Red blood cell storage is associated with length of stay and renal complications after cardiac surgery.

Background: The association of red blood cell (RBC) storage on morbidity outcome after cardiac surgery is debated. We sought to clarify the association of the age of transfused blood on outcome in patients undergoing cardiac surgery.

Study Design And Methods: Data were drawn from a prospective, observational cohort study of morbidity outcome in patients undergoing cardiac surgery.

Stroke at high altitude diagnosed in the field using portable ultrasound.

A tool that can differentiate ischemic stroke from other neurological conditions (eg, hemorrhagic stroke, high-altitude cerebral edema) in the field could enable more rapid thrombolysis when appropriate. The resources (eg, an MRI or CT scanner) to investigate stroke at high altitude may be limited, and hence a portable tool would be of benefit. Such a tool may also be of benefit in emergency departments when CT scanning is not available.

Tissue oxygen saturation and outcome after cardiac surgery.

Background: Cardiopulmonary bypass during cardiac surgery can result in a shortfall in oxygen delivery relative to demand, marked by a decrease in muscle tissue oxygen saturation as blood flow is redistributed to vital organs. Such "tissue shock" might impair postoperative recovery.

Objectives: To determine the association of changes in tissue oxygen saturation with postoperative outcome in cardiac surgery patients.

Structure to function: muscle failure in critically ill patients.

Impaired physical function and reduced physical activity are common findings in intensive care unit (ICU) survivors. More importantly, reduced muscle strength during critical illness is an independent predictor of survival. Skeletal muscle wasting as a direct consequence of critical illness has been suggested as the cause.

Variation in human performance in the hypoxic mountain environment.

Ascent to altitude is associated with a fall in barometric pressure, and with it a decline in the partial pressure of atmospheric (and thus alveolar) oxygen. As a result, a variety of adaptive physiological processes are engaged to mitigate the fall in tissue convective oxygen delivery which might otherwise occur. The magnitude and nature of such changes is also modified with time, a process known as acclimatization.

Climate change: how grave the threat?

There is now no dispute about climate change: it is happening, and human activity is driving it. Each day, the threat this poses becomes clearer--threatening our civilisation and also the survival of our species. The immediacy of this threat is also now recognised: it is not something 'for the next millenium' but for our lifetimes and those of our children.

Angiotensin-converting enzyme genotype and encephalopathy in Chernobyl cleanup workers.

Background And Purpose: To identify, using a genetic model, a key role for the renin-angiotensin system (RAS) in the development of dyscirculatory encephalopathy (DE) in Chernobyl cleanup workers (CCW). The insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE) gene denotes a substantial individual variation in RAS activity with the D-allele being associated with higher ACE activity.

Methods: Ninety-three male, Caucasian CCW were recruited from those under regular review at the All-Russia Centre of Emergency and Radiation Medicine, St.

Oxygen on Everest: the development of modern open-circuit systems for mountaineers.

The use of supplemental oxygen on Mt. Everest is now commonplace. From 1990 to 2006, more than 95% of those summiting the mountain did so using supplemental oxygen at some point during their ascent.

Angiotensin-converting enzyme genotype and late respiratory complications of mustard gas exposure.

Background: Exposure to mustard gas frequently results in long-term respiratory complications. However the factors which drive the development and progression of these complications remain unclear. The Renin Angiotensin System (RAS) has been implicated in lung inflammatory and fibrotic responses.

Genetophysiology: using genetic strategies to explore hypoxic adaptation.

The common inheritance of the same 20,000 to 25,000 genes defines us as human. However, substantial variation exists in the human genome, which determines how each of us will respond to any given (identical) environmental stimulus. The interaction of this variation with diverse environmental stimuli makes us all different from one another.

The medical impacts of climate change.

Carbon dioxide captured in fossil fuels over some 410 million years has been released in decades, and the earth is warming as a result. This threatens not just our health, but our very survival as a species.

Angiotensin-converting enzyme genotype and successful ascent to extreme high altitude.

Interindividual variation in acclimatization to altitude suggests a genetic component, and several candidate genes have been proposed. One such candidate is a polymorphism in the angiotensin converting enzyme (ACE) gene, where the insertion (I-allele), rather than the deletion (D-allele), of a 287 base pair sequence has been associated with lower circulating and tissue ACE activity and has a greater than normal frequency among elite endurance athletes and, in a single study, among elite high altitude mountaineers. We tested the hypothesis that the I-allele is associated with successful ascent to the extreme high altitude of 8000 m.

Increased gastric-end tidal P(CO2) gap during exercise at high altitude measured by gastric tonometry.

Using automated air gastric tonometry, the hypothesis that gastric perfusion is reduced while exercising at high altitude was explored. This prospective observational study of 5 well acclimatized healthy volunteers was performed during a medical research expedition to Chamlang base camp (5000 m), Hongu valley, Nepal. We used gastric tonometry at rest and during graded submaximal exercise.