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As astronauts frequently have motion sickness, NASA has done extensive research on the causes and treatments for motion sickness. One very promising looking treatment is for the person suffering from motion sickness to wear LCD shutter glasses that create a stroboscopic vision of 4 Hz with a dwell of 10 milliseconds.
Over-the-counter and prescription medications are readily available, such as dimenhydrinate, scopolamine, meclizine, promethazine, cyclizine, and cinnarizine. Cinnarizine is not available in the United States, as it is not approved by the FDA. As these medications often have side effects, anyone involved in high-risk activities while at sea (such as SCUBA divers) must evaluate the risks versus the benefits. Promethazine is especially known to cause drowsiness, which is often counteracted by ephedrine in a combination known as "the Coast Guard cocktail.". There are special considerations to be aware of when the common anti-motion sickness medications are used in the military setting where performance must be maintained at a high level.
Scopolamine is effective and is sometimes used in the form of transdermal patches (1.5 mg) or as a newer tablet form (0.4 mg). The selection of a transdermal patch or scopolamine tablet is determined by a doctor after consideration of the patient's age, weight, and length of treatment time required.
Many pharmacological treatments which are effective for nausea and vomiting in some medical conditions may not be effective for motion sickness. For example, metoclopramide and prochlorperazine, although widely used for nausea, are ineffective for motion-sickness prevention and treatment. This is due to the physiology of the CNS vomiting centre and its inputs from the chemoreceptor trigger zone versus the inner ear. Sedating anti-histamine medications such as promethazine work quite well for motion sickness, although they can cause significant drowsiness.
Ginger root is commonly thought to be an effective anti-emetic, but it is ineffective in treating motion sickness.
Religious leaders within the Navajo tribe repeatedly perform ceremonies to eliminate the all-consuming thoughts of the dead.
Several criteria are typically used to make a diagnosis of koro. The primary criteria is a patient's report of genital (typically penile or female nipple) retraction despite a lack of objective physical evidence demonstrating retraction. This is accompanied by severe anxiety related to the retraction, fear of death as a result of retraction, and use of mechanical means to prevent retraction. Cases that do not meet all the requirements are generally classified as koro-like symptoms or given a diagnosis of partial koro syndrome. It has been argued that the criteria are sufficient but not necessary to make a diagnosis of koro. Researchers have identified Koro as a possible "cultural relative" of Body Dysmorphic Disorder. DSM-IV explains the process of differential diagnosis between these two disorders.
The Simulator Sickness Questionnaire (SSQ) is currently the standard for measuring simulator sickness. The SSQ was developed based upon 1,119 pairs of pre-exposure/post-exposure scores from data that were collected and reported earlier. These data were collected from 10 Navy flight simulators representing both fixed-wing and rotary-wing aircraft. The simulators selected were both 6-DOF motion and fixed-base models, and also represented a variety of visual display technologies. The SSQ was developed and validated with data from pilots who reported to simulator training healthy and fit.
The SSQ is a self-report symptom checklist. It includes 16 symptoms that are associated with simulator sickness. Participants indicate the level of severity of the 16 symptoms that they are experiencing currently. For each of the 16 symptoms there are four levels of severity (none, slight, moderate, severe). The SSQ provides a Total Severity score as well as scores for three subscales (Nausea, Oculomotor, and Disorientation). The Total Severity score is a composite created from the three subscales. It is the best single measure because it provides an index of the overall symptoms. The three subscales provide diagnostic information about particular symptom categories:
- Nausea subscale is made up of symptoms such as increased salivation, sweating, nausea, stomach awareness, and burping.
- Oculomotor subscale includes symptoms such as fatigue, headache, eyestrain, and difficulty focusing.
- Disorientation subscale is composed of symptoms such as vertigo, dizzy (eyes open), dizzy (eyes closed), and blurred vision.
The three subscales are not orthogonal to one another. There is a general factor common to all of them. Nonetheless, the subscales provide differential information about participants' experience of symptoms and are useful for determining the particular pattern of discomfort produced by a given simulator. All scores have as their lowest level a natural zero (no symptoms) and increase with increasing symptoms reported.
A method to increase pilot resistance to airsickness consists of repetitive exposure to the flying conditions that initially resulted in airsickness. In other words, repeated exposure to the flight environment decreases an individual’s susceptibility to subsequent airsickness. Recently, several devices have been introduced that are intended to reduce motion sickness through stimulation of various body parts (usually the wrist).
A full medical, psychosexual and psychiatric history should be documented. The physician should explore the patient’s concerns about appearance and body image (ruling out body dysmorphic disorder). Additionally, the physician should inquire about overall beliefs, personal values, and assumptions that the patient is making about his or her genitals. Given that Koro is often an “attack” with a great deal of associated anxiety, the physician should ascertain the patient’s emotional state along with the timeline from onset to the presentation at the examination.
A physical examination should involve an assessment of overall health along with a detailed genital examination. In men, genital examination should be performed immediately after penile exposure, to avoid changes due to external temperature. The primary intent of the male exam is to exclude genuine penile anomalies such as hypospadias, epispadias and Peyronie's disease. The presence of a significant suprapubic fat pad should be noted as well. Careful measurements of flaccid length, stretched length and flaccid girth will also be useful. If male patients insist that their penis is shrinking and disappearing, measurements after intracavernosal alprostadil may be used in the office to determine the true erect length and to diagnose any penile abnormalities in the erect state. A physical examination should note any injuries inflicted by the patient in an effort to "prevent" retraction as further confirmation of Koro.
There are numerous alternative remedies for motion sickness. One such is ginger, but it is ineffective.
Ghost sickness is a cultural belief among some traditional indigenous peoples in North America, notably the Navajo, and some Muscogee and Plains cultures, as well as among Polynesian peoples. People who are preoccupied and/or consumed by the deceased are believed to suffer from ghost sickness. Reported symptoms can include general weakness, loss of appetite, suffocation feelings, recurring nightmares, and a pervasive feeling of terror. The sickness is attributed to ghosts () or, occasionally, to witches or witchcraft. Children are thought to be especially at risk of being affected because they are not as attached to their new bodies.
Space motion sickness is caused by changes in g-forces, which affect spatial orientation in humans. According to "Science Daily", "Gravity plays a major role in our spatial orientation. Changes in gravitational forces, such as the transition to weightlessness during a space voyage, influence our spatial orientation and require adaptation by many of the physiological processes in which our balance system plays a part. As long as this adaptation is incomplete, this can be coupled to motion sickness (nausea), visual illusions and disorientation."
Modern motion-sickness medications can counter space sickness but are rarely used because it is considered better to allow space travelers to adapt naturally over the first day or two than to suffer the drowsiness and other side effects of medication. However, transdermal dimenhydrinate anti-nausea patches are typically used whenever space suits are worn because vomiting into a space suit could be fatal, as it could obscure vision or block airflow. Space suits are generally worn during launch and landing by NASA crew members and always for extra-vehicular activities (EVAs). EVAs are consequently not usually scheduled for the first days of a mission to allow the crew to adapt, and transdermal dimenhydrinate patches are typically used as an additional backup measure.
Space adaptation syndrome (SAS) or space sickness is a condition experienced by around half of space travelers during adaptation to weightlessness. It is related to motion sickness, as the vestibular system adapts to weightlessness.
Simulator sickness is a subset of motion sickness that is typically experienced by pilots who undergo training for extended periods of time in flight simulators. Due to the spatial limitations imposed on these simulators, perceived discrepancies between the motion of the simulator and that of the vehicle can occur and lead to simulator sickness.
It is similar to motion sickness in many ways, but occurs in simulated environments and can be induced without actual motion. Symptoms of simulator sickness include discomfort, apathy, drowsiness, disorientation, fatigue, vomiting, and many more.
These symptoms can reduce the effectiveness of simulators in flight training and result in systematic consequences such as decreased simulator use, compromised training, ground safety, and flight safety. Pilots are less likely to want to repeat the experience in a simulator if they have suffered from simulator sickness and hence can reduce the number of potential users. It can also compromise training in two safety-critical ways:
1. It can distract the pilot during training sessions.
2. It can cause the pilot to adopt certain counterproductive behaviors to prevent symptoms from occurring.
Simulator sickness can also have post-training effects that can compromise safety after the simulator session, such as when the pilots drive away from the facility or fly while experiencing symptoms of simulator sickness.
The cause is the most mysterious aspect of the disease. Commentators then and now put much blame on the generally poor sanitation, sewage and contaminated water supplies of the time, which might have harboured the source of infection. The first outbreak at the end of the Wars of the Roses means that it may have been brought over from France by the French mercenaries whom Henry VII used to gain the English throne. However, the "Croyland Chronicle" mentions that Thomas Stanley, 1st Earl of Derby used the "sweating sickness" as an excuse not to join with Richard III's army prior to the Battle of Bosworth.
Relapsing fever has been proposed as a possible cause. This disease, which is spread by ticks and lice, occurs most often during the summer months, as did the original sweating sickness. However, relapsing fever is marked by a prominent black scab at the site of the tick bite and a subsequent skin rash.
Noting symptom overlap with hantavirus pulmonary syndrome, several scientists proposed an unknown hantavirus as the cause. A critique of this hypothesis included the argument that, whereas sweating sickness was thought to be transmitted from human to human, hantaviruses are rarely spread in this way. However, infection via human-to-human contact has been proven in hantavirus outbreaks in Argentina.
Sweating sickness, also known as "English sweating sickness" or "English sweate" (), was a mysterious and highly contagious disease that struck England, and later continental Europe, in a series of epidemics beginning in 1485. The last outbreak occurred in 1551, after which the disease apparently vanished. The onset of symptoms was dramatic and sudden, death often occurring within hours. Although its cause remains unknown, it has been suggested that an unknown species of hantavirus was responsible for the outbreak.
Lovesickness refers to an informal affliction that describes negative feelings associated with rejection, unrequited love or the absence of a loved one. It can manifest as physical as well as mental symptoms. It is not to be confused with the condition of being lovestruck, which refers to the physical and mental symptoms associated with falling in love. The term lovesickness is rarely used in medical or psychological fields.
Many people believe lovesickness was created as an explanation for longings, but it can be associated with depression and various mental health problems.
Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure, in particular, within 24 hours of diving. In 1995, 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours. An alternative diagnosis should be suspected if severe symptoms begin more than six hours following decompression without an altitude exposure or if any symptom occurs more than 24 hours after surfacing. The diagnosis is confirmed if the symptoms are relieved by recompression. Although MRI or CT can frequently identify bubbles in DCS, they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms.
Thalidomide was originally developed and prescribed as a cure for morning sickness in West Germany, but its use was discontinued when it was found to cause birth defects. The United States Food and Drug Administration never approved thalidomide for use as a cure for morning sickness.
There is a lack of good evidence to support the use of any particular intervention for morning sickness.
An optokinetic drum may be used to study visually induced sopite effects. The optokinetic drum is a rotating instrument in which test subjects are seated facing the wall of the drum. The interior surface of the drum is normally striped; thus, as the drum rotates, the subject’s eyes are subject to a moving visual field while the subject remains stationary. The speed of the drum and the duration of the test may be varied. Control groups are placed in a drum without stripes or rotation. After exposure to the rotating drum, subjects are surveyed to determine their susceptibility to motion sickness. A study in which the optokinetic drum was used to test the symptoms of the sopite syndrome showed increased mood changes in response to the visual cues, though these effects were compounded by other environmental factors such as boredom and lack of activity.
Immediate treatment with 100% oxygen, followed by recompression in a hyperbaric chamber, will in most cases result in no long-term effects. However, permanent long-term injury from DCS is possible. Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14.3% of the 268 divers surveyed had ongoing symptoms of Type II DCS, and 7% from Type I DCS. Long-term follow-ups showed similar results, with 16% having permanent neurological sequelae.
Diagnosis can be assisted with a number of different scoring systems.
Taravana is a disease often found among Polynesian island natives who habitually dive deep without breathing apparatus many times in close succession, usually for food or pearls. These free-divers may make 40 to 60 dives a day, each of 30 or 40 metres (100 to 140 feet).
Taravana seems to be decompression sickness. The usual symptoms are vertigo, nausea, lethargy, paralysis and death. The word "taravana" is Tuamotu Polynesian for "to fall crazily".
Taravana is also used to describe someone who is "crazy because of the sea".
A typical method for determining the effects of the sopite syndrome is through the use of one or several questionnaires. The available questionnaires for motion sickness and sopite syndrome are described by Lawson. Two such questionnaires widely used to evaluate motion sickness are the Pensacola Diagnostic Index and the Motion Sickness Questionnaire. These questionnaires are limited, however, in that they group symptoms of drowsiness with other non-sopite related effects, such as nausea and dizziness. Motion sickness is measured based on the cumulative ratings of all these symptoms without distinguishing different levels for each effect.
A Motion Sickness Assessment Questionnaire has been developed to test the multiple dimensions of motion sickness more thoroughly; this survey defines motion sickness as gastrointestinal (involving nausea), peripheral (referring to thermoregulatory effects such as clamminess and sweating), central (involving symptoms such as dizziness and lightheadedness), and sopite-related. This questionnaire may more accurately determine how subjects experience sopite symptoms relative to other motion sickness effects. Another questionnaire designed to measure sleepiness is the Epworth Sleepiness Scale.
The gold standard for diagnosis is identification of trypanosomes in a patient sample by microscopic examination. Patient samples that can be used for diagnosis include chancre fluid, lymph node aspirates, blood, bone marrow, and, during the neurological stage, cerebrospinal fluid. Detection of trypanosome-specific antibodies can be used for diagnosis, but the sensitivity and specificity of these methods are too variable to be used alone for clinical diagnosis. Further, seroconversion occurs after the onset of clinical symptoms during a "T. b. rhodesiense" infection, so is of limited diagnostic use.
Trypanosomes can be detected from patient samples using two different preparations. A wet preparation can be used to look for the motile trypanosomes. Alternatively, a fixed (dried) smear can be stained using Giemsa's or Field's technique and examined under a microscope. Often, the parasite is in relatively low abundance in the sample, so techniques to concentrate the parasites can be used prior to microscopic examination. For blood samples, these include centrifugation followed by examination of the buffy coat; mini anion-exchange/centrifugation; and the quantitative buffy coat (QBC) technique. For other samples, such as spinal fluid, concentration techniques include centrifugation followed by examination of the sediment.
Three serological tests are also available for detection of the parasite: the micro-CATT, wb-CATT, and wb-LATEX. The first uses dried blood, while the other two use whole blood samples. A 2002 study found the wb-CATT to be the most efficient for diagnosis, while the wb-LATEX is a better exam for situations where greater sensitivity is required.
In high-altitude conditions, oxygen enrichment can counteract the hypoxia related effects of altitude sickness. A small amount of supplemental oxygen reduces the equivalent altitude in climate-controlled rooms. At (), raising the oxygen concentration level by 5% via an oxygen concentrator and an existing ventilation system provides an effective altitude of (), which is more tolerable for those unaccustomed to high altitudes.
Oxygen from gas bottles or liquid containers can be applied directly via a nasal cannula or mask. Oxygen concentrators based upon pressure swing adsorption (PSA), VSA, or vacuum-pressure swing adsorption (VPSA) can be used to generate the oxygen if electricity is available. Stationary oxygen concentrators typically use PSA technology, which has performance degradations at the lower barometric pressures at high altitudes. One way to compensate for the performance degradation is to utilize a concentrator with more flow capacity. There are also portable oxygen concentrators that can be used on vehicular DC power or on internal batteries, and at least one system commercially available measures and compensates for the altitude effect on its performance up to . The application of high-purity oxygen from one of these methods increases the partial pressure of oxygen by raising the FiO (fraction of inspired oxygen).