Does This Patient Have Acute Mountain Sickness?: The Rational Clinical Examination Systematic Review

@article{Meier2017DoesTP,
  title={Does This Patient Have Acute Mountain Sickness?: The Rational Clinical Examination Systematic Review},
  author={David Meier and Tinh-Hai Collet and Isabella Locatelli and Jacques Cornuz and Bengt Kayser and David L. Simel and Claudio Sartori},
  journal={JAMA},
  year={2017},
  volume={318},
  pages={1810–1819}
}
Importance Acute mountain sickness (AMS) affects more than 25% of individuals ascending to 3500 m (11 500 ft) and more than 50% of those above 6000 m (19 700 ft). AMS may progress from nonspecific symptoms to life-threatening high-altitude cerebral edema in less than 1% of patients. It is not clear how to best diagnose AMS. Objective To systematically review studies assessing the accuracy of AMS diagnostic instruments, including the visual analog scale (VAS) score, which quantifies the overall… Expand
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TLDR
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TLDR
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TLDR
In lowlanders with mild to moderate COPD, the incidence of AMS/ARAHE at 3,100 m was moderate and not reduced by dexamethasone treatment, although the drug mitigated the altitude‐induced hypoxemia. Expand
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TLDR
Larger SpO 2 reduction after exercise at low altitude was an independent risk for AMS upon ascent, and was more robust in men than in women. Expand
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TLDR
In this cohort, AMS affected two out of five travelers and obesity and female sex were associated with increased risk, while Acetazolamide prophylaxis was associated with decreased risk of AMS. Expand
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TLDR
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TLDR
This review presents the most relevant general concepts of these 3 clinical variants of mountain sickness, which can be incapacitating and can result in complications and become life-threatening in a hostile environment such as high mountains. Expand
What is the best screening tool for diagnosing acute mountain sickness?
TLDR
A 2014 report of two case series evaluated standard dialectical behavioral therapy (DBT) and augmented DBT (early name for RO-DBB) in patients with anorexia nervosa treated in an outpatient setting and effectiveness of “augmented” DBT in nine medically stable women. Expand
Exercise performance and symptoms in lowlanders with COPD ascending to moderate altitude: randomized trial
TLDR
During sojourns at 1,650 m and 2,590 m, lowlanders with moderate to severe COPD experienced a mild reduction in exercise performance and nearly one quarter required oxygen therapy or descent to lower altitude because of adverse health effects. Expand
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TLDR
ONSD changes correlate with altitude and tend to increase in subjects with AMS, and small study number and high heterogeneity are the limitations of the study. Expand
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