International Society for Mountain Medicine VIWCMM Abstracts (Page 32) - Free Online Doc


International Society for Mountain Medicine - VIWCMM Abstracts (Page 32)

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2260m and 16m groups. No significant difference in heart structure was observed between the native Tibetan children and the Han Chinese at 3700m (p0.05). In conclusion, the heart structure in healthy children living at 3700m was significantly different compared with those in healthy children at middle high altitude and sea level. A high-altitude hypoxic environment did play a major role in the change of heart structure in healthy children; the racial differences between the Han and Tibetan children did not contribute. 70. INTERNATIONAL HIGH ALTITUDE PULMONARY EDEMA REGISTRY: TOOLS FOR THE NEW MILLINNEUM. Stuart Harris 1 , Stephen Thomas 1 , IHARC Investigators 3 . Massachusetts General Hospital, Harvard Medical School, Boston, MA. USA 1 , International High Altitude Research Collaborators 3 . The International High Altitude Pulmonary Edema Registry is a new, multi-center international collaborative study first conceived by physician-scientists at the 2002 Barcelona meeting of the ISMM. The Registry seeks to combine the limited data from multiple, single-sites into a single, large and significant cohort using a secured, web-based data instrument. The International HAPE Registry was founded and is governed by representatives of its international contributors, a group known as the International High Altitude Research Collaborators (IHARC). Over the last two years, the IHARC group, working with information technology staff and database researchers at Massachusetts General Hospital (Boston, USA), have developed the data instrument that is the International HAPE Registry. Through multiple revisions, the Registry has been honed to an essential 180+ data points most likely to inform future HAPE epidemiologic, pharmacologic, genetic, treatment and outcomes research. The Registry is web-based, with entry of data through an encrypted, secured server accessible only to participating IHARC study physicians (www.iharc.org). All participants will have signed a written informed consent prior to enrollment in the Registry. In mid-2004, high altitude centers across the United States and Asia began enrolling patients. Obstacles overcome in creating and implementing the Registry have included the disparity of sites involved (from isolated, high-altitude clinics to urban, tertiary-care medical centers), the traditional independence of prior (single-site) altitude research projects, and increasingly complex administrative hurdles for registry research as outlined in Dr. Engelfinger's editorial in the April 1, 2004 New England Journal of Medicine. The IHARC researchers continue to welcome new investigators to participate in the Registry. Our goals are simple: the collegial and productive pursuit of world class, high altitude research. 71. DEATHS DUE TO HIGH ALTITUDE ILLNESS AMONG TOURISTS CLIMBING MT. KILIMANJARO . Markus Hauser 1 , Andreas Mueller 1 , Britta Swai 2 , Emma Moshi 2 , Sendui Ole Nguyaine 3 . Medical Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania 1 , 3 , Pathology Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania 2 , Introduction: Mt. Kilimanjaro, the highest mountain in Africa, attracts more than 20 000 climbers each year. Although climbing experience is not required, less than 70% of the tourists reach the summit at 5895 m. Climbers who failed to reach the summit, suffer from various symptoms of High Altitude Illness (HAI) but fatal incidences are rare. Methods: Retrospective analysis of the autopsies of tourists who died while climbing Mt. Kilimanjaro from 01/1996 to 10/2003. Autopsy is legally required in Tanzania on all fatal incidences among tourists. Our Pathology Department is the only one in the vicinity to perform these, so the data reflect the actual number of fatal cases. Results: During the past 8 years, 25 tourists died while climbing Mt. Kilimanjaro, one died after reaching KCMC due to ARDS secondary to high altitude pulmonary oedema (HAPE). The age ranged from 29 to 74 years, 17 male, 8 female. 14/25 tourists died due to advanced HAI: 1/14 had high altitude cerebral oedema (HACE) only, 5/14 had HAPE, and 8/14 had findings of both HAPE and HACE. Non HAI-related deaths occurred in 11/25 climbers due to trauma (3), myocardial infarction (4), pneumonia (2), cardio-pulmonary failure of other underlying cause (1) and acute appendicitis (1). The estimated mortality rate for HAI was 7,7 per
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