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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have demonstrated a small but statistically significant decrease in forced vital capacity and in pulmonary flow rates among 126 persons studied daily for the first three days after arrival at an altitude of 2,835 meters (9,300 ft). Nearly half of these individuals had symptoms attributable to altitude sickness, and those with the most dyspnea and worst headache also showed the greatest changes in pulmonary function studied. We suggest that there is a relationship between the symptoms of altitude sickness and pulmonary function consistent with the appearance of early interstitial or alveolar edema.
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PMID:The relationship between acute mountain sickness and pulmonary ventilation at 2,835 meters (9,300 ft). 42 19

Eight patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) and average resting Pao2 of 66 mm Hg were studied clinically and physiologically at sea level and after ascent to 1,920 m. At sea level the patients were symptomatic but not disabled. After ascent the patients had only mild symptoms of fatigue and insomnia, and one had severe headache during exercise on the first day. Funduscopic changes were not observed, nor did cardiac or pulmonary findings change. Resting sea level Pao2 dropped to 51.5 mm Hg within three hours of ascent, and the Paco2 fell from 37.8 to 33.9 mm Hg. Over the next three days, the Pao2 increased to 54.5 mm Hg as hyperventilation continued. At exercise, sea level Pao2 dropped from a mean value of 63 to 46.8 mm Hg at altitude. Pulse rates at rest or exercise did not change. Normal values for 2,3-diphosphoglycerate (2,3-DPG) did not change after ascent at 16 and 42 hours. We believe aircraft flight or travel to moderate altitudes for this type of COPD patient is safe. Preexisting hypoxemia resulting from disease may facilitate the adaptation of patients to severe hypoxia and may prevent symptoms similar to acute mountain sickness.
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PMID:Short-term adaptation to moderate altitude. Patients with chronic obstructive pulmonary disease. 68 52

We assessed the severity of Acute Mountain Sickness (A.M.S.), indices of pulmonary gas exchange and nitrogen washout curves in healthy volunteers acutely exposed to high altitude. Symptoms of A.M.S. ranged from malaise to vomiting with intractable headache. The slope of phase III of the nitrogen washout curve increased most in those subjects with the most severe A.M.S. and who were most hypoxemic. The sickest subject also had the greatest increase in (A-a)DO2 and the largest increase in the slope of phase III. These abnormalities in gas exchange and nitrogen washout curves in the subjects with the most marked A.M.S. suggest that the manifestations of cerebral and pulmonary dysfunction at altitude develop simultaneously, although not necessarily by identical mechanisms.
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PMID:Nitrogen washout studies in acute mountain sickness. 87 Dec 78

The severity of acute mountain sickness (AMS) was investigated in healthy volunteers, airlifted to high altitude (5,360 m). Blood gases were measured at 2,990 m and 5,360 m. Symptoms of AMS were found in all subjects, but ranged from malaise to vomiting with intractable headache. The clinical severity of AMS was directly related to the arterial PCO2 and inversely to pH, but unrelated to the PO2 on arrival at high altitude. However, PO2 fell and was lowest 48 h after arrival at high altitude in those subjects with the most severe AMS. These were the only subjects to show an increase in the alveolar-arterial PO2 difference and in the venous admixture ratio during the first 48 h. These abnormalities in gas exchange, which developed in the subjects with the most marked cerebral symptoms, suggest that the manifestations of cerebral and pulmonary dysfunction at altitude develop simultaneously, a finding that suggests coexisting cerebral and pulmonary edema.
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PMID:Pulmonary gas exchange in acute mountain sickness. 98 74

Acute mountain sickness was known to the Chinese in ancient times, as they traversed mountain passes between the Great Headache and Little Headache mountains into present-day Afghanistan. The Jesuit priest, Father Joseph Acosta, lived in Peru during the sixteenth century; he described both this syndrome and deaths which occurred in the high Andes. The incidence of high-altitude illness will rise as previously remote sites become more accessible to trekkers and skiers. Prevention and treatment are important concerns for those physicians who wish to advise their more adventuresome patients properly. This article incorporates a selected review of pertinent investigations, in the English-language literature over the past five years, into material previously presented at travel symposia for clinicians managing the prophylaxis and treatment of acute mountain sickness.
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PMID:Current prevention and management of acute mountain sickness. 129 Feb 75

This investigation explores the relationship between psychological factors and acute mountain sickness (AMS). AMS occurs in most people staying more than a few hours above 3500 m. Symptoms include headache, nausea, vomiting, insomnia, anorexia, etc. Subjects studied were climbers preparing for an expedition to the Himalayas (80 men and 20 women). The psychological investigation consisted in two mono-factorial tests: STAI (anxiety inventory) and Bortner stress scale. After the expedition, subjects were classified into two groups: those who were susceptible to AMS and those who were not. Results indicated that the two groups differed for trait-anxiety on one hand, and for the level of anxiety before the final ascent on the other hand. In both cases, subjects susceptible to AMS were significantly more anxious than those who were not.
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PMID:Control of anxiety and acute mountain sickness in Himalayan mountaineers. 148 85

Acetazolamide is a useful prophylactic for acute mountain sickness causing marked reduction in headache, nausea, vomiting, weakness, etc. Improvements correlate with increased arterial oxygen concentrations, reduction in proteinuria and peripheral oedema and other objective measures of acute mountain sickness. Evidence that Acetazolamide is beneficial for pulmonary oedema or cerebral oedema is scanty because of the lower frequency of these severe forms of mountain sickness. Dexamethasone, used prophylactically, also reduces the symptoms of acute mountain sickness partly due to its euphoric effect. Use of Acetazolamide as a treatment for established acute mountain sickness has been investigated. Large doses of Acetazolamide increase arterial oxygen levels over a few hours and this leads to a reduction of symptoms but data is limited and faster acting carbonic anhydrides inhibitors such as Methazolamide may be preferable in an emergency situation. There is no comparison of the effectiveness of Acetazolamide with other drugs used for treating acute mountain sickness such as steroids and calcium channel blocking drugs. Also, there is no data on drug combinations which could have additive effects and thereby be more beneficial than individual drugs.
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PMID:Acetazolamide and high altitude diseases. 148 96

Chronic mountain sickness, which affects permanent residents of high altitudes, is the outcome of a progressive loss of ventilatory rate which naturally occurs with age and resulting in excessive hypoxemia and polycythemia. A theoretical model predicts the progressive failure of homeostatic control of the hemoglobin concentration when the values increase above those found at sea level. This is confirmed by lack of feedback mechanism between high altitude erythrocytosis and serum erythropoietin. The results of epidemiological studies are in agreement with the physiological findings. In a male population living at 4,300 m, an increase with age of the prevalences of excessive erythrocytosis (Hb > 213 g/l), blood oxygen saturation < 83%, headaches and a high score of symptoms of chronic mountain sickness has been found. The studies suggest the possibility that in addition to an accentuated hypoxemia, the excessive erythrocytosis may also result from an overreaction of the bone marrow to a fixed level of hypoxemia in ageing individuals.
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PMID:Pathophysiology and epidemiology of chronic mountain sickness. 148 2

Altitude sickness is a clinical syndrome that occurs with abrupt ascents to altitudes of 3000 metres and above. Symptoms include headache, malaise, fatigue, dizziness, anorexia, nausea and vomiting, and oliguria. At higher altitudes more severe illness resulting from pulmonary oedema or cerebral oedema can occur.
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PMID:Altitude sickness. 232 86

A clinical syndrome identical to the chronic mountain sickness of the Andes occurs commonly in Lhasa, Tibet. It affects, almost exclusively, the immigrant Han population and develops after an average of 15 years' residence at high altitude. The early symptoms are attributable to polycythaemia--headache, dizziness, loss of memory and fatigue being prominent. In the later stages of the disease, dyspnoea and peripheral oedema develop. Haemodynamic investigations show pulmonary hypertension with a normal cardiac output and dilatation of the right ventricle in the long-established case. Respiratory gas studies provide evidence of alveolar underventilation and ventilation: perfusion inhomogeneity. Both clinical and investigatory data suggest that the earlier stages of the disease are dominated by polycythaemia, while cardiopulmonary involvement increases with the duration of the disease. The disease is rare in women and uncommon in Tibetans. Cigarette smoking appears to be a contributory factor.
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PMID:Chronic mountain sickness in Tibet. 251 94


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