Will mountains trekkers have heart attacks?

Article Abstract:

The recent increased awareness in fitness has encouraged symptomless individuals to approach their physicians for a clearance before engaging in strenuous exercise such as jogging or aerobic dancing. However, there is no supporting evidence that such cursory examinations, even when coupled with exercise stress testing, are useful or effective in identifying individuals who are at risk because of underlying cardiac problems. As part of this trend, many individuals have become interested in taking up sports such as mountain trekking and cross-country skiing, which also expose the individual to high altitudes. Many physicians are in short supply of available scientific and medical knowledge about the effect of altitude on their patients and can only inform their patients of the basic physiologic concepts. The level of oxygen saturation in the blood mirrors the ambient level of oxygen (the partial pressure of oxygen). At 18,000 feet the level of oxygen saturation drops to approximately half the amount at sea level; at the summit of Mount Everest, oxygen saturation is approximately one-third of sea level. However, there is no data to support the concept that the level of oxygen at the top of Mount Everest can cause a normal heart to experience an infarction (heart attack). The greatest concern of the effect of altitude remains for patients who have had heart problems in the past and for those who have had surgical treatments such as coronary bypass operations. Data have shown that for these individuals there are risks of ascent. However, there is little data to explore the effects of visiting areas 8,000 feet above sea level on the 35 million people who do so yearly within the US. The author's approach is to inform patients of the risks; to remind them that when they seek an adventure in primitive areas the lack of availability of medical assistance is a risk; that if they have trouble with exercise at sea level, the problem will be more difficult at higher altitudes; and that they should allow time to acclimatize.

Causes of, Physiological aspects, Coronary heart disease, Hiking, Altitudes, Altitude, editorial

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Trial registration: A great idea switches from ignored to irresistible

Article Abstract:

The importance of the registration of clinical trials especially by pharmaceutical industry, which can completely avoid their medical, political, and public relations fiasco faced is discussed. It is stated that the financial cost of an effective, independent and transparent clinical trial register would amount to a tiny fraction of the costs of the trial themselves.

United States, Science & research, Research, Recording and registration

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Registering clinical trials

Article Abstract:

The US National Institutes of Health (NIH) should start a database of clinical trials and require all medical researchers to register their trial. This will make information about clinical trials accessible to the public and other doctors. The NIH has 20 years of experience maintaining the GenBank database and even recommended a clinical trials registry in 1994.

Services information, Services, Registries (in medicine), Registries (Medicine), Centralized databases

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