Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3,450 m.

High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life-threatening high-altitude pulmonary edema (HAPE), but there are limited data in this young population. We, therefore, assessed in 118 nonacclimatized healthy children and adolescents (mean ± SD; age: 11 ± 2 yr) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 h after rapid ascent to 3,450 m. Pulmonary artery pressure was more than twofold higher at high than at low altitude (35 ± 11 vs. 16 ± 3 mmHg; P < 0.0001), and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mmHg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost twofold larger increase in the 6- to 9- than in the 14- to 16-yr-old participants (24 ± 12 vs. 13 ± 8 mmHg; P = 0.004). Even in children with the most severe altitude-induced pulmonary hypertension, right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. HAPE appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.

Prevalence and time course of acute mountain sickness in older children and adolescents after rapid ascent to 3450 meters

OBJECTIVE: Acute mountain sickness is a frequent and debilitating complication of high-altitude exposure, but there is little information on the prevalence and time course of acute mountain sickness in children and adolescents after rapid ascent by mechanical transportation to 3500 m, an altitude at which major tourist destinations are located throughout the world. METHODS: We performed serial assessments of acute mountain sickness (Lake Louise scores) in 48 healthy nonacclimatized children and adolescents (mean +/- SD age: 13.7 +/- 0.3 years; 20 girls and 28 boys), with no previous high-altitude experience, 6, 18, and 42 hours after arrival at the Jungfraujoch high-altitude research station (3450 m), which was reached through a 2.5-hour train ascent. RESULTS: We found that the overall prevalence of acute mountain sickness during the first 3 days at high altitude was 37.5%. Rates were similar for the 2 genders and decreased progressively during the stay (25% at 6 hours, 21% at 18 hours, and 8% at 42 hours). None of the subjects needed to be evacuated to lower altitude. Five subjects needed symptomatic treatment and responded well. CONCLUSION: After rapid ascent to high altitude, the prevalence of acute mountain sickness in children and adolescents was relatively low; the clinical manifestations were benign and resolved rapidly. These findings suggest that, for the majority of healthy nonacclimatized children and adolescents, travel to 3500 m is safe and pharmacologic prophylaxis for acute mountain sickness is not needed.

Prevalence and time course of acute mountain sickness in older children and adolescents after rapid ascent to 3'450 meters

Rapport de synthèse :Grâce au développement de moyens de transport modernes, de plus en plus d'enfants et d'adolescents se rendent en haute altitude dans le cadre de leurs loisirs. Le mal aigu des montagnes est une complication fréquente des séjours en haute altitude. Ses symptômes en sont des maux de tête, une fatigue, des troubles du sommeil, des nausées et des vertiges. La vitesse d'ascension, |'attitude maximale atteinte, une susceptibilité individuelle ainsi qu'une acclimatation antérieure a l'attitude sont tous des facteurs influant sur le risque de développer un mal aigu des montagnes et sur sa sévérité. Bien que très fréquente chez l'adulte, nous ne possédions, au moment d'entreprendre |'étude faisant |'objet de cette thèse, que peu de données solides concernant la prévalence de cette affection chez l'enfant ainsi que sur son évolution au cours du temps. Cette étude a pour but de mesurer la prévalence du mal aigu des montagnes, et son évolution au cours du temps au sein d'un groupe d'enfants et d'adolescents dans des conditions contrôlées. C'est à dire en éliminant |'influence de facteurs confondants tels que l'importance de l'exercice physique fourni ou une différence dans la vitesse d'ascension. Pour ce faire nous avons évalué la présence de mal aigu des montagnes dans un groupe de 48 garçons et de filles âgés de 11 à 17 ans en bonne santé habituelle, n'ayant jamais séjourné en haute altitude au préalable. Afin d'évaluer la présence ou non de mal aigu des montagnes nous avons utilisé une version française du « Lake Louise Score >>. Les mesures furent effectuées 6,24 et 48 heures après |`arrivée à la station de recherche de la Jungfraujoch située à 3'450m. L'ascension a consisté en un trajet de train durant 2h30. Nos observations montrent que la prévalence du mal aigu des montagnes durant les 3 premiers jours ne dépasse jamais les 25%. Elle est similaire pour les deux sexes et diminue au cours du séjour. (17% après 24 heures, 8% après 48 heures) Aucun sujet n'a dû être évacué à une altitude inférieure, Cinq sujets ont eu besoin de recourir à un traitement symptomatique et y ont bien répondu Les résultats de cette étude démontrent que dans le groupe d'âge étudié, après une ascension rapide en haute altitude, la prévalence du mal aigu des montagnes est relativement faible, ses manifestations cliniques sont bénignes et, |lorsqu'' elles sont présentes, se résolvent rapidement. Ces observations suggèrent que pour la majorité des enfants et des adolescents en bonne santé et non habitués a |'attitude, un séjour en haute altitude ne présente pas de risque et une prophylaxie pharmacologique du mal aigu des montagnes n'est pas nécessaire.

Pb-210-Ra-226 and Ra-228-Th-232 systematics in young arc lavas: implications for magma degassing and ascent rates

New data show that island arc rocks have (Pb-210/Ra-226)(o) ratios which range from as low as 0.24 up to 2.88. In contrast, (Ra-22S/Th-232) appears always within error of I suggesting that the large Ra-226-excesses observed in arc rocks were generated more than 30 years ago. This places a maximum estimate on melt ascent velocities of around 4000 m/year and provides further confidence that the Ra-226 excesses reflect deep (source) processes rather than shallow level alteration or seawater contamination. Conversely, partial melting must have occurred more than 30 years prior to eruption. The Pb-210 deficits are most readily explained by protracted magma degassing. Using published numerical models, the data suggest that degassing occurred continuously for periods up to several decades just prior to eruption but no link with eruption periodicity was found. Longer periods are required if degassing is discontinuous, less than 100% efficient or if magma is recharged or stored after degassing. The long durations suggest much of this degassing occurs at depth with implications for the formation of hydrothermal and copper-porphyry systems. A suite of lavas erupted in 1985-1986 from Sangeang Api volcano in the Sunda arc are characterised by deficits of Pb-210 relative to Ra-226 from which 6-8 years of continuous Rn-222 degassing would be inferred from recent numerical models. These data also form a linear (Pb-210)/Pb-(Ra-226)/Pb array which might be interpreted as a 71-year isochron. However, the array passes through the origin suggesting displacement downwards from the equiline in response to degassing and so the slope of the array is inferred not to have any age significance. Simple modelling shows that the range of (Ra-226)/Pb ratios requires thousands of years to develop consistent with differentiation occurring in response to cooling at the base of the crust. Thus, degassing post-dated, and was not responsible for magma differentiation. The formation, migration and extraction of gas bubbles must be extremely efficient in mafic magma whereas the higher viscosity of more siliceous magmas retards the process and can lead to Pb-210 excesses. A possible negative correlation between (Pb-210/Ra-226)(o) and SO2 emission rate requires further testing but may have implications for future eruptions. (C) 2004 Elsevier B.V. All rights reserved.

Pb-210-Ra-226 and Ra-228-Th-232 systematics in young arc lavas: implications for magma degassing and ascent rates

New data show that island arc rocks have (Pb-210/Ra-226)(o) ratios which range from as low as 0.24 up to 2.88. In contrast, (Ra-22S/Th-232) appears always within error of I suggesting that the large Ra-226-excesses observed in arc rocks were generated more than 30 years ago. This places a maximum estimate on melt ascent velocities of around 4000 m/year and provides further confidence that the Ra-226 excesses reflect deep (source) processes rather than shallow level alteration or seawater contamination. Conversely, partial melting must have occurred more than 30 years prior to eruption. The Pb-210 deficits are most readily explained by protracted magma degassing. Using published numerical models, the data suggest that degassing occurred continuously for periods up to several decades just prior to eruption but no link with eruption periodicity was found. Longer periods are required if degassing is discontinuous, less than 100% efficient or if magma is recharged or stored after degassing. The long durations suggest much of this degassing occurs at depth with implications for the formation of hydrothermal and copper-porphyry systems. A suite of lavas erupted in 1985-1986 from Sangeang Api volcano in the Sunda arc are characterised by deficits of Pb-210 relative to Ra-226 from which 6-8 years of continuous Rn-222 degassing would be inferred from recent numerical models. These data also form a linear (Pb-210)/Pb-(Ra-226)/Pb array which might be interpreted as a 71-year isochron. However, the array passes through the origin suggesting displacement downwards from the equiline in response to degassing and so the slope of the array is inferred not to have any age significance. Simple modelling shows that the range of (Ra-226)/Pb ratios requires thousands of years to develop consistent with differentiation occurring in response to cooling at the base of the crust. Thus, degassing post-dated, and was not responsible for magma differentiation. The formation, migration and extraction of gas bubbles must be extremely efficient in mafic magma whereas the higher viscosity of more siliceous magmas retards the process and can lead to Pb-210 excesses. A possible negative correlation between (Pb-210/Ra-226)(o) and SO2 emission rate requires further testing but may have implications for future eruptions. (C) 2004 Elsevier B.V. All rights reserved.

Onset of quadriceps and torque variation in individuals with patellofemoral pain during stair ascent

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Characterization of biomechanical parameters during stair ascent

Stair climbing is a functional activity often cited as main complaint by patients with orthopedic – as patellofemoral pain syndrome – or neurologic alterations. Moreover, the stair climbing is usually used as therapeutic resource. However, few studies have been conducted to characterize the movement during the ascent or descent of stairs and these studies concluded that the high variability of the data could not confirm the results [Yu, 1997] . In this way, this study aimed to verify which parameters show less variation and so, are more appropriate to characterize the stair climbing.

Dominance hierarchies and social status ascent opportunity: Anticipatory behavioral and physiological adjustments in a Neotropical cichlid fish

In this work we characterized the social hierarchy of non-reproductive individuals of Cichlasoma dimerus (Heckel, 1840). independently for both sexes, and its relationship to the opportunity for social status ascent. Female and male individuals who were located on the top rank of the social hierarchy, ascended in social status when the opportunity arose, therefore indicating that dominance is directly correlated with social ascent likelihood. Dominance was positively correlated with size in males but not in females, suggesting for the latter a relationship with intrinsic features such as aggressiveness or personality rather than to body and/or ovarian size. Physiological and morphometrical variables related to reproduction, stress and body color were measured in non-reproductive fish and correlated with dominance and social ascent likelihood. Dominance was negatively correlated with plasma cortisol levels for both sexes. No correlation with dominance was found for androgen plasma levels (testosterone and 11-ketotestosterone). No correlation was detected between dominance and the selected morphological and physiological variables measured in females, suggesting no reproductive inhibition in this sex at a physiological level and that all females seem to be ready for reproduction. In contrast, social hierarchy of non-reproductive males was found to be positively correlated with follicle stimulating hormone (FSH) pituitary content levels and gonadosomatic indexes. This suggests an adaptive mechanism of non reproductive males, adjusting their reproductive investment in relation to their likelihood for social status ascent, as perceived by their position in the social hierarchy. This likelihood is translated into a physiological signal through plasma cortisol levels that inhibit gonad investment through pituitary inhibition of FSH, representing an anticipatory response to the opportunity for social status ascent. (C) 2012 Elsevier Inc. All rights reserved.

Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3,450 m

High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life-threatening high-altitude pulmonary edema (HAPE), but there are limited data in this young population. We, therefore, assessed in 118 nonacclimatized healthy children and adolescents (mean ± SD; age: 11 ± 2 yr) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 h after rapid ascent to 3,450 m. Pulmonary artery pressure was more than twofold higher at high than at low altitude (35 ± 11 vs. 16 ± 3 mmHg; P < 0.0001), and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mmHg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost twofold larger increase in the 6- to 9- than in the 14- to 16-yr-old participants (24 ± 12 vs. 13 ± 8 mmHg; P = 0.004). Even in children with the most severe altitude-induced pulmonary hypertension, right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. HAPE appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.