Pathophysiological bases of maladjustment formation in high mountains and polar zones

Abstract

The pathophysiological features of the development of maladjustment under mountain-cold conditions as a manifestation of the syndrome of mutual burdening are considered. In this study, contents of various literary sources, characterizing a person’s resistance to the effects of a complex of factors under high mountains and polar zones conditions, were analyzed. With the simultaneous exposure to hypoxia and hypothermia from a pathophysiological point of view, intersecting links of terminological “paths,” often having diametrically opposite dynamics of changes in the characterized concepts, will be significant. Thus, in the terminological mitochondrial “pathway” of energy metabolism, uncoupling proteins are present, which, to increase the resistance to hypothermia, should be activated to switch the energy metabolism to predominantly use fatty acids. However, hypoxic conditions should be suppressed to maintain the level of adenosine triphosphate acid available for cells. In the terminological tract of compensatory reactions in response to hypoxemia, the volume of pulmonary ventilation is released, which must increase to improve tolerance to hypoxia, which, under mountain-cold conditions, increased heat loss and promote the deterioration of the condition, i.e., tolerance to low temperatures. Under hypoxic and hypothermic conditions, a synergistic interaction can form, which can be manifested by the development of a syndrome of mutual burdening, which will result in a significant decrease in the functional capabilities of the body, result, and productivity. Maladjustment to mountain cold, with maximum probability, will manifest as disorders of the central nervous system, decreased physical performance, depletion of the functional and regulatory reserves of the body, functional immunodeficiency, decreased regenerative potential, and development of endogenous intoxication. With a high degree of probability, a significant synergistic interaction of hypoxia and hypothermia can be found in relation to the indicators of pulmonary ventilation, blood gases (hypercapnia), acid–base balance (gas alkalosis and lactic acidosis), heart rate (tachycardia), blood pressure (hypotension), central venous pressure (increase), blood viscosity (increase) and its coagulability (hypercoagulation), peroxide and free radical oxidation (activation), and protein catabolism (increase). These changes will negatively affect the functional state of specialists performing complex professional tasks in polar latitudes.

Keywords

hypoxia / hypothermia / Arctic / mountain-cold maladjustment / comorbidity / polar tension syndrome / functional state

References

[1] Majstrah EV. Patologicheskaya fiziologiya ohlazhdeniya cheloveka. Leningrad: Medicina; 1975. (In Russ.).

[2] Майстрах Е.В. Патологическая физиология охлаждения человека. Л.: Медицина, 1975.

[3] Barton A, Edholm O. Chelovek v usloviyah holoda. Fiziologicheskie i patologicheskie yavleniya, voznikayushchie pri dejstvii nizkih temperatur: per. s angl. Moscow: Izdatel’stvo inostrannoj literatury. 1957. (In Russ.).

[4] Бартон А., Эдхолм О. Человек в условиях холода. Физиологические и патологические явления, возникающие при действии низких температур / пер. с англ. М.: Издательство иностранной литературы, 1957.

[5] Novikov VS, Soroko SI, Shustov EB. Dezadaptacionnye sostoyaniya cheloveka pri ekstremal’nyh vozdejstviyah i ih korrekciya. Saint Petersburg: Politekhnika-prin; 2018. (In Russ.).

[6] Новиков В.С., Сороко С.И., Шустов Е.Б. Дезадаптационные состояния человека при экстремальных воздействиях и их коррекция. СПб.: Политехника-принт, 2018.

[7] Haskin VV. Energetika teploobrazovaniya i adaptaciya k holodu. Novosibirsk: Nauka; Sib. otd-nie; 1975. (In Russ.).

[8] Хаскин В.В. Энергетика теплообразования и адаптация к холоду. Новосибирск: Наука. Сиб. отд-ние, 1975.

[9] Bojko ER. Fiziologo-biohimicheskie osnovy zhiznedeyatel’nosti cheloveka na Severe. Ekaterinburg: Ural’skoe otdelenie RAN; 2005. (In Russ.).

[10] Бойко Е.Р. Физиолого-биохимические основы жизнедеятельности человека на Севере. Екатеринбург: Уральское отделение РАН, 2005.

[11] Novikov VS, Soroko SI. Fiziologicheskie osnovy zhiznedeyatel’nosti cheloveka v ekstremal’nyh usloviyah. Saint Petersburg: Politekhnika-print; 2017. (In Russ.).

[12] Новиков В.С., Сороко С.И. Физиологические основы жизнедеятельности человека в экстремальных условиях. СПб.: Политехника-принт, 2017.

[13] Fricke R. Mechanisms of human cold adaptation. Circumpolar health: Proc. of 8-th symp. Toronto. 2009;8:65–86.

[14] Fricke R. Mechanisms of human cold adaptation. Circumpolar health: Proc. of 8-th symp. Toronto. 2009. Vol. 8. P. 65–86.

[15] Cooper KE. Mechanisms of human cold adaptation. Circumpolar Health. University of Toronto Press. 2020;37–46. DOI: 10.3138/9781487579876-008

[16] Cooper K.E. Mechanisms of human cold adaptation. In: Circumpolar Health. University of Toronto Press, 2020. P. 37–46. DOI: 10.3138/9781487579876-008

[17] Berko J, Ingram DD, Shubhayu S. Deaths attributed to heat, cold, and other weather events in the United States, 2006–2010. Natll Health Stat Report. 2014;30(76):1–15.

[18] Berko J., Ingram DD., Shubhayu S. Deaths attributed to heat, cold, and other weather events in the United States, 2006–2010 // Natll Health Stat Report. 2014. Vol. 30, No. 76. P. 1–15.

[19] van Marken Lichtenbelt WD, Schrauwen P. Implications of nonshivering thermogenesis for energy balance regulation in humans. Am J Physiol Integr Comp Physiol. 2011;301(2):285–296. DOI: 10.1152/ajpregu.00652.2010

[20] van Marken Lichtenbelt W.D., Schrauwen P. Implications of nonshivering thermogenesis for energy balance regulation in humans // Am J Physiol Integr Comp Physiol. 2011. Vol. 301, No. 2. P. 285–296. DOI: 10.1152/ajpregu.00652.2010

[21] Seltenrich N. Between extremes: Health effects of heat and cold. Environ Health Perspect. 2015;123(11):276–280. DOI: 10.1289/ehp.123-A275

[22] Seltenrich N. Between extremes: Health effects of heat and cold // Environ Health Perspect. 2015. Vol. 123, No. 11. P. 276–280. DOI: 10.1289/ehp.123-A275

[23] Hasnulin VI. Sindrom polyarnogo napryazheniya. III Kaznacheevskie chteniya. Novosibirsk. 2008;26–39. (In Russ.).

[24] Хаснулин В.И. Синдром полярного напряжения // III Казначеевские чтения. Новосибирск. 2008. С. 26–39.

[25] Kulikov VYU, Kim EB. Kislorodnyj rezhim pri adaptacii cheloveka na Krajnem Severe. Novosibirsk: Nauka; 1987. (In Russ.).

[26] Куликов В.Ю., Ким Е.Б. Кислородный режим при адаптации человека на Крайнем Севере. Новосибирск, Наука, 1987.

[27] Panin LE. Energeticheskie aspekty adaptacii. Leningrad: Medicina, Leningrad. otdel. 1978. 191 p. (In Russ.).

[28] Панин Л.Е. Энергетические аспекты адаптации. Л.: Медицина, Ленинград. отд-ние, 1978. 191 c.

[29] Arendt J. Biological rhythms during residence in polar regions. Chronobiol. Int. 2012;29(4):379–394. DOI: 10.3109/07420528.2012.668997

[30] Arendt J. Biological rhythms during residence in polar regions // Chronobiol Int. 2012. Vol. 29, No. 4. P. 379–394. DOI: 10.3109/07420528.2012.668997

[31] Zinchenko VP, Meshcheryakov BG. Bol’shoj psihologicheskij slovar’. 4-e izd. Saint Petersburg: Prajm-Evroznak; 2009. (In Russ.).

[32] Зинченко В.П., Мещеряков Б.Г. Большой психологический словарь. 4-е изд. СПб.: Прайм-Еврознак, 2009.

[33] Metodologicheskie i metodicheskie problemy kontent-analiza. Tezisy dokladov. Vyp. 1,2. Saint Petersburg: [b.i.]; 1973. (In Russ.).

[34] Методологические и методические проблемы контент-анализа: Тезисы докл. Рабочего совещ. социологов. Вып. 1, 2. М., Л.: [б.и.]. 1973.

[35] Luk’yanova LD. Signal’nye mekhanizmy gipoksii. Moscow: RAN; 2019. (In Russ.).

[36] Лукьянова Л.Д. Сигнальные механизмы гипоксии. М.: РАН, 2019.

[37] Novikov VS, Karkishchenko VN, SHustov EB. Funkcional’noe pitanie cheloveka pri ekstremal’nyh vozdejstviyah. Saint Petersberg: Politekhnika-print; 2017. (In Russ.).

[38] Новиков В.С., Каркищенко В.Н., Шустов Е.Б. Функциональное питание человека при экстремальных воздействиях. СПб.: Политехника-принт, 2017.

[39] Buryh EA. Obshchie zakonomernosti i individual’nye osobennosti integrativnogo otveta organizma cheloveka na vozdejstvie ostroj normobaricheskoj gipoksii: аvtoref. diss. doktora med. nauk. Saint Petersberg: Institut evolyucionnoj fiziologii i biohimii im. IM. Sechenova RAN. 2020. (In Russ.).

[40] Бурых Э.А. Общие закономерности и индивидуальные особенности интегративного ответа организма человека на воздействие острой нормобарической гипоксии: автореф. дисс. … доктора мед. наук. СПб.: Институт эволюционной физиологии и биохимии им. И.М.Сеченова РАН, 2020.

[41] Nishi Y, Gagge AG. Physical indices of the cold environment. Ashrae J. 2002;1:47–51.

[42] Nishi Y., Gagge A.G. Physical indices of the cold environment // Ashrae J. 2002. Vol. 1. P. 47–51.

[43] Van Lir E, Stiknej K. Gipoksiya. Moscow: Medicina; 1967. (In Russ.).

[44] Ван Лир Э., Стикней К. Гипоксия. М.: Медицина, 1967.

[45] Eryuhin IA, SHlyapnikov SA. Ekstremal’noe sostoyanie organizma. Elementy teorii i prakticheskie problemy na klinicheskoj modeli tyazheloj sochetannoj travmy. Saint Petersburg: Eskulap; 1997. (In Russ.).

[46] Ерюхин И.А., Шляпников С.А. Экстремальное состояние организма. Элементы теории и практические проблемы на клинической модели тяжелой сочетанной травмы. СПб.: Эскулап, 1997.

[47] Sokolov VA. Mnozhestvennye i sochetannye travmy. Moscow: GEOTAR-Media; 2006. (In Russ.).

[48] Соколов В.А. Множественные и сочетанные травмы. М.: ГЭОТАР-Медиа, 2006.

[49] Kryukov E.V. Izmeneniya nespecificheskoi zaschiti i immuniteta u voennoslujaschih v processe adaptacii k voennoi slujbe. Voenno-medicinskii jurnal. 2003;324(12):60–61. (In Russ.).

[50] Крюков Е.В. Изменения неспецифической защиты и иммунитета у военнослужащих в процессе адаптации к военной службе Военно-медицинский журнал. 2003. Т. 324. № 12. С. 60–61.

[51] Кryukov E.V. Izmeneniya perekisnogo okisleniya lipidov i gemostaza u voennoslujaschih v processe adaptacii k voennoi slujbe. Voenno-medicinskii jurnal. 2003;324(11):72–73. (In Russ.).

[52] Крюков Е.В. Изменения перекисного окисления липидов и гемостаза у военнослужащих в процессе адаптации к военной службе Военно-медицинский журнал. 2003. Т. 324. № 11. С. 72–73.

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Kim A.E., Shustov E.B., Lemeshchenko A.V., Tsygan V.N.