Characteristics of age-related changes in blood pressure, oxyhemoglobin saturation, and physique in Bolivians residing at different altitudes: presentation of basic data for health promotion

High-altitude effect on corneal endothelial cells and prognosis in patients with cataract surgeries: a propensity score matched analysis

AIM

To compare analysis of the impact of high altitude on corneal endothelial cells, and the prognosis in patients with cataract surgeries.

METHODS

Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022 (average altitude=3000 m), and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included. The propensity score matching (PSM) method was applied to match the basic information of patients in both regions on a 1:1 basis. Corneal endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell ratio (HEX), duration of surgery, and pre- and postoperative visual acuity (VA) were compared retrospectively, and correlation tests were done.

RESULTS

Totally 223 pairs have been matched successfully. The HEX in the plateau group was higher than that in the plain group (61.95%±6.191% vs 44.91%±6.829%, P<0.001). For ECD and CV, no significant differences were observed between both groups (P>0.1). The pre- and postoperative VA of patients with cataract surgeries in the plateau group were lower (1.40±0.610 vs 0.71±0.514, P<0.001 & 0.68±0.479 vs 0.18±0.259, P<0.001), and the duration of surgery was longer than those in the plain group (27.06±14.900 min vs 16.03±8.033 min, P<0.001). No significant associations were found between the post-operative VA and the corneal endothelial parameters (P>0.05), while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery (P<0.05).

CONCLUSION

The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells, but may lead to the compensatory increase of their functions. In plateau patients, no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.

Nocturnal hypoxemia, blood pressure, vascular status and chronic mountain sickness in the highest city in the world

INTRODUCTION

Chronic mountain sickness (CMS) is a condition characterized by excessive erythrocytosis in response to chronic hypobaric hypoxia. CMS frequently triggers cardiorespiratory diseases such as pulmonary hypertension and right or left heart failure. Ambient hypoxia might be further amplified night-time by intermittent hypoxia related to sleep-disordered breathing (SDB) so that sleep disturbance may be an important feature of CMS. Our aim was to characterize in a cross-sectional study nocturnal hypoxaemia, SDB, blood pressure (BP), arterial stiffness and carotid intima-media thickness (CIMT) in highlanders living at extreme altitude.

METHODS

Men aged 18 to 55 years were prospectively recruited. Home sleep apnoea test, questionnaires (short-form health survey; Montreal cognitive assessment; Pittsburgh Sleep Questionnaire Index and the Insomnia severity index), 24-h ambulatory BP monitoring, CIMT and arterial stiffness were evaluated in 3 groups: i) Andean lowlanders (sea-level); ii) highlanders living at 3,800 m and iii) highlanders living at 5,100 m. Analyses were conducted in sub-groups according to 1) CMS severity 2) healthy subjects living at the three different altitude.

RESULTS

Ninety-two males were evaluated at their living altitudes. Among the 54 highlanders living at 5,100 m, subjects with CMS showed lower mean nocturnal oxygen saturation (SpO₂), SpO₂ nadir, lower pulse wave velocity and higher nocturnal BP variability than those with no-CMS. Lower nocturnal SpO₂ nadir was associated with higher CMS severity (ß= -0.14, p=.009). Among the 55 healthy subjects, healthy highlanders at 5,100 m were characterized by lower scores on quality of life and sleep quality scales and lower mean SpO₂ compared to lowlanders.

CONCLUSIONS

Lower nocturnal SpO₂ and higher nocturnal BP variability are associated with CMS severity in individuals living permanently at high altitude. The role of lower SpO₂ and higher nocturnal BP variability in the cardiovascular progression of CMS and in the overall prognosis of the disease need to be evaluated in further studies.

Effects of gender and grade on differences in physiotherapy students' interest and reasons for participating in overseas volunteer programs

[Purpose] The purpose of the present study was to evaluate the gender and grade differences in interest and reasons associated with overseas volunteer participation among physiotherapy students using a cross-sectional survey. [Participants and Methods] The participants were 1,093 physiotherapy students who were enrolled at the International University of Health and Welfare's Ohtawara, Narita, Odawara, and Fukuoka campuses in 2017. A cross-sectional design was used to study the differences between gender and among undergraduate grade levels. The degree of interest and reasons associated with overseas volunteer participation were evaluated by a questionnaire survey using a four-point scale. [Results] Female students were significantly more interested and active in overseas volunteer participation than male students. As for participation by students' grades, significant differences were found in three items only among female students. [Conclusion] Female students were significantly more active at volunteering than male students. It was suggested that we need to encourage students to engage in overseas volunteer participation from the time of admission, especially female students.