Recent publications in high altitude medicine

Dear colleagues and friends:


The organizing committee thanks all of those that expressed their interest in participating. We look forward to everyones participation with their interesting scientific work. You are all welcome.

We would like to inform you that some of our most recent publications are among the themes to be addressed at our forthcoming symposium:

High altitude diving depths.
Res Sports Med. 2007 Jul-Sep;15(3):213-23.
PMID: 17987509
http://dx.doi.org/10.1080/15438620701526795
Our pre-print copy can be read here

Thorsen HC, Zubieta-Calleja G, Paulev PE.

Decompression sickness following seawater hunting using underwater scooters.

Res Sports Med. 2007 Jul-Sep;15(3):225-39.
PMID: 17987510

Paulev PE, Siggaard-Andersen O.

Clinical application of the pO(2)-pCO(2) diagram.

Acta Anaesthesiol Scand. 2004 Oct;48(9):1105-14.
PMID: 15352956 [PubMed – indexed for MEDLINE]

Paulev PE, Zubieta-Calleja GR.

Essentials in the diagnosis of acid-base disorders and their high altitude application.
J Physiol Pharmacol. 2005 Sep;56 Suppl 4:155-70.
PMID: 16204789
Full pdf article. Read it here

Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Calleja N, Zubieta-Castillo G.

Hypoventilation in chronic mountain sickness: a mechanism to preserve energy.
J Physiol Pharmacol. 2006 Sep;57 Suppl 4:425-30.
PMID: 17072073
Full pdf article. Read it here

Zubieta-Castillo G Sr, Zubieta-Calleja GR Jr, Zubieta-Calleja L.

Chronic mountain sickness: the reaction of physical disorders to chronic hypoxia.

J Physiol Pharmacol. 2006 Sep;57 Suppl 4:431-42.
PMID: 17072074
Full pdf article. Read it here

Zubieta-Castillo G, Zubieta-Calleja GR, Zubieta-Calleja L, Zubieta-Calleja, Nancy.

Adaptation to life at the altitude of the summit of Everest.
Fiziol Zh. 2003;49(3):110-7. Review.

PMID: 12918259
Full pdf article. Read it here

Hope you enjoy them,

MERRY CHRISTMAS and a HAPPY NEW YEAR !!

Christmas

Poul-Erik Paulev, Gustavo Zubieta-Calleja and Gustavo Zubieta-Castillo (Sr).

Space Travel

Energy-efficient space travel alternative:

Hypobaric cabin pressure?

Gustavo Zubieta-Calleja (Jr)

The Panum Institute, Faculty of Health Sciences, University of Copenhagen

High Altitude Pathology Institute, Clinica IPPA. http://www.Altitudeclinic.com. La Paz, Bolivia

The following comments are conclusions of a “Doctor of Medical Sciences” dissertation, presented to the University of Copenhagen, entitled “Human Adaptation to High Altitude and Sea Level; Acid-Base Equilibrium, Ventilation and Circulation in Chronic Hypoxia” accepted for assessment on Sept 7th, 2007.

Based on 36 years of research related to high altitude polycythemia with Prof. Gustavo Zubieta-Castillo (Sr) in Bolivia and recently high altitude to sea level adaptation with Prof. Poul-Erik Paulev in Denmark, a greater understanding of the hematologic response to inspired oxygen pressure changes has led to the following:

Astronauts in the micro-gravity environment of space suffer many changes and among those anemia [1]. Thus far unexplained, neocytolisis has been described as the possible underlying mechanism [2, 3]. The adaptation to micro-gravity involves less use of muscle work and changes in ventilation and perfusion at lung level that the organism finds convenient to reduce the hematocrit following the least energy expenditure concept [4]. The knowledge and understanding of physiologic polycythemia (now known as polyerythrocythemia) upon ascent to high altitude and relative anemia following descent of high altitude residents to sea level [5, 6], allows for a logical proposal to bloodletting of high altitude residents on travel to sea level for periods longer than 20 days (an outstanding humanitarian blood resource) and similarly in astronauts when going into space. The logic is that they would economize energy avoiding the destructive hemolytic phase of adaptation. However, in astronauts, upon return to sea level, re-infusion of the phlebotomized blood could return the hematocrit to normal levels, although blood transfusion efficiency has lately been questioned. Erythropoyetine administration is also a possibility but less physiologic, more complicated and time limited.

Original space flights were carried out in a pure oxygen environment and one third the sea level pressure until serious fire accidents were encountered. Currently, the cabin pressure is normal sea level pressure at 760 mmHg with 20 % oxygen and 80 % nitrogen [7].

An alternative to the complication of space travel anemia would be to reduce the ambient oxygen tension within space vehicles, down to 2/3 the sea level pressure to around 495 mmHg (similar to the altitude of the city of La Paz with over 1.5 million inhabitants), in order to maintain a hypoxic stimulus and sustain the number of red blood cells for re-entry to Earth. Furthermore, the weightlessness space conditions require less oxygen consumption as there is less muscular use and hence tolerance to hypoxia can be increased. After an uncomplicated acute adaptation phase to hypoxia, with the adequate procedures, the astronauts can proceed with their normal routine during space travel. Upon return to sea level and the “relative hyperoxia”, the blood count should remain unchanged. This would create important advantages as there would be lower need for oxygen generation and pressure build-up, both high energy consumption processes. Likewise the Extravehicular Mobility Unit could benefit from a lower oxygen tension, less pressure difference with the space capsule, a speedier preparation and additionally more autonomy. Long space flights in the near future, would require less wasted resources in excess oxygen production and pressure. The return to the normal (relative hyperoxic) environment of sea level, would ease adaptation, as there would have been no reduction of the hematocrit during space flight [8]. Man faces future space travel where oxygen tensions will be a crucial life saving variable, and this proposal provides a physiological and physical energy-efficient alternative.

References

[1] Tavassoli M. Anemia of spaceflight. Blood. 1982 Nov;60(5):1059-67.

[2] De Santo NG, Cirillo M, Kirsch KA, Correale G, Drummer C, Frassl W, et al. Anemia and erythropoietin in space flights. Semin Nephrol. 2005 Nov;25(6):379-87.

[3] Rice L, Alfrey CP. The negative regulation of red cell mass by neocytolysis: physiologic and pathophysiologic manifestations. Cell Physiol Biochem. 2005;15(6):245-50.

[4] Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Calleja N, Zubieta-Castillo G. Hypoventilation in chronic mountain sickness: a mechanism to preserve energy. J Physiol Pharmacol. 2006 Sep;57 Suppl 4:425-30.

[5] Zubieta-Calleja GR, Paulev P-E, Zubieta-Calleja L, Zubieta-Castillo G. Altitude adaptation through hematocrit changes. J of Physiol and Pharmacol. 2007;58(Supplement in print).

[6] Zubieta-Castillo G, Sr., Zubieta-Calleja GR, Jr., Zubieta-Calleja L. Chronic mountain sickness: the reaction of physical disorders to chronic hypoxia. J Physiol Pharmacol. 2006 Sep;57 Suppl 4(2):431-42.

[7] NASA. Crew Compartment Cabin Pressurization. [cited 2007 June15, 2007]; Available from: http://spaceflight.nasa.gov/shuttle/reference/shutref/orbiter/eclss/cabinpress.html

[8] Zubieta-Calleja GR. Human adaptation to high altitude and to sea level: Acid-base equilibrium, ventilation, and circulation in chronic hypoxia. [Dissertation]. Copenhagen: University of Copenhagen; Sept 7th, 2007.

Photo courtesy of NASA, downloaded from http://www.geekphilosopher.com/MainPage/bkgStars.htm

The new Poul-Erik High Altitude Diving Laboratory

The Zubieta University proudly presents the new

Poul-Erik Paulev High Altitude Diving Laboratory
,

open to anyone interested in pursuing research related to high altitude diving in the Lake Titicaca (1 hour from La Paz) and also up to Lake Licancabur “the highest diving lagoon in the world”. We welcome theoretical studies and discussions with Prof. Paulev, for the constant improvement of diving science.
Visit the website….

Two Danish Physiologist and one Bolivian support soccer at high altitude

FIFA (Fédération Internationale de Football Association), Football’s governing body, has once more banned international matches from being played at more than 2,500m (8,200ft) above sea level. It then changed to 3000 m. They said the decision was made because of concerns over players’ health and possible distortion of competition.

Just want to pass along a letter mailed this week to Bolivia’s president, Evo Morales, by my colleague Gustavo Zubieta of the Institute of High Altitude Pathology in La Paz, in reference to the recent FIFA effort to ban high altitude soccer games.

Dr. Zubieta, one of the world’s leading authorities on high altitude physiology, is presently at the University of Copenhagen. The letter is also signed by Prof. Jens Bangsbo, an international authority on soccer physiology and Prof. Poul-Erik Paulev exercise physiologist from the University of Copenhagen.

The letter specifically notes that “based on extensive knowledge over many years of work in research on exercise, pressure changes, environmental changes and different conditions that the human body can tolerate during the practice of sports”, that “the world games of soccer can and should be played in the high altitude cities of La Paz.”

You can download a copy by clicking on the image above or accesing this link:

http://www.altitudeclinic.com/images/Bolivian%20President.pdf

En Español:
http://www.altitudeclinic.com/images/Traduccion_futbol_altura.pdf

Michael Moretti
High Altitude Medical Anthropologist
La Paz, Bolivia

June 24, 2007

II Symposium on the Effect of Chronic Hypoxia on Diseases at High Altitude


Dear Colleagues and friends from around the globe:

We are proud to send this 1st Announcement of the forthcoming:

Lake Titicaca 3800 m. One place of the itinerant symposium.

II Symposium

THE EFFECT OF CHRONIC HYPOXIA
ON DISEASES AT HIGH ALTITUDE
Aug 2-9, 2008

La Paz, Bolivia

Lake Titicaca 3800 m. Part of the itinerant symposium

Please visit our website:
http://zuniv.net/symposium2

We look forward to seeing you in 2008 !!!

Prof. Dr. Gustavo Zubieta-Castillo (Sr) and Prof. Dr. Gustavo Zubieta-Calleja (Jr)
http://altitudeclinic.com

Hanns-Christian Gunga visits La Paz


Once more our good friend Hanns-Christian Gunga was in La Paz in Dec, 2006 and we had a wonderful visit at the High Altitude Pathology Clinic and a great dinner at a local ***** restaurant. This time he came with Prof. Karl Kirsch of the Department of Physiology, Charite-Universitatsmedizin and Center of Space Medicine, Berlin, Germany. We made plans for joint research in our Pyramid in Chacaltaya.
This photo is in the waiting room of IPPA.

Seminar at the Centre for Cardiovascular Research Czech Republic

by Prof. Dr. Gustavo Zubieta-Calleja

On Nov 14th, 2006, I visited the Centre for Cardiovascular Research of the Czech Republic Academy of Sciences at Prague. I was very favorably impressed with the long standing pioneer work on the protective effect of chronic hypoxia with regards to myocardial infarction. After the publications of Hurtado in Peru(1950) affirming a lower incidence of myocardial infarction in people living at altitude, Kopecky and Daum (1958) and Poupa (1966) performed the first experimental studies using a model of high altitude hypoxia in a hypobaric chamber. Prof. Poupa was described by Prof. Bohuslav Ostadal, his succesor, as a true renaissance man that not only was extraordinary with the science but also multiple in his interests which included oil paintings.
Prof. Ostadal, transformed the center into an international renown Center of Excellence. In 2003 he was granted the Norman Alpert Award for his outstanding achievements in the area of Cardiovascular Science and Medicine.

Shown above, the solid II World War German hypobaric chamber that is in current use with rats exposed to 5 500 m of altitude as shown on the next picture. The simuloated altitude is quite similar to the altitude of the Chacaltaya high altitude pyramid laboratory.


Prof. Frantisek Kolar, shown at left, the current director, has boosted the research and in this opportunity kindly invited me to give a seminar entitled “ Cardiovascular and pulmonary physiological changes during exercise in high altitude residents: remarkable adaptation to chronic hypoxia.”
This talk presented the work performed at IPPA in relation to high altitude and particularly to the work of Prof. Dr. Gustavo Zubieta-Castillo (Sr) and his theory of adaptation to life at the hypoxic levels of the summit of Mt. Everest.
The research being performed at the centre
is most interesting and promising for practical solutions to the prevention of myocardial infarction through exposure to chronic hypoxia. The equipment used is high tech and on the leading edge in this type of research.

The work they perform is indeed of worlwide interest as there is a current worldwide scientific wave of interest on the effects of high altitude protective effects particularly in the coronary circulation. Prof. Emilio Marticorena of Peru has also greatly contributed to these modern concepts showing how high altitude helps with the rehabilitation of cardiac patients.



Dr. Ivana Ostadalova in charge of developmental cardiological research at the Centre.


The hypoxic chamber where rats are placed in an enviroment with a 10 % oxygen concentration. This chamber is similar to the chamber we have that is called Hyperoxic/Hypoxic Adaptation Chamber

We use it to treat patients with high altitude disease and also to perform research in humans at different altitudes.
Special thanks to Jan Neckar, a young enthusiastic and distinguished scientist of the Centre for the photographs here presented.


We also visited the echocardiography department where echocardiographic observation of myocardial infarcts in rats’ hearts is shown. This is highly complicated and requires much knowledge in the area. They are about to receive the latest techonolgy in this area and this will further boost their prestige in this important area of human health care.

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6th World High Altitude congress in China 2005



6th World Congress on Mountain Medicine and Physiology in Xining, China and Lasha, Tibet. 2004

Prof. Dr. Gustavo Zubieta-Castillo (left) and Prof. Dr. Gustavo Zubieta Calleja (right) in Lhasa, Tibet during the visit to one of the hospitals. Shown here are three tibetan monks.

Prof. Dr. Gustavo Zubieta-Castillo, a Tibetan Monk and Prof. Dale McMcall on the foreground in front of the Potala Palace in Lhasa, Tibet, considered one of the marvels of the world.

On the background Prof. Univ. Dr. Hanns-Christian Gunga.

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Berlin Frei University Fisiology Conference

Berlin Fiziology conference 2005 at The Department of Physiology of Berlin Frei University.
Center for Space Medicine under the direction of Prof. Dr. Univ. Hanns-Christian Gunga

Prof. Poul-Erik Paulev and Prof. Gustavo Zubieta-Calleja gave talks representing the Univ. of Copenhagen and the High Altitude Pathology Institute in La Paz, Bolivia

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