{"id":151,"date":"2010-07-22T17:39:25","date_gmt":"2010-07-22T21:39:25","guid":{"rendered":"http:\/\/altitudeclinic.com\/blog\/?p=151"},"modified":"2015-11-08T22:17:01","modified_gmt":"2015-11-09T02:17:01","slug":"forever-loss-of-adaptation-does-not-exist","status":"publish","type":"post","link":"https:\/\/altitudeclinic.com\/blog\/2010\/07\/forever-loss-of-adaptation-does-not-exist\/","title":{"rendered":"Forever: “Loss of Adaptation” does not exist!"},"content":{"rendered":"

Forever: “Loss of Adaptation” does not exist!<\/strong><\/p>\n

Prof. Dr. Gustavo Zubieta-Castillo (Sr)<\/p>\n

Honorary Director \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Espa\u00f1ol (mas abajo)<\/em><\/p>\n

\"\"<\/p>\n

Instituto Pulmonar y Patolog\u00eda de la Altura IPPA<\/p>\n

La Paz, Bolivia<\/p>\n

AltitudeClinic.com<\/p>\n

Chronic Mountain Sickness (CMS) is a term that does not explain the ethiopathogenesis of the disease in response to the effect of chronic hypoxia. There is no CMS, but rather pulmonary (mainly), cardiac, carotid, kidney, hematological or genetic disease. All these associated to an increase on the hematocrit or what is now known as polyerythrocythemia.<\/p>\n

CMS, was described by Carlos Monge Medrano close to 90 years ago, He was unable to find an explanation for the signs and symptoms and chose to use the term \u201cLOSS OF ADAPTATION\u201d.\u00a0 This was originally accepted, but today it can be appreciated as lacking significance. And should stop being used.<\/p>\n

Undoubtedly, CMS is a chronic hypoxic process resulting in an increase of hemoglobin, due to pulmonary lesions (fundamentally), that alter the pulmonary function, thereby reducing the oxihemoglobin saturation and stimulating the increase of red blood cells. This, essentially, in pulmonary lesions that are sequelae of diverse lung disease giving rise to intra-pulmonary shunts or uneven ventilation-perfusion. The term \u201cLOSS OF ADAPTATION\u201d, is even semantically inadequate, because in nature, living beings tend to adapt to different environments and circumstances. These could be: going to high altitude, temperature changes, solar radiation, UV radiation, diet changes, etc, etc . Consequently, to insist in contemporary medicine on the use of \u201cLOSS OF ADAPTATION\u201d, is not only a mistake, but rather foolishness!<\/p>\n

On the other hand, if one is convinced as to the cause of a disease, where other scientists are in disagreement, it is futile to incur in the use of insults. In the International Chronic Mountain Sickness Consensus Group, you Fabiola Leon-Velarde, recurred to them in your e-mail on January 09, 2005 with the expression as follows:<\/p>\n

\u201cThird, we have agreed in Xining that any member of the group who have had a different opinion in any point, should send a letter to the Journal informing about the discrepancy. Of course, if any member of the group do not agreed at all with the Consensus, he should ask that his name is retired from the list of names, otherwise his letter will appear a little bit esquizofrenic.\u201d<\/p>\n

Please note that you misspelled the word\u2026 \u00a0“schizophrenia”. This is what happens when one is not a medical doctor and\u00a0doesn’t\u00a0have medical knowledge. You live in Lima, at sea level,and your brief visits to high altitude, give you no authority or experience on disease at high altitude. Through your attitude, you are confusing world researchers. This has to be said for the sake of truth. Your knowledge should be restricted to the spectrum provided by your occupations instead of persisting on the use of \u201closs of adaptation\u201d in regards to CMS. To have written a book entitled \u201cDesadaptation a las grandes Alturas\u201d (Loss of adaptation to high altitude) is to insist and confirm that you hardly understand the basic concepts of nature. A grave mistake, with no return.<\/p>\n

In reference to this article please read \u201cConsensus statement on chronic and subacute high altitude diseases\u201d (1)<\/sub> . where we participated as a minority with an opposite standing versus \u201cLoss of Adaptation\u201d. We stated our concepts in regards to CMS within the aforementioned group (comments are available, on-line (3,4).<\/sub>) In that group, there were many prestigious scientists, from around the globe, but most of them lacked knowledge about diseases at high altitude.<\/p>\n

We urge the reader not to misinterpret us. We are not offended by the insult, and quite the contrary we laughed upon reading it as anecdotal. What we are doing here is setting things straight, for the sake of science. The term \u201closs of adaptation\u201d is inadmissible as it does not explain an ethiopathogenesis.<\/p>\n

We are so convinced, based on our fifty years of high altitude research and experience, that living beings not only adapt to life at 5000m, as it is well known, but rather even to\u00a0 8842m at the summit of Monte Everest.\u00a0 There can be no doubt.<\/p>\n

Similarly, pulmonary and cardiac patients in chronic hypoxic environments at high altitude, also adapt, hand in hand with their disease. Polyerythrocythemia, is one of the resulting hematologic mechanisms that allows for an increase of the oxygen content.<\/p>\n

You, on purpose, as you have done before, exclude us from participating in the\u00a0 THE VIII WORLD CONGRESS ON HIGH ALTITUDE MEDICINE AND PHYSIOLOGY – CARLOS MONGE CASSINELLI. Congratulations for naming it after our dear friend Choclo.We remind you that we initiated these world congresses successfully, in Bolivia, back in 1994. We invited everyone dedicated to high altitude to attend, including yourself as you were Choclo\u2019s collaborator.<\/p>\n

We are now at our III CHRONIC HYPOXIA SYMPOSIUM in October 2010 in La Paz, Bolivia. You and everyone are invited to attend, with no restrictions, nor political interest groups, that often block the participation of some, that think different.<\/p>\n

Throughout history, all living beings, go through\u00a0 evolution, in order to adapt to different environmental conditions. Even aging is an evolution, that goes to finish a vital cycle.\u00a0 It never goes in the reverse way. This concept of loss of adaptation is unacceptable.<\/p>\n

Again, \u201cThe organic systems of human beings and all other species tend to adapt to any environmental change and circumstance within an optimal period of time, and\u00a0 never tend towards regression which would inevitably lead to death\u201d <\/em>(2)<\/sub><\/p>\n

La Paz, March 11, 2010<\/p>\n

———————————————————————————————-<\/p>\n

Para siempre: La “Desadaptaci\u00f3n a la Altura”: No existe !<\/strong><\/p>\n

Prof. Dr. Gustavo Zubieta-Castillo (Sr)<\/p>\n

Director<\/p>\n

Instituto Pulmonar y Patolog\u00eda de la Altura IPPA<\/em><\/p>\n

La Paz, Bolivia<\/p>\n

El Mal de Monta\u00f1a Cr\u00f3nico\u00a0 (CMS), es un t\u00e9rmino inadecuado porque no explica la etiopatogenia de la enfermedad. Las enfermedades en la altura sufren el efecto de la hipoxia cr\u00f3nica. No existe el mal de monta\u00f1a cr\u00f3nico sino las enfermedades pulmonares de diferente etiopatologia que van asociadas al aumento del hematocrito o polieritrocitemia.<\/p>\n

Carlos Monge Medrano, describi\u00f3 admirablemente los s\u00edntomas y signos del Mal de Monta\u00f1a Cr\u00f3nico. Al no encontrar una etiolog\u00eda adecuada, para esa \u00e9poca, utiliz\u00f3 el termino DESADAPTACION. Este t\u00e9rmino aceptado al principio, se puede comprobar que actualmente no tiene significaci\u00f3n.<\/p>\n

El s\u00edndrome de Mal de Monta\u00f1a Cr\u00f3nico, se sabe actualmente, sin que pueda hacerse objeciones, es fundamentalmente, un proceso cr\u00f3nico hip\u00f3xico con un aumento del hematocrito. Esto debido a lesiones pulmonares que alteran la funci\u00f3n respiratoria y que impiden la adecuada saturaci\u00f3n de la sangre estimulando el aumento de los gl\u00f3bulos rojos. Sobretodo es debido a secuelas de lesiones pulmonares de diversa etiolog\u00eda con shunt pulmonar y\/o ventilaci\u00f3n no uniforme. El termino desadaptaci\u00f3n, es incluso sem\u00e1nticamente inadecuado porque en la naturaleza los seres biol\u00f3gicos tienden a la adaptaci\u00f3n a diferentes medios y circunstancias. Como ser: cambio de altura, de temperatura, radiaci\u00f3n solar, radiaci\u00f3n UV, cambio de alimentaci\u00f3n, etc, etc. De manera que insistir en la medicina contempor\u00e1nea con el termino desadaptaci\u00f3n, no solo es un error, sino una insensatez!<\/p>\n

Por otra parte si uno tiene la convicci\u00f3n sobre las causas de alguna enfermedad, con la cual no est\u00e1n de acuerdo otros cient\u00edficos, no es esto motivo, para que se recurra al insulto. La ecuanimidad esta en reconocer que uno puede equivocarse pero no tratar de imponer criterios recurriendo al insulto como lo esta haciendo Ud. Fabiola Leon Velarde.<\/p>\n

Para referencia est\u00e1 la publicaci\u00f3n \u201cConsensus statement on chronic and subacute high altitude diseases\u201d(1) donde participamos minoritariamente con una posici\u00f3n contraria a la Desadaptaci\u00f3n.(3,4). \u00a0Ese grupo de prestigiosos cient\u00edficos de todo el mundo, tenian escaso conocimiento de las enfermedades en la altura.<\/p>\n

Durante las reuniones previas en Jan09,2005, Ud. nos escribi\u00f3 (traducido al Espa\u00f1ol):<\/p>\n

\u201cTercero, hemos acordado en Xining, que cualquier miembro del grupo que tuviera una opini\u00f3n diferente, deber\u00eda enviar una carta al Journal informando de esa discrepancia. Por supuesto, si alg\u00fan miembro del grupo no esta de acuerdo con el Consenso, debe pedir que su nombre sea retirado de la lista de nombres, de otra manera su carta aparecer\u00eda algo esquizofr\u00e9nica. (<\/em>esquizofrenic en la version en ingles)<\/em>\u201d<\/em><\/p>\n

Ojo,\u00a0 en Ingl\u00e9s se escribe \u201cschizophrenia\u201d.<\/em><\/p>\n

Su audacia no tiene limites, porque Ud. no es medico y por lo tanto no sabe medicina. Ud. vive en Lima, a nivel del mar, y sus visitas espor\u00e1dicas a la altura no le dan ninguna autoridad ni experiencia y esta confundiendo a los investigadores presentando estos casos. Sus conocimientos deber\u00edan estar limitados al espectro que le permitan sus ocupaciones y no tratar de insistir de que el mal de monta\u00f1a es debido a \u201cdesadaptacion\u201d. Haber escrito un libro titulado \u201cDesadaptaci\u00f3n a las grandes alturas\u201d es insistir y confirmar que no se entiende los conceptos b\u00e1sicos de la naturaleza. Error cometido irremediablemente.<\/p>\n

No nos ofende, ni causa resentimiento que Ud. en esa oportunidad, nos llam\u00f3 esquizofrenicos, y sentimos por el contrario que es motivo de buen humor y anecdotico. Lo que estamos haciendo es afirmar que el termino desadaptaci\u00f3n es inadmisible porque no explica ni se\u00f1ala una etiopatologia.<\/p>\n

Estamos tan convencidos que el ser biol\u00f3gico no solo se adapta a la vida a los 5000m, sino hasta los 8842m en la cima del Monte Everest. No cabe duda… De igual forma los enfermos pulmonares o cardiacos en el ambiente hip\u00f3xico de la altura, tambi\u00e9n se adaptan con su enfermedad, resultando la polieritrocitemia, un mecanismo para aumentar el contenido de ox\u00edgeno.<\/p>\n

Ud. nos excluye intencionalmente del VIII Congreso Mundial de Medicina y Fisiolog\u00eda de la Altura, cuya serie, nosotros iniciamos exitosamente en Bolivia el a\u00f1o 1994, al que invitamos cordialmente a todos dedicados a la altura, incluy\u00e9ndola a Ud. por ser la colaboradora de nuestro amigo Carlos Monge Casinelli. Nos alegramos que el VIII sea en honor a nuestro amigo Choclo.<\/p>\n

Nosotros tenemos el III Simposio del Efecto de La Hipoxia Cr\u00f3nica en las Enfermedades en la Altura en Octubre 2010, al cual queda Ud. Cordialmente invitada, aqu\u00ed en La Paz. Todos est\u00e1n invitados a participar, sin restricciones, ni grupillos de inter\u00e9s pol\u00edtico com\u00fan, como frecuentemente ocurre bloqueando intencionalmente la participaci\u00f3n de algunos, que opinan diferente.<\/p>\n

A trav\u00e9s de la historia, todos los seres vivientes evolucionan, para adaptarse a diferentes condiciones ambientales. Incluso la edad es una forma de evoluci\u00f3n, que se dirige a finalizar un ciclo. Nunca va en sentido contrario. Este concepto de Desadaptacion es inaceptable.<\/p>\n

Nuevamente, \u201cLos sistemas org\u00e1nicos\u00a0<\/em>\u00a0de los seres humanos y de las otras especies tienden a la adaptaci\u00f3n a cualquier cambio ambiental, dentro de un periodo \u00f3ptimo de tiempo, y nunca tienden hacia la regresi\u00f3n que inevitablemente dar\u00eda curso a la muerte\u201d.<\/em>(2)<\/p>\n

 <\/p>\n

La Paz, 11 de marzo de 2010<\/p>\n

References<\/p>\n

1) Le\u00f3n-Velarde F, Maggiorini M, Reeves JT, Aldashev A, Asmus I, Bernardi L, Ge RL, Hackett P, Kobayashi T, Moore LG, Penaloza D, Richalet JP, Roach R, Wu T, Vargas E, Zubieta-Castillo G, Zubieta-Calleja G.<\/a><\/p>\n

Consensus statement on chronic and subacute high altitude diseases.<\/p>\n

High Alt Med Biol. 2005 Summer;6(2):147-57<\/p>\n

2) Zubieta-Castillo G Sr, Zubieta-Calleja GR Jr, Zubieta-Calleja L.<\/a><\/p>\n

Chronic mountain sickness: the reaction of physical disorders to chronic hypoxia.<\/p>\n

J Physiol Pharmacol. 2006 Sep;57 Suppl 4:431-42.<\/p>\n

3) http:\/\/altitudeclinic.com\/blog\/2010\/07\/chronic-mountain-sickness-discussion-part-1\/<\/a><\/p>\n

4) http:\/\/altitudeclinic.com\/blog\/2010\/07\/chronic-mountain-sickness-discussion-part-2\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

“Loss of adaptation” in Chronic Mountain Sickness does not exist. This obsolete term should definitely be discarded.<\/p>\n","protected":false},"author":1,"featured_media":152,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-adaptation"],"_links":{"self":[{"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/posts\/151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/comments?post=151"}],"version-history":[{"count":9,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/posts\/151\/revisions"}],"predecessor-version":[{"id":436,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/posts\/151\/revisions\/436"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/media\/152"}],"wp:attachment":[{"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/media?parent=151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/categories?post=151"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/altitudeclinic.com\/blog\/wp-json\/wp\/v2\/tags?post=151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}