Matiram Pun, MBBS
Potential Financial Conflicts of Interest: None disclosed.
Pun M.; Health Effects and Further Consequences of the Train From Golmud to Lhasa. Ann Intern Med. 2009;150:653. doi: 10.7326/0003-4819-150-9-200905050-00019
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Published: Ann Intern Med. 2009;150(9):653.
TO THE EDITOR:
I read with great interest the article by West (1) about the train from Golmud, China, to Lhasa, Tibet; its pathophysiologic aspects; and the approaches taken to address them. However, a few more points should be made.
First, it is important to consider the possible effects of high-altitude travel on travelers who have different kinds of comorbid conditions (for example, diseases of the heart and lung) (2) and the effects of long, high-altitude, and sedentary travel on the blood coagulation profile and other conditions, such as deep venous thrombosis, the antiphospholipid syndrome (3), sickle cell disease, and protein C and protein S deficiency.
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