" is an annual congregation in which the devotees trek a difficult route of around 40 km to reach to a cave at a height of approximately 14,000 feet at Pahalgam in the State of Jammu & Kashmir, India. These trekkers are subjected to stress and strain of the long mountainous route and difficult security scenario as a result of which they are prone to develop some surgical disorders. We ascertained the profile of non-traumatic surgical conditions met in these people at the various medical aid centres and the base hospital Pahalgam so that a policy could be framed to prevent these conditions. METHODS: This study was conducted at the Government Base Hospital Pahalgam, Kashmir, between June and August 2006. The patients with non traumatic surgical conditions attending the hospital were included in this study. Necessary investigations were done and patients requiring surgical intervention were operated upon. RESULTS: Of the 1,54,000 devotees who undertook the "yatra", in 2006 the personnel of the Directorate of Health Services, Kashmir, extended medical aid to 40,082 pilgrims. Of these 40,082 pilgrims, 172 were admitted on the surgical side for various non traumatic surgical disorders. The commonest cause for admission was exacerbation of acid peptic diseases. Nine emergency surgical procedures were conducted at the base hospital and the commonest cause for intervention was perforation of a duodenal ulcer. There was no mortality and the patients responded well to conservative ulcer procedures. INTERPRETATION & CONCLUSION: The stress of high altitude trekking and assembly of a large gathering of people during the annual "Amarnath Ji yatra" can pose a number of health related problems especially in the old and infirm people as was observed in the study. Pilgrims who intend taking up the yatra in future should seek medical advice prior to their departure. If a person is diagnosed to have peptic ulcer disease he or she should be put on anti-ulcer therapy to prevent potential complications.

Pulmonary function parameters changes at different altitudes in healthy athletes

Hypoxia and hypocapnia can cause broncho-constriction in human subjects, and this could have a bearing on performance at high altitude. The object of this study was to examine how pulmonary ventilatory functions during high-altitude trekking. This study is a cohort study on spirometric parameters at different altitudes. Fifty six healthy male volunteers from a university student population were enrolled in the study [ages 22.9 +/- 5.3 years]. Pulmonary function was assessed with a Spirolab II in all participants before ascending at baseline [1150 meter], after ascending at different altitudes [2850, 4150 meter], and after descending at sea level during a 3-day trek in Sialan Mount. This study indicates that in an actual trek, ascending results in significant decrease in forced vital capacity [FVC]. FVC significantly decreased with increasing altitude from baseline level and at the sea level it was significantly less than baseline level. Peak flow increased with increasing altitude from baseline [1150 m] to 2850 m and decreased with decreasing altitude [p < 0.01]. Maximal midexpiratory flow rate [FEF 25-75%] and forced expiratory volume in 1 second to forced expiratory volume ratio [FEV1.0%] significantly increased with increasing and decreasing altitude from baseline level [p < 0.001]. There was no significant change in FEV1. It could be concluded that changes in some pulmonary ventilatory parameters were proportional to the magnitude of change in altitude during a high-altitude trek. These changes are significant at the beginning of ascending

Evidence that chronic hypoxia causes reversible impairment on male fertility / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the effect of chronic hypoxia on human spermatogenic parameters and their recovery time.</p><p><b>METHODS</b>Seminological parameters of six male healthy mountain trekkers were evaluated in normoxia at sea level. After 26 days exposure to altitude (ranging from 2 000 m to 5 600 m, Karakorum Expedition) the same parameters were again evaluated after returning to sea level. These parameters were once again evaluated after 1 month and then again after 6 months.</p><p><b>RESULTS</b>Sperm count was found to be lower immediately after returning to sea level (P = 0.0004) and again after a month (P = 0.0008). Normal levels were reached after 6 months. Spermatic motility (%) shows no reduction immediately after returning to sea level (P = 0.0583), whereas after 1 month this reduction was significant (P = 0.0066). After 6 months there was a recovery to pre-hypoxic exposure values. Abnormal or immature spermatozoa (%) increased immediately after returning to sea level (P = 0.0067) and then again after 1 month (P = 0.0004). After 6 months there was a complete recovery to initial values. The total number of motile sperm in the ejaculate was found to be lower immediately after returning to sea level (P = 0.0024) and then again after 1 month (P = 0.0021). After 6 months there was a recovery to pre-hypoxic exposure values.</p><p><b>CONCLUSION</b>Chronic hypoxia induces a state of oligospermia and the normalization of such seminological parameters at the restoration of previous normoxic conditions after 6 months indicate the influence of oxygen supply in physiological mechanisms of spermatogenesis and male fertility.</p>

Analysis of Patients were Transported by 119 Helicopter from Mountain Accident Scenes in Seoul

PURPOSE: Geographic problems can make it difficult for rescue teams to access emergency patients in the mountains. We developed the aeromedical relief program in conjunction with fire department helicopter EMS teams. This study describes the clinical experience of patients transported from the mountains in this program. METHODS: We reviewed the employed protocols and the medical records of patients transported to our hospital from the mountains by the aeromedical transport system from June 2006 to June 2007. RESULTS: Thirty-one patients were transported by helicopter during the study period, most of them (84%) from Mt. Bukhan. The time interval from call for help to hospital arrival was 80+/-56 min, and rescue time alone was 30+/-24 min. Eleven patients (36%) were pronounced dead on arrival, and 11 patients were admitted for management. The number of trauma patients were 24 (77%), who had an average RTS score (excluding the 11 patients who expired before arrival) of 11.7+/-0.6. When the ground team and the aeromedical team were dispatched at the same time, the total transport time was 54.0+/-22.8 min, compared to 133.0 +/-75.7 min when the aeromedical team was dispatched only upon the request of the ground team, a large and statistically significant difference. CONCLUSION: This study suggests that the helicopter transport system can be successfully employed to achieve early access to patients in the mountains. To optimize the current program, cooperation between hospital and the regional helicopter EMS is required.

A study on the relationship between glutathione S-transferases gene polymorphism and susceptibility response to hypoxia / 中国应用生理学杂志

<p><b>AIM</b>To investigate the relationship between glutathione S-transferases gene polymorphism and susceptibility response to hypoxia.</p><p><b>METHODS</b>In the case-control study, the gene polymorphisms of glutathione S-transferases were tested in Tibetan mountaineers and sea-level Han Chinese by multiple-PCR and PCR-RELP.</p><p><b>RESULTS</b>The frequency of GSTT1 null genotype was significant different between Tibetan mountaineers and sea-level Han Chinese (P < 0.05), OR = 1.86 (95% CI = 1.01-3.39), and also for GSTP(1-105) mutant genotype in two groups (P < 0.01), OR = 2.19 (95% CI = 1.16-4.13). There was significant difference between A allele and G allele of GSTP(1-105) groups (P < 0.01). There was no difference for GSTM1 null genotype between two groups (P > 0.05), OR = 0.78 (95% CI = 0.43 - 1.42).</p><p><b>CONCLUSION</b>GSTT1 and GSTP(1-105) genotype may be associated with susceptibility response to altitude hypoxia.</p>