1
|
Kriemler S, Mateikaitė-Pipirienė K, Rosier A, Keyes LE, Paal P, Andjelkovic M, Beidleman BA, Derstine M, Pichler Hefti J, Hillebrandt D, Horakova L, Jean D. Frostbite and Mortality in Mountaineering Women: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2023; 24:247-258. [PMID: 37824760 DOI: 10.1089/ham.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Kriemler, Susi, Kastė Mateikaitė-Pipirienė, Alison Rosier, Linda E. Keyes, Peter Paal, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, and Dominique Jean; for the UIAA MedCom Writing Group on Women's Health in the Mountains. Frostbite and mortality in mountaineering women: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:247-258, 2023. Background: The harsh environment of high altitudes (HA) poses many serious health risks for mountaineers, including cold injuries and death. The aim of this work was to review whether female mountaineers are at special risk for frostbite or death at HA compared with their male counterparts. Methods: The UIAA Medical Commission convened an international author team to review women's health issues at HA and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified with additional publications found by hand search. The primary search focus was for articles assessing cold injuries and death in women mountaineers at HA. Results: We reviewed the literature and identified 20 relevant studies: 2 studies on frostbite at HA, plus 7 studies and 1 report for death at HA. An additional 10 studies about frostbite at low altitude were included. We found that female mountaineers at HA were at lower risk of death than their male counterparts, but sex differences in frostbite were inconclusive. Conclusions: The frequency of cold injuries and mortality in female mountaineers is not yet well studied, and the studies that have been published tend to lack precise exposure data. More studies and registries with sex-differentiated data are needed.
Collapse
Affiliation(s)
- Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Alison Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology, Perioperative and Intensive Care, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pediatrics, Infectious Diseases, and Altitude Medicine, Grenoble, France
| |
Collapse
|
2
|
Roger R, Kinch R, Morris M, Grebenik P. Changes in submaximal and maximal measures of cardio-respiratory fitness resulting from 6-days of mountain walking. J Sports Sci 2022; 40:2353-2358. [PMID: 36581606 DOI: 10.1080/02640414.2022.2150387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Trekking is a popular activity associated with cardiovascular benefits. The aim of the present study was to investigate changes in the submaximal heart rate, oxygen uptake, oxygen pulse, and blood lactate concentration associated with a 6-day mountain walk. Over a 12-year period, 134 male (age 21.0 ± 1.4 years) and 124 female undergraduates (age 20.8 ± 1.6 years) participated. Three days before the trek submaximal and maximal laboratory measures were made on participants walking on a motorized treadmill using a breath-by-breath system to measure oxygen uptake (VO2) during exercise. Oxygen uptake and heart rate were recorded during steady-state exercise at treadmill gradients 0, 4, 8, 12, and 16%. Measurements were made, at the same time of day, two days after the trek. There were significant improvements in both the walking economy and the relative exercise intensity (%VO2max) at submaximal treadmill gradients 0-16%. Post-trek, heart rate was lower while oxygen pulse was higher, at each treadmill gradient. There was a significant increase in the maximal oxygen uptake for men (+2.7%) and women (+2.9%). The results of the present study suggest that improvements in cardiorespiratory fitness are associated with a 6-day mountain walk with no sex difference in the exercise response. .
Collapse
Affiliation(s)
- Ramsbottom Roger
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Rhodri Kinch
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Martyn Morris
- School of Life Sciences, Coventry University, Coventry, UK
| | - Peter Grebenik
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| |
Collapse
|
3
|
Haunolder M, Apel C, Bertsch D, Cerfontaine C, van der Giet M, van der Giet S, Grass M, Heussen NM, Hundt N, Jäger J, Kühn C, Musiol S, Timmermann L, Wernitz K, Gieseler U, Morrison A, Schöffl V, Küpper T. Cardiovascular Risk Profiles and Pre-Existing Health Conditions of Trekkers in the Solu-Khumbu Region, Nepal. Int J Environ Res Public Health 2022; 19:16388. [PMID: 36554269 PMCID: PMC9779219 DOI: 10.3390/ijerph192416388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND High-altitude tourist trekking continues to grow in popularity on the Everest Trek in Nepal. We examined which pre-existing cardiovascular and health conditions these global trekkers had and what health issues they encountered during the trek, be it exacerbations of pre-existing conditions, or new acute ones. METHOD Trekkers (n = 350) were recruited from guesthouses along the Everest Trek, mostly at Tengboche (3860 m). After completing a questionnaire on their health and travel preparation, they underwent a basic physical examination with an interview. RESULTS Almost half (45%) had pre-existing conditions, mostly orthopaedic and cardiovascular diseases. The average age was 42.7 years (range 18-76). The average BMI was 23.4 kg/m2, but 21% were overweight. A third were smokers (30%), and 86% had at least one major cardiovascular risk factor. A quarter (25%) were suffering from manifest acute mountain sickness (AMS), and 72% had at least one symptom of AMS. Adequate pre-travel examination, consultation, and sufficient personal preparation were rarely found. In some cases, a distinct cardiovascular risk profile was assessed. Hypertensive patients showed moderately elevated blood pressure, and cholesterol levels were favourable in most cases. No cardiovascular emergencies were found, which was fortunate as timely, sufficient care was not available during the trek. CONCLUSION The results of earlier studies in the Annapurna region should be revalidated. Every trekker to the Himalayas should consult a physician prior to departure, ideally a travel medicine specialist. Preventative measures and education on AMS warrant special attention. Travellers with heart disease or with a pronounced cardiovascular risk profile should be presented to an internal medicine professional. Travel plans must be adjusted individually, especially with respect to adequate acclimatisation time and no physical overloading. With these and other precautions, trekking at high altitudes is generally safe and possible, even with significant pre-existing health conditions. Trekking can lead to invaluable personal experiences. Since organized groups are limited in their flexibility to change their itinerary, individual trekking or guided tours in small groups should be preferred.
Collapse
Affiliation(s)
- Miriam Haunolder
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical Department, St. Antonius Hospital, 52249 Eschweiler, Germany
| | - Christian Apel
- Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
- Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Daniela Bertsch
- Department of Internal Medicine & Cardiology, Ilmtalklinik, 85276 Pfaffenhofen, Germany
| | - Carina Cerfontaine
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Michael van der Giet
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Simone van der Giet
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Maren Grass
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Nicole Maria Heussen
- Department of Medical Statistics, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical School, Sigmund Freud Private University, 1020 Vienna, Austria
| | - Nina Hundt
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Julia Jäger
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Christian Kühn
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Sonja Musiol
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Lisa Timmermann
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Knut Wernitz
- Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Ulf Gieseler
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
| | - Audry Morrison
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | - Volker Schöffl
- Department of Sport Orthopaedics, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Trauma Surgery, University Hospital Erlangen-Nuremberg, 91054 Erlangen, Germany
- School of Applied and Clinical Sciences, Leeds Becket University, Leeds LS2 9JT, UK
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO 80045, USA
| | - Thomas Küpper
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
| |
Collapse
|
4
|
AKE AS, AYO JO. Effects of packing on the diurnal rhythms of respiratory and heart rates in donkeys during the hot-dry season. J Equine Sci 2022; 33:55-62. [PMID: 36699200 PMCID: PMC9843161 DOI: 10.1294/jes.33.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/20/2022] [Indexed: 01/19/2023] Open
Abstract
This study aimed to evaluate the effects of packing (load carrying) on the diurnal rhythms of respiratory and heart rates in donkeys during the hot-dry season. Twenty 2- to 3-years-old donkeys weighing 93 ± 2.7 kg were divided into two groups to serve as subjects: Group 1 was subjected to packing + trekking, while group 2 was subjected to trekking only. All donkeys trekked 20 km on each experimental day. The procedure was repeated three times at one-day intervals. Thermal environmental parameters were recorded. Respiratory rate (RR) and heart rate (HR) were measured before and immediately (15 min) after the packing and/or trekking period. Continuous recordings of parameters were performed for 27 hr at 3-hr intervals beginning 16 hr after the last packing and/or trekking period. The RR rose significantly (P<0.05) immediately after packing + trekking and trekking only, from 30.15 ± 0.5 and 27.52 ± 0.5 cycles/min before packing + trekking and trekking only, respectively, to 43.78 ± 3.0 and 46.30 ± 1.8 cycles/min after them, respectively. The HR (76.63 ± 4.5 beats/min) in the packing + trekking donkeys was higher (P<0.05) than that of the trekking-only donkeys (62.33 ± 2.7 beats/min). The acrophase and bathyphase of the HR in both groups were recorded during the photophase and scotophase, respectively, with higher values (P<0.05) in the packing + trekking donkeys than in the trekking-only donkeys. The circadian rhythms of RR and HR did not differ between the groups of donkeys. In conclusion, packing + trekking was more stressful to the donkeys, significantly increasing the HR of donkeys subjected to packing + trekking, compared with trekking only.
Collapse
Affiliation(s)
- Ayodele Stephen AKE
- Department of Veterinary Physiology, Faculty of
Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria,*Corresponding author.
| | - Joseph Olusegun AYO
- Department of Veterinary Physiology, Faculty of
Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| |
Collapse
|
5
|
Berendsen RR, Bärtsch P, Basnyat B, Berger MM, Hackett P, Luks AM, Richalet JP, Zafren K, Kayser B. Strengthening Altitude Knowledge: A Delphi Study to Define Minimum Knowledge of Altitude Illness for Laypersons Traveling to High Altitude. High Alt Med Biol 2022; 23:330-337. [PMID: 36201281 DOI: 10.1089/ham.2022.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Berendsen, Remco R., Peter Bärtsch, Buddha Basnyat, Marc Moritz Berger, Peter Hackett, Andrew M. Luks, Jean-Paul Richalet, Ken Zafren, Bengt Kayser, and the STAK Plenary Group. Strengthening altitude knowledge: a Delphi study to define minimum knowledge of altitude illness for laypersons traveling to high altitude. High Alt Med Biol. 23:330-337, 2022. Introduction: A lack of knowledge among laypersons about the hazards of high-altitude exposure contributes to morbidity and mortality from acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE) among high-altitude travelers. There are guidelines regarding the recognition, prevention, and treatment of acute-altitude illness for experts, but essential knowledge for laypersons traveling to high altitudes has not been defined. We sought expert consensus on the essential knowledge required for people planning to travel to high altitudes. Methods: The Delphi method was used. The panel consisted of two moderators, a core expert group and a plenary expert group. The moderators made a preliminary list of statements defining the desired minimum knowledge for laypersons traveling to high altitudes, based on the relevant literature. These preliminary statements were then reviewed, supplemented, and modified by a core expert group. A list of 33 statements was then presented to a plenary group of experts in successive rounds. Results: It took three rounds to reach a consensus. Of the 10 core experts invited, 7 completed all the rounds. Of the 76 plenary experts, 41 (54%) participated in Round 1, and of these 41 a total of 32 (78%) experts completed all three rounds. The final list contained 28 statements in 5 categories (altitude physiology, sleeping at altitude, AMS, HACE, and HAPE). This list represents an expert consensus on the desired minimum knowledge for laypersons planning high-altitude travel. Conclusion: Using the Delphi method, the STrengthening Altitude Knowledge initiative yielded a set of 28 statements representing essential learning objectives for laypersons who plan to travel to high altitudes. This list could be used to develop educational interventions.
Collapse
Affiliation(s)
- Remco R Berendsen
- Department of Anesthesiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Peter Bärtsch
- Department of Internal Medicine, University Hospital, Heidelberg, Germany
| | - Buddha Basnyat
- Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal
| | - Marc Moritz Berger
- Department of Anesthesiology and Intensive Care Medicine, Essen University Hospital, University Duisburg-Essen, Duisburg, Germany
| | - Peter Hackett
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Altitude Research Center, University of Colorado, Aurora, Colorado, USA
| | - Andrew M Luks
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA
| | - Jean-Paul Richalet
- INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France
| | - Ken Zafren
- Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA
| | - Bengt Kayser
- Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland
| | | |
Collapse
|
6
|
Nokkaew W, Intarapuk A, Sakulthai A, Wajjwalku W, Thongtip N. Study of fecal glucocorticoid metabolites in captive Asian elephants in Kanchanaburi Province, Thailand. Vet World 2022; 15:647-654. [PMID: 35497973 PMCID: PMC9047137 DOI: 10.14202/vetworld.2022.647-654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Over the past two decades, the number of elephant camps in Thailand has increased considerably, and captive elephants have become more popular within the tourism industry. Tourist activities involving elephant exhibitions and trekking potentially affect animal health and welfare. This study aimed to investigate the relationships between a novel stress biomarker, fecal glucocorticoid metabolites (fGCM), and various factors (sex, age, weather season, tourist season, and elephant usage patterns), monitoring the fGCM concentration during and after trekking activities ceased. Materials and Methods: Fecal samples of 20 captive Asian elephants from two camps in Kanchanaburi Province were collected monthly for 1 year. The fGCM concentrations were measured using enzyme immunoassay and evaluated relative to individual demography, season, and tourist trekking activity. The mean differences of fGCMs concentrations were compared by analysis of variance and t-test statistics according to data types with p<0.5. Results: Significant differences in mean fGCM concentrations were found between age categories (p=0.001), trekking and non-trekking animals (p=0.039), and during and after trekking (p=0.023). The mean fGCM concentration of elephants aged during 0-44 years (136.7 ng/g) was significantly higher than for animals over 44 years old (107.7 ng/g), and the elephant trekking group (144.9 ng/g) was significantly higher than the other group (124.7 ng/g). Within the trekking group, the mean fGCM concentrations gradually declined to 129.13 ng/g within 8 months of trekking cessation. Conclusion: Elephant’s ages and activities co-influenced the variance of fGCM concentrations. In addition, permanent tourist activity, especially trekking, can increase elephant stress. This study’s findings can be applied to the health status monitoring of captive elephants and result in improved animal welfare.
Collapse
Affiliation(s)
- Weerapun Nokkaew
- Graduate Program in Bio-Veterinary Science, Faculty of Veterinary Medicine, Kasetsart University, Chatuchak, Bangkok 10900, Thailand.,Wildlife Clinic, Faculty of Veterinary Medicine, Mahanakorn University of Technology, Nong Chok, Bangkok 10530, Thailand
| | - Apiradee Intarapuk
- Public Health Clinic, Faculty of Veterinary Medicine, Mahanakorn University of Technology, Nong Chok, Bangkok 10530, Thailand
| | - Apichaya Sakulthai
- Department of Farm Technology Management, Faculty of Agro-Industry, Panyapiwat Institute of Management, Nonthaburi, Thailand
| | - Worawidh Wajjwalku
- Akkhraratchakumari Veterinary College, Walailak University, Thasala, Nakhonsithammarat 80160, Thailand
| | - Nikorn Thongtip
- Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom 73140, Thailand.,Center for Agricultural Biotechnology, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom 73140, Thailand.,Center of Excellence on Agricultural Biotechnology (AG-BIO/PERDO-CHE), Bangkok, 10900, Thailand
| |
Collapse
|
7
|
Mrakic-Sposta S, Biagini D, Bondi D, Pietrangelo T, Vezzoli A, Lomonaco T, Di Francesco F, Verratti V. OxInflammation at High Altitudes: A Proof of Concept from the Himalayas. Antioxidants (Basel) 2022; 11:antiox11020368. [PMID: 35204250 PMCID: PMC8869289 DOI: 10.3390/antiox11020368] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 12/14/2022] Open
Abstract
High-altitude locations are fascinating for investigating biological and physiological responses in humans. In this work, we studied the high-altitude response in the plasma and urine of six healthy adult trekkers, who participated in a trek in Nepal that covered 300 km in 19 days along a route in the Kanchenjunga Mountain and up to a maximum altitude of 5140 m. Post-trek results showed an unbalance in redox status, with an upregulation of ROS (+19%), NOx (+28%), neopterin (+50%), and pro-inflammatory prostanoids, such as PGE2 (+120%) and 15-deoxy-delta12,14-PGJ2 (+233%). The isoprostane 15-F2t-IsoP was associated with low levels of TAC (−18%), amino-thiols, omega-3 PUFAs, and anti-inflammatory CYP450 EPA-derived mediators, such as DiHETEs. The deterioration of antioxidant systems paves the way to the overload of redox and inflammative markers, as triggered by the combined physical and hypoxic stressors. Our data underline the link between oxidative stress and inflammation, which is related to the concept of OxInflammation into the altitude hypoxia fashion.
Collapse
Affiliation(s)
- Simona Mrakic-Sposta
- Institute of Clinical Physiology, National Research Council (IFC-CNR), 20162 Milan, Italy; (S.M.-S.); (A.V.)
| | - Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, 56126 Pisa, Italy; (T.L.); (F.D.F.)
- Correspondence:
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti, 66100 Chieti, Italy; (D.B.); (T.P.)
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti, 66100 Chieti, Italy; (D.B.); (T.P.)
| | - Alessandra Vezzoli
- Institute of Clinical Physiology, National Research Council (IFC-CNR), 20162 Milan, Italy; (S.M.-S.); (A.V.)
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, 56126 Pisa, Italy; (T.L.); (F.D.F.)
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, 56126 Pisa, Italy; (T.L.); (F.D.F.)
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti, 66100 Chieti, Italy;
| |
Collapse
|
8
|
Bondi D, Aloisi AM, Pietrangelo T, Piccinelli R, Le Donne C, Jandova T, Pieretti S, Taraborrelli M, Santangelo C, Lattanzi B, Verratti V. Feeding Your Himalayan Expedition: Nutritional Signatures and Body Composition Adaptations of Trekkers and Porters. Nutrients 2021; 13:460. [PMID: 33573243 DOI: 10.3390/nu13020460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 01/08/2023] Open
Abstract
High-altitude exposure leads to many physiological challenges, such as weight loss and dehydration. However, little attention has been posed to the role of nutrition and ethnic differences. Aiming to fulfill this gap, five Italian trekkers and seven Nepalese porters, all males, recorded their diet in diaries during a Himalayan expedition (19 days), and the average daily intake of micro and macro-nutrients were calculated. Bioimpedance analysis was performed five times during the trek; muscle ultrasound was performed before and after the expedition, only for the Italians. The Nepalese group consumed a lot of rice and only Italians consumed cheese. Water intake was slightly over 3000 g/d for both groups. Nepalese diet had a higher density of dietary fibre and lower density of riboflavin, vitamins A, K, and B12. Intake of calcium was lower than recommended levels. Body mass index, waist circumference, fat-free mass, and total body water decreased in both groups, whereas resistance (Rz) increased. Italians reactance (Xc) increased at day 9, whereas that of Nepalese occurred at days 5, 9, and 16. The cross-sectional area of the Vastus lateralis was reduced after the expedition. Specific nutritional and food-related risk factors guidance is needed for diverse expedition groups. Loss of muscle mass and balance of fluids both deserve a particular focus as concerns altitude expeditions.
Collapse
|
9
|
Chicharro-Luna E, Martínez-Nova A, Ortega-Ávila AB, Requena-Martínez A, Gijón-Noguerón G. Prevalence and risk factors associated with the formation of dermal lesions on the foot during hiking. J Tissue Viability 2020; 29:218-23. [PMID: 32371147 DOI: 10.1016/j.jtv.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/02/2020] [Accepted: 04/20/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study is to assess the prevalence of blisters on the foot during hiking and the factors associated with this condition. MATERIAL AND METHODS A cross-sectional observational comparative study was conducted of 315 patients treated at two hostels, located on the Way of Saint James, in northern Spain. The study participants were interviewed and clinically examined to obtain sociodemographic and clinical variables. The variables recorded concerned the type of terrain covered (asphalt or dirt trails), the weight carried (backpack), the footwear used (weight, type, impermeability), the type of socks worn and the hydration of the skin obtained. The inclusion criteria were at least 18 years and to walk at least 20 km in the last five days. RESULTS 74% (n = 233) of the hikers presented a bullous lesion on the foot after completing several stages of hiking. The most frequent locations were the first or second metatarsal head and the fifth toe. Logistic regression showed that risk factors for the appearance of blistering were the number of kilometres walked on asphalt (p = .001 [95% CI (1.019-1.064)]) and having wet socks at the end of the day (p = . 006 [95% CI (1.286-4.479)]). The protective factors identified were walking on a dirt, grass or gravel surface (p < .001 [95% CI (0.982- 0.995)]) and using customised plantar orthoses (p = .001 [95% CI (0.085) - 0.512)]). CONCLUSIONS The type of terrain is a determining factor in the appearance of blisters. Walking on a dirt trail reduces the risk. Using custom made insoles and controlling humidity are other factors that should be considered as preventive measures.
Collapse
|
10
|
VanBaak KD, Nally LM, Finigan RT, Jurkiewicz CL, Burnier AM, Conrad BP, Khodaee M, Lipman GS. Wilderness Medical Society Clinical Practice Guidelines for Diabetes Management. Wilderness Environ Med 2019; 30:S121-S140. [PMID: 31753543 DOI: 10.1016/j.wem.2019.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022]
Abstract
The Wilderness Medical Society convened an expert panel in 2018 to develop a set of evidence-based guidelines for the treatment of type 1 and 2 diabetes, as well as the recognition, prevention, and treatment of complications of diabetes in wilderness athletes. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures, as well as best practice recommendations for both routine and urgent therapeutic management of diabetes and glycemic complications. These recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks or burdens for each recommendation.
Collapse
Affiliation(s)
- Karin D VanBaak
- Department of Family Medicine and Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO.
| | - Laura M Nally
- Department of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT
| | | | - Carrie L Jurkiewicz
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
| | | | - Barry P Conrad
- Division of Endocrinology, Stanford Children's Hospital, Stanford, CA
| | - Morteza Khodaee
- Department of Family Medicine and Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO
| | - Grant S Lipman
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
| |
Collapse
|
11
|
Gatterer H, Niedermeier M, Pocecco E, Frühauf A, Faulhaber M, Menz V, Burtscher J, Posch M, Ruedl G, Burtscher M. Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season-A Narrative Review. Int J Environ Res Public Health 2019; 16:E3920. [PMID: 31618960 DOI: 10.3390/ijerph16203920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 01/21/2023]
Abstract
Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. Epidemiological data represent an important basis for the development of preventive measures. Therefore, the aim of this review is to compare mortality rates and potential risk factors across different (summer) mountain sports activities. A comprehensive literature search was performed on the death risk (mortality) in mountain sports, primarily practiced during the summer season, i.e., mountain hiking, mountain biking, paragliding, trekking, rock, ice and high-altitude climbing. It was found that the death risk varies considerably between different summer mountain sports. Mortality during hiking, trekking and biking in the mountains was lower compared to that during paragliding, or during rock, ice or high-altitude climbing. Traumatic deaths were more common in activities primarily performed by young adults, whereas the number of deaths resulting from cardiovascular diseases was higher in activities preferred by the elderly such as hiking and trekking. Preventive efforts must consider the diversity of mountain sports activities including differences in risk factors and practitioners and may more particularly focus on high-risk activities and high-risk individuals.
Collapse
|
12
|
Brito JP, Garrido N, Romero F, de Araújo Junior AT, Reis VM. Effects of Backpack Load and Trekking Poles on Energy Expenditure During Field Track Walking. Sports Med Int Open 2018; 2:E117-E122. [PMID: 30539128 PMCID: PMC6259461 DOI: 10.1055/a-0637-8719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/07/2018] [Accepted: 05/18/2018] [Indexed: 11/23/2022] Open
Abstract
This study evaluates the effects of the use of backpack load and trekking poles on field track walking energy expenditure. Twenty male volunteer pole walkers (age: 22.70±2.89 years; body mass: 77.90±11.19 kg; height: 1.77±0.06 m; percentage of body fat: 14.6±6.0%) walked at a self-selected pace on a pedestrian field track over a period of more than six months. Each subject was examined at random based on four walking conditions: non-poles and non-load, with poles and non-load, non-poles and with load, with poles and with load. Heart rate, oxygen uptake and energy expenditure were continuously recorded by a portable telemetric system. Non-load walking speed was lower during walking with poles when compared with no poles ( p ≤0.05). Oxygen uptake, energy expenditure and heart rate varied significantly across different conditions. Our results suggest that the use of trekking poles does not influence energy expenditure when walking without an additional load, but it can have an effect during backpack load walking. Moreover, our results indicate that the use of trekking poles may not be helpful to lower the exertion perceived by the subjects when walking with an additional load.
Collapse
Affiliation(s)
- João Paulo Brito
- Sports Sciences School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior, Portugal
| | - Nuno Garrido
- University of Trás-os-Montes and Alto Douro, Sports, Exercise and Health Department, Vila Real, Portugal
| | - Félix Romero
- Sports Sciences School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior, Portugal
| | | | - Victor Machado Reis
- Research Center for Sports, Health & Human Development, University of Trás-os-Montes & Alto Douro, Vila Real, Portugal
| |
Collapse
|
13
|
Nabrdalik K, Kwiendacz H, Gubała M, Tyrała K, Seweryn M, Tomasik A, Sawczyn T, Kukla M, Grzeszczak W, Gumprecht J. Diabetes-Related Knowledge of Polish National Mountain Leaders. High Alt Med Biol 2018; 19:237-243. [PMID: 29924643 DOI: 10.1089/ham.2017.0168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Nabrdalik, Katarzyna, Hanna Kwiendacz, Monika Gubała, Kinga Tyrała, Mariusz Seweryn, Andrzej Tomasik, Tomasz Sawczyn, Michał Kukla, Władysław Grzeszczak, and Janusz Gumprecht. Diabetes-related knowledge of Polish national mountain leaders. High Alt Med Biol. 19:237-243, 2018.-Mountain trekking is a popular activity for patients with diabetes. In Poland, mountain leaders often accompany organized groups to ensure their safety during treks; we aimed to evaluate their competency in caring for diabetic clients by assessing their diabetes-related knowledge. This was a cross-sectional study among Polish, certified, active mountain leaders carried out by means of an anonymous, standardized 41-item questionnaire adapted from a study by Wee et al. It was distributed through e-mail to 500 leaders. A total of 106 (21.2%) mountain leaders completed the questionnaire (males 60.4%) with a mean (standard deviation [SD]) age of 38.6 (13.5) years. Their mean (SD) length of experience acting as a mountain leader was 11.9 (10.2) years. The average score was 72.4% of the maximum possible (29.7 of 41 points). Results varied significantly depending on gender (p = 0.006). The percentage of correct answers among questions in each section varied between 23.6% and 100%. The main sources of diabetes-related knowledge identified by respondents were members of their family and their friends who suffer from diabetes (33%). First aid courses were indicated as sources of information by only 12.6% of the informants. Results of the questionnaire revealed that respondents did have a reasonable level of diabetes-related knowledge. There were topics in which the respondents achieved lower than an average score, demonstrating a need for further education.
Collapse
Affiliation(s)
- Katarzyna Nabrdalik
- 1 Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Hanna Kwiendacz
- 1 Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Monika Gubała
- 2 Student's Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Kinga Tyrała
- 2 Student's Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Mariusz Seweryn
- 3 Department of Epidemiology, Medical University of Silesia , Katowice, Poland
| | - Andrzej Tomasik
- 4 Second Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Tomasz Sawczyn
- 5 Department of Physiology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Michał Kukla
- 6 Department of Gastroenterology and Hepatology in Katowice, Medical University of Silesia , Katowice, Poland
| | - Władysław Grzeszczak
- 1 Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Janusz Gumprecht
- 1 Department of Internal Medicine, Diabetology and Nephrology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| |
Collapse
|
14
|
Grainer A, Zerbini L, Reggiani C, Marcolin G, Steele J, Pavei G, Paoli A. Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain Environment. Int J Environ Res Public Health 2017; 14:ijerph14101235. [PMID: 29039775 PMCID: PMC5664736 DOI: 10.3390/ijerph14101235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022]
Abstract
Background: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a natural mountain environment. Methods: Twenty one subjects (13 male/8 female, aged 41 ± 12 years, body mass index BMI 24.1 ± 3.7), walked three distinct uphill paths (length 2.2/3.4/7 km) with (NW) or without (W) walking poles over two separate days. Heart rate (HR), energy expenditure (EE), step length (SL), walking speed (WS), total steps number (SN) and rating of perceived exertion (RPE) were monitored. Results: HR (+18%) and EE (+20%) were higher in NW than in W whilst RPE was similar. SN (−12%) was lower and SL (+15%) longer in NW. WS was higher (1.64 vs. 1.53 m s−1) in NW. Conclusions: Our data confirm that, similarly to previous laboratory studies, differences in a range of walking variables are present between NW and W when performed in a natural environment. NW appears to increase EE compared to W, despite a similar RPE. Thus, NW could be a useful as aerobic training modality for weight control and cardiorespiratory fitness.
Collapse
Affiliation(s)
- Alessandro Grainer
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, 35131 Padova, Italy.
| | - Livio Zerbini
- CeRiSM, Sport Mountain Health Research Center, 38068 Rovereto, Italy.
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, 35131 Padova, Italy.
| | - Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, 35131 Padova, Italy.
| | - James Steele
- Centre for Health, Exercise and Sport Science, Southampton Solent University, Southampton SO14 0YN, UK.
| | - Gaspare Pavei
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, 35131 Padova, Italy.
| |
Collapse
|
15
|
Maeo S, Ochi Y, Yamamoto M, Kanehisa H, Nosaka K. Effect of a prior bout of preconditioning exercise on muscle damage from downhill walking. Appl Physiol Nutr Metab 2014; 40:274-9. [PMID: 25693898 DOI: 10.1139/apnm-2014-0390] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated whether reduced-duration downhill walking (DW) would confer a protective effect against muscle damage induced by a subsequent bout of longer duration DW performed 1 week or 4 weeks later. Healthy young adults were allocated to a control or one of the preconditioning exercise (PRE-1wk or PRE-4wk) groups (10 men and 4 women per group). PRE-1wk and PRE-4wk groups performed 20-min DW (-28% slope, 5 km/h, 10% body mass added to a backpack) 1 week and 4 weeks before 40-min DW, respectively, and the control group performed 40-min DW only. Maximal voluntary contraction (MVC) knee extension torque, plasma creatine kinase (CK) activity, and muscle soreness (100-mm visual analog scale) were measured before, immediately after, and 24, 48, and 72 h after DW, and the changes in these variables were compared among groups. The control group showed symptoms of muscle damage (e.g., prolonged decrease in MVC: -14% ± 10% at 48 h post-DW) after 40-min DW. Changes in all variables after 40-min DW of PRE-1wk and PRE-4wk groups were 54%-61% smaller (P < 0.05) than the control group, without significant differences between PRE-1wk and PRE-4wk groups for MVC and plasma CK activity. Importantly, changes after the preconditioning exercise (20-min DW) were 67%-69% smaller (P < 0.05) than those after the 40-min DW of the control group. These findings suggest that 20-min DW resulting in minor muscle damage conferred a protective effect against subsequent 40-min DW, and its effect could last for more than 4 weeks.
Collapse
Affiliation(s)
- Sumiaki Maeo
- Sports and Life Science, National Institute of Fitness and Sports in Kanoya, 1 Shiromizu, Kanoya, Kagoshima 891-2393, Japan., Japan Society for the Promotion of Science, Kouji, Tokyo 102-0088, Japan., School of Exercise and Health Sciences, Centre for Exercise and Sports Science Research, Edith Cowan University, Joondalup, WA 6027, Australia
| | | | | | | | | |
Collapse
|