Drug Use on Mont Blanc: A Study Using Automated Urine Collection

Mont Blanc, the summit of Western Europe, is a popular but demanding high-altitude ascent. Drug use is thought to be widespread among climbers attempting this summit, not only to prevent altitude illnesses, but also to boost physical and/or psychological capacities. This practice may be unsafe in this remote alpine environment. However, robust data on medication during the ascent of Mont Blanc are lacking. Individual urine samples from male climbers using urinals in mountain refuges on access routes to Mont Blanc (Goûter and Cosmiques mountain huts) were blindly and anonymously collected using a hidden automatic sampler. Urine samples were screened for a wide range of drugs, including diuretics, glucocorticoids, stimulants, hypnotics and phosphodiesterase 5 (PDE-5) inhibitors. Out of 430 samples analyzed from both huts, 35.8% contained at least one drug. Diuretics (22.7%) and hypnotics (12.9%) were the most frequently detected drugs, while glucocorticoids (3.5%) and stimulants (3.1%) were less commonly detected. None of the samples contained PDE-5 inhibitors. Two substances were predominant: the diuretic acetazolamide (20.6%) and the hypnotic zolpidem (8.4%). Thirty three samples were found positive for at least two substances, the most frequent combination being acetazolamide and a hypnotic (2.1%). Based on a novel sampling technique, we demonstrate that about one third of the urine samples collected from a random sample of male climbers contained one or several drugs, suggesting frequent drug use amongst climbers ascending Mont Blanc. Our data suggest that medication primarily aims at mitigating the symptoms of altitude illnesses, rather than enhancing performance. In this hazardous environment, the relatively high prevalence of hypnotics must be highlighted, since these molecules may alter vigilance

Cerebral hemodynamic and ventilatory responses to hypoxia, hypercapnia, and hypocapnia during 5 days at 4,350 m.

International audienceThis study investigated the changes in cerebral near-infrared spectroscopy (NIRS) signals, cerebrovascular and ventilatory responses to hypoxia and CO2 during altitude exposure. At sea level (SL), after 24 hours and 5 days at 4,350 m, 11 healthy subjects were exposed to normoxia, isocapnic hypoxia, hypercapnia, and hypocapnia. The following parameters were measured: prefrontal tissue oxygenation index (TOI), oxy- (HbO2), deoxy- and total hemoglobin (HbTot) concentrations with NIRS, blood velocity in the middle cerebral artery (MCAv) with transcranial Doppler and ventilation. Smaller prefrontal deoxygenation and larger ΔHbTot in response to hypoxia were observed at altitude compared with SL (day 5: ΔHbO2-0.6±1.1 versus -1.8±1.3 μmol/cmper mm Hg and ΔHbTot 1.4±1.3 versus 0.7±1.1 μmol/cm per mm Hg). The hypoxic MCAv and ventilatory responses were enhanced at altitude. Prefrontal oxygenation increased less in response to hypercapnia at altitude compared with SL (day 5: ΔTOI 0.3±0.2 versus 0.5±0.3% mm Hg). The hypercapnic MCAv and ventilatory responses were decreased and increased, respectively, at altitude. Hemodynamic responses to hypocapnia did not change at altitude. Short-term altitude exposure improves cerebral oxygenation in response to hypoxia but decreases it during hypercapnia. Although these changes may be relevant for conditions such as exercise or sleep at altitude, they were not associated with symptoms of acute mountain sickness

Visions of Utopia: Sweden, the BBC and the Welfare State

Drawing on manuscripts and transcripts of BBC programme output, and material from the Radio Times, and the BBC’s The Listener magazine, this article analyses radio talks and programmes that focused on Sweden in the immediate years after the Second World War when the Swedish model was widely popularised abroad. The article argues that BBC output entangled domestic politics and transnational ideas around post-war reconstruction and welfare. Sweden was used as a lens through which a modern welfare state could be visualised and justified. This was however Utopia in two senses since the image of Sweden presented was in itself a highly idealised representation

Skeletal Muscle Myofibrillar and Sarcoplasmic Protein Synthesis Rates Are Affected Differently by Altitude-Induced Hypoxia in Native Lowlanders

As a consequence to hypobaric hypoxic exposure skeletal muscle atrophy is often reported. The underlying mechanism has been suggested to involve a decrease in protein synthesis in order to conserve O2. With the aim to challenge this hypothesis, we applied a primed, constant infusion of 1-13C-leucine in nine healthy male subjects at sea level and subsequently at high-altitude (4559 m) after 7–9 days of acclimatization. Physical activity levels and food and energy intake were controlled prior to the two experimental conditions with the aim to standardize these confounding factors. Blood samples and expired breath samples were collected hourly during the 4 hour trial and vastus lateralis muscle biopsies obtained at 1 and 4 hours after tracer priming in the overnight fasted state. Myofibrillar protein synthesis rate was doubled; 0.041±0.018 at sea-level to 0.080±0.018%⋅hr−1 (p<0.05) when acclimatized to high altitude. The sarcoplasmic protein synthesis rate was in contrast unaffected by altitude exposure; 0.052±0.019 at sea-level to 0.059±0.010%⋅hr−1 (p>0.05). Trends to increments in whole body protein kinetics were seen: Degradation rate elevated from 2.51±0.21 at sea level to 2.73±0.13 µmol⋅kg−1⋅min−1 (p = 0.05) at high altitude and synthesis rate similar; 2.24±0.20 at sea level and 2.43±0.13 µmol⋅kg−1⋅min−1 (p>0.05) at altitude. We conclude that whole body amino acid flux is increased due to an elevated protein turnover rate. Resting skeletal muscle myocontractile protein synthesis rate was concomitantly elevated by high-altitude induced hypoxia, whereas the sarcoplasmic protein synthesis rate was unaffected by hypoxia. These changed responses may lead to divergent adaptation over the course of prolonged exposure

The Ergogenic Effect of Recombinant Human Erythropoietin on V̇O2max Depends on the Severity of Arterial Hypoxemia

Treatment with recombinant human erythropoietin (rhEpo) induces a rise in blood oxygen-carrying capacity (CaO2) that unequivocally enhances maximal oxygen uptake (V̇O2max) during exercise in normoxia, but not when exercise is carried out in severe acute hypoxia. This implies that there should be a threshold altitude at which V̇O2max is less dependent on CaO2. To ascertain which are the mechanisms explaining the interactions between hypoxia, CaO2 and V̇O2max we measured systemic and leg O2 transport and utilization during incremental exercise to exhaustion in normoxia and with different degrees of acute hypoxia in eight rhEpo-treated subjects. Following prolonged rhEpo treatment, the gain in systemic V̇O2max observed in normoxia (6–7%) persisted during mild hypoxia (8% at inspired O2 fraction (FIO2) of 0.173) and was even larger during moderate hypoxia (14–17% at FIO2 = 0.153–0.134). When hypoxia was further augmented to FIO2 = 0.115, there was no rhEpo-induced enhancement of systemic V̇O2max or peak leg V̇O2. The mechanism highlighted by our data is that besides its strong influence on CaO2, rhEpo was found to enhance leg V̇O2max in normoxia through a preferential redistribution of cardiac output toward the exercising legs, whereas this advantageous effect disappeared during severe hypoxia, leaving augmented CaO2 alone insufficient for improving peak leg O2 delivery and V̇O2. Finally, that V̇O2max was largely dependent on CaO2 during moderate hypoxia but became abruptly CaO2-independent by slightly increasing the severity of hypoxia could be an indirect evidence of the appearance of central fatigue

Effets d'un entraînement en altitude de type "Live high - Train low" sur la performance athlétique et mécanismes de contrôle : une étude en double insu contre groupe placebo: Implications directes pour l’entraînement et l’optimisation de la performance

Résider en altitude tout en s’entraînant en plaine (live high-train low, LHTL) est susceptibled’améliorer la performance en endurance chez l’athlète. Cependant, à ce jour, aucune étudene peut exclure l’éventuelle contribution d’un potentiel effet placebo, expliquant en partie legain de performance. A partir d’une méthodologie en double insu versus groupe placebo,nous avons formulé l’hypothèse que les gains de performance induits par LHTL sont liés àdes mécanismes physiologiques et non à un effet placebo. Pour cela, seize cyclistesd’endurance de haut niveau ont suivi un programme d’entraînement de huit semaines àbasse altitude (< 1200 m). Après deux semaines de phase préparatoire, les athlètes ontséjourné 16h/jour durant les quatre semaines suivantes dans des chambres ventilées soitavec de l’air normal (groupe placebo, n = 6), soit avec de l’hypoxie normobarecorrespondant à une altitude de 3000 m (groupe LHTL, n = 10). Les mesures physiologiquesont été réalisées deux fois durant la période préparatoire, après trois et quatre semainesd’intervention LHTL puis encore une et deux semaines après l’intervention LHTL. Lesquestionnaires ont révélés que les sujets ignoraient le traitement qui leur était administré.La charge d’entraînement hebdomadaire était similaire entre les groupes. La masse totaled’hémoglobine, la consommation maximale d’O2 en normoxie et à l’altitude simulée de 2500m, ainsi que la puissance moyenne durant une épreuve simulée de compétition cycliste de26,15 km (« contre la montre »), sont restés inchangés dans les deux groupes, tout au longde l’étude. L’efficience musculaire (consommation d’O2 mesurée à 200 W) n’a pas étémodifiée lors de l’intervention LHTL dans aucun des deux groupes. En conclusion, ni laperformance en endurance, ni les variables physiologiques associées n’ont été améliorées àl’issue de quatre semaines d’intervention LHTL

Does 'altitude training' increase exercise performance in elite athletes?

What is the topic of this review? The aim is to evaluate the effectiveness of various altitude training strategies as investigated within the last few years. What advances does it highlight? Based on the available literature, the foundation to recommend altitude training to athletes is weak. Athletes may use one of the various altitude training strategies to improve exercise performance. The scientific support for such strategies is, however, not as sound as one would perhaps imagine. The question addressed in this review is whether altitude training should be recommended to elite athletes or not