Browsing by Autor "Natalia Zubieta-DeUrioste"

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COVID-19: Multiple Diseases Simulating Extreme High-Altitude Exposure? Oxygen Transport Physiology and Scarce Need of Ventilators; Andean Condor&rsquo;s-Eye-View
(2020) Gustavo Zubieta‐Calleja; Natalia Zubieta-DeUrioste; Thuppil Venkatesh; Kusal Das; Jorge Soliz
The critical hypoxia in COVID-19 patients during this pandemic, has taken away many lives all around the globe. The mechanism has been poorly understood and initially, word got around that it was a SARS (Severe Acute Respiratory Syndrome) pneumonia. The atypical images in lung computerized axial tomography (CAT) scans were alarming. This immediately alerted everyone including poor countries to purchase lacking sophisticated ventilator equipment. However, in some countries, even 88% of the patients on ventilators lost their lives. New observations and pathological findings are gradually clarifying the disease. What seems evident is that it is not only one disease but several, with different responses in different countries and different altitudes. The critical hypoxia and &laquo;gasping&raquo; present in some patients are not totally understood. It was mentioned that it could be like a High-Altitude Pulmonary Edema (HAPE). Hereby, as high-altitude medicine and hypoxia physiology specialists, we compare the pathophysiology with that of high-altitude exposure in order to understand the mechanisms involved. Some differences in lung radiological images along with transmission and viral attack mechanisms are discussed. The oxygen transport triad used at high-altitude can be applied on this pathology in order to propose even the use of erythropoietin (EPO) early in the treatment. The immune system is the most important long-term survival tool, so we suggest a short-term strategy: the use of special Earth open-circuit astronaut-resembling suits with effective outside air filtering re-breathing mechanisms in order to return to work and daily activities, without contamination risk. Thereby, the curve can be flattened without quarantine and the economy could recover.
Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?
(Elsevier BV, 2020) Christian Arias‐Reyes; Natalia Zubieta-DeUrioste; Liliana Poma-Machicao; Fernanda Aliaga‐Raduán; Favio Carvajal-Rodriguez; Mathias Dutschmann; Edith M. Schneider Gasser; Gustavo Zubieta‐Calleja; Jorge Soliz
Low Altitude Peripheral Edema (LAPE): The Opposite of HAPE or HACE
(Elsevier BV, 2017) Gustavo Zubieta‐Calleja; Natalia Zubieta-DeUrioste
Millions of permanent high-altitude residents, born at high altitude, living normal lives, practicing sports, sleeping well, reproducing, and enjoying entertainment, occasionally descend to sea level, for work or leisure. This is a change where the organism perfectly adapted to chronic hypoxia is suddenly exposed to a hyperoxic environment and needs to adapt to the new circumstance. Although no alarming symptoms and signs such as those that can be seen in acute mountain sickness exist like headaches, nausea, or vomiting, there are signs that show evident changes in the body. One of the most striking is edema of lower limbs that can become more pronounced at 2 weeks of stay. Although there may be an initial edema due to long airplane travel times, this usually goes away within one or two days. However, after around 2 weeks, a positive Godet sign develops in both legs that can be quite impressive. The Godet sign, found by pressing during a few seconds on the skin in front of the tibia, displaces excessive fluid found in the interstitial subcutaneous spaces and gives rise to the formation of an evident concave impression. This sign is usually found in patients suffering from cardiac insufficiency, renal insufficiency, anasarca with low blood protein levels or inflammation. If a sea level physician would evaluate one of the high-altitude residents, at that moment, he would surely think of cardiac insufficiency, and may event start treatment with diuretics or digitalis. Possible mechanisms involve an increase of Sialic acid, found above or borderline of the normal maximum limits found during tests, in 4 subjects. Urine tests also showed an acid pH = 6.0, in spite of been on vegetarian diets, on a recent trip to India. Upon ascent to high altitude, there is central edema and that is why acute mountain sickness, high altitude pulmonary edema and high altitude cerebral edema, occur. Conversely, on descending to sea level, peripheral edema occurs. Going higher, oxygen needs to be transported preferably to the life-sustaining organs: brain, heart, and lungs, whereas going lower there is “excessive” amounts of oxygen and peripheral edema occurs possibly as a defense mechanism to reduce oxygen transport to the life sustaining organs, as it is sensed toxic. The hematologic adaptation with a decrease of the hematocrit to sea level values, is linear and takes around 20 days, going from 3500 m. Hence, once the hematocrit is at the optimal values for sea level, the peripheral edema decreases and is not as evident. Consequently, the Altitude Adaptation Formula stands valid even going down and hence it is best to include the altitude change in the denominator: Adaptation to altitude = time / altitude ∆
Low serum erythropoietin levels are associated with fatal COVID-19 cases at 4,150 meters above sea level
(Elsevier BV, 2021) Antonio Viruez-Soto; Mónica Marlene López-Dávalos; Gabriel Rada-Barrera; Alfredo Merino‐Luna; Daniel Molano-Franco; Amílcar Tinoco-Solorozano; Natalia Zubieta-DeUrioste; Gustavo Zubieta‐Calleja; Christian Arias‐Reyes; Jorge Soliz
Modification and Further Applications of the Adaptation to High Altitude Formula
(Elsevier BV, 2017) Gustavo Zubieta‐Calleja; Natalia Zubieta-DeUrioste
Adaptation to high altitude is fundamental for life to go on. It is a time and altitude dependent phenomena, because the organism needs the adequate time to build the defense mechanisms to face environmental changes. Quoting the late Gustavo Zubieta-Castillo: “The organic systems of human beings and all other species tend to adapt to any environmental change and circumstance within an optimal period of time, and never tend towards regression which would inevitably lead to death.” Adaptation to altitude = time / altitude ∆ It is important to note that altitude changes require adaptation going both ways: going up in altitude or for high altitude residents, going down. This formula was originally developed using the changes in altitude going higher, because it was thought worldwide that the normal physiology of the body was developed at sea level, only. However, high altitude residents are perfectly adapted to life in their own environment. Hence it has been found convenient to include in the formula, in the denominator “altitude ∆” i.e. altitude change, instead of only the term “altitude.” This, we find pivotal because the organism of high altitude residents going down to sea level, has to adapt to the “relative hyperoxic environment.” It is wrongly assumed that for high altitude residents, going to a lower altitude where there is more oxygen pressure, as a result of a higher barometric pressure, is beneficial. We strongly question this, as high altitude residents, being born, developed and carrying out normal lives in the mountain cities of the world living in perfect harmony with our environment. We, as Andean high altitude residents, have higher hematocrit and hemoglobin values, as the fundamental compensating biological response. All living beings, humans, animals and plants and presumably other microscopic organisms suffer biologic changes on barometric pressure changes. In other words, physical changes in the environment, induce biological changes. The rules governing physics are imbedded within biology. The formula of adaptation is not only useful for high altitude adaptation, but rather can be used for any type of adaptation, where the organism in order to survive, needs to find the most energy efficient, fastest rebuild or healing process of the organic systems. An example can be found with a wound in the skin. When the two borders are sutured, the healing process takes around 1 week. This would be: healing adaptation = time/tissue. This formula changes in time if the tissue is skin or bone, the later requiring a longer time of a few months. This formula also varies with age, taking longer for the older people: Adaptation to healing = time/age. It should be well understood, that the healthier the subject, the better the adaptation. But it also applies to allergic reactions to mosquito bites in those not habituated to them in comparison to those living in those areas. Likewise, a viral aggression like flu, has a latent period of immunity that follows the same rule: Adaptation to viral aggression = time/type of viral agent. This formula has other additional variables like nutrition, stress and aggressiveness of the viral agent. Furthermore it also applies to adaptation to smell. When a new perfume is smelled for the first time it is very strong, but persistent use of it changes the capacity of sensing it: Adaptation to smell = time/scent. Muscle adaptation to exercise also follows the same formula: Adaptation to exercise = time/exercise ∆. The more exercise, the greater the hypertrophy of the muscles and vice-versa. In conclusion the Adaptation Formula is a fundamental formula that applies to all biological adaptation processes in the multiple survival mechanisms of all living beings, and can be generalized as: Adaptation = time / change.
Oxygen therapy limiting peripheral oxygen saturation to 89-93% is associated with a better survival prognosis for critically ill COVID-19 patients at high altitudes
(Elsevier BV, 2022) Antonio Viruez‐Soto; Samuel Arias; Ronnie Casas‐Mamani; Gabriel Rada-Barrera; Alfredo Merino‐Luna; Daniel Molano-Franco; Amílcar Tinoco-Solórzano; Danuzia A. Marques; Natalia Zubieta-DeUrioste; Gustavo Zubieta‐Calleja
Retraction notice to “Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: A view from the High Andes” [Respir. Physiol. Neurobiol. (2021) 103628]
(Elsevier BV, 2021) Gustavo Zubieta‐Calleja; Natalia Zubieta-DeUrioste