Derstine, Mia, Dominique Jean, Beth A. Beidleman, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, Susi Kriemler, Kasté Mateikaité-Pipiriené, Peter Paal, Alison Rosier, Marija Andjelkovic, and Linda E. Keyes. Acute mountain sickness and high altitude cerebral edema in women: A scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:259-267, 2023. Background: Acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) are illnesses associated with rapid ascent to altitudes over 2,500 m in unacclimatized lowlanders. The aim of this scoping review is to summarize the current knowledge on sex differences in the epidemiology, pathophysiology, symptomatology, and treatment of AMS and HACE, especially in women. Methods and Results: The UIAA Medical Commission convened an international author team to review women's health issues at high altitude and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including AMS, HACE, and high altitude), with additional publications found by hand search. The primary search focus was for articles assessing lowland women sojourning at high altitude. Results: The literature search yielded 7,165 articles, 37 of which were ultimately included. The majority of publications included did not find women at increased risk for AMS or HACE. There was extremely limited sex-specific data on risk factors or treatment. Conclusions: There is a limited amount of data on female-specific findings regarding AMS and HACE, with most publications addressing only prevalence or incidence with regard to sex. As such, general prevention and treatment strategies for AMS and HACE should be used regardless of sex.

• Klíčová slova
• AMS, HACE, guidelines, headache, hormones, literature review, mountaineering, sex, travel, women,
• MeSH
• akutní nemoc MeSH
• edém mozku * epidemiologie   etiologie   prevence a kontrola   MeSH
• lidé MeSH
• nadmořská výška MeSH
• rizikové faktory MeSH
• výšková nemoc * epidemiologie   etiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Mateikaitė-Pipirienė, Kastė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J. Rosier, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, and Linda E. Keyes for the UIAA MedCom writing group on Women's Health in the Mountains. Menopause and high altitude: A scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 25:1-8, 2024. Background: Older people are an important fraction of mountain travelers and climbers, many of them postmenopausal women. The aim of this work was to review health issues that older and postmenopausal women may experience at high altitude, including susceptibility to high-altitude illness. Methods: We performed a scoping review for the UIAA Medical Commission series on Women's Health in the mountains. We searched PubMed and Cochrane libraries and performed an additional manual search. The primary search focused on articles assessing lowland women sojourning at high altitude. Results: We screened 7,165 potential articles. The search revealed three relevant articles, and the manual search another seven articles and one abstract. Seven assessed menopausal low-altitude residents during a high-altitude sojourn or performing hypoxic tests. Four assessed high-altitude residents. We summarize the results of these 11 studies. Conclusions: Data are limited on the effects of high altitude on postmenopausal women. The effects of short-term, high-altitude exposure on menopause symptoms are unknown. Menopause has minimal effect on the physiological responses to hypoxia in physically fit women and does not increase the risk of acute mountain sickness. Postmenopausal women have an increased risk of urinary tract infections, which may be exacerbated during mountain travel. More research is needed on the physiology and performance of older women at high altitude.

• Klíčová slova
• altitude sickness, athletic performance, expeditions, mountains, osteoporosis, postmenopausal, urinary tract infection, women,
• MeSH
• cestování MeSH
• hypoxie MeSH
• lidé MeSH
• menopauza MeSH
• nadmořská výška * MeSH
• senioři MeSH
• výšková nemoc * etiologie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Horakova, Lenka, Peter Paal, Jacqueline Pichler Hefti, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, David Hillebrandt, Dominique Jean, Kastė Mateikaitė-Pipirienė, Alison J. Rosier, Susi Kriemler, and Linda E. Keyes. Women's health at high altitude: An introduction to a 7-part series by the International Climbing and Mountaineering Federation Medical Commission. High Alt Med Biol. 24:243-246, 2023. Background: Women have been traveling to high altitude since the inception of modern mountaineering. Although there are distinct female-specific features such as menstruation and menopause relevant to adaptation to and performance at high altitude, very little data exist on women's high-altitude health. To summarize what is known to date, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA) has created a series of articles on women's health, high altitude illness, and performance at high altitude. Methods: Assembling an international author team, two types of manuscripts were developed: (1) reviews on female-specific topics such as pregnancy; (2) reviews on sex differences in high-altitude related illnesses, nutrition, cold injuries, and mortality. Results: The literature search yielded 7,165 articles, with 482 studies meeting the inclusion criteria for full-text review. The authors of individual chapters reviewed these articles and performed additional hand searches. Conclusions: Some important questions on women sojourning and exercising at high altitude have been studied, but many are still awaiting a qualified and evidence-based response. Our seven reviews, to be published in future issues of this journal, summarize what is known about lowland women sojourning at high altitude, provide recommendations, and highlight knowledge gaps in high altitude women's medicine.

• Klíčová slova
• acute mountain sickness, altitude sickness, emergency medicine, high altitude medicine, women,
• MeSH
• horolezectví * zranění   MeSH
• lidé MeSH
• nadmořská výška MeSH
• ruka MeSH
• těhotenství MeSH
• výšková nemoc * MeSH
• zdraví žen MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Mountaineering brings many health risks, one of which is mountain sickness. Its mildest form - acute mountain sickness - is mainly characterized by subjective symptoms (headache, loss of appetite, insomnia, weakness, nausea and rarely also vomiting). Advanced and life-threatening forms are characterized by tissue edema - cerebral or pulmonary high altitude edema. The common denominator of these acute forms is the low oxygen tension leading to hypoxemia and tissue ischemia. Sum of maladaptive or adaptive processes can modify the clinical picture. Underlying mechanisms of the chronic forms of pulmonary disease are the adaptation processes - pulmonary hypertension and polycythemia leading to heart failure.The only causal therapeutic intervention is to restore adequate oxygen tension, descend to lower altitudes or oxygen therapy. Pharmacotherapy has only a supportive effect. The prophylaxis includes stimulation of the respiratory center by carbonic anhydrase inhibitors (acetazolamide) antiedematous treatment with glucocorticoids (dexamethasone), increase lymphatic drainage of the lungs and brain by β2-agonists (salmeterol) or mitigation of pulmonary hypertension by calcium channel blockers or phosphodiesterase-5 inhibitors (sildenafil or tadalafil).

• Klíčová slova
• acute mountain sickness - high-altitude pulmonary edema - high-altitude cerebral edema - pathophysiology - clinical picture - treatment.,
• MeSH
• acetazolamid terapeutické užití   MeSH
• akutní nemoc MeSH
• blokátory kalciových kanálů terapeutické užití   MeSH
• dexamethason terapeutické užití   MeSH
• edém mozku MeSH
• fyziologická adaptace fyziologie   MeSH
• kombinovaná terapie MeSH
• kyslík krev   MeSH
• lidé MeSH
• nadmořská výška MeSH
• oxygenoterapie MeSH
• plicní hypertenze komplikace   diagnóza   patofyziologie   terapie   MeSH
• salmeterol xinafoát terapeutické užití   MeSH
• výšková nemoc diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• acetazolamid MeSH
• blokátory kalciových kanálů MeSH
• dexamethason MeSH
• kyslík MeSH
• salmeterol xinafoát MeSH

Pichler Hefti, Jacqueline, Dominique Jean, Alison Rosier, Mia Derstine, David Hillebrandt, Lenka Horakova, Linda E. Keyes, Kastė Mateikaitė-Pipirienė, Peter Paal, Marija Andjelkovic, Beth Beidlemann, and Susi Kriemler. High-altitude pulmonary edema in women: a scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 24:268-273, 2023. Background: High-altitude pulmonary edema (HAPE) can occur >2,500-3,000 m asl and is a life-threatening medical condition. This scoping review aims to summarize the current data on sex differences in HAPE. Methods: The International Climbing and Mountaineering Federation (UIAA) Medical Commission convened an international author team to review women's health issues at high altitude. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including HAPE), with additional publications found by hand search. The primary search focus was for original articles that included minimum one woman and at least a rudimentary subgroup analysis. Results: The literature search yielded 7,165 articles, 416 of which were relevant for HAPE, and 7 of which were ultimately included here. Six were case series, consistently reporting a lower HAPE prevalence in women. The one retrospective case-control study reported male HAPE prevalence at 10/100,000 and female at 0.74/100,000. No studies were identified that directly compared sex differences in the prevalence of HAPE. No published data was found for topics other than epidemiology. Conclusions: Few studies and associated methodological limitations allow few conclusions to be drawn. Incidence of HAPE may be lower in women than in men. We speculate that besides physiological aspects, behavioral differences may contribute to this potential sex difference.

• Klíčová slova
• gender differences, high altitude, high-altitude pulmonary edema, women's health,
• MeSH
• lidé MeSH
• nadmořská výška MeSH
• plicní edém * epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• studie případů a kontrol MeSH
• výšková nemoc * epidemiologie   komplikace   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Control (physiological saline treated) and ascorbic acid (AA) treated (1 mg.g-1 b.w. one hour before exposure) 18-day-old rats were exposed for 1 hour to high altitude in a hypobaric chamber and the mean lethal altitudes were calculated. AA displayed a protective effect, so that in two identical experiments the mean lethal altitude was 10,900 and 10,150 m in controls, while it was 11,500 and 11,450 m in AA treated animals.

• MeSH
• krysa rodu Rattus MeSH
• kyselina askorbová farmakologie   MeSH
• výšková nemoc mortalita   prevence a kontrola   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kyselina askorbová MeSH

• Klíčová slova
• ALTITUDE *,
• MeSH
• myši MeSH
• nadmořská výška * MeSH
• výšková nemoc * MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The mixture of flavonoids (silymarin) from Carduus Marianus (0.9 mg.g-1 body weight) and/or ascorbic acid (0.4 mg.g-1 body weight) were administered in the food to 21 day-old (b.w. 35-45 g) rats for one week. Then the animals were exposed, in a hypobaric chamber, to simulated altitude 8,000-12,000 m for one hour. Mean lethal altitude was calculated by the Behrens equation: it was 10,150 m in controls, 10,550 m in ascorbic acid treated, 10,500 m in silymarin and tocopherol treated and 10,450 m in animals, receiving both ascorbic acid and silymarin. Thus silymarin protected the animals against lethality of high-altitude hypoxia. The effect of ascorbic acid and silymarin were not additive.

• MeSH
• krysa rodu Rattus MeSH
• kyselina askorbová terapeutické užití   MeSH
• potkani Wistar MeSH
• scavengery volných radikálů terapeutické užití   MeSH
• silymarin terapeutické užití   MeSH
• vitamin E terapeutické užití   MeSH
• výšková nemoc prevence a kontrola   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• kyselina askorbová MeSH
• scavengery volných radikálů MeSH
• silymarin MeSH
• vitamin E MeSH

• Klíčová slova
• ANOXIA/experimental *,
• MeSH
• hypoxie * MeSH
• nadmořská výška * MeSH
• výšková nemoc * MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• ADAPTATION *, ALTITUDE/effects *, DEFECTS, CONGENITAL/physiology *,
• MeSH
• aklimatizace * MeSH
• fyziologická adaptace * MeSH
• myokard * MeSH
• nadmořská výška * MeSH
• vrozené vady fyziologie   MeSH
• výšková nemoc * MeSH
• Publikační typ
• časopisecké články MeSH