Browsing by Autor "Spielvogel, H"

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Coca y esfuerzo físico
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1997) Spielvogel, H
En la “Crónica del Perú” Pedro Cieza de León da cuenta de que al inquirir a algunos indios por qué mascaban coca, ellos respondieron que al hacerlo “sienten poca hambre y se hallan en gran vigor y fuerza”. Cuatrocientos años más tarde, Carter y Mamani (1986), en el capítulo “Aspectos sociales del consumo de coca “del libro” “Coca en Bolivia” expresan que, tanto hombres como mujeres, consumen la coca, entre otras razones, para evitar el cansancio durante el trabajo. Citamos tres testimonios entre las numerosas encuestas que contiene el libro: “Parece que al mascar nos quitaba las penas y trabajábamos sin cansancio “(Casimiro Mamani), “Pero la coca nos da coraje y valor para el trabajo y acompaña en las penas” (Josefa Cusipoma); “Mis maestros (albañiles siempre me han dicho que la coca les hace más fuertes para el trabajo” (Eugenio Ballesteros). Esto nos demuestra que, entonces como ahora, las razones son las mismas para el consumo de coca, no obstante haber transcurrido cuatro siglos.
[Effects of coca chewing on the glucose tolerance test].
(1997) Galarza Guzmán, M; Peñaloza Imaña, R; Echalar Afcha, L; Aguilar Valerio, M; Spielvogel, H; Sauvain, M
The effects of coca chewing on the glucose tolerance test were measured. The subjects were 14 habitual coca chewers and 14 non-chewers. All were of Aymara ancestry and came from a rural community from the "Altiplano" close to the city of La Paz. The coca users chewed coca leaves during 3 1/2 hours of the test. The non-chewers showed a significant hypoglycemia at 120 minutes of the test. This effect was not observed in the coca chewers. The hormonal counter-regulation response to hypoglycemia worked perfectly in non-chewers, since glucose levels reached normal values at 180 minutes of the test. These results suggest that coca chewers, at high altitude do not present hypoglycemia, due to an antagonic action of coca metabolites on insulin; allowing a greater availability of glucose in the organism. This would have a positive effect on metabolism in an environment of hypobaric hypoxia, known to lead to situations of hypoglycemia.
Effects of posture on pulmonary diffusion capacity and regional distribution of pulmonary blood flow in normal male and female high altitude dwellers at 3,650 m. (12,200 ft)
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1978) Spielvogel, H
Abstract. Studies of the distribution of pulmonary blood flow (Q) at the altitude of La Paz (3,650 m) were extended to the left upper (LUZ) and left lower lung zones (LLZ) from those previously reported for the right lung alone. Comparisons between 2 groups of male and female high altitude dwellers (HAD) continue to show that in female HAD little change occurs in mean QLUZ with adoption of the vertical position and corroborates the minor change previously reported in QRUZ of a female HAD. In contrast to female HAD, both QRUZ and QLUZ in male HAD reduce by about 25% with adoption of the vertical position. The distribution patterns of Q with changes in posture in the sexes at altitude were compared with the changes in magnitude observed in the same group during measurements of DLCO in recumbency and in the vertical positions. DLCO was corrected for BSA and HB. In male HAD DLCO became reduced by 19.7% in the vertical position, which is 7.2% below the differences in Q observed with change in posture. Female HAD showed a mean change of only 5.5% in DLCO with adoption of the vertical position and this is 6.4% less than the corresponding change in Q. The vertical DLCO index and the perfusion zones in female HAD are thus significantly larger than those of vertical sea-level women. By contrast, no such difference obtains in respect of vertical DLCO and perfusion zones between vertical males at altitude and sea level.
Effects of posture on pulmonary diffusion capacity and regional distribution of pulmonary blood flow in normal male and female high altitude dwellers at 3650 m. (12,200 ft)
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1976) Spielvogel, H
Resume. Le présent travail complète une étude antérieure sur la distribution de la perfusion entre les parties haute et basse du poumon chez les sujets résidents permanents d’altitude (La Paz 3.650 m. PB 496 mm Hg). Les premières observations portaient sur la distribution du débit dans le poumon droit (fig. 9) ; cette fois, c’est la distribution dans le poumon gauche qui a été mesurée et, ceci, compartivement chez la femme et l’homme. - les résultats confirment la discrétion des changements de la répartition du débit lors su passage de la position couchée a la position assise chez la femme ; alors que chez les hommes, il a une réduction de 25% environ de la perfusion de la partie haute (fig. 10). - les modifications de la répartition du débit sanguin pulmonaire ont été confrontées à celle de la diffusion du CO…
El comportamiento de la hipertensión pulmonar en cardiopatías quirúrgicamente corregibles en residentes de grandes alturas La Paz-Bolivia
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1974) Spielvogel, H
En una evaluación clínica de diferentes cardiopatías que normalmente están asociados con hipertensión pulmonar y cuyos datos han sido publicados anteriormente (1), nos pareció razonable de separar el componente fisiológico de la hipertensión pulmonar que es atribuible a la altura solamente, del componente que tiene su origen en la enfermedad cardiaca presente. La suma de estos componentes acentúa evidentemente los signos clínicos de la hipertensión pulmonar en los pacientes de La Paz y su desglosamiento ayudaría a la comprensión de signos físicos residuales después de una exitosa cirugía de estenosis mitral, comunicaciones interventriculares e interauriculares y persistencia de ductos.
Langfristige höhenanpassung in den Bolivianischen Anden
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1995) Spielvogel, H
SUMMARY. The present report gives basic facts on geography, population and history of the Andean region of Bolivia. Based on research carried out at the Instituto Boliviano de Biología de Altura (I.B.B.A.), Universidad Mayor de San Andres, in La Paz, the main features of long term adaptation to high altitude either by birth and continous residence or early migration are reported. Altitude hypoxia has a small or no effect at all on longitudinal growth. Total lung capacity is increased mainly by increase of residual volume and secondly by increase of vital capacity. Highland Aymara have an accelerated growth of thorax dimensions and lung function as compared to high-altitude natives of European ancestry. Development of European girls born at high altitude is delayed by about 0.8 years, whereas growth and development of prepubertal boys of low socio-economic level is delayed by 2 years at high altitude as well as in the lowlands. Other features like blunted respiratory drive, increased diffusing capacity, increase of P5O, of pulmonary artery pressure and hemoglobin concentration are also described as well as the effect of high altitude hypoxia on the right ventricle in infants. With respect to work capacity expressed as maximal oxygen consumption (VO₂ max), a decrease of 11-15% is seen in children compared to similar sea level children. Adolescent boys of Aymara ancestry and of European ancestry have similar VO₂ max's. Finally, high altitude natives increase their VO₂ max less when inhaling additional O₂ than acclimatized sea level natives. With a training program used at lowland in lowland subjects, high altitude natives increase their V0₂ max in the same degree, additional oxygen does not bring a greater increase of V0₂ max. Maximal lactate concentrations are similar at high and low altitude, but high altitude natives trained in normoxia show a decreased buffer capacity.
The effects of high altitude on pulmonary hypertension of cardiopathies, at La Paz, Bolivia
(Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica, 1969) Spielvogel, H
Summary. This investigation concerns a comparison of hemodynamic data derived from eleven patients without cardio-pulmonary disease, living at La Paz, Bolivia, an ten patients with a variety of cardiopathies common to that city. Alveolar hypoxia alone elevates mean pulmonary artery-pressure (MPAP) to 22.9 mm Hg. Mean total pulmonary vascular resistance (TPR) in the normal was 312 and mean pulmonary arteriolar resistance (PAR) 219 dynes / sec / cm-5. The corresponding values in patients with different cardiopathies were MPAP – 50.0 mm Hg; TPR – 527.5 and PAR – 524.6 dynes /se / cm-5 respectively. These differences were statistically significant. In two patients with Monge’s disease corresponding mean values were higher than in the patients with cariopathies, namely MPAP -51.5 mm Hg; TPVR – 668.5 and PAR – 568.5 dynes /sec/ cm-5 respectively. No significant differences emerged in respect of 1, cardiac outpunt, 2. right atrial pressure, 3. pulmonary capillary pressure, 4. systemic artery pressure, 5. systemic vascular resistance.