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Sample records for chronic mountain sickness

  1. Pathology of chronic mountain sickness

    PubMed Central

    Arias-Stella, Javier; Krüger, Hever; Recavarren, Sixto

    1973-01-01

    Arias-Stella, J., Krüger, H., and Recavarren, S. (1973).Thorax, 28, 701-708. Pathology of chronic mountain sickness. Pathological data on chronic mountain sickness are scarce due to the fact that the disease is ameliorated or cured by descent to a low altitude. In this report we describe a case of chronic mountain sickness occurring in a woman of 48 years at Cerro de Pasco (4,300 m above sea level). The necropsy findings are compared with the limited pathological observations reported by others. It is apparent from our findings that in fatal cases the main changes are located within the pulmonary circulation. So far histological studies have been reported only in cases of the secondary form of chronic mountain sickness. The basic pathology of the primary form (Monge's disease) remains to be defined. Images PMID:4787982

  2. The genetic basis of chronic mountain sickness.

    PubMed

    Ronen, Roy; Zhou, Dan; Bafna, Vineet; Haddad, Gabriel G

    2014-11-01

    Chronic mountain sickness (CMS) is a disease that affects many high-altitude dwellers, particularly in the Andean Mountains in South America. The hallmark symptom of CMS is polycythemia, which causes increased risk of pulmonary hypertension and stroke (among other symptoms). A prevailing hypothesis in high-altitude medicine is that CMS results from a population-specific "maladaptation" to the hypoxic conditions at high altitude. In contrast, the prevalence of CMS is very low in other high-altitude populations (e.g., Tibetans and Ethiopians), which are seemingly well adapted to hypoxia. In recent years, concurrent with the advent of genomic technologies, several studies have investigated the genetic basis of adaptation to altitude. These studies have identified several candidate genes that may underlie the adaptation, or maladaptation. Interestingly, some of these genes are targeted by known drugs, raising the possibility of new treatments for CMS and other ischemic diseases. We review recent discoveries, alongside the methodologies used to obtain them, and outline some of the challenges remaining in the field. ©2014 Int. Union Physiol. Sci./Am. Physiol. Soc.

  3. Exercise pathophysiology in patients with chronic mountain sickness exercise in chronic mountain sickness.

    PubMed

    Groepenhoff, Herman; Overbeek, Marieke J; Mulè, Massimiliano; van der Plas, Mart; Argiento, Paola; Villafuerte, Francisco C; Beloka, Sophia; Faoro, Vitalie; Macarlupu, Jose L; Guenard, Herve; de Bisschop, Claire; Martinot, Jean-Benoit; Vanderpool, Rebecca; Penaloza, Dante; Naeije, Robert

    2012-10-01

    Chronic mountain sickness (CMS) is characterized by a combination of excessive erythrocytosis,severe hypoxemia, and pulmonary hypertension, all of which affect exercise capacity. Thirteen patients with CMS and 15 healthy highlander and 15 newcomer lowlander control subjects were investigated at an altitude of 4,350 m (Cerro de Pasco, Peru). All of them underwent measurements of diffusing capacity of lung for nitric oxide and carbon monoxide at rest, echocardiography for estimation of mean pulmonary arterial pressure and cardiac output at rest and at exercise, and an incremental cycle ergometer cardiopulmonary exercise test. The patients with CMS, the healthy highlanders, and the newcomer lowlanders reached a similar maximal oxygen uptake at 32 1, 32 2, and 33 2 mL/min/kg, respectively, mean SE( P 5 .8), with ventilatory equivalents for C O 2 vs end-tidal P CO 2 , measured at the anaerobic threshold,of 0.9 0.1, 1.2 0.1, and 1.4 0.1 mm Hg, respectively ( P , .001); arterial oxygen content of 26 1, 21 2, and 16 1 mL/dL, respectively ( P , .001); diffusing capacity for carbon monoxide corrected for alveolar volume of 155% 4%, 150% 5%, and 120% 3% predicted, respectively( P , .001), with diffusing capacity for nitric oxide and carbon monoxide ratios of 4.7 0.1 at sea level decreased to 3.6 0.1, 3.7 0.1, and 3.9 0.1, respectively ( P , .05) and a maximal exercise mean pulmonary arterial pressure at 56 4, 42 3, and 31 2 mm Hg, respectively ( P , .001). The aerobic exercise capacity of patients with CMS is preserved in spite of severe pulmonary hypertension and relative hypoventilation, probably by a combination of increased oxygen carrying capacity of the blood and lung diffusion, the latter being predominantly due to an increased capillary blood volume.

  4. Chronic Mountain Sickness: Clinical Aspects, Etiology, Management, and Treatment.

    PubMed

    Villafuerte, Francisco C; Corante, Noemí

    2016-06-01

    Villafuerte, Francisco C., and Noemí Corante. Chronic mountain sickness: clinical aspects, etiology, management, and treatment. High Alt Med Biol. 17:61-69, 2016.-Millions of people worldwide live at a high altitude, and a significant number are at risk of developing Chronic Mountain Sickness (CMS), a progressive incapacitating syndrome caused by lifelong exposure to hypoxia. CMS is characterized by severe symptomatic excessive erythrocytosis (EE; Hb ≥19 g/dL for women and Hb ≥21 g/dL for men) and accentuated hypoxemia, which are frequently associated with pulmonary hypertension. In advanced cases, the condition may evolve to cor pulmonale and congestive heart failure. Current knowledge indicates a genetic predisposition to develop CMS. However, there are important risk factors and comorbidities that may trigger and aggravate the condition. Thus, appropriate medical information on CMS is necessary to provide adequate diagnosis and healthcare to high-altitude inhabitants. After reviewing basic clinical aspects of CMS, including its definition, diagnosis, and common clinical findings, we discuss aspects of its etiology, and address its epidemiology, risk factors, and treatment.

  5. Chronic Mountain Sickness: Clinical Aspects, Etiology, Management, and Treatment

    PubMed Central

    Corante, Noemí

    2016-01-01

    Abstract Villafuerte, Francisco C., and Noemí Corante. Chronic mountain sickness: clinical aspects, etiology, management, and treatment. High Alt Med Biol. 17:61–69, 2016.—Millions of people worldwide live at a high altitude, and a significant number are at risk of developing Chronic Mountain Sickness (CMS), a progressive incapacitating syndrome caused by lifelong exposure to hypoxia. CMS is characterized by severe symptomatic excessive erythrocytosis (EE; Hb ≥19 g/dL for women and Hb ≥21 g/dL for men) and accentuated hypoxemia, which are frequently associated with pulmonary hypertension. In advanced cases, the condition may evolve to cor pulmonale and congestive heart failure. Current knowledge indicates a genetic predisposition to develop CMS. However, there are important risk factors and comorbidities that may trigger and aggravate the condition. Thus, appropriate medical information on CMS is necessary to provide adequate diagnosis and healthcare to high-altitude inhabitants. After reviewing basic clinical aspects of CMS, including its definition, diagnosis, and common clinical findings, we discuss aspects of its etiology, and address its epidemiology, risk factors, and treatment. PMID:27218284

  6. Chronic mountain sickness, optimal hemoglobin, and heart disease.

    PubMed

    Vargas, Enrique; Spielvogel, Hilde

    2006-01-01

    For the male inhabitants of La Paz, Bolivia (3200-4100 m), and other high altitude regions in America and Asia, chronic mountain sickness (CMS) is a major health problem. Since CMS was first described by Carlos Monge in the Peruvian Andes in 1925, numerous research papers have been devoted to this topic, but many unanswered questions still exist with respect to the beginning of the disease and its cause(s). The experience with CMS has shown that an excessively high hemoglobin concentration is not favorable for high altitude acclimatization, and the hypothesis of theoretically "optimal" hematocrit and "optimal" hemoglobin has been made. The calculated optimal hemoglobin concentration of 14.7 g/dL for resting men in the Andes is discussed as theoretical and not applicable in real life. The most frequent congenital and acquired heart diseases are discussed, such as patent ductus, atrial septum defect, ventricle septum defect among congenital heart diseases and the still very frequent rheumatic valve cardiopathies and Chagas disease as acquired cardiopathies. Among the typical acquired heart diseases of the high altitude dweller, special attention is given to chronic cor pulmonale as a consequence of severe CMS with pulmonary hypertension.

  7. Hypoventilation in chronic mountain sickness: a mechanism to preserve energy.

    PubMed

    Zubieta-Calleja, G R; Paulev, P-E; Zubieta-Calleja, L; Zubieta-Calleja, N; Zubieta-Castillo, G

    2006-09-01

    Chronic Mountain Sickness (CMS) patients have repeatedly been found to hypoventilate. Low saturation in CMS is attributed to hypoventilation. Although this observation seems logical, a further understanding of the exact mechanism of hypoxia is mandatory. An exercise study using the Bruce Protocol in CMS (n = 13) compared to normals N (n = 17), measuring ventilation (VE), pulse (P), and saturation by pulse oximetry (SaO(2)) was performed. Ventilation at rest while standing, prior to exercise in a treadmill was indeed lower in CMS (8.37 l/min compared with 9.54 l/min in N). However, during exercise, stage one through four, ventilation and cardiac frequency both remained higher than in N. In spite of this, SaO(2) gradually decreased. Although CMS subjects increased ventilation and heart rate more than N, saturation was not sustained, suggesting respiratory insufficiency. The degree of veno-arterial shunting of blood is obviously higher in the CMS patients both at rest and during exercise as judged from the SaO(2) values. The higher shunt fraction is due probably to a larger degree of trapped air in the lungs with uneven ventilation of the CMS patients. One can infer that hypoventilation at rest is an energy saving mechanism of the pneumo-dynamic and hemo-dynamic pumps. Increased ventilation would achieve an unnecessary high SaO(2) at rest (low metabolism). This is particularly true during sleep.

  8. Cerebral Edema in Chronic Mountain Sickness: a New Finding

    PubMed Central

    Bao, Haihua; Wang, Duoyao; Zhao, Xipeng; Wu, Youshen; Yin, Guixiu; Meng, Li; Wang, Fangfang; Ma, Lan; Hackett, Peter; Ge, Ri-Li

    2017-01-01

    We observed patients with chronic mountain sickness (CMS) in our clinic who developed progressive neurological deterioration (encephalopathy) and we wished to investigate this. We studied nine such CMS patients, and compared them to 21 CMS patients without encephalopathy, and to 15 healthy control subjects without CMS. All 45 subjects lived permanently at 3200–4000 m. Measurements at 2260 m included CMS symptom score, multi-slice CT, perfusion CT, pulse oximetry (SpO2%), and hemoglobin concentration (Hb). One patient had MRI imaging but not CT; 5 had CSF pressure measurements. CMS subjects had lower SpO2, higher Hb, higher brain blood density, lower mean cerebral blood flow (CBF), and significant cerebral circulatory delay compared to controls. The nine CMS subjects with neurological deterioration showed diffuse cerebral edema on imaging and more deranged cerebral hemodynamics. CSF pressure was elevated in those with edema. We conclude that cerebral edema, a previously unrecognized complication, may develop in CMS patients and cause encephalopathy. Contributing factors appear to be exaggerated polycythemia and hypoxemia, and lower and sluggish CBF compared to CMS patients without cerebral edema; but what triggers this complication is unknown. Recognition and treatment of this serious complication will help reduce morbidity and mortality from CMS. PMID:28233815

  9. The heart and pulmonary circulation at high altitudes: healthy highlanders and chronic mountain sickness.

    PubMed

    Penaloza, Dante; Arias-Stella, Javier

    2007-03-06

    More than 140 million people worldwide live >2500 m above sea level. Of them, 80 million live in Asia, and 35 million live in the Andean mountains. This latter region has its major population density living above 3500 m. The primary objective of the present study is to review the physiology, pathology, pathogenesis, and clinical features of the heart and pulmonary circulation in healthy highlanders and patients with chronic mountain sickness. A systematic review of worldwide literature was undertaken, beginning with the pioneering work done in the Andes several decades ago. Original articles were analyzed in most cases and English abstracts or translations of articles written in Chinese were reviewed. Pulmonary hypertension in healthy highlanders is related to a delayed postnatal remodeling of the distal pulmonary arterial branches. The magnitude of pulmonary hypertension increases with the altitude level and the degree of exercise. There is reversal of pulmonary hypertension after prolonged residence at sea level. Chronic mountain sickness develops when the capacity for altitude adaptation is lost. These patients have moderate to severe pulmonary hypertension with accentuated hypoxemia and exaggerated polycythemia. The clinical picture of chronic mountain sickness differs from subacute mountain sickness and resembles other chronic altitude diseases described in China and Kyrgyzstan. The heart and pulmonary circulation in healthy highlanders have distinct features in comparison with residents at sea level. Chronic mountain sickness is a public health problem in the Andean mountains and other mountainous regions around the world. Therefore, dissemination of preventive and therapeutic measures is essential.

  10. Chronic mountain sickness. A view from the crow's nest.

    PubMed

    Reeves, J T; Weil, J V

    2001-01-01

    Chronic mountain sickness (CMS) is a poorly understood syndrome, characterized by hypoxemia and polycythemia and occurring in persons residing at high altitude. To better characterize the disorder, we have reviewed measurements in more than 750 men and 200 women living at altitude as published and as submitted by colleagues. In men, blood hemoglobin concentration (Hb) and arterial oxygen saturation (SaO2) related to altitude (r=0.72). There was greater variability in both SaO2 and hemoglobin above than below 3000 m, largely due to inter-individual variations in effective ventilation. For the entire cohort, a linear relationship (r=0.72) of an index of hematopoietic response (Hb) to an index of stimulus (SaO2) was independent of age, altitude, duration of altitude residence greater than one year, ethnic origin, geographic location, presence or absence of CMS and nearly independent of gender. A potentially important and usually unrecognized variation in the hypoxic stimulus was desaturation during sleep. Contributions to variation in response include ingested toxins, such as cobalt, and nutritional deficiencies, including iron. Pulmonary hypertension was related to chronic hypoxia, with an uncertain contribution from polycythemia. In CMS there were profound hypoxemia at night, decrease in cerebral blood flow, and loss of cerebral blood flow regulation, possibly causing the cerebral symptoms. We speculate that the relationship of Hb to SaO2 is more useful than of hemoglobin to altitude, that hypoventilation awake and asleep are the primary causes accentuating altitude-hypoxia, and that the brain is the primary target organ in the disorder.

  11. Is restless legs syndrome associated with chronic mountain sickness?

    PubMed

    Vizcarra-Escobar, Darwin; Mendiola-Yamasato, Andrea; Risco-Rocca, Jorge; Mariños-Velarde, Alejandro; Juárez-Belaunde, Alan; Anculle-Arauco, Victor; Rivera-Chira, María

    2015-08-01

    Restless legs syndrome (RLS) and chronic mountain sickness (CMS) share physiological traits. Our objective was to explore a possible association between RLS and CMS. We carried a cross-sectional study with male subjects living between 4100 and 4300 m above sea level. Participants underwent a clinical interview, physical examination, electrocardiographic (EKG) recording, and spirometry. We classified subjects into CMS, Limbo, and healthy high-altitude dwellers (hHAD), according to their Quinghai score and hematocrit levels. We applied the "Paradigm of questions for epidemiological studies of RLS," The International Restless Leg Syndrome Study Group Scale, and the Pittsburgh Sleep Quality Index. Logistic regression analysis was used to determine the association between variables. Seventy-eight male subjects were included. Forty subjects were hHAD, 23 were CMS patients, and 15 participants were considered as Limbo. CMS and Limbo subjects had a higher frequency of RLS (p <0.05). Limbo subjects had the highest severity score for RLS. There were no differences in age, body mass index (BMI), or tobacco use between RLS patients and non-sufferers. In the multivariate analysis, CMS was not associated with RLS diagnosis. Oxygen saturation (p = 0.019), poor sleep quality (p <0.01), and Quinghai score of ≥6 (p = 0.026) were independently associated with RLS diagnosis. Our results did not show a direct association between RLS and CMS; however, RLS was associated with reduced oxygen saturation. Hence, RLS could represent an early clinical manifestation of hypoxia, or, in CMS natural history, an early sign of maladaptation to high altitude. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Effects and mechanisms of acetyl-L-cysteine in rats with chronic mountain sickness with H1-NMR metabolomics methods.

    PubMed

    Maimaitiyimin, Dilinuer; Aikemu, Ainiwaer; Kamilijiang, Mayila; Salamu, Adila; Zhang, Xiangyang

    2014-05-10

    We established a rat model of chronic mountain sickness using acetyl-L-cysteine. Then we studied the effects and mechanisms of acetyl-L-cysteine (Da) in rats with chronic mountain sickness using nuclear magnetic resonance (H1-NMR) metabolomics methods. Using NMR spectroscopy combined with pattern recognition and orthogonal partial least squares discriminant analysis, we analyzed the impact of Da on blood metabolism in rats with chronic mountain sickness by determining different metabolites and changes in metabolic network in the blood of rats with mountain sickness after the intragastric administration of different doses of Da suspension. Increased levels of amino acids (valine, tyrosine, 1-methyl-histidine, leucine, phenylalanine, and methionine) were detected in the blood of rats in the chronic mountain sickness group, yet significantly decreased levels were detected in control rats. At the same time, β-glucose and α-glucose levels were markedly elevated in the blood of rats in the model group but decreased in the chronic mountain sickness group, which indicated a statistically significant difference compared with the chronic altitude sickness model group (P<0.05). Da has a significant impact on the metabolism of rats with chronic mountain sickness. Da may act on the disturbed glucose metabolism and amino acid metabolism in rats triggered by chronic mountain sickness, resulting in the treatment and prevention of this disease.

  13. Novel Insights into Cardiovascular Regulation in Patients with Chronic Mountain Sickness.

    PubMed

    Rimoldi, Stefano F; Rexhaj, Emrush; Villena, Mercedes; Salmon, Carlos Salinas; Allemann, Yves; Scherrer, Urs; Sartori, Claudio

    2016-01-01

    Studies of high-altitude populations, and in particular of maladapted subgroups, may provide important insight into underlying mechanisms involved in the pathogenesis of hypoxemia-related disease in general. Chronic mountain sickness (CMS) is a major public health problem in mountainous regions of the world affecting many millions of high-altitude dwellers. It is characterized by exaggerated chronic hypoxemia, erythrocytosis, and mild pulmonary hypertension. In later stages these patients often present with right heart failure and are predisposed to systemic cardiovascular disease, but the underlying mechanisms are poorly understood. Here, we present recent new data providing insight into underlying mechanisms that may cause these complications.

  14. Acute mountain sickness

    MedlinePlus

    ... occur with more severe acute mountain sickness include: Blue color to the skin (cyanosis) Chest tightness or congestion Confusion Cough Coughing up blood Decreased consciousness or withdrawal from social interaction Gray ...

  15. Pulmonary blood volume (PRV) in rats with chronic mountain sickness

    SciTech Connect

    Ou, L.C.; Sardella, G.L.; Hill, N.S.; Tenney, S.M.

    1986-03-05

    Upon chronic exposure to severe hypoxia, Hilltop (H) strain of Sprague-Dawley rats develops excessive polycythemia, severe hypervolemia and marked elevation in pulmonary arterial pressure (PAP), whereas Madison (M) strain develops only moderate responses. Hypervolemia is expected to increase the PBV which might contribute to the development of severe pulmonary hypertension. Two groups of 6 animals each of the H and M strains were exposed to sea level (SL) and a simulated altitude of 18,000 ft for 14 days. At the end of exposure each animal was measured for RBC volume (RBCV), total blood volume (TBV), PBV and PAP under normoxia for control and under hypoxia (10% O/sub 2/) for the hypoxic groups. RBCV was determined by /sup 51/Cr-RBC dilution and PBV was trapped by tightening an implanted loose ligature around the ascending aorta and PA. There were not strain differences in all parameters studied at SL. RBCV, TBV and PAP increased with hypoxia in both strains but significantly more so in H than M. PBV per g lung WT decreased in both strains despite elevated TBV and PAP, but more so in M than H. There were good correlations between the PBV and TBV, and between PAP and PBV in the hypoxic H and M rats. The data suggest that chronic hypoxia reduced the distensibility and perhaps the vascular capacity of the lungs such that small relative increase in PBV could significantly contribute to the rise in PAP.

  16. The treatment of Uygur medicine Dracocephalum moldavica L on chronic mountain sickness rat model

    PubMed Central

    Maimaitiyiming, Dilinuer; Hu, Guangmei; Aikemu, Ainiwaer; Hui, Shi Wen; Zhang, Xiangyang

    2014-01-01

    Aim: Dracocephalum moldavica L, a traditional Uygur medicine, possesses some key cardiac activities. However, till date, no reports are available on the use of D. moldavica against chronic mountain sickness (CMS), which is a medical condition that affects the residents of high altitude. The present study was designed to explore the treatment efficacy of D. moldavica on CMS. Materials and Methods: 80 of the 100 Sprague Dawley rats enrolled were bred in simulated high altitude environment and the remaining 20 rats were kept in the plains. Water and alcohol extracts of D. moldavica were prepared. CMS rat model was prepared, and the rat hearts were removed for histopathological analysis. Blood samples were taken for hematological and biochemical analyses. Rat pulmonary artery pressure was determined to study the treatment efficacy. Results: In the CMS model group, the levels of interleukin-6 (IL-6), C-reactive protein (CRP), and malondialdehyde (MDA) were found to be significantly higher than the control group; while the concentrations of SOD and GSH-Px decreased. D. moldavica could improve these levels, decrease pulmonary artery pressure, and improve the cardiac pathological state. Conclusions: The study results show that IL-6, CRP, MDA, SOD and GSH-Px participate and mediate the formation of CMS and D. moldavica is found to possess noticeable effects on CMS. The present study explored the basics of high altitude sickness and laid the foundation for further progress of Uygur medicines on the treatment of altitude sickness. Further preclinical and clinical studies with more sample size are recommended. PMID:25422549

  17. Noninvasive Assessment of Excessive Erythrocytosis as a Screening Method for Chronic Mountain Sickness at High Altitude.

    PubMed

    Vyas, Kaetan J; Danz, David; Gilman, Robert H; Wise, Robert A; León-Velarde, Fabiola; Miranda, J Jaime; Checkley, William

    2015-06-01

    Vyas, Kaetan J., David Danz, Robert H. Gilman, Robert A. Wise, Fabiola León-Velarde, J. Jaime Miranda, and William Checkley. Noninvasive assessment of excessive erythrocytosis as a screening method for chronic mountain sickness at high altitude. High Alt Med Biol 16:162-168, 2015.--Globally, over 140 million people are at risk of developing chronic mountain sickness, a common maladaptation to life at high altitude (>2500 meters above sea level). The diagnosis is contingent upon the identification of excessive erythrocytosis (EE). Current best practices to identify EE require a venous blood draw, which is cumbersome for large-scale surveillance. We evaluated two point-of-care biomarkers to screen for EE: noninvasive spot-check tests of total hemoglobin and oxyhemoglobin saturation (Pronto-7, Masimo Corporation). We conducted paired evaluations of total serum hemoglobin from a venous blood draw and noninvasive, spot-check testing of total hemoglobin and oxyhemoglobin saturation with the Pronto-7 in 382 adults aged ≥35 years living in Puno, Peru (3825 meters above sea level). We used the Bland-Altman method to measure agreement between the noninvasive hemoglobin assessment and the gold standard lab hemoglobin analyzer. Mean age was 58.8 years and 47% were male. The Pronto-7 test was unsuccessful in 21 (5%) participants. Limits of agreement between total hemoglobin measured via venous blood draw and the noninvasive, spot-check test ranged from -2.8 g/dL (95% CI -3.0 to -2.5) to 2.5 g/dL (95% CI 2.2 to 2.7), with a bias of -0.2 g/dL (95% CI -0.3 to -0.02) for the difference between total hemoglobin and noninvasive hemoglobin concentrations. Overall, the noninvasive spot-check test of total hemoglobin had a better area under the receiver operating characteristic curve compared to oxyhemoglobin saturation for the identification of EE as measured by a gold standard laboratory hemoglobin analyzer (0.96 vs. 0.82; p<0.001). Best cut-off values to screen for EE with

  18. Whole-Genome Sequencing Uncovers the Genetic Basis of Chronic Mountain Sickness in Andean Highlanders

    PubMed Central

    Zhou, Dan; Udpa, Nitin; Ronen, Roy; Stobdan, Tsering; Liang, Junbin; Appenzeller, Otto; Zhao, Huiwen W.; Yin, Yi; Du, Yuanping; Guo, Lixia; Cao, Rui; Wang, Yu; Jin, Xin; Huang, Chen; Jia, Wenlong; Cao, Dandan; Guo, Guangwu; Gamboa, Jorge L.; Villafuerte, Francisco; Callacondo, David; Xue, Jin; Liu, Siqi; Frazer, Kelly A.; Li, Yingrui; Bafna, Vineet; Haddad, Gabriel G.

    2013-01-01

    The hypoxic conditions at high altitudes present a challenge for survival, causing pressure for adaptation. Interestingly, many high-altitude denizens (particularly in the Andes) are maladapted, with a condition known as chronic mountain sickness (CMS) or Monge disease. To decode the genetic basis of this disease, we sequenced and compared the whole genomes of 20 Andean subjects (10 with CMS and 10 without). We discovered 11 regions genome-wide with significant differences in haplotype frequencies consistent with selective sweeps. In these regions, two genes (an erythropoiesis regulator, SENP1, and an oncogene, ANP32D) had a higher transcriptional response to hypoxia in individuals with CMS relative to those without. We further found that downregulating the orthologs of these genes in flies dramatically enhanced survival rates under hypoxia, demonstrating that suppression of SENP1 and ANP32D plays an essential role in hypoxia tolerance. Our study provides an unbiased framework to identify and validate the genetic basis of adaptation to high altitudes and identifies potentially targetable mechanisms for CMS treatment. PMID:23954164

  19. Effects of chronic normobaric hypoxic and hypercapnic exposure in rats: Prevention of experimental chronic mountain sickness by hypercapnia

    NASA Astrophysics Data System (ADS)

    Lincoln, B.; Bonkovsky, H. L.; Ou, Lo-Chang

    1987-09-01

    A syndrome of experimental chronic mountain sickness can be produced in the Hilltop strain of Sprague-Dawley rats by chronic hypobaric hypoxic exposure. This syndrome is characterized by polycythemia, plasma hemoglobinemia, pulmonary hypertension and right ventricular hypertrophy with eventual failure and death. It has generally been assumed that these changes are caused by chronic hypoxemia, not by hypobaric exposure per se. We have now confirmed this directly by showing that chronic normobaric hypoxic exposure (10.5% O2) produces similar hematologic and hemodynamic changes. Further, the addition of hypercapnic exposure to the hypoxic exposure blunted or prevented the effects of the hypoxic exposure probably by stimulating respiration, thus increasing the rate of oxygen delivery to the cells. Changes in the rate-controlling enzymes of hepatic heme metabolism, 5-aminolevulinate synthase and heme oxygenase, and in cytochrome(s) P-450, the major hepatic hemoprotein(s), were also measured in hypoxic and hypercapnic rats. Hypoxia decreased 5-aminolevulinate synthase and increased cytochrome(s) P-450, probably by increasing the size of a “regulatory” heme pool within hepatocytes. These changes were also prevented by the addition of hypercapnic to hypoxic exposure.

  20. Noninvasive Assessment of Excessive Erythrocytosis as a Screening Method for Chronic Mountain Sickness at High Altitude

    PubMed Central

    Vyas, Kaetan J.; Danz, David; Gilman, Robert H.; Wise, Robert A.; León-Velarde, Fabiola; Jaime Miranda, J.

    2015-01-01

    Abstract Vyas, Kaetan J., David Danz, Robert H. Gilman, Robert A. Wise, Fabiola León-Velarde, J. Jaime Miranda, and William Checkley. Noninvasive assessment of excessive erythrocytosis as a screening method for chronic mountain sickness at high altitude. High Alt Med Biol 16:162–168, 2015.—Globally, over 140 million people are at risk of developing chronic mountain sickness, a common maladaptation to life at high altitude (>2500 meters above sea level). The diagnosis is contingent upon the identification of excessive erythrocytosis (EE). Current best practices to identify EE require a venous blood draw, which is cumbersome for large-scale surveillance. We evaluated two point-of-care biomarkers to screen for EE: noninvasive spot-check tests of total hemoglobin and oxyhemoglobin saturation (Pronto-7, Masimo Corporation). We conducted paired evaluations of total serum hemoglobin from a venous blood draw and noninvasive, spot-check testing of total hemoglobin and oxyhemoglobin saturation with the Pronto-7 in 382 adults aged ≥35 years living in Puno, Peru (3825 meters above sea level). We used the Bland-Altman method to measure agreement between the noninvasive hemoglobin assessment and the gold standard lab hemoglobin analyzer. Mean age was 58.8 years and 47% were male. The Pronto-7 test was unsuccessful in 21 (5%) participants. Limits of agreement between total hemoglobin measured via venous blood draw and the noninvasive, spot-check test ranged from −2.8 g/dL (95% CI −3.0 to −2.5) to 2.5 g/dL (95% CI 2.2 to 2.7), with a bias of −0.2 g/dL (95% CI −0.3 to −0.02) for the difference between total hemoglobin and noninvasive hemoglobin concentrations. Overall, the noninvasive spot-check test of total hemoglobin had a better area under the receiver operating characteristic curve compared to oxyhemoglobin saturation for the identification of EE as measured by a gold standard laboratory hemoglobin analyzer (0.96 vs. 0.82; p<0.001). Best cut-off values

  1. Abnormal energy regulation in early life: childhood gene expression may predict subsequent chronic mountain sickness

    PubMed Central

    Huicho, Luis; Xing, Guoqiang; Qualls, Clifford; Rivera-Ch, María; Gamboa, Jorge L; Verma, Ajay; Appenzeller, Otto

    2008-01-01

    Background Life at altitude depends on adaptation to ambient hypoxia. In the Andes, susceptibility to chronic mountain sickness (CMS), a clinical condition that occurs to native highlanders or to sea level natives with prolonged residence at high altitude, remains poorly understood. We hypothesized that hypoxia-associated gene expression in children of men with CMS might identify markers that predict the development of CMS in adults. We assessed distinct patterns of gene expression of hypoxia-responsive genes in children of highland Andean men, with and without CMS. Methods We compared molecular signatures in children of highland (HA) men with CMS (n = 10), without CMS (n = 10) and in sea level (SL) children (n = 20). Haemoglobin, haematocrit, and oxygen saturation were measured. Gene expression in white cells was assessed at HA and then, in the same subjects, within one hour of arrival at sea level. Results HA children showed higher expression levels of genes regulated by HIF (hypoxia inducible factor) and lower levels of those involved in glycolysis and in the tricarboxilic acid (TCA) cycle. Pyruvate dehydrogenase kinase 1(PDK1) and HIF prolyl hydroxylase 3 (HPH3) mRNA expressions were lowest in children of CMS fathers at altitude. At sea level the pattern of gene expression in the 3 children's groups was indistinguishable. Conclusion The molecular signatures of children of CMS patients show impaired adaptation to hypoxia. At altitude children of CMS fathers had defective coupling between glycolysis and mitochondria TCA cycle, which may be a key mechanism/biomarker for adult CMS. Early biologic markers of disease susceptibility in Andeans might impact health services and social planning. PMID:18954447

  2. Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness.

    PubMed

    Villafuerte, Francisco C; Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola

    2016-07-01

    Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS patients suggesting increased Epo availability (increased Epo/sEpoR). The present study aimed to characterize the nocturnal concentration profile of sEpoR and Epo and their relationship with SpO2, Hct, and serum testosterone in healthy highlanders (HH) and CMS patients. Epo and sEpoR concentrations were evaluated every 4 h (6 PM to 6 AM) and nighttime SpO2 was continuously monitored (10 PM to 6 AM) in 39 male participants (CMS, n = 23; HH, n = 16) aged 21-65 yr from Cerro de Pasco, Peru (4,340 m). CMS patients showed higher serum Epo concentrations throughout the night and lower sEpoR from 10 PM to 6 AM. Consequently, Epo/sEpoR was significantly higher in the CMS group at every time point. Mean sleep-time SpO2 was lower in CMS patients compared with HH, while the percentage of sleep time spent with SpO2 < 80% was higher. Multiple-regression analysis showed mean sleep-time SpO2 and Epo/sEpoR as significant predictors of hematocrit corrected for potential confounders (age, body mass index, and testosterone). Testosterone levels were associated neither with Hct nor with erythropoietic factors. In conclusion, our results show sustained erythropoietic stimulus driven by the Epo system in CMS patients, further enhanced by a continuous exposure to accentuated nocturnal hypoxemia.

  3. Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness

    PubMed Central

    Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola

    2016-01-01

    Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS patients suggesting increased Epo availability (increased Epo/sEpoR). The present study aimed to characterize the nocturnal concentration profile of sEpoR and Epo and their relationship with SpO2, Hct, and serum testosterone in healthy highlanders (HH) and CMS patients. Epo and sEpoR concentrations were evaluated every 4 h (6 PM to 6 AM) and nighttime SpO2 was continuously monitored (10 PM to 6 AM) in 39 male participants (CMS, n = 23; HH, n = 16) aged 21-65 yr from Cerro de Pasco, Peru (4,340 m). CMS patients showed higher serum Epo concentrations throughout the night and lower sEpoR from 10 PM to 6 AM. Consequently, Epo/sEpoR was significantly higher in the CMS group at every time point. Mean sleep-time SpO2 was lower in CMS patients compared with HH, while the percentage of sleep time spent with SpO2 < 80% was higher. Multiple-regression analysis showed mean sleep-time SpO2 and Epo/sEpoR as significant predictors of hematocrit corrected for potential confounders (age, body mass index, and testosterone). Testosterone levels were associated neither with Hct nor with erythropoietic factors. In conclusion, our results show sustained erythropoietic stimulus driven by the Epo system in CMS patients, further enhanced by a continuous exposure to accentuated nocturnal hypoxemia. PMID:27125843

  4. Neurological manifestations in chronic mountain sickness: the burning feet-burning hands syndrome

    PubMed Central

    Thomas, P; King, R; Feng, S; Muddle, J; Workman, J; Gamboa, J; Tapia, R; Vargas, M; Appenzeller, O

    2000-01-01

    OBJECTIVE—To characterise the clinical features and nerve biopsy findings in patients with chronic mountain sickness (CMS) living in the Peruvian Andes, with particular attention to the occurrence of the "burning feet-burning hands" syndrome.
METHODS—Symptoms and signs were documented clinically in 10 patients with CMS and compared with those in five healthy subjects all living at 4338 metres altitude. Sural nerve biopsies were obtained from three patients with CMS.The nerve fibre population and endoneurial microvessels were analyzed morphometrically.
RESULTS—All patients with CMS experienced burning and tingling paraesthesiae in the distal parts of their limbs. Similar but milder symptoms confined to the feet occurred in four of five controls. Three patients with CMS had a mild sensory neuropathy on examination, controls were clinically normal. Nerve biopsies showed a mild demyelinating neuropathy in all three with a reduction in the unmyelinated axon population in one. The endoneurial blood vessels showed a reduced thickness in the basal laminal zone compared with control values but were otherwise normal.
CONCLUSIONS—Apart from well recognised symptoms and signs of CMS, the study has shown that such patients may also exhibit a mild sensory neuropathy. Its relation to the burning feet-burning hands syndrome, which was not confined to the patients but was also found in controls at altitude, is uncertain. The time course and pattern of the centrifugal resolution of the burning paraesthesiae complex on low altitude sojourn of high altitude natives raises the possibility that a mechanism involving altered axonal transport may be involved. The reduced thickness of the basal laminal zone of microvessels implies that adaptive structural changes to hypobaric hypoxia may also occur in peripheral nerve and are similar to those reported in other tissues of high altitude natives.

 PMID:10990502

  5. Role of the spleen in the exaggerated polycythemic response to hypoxia in chronic mountain sickness in rats.

    PubMed

    Kam, H Y; Ou, L C; Thron, C D; Smith, R P; Leiter, J C

    1999-11-01

    In a rat model of chronic mountain sickness, the excessive polycythemic response to hypoxic exposure is associated with profound splenic erythropoiesis. We studied the uptake and distribution of radioactive iron and red blood cell (RBC) morphology in intact and splenectomized rats over a 30-day hypoxic exposure. Retention of (59)Fe in the plasma was correlated with (59)Fe uptake by both spleen and marrow and the appearance of (59)Fe-labeled RBCs in the blood. (59)Fe uptake in both the spleen and the marrow paralleled the production of nucleated RBCs. Splenic (59)Fe uptake was approximately 10% of the total marrow uptake under normoxic conditions but increased to 60% of the total marrow uptake during hypoxic exposure. Peak splenic (59)Fe uptake and splenomegaly occurred at the most intense phase of erythropoiesis and coincided with the rapid appearance of (59)Fe-labeled RBCs in the blood. The bone marrow remains the most important erythropoietic organ under both resting and stimulated states, but inordinate splenic erythropoiesis in this rat strain accounts in large measure for the excessive polycythemia during the development of chronic mountain sickness in chronic hypoxia.

  6. Prevalence of Chronic Mountain Sickness in high altitude districts of Himachal Pradesh

    PubMed Central

    Sahota, Inderjeet Singh; Panwar, Nidhi Singh

    2013-01-01

    Introduction: Chronic Mountain Sickness (CMS) is a maladaptation condition that can affect people who reside permanently at high altitude (HA). It is characterized by polycythemia, hypoxemia and dyspnea and can be fatal. Over 140 million people live permanently at HA around the world. Unfortunately, research into CMS is lacking and accurate data on the prevalence of this condition do not exist for many regions around the world. In this study, we sought to examine prevalence rates of CMS in the Indian Himalayas, focusing on the Northern State of Himachal Pradesh. Materials and Methods: We surveyed 83 individuals (69 males) in eight towns across the HA districts of Sirmaur, Kinnaur and Lahaul and Spiti in Himachal Pradesh, India. Altitudes ranged from 2350 to 4150 m. We used an adapted Qinghai CMS scoring system to diagnose CMS. Information related to subject demographics, medical history, socioeconomic status, and geography were collected to identify risk factors for CMS. Physiologic recordings of oxygen saturation (SpO2) and pulse rate were made through pulse oximetry. Results: Overall CMS prevalence was 6.17% and mean altitude was 3281 m. At altitudes above 3000 m CMS prevalence rose to 13.73%. All cases of CMS were mild and there was a significant positive correlation between CMS scores and altitude (R = 0.784, P = 0.0213). Mean SpO2 was 90.7 ± 0.4% and mean pulse rate was 80.3 ± 1.3 bpm. SpO2 significantly correlated with altitude (R = −0.929, P < 0.001). In our study, age, gender, and tobacco use were not independent risk factors for CMS. Individuals with CMS lived at higher altitudes than their non-CMS counterparts (3736.00 ± 113.30 m vs. 3279.80 ± 69.50 m, respectively; P = 0.017). Conclusion: CMS prevalence in HA towns of the Indian Himalayas of Himachal Pradesh is 6.17% and 13.73% for towns above 3000 m. Further research is required to determine the prevalence of CMS in other regions of the world and to determine risk factors associated with CMS. PMID

  7. Chronic mountain sickness score was related with health status score but not with hemoglobin levels at high altitudes

    PubMed Central

    Gonzales, Gustavo F.; Rubio, Julio; Gasco, Manuel

    2013-01-01

    Chronic mountain sickness (CMS) or lack of adaptation to live in high altitudes is related to environmental hypoxia and excessive erythrocytosis (EE) (Hemoglobin>21 and >19g/dl for men and women, respectively). Diagnosis of CMS (“Qinghai CMS Score”) is based on seven signs/symptoms (breathlessness and/or palpitations, sleep disturbance, cyanosis, dilatation of veins, paresthesia, headache, tinnitus) and the score for EE. The present study was designed to determine the association between hemoglobin, Qinghai CMS score, CMS clinical score (7 signs/symptoms) and Health Status using a health survey composed of 20 items. The rate of CMS (32.6%) was higher than the rate of EE (9.7%; P<0.002). A significant inverse relationship was observed between CMS clinical score and health status score (r=−0.56 for men, and r=−0.55 for women, P<0.01). However, CMS clinical score was not different in groups with different Hb levels. Health status score was significantly higher in subjects without CMS. In conclusion, elevated hemoglobin levels were not associated with elevated CMS clinical score. PMID:23770310

  8. Left ventricular adaptation to high altitude: speckle tracking echocardiography in lowlanders, healthy highlanders and highlanders with chronic mountain sickness.

    PubMed

    Dedobbeleer, Chantal; Hadefi, Alia; Pichon, Aurelien; Villafuerte, Francisco; Naeije, Robert; Unger, Philippe

    2015-04-01

    Hypoxic exposure depresses myocardial contractility in vitro, but has been associated with indices of increased cardiac performance in intact animals and in humans, possibly related to sympathetic nervous system activation. We explored left ventricular (LV) function using speckle tracking echocardiography and sympathetic tone by spectral analysis of heart rate variability (HRV) in recently acclimatized lowlanders versus adapted or maladapted highlanders at high altitude. Twenty-six recently acclimatized lowlanders, 14 healthy highlanders and 12 highlanders with chronic mountain sickness (CMS) were studied. Control measurements at sea level were also obtained in the lowlanders. Altitude exposure in the lowlanders was associated with slightly increased blood pressure, decreased LV volumes and decreased longitudinal strain with a trend to increased prevalence of post-systolic shortening (p = 0.06), whereas the low frequency/high frequency (LF/HF) ratio increased (1.62 ± 0.81 vs. 5.08 ± 4.13, p < 0.05) indicating sympathetic activation. Highlanders had a similarly raised LF/HF ratio, but no alteration in LV deformation. Highlanders with CMS had no change in LV deformation, no significant increase in LF/HF, but decreased global HRV still suggestive of increased sympathetic tone, and lower mitral E/A ratio compared to healthy highlanders. Short-term altitude exposure in lowlanders alters indices of LV systolic function and increases sympathetic nervous system tone. Life-long altitude exposure in highlanders is associated with similar sympathetic hyperactivity, but preserved parameters of LV function, whereas diastolic function may be altered in those with CMS. Altered LV systolic function in recently acclimatized lowlanders may be explained by combined effects of hypoxia and changes in loading conditions.

  9. The clinical assessment of acute mountain sickness.

    PubMed

    Fletcher, R F; Wright, A D; Jones, G T; Bradwell, A R

    1985-01-01

    During three expeditions to high altitude the Birmingham Medical Research Expeditionary Society has studied the effects of the ascents on its members. The severity of acute mountain sickness (AMS) produced was assessed by three methods, interview, self assessment and peer review. Physical examination was unhelpful. The results of the three methods were closely correlated. Clinical interview permitted allowances to be made for individual factors such as fatigue. There was no tendency for self assessment to indicate effects consistently more or less than the other methods. Peer review revealed a wide spread of opinions but the large number of observers allowed the derivation of plausible mean values. Correlation of AMS with arterial pH and PaCO2 showed little relationship but correlation with PaO2 was good, particularly for self assessment. As all the methods are subjective a combination of techniques is recommended for future expeditions.

  10. Budesonide Versus Acetazolamide for Prevention of Acute Mountain Sickness.

    PubMed

    Lipman, Grant S; Pomeranz, David; Burns, Patrick; Phillips, Caleb; Cheffers, Mary; Evans, Kristina; Jurkiewicz, Carrie; Juul, Nick; Hackett, Peter

    2017-06-28

    Inhaled budesonide has been suggested as a novel prevention for acute mountain sickness. However, efficacy has not been compared with the standard acute mountain sickness prevention medication acetazolamide. This double-blind, randomized, placebo-controlled trial compared inhaled budesonide versus oral acetazolamide versus placebo, starting the morning of ascent from 1240 m (4100 ft) to 3810 m (12,570 ft) over 4 hours. The primary outcome was acute mountain sickness incidence (headache and Lake Louise Questionnaire ≥3 and another symptom). A total of 103 participants were enrolled and completed the study; 33 (32%) received budesonide, 35 (34%) acetazolamide, and 35 (34%) placebo. Demographics were not different between the groups (P > .09). Acute mountain sickness prevalence was 73%, with severe acute mountain sickness of 47%. Fewer participants in the acetazolamide group (n = 15, 43%) developed acute mountain sickness compared with both budesonide (n = 24, 73%) (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.3-10.1) and placebo (n = 22, 63%) (OR 0.5, 95% CI 0.2-1.2). Severe acute mountain sickness was reduced with acetazolamide (n = 11, 31%) compared with both budesonide (n = 18, 55%) (OR 2.6, 95% CI 1-7.2) and placebo (n = 19, 54%) (OR 0.4, 95% CI 0.1-1), with a number needed to treat of 4. Budesonide was ineffective for the prevention of acute mountain sickness, and acetazolamide was preventive of severe acute mountain sickness taken just before rapid ascent. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Prevalence of acute mountain sickness in the Swiss Alps.

    PubMed Central

    Maggiorini, M; Bühler, B; Walter, M; Oelz, O

    1990-01-01

    OBJECTIVE--To assess the prevalence of symptoms and signs of acute mountain sickness of the Swiss Alps. DESIGN--A study using an interview and clinical examination in a representative population of mountaineers. Positive symptoms and signs were assigned scores to quantify the severity of acute mountain sickness. SETTING--Four huts in the Swiss Alps at 2850 m, 3050 m, 3650 m, and 4559 m. SUBJECTS--466 Climbers, mostly recreational: 47 at 2850 m, 128 at 3050 m, 82 at 3650, and 209 at 4559 m. RESULTS--In all, 117 of the subjects were entirely free of symptoms and clinical signs of acute mountain sickness; 191 had one or two symptoms and signs; and 158 had more than two. Those with more than two symptoms and signs were defined as suffering from acute mountain sickness. At 4559 m 11 climbers presented with high altitude pulmonary oedema or cerebral oedema, or both. Men and women were equally affected. The prevalence of acute mountain sickness correlated with altitude: it was 9% at 2850 m, 13% at 3050 m, 34% at 3650 m, and 53% at 4559 m. The most frequent symptoms and signs were insomnia, headache, peripheral oedema, and scanty pulmonary rales. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales were associated with other symptoms and signs and therefore characteristic of acute mountain sickness. CONCLUSION--Acute mountain sickness is not an uncommon disease at moderately high altitude--that is, above 2800 m. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales indicate severe acute mountain sickness, and subjects who suffer these should immediately descend to lower altitudes. PMID:2282425

  12. Acute Mountain Sickness and Hemoconcentration in Next Generation Spacecraft

    NASA Technical Reports Server (NTRS)

    Conkin, Johnny

    2009-01-01

    This slide presentation reviews the threat astronauts face from acute mountain sickness (AMS). It includes information about the symptoms of AMS, the potential threat to astronauts, and future efforts to mitigate the AMS threat.

  13. Speech motor control and acute mountain sickness

    NASA Technical Reports Server (NTRS)

    Cymerman, Allen; Lieberman, Philip; Hochstadt, Jesse; Rock, Paul B.; Butterfield, Gail E.; Moore, Lorna G.

    2002-01-01

    BACKGROUND: An objective method that accurately quantifies the severity of Acute Mountain Sickness (AMS) symptoms is needed to enable more reliable evaluation of altitude acclimatization and testing of potentially beneficial interventions. HYPOTHESIS: Changes in human articulation, as quantified by timed variations in acoustic waveforms of specific spoken words (voice onset time; VOT), are correlated with the severity of AMS. METHODS: Fifteen volunteers were exposed to a simulated altitude of 4300 m (446 mm Hg) in a hypobaric chamber for 48 h. Speech motor control was determined from digitally recorded and analyzed timing patterns of 30 different monosyllabic words characterized as voiced and unvoiced, and as labial, alveolar, or velar. The Environmental Symptoms Questionnaire (ESQ) was used to assess AMS. RESULTS: Significant AMS symptoms occurred after 4 h, peaked at 16 h, and returned toward baseline after 48 h. Labial VOTs were shorter after 4 and 39 h of exposure; velar VOTs were altered only after 4 h; and there were no changes in alveolar VOTs. The duration of vowel sounds was increased after 4 h of exposure and returned to normal thereafter. Only 1 of 15 subjects did not increase vowel time after 4 h of exposure. The 39-h labial (p = 0.009) and velar (p = 0.037) voiced-unvoiced timed separations consonants and the symptoms of AMS were significantly correlated. CONCLUSIONS: Two objective measures of speech production were affected by exposure to 4300 m altitude and correlated with AMS severity. Alterations in speech production may represent an objective measure of AMS and central vulnerability to hypoxia.

  14. Speech motor control and acute mountain sickness

    NASA Technical Reports Server (NTRS)

    Cymerman, Allen; Lieberman, Philip; Hochstadt, Jesse; Rock, Paul B.; Butterfield, Gail E.; Moore, Lorna G.

    2002-01-01

    BACKGROUND: An objective method that accurately quantifies the severity of Acute Mountain Sickness (AMS) symptoms is needed to enable more reliable evaluation of altitude acclimatization and testing of potentially beneficial interventions. HYPOTHESIS: Changes in human articulation, as quantified by timed variations in acoustic waveforms of specific spoken words (voice onset time; VOT), are correlated with the severity of AMS. METHODS: Fifteen volunteers were exposed to a simulated altitude of 4300 m (446 mm Hg) in a hypobaric chamber for 48 h. Speech motor control was determined from digitally recorded and analyzed timing patterns of 30 different monosyllabic words characterized as voiced and unvoiced, and as labial, alveolar, or velar. The Environmental Symptoms Questionnaire (ESQ) was used to assess AMS. RESULTS: Significant AMS symptoms occurred after 4 h, peaked at 16 h, and returned toward baseline after 48 h. Labial VOTs were shorter after 4 and 39 h of exposure; velar VOTs were altered only after 4 h; and there were no changes in alveolar VOTs. The duration of vowel sounds was increased after 4 h of exposure and returned to normal thereafter. Only 1 of 15 subjects did not increase vowel time after 4 h of exposure. The 39-h labial (p = 0.009) and velar (p = 0.037) voiced-unvoiced timed separations consonants and the symptoms of AMS were significantly correlated. CONCLUSIONS: Two objective measures of speech production were affected by exposure to 4300 m altitude and correlated with AMS severity. Alterations in speech production may represent an objective measure of AMS and central vulnerability to hypoxia.

  15. Current prevention and management of acute mountain sickness.

    PubMed Central

    Bia, F. J.

    1992-01-01

    Acute mountain sickness was known to the Chinese in ancient times, as they traversed mountain passes between the Great Headache and Little Headache mountains into present-day Afghanistan. The Jesuit priest, Father Joseph Acosta, lived in Peru during the sixteenth century; he described both this syndrome and deaths which occurred in the high Andes. The incidence of high-altitude illness will rise as previously remote sites become more accessible to trekkers and skiers. Prevention and treatment are important concerns for those physicians who wish to advise their more adventuresome patients properly. This article incorporates a selected review of pertinent investigations, in the English-language literature over the past five years, into material previously presented at travel symposia for clinicians managing the prophylaxis and treatment of acute mountain sickness. PMID:1290275

  16. The Local HIF-2α/EPO Pathway in the Bone Marrow is Associated with Excessive Erythrocytosis and the Increase in Bone Marrow Microvessel Density in Chronic Mountain Sickness

    PubMed Central

    Su, Juan; Cui, Sen; Ji, Linhua; Geng, Hui; Chai, Kexia; Ma, Xiaojing; Bai, Zhenzhong; Yang, Yingzhong; Wuren, Tana; Ge, Ri-Li; Rondina, Matthew T.

    2015-01-01

    Abstract Juan Su, Zhanquan Li, Sen Cui, Linhua Ji, Hui Geng, Kexia Chai, Xiaojing Ma, Zhenzhong Bai, Yingzhong Yang, Tana Wuren, Ri-Li Ge, and Matthew T. Rondina. The local HIF-2α/EPO pathway in the bone marrow is associated with excessive erythrocytosis and the increase in bone marrow microvessel density in chronic mountain sickness. High Alt Med Biol. 16:318–330, 2015.—Aim: Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis, and angiogenesis may be involved in the pathogenesis of this disease. The bone marrow niche is the primary site of erythropoiesis and angiogenesis. This study was aimed at investigating the associations of the levels of hypoxia-inducible factors (HIFs), erythropoietin (EPO), and erythropoietin receptor (EPOR), as well as microvessel density (MVD) in the bone marrow with CMS. Results: A total of 34 patients with CMS and 30 control subjects residing in areas at altitudes of 3000–4500 m were recruited for this study. The mRNA and protein expression of HIF-2α and EPO in the bone marrow cells was significantly higher in the CMS patients than in the controls. Moreover, changes in HIF-2α expression in CMS patients were significantly correlated with EPO and hemoglobin levels. In contrast, the expression of mRNA and protein expression of HIF-1α and EPOR did not differ significantly between the CMS and control patients. Increased MVD was observed in the bone marrow of the patients with CMS and it was significantly correlated with hemoglobin. Conclusions: Bone marrow cells of CMS patients may show enhanced activity of the HIF-2α/EPO pathway, and EPO may regulate the erythropoiesis and vasculogenesis through autocrine or/and paracrine mechanisms in the bone marrow niche. The increased MVD in the bone marrow of CMS patients appears to be involved in the pathogenesis of this disease. PMID:26625252

  17. Inhaled budesonide and oral dexamethasone prevent acute mountain sickness.

    PubMed

    Zheng, Cheng-Rong; Chen, Guo-Zhu; Yu, Jie; Qin, Jun; Song, Pan; Bian, Shi-Zhu; Xu, Bai-Da; Tang, Xu-Gang; Huang, Yong-Tao; Liang, Xiao; Yang, Jie; Huang, Lan

    2014-10-01

    This double-blind, randomized controlled trial aimed to investigate inhaled budesonide and oral dexamethasone compared with placebo for their prophylactic efficacy against acute mountain sickness after acute high-altitude exposure. There were 138 healthy young male lowland residents recruited and randomly assigned to receive inhaled budesonide (200 μg, twice a day [bid]), oral dexamethasone (4 mg, bid), or placebo (46 in each group). They traveled to 3900 m altitude from 400 m by car. Medication started 1 day before high-altitude exposure and continued until the third day of exposure. Primary outcome measure was the incidence of acute mountain sickness after exposure. One hundred twenty-four subjects completed the study (42, 39, and 43 in the budesonide, dexamethasone, and placebo groups, respectively). Demographic characteristics were comparable among the 3 groups. After high-altitude exposure, significantly fewer participants in the budesonide (23.81%) and dexamethasone (30.77%) groups developed acute mountain sickness compared with participants receiving placebo (60.46%) (P = .0006 and P = .0071, respectively). Both the budesonide and dexamethasone groups had lower heart rate and higher pulse oxygen saturation (SpO2) than the placebo group at altitude. Only the budesonide group demonstrated less deterioration in forced vital capacity and sleep quality than the placebo group. Four subjects in the dexamethasone group reported adverse reactions. Both inhaled budesonide (200 μg, bid) and oral dexamethasone (4 mg, bid) were effective for the prevention of acute mountain sickness, especially its severe form, compared with placebo. Budesonide caused fewer adverse reactions than dexamethasone. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Prediction of Acute Mountain Sickness using a Blood-Based Test

    DTIC Science & Technology

    2015-01-01

    Award Number: W81XWH-11-2-0034 TITLE: Prediction of Acute Mountain Sickness using a Blood-Based Test PRINCIPAL INVESTIGATOR: Robert Roach...Acute Mountain Sickness using a Blood-Based Test 5a. CONTRACT NUMBER: 5b. GRANT NUMBER W81XWH-11-2-0034 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR... mountain sickness or who was AMS resistant. In Phase II, results suggest a completely independent sample was equally effective in predicting AMS

  19. Prevalence of acute mountain sickness in the Eastern Alps.

    PubMed

    Mairer, Klemens; Wille, Maria; Bucher, Thomas; Burtscher, Martin

    2009-01-01

    Little information is available on the prevalence of acute mountain sickness (AMS) in the Eastern Alps compared with the Western Alps. Because of differences regarding the populations of mountaineers, we hypothesized that the prevalence differs between the Eastern and Western Alps. Thus, we determined the prevalence and risk factors of AMS at four different altitudes in the Eastern Alps of Austria. Four hundred and thirty-one recreational hikers were studied using questionnaires on the morning of their first night at high altitude. A diagnosis of AMS was based on a Lake Louise Score > or =4, the presence of headache, and at least one additional symptom. Overall 16.2% of the subjects met the criteria for AMS, and the prevalence of AMS increased significantly with altitude (2200 m: 6.9%; 2500 m: 9.1%; 2800 m: 17.4%; 3500 m: 38.0%). Heavy perceived exertion, a history of migraine, the absolute altitude reached, little mountaineering experience, and inadequate water intake (< or =2 L) were independent AMS risk factors. The reported altitude-related AMS prevalence in the Western Alps is 4% to 8% lower compared with that found in this study for the Eastern Alps. In conclusion, the prevalence of AMS is higher in the tourist population of the Eastern Alps compared to the more experienced mountaineers of the Western Alps. Consideration of easily modifiable risk factors such as individual exertion and water intake could markedly reduce AMS and contribute to the enjoyment of mountaineering.

  20. Vascular endothelial growth factor and acute mountain sickness.

    PubMed

    Nilles, Eric; Sayward, Helen; D'Onofrio, Gail

    2009-01-01

    Despite causing significant morbidity throughout the mountainous regions of the world, the pathophysiology of acute mountain sickness (AMS) remains poorly understood. This study aims to improve the understanding of altitude illness by determining if vascular endothelial growth factor (VEGF) plays a role in the development of AMS. The purpose of this study was to determine if elevated plasma VEGF correlates with increased symptoms of AMS at high altitude. This is a prospective study of a cohort of healthy climbers on Denali (Mount McKinley) in Alaska at 14, 200 feet. Baseline demographics, medications, rates of ascent, and AMS scores were recorded. Pulse oximetry measurements and venous blood samples were obtained. Comparisons were made between mountaineers with and without AMS. Seventy-two climbers were approached for participation in the study; 21 (29%) refused. Of the 51 climbers participating in the study, 14 subjects (27.5%) had symptoms of AMS and 37 subjects (72.5%) were free of symptoms of AMS. Plasma VEGF levels were 79.14 pg/dl (SD: 121.44) and 57.57pg/dl (SD: 102.71) in the AMS and non-AMS groups, respectively. These results were nonsignificant. Similarly, comparison of sex, age, rate of ascent, pulse oximetry values, or history of altitude illness did not reveal significant differences between the AMS and non-AMS groups. This study does not provide evidence in support of the theory that plasma VEGF correlates with symptoms of AMS.

  1. Acute Mountain Sickness Symptoms Depend on Normobaric versus Hypobaric Hypoxia

    PubMed Central

    Strangman, Gary E.; Harris, N. Stuart; Muza, Stephen R.

    2016-01-01

    Acute mountain sickness (AMS), characterized by headache, nausea, fatigue, and dizziness when unacclimatized individuals rapidly ascend to high altitude, is exacerbated by exercise and can be disabling. Although AMS is observed in both normobaric (NH) and hypobaric hypoxia (HH), recent evidence suggests that NH and HH produce different physiological responses. We evaluated whether AMS symptoms were different in NH and HH during the initial stages of exposure and if the assessment tool mattered. Seventy-two 8 h exposures to normobaric normoxia (NN), NH, or HH were experienced by 36 subjects. The Environmental Symptoms Questionnaire (ESQ) and Lake Louise Self-report (LLS) were administered, resulting in a total of 360 assessments, with each subject answering the questionnaire 5 times during each of their 2 exposure days. Classification tree analysis indicated that symptoms contributing most to AMS were different in NH (namely, feeling sick and shortness of breath) compared to HH (characterized most by feeling faint, appetite loss, light headedness, and dim vision). However, the differences were not detected using the LLS. These results suggest that during the initial hours of exposure (1) AMS in HH may be a qualitatively different experience than in NH and (2) NH and HH may not be interchangeable environments. PMID:27847819

  2. Plasma vascular endothelial growth factor in acute mountain sickness.

    PubMed

    Maloney, J; Wang, D; Duncan, T; Voelkel, N; Ruoss, S

    2000-07-01

    To investigate the hypothesis that an increase in circulating vascular endothelial growth factor (VEGF) occurs in mountaineers at high altitude, particularly in association with acute mountain sickness (AMS) and/or low hemoglobin oxygen saturation. : Collection of medical histories, AMS scores, plasma samples, and arterial oxygen saturation (SaO(2)) measurements from mountaineers at 1,500 feet (sea level) and at 14,200 feet. Mount McKinley ("Denali"), AK. Sixty-six mountaineers. None. Plasma VEGF at 14,200 feet was not increased in any group. In fact, plasma VEGF was significantly lower in subjects who did not develop AMS (53 +/- 7.9 pg/mL; mean +/- SEM; n = 47) compared to control subjects at sea level (98.4 +/- 14.3 pg/mL; n = 7; p = 0.005). Plasma VEGF at 14, 200 feet for subjects with AMS (62 +/- 12 pg/mL; n = 15) did not differ significantly from subjects at 14,200 feet without AMS, or from control subjects at sea level. Of a small number of subjects with paired specimens at sea level and at base camp (n = 5), subjects who exhibited a decrease in plasma VEGF at 14,200 feet were those who did not develop AMS. Neither SaO(2), prior AMS, AMS symptom scores, or acetazolamide use were correlated with plasma VEGF. Subjects at high altitude who do not develop AMS have lower plasma VEGF levels compared to control subjects at sea level. Plasma VEGF at high altitude is not elevated in association with AMS or hypoxia. Sustained plasma VEGF at altitude may reflect a phenotype more susceptible to AMS.

  3. Prediction of Acute Mountain Sickness using a Blood-Based Test

    DTIC Science & Technology

    2016-01-01

    1 Award Number: W81XWH-11-2-0034 TITLE: Prediction of Acute Mountain Sickness using a Blood-Based Test PRINCIPAL INVESTIGATOR: Robert Roach...Acute Mountain Sickness using a Blood-Based Test 5a. CONTRACT NUMBER: 5b. GRANT NUMBER W81XWH-11-2-0034 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...from a sample taken at sea level could be used to successfully predict in 9 out of 10 individuals who went on to develop acute mountain sickness or

  4. Resting and exercising cardiorespiratory variables and acute mountain sickness.

    PubMed

    Hooper, T J; Levett, D Z H; Mellor, A J; Grocott, M P W

    2010-01-01

    The incidence of Acute Mountain Sickness (AMS) is increasing. In a military context our current operational areas include mountainous regions with the implications of AMS including loss of operational tempo and logistical overstretch. Oxygen saturation and heart rate variability have in some studies been predictive of AMS while in others not. No single factor has been demonstrated consistently to be predictive of developing AMS. During an expedition to climb Mt Aconcagua (6959m) we explored the relationship between cardiorespiratory variables and AMS. In 11 subjects we measured simple physiological variables and Lake Louise Score both pre and post a standardised exercise challenge at on arrival at different altitudes and after a period of acclimatization. The changes in cardiorespiratory variables we observed with altitude were consistent with previous studies. Heart rate, respiratory rate and blood pressure increased whilst oxygen saturation reduced. Over time at altitude, respiratory rate and heart rate were maintained whilst there was a reduction in blood pressure towards sea level values. Oxygen saturations improved over time at altitude and the change in heart rate on exercise was reduced with acclimatization. In this small pilot study individuals with AMS may have a greater heart rate response to exercise than non-AMS subjects and this may warrant further investigation. The incidence of AMS in our study was low reflecting a conservative ascent profile. Further larger studies are necessary to fully assess the predictive value of cardiorespiratory variables in AMS.

  5. [Exercise and the detection of severe acute mountain sickness].

    PubMed

    Garófoli, Adrian; Montoya, Paula; Elías, Carlos; Benzo, Roberto

    2010-01-01

    Acute mountain sickness (AMS) is a group of non-specific symptoms, seen in subjects that ascend from low to high altitude too quickly, without allowing sufficient time to acclimatize. Usually it is self-limiting, but the severe forms (pulmonary and cerebral edema) can be fatal. Exaggerated hypoxemia at rest is related to later development of AMS but its predictive value is limited. Since exercise at altitude induces greater hypoxemia and symptoms, we postulated the predictive value of a simple exercise test to prognosticate severe AMS. We studied the predictive value of the oxygen saturation during rest and sub-maximum exercise at 2.700 m and 4.300 m in 63 subjects that intended the ascent to Mount Aconcagua (6.962 m). We considered exercise oxygen desaturation to a drop of 5% respect to the resting value. Lake-Louise Score was used to quantify the presence of severe AMS. Six subjects developed severe AMS (9.5%) and required evacuation. Resting oxygen saturation at 2.700 m was not significant to classify subjects that then developed severe AMS. The association of oxygen desaturation during exercise at 2.700 m plus inappropriate resting oxygen saturation at 4.300 m was significant to classify the subjects that then developed severe AMS with a positive predictive value of 80% and a negative predictive value of 97%. Our results are relevant for mountaineering and suggest the use of a simple exercise test in the prediction of severe AMS.

  6. Vascular endothelial growth factor and acute mountain sickness

    PubMed Central

    Nilles, Eric; Sayward, Helen; D'Onofrio, Gail

    2009-01-01

    Study Objective: Despite causing significant morbidity throughout the mountainous regions of the world, the pathophysiology of acute mountain sickness (AMS) remains poorly understood. This study aims to improve the understanding of altitude illness by determining if vascular endothelial growth factor (VEGF) plays a role in the development of AMS. The purpose of this study was to determine if elevated plasma VEGF correlates with increased symptoms of AMS at high altitude. Patients and Methods: This is a prospective study of a cohort of healthy climbers on Denali (Mount McKinley) in Alaska at 14, 200 feet. Baseline demographics, medications, rates of ascent, and AMS scores were recorded. Pulse oximetry measurements and venous blood samples were obtained. Comparisons were made between mountaineers with and without AMS. Results: Seventy-two climbers were approached for participation in the study; 21 (29%) refused. Of the 51 climbers participating in the study, 14 subjects (27.5%) had symptoms of AMS and 37 subjects (72.5%) were free of symptoms of AMS. Plasma VEGF levels were 79.14 pg/dl (SD: 121.44) and 57.57pg/dl (SD: 102.71) in the AMS and non-AMS groups, respectively. These results were nonsignificant. Similarly, comparison of sex, age, rate of ascent, pulse oximetry values, or history of altitude illness did not reveal significant differences between the AMS and non-AMS groups. Conclusion: This study does not provide evidence in support of the theory that plasma VEGF correlates with symptoms of AMS. PMID:19561948

  7. Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation.

    PubMed

    Erba, P; Anastasi, S; Senn, O; Maggiorirni, M; Bloch, K E

    2004-08-01

    The purpose of the study was to investigate determinants of acute mountain sickness after rapid ascent to high altitude. A total of 21 climbers were studied ascending from <1,200 m to Capanna Regina Margherita, a hut in the Alps at 4,559 m, within <24 h. During their overnight stay at 4,559 m, breathing patterns and ventilation were recorded by calibrated respiratory inductive plethysmography along with pulse oximetry. In the following morning, acute mountain sickness was assessed. Altogether, 11 mountaineers developed pronounced symptoms of acute mountain sickness (Lake Louise score > or =5) and 10 did not (controls). Compared to controls, subjects with acute mountain sickness had lower nocturnal oxygen saturation (mean+/-SD 59+/-13% versus 73+/-6%), higher minute ventilation (7.94+/-2.35 versus 6.06+/-1.34 L x min(-1)), and greater mean inspiratory flow, a measure of respiratory centre drive (0.29+/-0.09 versus 0.22+/-0.05 L x s(-1)). Periodic respiration was prevalent but not significantly different among the two groups (apnoea/hypopnea index 60.1+/-34.6 versus 47.1+/-42.6 events per h). The data suggest that pronounced nocturnal hypoxemia, which was not related to hypoventilation, may have promoted acute mountain sickness. Periodic breathing seems not to play a predominant role in the pathogenesis of acute mountain sickness.

  8. Optic Nerve Sheath Diameter Increase on Ascent to High Altitude: Correlation With Acute Mountain Sickness.

    PubMed

    Kanaan, Nicholas C; Lipman, Grant S; Constance, Benjamin B; Holck, Peter S; Preuss, James F; Williams, Sarah R

    2015-09-01

    Elevated optic nerve sheath diameter on sonography is known to correlate with increased intracranial pressure and is observed in acute mountain sickness. This study aimed to determine whether optic nerve sheath diameter changes on ascent to high altitude are associated with acute mountain sickness incidence. Eighty-six healthy adults enrolled at 1240 m (4100 ft), drove to 3545 m (11,700 ft) and then hiked to and slept at 3810 m (12,500 ft). Lake Louise Questionnaire scores and optic nerve sheath diameter measurements were taken before, the evening of, and the morning after ascent. The incidence of acute mountain sickness was 55.8%, with a mean Lake Louise Questionnaire score ± SD of 3.81 ± 2.5. The mean maximum optic nerve sheath diameter increased on ascent from 5.58 ± 0.79 to 6.13 ± 0.73 mm, a difference of 0.91 ± 0.55 mm (P = .09). Optic nerve sheath diameter increased at high altitude regardless of acute mountain sickness diagnosis; however, compared to baseline values, we observed a significant increase in diameter only in those with a diagnosis of acute mountain sickness (0.57 ± 0.77 versus 0.21 ± 0.76 mm; P = .04). This change from baseline, or Δ optic nerve sheath diameter, was associated with twice the odds of developing acute mountain sickness (95% confidence interval, 1.08-3.93). The mean optic nerve sheath diameter increased on ascent to high altitude compared to baseline values, but not to a statistically significant degree. The magnitude of the observed Δ optic nerve sheath diameter was positively associated with acute mountain sickness diagnosis. No such significant association was found between acute mountain sickness and diameter elevation above standard cutoff values, limiting the utility of sonography as a diagnostic tool. © 2015 by the American Institute of Ultrasound in Medicine.

  9. Epidemiology of acute mountain sickness on Jade Mountain, Taiwan: an annual prospective observational study.

    PubMed

    Wang, Shih-Hao; Chen, Yu-Cheng; Kao, Wei-Fong; Lin, Yu-Jr; Chen, Jih-Chang; Chiu, Te-Fa; Hsu, Tai-Yi; Chen, Hang-Cheng; Liu, Shih-Wei

    2010-01-01

    Acute mountain sickness (AMS) is a pathophysiological symptom complex that occurs in high altitude areas. The AMS prevalence is reportedly 28% on Jade Mountain, the highest mountain (3952 m) in Taiwan. We conducted this study owing to the lack of annual epidemiological data on AMS in Taiwan. Between April 2007 and March 2008, 1066 questionnaires were completed by trekkers visiting Paiyun Lodge on Jade Mountain. Information in the questionnaire included demographic data, mountaineering experience, AMS history, and trekking schedule. Weather data were obtained from the Central Weather Bureau of Taiwan. The Lake Louise AMS score was used to record symptoms and diagnose AMS. The chi-square test or the Student t test was used to evaluate associations between variables and AMS. In our study, the AMS prevalence was 36%. It increased significantly at different rates at different locations on the Jade Mountain trail and varied significantly in different months. Rainy weather tended to slightly increase the incidence of AMS. A lower incidence of AMS was correlated with hig-altitude trekking experience or preexposure (p < 0.05), whereas a higher incidence of AMS was correlated with a prior history of AMS (p < 0.05). The trekkers with AMS were significantly younger, ascended faster from their residence to the entrance or to Paiyun Lodge, and ascended slower from the entrance to the Paiyun Lodge (p < 0.05), but the differences lacked clinical significance. No differences in the incidence of AMS based on blood type, gender, or obesity were observed. The most common symptom among all trekkers was headache, followed by difficulty sleeping, fatigue or weakness, gastrointestinal (GI) symptoms, and dizziness or lightheadedness. In conclusion, the AMS prevalence on Jade Mountain was 36%, varied by month, and correlated with trekking experience, preexposure, and a prior history of AMS. The overall presentation of AMS was similar to that on other major world mountains.

  10. Acute mountain sickness and retinal evaluation by optical coherence tomography.

    PubMed

    Ascaso, Francisco J; Nerín, María A; Villén, Laura; Morandeira, José R; Cristóbal, José A

    2012-01-01

    Acute mountain sickness (AMS), the commonest form of altitude illness, might represent early-stage high altitude cerebral edema (HACE). Optical coherence tomography (OCT) was used to evaluate optic nerve head (ONH) consequences following a sojourn to extreme altitude. This prospective study included 4 high-altitude expeditions in Himalayas. Twenty-four eyes of 12 healthy male climbers underwent baseline and postexpedition complete ophthalmic evaluation, including OCT to measure the peripapillary retinal nerve fiber layer (RNFL) thickness, ONH parameters, and macular thickness and volume. Lake Louise Scoring (LLS) self-report questionnaire was used to estimate AMS severity. All mountaineers experienced symptoms of AMS (LLS: 5.1±1.1, range 4.0-7.0). Average peripapillary RNFL thickness showed a significant increase in postexpedition examination (94±23 µm, 47-115), compared with baseline values (89±19 µm, range 45-114) (p=0.034). Superior (p=0.036) and temporal (p=0.010) quadrants also showed an increased RNFL thickness following exposure to high altitude. Vertical integrated rim area (VIRA) was significantly higher in postexpedition examination (0.71±0.43 mm(3), 0.14-1.50) than in baseline examination (0.51±0.26 mm(3), 0.11-1.00) (p=0.002). Horizontal integrated rim width was significantly higher in postexpedition examination (1.90±0.32 mm(2), range 1.37-2.34) than in baseline examination (1.77±0.27 mm(2), 1.27-2.08) (p=0.004). There was no correlation between LLS and OCT parameters (p>0.05). In climbers with AMS, OCT was able to detect subtle increases in the peripapillary RNFL thickness and in some ONH measurements, even in absence of HACE and papilledema. These changes might be a sensitive parameter in physiologic acclimatization and in the pathogenesis of AMS.

  11. Survey of acute mountain sickness on Mauna Kea.

    PubMed

    Onopa, Janet; Haley, Amanda; Yeow, Mei Ean

    2007-01-01

    Although thousands of people ascend 4205 m to visit the summit of Mauna Kea each year, there has been no information on the rate of altitude illness triggered by such visits. Two surveys were used: one for tourists driving up to the summit and the other for summit astronomy workers staying at lodging facilities at intermediate altitude. The surveys included the standardized Lake Louise Self-report Acute Mountain Sickness (AMS) Questionnaire that, when scored, gave the Lake Louise Symptoms Score (LLSS). Thirty percent of surveyed day visitors and 69% of surveyed professional astronomy staff had AMS, defined as a LLSS score of 3 or greater, with headache. Nine participants reported "disorientation/confusion" or greater consciousness changes. A majority of astronomy professionals reported fatigue, disturbed sleep, reduced activity, and mental status changes. Few took any AMS medications. The incidence of AMS in visitors to Mauna Kea's summit warrants increased education and increased availability of supplemental oxygen at the summit. The absence of reported serious altitude illness in the community is probably due to the rapid descent available on Mauna Kea, with prompt reversibility of adverse effects.

  12. High-altitude headache and acute mountain sickness.

    PubMed

    Carod-Artal, F J

    2014-01-01

    Headache is the most common complication associated with exposure to high altitude, and can appear as an isolated high-altitude headache (HAH) or in conjunction with acute mountain sickness (AMS). The purpose of this article is to review several aspects related to diagnosis and treatment of HAH. HAH occurs in 80% of all individuals at altitudes higher than 3000 meters. The second edition of ICHD-II includes HAH in the chapter entitled "Headaches attributed to disorder of homeostasis". Hypoxia elicits a neurohumoral and haemodynamic response that may provoke increased capillary pressure and oedema. Hypoxia-induced cerebral vasodilation is a probable cause of HAH. The main symptom of AMS is headache, frequently accompanied by sleep disorders, fatigue, dizziness and instability, nausea and anorexia. Some degree of individual susceptibility and considerable inter-individual variability seem to be present in AMS. High-altitude cerebral oedema is the most severe form of AMS, and may occur above 2500 meters. Brain MRI studies have found variable degrees of oedema in subcortical white matter and the splenium of the corpus callosum. HAH can be treated with paracetamol or ibuprofen. Pharmacological treatment of AMS is intended to increase ventilatory drive with drugs such as acetazolamide, and reduce inflammation and cytokine release by means of steroids. Symptom escalation seems to be present along the continuum containing HAH, AMS, and high-altitude cerebral oedema. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  13. Network Analysis Reveals Distinct Clinical Syndromes Underlying Acute Mountain Sickness

    PubMed Central

    Hall, David P.; MacCormick, Ian J. C.; Phythian-Adams, Alex T.; Rzechorzek, Nina M.; Hope-Jones, David; Cosens, Sorrel; Jackson, Stewart; Bates, Matthew G. D.; Collier, David J.; Hume, David A.; Freeman, Thomas; Thompson, A. A. Roger; Baillie, John Kenneth

    2014-01-01

    Acute mountain sickness (AMS) is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS), we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25). These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes. PMID:24465370

  14. Network analysis reveals distinct clinical syndromes underlying acute mountain sickness.

    PubMed

    Hall, David P; MacCormick, Ian J C; Phythian-Adams, Alex T; Rzechorzek, Nina M; Hope-Jones, David; Cosens, Sorrel; Jackson, Stewart; Bates, Matthew G D; Collier, David J; Hume, David A; Freeman, Thomas; Thompson, A A Roger; Baillie, John Kenneth

    2014-01-01

    Acute mountain sickness (AMS) is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS), we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25). These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes.

  15. Dexamethasone for prevention and treatment of acute mountain sickness.

    PubMed

    Hackett, P H; Roach, R C; Wood, R A; Foutch, R G; Meehan, R T; Rennie, D; Mills, W J

    1988-10-01

    We wished to determine in a field study the effectiveness of dexamethasone for prevention and treatment of acute mountain sickness (AMS). Prevention Trial: We transported 15 subjects from sea level to 4,400 m (PB = 400 mm Hg) on Denali (Mt. McKinley) by means of a 1-h helicopter flight. In a randomized, double-blind fashion we gave eight subjects a placebo and seven subjects 2 mg dexamethasone orally every 6 h, starting 1 h before take-off. The entire placebo group and five of the dexamethasone group developed AMS within 5 h, and became progressively more ill until 12 h when the trial was terminated. We concluded that 2 mg of dexamethasone every 6 h did not prevent AMS in active soldiers rapidly transported to high altitude. Treatment Trial: We treated 11 of those with moderate to severe AMS (symptom score 4.5 +/- 0.7, range 3 to 11) with 4 mg of dexamethasone every 6 h orally or intramuscularly for 24 h. All were markedly improved at 12 h (symptom score 1.0 +/- 0.3, p less than 0.001, range 0 to 3), but symptoms increased after the drug was discontinued at 24 h (symptom score = 2.4 +/- 0.5). We conclude that dexamethasone in a dosage of 4 mg PO or IM every 6 h is an effective treatment for AMS, but that illness may recur with abrupt discontinuation of the drug.

  16. Comparison of scoring systems for assessment of acute mountain sickness.

    PubMed

    Wagner, Dale R; Teramoto, Masaru; Knott, Jonathan R; Fry, Jack P

    2012-12-01

    The purpose of this study was to compare three commonly used scoring systems of acute mountain sickness (AMS)-the 5-item Lake Louise Self-report (LLS), the 11-item abridged version of the Environmental Symptoms Questionnaire (ESQ-III), and a 100 mm visual analog scale (VAS)-on climbers (N=63; 34.6±9.9 years) making a 1-day ascent of a 5640 m peak after a rest of ~10 h at 4260 m. The prevalence of AMS was 63% when defined as LLS ≥3, 49% when defined as either LLS ≥5 or ESQ-III ≥0.7, and 41% when defined as the combined LLS and ESQ-III criteria. Despite the agreement in prevalence between the LLS ≥5 and ESQ-III ≥0.7, there was a discrepancy in AMS classification in 16% of the cases. A VAS cut-off point corresponding to the combined LLS and ESQ-III criteria was 16 mm. The sensitivity and specificity of the VAS for diagnosing AMS compared to combined LLS and ESQ-III criteria were 85% and 92%, respectively. All of the scoring systems were significantly correlated (τ=0.60 to 0.73, p<0.01); however, residual scores were large. We cannot recommend interchanging the diagnostic results from the LLS, ESQ-III, and VAS, and standardization is needed for the administration of the VAS.

  17. Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia

    PubMed Central

    Clarke, C

    2006-01-01

    This article summarises the medical problems of travel to altitudes above 3000 m. These are caused by chronic hypoxia. Acute mountain sickness (AMS), a self limiting common illness is almost part of normal acclimatisation—a transient condition lasting for several days. However, in <2% of people staying above 4000 m, serious illnesses related to hypoxia develop – high altitude pulmonary oedema and cerebral oedema. These are potentially fatal but can be largely avoided by gradual ascent. Short vacations, pressure from travel companies and peer groups often encourage ascent to 4000 m more rapidly than is prudent. Sensible guidelines for ascent are outlined, clinical features, management and treatment of these conditions. PMID:17099095

  18. Arterial oxygen saturation for prediction of acute mountain sickness.

    PubMed

    Roach, R C; Greene, E R; Schoene, R B; Hackett, P H

    1998-12-01

    Acute mountain sickness (AMS) is a usually self-limiting syndrome encompassing headache, nausea and dizziness. AMS is seen in those that go from low to high altitudes too quickly, without allowing sufficient time to acclimatize. At present, susceptibility to AMS cannot be predicted. One feature of AMS noted in some studies is impaired gas exchange. If impaired gas exchange presages AMS then those individuals with exaggerated hypoxemia at high altitude may be more likely to develop AMS. If true, then monitoring of arterial oxygen saturation (SaO2%) may differentiate AMS-resistant individuals from those with impending AMS. To test this hypothesis, we measured SaO2% and AMS symptom scores in 102 healthy asymptomatic climbers at 4200 m on Denali (Mt. McKinley) prior to their further ascent toward the summit at 6194 m, and on their return from higher altitudes to 4200 m. The results show that exaggerated hypoxemia in asymptomatic climbers prior to further ascent correlates with subsequent AMS (r = -0.48, p < 0.001). Criteria are presented for identification of 80-100% of those climbers who later become ill with AMS. We conclude that resting arterial hypoxemia is related to later development of clinical AMS, and can exclude the occurrence and caution those at risk for development of subsequent AMS. Likely mechanisms are hypoventilation relative to normally acclimatizing individuals and/or abnormalities of gas exchange. Thus, non-invasive oximetry provides a simple, specific indicator of inadequate acclimatization to high altitudes and impending AMS.

  19. Mt. Whitney: determinants of summit success and acute mountain sickness.

    PubMed

    Wagner, Dale R; D'Zatko, Kim; Tatsugawa, Kevin; Murray, Ken; Parker, Daryl; Streeper, Tim; Willard, Kevin

    2008-10-01

    The aim of this study was to determine the prevalence of summit success and acute mountain sickness (AMS) on Mt. Whitney (4419 m) and to identify variables that contribute to both. Hikers (N = 886) attempting the summit were interviewed at the trailhead upon their descent. Questionnaires included demographic and descriptive data, acclimatization and altitude history, and information specific to the ascent. The Lake Louise Self-Assessment Score was used to make a determination about the occurrence of AMS. Logistic regression techniques were used to calculate odds ratios (OR) for AMS and summit success. Forty-three percent of the sample met the criteria for AMS, and 81% reached the summit. The odds of experiencing AMS were reduced with increases in age (adjusted 10-yr OR = 0.78; P < 0.001), number of hours spent above 3000 m in the 2 wk preceding the ascent (adjusted 24-h OR = 0.71; P < 0.001), and for females (OR = 0.68; P = 0.02). Climbers who had a history of AMS (OR = 1.41; P = 0.02) and those taking analgesics (OR = 2.39; P < 0.001) were more likely to experience AMS. As climber age increased, the odds of reaching the summit decreased (adjusted 10-yr OR = 0.75; P < 0.001). However, increases in the number of hours per week spent training (adjusted 5-h OR = 1.24; P = 0.05), rate of ascent (adjusted 50 m x h(-1) OR = 1.13; P = 0.04), and previous high-altitude record (adjusted 500 m OR = 1.26; P < 0.001) were all associated with increased odds for summit success. A high percentage of trekkers reached the summit despite having symptoms of AMS.

  20. Acute mountain sickness impact among travelers to Cusco, Peru.

    PubMed

    Salazar, Hugo; Swanson, Jessica; Mozo, Karen; White, A Clinton; Cabada, Miguel M

    2012-07-01

    Increasing numbers of travelers are visiting high altitude locations in the Andes. The epidemiology of acute mountain sickness (AMS) among tourists to high altitude in South America is not well understood. A cross-sectional study to evaluate the epidemiology, pre-travel preparation, and impact of AMS among travelers to Cusco, Peru (3,400 m) was performed at Cusco's International Airport during June 2010. Foreign travelers, 18 years or older, staying 15 days or less, departing Cusco were invited to participate. Demographic, itinerary, and behavioral data were collected. The Lake Louise Clinical score (LLCS) was used to assess AMS symptoms. In total, 991 travelers participated, median age 32 years (interquartile range 25-49), 55.5% female, 86.7% tourists, mostly from the United States (48.2%) and England (8.1%). Most (76.7%) flew from sea level to Cusco and 30.5% visited high altitude in the previous 2 months. Only 29.1% received AMS advice from a physician, 19% recalled advice on acetazolamide. Coca leaf products (62.8%) were used more often than acetazolamide (16.6%) for prevention. AMS was reported by 48.5% and 17.1% had severe AMS. One in five travelers with AMS altered their travel plans. Travelers older than 60 years, with recent high altitude exposure, who visited lower cities in their itinerary, or used acetazolamide were less likely to have AMS. Using coca leaf products was associated with increased AMS frequency. AMS was common and adversely impacted plans of one in five travelers. Acetazolamide was associated with decreased AMS but was prescribed infrequently. Other preventive measures were not associated with a decrease in AMS in this population. Pre-travel preparation was suboptimal. © 2012 International Society of Travel Medicine.

  1. Incidence and risk factors associated with acute mountain sickness in children trekking on Jade Mountain, Taiwan.

    PubMed

    Chan, Cheng-Wei; Lin, Yin-Chou; Chiu, Yu-Hui; Weng, Yi-Ming; Li, Wen-Cheng; Lin, Yu-Jr; Wang, Shih-Hao; Hsu, Tai-Yi; Huang, Kuo-Feng; Chiu, Te-Fa

    2016-01-01

    Acute mountain sickness (AMS) is a pathophysiological symptom complex that occurs in high-altitude areas. The incidence of AMS on Jade Mountain, the highest peak in Taiwan (3952 m), has been reported to be ∼36%. There is a lack of data in children trekking at altitude in Taiwan. The purpose of this study was to determine the incidence, risk factors and symptoms of AMS in children trekking on Jade Mountain, Taiwan. This prospective cohort study included a total of 96 healthy non-acclimatized children aged 11-12 years who trekked from an elevation of 2600-3952 m in 3 days. The Lake Louise AMS score was used to record symptoms associated with AMS. AMS were reported in 59% of children trekking on Jade Mountain over a 3 day period. AMS incidence increased significantly with increasing altitude. The most common AMS symptom was headache, followed by fatigue or weakness, difficulty sleeping, dizziness or lightheadedness and gastrointestinal symptoms. Children who had experienced upper respiratory infection (URI) within the 7 days before their trek tended to have a greater risk for development of AMS. AMS incidence did not significantly differ according to gender, recent acute gastroenteritis, menstruation and body mass index. The incidence of AMS in children trekking on Jade Mountain is greater than that observed in adults, and was associated with altitude and recent URI. © The Author 2016. Published by Oxford University Press on behalf of International society of travel medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Change in oxygen saturation does not predict acute mountain sickness on Jade Mountain.

    PubMed

    Chen, Hang-Cheng; Lin, Wen-Ling; Wu, Jiunn-Yih; Wang, Shih-Hao; Chiu, Te-Fa; Weng, Yi-Ming; Hsu, Tai-Yi; Wu, Meng-Huan

    2012-06-01

    The purpose of this trial was to establish whether changes in resting oxygen saturation (Spo(2)) during ascent of Jade Mountain is useful in predicting acute mountain sickness (AMS). AMS-risk factors were also assessed. A prospective trial was conducted on Jade Mountain, Taiwan from October 18 to October 27, 2008. Resting oxygen saturation (Spo(2)) and heart rate (HR) were measured in subjects at the trail entrance (2610 m), on arrival at Paiyun Lodge (3402 m) on day 1, and at Paiyun Lodge after reaching the summit (3952 m) the next day (day 2). AMS was diagnosed with Lake Louise criteria (AMS score ≥4). A total of 787 subjects were eligible for analysis; 286 (32.2%) met the criteria for AMS. Subjects who developed AMS had significantly lower Spo(2) than those who did not at the trail entrance (93.1% ± 2.1% vs 93.5% ± 2.3%; P = .023), on arrival at Paiyun Lodge on day 1 (86.2% ± 4.7% vs 87.6% ± 4.3%; P < .001), and on the return back to the Paiyun Lodge after a summit attempt on day 2 (85.5% ± 3.5% vs 89.6% ± 3.2%; P < .001), respectively. Trekkers with AMS were significantly younger (40.0 vs 43.2 years; P < .001), and had less high altitude (>3000 m) travel in the previous 3 months (29.9% vs 37.1%; P = .004). Subjects with AMS had a lower Spo(2) than those without AMS; however, the differences between the 2 groups were not clinically significant. The results of this study do not support the use of pulse oximetry in predicting AMS on Jade Mountain. Copyright © 2012 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  3. Acetazolamide in the treatment of acute mountain sickness: clinical efficacy and effect on gas exchange.

    PubMed

    Grissom, C K; Roach, R C; Sarnquist, F H; Hackett, P H

    1992-03-15

    To determine the efficacy of acetazolamide in the treatment of patients with acute mountain sickness and the effect of the drug on pulmonary gas exchange in acute mountain sickness. A randomized, double-blind, placebo-controlled trial. The Denali Medical Research Project high-altitude research station (4200 m) on Mt. McKinley, Alaska. Twelve climbers attempting an ascent of Mt. McKinley (summit, 6150 m) who presented to the medical research station with acute mountain sickness. Climbers were randomly assigned to receive acetazolamide, 250 mg orally, or placebo at 0 (baseline) and 8 hours after inclusion in the study. An assessment of acute mountain sickness using a symptom score and pulmonary gas exchange measurements was done at baseline and at 24 hours. After 24 hours, five of six climbers treated with acetazolamide were healthy, whereas all climbers who received placebo still had acute mountain sickness (P = 0.015). Arterial blood gas specimens were obtained from three of the six acetazolamide recipients and all of the placebo recipients. The alveolar to arterial oxygen pressure difference (PAO2-PaO2 difference) decreased slightly over 24 hours in the acetazolamide group (-0.8 +/- 1.2 mm Hg) but increased in the placebo group (+3.3 +/- 2.3 mm Hg) (P = 0.024). Acetazolamide improved PaO2 over 24 hours (+2.9 +/- 0.8 mm Hg) when compared with placebo (-1.3 +/- 2.8 mm Hg) (P = 0.045). In established cases of acute mountain sickness, treatment with acetazolamide relieves symptoms, improves arterial oxygenation, and prevents further impairment of pulmonary gas exchange.

  4. ALMA to Help Solving Acute Mountain Sickness Mystery

    NASA Astrophysics Data System (ADS)

    2007-04-01

    , family and social isolation, commuting, intermittent high altitude exposure and other environmental challenges such as low temperatures. "An adequate acclimatisation to 2500m altitude requires around two weeks, and we can thus speculate that going to 5000m would require more than one month to achieve complete acclimatisation," said Professor Juan Silva Urra, from the University of Antofagasta. However, short and long term effects of regular commuting between sea level and high altitude have scarcely been studied in biomedical terms. Scientifically based guidelines for appropriate preventive handling and care under these conditions are lacking and the new study will help bridging this gap. Among the studies to be done, some involve continuous monitoring of the human body through portable devices, including measurements of hormone levels and application of psychometric tests. All measurements at 5000m will be carried out on a voluntary basis, under strict safety protocols, with the presence of a doctor from the investigation team, paramedic personnel form ALMA and an ambulance. The symptoms of Acute Mountain Sickness are headache, sicknesses, gastrointestinal inconveniences, fatigue and insomnia that, depending on their intensities, decrease the capacity to carry out the most routine activities. The valuable data collected will enhance our knowledge of human physiology in extreme environments, generating recommendations that will improve wellbeing and health not only in high-altitude observatories, but also in mining and Antarctic personnel. "We are pleased that ALMA is contributing to other disciplines, like medicine, even before the antennas begin to explore the universe," said Felix Mirabel, ESO's representative in Chile. "This outstanding long-term research that will provide crucial information of human physiology to experts worldwide, has been made possible thanks to the combined effort of Chilean and European universities, in collaboration with ALMA". The Atacama

  5. Hematological indices, mountain sickness and MRI brain abnormalities in professional and amateur mountain climbers after altitude exposure.

    PubMed

    Fayed, Nicolás; Diaz, Lizeth; Dávila, Jorge; Medrano, Jaime

    2010-03-01

    The purpose of this work was to correlate the presence of brain abnormalities on magnetic resonance imaging (MRI) with changes in hematological variables and the presence of mountain sickness in 21 mountain climbers involved in two different expeditions to high mountains, Everest and Aconcagua, without supplementary oxygen and recommended acclimatization for this kind of activities. The climbers underwent medical examination, hematological studies, electrocardiogram and MRI of the cerebrum. Wilcoxon signed-rank test was used to evaluate the changes in hematocrit, hemoglobin, red blood cells, iron and ferritin. Mountain sickness was correlated with the age of the climbers and the altitude ascended, final hemoglobin and final mean corpuscular hemoglobin concentration. There were no differences related to conditions of professional or amateur climbers and the changes of those hematological variables, as seen with the nominal regression. We found more brain damage on MRI in amateur than professional climbers. Amateur climbers are more susceptible to suffer acute mountain sickness and permanent cerebral damage than professional climbers after high altitude exposure.

  6. A randomized trial of dexamethasone and acetazolamide for acute mountain sickness prophylaxis.

    PubMed

    Ellsworth, A J; Larson, E B; Strickland, D

    1987-12-01

    Forty-seven climbers participated in a double-blind, randomized trial comparing acetazolamide 250 mg, dexamethasone 4 mg, and placebo every eight hours as prophylaxis for acute mountain sickness during rapid, active ascent of Mount Rainier (elevation 4,392 m). Forty-two subjects (89.4 percent) achieved the summit in an average of 34.5 hours after leaving sea level. At the summit or high point attained above base camp, the group taking dexamethasone reported less headache, tiredness, dizziness, nausea, clumsiness, and a greater sense of feeling refreshed (p less than or equal to 0.05). In addition, they reported fewer problems of runny nose and feeling cold, symptoms unrelated to acute mountain sickness. The acetazolamide group differed significantly (p less than or equal to 0.05) from other groups at low elevations (1,300 to 1,600 m), in that they experienced more feelings of nausea and tiredness, and they were less refreshed. These drug side effects probably obscured the previously established prophylactic effects of acetazolamide for acute mountain sickness. Separate analysis of an acetazolamide subgroup that did not experience side effects at low elevations revealed a prophylactic effect of acetazolamide similar in magnitude to the dexamethasone effect but lacking the euphoric effects of dexamethasone. This study demonstrates that prophylaxis with dexamethasone can reduce the symptoms associated with acute mountain sickness during active ascent and that acetazolamide can cause side effects that may limit its effectiveness as prophylaxis against the disease.

  7. Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

    PubMed Central

    Ellsworth, A. J.; Meyer, E. F.; Larson, E. B.

    1991-01-01

    Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route. PMID:2028586

  8. Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

    PubMed

    Ellsworth, A J; Meyer, E F; Larson, E B

    1991-03-01

    Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route.

  9. Relationship of altitude mountain sickness and smoking: a Catalan traveller's cohort study.

    PubMed

    Sánchez-Mascuñano, Alba; Masuet-Aumatell, Cristina; Morchón-Ramos, Sergio; Ramon, Josep M

    2017-09-24

    The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  10. Strategies for the prevention of acute mountain sickness and treatment for large groups making a rapid ascent in China.

    PubMed

    Luo, Yongjun; Yang, Xiaohong; Gao, Yuqi

    2013-10-30

    Approximately 26.8% of China's land area has an elevation of 3000 m above sea level or higher. Because of recent demands for economic development and new construction in highland areas, many people have relocated from the plains to high plateau regions and have to face the possibility of contracting acute mountain sickness. Therefore, prevention and treatment strategies are necessary to reduce the incidence of acute mountain sickness in people who rapidly ascend to plateau areas. This paper describes the Chinese experience when large numbers of people moved to the plateau and the steps that were taken to deal with this illness. These steps included implementing basic prevention measures, increasing medical awareness among populations ascending to high altitudes, and installing standardized medical management systems to prevent and treat acute mountain sickness before, during, and after ascent. The incidence of acute mountain sickness can be reduced by improving prevention and treatment and by implementing the recommendations described in this manuscript.

  11. The sharpened Romberg test for assessing ataxia in mild acute mountain sickness.

    PubMed

    Johnson, Brian G; Wright, Alex D; Beazley, Margaret F; Harvey, Timothy C; Hillenbrand, Peter; Imray, Christopher H E

    2005-01-01

    To evaluate the Sharpened Romberg Test (SRT) as a measure of ataxia in subjects with mild acute mountain sickness in order to determine its sensitivity and specificity. The SRT was performed in 23 subjects during ascent to 5260 m. The SRT was more often abnormal than the traditional heel-to-toe test, and at the highest altitude it was related to higher median Lake Louise symptom scores with predictive values of 60% sensitivity and 89% specificity. Our evaluation of the SRT appears to agree with similar studies on ataxia showing a lack of correlation between ataxia and symptoms of acute mountain sickness at altitudes below 5260 m. The SRT was easy to perform and provided a quantitative assessment of truncal ataxia in the field without the need for specialized equipment.

  12. Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review

    PubMed Central

    Dumont, Lionel; Mardirosoff, Chahé; Tramèr, Martin R

    2000-01-01

    Objective To quantify efficacy and harm of pharmacological prevention of acute mountain sickness. Data sources Systematic search (Medline, Embase, Cochrane Library, internet, bibliographies, authors) in any language, up to October 1999. Study selection Randomised placebo controlled trials. Data extraction Dichotomous data on efficacy and harm from 33 trials (523 subjects received 13 different interventions, 519 a placebo). Data synthesis At above 4000 m the mean incidence of acute mountain sickness with placebo was 67% (range 25% to 100%); incidence depended on the rate of ascent, but not on the altitude or the mode of ascent. Across all ascent rates, dexamethasone 8-16 mg prevented acute mountain sickness (relative risk 2.50 (95% confidence interval 1.71 to 3.66); number needed to treat (NNT) 2.8 (2.0 to 4.6)), without evidence of dose responsiveness. Acetazolamide 750 mg was also efficacious (2.18 (1.52 to 3.15); NNT 2.9 (2.0 to 5.2)), but 500 mg was not. In two trials, adverse reaction (including depression) occurred after dexamethasone was stopped abruptly (4.45 (1.08 to 18); NNT 3.7 (2.5 to 6.9)). With acetazolamide, paraesthesia (4.02 (1.71 to 9.43); NNT 3.0 (2.0 to 6.0)) and polyuria (4.24 (1.92 to 9.37); NNT 3.6 (2.5 to 6.2)) were reported. Data were sparse on nifedipine, frusemide (furosemide), dihydroxyaluminium-sodium, spironolactone, phenytoin, codeine, phenformin, antidiuretic hormone, and ginkgo biloba. Conclusions At above 4000 m, with a high ascent rate, fewer than three subjects need to be treated with prophylactic dexamethasone 8-16 mg or acetazolamide 750 mg for one subject not to experience acute mountain sickness who would have done so had they all received a placebo. Acetazolamide 500 mg does not work. PMID:10915127

  13. Predictive Models of Acute Mountain Sickness after Rapid Ascent to Various Altitudes

    DTIC Science & Technology

    2013-01-01

    prevent or effectively manage AMS has become increas- ingly important (7). Despite decades of research, no models exist to predict AMS severity and... different grades of AMS severity (i.e., mild, moderate, and severe). The purpose of this study, therefore, was to develop the first predictive models of AMS...ACUTE MOUNTAIN SICKNESS PREDICTION MODELS Medicine & Science in Sports & Exercised 793 A PPLIED SC IEN C ES Copyright © 2013 by the American College of

  14. Acute mountain sickness, antacids, and ventilation during rapid, active ascent of Mount Rainier.

    PubMed

    Roach, R C; Larson, E B; Hornbein, T F; Houston, C S; Bartlett, S; Hardesty, J; Johnson, D; Perkins, M

    1983-05-01

    A double-blind randomized study of 45 climbers on Mt. Rainier was conducted to test the effectiveness of antacids in preventing acute mountain sickness. All 45 climbed to 3353 m, and 31 continued to the summit. Ten climbers listed acute mountain sickness as the reason for not attaining the summit. Of symptoms monitored throughout the climb, neither headache, nausea, dizziness, pounding heart, nor shortness of breath differed in severity between antacid-treated and placebo-treated groups. In both groups vital capacity decreased significantly with ascent (p less than 0.05), while peak flow (p less than 0.005) and minute ventilation (p less than 0.001) increased significantly. The 7 climbers with the most severe AMS symptom scores above 4000 m had significantly lower peak flow at sea level prior to ascent compared with the other 25 climbers who completed sea level tests (p less than 0.005). The results of this study fail to document efficacy for antacid use for the prevention of acute mountain sickness.

  15. Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis

    PubMed Central

    Low, Emma V; Gupta, Vaibhav; Schedlbauer, Angela; Grocott, Michael P W

    2012-01-01

    Objectives To assess the efficacy of three different daily doses of acetazolamide in the prevention of acute mountain sickness and to determine the lowest effective dose. Design Systematic review and meta-analysis. Data sources Medline and Embase along with a hand search of selected bibliographies. No language restrictions were applied. Study selection Randomised controlled trials assessing the use of acetazolamide at 250 mg, 500 mg, or 750 mg daily versus placebo in adults as a drug intervention for the prophylaxis of acute mountain sickness. Included studies were required to state the administered dose of acetazolamide and to randomise participants before ascent to either acetazolamide or placebo. Two reviewers independently carried out the selection process. Data extraction Two reviewers extracted data concerning study methods, pharmacological intervention with acetazolamide, method of assessment of acute mountain sickness, and event rates in both control and intervention groups, which were verified and analysed by the review team collaboratively. Data synthesis 11 studies (with 12 interventions arms) were included in the review. Acetazolamide at doses of 250 mg, 500 mg, and 750 mg were all effective in preventing acute mountain sickness above 3000 m, with a combined odds ratio of 0.36 (95% confidence interval 0.28 to 0.46). At a dose of 250 mg daily the number needed to treat for acetazolamide to prevent acute mountain sickness was 6 (95% confidence interval 5 to 11). Heterogeneity ranged from I2=0% (500 mg subgroup) to I2=44% (750 mg subgroup). Conclusions Acetazolamide in doses of 250 mg, 500 mg, and 750 mg daily are all more effective than placebo for preventing acute mountain sickness. Acetazolamide 250 mg daily is the lowest effective dose to prevent acute mountain sickness for which evidence is available. PMID:23081689

  16. Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis.

    PubMed

    Low, Emma V; Avery, Anthony J; Gupta, Vaibhav; Schedlbauer, Angela; Grocott, Michael P W

    2012-10-18

    To assess the efficacy of three different daily doses of acetazolamide in the prevention of acute mountain sickness and to determine the lowest effective dose. Systematic review and meta-analysis. Medline and Embase along with a hand search of selected bibliographies. No language restrictions were applied. Randomised controlled trials assessing the use of acetazolamide at 250 mg, 500 mg, or 750 mg daily versus placebo in adults as a drug intervention for the prophylaxis of acute mountain sickness. Included studies were required to state the administered dose of acetazolamide and to randomise participants before ascent to either acetazolamide or placebo. Two reviewers independently carried out the selection process. Two reviewers extracted data concerning study methods, pharmacological intervention with acetazolamide, method of assessment of acute mountain sickness, and event rates in both control and intervention groups, which were verified and analysed by the review team collaboratively. 11 studies (with 12 interventions arms) were included in the review. Acetazolamide at doses of 250 mg, 500 mg, and 750 mg were all effective in preventing acute mountain sickness above 3000 m, with a combined odds ratio of 0.36 (95% confidence interval 0.28 to 0.46). At a dose of 250 mg daily the number needed to treat for acetazolamide to prevent acute mountain sickness was 6 (95% confidence interval 5 to 11). Heterogeneity ranged from I(2)=0% (500 mg subgroup) to I(2)=44% (750 mg subgroup). Acetazolamide in doses of 250 mg, 500 mg, and 750 mg daily are all more effective than placebo for preventing acute mountain sickness. Acetazolamide 250 mg daily is the lowest effective dose to prevent acute mountain sickness for which evidence is available.

  17. Different duration of high-altitude pre-exposure associated with the incidence of acute mountain sickness on Jade Mountain.

    PubMed

    Weng, Yi-Ming; Chiu, Yu-Hui; Lynn, Jiun-Jen; Li, Wen-Cheng; Wang, Shih-Hao; Kao, Wei-Fong; Hsu, Tai-Yi; Chiu, Te-Fa; Lin, Yu-Jr; Chan, Chang-Wei

    2013-07-01

    The objective of this study is to determine the association between the duration of high-altitude (>3000 m) pre-exposure and acute mountain sickness (AMS) incidence. A prospective observational study was conducted on 2 random days each month from April 2007 to March 2008 at Paiyun Lodge (3402 m), Jade Mountain, Taiwan. Demographic data, prior AMS history, symptoms, and scores and the days and times of high-altitude pre-exposure within the preceding 2 months were obtained from lowland (<1500 m) trekkers. Totally, 1010 questionnaires were analyzed; 106, 76, and 828 trekkers had pre-exposure lasting at least 3 days (group 1), less than 3 days (group 2), and 0 days (group 3), respectively. Acute mountain sickness incidence was significantly higher in groups 2 and 3 than in group 1 (21.70%, 35.53%, 37.08%, respectively; P = .008). Logistic regression analysis indicated a significantly lower AMS risk in group 1 (group 1, P = .004; odds ratio [OR], 0.479; 95% confidence interval [CI], 0.290-0.791; group 2, P = .226; OR, 0.725; 95% CI, 0.430-1.221). In group 1, 28 and 78 trekkers had single and intermittent multiple pre-exposure, respectively. There was no difference in the incidence or severity of AMS symptoms between single and intermittent multiple pre-exposure (AMS, P = .838; headache, P = .891; dizziness or lightheadedness, P = .414; fatigue and/or weakness, P = .957; gastrointestinal symptoms, P = .257; difficulty sleeping, P = .804; AMS score, P = .796). High-altitude pre-exposure lasting at least 3 days within the preceding 2 months was associated with a significant lower AMS incidence during a subsequent ascent among Jade Mountain trekkers. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. The first documented description of mountain sickness: the Andean or Pariacaca story.

    PubMed

    Gilbert, D L

    1983-06-01

    We describe here for the first time the actual route that Acosta took when he described mountain sickness so vividly in the sixteenth century. We have shown that when Acosta mentioned Pariacaca as the geographical site where he experienced high altitude sickness, this referred not only to the modern peak of Pariachaca, but to the snow covered mountains by this Cerro, and the Central Maritime Andean Range in Peru. In addition, the name Pariacaca also referred to a tambo or inn located on the plateau or Puno of Pariacaca. The location of this route has been obtained by locating primary descriptions on maps from the sixteenth to the eighteenth centuries. Using twentieth century maps, we have been able to identify the described sites along the road and the trail which still exists by them. In addition, using detailed topographical maps, an altitude profile of the trail was obtained. The maximum altitude on this trail or old road reached 4800 m (15750 ft), about the same elevation as the summit of Mt. Blanc, the highest mountain in western Europe.

  19. Metric properties of the Spanish version of the Lake Louise Acute Mountain Sickness Questionnaire.

    PubMed

    Carod-Artal, F J; Ezpeleta Echávarri, D; Guerrero Peral, A L

    2011-01-01

    To assess the metric properties of the Lake Louise Acute Mountain Sickness (LLAMSQ) five-item questionnaire. At the end of the course "Neuroscience in pre-Columbian Andean cultures" (Peru, 2009), the participants answered the self-reported version of the LLAMSQ. The following psychometric attributes were explored: acceptability (observed versus possible scores; floor and ceiling effects), scaling assumptions (item-total correlation > 0.30), internal consistency (Cronbach́s alpha), precision (standard error of measurement), and convergent and discriminative validity. Differences in mean score of LLAMSQ between symptomatic acute mountain sickness subjects and asymptomatic ones were calculated. The participants stayed for days at Cuzco (3,400 meters above sea level, MASL), Sacred valley (2,850 MASL) and Machu Picchu (2,450 MASL). Seventy people (60% males; mean age 50±8 years; 88.6% neurologists) were included in the study. LLAMSQ mean score was 3.36±2.02 (median 3; skewness 0.61). Ceiling and floor effects were 7.3% and 1.4%, respectively. Cronbach́s alpha was 0.61, and standard error of measurement 1.26. LLAMSQ mean score significantly correlated (r=0.41, P=.002) with physical items (ataxia, dyspnoea, tremor, mental symptoms). LLAMSQ mean scores were significantly higher (worse) in those subjects who presented with acute sickness mountain (5.8 vs 3.0; Mann-Whitney, P<.0001). Metric properties of the LLASMQ Spanish version are adequate. This questionnaire seems to be useful in the early detection of high-altitude illness. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  20. Rhodiola crenulata extract for prevention of acute mountain sickness: a randomized, double-blind, placebo-controlled, crossover trial

    PubMed Central

    2013-01-01

    Background Rhodiola crenulata (R. crenulata) is widely used to prevent acute mountain sickness in the Himalayan areas and in Tibet, but no scientific studies have previously examined its effectiveness. We conducted a randomized, double-blind, placebo-controlled crossover study to investigate its efficacy in acute mountain sickness prevention. Methods Healthy adult volunteers were randomized to 2 treatment sequences, receiving either 800 mg R. crenulata extract or placebo daily for 7 days before ascent and 2 days during mountaineering, before crossing over to the alternate treatment after a 3-month wash-out period. Participants ascended rapidly from 250 m to 3421 m on two separate occasions: December 2010 and April 2011. The primary outcome measure was the incidence of acute mountain sickness, as defined by a Lake Louise score ≥ 3, with headache and at least one of the symptoms of nausea or vomiting, fatigue, dizziness, or difficulty sleeping. Results One hundred and two participants completed the trial. There were no demographic differences between individuals taking Rhodiola-placebo and those taking placebo-Rhodiola. No significant differences in the incidence of acute mountain sickness were found between R. crenulata extract and placebo groups (all 60.8%; adjusted odds ratio (AOR) = 1.02, 95% confidence interval (CI) = 0.69–1.52). The incidence of severe acute mountain sickness in Rhodiola extract vs. placebo groups was 35.3% vs. 29.4% (AOR = 1.42, 95% CI = 0.90–2.25). Conclusions R. crenulata extract was not effective in reducing the incidence or severity of acute mountain sickness as compared to placebo. Trial registration ClinicalTrials.gov NCT01536288. PMID:24176010

  1. The Effects of Propranolol on Acute Mountain Sickness (AMS) and Well- Being at 4300 Meters Altitude

    DTIC Science & Technology

    1989-06-02

    Company, 1984. 11. Sampson JB , Cymerman A, Burse EL, Maher JT, Rock PB. Procedures for the measurement of acute mountain sickness. Aviat. Space...Environ. Med. 1983;54:1063-73. 12. Sampson JB , Kobrick JL. The environmental symptoms questionnaire: Revisions and new field data. Aviat. Space Environ. Med...0 L LU 0 0 I- . U V- -J X < LULLI fe A 0-0 z LU CL >_ LU Q . m W4-q 0 00 0. _m - n* +HI H+- H 4; . C66c; 6 6 vicie 0 h J02 00~- 0 0 M 0n*o-ir q- 00D DC

  2. Determinants of acute mountain sickness and success on Mount Aconcagua (6962 m).

    PubMed

    Pesce, Carlos; Leal, Conxita; Pinto, Hernán; González, Gabriela; Maggiorini, Marco; Schneider, Michael; Bärtsch, Peter

    2005-01-01

    To investigate the determinants of acute mountain sickness (AMS) and of summiting in expedition-style mountaineering, 919 mountaineers (15.4% female) leaving Aconcagua Provincial Park at the end of an expedition to Mt. Aconcagua (6962 m) via the normal route were retrospectively evaluated by questionnaires. Symptoms of AMS were reported from the day when mountaineers felt worst. The prevalence of AMS, defined as a Lake Louise Score (self-assessment) > 4, was 39%. Low AMS scores were associated with faster ascent rates. The following parameters were independent predictors for AMS: no susceptibility for AMS (odds ratio, OR, 0.24; 95% confidence interval 0.17 to 0.35) more than 10 exposures per year above 3000 m (OR 0.60; 0.41 to 0.86), and previous exposures above 6000 m (OR, 0.48; 0.33 to 0.68). This last variable increased the OR for summiting 3.7-fold while female gender reduced this OR to 0.41 (0.25 to 0.67). Susceptibility and few exposures to high altitude are major predictors for AMS on Aconcagua, but AMS does not substantially reduce the chances for summiting. Those who are often in the mountains and who have already climbed to altitudes above 6000 m and are not susceptible for AMS have the best options for summiting Aconcagua.

  3. The prevalence of and risk factors for acute mountain sickness in the Eastern and Western Alps.

    PubMed

    Mairer, Klemens; Wille, Maria; Burtscher, Martin

    2010-01-01

    Acute mountain sickness (AMS) is the most common condition of high altitude illnesses. Its prevalence varies between 15% and 80% depending on the speed of ascent, absolute altitude reached, and individual susceptibility. Additionally, we assumed that the more experienced mountaineers of the Western Alps are less susceptible to developing AMS than recreational mountaineers of the Eastern Alps or tourist populations. Therefore, the main goals of the present study were the collection of data regarding the AMS prevalence and triggers in both the Eastern and Western Alps using identical methods. A total of 162 mountaineers, 79 in the Eastern Alps (3454 m) and 83 in the Western Alps (3817 m) were studied on the morning after their first night at high altitude. A diagnosis of AMS was based on a Lake Louise Score (LLS) ≥4, the presence of headache, and at least one additional symptom. Thirty of 79 subjects (38.0%) suffered from AMS at 3454 m in the Eastern Alps as did 29 of 83 (34.9%) at 3817 m in the Western Alps. After adjustment for altitude, the prevalence in the Western Alps constituted 24.5%, which differed significantly (p = 0.04) from that found in the Eastern Alps. The lower mountaineering experience of mountaineers in the Eastern Alps turned out to be the only factor for explaining their higher AMS prevalence. Thus, expert advice by mountain guides or experienced colleagues could help to reduce the AMS risk in these subjects.

  4. Prevalence of acute mountain sickness on Mount Fuji: A pilot study.

    PubMed

    Horiuchi, Masahiro; Endo, Junko; Akatsuka, Shin; Uno, Tadashi; Jones, Thomas E

    2016-04-01

    Few studies have investigated climbing-related acute mountain sickness (AMS) on Mt Fuji. Although several studies of AMS have been conducted elsewhere, Mt Fuji is unique because there are many mountain lodges between the fifth station (a common starting point for climbers at an altitude of 2305 m) and the summit (3776 m), and many climbers commonly sleep overnight at mountain lodges during their ascents. This study surveyed the prevalence of AMS among climbers on Mt Fuji to determine which factors, if any, were related to the risk of developing AMS. This study collected data from 345 participants who climbed Mt Fuji in August 2013, including information regarding age, sex, climbing experience and whether the climber stayed at a mountain lodge (n = 239). AMS was surveyed using the Lake Louise Score (LLS) questionnaire. The item on perceived sleep quality was excluded for those who did not stay at a mountain lodge (n = 106). The overall prevalence of AMS was 29.5% (≥ 3 LLS with headache). According to a univariate analysis, AMS was not associated with sex (male vs female), age group (20-29, 30-39, 40-49 or >50 years) or stay at a mountain lodge (single day vs overnight stay). Conversely, prior experience climbing Mt Fuji (no prior attempts vs one or more prior attempts) was related to the risk of AMS. In addition, there was a significant deviation in the number of participants reporting poor sleep, and total sleep time was significantly shorter in participants with AMS. These preliminary findings suggest that no single factor can explain the risk for developing AMS while climbing Mt Fuji. In addition, impaired perceived sleep quality was associated with the severity of AMS in climbers who stayed overnight at a mountain lodge. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  5. Do work factors modify the association between chronic health problems and sickness absence among older employees?

    PubMed

    Leijten, Fenna R M; van den Heuvel, Swenne G; Ybema, Jan Fekke; Robroek, Suzan J W; Burdorf, Alex

    2013-09-01

    The aim of this study was to (i) assess how common chronic health problems and work-related factors predict sickness absence and (ii) explore whether work-related factors modify the effects of health problems on sickness absence. A one-year longitudinal study was conducted among employed persons aged 45-64 years from the Study on Transitions in Employment, Ability and Motivation (N = 8984). The presence of common chronic health problems and work-related factors was determined at baseline and self-reported sickness absence at one-year follow-up by questionnaire. Multinomial multivariate logistic regression analyses were conducted to assess associations between health, work factors, and sickness absence, and relative excess risk due to interaction (RERI) techniques were used to test effect modification. Common health problems were related to follow-up sickness absence, most strongly to high cumulative sickness absence (> 9 days per year). Baseline psychological health problems were strongly related to high sickness absence at follow-up [odds ratio (OR) 3.67, 95% confidence interval (95% CI) 2.80-4.82]. Higher job demands at baseline increased the likelihood of high sickness absence at follow-up among workers with severe headaches [RERI 1.35 (95% CI 0.45-2.25)] and psychological health problems [RERI 3.51 (95% CI 0.67-6.34)] at baseline. Lower autonomy at baseline increased the likelihood of high sickness absence at follow-up among those with musculoskeletal [RERI 0.57 (95% CI 0.05-1.08)], circulatory [RERI 0.82 (95% CI 0.00-1.63)], and psychological health problems [RERI 2.94 (95% CI 0.17-5.70)] at baseline. Lower autonomy and higher job demands increased the association of an array of common chronic health problems with sickness absence, and thus focus should be placed on altering these factors in order to reduce sickness absence and essentially promote sustainable employability.

  6. Altitude mountain sickness among tourist populations: a review and pathophysiology supporting management with hyperbaric oxygen.

    PubMed

    Butler, Gleen J; Al-Waili, N; Passano, D V; Ramos, J; Chavarri, J; Beale, J; Allen, M W; Lee, B Y; Urteaga, G; Salom, K

    2011-01-01

    In the mountain climbing community, conventional prevention of altitude mountain sickness (AMS) relies primarily on a formal acclimatization period. AMS symptoms during mountaineering climbs are managed with medication, oxygen and minor recompression (1524-2438 m altitude) using a portable chamber, such as the Gamow Bag. This is not always an acceptable therapy alternative in a predominantly elderly tourist population. The primary problem with reduced pressure at high altitude is hypoxaemia, which causes increased sympathetic activity, induces pulmonary venous constriction, while increasing pulmonary blood flow and regional perfusion. Rapid assents to altitude contribute to an increased incidence of decompression sickness (DCS). The treatment of choice for DCS is hyperbaric oxygenation, thus, treatment of high-altitude induced hypoxaemia using hyperbaric oxygenation (HBO(2)) is logical. Life Support Technologies group and the Center for Investigation of Altitude Medicine (CIMA, in Cusco, Peru) propose a comprehensive and multidisciplinary approach to AMS management. This approach encompasses traditional and advanced medical interventions including the use of a clinical HBO(2) chamber capable of recompression to three times greater than sea level pressure (3 atmosphere absolute (ATA)). The system uses a series of AMS hyperbaric treatment profiles that LST has previously developed to the US military and NASA, and that take greater advantage of vasoconstrictive effects of oxygen under true hyperbaric conditions of 1.25 ATA. These profiles virtually eliminate AMS rebound after the initial treatment often seen in conventional AMS treatment, where the patient is either treated at altitude, or does not recompress back to sea level or greater pressure (1.25 ATA), but returns directly to the same altitude where AMS symptoms first manifested.

  7. Determinants of summiting success and acute mountain sickness on Mt Kilimanjaro (5895 m).

    PubMed

    Davies, Andrew J; Kalson, Nicholas S; Stokes, Suzy; Earl, Mark D; Whitehead, Adam G; Frost, Hannah; Tyrell-Marsh, Ian; Naylor, Jon

    2009-01-01

    To determine the incidence of acute mountain sickness (AMS), the frequency of summiting success, and the factors that affect these in trekkers on Kilimanjaro, one of the world's most summitted high-altitude peaks. The study group comprised 312 trekkers attempting Mt Kilimanjaro summit by the Marango Route. Trekkers ascended over 4 or 5 days along a fixed ascent profile, stopping at 3 huts on ascent (2700 m, 3700 m, and 4700 m) before attempting the summit. Researchers were stationed at each hut for 16 days. Each night we measured heart rate, respiratory rate, blood pressure, oxygen saturation, and Lake Louise Score. We recorded the highest altitude that trekkers reached on the mountain. Of 181 complete sets of data, 111 (61%) trekkers reached the summit, and 139 (77%) developed AMS. Physiological results were not related to summit success. The incidence of AMS and summiting success were similar in those on the 4- or 5-day route. Trekkers on the 5-day route who used acetazolamide were less likely to develop AMS and more likely to summit than were those not taking acetazolamide (P = <.05); this difference was not present with trekkers on the 4-day route. The risk of developing AMS is high on Mt Kilimanjaro. Although taking an extra day to acclimatize with the use of acetazolamide did provide some protection against AMS, ideally trekkers need a more gradual route profile for climbing this mountain.

  8. Relation between perceived health and sick leave in employees with a chronic illness.

    PubMed

    Boot, Cécile R L; Koppes, Lando L J; van den Bossche, Seth N J; Anema, Johannes R; van der Beek, Allard J

    2011-06-01

    To improve work participation in individuals with a chronic illness, insight into the role of work-related factors in the association between health and sick leave is needed. The aim of this study was to gain insight into the contribution of work limitations, work characteristics, and work adjustments to the association between health and sick leave in employees with a chronic illness. All employees with a chronic illness, between 15 and 65 years of age (n = 7,748) were selected from The Netherlands Working Conditions Survey. The survey included questions about perceived health, working conditions, and sick leave. Block-wise multivariate linear regression analyses were performed and, in different blocks, limitations at work, work characteristics, and work adjustments were added to the model of perceived health status. Changes in regression coefficient (B) (%) were calculated for the total group and for sub-groups per chronic illness. When work limitations were added to the model, the B between health and sick leave decreased by 18% (5.0 to 4.1). Adding work characteristics did not decrease the association between health and sick leave, but the B between work limitations and sick leave decreased by 14%, (5.3 to 4.5). When work adjustments were added to the model, the Bs between sick leave and work limitations and work characteristics changed from 4.5 to 3.4 for work limitations and from 2.1 to 1.9 for temporary contract and from -0.8 to -1.0 for supervisor support. The association between health and sick leave was explained by limitations at work, work characteristics, and work adjustments. Paying more attention to work limitations, characteristics and adjustments offers opportunities to reduce the negative consequences of chronic illness.

  9. Ataxia in acute mountain sickness does not improve with short-term oxygen inhalation.

    PubMed

    Baumgartner, Ralf W; Bärtsch, Peter

    2002-01-01

    Stability of stance declines at high altitude in subjects with and without acute mountain sickness (AMS), suggesting that postural ataxia might result from different hypoxia-related mechanisms than those causing the signs and symptoms of AMS. The aim of this study was to determine whether short-term oxygen inhalation improves stability of stance assessed by static posturography and/or the symptoms of AMS. Twenty male volunteers with cerebral AMS scores above 0.70 were investigated the first or second morning of their stay at an altitude of 4559 m. Posturographic parameters remained unchanged, whereas cerebral AMS scores decreased (p < 0.001) after inhalation of 3 L/min of oxygen for at least 10 min. We conclude that ataxia of stance assessed by posturography may result from different hypoxia-triggered mechanisms that need more time for recovery than those causing AMS.

  10. Acute Mountain Sickness, Hypoxia, Hypobaria and Exercise Duration each Affect Heart Rate.

    PubMed

    DiPasquale, D M; Strangman, G E; Harris, N S; Muza, S R

    2015-07-01

    In this study, we quantified the changes in post-exercise resting heart rate (HRrst) associated with acute mountain sickness (AMS), and compared the effects of hypobaric hypoxia (HH) and normobaric hypoxia (NH) on HRrst. We also examined the modulating roles of exercise duration and exposure time on HRrst. Each subject participated in 2 of 6 conditions: normobaric normoxia (NN), NH, or HH (4 400 m altitude equivalent) combined with either 10 or 60 min of moderate cycling at the beginning of an 8-h exposure. AMS was associated with a 2 bpm higher HRrst than when not sick, after taking into account the ambient environment, exercise duration, and SpO2. In addition, HRrst was elevated in both NH and HH compared to NN with HRrst being 50% higher in HH than in NH. Participating in long duration exercise led to elevated resting HRs (0.8-1.4 bpm higher) compared with short exercise, while short exercise caused a progressive increase in HRrst over the exposure period in both NH and HH (0.77-1.2 bpm/h of exposure). This data suggests that AMS, NH, HH, exercise duration, time of exposure, and SpO2 have independent effects on HRrst. It further suggests that hypobaria exerts its own effect on HRrst in hypoxia. Thus NH and HH may not be interchangeable environments. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Is acute mountain sickness related to trait anxiety? A normobaric chamber study.

    PubMed

    Niedermeier, Martin; Waanders, Robb; Menz, Verena; Wille, Maria; Kopp, Martin; Burtscher, Martin

    2017-03-15

    Some mountaineers are more prone to the occurrence of acute mountain sickness (AMS) than others. State anxiety during altitude exposure might be associated with AMS development. We hypothesized that trait anxiety might be higher in AMS cases compared to non-AMS cases. The aim of the present study was to study the relationship between AMS development and trait anxiety. In an observational study design, AMS incidence during a 12-hour exposure to normobaric hypoxia (FiO2=12.6%, equivalent to 4500m) was determined by the Lake Louise Scoring System. Trait anxiety (State Trait Anxiety Inventory) and confounding variables were assessed in a follow-up questionnaire (37months after hypoxic exposure). Twenty nine participants returned the follow-up questionnaire. AMS incidence was 38%. Both unadjusted and adjusted logistic regression analyses did not reveal trait anxiety as a significant variable in relation to AMS. Based on the findings of this preliminary study, there is no evidence that AMS development under normobaric conditions is related to trait anxiety. Differences to previous studies might be explained by the type of hypoxia, by different sample characteristics and by considering sleep disturbances in the calculation of the AMS score. However, future studies with larger sample sizes may help to clear the relationship between AMS development and the personality factor anxiety. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Prevalence of acute mountain sickness among Finnish trekkers on Mount Kilimanjaro, Tanzania: an observational study.

    PubMed

    Karinen, Heikki; Peltonen, Juha; Tikkanen, Heikki

    2008-01-01

    The aim of this study was to evaluate the prevalence of acute mountain sickness (AMS) among trekkers on Mount Kilimanjaro during the winter season of 2006-2007. A A total of 130 Finnish trekkers at Marungu route were asked to complete daily a Lake Louise self-report and clinical assessment score questionnaire with the help of a trainee Finnish guide during their trek to Kilimanjaro. A Lake Louise questionnaire score>or=3 indicated AMS. Altogether 112 mountaineers or travelers [54 men, 58 women, mean age 51+/-10 (SD) years] were studied. Fifty-nine travelers (53%) reached Gillman's Point or Uhuru Peak. The incidence of AMS among Finnish Kilimanjaro trekkers was 75%. The most common high altitude symptoms were headache, followed by sleeping problems and fatigue or weakness. The incidence of AMS is high among trekkers climbing Mount Kilimanjaro.The main reason for this seems to be rapid ascent. Kilimanjaro treks normally have a fixed timetable, and for commercial reasons there is little opportunity to spend extra days for acclimatization in the camps. Some contributing factors are preventable, so we recommend an educational program for all the trekking agencies that guide on this peak and, in particular, the Tanzania-based guiding agencies, which, typically, are driving these very fast ascent rates.

  13. Inflammatory fatigue and sickness behaviour - lessons for the diagnosis and management of chronic fatigue syndrome.

    PubMed

    Arnett, S V; Clark, I A

    2012-12-10

    Persistent and severe fatigue is a common part of the presentation of a diverse range of disease processes. There is a growing body of evidence indicating a common inflammatory pathophysiology underlying many conditions where fatigue is a primary patient concern, including chronic fatigue syndrome. This review explores current models of how inflammatory mediators act on the central nervous system to produce fatigue and sickness behaviour, and the commonality of these processes in conditions as diverse as surgical trauma, infection, various cancers, inflammatory bowel disease, connective tissue diseases and autoimmune diseases. We also discuss evidence indicating chronic fatigue syndrome may have important pathophysiological similarities with cytokine mediated sickness behaviour, and what lessons can be applied from sickness behaviour to chronic fatigue syndrome with regards to the diagnosis and management.

  14. Visual analogue self-assessment of acute mountain sickness in adolescents: experience from two Himalayan expeditions.

    PubMed

    Slingo, Mary E; Lowe, Fionna S J; Pieri, Andrew R P; Imray, Chris H E

    2012-09-01

    Recent studies have investigated visual analogue scales (VAS) as an alternative to the Lake Louise AMS Self-Report Score (LLS) for the self-assessment of acute mountain sickness (AMS). We investigated their use in adolescents. The study was conducted during the 2009 and 2010 British Schools Exploring Society 35-day expeditions to Ladakh. Comparable ascent profiles were followed, reaching a maximum altitude of 6000 m. LLS and VAS AMS scores were recorded each morning. VAS comprised 100 mm lines for each LLS symptom; VAS scores were summed to give a composite daily total (VAS(c), expressed as a percentage). In 2010, an additional line was used to score overall "altitude sickness' (VAS(o)). 42 individuals participated in 2009 (83% compliance; mean age 17.4 years); 28 in 2010 (82% compliance; 17.5 years). 759 data points were recorded in 2009; 529 in 2010. There was a significant correlation between LLS and VAS(c) on both expeditions (rho=0.80, p<0.001 in 2009; rho=0.65, p<0.001 in 2010). These significant correlations remained when cases of AMS were analyzed separately. However, in all cases, the relationship between LLS and VAS was distorted, with a tendency for VAS to underscore symptoms of AMS when LLS<5. A VAS(c) value of 5.5% had an 82% specificity and sensitivity for all cases of AMS; VAS(c) of 9.5% had a 90% specificity and sensitivity for moderate and severe AMS. Whilst adolescents are capable of self-monitoring for AMS using VAS, the relationship with LLS is distorted. The LLS, despite its limitations, therefore remains the preferred method for the self-assessment of AMS in adolescents.

  15. The Use of Hypoxic and Carbon Dioxide Sensitivity Tests of Predict the Incidence and Severity of Acute Mountain Sickness in Soldiers Exposed to an Elevation of 3800 Meters

    DTIC Science & Technology

    1991-02-20

    rr_;-m200wor,i~ Aclute mountain sickness (AMS) is characterized by headache , nausea, and dizzineswith individual differences occurring susceptibility...unique requirements of the ventilatory collection system used in this study. vi SUMMARY Acute mountain sickness (AMS) is characterized by headache , nausea...complax which includes headache , nausea, dizziness, weakness, and insomnia (Johnson and Rock 1988; Malconian and Rock 1988). In general, the symptoms

  16. A Signature of Circulating microRNAs Predicts the Susceptibility of Acute Mountain Sickness.

    PubMed

    Liu, Bao; Huang, He; Wu, Gang; Xu, Gang; Sun, Bing-Da; Zhang, Er-Long; Chen, Jian; Gao, Yu-Qi

    2017-01-01

    Background: Acute mountain sickness (AMS) is a common disabling condition in individuals experiencing high altitudes, which may progress to life-threatening high altitude cerebral edema. Today, no established biomarkers are available for prediction the susceptibility of AMS. MicroRNAs emerge as promising sensitive and specific biomarkers for a variety of diseases. Thus, we sought to identify circulating microRNAs suitable for prediction the susceptible of AMS before exposure to high altitude. Methods: We enrolled 109 healthy man adults and collected blood samples before their exposure to high altitude. Then we took them to an elevation of 3648 m for 5 days. Circulating microRNAs expression was measured by microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). AMS was defined as Lake Louise score ≥3 and headache using Lake Louise Acute Mountain Sickness Scoring System. Results: A total of 31 microRNAs were differentially expressed between AMS and Non-AMS groups, 15 up-regulated and 16 down-regulated. Up-regulation of miR-369-3p, miR-449b-3p, miR-136-3p, and miR-4791 in patients with AMS compared with Non-AMS individuals were quantitatively confirmed using qRT-PCR (all, P < 0.001). With multiple logistic regression analysis, a unique signature encompassing miR-369-3p, miR-449b-3p, and miR-136-3p discriminate AMS from Non-AMS (area under the curve 0.986, 95%CI 0.970-1.000, P < 0.001, LR+: 14.21, LR-: 0.08). This signature yielded a 92.68% sensitivity and a 93.48% specificity for AMS vs. Non-AMS. Conclusion: The study here, for the first time, describes a signature of three circulating microRNAs as a robust biomarker to predict the susceptibility of AMS before exposure to high altitude.

  17. A Signature of Circulating microRNAs Predicts the Susceptibility of Acute Mountain Sickness

    PubMed Central

    Liu, Bao; Huang, He; Wu, Gang; Xu, Gang; Sun, Bing-Da; Zhang, Er-Long; Chen, Jian; Gao, Yu-Qi

    2017-01-01

    Background: Acute mountain sickness (AMS) is a common disabling condition in individuals experiencing high altitudes, which may progress to life-threatening high altitude cerebral edema. Today, no established biomarkers are available for prediction the susceptibility of AMS. MicroRNAs emerge as promising sensitive and specific biomarkers for a variety of diseases. Thus, we sought to identify circulating microRNAs suitable for prediction the susceptible of AMS before exposure to high altitude. Methods: We enrolled 109 healthy man adults and collected blood samples before their exposure to high altitude. Then we took them to an elevation of 3648 m for 5 days. Circulating microRNAs expression was measured by microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). AMS was defined as Lake Louise score ≥3 and headache using Lake Louise Acute Mountain Sickness Scoring System. Results: A total of 31 microRNAs were differentially expressed between AMS and Non-AMS groups, 15 up-regulated and 16 down-regulated. Up-regulation of miR-369-3p, miR-449b-3p, miR-136-3p, and miR-4791 in patients with AMS compared with Non-AMS individuals were quantitatively confirmed using qRT-PCR (all, P < 0.001). With multiple logistic regression analysis, a unique signature encompassing miR-369-3p, miR-449b-3p, and miR-136-3p discriminate AMS from Non-AMS (area under the curve 0.986, 95%CI 0.970–1.000, P < 0.001, LR+: 14.21, LR–: 0.08). This signature yielded a 92.68% sensitivity and a 93.48% specificity for AMS vs. Non-AMS. Conclusion: The study here, for the first time, describes a signature of three circulating microRNAs as a robust biomarker to predict the susceptibility of AMS before exposure to high altitude. PMID:28228730

  18. High Altitude Headache and Acute Mountain Sickness at Moderate Elevations in a Military Population During Battalion-Level Training Exercises

    DTIC Science & Technology

    2012-08-01

    Battalion-Level Training Exercises Jacob N. Norris Erik Viirre Hilary Aralis Michael K. Sracic Darren Thomas Jeffery H. Gertsch Report No. 10...Training Exercises LT Jacob N. Norris, MSC USN*; Erik Viirre, MD, PhD*; Hilary Aralis, MPH*; LT Michael K. Sracic, MC USNf; LT Darren Thomas, MC USNt...altitude diseases. Ann litem Med 2004; 141(10): 789-800. 3. Bartsch P, Bailey DM, Berger MM, Knauth M, Baumgartner RW: Acute mountain sickness

  19. Diabetic ketoacidosis and acute mountain sickness: case report and review of treatment options in type 1 diabetes mellitus.

    PubMed

    Miller, Steven C M

    2015-06-01

    A 30-year-old man with a 20-year history of well-controlled type 1 diabetes mellitus and no microvascular complications traveled from near sea level to an altitude of 3000 m within 6 hours. At altitude, his blood glucose levels began to rise, necessitating increased insulin delivery. Typical symptoms of acute mountain sickness (AMS) developed, and he became increasingly hyperglycemic and unwell. Upon presentation to an emergency clinic, diabetic ketoacidosis (DKA) was diagnosed and was managed with insulin, intravenous fluids with potassium, and acetazolamide orally. No other potential causes for diabetic ketoacidosis were identified. Hyperglycemia, ketosis, and acidosis resolved with treatment as expected, but an increased insulin requirement was noted for the next 48 hours, until returning to expected levels when acetazolamide was discontinued. This case describes an episode of mild diabetic ketoacidosis potentially precipitated by moderate to severe acute mountain sickness, and an apparent hyperglycemic effect of acetazolamide. Individuals with type 1 diabetes traveling to altitude and their physicians should be vigilant for this complication and should be aware of the effects of conventional first-line therapies for acute mountain sickness on insulin requirement, glycemic control, and preexisting microvascular diabetes complications.

  20. Effects of exercise and hypoxia on heart rate variability and acute mountain sickness.

    PubMed

    Mairer, K; Wille, M; Grander, W; Burtscher, M

    2013-08-01

    Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. Exercise, a characteristic feature of hiking and mountaineering, has been suggested to exacerbate AMS prevalence and to cause modifications of the autonomic nervous system. A reduction of the heart rate variability (HRV) is a common finding during acute hypoxia, however characteristics of HRV during exercise in subjects suffering from AMS are unknown. Therefore, the aim of the present study was to investigate the effects of acute normobaric hypoxia (FiO2=11.0% ≙ 5 500 m) at rest (PHE) and during exercise (AHE) on the cardiac autonomic function and the development of AMS in 20 healthy, male individuals. HRV recordings were performed during normoxia and after 2, 4, 6 and 8 h in hypoxia during PHE and AHE, respectively. AMS was assessed using the Lake Louise Score. During PHE 50% of participants developed AMS and 70% during AHE (p=0.22). The analysis of HRV data showed a significant reduction of total power (TP), high frequency (HF) and low frequency (LF) components and an increase of the LF:HF ratio during PHE, however without further modification during AHE. Exercise did not increase AMS prevalence or severity, but increased "non-gastrointestinal" symptoms including headache, fatigue and dizziness. HRV indices were not related to the overall incidence of AMS or the development of "non-gastrointestinal" symptoms but we detected significant correlations between gastrointestinal complaints and HRV components. Thus, we suggest that the cardiac autonomic modulation during acute normobaric hypoxia does not play an important role in the development of AMS, but seems to be related to gastrointestinal complaints at high altitude. However, the influence of moderate exercise on HRV and AMS is minor, only "non-GI" symptoms seem to be exacerbated when exercise is applied. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Non-high altitude methods for rapid screening of susceptibility to acute mountain sickness

    PubMed Central

    2013-01-01

    Background Acute mountain sickness (AMS) refers to the cerebral abnormalities typically triggered by exposure to hypobaric hypoxia at high altitude. Although AMS is not often life threatening, it can seriously impact health quality and decrease productivity. Thus, detection of potential susceptibility to AMS has become important for people arriving at high-altitude plateaus for the first time, including laborers and military staff. The aim of this review was to examine techniques which efficiently assess the susceptibility to AMS prior to exposure to high altitude. Methods By searching online databases, we retrieved studies with associations between AMS and methods to detect the susceptible people who were not exposed to high altitudes. Studies reporting significant correlation coefficients between screening methods and AMS scores were included. Results Several screening techniques of AMS susceptibility were found including cold pressor test, heart rate variability, and lung functions. Of these markers, heart rate variability was positively associated with AMS scores, while the rest were negatively associated with AMS scores. Conclusions We identified three physiological markers that were significantly associated with the risk of AMS. Although it is well known that simple sea level tests are not really helpful in predicting AMS currently, these markers, to some degree, may be employed as references in predicting susceptibility. PMID:24079477

  2. Reversible Brain Abnormalities in People Without Signs of Mountain Sickness During High-Altitude Exposure

    PubMed Central

    Fan, Cunxiu; Zhao, Yuhua; Yu, Qian; Yin, Wu; Liu, Haipeng; Lin, Jianzhong; Yang, Tianhe; Fan, Ming; Gesang, Luobu; Zhang, Jiaxing

    2016-01-01

    A large proportion of lowlanders ascending to high-altitude (HA) show no signs of mountain sickness. Whether their brains have indeed suffered from HA environment and the persistent sequelae after return to lowland remain unknown. Thirty-one sea-level college students, who had a 30-day teaching on Qinghai-Tibet plateau underwent MRI scans before, during, and two months after HA exposure. Brain volume, cortical structures, and white matter microstructure were measured. Besides, serum neuron-specific enolase (NSE), C-reactive protein, and interleukin-6 and neuropsychiatric behaviors were tested. After 30-day HA exposure, the gray and white matter volumes and cortical surface areas significantly increased, with cortical thicknesses and curvatures changed in a wide spread regions; Anisotropy decreased with diffusivities increased in multiple sites of white matter tracts. Two months after HA exposure, cortical measurements returned to basal level. However, increased anisotropy with decreased diffusivities was observed. Behaviors and serum inflammatory factor did not significant changed during three time-point tests. NSE significantly decreased during HA but increased after HA exposure. Results suggest brain swelling occurred in people without neurological signs at HA, but no negative sequelae in cortical structures and neuropsychiatric functions were left after the return to lowlands. Reoxygenation changed white matter microstructure. PMID:27633944

  3. MRI evidence: acute mountain sickness is not associated with cerebral edema formation during simulated high altitude.

    PubMed

    Mairer, Klemens; Göbel, Markus; Defrancesco, Michaela; Wille, Maria; Messner, Hubert; Loizides, Alexander; Schocke, Michael; Burtscher, Martin

    2012-01-01

    Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. However, the underlying mechanisms causing the symptoms of AMS are still unknown. It has been suggested that AMS is a mild form of high-altitude cerebral edema both sharing a common pathophysiological mechanism. We hypothesized that brain swelling and consequently AMS development is more pronounced when subjects exercise in hypoxia compared to resting conditions. Twenty males were studied before and after an eight hour passive (PHE) and active (plus exercise) hypoxic exposure (AHE) (F(i)O(2) = 11.0%, P(i)O(2)∼80 mmHg). Cerebral edema formation was investigated with a 1.5 Tesla magnetic resonance scanner and analyzed by voxel based morphometry (VBM), AMS was assessed using the Lake Louise Score. During PHE and AHE AMS was diagnosed in 50% and 70% of participants, respectively (p>0.05). While PHE slightly increased gray and white matter volume and the apparent diffusion coefficient, these changes were clearly more pronounced during AHE but were unrelated to AMS. In conclusion, our findings indicate that rest and especially exercise in normobaric hypoxia are associated with accumulation of water in the extracellular space, however independent of AMS development. Thus, it is suggested that AMS and HACE do not share a common pathophysiological mechanism.

  4. Factors associated with acute mountain sickness in young Chinese men on entering highland areas.

    PubMed

    Li, Xiaoxiao; Tao, Fasheng; You, Haiyan; Pei, Tao; Gao, Yuqi

    2015-03-01

    The aim of this study was to explore the prediction factors for incidence of acute mountain sickness (AMS) in young males newly entering highland areas. A retrospective study of 4367 records of male highland soldiers from 2000 to 2005 was done. The factors were tested by logistic regression. After selection by univariate model, ethnicity, altitude, season, deployment type, and prophylaxis were inserted into a multivariate model. The adjusted odds ratio (AOR) was 0.078 for Tibetan compared with Han. AORs for altitudes 3600 to 3700, 4000 to 4300, and 4600 to 4700 m versus 2900 to 3100 m were 4.490, 4.532, and 4.964, respectively. AOR for cold season versus warm season was 1.332. AORs for emergency land deployment and air deployment versus normal land deployment were 2.261 and 1.614, respectively. The AOR was 0.741 for prophylaxis versus none. The area under receiver operating characteristic curve was 0.731 (optimal cutoff = 0.370). Adjusting for altitude, risk factors that contributed to AMS were being non-Tibetan, cold season, greater speed of transport, emergency conditions, and without prophylaxis. The model established is acceptable for assisting AMS prediction. © 2011 APJPH.

  5. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness.

    PubMed

    Wagner, Dale R; Tatsugawa, Kevin; Parker, Daryl; Young, Troy A

    2007-01-01

    Acute mountain sickness (AMS) is a common condition that affects people that ascend too rapidly to high altitude. It is typically assessed with the Lake Louise AMS Self-report Score (LLSelf) that uses a categorical numeric rating scale to answer five questions addressing AMS-related symptoms, such as headache. A 100-mm visual analog scale (VAS) is commonly used to assess subjective phenomena such as pain, but this scale has never been used for the self-assessment of AMS. The purpose of this study was to compare a VAS score to the total LLSelf and to evaluate the test-retest and interrater reliability of the VAS when used as an assessment of AMS. Participants (N = 356) completed both the LLSelf and the VAS on the summit of Mt. Whitney (4419 m). There was a significant relationship (r = 0.65, p < 0.01) between the LLSelf (2.8 +/- 2.0, mean +/- SD) and the VAS (14.4 +/- 14.1 mm). Fifty-seven participants were randomly selected for reliability testing of the VAS. Both test-retest reliability (ICC = 0.996, 95% CI = 0.992 to 0.998) and interrater reliability (ICC = 1.000, 95% CI = 0.999 to 1.000) were high. The mean difference in the VAS score between tests was <1 mm, as was the difference between raters. These results demonstrate excellent reliability for the VAS as an assessment of AMS.

  6. Variables contributing to acute mountain sickness on the summit of Mt Whitney.

    PubMed

    Wagner, Dale R; Fargo, Jamison D; Parker, Daryl; Tatsugawa, Kevin; Young, Troy A

    2006-01-01

    The interaction of 15 variables representing physical characteristics, previous altitude exposure, and ascent data was analyzed to determine their contribution to acute mountain sickness (AMS). Questionnaires were obtained from 359 volunteers upon reaching the summit of Mt Whitney (4419 m). Heart rate and arterial oxygen saturation were measured with a pulse oximeter, and AMS was identified by Lake Louise Self-Assessment scoring. Multiple logistic regression analysis was used to identify significant protective and risk factors for AMS. Thirty-three percent of the sample met the criteria for AMS. The odds of experiencing AMS were greater for those who reported a previous altitude illness (adjusted odds ratio [OR] = 2.00, P < .01) or who were taking analgesics during the ascent (adjusted OR = 2.09, P < .01). Odds for AMS decreased with increasing age (adjusted OR = 0.82, P < .0001), a greater number of climbs above 3000 m in the past month (adjusted OR = 0.92, P < .05), and use of acetazolamide during the ascent (adjusted OR = 0.33, P < .05). The significant determinants of AMS on the summit of Mt Whitney were age, a history of altitude illness, number of climbs above 3000 m in the past month, and use of acetazolamide and analgesics during ascent.

  7. Influence of Acute Normobaric Hypoxia on Hemostasis in Volunteers with and without Acute Mountain Sickness

    PubMed Central

    Schaber, Marc; Leichtfried, Veronika; Fries, Dietmar; Wille, Maria; Gatterer, Hannes; Faulhaber, Martin; Würtinger, Philipp; Schobersberger, Wolfgang

    2015-01-01

    Introduction. The aim of the present study was to investigate whether a 12-hour exposure in a normobaric hypoxic chamber would induce changes in the hemostatic system and a procoagulant state in volunteers suffering from acute mountain sickness (AMS) and healthy controls. Materials and Methods. 37 healthy participants were passively exposed to 12.6% FiO2 (simulated altitude hypoxia of 4,500 m). AMS development was investigated by the Lake Louise Score (LLS). Prothrombin time, activated partial thromboplastin time, fibrinogen, and platelet count were measured and specific methods (i.e., thromboelastometry and a thrombin generation test) were used. Results. AMS prevalence was 62.2% (LLS cut off of 3). For the whole group, paired sample t-tests showed significant increase in the maximal concentration of generated thrombin. ROTEM measurements revealed a significant shortening of coagulation time and an increase of maximal clot firmness (InTEM test). A significant increase in maximum clot firmness could be shown (FibTEM test). Conclusions. All significant changes in coagulation parameters after exposure remained within normal reference ranges. No differences with regard to measured parameters of the hemostatic system between AMS-positive and -negative subjects were observed. Therefore, the hypothesis of the acute activation of coagulation by hypoxia can be rejected. PMID:26451374

  8. Incidence and severity of acute mountain sickness and associated symptoms in children trekking on Xue Mountain, Taiwan.

    PubMed

    Cheng, Fei-Ying; Jeng, Mei-Jy; Lin, Yin-Chou; Wang, Shih-Hao; Wu, Shih-Hao; Li, Wen-Cheng; Huang, Kuo-Feng; Chiu, Te-Fa

    2017-01-01

    Acute mountain sickness (AMS) occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher. The aim of this study was to examine the incidence and severity of AMS and associated symptoms in children. The prospective observational study included 197 healthy, non-acclimatized 11 and 12-year-old children trekking the round-trip from the trailhead to the summit of Xue Mountain, Taiwan (2,179 m to 3,886 m) over 3 days. AMS was evaluated at Qika Hut (2,460 m) on Day 1, at Sanliujiu Hut on Day 2 (3,100 m), and at the same altitude (3,100 m) after reaching the summit on Day 3. We used the Lake Louise Score (LLS) to diagnose AMS and record daily AMS-associated symptoms. We gave acetazolamide to children with mild to moderate AMS. Dexamethasone was reserved for individuals suffering from severe AMS. Acetaminophen was administrated to children with headache, and metoclopramide for those with nausea or vomiting. There were 197 subjects eligible for analysis. The overall incidence of AMS was 40.6%, which was higher in males and in subjects with a higher body mass index (BMI) (p < 0.05). The prevalence of AMS on Day 1 was 5.6%, which was significantly lower than that on Day 2 (29.4%) and Day 3 (23.4%). The mean LLS of all subjects was 1.77 ± 2.08. The overall incidence of severe AMS (LLS ≥ 5) was 12.5%. The mean LLS of the AMS group (3.02 ± 2.46) was significantly higher than that of the non-AMS group (0.92 ± 1.16, p < 0.001). Among the AMS group, the mean LLS was 1.00 ± 1.55 on Day 1, 4.09 ± 1.97 on Day 2, and 3.98 ± 2.42 on Day 3. The most common symptom was sleep disturbance followed by dizziness, and headache. The prevalence of headache was 46.2% on Day 2 at 3,100 m, and 31.3% on Day 3 at the same altitude after climbing the summit (3,886 m). Males experienced significantly more headache and fatigue than females (p < 0.05). The LLS and prevalence of all AMS symptoms were significantly higher in the AMS than the non-AMS group (p < 0

  9. Effect of Intravenous Iron Supplementation on Acute Mountain Sickness: A Preliminary Randomized Controlled Study

    PubMed Central

    Ren, Xuewen; Zhang, Qiuying; Wang, Hao; Man, Chunyan; Hong, Heng; Chen, Li; Li, Tanshi; Ye, Ping

    2015-01-01

    Background The aim of this study was to assess the role of intravenous iron supplementation in the prevention of AMS. Material/Methods This was a randomized, double-blinded, placebo-controlled study. Forty-one (n=41) healthy Chinese low-altitude inhabitants living in Beijing, China (altitude of about 50 meters) were randomly assigned into intravenous iron supplementation (ISS group; n=21) and placebo (CON group; n=20) groups. Participants in the ISS group received iron sucrose supplement (200 mg) before flying to Lhasa, China (altitude of 4300 meters). Acute mountain sickness (AMS) severity was assessed with the Lake Louise scoring (LLS) system within 5 days after landing on the plateau (at high altitude). Routine check-ups, clinical biochemistry, and blood tests were performed before departure and 24 h after arrival. Results A total of 38 participants completed the study (ISS group: n=19; CON group: n=19). The rate of subjects with AMS (LLS>3) was lower in the ISS group compared with the CON group, but no significant differences were obtained (P>0.05). There were no differences in patients’ baseline characteristics. The physiological indices were similar in both groups except for serum iron concentrations (19.44±10.02 vs. 85.10±26.78 μmol/L) and transferrin saturation rates (28.20±12.14 vs. 68.34±33.12%), which were significantly higher in the ISS group (P<0.05). Finally, heart rate was identified as a contributing factor of LLS. Conclusions These preliminary findings suggest that intravenous iron supplementation has no significant protective effect on AMS in healthy Chinese low-altitude inhabitants. PMID:26175087

  10. Nrf2 Activation: A potential strategy for the prevention of Acute Mountain Sickness

    PubMed Central

    Lisk, Christina; McCord, Joe; Bose, Swapan; Sullivan, Tim; Loomis, Zoe; Nozik-Grayck, Eva; Schroeder, Thies; Hamilton, Karyn; Irwin, David C.

    2014-01-01

    Introduction Reactive oxygen species (ROS) formed during acute high altitude exposure contributes to cerebral vascular leak and development of acute mountain sickness (AMS). Nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2) is a transcription factor that regulates expression of greater than 90% of antioxidant genes, but prophylactic treatment with Nrf2 activators has not yet been tested as an AMS therapy. We hypothesized that prophylactic activation of the antioxidant genome with Nrf2 activators would attenuate high altitude-induced ROS formation and cerebral vascular leak, and that some drugs currently used to treat AMS symptoms have an additional trait of Nrf2 activation. Methods Drugs commonly used to treat AMS were screened with a luciferase reporter cell system for their effectiveness to activate Nrf2, as well as tested for their ability to decrease high altitude cerebral vascular leak in vivo. Compounds that showed favorable results for Nrf2 activation from our screen and attenuated high altitude cerebral vascular leak in vivo were further tested in brain microvascular endothelial cells (BMEC) to determine if they attenuated hypoxia-induced ROS production and monolayer permeability. Results Of 9 drugs tested, with the exception of dexamethasone, only drugs that showed the ability to activate Nrf2 (Protandim, methazolamide, nifedipine, amlodipine, ambrisentan, and sitaxentan) decreased high altitude-induced cerebral vascular leak in vivo. In vitro, Nrf2 activation in BMEC prior to 24 h hypoxia exposure attenuated hypoxic-induced hydrogen peroxide production and permeability. Conclusions Prophylactic Nrf2 activation is effective at reducing brain vascular leak from acute high altitude exposures. Compared to acetazolamide, methazolamide may offer better protection against AMS. Nifedipine, in addition to its known vasodilatory activities in the lung and protection against high altitude pulmonary edema, may provide protection against brain vascular leak

  11. Nrf2 activation: a potential strategy for the prevention of acute mountain sickness.

    PubMed

    Lisk, Christina; McCord, Joe; Bose, Swapan; Sullivan, Tim; Loomis, Zoe; Nozik-Grayck, Eva; Schroeder, Thies; Hamilton, Karyn; Irwin, David C

    2013-10-01

    Reactive oxygen species (ROS) formed during acute high altitude exposure contribute to cerebral vascular leak and development of acute mountain sickness (AMS). Nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2) is a transcription factor that regulates expression of greater than 90% of antioxidant genes, but prophylactic treatment with Nrf2 activators has not yet been tested as an AMS therapy. We hypothesized that prophylactic activation of the antioxidant genome with Nrf2 activators would attenuate high-altitude-induced ROS formation and cerebral vascular leak and that some drugs currently used to treat AMS symptoms have an additional trait of Nrf2 activation. Drugs commonly used to treat AMS were screened with a luciferase reporter cell system for their effectiveness to activate Nrf2, as well as being tested for their ability to decrease high altitude cerebral vascular leak in vivo. Compounds that showed favorable results for Nrf2 activation from our screen and attenuated high altitude cerebral vascular leak in vivo were further tested in brain microvascular endothelial cells (BMECs) to determine if they attenuated hypoxia-induced ROS production and monolayer permeability. Of nine drugs tested, with the exception of dexamethasone, only drugs that showed the ability to activate Nrf2 (Protandim, methazolamide, nifedipine, amlodipine, ambrisentan, and sitaxentan) decreased high-altitude-induced cerebral vascular leak in vivo. In vitro, Nrf2 activation in BMECs before 24h hypoxia exposure attenuated hypoxic-induced hydrogen peroxide production and permeability. Prophylactic Nrf2 activation is effective at reducing brain vascular leak from acute high altitude exposures. Compared to acetazolamide, methazolamide may offer better protection against AMS. Nifedipine, in addition to its known vasodilatory activities in the lung and protection against high altitude pulmonary edema, may provide protection against brain vascular leak as well. Copyright © 2013

  12. Continuous positive airway pressure treatment for acute mountain sickness at 4240 m in the Nepal Himalaya.

    PubMed

    Johnson, Pamela L; Johnson, Claire C; Poudyal, Prasanta; Regmi, Nirajan; Walmsley, Megan A; Basnyat, Buddha

    2013-09-01

    Acute mountain sickness (AMS) is very common at altitudes above 2500 m. There are few treatment options in the field where electricity availability is limited, and medical assistance or oxygen is unavailable or difficult to access. Positive airway pressure has been used to treat AMS at 3800 m. We hypothesized that continuous positive airway pressure (CPAP) could be used under field conditions powered by small rechargeable batteries. Methods Part 1. 5 subjects trekked to 3500 m from 2800 m in one day and slept there for one night, ascending in the late afternoon to 3840 m, where they slept using CPAP 6-7 cm via mask. The next morning they descended to 3500 m, spent the day there, ascended in late afternoon to 3840 m, and slept the night without CPAP. Continuous overnight oximetry was recorded and the Lake Louise questionnaire for AMS administered both mornings. Methods Part 2. 14 trekkers with symptoms of AMS were recruited at 4240 m. All took acetazolamide. The Lake Louise questionnaire was administered, oximetry recorded, and CPAP 6-7 cm was applied for 10-15 min. CPAP was used overnight and oximetry recorded continuously. In the morning the Lake Louise questionnaire was administered, and oximetry recorded for 10-15 min. The equipment used in both parts was heated, humidified Respironics RemStar® machines powered by Novuscell™ rechargeable lithium ion batteries. Oximetry was recorded using Embletta™ PDS. Results Part 1. CPAP improved overnight Sao2 and eliminated AMS symptoms in the one subject who developed AMS. CPAP was used for 7-9 h and the machines operated for >8 h using the battery. Results Part 2. CPAP use improved Sao2 when used for 10-15 min at the time of recruitment and overnight CPAP use resulted in significantly reduced AMS symptoms. Conclusion. CPAP with rechargeable battery may be a useful treatment option for trekkers and climbers who develop AMS.

  13. Incidence of acute mountain sickness in UK Military Personnel on Mount Kenya.

    PubMed

    Hazlerigg, Antonia; Woods, D R; Mellor, A J

    2016-12-01

    Acute mountain sickness (AMS) is a common problem of trekkers to high altitude. The UK military train at high altitude through adventurous training (AT) or as exercising troops. The ascent of Point Lenana at 4985 m on Mount Kenya is frequently attempted on AT. This study sought to establish the incidence of AMS within this population, to aid future planning for military activities at altitude. A voluntary questionnaire was distributed to all British Army Training Unit Kenya based expeditions attempting to ascend Mount Kenya during the period from February to April 2014. The questionnaire included twice daily Lake Louise and Borg (perceived exertion scale) self-scoring. All expeditions were planned around a 5-day schedule, which included reserve time for acclimatisation, illness and inclement weather. Data were collected on 47 participants, 70% of whom reached the summit of Point Lenana. 62% (29/47) self-reported AMS (defined as Lake Louise score (LLS) ≥3) on at least one occasion during the ascent, and 34% (10/29) suffered severe AMS (LLS ≥6). Those who attempted the climb within 2 weeks of arrival in Kenya had a higher incidence of AMS (12/15 (80%) vs 17/32 (53%), p=0.077). Participants recording a high Borg score were significantly more likely to develop AMS (16/18 vs 9/21, p=0.003). This represents the first informative dataset for Mount Kenya ascents and altitude. The incidence of AMS during AT on Mount Kenya using this ascent profile is high. Adapting the current ascent profile, planning the ascent after time in country and reducing perceived exertion during the trek may reduce the incidence of AMS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Physiological variables associated with the development of acute mountain sickness at the South Pole

    PubMed Central

    Harrison, Michael F; Anderson, Paul J; Miller, Andrew D; O'Malley, Kathy A; Richert, Maile L; Johnson, Jacob B; Johnson, Bruce D

    2013-01-01

    Exposure to altitudes >2500 m can result in acute mountain sickness (AMS), a mild and usually self-limiting condition. Research has attempted to identify factors associated with developing AMS without controlling important factors related to the ascent or collecting a comprehensive set of variables. Objectives The Antarctic Study of Altitude Physiology (ASAP) investigated variables associated with the development of AMS in adults experiencing rapid passive transport to altitude by airplane. Design Our prospective observational trial collected data, including personal history, anthropometrics, vital signs, blood samples and pulmonary function, at sea level and at altitude. Statistical analysis utilised independent sample t tests to investigate between-group differences (p<0.05) and a forward, step-wise binary logisitic regression analysis was performed. Participants Of 248 eligible ASAP participants, those who did not use acetazolamide (N=98) were included in the present analysis. Primary outcome measures The diagnosis of AMS using the Lake Louise Symptom Score. Results Analysis of participants not using acetazolamide (n=90) found 30 participants developed AMS and 60 participants did not. Estimated plasma volume decreased significantly at altitude (p=0.025) in the AMS group as compared with the No AMS group while body weight did not change (p=0.125). Serum sodium (p=0.045) and low-density lipoprotein (LDL) (p=0.049) levels were higher in the No AMS group. A logistic regression analysis emphasised the contributions of LDL and eosinophil levels in the development of AMS. Conclusions These results suggest that the body water regulation and inflammation are key factors in AMS development when all other factors such as the level of physical exertion during ascent, the rate and magnitude of ascent and the use of acetazolamide are controlled. PMID:23869103

  15. Symptoms of infection and acute mountain sickness; associated metabolic sequelae and problems in differential diagnosis.

    PubMed

    Bailey, Damian M; Davies, Bruce; Castell, Linda M; Collier, David J; Milledge, James S; Hullin, David A; Seddon, Paul S; Young, Ian S

    2003-01-01

    Infections and acute mountain sickness (AMS) are common at high altitude, yet their precise etiologies remain elusive and the potential for differential diagnosis is considerable. The present study was therefore designed to compare clinical nonspecific symptoms associated with these pathologies and basic changes in free radical and amino-acid metabolism. Nineteen males were examined at rest and after maximal exercise at sea level before (SL(1)/SL(2)) and following a 20 +/- 5 day ascent to Kanchenjunga base camp located at 5100 m (HA). Four subjects with symptoms consistent with an ongoing respiratory and recent gastrointestinal infection were also diagnosed with clinical AMS on the evening of day 1 at HA. These and six other subjects recovering from symptoms consistent with a respiratory infection presented with a greater increase (HA minus SL(1)) in AMS scores and resting venous concentration of lipid hydroperoxides (LH) and in total creatine phosphokinase and ratio of free tryptophan/branched chain amino acids, and greater decrease in glutamine (Gln) compared to healthy controls (n = 9, p < 0.05). The decrease in Gln was consistently related to the altitude/exercise-induced increase in LH (r = -0.69/r = -0.45; p < 0.05) and altitude-induced increase in myoglobin (r = -0.73, p < 0.05). These findings highlight the potential for the misdiagnosis of altitude illness due to the similarity of nonspecific constitutional symptoms associated with infection and AMS. Both conditions were characterized by parallel changes in peripheral biomarkers related to free-radical, skeletal muscle damage and amino acid metabolism. While clearly not establishing cause and effect, free radical-mediated changes in peripheral amino acid metabolism known to influence immune and cerebral serotoninergic function may enhance susceptibility to and/or delay recovery from altitude illness.

  16. Polymorphisms of hypoxia-related genes in subjects susceptible to acute mountain sickness.

    PubMed

    Ding, Hui; Liu, Qiuling; Hua, Minglei; Ding, Mengjiang; Du, Haike; Zhang, Weilong; Li, Zengde; Zhang, Jianpeng

    2011-01-01

    The occurrence of acute mountain sickness (AMS), which develops in some individuals who ascend to altitudes above 2,500 m, may be associated with 4 hypoxia-related genes (HIF-1, VEGFA, HSP-70 and eNOS). The aim of our study was to investigate the potential role of the 4 hypoxia-related genes in AMS pathogenesis. We therefore evaluated single-nucleotide polymorphisms (SNPs) of the genes in an association study using a case-control design. At an altitude of 4,600 m, 64 male Chinese patients with AMS, defined according to the Lake Louise consensus criteria, were compared to 64 Chinese men free of symptoms of AMS. Clinical data, such as age, history of diseases, oxygen saturation (SpO(2)) and heart rate, were obtained. Genotypes of selected SNPs of these genes in patients were compared with those in controls. The mean SpO(2) and heart rate of the AMS and control groups were similar before ascent to high altitude (p = 0.79, p = 0.62) but, 24 h after ascent, the mean SpO(2) of the AMS group was significantly lower than that of the control group (p = 0.001), and the mean heart rate of the AMS group was significantly higher than that of the control group (p = 0.001). Twenty-eight of the 48 SNPs investigated were successfully genotyped, and SNP allele frequencies were obtained. The rs3025039 SNP and the haplotype (rs1413711, rs833070 and rs3025000) in the VEGFA gene were significantly associated with AMS (p = 0.0435 and 0.024, respectively). Our study demonstrates a possible association between the VEGFA gene and AMS. We conclude that VEGFA may have an important role in the AMS process. Copyright © 2011 S. Karger AG, Basel.

  17. Acute Mountain Sickness (AMS) Knowledge Among High Altitude Marathon Runners Competing in the Everest Marathon.

    PubMed

    Letchford, Abigail; Paudel, Rudra; Thomas, Owen D; Booth, Adam S; Imray, Christopher H E

    2016-03-01

    Although there are a number of studies on trekkers' knowledge of acute mountain sickness (AMS), there is little current literature on other groups at altitude, for example, marathon runners. Increased knowledge of AMS is associated with a lower incidence of AMS. The purpose of this study was to determine AMS knowledge of marathon runners with an aim to improve AMS information distribution. Incidence of AMS was also determined. Participants completed a self-assessment AMS knowledge questionnaire in Kathmandu before starting the acclimatization trek for the Tenzing Hillary Everest Marathon in Nepal. Lake Louise Scoring questionnaires were completed every day of the 12-day acclimatization trek. The majority (86%; 43 of 50) of participants obtained information about AMS before the marathon, with the Internet providing the most common source (50%; 25 of 50). Ninety-two percent (46 of 50) of participants rated their knowledge as average or above, and self-assessment correlated with knowledge questionnaire scores (r = .479, P < .001). However, 48% (24 of 50) did not know it was unsafe to ascend with mild AMS symptoms, and 66% (33 of 50) thought it was safe to go higher with symptoms relieved by medication. Only 50% (25 of 50) knew AMS could occur from 2500 m. Thirty-eight percent (19 of 50) of participants had AMS during the acclimatization trek, and 6% (3 of 50) experienced it during the race. This study adds to previous literature regarding knowledge and incidence of AMS. It further highlights that more needs to be done to improve knowledge through better information dissemination, with inclusion of scenario-based information to aid application of this knowledge to practical situations. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  18. Field Ultrasound Evaluation of Central Volume Status and Acute Mountain Sickness.

    PubMed

    Pitman, Justin T; Thapa, Ghan B; Harris, N Stuart

    2015-09-01

    To investigate whether ultrasonography can be used for field volume status assessment and to determine whether a detectable difference in intravascular volume exists in individuals with acute mountain sickness (AMS) compared with those without. Study was performed at the Himalayan Rescue Association Clinic in Manang, Nepal, located on the Annapurna trekking circuit at an altitude of 3519 m (11545 feet). A convenience sample was taken from individuals trekking over 5 to 8 days from 760 m (2490 feet) to 3519 m (11,545 feet), comparing asymptomatic trekkers vs those who experienced AMS. Subjects were evaluated for AMS based on the Lake Louise AMS Questionnaire (LLS ≥ 3 indicates AMS). After medical screening examination, both groups (control, n = 51; AMS, n = 18) underwent ultrasonography to obtain measurements of inferior vena cava collapsibility index (IVC CI) and left ventricular outflow tract velocity-time integral (LVOT VTI) before and after a passive leg raise (PLR) maneuver. There was no statistically significant difference between groups regarding change in heart rate before and after PLR, or IVC CI; however, there was a statistically significant greater increase in LVOT VTI after PLR maneuver in control group subjects compared with those with AMS (18.96% control vs 11.71% AMS; P < .01). Ultrasonography is a useful tool in the assessment of intravascular volume at altitude. In this sample, we found ultrasonographic evidence that subjects with AMS have a higher intravascular volume than asymptomatic individuals. These data support the hypothesis that individuals with AMS have decreased altitude-related diuresis compared with asymptomatic individuals. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  19. Prediction of acute mountain sickness by monitoring arterial oxygen saturation during ascent.

    PubMed

    Karinen, Heikki M; Peltonen, Juha E; Kähönen, Mika; Tikkanen, Heikki O

    2010-01-01

    Acute mountain sickness (AMS) is a common problem while ascending at high altitude. AMS may progress rapidly to fatal results if the acclimatization process fails or symptoms are neglected and the ascent continues. Extensively reduced arterial oxygen saturation at rest (R-Spo₂) has been proposed as an indicator of inadequate acclimatization and impending AMS. We hypothesized that climbers less likely to develop AMS on further ascent would have higher Spo₂ immediately after exercise (Ex-Spo₂) at high altitudes than their counterparts and that these postexercise measurements would provide additional value for resting measurements to plan safe ascent. The study was conducted during eight expeditions with 83 ascents. We measured R-Spo₂ and Ex-Spo₂ after moderate daily exercise [50 m walking, target heart rate (HR) 150 bpm] at altitudes of 2400 to 5300 m during ascent. The Lake Louise Questionnaire was used in the diagnosis of AMS. Ex-Spo₂ was lower at all altitudes among those climbers suffering from AMS during the expeditions than among those climbers who did not get AMS at any altitude during the expeditions. Reduced R-Spo₂ and Ex-Spo₂ measured at altitudes of 3500 and 4300 m seem to predict impending AMS at altitudes of 4300 m (p < 0.05 and p < 0.01) and 5300 m (both p < 0.01). Elevated resting HR did not predict impending AMS at these altitudes. Better aerobic capacity, younger age, and higher body mass index (BMI) were also associated with AMS (all p < 0.01). In conclusion, those climbers who successfully maintain their oxygen saturation at rest, especially during exercise, most likely do not develop AMS. The results suggest that daily evaluation of Spo₂ during ascent both at rest and during exercise can help to identify a population that does well at altitude.

  20. Effect of Intravenous Iron Supplementation on Acute Mountain Sickness: A Preliminary Randomized Controlled Study.

    PubMed

    Ren, Xuewen; Zhang, Qiuying; Wang, Hao; Man, Chunyan; Hong, Heng; Chen, Li; Li, Tanshi; Ye, Ping

    2015-07-15

    The aim of this study was to assess the role of intravenous iron supplementation in the prevention of AMS. This was a randomized, double-blinded, placebo-controlled study. Forty-one (n=41) healthy Chinese low-altitude inhabitants living in Beijing, China (altitude of about 50 meters) were randomly assigned into intravenous iron supplementation (ISS group; n=21) and placebo (CON group; n=20) groups. Participants in the ISS group received iron sucrose supplement (200 mg) before flying to Lhasa, China (altitude of 4300 meters). Acute mountain sickness (AMS) severity was assessed with the Lake Louise scoring (LLS) system within 5 days after landing on the plateau (at high altitude). Routine check-ups, clinical biochemistry, and blood tests were performed before departure and 24 h after arrival. A total of 38 participants completed the study (ISS group: n=19; CON group: n=19). The rate of subjects with AMS (LLS>3) was lower in the ISS group compared with the CON group, but no significant differences were obtained (P>0.05). There were no differences in patients' baseline characteristics. The physiological indices were similar in both groups except for serum iron concentrations (19.44±10.02 vs. 85.10±26.78 μmol/L) and transferrin saturation rates (28.20±12.14 vs. 68.34±33.12%), which were significantly higher in the ISS group (P<0.05). Finally, heart rate was identified as a contributing factor of LLS. These preliminary findings suggest that intravenous iron supplementation has no significant protective effect on AMS in healthy Chinese low-altitude inhabitants.

  1. Acute mountain sickness, inflammation, and permeability: new insights from a blood biomarker study

    PubMed Central

    Subudhi, Andrew W.; Wilson, Megan J.; Dimmen, Andrew C.; Pecha, Travis; Roach, Robert C.

    2011-01-01

    The pathophysiology of acute mountain sickness (AMS) is unknown. One hypothesis is that hypoxia induces biochemical changes that disrupt the blood-brain barrier (BBB) and, subsequently, lead to the development of cerebral edema and the defining symptoms of AMS. This study explores the relationship between AMS and biomarkers thought to protect against or contribute to BBB disruption. Twenty healthy volunteers participated in a series of hypobaric hypoxia trials distinguished by pretreatment with placebo, acetazolamide (250 mg), or dexamethasone (4 mg), administered using a randomized, double-blind, placebo-controlled, crossover design. Each trial included peripheral blood sampling and AMS assessment before (−15 and 0 h) and during (0.5, 4, and 9 h) a 10-h hypoxic exposure (barometric pressure = 425 mmHg). Anti-inflammatory and/or anti-permeability [interleukin (IL)-1 receptor agonist (IL-1RA), heat shock protein (HSP)-70, and adrenomedullin], proinflammatory (IL-6, IL-8, IL-2, IL-1β, and substance P), angiogenic, or chemotactic biomarkers (macrophage inflammatory protein-1β, VEGF, TNF-α, monocyte chemotactic protein-1, and matrix metalloproteinase-9) were assessed. AMS-resistant subjects had higher IL-1RA (4 and 9 h and overall), HSP-70 (0 h and overall), and adrenomedullin (overall) compared with AMS-susceptible subjects. Acetazolamide raised IL-1RA and HSP-70 compared with placebo in AMS-susceptible subjects. Dexamethasone also increased HSP-70 and adrenomedullin in AMS-susceptible subjects. Macrophage inflammatory protein-1β was higher in AMS-susceptible than AMS-resistant subjects after 4 h of hypoxia; dexamethasone minimized this difference. Other biomarkers were unrelated to AMS. Resistance to AMS was accompanied by a marked anti-inflammatory and/or anti-permeability response that may have prevented downstream pathophysiological events leading to AMS. Conversely, AMS susceptibility does not appear to be related to an exaggerated inflammatory response

  2. Elevated plasma cholecystokinin at high altitude: metabolic implications for the anorexia of acute mountain sickness.

    PubMed

    Bailey, D M; Davies, B; Milledge, J S; Richards, M; Williams, S R; Jordinson, M; Calam, J

    2000-01-01

    The aims of the present study were to measure the satiety neuropeptide cholecystokinin (CCK) in humans at terrestrial high altitude to investigate its possible role in the pathophysiology of anorexia, cachexia, and acute mountain sickness (AMS). Nineteen male mountaineers aged 38 +/- 12 years participated in a 20 +/- 5 day trek to Mt. Kanchenjunga basecamp (BC) located at 5,100 m, where they remained for 7 +/- 5 days. Subjects were examined at rest and during a maximal exercise test at sea-level before/after the expedition (SL1/SL2) and during the BC sojourn. There was a mild increase in Lake Louise AMS score from 1.1 +/- 1.2 points at SL1 to 2.3 +/- 2.3 points by the end of the first day at BC (P < 0.05). A marked increase in resting plasma CCK was observed on the morning of the second day at BC relative to sea-level control values (62.9 +/- 42.2 pmol/L(-1) vs. SL1: 4.3 +/- 8.3 pmol/L(-1), P < 0.05 vs. SL2: 26.5 +/- 25.2 pmol/L(-1), P < 0.05). Maximal exercise increased CCK by 78.5 +/- 24.8 pmol/L(-1), (P < 0.05 vs. resting value) during the SL1 test and increased the plasma concentration of non-esterified fatty acids and glycerol at BC (P < 0.05 vs. SL1/SL2). The CCK response was not different in five subjects who presented with anorexia on Day 2 compared with those with a normal appetite. While there was no relationship between the increase in CCK and AMS score at BC, a more pronounced increase in resting CCK was observed in subjects with AMS (> or =3 points at the end of Day 1 at BC) compared with those without (+98.9 +/- 1.4 pmol/L(-1) vs. +67.6 +/- 37.2 pmol/L(-1), P < 0.05). Caloric intake remained remarkably low during the stay at BC (8.9 +/- 1.4 MJ.d(-1)) despite a progressive decrease in total body mass (-4.5 +/- 2.1 kg after 31 +/- 13 h at BC, P < 0.05 vs. SL1/SL2), which appeared to be due to a selective loss of torso adipose tissue. These findings suggest that the satiogenic effects of CCK may have contributed to the observed caloric deficit and

  3. Quality of life and illness perception in working and sick-listed chronic RSI patients

    PubMed Central

    Frings-Dresen, Monique H. W.

    2007-01-01

    Objective To study differences between working and sick-listed chronic repetitive strain injury (RSI) patients in the Netherlands with respect to indices of quality of life and illness perception. Methods In a cross-sectional design, one questionnaire was sent to all 3,250 members of the national RSI patient association. For descriptive purposes, demographics, work status and complaint-related variables such as severity, type, duration, and extent of complaints were asked for. Indices of quality of life were assessed through seven SF-36 subscales (physical (role) functioning, emotional role functioning, social functioning, pain, mental health and vitality). A work-ability estimate and VAS scales were used to assess complaint-related decrease in quality of life. Illness perception was assessed through the brief illness perception questionnaire (IPQ-B). Working patients and sick-listed patients were identified. Tests between the two independent groups were performed and P-values < 0.01 were considered significant. Results Data from 1,121 questionnaires were used. Two-thirds of the respondents worked and one-third were sick-listed. Average duration of complaints was over 5 years in both groups. The sick-listed patients reported significantly more severe and extensive complaints than did the working patients. In addition, sick-listed patients reported significantly poorer mental health, physical (role) functioning, emotional role functioning, pain, vitality, and work-ability. With respect to illness perception, both groups showed the same concerns about their complaints, but sick-listed patients had significantly more distorted perceptions in their emotional response, identity, treatment control, personal control, timeline, and life consequences. Complaint-related decrease in quality of life was 31% in the working patients and 49% in the sick-listed patients. Conclusion The study found a greater number and severe complaints among sick-listed chronic RSI patients and

  4. Non-invasive Positive Pressure Ventilation during Sleep at 3800m: relationship to Acute Mountain Sickness and sleeping oxyhemoglobin saturation

    PubMed Central

    Johnson, PL; Popa, DA; Prisk, GK; Sullivan, CE; Edwards, N

    2014-01-01

    Background and objectives Ascent to high altitude results in hypobaric hypoxia and some individuals will develop Acute Mountain Sickness, which has been shown to be associated with low oxyhemoglobin saturation during sleep. Previous research has shown that positive end-expiratory pressure by use of expiratory valves in a face mask while awake, results in a reduction in AMS symptoms and higher oxyhemoglobin saturation. We aimed to test whether pressure ventilation during sleep would prevent AMS by keeping oxyhaemoglobin higher during sleep. Methods We compared sleeping oxyhemoglobin saturation and the incidence and severity of Acute Mountain Sickness in seven subjects sleeping for two consecutive nights at 3800m above sea level using either non-invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of Acute Mountain Sickness was assessed by administration of the Lake Louise questionnaire. Results We found significant increases in the mean and minimum sleeping oxyhemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation. Conclusion The use of positive pressure ventilation during sleep at 3800m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation. PMID:20051046

  5. Effect of hypohydration and altitude exposure on aerobic exercise performance and acute mountain sickness.

    PubMed

    Castellani, John W; Muza, Stephen R; Cheuvront, Samuel N; Sils, Ingrid V; Fulco, Charles S; Kenefick, Robert W; Beidleman, Beth A; Sawka, Michael N

    2010-12-01

    Hypoxia often causes body water deficits (hypohydration, HYPO); however, the effects of HYPO on aerobic exercise performance and prevalence of acute mountain sickness (AMS) at high altitude (ALT) have not been reported. We hypothesized that 1) HYPO and ALT would each degrade aerobic performance relative to sea level (SL)-euhydrated (EUH) conditions, and combining HYPO and ALT would further degrade performance more than one stressor alone; and 2) HYPO would increase the prevalence and severity of AMS symptoms. Seven lowlander men (25 ± 7 yr old; 82 ± 11 kg; mean ± SD) completed four separate experimental trials. Trials were 1) SL-EUH, 2) SL-HYPO, 3) ALT-EUH, and 4) ALT-HYPO. In HYPO, subjects were dehydrated by 4% of body mass. Subjects maintained hydration status overnight and the following morning entered a hypobaric chamber (at SL or 3,048 m, 27°C) where they completed 30 min of submaximal exercise immediately followed by a 30-min performance time trial (TT). AMS was measured with the Environmental Symptoms Questionnaire-Cerebral Score (AMS-C) and the Lake Louise Scoring System (LLS). The percent change in TT performance, relative to SL-EUH, was -19 ± 12% (334 ± 64 to 278 ± 87 kJ), -11 ± 10% (334 ± 64 to 293 ± 33 kJ), and -34 ± 22% (334 ± 64 to 227 ± 95 kJ), for SL-HYPO, ALT-EUH, and ALT-HYPO, respectively. AMS symptom prevalence was 2/7 subjects at ALT-EUH for AMS-C and LLS and 5/7 and 4/7 at ALT-HYPO for AMS-C and LLS, respectively. The AMS-C symptom severity score (AMS-C score) tended to increase from ALT-EUH to ALT-HYPO but was not significant (P = 0.07). In conclusion, hypohydration at 3,048 m 1) degrades aerobic performance in an additive manner with that induced by ALT; and 2) did not appear to increase the prevalence/severity of AMS symptoms.

  6. Visual analog scale (VAS) for assessment of acute mountain sickness (AMS) on Aconcagua.

    PubMed

    Van Roo, Jon D; Lazio, Matthew P; Pesce, Carlos; Malik, Sanjeev; Courtney, D Mark

    2011-03-01

    The Lake Louise AMS Self-Report Score (LLSelf) is a commonly used, validated assessment of acute mountain sickness (AMS). We compared LLSelf and visual analog scales (VAS) to quantify AMS on Aconcagua (6962 m). Prospective observational cohort study at Plaza de Mulas base camp (4365 m), Aconcagua Provincial Park, Argentina. Volunteers climbing in January 2009 were enrolled at base camp and ascended at their own pace. They completed the LLSelf, an overall VAS [VAS(o)], and 5 individual VAS [VAS(i)] corresponding to the items of the LLSelf when symptoms were maximal. Composite VAS [VAS(c)] was calculated as the sum of the 5 VAS(i). A total of 127 volunteers consented to the study. Response rate was 52.0%. AMS occurred in 77.3% of volunteers, while 48.5% developed severe AMS. Median (interquartile range, IQR) LLSelf was 4 (3-7). Median (IQR) VAS(o) was 36 mm (23-59). VAS(o) was linear and correlated with LLSelf: slope = 6.7 (95% CI: 4.4-9.0), intercept = 3.0 (95% CI: -10.0-16.1), ρ = 0.71, τ = 0.55, R(2) = 0.45, p < 0.001. Median (IQR) VAS(c) was 29 (13-44). VAS(c) was also linear and correlated with LLSelf: slope = 5.9 (95% CI: 4.9-6.9), intercept = -0.6 (95% CI: -6.3-5.1), ρ = 0.83, τ = 0.68, R(2) = 0.73, p < 0.001. The relationship between the 5 VAS(i) and LLSelf(i) was less significant and less linear than that between VAS(o), VAS(c), and LLSelf. While both VAS(o) and VAS(c) for assessment of AMS appear to be linear with respect to LLSelf, the amount of scatter within the VAS is considerable. The LLSelf remains the gold standard for the diagnosis of AMS. Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  7. REGIONAL CEREBRAL BLOOD FLOW DURING ACUTE HYPOXIA IN INDIVIDUALS SUSCEPTIBLE TO ACUTE MOUNTAIN SICKNESS

    PubMed Central

    Dyer, Edward AW; Hopkins, Susan R; Perthen, Joanna E; Buxton, Richard B; Dubowitz, David J

    2008-01-01

    Individuals susceptible to high altitude pulmonary edema show altered pulmonary vascular responses within minutes of exposure to hypoxia. We hypothesized that a similar acute-phase vulnerability to hypoxia may exist in the brain of individuals susceptible to acute mountain sickness (AMS). In established AMS and high-altitude cerebral edema, there is a propensity for vasogenic white matter edema. We therefore hypothesized that increased cerebral blood flow (CBF) during acute hypoxia would also be disproportionately greater in white matter (WM) than grey matter (GM) in AMS-susceptible subjects. We quantified regional CBF using arterial spin labeling MRI during 30-minutes hypoxia (FIO2=0.125) in 2 groups: AMS-susceptible (AMS-S, n=6) who invariably experienced AMS at altitude, and AMS-resistant (AMS-R, n=6) who never experienced AMS despite multiple rapid ascents. SaO2 during hypoxia did not differ between groups (AMS-S=87±4%, AMSR=89±3%, p=0.3). Steady-state whole-brain CBF increased in hypoxia (p<0.005), but did not differ between groups (Normoxia: AMS-S=42.7±14.0ml/100g/min, AMS-R=41.7±10.1ml/100g/min, Hypoxia: AMS-S=47.8±19.5ml/100g/min, AMS-R=48.2±10.1ml/100g/min, p=0.65), and cerebral oxygen delivery remained constant. The percent change in CBF did not differ between brain regions or between groups (although absolute CBF change was greater in GM): (GM: AMS-S=6.1±7.7ml/100g/min (10±11%), AMS-R=8.3±5.7ml/100g/min (17±11%) p=0.57; WM: AMS-S=4.3±5.1ml/100g/min (12±15%), AMS-R=4.8±2.9ml/100g/min (16±9%), p= 0.82). Conclusion: CBF increases in acute hypoxia, but is not different between WM and GM, irrespective of AMS susceptibility. Acute phase differences in regional CBF during acute hypoxia are not a primary feature of susceptibility to AMS. PMID:18088570

  8. Population level determinants of acute mountain sickness among young men: a retrospective study.

    PubMed

    Li, Xiaoxiao; Tao, Fasheng; Pei, Tao; You, Haiyan; Liu, Yan; Gao, Yuqi

    2011-09-28

    Many visitors, including military troops, who enter highland regions from low altitude areas may suffer from acute mountain sickness (AMS), which negatively impacts workable man-hours and increases healthcare costs. The aim of this study was to evaluate the population level risk factors and build a multivariate model, which might be applicable to reduce the effects of AMS on Chinese young men traveling to this region. Chinese highland military medical records were used to obtain data of young men (n = 3727) who entered the Tibet plateau between the years of 2006-2009. The relationship between AMS and travel profile, demographic characteristics, and health behaviors were evaluated by logistic regression. Univariate logistic models estimated the crude odds ratio. The variables that showed significance in the univariate model were included in a multivariate model to derive adjusted odds ratios and build the final model. Data corresponding to odd and even years (2 subsets) were analyzed separately and used in a simple cross-validation. Univariate analysis indicated that travel profile, prophylactic use, ethnicity, and province of birth were all associated with AMS in both subsets. In multivariate analysis, young men who traveled from lower altitude (600-800 m vs. 1300-1500 m, adjusted odds ratio (AOR) = 1.32-1.44) to higher altitudes (4100-4300 m vs. 2900-3100 m, AOR = 3.94-4.12; 3600-3700 m vs. 2900-3100 m, AOR = 2.71-2.74) by air or rapid land transport for emergency mission deployment (emergency land deployment vs. normal land deployment, AOR = 2.08-2.11; normal air deployment vs. normal land deployment, AOR = 2.00-2.20; emergency air deployment vs. normal land deployment, AOR = 2.40-3.34) during the cold season (cold vs. warm, AOR = 1.25-1.28) are at great risk for developing AMS. Non-Tibetan male soldiers (Tibetan vs. Han, AOR = 0.03-0.08), born and raised in lower provinces (eastern vs. northwestern, AOR = 1.32-1.39), and deployed without prophylaxis

  9. Endothelial selectins in acute mountain sickness and high-altitude pulmonary edema.

    PubMed

    Grissom, C K; Zimmerman, G A; Whatley, R E

    1997-12-01

    Mechanical or inflammatory injury to pulmonary endothelial cells may cause impaired pulmonary gas exchange in acute mountain sickness (AMS) and noncardiogenic pulmonary edema in high-altitude pulmonary edema (HAPE). This study was designed to determine whether markers of endothelial cell activation or injury, plasma E- and P-selectin, were increased after ascent to high altitude, in AMS or in HAPE. We collected clinical data and plasma specimens in control subjects at sea level and after ascent to 4,200 m, and in climbers with AMS or HAPE at 4,200 m. Data analysis was performed using standard nonparametric statistical methods, and results reported as mean+/-SD. National Park Service medical camp at 4,200 m on Mt. McKinley (Denali), Alaska. Blood samples and clinical data were collected from 17 healthy climbers at sea level and again after ascent to 4,200 m, and from a different group of 13 climbers with AMS and 8 climbers with HAPE at 4,200 m. Climbers with AMS were divided into normoxic (n=7) and hypoxemic (n=6) groups. Using an enzyme immunoassay technique, plasma E-selectin concentrations were found to be increased in the 17 control subjects after ascent to 4,200 m (17.2+/-8.2 ng/mL) as compared to sea level (12.9+/-8.2 ng/mL) (p=0.001). Plasma E-selectin concentrations were also increased in subjects with hypoxemic AMS (30.6+/-13.4 ng/mL) and HAPE (23.3+/-9.1 ng/mL) compared to control subjects at sea level (p=0.009). Increased plasma E-selectin concentration significantly correlated with hypoxemia (p=0.006). Plasma P-selectin concentrations were unchanged after ascent to 4,200 m and in subjects with AMS and HAPE. Because E-selectin is produced only by endothelial cells, increased plasma E-selectin after ascent to high altitude and in hypoxemic climbers with AMS and HAPE provides evidence that endothelial cell activation or injury is a component of hypoxic altitude illness.

  10. Improving medical students' attitudes towards the chronic sick: a role for social science research.

    PubMed

    Mullen, Kenneth; Nicolson, Malcolm; Cotton, Philip

    2010-11-22

    Many medical students are negatively disposed toward the elderly and chronic sick. The present study assessed the impact of a community-based teaching initiative, the Life History Project, on students' attitudes to these groups. A questionnaire including Likert based responses and free text comments was distributed to all first-year MBChB students after completion of their Life History coursework. Data was analysed using SPSS and content analysis. A high proportion of students believed the Life History Project had increased their understanding of both psychological and social aspects of health and illness and the role of the humanistic social sciences within this. We discovered that the Life History Project not only gave students first-hand experience of the elderly and chronic sick but also had a positive effect on their attitudes towards these groups. The qualitative free text comments corroborated these views. It is possible to positively influence medical students' attitudes towards these stigmatised groups; it is therefore important that we continue to enhance opportunities for learning about the impact of chronic illness on individuals and society throughout the curriculum.

  11. Risk determinants of acute mountain sickness in trekkers in the Nepali Himalaya: a 24-year follow-up.

    PubMed

    McDevitt, Marion; McIntosh, Scott E; Rodway, George; Peelay, Jitsupa; Adams, Doug L; Kayser, Bengt

    2014-06-01

    Exposure to altitude may lead to acute mountain sickness (AMS) in nonacclimatized individuals. We surveyed AMS prevalence and potential risk factors in trekkers crossing a 5400-m pass in Nepal and compared the results with those of 2 similar studies conducted 12 and 24 years earlier. In April 2010, 500 surveys were distributed to English-speaking trekkers at 3500 m on their way to 5400 m, of which 332 (66%) surveys were returned complete. Acute mountain sickness was quantified with the Lake Louise Scoring System (LLSS, cutoff ≥3 and ≥5) and the Environmental Statistical Questionnaire III AMS-C score (ESQ-III, cutoff ≥0.7). We surveyed demographics, body mass index (BMI), smoking habit, rate of ascent, awareness of AMS, and acetazolamide use. Prevalence of AMS was 22%, 23%, and 48% (ESQ-III ≥0.7, LLSS ≥5, and LLSS ≥3, respectively) lower when compared with earlier studies. Risk factors for AMS were younger age, female sex, higher BMI, and smoking habit. Forty-two percent had elementary knowledge about the risk and prevention of AMS. Forty-four percent used acetazolamide. Trekkers took longer to climb from 3500 to 5400 m than in earlier studies. Prevalence of AMS continued to decline over a period of 24 years, likely as a result of slower ascent and increased use of acetazolamide. The AMS risk factors of younger age, female sex, and high BMI are consistent with prior studies. Awareness of risk and prevention of AMS remains low, indicating an opportunity to better educate trekkers and potentially further reduce AMS prevalence. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  12. Chronic wasting disease in a Rocky Mountain elk.

    PubMed

    Ball, Katherine

    2002-11-01

    A 24-month-old Rocky Mountain elk was presented because of suspected chronic wasting disease (CWD). The animal was emaciated, had retained its winter hair, and had abnormal behavior patterns suggestive of CWD, including bruxism, ptyalism, and diminished flight zone size. Immunohistochemical analysis of the brain confirmed the diagnosis of CWD.

  13. High altitude headache and acute mountain sickness at moderate elevations in a military population during battalion-level training exercises.

    PubMed

    Norris, Jacob N; Viirre, Erik; Aralis, Hilary; Sracic, Michael K; Thomas, Darren; Gertsch, Jeffery H

    2012-08-01

    Few studies have evaluated high altitude headache (HAH) and acute mountain sickness (AMS) in military populations training at moderate (1,500-2,500 m) to high altitudes (>2,500 m). In the current study, researchers interviewed active duty personnel training at Marine Corps Mountain Warfare Training Center. Participants were asked about HAH and AMS symptoms, potential risk factors, and medications used. In a sample of 192 U.S. Navy and Marine Corps personnel, 14.6% reported AMS (Lake Louise Criteria > or = 3) and 28.6% reported HAH. Dehydration and recent arrival at altitude (defined as data collected on days 2-3) were significantly associated with AMS; decreased sleep allowance was significantly associated with HAH. Although ibuprofen/Motrin users were more likely to screen positive for AMS, among AMS-positive participants, ibuprofen/Motrin users had decreased likelihood of reporting robust AMS relative to non-ibuprofen/Motrin users (p < 0.01). These results suggest that maintenance of hydration and adequate sleep allowance may be critical performance requirements at altitude. Further, ibuprofen/Motrin may be a reasonable treatment for the symptoms of AMS and HAH, although further study is warranted.

  14. Chronic Physical Stress Does Not Interact with Epstein-Barr Virus (EBV)-Encoded Dutpase to Alter the Sickness Response

    PubMed Central

    Weil, Zachary M.; Abi Salloum, Bachir; Ariza, Maria Eugenia; Williams, Marshall; Reader, Brenda; Glaser, Ronald; Sheridan, John; Nelson, Randy J.

    2016-01-01

    Most adult humans have been infected with Epstein-Barr virus (EBV), which is thought to contribute to the development of chronic fatigue syndrome. Stress is known to influence the immune system and can exacerbate the sickness response. Although a role for psychological stress in the sickness response, particularly in combination with EBV-encoded deoxyuridine triphosphate nucleotidohydrolase (dUTPase) has been established, and the role of physical stressors in these interactions remains unspecified. In this study, we seek to determine the interaction of chronic physical (swim) stress and EBV-encoded dUTPase injection. We hypothesize that a chronic physical stressor will exacerbate the sickness response following EBV-encoded dUTPase injection. To test this hypothesis mice receive daily injections of EBV-encoded dUTPase or vehicle and are subjected to 15 min of swim stress each day for 14 days or left unmanipulated. On the final evening of injections mice undergo behavioral testing. EBV-encoded dUTPase injection alone produces some sickness behaviors. The physical swimming stress does not alter the sickness response. PMID:27175311

  15. Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence

    PubMed Central

    2012-01-01

    Background A waterborne outbreak of Giardia lamblia gastroenteritis led to a high prevalance of long-lasting fatigue and abdominal symptoms. The aim was to describe the clinical characteristics, disability and employmentloss in a case series of patients with Chronic Fatigue Syndrome (CFS) after the infection. Methods Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS. Fatigue was self-rated by the Fatigue Severity Scale (FSS). Physical and mental health status and functional impairment was measured by the Medical Outcome Severity Scale-short Form-36 (SF-36). The Hospital Anxiety and Depression Scale (HADS) was used to measure co-morbid anxiety and depression. Inability to work or study because of fatigue was determined by sickness absence certified by a doctor. Results A total of 58 (60%) out of 96 patients with long-lasting post-infectious fatigue after laboratory confirmed giardiasis were diagnosed with CFS. In all, 1262 patients had laboratory confirmed giardiasis. At the time of referral (mean illness duration 2.7 years) 16% reported improvement, 28% reported no change, and 57% reported progressive course with gradual worsening. Mean FSS score was 6.6. A distinctive pattern of impairment was documented with the SF-36. The physical functioning, vitality (energy/fatigue) and social functioning were especially reduced. Long-term sickness absence from studies and work was noted in all patients. Conclusion After giardiasis enteritis at least 5% developed clinical characteristics and functional impairment comparable to previously described post-infectious fatigue syndrome. PMID:22316329

  16. Sickness absence as a prognostic marker for common chronic conditions: analysis of mortality in the GAZEL study

    PubMed Central

    Kivimaki, Mika; Head, Jenny; Ferrie, Jane E.; Singh-Manoux, Archana; Westerlund, Hugo; Vahtera, Jussi; Leclerc, Annette; Melchior, Maria; Chevalier, Anne; Alexanderson, Kristina; Zins, Marie; Goldberg, Marcel

    2008-01-01

    Objectives To determine whether sickness absence is a prognostic marker in terms of mortality among people with common chronic conditions. Methods Prospective occupational cohort study of 13 077 men and 4871 women aged 37 to 51 from the National Gas and Electricity Company, France. Records of physician-certified sickness absences over a 3-year period were obtained from employers’ registers. Chronic conditions were assessed in annual surveys over the same period. The main outcome measure was all-cause mortality (803 deaths, mean follow-up after assessment of sickness absence, 13.9 years) Results In Cox proportional-hazard models adjusted for age, sex, socioeconomic position and co-morbidity, >28 annual sickness absence days vs no absence days was associated with an excess mortality risk among those with cancer (hazard ratio 5.4, 95% CI 2.2 to 13.1), depression (1.7, 1.1 to 2.8), chronic bronchitis/asthma (2.7, 1.6 to 4.6), and hypertension (1.6, 1.0 to 2.6). The corresponding hazard ratios for more than 5 long (>14 days) sickness absence episodes per 10 person-years vs no such episodes were 5.4 (2.2 to 13.1), 1.8 (1.3 to 2.7), 2.0 (1.3 to 3.2) and 1.8 (1.2 to 2.7), respectively. Areas under receiver-operating-characteristics curves for these absence measures varied between 0.56 and 0.73 indicating the potential of these measures to distinguish groups at high risk of mortality. The findings were consistent across sex, age and socioeconomic groups and in those with and without co-morbid conditions. Conclusion Data on sickness absence may provide useful prognostic information for common chronic conditions at the population level. PMID:18611969

  17. Behavioural alterations are independent of sickness behaviour in chronic experimental Chagas disease

    PubMed Central

    Vilar-Pereira, Glaucia; Ruivo, Leonardo Alexandre de Souza; Lannes-Vieira, Joseli

    2015-01-01

    The existence of the nervous form of Chagas disease is a matter of discussion since Carlos Chagas described neurological disorders, learning and behavioural alterations in Trypanosoma cruzi-infected individuals. In most patients, the clinical manifestations of the acute phase, including neurological abnormalities, resolve spontaneously without apparent consequence in the chronic phase of infection. However, chronic Chagas disease patients have behavioural changes such as psychomotor alterations, attention and memory deficits, and depression. In the present study, we tested whether or not behavioural alterations are reproducible in experimental models. We show that C57BL/6 mice chronically infected with the Colombian strain of T. cruzi (150 days post-infection) exhibit behavioural changes as (i) depression in the tail suspension and forced swim tests, (ii) anxiety analysed by elevated plus maze and open field test sand and (iii) motor coordination in the rotarod test. These alterations are neither associated with neuromuscular disorders assessed by the grip strength test nor with sickness behaviour analysed by temperature variation sand weight loss. Therefore, chronically T. cruzi-infected mice replicate behavioural alterations (depression and anxiety) detected in Chagas disease patients opening an opportunity to study the interconnection and the physiopathology of these two biological processes in an infectious scenario. PMID:26676323

  18. Incidence and predictors of acute mountain sickness among trekkers on Mount Kilimanjaro.

    PubMed

    Jackson, Stewart J; Varley, James; Sellers, Claudia; Josephs, Katherine; Codrington, Lucy; Duke, Georgina; Njelekela, Marina A; Drummond, Gordon; Sutherland, Andrew I; Thompson, A A Roger; Baillie, J Kenneth

    2010-01-01

    We investigated the incidence of AMS amongst a general population of trekkers on Mount Kilimanjaro, using the Lake Louise consensus scoring system (LLS). Additionally we examined the effect of prophylactic acetazolamide and different ascent profiles. Climbers on 3 different ascent itineraries were recruited. At 2743 m we recruited 177 participants (mean age 31, range [18-71]) who completed LLS together with an epidemiological questionnaire. At 4730 m participants (n=189, male=108, female=68, mean age 33, range [1871]) completed LLS, 136 of whom had been followed up from 2730 m. At 2743 m, 3% (5/177) of climbers were AMS positive, and 47% (89/189) of climbers from all itineraries were AMS positive at 4730 m. Of climbers attempting the Marangu itineraries, 33% (45/136) were taking acetazolamide. This group had a similar rate of AMS and no statistical difference in severity of LLS when compared with those not taking prophylactic drugs. We also did not demonstrate a difference between the incidence of AMS in climbers who did or did not take a rest day at 3700  m. However, there was a significant reduction in the incidence of AMS amongst pre-acclimatized subjects. Consistent with previous work, we found that the rate of AMS on Mount Kilimanjaro is high. Furthermore, at these fast ascent rates, there was no evidence of a protective effect of acetazolamide or a single rest day. There is a need to increase public awareness of the risks of altitude sickness and we advocate a pragmatic "golden rules" approach (http://www.altitude.org/altitude_sickness.php).

  19. What to do with chronically sick animals? Pastoralists’ management strategies in the far north region of Cameroon

    PubMed Central

    Profitós, Jessica M Healy; Moritz, Mark; Garabed, Rebecca B

    2014-01-01

    While the goal of African pastoralists is health and longevity of herd and household, some of their management strategies appear to counter this long-term goal. Pastoralists in the far north region of Cameroon, for example, do not always remove chronically sick animals from their herds, even though chronic diseases, such as brucellosis, are contagious and have the potential to cause fertility problems in the herd. We used ethnographic and epidemiologic methods to understand why pastoralists do not remove chronically sick animals and whether their management strategies have an impact on herd fertility. We used semi-structured interviews to collect data on pastoralists’ understandings of disease and its impacts on fertility as well as data on herd management. We compared these data with disease prevalence and herd fertility data to measure the effect of management strategies on herd fertility. We found that the percentage of chronically sick animals in a herd negatively correlated with herd fertility, but this was not true for the prevalence of brucellosis. Thus, preliminary examination of disease costs and benefits suggests that herders’ decisions to keep sick animals in their herds may lower herd fertility, but this is not due to brucellosis alone. The results of this study underline the complexity of infectious disease ecology in pastoral systems and the need for holistic and comprehensive studies of the ecology of infectious diseases in pastoral systems. PMID:25309717

  20. Continuous Positive Airway Pressure Treatment for Acute Mountain Sickness at 4240 m in the Nepal Himalaya

    PubMed Central

    Johnson, Claire C.; Poudyal, Prasanta; Regmi, Nirajan; Walmsley, Megan A.; Basnyat, Buddha

    2013-01-01

    Abstract Johnson, Pamela L., Claire C. Johnson, Prasanta Poudyal, Nirajan N. Regmi, Megan A. Walmsley, and Buddha Basnyat. Continuous positive airway pressure treatment for acute mountain sickness at 4240 m in the Nepal Himalaya. High Alt Med Biol 14:230–233, 2013.—Acute mountain sickness (AMS) is very common at altitudes above 2500 m. There are few treatment options in the field where electricity availability is limited, and medical assistance or oxygen is unavailable or difficult to access. Positive airway pressure has been used to treat AMS at 3800 m. We hypothesized that continuous positive airway pressure (CPAP) could be used under field conditions powered by small rechargeable batteries. Methods Part 1. 5 subjects trekked to 3500 m from 2800 m in one day and slept there for one night, ascending in the late afternoon to 3840 m, where they slept using CPAP 6–7 cm via mask. The next morning they descended to 3500 m, spent the day there, ascended in late afternoon to 3840 m, and slept the night without CPAP. Continuous overnight oximetry was recorded and the Lake Louise questionnaire for AMS administered both mornings. Methods Part 2. 14 trekkers with symptoms of AMS were recruited at 4240 m. All took acetazolamide. The Lake Louise questionnaire was administered, oximetry recorded, and CPAP 6–7 cm was applied for 10–15 min. CPAP was used overnight and oximetry recorded continuously. In the morning the Lake Louise questionnaire was administered, and oximetry recorded for 10–15 min. The equipment used in both parts was heated, humidified Respironics RemStar® machines powered by Novuscell™ rechargeable lithium ion batteries. Oximetry was recorded using Embletta™ PDS. Results Part 1. CPAP improved overnight Sao2 and eliminated AMS symptoms in the one subject who developed AMS. CPAP was used for 7–9 h and the machines operated for >8 h using the battery. Results Part 2. CPAP use improved Sao2 when used for 10–15

  1. Effect of Dexamethasone on Symptoms of Acute Mountain Sickness at Pikes Peak, Colorado (4300m),

    DTIC Science & Technology

    1986-05-01

    WORK UNIT NUMBERS U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760 3EI62777A879 64683304126 II. CONTROLLING OFFICE NAME AND...use of dexamethasone. Among these are whether the drug works in the actual mountain environment and what effect it has on normal acclimatization. The... antacids , and ventilation during rapid, active ascent of Mount Rainier. Aviat. Space Env iron. Med. 1983;54: 397-401. 18. Sampson JB, Cymerman A

  2. Scapular dyskinesis and SICK syndrome in patients with a chronic type III acromioclavicular dislocation. Results of rehabilitation.

    PubMed

    Carbone, Stefano; Postacchini, Roberto; Gumina, Stefano

    2015-05-01

    Scapular dyskinesis has been related to acromioclavicular injuries. A rehabilitation protocol has been studied in order to treat scapular dyskinesis, but it has not yet been evaluated. This rehabilitation programme was adopted to improve the shoulder function, thereby improving the scapular dyskinesis in patients with chronic acromioclavicular dislocation. Twenty-four patients diagnosed with chronic type III acromioclavicular dislocation and scapular dyskinesis that have already been conservatively treated were enrolled in the rehabilitation protocol and analysed. Fourteen of these patients had a Scapular Inferior Coracoid dysKinesis (SICK) Syndrome. The adopted rehabilitation protocol consisted of 12 strengthening and stretching exercises of the scapulae. The final follow-ups were performed after 6 weeks, 6 months and 12 months using clinical measurements of scapular position and clinical evaluation of the scapular motion. In order to evaluate the SICK scapula syndrome, we used the SICK Scapula Rating Scale. The shoulder function was evaluated with a Constant Score and a Subjective Shoulder Value. After 12 months, the follow-up concluded that the scapular dyskinesis was no longer present in 18/23 patients (78.2 %). SICK scapula syndrome was observed in 4/8 patients with a scapular malposition. The Scapula Rating Scale score in 4 patients with SICK scapula was 7.5 points. After 12 months of rehabilitation, the mean Constant Score and Subjective Shoulder Value grew up to 85 points. The scapular dyskinesis and SICK syndrome secondary to chronic type III AC dislocation can be treated with the proposed rehabilitation protocol resulting in positive improvements of the shoulder function within 6 weeks; however, patients that do not respond to the rehabilitation programme will not improve with extended rehabilitation time. It is important to advise patients of the specific exercises for the prevention/treatment of scapular dyskinesis in the rehabilitation programme after

  3. Ski sickness.

    PubMed

    Häusler, R

    1995-01-01

    Dizziness with illusionary rotatory or pendular sensations and dysequilibrium accompanied by nausea and occasionally by vomiting may appear during down-hill skiing. It is proposed that the condition is called "ski sickness". Ski sickness seems to represent a special form of motion sickness produced by unusual and contradictory sensory information between the visual, vestibular and somato-sensory system. The pathophysiology seems to be related to vestibular overstimulation from winding turns on uneven ground, insufficient visual control, specially on foggy days with reduced visibility (on so called "white days"), often in connection with minor ophthalmologic problems such as myopia or astigmatism and altered somato-sensory input due to the wearing of ski boots and skis. Psychological factors such as fear of heights, fear of mountains, high speed and falling may contribute as well as the atmospheric pressure changes in the ear when descending rapidly from high to low altitude. The symptoms of ski sickness can be relieved by vestibular suppressants. The present report indicates various characteristics of a series of 11 persons suffering from ski sickness.

  4. Intravenous iron supplementation may protect against acute mountain sickness: a randomized, double-blinded, placebo-controlled trial.

    PubMed

    Talbot, Nick P; Smith, Thomas G; Privat, Catherine; Nickol, Annabel H; Rivera-Ch, Maria; León-Velarde, Fabiola; Dorrington, Keith L; Robbins, Peter A

    2011-01-01

    Acute mountain sickness (AMS) is a common and disabling condition that occurs in healthy individuals ascending to high altitude. Based on the ability of iron to influence cellular oxygen sensing pathways, we hypothesized that iron supplementation would protect against AMS. To examine this hypothesis, 24 healthy sea-level residents were randomized to receive either intravenous iron(III)-hydroxide sucrose (200 mg) or saline placebo, before ascending rapidly to Cerro de Pasco, Peru (4340 m). The Lake Louise scoring system was used to assess incidence and severity of AMS at sea level and on the first full day at altitude. No significant difference in absolute AMS score was detected between the two groups either at baseline or at high altitude. However, the mean increase in AMS score was 65% smaller in the iron group than in the saline group (p<0.05), and the change in AMS score correlated negatively with the change in ferritin (R=-0.43; p<0.05). Hematocrit and arterial oxygen saturation were unaffected by iron. In conclusion, this preliminary randomized, double-blinded, placebo-controlled trial suggests that intravenous iron supplementation may protect against the symptoms of AMS in healthy volunteers.

  5. Effects of multidisciplinary inpatient rehabilitation for chronic back or neck pain: a register-linkage study of sickness absences and analgesic purchases in an occupational cohort.

    PubMed

    Suoyrjö, H; Hinkka, K; Oksanen, T; Kivimäki, M; Klaukka, T; Pentti, J; Vahtera, J

    2008-03-01

    To determine the effects of multidisciplinary in-patient rehabilitation for chronic back or neck pain on sickness absences and analgesic purchases. A prospective observational study. 10 towns in Finland. 34 838 local government employees, including 418 participants in rehabilitation for chronic back pain and 195 participants in rehabilitation for chronic neck pain between 1994 and 2002. The annual rates of short (1-3 days), long (>3 days), and very long (>21 days) sickness absences and the defined daily doses (DDD) of prescribed analgesics. The rate of very long (>21 days) sickness absence among the chronic back pain rehabilitees was 3.03-fold (95% CI 2.55 to 3.60) compared to the non-rehabilitees in the year before rehabilitation. This ratio declined to 1.88 (95% CI 1.65 to 2.37) three years after rehabilitation. No further decline in the rate of very long sickness absence was observed in the subsequent years. For chronic neck pain rehabilitees, no evidence of the effectiveness of rehabilitation on sickness absence was found. In relation to consumption of analgesics, the mean rate of DDDs declined among the back and neck pain rehabilitees after rehabilitation compared to the non-rehabilitees. Multidisciplinary in-patient rehabilitation for chronic back pain may decrease the risk of very long sickness absence for three years. In relation to rehabilitation for chronic neck pain, no changes in sickness absences were found.

  6. Metacognitions Are Associated with Subjective Memory Problems in Individuals on Sick Leave due to Chronic Fatigue

    PubMed Central

    Jacobsen, Henrik B.; Aasvik, Julie K.; Borchgrevink, Petter C.; Landrø, Nils I.; Stiles, Tore C.

    2016-01-01

    Background: Subjective cognitive impairments are frequent, but poorly understood in patients with chronic fatigue. We hypothesized that maladaptive metacognitive beliefs at baseline were associated with baseline subjective cognitive impairments, that they predict subjective cognitive impairments at treatment termination, and that a reduction in maladaptive metacognitive beliefs was associated with less subjective cognitive impairments at treatment termination, independent of changes in fatigue, pain, insomnia, depression, and anxiety. Methods: In this non-controlled study, patients (n = 137) on sick leave due to chronic fatigue received a 3.5-week inpatient RTW rehabilitation program. Of these patients 69 (50.4%) was referred with a ICPC-2 diagnosis of chronic fatigue. Patients completed questionnaires about metacognitive beliefs, somatic complaints, psychological complaints, and cognitive impairments before and after treatment. To test the hypotheses we performed paired t-tests of change, as well as seven hierarchical linear regressions. Results: Results showed that baseline maladaptive metacognitive beliefs were significantly associated with subjective cognitive impairments at baseline, controlling for symptoms. Score on baseline metacognitive beliefs did not predict impairments post-treatment. Testing specific maladaptive beliefs, pre-treatment scores on cognitive confidence were associated with subjective cognitive impairments both pre and post-treatment, controlling for symptoms. Post-treatment metacognitive beliefs and post-treatment cognitive confidence were associated with post-treatment subjective cognitive impairments, controlling for pre-treatment impairments and pre-treatment metacognitive beliefs, as well as pre and post-scores on symptom measures. Conclusion: This study reports associations between maladaptive metacognitive beliefs and subjective cognitive impairments in patients with chronic fatigue. Targeting metacognitive beliefs could prove an

  7. A rat model of chronic moderate alcohol consumption and risk of decompression sickness.

    PubMed

    Buzzacott, Peter; Mazur, Aleksandra; Wang, Qiong; Lambrechts, Kate; Theron, Michael; Guerrero, François

    2015-06-01

    This study aimed to establish if chronic, moderate, pre-dive alcohol consumption had any affect upon susceptibility to decompression sickness (DCS) in rats. A treatment group of 15 rats were given water containing 12 mL ·L ⁻¹ of ethanol for four weeks. Controls (n = 15) were given water. Both groups were compressed with air to 1,000 kPa, followed by staged decompression. An additional 30 control rats from a similar previous experiment were added, raising the control-treatment ratio to 3:1. Rats in the treatment group consumed the equivalent of an 80 kg man drinking 2 L of 5 % alcohol by volume beer per day, which is three times the recommended daily limit for men. Overall, comparing the treatment group with the combined control groups neither weight (P = 0.23) nor alcohol consumption (P = 0.69) were associated with DCS. We observed that chronic, moderate alcohol consumption prior to compression was neither prophylactic nor deleterious for DCS in young, male rats.

  8. Ginkgo biloba for the prevention of severe acute mountain sickness (AMS) starting one day before rapid ascent.

    PubMed

    Gertsch, Jeffrey H; Seto, Todd B; Mor, Joanne; Onopa, Janet

    2002-01-01

    Previous studies suggest that 5 days of prophylactic ginkgo decreases the incidence of acute mountain sickness (AMS) during gradual ascent. This trial was designed to determine if ginkgo is an effective prophylactic agent if begun 1 day prior to rapid ascent. In this double-blind, randomized, placebo-controlled trial, 26 participants residing at sea level received ginkgo (60 mg TID) or placebo starting 24 h before ascending Mauna Kea, Hawaii. Subjects were transported from sea level to the summit (4205 m) over 3 hours, including 1 hour at 2835 m. The Lake Louise Self-report Questionnaire constituted the primary outcome measure at baseline, 2835 m, and after 4 h at 4205 m. AMS was defined as a Lake Louise Self-report Score (LLSR) >/= 3 with headache. Subjects who developed severe AMS were promptly transported to lower altitude for the remainder of the study. The ginkgo (n = 12) and placebo (n = 14) groups were well matched (58% vs. 50% female; median age 28 yr, range 22-53 vs. 33 yr, range 21-53; 58% vs. 57% Caucasian). Two (17%) subjects on ginkgo and nine (64%) on placebo developed severe AMS and required descent for their safety (p = 0.021); all recovered without sequelae. Median LLSR at 4205 m was significantly lower for ginkgo versus placebo (4, range 1-8 vs. 5, range 2-9, p = 0.03). Ginkgo use did not reach statistical significance for lowering incidence of AMS compared with placebo (ginkgo 7/12, 58.3% vs. placebo 13/14, 92.9%, p = 0.07). Twenty-one of 26 (81%) subjects developed AMS overall. This is the first study to demonstrate that 1 day of pretreatment with ginkgo 60 mg TID may significantly reduce the severity of AMS prior to rapid ascent from sea level to 4205 m.

  9. Physiological and psychological illness symptoms at high altitude and their relationship with acute mountain sickness: a prospective cohort study.

    PubMed

    Oliver, Samuel J; Sanders, Stephan J; Williams, Catherine J; Smith, Zoe A; Lloyd-Davies, Emma; Roberts, Ross; Arthur, Calum; Hardy, Lew; Macdonald, Jamie H

    2012-07-01

    The aim of this prospective observational cohort study was to investigate relationships between acute mountain sickness (AMS) and physical and mental health during a high altitude expedition. Forty-four participants (mean age, 34 ± 13 y; body mass index, 23.6 ± 3.5 kg·m(2) ; 57% male) completed the Dhaulagiri base camp trek in Nepal, a 19-day expedition attaining 5,372 m. Participants self-reported the following daily physical and mental health: AMS (defined by Lake Louise diagnosis and individual and total symptom scores), upper respiratory symptoms, diarrhea, and anxiety, plus physiological and behavioral factors. The rate of Lake Louise-defined AMS per 100 person days was 9.2 (95% CI: 7.2-11.7). All investigated illnesses except diarrhea increased with altitude (all p < 0.001 by analysis of variance). Total AMS symptom score was associated with a lower arterial oxygen saturation, higher resting heart rate, more upper respiratory and diarrhea symptoms, greater anxiety, and lower fluid intake (all p < 0.02 by longitudinal multiple regression analyses). However, only upper respiratory symptoms, heart rate, arterial oxygen saturation, and fluid intake predicted future AMS symptoms [eg, an increase in upper respiratory symptoms by 5 units predicted an increase in the following day's AMS total symptom score by 0.72 units (0.54-0.89)]. Upper respiratory symptoms and anxiety increasingly contributed to symptom burden as altitude was gained. Data were consistent with increased heart rate, decreased arterial oxygen saturation, reduced fluid intake, and upper respiratory symptoms being causally associated with AMS. Upper respiratory symptoms and fluid intake are the simplest targets for intervention to reduce AMS during high altitude exposure. © 2012 International Society of Travel Medicine.

  10. Differences Between the “Chinese AMS Score” and the Lake Louise Score in the Diagnosis of Acute Mountain Sickness

    PubMed Central

    Wu, Jialin; Gu, Haoran; Luo, Yongjun

    2016-01-01

    Abstract The Chinese AMS score (CAS) is used in clinical medicine and research to diagnosis acute mountain sickness (AMS). However, the Lake Louise Score (LLS) is the well-accepted standard for diagnosing AMS. The difference between the CAS and LLS questionnaires is that the CAS considers more nonspecific symptoms. The aim of the present study was to evaluate differences in AMS prevalence according to the LLS and CAS criteria. We surveyed 58 males who traveled from Chongqing (300 m) to Lhasa (3658 m) via the Qinghai-Tibet train. Cases of AMS were diagnosed using LLS and CAS questionnaires in a few railway stations at different evaluation areas along the road. We subsequently evaluated discrepancies in values related to the prevalence of AMS determined using the 2 types of questionnaires (CAS and LLS). The prevalence of CAS-diagnosed AMS indicated that the percentage of AMS cases among the 58 young men was 29.3% in Golmud, 60.3% in Tanggula, 63.8% in Lhasa, 22.4% on the first day after arrival in Lhasa, 27.6% on the second day, 24.1% on the third day, and 12.1% on the fourth day. The prevalence of LLS-diagnosed AMS in Golmud was 10.3%, 38% in Lhasa, and 6.9% on day 1, the prevalence in each station was lower than that as assessed by the CAS. Our experimental data indicate that AMS diagnoses ascertained using the CAS indicate a higher AMS prevalence than those ascertained using the LLS. Through statistical analysis, the CAS seems capable of effectively diagnosing AMS as validated by LLS (sensitivity 61.8%, specificity 92.7%). PMID:27227918

  11. Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation--independent of absolute altitude?

    PubMed

    Leichtfried, Veronika; Basic, Daniel; Burtscher, Martin; Gothe, Raffaella Matteucci; Siebert, Uwe; Schobersberger, Wolfgang

    2016-03-01

    Commercialization of trekking tourism enables untrained persons to participate in trekking tours. Because hypoxia is one of the main purported triggers for acute mountain sickness (AMS), pulse oximetry, which measures arterial oxygen saturation (SPO2), is discussed to be a possible and useful tool for the diagnosis of AMS. The purpose of this study was to evaluate possible associations between SPO2 values and the occurrence of AMS. In 204 trekkers, SPO2 values (pulse oximetry) were measured and the Lake Louise Self-assessment Score (LLS) was administered over the first 7 days of their trekking tours. During treks at altitudes of 2500-5500 m in Nepal, India, Africa, and South America, 100 participants suffered from mild AMS, 3 participants suffered from severe AMS, and 9 participants reported both mild and severe AMS. The lowest mean SPO2 was 85.5 (95 % confidence interval (CI), 83.9-86.1 %) on day 5. SPO2 and LLS exhibited a weak to moderate negative correlation for all days of the study (ρ ranging from -0.142 to -0.370). Calculation of time-shifted associations of 24 and 48 h resulted in the disappearance of most associations. Susceptibility to headaches (odds ratio (OR) 2.9-7.2) and a history of AMS (OR 2.2-3.1) were determined to be potential risk factors for the development of AMS. Since there is no strong altitude-independent association between AMS and SPO2 during the first week of high-altitude adaptation, the implementation of pulse oximetry during trekking in order to detect and predict AMS remains questionable.

  12. Sea-level assessment of dynamic cerebral autoregulation predicts susceptibility to acute mountain sickness at high altitude.

    PubMed

    Cochand, Nicholas J; Wild, Michael; Brugniaux, Julien V; Davies, Peter J; Evans, Kevin A; Wise, Richard G; Bailey, Damian M

    2011-12-01

    Dynamic cerebral autoregulation is impaired in subjects who develop acute mountain sickness (AMS), a neurological disorder characterized by headache. The present study examined if the normoxic sea-level measurement of dynamic cerebral autoregulation would predict subsequent susceptibility to AMS during rapid ascent to terrestrial high altitude. A dynamic cerebral autoregulation index was determined in 18 subjects at sea level from continuous recordings of middle cerebral artery blood flow velocity (Doppler ultrasonography) and arterial blood pressure (finger photoplethysmography) after recovery from transiently induced hypotension. Six hours after passive ascent to 3800 m (Mt Elbrus, Russia), the Lake Louise and Environmental Symptoms Cerebral Symptoms questionnaires were used to assess AMS. AMS scores increased markedly at high-altitude (Lake Louise: +3±2 points, P=0.001 and Environmental Symptoms Cerebral Symptoms: +0.6±0.9 points, P=0.0003 versus sea level). Inverse relationships were observed between the sea-level autoregulation index score and the high-altitude-induced increases in the Lake Louise (r=-0.62, P=0.007) and Environmental Symptoms Cerebral Symptoms (r=-0.78, P=0.01) scores. One subject with a history of high-altitude pulmonary and cerebral edema presented with the lowest sea-level autoregulation index score (3.7 versus group: 6.2±1.0 points) and later developed high-altitude cerebral edema at 4800 m during the summit bid. These findings suggest that a lower baseline autoregulation index may be considered a potential risk factor for AMS. This laboratory measurement may prove a useful screening tool for the expedition doctor when considering targeted pharmacological prophylaxis in individuals deemed "AMS-susceptible."

  13. Non-invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation.

    PubMed

    Johnson, Pamela L; Popa, Daniel A; Prisk, G Kim; Edwards, Natalie; Sullivan, Colin E

    2010-02-01

    Overnight oxyhaemoglobin desaturation is related to AMS. AMS can be debilitating and may require descent. Positive pressure ventilation during sleep at high altitude may prevent AMS and therefore be useful in people travelling to high altitude, who are known to suffer from AMS. Ascent to high altitude results in hypobaric hypoxia and some individuals will develop acute mountain sickness (AMS), which has been shown to be associated with low oxyhaemoglobin saturation during sleep. Previous research has shown that positive end-expiratory pressure by use of expiratory valves in a face mask while awake results in a reduction in AMS symptoms and higher oxyhaemoglobin saturation. We aimed to determine whether positive pressure ventilation would prevent AMS by increasing oxygenation during sleep. We compared sleeping oxyhaemoglobin saturation and the incidence and severity of AMS in seven subjects sleeping for two consecutive nights at 3800 m above sea level using either non-invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of AMS were assessed by administration of the Lake Louise questionnaire. We found significant increases in the mean and minimum sleeping oxyhaemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation. The use of positive pressure ventilation during sleep at 3800 m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation.

  14. Risk Determinants of Acute Mountain Sickness and Summit Success on a 6-Day Ascent of Mount Kilimanjaro (5895 m).

    PubMed

    Lawrence, James S; Reid, Stephen A

    2016-03-01

    The aims of this study were to assess incidence of acute mountain sickness (AMS) and summit success on a 6-day ascent profile of Mt. Kilimanjaro and evaluate potential risk factors for these outcomes. All trekkers through a single Australian tour company between August 2012 and July 2014 were included. Participants ascended via the Rongai route and attempted the summit on day 6. Daily assessments were made using the self-reported Lake Louise score (LLS) questionnaire. Two different AMS diagnostic criteria (LLS ≥ 3 and LLS ≥ 5) were used for data analysis. Risk factors for development of AMS and summit success were analyzed. Over the 24-month period a total of 175 participants undertook the trek. Incidence of AMS was 52.6% (LLS ≥ 3) and 22.9% (LLS ≥ 5). Summit success was 88%. Age, sex, body mass index, and acetazolamide use were not associated with risk of AMS development. Age ≥ 40 years (P = .0002) and female sex (P = .0004) were both significantly associated with reduced summit success rate. Our cohort found a lower incidence of AMS and better summit success on a 6-day ascent of Mt Kilimanjaro than previously described in other groups on 4- and 5-day ascents. Female sex and age ≥ 40 years both predicted failure to summit, but did not increase risk of developing AMS. AMS is a common cause of morbidity on Mt. Kilimanjaro, and although the risk can be mitigated by a slower ascent, there is an ongoing need for education of individual trekkers, tour companies, and local authorities. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  15. Differences Between the "Chinese AMS Score" and the Lake Louise Score in the Diagnosis of Acute Mountain Sickness.

    PubMed

    Wu, Jialin; Gu, Haoran; Luo, Yongjun

    2016-05-01

    The Chinese AMS score (CAS) is used in clinical medicine and research to diagnosis acute mountain sickness (AMS). However, the Lake Louise Score (LLS) is the well-accepted standard for diagnosing AMS. The difference between the CAS and LLS questionnaires is that the CAS considers more nonspecific symptoms. The aim of the present study was to evaluate differences in AMS prevalence according to the LLS and CAS criteria. We surveyed 58 males who traveled from Chongqing (300 m) to Lhasa (3658 m) via the Qinghai-Tibet train. Cases of AMS were diagnosed using LLS and CAS questionnaires in a few railway stations at different evaluation areas along the road. We subsequently evaluated discrepancies in values related to the prevalence of AMS determined using the 2 types of questionnaires (CAS and LLS). The prevalence of CAS-diagnosed AMS indicated that the percentage of AMS cases among the 58 young men was 29.3% in Golmud, 60.3% in Tanggula, 63.8% in Lhasa, 22.4% on the first day after arrival in Lhasa, 27.6% on the second day, 24.1% on the third day, and 12.1% on the fourth day. The prevalence of LLS-diagnosed AMS in Golmud was 10.3%, 38% in Lhasa, and 6.9% on day 1, the prevalence in each station was lower than that as assessed by the CAS. Our experimental data indicate that AMS diagnoses ascertained using the CAS indicate a higher AMS prevalence than those ascertained using the LLS. Through statistical analysis, the CAS seems capable of effectively diagnosing AMS as validated by LLS (sensitivity 61.8%, specificity 92.7%).

  16. Oximetry fails to predict acute mountain sickness or summit success during a rapid ascent to 5640 meters.

    PubMed

    Wagner, Dale R; Knott, Jonathan R; Fry, Jack P

    2012-06-01

    The purpose of this study was to determine whether arterial oxygen saturation (Spo(2)) and heart rate (HR), as measured by a finger pulse oximeter on rapid arrival to 4260 m, could be predictive of acute mountain sickness (AMS) or summit success on a climb to 5640 m. Climbers (35.0 ± 10.1 years; 51 men, 5 women) were transported from 2650 m to the Piedra Grande hut at 4260 m on Pico de Orizaba within 2 hours. After a median time of 10 hours at the hut, they climbed toward the summit (5640 m) and returned, with a median trip time of 14 hours. The Lake Louise Self-Assessment Scale (LLSS) for AMS, HR, and Spo(2) were collected on arrival at the hut and repeated immediately before and after the climbers' summit attempts. Average Spo(2) for all participants at 4260 m before their departure for the summit was 84.4% ± 3.7%. Thirty-seven of the 56 participants reached the summit, and 59% of all climbers met the criteria for AMS during the ascent. The Spo(2) was not significantly different between those who experienced AMS and those who did not (P = .82); neither was there a difference in Spo(2) between summiteers and nonsummiteers (P = .44). Climbers' HR just before the summit attempt was not related to AMS but was significantly lower for summiteers vs nonsummiteers (P = .04). The Spo(2) does not appear to be predictive of AMS or summit success during rapid ascents. Copyright © 2012 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  17. Acute Mountain Sickness Symptom Severity at the South Pole: The Influence of Self-Selected Prophylaxis with Acetazolamide

    PubMed Central

    Johnson, Jacob B.; Richert, Maile; Miller, Andrew D.

    2016-01-01

    Introduction Acetazolamide, a carbonic anhydrase inhibitor, remains the only FDA approved pharmaceutical prophylaxis for acute mountain sickness (AMS) though its effectiveness after rapid transport in real world conditions is less clear. Methods Over 2 years, 248 healthy adults traveled by airplane from sea level (SL) to the South Pole (ALT, ~3200m) and 226 participants provided Lake Louise Symptom Scores (LLSS) on a daily basis for 1 week; vital signs, blood samples, and urine samples were collected at SL and at ALT. Acetazolamide was available to any participant desiring prophylaxis. Comparisons were made between the acetazolamide with AMS (ACZ/AMS) (n = 42), acetazolamide without AMS (ACZ/No AMS)(n = 49), no acetazolamide with AMS (No ACZ/AMS) (n = 56), and the no acetazolamide without AMS (No ACZ/No AMS) (n = 79) groups. Statistical analysis included Chi-squared and one-way ANOVA with Bonferroni post-hoc tests. Significance was p≤0.05. Results No significant differences were found for between-group characteristics or incidence of AMS between ACZ and No ACZ groups. ACZ/AMS reported greater LLSS, BMI, and red cell distribution width. ACZ/No AMS had the highest oxygen saturation (O2Sat) at ALT. No significant differences were found in serum electrolyte concentrations or PFT results. Discussion Acetazolamide during rapid ascent provided no apparent protection from AMS based on LLSS. However, it is unclear if this lack of effect was directly associated with the drug or if perhaps there was some selection bias with individuals taking ACZ more likely to have symptoms or if there may have been more of perceptual phenomenon related to a constellation of side effects. PMID:26848757

  18. Vascular Endothelial Function Assessed by Postischemic Diastolic Blood Pressure Is Associated with Acclimatization and Acute Mountain Sickness.

    PubMed

    He, Lipeng; Jiang, Yu; Su, Hai; Li, Juxiang; Cheng, Xiaoshu

    2016-03-01

    This study assessed whether the brachial diastolic blood pressure (DBP) decline induced by 5-minute arm ischemia is associated with acclimatization and acute mountain sickness (AMS). Forty-two age- and body mass index-matched young male residents at sea level (<400 m) or moderate altitude (1000-2000 m above sea level) were enrolled. All subjects had never been to 3200 m before. Brachial BP was measured at a station at 1380 m altitude before and 1, 5, and 10 minutes after right arm ischemia. AMS score was evaluated after 3-day training at a high altitude of 3200 m. In moderate altitude versus sea-level residents: (1) systolic BP curves for both arms overlapped well; (2) mean right arm DBP decline post right arm ischemia was larger, while left arm, which was not subjected to ischemia, did not show DBP decline in either group; and (3) AMS scores were significantly lower (3.19 ± 2.16 vs. 5.52 ± 4.58, p = 0.043) in those residing at moderate altitude compared to those from low altitude. There was a low negative correlation between AMS score and right arm area between curves-DBP (r = -0.320, p = 0.039). Moderate altitude relative to sea-level residents had a larger mean postischemic DBP decline in weak but significant association with lower mean AMS score at 3200 m. These data suggest that differences in vascular endothelial function related to altitude of residence persist during travel to high altitude and might contribute to AMS risk.

  19. Thin Air Resulting in High Pressure: Mountain Sickness and Hypoxia-Induced Pulmonary Hypertension

    PubMed Central

    Richter, Manuel; Tello, Khodr; Sommer, Natascha; Gall, Henning; Ghofrani, Hossein Ardeschir

    2017-01-01

    With rising altitude the partial pressure of oxygen falls. This phenomenon leads to hypobaric hypoxia at high altitude. Since more than 140 million people permanently live at heights above 2500 m and more than 35 million travel to these heights each year, understanding the mechanisms resulting in acute or chronic maladaptation of the human body to these circumstances is crucial. This review summarizes current knowledge of the body's acute response to these circumstances, possible complications and their treatment, and health care issues resulting from long-term exposure to high altitude. It furthermore describes the characteristic mechanisms of adaptation to life in hypobaric hypoxia expressed by the three major ethnic groups permanently dwelling at high altitude. We additionally summarize current knowledge regarding possible treatment options for hypoxia-induced pulmonary hypertension by reviewing in vitro, rodent, and human studies in this area of research. PMID:28522921

  20. A narrative review on the similarities and dissimilarities between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and sickness behavior

    PubMed Central

    2013-01-01

    It is of importance whether myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a variant of sickness behavior. The latter is induced by acute infections/injury being principally mediated through proinflammatory cytokines. Sickness is a beneficial behavioral response that serves to enhance recovery, conserves energy and plays a role in the resolution of inflammation. There are behavioral/symptomatic similarities (for example, fatigue, malaise, hyperalgesia) and dissimilarities (gastrointestinal symptoms, anorexia and weight loss) between sickness and ME/CFS. While sickness is an adaptive response induced by proinflammatory cytokines, ME/CFS is a chronic, disabling disorder, where the pathophysiology is related to activation of immunoinflammatory and oxidative pathways and autoimmune responses. While sickness behavior is a state of energy conservation, which plays a role in combating pathogens, ME/CFS is a chronic disease underpinned by a state of energy depletion. While sickness is an acute response to infection/injury, the trigger factors in ME/CFS are less well defined and encompass acute and chronic infections, as well as inflammatory or autoimmune diseases. It is concluded that sickness behavior and ME/CFS are two different conditions. PMID:23497361

  1. A narrative review on the similarities and dissimilarities between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and sickness behavior.

    PubMed

    Morris, Gerwyn; Anderson, George; Galecki, Piotr; Berk, Michael; Maes, Michael

    2013-03-08

    It is of importance whether myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a variant of sickness behavior. The latter is induced by acute infections/injury being principally mediated through proinflammatory cytokines. Sickness is a beneficial behavioral response that serves to enhance recovery, conserves energy and plays a role in the resolution of inflammation. There are behavioral/symptomatic similarities (for example, fatigue, malaise, hyperalgesia) and dissimilarities (gastrointestinal symptoms, anorexia and weight loss) between sickness and ME/CFS. While sickness is an adaptive response induced by proinflammatory cytokines, ME/CFS is a chronic, disabling disorder, where the pathophysiology is related to activation of immunoinflammatory and oxidative pathways and autoimmune responses. While sickness behavior is a state of energy conservation, which plays a role in combating pathogens, ME/CFS is a chronic disease underpinned by a state of energy depletion. While sickness is an acute response to infection/injury, the trigger factors in ME/CFS are less well defined and encompass acute and chronic infections, as well as inflammatory or autoimmune diseases. It is concluded that sickness behavior and ME/CFS are two different conditions.

  2. Serum sickness

    MedlinePlus

    Drug allergy - serum sickness; Allergic reaction - serum sickness; Allergy - serum sickness ... penicillin, cefaclor, and sulfa) can cause a similar reaction. Injected proteins such as antithymocyte globulin (used to ...

  3. Cyclosporin A reduces expression of adhesion molecules in the kidney of rats with chronic serum sickness

    PubMed Central

    Rincón, J; Parra, G; Quiroz, Y; Benatuil, L; Rodríguez-Iturbe, B

    2000-01-01

    Treatment with cyclosporin A (CsA) improves proteinuria and reduces renal cellular infiltration in chronic serum sickness (CSS). We examined if these effects were associated with a reduced renal expression of CD54 and its ligands, interferon-gamma (IFN-γ), tumour necrosis factor-alpha (TNF-α) and MHC class II molecules. We studied two groups of rats in which CSS was induced by daily injections of ovalbumin (OVA): a group treated with CsA (OVA.CsA group, n = 11) and a group that received no treatment (OVA.CSS group, n = 11). An additional group of five rats (control group) received only phosphate buffer. Immunostaining techniques were used to follow CSS and to study the expression of CD54, CD18, CD11b/c, IFN-γ, TNF-α and MHC class molecules. Proteinuria (mg/24 h) was reduced from 248·2 ± 73·1 (OVA.CCS group) to 14·5 ± 13·1 with CsA treatment (P < 0·0001). The renal expression of CD54 and its ligands (CD18 and CD11b/c) was reduced by 50% to 75%. Correspondingly, there was a 60% to 85% reduction in the number of infiltrating leucocytes. The number of cells expressing TNF-α, IFN-γ and MHC II molecules was also reduced. CsA reduces expression of CD54 and its ligands. This effect is associated with a reduction of cellular infiltration, IFN-γ, TNF-α-producing cells and with MHC II expression in the kidney. These findings suggest that expression of adhesion molecules plays a critical role in CSS and underline the importance of cellular immunity in this experimental model. PMID:10931158

  4. Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?

    PubMed Central

    Huibers, M; Beurskens, A; Prins, J; Kant, I.; Bazelmans, E; van Schayck, C P; Knottnerus, J; Bleijenberg, G

    2003-01-01

    Background: Persistent fatigue among employees, burnout, and chronic fatigue syndrome (CFS) are three fatigue conditions that share some characteristics in theory. However, these conditions have not been compared in empirical research, despite conceptual similarities. Methods: This cross sectional study aimed to investigate relations between persistent fatigue, burnout, and CFS by describing the clinical features of a sample of 151 fatigued employees on sick leave. Using validated instruments, subgroups based on research criteria for CFS and burnout within the sample of fatigued employees and a reference group of 97 diagnosed CFS patients were compared. Analyses of covariance were performed. Results: A total of 66 (43.7%) fatigued employees met research criteria for CFS (except symptom criteria) and 76 (50.3%) met research criteria for burnout. "CFS-like employees" (fatigued employees who met CFS criteria) reported stronger somatic attributions than "non-CFS-like employees". Burnt out CFS-like employees were more depressed and distressed than CFS-like employees who were not burnt out. Burnout cases among the non-CFS-like employees had stronger psychological attributions than fatigued employees who were not burnt out. Compared to diagnosed CFS patients, CFS-like employees merely had a shorter duration of fatigue complaints. Burnt out CFS-like employees had stronger psychological attributions and were more distressed than CFS patients. Conclusions: Fatigued employees shared many important characteristics with CFS patients, regardless of burnout status, and many fatigued employees met CFS criteria and/or burnout criteria. Differences however concerned the causal attributions that were made. This raises questions about the role of causal attributions: are they modified by fatigue complaints or do they determine illness outcome? PMID:12782744

  5. Social inequalities in 'sickness': European welfare states and non-employment among the chronically ill.

    PubMed

    van der Wel, Kjetil A; Dahl, Espen; Thielen, Karsten

    2011-12-01

    The aim of this paper is to examine educational inequalities in the risk of non-employment among people with illnesses and how they vary between European countries with different welfare state characteristics. In doing so, the paper adds to the growing literature on welfare states and social inequalities in health by studying the often overlooked 'sickness'-dimension of health, namely employment behaviour among people with illnesses. We use European Union Statistics on Income and Living Conditions (EU-SILC) data from 2005 covering 26 European countries linked to country characteristics derived from Eurostat and OECD that include spending on active labour market policies, benefit generosity, income inequality, and employment protection. Using multilevel techniques we find that comprehensive welfare states have lower absolute and relative social inequalities in sickness, as well as more favourable general rates of non-employment. Hence, regarding sickness, welfare resources appear to trump welfare disincentives.

  6. An analysis of sickness absence in chronically ill patients receiving Complementary and Alternative Medicine: A longterm prospective intermittent study

    PubMed Central

    Moebus, Susanne; Lehmann, Nils; Bödeker, Wolfgang; Jöckel, Karl-Heinz

    2006-01-01

    Background The popularity of complementary and alternative medicine (CAM) has led to a growing amount of research in this area. All the same little is known about the effects of these special treatments in every-day practice of primary care, delivered by general practitioners within the health insurance system. From 1994 to 2000 more than 20 German Company health insurances initiated the first model project on CAM according to the German social law. Aim of this contribution is to investigate the effectiveness of multi-modal CAM on chronic diseases within primary health care. Methods A long-term prospective intermittent study was conducted including 44 CAM practitioners and 1221 self-selected chronically ill patients (64% women) of whom 441 were employed. Main outcome measure is sick-leave, controlled for secular trends and regression-to-the mean and self-perceived health status. Results Sick-leave per year of 441 patients at work increased from 22 (SD ± 45.2) to 31 (± 61.0) days within three years prior to intervention, and decreased to 24 (± 55.6) in the second year of treatment, sustaining at this level in the following two years. Detailed statistical analysis show that this development exceeds secular trends and the regression-toward-the-mean effect. Sick-leave reduction was corroborated by data on self-reported improvement of patients' health status. Conclusion Results of this longterm observational study show a reduction of sick leave in chronically ill patients after a complex multimodal CAM intervention. However, as this is an uncontrolled observational study efficacy of any specific CAM treatment can not be proven. The results might indicate an general effectiveness of CAM in primary care, worthwhile further investigations. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, provide information on the magnitude of the effects to facilitate subsequent definitive randomised controlled

  7. Chronic atrial fibrillation and stroke in paced patients with sick sinus syndrome. Relevance of clinical characteristics and pacing modalities.

    PubMed

    Sgarbossa, E B; Pinski, S L; Maloney, J D; Simmons, T W; Wilkoff, B L; Castle, L W; Trohman, R G

    1993-09-01

    The goal of the report was to study the long-term incidence and the independent predictors for chronic atrial fibrillation and stroke in 507 paced patients with sick sinus syndrome, adjusting for differences in baseline clinical variables with multivariate analysis. From 1980 to 1989, we implanted 376 dual-chamber, 19 atrial, and 112 ventricular pacemakers to treat patients with sick sinus syndrome. After a maximum follow-up of 134 months (mean: 59 +/- 38 months for chronic atrial fibrillation, 65 +/- 37 months for stroke), actuarial incidence of chronic atrial fibrillation was 7% at 1 year, 16% at 5 years, and 28% at 10 years. Independent predictors for this event, from Cox's proportional hazards model, were history of paroxysmal atrial fibrillation (P < .001; hazard ratio [HR] = 16.84), use of antiarrhythmic drugs before pacemaker implant (P < .001; HR = 2.25), ventricular pacing mode (P = .003; HR = 1.98), age (P = .005; HR = 1.03), and valvular heart disease (P = .008; HR = 2.05). For patients with preimplant history of paroxysmal atrial fibrillation, independent predictors were prolonged episodes of paroxysmal atrial fibrillation (P < .001; HR = 2.56), long history of paroxysmal atrial fibrillation (P = .004; HR = 2.05), ventricular pacing mode (P = .025; HR = 1.69), use of antiarrhythmic drugs before pacemaker implant (P = .024; HR = 1.71), and age (P = .04; HR = 1.02). Actuarial incidence of stroke was 3% at 1 year, 5% at 5 years, and 13% at 10 years. Independent predictors for stroke were history of cerebrovascular disease (P < .001; HR = 5.22), ventricular pacing mode (P = .008; HR = 2.61), and history of paroxysmal atrial fibrillation (P = .037; HR = 2.81). Development of chronic atrial fibrillation and stroke in paced patients with sick sinus syndrome are strongly determined by clinical variables and secondarily by the pacing modality. Ventricular pacing mode predicts chronic atrial fibrillation in patients with preimplant paroxysmal atrial fibrillation

  8. Mountains

    SciTech Connect

    Fuller, M.

    1989-01-01

    This book covers the following topics: Above the forest: the alpine tundra; Solar energy, water, wind and soil in mountains; Mountain weather; Mountain building and plate tectonics; Mountain walls: forming, changing, and disappearing; Living high: mountain ecosystems; Distribution of mountain plants and animals; On foot in the mountains: how to hike and backpack; Ranges and peaks of the world. Map and guidebook sources, natural history and mountain adventure trips, mountain environmental education centers and programs, and sources of information on trails for the handicapped are included.

  9. A 7-year follow-up of multidisciplinary rehabilitation among chronic neck and back pain patients. Is sick leave outcome dependent on psychologically derived patient groups?

    PubMed

    Bergström, Gunnar; Bergström, Cecilia; Hagberg, Jan; Bodin, Lennart; Jensen, Irene

    2010-04-01

    A valid method for classifying chronic pain patients into more homogenous groups could be useful for treatment planning, that is, which treatment is effective for which patient, and as a marker when evaluating treatment outcome. One instrument that has been used to derive subgroups of patients is the Multidimensional Pain Inventory (MPI). The primary aim of this study was to evaluate a classification method based on the Swedish version of the MPI, the MPI-S, to predict sick leave among chronic neck and back pain patients for a period of 7 years after vocational rehabilitation. As hypothesized, dysfunctional patients (DYS), according to the MPI-S, showed a higher amount of sickness absence and disability pension expressed in days than adaptive copers (AC) during the 7-years follow-up period, even when adjusting for sickness absence prior to rehabilitation (355.8days, 95% confidence interval, 71.7; 639.9). Forty percent of DYS patients and 26.7% of AC patients received disability pension during the follow-up period. However, this difference was not statistically significant. Further analyses showed that the difference between patient groups was most pronounced among patients with more than 60days of sickness absence prior to rehabilitation. Cost-effectiveness calculations indicated that the DYS patients showed an increase in production loss compared to AC patients. The present study yields support for the prognostic value of this subgroup classification method concerning long-term outcome on sick leave following this type of vocational rehabilitation.

  10. Depression and gender differences among younger immigrant patients on sick leave due to chronic back pain: a primary care study.

    PubMed

    Taloyan, Marina; Löfvander, Monica

    2014-01-01

    Mental ill-health and pain are major causes for disability compensation in female adults in Sweden. Aims The aims of this study were to (1) analyse gender differences in the prevalence of depression among immigrant patients with chronic back pain and (2) explore whether factors such as age, marital status, educational level, religious faith, number of children and number of diagnosed pain sites could explain these differences. The study sample consisted of 245 sick-listed primary care patients in consecutive order aged 18 through 45 years with a median duration of sick leave of 10 months for back pain and participating in a rehabilitation programme. Explanatory variables included physicians' diagnosed pain sites, age, marital status, education, number of children and religious affiliation. Predictive factors for depression were analysed using logistic regression. The women differed significantly from the men in three aspects: they were less educated, had more children and had more multiple pain sites, that is, 68% versus 45%. In the age-adjusted model, women were twice as likely to have depression (odds ratio (OR) 2.1). Regardless the gender, those with intermediate education of 9-11 years had the lowest odds of outcome compared with those with <0-8 years and ⩾12 years education. Finally, after adjusting for all explanatory variables, the ORs of depression for women decreased to a non-significant level (OR 1.8; 95% confidence interval (CI) 0.94-3.43). Furthermore, regardless of the gender, those with multiple pain sites had twice higher odds (OR 2.04; 95% CI 1.11-3.74) of depression than those with fewer pain sites. Gender differences in odds of depression in our study could be explained by a higher prevalence of diagnosed multiple pain sites in women. This calls for tailor-made treatments that focus on the pain relief needs of immigrant women with low education and chronic back pain.

  11. Inoculation of Bacillus Calmette-Guerin to mice induces an acute episode of sickness behavior followed by chronic depressive-like behavior

    PubMed Central

    Moreau, Maïté; André, Caroline; O’Connor, Jason C.; Dumich, Sara A.; Woods, Jeffrey A.; Kelley, Keith W.; Dantzer, Robert; Lestage, Jacques; Castanon, Nathalie

    2010-01-01

    Although cytokine-induced sickness behavior is now well-established, the mechanisms by which chronic inflammation and depression are linked still remain elusive. Therefore this study aimed to develop a suitable model to identify the neurobiological basis of depressive-like behavior induced by chronic inflammation, independently of sickness behavior. We chose to measure the behavioral consequences of chronic inoculation of mice with Bacillus Calmette-Guerin (BCG), which has been shown to chronically activate both lung and brain indoleamine 2,3-dioxygenase (IDO), a tryptophan-catabolizing enzyme that mediates the occurrence of depressive-like behavior following acute innate immune system activation. BCG inoculation induced an acute episode of sickness (approximately 5 days) that was followed by development of delayed depressive-like behaviors lasting over several weeks. Transient body weight loss, reduction of motor activity and the febrile response to BCG were dissociated temporarily from a sustained increase in the duration of immobility in both forced swim and tail suspension tests, reduced voluntary wheel running and decreased preference for sucrose (a test of anhedonia). Moreover, we show that a distinct pattern of cytokine production and IDO activation parallels the transition from sickness to depression. Protracted depressive-like behavior, but not sickness behavior, was associated with sustained increase in plasma interferon-γ and TNF-α concentrations and peripheral IDO activation. Together, these promising new data establish BCG inoculation of mice as a reliable rodent model of chronic inflammation-induced depressive-like behaviors that recapitulate many clinical observations and provide important clues about the neurobiological basis through which cytokines may have an impact on affective behaviors. PMID:18479887

  12. Sleeping sickness.

    PubMed

    Malvy, D; Chappuis, F

    2011-07-01

    Human African trypanosomiasis (HAT), or sleeping sickness, is a vector-borne disease that flourishes in impoverished, rural parts of sub-Saharan Africa. It is caused by infection with the protozoan parasite Trypanosoma brucei and is transmitted by tsetse flies of the genus Glossina. The majority of cases are caused by T. b. gambiense, which gives rise to the chronic, anthroponotic endemic disease in Western and Central Africa. Infection with T. b. rhodesiense leads to the acute, zoonotic form of Eastern and Southern Africa. The parasites live and multiply extracellularly in the blood and tissue fluids of their human host. They have elaborated a variety of strategies for invading hosts, to escape the immune system and to take advantage of host growth factors. HAT is a challenging and deadly disease owing to its complex epidemiology and clinical presentation and, if left untreated, can result in high death rates. As one of the most neglected tropical diseases, HAT is characterized by the limited availability of safe and cost-effective control tools. No vaccine against HAT is available, and the toxicity of existing old and cumbersome drugs precludes the adoption of control strategies based on preventive chemotherapy. As a result, the keystones of interventions against sleeping sickness are active and passive case-finding for early detection of cases followed by treatment, vector control and animal reservoir management. New methods to diagnose and treat patients and to control transmission by the tsetse fly are needed to achieve the goal of global elimination of the disease.

  13. Prediction of Susceptibility to Acute Mountain Sickness Using Hypoxia-Induced Intrapulmonary Arteriovenous Shunt and Intracardiac Shunt Fractions

    DTIC Science & Technology

    2013-10-01

    intracardiac shunting (through patent foramen ovale (PFO)) are responsible for the greater degree of arterial hypoxemia in AMS susceptible subjects compared...arteriovenous anastomoses, patent foramen ovale and nuclear medicine shunt fraction quantification Post-doctoral fellow JJ Duke is working to complete...significant differences. Non-Task Specific Accomplishments: Collaboration with Dr. Robert Roach, role of patent foramen ovale in symptoms of acute mountain

  14. Motion Sickness

    MedlinePlus

    Motion sickness is a common problem in people traveling by car, train, airplanes, and especially boats. Anyone ... children, pregnant women, and people taking certain medicines. Motion sickness can start suddenly, with a queasy feeling ...

  15. "Here we're all in the same boat"--a qualitative study of group based rehabilitation for sick-listed citizens with chronic pain.

    PubMed

    Andersen, Lotte Nygaard; Kohberg, Maria; Herborg, Lene Gram; Søgaard, Karen; Roessler, Kirsten Kaya

    2014-08-01

    Musculoskeletal pain impacts upon everyday life. A degree of chronicity may pose an increased risk of sickness absence. One of two rehabilitative interventions, "Tailored Physical Activity" or "Chronic Pain Self-Management Program", was offered to sick-listed citizens who experienced pain. The objectives of this paper were to: (1) Assess what factors are experienced as problematic for sick-listed citizens in everyday life with chronic pain, and (2) Evaluate the significance of two distinct rehabilitative interventions on the future everyday lives of sick-listed citizens. Seven semi-structured interviews with sick-listed citizens were analyzed using a phenomenological-hermeneutical approach. Results were discussed by applying the theoretical framework of Antonovsky's salutogenetic model and Yaloms principles for group psychology. The potential for development of citizen's coping is evaluated based on Roessler's notion of progression. The analysis revealed four main themes: (1) Living with pain and unemployment; (2) "Putting my foot down" and "asking for help"; (3) Significance of the group, including instructors, and; (4) Aspects significant to progression. Unemployment is a major life event that promotes stress and can be accompanied by problems related to depressed mood, acceptance of the life situation, feelings of not being useful, feelings of losing control and identity conflicts. Group characteristics that gave a significant basis for progression in the self-management program are both emotional and instrumental, while the physical training program offers a "here-and-now"-experience and motivation to participate. This study indicates that the self-management program could potentially improve coping while the physical activity program revealed one example of a means of progression.

  16. Morning Sickness

    MedlinePlus

    ... legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana ... during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your ... there medical treatment for morning sickness? Yes. If you can’ ...

  17. Morning Sickness

    MedlinePlus

    ... legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana ... during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your ... there medical treatment for morning sickness? Yes. If you can’ ...

  18. Is poor sleep quality at high altitude separate from acute mountain sickness? Factor structure and internal consistency of the Lake Louise Score Questionnaire.

    PubMed

    Macinnis, Martin J; Lanting, Shawnda C; Rupert, Jim L; Koehle, Michael S

    2013-12-01

    The factor structure and internal consistency of the Lake Louise Score Questionnaire (LLSQ) have not been determined in a large population at high altitude; however, a single-factor structure and a high internal consistency are preferable for accurate clinical and research applications of the LLSQ. A large group of Nepalese pilgrims (n=491) were assessed for acute mountain sickness with a verbal Nepali translation of the LLSQ after rapidly ascending from 1950 m to 4380 m. The factor structure and internal consistency of the LLSQ were determined with a confirmatory factor analysis (CFA) and the ordinal alpha coefficient, respectively. A one-factor structure with all five items of the LLSQ was accepted. Four items (headache, gastrointestinal upset, fatigue/weakness, and dizziness/lightheadedness) loaded strongly on this factor (>0.70), but sleep quality had a low factor loading (0.33). The internal consistency (ordinal alpha coefficient) was 0.79, but removing the sleep quality item improved this value to 0.84. The sleep quality item of the LLSQ was weakly related to the other items of the LLSQ. Future research should further investigate whether impaired sleep at altitude should be considered separately from other symptoms of AMS.

  19. Analysis of High-altitude Syndrome and the Underlying Gene Polymorphisms Associated with Acute Mountain Sickness after a Rapid Ascent to High-altitude

    NASA Astrophysics Data System (ADS)

    Yu, Jie; Zeng, Ying; Chen, Guozhu; Bian, Shizhu; Qiu, Youzhu; Liu, Xi; Xu, Baida; Song, Pan; Zhang, Jihang; Qin, Jun; Huang, Lan

    2016-12-01

    To investigated the objective indicators and potential genotypes for acute mountain sickness (AMS). 176 male subjects were evaluated for symptoms scores and physiological parameters at 3700 m. EPAS1 gene polymorphisms were explored and verified effects of potential genotypes on pulmonary function by inhaled budesonide. The incidence of AMS was 53.98% (95/176). The individuals who suffered from headache with anxiety and greater changes in heart rate (HR), the forced vital capacity (FVC), and mean flow velocity of basilar artery (Vm-BA), all of which were likely to develop AMS. The rs4953348 polymorphism of EPAS1 gene had a significant correlation with the SaO2 level and AMS, and a significant difference in the AG and GG genotype distribution between the AMS and non-AMS groups. The spirometric parameters were significantly lower, but HR (P = 0.036) and Vm-BA (P = 0.042) significantly higher in the AMS subjects with the G allele than those with the A allele. In summary, changes in HR (≥82 beats/min), FVC (≤4.2 Lt) and Vm-BA (≥43 cm/s) levels may serve as predictors for diagnosing AMS accompanied by high-altitude syndrome. The A allele of rs4953348 is a protective factor for AMS through HR and Vm-BA compensation, while the G allele may contribute to hypoxic pulmonary hypertension in AMS.

  20. Reduced incidence and severity of acute mountain sickness in Qinghai-Tibet railroad construction workers after repeated 7-month exposures despite 5-month low altitude periods.

    PubMed

    Wu, Tian Yi; Ding, Shou Quan; Liu, Jin Liang; Yu, Man Tang; Jia, Jian Hou; Duan, Jun Qing; Chai, Zuo Chuan; Dai, Rui Chen; Zhang, Sheng Lin; Liang, Bao Zhu; Zhao, Ji Zhui; Qi, De Tang; Sun, Yong Fu; Kayser, Bengt

    2009-01-01

    The construction of the Qinghai-Tibet railroad provided a unique opportunity to study the relation between intermittent altitude exposure and acute mountain sickness (AMS). For 5 yr, workers spent 7-month periods at altitude interspaced with 5-month periods at sea level; the incidence, severity, and risk factors of AMS were prospectively investigated. Six hundred lowlanders commuted for 5 yr between near sea level and approximately 4500 m and were compared to 600 other lowland workers, recruited each year upon their first ascent to high altitude as newcomers, and to 200 Tibetan workers native to approximately 4500 m. AMS was assessed with the Lake Louise Scoring System. The incidence and severity of AMS in commuters were lower upon each subsequent exposure, whereas they remained similar in newcomers each year. AMS susceptibility was thus lowered by repeated exposure to altitude. Repeated exposure increased resting Sao(2) and decreased resting heart rate. Tibetans had no AMS, higher Sao(2), and lower heart rates. In conclusion, repetitive 7-month exposures increasingly protect lowlanders against AMS, even when interspaced with 5-month periods spent at low altitude, but do not allow attaining the level of adaptation of altitude natives.

  1. Heart rate variability changes at 2400 m altitude predicts acute mountain sickness on further ascent at 3000–4300 m altitudes

    PubMed Central

    Karinen, Heikki M.; Uusitalo, Arja; Vähä-Ypyä, Henri; Kähönen, Mika; Peltonen, Juha E.; Stein, Phyllis K.; Viik, Jari; Tikkanen, Heikki O.

    2012-01-01

    Objective: If the body fails to acclimatize at high altitude, acute mountain sickness (AMS) may result. For the early detection of AMS, changes in cardiac autonomic function measured by heart rate variability (HRV) may be more sensitive than clinical symptoms alone. The purpose of this study was to ascertain if the changes in HRV during ascent are related to AMS. Methods: We followed Lake Louise Score (LLS), arterial oxygen saturation at rest (R-SpO2) and exercise (Ex-SpO2) and HRV parameters daily in 36 different healthy climbers ascending from 2400 m to 6300 m altitudes during five different expeditions. Results: After an ascent to 2400 m, root mean square successive differences, high-frequency power (HF2 min) of HRV were 17–51% and Ex-SpO2 was 3% lower in those climbers who suffered from AMS at 3000 to 4300 m than in those only developing AMS later (≥5000 m) or not at all (all p < 0.01). At the altitude of 2400 m RMSSD2 min ≤ 30 ms and Ex-SpO2 ≤ 91% both had 92% sensitivity for AMS if ascent continued without extra acclimatization days. Conclusions: Changes in supine HRV parameters at 2400 m were related to AMS at 3000–4300 m Thus, analyses of HRV could offer potential markers for identifying the climbers at risk for AMS. PMID:22969727

  2. Analysis of High-altitude Syndrome and the Underlying Gene Polymorphisms Associated with Acute Mountain Sickness after a Rapid Ascent to High-altitude

    PubMed Central

    Yu, Jie; Zeng, Ying; Chen, Guozhu; Bian, Shizhu; Qiu, Youzhu; Liu, Xi; Xu, Baida; Song, Pan; Zhang, Jihang; Qin, Jun; Huang, Lan

    2016-01-01

    To investigated the objective indicators and potential genotypes for acute mountain sickness (AMS). 176 male subjects were evaluated for symptoms scores and physiological parameters at 3700 m. EPAS1 gene polymorphisms were explored and verified effects of potential genotypes on pulmonary function by inhaled budesonide. The incidence of AMS was 53.98% (95/176). The individuals who suffered from headache with anxiety and greater changes in heart rate (HR), the forced vital capacity (FVC), and mean flow velocity of basilar artery (Vm-BA), all of which were likely to develop AMS. The rs4953348 polymorphism of EPAS1 gene had a significant correlation with the SaO2 level and AMS, and a significant difference in the AG and GG genotype distribution between the AMS and non-AMS groups. The spirometric parameters were significantly lower, but HR (P = 0.036) and Vm-BA (P = 0.042) significantly higher in the AMS subjects with the G allele than those with the A allele. In summary, changes in HR (≥82 beats/min), FVC (≤4.2 Lt) and Vm-BA (≥43 cm/s) levels may serve as predictors for diagnosing AMS accompanied by high-altitude syndrome. The A allele of rs4953348 is a protective factor for AMS through HR and Vm-BA compensation, while the G allele may contribute to hypoxic pulmonary hypertension in AMS. PMID:27982053

  3. Direct measurement of intracranial pressure at high altitude and correlation of ventricular size with acute mountain sickness: Brian Cummins' results from the 1985 Kishtwar expedition.

    PubMed

    Wilson, Mark H; Milledge, James

    2008-11-01

    The "tight-fit" hypothesis and subsequent current understanding of acute mountain sickness (AMS) is that individuals with less compliant cerebrospinal fluid systems (smaller ventricles and cerebrospinal fluid spaces) have a greater increase in intracranial pressure (ICP) for a given increase in brain volume as a result of hypoxic cerebral edema. There has only been 1 study of direct (telemetric) ICP measurement at high altitude. This was performed in 1985 on 3 subjects by Brian Cummins up to a maximum height of 16,500 ft (5030 m). The group also investigated the "tight-fit" hypothesis by correlating computed tomographic scans that measured ventricular size (read blindly) with headache score and AMS symptomatology in 10 subjects. Unfortunately, the data were thought to have been destroyed by fire, and, hence, the findings were not published. The data have now been rediscovered, and this article reviews the methodology and findings of this unique piece of work. The ICP monitoring study demonstrated that ICP remained normal at rest at all altitudes; however, in the single subject with AMS, there was a dramatic increase in ICP even on minimal exertion. The computed tomographic scan analysis of brain compliance demonstrated an inverse correlation between ventricular size and headache score. This unique research, which is unlikely to ever be repeated, is the only report of direct ICP measurement at high altitude. This and the computed tomographic study provide the first objective evidence supporting the "tight-fit" hypothesis of AMS.

  4. Effects of dietary nitrate supplementation on symptoms of acute mountain sickness and basic physiological responses in a group of male adolescents during ascent to Mount Everest Base Camp.

    PubMed

    Hennis, Philip J; Mitchell, Kay; Gilbert-Kawai, Edward; Bountziouka, Vassiliki; Wade, Angie; Feelisch, Martin; Grocott, Michael P; Martin, Daniel S

    2016-11-30

    The purpose of this study was to investigate the effects of dietary nitrate supplementation, in the form of beetroot juice, on acute mountain sickness (AMS) symptoms and physiological responses, in a group of young males trekking to Mount Everest Base Camp (EBC). Forty healthy male students (mean age (SD): 16 (1) yrs) trekked to EBC over 11 days. Following an overnight fast, each morning participants completed the Lake Louise AMS questionnaire and underwent a series of physiological tests: resting blood pressure as well as resting and exercising heart rate, respiratory rate, and peripheral oxygen saturation. The exercise test consisted of a standardised 2-min stepping protocol and measurements were taken in the last 10 s. Participants in the intervention arm of the study consumed 140 ml of concentrated beetroot juice daily, containing approximately 10 mmol of nitrate, while those in the control arm consumed 140 ml of concentrated blackcurrant cordial with negligible nitrate content. Drinks were taken for the first seven days at high altitude (days 2-8), in two equal doses; one with breakfast, and one with the evening meal. Mixed modelling revealed no significant between-groups difference in the incidence of AMS (Odds Ratio - nitrate vs.

  5. Twice-daily assessment of trekkers on Kilimanjaro's Machame route to evaluate the incidence and time-course of acute mountain sickness.

    PubMed

    Meyer, Joel

    2012-12-01

    Acute mountain sickness (AMS) in high altitude trekkers is common, often trek-limiting, and occasionally fatal. The incidence of AMS can be modified by prudent ascent profile and route selection. It is not known whether the 6-day Machame route may enhance acclimatization on Kilimanjaro (5895 m) by 'sleeping low' on the third day. This report presents real time twice-daily AMS data from 28 healthy adult trekkers on the Machame route. The incidences of AMS and severe AMS were: 0% and 0% (day 1); 11% and 4% (day 2); 25% and 4% (day 3); 25% and 0% (day 4); 86% and 61% (summit day 5); and 7% and 0% (day 6), respectively. High altitude cerebral edema occurred in 4 of 28 trekkers (14%). On summit day, the median Lake Louise Symptom Score (LLSS) was 8 (range 2 to 15). Twice-daily measurements of AMS symptoms provide detailed insight into the time-course and evolution of AMS during ascent on Kilimanjaro. The 6-day Machame route may delay the onset but does not ultimately protect against AMS. The extremely high incidence and severity of AMS on summit day is of major concern to trekkers, portering staff, expedition medical staff, and leaders.

  6. AltitudeOmics: cerebral autoregulation during ascent, acclimatization, and re-exposure to high altitude and its relation with acute mountain sickness.

    PubMed

    Subudhi, Andrew W; Fan, Jui-Lin; Evero, Oghenero; Bourdillon, Nicolas; Kayser, Bengt; Julian, Colleen G; Lovering, Andrew T; Panerai, Ronney B; Roach, Robert C

    2014-04-01

    Cerebral autoregulation (CA) acts to maintain brain blood flow despite fluctuations in perfusion pressure. Acute hypoxia is thought to impair CA, but it is unclear if CA is affected by acclimatization or related to the development of acute mountain sickness (AMS). We assessed changes in CA using transfer function analysis of spontaneous fluctuations in radial artery blood pressure (indwelling catheter) and resulting changes in middle cerebral artery blood flow velocity (transcranial Doppler) in 21 active individuals at sea level upon arrival at 5,260 m (ALT1), after 16 days of acclimatization (ALT16), and upon re-exposure to 5,260 m after 7 days at 1,525 m (POST7). The Lake Louise Questionnaire was used to evaluate AMS symptom severity. CA was impaired upon arrival at ALT1 (P < 0.001) and did not change with acclimatization at ALT16 or upon re-exposure at POST7. CA was not associated with AMS symptoms (all R < 0.50, P > 0.05). These findings suggest that alterations in CA are an intrinsic consequence of hypoxia and are not directly related to the occurrence or severity of AMS.

  7. A pilot study on the prevalence of Acute Mountain Sickness at the Sikh pilgrimage of Hemkund Sahib in the Indian Himalayas

    PubMed Central

    Sahota, Inderjeet S.; Panwar, Nidhi S.

    2013-01-01

    Background: Hemkund Sahib is a popular pilgrimage located at 4,330 m in the Garhwal range of the Indian Himalayas. Many travelers to the region have observed pilgrims exhibiting Acute Mountain Sickness (AMS)-like symptoms. However, no systematic study on its prevalence at Hemkund has been conducted. Materials and Methods: We surveyed 25 adults. AMS rates were determined using a standard Lake Louise Score (LLS). Responses to questions related to awareness of AMS, the perceived difficulty of the trek, and physiological data including arterial oxygen saturation (SpO2) and pulse rate, amongst others, were collected. Results: Overall prevalence of AMS was 28% (mild AMS 20%, severe AMS 8%). Borg Rating of Perceived Exertion (RPE) was 3.9/10. Water consumption for the 4-5 hour trek to Hemkund was only 0.9 L and 20% of pilgrims consumed no water at all. Nine pilgrims claimed to be aware of AMS although only one had taken prophylactic medication. SpO2 was 82.2 ± 1.2% and pulse rate was 106.5 ± 2.9 bpm (mean ± SEM). There were no differences in non-LLS-related parameters when pilgrims were subdivided by presence or absence of AMS. Conclusion: This pilot study has, for the first time, documented the prevalence of AMS amongst pilgrims to Hemkund Sahib in the Indian Himalayas. PMID:24082642

  8. Analysis of High-altitude Syndrome and the Underlying Gene Polymorphisms Associated with Acute Mountain Sickness after a Rapid Ascent to High-altitude.

    PubMed

    Yu, Jie; Zeng, Ying; Chen, Guozhu; Bian, Shizhu; Qiu, Youzhu; Liu, Xi; Xu, Baida; Song, Pan; Zhang, Jihang; Qin, Jun; Huang, Lan

    2016-12-16

    To investigated the objective indicators and potential genotypes for acute mountain sickness (AMS). 176 male subjects were evaluated for symptoms scores and physiological parameters at 3700 m. EPAS1 gene polymorphisms were explored and verified effects of potential genotypes on pulmonary function by inhaled budesonide. The incidence of AMS was 53.98% (95/176). The individuals who suffered from headache with anxiety and greater changes in heart rate (HR), the forced vital capacity (FVC), and mean flow velocity of basilar artery (Vm-BA), all of which were likely to develop AMS. The rs4953348 polymorphism of EPAS1 gene had a significant correlation with the SaO2 level and AMS, and a significant difference in the AG and GG genotype distribution between the AMS and non-AMS groups. The spirometric parameters were significantly lower, but HR (P = 0.036) and Vm-BA (P = 0.042) significantly higher in the AMS subjects with the G allele than those with the A allele. In summary, changes in HR (≥82 beats/min), FVC (≤4.2 Lt) and Vm-BA (≥43 cm/s) levels may serve as predictors for diagnosing AMS accompanied by high-altitude syndrome. The A allele of rs4953348 is a protective factor for AMS through HR and Vm-BA compensation, while the G allele may contribute to hypoxic pulmonary hypertension in AMS.

  9. Detection of anticonductive tissue autoantibodies in a patient with chronic intestinal pseudo-obstruction and sick sinus syndrome.

    PubMed

    Caio, Giacomo; Volta, Umberto; Cerrato, Enrico; Clavenzani, Paolo; Montali, Nicolò; Cogliandro, Rosanna; Stanghellini, Vincenzo; Golzio, Pier Giorgio; Gaita, Fiorenzo; Farrugia, Gianrico; De Giorgio, Roberto

    2013-11-01

    A 26-year-old patient was diagnosed as having chronic intestinal pseudo-obstruction with manometric and histopathologic features suggestive of an intestinal myopathy. Histology was characterized by smooth muscle degeneration without inflammatory or immune cells. The severe gut dysfunction required full parenteral nutritional support. After a few months, the patient developed symptomatic tachy-brady arrhythmia episodes with syncopes. A thorough diagnostic work-up led to a diagnosis of sick sinus syndrome, which was managed by pacemaker implantation and administration of β-blockers. This led to a partial improvement in tachy-brady arrhythmia episodes. Nonetheless, the patient continued to experience sustained supraventricular tachyarrhythmia runs, poorly responsive to increasing β-blocker doses. To investigate the origin of the cardiologic impairment, the patient was tested for anticonductive tissue autoantibodies, which were positive, thus supporting a possible autoimmune origin of the dysrhythmia. Other autoantibodies were negative. On the basis of these findings, the patient was treated with high-dose steroids, which were then tapered. The patient responded to the steroid treatment and did not experience further episodes of syncope and tachyarrhythmias. The severe gut dysfunction remained unchanged. This case highlights an association between severe gut dysfunction and cardiac conductive tissue abnormalities, with autoantibodies to conductive tissue possibly causing the dysrhythmia. The severe gut and heart (likely autoimmune-mediated) dysfunction presented in this case provides a basis to further assess a link between intestinal and cardiac abnormal rhythmicity.

  10. Association analysis of PRNP gene region with chronic wasting disease in Rocky Mountain elk

    USDA-ARS?s Scientific Manuscript database

    Background: Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) of cervids including whitetail (Odocoileus virginianus) and mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces). A leucine variant at position 132 (132L) in...

  11. Too sick for school? Parent influences on school functioning among children with chronic pain

    PubMed Central

    Logan, Deirdre E.; Simons, Laura E.; Carpino, Elizabeth

    2013-01-01

    Parental responses to children with chronic pain have been shown to influence the extent of the child’s functional disability, but these associations have not been well-studied in relation to children’s pain-related school functioning. The current study tests the hypothesis that parental pain catastrophizing and parental protective responses to child pain influence the extent of school impairment in children with chronic pain. A mediational model was tested to determine whether parental protective behaviors serve a mediating role between parental pain catastrophizing and child school impairment. Study participants were a clinical sample of 350 children ages 8–17 with chronic pain and their parents. Measures of pain characteristics, demographic characteristics, child depressive symptoms, school attendance rates, overall school functioning, parental pain catastrophizing and parental protective responses to pain were collected. Results show that, controlling for the known influences of pain intensity and child depressive symptoms, parental pain catastrophizing and parental protective responses to child pain each independently predict child school attendance rates and reports of overall school impairment. Parental protectiveness was found to mediate the association between parental cognitions (i.e. parent pain catastrophizing) and child school functioning outcomes. These findings underscore the importance of intervening with parents to foster parental responses to child pain that help children engage and succeed in the school environment despite pain. PMID:22169177

  12. Too sick for school? Parent influences on school functioning among children with chronic pain.

    PubMed

    Logan, Deirdre E; Simons, Laura E; Carpino, Elizabeth A

    2012-02-01

    Parental responses to children with chronic pain have been shown to influence the extent of the child's functional disability, but these associations have not been well studied in relation to children's pain-related school functioning. The current study tests the hypothesis that parental pain catastrophizing and parental protective responses to child pain influence the extent of school impairment in children with chronic pain. A mediational model was tested to determine whether parental protective behaviors serve a mediating role between parental pain catastrophizing and child school impairment. Study participants were a clinical sample of 350 children ages 8-17 years with chronic pain and their parents. Measures of pain characteristics, demographic characteristics, child depressive symptoms, school attendance rates, overall school functioning, parental pain catastrophizing, and parental protective responses to pain were collected. Results show that, controlling for the known influences of pain intensity and child depressive symptoms, parental pain catastrophizing and parental protective responses to child pain each independently predict child school attendance rates and reports of overall school impairment. Parental protectiveness was found to mediate the association between parental cognitions (i.e., parent pain catastrophizing) and child school functioning outcomes. These findings underscore the importance of intervening with parents to foster parental responses to child pain that help children engage and succeed in the school environment despite pain. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  13. Mountains

    Treesearch

    Regina M. Rochefort; Laurie L. Kurth; Tara W. Carolin; Robert R. Mierendorf; Kimberly Frappier; David L. Steenson

    2006-01-01

    This chapter concentrates on subalpine parklands and alpine meadows of southern British Columbia, Washington, Oregon, and western Montana. These areas lie on the flanks of several mountain ranges including the Olympics, the Cascades of Oregon and Washington, and the Coast Mountains in British Columbia.

  14. MEDEX2015: Greater Sea-Level Fitness Is Associated with Lower Sense of Effort During Himalayan Trekking Without Worse Acute Mountain Sickness.

    PubMed

    Rossetti, Gabriella M K; Macdonald, Jamie H; Smith, Matthew; Jackson, Anna R; Callender, Nigel; Newcombe, Hannah K; Storey, Heather M; Willis, Sebastian; van den Beukel, Jojanneke; Woodward, Jonathan; Pollard, James; Wood, Benjamin; Newton, Victoria; Virian, Jana; Haswell, Owen; Oliver, Samuel J

    2017-06-01

    Rossetti, Gabriella M.K., Jamie H. Macdonald, Matthew Smith, Anna R. Jackson, Nigel Callender, Hannah K. Newcombe, Heather M. Storey, Sebastian Willis, Jojanneke van den Beukel, Jonathan Woodward, James Pollard, Benjamin Wood, Victoria Newton, Jana Virian, Owen Haswell, and Samuel J. Oliver. MEDEX2015: Greater sea-level fitness is associated with lower sense of effort during Himalayan trekking without worse acute mountain sickness. High Alt Med Biol. 18:152-162, 2017.-This study examined the complex relationships of fitness and hypoxic sensitivity with submaximal exercise responses and acute mountain sickness (AMS) at altitude. Determining these relationships is necessary before fitness or hypoxic sensitivity tests can be recommended to appraise individuals' readiness for altitude. Forty-four trekkers (26 men; 18 women; 20-67 years) completed a loaded walking test and a fitness questionnaire in normoxia to measure and estimate sea-level maximal aerobic capacity (maximum oxygen consumption [[Formula: see text]O2max]), respectively. Participants also completed a hypoxic exercise test to determine hypoxic sensitivity (cardiac, ventilatory, and arterial oxygen saturation responses to acute hypoxia, fraction of inspired oxygen [Fio2] = 0.112). One month later, all participants completed a 3-week trek to 5085 m with the same ascent profile. On ascent to 5085 m, ratings of perceived exertion (RPEascent), fatigue by Brunel Mood Scale, and AMS were recorded daily. At 5085 m, RPE during a fixed workload step test (RPEfixed) and step rate during perceptually regulated exercise (STEPRPE35) were recorded. Greater sea-level [Formula: see text]O2max was associated with, and predicted, lower sense of effort (RPEascent; r = -0.43; p < 0.001; RPEfixed; r = -0.69; p < 0.001) and higher step rate (STEPRPE35; r = 0.62; p < 0.01), but not worse AMS (r = 0.13; p = 0.4) or arterial oxygen desaturation (r = 0.07; p = 0.7). Lower RPEascent

  15. [Motion sickness].

    PubMed

    Taillemite, J P; Devaulx, P; Bousquet, F

    1997-01-01

    Motion sickness is a general term covering sea-sickness, car-sickness, air-sickness, and space-sickness. Symptoms can occur when a person is exposed to unfamiliar movement whether real or simulated. Despite progress in the technology and comfort of modern transportation (planes, boats, and overland vehicles), a great number of travelers still experience motion sickness. Bouts are characterized by an initial phase of mild discomfort followed by neurologic and gastro-intestinal manifestations. The delay in onset depends on specific circumstances and individual susceptibility. Attacks are precipitated by conflicting sensory, visual, and vestibular signals but the underlying mechanism is unclear. Most medications used for prevention and treatment (e.g. anticholinergics and antihistamines) induce unwanted sedation. Furthermore no one drug is completely effective or preventive under all conditions.

  16. Who are more at risk for acute mountain sickness: a prospective study in Qinghai-Tibet railroad construction workers on Mt. Tanggula.

    PubMed

    Wu, Tian-yi; Ding, Shou-quan; Liu, Jin-liang; Jia, Jian-hou; Chai, Zuo-chun; Dai, Rui-chen

    2012-04-01

    It is important to determine the incidence of acute mountain sickness (AMS) among workers at altitudes between 3500 m and 5000 m on Mt. Tanggula during the construction of the Qinghai-Tibet railroad. This study explored the risk factors predisposing workers to developing AMS and attempted to develop more effective ways of preventing and treating AMS. A total of 11,182 workers were surveyed by completing twice daily a Lake Louise questionnaire, and a score ≥ 3 indicated AMS. The contributing risk factors were assessed for at least 2 months for the duration of the study in the years from 2001 to 2003. A risk model was developed by multiple Logistic regression. Standard statistical methods were used to analyze data. AMS occurred in 56% of workers working at high altitudes on Mt. Tanggula. The incidence of AMS increased with increasing altitude. Rapid ascent to an altitude above 3500 m, sea-level or lowland newcomers, young people under 25 years of age, heavy physical exertion, obese person, and arterial oxygen saturation (SaO2) below 80% were independent AMS risk factors. No significant association was found between AMS and sex or taking Rhodiola. Medical education contributed to an early diagnosis of AMS. This study used the Lake Louise scoring system suggesting that it is a well-validated standard for field evaluation of AMS and for making an early diagnosis. These studies have described many variables regarding risk factors for the development of AMS. Risk factors which can be modified should be attended to, and the physicians should carry out check-ups and tests to identify subjects who are more at risk. Prevention consists in continuous gradual ascent, medical education, and prompt descent to avoid progression in patients with serious AMS. It is most important to effectively control the risk factors of AMS.

  17. Benzolamide improves oxygenation and reduces acute mountain sickness during a high-altitude trek and has fewer side effects than acetazolamide at sea level.

    PubMed

    Collier, David J; Wolff, Chris B; Hedges, Anne-Marie; Nathan, John; Flower, Rod J; Milledge, James S; Swenson, Erik R

    2016-06-01

    Acetazolamide is the standard carbonic anhydrase (CA) inhibitor used for acute mountain sickness (AMS), however some of its undesirable effects are related to intracellular penetrance into many tissues, including across the blood-brain barrier. Benzolamide is a much more hydrophilic inhibitor, which nonetheless retains a strong renal action to engender a metabolic acidosis and ventilatory stimulus that improves oxygenation at high altitude and reduces AMS. We tested the effectiveness of benzolamide versus placebo in a first field study of the drug as prophylaxis for AMS during an ascent to the Everest Base Camp (5340 m). In two other studies performed at sea level to test side effect differences between acetazolamide and benzolamide, we assessed physiological actions and psychomotor side effects of two doses of acetazolamide (250 and 1000 mg) in one group of healthy subjects and in another group compared acetazolamide (500 mg), benzolamide (200 mg) and lorazepam (2 mg) as an active comparator for central nervous system (CNS) effects. At high altitude, benzolamide-treated subjects maintained better arterial oxygenation at all altitudes (3-6% higher at all altitudes above 4200 m) than placebo-treated subjects and reduced AMS severity by roughly 50%. We found benzolamide had fewer side effects, some of which are symptoms of AMS, than any of the acetazolamide doses in Studies 1 and 2, but equal physiological effects on renal function. The psychomotor side effects of acetazolamide were dose dependent. We conclude that benzolamide is very effective for AMS prophylaxis. With its lesser CNS effects, benzolamide may be superior to acetazolamide, in part, because some of the side effects of acetazolamide may contribute to and be mistaken for AMS.

  18. The effects of a 5-lipoxygenase inhibitor on acute mountain sickness and urinary leukotriene e4 after ascent to high altitude.

    PubMed

    Grissom, Colin K; Richer, Lori D; Elstad, Mark R

    2005-02-01

    Elevated urine and blood leukotriene levels have been reported after ascent to high altitude in association with acute mountain sickness (AMS) and high-altitude pulmonary edema. Zileuton is an inhibitor of the enzyme 5-lipoxygenase that catalyzes conversion of arachidonic acid to leukotrienes. Study objectives and design: The objectives of this randomized, double-blind, placebo-controlled clinical trial were to determine whether zileuton (600 mg po qid) is effective prophylaxis for AMS, and to measure the effect of ascent to high altitude and zileuton on urinary leukotriene E(4) levels. The study group consisted of volunteers from among climbers on the West Buttress of Mt. McKinley (Denali), Alaska. After baseline urine samples at sea level, subjects flew by airplane to 2,300 m, and then ascended to the 4,200-m camp in 5 to 10 days. Using an enzyme immunoassay, urinary leukotriene E(4) was found to decrease after ascent to high altitude in both the zileuton and placebo groups. Urinary leukotriene E(4) in the zileuton group (n = 9) decreased from 67 +/- 35 pg/mg creatinine at sea level to 33 +/- 22 pg/mg creatinine at high altitude (p = 0.003) [mean +/- SD]. Urinary leukotriene E(4) in the placebo group (n = 9) decreased from 97 +/- 82 pg/mg creatinine at sea level to 44 +/- 21 pg/mg creatinine at high altitude (p = 0.045). One subject in the zileuton group and three subjects in the placebo group met Lake Louise criteria for AMS after arriving at 4,200 m (p = 0.257). Elevated leukotrienes are not associated with ascent to high altitude. In subjects with AMS, urinary leukotrienes were not elevated, suggesting that leukotrienes may not be a component of the pathophysiology of AMS. The low incidence of AMS and the small sample size in this study prevented determination of whether zileuton is effective prophylaxis for AMS.

  19. A Preliminary Genome-Wide Association Study of Acute Mountain Sickness Susceptibility in a Group of Nepalese Pilgrims Ascending to 4380 m.

    PubMed

    MacInnis, Martin J; Widmer, Nadia; Timulsina, Utsav; Subedi, Ankita; Siwakoti, Ashmita; Pandit, Bidur Prasad; Freeman, Michael G; Carter, Eric A; Manokhina, Irina; Thapa, Ghan Bahadur; Koehle, Michael S

    2015-12-01

    There is significant interindividual variation in acute mountain sickness (AMS) susceptibility in humans. To identify genes related to AMS susceptibility, we used a genome-wide association study (GWAS) to simultaneously test associations between genetic variants dispersed throughout the genome and the presence and severity of AMS. DNA samples were collected from subjects who ascended rapidly to Gosainkunda, Nepal (4380 m), as part of the 2005, 2010, and 2012 Janai Purnima festivals. The Lake Louise Score was used to measure AMS severity. The primary analysis was based on 99 male subjects (43 with AMS; 56 without AMS). Genotyping for the GWAS was performed using Infinium Human Core Exome Bead Chips (542,556 single-nucleotide polymorphisms were assayed), and validation genotyping was performed with pyrosequencing in two additional cohorts (n = 101 for each). In total, 270,389 single nucleotide polymorphisms (SNPs) passed quality control, and 4 SNPs (one intronic, three nonsynonymous) in the FAM149A gene were associated with AMS severity after correcting for multiple hypothesis testing (p = 1.8E-7); however, in the validation cohorts, FAM149A was not associated with the presence or severity of AMS. No other genes were associated with AMS susceptibility at the genome-wide level. Due to the large influence of environmental factors (i.e., ascent rate and altitude attained) and the difficulties associated with the AMS phenotype (i.e., low repeatability, nonspecific symptoms, potentially independent ailments), we suggest that future studies addressing the variation in the acute human hypoxia response should focus on objective responses to acute hypoxia instead of AMS.

  20. Female sickness absenteeism in Poland.

    PubMed

    Indulski, J A; Szubert, Z

    1996-01-01

    It is observed that the working activity period has recently been decreasing in Poland; this applies to both the male and female populations. Since women constitute 48% of all workers employed in the national economy, this tendency may pose an important problem for the community and public health. The main information source for the absenteeism analysis are medical certificates which in Poland obligatorily document every instance of a sick-leave from work, irrespective of the length of sickness. A 15% random sample of all sickness certificates constitutes a database for the monitoring system of sickness absence. The lost time rate is the main parameter analysed by the system. In 1994 the rate of female sickness absence in Poland amounted to 25.1 days per one employee. In Poland the main causes of female sickness absence are: respiratory diseases--18% of all sickness absence (in the 16-19 age group--49%), and disorders of female genital tract and complications of pregnancy, childbirth and puerperium (17% of all sickness absence and 48% in the 20-29 age group). The most important chronic diseases that substantially contribute to the level of sickness absence include: musculoskeletal diseases (15%), diseases of the circulatory system (15%) and the nervous system and sense organs (11%). Over the period of 1990-1994 the highest rate of the female sickness absence related to gynecological diseases and pregnancy complications (mean annual increase--22%), and the musculoskeletal diseases (mean annual increase--10%).

  1. Effect of repeated normobaric hypoxia exposures during sleep on acute mountain sickness, exercise performance, and sleep during exposure to terrestrial altitude.

    PubMed

    Fulco, Charles S; Muza, Stephen R; Beidleman, Beth A; Demes, Robby; Staab, Janet E; Jones, Juli E; Cymerman, Allen

    2011-02-01

    There is an expectation that repeated daily exposures to normobaric hypoxia (NH) will induce ventilatory acclimatization and lessen acute mountain sickness (AMS) and the exercise performance decrement during subsequent hypobaric hypoxia (HH) exposure. However, this notion has not been tested objectively. Healthy, unacclimatized sea-level (SL) residents slept for 7.5 h each night for 7 consecutive nights in hypoxia rooms under NH [n = 14, 24 ± 5 (SD) yr] or "sham" (n = 9, 25 ± 6 yr) conditions. The ambient percent O(2) for the NH group was progressively reduced by 0.3% [150 m equivalent (equiv)] each night from 16.2% (2,200 m equiv) on night 1 to 14.4% (3,100 m equiv) on night 7, while that for the ventilatory- and exercise-matched sham group remained at 20.9%. Beginning at 25 h after sham or NH treatment, all subjects ascended and lived for 5 days at HH (4,300 m). End-tidal Pco(2), O(2) saturation (Sa(O(2))), AMS, and heart rate were measured repeatedly during daytime rest, sleep, or exercise (11.3-km treadmill time trial). From pre- to posttreatment at SL, resting end-tidal Pco(2) decreased (P < 0.01) for the NH (from 39 ± 3 to 35 ± 3 mmHg), but not for the sham (from 39 ± 2 to 38 ± 3 mmHg), group. Throughout HH, only sleep Sa(O(2)) was higher (80 ± 1 vs. 76 ± 1%, P < 0.05) and only AMS upon awakening was lower (0.34 ± 0.12 vs. 0.83 ± 0.14, P < 0.02) in the NH than the sham group; no other between-group rest, sleep, or exercise differences were observed at HH. These results indicate that the ventilatory acclimatization induced by NH sleep was primarily expressed during HH sleep. Under HH conditions, the higher sleep Sa(O(2)) may have contributed to a lessening of AMS upon awakening but had no impact on AMS or exercise performance for the remainder of each day.

  2. Acute mountain sickness among tourists visiting the high-altitude city of Lhasa at 3658 m above sea level: a cross-sectional study.

    PubMed

    Gonggalanzi; Labasangzhu; Nafstad, Per; Stigum, Hein; Wu, Tianyi; Haldorsen, Øyvind Drejer; Ommundsen, Kristoffer; Bjertness, Espen

    2016-01-01

    Traveling to Tibet implies a risk for developing acute mountain sickness (AMS), and the size of this problem is likely increasing due to the rising number of tourists. No previous study on AMS has been conducted among the general tourist population in Tibet. Thus, the aim of this study was to estimate the prevalence and determinants of AMS in a large tourist population visiting Lhasa. A sample of 2385 tourists was recruited from seven randomly selected hotels in Lhasa between June and October 2010. Within three days of their first arrival, the participants filled in a questionnaire based on the Lake Louise Scoring System (LLSS) about AMS-related symptoms and potential contributing factors. AMS was defined as the presence of headache and a cumulative Lake Louise Score ≥4. After estimating the prevalence of AMS, a Log-Binomial Model was applied to analyse the relationship between AMS and selected risk factors. The prevalence of AMS was 36.7 % (95 % CI: 34.6-38.7 %) and was not dependent on tourists' country of origin. Among the participants who developed AMS, 47.6 % reported that they experienced symptoms within the first 12 h after arriving in Lhasa, and 79.0 % reported that they had to reduce their activity level. A poor or average health condition (adjusted PR 1.63, 95 % CI 1.38-1.93), an age below 55 years (adjusted PR 1.29, 95 % CI 1.04-1.60), a rapid ascent to Lhasa (adjusted PR 1.17, 95 % CI 1.02-1.34) were independent AMS risk factors, while smoking (adjusted PR 0.75, 95 % CI 0.59-0.96) and pre-exposure to high altitude (adjusted PR 0.71, 95 % CI 0.60-0.84) reduced the risk of AMS. AMS is commonly experienced by tourists visiting Lhasa Tibet, and often affects their activities. The tourists' country of origin did not seem to affect their risk of AMS, and their age was inversely related to AMS. Subjects planning to visit a high-altitude area should be prepared for experiencing AMS-related problems, and consider preventive measures such as pre

  3. Efficacy of residence at moderate versus low altitude on reducing acute mountain sickness in men following rapid ascent to 4300 m.

    PubMed

    Staab, Janet E; Beidleman, Beth A; Muza, Stephen R; Fulco, Charles S; Rock, Paul B; Cymerman, Allen

    2013-03-01

    To determine if residence at moderate (~2000 m) compared to low (<50 m) altitude reduces acute mountain sickness (AMS) in men during subsequent rapid ascent to a higher altitude. Nine moderate-altitude residents (MAR) and 18 sea-level residents (SLR) completed the Environmental Symptoms Questionnaire (ESQ) at their respective baseline residence and again at 12, 24, 48, and 72 h at 4300 m to assess the severity and prevalence of AMS. AMS cerebral factor score (AMS-C) was calculated from the ESQ at each time point. AMS was judged to be present if AMS-C was ≥0.7. Resting end-tidal CO2 (PETco2) and arterial oxygen saturation (Sao2) were assessed prior to and at 24, 48, and 72 h at 4300 m. Resting venous blood samples were collected prior to and at 72 h at 4300 m to estimate plasma volume (PV) changes. MAR compared to SLR: 1) AMS severity at 4300 was lower (p<0.05) at 12 h (0.50±0.69 vs. 1.48±1.28), 24 h (0.15±0.19 vs. 1.39±1.19), 48 h (0.10±0.18 vs. 1.37±1.49) and 72 h (0.08±0.12 vs. 0.69±0.70); 2) AMS prevalence at 4300 was lower (p<0.05) at 12 h (22% vs. 72%), 24 h (0% vs. 56%), 48 h (0% vs. 56%), and 72 h (0% vs. 45%); 3) resting Sao2 (%) was lower (p<0.05) at baseline (95±1 vs. 99±1) but higher (p<0.05) at 4300 at 24 h (86±2 vs. 81±5), 48 h (88±3 vs. 83±6), and 72 h (88±2 vs. 83±5); and 4) PV (%) did not differ at 72 h at 4300 m in the MAR (4.5±6.7) but was reduced for the SLR (-8.1±10.4). These results suggest that ventilatory and hematological acclimatization acquired while living at moderate altitude, as indicated by a higher resting Sao2 and no reduction in PV during exposure to a higher altitude, is associated with greatly reduced AMS after rapid ascent to high altitude.

  4. Car Sickness

    MedlinePlus

    ... or Animals Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic ... Vaccine Preventable Diseases Healthy Children > Health Issues > Conditions > Head Neck & Nervous System > Car Sickness Health Issues Listen Español ...

  5. Motion Sickness

    MedlinePlus

    ... sickness from certain visual activities, such as playing video games or watching spinning objects. Symptoms can strike without ... of your body. For example, when playing a video game, your eyes may sense that you are moving ...

  6. Sickness absenteeism

    PubMed Central

    Fortuin, G. J.

    1955-01-01

    In this paper, sickness statistics are discussed, with special reference to the differences between medical statistics and those of the sickness benefit organizations. Special attention is paid to the comparability of data from different sources. The distribution of sickness absence among workers appears to be approximately similar to that of a chance event (Poisson distribution). This conclusion applies to pre-war years as well as to the post-war period. Although in the latter period the annual average of sickness absences per worker is much greater, there are no indications that the increase in the frequency rate has to be attributed to specified groups of workers; all workers are equally responsible. The high disability rate cannot be accounted for today by causes such as malnutrition, so the phenomenon must be due to a lowering of the standards by which incapacity for work is judged. Since it is the family physician who sets these standards for the worker, it follows that it is he who is largely responsible for the increased rate of sickness absenteeism. The fact that social insurance has concealed the economic consequences of disabling illnesses from the doctor as well as from the patient is one of the reasons why physicians have tended to relax their disability standards. Family physicians practising under favourable and almost identical conditions within the framework of an industrial health centre may, nevertheless, show considerable differences in attitude. When disability rates were computed separately for the practices of nine general practitioners in the full-time employment of the Medical Department of Philips' Gloeilampenfabrieken, Eindhoven, Netherlands, the results showed that there was no common opinion among the doctors with regard to standards of disability. A closer examination of the available data allows the conclusion to be drawn that it is in the power of medicine to reduce sickness absenteeism substantially without damaging the worker

  7. Association analysis of PRNP gene region with chronic wasting disease in Rocky Mountain elk

    PubMed Central

    2010-01-01

    Background Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) of cervids including white-tailed (Odocoileus virginianus) and mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces). A leucine variant at position 132 (132L) in prion protein of Rocky Mountain elk confers a long incubation time with CWD, but not complete resistance. However, variants in regulatory regions outside the open reading frame of PRNP have been associated with varying degrees of susceptibility to prion disease in other species, and some variants have been observed in similar regions of Rocky Mountain elk PRNP. Thus, additional genetic variants might provide increased protection, either alone or in combination with 132L. Findings This study provided genomic sequence of all exons for PRNP of Rocky Mountain elk. Many functional sites in and around the PRNP gene region were sequenced, and this report approximately doubled (to 75) the number of known variants in this region. A haplotype-tagging approach was used to reduce the number of genetic variants required to survey this variation in the PRNP gene region of 559 Rocky Mountain elk. Eight haplotypes were observed with frequencies over 1.0%, and one haplotype was present at 71.2% frequency, reflecting limited genetic diversity in the PRNP gene region. Conclusions The presence of 132L cut odds of CWD by more than half (Odds Ratio = 0.43; P = 0.0031), which was similar to a previous report. However after accounting for 132L, no association with CWD was found for any additional variants in the PRNP region (P > 0.05). PMID:21087518

  8. Increased risk of chronic wasting disease in Rocky Mountain elk associated with decreased magnesium and increased manganese in brain tissue

    USDA-ARS?s Scientific Manuscript database

    Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) or prion disease of Rocky Mountain elk in North America. CWD is a fatal neurodegenerative disease in which the prolonged and variable incubation time is controlled in part by the host prion precursor genotype. The mis...

  9. Efficacy of ‘Tailored Physical Activity’ or ‘Chronic Pain Self-Management Program’ on return to work for sick-listed citizens: design of a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Pain affects quality of life and can result in absence from work. Treatment and/or prevention strategies for musculoskeletal pain-related long-term sick leave are currently undertaken in several health sectors. Moreover, there are few evidence-based guidelines for such treatment and prevention. The aim of this study is to evaluate the efficacy of ‘Tailored Physical Activity’ or ‘Chronic Pain Self-Management Program’ for sick-listed citizens with pain in the back and/or the upper body. Methods This protocol describes the design of a parallel randomised controlled trial on the efficacy of ‘Tailored Physical Activity’ or a ‘Chronic Pain Self-management Program’ versus a reference group for sick-listed citizens with complaints of pain in the back or upper body. Participants will have been absent from work due to sick-listing for 3 to 9 weeks at the time of recruitment. All interventions will be performed at the ‘Health Care Center’ in the Sonderborg Municipality, and a minimum of 138 participants will be randomised into one of the three groups. All participants will receive ‘Health Guidance’, a (1.5-hour) individualised dialogue focusing on improving ways of living, based on assessments of risk behavior, motivation for change, level of self-care and personal resources. In addition, the experimental groups will receive either ‘Tailored Physical Activity’ (three 50-minute sessions/week over 10 weeks) or ‘Chronic Pain Self-Management Program’ (2.5-hours per week over 6 weeks). The reference group will receive only ‘Health Guidance’. The primary outcome is the participants’ sick-listed status at 3 and 12 months after baseline. The co-primary outcome is the time it takes to return to work. In addition, secondary outcomes include anthropometric measurements, functional capacity and self-reported number of sick days, musculoskeletal symptoms, general health, work ability, physical capacity, kinesiophobia, physical functional

  10. Disseminated vasculomyelinopathy in the peripheral nervous system mediated by immune complexes (ICs). Immunohistochemical studies of sciatic nerves in chronic serum sickness (CHSS) in rabbits.

    PubMed

    Krajewski, S; Szablowska-Krajewska, M

    1986-02-01

    Histological examination of 20 sciatic nerves from rabbits with experimental chronic serum sickness (CHSS) revealed patchy vasculitis of the vasa nervorum of various intensity. The vessel lesions ranged from endothelial proliferation to vessel wall necrosis with fibrinoid degeneration and infiltration by lymphocytes, plasma cells, macrophages and, sporadically, by neutrophils. Perivascularly, there were oedema, chronic infiltrates or small haemorrhages. The myelinated fibres in close relation to the vascular system were focally depleted and features of perivascular demyelination were found. Teased fibres showed paranodal and segmental demyelination, axonal degeneration and, sporadically, remyelination. In all cases, immunofluorescent deposits of bovine serum albumin (BSA), IgG and C3 complement were found in and around some vasa nervorum. Other indirect evidence for immune complex (IC) deposition was provided by ultrastructural examination where vascular and endoneurial osmophilic deposits were found; in 4 cases with paracrystalline organization resembling cryoglobulin component. IC-mediated vasculitis led to blood-nerve barrier impairment and leakage of serum proteins into the endoneurial space. The morphological and immunohistochemical changes in this model which develop after a latency period of 2 or more weeks, strongly resemble those observed in human acquired inflammatory demyelinating polyradiculoneuropathies or in connective tissue diseases.

  11. Morning sickness.

    PubMed

    Dean, Erin

    2016-08-10

    Essential facts Eight out of ten pregnant women are affected by nausea and vomiting in pregnancy. It is one of the most common reasons for pregnant women being admitted to hospital. Despite being known as morning sickness, symptoms can occur at any time of the day or night. The severe form of nausea and vomiting in pregnancy, hyperemesis gravidarum, is much rarer and affects up to 3% of pregnant women. For most women, their symptoms improve or disappear by around week 14, although for some it can last longer.

  12. Acclimatization to chronic intermittent hypoxia in mine workers: a challenge to mountain medicine in Chile.

    PubMed

    Farias, Jorge G; Jimenez, Daniel; Osorio, Jorge; Zepeda, Andrȩa B; Figueroa, Carolina A; Pulgar, Victor M

    2013-01-01

    In the past two decades, Chile has developed intense mining activity in the Andes mountain range, whose altitude is over 4,000 meters above sea level. It is estimated that a workforce population of over 55,000 is exposed to high altitude hypobaric hypoxia. The miners work under shift systems which vary from 4 to 20 days at the worksite followed by rest days at sea level, in a cycle repeated for several years. This Chronic Intermittent Hypoxia (CIH) constitutes an unusual condition for workers involving a series of changes at the physiological, cellular and molecular levels attempting to compensate for the decrease in the environmental partial pressure of oxygen (PO₂). The mine worker must become acclimatized to CIH, and consequently undergoes an acute acclimatization process when he reaches the worksite and an acute reverse process when he reaches sea level. We have observed that after a period of 3 to 8 years of CIH exposure workers acclimatize well, and evidence from our studies and those of others indicates that CIH induces acute and chronic multisystem adjustments which are effective in offsetting the reduced availability of oxygen at high altitudes. The aims of this review are to summarize findings of the physiological responses to CIH exposure, highlighting outstanding issues in the field.

  13. "I'm just not that sick": pain medication and identity in Mexican American women with chronic pain.

    PubMed

    Monsivais, Diane B; Engebretson, Joan C

    2012-09-01

    To describe the beliefs and attitudes about self-identity and pain medication in a sample of Mexican American women with chronic pain living in the El Paso, Texas, area. The findings are drawn from a larger qualitative study of 15 women describing the expression and communication of chronic pain symptoms, pain-related cultural beliefs, decision making, and treatment preferences of chronic pain. Participants who had chronic pain syndromes for at least 1 year were recruited from a pain clinic and fibromyalgia support group. In-depth, open-ended interviews, fieldwork, and participant observation were used to gather information using a focused clinical ethnographic approach. Interviews were audiotaped and transcribed verbatim. A shared central theme was controlling the use of pain medications to control perceived negative associations with pain medication. The negative associations resulted in women rejecting use of medication to preserve their legitimate identity. This perception can be destructive and can lead to poor pain control. Providing patients with anticipatory guidance about common barriers to taking pain medication may allow medication use consistent with improved pain control.

  14. Lung oxidative stress as related to exercise and altitude. Lipid peroxidation evidence in exhaled breath condensate: a possible predictor of acute mountain sickness.

    PubMed

    Araneda, O F; García, C; Lagos, N; Quiroga, G; Cajigal, J; Salazar, M P; Behn, C

    2005-12-01

    Lung oxidative stress (OS) was explored in resting and in exercising subjects exposed to moderate and high altitude. Exhaled breath condensate (EBC) was collected under field conditions in male high-competition mountain bikers performing a maximal cycloergometric exercise at 670 m and at 2,160 m, as well as, in male soldiers climbing up to 6,125 m in Northern Chile. Malondialdehyde concentration [MDA] was measured by high-performance liquid chromatography in EBC and in serum samples. Hydrogen peroxide concentration [H(2)O(2)] was analysed in EBC according to the spectrophotometric FOX(2) assay. [MDA] in EBC of bikers did not change while exercising at 670 m, but increased from 30.0+/-8.0 to 50.0+/-11.0 nmol l(-1) (P<0.05) at 2,160 m. Concomitantly, [MDA] in serum and [H(2)O(2)] in EBC remained constant. On the other hand, in mountaineering soldiers, [H(2)O(2)] in EBC under resting conditions increased from 0.30+/-0.12 mumol l(-1) at 670 m to 1.14+/-0.29 mumol l(-1) immediately on return from the mountain. Three days later, [H(2)O(2)] in EBC (0.93 +/-0.23 mumol l(-1)) continued to be elevated (P<0.05). [MDA] in EBC increased from 71+/-16 nmol l(-1) at 670 m to 128+/-26 nmol l(-1) at 3,000 m (P<0.05). Changes of [H(2)O(2)] in EBC while ascending from 670 m up to 3,000 m inversely correlated with concomitant variations in HbO2 saturation (r=-0.48, P<0.05). AMS score evaluated at 5,000 m directly correlated with changes of [MDA] in EBC occurring while the subjects moved from 670 to 3,000 m (r=0.51, P<0.05). Lung OS may constitute a pathogenic factor in AMS.

  15. “You Get Reminded You’re a Sick Person”: Personal Data Tracking and Patients With Multiple Chronic Conditions

    PubMed Central

    Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

    2015-01-01

    Background Consumer health information technologies (HIT) that encourage self-tracking, such as diet and fitness tracking apps and disease journals, are attracting widespread interest among technology-oriented consumers (such as “quantified self” advocates), entrepreneurs, and the health care industry. Such electronic technologies could potentially benefit the growing population of patients with multiple chronic conditions (MCC). However, MCC is predominantly a condition of the elderly and disproportionately affects the less affluent, so it also seems possible that the barriers to use of consumer HIT would be particularly severe for this patient population. Objective Our aim was to explore the perspectives of individuals with MCC using a semistructured interview study. Our research questions were (1) How do individuals with MCC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? Methods We used semistructured interviews with patients with multiple chronic diseases and providers with experience caring for such patients, as well as participation in a diabetes education group to triangulate emerging themes. Data were analyzed using grounded theory and thematic analysis. Recruitment and analysis took place iteratively until thematic saturation was reached. Results Interviews were conducted with 22 patients and 7 health care providers. The patients had an average of 3.5 chronic conditions, including type 2 diabetes, heart disease, chronic pain, and depression, and had regular relationships with an average of 5 providers. Four major themes arose from the interviews: (1) tracking this data feels like work for many patients, (2) personal medical data for individuals with chronic conditions are not simply objective facts, but instead provoke strong positive and negative emotions, value judgments, and diverse interpretations, (3) patients track for different purposes, ranging from sense-making to self

  16. "You Get Reminded You're a Sick Person": Personal Data Tracking and Patients With Multiple Chronic Conditions.

    PubMed

    Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

    2015-08-19

    Consumer health information technologies (HIT) that encourage self-tracking, such as diet and fitness tracking apps and disease journals, are attracting widespread interest among technology-oriented consumers (such as "quantified self" advocates), entrepreneurs, and the health care industry. Such electronic technologies could potentially benefit the growing population of patients with multiple chronic conditions (MCC). However, MCC is predominantly a condition of the elderly and disproportionately affects the less affluent, so it also seems possible that the barriers to use of consumer HIT would be particularly severe for this patient population. Our aim was to explore the perspectives of individuals with MCC using a semistructured interview study. Our research questions were (1) How do individuals with MCC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? We used semistructured interviews with patients with multiple chronic diseases and providers with experience caring for such patients, as well as participation in a diabetes education group to triangulate emerging themes. Data were analyzed using grounded theory and thematic analysis. Recruitment and analysis took place iteratively until thematic saturation was reached. Interviews were conducted with 22 patients and 7 health care providers. The patients had an average of 3.5 chronic conditions, including type 2 diabetes, heart disease, chronic pain, and depression, and had regular relationships with an average of 5 providers. Four major themes arose from the interviews: (1) tracking this data feels like work for many patients, (2) personal medical data for individuals with chronic conditions are not simply objective facts, but instead provoke strong positive and negative emotions, value judgments, and diverse interpretations, (3) patients track for different purposes, ranging from sense-making to self-management to reporting to the doctor, and (4

  17. Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: the role of undiagnosed mental health comorbidity.

    PubMed

    Olaya-Contreras, Patricia; Styf, Jorma

    2013-05-01

    To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.

  18. Increased risk of chronic wasting disease in Rocky Mountain elk associated with decreased magnesium and increased manganese in brain tissue

    PubMed Central

    White, Stephen N.; O’Rourke, Katherine I.; Gidlewski, Thomas; VerCauteren, Kurt C.; Mousel, Michelle R.; Phillips, Gregory E.; Spraker, Terry R.

    2010-01-01

    Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) of Rocky Mountain elk in North America. Recent studies suggest that tissue and blood mineral levels may be valuable in assessing TSE infection in sheep and cattle. The objectives of this study were to examine baseline levels of copper, manganese, magnesium, zinc, selenium, and molybdenum in the brains of Rocky Mountain elk with differing prion genotypes and to assess the association of mineral levels with CWD infection. Elk with leucine at prion position 132 had significantly lower magnesium levels than elk with 2 copies of methionine. Chronic wasting disease-positive elk had significantly lower magnesium than control elk. The incorporation of manganese levels in addition to magnesium significantly refined explanatory ability, even though manganese alone was not significantly associated with CWD. This study demonstrated that mineral analysis may provide an additional disease correlate for assessing CWD risk, particularly in conjunction with genotype. PMID:20357959

  19. Increased risk of chronic wasting disease in Rocky Mountain elk associated with decreased magnesium and increased manganese in brain tissue.

    PubMed

    White, Stephen N; O'Rourke, Katherine I; Gidlewski, Thomas; VerCauteren, Kurt C; Mousel, Michelle R; Phillips, Gregory E; Spraker, Terry R

    2010-01-01

    Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) of Rocky Mountain elk in North America. Recent studies suggest that tissue and blood mineral levels may be valuable in assessing TSE infection in sheep and cattle. The objectives of this study were to examine baseline levels of copper, manganese, magnesium, zinc, selenium, and molybdenum in the brains of Rocky Mountain elk with differing prion genotypes and to assess the association of mineral levels with CWD infection. Elk with leucine at prion position 132 had significantly lower magnesium levels than elk with 2 copies of methionine. Chronic wasting disease-positive elk had significantly lower magnesium than control elk. The incorporation of manganese levels in addition to magnesium significantly refined explanatory ability, even though manganese alone was not significantly associated with CWD. This study demonstrated that mineral analysis may provide an additional disease correlate for assessing CWD risk, particularly in conjunction with genotype.

  20. Endocrine correlates of susceptibility to motion sickness

    NASA Technical Reports Server (NTRS)

    Kohl, R. L.

    1985-01-01

    Motion sickness releases ACTH, epinerphrine, and norepinephrine. The endocrine responses to motion sickness, adaptive responses leading to the resolution of the syndrome, and the way in which antimotion-sickness drugs influence the endocrine responses were studied. Susceptible or insusceptible subjects were administered antimotion-sickness drugs prior to stressful stimulation. Insusceptible subjects displayed more pronounced elevations of ACTH, epinephrine, and norepinephrine after stressful motion. Predrug levels of ACTH were higher in insusceptible subjects (p less than 0.01). Acute blockade of hormone responses to stressful motion or alteration of levels of ACTH by drugs were not correlated with individual susceptibility. No correlation was apparent between epinephrine and ACTH release. These endocrine differences may represent neurochemical markers for susceptibility to motion, stress, or general adaptability, and it may be that the chronic modulation of their levels might be more effective in preventing motion sickness than the acute blockage or stimulation of specific receptors.

  1. Endocrine correlates of susceptibility to motion sickness

    NASA Technical Reports Server (NTRS)

    Kohl, R. L.

    1985-01-01

    Motion sickness releases ACTH, epinerphrine, and norepinephrine. The endocrine responses to motion sickness, adaptive responses leading to the resolution of the syndrome, and the way in which antimotion-sickness drugs influence the endocrine responses were studied. Susceptible or insusceptible subjects were administered antimotion-sickness drugs prior to stressful stimulation. Insusceptible subjects displayed more pronounced elevations of ACTH, epinephrine, and norepinephrine after stressful motion. Predrug levels of ACTH were higher in insusceptible subjects (p less than 0.01). Acute blockade of hormone responses to stressful motion or alteration of levels of ACTH by drugs were not correlated with individual susceptibility. No correlation was apparent between epinephrine and ACTH release. These endocrine differences may represent neurochemical markers for susceptibility to motion, stress, or general adaptability, and it may be that the chronic modulation of their levels might be more effective in preventing motion sickness than the acute blockage or stimulation of specific receptors.

  2. Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial.

    PubMed

    Beemster, Timo T; van Velzen, Judith M; van Bennekom, Coen A M; Frings-Dresen, Monique H W; Reneman, Michiel F

    2015-07-28

    Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the design of a non-inferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain. A non-inferiority study design will be applied. The study population consists of workers who are on part-time or full-time sick leave due to subacute or chronic nonspecific musculoskeletal pain. Two multidisciplinary vocational rehabilitation programs following the bio-psychosocial approach will be evaluated in this study: 40-h vocational rehabilitation and 100-h vocational rehabilitation, both delivered over a maximum of 15 weeks. The 100-h vocational rehabilitation comprises five modules: work participation coordination, graded activity, cognitive behavioral therapy, group education, and relaxation. The 40-h vocational rehabilitation comprises work participation coordination and a well-reasoned choice from the other four modules. Four rehabilitation centers will participate in this study, each delivering both interventions. Patients will be randomized into one of the interventions, stratified for the duration of sick leave (<6 weeks or ≥ 6 weeks) and type of sick leave (part-time or full-time). The primary outcome is work participation, measured by self-reported sick leave days, and will be assessed at baseline, mid-term, discharge, and at 2, 4, 6, 8, 10, and 12 months follow-up. Secondary outcomes are work ability, disability, quality of life, and physical functioning and will be assessed at baseline, discharge, and at 6 and 12 months follow-up. Cost outcomes are absenteeism

  3. The effect of angiotensin-converting enzyme genotype on acute mountain sickness and summit success in trekkers attempting the summit of Mt. Kilimanjaro (5,895 m).

    PubMed

    Kalson, Nicholas S; Thompson, Julian; Davies, Andrew J; Stokes, Suzy; Earl, Mark D; Whitehead, Adam; Tyrrell-Marsh, Ian; Frost, Hannah; Montgomery, Hugh

    2009-02-01

    The I-allele rather than the D-allele of the human angiotensin converting enzyme (ACE) gene has been associated with high-altitude mountaineering success. We investigated whether the I-allele was associated with summit success, and also with AMS development, in altitude-naïve trekkers. Subjects ascended from 1,860 m to the summit over 4 days (n = 34, 'direct-profile') or 5 days (n = 82, 'slower-profile'). Proportionally more II direct-profile subjects were successful than ID or DD, although the difference was not significant (100% of II subjects, 52% ID and 43% DD, P = 0.09). There was no difference in success amongst subjects on the slower-profile (50% II, 45% ID and 58% DD, P = 0.54). There was a non-significant trend for increasing AMS scores in ID/DD subjects. Amongst tourist trekkers on Mt. Kilimanjaro the I-allele is not associated with summit success. No evidence is found to support an association between ACE genotype and AMS development.

  4. Morning sickness (image)

    MedlinePlus

    Morning sickness usually begins during the first month of pregnancy and continues until the 14th to 16th week. ... have nausea and vomiting through their entire pregnancy. Morning sickness is very common and does not hurt the ...

  5. Managing Motion Sickness

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_166982.html Managing Motion Sickness You may never love some pursuits, like ... there anything you can do to quell your motion sickness so you can join in the fun? ...

  6. Equine grass sickness.

    PubMed

    Pirie, R S; Jago, R C; Hudson, N P H

    2014-09-01

    Equine grass sickness (EGS; equine dysautonomia) is a polyneuronopathy affecting both the central and the peripheral nervous systems of horses. As the name implies, EGS almost exclusively affects grazing horses, resulting in the development of a characteristic array of clinical signs, most of which can be attributed to neuronal degeneration in the autonomic and enteric nervous systems. Varying disease severities occur, largely determined by the extent of neuronal degeneration in the myenteric and submucous plexuses of the enteric nervous system. Extensive neuronal degeneration, as seen in acute and subacute forms of EGS, results in intestinal dysmotility, the severity of which is incompatible with survival. In comparison, a proportion of chronic forms of EGS, characterised by less severe neuronal degeneration, will survive. Despite extensive research efforts since EGS was first reported over 100 years ago, the precise aetiology remains elusive. This article reviews much of the scientific literature on EGS, covering epidemiology, pathology, diagnosis, treatment and aetiological hypotheses. © 2014 EVJ Ltd.

  7. [Sleeping sickness, a reemerging sickness].

    PubMed

    Dumas, M

    2000-01-01

    Human African Trypanosomiasis (THA) has reappeared in most intertropical countries of Black Africa and an estimated 400,000 new cases are reported every year. Genetic tests which now make possible the differentiation of morphologically similar trypanosome subspecies showed that a large variety of game and domestic animals act as reservoir hosts of Trypanosoma brucei gambiense, thus making it even more difficult to fight the disease. The detection of cases and their treatment are absolutely necessary in preventing the spread of the disease. This can only be carried out with mobile medical teams which seek out patients. This detection currently calls on techniques which isolate trypanosomes and serological techniques. The collection of data with regards to different geographical positions, makes it possible to determine exactly which regions are affected, possibly affected or sound. Although the diagnosis of the hemo-lymphatic stage can be determined without any great problem nowadays, the point at which the trypanosome invades CNS tissues and the ways in which it occurs are as yet unknown, even though the role of nitric oxyde and cytokines is better understood. Antibodies, anti-neurofilaments and anti-galactocerebrosides when found in the cerebro-spinal fluid are characteristic of the nervous stage of the disease. This condition is really sleeping sickness, not only hypersomnia. The more seriously the patient is affected the shorter the sleep-wake cycles are during the nycthemeron. These early disorders can be quickly reversed thanks to therapy, which to day uses melarsoprol, an arsenical drug, which cannot be of great promise as it is very toxic. Current research into nitro-imidazole derivatives (particularly megazol) seems a promising therapy as they were effective in vitro and in vivo, in rodents and primates.

  8. Serum sickness syndrome.

    PubMed

    Lin, R Y

    1986-01-01

    Numerous agents are known to cause serum sickness reactions. Although generally a benign disorder, serum sickness must be distinguished from various rheumatic and infectious disorders. The causative agent must be identified in order to avoid subsequent reactions. With the introduction of new drugs and biotechnically produced hormones and antibodies, new causes of serum sickness reactions are likely.

  9. Renal pathology and urinary protein excretion in a 14-month-old Bernese mountain dog with chronic renal failure.

    PubMed

    Raila, J; Aupperle, H; Raila, G; Schoon, H-A; Schweigert, F J

    2007-04-01

    The renal pathology and urinary protein pattern of a 14-month-old female Bernese mountain dog with chronic renal failure was investigated. Sodium dodecyl sulphate-polyacrylamid gel electrophoresis and subsequent Western blot analysis of urine showed the presence of heavy and light chains of immunoglobulin, transferrin, albumin, vitamin D-binding protein, transthyretin and retinol-binding protein (RBP), but no excretion of Tamm-Horsfall protein (THP). Histopathological examinations of the kidneys revealed severe membranous glomerulonephritis accompanied by tubular dilatation, tubular atrophy and interstitial fibrosis. The renal expression of megalin, the main endocytic receptor for the re-uptake of proteins in proximal tubules, RBP and THP was reduced or completely absent, indicating severe tubular dysfunction. The identified urinary proteins may be of interest as additional markers for the diagnosis of juvenile nephropathy in Bernese mountain dogs.

  10. Priorities for the elimination of sleeping sickness.

    PubMed

    Welburn, Susan C; Maudlin, Ian

    2012-01-01

    Sleeping sickness describes two diseases, both fatal if left untreated: (i) Gambian sleeping sickness caused by Trypanosoma brucei gambiense, a chronic disease with average infection lasting around 3 years, and (ii) Rhodesian sleeping sickness caused by T. b. rhodesiense, an acute disease with death occurring within weeks of infection. Control of Gambian sleeping sickness is based on case detection and treatment involving serological screening, followed by diagnostic confirmation and staging. In stage I, patients can remain asymptomatic as trypanosomes multiply in tissues and body fluids; in stage II, trypanosomes cross the blood-brain barrier, enter the central nervous system and, if left untreated, death follows. Staging is crucial as it defines the treatment that is prescribed; for both forms of disease, stage II involves the use of the highly toxic drug melarsoprol or, in the case of Gambian sleeping sickness, the use of complex and very expensive drug regimes. Case detection of T. b. gambiense sleeping sickness is known to be inefficient but could be improved by the identification of parasites using molecular tools that are, as yet, rarely used in the field. Diagnostics are not such a problem in relation to T. b. rhodesiense sleeping sickness, but the high level of under-reporting of this disease suggests that current strategies, reliant on self-reporting, are inefficient. Sleeping sickness is one of the 'neglected tropical diseases' that attracts little attention from donors or policymakers. Proper quantification of the burden of sleeping sickness matters, as the primary reason for its 'neglect' is that the true impact of the disease is unknown, largely as a result of under-reporting. Certainly, elimination will not be achieved without vast improvements in field diagnostics for both forms of sleeping sickness especially if there is a hidden reservoir of 'chronic carriers'. Mass screening would be a desirable aim for Gambian sleeping sickness and could be

  11. Prevention of Acute Mountain Sickness by Dexamethasone,

    DTIC Science & Technology

    1983-07-27

    Fujishima M , Busto R. Mechanisms of cerebral vasodilatation in hypoxia. 3 Appi Physiol 1970; 29:223-9. 14. Severinghaus 3W, Chiodi H, Eger El...2? JUL 83 USARIEM- M -38/83 UNCLARSSIFIED F/G 6/5 N S 11111 - 1111 1.10 II1g j1.25 111 .4 j~.6 MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF...to a simulated altitude of 4570 m (15,000 ft) on two occasions. On S one occasion, they received dexamethasone (4 mg every 6 h) for 36 h before and

  12. Preliminary Model of Acute Mountain Sickness Severity

    DTIC Science & Technology

    2010-10-01

    variance, the Akaike information criterion (AIC) and Bayesian information criterion (BIC) were utilized in selecting the final model using the... information and completed an Environmental Symptoms Questionnaire (ESQ). The ESQ assessed AMS severity using the validated AMS-Cerebral (AMS-C) factor...reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching

  13. The sick building syndrome

    PubMed Central

    Joshi, Sumedha M.

    2008-01-01

    The sick building syndrome comprises of various nonspecific symptoms that occur in the occupants of a building. This feeling of ill health increases sickness absenteeism and causes a decrease in productivity of the workers. As this syndrome is increasingly becoming a major occupational hazard, the cause, management and prevention of this condition have been discussed in this article. PMID:20040980

  14. Acute high-altitude sickness.

    PubMed

    Luks, Andrew M; Swenson, Erik R; Bärtsch, Peter

    2017-01-01

    At any point 1-5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases. Copyright ©ERS 2017.

  15. Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study

    PubMed Central

    2012-01-01

    Background Efforts undertaken during the return to work (RTW) process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES) in cases of sick-listed employees with chronic low back pain (CLBP). Methods Using focus groups consisting of Labor Experts (LE's) working at the Dutch Social Insurance Institute, arguments and underlying grounds relevant to the assessment of RTW-ES were investigated. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model). Results Two focus groups yielded 19 factors, of which 12 are categorized in the ICF model under activities (e.g. functional capacity) and in the personal (e.g. age, tenure) and environmental domain (e.g. employer-employee relationship). The remaining 7 factors are categorized under intervention, job accommodation and measures. Conclusions This focus group study shows that 19 factors may be relevant to RTW-ES in sick-listed employees with CLBP. Providing these results to professionals assessing RTW-ES might contribute to a more transparent and systematic approach. Considering the importance of the quality of the RTW process, optimizing the RTW-ES assessment is essential. PMID:22272831

  16. Motion sickness in migraine sufferers.

    PubMed

    Marcus, Dawn A; Furman, Joseph M; Balaban, Carey D

    2005-12-01

    Motion sickness commonly occurs after exposure to actual motion, such as car or amusement park rides, or virtual motion, such as panoramic movies. Motion sickness symptoms may be disabling, significantly limiting business, travel and leisure activities. Motion sickness occurs in approximately 50% of migraine sufferers. Understanding motion sickness in migraine patients may improve understanding of the physiology of both conditions. Recent literature suggests important relationships between the trigeminal system and vestibular nuclei that may have implications for both motion sickness and migraine. Studies demonstrating an important relationship between serotonin receptors and motion sickness susceptibility in both rodents and humans suggest possible new motion sickness prevention therapies.

  17. Travelers' Health: Motion Sickness

    MedlinePlus

    ... Safety Blood Clots Bug Bites Business Travel Cold Climates Counterfeit Drugs Cruise Ship Travel Families with Children ... Abroad Getting Sick After Travel High Altitudes Hot Climates Humanitarian Aid Workers Humanitarian Aid Workers in Ecuador ...

  18. The first 10 years of the dialysis-transplantation program at The Hospital for Sick Children, Toronto. 2. Transplantation and complications of chronic renal failure.

    PubMed Central

    Arbus, G. S.; Galiwango, J.; DeMaria, J. E.; Churchill, B. M.

    1980-01-01

    Between January 1969 and August 1977, 78 children received 100 kidney transplants (94 from cadavers and 6 from living donors) at The Hospital for Sick Children, Toronto. Since 1971 the average wait for a first cadaveric transplant has been less than 5 months. Preferably the kidney is placed in a location that has not previously undergone an operation, usually the iliac fossa on the side opposite that from which the donor kidney was taken. Immunosuppressive therapy begins with prednisone (or methylprednisolone), 3 mg/kg body weight per day; the dose is gradually decreased until a maintenance dose of 10 to 20 mg every 48 hours is reached 3 to 6 months postoperatively. Azathioprine, 2 to 3 mg/kg body weight, is also given each day. Early recognition or prevention of renal osteodystrophy, the toxic effects of steroids, psychosocial problems, growth retardation and hypertension minimize their effects on these patients. PMID:6988065

  19. Poor sleep quality predicts decreased cognitive function independently of chronic mountain sickness score in young soldiers with polycythemia stationed in Tibet.

    PubMed

    Kong, Fan-Yi; Li, Qiang; Liu, Shi-Xiang

    2011-01-01

    Little is known about the association between poor sleep and cognitive function in people with polycythemia at high altitude. The aim of this study was to survey the sleep quality of individuals with polycythemia at high altitude and determine its association with cognitive abilities. We surveyed 230 soldiers stationed in Tibet (all men; mean age 21-52±4.30 yr) at altitudes ranging from 3658 to 3996 m. All participants were given a blood tests for hemoglobin level and a questionnaire survey of cognitive function. Polycythemia was defined as excessive erythrocytosis (Hb≥21 g/dL in men or ≥19 g/dL in women). Poor sleepers were defined as having a global Pittsburgh Sleep Quality Index score (PSQI)>5. Cognitive abilities were determined by the Chinese revision of the Wechsler Adult Intelligence Scale and the Benton Visual Retention Test. Multiple linear regression analysis was used to determine the association between the PSQI and cognitive function. Logistic regression analysis was performed to determine the independent effect of sleep quality on cognitive function. The global PSQI score of enrolled participants was 8.14±3.79. Seventy-five (32.6%) soldiers were diagnosed with polycythemia. The proportion of poor sleepers was 1.45 times greater in those with polycythemia compared with those without polycythemia [95% (confidence interval) CI 1.82-2.56], and they had a statistically significant lower score for cognitive function. Multiple linear regression analysis showed that the global PSQI score was negatively associated with IQ (β=0.11, 95% CI -0.16 to -0.05) and digit symbol scores (β=0.66, 95% CI -0.86 to -0.44). Poor sleep quality was determined to be an independent predictor of impaired IQ [odds ratio (OR) 1.59, 95% CI 1.30-1.95] and digit symbol score (OR 1.18, 95% CI 1.07-1.31) in logistic regression analysis. The present study showed that for young soldiers with polycythemia at high altitude impaired subjective sleep quality was an independent predictor of decreased cognitive function, especially IQ and verbal short-term memory.

  20. Space motion sickness

    NASA Technical Reports Server (NTRS)

    Homick, J. L.

    1979-01-01

    Research on the etiology, prediction, treatment and prevention of space motion sickness, designed to minimize the impact of this syndrome which was experienced frequently and with severity by individuals on the Skylab missions, on Space Shuttle crews is reviewed. Theories of the cause of space motion sickness currently under investigation by NASA include sensory conflict, which argues that motion sickness symptoms result from a mismatch between the total pattern of information from the spatial senses and that stored from previous experiences, and fluid shift, based upon the redistribution of bodily fluids that occurs upon continued exposure to weightlessness. Attempts are underway to correlate space motion sickness susceptibility to different provocative environments, vestibular and nonvestibular responses, and the rate of acquisition and length of retention of sensory adaptation. Space motion sickness countermeasures under investigation include various drug combinations, of which the equal combination of promethazine and ephedrine has been found to be as effective as the scopolomine and dexedrine combination, and vestibular adaptation and biofeedback training and autogenic therapy.

  1. [Serum sickness in diphtheria].

    PubMed

    Vozianova, Zh I; Chepilko, K I

    1999-01-01

    As many as 2247 patients with different clinical forms of diphtheria were examined. Antidiphtheric serum (ADS) was administered in 1556 children, the dosage being determined by condition of the patient. Serum sickness developed at day 7 to 9 in 24 (1.5%); 10 patients were found to run a mild course, 14--moderately severe. 6 patients had allergic reactions: 3--to antibiotic (penicillin), urticaria type, 1--to pertussoid-tetanic anatoxin, 2 had pollinosis-type reaction. Thus, serum sickness has practical value, which fact requires a detailed allergic history together with skin tests to be performed before the administration of ADS.

  2. Obesity and sickness absence: results from the CHAP study.

    PubMed

    Harvey, S B; Glozier, N; Carlton, O; Mykletun, A; Henderson, M; Hotopf, M; Holland-Elliott, K

    2010-08-01

    Obesity is an increasing public health problem. A small number of studies have examined the relationship between obesity and sickness absence, with mixed results, particularly regarding short-term sickness absence. To determine if obesity is associated with short- and long-term sickness absence and to investigate the mechanisms that may underlie any association. Cross-sectional (n = 1489) and prospective (n = 625) analyses were conducted on staff from London Underground Ltd. All participants underwent regular clinical examinations that involved their height and weight being measured, obesity-related medical problems being diagnosed and psychiatric disorders being identified. The number of days taken for short- (<10 days in an episode) and long-term sickness absence were recorded by managers on an electronic database. There was a positive linear association between employees' body mass index (BMI) and the number of days' work missed due to sickness absence on both cross-sectional and prospective analyses (P < 0.001). Obesity was a risk factor for both short- and long-term sickness absence. Obese individuals typically took an extra 4 days sick leave every year. The majority of the increased risk for long-term sickness absence appeared to be mediated via co-morbid chronic medical conditions. The excess short-term sickness absence was not explained by obesity-related medical problems, psychiatric disorders or workplace factors. Obese employees take significantly more short- and long-term sickness absence than workers of a healthy weight. There is growing evidence to support employers becoming more involved in tackling obesity.

  3. Gene expression alterations in Rocky Mountain elk infected with chronic wasting disease

    PubMed Central

    Basu, Urmila; Almeida, Luciane M.; Dudas, Sandor; Graham, Catherine E.; Czub, Stefanie; Moore, Stephen S.; Guan, Le Luo

    2012-01-01

    Chronic wasting disease (CWD) is an invariably fatal neurologic disease that naturally infects mule deer, white tailed deer and elk. The understanding of CWD neurodegeneration at a molecular level is very limited. In this study, microarray analysis was performed to determine changes in the gene expression profiles in six different tissues including brain, midbrain, thalamus, spleen, RPLN and tonsil of CWD-infected elk in comparison to non-infected healthy elk, using 24,000 bovine specific oligo probes. In total, 329 genes were found to be differentially expressed (> 2.0-fold) between CWD negative and positive brain tissues, with 132 genes upregulated and 197 genes downregulated. There were 249 DE genes in the spleen (168 up- and 81 downregulated), 30 DE genes in the retropharyngeal lymph node (RPLN) (18 up- and 12 downregulated), and 55 DE genes in the tonsil (21 up- and 34 downregulated). Using Gene Ontology (GO), the DE genes were assigned to functional groups associated with cellular process, biological regulation, metabolic process, and regulation of biological process. For all brain tissues, the highest ranking networks for DE genes identified by Ingenuity Pathway Analysis (IPA) were associated with neurological disease, cell morphology, cellular assembly and organization. Quantitative real-time PCR (qRT-PCR) validated the expression of DE genes primarily involved in different regulatory pathways, including neuronal signaling and synapse function, calcium signaling, apoptosis and cell death and immune cell trafficking and inflammatory response. This is the first study to evaluate altered gene expression in multiple organs including brain from orally infected elk and the results will improve our understanding of CWD neurodegeneration at the molecular level. PMID:22561165

  4. Gene expression alterations in Rocky Mountain elk infected with chronic wasting disease.

    PubMed

    Basu, Urmila; Almeida, Luciane M; Dudas, Sandor; Graham, Catherine E; Czub, Stefanie; Moore, Stephen S; Guan, Le Luo

    2012-07-01

    Chronic wasting disease (CWD) is an invariably fatal neurologic disease that naturally infects mule deer, white tailed deer and elk. The understanding of CWD neurodegeneration at a molecular level is very limited. In this study, microarray analysis was performed to determine changes in the gene expression profiles in six different tissues including brain, midbrain, thalamus, spleen, RPLN and tonsil of CWD-infected elk in comparison to non-infected healthy elk, using 24,000 bovine specific oligo probes. In total, 329 genes were found to be differentially expressed (> 2.0-fold) between CWD negative and positive brain tissues, with 132 genes upregulated and 197 genes downregulated. There were 249 DE genes in the spleen (168 up- and 81 downregulated), 30 DE genes in the retropharyngeal lymph node (RPLN) (18 up- and 12 downregulated), and 55 DE genes in the tonsil (21 up- and 34 downregulated). Using Gene Ontology (GO), the DE genes were assigned to functional groups associated with cellular process, biological regulation, metabolic process, and regulation of biological process. For all brain tissues, the highest ranking networks for DE genes identified by Ingenuity Pathway Analysis (IPA) were associated with neurological disease, cell morphology, cellular assembly and organization. Quantitative real-time PCR (qRT-PCR) validated the expression of DE genes primarily involved in different regulatory pathways, including neuronal signaling and synapse function, calcium signaling, apoptosis and cell death and immune cell trafficking and inflammatory response. This is the first study to evaluate altered gene expression in multiple organs including brain from orally infected elk and the results will improve our understanding of CWD neurodegeneration at the molecular level.

  5. Prescriptions for Sick Schools.

    ERIC Educational Resources Information Center

    Ornstein, Allan C.

    1993-01-01

    Increasing insulation in schools as an energy-saving measure has given rise to the Sick Building Syndrome (SBS), which afflicts roughly one-third of the nation's schools. This article examines asbestos, radon, electromagnetic radiation, and chemical pollutants and describes steps to make schools environmentally safe for students. School officials…

  6. Prescriptions for Sick Schools.

    ERIC Educational Resources Information Center

    Ornstein, Allan C.

    1993-01-01

    Increasing insulation in schools as an energy-saving measure has given rise to the Sick Building Syndrome (SBS), which afflicts roughly one-third of the nation's schools. This article examines asbestos, radon, electromagnetic radiation, and chemical pollutants and describes steps to make schools environmentally safe for students. School officials…

  7. Travelers' Health: Motion Sickness

    MedlinePlus

    ... Travel Families with Children Fish Poisoning in Travelers Food and Water Getting Health Care Abroad Getting Sick After Travel High Altitudes Hot Climates Humanitarian Aid Workers Humanitarian Aid Workers in Ecuador Insurance International Adoption Jet Lag Last-Minute Travel Long-Term ...

  8. Pregnancy sickness: a biopsychological perspective.

    PubMed

    Cardwell, Michael S

    2012-10-01

    Pregnancy sickness is a universal phenomenon, affecting 70% to 85% of all pregnant women. The primary symptoms of pregnancy sickness are nausea, vomiting, and food aversions. In the past, pregnancy sickness was attributed to psychological disturbances of the pregnant woman. However, recent evolutionary psychological and biopsychological studies have reconsidered pregnancy sickness as an embryo-protective mechanism, an evolutionary adaptation to protect the embryo from phytotoxins and other environmental hazards. The biopsychological perspective of pregnancy sickness as an embryo-protective mechanism is presented.

  9. In utero transmission and tissue distribution of chronic wasting disease-associated prions in free-ranging Rocky Mountain elk

    PubMed Central

    Selariu, Anca; Powers, Jenny G.; Nalls, Amy; Brandhuber, Monica; Mayfield, Amber; Fullaway, Stephenie; Wyckoff, Christy A.; Goldmann, Wilfred; Zabel, Mark M.; Wild, Margaret A.; Hoover, Edward A.

    2015-01-01

    The presence of disease-associated prions in tissues and bodily fluids of chronic wasting disease (CWD)-infected cervids has received much investigation, yet little is known about mother-to-offspring transmission of CWD. Our previous work demonstrated that mother-to-offspring transmission is efficient in an experimental setting. To address the question of relevance in a naturally exposed free-ranging population, we assessed maternal and fetal tissues derived from 19 elk dam–calf pairs collected from free-ranging Rocky Mountain elk from north-central Colorado, a known CWD endemic region. Conventional immunohistochemistry identified three of 19 CWD-positive dams, whereas a more sensitive assay [serial protein misfolding cyclic amplification (sPMCA)] detected CWD prion seeding activity (PrPCWD) in 15 of 19 dams. PrPCWD distribution in tissues was widespread, and included the central nervous system (CNS), lymphoreticular system, and reproductive, secretory, excretory and adipose tissues. Interestingly, five of 15 sPMCA-positive dams showed no evidence of PrPCWD in either CNS or lymphoreticular system, sites typically assessed in diagnosing CWD. Analysis of fetal tissues harvested from the 15 sPMCA-positive dams revealed PrPCWD in 80 % of fetuses (12 of 15), regardless of gestational stage. These findings demonstrated that PrPCWD is more abundant in peripheral tissues of CWD-exposed elk than current diagnostic methods suggest, and that transmission of prions from mother to offspring may contribute to the efficient transmission of CWD in naturally exposed cervid populations. PMID:26358706

  10. In utero transmission and tissue distribution of chronic wasting disease-associated prions in free-ranging Rocky Mountain elk.

    PubMed

    Selariu, Anca; Powers, Jenny G; Nalls, Amy; Brandhuber, Monica; Mayfield, Amber; Fullaway, Stephenie; Wyckoff, Christy A; Goldmann, Wilfred; Zabel, Mark M; Wild, Margaret A; Hoover, Edward A; Mathiason, Candace K

    2015-11-01

    The presence of disease-associated prions in tissues and bodily fluids of chronic wasting disease (CWD)-infected cervids has received much investigation, yet little is known about mother-to-offspring transmission of CWD. Our previous work demonstrated that mother-to-offspring transmission is efficient in an experimental setting. To address the question of relevance in a naturally exposed free-ranging population, we assessed maternal and fetal tissues derived from 19 elk dam-calf pairs collected from free-ranging Rocky Mountain elk from north-central Colorado, a known CWD endemic region. Conventional immunohistochemistry identified three of 19 CWD-positive dams, whereas a more sensitive assay [serial protein misfolding cyclic amplification (sPMCA)] detected CWD prion seeding activity (PrPCWD) in 15 of 19 dams. PrPCWD distribution in tissues was widespread, and included the central nervous system (CNS), lymphoreticular system, and reproductive, secretory, excretory and adipose tissues. Interestingly, five of 15 sPMCA-positive dams showed no evidence of PrPCWD in either CNS or lymphoreticular system, sites typically assessed in diagnosing CWD. Analysis of fetal tissues harvested from the 15 sPMCA-positive dams revealed PrPCWD in 80 % of fetuses (12 of 15), regardless of gestational stage. These findings demonstrated that PrPCWD is more abundant in peripheral tissues of CWD-exposed elk than current diagnostic methods suggest, and that transmission of prions from mother to offspring may contribute to the efficient transmission of CWD in naturally exposed cervid populations.

  11. Chronic fatigue syndrome‐like caseness as a predictor of work status in fatigued employees on sick leave: four year follow up study

    PubMed Central

    Huibers, M J H; Leone, S S; Kant, IJ; Knottnerus, J A

    2006-01-01

    Objective To assess whether CFS‐like caseness (meeting the criteria for chronic fatigue syndrome (CFS)) predicts work status in the long term. Methods Prospective study in a sample of fatigued employees absent from work. Data were collected at baseline and four years later, and included CFS‐like caseness and work status (inactive work status and full work incapacity). Results CFS‐like cases at baseline were three times more likely to be unable to work at follow up than fatigued employees who did not meet CFS criteria at baseline (ORs 3–3.3). These associations grew even stronger when demographic and clinical confounders were controlled for (ORs 3.4–4.4). Conclusion A CFS‐like status (compared to non‐CFS fatigue) proved to be a strong predictor of an inactive work status and full work incapacity in the long term. Since little is known about effective interventions that prevent absenteeism and work incapacity or facilitate return to work in subjects with chronic fatigue, there is a great need for powerful early interventions that restore or preserve the ability to work, especially for workers who meet criteria for CFS. PMID:16698810

  12. Sudden emesis following parabolic flight maneuvers Implications for space motion sickness

    NASA Technical Reports Server (NTRS)

    Lackner, J. R.; Graybiel, A.

    1986-01-01

    Episodes of emesis unaccompanied by the usual prodomal signs of motion sickness have been reported by astronauts in the Space Shuttle program. Such reports have raised the issue whether space motion sickness has different characteristics from terrestrial motion sickness. Evidence is presented here from parabolic flight experiments that sudden vomiting can occur in response to a provocative vestibular stimulus even when no premonitory symptoms are being experienced. Accordingly, in chronic exposure conditions, the absence of prominent signs or symptoms of motion sickness does not necessarily mean an absence of sensitization.

  13. "The land of the sick and the land of the healthy": Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States.

    PubMed

    Whittle, Henry J; Palar, Kartika; Ranadive, Nikhil A; Turan, Janet M; Kushel, Margot; Weiser, Sheri D

    2017-10-01

    Disability benefits have become an increasingly prominent source of cash assistance for impoverished American citizens over the past two decades. This development coincided with cuts and market-oriented reforms to state and federal welfare programs, characteristic of the wider political-economic trends collectively referred to as neoliberalism. Recent research has argued that contemporary discourses on 'disability fraudsters' and 'malingerers' associated with this shift represent the latest manifestation of age-old stigmatization of the 'undeserving poor'. Few studies, however, have investigated how the system of disability benefits, as well as these stigmatizing discourses, shapes the lived experience of disabling physical illness in today's United States. Here we present qualitative data from 64 semi-structured interviews with low-income individuals living with HIV and/or type 2 diabetes mellitus to explore the experience of long-term, work-limiting disability in the San Francisco Bay Area. Interviews were conducted between April and December 2014. Participants explained how they had encountered what they perceived to be excessive, obstructive, and penalizing bureaucracy from social institutions, leading to destitution and poor mental health. They also described being stigmatized as disabled for living with chronic ill health, and simultaneously stigmatized as shirking and malingering for claiming disability benefits as a result. Notably, this latter form of stigma appeared to be exacerbated by the bureaucracy of the administrating institutions. Participants also described intersections of health-related stigma with stigmas of poverty, gender, sexual orientation, and race. The data reveal a complex picture of poverty and intersectional stigma in this population, potentiated by a convoluted and inflexible bureaucracy governing the system of disability benefits. We discuss how these findings reflect the historical context of neoliberal cuts and reforms to social

  14. [Hazards of mountain climbing and hiking].

    PubMed

    Fischer, Rainald

    2005-09-22

    At elevations above 1500 m, even a healthy person undergoes acclimatization. To avoid problems such as acute mountain sickness (AMS), high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE), the speed of ascent and the daily sleeping elevation are of primary importance. Mild symptoms and peripheral swelling are usually harmless. However, when the severity of altitude sickness progresses, rapid therapy and immediate transport to lower elevations can be life-saving under certain conditions. A sojourn in the mountains requires effective preparation and prophylaxis against oxygen deficiency, increased UV radiation, as well as against the possibility of hypothermia and frostbite.

  15. A time-series study of sick building syndrome: chronic, biotoxin-associated illness from exposure to water-damaged buildings.

    PubMed

    Shoemaker, Ritchie C; House, Dennis E

    2005-01-01

    The human health risk for chronic illnesses involving multiple body systems following inhalation exposure to the indoor environments of water-damaged buildings (WDBs) has remained poorly characterized and the subject of intense controversy. The current study assessed the hypothesis that exposure to the indoor environments of WDBs with visible microbial colonization was associated with illness. The study used a cross-sectional design with assessments at five time points, and the interventions of cholestyramine (CSM) therapy, exposure avoidance following therapy, and reexposure to the buildings after illness resolution. The methodological approach included oral administration of questionnaires, medical examinations, laboratory analyses, pulmonary function testing, and measurements of visual function. Of the 21 study volunteers, 19 completed assessment at each of the five time points. Data at Time Point 1 indicated multiple symptoms involving at least four organ systems in all study participants, a restrictive respiratory condition in four participants, and abnormally low visual contrast sensitivity (VCS) in 18 participants. Serum leptin levels were abnormally high and alpha melanocyte stimulating hormone (MSH) levels were abnormally low. Assessments at Time Point 2, following 2 weeks of CSM therapy, indicated a highly significant improvement in health status. Improvement was maintained at Time Point 3, which followed exposure avoidance without therapy. Reexposure to the WDBs resulted in illness reacquisition in all participants within 1 to 7 days. Following another round of CSM therapy, assessments at Time Point 5 indicated a highly significant improvement in health status. The group-mean number of symptoms decreased from 14.9+/-0.8 S.E.M. at Time Point 1 to 1.2+/-0.3 S.E.M., and the VCS deficit of approximately 50% at Time Point 1 was fully resolved. Leptin and MSH levels showed statistically significant improvement. The results indicated that CSM was an effective

  16. Morning Sickness: Nausea and Vomiting of Pregnancy

    MedlinePlus

    ... About ACOG Morning Sickness: Nausea and Vomiting of Pregnancy Home For Patients Search FAQs Morning Sickness: Nausea ... PDF Format Morning Sickness: Nausea and Vomiting of Pregnancy Pregnancy How common is nausea and vomiting of ...

  17. Space motion sickness

    NASA Technical Reports Server (NTRS)

    Vanderploeg, J. M.; Stewart, D. F.; Davis, J. R.

    1986-01-01

    Space motion sickness clinical characteristics, time course, prediction of susceptibility, and effectiveness of countermeasures were evaluated. Although there is wide individual variability, there appear to be typical patterns of symptom development. The duration of symptoms ranges from several hours to four days with the majority of individuals being symptom free by the end of third day. The etiology of this malady remains uncertain but evidence points to reinterpretation of otolith inputs as being a key factor in the response of the neurovestibular system. Prediction of susceptibility and severity remains unsatisfactory. Countermeasures tried include medications, preflight adaptation, and autogenic feedback training. No countermeasure is entirely successful in eliminating or alleviating symptoms.

  18. The sick building syndrome

    SciTech Connect

    Wallace, L.A. )

    1988-01-01

    The possible causes for sick building syndrome (SBS) may be classified as physical, chemical, biological, or psychological. Physical causes range from simple factors such as temperature and ventilation to more complex factors such as electric ions and the positive/negative ion ration. Chemical factors include reactive chemicals such as formaldehyde; central nervous system depressants such as many common solvents; odor counteractants; and pesticides. Biological causes include molds, bacteria, and allergens. Recent papers bearing on SBS are discussed under the first three categories above (physical, chemical, biological). Large multifactorial studies including two or more categories are discussed.

  19. SERUM SICKNESS IN RABBITS

    PubMed Central

    Fleisher, Mover S.; Jones, Lloyd

    1931-01-01

    1. The injection of a single large dose of normal horse serum into rabbits results in the appearance 3 to 8 days later of erythematous and edematous reactions on the ears in 68.9 per cent of the animals. 2. The injections may be given by any of several routes and reactions appear when the site of injection is definitely distant from the ears. 3. Injections of various antisera into rabbits cause the appearance of similar reactions. 4. These reactions can be considered as manifestations of serum sickness in rabbits. PMID:19869943

  20. Space motion sickness

    NASA Technical Reports Server (NTRS)

    Vanderploeg, J. M.; Stewart, D. F.; Davis, J. R.

    1986-01-01

    Space motion sickness clinical characteristics, time course, prediction of susceptibility, and effectiveness of countermeasures were evaluated. Although there is wide individual variability, there appear to be typical patterns of symptom development. The duration of symptoms ranges from several hours to four days with the majority of individuals being symptom free by the end of third day. The etiology of this malady remains uncertain but evidence points to reinterpretation of otolith inputs as being a key factor in the response of the neurovestibular system. Prediction of susceptibility and severity remains unsatisfactory. Countermeasures tried include medications, preflight adaptation, and autogenic feedback training. No countermeasure is entirely successful in eliminating or alleviating symptoms.

  1. SICK BUILDING SYNDROME: POSSIBLE ASSOCIATIONS WITH EXPOSURE TO MYCOTOXINS FROM INDOOR AIR FUNGI.

    EPA Science Inventory

    Introduction. Chronic human illness associated with residential or occupational buildings, commonly referred to as sick building syndrome (SBS), may be a multifactorial condition, involving in some cases volatile organic compounds, CO or CO2, pesticides, biologic agents, temperat...

  2. SICK BUILDING SYNDROME: POSSIBLE ASSOCIATIONS WITH EXPOSURE TO MYCOTOXINS FROM INDOOR AIR FUNGI.

    EPA Science Inventory

    Introduction. Chronic human illness associated with residential or occupational buildings, commonly referred to as sick building syndrome (SBS), may be a multifactorial condition, involving in some cases volatile organic compounds, CO or CO2, pesticides, biologic agents, temperat...

  3. Motion sickness on tilting trains

    PubMed Central

    Cohen, Bernard; Dai, Mingjia; Ogorodnikov, Dmitri; Laurens, Jean; Raphan, Theodore; Müller, Philippe; Athanasios, Alexiou; Edmaier, Jürgen; Grossenbacher, Thomas; Stadtmüller, Klaus; Brugger, Ueli; Hauser, Gerald; Straumann, Dominik

    2011-01-01

    Trains that tilt on curves can go faster, but passengers complain of motion sickness. We studied the control signals and tilts to determine why this occurs and how to maintain speed while eliminating motion sickness. Accelerometers and gyros monitored train and passenger yaw and roll, and a survey evaluated motion sickness. The experimental train had 3 control configurations: an untilted mode, a reactive mode that detected curves from sensors on the front wheel set, and a predictive mode that determined curves from the train's position on the tracks. No motion sickness was induced in the untilted mode, but the train ran 21% slower than when it tilted 8° in either the reactive or predictive modes (113 vs. 137 km/h). Roll velocities rose and fell faster in the predictive than the reactive mode when entering and leaving turns (0.4 vs. 0.8 s for a 4°/s roll tilt, P<0.001). Concurrently, motion sickness was greater (P<0.001) in the reactive mode. We conclude that the slower rise in roll velocity during yaw rotations on entering and leaving curves had induced the motion sickness. Adequate synchronization of roll tilt with yaw velocity on curves will reduce motion sickness and improve passenger comfort on tilting trains.—Cohen, B., Dai, M., Ogorodnikov, D., Laurens, J., Raphan, T., Müller, P., Athanasios, A., Edmaier, J., Grossenbacher, T., Stadtmüller, K., Brugger, U., Hauser, G., Straumann, D. Motion sickness on tilting trains. PMID:21788449

  4. Prediction of helicopter simulator sickness

    SciTech Connect

    Horn, R.D.; Birdwell, J.D. . Dept. of Electrical and Computer Engineering); Allgood, G.O. )

    1990-01-01

    Machine learning methods from artificial intelligence are used to identify information in sampled accelerometer signals and associative behavioral patterns which correlates pilot simulator sickness with helicopter simulator dynamics. These simulators are used to train pilots in fundamental procedures, tactics, and response to emergency conditions. Simulator sickness induced by these systems represents a risk factor to both the pilot and manufacturer. Simulator sickness symptoms are closely aligned with those of motion sickness. Previous studies have been performed by behavioral psychologists using information gathered with surveys and motor skills performance measures; however, the results are constrained by the limited information which is accessible in this manner. In this work, accelerometers were installed in the simulator cab, enabling a complete record of flight dynamics and the pilot's control response as a function of time. Given the results of performance measures administered to detect simulator sickness symptoms, the problem was then to find functions of the recorded data which could be used to help predict the simulator sickness level and susceptibility. Methods based upon inductive inference were used, which yield decision trees whose leaves indicate the degree of simulator-induced sickness. The long-term goal is to develop a gauge'' which can provide an on-line prediction of simulator sickness level, given a pilot's associative behavioral patterns (learned expectations). This will allow informed decisions to be made on when to terminate a hop and provide an effective basis for determining training and flight restrictions placed upon the pilot after simulator use. 6 refs., 6 figs.

  5. Is Your School Building Sick?

    ERIC Educational Resources Information Center

    Foltz, Rose G.

    1996-01-01

    A sick school building has indoor air problems that pose health risks for everyone inside. The paper discusses what makes a school sick and what interested parties can do about it by targeting the problem together, making classroom changes, and making schoolwide changes. Resources for further information are included. (SM)

  6. THE AMELIORATIVE EFFECTS OF HEPARIN AND DEPOLYMERIZED HYALURONATE ON DECOMPRESSION SICKNESS IN RATS,

    DTIC Science & Technology

    DECOMPRESSION SICKNESS, DRUGS), (* MUCOPOLYSACCHARIDES , DECOMPRESSION SICKNESS), (*HEPARIN, DECOMPRESSION SICKNESS), (*ANTICOAGULANTS, DECOMPRESSION SICKNESS), RATS, COUMARINS, BLOOD COAGULATION, DOSAGE, LIPIDS, CANADA

  7. Mountain Warfare: The Need for Specialist Training

    DTIC Science & Technology

    2006-05-31

    frostbite , snow blindness, and sunburn, are also common at high altitudes. Soldiers need to be taught precautionary measures to prevent unnecessary exposure...Various problems associated with mountain terrain, such as frostbite , snow blindness, mountain sickness, and edema, occur more easily and frequently. In...builds perspiration inside the clothing, which can freeze and cause frostbite . Sunny weather does not always spell good news, as it may lead to snow

  8. Motion sickness in ancient China: Seasickness and cart-sickness.

    PubMed

    Brandt, Thomas; Bauer, Matthias; Benson, Judy; Huppert, Doreen

    2016-07-19

    To find and analyze descriptions of motion sickness in Chinese historical sources. Databases and dictionaries were searched for various terms for seasickness and travel sickness, which were then entered into databases of full texts allowing selection of relevant passages from about the third to the 19th century ad. Already in 300 ad the Chinese differentiated cart-sickness, particularly experienced by persons from the arid north of China, from a ship-illness experienced by persons from the south, where rivers were important for transportation and travel. In the Middle Ages, a third form of motion sickness was called litter-influence experienced by persons transported in a bed suspended between 2 long poles. The ancient Chinese recognized the particular susceptibility of children to motion sickness. Therapeutic recommendations include drinking the urine of young boys, swallowing white sand-syrup, collecting water drops from a bamboo stick, or hiding some earth from the middle of the kitchen hearth under the hair. The Chinese medical classics distinguished several forms of travel sickness, all of which had their own written characters. The pathophysiologic mechanism was explained by the medicine of correspondences, which was based on malfunctions within the body, its invasion by external pathogens like wind, or the deficit or surfeit of certain bodily substances such as the life force Qi. The concept of motion as the trigger of sickness initially appeared in a chapter on warding off the influence of demons and corpses, e.g., ancient magic and beliefs. © 2016 American Academy of Neurology.

  9. Decompression and decompression sickness.

    PubMed

    Mahon, Richard T; Regis, David P

    2014-07-01

    The ever-present desire of humankind to explore new limits introduced us to the syndrome of decompression sickness (DCS). This broad overview of DCS is aimed at its pathophysiology and basics of therapeutic strategies. After a brief explanation of decompression theory, historical vignettes will serve to inform the practical application of our increasing understanding of DCS risks. The pathophysiology, current practices, role of bubble monitoring, risk factors, and potential long-term effects of DCS are also discussed. The goal is to explain the current state of DCS understanding in the context of a robust observational and empirical history. However, DCS remains a syndrome consisting of a constellation of symptoms following a change in ambient pressure. Though great strides have been made, significant knowledge gaps remain. If the coming years advance the field even a fraction of what its predecessors accomplished, the health and safety of those who endeavor in the environment of changing pressures most certainly will be improved.

  10. [Workplace bullying and sickness absenteeism].

    PubMed

    Campanini, Paolo; Conway, Paul Maurice; Neri, Luca; Punzi, Silvia; Camerino, Donatella; Costa, Giovanni

    2013-01-01

    To assess the relationship between workplace bullying and sickness absenteeism in a large sample of Italian workers. A cross-sectional study conducted by means of questionnaires. In all, 8,992 subjects filled in a questionnaire to detect workplace bullying, the presence of work stress factors and days of sickness absence in the last year. Workplace bullying and psychosocial stressor were measured by the means of the CDL 2.0 questionnaire. Days of sickness absence reported by the subjects. On average, days of sickness absence were 7.4, and 7.2% of the respondents were defined as bullied. Results from logistic regression analyses showed that a workplace bullying was associated with more days of sickness absence after controlling for gender, age, professional qualification, company sector and juridical nature and other psychosocial factors (men: OR =1.62; women: OR =2.15). The present study confirms that workers exposed to a workplace bullying reported higher sickness absenteeism as compared with non-exposed subjects, also when a potentially highly stressful work environment is considered. The results of the present study support that workplace bullying may be viewed as an extreme stressful condition. Interventions to avoid workplace bullying not only favoure workers' health, but also avoid the company costs associated with workers' sickness absenteeism.

  11. Neural mechanisms of motion sickness

    NASA Technical Reports Server (NTRS)

    Crampton, G. H.; Daunton, N. G.

    1983-01-01

    The possibility that there might be a neuro-homoral cerebrospinal fluid link in motion sickness was directly tested by blocking the flow of CSF from the third into the fourth ventricle in cats. Evidence obtained thus far is consistent with the hypothesis. Cats with demonstrably sound plugs did not vomit in response to an accelerative motion sickness stimulus, whereas cats with imperfect 'leaky' plugs vomited with little or no delay in latency. Althoough there are several putative candidates, the identification of a humoral motion sickness substance is a matter of conjecture.

  12. Progressive accumulation of the abnormal conformer of the prion protein and spongiform encephalopathy in the obex of nonsymptomatic and symptomatic Rocky Mountain elk (Cervus elaphus nelsoni) with chronic wasting disease

    USDA-ARS?s Scientific Manuscript database

    Chronic wasting disease (CWD), a transmissible spongiform encephalopathy, has been reported in captive and free-ranging cervids. An abnormal isoform of a prion protein (PrP-CWD) has been associated with CWD in Rocky Mountain elk (Cervus elaphus nelsoni) and this prion protein can be detected with i...

  13. Detection of the Abnormal Isoform of the Prion Protein Associated With Chronic Wasting Disease in the Optic Pathways of the Brain and Retina of Rocky Mountain Elk (Cervus elaphus nelsoni)

    USDA-ARS?s Scientific Manuscript database

    Eyes and nuclei of the visual pathways in the brain from 30 Rocky Mountain elk representing 3 PRNP genotypes, naturally or experimentally infected with chronic wasting disease, a prion disease of deer and elk. Elk were scored for relative disease progression by immunohistochemistry analysis of the ...

  14. Treatment of severe motion sickness with antimotion sickness drug injections

    NASA Technical Reports Server (NTRS)

    Graybiel, Ashton; Lackner, James R.

    1987-01-01

    This report concerns the use of intramuscular injections of scopolamine, promethazine, and dramamine to treat severely motion sick individuals participating in parabolic flight experiments. The findings indicate that a majority of individuals received benefit from 50-mg injections of promethazine or 0.5 mg-injections of scopolamine. By contrast, 50-mg injections of dramamine and 25-mg injections of promethazine were nonbeneficial. The use of antimotion drug injections for treating space motion sickness is discussed.

  15. Treatment of severe motion sickness with antimotion sickness drug injections

    NASA Technical Reports Server (NTRS)

    Graybiel, Ashton; Lackner, James R.

    1987-01-01

    This report concerns the use of intramuscular injections of scopolamine, promethazine, and dramamine to treat severely motion sick individuals participating in parabolic flight experiments. The findings indicate that a majority of individuals received benefit from 50-mg injections of promethazine or 0.5 mg-injections of scopolamine. By contrast, 50-mg injections of dramamine and 25-mg injections of promethazine were nonbeneficial. The use of antimotion drug injections for treating space motion sickness is discussed.

  16. Efficacy of phosphatidylcholine in the modulation of motion sickness susceptibility

    NASA Technical Reports Server (NTRS)

    Kohl, R. L.; Ryan, P.; Homick, J. L.

    1985-01-01

    This study evaluated the efficacy of pharmacological doses of phosphatidylcholine (lecithin) in the modulation of motion sickness induced by exposure to coriolis stimulation in a rotating chair. Subjects received daily dietary supplements of 25 grams of lecithin (90 percent phosphatidylcholine) and were tested for their susceptibility to motion sickness after 4 h, 2 d, and 21 d. A small but statistically significant increase in susceptibility (+15 percent) was noted 4 h after supplemental phosphatidylcholine, with four of nine subjects demonstrating a marked increase in susceptibility. This finding was attributed to choline's stimulatory action on cholinergic systems, an action which opposes that of the classical antimotion sickness drug scopolamine. Chronic lecithin loading revealed a trend towards reduced susceptibility, possibly indicating the occurrence of adaptive mechanisms such as receptor down-regulation. Withdrawal from lecithin loading, perhaps coupled with anticholinergic treatment, might prove to be a potent prophylactic regimen and ought to be tested.

  17. Chronic Radiation Sickness Among Techa Riverside Residents

    DTIC Science & Technology

    1998-02-01

    diseases (ICD-9 class 9), 30 - urogenital tract impairment (ICD-9 class 10), and 0 trauma (ICD-9 class 17) were almost similar in the CRS cohort and the...10.54 9. Diseases of the digestive system 5 2.26 258 2.21 10. Diseases of the urogenital system 2 0.90 105 0.90 11. Pregnancy complications 47 0.40 12...liver, and pancreas (summarized), (b) breast can- cer, (c) cancer of the urogenital organs, and (d) leu- In patients with CRS, only one case of cancer

  18. Sickness absence among health workers in belo horizonte, brazil

    PubMed Central

    Bassi, Iara; Assunção, Ada Ávila; Pimenta, Adriano Marçal; Benavides, Fernando G.; Ubalde-Lopez, Monica

    2016-01-01

    Objectives: To describe the prevalence of sickness absence and to analyze factors associated with the outcome according to gender in a sample of healthcare workers at the Belo Horizonte Health Department. Method: This study was based on a Belo Horizonte Health Department survey carried out between September 2008 and January 2009. From a randomly selected sample of 2,205 workers, 1,808 agreed to participate. Workers were classified into Health Staff or Health Care. Other explanatory variables were social and demographic data, work characteristics, and personal health. The Poisson regression was applied to analyze factors associated with sickness absence by the prevalence ratio (PR). Results: The overall prevalence of sickness absence was 31.5% (23.8% for men and 34.6% for women). In the final model, we found higher rates of sickness absence in both male and female workers involved in tasks with high psychosocial demands (PR=1.86 men; PR=1.38 women) and in those that reported using medication for treating chronic diseases (PR=1.96 men; PR=1.50 women). Women having a permanent job contract had a higher prevalence of sickness absence than those having a temporary job contract (PR=1.71). Conclusion: Our findings suggest a paradox in how healthcare is organized: good results in terms of its global objective of providing healthcare for citizens contrast with lack of effective measures for protecting healthcare workers. PMID:27010082

  19. Dark Adaptation at High Altitude: An Unexpected Pupillary Response to Chronic Hypoxia in Andean Highlanders.

    PubMed

    Healy, Katherine; Labrique, Alain B; Miranda, J Jaime; Gilman, Robert H; Danz, David; Davila-Roman, Victor G; Huicho, Luis; León-Velarde, Fabiola; Checkley, William

    2016-09-01

    Healy, Katherine, Alain B. Labrique, J. Jaime Miranda, Robert H. Gilman, David Danz, Victor G. Davila-Roman, Luis Huicho, Fabiola León-Velarde, and William Checkley. Dark adaptation at high altitude: an unexpected pupillary response to chronic hypoxia in Andean highlanders. High Alt Med Biol. 17:208-213, 2016.-Chronic mountain sickness is a maladaptive response to high altitude (>2500 m above sea level) and is characterized by excessive erythrocytosis and hypoxemia resulting from long-term hypobaric hypoxia. There is no known early predictor of chronic mountain sickness and the diagnosis is based on the presence of excessive erythrocytosis and clinical features. Impaired dark adaptation, or an inability to visually adjust from high- to low-light settings, occurs in response to mild hypoxia and may serve as an early predictor of hypoxemia and chronic mountain sickness. We aimed to evaluate the association between pupillary response assessed by dark adaptometry and daytime hypoxemia in resident Andean highlanders aged ≥35 years living in Puno, Peru. Oxyhemoglobin saturation (SpO2) was recorded using a handheld pulse oximeter. Dark adaptation was quantitatively assessed as the magnitude of pupillary contraction to light stimuli of varying intensities (-2.9 to 0.1 log-cd/m(2)) using a portable dark adaptometer. Individual- and stimulus-specific multilevel analyses were conducted using mixed-effect models to elicit the relationship between SpO2 and pupillary responsiveness. Among 93 participants, mean age was 54.9 ± 11.0 years, 48% were male, 44% were night blind, and mean SpO2 was 89.3% ± 3.4%. The magnitude of pupillary contraction was greater with lower SpO2 (p < 0.01), and this dose relationship remained significant in multiple variable analyses (p = 0.047). Pupillary responsiveness to light stimuli under dark-adapted conditions was exaggerated with hypoxemia and may serve as an early predictor of chronic mountain sickness. This unexpected

  20. Space sickness on earth

    NASA Astrophysics Data System (ADS)

    Nooij, S. A. E.; Bos, J. E.; Groen, E. L.; Bles, W.; Ockels, W. J.

    2007-09-01

    During the first days in space, i.e., after a transition from 1G to 0G, more than 50% of the astro- (and cosmonauts) suffer from the Space Adaptation Syndrome (SAS).The symptoms of SAS, like nausea and dizziness, are especially provoked by head movements. Astronauts have mentioned close similarities between the symptoms of SAS and the symptoms they experienced after a 1 hour centrifuge run on Earth, i.e., after a transition from 3G to 1G (denoted by Sickness Induced by Centrifugation, SIC). During several space missions, we related susceptibility to SAS and to SIC in 11 astronauts and found 4 of them being susceptible to both SIC and SAS, and 7 being not susceptible to SIC nor to SAS. This correspondence in susceptibility suggests that SIC and SAS share the same underlying mechanism. To further study this mechanism, several vestibular parameters have been investigated (e.g. postural stability, vestibularly driven eye movements, subjective vertical). We found some striking changes in individual cases that are possibly due to the centrifuge run. However, the variability between subjects generally is very large, making physiological links to SIC and SAS still hard to find.

  1. The cost of sickness: on the effect of the duration of sick leave on post-sick leave earnings.

    PubMed

    Andersen, Signe Hald

    2010-05-01

    Studies analysing the effect of the duration of sick leave on subsequent labour market outcomes do not consider the potential endogenous relationship between duration and labour market outcomes. This paper deals with this shortcoming by using a consistent estimator attained through Instrumental Variables methods for estimating the effect of the duration of a sick leave spell on post-sick leave earnings. I use Danish administrative data and a major 2001 reform of the sick leave system as the instrument for duration. I find that the duration of a sick leave spell has both short and long term effects on post-sick leave earnings.

  2. Workers' opinions on the effect of contact with health care providers on sickness absence duration.

    PubMed

    Steenbeek, Romy

    2014-01-01

    Because of the aging working population and the increasing age of retirement the number of workers with chronic illnesses and disabilities is growing. It is important that workers with health complaints receive efficient health care in order to remain fully or at least partly productive. To explore workers' opinions about the effectiveness of contact with health care providers in shortening sickness absence duration. Data come from a four-wave study from 2005 to 2008 among Dutch workers (n=1,424). Data were obtained on visits to health care providers, sickness absence and workers' opinions on whether and how their absence could have been shortened. A third of the workers were of the opinion that the health care provider (most often the general practitioner, GP) had played a role in preventing sickness absence and 35% were of the opinion that the health care provider had limited their absence. Most often the physical therapist (71%) and mental health therapist (61%) shortened sickness absence duration, in contrast to the occupational physician (OP, 25%) and GP (32%). The effectiveness of the health care providers' treatment was associated with the cause of sickness absence. Approximately 15% of the workers reported that their sickness absence could have been shortened if health care providers had provided the proper treatment and if waiting times had been reduced. Health care providers differ in their potential to shorten sickness absence duration. Health care providers can further reduce sickness absence and health care costs by providing the proper treatment and by reducing waiting times.

  3. Sick-building syndrome.

    PubMed Central

    Stolwijk, J A

    1991-01-01

    The sick-building syndrome (SBS) is defined as the occurrence of an excessive number of subjective complaints by the occupants of a building. These complaints include headache, irritation of the eyes, nose, and throat, lethargy, inability to concentrate, objectionable odors, and less frequently, nausea, dizziness, chest tightness, etc. These complaints will always be reported by a fraction of the occupants of any building if a questionnaire is administered that asks the respondent to recall any subjective symptoms they remember having had in the last 2 weeks or or over some period of time. It is often considered that SBS symptom reports have a minimum prevalence of about 15 to 20% for a 2-week recall period. SBS symptoms reported by 30% or more of occupants are indicative of conditions in the building environment that warrant attention. It is not often that a clear, single cause is responsible for the excess symptom reports. The following factors, often in combinations, are seen to contribute to SBS: outdoor air supply that is inadequate, ventilation distribution or effectiveness that is inadequate, the presence of temporary or long-term sources of contaminants such as tobacco smoke, adhesives, composite materials such as chipboard, and the growth of microorganisms in the HVAC equipment or in carpets or other furnishings. Depending on which causes contribute, the condition may be intermittent or even temporary. Psychosocial factors such as labor-management relations and satisfaction or dissatisfaction with other factors in the work environment can have a profound influence on the level of response of the occupants to their environment. Although hard data are difficult to collect, it is likely that productivity in the office environment is sensitive to conditions causing SBS. PMID:1821387

  4. Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana.

    PubMed

    Škerjanc, Alenka; Dodič Fikfak, Metoda

    2014-12-01

    The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals. Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires. There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4-133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7-30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7-12.3). The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations.

  5. Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana

    PubMed Central

    ŠKERJANC, Alenka; DODIČ FIKFAK, Metoda

    2014-01-01

    Objectives The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals. Methods Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires. Results There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3). Conclusions The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations. PMID:27669513

  6. Cytokine-induced sickness behavior.

    PubMed

    Kelley, Keith W; Bluthé, Rose-Marie; Dantzer, Robert; Zhou, Jian-Hua; Shen, Wen-Hong; Johnson, Rodney W; Broussard, Suzanne R

    2003-02-01

    The behavioral repertoire of humans and animals changes dramatically following infection. Sick individuals have little motivation to eat, are listless, complain of fatigue and malaise, loose interest in social activities and have significant changes in sleep patterns. They display an inability to experience pleasure, have exaggerated responses to pain and fail to concentrate. Proinflammatory cytokines acting in the brain cause sickness behaviors. These nearly universal behavioral changes are a manifestation of a central motivational state that is designed to promote recovery. Exaggerated symptoms of sickness in cancer patients, such as cachexia, can be life-threatening. However, quality of life is often drastically impaired before the cancer becomes totally debilitating. Although basic studies in psychoneuroimmunology have defined proinflammatory cytokines as the central mediators of sickness behavior, a much better understanding of how cytokine and neurotransmitter receptors communicate with each other is needed. Advances that have been made during the past decade should now be extended to clinical studies in an attempt to alleviate sickness symptoms and improve quality of life for cancer patients.

  7. Some characteristics of repeated sickness absence

    PubMed Central

    Ferguson, David

    1972-01-01

    such absences in individuals in successive years were relatively highly correlated. All types of repeater were commoner in Sydney than in the other capital city offices, which differed little from each other. Repeaters were more common among those whose absence was attributed to neurosis, alimentary and upper respiratory tract disorder, and injury. Out of more than 90 health, personal, social, and industrial attributes determined at examination, only two (ethanol habit and adverse attitude to pay) showed any statistically significant association when telegraphist repeaters in Sydney were compared with employees who were rarely absent. Though repeating tended to be associated with chronic or recurrent ill health revealed at examination, one quarter of repeaters had little such ill health and one quarter of rarely absent employees had much. It was concluded that, in the population studied, the fitting of the negative binomial to frequency of certified sickness absence could, in the circumstances of the study, reasonably be given an interpretation of proneness. In that population also repeating varies geographically and occupationally, and is poorly associated with disease and other attributes uncovered at examination, with the exception of the ethanol habit. Repeaters are more often neurotic than employees who are rarely absent but also are more often stable double jobbers. The repeater should be identified for what help may be given him, if needed, otherwise it would seem more profitable to attack those features in work design and organization which influence motivation to come to work. Social factors which predispose to repeated absence are less amenable to modification. PMID:4636662

  8. Controlling sleeping sickness - a review.

    PubMed

    Welburn, S C; Maudlin, I; Simarro, P P

    2009-12-01

    Following a period characterized by severe epidemics of sleeping sickness, restoration of effective control and surveillance systems has raised the question of eliminating the disease from sub-Saharan Africa. Given sufficient political and financial support, elimination is now considered a reasonable aim in countries reporting zero or less than 100 cases per year. This success may lead health authorities across the affected region to downgrade the disease from 'neglected' to simply being ignored. In view of the significant levels of under-reporting of sleeping sickness mortality in rural communities, this could be a short-sighted policy. Loss of capacity to deal with new epidemics, which can arise as a consequence of loss of commitment or civil upheaval, would have serious consequences. The present period should be seen as a clear opportunity for public-private partnerships to develop simpler and more cost-effective tools and strategies for sustainable sleeping sickness control and surveillance, including diagnostics, treatment and vector control.

  9. Should MA plans try to attract the sick?

    PubMed

    Jacobs, M Orry

    2015-11-01

    Although attracting a mixture of well and sick patients provides a good risk mix for managed care plans, bringing in more high-risk enrollees may mean a higher reward for both patients and providers. Data systems and analytics have improved, allowing hospitals and health systems to better mitigate the risks associated with sicker patients. These new technologies and capabilities can enable these provider organizations to better manage care for patients who require treatment for multiple chronic conditions.

  10. Ultrasonographic appearance of adrenal glands in healthy and sick cats.

    PubMed

    Combes, Anaïs; Pey, Pascaline; Paepe, Dominique; Rosenberg, Dan; Daminet, Sylvie; Putcuyps, Ingrid; Bedu, Anne-Sophie; Duchateau, Luc; de Fornel-Thibaud, Pauline; Benchekroun, Ghita; Saunders, Jimmy H

    2013-06-01

    The first part of the study aimed to describe prospectively the ultrasonographic features of the adrenal glands in 94 healthy cats and 51 chronically sick cats. It confirmed the feasibility of ultrasonography of adrenal glands in healthy and chronically sick cats, which were not statistically different. The typical hypoechoic appearance of the gland surrounded by hyperechoic fat made it recognisable. A sagittal plane of the gland, not in line with the aorta, may be necessary to obtain the largest adrenal measurements. The reference intervals of adrenal measurements were inferred from the values obtained in the healthy and chronically sick cats (mean ± 0.96 SD): adrenal length was 8.9-12.5 mm; cranial height was 3.0-4.8 mm; caudal height was 3.0-4.5 mm. The second part of the study consisted of a retrospective analysis of the ultrasonographic examination of the adrenal glands in cats with adrenal diseases (six had hyperaldosteronism and four had pituitary-dependent hyperadrenocorticism) and a descriptive comparison with the reference features obtained in the control groups from the prospective study. Cats with hyperaldosteronism presented with unilateral severely enlarged adrenal glands. However, a normal contralateral gland did not preclude a contralateral infiltration in benign or malignant adrenal neoplasms. The ultrasonographic appearance of the adrenal glands could not differentiate benign and malignant lesions. The ultrasonographic appearance of pituitary-dependent hyperadrenocorticism was mainly a symmetrical adrenal enlargement; however, a substantial number of cases were within the reference intervals of adrenal size.

  11. Separate and combined associations of pain and emotional exhaustion with sickness absence.

    PubMed

    Saastamoinen, Peppiina; Leino-Arjas, Päivi; Rahkonen, Ossi; Lahelma, Eero

    2016-01-01

    Pain and emotional exhaustion are prevalent conditions with consequences for sickness absence. Although they often co-occur, their combined associations with sickness absence are poorly understood. This study aimed to examine the separate and combined associations of pain and emotional exhaustion with subsequent sickness absence. The data were derived from a cross-sectional questionnaire survey sent to 40 to 60-year-old employees of the City of Helsinki in 2000 to 2002 (n = 6457) linked with the City of Helsinki personnel register information on sickness absence (3 years on from the survey). Self-certified (1-3 days) and medically certified sickness absence spells (4-14 days, more than 14 days) were used as outcomes. Acute and chronic pain and emotional exhaustion were measured in a questionnaire survey. For the purposes of this study, sickness absence and pain variables were merged to form a new variable with 6 mutually exclusive categories. The main statistical method was negative binomial regression analysis. The synergy index was used to estimate the interaction. Among women, acute and chronic pain with and without emotional exhaustion predicted sickness absence, particularly absence lasting for more than 2 weeks, whereas emotional exhaustion alone did not. The associations persisted when further adjusted for socioeconomic and sociodemographic factors, health-related behaviors, and somatic and mental health. A synergistic interaction effect was found for co-occurring pain and emotional exhaustion on medically certified sickness absence. The results for men were mainly similar, but less stable. In order to tackle sickness absence, special attention should be paid to the prevention and treatment of employees with co-occurring pain and emotional exhaustion.

  12. Acute pulmonary oedema on the Ruwenzori mountain range.

    PubMed Central

    Naeije, R; Mélot, C

    1990-01-01

    A 40 year old man had an episode of severe pulmonary oedema at 4000-5000 m during the ascent of the Margherita peak (5109 m) of Mount Stanley on the Ruwenzori. He had taken acetazolamide and high dose dexamethasone to treat symptoms of acute mountain sickness. Six years before he had been studied by right heart catheterisation as a healthy volunteer during hypoxic breathing at sea level. His pulmonary vascular reactivity had been within the normal range for 32 healthy subjects. This man had high altitude pulmonary oedema despite currently recommended treatments for acute mountain sickness and normal pulmonary vascular reactivity to hypoxia at sea level. PMID:2271350

  13. Space Motion Sickness Monitoring Experiment: Spacelab 1,

    DTIC Science & Technology

    overall discomfort, and vomited repeatedly. Symptom pattern was generally similar to that seen in the individuals preflight, except that: prodromal nausea ...contact cues around the body. Drugs known to be effective in preventing motion sickness were judged helpful in limiting symptoms, including vomiting . Results support the view that space sickness is a form of motion sickness.

  14. Self Motion Perception and Motion Sickness

    NASA Technical Reports Server (NTRS)

    Fox, Robert A. (Principal Investigator)

    1991-01-01

    The studies conducted in this research project examined several aspects of motion sickness in animal models. A principle objective of these studies was to investigate the neuroanatomy that is important in motion sickness with the objectives of examining both the utility of putative models and defining neural mechanisms that are important in motion sickness.

  15. Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease.

    PubMed

    Biering, Karin; Lund, Thomas; Andersen, Johan Hviid; Hjollund, Niels Henrik

    2015-12-01

    During the last decades mortality has declined in patients with coronary heart disease due to improvements in treatments and changes in life style, resulting in more people living with chronic heart disease. This implies that focus on rehabilitation and re-integration to the work-force becomes increasingly important. Previous studies among healthy workers suggest that the psychosocial working environment is associated with sickness absence. Whether the psychosocial working environment plays a role for patients with existing cardiovascular disease on return to work and sickness absence is less studied. A cohort of patients under 67 years and treated with percutaneous coronary intervention (PCI) was established in 2006. Three months after the procedure the patients (n = 625) answered a questionnaire about their psychosocial working environment. Patients were followed in registers for the following year. We examined the association between psychosocial working environment and sickness absence at 3 months, 1 year and new sick-listings during the first year with logistic regression. A total of 528 patients had returned to work 3 months after the PCI, while 97 was still sick-listed. After 1 year one was dead, 465 were working and 85 were receiving health related benefits, while 74 had left the workforce permanently. A number of 106 patients were sick-listed during the whole first year or had left the workforce permanently. After the initial return to work, 90 experienced a new sickness absence during the first year while the remaining 429 did not. High work pace, low commitment to the workplace, low recognition (rewards) and low job control were associated with sickness absence at 3 months, but not after 1 year. Low job control as well as job strain (combination of high demands and low control) was associated with new sick-listings. The psychosocial working environment was associated with sickness absence 3 months after the PCI, but not 1 year after.

  16. Christmas Mountains

    Atmospheric Science Data Center

    2013-04-17

    article title:  Christmas Mountains     View Larger ... of New Brunswick. Located above image center are the Christmas Mountains, a region of old-growth forest nestled in a remote ... date:  Mar 8, 2001 Images:  Christmas Mountains location:  Canada ...

  17. Impact of age and sex of Rocky Mountain elk (Cervus elaphus nelsoni) on follicle counts from rectal mucosal biopsies for preclinical detection of chronic wasting disease.

    PubMed

    Spraker, Terry R; VerCauteren, Kurt C; Gidlewski, Tom L; Munger, Randy D; Walter, W David; Balachandran, Aru

    2009-11-01

    To determine if the number of rectal lymphoid follicles decreases with respect to age and sex relative to diagnosis of chronic wasting disease (CWD), rectal biopsies (n = 1,361) were taken from captive Rocky Mountain elk (Cervus elaphus nelsoni) at 4 ranches in the western United States between 2005 and 2008. Rectal tissues were stained with a monoclonal antibody (F99/97.6.1), which selectively stains the abnormal isoform of the prion protein associated with CWD of elk. The number of lymphoid follicles obtained from typical biopsy tissues decreased with the age of the animal. The acceptable number of lymphoid follicles for detection of CWD was not considered to be a problem in elk up to 8.5 years of age, but in elk over 8.5 years of age, the follicle count was considered to be low. Sex of the animal had no effect on the number of lymphoid follicles observed in each age group. Rectal biopsies were an accurate test to diagnose preclinical stages of CWD in elk but may be best suited to elk that are less then 8.5 years of age.

  18. Sick of sitting

    PubMed Central

    Levine, James A.

    2015-01-01

    Sitting too much kills. Epidemiological, physiological and molecular data suggest that sedentary lifestyle can explain, in part, how modernity is associated with obesity, more than 30 chronic diseases and conditions and high healthcare costs. Excessive sitting—sitting disease—is not innate to the human condition. People were designed to be bipedal and, before the industrial revolution, people moved substantially more throughout the day than they do presently. It is encouraging that solutions exist to reverse sitting disease. Work environments, schools, communities and cities can be re-imagined and reinvented as walking spaces, and people thereby offered more active, happier, healthier and more productive lives. PMID:26003325

  19. Mechanisms of antimotion sickness drugs

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Manno, J. E.; Wood, M. J.; Manno, B. R.; Redetzki, H. M.

    1987-01-01

    Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg, and amphetamine 10 mg. Scopolamine increased tolerated head movements over placebo level by + 81; scopolamine 1 mg + 183; d-amphetamine by + 118; scopolamine 0.6/d-amphetamine by + 165; and scopolamine 1 mg/d-amphetamine 10 mg by + 201. The drugs effective in preventing motion sickness are considered to be divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications. It is concluded that the balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness.

  20. Mechanisms of antimotion sickness drugs

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Manno, J. E.; Wood, M. J.; Manno, B. R.; Redetzki, H. M.

    1987-01-01

    Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg, and amphetamine 10 mg. Scopolamine increased tolerated head movements over placebo level by + 81; scopolamine 1 mg + 183; d-amphetamine by + 118; scopolamine 0.6/d-amphetamine by + 165; and scopolamine 1 mg/d-amphetamine 10 mg by + 201. The drugs effective in preventing motion sickness are considered to be divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications. It is concluded that the balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness.

  1. Physiology of motion sickness symptoms

    NASA Technical Reports Server (NTRS)

    Harm, Deborah L.

    1990-01-01

    Motion sickness research is reviewed with the emphasis placed on theories developed to explain its symptomatology. A general review of central nervous system, autonomic nervous system, and neuroendocrine system involvement in the syndrome. Particular attention is given to signs, symptoms, and physiological correlates, methodological issues, and directions for future research based on a dynamic interactive systems model.

  2. Sleeping sickness and the brain.

    PubMed

    Enanga, B; Burchmore, R J S; Stewart, M L; Barrett, M P

    2002-05-01

    Recent progress in understanding the neuropathological mechanisms of sleeping sickness reveals a complex relationship between the trypanosome parasite that causes this disease and the host nervous system. The pathology of late-stage sleeping sickness, in which the central nervous system is involved, is complicated and is associated with disturbances in the circadian rhythm of sleep. The blood-brain barrier, which separates circulating blood from the central nervous system, regulates the flow of materials to and from the brain. During the course of disease, the integrity of the blood-brain barrier is compromised. Dysfunction of the nervous system may be exacerbated by factors of trypanosomal origin or by host responses to parasites. Microscopic examination of cerebrospinal fluid remains the best way to confirm late-stage sleeping sickness, but this necessitates a risky lumbar puncture. Most drugs, including many trypanocides, do not cross the blood-brain barrier efficiently. Improved diagnostic and therapeutic approaches are thus urgently required. The latter might benefit from approaches which manipulate the blood-brain barrier to enhance permeability or to limit drug efflux. This review summarizes our current understanding of the neurological aspects of sleeping sickness, and envisages new research into blood-brain barrier models that are necessary to understand the interactions between trypanosomes and drugs active against them within the host nervous system.

  3. Endocrine aspects of high altitude acclimatization and acute mountain sickness.

    PubMed

    Woods, D R; Stacey, M; Hill, N; de Alwis, N

    2011-03-01

    The acute acclimatization to high altitude is underpinned by a diuresis (and to a lesser extent a natriuresis) that facilitates a reduction in plasma volume. This allows a haemoconcentration to occur that increases the oxygen carrying capacity of a given volume of blood, a vital effect in the presence of a reduced partial pressure of oxygen. This critical acclimatization process is orchestrated by the endocrine system. This review will present the key evidence regarding the changes in several important hormones that affect this process.

  4. Self-Motion Perception and Motion Sickness

    NASA Technical Reports Server (NTRS)

    Fox, Robert A.

    1991-01-01

    Motion sickness typically is considered a bothersome artifact of exposure to passive motion in vehicles of conveyance. This condition seldom has significant impact on the health of individuals because it is of brief duration, it usually can be prevented by simply avoiding the eliciting condition and, when the conditions that produce it are unavoidable, sickness dissipates with continued exposure. The studies conducted examined several aspects of motion sickness in animal models. A principle objective of these studies was to investigate the neuroanatomy that is important in motion sickness with the objectives of examining both the utility of putative models and defining neural mechanisms that are important in motion sickness.

  5. Absence and leave; sick leave. Final rule.

    PubMed

    2010-12-03

    The U.S. Office of Personnel Management is issuing final regulations on the use of sick leave and advanced sick leave for serious communicable diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up to 26 weeks of accrued or accumulated sick leave for unpaid Family and Medical Leave Act (FMLA) leave to care for a seriously injured or ill covered servicemember, as authorized under the National Defense Authorization Act for Fiscal Year 2008, including up to 30 days of advanced sick leave for this purpose. Finally, we are reorganizing the existing sick leave regulations to enhance reader understanding and administration of the program.

  6. Theory of antimotion sickness drug mechanisms.

    NASA Technical Reports Server (NTRS)

    Wood, D. C.; Graybiel, A.

    1972-01-01

    The results of a series of antimotion sickness drug evaluations indicates that drugs with central anticholinergic actions and drugs that increase central sympathetic activity are effective against motion sickness. The combination of these actions produces a synergistic effect against motion sickness. The effect of these medications on central acetylcholine or on norepinephrine could alter a balance between the neurons in the vestibular and reticular areas which influence motion sickness and also sympathetic and parasympathetic reactions. It is suggested that this could be their mechanism of action in preventing motion sickness.

  7. Theory of antimotion sickness drug mechanisms.

    NASA Technical Reports Server (NTRS)

    Wood, D. C.; Graybiel, A.

    1972-01-01

    The results of a series of antimotion sickness drug evaluations indicates that drugs with central anticholinergic actions and drugs that increase central sympathetic activity are effective against motion sickness. The combination of these actions produces a synergistic effect against motion sickness. The effect of these medications on central acetylcholine or on norepinephrine could alter a balance between the neurons in the vestibular and reticular areas which influence motion sickness and also sympathetic and parasympathetic reactions. It is suggested that this could be their mechanism of action in preventing motion sickness.

  8. The challenge of Trypanosoma brucei gambiense sleeping sickness diagnosis outside Africa.

    PubMed

    Lejon, V; Boelaert, M; Jannin, J; Moore, A; Büscher, P

    2003-12-01

    Sleeping sickness is a lethal African disease caused by parasites of the Trypanosoma brucei subspecies, which is transmitted by tsetse flies. Occasionally, patients are reported outside Africa. Diagnosis of such imported cases can be problematic when the infection is due to Trypanosoma brucei gambiense, the chronic form of sleeping sickness found in west and central Africa. The low number of trypanosomes in the blood and the non-specific, variable symptoms make the diagnosis difficult, particularly when the index of suspicion is low. When the trypanosomes have penetrated into the central nervous system, neuropathological signs become apparent but even at this stage, misdiagnosis is frequent. Rapid and correct diagnosis of sleeping sickness can avoid inappropriate or delayed treatment and even death of the patient. In this article, an overview on diagnosis of imported cases of T b gambiense sleeping sickness is given, and possible pitfalls in the diagnostic process are highlighted. Bioclinical parameters that should raise the suspicion of sleeping sickness in a patient who has been in west or central Africa are discussed. Techniques for diagnosis are reviewed. A clinician suspecting sleeping sickness should contact a national reference centre for tropical medicine in his or her country, or the WHO, Geneva, Switzerland, or the Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA, for clinical consultation and provision of specific diagnostic tests. Appropriate drugs for sleeping sickness treatment are also provided by WHO and the CDC.

  9. [Simulator sickness and its measurement with Simulator Sickness Questionnaire (SSQ)].

    PubMed

    Biernacki, Marcin P; Kennedy, Robert S; Dziuda, Łukasz

    One of the most common methods for studying the simulator sickness issue is the Simulator Sickness Questionnaire (SSQ) (Kennedy et al., 1993). Despite the undoubted popularity of the SSQ, this questionnaire has not as yet been standardized and translated, which could allow us to use it in Poland for research purposes. The aim of our article is to introduce the SSQ to Polish readers, both researchers and practitioners. In the first part of this paper, the studies using the SSQ are discussed, whereas the second part consists of the description of the SSQ test procedure and the calculation method of sample results. Med Pr 2016;67(4):545-555. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  10. Fear avoidance beliefs influence duration of sick leave in Spanish low back pain patients.

    PubMed

    Kovacs, Francisco M; Muriel, Alfonso; Castillo Sánchez, María Dolores; Medina, José María; Royuela, Ana

    2007-07-15

    Follow-up study. To estimate the influence of fear avoidance beliefs (FAB) on 1-year low back pain (LBP)-related sick leave. As opposed to Anglo-Saxon and Northern European subjects, in Spanish LBP patients the influence of FAB on disability and quality of life is virtually irrelevant. Twelve primary care and 9 hospital services from 7 different regions of Spain recruited 165 workers who visited the National Health Service for LBP. None was excluded. On their first visit and 14 days later, patients were given 2 independent Visual Analogue Scales (VAS) for LBP and leg pain, as well as the validated Spanish versions of the Fear Avoidance Beliefs (FABQ), Roland-Morris (RMQ), and SF-12 questionnaires. During the following 12-month period, the number of days on sick leave because of LBP was registered. Differences in sick leave throughout the study period were associated with baseline differences in chronicity, severity of low back (not referred) pain, disability, FAB, physical and mental quality of life, being on sick leave when entering the study, and duration of previous sick leave. Ordinal logistic regression models showed that each additional point in the total FAB baseline score increases by 2.4% the odds of being on sick leave for up to 60 days during the following year and by 7.7% the odds of being sick listed for 61 days or more. Corresponding figures for FAB-Work scores are 4.2% and 11%. No variable modifies the effect of FAB on sick leave. Although in Spanish patients the influence of FAB on disability and quality of life is irrelevant, baseline FABQ score does influence LBP-related sick leave during the following year. This seems to be a direct effect of FAB, since there is no confounding by any other variable.

  11. Spacelab experiments on space motion sickness

    NASA Technical Reports Server (NTRS)

    Oman, C. M.

    1985-01-01

    Recent research results from ground and flight experiments on motion sickness and space sickness conducted by the Man Vehicle Laboratory are reviewed. New tools developed include a mathematical model for motion sickness, a method for quantitative measurement of skin pallor and blush in ambulatory subjects, and a magnitude estimation technique for ratio scaling of nausea or discomfort. These have been used to experimentally study the time course of skin pallor and subjective symptoms in laboratory motion sickness. In prolonged sickness, subjects become hypersensitive to nauseogenic stimuli. Results of a Spacelab-1 flight experiment are described in which 4 observers documented the stimulus factors for and the symptoms/signs of space sickness. The clinical character of space sickness differs somewhat from acute laboratory motion sickness. However SL-1 findings support the view that space sickness is fundamentally a motion sickness. Symptoms were subjectively alleviated by head movement restriction, maintenance of a familiar orientation with respect to the visual environment, and wedging between or strapping onto surfaces which provided broad contact cues confirming the absence of body motion.

  12. Spacelab experiments on space motion sickness

    NASA Technical Reports Server (NTRS)

    Oman, C. M.

    1987-01-01

    Recent research results from ground and flight experiments on motion sickness and space sickness conducted by the Man Vehicle Laboratory are reviewed. New tools developed include a mathematical model for motion sickness, a method for quantitative measurements of skin pallor and blush in ambulatory subjects, and a magnitude estimation technique for ratio scaling of nausea or discomfort. These have been used to experimentally study the time course of skin pallor and subjective symptoms in laboratory motion sickness. In prolonged sickness, subjects become hypersensitive to nauseogenic stimuli. Results of a Spacelab-1 flight experiment are described in which four observers documented the stimulus factors for and the symptoms/signs of space sickness. The clinical character of space sickness differs somewhat from acute laboratory motion sickness. However SL-1 findings support the view that space sickness is fundamentally a motion sickness. Symptoms were subjectively alleviated by head movement restriction, maintenance of a familiar orientation with respect to the visual environment, and wedging between or strapping onto surfaces which provided broad contact cues confirming the absence of body motion.

  13. Spaceflight Decompression Sickness Contingency Plan

    NASA Technical Reports Server (NTRS)

    Dervay, Joseph P.

    2007-01-01

    A viewgraph presentation on the Decompression Sickness (DCS) Contingency Plan for manned spaceflight is shown. The topics include: 1) Approach; 2) DCS Contingency Plan Overview; 3) Extravehicular Activity (EVA) Cuff Classifications; 4) On-orbit Treatment Philosophy; 5) Long Form Malfunction Procedure (MAL); 6) Medical Checklist; 7) Flight Rules; 8) Crew Training; 9) Flight Surgeon / Biomedical Engineer (BME) Training; and 10) DCS Emergency Landing Site.

  14. Space motion sickness status report

    NASA Technical Reports Server (NTRS)

    Kutyna, Frank

    1986-01-01

    The space motion sickness (SMS) component of the multifactor space adaptation syndrome is anticipated to be a major problem in the spaceflight and habitation conditions that will be encountered in NASA Space Station tours and Mars voyages. The minimization of maladaptive physiological responses while enhancing those mechanisms that can best cope with the gravitoinertial conditions of space flight will require an intimate knowledge of the physiology of adaptive processes. The homeostatic mechanisms involved in SMS are inherent in human physiology.

  15. [Return of African sleeping sickness].

    PubMed

    Stingl, Peter

    2006-09-14

    At present there is a steady rise in African sleeping sickness (trypanosomiasis) transmitted by the Tsetse fly, and which if left untreated, is fatal. Thanks to more than so years of neglect by research, our therapeutic repertoire is limited to medications with a high level of toxicity. Both WHO and international aid organizations are pushing hard for the development of new, more efficient drugs that can be readily applied in the field.

  16. Sickness Behavior in Honey Bees

    PubMed Central

    Kazlauskas, Nadia; Klappenbach, Martín; Depino, Amaicha M.; Locatelli, Fernando F.

    2016-01-01

    During an infection, animals suffer several changes in their normal physiology and behavior which may include lethargy, appetite loss, and reduction in grooming and general movements. This set of alterations is known as sickness behavior and although it has been extensively believed to be orchestrated primarily by the immune system, a relevant role for the central nervous system has also been established. The aim of the present work is to develop a simple animal model to allow studying how the immune and the nervous systems interact coordinately during an infection. We administered a bacterial lipopolysaccharide (LPS) into the thorax of honey bees to mimic a bacterial infection, and then we evaluated a set of stereotyped behaviors of the animals that might be indicative of sickness behavior. First, we show that this immune challenge reduces the locomotor activity of the animals in a narrow time window after LPS injection. Furthermore, bees exhibit a loss of appetite 60 and 90 min after injection, but not 15 h later. We also demonstrate that LPS injection reduces spontaneous antennal movements in harnessed animals, which suggests a reduction in the motivational state of the bees. Finally, we show that the LPS injection diminishes the interaction between animals, a crucial behavior in social insects. To our knowledge these results represent the first systematic description of sickness behavior in honey bees and provide important groundwork for the study of the interaction between the immune and the neural systems in an insect model. PMID:27445851

  17. Decompression sickness during saturation dives.

    PubMed

    Berghage, T E

    1976-12-01

    Available Navy saturation diving data were analyzed for an evaluation of the therapeutic adequacy of decompression sickness treatment procedures and for delineation of precipitant factors in the etiology and treatment of decompression sickness during saturation dives. None of the cases of decompression sickness recorded during saturation dives involved more than musculoskeletal or joint pain, and in 96% of the cases the joint pain was confined to the diver's knees. In 89% of the cases symptoms appeared while the divers were still under pressure. The subsequent recompression treatment of these cases resulted in full relief in only 35% of the cases; the remaining 65% completed the therapy and subsequent decompression with residual pain which diminished over a period of weeks. The adequacy of the recompression appears to be inversely proportional to the depth of reported onset of symptoms and the time required to obtain even partial relief is directly related to the magnitude of the recompression ratio used. Four explanations are suggested for the limited recompression therapy common in saturation diving: increase in musculoskeletal pain with recompression, peer pressure to avoid extension of the chamber confinement, lack of severe neurological symptoms, and the tremendous depths required to obtain a reasonable recompression ratio. The author further suggests that future treatment procedures will require a departure from the accepted concept of radically decreasing the volume of inert gas bubbles by increasing pressure.

  18. [Charity in nursing the sick].

    PubMed

    Urbanek, B

    1999-01-01

    The need for support in case of illness or poverty has probably existed ever since. In ancient times this need was indicated by means of a mythical Aesculapius staff. The importance of charity toward one's neighbors was already emphasized by Hippocrates, also in his wording of the medical oath. In those times, however, rationalism determined actual approach towards the sick or unfortunate, and such concepts as "charitas" or "misericordia" were unfamiliar in the contemporary Greece and Rome. The care for the poor and the needy, defined as charity, was adopted by Christianity from the orthodox legislature. In Hebrew it was signified by the words "hesed" and emet". In exegesis it was expressed in terms of selfless and sympathetic attitude to other people, which was also reflected by nursing the sick. However, in Christianity, it developed from the duty into a virtue improving both the supporter and the supported person. The basis for that was thanksgiving, as the answer to the God's mercy. The subject of mercy was then all the misfortune of man, including disease, and the source of charity absolute kindness aiming at eliminating destitution. Since the Middle Ages people have believed that the failure to perform the duty of charity virtue was the abuse of the divine law of ownership. This view became a factor of social dynamics. It made a purpose for the communities predestined to nurse the sick, including the female communities e.g. the charity sisters, or the male communities such as the brothers of the order. At the same time, it resulted in the fact that the commitment of women to the organized service provided to the sick enabled their social promotion and also, indirectly, it had an impact on increasing their role in the Catholic Church. This article, based on various sources, including among others the Old and the New Testament, the rules of orders, the statutes of charity associations, etc., constitutes an attempt to present the process of developing the care

  19. Motion sickness: Can it be controlled

    NASA Technical Reports Server (NTRS)

    Carnes, David

    1988-01-01

    NASA is one of the few research centers concerned with motion sickness. Since the physiology of man has been developed in the one-gravity field Earth, the changes experienced by man in space are unique, and often result in symptoms that resemble motion sickness on Earth. NASA is concerned with motion sickness because it is very uncomfortable for the astronauts. Another concern of NASA is the possibility of a motion sickness astronaut regurgitating while he or she is sealed in an airtight space suit. This could be fatal. Motivated by these reasons, NASA spent thousands of dollars in research and development for a drug or technique for combating motion sickness. Several different treatments were developed for this disorder. Three of the most effective ways of combatting motion sickness are discussed.

  20. Preventing Sickness Absence With Career Management Intervention

    PubMed Central

    Toppinen-Tanner, Salla; Böckerman, Petri; Mutanen, Pertti; Martimo, Kari-Pekka; Vuori, Jukka

    2016-01-01

    This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence. Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a randomized controlled trial. Sickness absence data were collected covering a period from 1 year before (baseline) to approximately 2 years after the intervention (follow-up). The data were analyzed using zero-inflated negative binomial models. After controlling for baseline absence, age, gender, and organization, the intervention was effective in decreasing the number of longer sickness absences (lasting longer than > 2 weeks), but no other significant effects were found. These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations. PMID:27930479

  1. Appalachian Mountains

    Atmospheric Science Data Center

    2014-05-15

    article title:  Appalachian Mountains     View Larger Image Multi-angle views of the Appalachian Mountains, March 6, 2000 . The true-color image at left is a ... location:  United States region:  Eastern United States Order:  3 ...

  2. Appalachian Mountains

    Atmospheric Science Data Center

    2014-05-15

    article title:  Aerosols over the Appalachian Mountains     View ... Imaging SpectroRadiometer (MISR) acquired these views of the Appalachian Mountains on March 6, 2000. The image at left is a downward-looking ... location:  United States region:  Eastern United States Order:  2 ...

  3. Animal models in motion sickness research

    NASA Technical Reports Server (NTRS)

    Daunton, Nancy G.

    1990-01-01

    Practical information on candidate animal models for motion sickness research and on methods used to elicit and detect motion sickness in these models is provided. Four good potential models for use in motion sickness experiments include the dog, cat, squirrel monkey, and rat. It is concluded that the appropriate use of the animal models, combined with exploitation of state-of-the-art biomedical techniques, should generate a great step forward in the understanding of motion sickness mechanisms and in the development of efficient and effective approaches to its prevention and treatment in humans.

  4. Animal models in motion sickness research

    NASA Technical Reports Server (NTRS)

    Daunton, Nancy G.

    1990-01-01

    Practical information on candidate animal models for motion sickness research and on methods used to elicit and detect motion sickness in these models is provided. Four good potential models for use in motion sickness experiments include the dog, cat, squirrel monkey, and rat. It is concluded that the appropriate use of the animal models, combined with exploitation of state-of-the-art biomedical techniques, should generate a great step forward in the understanding of motion sickness mechanisms and in the development of efficient and effective approaches to its prevention and treatment in humans.

  5. Office design's impact on sick leave rates.

    PubMed

    Bodin Danielsson, Christina; Chungkham, Holendro Singh; Wulff, Cornelia; Westerlund, Hugo

    2014-01-01

    The effect of office type on sickness absence among office employees was studied prospectively in 1852 employees working in (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Sick leaves were self-reported two years later as number of (a) short and (b) long (medically certified) sick leave spells as well as (c) total number of sick leave days. Multivariate logistic regression analysis was used, with adjustment for background factors. A significant excess risk for sickness absence was found only in terms of short sick leave spells in the three open-plan offices. In the gender separate analysis, this remained for women, whereas men had a significantly increased risk in flex-offices. For long sick leave spells, a significantly higher risk was found among women in large open-plan offices and for total number of sick days among men in flex-offices. A prospective study of the office environment's effect on employees is motivated by the high rates of sick leaves in the workforce. The results indicate differences between office types, depending on the number of people sharing workspace and the opportunity to exert personal control as influenced by the features that define the office types.

  6. 20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... employee mistakenly registered for unemployment benefits when he or she should have applied for sickness... office of the Board within a reasonable time after unemployment benefits were denied; or...

  7. 20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... employee mistakenly registered for unemployment benefits when he or she should have applied for sickness... office of the Board within a reasonable time after unemployment benefits were denied; or...

  8. 20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... employee mistakenly registered for unemployment benefits when he or she should have applied for sickness... office of the Board within a reasonable time after unemployment benefits were denied; or...

  9. Sickness absence among female employees with migraine and co-existing conditions.

    PubMed

    Mäki, K; Vahtera, J; Virtanen, M; Elovainio, M; Pentti, J; Keltikangas-Järvinen, L; Kivimäki, M

    2008-11-01

    This prospective cohort study examined the risk of sickness absence among 27,127 female public-sector employees by status of migraine and co-existing conditions. A baseline survey was used to assess chronic disorders and demographic factors. Information on sickness absence in the 3 years following the survey was obtained from employers' registers. Migraine was related to 5.4 extra sickness absence days per person-year, with the corresponding figures being 14.6 and 6.1 for depression and respiratory disorders, respectively. After adjusting for age, marital status, socioeconomic status and presence of depression or respiratory disorders, employees with migraine had a 1.21 (95% confidence interval 1.18, 1.24) times higher risk of self-certified sickness absence episodes (< or = 3 days) than did those without migraine. The corresponding excess risk for medically certified absence episodes (> 3 days) was 1.15 (1.12, 1.19). Among employees with depression or respiratory disorders, secondary migraine was associated with an increased risk of sickness absence episode of 1.15 to 1.23. These findings suggest that migraine is associated with increased risk of recorded sickness absence independent of depression and respiratory disorders.

  10. SICK: THE SPECTROSCOPIC INFERENCE CRANK

    SciTech Connect

    Casey, Andrew R.

    2016-03-15

    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal

  11. sick: The Spectroscopic Inference Crank

    NASA Astrophysics Data System (ADS)

    Casey, Andrew R.

    2016-03-01

    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal

  12. SEROTONIN AND OTHER VASOACTIVE AGENTS IN EXPERIMENTAL DECOMPRESSION SICKNESS,

    DTIC Science & Technology

    SEROTONIN, DECOMPRESSION SICKNESS), (*VASOACTIVE AGENTS, DECOMPRESSION SICKNESS), RATS, EXERCISE(PHYSIOLOGY), DOSAGE, CHEMOTHERAPEUTIC AGENTS, BLOOD ANALYSIS, TOXICITY, BLOOD CIRCULATION, MORTALITY RATES , CANADA

  13. Predicting motion sickness during parabolic flight

    NASA Technical Reports Server (NTRS)

    Harm, Deborah L.; Schlegel, Todd T.

    2002-01-01

    BACKGROUND: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study, we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. METHODS: Sixteen subjects (10 men and 6 women) flew four sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days before the flight. RESULTS: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p=0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. CONCLUSIONS: The linear combination of resting levels of salivary amylase, high-frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

  14. Predicting Motion Sickness During Parabolic Flight

    NASA Technical Reports Server (NTRS)

    Harm, Deborah L.; Schlegel, Todd T.

    2002-01-01

    Background: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. Methods: Sixteen subjects (10 men and 6 women) flew 4 sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days prior to the flight. Results: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p= 0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. Conclusions: The linear combination of resting levels of salivary amylase, high frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

  15. Predicting motion sickness during parabolic flight

    NASA Technical Reports Server (NTRS)

    Harm, Deborah L.; Schlegel, Todd T.

    2002-01-01

    BACKGROUND: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study, we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. METHODS: Sixteen subjects (10 men and 6 women) flew four sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days before the flight. RESULTS: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p=0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. CONCLUSIONS: The linear combination of resting levels of salivary amylase, high-frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

  16. Metals: In Sickness and in Health

    MedlinePlus

    ... Metals: In Sickness and in Health Inside Life Science View All Articles | Inside Life Science Home Page Metals: In Sickness and in Health ... Fats Do in the Body? This Inside Life Science article also appears on LiveScience . Learn about related ...

  17. [Sleeping sickness: end of the epidemic outbreak?].

    PubMed

    Bisser, S; Courtioux, B

    2012-03-01

    Sleeping sickness or human African trypanosomiasis is a parasitic disease transmitted by tsetse flies and therefore confined to its habitat, the central part of the African continent. Two disease forms are linked to two different parasites: T. b. gambiense and T. b. rhodesiense. Actual epidemiological data and precise and dynamic mapping of foci are in favor of a real decrease of the disease. Not all areas are under control and resurgence can still not be avoided from the remote areas where the disease is endemic. However, recent advances in knowledge in parasite genetics are giving hope of control. In 2009, for the first time since 50 years, less than 10,000 cases were declared to the World Health Organization. Clinical trials allowed revising some clinical concepts and linking them with parasite genetics: both disease forms can show variations from asymptomatic, chronic to acute and are linked to genetic differences in the host or the parasite. Parasitological diagnosis may be facilitated by the introduction of individual rapid tests and PCR-based field tests. Knowledge in mechanisms of brain invasion and screenings of inflammatory molecules allow new marker combinations for staging but they do not avoid lumbar puncture. Therapeutic options remain limited but there is hope to develop a new drug orally available in a near future.

  18. Meniere's, migraine, and motion sickness.

    PubMed

    Golding, John F; Patel, Mitesh

    2017-05-01

    Elevated Motion Sickness Susceptibility (MSS) in Meniere?s disease (MD) is likely to be a consequence of the onset of MD and not migraine per se. Pathologies of the vestibular system influence MSS. Bilateral vestibular deficits lower MSS, vestibular neuritis or benign paroxysmal positional vertigo have little overall effect, whereas vestibular migraine elevates MSS. However, less is known about MSS in MD, a condition in which many patients experience vestibular loss and migraine symptoms. The authors conducted an online survey that posed diagnostic and disease questions before addressing frequency of headaches, migraines, visual display dizziness (VDD), syncope, social life, and work impact of dizziness (SWID4) and motion sickness susceptibility (MSSQ). The two groups were: diagnosed MD individuals with hearing loss (n = 751) and non-MD individuals in the control group (n = 400). The MD group showed significantly elevated MSS, more headache and migraine, increased VDD, higher SWID4 scores, and increased syncope. MSS was higher in MD than controls only after the development of MD, but not before, nor in childhood. Although elevated in MD compared with controls, MSS was lower than migraine patients from past data. Multivariate analysis revealed VDD, SWID4, and MSS in adulthood as the strongest predictors of MD, but not headache nor migraine.

  19. Stone Mountain

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This color image taken by the panoramic camera onboard the Mars Exploration Rover Opportunity shows the part of the rock outcrop dubbed Stone Mountain at Meridiani Planum, Mars. Scientists are examining Stone Mountain with the instruments on the rover's instrument deployment device, or 'arm,' in search of clues about the composition of the rock outcrop. [figure removed for brevity, see original site] A Patch of Stone (Figure credit: NASA/JPL/Cornell/USGS)

    The colorless square in this color image of the martian rock formation called Stone Mountain is one portion of the rock being analyzed with tools on the Mars Exploration Rover Opportunity's instrument deployment device, or 'arm.' The square area is approximately 3 centimeters (1.2 inches) across. Stone Mountain is located within the rock outcrop on Meridiani Planum, Mars. The image was taken by the rover's panoramic camera.

  20. Stone Mountain

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This color image taken by the panoramic camera onboard the Mars Exploration Rover Opportunity shows the part of the rock outcrop dubbed Stone Mountain at Meridiani Planum, Mars. Scientists are examining Stone Mountain with the instruments on the rover's instrument deployment device, or 'arm,' in search of clues about the composition of the rock outcrop. [figure removed for brevity, see original site] A Patch of Stone (Figure credit: NASA/JPL/Cornell/USGS)

    The colorless square in this color image of the martian rock formation called Stone Mountain is one portion of the rock being analyzed with tools on the Mars Exploration Rover Opportunity's instrument deployment device, or 'arm.' The square area is approximately 3 centimeters (1.2 inches) across. Stone Mountain is located within the rock outcrop on Meridiani Planum, Mars. The image was taken by the rover's panoramic camera.

  1. Preventing recurrence of severe morning sickness

    PubMed Central

    Koren, Gideon; Maltepe, Caroline

    2006-01-01

    QUESTION A recent Motherisk article showed that initiating antinauseants even before symptoms start could prevent recurrence of severe morning sickness. In the study described, however, different physicians used different drugs. How can one be sure which drugs work? ANSWER The study of 26 women who had had severe morning sickness during previous pregnancies showed that using antiemetics before symptoms of morning sickness started appeared to prevent recurrence of severe morning sickness in subsequent pregnancies. Physicians in the United States used various antinauseant drugs. Physicians in Canada administered only one drug, the combination of doxylamine-pyridoxine (Diclectin®), to 12 women. Subanalysis of these 12 women revealed that pre-emptive use of doxylamine-pyridoxine significantly decreased the likelihood that severe morning sickness would recur. PMID:17279232

  2. [Income reduction due to sickness benefits--when does sickness make you poor?].

    PubMed

    Mielck, A; Huber, C A

    2005-01-01

    When absent from work due to sickness, most employees in Germany receive continued pay from their employer for six weeks. After this period, sick employees receive sickness benefits from their Statutory Sickness Fund. These sickness benefits are calculated in a rather complicated way as a percentage of gross and net salary. The paper focuses on two questions that have rarely been studied: which income groups show a particularly large difference between net salary and net sickness benefits? Which income groups move below the poverty line after receiving sickness benefits? We calculated how much sickness benefit is actually paid to the insured, for different income and tax groups. The definition for the poverty line is outlined as well. Due to methodological difficulties, the comparison between sickness benefits and poverty must be confined to single-person households. In the income groups chosen here (gross salary up to 4000 Euro per month), net sickness benefits amount to about 77 % of net salary, for all insured. Financial problems can mainly be expected for the lower and the upper income groups. Expressed in absolute terms, the upper income groups experience a large reduction in net income. The lower income groups come close to the poverty line or fall below it. Sickness benefits provide income in case of sickness; this is an important achievement of social policy. However, we should study the financial burden which sickness benefits could have for the insured. More in-depth analyses would require data that are not yet available (e. g. on the number of insured per income group and the income of other household members). The analyses presented here already show that sickness benefits could lead to severe financial problems for at least some insured. They point to the need for more studies in this neglected field.

  3. [Classification of altitude decompression sickness].

    PubMed

    Katuntsev, V P

    2000-01-01

    The article is devoted to the discussion of principles of and approaches to classification of altitude decompression sickness (DCS), one of the most methodically formidable aspects of the problem. Based on his own multiyear experience in altitude DCS investigations and critical review of literature, the author reasons his concept of clinical classification of altitude DCS. The author's concept places emphasis on obligatory consideration of three stages in DCS development: A--pre-disease (the premorbid syndrome), B--uncomplicated (light) and C--complicated (severe) forms. The objective sign of the premorbid state is "silent" gas bubbles in organism detectable by ultrasonic devices. Signs of uncomplicated altitude DCS are musculoarticular pains, local edema and skin itching. Complicated altitude DCS is diagnosed by systemic (respiratory, neurological and cardiovascular) disorders.

  4. Decompression sickness in caisson workers

    PubMed Central

    Ghawabi, Samir H. El; Mansour, Mohamed B.; Youssef, Fatma L.; Ghawabi, Mohamed H. El; Latif, Mohamed M. Abd El

    1971-01-01

    El Ghawabi, S. H., Mansour, M. B., Youssef, F. L., El Ghawabi, M. H., and Abd El Latif, M. M. (1971).Brit. J. industr. Med.,28, 323-329. Decompression sickness in caisson workers. An investigation of 55 bridge construction workers is reported. The overall bends rate was 0·97%. (The term `bends' as used in this study is defined in the paper.) Chokes were encountered in 67·27% of workers. A clinical, haematological, and radiological study was performed. Definite bony changes were found in 43·6% of all workers; 91·6% of these had lesions around the elbow. The presence of dense areas in the neck of the scapula is reported in two cases for the first time. The relatively high haematocrit value is thought to play a part in the pathogenesis of bone infarction through its relation with blood viscosity. Images PMID:5124832

  5. Diplopia in Green Tobacco Sickness.

    PubMed

    Satora, Leszek; Goszcz, Halina; Gomółka, Ewa; Biedroń, Witold

    2009-01-01

    This paper examines the first reported case of Green Tobacco Sickness (GTS) in Poland. A 25-year-old man who worked in a tobacco field for 14 hours with no protective measures experienced symptoms of GTS, and additionally, diplopia, after leaving the field. Upon hospital admission, diplopia was no longer observed. Diplopia was most probably caused by disturbances to the cholinergic neuromuscular transmission, secondary to nicotine. These neurological disturbances, the first of their kind observed in the course of GTS, deserve special attention. The case shows a potential adverse health effect related to tobacco harvest, as most Polish tobacco plantations are not mechanized. Polish farmers should be obligated to protect their workers with protective clothing, shoes, gloves and masks. Recommendations for tobacco harvester health are put forth in the paper.

  6. [Sick house syndrome: governmental actions and challenges].

    PubMed

    Hasegawa, Tomonori; Kigawa, Mika

    2009-05-01

    Since the 1980s, sick house syndrome has become one of the major challenges in environmental health. In Japan in 1980, first governmental measures were taken to limit formaldehyde release from building materials. In 2003, the Building Standards Law and the Community Health Law were revised, and these laws clarified the responsibility of building companies, local governments and health officers in preventing sick house syndrome. Telephone survey results demonstrated the decrease in the prevalence of sick house syndrome between 2002 and 2006 in Tokyo and Sapporo. Knowledge about sick house syndrome enabling patients to better deal with the syndrome and stricter regulations seem to have contributed to the decrease in the prevalence of the syndrome. Questionnaire surveys carried out through regional health centers demonstrated that the number of possible sick house syndrome patients visiting regional health centers varied, possibly reflecting different local prevalences and needs. Most of the regional health centers had staff members who were able to measure in-house environments, but their ability to discuss on health-related issues was limited, and cooperation between the centers and healthcare organizations was not sufficient. Information about healthcare organizations that can treat patients with sick house syndrome and simple self-diagnostic tools were among the most often cited useful support needs. Establishment of a hub regional health center to construct a comprehensive consultation and referral system that can meet local needs in dealing with sick house syndrome is recommended.

  7. Motion sickness: a negative reinforcement model.

    PubMed

    Bowins, Brad

    2010-01-15

    Theories pertaining to the "why" of motion sickness are in short supply relative to those detailing the "how." Considering the profoundly disturbing and dysfunctional symptoms of motion sickness, it is difficult to conceive of why this condition is so strongly biologically based in humans and most other mammalian and primate species. It is posited that motion sickness evolved as a potent negative reinforcement system designed to terminate motion involving sensory conflict or postural instability. During our evolution and that of many other species, motion of this type would have impaired evolutionary fitness via injury and/or signaling weakness and vulnerability to predators. The symptoms of motion sickness strongly motivate the individual to terminate the offending motion by early avoidance, cessation of movement, or removal of oneself from the source. The motion sickness negative reinforcement mechanism functions much like pain to strongly motivate evolutionary fitness preserving behavior. Alternative why theories focusing on the elimination of neurotoxins and the discouragement of motion programs yielding vestibular conflict suffer from several problems, foremost that neither can account for the rarity of motion sickness in infants and toddlers. The negative reinforcement model proposed here readily accounts for the absence of motion sickness in infants and toddlers, in that providing strong motivation to terminate aberrant motion does not make sense until a child is old enough to act on this motivation.

  8. Globus pallidus lesions associated with high mountain climbing.

    PubMed Central

    Jeong, Jee Hyang; Kwon, Jay C.; Chin, Juhee; Yoon, Soo Jin; Na, Duk L.

    2002-01-01

    Acute mountain sickness (AMS) occurs commonly in hikers who are rapidly exposed to high altitude environments. Despite the numerous reports of AMS, few studies have reported pallidal lesions associated with altitude sickness. A previously healthy 49-yr-old Korean patient, after ascent to 4,700 m, suffered symptoms consistent with AMS. After returning home, the patient showed changes in personality characterized by abulia, indifference, and indecisiveness. T2 weighted brain magnetic resonance imaging showed high signal lesions involving bilateral globus pallidus. Our case suggests that globus pallidus injury should be included in the differential diagnosis of patients with personality or cognitive change after recovery from AMS. PMID:12483018

  9. Labyrinthine lesions and motion sickness susceptibility.

    PubMed

    Dai, Mingjia; Raphan, Theodore; Cohen, Bernard

    2007-04-01

    The angular vestibulo-ocular reflex (aVOR) has a fast pathway, which mediates compensatory eye movements, and a slow (velocity storage) pathway, which determines its low frequency characteristics and orients eye velocity toward gravity. We have proposed that motion sickness is generated through velocity storage, when its orientation vector, which lies close to the gravitational vertical, is misaligned with eye velocity during head motion. The duration of the misalignment, determined by the dominant time constant of velocity storage, causes the buildup of motion sickness. To test this hypothesis, we studied bilateral labyrinthine-defective subjects with short vestibular time constants but normal aVOR gains for their motion sickness susceptibility. Time constants and gains were taken from rotational responses. Motion sickness was generated by rolling the head while rotating, and susceptibility was assessed by the number of head movements made before reaching intolerable levels of nausea. More head movements signified lower motion sickness susceptibility. Labyrinthine-defective subjects made more head movements on their first exposure to roll while rotating than normals (39.8 +/- 7.2 vs 13.7 +/- 5.5; P < 0.0001). Normals were tested eight times, which habituated their time constants and reduced their motion sickness susceptibility. Combining data from all subjects, there was a strong inverse relationship between time constants and number of head movements (r = 0.94), but none between motion sickness susceptibility and aVOR gains. This provides further evidence that motion sickness is generated through velocity storage, not the direct pathway, and suggests that motion sickness susceptibility can be reduced by reducing the aVOR time constant.

  10. General autonomic components of motion sickness

    NASA Technical Reports Server (NTRS)

    Cowings, Patricia S.; Suter, Steve; Toscano, William B.; Kamiya, Joe; Naifeh, Karen

    1986-01-01

    This report refers to a body of investigations directed toward the examination of autonomic nervous system responses to motion sickness. Heart rate, respiration rate, finger pulse volume, and basal skin resistance were measured on 127 men and women before, during, and after exposure to a nauseogenic rotating chair test. Significant changes in all autonomic responses were observed across the tests (p less than .05). Significant differences in autonomic responses among groups divided according to motion sickness susceptibility were also observed (p less than .05). Results suggest that the examination of autonomic responses as an objective indicator of motion sickness malaise is warranted and may contribute to the overall understanding of the syndrome.

  11. Illusory self motion and simulator sickness

    NASA Technical Reports Server (NTRS)

    Hettinger, Lawrence J.

    1991-01-01

    Presented here is a discussion of simulator sickness (with applications to motion sickness and space sickness) based on the notion of senses as perceptual systems, and the sensory conflict theory. Most forms of the sensory conflict theory unnecessarily propose the existence of a neural store. The neural store is thought to consist of a record of previous perceptual experiences against which currently experienced patterns of stimulation are compared. The authors seek to establish that in its most parsimonious form the sensory conflict theory does not require a construct such as the neural store. In its simpler form, the sensory conflict theory complements and extends Gibson's view of the senses as perceptual systems.

  12. Space motion sickness monitoring experiment - Spacelab 1

    NASA Technical Reports Server (NTRS)

    Oman, Charles M.; Lichtenberg, Byron K.; Money, Kenneth E.

    1990-01-01

    A detailed firsthand report on symptoms and signs of space motion sickness and fluid shift observed by four specially trained crewmembers during Shuttle/Spacelab 1, launched on November 28, 1983 is presented. Results show that three crewmen experienced persistent overall discomfort and vomited repeatedly. Symptom pattern was generally similar to that seen in the individuals preflight, except that prodromalnausea was brief or absent in some cases. Symptoms were clearly modulated by head movement, were exacerbated by unfamiliar visual cues, and could be reduced by physical restraint providing contact cues around the body. The results support the view that space sickness is a form of motion sickness.

  13. Space motion sickness monitoring experiment - Spacelab 1

    NASA Technical Reports Server (NTRS)

    Oman, Charles M.; Lichtenberg, Byron K.; Money, Kenneth E.

    1990-01-01

    A detailed firsthand report on symptoms and signs of space motion sickness and fluid shift observed by four specially trained crewmembers during Shuttle/Spacelab 1, launched on November 28, 1983 is presented. Results show that three crewmen experienced persistent overall discomfort and vomited repeatedly. Symptom pattern was generally similar to that seen in the individuals preflight, except that prodromalnausea was brief or absent in some cases. Symptoms were clearly modulated by head movement, were exacerbated by unfamiliar visual cues, and could be reduced by physical restraint providing contact cues around the body. The results support the view that space sickness is a form of motion sickness.

  14. Caucasus Mountains

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Often regarded as the southeastern border of Europe, the Caucasus Mountains can be seen here stretching from the Black Sea (left) to the Caspian Sea (right). The mountain range spans 700 miles (1125 km), crossing the countries of Russian Federation, Georgia, and Azerbaijan from left to right respectively. With a snowline of approximately 11,000 feet and peaks such as Mt. Elbrus, that reach 15,000 feet, much of the snow visible in this image is present year round. Also visible in this image are apparent phytoplankton blooms in the Caspian Sea, marked by blue-green swirls.

  15. Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways.

    PubMed

    Maes, Michael; Berk, Michael; Goehler, Lisa; Song, Cai; Anderson, George; Gałecki, Piotr; Leonard, Brian

    2012-06-29

    It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers.

  16. Sick Baby? When to Seek Medical Attention

    MedlinePlus

    Healthy Lifestyle Infant and toddler health When a healthy baby gets sick, don't panic. Understand when to ... 20, 2016 Original article: http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/healthy-baby/ ...

  17. P6 acupressure reduces morning sickness.

    PubMed

    Dundee, J W; Sourial, F B; Ghaly, R G; Bell, P F

    1988-08-01

    A prospective study was designed to test the efficacy of pressure at the P6 (Neiguan) acupuncture point, in preventing morning sickness. Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 4 consecutive days following daily pressure at P6 point, pressure at a point near the right elbow and with no treatment. Troublesome sickness was significantly less in both the genuine (23/119) and dummy (41/112) pressure groups as compared with the control series (67/119). When the data are adversely 'weighted' to compensate for the lower incidence of fully completed returns in the active treatment groups, only the P6 group show a significant reduction in sickness. No side effects occurred in either group and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect.

  18. General Automatic Components of Motion Sickness

    NASA Technical Reports Server (NTRS)

    Suter, S.; Toscano, W. B.; Kamiya, J.; Naifeh, K.

    1985-01-01

    A body of investigations performed in support of experiments aboard the space shuttle, and designed to counteract the symptoms of Space Adaptation Syndrome, which resemble those of motion sickness on Earth is reviewed. For these supporting studies, the automatic manifestations of earth-based motion sickness was examined. Heart rate, respiration rate, finger pulse volume and basal skin resistance were measured on 127 men and women before, during and after exposure to nauseogenic rotating chair tests. Significant changes in all autonomic responses were observed across the tests. Significant differences in autonomic responses among groups divided according to motion sickness susceptibility were also observed. Results suggest that the examination of autonomic responses as an objective indicator of motion sickness malaise is warranted and may contribute to the overall understanding of the syndrome on Earth and in Space.

  19. Motion Sickness, Stress and the Endocannabinoid System

    PubMed Central

    Choukèr, Alexander; Kaufmann, Ines; Kreth, Simone; Hauer, Daniela; Feuerecker, Matthias; Thieme, Detlef; Vogeser, Michael; Thiel, Manfred; Schelling, Gustav

    2010-01-01

    Background A substantial number of individuals are at risk for the development of motion sickness induced nausea and vomiting (N&V) during road, air or sea travel. Motion sickness can be extremely stressful but the neurobiologic mechanisms leading to motion sickness are not clear. The endocannabinoid system (ECS) represents an important neuromodulator of stress and N&V. Inhibitory effects of the ECS on N&V are mediated by endocannabinoid-receptor activation. Methodology/Principal Findings We studied the activity of the ECS in human volunteers (n = 21) during parabolic flight maneuvers (PFs). During PFs, microgravity conditions (<10−2 g) are generated for approximately 22 s which results in a profound kinetic stimulus. Blood endocannabinoids (anandamide and 2-arachidonoylglycerol, 2-AG) were measured from blood samples taken in-flight before start of the parabolic maneuvers, after 10, 20, and 30 parabolas, in-flight after termination of PFs and 24 h later. Volunteers who developed acute motion sickness (n = 7) showed significantly higher stress scores but lower endocannabinoid levels during PFs. After 20 parabolas, blood anandamide levels had dropped significantly in volunteers with motion sickness (from 0.39±0.40 to 0.22±0.25 ng/ml) but increased in participants without the condition (from 0.43±0.23 to 0.60±0.38 ng/ml) resulting in significantly higher anandamide levels in participants without motion sickness (p = 0.02). 2-AG levels in individuals with motion sickness were low and almost unchanged throughout the experiment but showed a robust increase in participants without motion sickness. Cannabinoid-receptor 1 (CB1) but not cannabinoid-receptor 2 (CB2) mRNA expression in leucocytes 4 h after the experiment was significantly lower in volunteers with motion sickness than in participants without N&V. Conclusions/Significance These findings demonstrate that stress and motion sickness in humans are associated with impaired endocannabinoid activity

  20. Return-to-Work Self-Efficacy and Actual Return to Work Among Long-Term Sick-Listed Employees.

    PubMed

    Volker, D; Zijlstra-Vlasveld, M C; Brouwers, E P M; van Lomwel, A G C; van der Feltz-Cornelis, C M

    2015-06-01

    Considering the costs incurred by sickness absence and the implications for the workers' quality of life, a fast return to work (RTW) is important. Self-efficacy (SE) seems to be an important predictor of RTW for employees with mental health problems. The predictive value of return-to-work self-efficacy (RTW-SE) has not been examined in employees on long-term sickness absence due to any cause. The aim of this study is to investigate whether RTW-SE is a predictor of time to RTW in long-term sick-listed employees with all-cause sickness absence. Furthermore, the relative contribution of RTW-SE in predicting RTW will be examined compared to health-related, job-related and personal factors. In a longitudinal study, sick-listed employees who were currently on sick leave for more than 4 weeks filled out a self-report questionnaire. Demographics, health-related, personal, and job-related factors, and RTW-SE were measured. Employees were followed for 2 years to determine the duration until full RTW. Cox proportional hazards regression analyses were used to identify factors associated with time to RTW. Data were collected from 493 sick-listed employees. RTW-SE was a significant predictor of RTW. In a multivariate model, low RTW-SE, the thought of not being able to work while having symptoms (illness behaviour) and having chronic medical conditions were predictors of a longer duration until RTW. When guiding long-term sick-listed employees, it is important to focus on factors such as SE and illness behaviour, instead of just focusing on the symptoms of the sick-listed employee.

  1. Cardiovascular dynamics during space sickness and deconditioning

    NASA Technical Reports Server (NTRS)

    Goldberger, Ary L.; Rigney, David R.

    1991-01-01

    We are currently funded by NASA for the project, 'Cardiovascular Dynamics During Space Sickness and Deconditioning.' NASA has given priority to the investigation of two problems encountered in the long-term space flights currently being planned: (1) space motion sickness; and (2) cardiovascular deconditioning. We have proposed to use spectral and nonlinear dynamical analysis of heart rate data to quantify the presence of these problems and to evaluate countermeasures against them.

  2. Airborne testing of three antimotion sickness preparations

    NASA Technical Reports Server (NTRS)

    Johnson, W. H.; Money, K. E.; Graybiel, A.

    1976-01-01

    Thirteen human volunteers were exposed to weekly flights in which standardized, steep turns were used to produce motion sickness. A combination of promethazine hydrochloride (25 mg) plus ephedrine sulphate (25 mg) was found to be equally as effective as the combination of 1-scopolamine hydrobromide (0.35 mg) plus d-amphetamine sulphate (5 mg). Droperidol (2.5 mg) was indistinguishable from the placebo. It was concluded that the treatment of choice for motion sickness is promethazine plus ephedrine.

  3. Relative deprivation and sickness absence in Sweden.

    PubMed

    Helgertz, Jonas; Hess, Wolfgang; Scott, Kirk

    2013-08-29

    A high prevalence of sickness absence in many countries, at a substantial societal cost, underlines the importance to understand its determining mechanisms. This study focuses on the link between relative deprivation and the probability of sickness absence. 184,000 men and women in Sweden were followed between 1982 and 2001. The sample consists of working individuals between the ages of 19 and 65. The outcome is defined as experiencing more than 14 days of sickness absence during a year. Based on the complete Swedish population, an individual's degree of relative deprivation is measured through income compared to individuals of the same age, sex, educational level and type. In accounting for the possibility that sickness absence and socioeconomic status are determined by common factors, discrete-time duration models were estimated, accounting for unobserved heterogeneity through random effects. The results confirm that the failure to account for the dynamics of the individual's career biases the influence from socioeconomic characteristics. Results consistently suggest a major influence from relative deprivation, with a consistently lower risk of sickness absence among the highly educated. Altering individual's health behavior through education appears more efficient in reducing the reliance on sickness absence, rather than redistributive policies.

  4. Susceptibility to motion sickness among Skylab astronauts

    NASA Technical Reports Server (NTRS)

    Graybiel, A.; Miller, E. F., II; Homick, J. L.

    1974-01-01

    The mechanisms causing susceptibility to motion sickness in zero gravity are not well understood. Preflight and postflight motion sickness susceptibility tests conducted on the three Skylab crews are described. Under operational conditions, the first Skylab crew experienced no motion sickness, while the other two crews did. Susceptibility was greater in the Skylab workshop than in the command module. Weightlessness in itself is a unique motion environment. Changes occur in nonrigid body parts and in the response of macular receptors in the otolith organs. Tests in parabolic flight, where zero gravity is the only significant factor in motion sickness susceptibility, indicate that some people need to adapt to weightlessness and others do not. A comparison of all US and Soviet manned missions indicates that a headward shift of fluid on transition to zero gravity is not a predisposing factor in motion sickness. Under certain conditions after adaptation susceptibility was lower in the Skylab workshop than on the ground. The anti-motion sickness drugs used in Skylab are judged effective for prevention and treatment.

  5. Fever and sickness behavior: Friend or foe?

    PubMed

    Harden, L M; Kent, S; Pittman, Q J; Roth, J

    2015-11-01

    Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness.

  6. Sick but yet at work. An empirical study of sickness presenteeism

    PubMed Central

    Aronsson, G.; Gustafsson, K.; Dallner, M.

    2000-01-01

    STUDY OBJECTIVE—The study is an empirical investigation of sickness presenteeism in relation to occupation, irreplaceability, ill health, sickness absenteeism, personal income, and slimmed down organisation.
DESIGN—Cross sectional design.
SETTING—Swedish workforce.
PARTICIPANTS—The study group comprised a stratified subsample of 3801 employed persons working at the time of the survey, interviewed by telephone in conjunction with Statistics Sweden's labour market surveys of August and September 1997. The response rate was 87 per cent.
MAIN RESULTS—A third of the persons in the total material reported that they had gone to work two or more times during the preceding year despite the feeling that, in the light of their perceived state of health, they should have taken sick leave. The highest presenteeism is largely to be found in the care and welfare and education sectors (nursing and midwifery professionals, registered nurses, nursing home aides, compulsory school teachers and preschool/primary educationalists. All these groups work in sectors that have faced personnel cutbacks during the 1990s). The risk ratio (odds ratio (OR)) for sickness presenteeism in the group that has to re-do work remaining after a period of absence through sickness is 2.29 (95% CI 1.79, 2.93). High proportions of persons with upper back/neck pain and fatigue/slightly depressed are among those with high presenteeism (p< 0.001). Occupational groups with high sickness presenteeism show high sickness absenteeism (ρ = 0.38; p<.01) and the hypothesis on level of pay and sickness presenteeism is also supported (ρ = −0.22; p<0.01).
CONCLUSIONS—Members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by study results. The categories with

  7. Green tobacco sickness in Poland.

    PubMed

    Satora, Leszek; Goszcz, Halina; Gomółka, Ewa; Biedroń, Witold

    2009-03-01

    Green tobacco sickness (GTS) is an illness associated with exposure to nicotine originating directly from the growing tobacco plant. The exposure takes place in the course of activities during tobacco farming. Nausea, vomiting, headache and dizziness are the symptoms typical of GTS. The GTS cases have been most commonly reported in the USA, Japan, India and Italy. The first case of GTS in Poland has been diagnosed in a young man working on a Virginia bright tobacco plantation. The patient had symptoms typical of GTS. The toxicological analysis of urine demonstrated the presence of cotinine at the level of 869 ng/ml. Intravenous fluids, anticholinergic agents and potassium supplementation were used in the treatment. Interestingly, diplopia at the initial stage of tobacco poisoning and horizontal nystagmus, which resolved on the 2nd day of hospital stay were observed. We believe that cases of GTS occur in Poland; however patients do not seek medical care. Given that the majority of activities during tobacco farming in Poland are performed manually, it seems necessary to launch a public awareness campaign on GTS and decontamination methods.

  8. European EVA decompression sickness risks

    NASA Astrophysics Data System (ADS)

    Vogt, Lorenz; Wenzel, Jürgen; Skoog, A. I.; Luck, S.; Svensson, Bengt

    For the first manned flight of Hermes there will be a capability of performing EVA. The European EVA Space Suit will be an anthropomorphic system with an internal pressure of 500 hPa of pure oxygen. The pressure reduction from the Hermes cabin pressure of 1013 hPa will induce a risk for Decompression Sickness (DCS) for the EVA crewmember if no adequate protective procedures are implemented. Specific decompression procedures have to be developed. From a critical review of the literature and by using knowledge gained from research conducted in the past in the fields of diving and aerospace medicine safe protective procedures are proposed for the European EVA scenario. An R factor of 1.2 and a tissue half-time ( t1/2) of 360 minutes in a single-tissue model have been identified as appropriate operational values. On the basis of an acceptable risk level of approximately 1%, oxygen prebreathing times are proposed for (a) direct pressure reduction from 1013 hPa to a suit pressure of 500 hPa, and (b) staged decompression using a 700 hPa intermediate stage in the spacecraft cabin. In addition, factors which influence individual susceptibility to DCS are identified. Recommendations are also given in the areas of crew selection and medical monitoring requirements together with therapeutic measures that can be implemented in the Hermes scenario. A method for demonstration of the validity of proposed risks and procedures is proposed.

  9. [Severe decompression sickness in divers].

    PubMed

    Beuster, W; van Laak, U

    1999-01-01

    The term "decompression illness (DCI)" is a disorder which arises from the presence of ectopic gas bubbles following decompression. Scuba diving poses the risk of two typically clinical syndromes: decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from the formation of gas bubbles in the tissues of the body and in the blood due to rapid reduction of the environmental pressure. AGE is caused by pulmonary overinflation if the breathing gas cannot be exhaled adequately during the ascent. Although the pathophysiological mechanisms of these two disorders are quite different, both of them lead to the same result: inert gas bubbles that may cause impairment of vital functions due to hypoxia. Recognizing the signs and symptoms of DCI is the first step of the therapy. The emergency treatment contains: basic life support, advanced life support--if necessary, horizontal positioning of the victim, administration of 100% normobaric oxygen via face mask or endotracheal tube, rehydration, rapid transportation to the nearest emergency department/hyperbaric facility for definitive treatment in order to prevent serious neurological sequelae.

  10. Prognosis for a sick planet.

    PubMed

    Maslin, Mark

    2008-12-01

    Global warming is the most important science issue of the 21st century, challenging the very structure of our global society. The study of past climate has shown that the current global climate system is extremely sensitive to human-induced climate change. The burning of fossil fuels since the beginning of the industrial revolution has already caused changes with clear evidence for a 0.75 degrees C rise in global temperatures and 22 cm rise in sea level during the 20th century. The Intergovernmental Panel on Climate Change synthesis report (2007) predicts that global temperatures by 2100 could rise by between 1.1 degrees C and 6.4 degrees C. Sea level could rise by between 28 cm and 79 cm, more if the melting of the polar ice caps accelerates. In addition, weather patterns will become less predictable and the occurrence of extreme climate events, such as storms, floods, heat waves and droughts, will increase. The potential effects of global warming on human society are devastating. We do, however, already have many of the technological solutions to cure our sick planet.

  11. A new goldfish model to evaluate pharmacokinetic and pharmacodynamic effects of drugs used for motion sickness in different gravity loads

    NASA Astrophysics Data System (ADS)

    Lathers, Claire M.; Mukai, Chiaki; Smith, Cedric M.; Schraeder, Paul L.

    2001-08-01

    This paper proposes a new goldfish model to predict pharmacodynamic/pharmacokinetic effects of drugs used to treat motion sickness administered in differing gravity loads. The assumption of these experiments is that the vestibular system is dominant in producing motion sickness and that the visual system is secondary or of small import in the production of motion sickness. Studies will evaluate the parameter of gravity and the contribution of vision to the role of the neurovestibular system in the initiation of motion sickness with and without pharmacologic agents. Promethazine will be studied first. A comparison of data obtained in different groups of goldfish will be done (normal vs. acutely and chronically bilaterally blinded vs. sham operated). Some fish will be bilaterally blinded 10 months prior to initiation of the experiment (designated the chronically bilaterally blinded group of goldfish) to evaluate the neuroplasticity of the nervous system and the associated return of neurovestibular function. Data will be obtained under differing gravity loads with and without a pharmacological agent for motion sickness. Experiments will differentiate pharmacological effects on vision vs. neurovestibular input to motion sickness. Comparison of data obtained in the normal fish and in acutely and chronically bilaterally blinded fish with those obtained in fish with intact and denervated otoliths will differentiate if the visual or neurovestibular system is dominant in response to altered gravity and/or drugs. Experiments will contribute to validation of the goldfish as a model for humans since plasticity of the central nervous system allows astronauts to adapt to the altered visual stimulus conditions of 0-g. Space motion sickness may occur until such an adaptation is achieved.

  12. Junior doctors need training in sickness certification.

    PubMed

    Walters, Gareth; Blakey, Kate; Dobson, Chris

    2010-03-01

    A recent report highlights the need for clear standards of practice regarding working-age health. Despite this, little is known about training or performance of sickness certification by junior doctors in secondary care. To see what sickness certification training had been received by practising hospital postgraduate trainees and establish how confident and knowledgeable they were in this area. We also evaluated the feasibility and face validity of a paper-based educational module. We surveyed 51 junior doctors in a variety of specialties, at all grades. Questions concerned training and practice of sickness certification and assessing capacity for work. A knowledge test regarding formal guidelines, use of forms and self-certification was undertaken, before participants evaluated a 10 min training module. Seventy-nine per cent of participants lacked knowledge in sickness certification, and 55% were not confident to assess capacity for work; 66% had received no training at all and 71% participants followed no guideline. Many could not identify or explain the use of certificates: MED-3 (50 or 71%, respectively), MED-5 (42 or 38%, respectively), MED-10 (0 or 17%, respectively), RM-7 (2 or 6%, respectively) and DS-1500 (6 or 8%, respectively). Majority of participants thought that an educational module could increase knowledge and skill in sickness certification (96%) and in assessing work capacity (74%). Junior doctors are involved in sickness certification, but there is a lack of training at undergraduate and postgraduate level, and many are unaware of formal guidance. The majority of junior doctors are concerned about lack of knowledge in this area and to a lesser extent in assessing patients' capacity to work. A simple educational module could improve confidence, knowledge and skills in sickness certification.

  13. Hypobaric Decompression Sickness Treatment Model.

    PubMed

    Conkin, Johnny; Abercromby, Andrew F J; Dervay, Joseph P; Feiveson, Alan H; Gernhardt, Michael L; Norcross, Jason R; Ploutz-Snyder, Robert; Wessel, James H

    2015-06-01

    The Hypobaric Decompression Sickness (DCS) Treatment Model links a decrease in computed bubble volume from increased pressure (ΔP), increased oxygen (O2) partial pressure, and passage of time during treatment to the probability of symptom resolution [P(SR)]. The decrease in offending volume is realized in two stages: 1) during compression via Boyles law; and 2) during subsequent dissolution of the gas phase via the oxygen window. We established an empirical model for the P(SR) while accounting for multiple symptoms within subjects. The data consisted of 154 cases of hypobaric DCS symptoms with ancillary information from tests on 56 men and 18 women. Our best estimated model is P(SR)=1/(1+exp(-(ln(ΔP)-1.510+0.795×AMB-0.00308×Ts)/0.478)), where ΔP is pressure difference (psid); AMB=1 if ambulation took place during part of the altitude exposure, otherwise AMB=0; and Ts is the elapsed time in minutes from the start of altitude exposure to recognition of a DCS symptom. Values of ΔP as inputs to the model would be calculated from the Tissue Bubble Dynamics Model based on the effective treatment pressure: ΔP=P2-P1|=P1×V1/V2-P1, where V1 is the computed volume of a bubble at low pressure P1 and V2 is computed volume after a change to a higher pressure P2. If 100% ground-level oxygen was breathed in place of air, then V2 continues to decrease through time at P2 at a faster rate.

  14. Drug development against sleeping sickness: old wine in new bottles?

    PubMed

    Stein, J; Mogk, S; Mudogo, C N; Sommer, B P; Scholze, M; Meiwes, A; Huber, M; Gray, A; Duszenko, M

    2014-01-01

    Atoxyl, the first medicinal drug against human African trypanosomiasis (HAT), also known as sleeping sickness, was applied more than 100 years ago. Ever since, the search for more effective, more specific and less toxic drugs continued, leading to a set of compounds currently in use against this devastating disease. Unfortunately, none of these medicines fulfill modern pharmaceutical requirements and may be considered as therapeutic ultima ratio due to the many, often severe side effects. Starting with a historic overview on drug development against HAT, we present a selection of trypanosome specific pathways and enzymes considered as highly potent druggable targets. In addition, we describe cellular mechanisms the parasite uses for differentiation and cell density regulation and present our considerations how interference with these steps, elementary for life cycle progression and infection, may lead to new aspects of drug development. Finally we refer to our recent work about CNS infection that offers novel insights in how trypanosomes hide in an immune privileged area to establish a chronic state of the disease, thereby considering new ways for drug application. Depressingly, HAT specific drug development has failed over the last 30 years to produce better suited medicine. However, unraveling of parasite-specific pathways and cellular behavior together with the ability to produce high resolution structures of essential parasite proteins by X-ray crystallography, leads us to the optimistic view that development of an ultimate drug to eradicate sleeping sickness from the globe might just be around the corner.

  15. Stroboscopic Vision as a Treatment Motion Sickness

    NASA Technical Reports Server (NTRS)

    Reschke, Millard F.; Somers, J. T.; Ford, G.; Krnavek, J. M.; Hwang, E. y.; Kornilova, L. N.; Leigh, R. J.

    2006-01-01

    Results obtained from space flight indicate that most space crews will experience some symptoms of motion sickness causing significant impact on the operational objectives that must be accomplished to assure mission success. Based on the initial work of Melvill-Jones, we have evaluated stroboscopic vision as a method of preventing motion sickness. Methods: Nineteen subjects read text while making +/-20deg head movements in the horizontal plane at 0.2 Hz while wearing left-right reversing prisms during exposure to 4 Hz stroboscopic or normal room illumination. Testing was repeated using LCD shutter glasses as the stroboscopic source with an additional 19 subjects. Results: With Strobe, motion sickness was significantly lower than with normal room illumination. Results with the LCD shutter glasses were analogous to those observed with environmental strobe. Conclusions: Stroboscopic illumination appears to be effective where retinal slip is a factor in eliciting motion sickness. Additional research is evaluating the glasses efficacy for, carsickness, sickness in parabolic flight and seasickness. There is evidence from pilot studies showing that the glasses reduce saccade velocity to visually presented targets by approximately half of the normal values. It is interesting to note that adaptation to space flight may also slow saccade velocity.

  16. Influence of modified work on return to work for employees on sick leave due to musculoskeletal complaints.

    PubMed

    van Duijn, Miranda; Lötters, Freek; Burdorf, Alex

    2005-05-01

    To determine which individual and work-related factors are associated with performing modified work and to evaluate the influence of modified work on the duration of sick leave and health-related outcomes among employees with musculoskeletal complaints. A prospective study with 12 months follow-up. In this prospective study a total of 164 employees on sick leave for 2-6 weeks due to musculoskeletal complaints completed 2 questionnaires. At baseline we gathered information about individual characteristics, physical and psychosocial workload, and disease specific and general health. The follow-up questionnaire, sent to respondents who returned to their original job on full duty, collected information about having performed modified work, and disease-specific and general health. Employees were less likely to perform modified work when their regular work was characterized by frequent lifting and their relationship with colleagues was less than good. Employees were more likely to return to modified work when they had a better mental health, had prolonged periods of standing in their regular job and had less skill discretion. Duration of sick leave was influenced by chronicity of complaints and disability, but not by modified work. Modified work, as the only advice given by a occupational health physician, did not influence the total duration of sick leave nor the improvement in health during sick leave for employees on sick leave due to musculoskeletal complaints.

  17. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality

    PubMed Central

    2012-01-01

    Background Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1). The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5) % and 58.5 (95% CI: 51.1 – 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6) % and 98.9 (95% CI: 98.3 – 99.3) %. Conclusions The DREAM register offered valid measures of sick leave spells of at

  18. Sick of waiting: Does waiting for elective treatment cause sickness absence?

    PubMed

    Dyrstad, Karin; Halvorsen, Thomas; Hem, Karl-Gerhard; Rohde, Tarald

    2016-12-01

    Sickness absence represents a substantial cost in most of Western Europe, whether the insurance scheme is public or private. The objective of this study was to analyse whether waiting time for elective treatment in specialist health care is associated with the length of individual sickness absence in Norway. To estimate the association between waiting time and the duration of sick leave, we used data from the working population aged 18-67 years in 2010-2012. The files combined register data from The Norwegian Patient Registry with individual characteristics and sickness absence data from Statistics Norway, and was analysed using zero-truncated negative binomial regression. We found that about one in four employees who had one or more spells of sick leave in the period, was also waiting for consultation or treatment in specialist health care. Yet, the length of the waiting period had no substantial effect on the length of sickness absence (i.e., less than 0.1% reduction). Therefore, while measures to reduce waiting times for hospital treatment in many instances could be beneficial for the individual patient, such policies would probably not have any substantial impact on the national sickness absence rate.

  19. Coriolis effects and motion sickness modelling.

    PubMed

    Bles, W

    1998-11-15

    Coriolis effects are notorious in relation to disorientation and motion sickness in aircrew. A review is provided of experimental data on these Coriolis effects, including the modulatory effects of adding visual or somatosensory rotatory motion information. A vector analysis of the consequences of head movements during somatosensory, visual and/or vestibular rotatory motion stimulation revealed that the more the sensed angular velocity vector after the head movements is aligned with the gravitoinertial force vector, the less nauseating effects are experienced. It is demonstrated that this is a special case of the subjective vertical conflict theory on motion sickness that assumes that motion sickness may be provoked if a discrepancy is detected between the subjective vertical and the sensed vertical as determined on the basis of incoming sensory information.

  20. Predictors of differences in the perception of antimicrobial resistance risk in the treatment of sick, at-risk, and high-risk feedlot cattle.

    PubMed

    Jan, Jie-Sheng; McIntosh, Wm Alex; Dean, Wesley; Scott, H Morgan

    2012-09-01

    Concerns exist that some uses of antimicrobials in cattle may lead to the emergence, proliferation, dissemination and persistence of resistant pathogenic bacteria in animal agriculture, which in turn can infect humans via the food supply. The degree of perceived risk varies with the clinical indication for which the antimicrobial in question is used. In this study, four uses of antimicrobials are considered, including in acutely sick, chronically sick, at-risk, and high-risk cattle, contrasting the degree of risk among these uses. Using a random sample of 103 feedlot cattle veterinarians and variables drawn from the theory of planned behavior, we predict differences in risk perception by clinical indication with differences in perceived efficacy of antimicrobials, social pressures to use antimicrobials, and moral obligations to use antimicrobials. In most models, veterinarians who perceived that others in the feedlot industry (i.e., other feedlot veterinarians, nutritionists, feedlot clients, and retained owners of cattle) were more likely to expect them to use antimicrobials in one situation versus another, the less likely those veterinarians perceived the risk of antimicrobial risk to be greater in the former versus the latter situation. Only two of these contrasts contained influences outside the immediate feedlot relationships. This exception involves the 'downstream' public: meat packers, retailers, and consumers. Veterinarians who believe that using antimicrobials for acutely sick cattle is more beneficial than using antimicrobials for chronically sick cattle were more likely to believe that antimicrobial resistance was a less probable outcome in acutely sick cattle than in chronically sick cattle.

  1. Do lower vertebrates suffer from motion sickness?

    NASA Astrophysics Data System (ADS)

    Lychakov, Dmitri

    The poster presents literature data and results of the author’s studies with the goal to find out whether the lower animals are susceptible to motion sickness (Lychakov, 2012). In our studies, fish and amphibians were tested for 2 h and more by using a rotating device (f = 0.24 Hz, a _{centrifugal} = 0.144 g) and a parallel swing (f = 0.2 Hz, a _{horizontal} = 0.059 g). The performed studies did not revealed in 4 fish species and in toads any characteristic reactions of the motion sickness (sopite syndrome, prodromal preparatory behavior, vomiting). At the same time, in toads there appeared characteristic stress reactions (escape response, an increase of the number of urinations, inhibition of appetite), as well as some other reactions not associated with motion sickness (regular head movements, eye retractions). In trout fry the used stimulation promoted division of the individuals into the groups differing by locomotor reaction to stress, as well as the individuals with the well-expressed compensatory reaction that we called the otolithotropic reaction. Analysis of results obtained by other authors confirms our conclusions. Thus, the lower vertebrates, unlike mammals, are immune to motion sickness either under the land conditions or under conditions of weightlessness. On the basis of available experimental data and theoretical concepts of mechanisms of development the motion sickness, formulated in several hypotheses (mismatch hypothesis, Traisman‘ s hypothesis, resonance hypothesis), there presented the synthetic hypothesis of motion sickness that has the conceptual significance. According to the hypothesis, the unusual stimulation producing sensor-motor or sensor-sensor conflict or an action of vestibular and visual stimuli of frequency of about 0.2 Hz is perceived by CNS as poisoning and causes the corresponding reactions. The motion sickness actually is a byproduct of technical evolution. It is suggested that in the lower vertebrates, unlike mammals

  2. Neurohumoral mechanism of space motion sickness.

    PubMed

    Grigoriev, A I; Egorov, A D; Nichiporuk, I A

    1988-02-01

    This paper reviews existing hypotheses concerning the mechanisms of adaptation of the vestibular apparatus and related somatosensory systems to microgravity with reference to the flight data. Having in view theoretical concepts and experimental data accumulated in space flights, a conceptual model of the development of a funtional system responsible for the termination of vestibular dysfuntion and space motion sickness manifestations is presented. It is also shown that changes in the hormonal status during motion sickness induced by vestibular stimulation give evidence that endocrine regulation of certain functions can be involved in adaptive responses.

  3. Evidence Report: Risk of Decompression Sickness (DCS)

    NASA Technical Reports Server (NTRS)

    Conkin, Johnny; Norcross, Jason R.; Wessel, James H. III; Abercromby, Andrew F. J.; Klein, Jill S.; Dervay, Joseph P.; Gernhardt, Michael L.

    2013-01-01

    The Risk of Decompression Sickness (DCS) is identified by the NASA Human Research Program (HRP) as a recognized risk to human health and performance in space, as defined in the HRP Program Requirements Document (PRD). This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. Given that tissue inert gas partial pressure is often greater than ambient pressure during phases of a mission, primarily during extravehicular activity (EVA), there is a possibility that decompression sickness may occur.

  4. [The adventures of "Sick Building Syndrome"].

    PubMed

    Barthe, Yannick; Rémy, Catherine

    2010-01-01

    The Sick Building syndrome concept is used to describe a variety of minor symptoms that afflict groups of people in the workplace or in public buildings. In theory, the sick building syndrome is characterized by an unspecified etiology: it underlines a multiplicity of possible causes, environmental or psychosocial, which produce various effects. In practice, the concept is often misused as a synonym of the psychogenic syndrome. The paper explores this "etiological reduction" and highlights some of the problematic consequences. The authors advocate for the recognition of uncertainty, which is in their opinion, a source and driver of renewed reflection in the public health area.

  5. Gastrointestinal motility in space motion sickness

    NASA Technical Reports Server (NTRS)

    Thornton, William E.; Linder, Barry J.; Moore, Thomas P.; Pool, Sam L.

    1987-01-01

    Gastrointestinal symptoms in space motion sickness (SMS) are significantly different from those in ordinary motion sickness (MS). Recording and tabulation of sounds was the only technique that could be used as a measure of motility during spaceflight operations. There were 17 subjects, six unaffected by SMS, who made ambulatory recordings preflight and inflight. With one exception, all those affected had sharply reduced sounds, while those unaffected had increases or moderate reductions. The mechanism of vomiting in SMS appears to be secondary to this ileus, in contrast to vomiting in ordinary MS, where the emesis center is thought to be directly triggered by the vestibular system.

  6. Paid Sick Leave and Job Stability.

    PubMed

    Hill, Heather D

    2013-05-01

    A compelling, but unsubstantiated, argument for paid sick leave legislation is that workers with leave are better able to address own and family member health needs without risking a voluntary or involuntary job separation. This study tests that claim using the Medical Expenditure Panel Survey and regression models controlling for a large set of worker and job characteristics, as well as with propensity score techniques. Results suggest that paid sick leave decreases the probability of job separation by at least 2.5 percentage points, or 25%. The association is strongest for workers without paid vacation leave and for mothers.

  7. Paid Sick Leave and Job Stability

    PubMed Central

    Hill, Heather D.

    2013-01-01

    A compelling, but unsubstantiated, argument for paid sick leave legislation is that workers with leave are better able to address own and family member health needs without risking a voluntary or involuntary job separation. This study tests that claim using the Medical Expenditure Panel Survey and regression models controlling for a large set of worker and job characteristics, as well as with propensity score techniques. Results suggest that paid sick leave decreases the probability of job separation by at least 2.5 percentage points, or 25%. The association is strongest for workers without paid vacation leave and for mothers. PMID:24235780

  8. 2. EAGLE MOUNTAIN SWITCHYARD. EAGLE MOUNTAIN PUMP PLANT CAN BE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. EAGLE MOUNTAIN SWITCHYARD. EAGLE MOUNTAIN PUMP PLANT CAN BE SEEN THROUGH SWITCHYARD IN BACKGROUND. 165MM LENS. - Eagle Mountain Pump Plant, Ten miles north of Route 10, southeast of Eagle Mountain, Eagle Mountain, Riverside County, CA

  9. 20 CFR 335.6 - Payment of sickness benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... fourth consecutive day of sickness in a period of continuing sickness, as defined in § 335.1(c), but... an initial period of continuing sickness from June 14 through July 25, and all days in that period... her subsequent registration period covers June 28 to July 11, and July 12 to July 25. In the one-week...

  10. 20 CFR 335.2 - Manner of claiming sickness benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required...

  11. 20 CFR 335.6 - Payment of sickness benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as...

  12. 20 CFR 335.6 - Payment of sickness benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as...

  13. 20 CFR 335.2 - Manner of claiming sickness benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required...

  14. 20 CFR 335.2 - Manner of claiming sickness benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required...

  15. 20 CFR 335.2 - Manner of claiming sickness benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required...

  16. 5 CFR 630.402 - Requesting sick leave.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Requesting sick leave. 630.402 Section 630.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.402 Requesting sick leave. An employee must file an application—written, oral, or...

  17. Methods of Reducing Sick Leave Abuse. An ERS Information Aid.

    ERIC Educational Resources Information Center

    Stemnock, Suzanne K.

    A perennial concern to educational administrators is the abuse of sick leave by school employees. Numerous suggestions have been offered for reducing the abuse of sick leave both within education and industry. This publication reviews 12 research studies that evaluate plans for reducing sick leave abuse among various categories of employees. Also…

  18. Differences in sickness absence between self-employed and employed doctors: a cross-sectional study on national sample of Norwegian doctors in 2010.

    PubMed

    Rosta, Judith; Tellnes, Gunnar; Aasland, Olaf G

    2014-05-02

    Doctors have a low prevalence of sickness absence. Employment status is a determinant in the multifactorial background of sickness absence. The effect of doctors' employment status on sickness absence is unexplored. The study compares the number of sickness absence days during the last 12 months and the impact of employment status, psychosocial work stress, self-rated health and demographics on sickness absence between self-employed practitioners and employed hospital doctors in Norway. The study population consisted of a representative sample of 521 employed interns and consultants and 313 self-employed GPs and private practice specialists in Norway, who received postal questionnaires in 2010. The questionnaires contained items on sickness absence days during the last 12 months, employment status, demographics, self-rated health, professional autonomy and psychosocial work stress. 84% (95% CI 80 to 88%) of self-employed and 60% (95% CI 55 to 64%) of employed doctors reported no absence at all last year. In three multivariate logistic regression models with sickness absence as response variable, employment category was a highly significant predictor for absence vs. no absence, 1 to 3 days of absence vs. no absence and 4 to 99 days of absence vs. no absence), while in a model with 100 or more days of absence vs. no absence, there was no difference between employment categories, suggesting that serious chronic disease or injury is less dependent on employment category. Average or poor self-rated health and low professional autonomy, were also significant predictors of sickness absence, while psychosocial work stress, age and gender were not. Self-employed GPs and private practice specialist reported lower sickness absence than employed hospital doctors. Differences in sickness compensation, and organisational and individual factors may to a certain extent explain this finding.

  19. Effect of domperidone on ventilation and polycythemia after 5 weeks of chronic hypoxia in rats.

    PubMed

    Gamboa, J; Macarlupú, J L; Rivera-Chira, M; Monge-C, C; León-Velarde, F

    2003-04-15

    Chronically hypoxic humans and some mammals have attenuated ventilatory responses, which have been associated with high dopamine level in carotid bodies. Alveolar hypoventilation and blunted ventilatory response have been recognized to be at the basis of Chronic Mountain Sickness by generating arterial hypoxemia and polycythemia. To investigate whether dopamine antagonism could decrease the hemoglobin concentration by stimulating resting ventilation (VE) and/or hypoxic ventilatory response, 18 chronically hypoxic rats (5 weeks, PB=433 Torr) were studied with and without domperidone treatment (a peripheral dopamine antagonist). Acute and prolonged treatment significantly increased poikilocapnic ventilatory response to hypoxia (RVE ml/min/kg=VE at 0.1 FI(O(2))-VE at 0.21 FI(O(2))), from 506+/-36 to 697+/-48; and from 394+/-37 to 660+/-81, respectively. In addition, Domperidone treatment decreased hemoglobin concentration from 21.6+/-0.29 to 18.9+/-0.19 (P<0.01) in rats chronically exposed to hypobaric hypoxia. Our study suggests that the stimulant effect of D(2)-R blockade on ventilatory response to hypoxia seems to compensate the low hypoxic peripheral chemosensitivity after chronic exposure and the latter in turn decrease hemoglobin concentration.

  20. Impaired acclimatization to chronic hypoxia in adult male and female rats following neonatal hypoxia.

    PubMed

    Lumbroso, Delphine; Joseph, Vincent

    2009-08-01

    We tested the hypothesis that neonatal exposure to hypoxia alters acclimatization to chronic hypoxia later in life. Rat pups were exposed to normobaric hypoxia (12% O(2); nHx group) in a sealed chamber, or to normoxia (21% O(2); nNx group) from the day before birth to postnatal day 10. The animals were then raised in normal conditions until reaching 12 wk of age. At this age, we assessed ventilatory and hematological acclimatization to chronic hypoxia by exposing male and female nHx and nNx rats for 2 wk to 10% O(2). Minute ventilation, metabolic rate, hypoxic ventilatory response, hematocrit, and hemoglobin levels were measured both before and after acclimatization. We also quantified right ventricular hypertrophy as an index of pulmonary hypertension both before and after acclimatization. There was a significant effect of neonatal hypoxia that decreases ventilatory response (relative to metabolic rate, VE/VCO(2)) to acute hypoxia before acclimatization in males but not in females. nHx rats had an impaired acclimatization to chronic hypoxia characterized by altered respiratory pattern and elevated hematocrit and hemoglobin levels after acclimatization, in both males and females. Right ventricular hypertrophy was present before and after acclimatization in nHx rats, indicating that neonatal hypoxia results in pulmonary hypertension in adults. We conclude that neonatal hypoxia impairs acclimatization to chronic hypoxia in adults and may be a factor contributing to the establishment of chronic mountain sickness in humans living at high altitude.

  1. Promoting the Spiritual Development of Sick Children

    ERIC Educational Resources Information Center

    Pridmore, Pat; Pridmore, John

    2004-01-01

    This paper considers whether there are aspects of spiritual pedagogy specific to the education of children who are sick and asks how these concerns are to be addressed. The context of the enquiry is England and Wales where the promotion of the spiritual development of children is a legislative requirement. The focus of the study is on sick…

  2. Sensory neurobiology: demystifying the sick sense.

    PubMed

    Bozza, Thomas

    2015-02-16

    The vomeronasal organ, a sensory structure within the olfactory system, detects chemical signals that affect social and sexual behaviors and that elicit responses to predator odors. A recent study demonstrates that innate avoidance of sick conspecifics requires an intact vomeronasal organ, expanding the repertoire of biological functions known to be mediated by this olfactory subsystem.

  3. Serum sickness-like reaction with clarithromycin.

    PubMed

    Sohail, Muhammad Adnan; Nasir, Junaid; Ikram, Umaira; Genese, Thomas

    2011-04-01

    Serum sickness-like reaction is a rare immunological condition which may develop following exposure to certain drugs such as penicillins, cephalosporins, and trimethoprim-sulfamethoxazole, among many others. It is described classically as a type III hypersensitivity response to heterologous proteins. Its true mechanism is still unclear. We present a case of serum sickness-like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness-like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness-like reaction to clarithromycin has never been reported previously. This case emphasizes the need for increased clinical awareness of such an adverse outcome to clarithromycin use.

  4. [The sick individual as a concept].

    PubMed

    Tejerizo López, Luis Carlos

    2011-01-01

    We start from the premise, shared by some current philosophical movements and by the author, which states that philosophy is not contemplation, or reflection, or introspection or communication. Philosophy is the art of shaping, inventing and creating concepts. It is an explicit way of introducing new differences in life, a different reading level, a specific jargon, which may imply revealing the flip side of the coin, or a dissimilar view of the side facing us. The philosopher is the friend of the concept, he holds it in his power, which means, basically and in all honesty, that philosophy is the discipline of creating concepts. Let us remember the brilliant idea of the Russian director Tarkovsky, who announced his greatest ambition as an artist: "To capture time". At the same time, we must recall one of the sayings of this director: "Every film I have directed and I intend to direct is always tied to characters who have something to overcome". The healthy individual lives in a specific time, with precise coordinates, aware that his life consists only of living that time. That is, living as defined by Josep María Esquirol: "Then we could also see that the best way of living the present is not to run after the fleeing time, but to see and live the opportunity that appears before us". One of the many circumstances that can intercept the way we see and live the opportunity that appears before us is sickness, one of those inescapable experiences we have not been taught how to pay an adequate attention to, and the meaning of which can, in a way, go unnoticed. As "time" goes by, the circumstance that we consider to be the basis on which existence is founded, sickness can appear, thus introducing a new dimension in the time of the healthy individual. For this reason we, as doctors and professionals, know that sickness "is tied to characters who have something to overcome". In view of the fact that a sickness invades a healthy individual and transforms him into a sick one

  5. Stroboscopic Goggles for Reduction of Motion Sickness

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Somers, Jeffrey T.

    2005-01-01

    A device built around a pair of electronic shutters has been demonstrated to be effective as a prototype of stroboscopic goggles or eyeglasses for preventing or reducing motion sickness. The momentary opening of the shutters helps to suppress a phenomenon that is known in the art as retinal slip and is described more fully below. While a number of different environmental factors can induce motion sickness, a common factor associated with every known motion environment is sensory confusion or sensory mismatch. Motion sickness is a product of misinformation arriving at a central point in the nervous system from the senses from which one determines one s spatial orientation. When information from the eyes, ears, joints, and pressure receptors are all in agreement as to one s orientation, there is no motion sickness. When one or more sensory input(s) to the brain is not expected, or conflicts with what is anticipated, the end product is motion sickness. Normally, an observer s eye moves, compensating for the anticipated effect of motion, in such a manner that the image of an object moving relatively to an observer is held stationary on the retina. In almost every known environment that induces motion sickness, a change in the gain (in the signal-processing sense of gain ) of the vestibular system causes the motion of the eye to fail to hold images stationary on the retina, and the resulting motion of the images is termed retinal slip. The present concept of stroboscopic goggles or eyeglasses (see figure) is based on the proposition that prevention of retinal slip, and hence, the prevention of sensory mismatch, can be expected to reduce the tendency toward motion sickness. A device according to this concept helps to prevent retinal slip by providing snapshots of the visual environment through electronic shutters that are brief enough that each snapshot freezes the image on each retina. The exposure time for each snapshot is less than 5 ms. In the event that a higher

  6. Wanting to work: managing the sick role in high-stake sickness insurance meetings.

    PubMed

    Flinkfeldt, Marie

    2017-05-15

    This article respecifies and develops Parsons's sick role theory, focusing on the postulate that the sick person must 'want' to get well. Using conversation analysis and discursive psychology to study how the psychological term 'want' is used in high-stake, multi-professional meetings with sickness benefit claimants in Sweden, the article shows how establishing that one 'wants' to get well requires extensive interactional work. In the examined meetings, the sick person's 'want' formulations make explicit the relationship between 'wants' and illness or inabilities, thus allowing for motivational character to be established without committing to its implications, and without appearing strategic or biased. By contrast, professional parties in the meetings invoke the sick person's 'wants' either to hold them accountable, or for establishing a desired course of recovery, confirming the centrality of such 'wants' in this setting as well as the risks associated with expressing them. The article suggests that analysing psychological matters as they are oriented to by participants renders sick role theory relevant for a wide range of settings and respecifies criticism of the model. © 2017 Foundation for the Sociology of Health & Illness.

  7. Mountains: An Overview.

    ERIC Educational Resources Information Center

    Byers, Alton; Gilligan, Nancy; Golston, Syd; Linville, Rex

    1999-01-01

    Introduces the lessons from "Mountain: A Global Resource" that were developed by the National Council for the Social Studies (NCSS) and The Mountain Institute for use by NCSS members and their students. Provides an overview that introduces the mountains, mountain cultures, historical perceptions, and the geographical importance of…

  8. [Duration of maternity leave and sick leave during pregnancy].

    PubMed

    Tophøj, A; Sabroe, S

    1999-09-06

    The aim of the project was to describe the reasons for sick leave during pregnancy. This article presents data on a subgroup of women on sick leave. The purpose of this reanalysis was to examine whether women with short maternity leave had longer sick leave during pregnancy. Pregnant women in a Danish County applying for sick leave in a year were consecutively included in the study. Data were obtained by questionnaires during 1991-1992. Women with rights to a longer maternity leave, obtained through collective bargaining, were mainly employed in occupational groups related to the public sector and were on sick leave significantly longer, than women with short maternity leave, obtained only through legislation. The diagnoses differed among the two groups. Data suggest unequal possibilities for obtaining pregnancy related sick leave, as women with longer predelivery leave and a more secure employment situation had significantly longer sick leave than other women.

  9. Sick leave patterns in common musculoskeletal disorders – a study of doctor prescribed sick leave

    PubMed Central

    2014-01-01

    Background Comparative data on sick leave within musculoskeletal disorders (MSDs) is limited. Our objective was to give a descriptive overview of sick leave patterns in different MSDs. Methods Using electronic medical records, we collected information on dates and diagnostic codes for all available sick leave certificates, during 2 years (2009–2010), in the North Western part of the Skåne region in Sweden (22 public primary health care centres and two general hospitals). Using the International Classification of Diseases (ICD) 10 codes on the certificates we studied duration, age and sex distribution and recurrent periods of sick leave for six strategically chosen MSDs; low back pain (M54) disc disorders (M51), knee osteoarthritis (M17) hip osteoarthritis (M16) rheumatoid arthritis (M05-M06) and myalgia (M79). Results All together 20 251 sick leave periods were issued for 16 673 individuals 16–64 years of age (53% women). Out of the selected disorders, low back pain and myalgia had the shortest sick leave periods, with a mean of 26 and 27 days, respectively, while disc disorders and rheumatoid arthritis had the longest periods with a mean of 150 and 147 days. For low back pain and myalgia 27% and 26% of all sick leave was short (8–14 days) and only 11% and 13%, were long (≥90 days). For the other selected MSDs, less than 5% of the periods were short. For disc disorders, hip osteoarthritis and rheumatoid arthritis, more than 60% of the periods were long (p > 0.001). For back disorders and myalgia most periods were issued in the age groups between 40–49, with similar patterns for women and men. Osteoarthritis and rheumatoid arthritis had most periods in the age groups of 50–64, and patterns for women and men differed. Low back pain, rheumatoid arthritis and myalgia had the greatest share of recurrent sick leave (31%, 34% and 32% respectively). Conclusion Duration, age and sex distribution and numbers of recurrent sick leave varies considerably

  10. Evaluation of Reproductive Function for Patients with Chronic Radiation Sickness

    DTIC Science & Technology

    1998-05-01

    was the age at menopause . However, no difference was noted between the exposed and control populations with regard to fertility, spontaneous...with CRS. The information on age at menarche and that at menopause , duration of the menstrual cycle, pains and quantity of discharge, was collected...age, pathological conditions in the premenstrual period, climacteric syndrome, etc. The menstrual syndrome will be discussed in detail in the next

  11. CHANGES OF PULMONARY BLOOD VESSELS IN CHRONIC RADIATION SICKNESS,

    DTIC Science & Technology

    revealed during angiocardiography. In the initial period of disease in connection with dystonia , developed in contraction of big vessels and...the characteristics of vascular circulator dystonia are absent or are weakly expressed, but the unusual flow of contrast medium from the arteries

  12. Anti-inflammatory Effect of Astaxanthin on the Sickness Behavior Induced by Diabetes Mellitus.

    PubMed

    Ying, Chang-jiang; Zhang, Fang; Zhou, Xiao-yan; Hu, Xiao-tong; Chen, Jing; Wen, Xiang-ru; Sun, Ying; Zheng, Kui-yang; Tang, Ren-xian; Song, Yuan-jian

    2015-10-01

    Chronic inflammation appears to play a critical role in sickness behavior caused by diabetes mellitus. Astaxanthin has been used in treating diabetes mellitus and diabetic complications because of its neuroprotective and anti-inflammatory actions. However, whether astaxanthin can improve sickness behavior induced by diabetes and its potential mechanisms are still unknown. The aim of this study was to investigate the effects of astaxanthin on diabetes-elicited abnormal behavior in mice and its corresponding mechanisms. An experimental diabetic model was induced by streptozotocin (150 mg/kg) and astaxanthin (25 mg/kg/day) was provided orally for 10 weeks. Body weight and water consumption were measured, and the sickness behavior was evaluated by the open field test (OFT) and closed field test (CFT). The expression of glial fibrillary acidic protein (GFAP) was measured, and the frontal cortical cleaved caspase-3 positive cells, interleukin-6 (IL-6), and interleukin-1β (IL-1β) expression levels were also investigated. Furthermore, cystathionine β-synthase (CBS) in the frontal cortex was detected to determine whether the protective effect of astaxanthin on sickness behavior in diabetic mice is closely related to CBS. As expected, we observed that astaxanthin improved general symptoms and significantly increase horizontal distance and the number of crossings in the OFT and CFT. Furthermore, data showed that astaxanthin could decrease GFAP-positive cells in the brain and down-regulate the cleaved caspase-3, IL-6, and IL-1β, and up-regulate CBS in the frontal cortex. These results suggest that astaxanthin provides neuroprotection against diabetes-induced sickness behavior through inhibiting inflammation, and the protective effects may involve CBS expression in the brain.

  13. Detection of the abnormal isoform of the prion protein associated with chronic wasting disease in the optic pathways of the brain and retina of Rocky Mountain elk (Cervus elaphus nelsoni).

    PubMed

    Spraker, T R; O'Rourke, K I; Gidlewski, T; Powers, J G; Greenlee, J J; Wild, M A

    2010-05-01

    Eyes and nuclei of the visual pathways in the brain were examined in 30 Rocky Mountain elk (Cervus elaphus nelsoni) representing 3 genotypes of the prion protein gene PRNP (codon 132: MM, ML, or LL). Tissues were examined for the presence of the abnormal isoform of the prion protein associated with chronic wasting disease (PrP(CWD)). Nuclei and axonal tracts from a single section of brain stem at the level of the dorsal motor nucleus of the vagus nerve were scored for intensity and distribution of PrP(CWD) immunoreactivity and degree of spongiform degeneration. This obex scoring ranged from 0 (elk with no PrP(CWD) in the brain stem) to 10 (representing elk in terminal stage of disease). PrP(CWD) was detected in the retina of 16 of 18 (89%) elk with an obex score of > 7. PrP(CWD) was not detected in the retina of the 3 chronic wasting disease-negative elk and 9 elk with an obex score of < 6. PrP(CWD) was found in the nuclei of the visual pathways in the brain before it was found in the retina. Within the retina, PrP(CWD) was first found in the inner plexiform layer, followed by the outer plexiform layer. Intracytoplasmic accumulation of PrP(CWD) was found in a few neurons in the ganglion cell layer in the PRNP 132ML elk but was a prominent feature in the PRNP 132LL elk. Small aggregates of PrP(CWD) were present on the inner surface of the outer limiting membrane in PRNP 132LL elk but not in PRNP 132MM or 132ML elk. This study demonstrates PrP(CWD) accumulation in nuclei of the visual pathways of the brain, followed by PrP(CWD) in the retina.

  14. Progressive accumulation of the abnormal conformer of the prion protein and spongiform encephalopathy in the obex of nonsymptomatic and symptomatic Rocky Mountain elk (Cervus elaphus nelsoni) with chronic wasting disease.

    PubMed

    Spraker, Terry R; Gidlewski, Thomas; Powers, Jenny G; Nichols, Tracy; Balachandran, Aru; Cummings, Bruce; Wild, Margaret A; VerCauteren, Kurt; O'Rourke, Katherine I

    2015-07-01

    The purpose of our study was to describe the progressive accumulation of the abnormal conformer of the prion protein (PrP(CWD)) and spongiform degeneration in a single section of brain stem in Rocky Mountain elk (Cervus elaphus nelsoni) with chronic wasting disease (CWD). A section of obex from 85 CWD-positive elk was scored using the presence and abundance of PrP(CWD) immunoreactivity and spongiform degeneration in 10 nuclear regions and the presence and abundance of PrP(CWD) in 10 axonal tracts, the subependymal area of the fourth ventricle, and the thin subpial astrocytic layer (glial limitans). Data was placed in a formula to generate an overall obex score. Data suggests that PrP(CWD) immunoreactivity and spongiform degeneration has a unique and relatively consistent pattern of progression throughout a section of obex. This scoring technique utilizing a single section of obex may prove useful in future work for estimating the presence and abundance of PrP(CWD) in peripheral tissues and the nervous system in elk with CWD. © 2015 The Author(s).

  15. [Lung transplanted patient climbing a mountain higher than 4,000 metres. Comparison with healthy climbers].

    PubMed

    Botella de Maglia, Javier; Fuster Escrivà, Antoni

    2007-09-15

    To ascertain if a bilaterally lung transplanted patient can climb a mountain higher than 4,000 metres and to compare the evolution of his physiological parameters during the ascent with those of healthy mountaineers. Heart rate, blood pressure, arterial oxygen saturation (SaO2), forced vital capacity, forced expiratory volume in one second, Tiffenau test, 25-75 mesoexpiratory flow, peak flow, severity of dyspnoea (analogic score) and symptoms and signs of acute mountain sickness (lake Louise and Serrano-Alcócer scores) were measured in a bilaterally lung transplanted patient and in 4 healthy mountaineers at sea level and at different altitudes during the ascent of Breithorn (4,164 m) from Zermatt in 3 days. All subjects attained the summit. The transplanted patient suffered from an acute mountain sickness at 2,700 m but recovered spontaneously. No other substantial differences were found during the climb between the patient's physiological parameters and those of the healthy controls. On the summit (third day) the patient's SaO2 (90%) was higher than the figure which should be theoretically expected for this altitude among non-acclimatised subjects (81%). Our study confirms that it is possible for a bilaterally lung transplanted patient to climb by his own effort a mountain higher than 4,000 m with no physiological changes other than those experienced by healthy mountaineers. Considering the spontaneous recovery from the acute mountain sickness and the high SaO2 on the summit of Breithorn, we conclude that lung transplantation does not necessarily prevent altitude acclimatisation.

  16. Immune-to-Brain Communication Pathways in Inflammation-Associated Sickness and Depression.

    PubMed

    D'Mello, Charlotte; Swain, Mark G

    A growing body of evidence now highlights a key role for inflammation in mediating sickness behaviors and depression. Systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, and chronic liver disease have high comorbidity with depression. How the periphery communicates with the brain to mediate changes in neurotransmission and thereby behavior is not completely understood. Traditional routes of communication between the periphery and the brain involve neural and humoral pathways with TNFα, IL-1β, and IL-6 being the three main cytokines that have primarily been implicated in mediating signaling via these pathways. However, in recent years communication via peripheral immune-cell-to-brain and the gut-microbiota-to-brain routes have received increasing attention for their ability to modulate brain function. In this chapter we discuss periphery-to-brain communication pathways and their potential role in mediating inflammation-associated sickness behaviors and depression.

  17. Motion sickness in the squirrel monkey

    NASA Technical Reports Server (NTRS)

    Ordy, J. M.; Brizzee, K. R.

    1980-01-01

    In this study of susceptibility to motion sickness the specific aims were to examine the effects of combined vertical rotation and horizontal acceleration, phenotype, sex, visual cues, morning and afternoon testing, and repeated test exposures on incidence, frequency, and latency of emetic responses. The highest emetic incidence of 89% with an emetic frequency of 2.0 during 60 min and a latency of 19 min from onset of testing occurred at 25 rpm and 0.5 Hz linear acceleration. Since the emetic responses were quite similar to man in eliciting motion stimuli it was concluded that the squirrel monkey represents a very suitable primate model for studies of motion and space sickness.

  18. Study on experimental motion sickness in children.

    PubMed

    Takahashi, M; Toriyabe, I; Takei, Y; Kanzaki, J

    1994-05-01

    To clarify the characteristics of motion sickness in children we investigated autonomic nervous symptoms and instability evoked by walking while wearing horizontally reversing goggles in 90 children aged 4 to 15 years. Kindergarten children had hardly any autonomic nervous symptoms except headache; however, they often fell, could not stand up or move, and exhibited a to-and-fro deviation gait. Although the frequency and severity of sickness gradually increased during growth, the severity of gait disorder became milder as age increased. On the basis of these findings it seems likely that functions which perceive disorder of spatial orientation and action are immature in young children, and once spatial orientation is impaired, instability becomes very severe, since inadequate control is not stopped by an alarm function against disorientation.

  19. Motion sickness in the squirrel monkey

    NASA Technical Reports Server (NTRS)

    Ordy, J. M.; Brizzee, K. R.

    1980-01-01

    In this study of susceptibility to motion sickness the specific aims were to examine the effects of combined vertical rotation and horizontal acceleration, phenotype, sex, visual cues, morning and afternoon testing, and repeated test exposures on incidence, frequency, and latency of emetic responses. The highest emetic incidence of 89% with an emetic frequency of 2.0 during 60 min and a latency of 19 min from onset of testing occurred at 25 rpm and 0.5 Hz linear acceleration. Since the emetic responses were quite similar to man in eliciting motion stimuli it was concluded that the squirrel monkey represents a very suitable primate model for studies of motion and space sickness.

  20. Vertical Heterophoria and Susceptibility to Visually-induced Motion Sickness

    PubMed Central

    Jackson, Danielle N.; Bedell, Harold E.

    2013-01-01

    Motion sickness is reported to be a common symptom in patients with vertical heterophoria. The goal of this study was to assess the relationship between vertical phoria and susceptibility to motion sickness in a non-clinical sample of 43 subjects. Vertical phoria was measured with a Maddox rod after 30 s of occlusion. To evaluate susceptibility to motion sickness, subjects read text while sitting inside a rotating optokinetic drum for 10 min. Subjects rated their level of motion sickness at 1 min intervals during drum rotation and the magnitude of 13 motion-sickness symptoms after drum rotation ended. The magnitude of vertical phoria ranged from 0 to 2.13 prism diopters (pd) with a mean of 0.46 pd and correlated significantly with both the maximum rating of motion sickness during drum rotation and the summed symptom score following rotation. A vertical phoria of 0.75 pd discriminated best between subjects with low vs. high summed motion-sickness-symptom scores (p < 0.0001). Introducing a prism to artificially increase the phoria of 12 subjects with vertical phorias < 0.75 pd increased motion-sickness symptoms in only 1 subject. Prisms that reduced the phoria of subjects with vertical phorias > 0.75 pd reduced motion-sickness symptoms in 2 of the 4 subjects tested. The results confirm an association between vertical phoria and motion sickness, but suggest the relationship may not be causal. PMID:22390327

  1. Sickness absence and flight type exposure in flight crew members.

    PubMed

    van Drongelen, A; van der Beek, A J; Penders, G B S; Hlobil, H; Smid, T; Boot, C R L

    2015-01-01

    Shift work research has shown that the relationship between exposure to irregular working times and sickness absence may differ between working populations. Not much is known about the prevalence of sickness absence in flight crews or about the relationship between exposure to different flight schedules and sickness absence in this population. To examine the association between cumulative exposure to different flight types and sickness absence in flight crew members. The study population consisted of flight crew members from a 5 year historic cohort. Flight schedule and sickness absence data were obtained from company records. The association between the cumulative exposure to different flight types and sickness absence episodes of >7 days was determined using univariate and multivariate logistic regression analyses. Adjusted models were obtained by adding potential confounders. Previous sickness absence was added to compose the fully adjusted models. The records of 8228 employees were analysed. The fully adjusted univariate analyses showed that the numbers of medium-haul flights and flights with time zone crossings were associated with an increase in the odds for sickness absence. The fully adjusted multivariate analyses showed no significant associations between flight types and sickness absence. Cumulative exposure to flight types was not independently associated with sickness absence in flight crew members when previous sickness absence was taken into account. Because sickness absence in the past can predict future absence, preventive strategies targeted at flight crew members with a history of high sickness absence may be effective. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Glucose and insulin modulate sickness responses in male Siberian hamsters.

    PubMed

    Carlton, Elizabeth D; Demas, Gregory E

    2017-02-01

    Mounting a sickness response is an energetically expensive task and requires precise balancing of energy allocation to ensure pathogen clearance while avoiding compromising energy reserves. Sickness intensity has previously been shown to be modulated by food restriction, body mass, and hormonal signals of energy. In the current study, we tested the hypothesis that sickness intensity is modulated by glucose availability and an endocrine signal of glucose availability, insulin. We utilized male Siberian hamsters (Phodopus sungorus) and predicted that pharmacological induction of glucoprivation with 2-deoxy-d-glucose (2-DG), a non-metabolizable glucose analog that disrupts glycolysis, would attenuate energetically expensive sickness symptoms. Alternatively, we predicted that treatment of animals with insulin would enhance energetically expensive sickness symptoms, as insulin would act as a signal of increased glucose availability. Upon experimental treatment with lipopolysaccharide (LPS), we found that glucose deprivation resulted in increased sickness-induced hypothermia as compared to control- and insulin-treated animals; however, it did not have any effects on sickness-induced anorexia or body mass loss. Insulin treatment resulted in an unexpectedly exaggerated sickness response in animals of lesser body masses; however, in animals of greater body masses, insulin actually attenuated sickness-induced body mass loss and had no effects on hypothermia or anorexia. The effects of insulin on sickness severity may be modulated by sensitivity to sickness-induced hypoglycemia. Collectively, these results demonstrate that both glucose availability and signals of glucose availability can modulate the intensity of energetically expensive sickness symptoms, but their effects differ among different sickness symptoms and are sensitive to energetic context. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Guidelines for Alleviation of Simulator Sickness Symptomatology

    DTIC Science & Technology

    1987-03-01

    from perceptual learning or the "neural store " (Reason, 1969; 1978) troubleshooting begins and the subject feels sick. Given the principles of learning...behavior is considered to be an output "function of external stimuli or situations. In human engineering, the stimulus may be energy (e.g., lighting...providing certain conditions are met. In general, the organism samples over time or past history (neural store ) to determine whether phenomena which are

  4. Space Flight Decompression Sickness Contingency Plan

    NASA Technical Reports Server (NTRS)

    Dervay, Joseph; Gernhardt, Michael L.; Ross, Charles E.; Hamilton, Douglas; Homick, Jerry L. (Technical Monitor)

    2000-01-01

    The purpose was to develop an enhanced plan to diagnose, treat, and manage decompression sickness (DCS) during extravehicular activity (EVA). This plan is merited by the high frequency of upcoming EVAs necessary to construct and maintain the International Space Station (ISS). The upcoming ISS era will demand a significant increase in EVA. The DCS Risk and Contingency Plan provided a new and improved approach to DCS reporting, treatment, management, and training.

  5. Serum sickness-like reactions to cefaclor.

    PubMed

    Stricker, B H; Tijssen, J G

    1992-10-01

    In this study, we evaluated whether the high number of reports of serum sickness to cefaclor was present in every country and year, and whether these figures from voluntary reporting facilitated an estimation of the relative risk. A nested case-control study was performed with reports of all suspected adverse reactions (ADR) to cefaclor, amoxicillin and cephalexin in the period 1968-1987, as reported to the WHO Collaborating Center for International Drug Monitoring from the U.S.A., the U.K., Sweden, Canada and Germany. The ADR-reporting odds ratio was defined as the ratio of the odds of the number of ADR-reports of serum sickness to cefaclor and amoxicillin or cephalexin and the odds of similar reports of non-serum sickness to cefaclor and amoxicillin or cephalexin. The ADR-reporting odds ratio adjusted for country, age, gender, origin of the report and year of marketing was 12.4 for cefaclor vs amoxicillin and 18.5 for cefaclor vs cephalexin. In children (< 15 years of age) and in adults (> 15 years of age), the relative risk of developing serum sickness of cefaclor vs amoxicillin was estimated at 13.9 (95% confidence interval (95% CI): 6.0-32.2) and 2.9 (95% CI: 0.9-9.4) respectively in the U.S.A., and at 15.1 (95% CI: 7.2-31.5) and 5.5 (95% CI: 2.0-15.0) respectively in the other four countries together. In this study, the ADR-reporting odds ratio facilitated a valid estimation of the relative risk.

  6. Short-term responses of the kidney to high altitude in mountain climbers

    PubMed Central

    Goldfarb-Rumyantzev, Alexander S.; Alper, Seth L.

    2014-01-01

    In high-altitude climbers, the kidneys play a crucial role in acclimatization and in mountain sickness syndromes [acute mountain sickness (AMS), high-altitude cerebral edema, high-altitude pulmonary edema] through their roles in regulating body fluids, electrolyte and acid–base homeostasis. Here, we discuss renal responses to several high-altitude-related stresses, including changes in systemic volume status, renal plasma flow and clearance, and altered acid–base and electrolyte status. Volume regulation is considered central both to high-altitude adaptation and to maladaptive development of mountain sickness. The rapid and powerful diuretic response to the hypobaric hypoxic stimulus of altitude integrates decreased circulating concentrations of antidiuretic hormone, renin and aldosterone, increased levels of natriuretic hormones, plasma and urinary epinephrine, norepinephrine, endothelin and urinary adrenomedullin, with increased insensible fluid losses and reduced fluid intake. The ventilatory and hormonal responses to hypoxia may predict susceptibility to AMS, also likely influenced by multiple genetic factors. The timing of altitude increases and adaptation also modifies the body's physiologic responses to altitude. While hypovolemia develops as part of the diuretic response to altitude, coincident vascular leak and extravascular fluid accumulation lead to syndromes of high-altitude sickness. Pharmacological interventions, such as diuretics, calcium blockers, steroids, phosphodiesterase inhibitors and β-agonists, may potentially be helpful in preventing or attenuating these syndromes. PMID:23525530

  7. A Countermeasure for Space Motion Sickness

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Somers, J. T.; Leigh, R. J.; Jones, G. Melvill

    2006-01-01

    Overall, the results obtained in both the U.S. and the Russian space programs indicate that most space crews will experience some symptoms of motion sickness (MS) causing significant impact on the operational objectives that must be accomplished to assure mission success. At this time the primary countermeasure for MS requires the administration of Promethazine. Promethazine is not a benign drug, and is most frequently administered just prior to the sleep cycle to prevent its side effects from further compromising mission objectives. Clearly other countermeasures for SMS must be developed. Currently the primary focus is on two different technologies: (1) developing new and different pharmacological compounds with less significant side effects, (2) preflight training. The primary problem with all of these methods for controlling MS is time. New drugs that may be beneficial are years from testing and development, and preflight training requires a significant investment of crew time during an already intensive pre-launch schedule. Granted, motion sickness symptoms can be minimized with either of the two methods detailed above, however, it may be possible to develop a countermeasure that does not require either extensive adaptation time or exposure to motion sickness. Approximately 25 years ago Professor Geoffrey Melvill Jones presented his work on adaptation of the vestibuloocular reflex (VOR) using optically reversed vision (left-right prisms) during head rotations in the horizontal plane. It was of no surprise that most subjects experienced motion sickness while wearing the optically reversing prisms. However, a serendipitous finding emerged during this research showing that the same subjects did not experience motion sickness symptoms when wearing the reversing prisms under stroboscopic illumination. The mechanism, by which this side-effect was believed to have occurred, is not clearly understood. However, the fact that no motion sickness was ever noted, suggests

  8. Childhood serum sickness: a case report.

    PubMed

    Chao, Y K; Shyur, S D; Wu, C Y; Wang, C Y

    2001-09-01

    Childhood serum sickness is a rare allergic disease that follows the administration of a foreign antigenic material, most commonly caused by injecting a protein or haptenic drug. The disease is a type III hypersensitivity reaction mediated by deposits of circulating immune complexes in small vessels, which leads to complement activation and subsequent inflammation. The clinical features are fever, cutaneous eruptions, lymphadenopathy, arthralgias, albuminuria, and nephritis. Serum sickness is an acute self-limited disease. We report a 3-year-old child who presented with fever and a rash; an invasive bacterial infection was strongly suspected. He was therefore given penicillin and gentamicin and responded well. At day 4 after admission, he developed a serum sickness reaction and showed symptoms of arthralgias, generalized edema, purpura, and gross hematuria. The white blood cell count was 12 190/mm3 with 7% eosinophils. Urinalysis revealed red blood cell above 100 per high power field, white blood cell 10 to 15 per high power field, and proteinuria. The antibiotics were discontinued and hydrocortisone (20 mg/kg/d), diphenhydramine HCl (4 mg/kg/d), aspirin (66 mg/kg/d) was administered, plus 1 dose of epinephrine (0.01 mL/kg) administered intramuscularly. On day 7, the 3rd day after withholding antibiotics, his condition dramatically improved. The clinical symptoms resolved progressively and his urinalysis returned to normal.

  9. Sick sinus syndrome. Symptomatic cases in children.

    PubMed Central

    Radford, D J; Izukawa, T

    1975-01-01

    In 20 children needing treatment for symptomatic sick sinus syndrome, the average age at presentation was 7.1 years and ranged from 9 months to 18 years. Symptoms were never precise but, in retrospect, 5 children had syncope, 7 had a rapid heart action, 6 had dyspnoea or tachypnoea, 2 had nonspecific chest pains, 2 had pale spells, and 1 had a sudden hemiplegia. Symptoms followed cardiac surgery in 15 cases and were related to unoperated congenital heart disease in 2 and to myocarditis in 2. The aetiology was unknown in 1 case. The type of cardiac surgery resulting in the development of the sick sinus syndrome was predominantly related to atrial suturing. Both tachy- and bradydysrhythmias were found, including wandering atrial pacemaker (9 cases), junctional rhythm (19 cases), supraventricular tachycardia (9 cases), atrial flutter (11 cases), and atrial fibrillation (2 cases). Both atrial (8 cases) and ventricular (7 cases) premature beats were seen. All patients were given trials of drug therapy but difficulties were encountered. Cardioversion was used for tachyarrhythmias in 11 cases without serious problems. Six children had permanent cardiac pacemakers inserted with good results. Recognition of the sick sinus syndrome in childhood is important and treatment must be regulated by the severity of symptoms. Images FIG. PMID:1211960

  10. Motion sickness: a cholinomimetic agent hypothesis.

    PubMed

    Sheehan, Scott E; Oman, Charles M; Duda, Kevin R

    2011-01-01

    Motion sickness has been defined as a set of physiological signs and symptoms produced as a result of prolonged sensory conflict in central nervous system vestibular centers. It has long been noted that the particular pattern of motion sickness signs and symptoms does not fit the conventional "fight or flight vs. rest and digest" autonomic synergy. We argue that most of the progression of symptoms is consistent with a new etiologic hypothesis: that an as-yet-unidentified ganglionic cholinomimetic agent is slowly released in proportion to sensory conflict. The agent accumulates systemically and stimulates the peripheral sympathetic and parasympathetic ganglia, the adrenal medulla, and potentiates the response of central cholinergic emetic pathways to the same conflict stimulus. The predominant effects of ganglionic stimulation on each autonomic organ, determined by resting tone, are selectively enhanced or inhibited by adrenal catecholamine release, producing the atypical pattern of autonomic changes seen in motion sickness. The adrenergic response may eventually also counter the central emetic drive. The hypothesis could be experimentally pursued via human and animal experiments employing a nicotinic antagonist that has both central and peripheral ganglionic actions such as mecamylamine.

  11. Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences.

    PubMed

    Bränström, R; Arrelöv, B; Gustavsson, C; Kjeldgård, L; Ljungquist, T; Nilsson, G H; Alexanderson, K

    2014-01-01

    Physicians' work with sickness certifications is an understudied field. The aims of this study were to gain knowledge of experiences concerning the sickness certification process among physicians working at oncology clinics. In 2008, all physicians working in Sweden (n = 36 898) were sent a questionnaire concerning sick-listing practices. All respondents working at an oncology clinic (n = 428) were included in the current study. Most of the physicians had sickness certification consultations at least weekly (91.3%). More than one fifth (22.3%) reported that they worked at a clinic with a workplace policy regarding the handling of sickness certification and 61.1% reported receiving at least some support in such cases from their immediate manager. Issuing unnecessary long sickness certificates were related to experiencing delicate interactions with patients and to lack of time. To a moderate degree, further competence was requested regarding: different types of compensation in the social insurance system, responsibilities of the Social Insurance Agency and employers, and sickness insurance rules. The large majority of physicians working in oncology reported regularly having consultations involving sickness certification. Overall, they reported few problems, low level of need for more competence regarding sickness certification, and low frequency of issuing sickness absences for longer periods than necessary.

  12. [Pregnant women's sick leave is behind the increased sick leave among women of fertile age. A study of pregnant women's sick leave 1978-1997].

    PubMed

    Sydsjö, A; Sydsjö, G

    2001-08-08

    Sick leave rates among pregnant women have been found to vary substantially over time. 8,884 woman delivered at Linköping and Värnamo Women's Clinics in 1978, 1986, 1988, 1992, 1995 and 1997 were studied. Sick leave nearly doubled between 1978 and 1986, and dropped back to the 1978 level in 1997. The somewhat paradoxical findings in our surveys indicate that attitudes, especially as observed in the youngest age groups, together with a sensible adaptation to the prevailing terms of the social security system, may well be the most plausible explanation. Studies on sick leave among women of fertile age should preferably also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a profound impact on sick leave statistics among all insured women of fertile age.

  13. Morning sickness and vitamin B6 status of pregnant women.

    PubMed

    Schuster, K; Bailey, L B; Dimperio, D; Mahan, C S

    1985-01-01

    The relationship between the vitamin B6 status of 180 pregnant women and the incidence and degree of morning sickness experienced during the first trimester was investigated. There were no significant differences in plasma pyridoxal 5'-phosphate (PLP), erythrocyte aspartate aminotransferase (AspAT) activity, and stimulation of erythrocyte AspAT activity by exogenous PLP between subjects who experienced morning sickness and those who did not. No relationship was found between these indicators of vitamin B6 status and the degree of morning sickness experienced by this group during early pregnancy. There were no differences in the number of women who experienced morning sickness or in the number with different degrees of sickness when plasma levels of PLP, erythrocyte AspAT activity or stimulation by PLP were divided into upper and lower 50th percentile groups and compared. Therefore these data show no relationship between vitamin B6 status and the incidence or degree of morning sickness.

  14. Severe serum sickness reaction to oral and intramuscular penicillin.

    PubMed

    Clark, Brychan M; Kotti, George H; Shah, Anand D; Conger, Nicholas G

    2006-05-01

    Serum sickness is a type III hypersensitivity reaction mediated by immune complex deposition with subsequent complement activation, small-vessel vasculitis, and tissue inflammation. Although the overall incidence of serum sickness is declining because of decreased use of heterologous sera and improved vaccinations, rare sporadic cases of serum sickness from nonprotein drugs such as penicillins continue to occur. Drug-induced serum sickness is usually self-limited, with symptoms lasting only 1-2 weeks before resolving. We report an unusual case of a severe and prolonged serum sickness reaction that occurred after exposure to an intramuscular penicillin depot injection (probable relationship by Naranjo score) and discuss how pharmacokinetics may have played a role. Clinicians should be familiar with serum sickness reactions particularly as they relate to long-acting penicillin preparations. Accurate diagnosis in conjunction with cessation of drug exposure and prompt initiation of antiinflammatory treatment with corticosteroids can produce complete recovery

  15. Scopolamine for preventing and treating motion sickness.

    PubMed

    Spinks, A B; Wasiak, J; Villanueva, E V; Bernath, V

    2004-01-01

    Motion sickness - the discomfort experienced when perceived motion disturbs the organs of balance - may include symptoms such as nausea, vomiting, pallor, cold sweats, hypersalivation, hyperventilation and headaches. The control and prevention of these symptoms have included pharmacological, behavioural and complementary therapies. Although scopolamine has been used in the treatment and prevention of motion sickness for decades, there have been no systematic reviews of its effectiveness. To assess the effectiveness of scopolamine versus no therapy, placebo, other drugs, behavioural and complementary therapy or two or more of the above therapies in combination for motion sickness in persons (both adults and children) without known vestibular, visual or central nervous system pathology. The Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2003), MEDLINE (OVID, 1966 to March Week 1 2004), EMBASE (1974 to 2004) CINAHL (Ovid, 1982 to March Week 1 2004) and reference lists of retrieved studies were searched for relevant studies. No language restrictions were applied. All parallel-arm, randomised controlled trials (RCTs) focusing on scopolamine versus no therapy, placebo, other drugs, behavioural and complementary therapy or two or more of the above therapies in combination were included. Outcomes relating to the prevention of onset or treatment of clinically-defined motion sickness, task ability and psychological tests, changes in physiological parameters and adverse effects were considered. Data from the studies were extracted independently by two authors using standardised forms. Study quality was assessed. Dichotomous data were expressed as odds ratio (OR) and a pooled OR was calculated using the random effects model. Of 27 studies considered potentially relevant, 12 studies enrolling 901 subjects met the entry criteria. Scopolamine was administered via transdermal

  16. Operation Everest II. Altitude Decompression Sickness during Repeated Altitude Exposure,

    DTIC Science & Technology

    1986-05-01

    James Alexander, Maureen Andrew, James Anholm, Louis Banderet, Dick Burse, Jonathan Carter, Howard Green, Geoff r Coates , Howard Donner, Ulrich Duncan...sickness: advances and interpretations. Aerospace Med. 1971, 42:255-267. 4. Behnke, A.R. Decompression sickness incident to deep sea diving and high...Med. pp. 1974, 297-300. 10. Fryer , D.I. Decompression sickness at 18,500 feet. A case history with comment. Aerospace Med. 1964, 35:479-481. 11. Fryer

  17. Serum sickness-like illness associated with ciprofloxacin.

    PubMed

    Slama, T G

    1990-05-01

    Serum sickness is a systemic hypersensitivity reaction initially reported in children receiving horse serum. Drugs such as penicillins, cephalosporins, and sulfonamides are now noted to be the most common etiologic agents of serum sickness-like reactions. This case report describes a serum sickness-like reaction temporally related to ciprofloxacin, a previously unreported adverse effect of this drug or any of the other quinolones.

  18. Chinese hyper-susceptibility to vection-induced motion sickness

    NASA Technical Reports Server (NTRS)

    Stern, Robert M.; Hu, Senqi; Leblanc, Ree; Koch, Kenneth L.

    1993-01-01

    Little is known about the factors that control individual differences in susceptible to motion sickness. A serendipitous observation in our laboratory that most Chinese subjects become motion sick prompted this study. We used a rotating optokinetic drum to provoke motion sickness and compared gastric responses and symptom reports of Chinese, European-American, and African-American subjects. There was no difference in the responses of European-American and African-American subjects; however, Chinese subjects showed significantly greater disturbances in gastric activity and reported significantly more severe symptoms. We suggest that this hypersusceptibility presents a natural model for the study of physiological mechanisms of nausea and other symptoms of motion sickness.

  19. Rocky Mountain spotted fever

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000654.htm Rocky Mountain spotted fever To use the sharing features on this page, please enable JavaScript. Rocky Mountain spotted fever is a disease caused by a ...

  20. Lesson 2: Sacred Mountains.

    ERIC Educational Resources Information Center

    Byers, Alton; Gilligan, Nancy; Golston, Syd; Linville, Rex

    1999-01-01

    Presents a lesson in which the students are divided into four Mountain Study Teams in order to examine a sacred mountain. Explains that the students in each group assume a particular role, such as an historian or scientist. Provides a profile on the four mountains and a definition of the seven student roles. (CMK)

  1. Mountains of Titan

    NASA Image and Video Library

    2012-12-14

    This map of Saturn moon Titan identifies the locations of mountains named by the International Astronomical Union. By convention, mountains on Titan are named for mountains from Middle-earth, the fictional setting in fantasy novels by J.R.R. Tolkien.

  2. Positive and negative consequences of sick leave for the individual, with special focus on part-time sick leave.

    PubMed

    Sieurin, Leif; Josephson, Malin; Vingård, Eva

    2009-01-01

    To describe the consequences of long-term sick leave (>28 days) on working situation, health and lifestyle among employees from the public sector in Sweden. Employees in four county councils and two municipalities on long term sick leave on 1 November 2005 (n = 1,128) answered a questionnaire in February 2006. The response rate was 71.7%. Eighty seven per cent were still on sick leave when the questionnaire was answered: 54% part time and 33% full time. Reporting positive consequences was rare but reporting negative consequences, such as effects on the development of salary, the possibilities of pursuing a career or to change to another job were common. Sick leave seemed to lead to a considerable loss of zest for work, even if the respondents were back in work full time. Regardless of the negative consequences at work, 92% of those on part-time sick leave believed that the part-time sick leave was good for them even if many thought it had negative consequences for employer and colleagues. Long-term sick leave has negative consequences for the individual in work situations, even for those back at work full time. The development of salary and career seem to be most affected. The attitude towards part-time sick leave was positive and this result indicates that there is a potential for an increased degree of partial return to work in the group of people on long-term sick leave.

  3. Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Stewart, J. J.; Wood, M. J.; Manno, J. E.; Manno, B. R.

    1990-01-01

    In addition to nausea and vomiting, motion sickness involves slowing of brain waves, loss of performance, inhibition of gastric motility and the Sopite Syndrome. The therapeutic effects of antimotion sickness drugs on these reactions were evaluated. The subjects were rotated to the M-III end-point of motion sickness. Intramuscular (IM) medications were then administered. Side effects before and after rotation were reported on the Cornell Medical Index. Brain waves were recorded on a Grass Model 6 Electroencephalograph (EEG), and gastric emptying was studied after an oral dose of 1 mCi Technetium 99m DTPA in 10 oz. isotonic saline. An increase in dizziness and drowsiness was reported with placebo after rotation. This was not prevented by IM scopolamine 0.1 mg or ephedrine 25 mg. EEG recordings indicated a slowing of alpha waves with some thea and delta waves from the frontal areas after rotation. IM ephedine and dimenhydrinate counteracted the slowing while 0.3 mg scopolamine had an additive effect. Alterations of performance on the pursuit meter correlated with the brain wave changes. Gastric emptying was restored by IM metoclopramide. Ephedrine IM but not scopolamine is effective for some of the secondary effects of motion sickness after it is established.

  4. Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Stewart, J. J.; Wood, M. J.; Manno, J. E.; Manno, B. R.

    1990-01-01

    In addition to nausea and vomiting, motion sickness involves slowing of brain waves, loss of performance, inhibition of gastric motility and the Sopite Syndrome. The therapeutic effects of antimotion sickness drugs on these reactions were evaluated. The subjects were rotated to the M-III end-point of motion sickness. Intramuscular (IM) medications were then administered. Side effects before and after rotation were reported on the Cornell Medical Index. Brain waves were recorded on a Grass Model 6 Electroencephalograph (EEG), and gastric emptying was studied after an oral dose of 1 mCi Technetium 99m DTPA in 10 oz. isotonic saline. An increase in dizziness and drowsiness was reported with placebo after rotation. This was not prevented by IM scopolamine 0.1 mg or ephedrine 25 mg. EEG recordings indicated a slowing of alpha waves with some thea and delta waves from the frontal areas after rotation. IM ephedine and dimenhydrinate counteracted the slowing while 0.3 mg scopolamine had an additive effect. Alterations of performance on the pursuit meter correlated with the brain wave changes. Gastric emptying was restored by IM metoclopramide. Ephedrine IM but not scopolamine is effective for some of the secondary effects of motion sickness after it is established.

  5. Identifying the Subtle Presentation of Decompression Sickness.

    PubMed

    Alea, Kenneth

    2015-12-01

    Decompression sickness is an inherent occupational hazard that has the possibility to leave its victims with significant long-lasting effects that can potentially impact an aircrew's flight status. The relative infrequency of this hazard within the military flying community along with the potentially subtle presentation of decompression sickness (DCS) has the potential to result in delayed diagnosis and treatment, leading to residual deficits that can impact a patient's daily life or even lead to death. The patient presented in this work was diagnosed with a Type II DCS 21 h after a cabin decompression at 35,000 ft (10,668 m). The patient had been asymptomatic with a completely normal physical/neurological exam following his flight. The following day, he presented with excessive fatigue and on re-evaluation was recommended for hyperbaric therapy, during which his symptoms completely resolved. He was re-evaluated 14 d later and cleared to resume flight duties without further incident. The manifestation of this patient's decompression sickness was subtle and followed an evaluation that failed to identify any focal findings. A high index of suspicion with strict follow-up contributed to the identification of DCS in this case, resulting in definitive treatment and resolution of the patient's symptoms. Determination of the need for hyperbaric therapy following oxygen supplementation and a thorough history and physical is imperative. If the diagnosis is in question, consider preemptive hyperbaric therapy as the benefits of treatment in DCS outweigh the risks of treatment. Finally, this work introduces the future potential of neuropsychological testing for both the diagnosis of DCS as well as assessing the effectiveness of hyperbaric therapy in Type II DCS.

  6. Cognitive cues and visually induced motion sickness.

    PubMed

    Golding, John F; Doolan, Kim; Acharya, Amish; Tribak, Maryame; Gresty, Michael A

    2012-05-01

    The importance of cognitive processing of orientation cues in visually induced motion sickness and vection is often overlooked. Upright versus inverted visual scenes containing cues of different levels of salience were compared. Panoramic scenes of 360 degrees were projected in the visual equivalent to the nauseogenic situation of rotating about an axis tilted from the vertical with a field of view of 84 degrees rotating at 0.2 Hz (72 degrees x s(-1)). Exposures were for 10 min or until moderate nausea developed. The design was counterbalanced repeated measures. Pilot Study: Subjects (N = 12) viewed visual conditions: a distant bland coastline scene as from an aircraft, tilted 30 degrees (Up); the same scene but inverted (Invert); and the scene morphed with no obvious orientation cues (Abstract). Main Experiment: Subjects (N = 22) viewed a city street scene containing numerous unambiguous and strong verticality cues under two conditions: upright (Up) and inverted (Invert), with 18 degrees tilt of rotational axis. Pilot Study: there were no significant differences between conditions in time (mean +/- SD min) to nausea endpoint (Up: 7.4 +/- 3.1; Invert: 7.1 +/- 3.1;Abstract: 7.8 +/- 2.4), nor for total symptom scores, nor for vection. Main Experiment: the upright scene was significantly more nauseogenic than the inverted, with shorter times to nausea endpoint (Up: 8.7 +/- 2.3; Invert: 9.2 +/- 2.2) and greater total symptom scores. Vection was marginally greater for Up than Invert. Salient and unambiguous higher order cognitive cues may modulate the development of motion sickness induced by optokinetic stimuli. There was no one-to-one correspondence between vection and motion sickness.

  7. Assessment of Psychophysiological Responses During Motion Sickness Testing

    NASA Technical Reports Server (NTRS)

    Stoud, Cynthia S.; Toscano, William B.; Cowings, Patricia; Freidman, Gary

    1994-01-01

    The purpose of this investigation is to evaluate a methodology designed to accurately trace the temporal progression of motion sickness and space motion sickness symptoms. With this method, subjects continuously monitor their own motion sickness symptoms during exposure to a provocative stimulus as symptoms occur, in contrast to previous methods during which subjects report symptoms verbally at discrete time intervals. This method not only is comparable to previous methods in the type of symptoms that subjects report, but subjects report symptoms more frequently. Frequent reporting of motion sickness symptoms allows researchers to detail the waxing and waning of motion sickness symptoms for each individual. Previous research has shown that physiological responses to motion sickness stimuli are characterized by unique individual differences in response patterns. By improving our assessment of motion sickness symptoms with continuous monitoring of symptoms, the relationship between specific physiological responses and sickness levels can be more accurately determined for each individual. Results from this study show significant positive relationships between skin conductance levels and symptom levels for ten individuals; a significant positive relationship between temperature and symptom levels for 5 of 10 individuals; and both positive and negative relationships between respiration, heart rate, blood volume pulse and symptom levels. Continuous monitoring of motion sickness symptoms can be used to more accurately assess motion sickness to aid in the evaluation of countermeasures. In addition, recognition of the onset of symptoms that are strongly related to specific physiological responses could be used as cues to initiate procedures (e.g., Autogenic Feedback Training) to prevent the development of severe motion sickness symptoms.

  8. Assessment of Psychophysiological Responses During Motion Sickness Testing

    NASA Technical Reports Server (NTRS)

    Stoud, Cynthia S.; Toscano, William B.; Cowings, Patricia; Freidman, Gary

    1994-01-01

    The purpose of this investigation is to evaluate a methodology designed to accurately trace the temporal progression of motion sickness and space motion sickness symptoms. With this method, subjects continuously monitor their own motion sickness symptoms during exposure to a provocative stimulus as symptoms occur, in contrast to previous methods during which subjects report symptoms verbally at discrete time intervals. This method not only is comparable to previous methods in the type of symptoms that subjects report, but subjects report symptoms more frequently. Frequent reporting of motion sickness symptoms allows researchers to detail the waxing and waning of motion sickness symptoms for each individual. Previous research has shown that physiological responses to motion sickness stimuli are characterized by unique individual differences in response patterns. By improving our assessment of motion sickness symptoms with continuous monitoring of symptoms, the relationship between specific physiological responses and sickness levels can be more accurately determined for each individual. Results from this study show significant positive relationships between skin conductance levels and symptom levels for ten individuals; a significant positive relationship between temperature and symptom levels for 5 of 10 individuals; and both positive and negative relationships between respiration, heart rate, blood volume pulse and symptom levels. Continuous monitoring of motion sickness symptoms can be used to more accurately assess motion sickness to aid in the evaluation of countermeasures. In addition, recognition of the onset of symptoms that are strongly related to specific physiological responses could be used as cues to initiate procedures (e.g., Autogenic Feedback Training) to prevent the development of severe motion sickness symptoms.

  9. Analytic gain in probabilistic decompression sickness models.

    PubMed

    Howle, Laurens E

    2013-11-01

    Decompression sickness (DCS) is a disease known to be related to inert gas bubble formation originating from gases dissolved in body tissues. Probabilistic DCS models, which employ survival and hazard functions, are optimized by fitting model parameters to experimental dive data. In the work reported here, I develop methods to find the survival function gain parameter analytically, thus removing it from the fitting process. I show that the number of iterations required for model optimization is significantly reduced. The analytic gain method substantially improves the condition number of the Hessian matrix which reduces the model confidence intervals by more than an order of magnitude. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Ethnic differences in certified sickness absence.

    PubMed Central

    Baker, C C; Pocock, S J

    1982-01-01

    The certified sickness absence of 4482 employees in one plant of a large manufacturing company in South-east England was studied for 12 months. The absences in the principal ethnic groups, Caucasian, Asian, and West Indian were compared. After standardisation for age and job grade in each department the Asians had twice the spells per man and nearly twice the days lost per man compared with the Caucasians. Compared with the Caucasians there was slightly more absence in West Indians. Various factors affect absence, and one reason for these differences may be that the three ethnic groups appreciate painful or unpleasant stimuli to a different degree. PMID:7093156

  11. Morbidity, injuries and sick absence in fishermen and seafarers--a prospective study.

    PubMed

    Tomaszunas, S; Wecławik, Z; Lewiński, M

    1988-01-01

    In the period 1986-1988 a prospective study comprising 30 crew members of deep-sea factory-trawlers (altogether 2468 fishermen) and 85 of the merchant navy vessels (total 2906 seafarers). At least one chronic ailment or a deviation from the norm was found in 32.5% of fishermen and in 45.4% of seafarers. On the average the seafarers were older than their counterparts fishermen by 2 years and 2 month. Traumas, fractures, wounds and injuries were the most often, the prevailing reason for the sick absence (619 days sick absence per 1000 fishermen and 1075 days sick absence per 1000 seamen annually). The most frequent in fishermen were: acute infections of the respiratory tract, skin diseases, diseases of the oral cavity and teeth, diseases of the articulations. The diseases of a highest prevalence in seafarers were: acute infections of the respiratory tract, diseases of the oral cavity and teeth, skin diseases, gastritis and duodenitis. There were noted 27 serious ailments and 9 accidents requiring repatriations on shore and home in fishermen and 18 such diseases and 21 accidents in seafarers.

  12. Standardization of motion sickness induced by left-right and up-down reversing prisms

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Vanderploeg, J. M.; Brumley, E. A.; Kolafa, J. J.; Wood, S. J.

    1990-01-01

    Reversing prisms are known to produce symptoms of motion sickness, and have been used to provide a chronic stimulus for training subjects on symptom recognition and regulation. However, testing procedures with reversing prisms have not been standardized. A set of procedures were evaluated which could be standardized using prisms for provocation and to compare the results between Right/Left Reversing Prisms (R/L-RP) and Up/Down Reversing Prisms (U/D-RP). Fifteen subjects were tested with both types of prisms using a self paced walking course throughout the laboratory with work stations established at specified intervals. The work stations provided tasks requiring eye-hand-foot coordination and various head movements. Comparisons were also made between these prism tests and two other standardized susceptibility tests, the KC-135 parabolic static chair test and the Staircase Velocity Motion Test (SVMT). Two different types of subjective symptom reports were compared. The R/L-RP were significantly more provocative than the U/D-RP. The incidence of motion sickness symptoms for the R/L-RP was similar to the KC-135 parabolic static chair test. Poor correlations were found between the prism tests and the other standardized susceptibility tests, which might indicate that different mechanisms are involved in provoking motion sickness for these different tests.

  13. Standardization of motion sickness induced by left-right and up-down reversing prisms

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Vanderploeg, J. M.; Brumley, E. A.; Kolafa, J. J.; Wood, S. J.

    1990-01-01

    Reversing prisms are known to produce symptoms of motion sickness, and have been used to provide a chronic stimulus for training subjects on symptom recognition and regulation. However, testing procedures with reversing prisms have not been standardized. A set of procedures were evaluated which could be standardized using prisms for provocation and to compare the results between Right/Left Reversing Prisms (R/L-RP) and Up/Down Reversing Prisms (U/D-RP). Fifteen subjects were tested with both types of prisms using a self paced walking course throughout the laboratory with work stations established at specified intervals. The work stations provided tasks requiring eye-hand-foot coordination and various head movements. Comparisons were also made between these prism tests and two other standardized susceptibility tests, the KC-135 parabolic static chair test and the Staircase Velocity Motion Test (SVMT). Two different types of subjective symptom reports were compared. The R/L-RP were significantly more provocative than the U/D-RP. The incidence of motion sickness symptoms for the R/L-RP was similar to the KC-135 parabolic static chair test. Poor correlations were found between the prism tests and the other standardized susceptibility tests, which might indicate that different mechanisms are involved in provoking motion sickness for these different tests.

  14. The impact of childhood sickness on adult socioeconomic outcomes: Evidence from late 19th century America

    PubMed Central

    Warren, John Robert; Knies, Laurie; Haas, Steven; Hernandez, Elaine M.

    2013-01-01

    We use family fixed-effects models to estimate the impact of childhood health on adult literacy, labor force outcomes, and marital status among pairs of white brothers observed as children in the 1880 U.S. Census and then as adults in the 1900–1930 Censuses. Given our focus on the 19th century, we observed a wider array of infectious, chronic, and traumatic health problems than is observed using data that are more recent; our results thus provide some insights into circumstances in modern developing countries where similar health problems are more frequently observed. Compared to their healthy siblings, sick brothers were less likely to be located (and thus more likely to be dead) 20–50 years after their 1880 enumeration. Sick brothers were also less likely to be literate, to have ever been married, and to have reported an occupation. However, among those with occupations, sick and healthy brothers tended to do similar kinds of work. We discuss the implications of our results for research on the impact of childhood health on socioeconomic outcomes in developed and developing countries. PMID:22809795

  15. Organizational characteristics as predictors of work disability: a prospective study among sick employees of for-profit and not-for-profit organizations.

    PubMed

    Schröer, C A P; Janssen, M; van Amelsvoort, L G P M; Bosma, H; Swaen, G M H; Nijhuis, F J N; van Eijk, J

    2005-09-01

    This article reports a prospective study that focused on the influence of organizational structure and organizational culture on the outcome of sickness absence, return to work or work disability. Former studies of determinants of work disability hardly have given attention to organizational characteristics and, if so, not following a appropriate prospective design. The study population consisted of 455 employees of 45 for-profit and not-for-profit companies participating in the Maastricht Cohort Study on fatigue at work who were on sick leave for at least 6 weeks. Both independent variables which were type of company, size, centralization of decision making and organizational culture, and covariates, which were sex, age, educational level, fatigue, and chronic illness, were all measured before employees reported sick. The dependent variable outcome of the sickness absence, mainly return to work or work disability, was measured 15 months after reporting sick. Multilevel logistic regression analysis, with organizational characteristics as level 2 independent variables and demographic and health characteristics as covariates, suggested that the type of company (for-profit/private or not-for-profit/public) is predictive of the outcome of sickness absence (crude OR = 2.21; CI: 1.16-4.20), but this may be partially due to a higher proportion of fatigued and chronically ill employees in not-for-profit companies (adjusted OR = 2.09; CI: 0.93-4.37). Findings about the role of some other organizational characteristics, like organizational culture, were inconclusive. Organizational characteristics should next to health characteristics be included in the models of studies which aim at predicting which sick employees are at risk for work disability. To prevent work disability not-for-profit companies might be stimulated to more active return-to-work policy by charging them with the costs of it.

  16. Comparative characteristics of Staphylococcus sciuri, Staphylococcus lentus and Staphylococcus gallinarum isolated from healthy and sick hosts.

    PubMed

    Adegoke, G O

    1986-02-01

    Of 136 strains of coagulase-negative staphylococci isolated from healthy and sick human beings, goats, sheep, antelope and other animals, 88 (64.7%) were Staphylococcus sciuri and 35 (25.7%) were S. lentus and the remainder Staphylococcus gallinarum. The strains of S. sciuri were isolated from humans with boils and wounds, goats with pestes des petits ruminants (PPR) and dogs with nasal discharge. One isolate of S. gallinarum came from a fowl with chronic respiratory disease and 11 others were isolated from goats. The characteristics of S. sciuri, S. lentus and S. gallinarum isolated from different sources were similar.

  17. Serum sickness reaction with skin involvement induced by bee venom injection therapy

    PubMed Central

    Seo, Hyun-Jung

    2015-01-01

    Bee venom injection therapy is an alternative treatment sometimes used for chronic inflammatory diseases, including rheumatoid arthritis and multiple sclerosis, to reduce pain. Several chemical components of bee venom have anti-inflammatory effects, and apitoxin, one of the mixed components, has been used for pain prevention therapy. However, there have been no large-scale investigations regarding the efficacy or side effects or apitoxin. In this study, a case of serum sickness reaction that developed after receiving bee venom injection therapy is reported. PMID:26539406

  18. Reliability of provocative tests of motion sickness susceptibility

    NASA Technical Reports Server (NTRS)

    Calkins, D. S.; Reschke, M. F.; Kennedy, R. S.; Dunlop, W. P.

    1987-01-01

    Test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: (1) Coriolis sickness sensitivity test; (2) staircase velocity movement test; and (3) parabolic flight static chair test. The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability.

  19. Systematic review of active workplace interventions to reduce sickness absence

    PubMed Central

    2013-01-01

    Background The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. Aims To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. Methods We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with an active role in the intervention, (ii) intervention done partly or fully at the workplace or at the initiative of the workplace and (iii) sickness absence reported. Two reviewers independently screened articles, extracted data and assessed risk of bias. A narrative synthesis was used. Results We identified 2036 articles of which, 93 were assessed in full text. Seventeen articles were included (2 with low and 15 with medium risk of bias), with a total of 24 comparisons. Five interventions from four articles significantly reduced sickness absence. We found moderate evidence that graded activity reduced sickness absence and limited evidence that the Sheerbrooke model (a comprehensive multidisciplinary intervention) and cognitive behavioural therapy (CBT) reduced sickness absence. There was moderate evidence that workplace education and physical exercise did not reduce sickness absence. For other interventions, the evidence was insufficient to draw conclusions. Conclusions The review found limited evidence that active workplace interventions were not generally effective in reducing sickness absence, but there was moderate evidence of effect for graded activity and limited evidence for the effectiveness of the Sheerbrooke model and CBT. PMID:23223750

  20. 75 FR 75363 - Absence and Leave; Sick Leave

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... leave for general family care and bereavement purposes is permitted under the law. Section 6311 gives... condition, establishing 13 days of sick leave for general family care and bereavement, and permitting an agency to advance sick leave for general family care and bereavement). Enacted in 1994, the ]...

  1. Locality and habitus: the origins of sickness absence practices.

    PubMed

    Virtanen, P; Nakari, R; Ahonen, H; Vahtera, J; Pentti, J

    2000-01-01

    This article aims to understanding the differences observed in the sickness absence practices of three municipal work organisations. Sickness absence figures were contextualised with a two-level analysis. The working communities were studied with the material collected for the study from documents, interviews, and a postal questionnaire survey on psychosocial working conditions. At the locality level the quality and quantity of economic, social, and cultural capitals were assessed. On the basis of this material, community diagnoses of the three localities are presented. The relationship of the way of life and being ill in the locality to the sickness absences among the employees of the municipality is discussed using the concepts of 'field', 'habitus', 'practice' and 'capital' as presented by Bourdieu. Sickness absence practices seem to be connected to the relative dominance of social classes in the locality. We conclude that the sickness absence practice of the municipal working community is an expression of the sickness absence habitus which is deeply rooted in the social history of the locality and in the health-related behaviour of the residents. In being not too structuralistic and not too relativistic, Bourdieu's theory helps us to understand the reality of the sickness absences; they can only be influenced marginally and temporarily by simple intervention measures in the work-places. More lasting changes in the level of sickness absences would require profound changes in the working community and-ultimately-in the whole locality.

  2. Xylazine emesis, yohimbine and motion sickness susceptibility in the cat

    NASA Technical Reports Server (NTRS)

    Lucot, James B.; Crampton, George H.

    1986-01-01

    The possible role of the alpha-2 adrenoceptors in xylazine-induced vomiting and in motion sickness was investigated. Cats were divided into two groups according to motion sickness susceptibility and were observed after s.c. injections of xylazine. The incidence of vomiting increased with the dose, and at each dose the high susceptibility group had a greater emetic incidence than the low susceptibility group. In another experiment with cats divided into two groups according to motion sickness susceptibility, s.c. administration of yohimbine effectively antagonized the xylazine-induced emesis in both susceptibility groups. The cats in the latter experiment were then challenged with a motion sickness stimulus after s.c. pretreatment with yohimbine. Yohimbine failed to prevent motion sickness but did occasion an unexplained variability in the incidence of vomiting. These findings suggest that the emetic effect of xylazine results from stimulation of alpha-2 adrenoceptors but that these receptors are not fundamental to feline motion sickness. The fact that susceptibilities to xylazine-induced emesis and to motion sickness are correlated suggests a point of interaction other than the area postrema, which is known to be essential for xylazine-induced vomiting but not for motion sickness in the cat.

  3. Early Effects of the San Francisco Paid Sick Leave Policy

    PubMed Central

    Colla, Carrie H.; Dow, William H.; Dube, Arindrajit; Lovell, Vicky

    2014-01-01

    Objectives. We examined employers’ responses to San Francisco, California’s 2007 Paid Sick Leave Ordinance. Methods. We used the 2009 Bay Area Employer Health Benefits Survey to describe sick leave policy changes and the policy’s effects on firm (n = 699) operations. Results. The proportion of firms offering paid sick leave in San Francisco grew from 73% in 2006 to 91% in 2009, with large firms (99%) more likely to offer sick leave than are small firms (86%) in 2009. Most firms (57%) did not make any changes to their sick leave policy, although 17% made a major change to sick leave policy to comply with the law. Firms beginning to offer sick leave reported reductions in other benefits (39%), worse profitability (32%), and increases in prices (18%) but better employee morale (17%) and high support for the policy (71%). Many employers (58%) reported some difficulty understanding legal requirements, complying administratively, or reassigning work responsibilities. Conclusions. There was a substantial increase in paid sick leave coverage after the mandate. Employers reported some difficulties in complying with the law but supported the policy overall. PMID:24432927

  4. The Role of Work Group in Individual Sickness Absence Behavior

    ERIC Educational Resources Information Center

    Vaananen, Ari; Tordera, Nuria; Kivimaki, Mika; Kouvonen, Anne; Pentti, Jaana; Linna, Anne; Vahtera, Jussi

    2008-01-01

    The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey, and data on sickness absence…

  5. 31 CFR 29.332 - Unused sick leave.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Satisfied by June 30, 1997 § 29.332 Unused sick leave. (a) For employees separated for retirement as of June... the applicable plan. (b) For employees separated for retirement after June 30, 1997, no unused sick leave is creditable toward Federal Benefit Payments. ...

  6. 5 CFR 831.302 - Unused sick leave.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... annuity is increased by the days of unused sick leave to his credit under a formal leave system. (b) An...) A formal leave system is one which is provided by law or regulation or operates under written rules... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Unused sick leave. 831.302 Section...

  7. 5 CFR 630.502 - Sick leave recredit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... different leave systems under section 6308 of title 5, United States Code, 7 calendar days of sick leave are... leave system to which he or she can transfer only a part of his or her sick leave is entitled to a... employee returns to the leave system under which it was earned on or after December 2, 1994. (f)...

  8. Living and working with sickness: a qualitative study.

    PubMed

    Edwards, Suzanne; Gabbay, Mark

    2007-06-01

    To explore patients' views and experiences of long-term sickness absence, and their attitudes with regard to return to work. The study design and analysis were guided by a narrative psychology perspective. In-depth, biographical narrative interviews were conducted with 26 individuals, aged between 30 and 65 years, who had been certified absent for longer than 6 weeks. Follow-up data were collected at 12 months. The narrative analysis techniques used were holistic content, holistic form, categorical content, and categorical form. This paper illustrates our findings obtained mainly using the holistic-form approach. Long-term absence reduces attachment to work and impacts on work identity. Three distinct narrative patterns emerged from the data analysis. The first was 'uncomplicated absence', usually triggered by an acute event with an uncomplicated resolution; the second, 'complicated absence', typically involved gradually deteriorating health and social complications with a less predictable recovery; the third pattern, 'sustained absence', was associated with chronic deterioration in health, often complex and multidimensional in nature. These three patterns offer an insight into how well individuals are coping with their underlying health condition. Narrative analysis tools could be developed to help identify those patients who would: (1) respond favourably to 'return to work' interventions; or (2) benefit from additional health service support.

  9. Late Stage Infection in Sleeping Sickness

    PubMed Central

    Acker, Sven; Frey, Claudia; Meinert, Monika; Schönfeld, Caroline; Lazarus, Michael; Urade, Yoshihiro; Kubata, Bruno Kilunga; Duszenko, Michael

    2012-01-01

    At the turn of the 19th century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles. PMID:22496723

  10. Morning sickness: impact on offspring salt preference.

    PubMed

    Crystal, S R; Bernstein, I L

    1995-12-01

    These studies examined the relationship between salt preference of adult offspring and their mothers' symptoms of morning sickness during pregnancy. College students who could provide information about their mothers' symptoms of morning sickness completed a survey about their dietary salt intake (study 1; n = 169) or rated and consumed ten snack foods (study 2; n = 66). In study 1 a salt-use score was calculated based on responses to the Salt Intake Questionnaire; offspring of women with moderate or severe vomiting reported a significantly higher level of salt use (p < 0.01) than those whose mothers report little or no symptoms. In study 2 saltiness and pleasantness ratings of high-salt foods, intake of those foods and total sodium intake were the focus of analysis. Offspring of women reporting moderate or severe vomiting showed a significantly greater preference for the snack food subjects rated as saltiest than those whose mothers reported no or mild vomiting. They also ate more of that food and consumed more total sodium during the test session. Effects were stronger in Caucasian than Asian subjects. These studies suggest that moderate to severe vomiting during pregnancy can be associated with significantly higher salt intake in offspring. Thus, a gestational event may be an important determinant of salt intake and preference in adulthood.

  11. Late stage infection in sleeping sickness.

    PubMed

    Wolburg, Hartwig; Mogk, Stefan; Acker, Sven; Frey, Claudia; Meinert, Monika; Schönfeld, Caroline; Lazarus, Michael; Urade, Yoshihiro; Kubata, Bruno Kilunga; Duszenko, Michael

    2012-01-01

    At the turn of the 19(th) century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles.

  12. The impact of downsizing on remaining workers' sickness absence.

    PubMed

    Østhus, Ståle; Mastekaasa, Arne

    2010-10-01

    It is generally assumed that organizational downsizing has considerable negative consequences, not only for workers that are laid off, but also for those who remain employed. The empirical evidence with regard to effects on sickness absence is, however, inconsistent. This study employs register data covering a major part of the total workforce in Norway over the period 2000-2003. The number of sickness absence episodes and the number of sickness absence days are analysed by means of Poisson regression. To control for both observed and unobserved stable individual characteristics, we use conditional (fixed effects) estimation. The analyses provide some weak indications that downsizing may lead to slightly less sickness absence, but the overall impression is that downsizing has few if any effects on the sickness absence of the remaining employees.

  13. Motion sickness elicited by passive rotation in squirrel monkeys

    NASA Technical Reports Server (NTRS)

    Daunton, Nancy G.; Fox, Robert A.

    1991-01-01

    Current theory and recent evidence suggest that motion sickness occurs under conditions of sensory input in which the normal motor programs for producing eye, head, and body movements are not functionally effective, i.e. under conditions in which there are difficulties in maintaining posture and controlling eye movements. Conditions involving conflicting or inconsistent visual-vestibular (VV) stimulation should thus result in greater sickness rates since the existing motor programs do not produce effective control of eye-head-body movements under such conditions. It is felt that the relationship of postural control to motion sickness is an important one and one often overlooked. The results are reported which showed that when postural requirements were minimized by fully restraining squirrel monkeys during hypogravity parabolic flight, no animals became motion sick, but over 80 percent of the same 11 animals became sick if they were unrestrained and maintained control of their posture.

  14. Stroboscopic Vision as a Treatment for Space Motion Sickness

    NASA Technical Reports Server (NTRS)

    Reschke, Millard F.; Somers, Jeffrey T.; Ford, George; Krnavek, Jody M.

    2007-01-01

    Results obtained from space flight indicate that most space crews will experience some symptoms of motion sickness causing significant impact on the operational objectives that must be accomplished to assure mission success. Based on the initial work of Melvill Jones we have evaluated stroboscopic vision as a method of preventing motion sickness. Given that the data presented by professor Melvill Jones were primarily post hoc results following a study not designed to investigate motion sickness, it is unclear how motion sickness results were actually determined. Building on these original results, we undertook a three part study that was designed to investigate the effect of stroboscopic vision (either with a strobe light or LCD shutter glasses) on motion sickness using: (1) visual field reversal, (2) Reading while riding in a car (with or without external vision present), and (3) making large pitch head movements during parabolic flight.

  15. Desensitization protocol for rituximab-induced serum sickness.

    PubMed

    Fajt, Merritt L; Petrov, Andrej A

    2014-01-01

    Rituximab, a chimeric anti-CD20 monoclonal antibody, is used to treat rheumatologic and hematologic diseases. Serum sickness, a Type III delayed hypersensitivity reaction, has been reported with rituximab treatment. Traditionally, drug desensitization has been used to treat Type I IgE-mediated hypersensitivity reactions. We report the first case of successful drug desensitization to rituximab in a patient with medication-induced serum sickness. In our case, a 37-year-old woman with Sjogren's syndrome and papillary thyroid carcinoma developed serum sickness 72 hours following rituximab infusion for gastric mucosal associated lymphoma tissue (MALT). Her MALT progressed after stopping rituximab. She underwent a rapid 12-step intravenous rituximab desensitization without recurrence of serum sickness. Following the completion of 4 rituximab desensitizations, she had gastric MALT remission. She received 25 maintenance rituximab doses using this desensitization protocol quarterly without complications. This is the first report documenting rituximab desensitization for the treatment of delayed drug reactions like serum sickness.

  16. Neuronal mechanisms and the treatment of motion sickness.

    PubMed

    Schmäl, F

    2013-01-01

    The aim of this review is to provide an overview of the physiological basis, clinical picture and treatment options for motion sickness. Motion sickness is a well-known nausea and vomiting syndrome in otherwise healthy people. The physical signs of motion sickness occur in both humans and animals during travel by sea, automobile or airplane and in space. Furthermore, some other special situations, such as simulators, the cinema and video games, have been described as causing pseudomotion sickness. Children between 2 and 12 years old are most susceptible to motion sickness, and women are more frequently affected than men. Predisposing factors include menstruation, pregnancy, migraines and possibly a side difference in the mass of otoconia in the vestibular organs. Therapy is directed towards decreasing conflicting sensory input, accelerating the process of adaptation and controlling nausea and vomiting. To control these vegetative symptoms, scopolamine and antihistamines are the most effective drugs.

  17. The effect of multimorbidity on sickness absence by specific diagnoses.

    PubMed

    Ubalde-Lopez, M; Delclos, G L; Benavides, F G; Calvo-Bonacho, E; Gimeno, D

    2017-03-01

    As the world's population ages, the prevalence of multiple chronic and non-chronic health-related conditions is increasing. Research on multimorbidity, the co-occurrence of two or more health-related conditions, has mainly involved patient and older populations. Its effect in working populations, presumably younger and healthier, is not well known but could conceivably affect sickness absence (SA) and ability to return to work. To examine the effect of multimorbidity on the incidence and duration of SA episodes by frequent diagnostic groups. A prospective study (in 2006-2008) of workers in Spain. Information on health-related conditions was gathered with a standardized questionnaire and used to construct a sex-specific multidimensional multimorbidity score (MDMS). In order to estimate the effect of MDMS on incidence and duration of SA episodes due to cardiovascular diseases (CVD), musculoskeletal disorders (MSD) and mental health disorders (MHD), we fitted Cox models adjusted by age, occupational social class and number of prior SA episodes for both sexes. The study population was 372370. Men with high MDMS showed a trend towards higher incidence risk for SA due to CVD and MSD [adjusted hazard ratio (aHR) = 2.03; 95% confidence interval (CI) 1.48-2.78 and aHR = 1.20; 95% CI 1.01-1.43, respectively]. Women showed a similar trend for MSD, but MHD had the strongest association (aHR = 4.78; 95% CI 1.97-11.62) for high MDMS. In both sexes, the effect of MDMS was strongest among those without a prior SA. No consistent associations with SA duration were observed. Multimorbidity increased the risk of incident musculoskeletal, mental and cardiovascular SA episodes but not their duration.

  18. When Is a Child Too Sick? Devising a "Sick Child" Policy for Your Center

    ERIC Educational Resources Information Center

    Button, Lana

    2008-01-01

    Determining if a child is too sick for child care isn't always easy. The teacher might be convinced the child is too ill for school, while the parent may feel their child is just a little under the weather. One is trying to clear her room of germs and protect the well-being of the other children and the other is trying to get to work. In the…

  19. Overcoming neonatal sickness: Sex-specific effects of sickness on physiology and social behavior.

    PubMed

    Sylvia, Kristyn E; Demas, Gregory E

    2017-10-01

    Early-life environmental stressors, including sickness, have the potential to disrupt development in ways that could severely impact fitness. Despite what is known about the effects of sickness on reproduction, the precise physiological mechanisms have not yet been determined. The goal of this study was to investigate the effects of a neonatal immune challenge on adult reproductive physiology and opposite-sex social behavior. Male and female Siberian hamster (Phodopus sungorus) pups were administered lipopolysaccharide ([LPS]; a cell wall component of gram-negative bacteria) or saline injections on postnatal days 3 and 5 and body mass, food intake, and measures of reproductive maturity were taken throughout development. In adulthood, hamsters were placed in staged mating pairs with reproductively mature individuals of the opposite sex, during which a series of behaviors were scored. We found that although males and females showed no change in food intake, body mass, or reproductive behaviors, LPS-treated females had abnormal estrous cycles and smaller ovaries. Females also showed increased investigation of and increased aggression towards males in a reproductive context. In contrast, LPS-treated males showed no change in any physiological measures, nor did they show any changes in behavior. The present findings demonstrate that females may be more robustly affected by neonatal sickness than males and that these effects could have potential impacts on reproductive success. Collectively, the results of this study can be used to expand upon what is already known about sickness and reproduction, specifically the importance of social behaviors involved in pre-copulation and information necessary to choose the appropriate mate. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. When Is a Child Too Sick? Devising a "Sick Child" Policy for Your Center

    ERIC Educational Resources Information Center

    Button, Lana

    2008-01-01

    Determining if a child is too sick for child care isn't always easy. The teacher might be convinced the child is too ill for school, while the parent may feel their child is just a little under the weather. One is trying to clear her room of germs and protect the well-being of the other children and the other is trying to get to work. In the…

  1. Threshold altitude resulting in decompression sickness

    NASA Technical Reports Server (NTRS)

    Kumar, K. V.; Waligora, James M.; Calkins, Dick S.

    1990-01-01

    A review of case reports, hypobaric chamber training data, and experimental evidence indicated that the threshold for incidence of altitude decompression sickness (DCS) was influenced by various factors such as prior denitrogenation, exercise or rest, and period of exposure, in addition to individual susceptibility. Fitting these data with appropriate statistical models makes it possible to examine the influence of various factors on the threshold for DCS. This approach was illustrated by logistic regression analysis on the incidence of DCS below 9144 m. Estimations using these regressions showed that, under a noprebreathe, 6-h exposure, simulated EVA profile, the threshold for symptoms occurred at approximately 3353 m; while under a noprebreathe, 2-h exposure profile with knee-bends exercise, the threshold occurred at 7925 m.

  2. The Person in a State of Sickness.

    PubMed

    Árnason, Vilhjálmur; Hjörleifsson, Stefán

    2016-04-01

    In this article, we discuss the ideas of Eric J. Cassell about the patient-professional relationship. We argue that his approach combines in an interesting way features from the literature on patient autonomy and paternalistic practices. We suggest that these seemingly paternalistic features of practicing medicine, which are widely either ignored or condemned in bioethical discussion, are of vital significance in medical practice. In the first sections of the article, we describe the main features of Cassell's understanding of the sick person and his version of personalized medicine. We pay particular attention to his notion of information control and compare his ideas about conversation with patients to Hans-Georg Gadamer's analysis of patient-professional dialogue. In the latter part of the article, we explore through a couple of examples the implications these ideas have for medical practice.

  3. Age, weight and decompression sickness in rats.

    PubMed

    Buzzacott, Peter; Theron, Michael; Mazur, Aleksandra; Wang, Qiong; Lambrechts, Kate; Eftedal, Ingrid; Ardestani, Simin Berenji; Guerrero, François

    2016-01-01

    The aim of this study was to determine if, after controlling for weight, age is associated with decompression sickness (DCS) in rats. Following compression-decompression, male rats aged 11 weeks were observed for DCS. After two weeks recovery, surviving rats were re-dived using the same compression-decompression profile. In this experiment, there was a clear difference between DCS outcome at ages 11 or 13 weeks in matched rats (p = 0.002). Even with weight included in the model, age was significantly associated with DCS (p = 0.01), yet after removal of weight the association was much stronger (p = 0.002). We believe that age is likely to be found associated with the probability of DCS in a larger dataset with a wider range of parameters, after accounting for the effect of weight.

  4. Echo imaging in decompression sickness research

    NASA Astrophysics Data System (ADS)

    Olson, Robert M.; Pilmanis, Andrew A.; Scoggins, Terrell E.

    For two decades a noninvasive, ultrasonic Doppler device has been available to detect the bubbles associated with decompression sickness (DCS) in humans. Although it is of undisputed value in DCS research, this device has some limitations. First, the signals from the bubbles produce sounds rather than visual images. Second, the bubbles have to be in motion and thus in the vascular system to be detected. Finally, no estimate of bubble size is easily available. A new type of ultrasonic device which overcomes these limitations has recently become available. This device was used to examine four decompressed subjects and it was found that this new device produces visual images of bubbles. These bubbles can be seen even if they are outside the vascular system and thus stationary. A preliminary attempt at estimating bubble size with this device is presented.

  5. Side effects of antimotion sickness drugs

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Manno, J. E.; Manno, B. R.; Redetzki, H. M.; Wood, M. D.; Vekovius, W. A.

    1984-01-01

    The effects on operational proficiency of the antimotion sickness drugs scopolamine, promethazine and d-amphetamine are tested using a computerized pursuit meter. Proficiency is not significantly affected by oral doses of 0.25 mg or 0.50 mg scopolamine but is descreased by oral or I.M. doses of 25 mg promethazine. The performance decrement associated with 25 mg oral promethazine is prevented when combined with 10 mg oral d-amphetamine. The combination of 25 mg I.M. promethazine, 25 mg oral promethazine and 10 mg d-amphetamine produces less performance decrement than oral or I.M. doses of promethazine alone, though more performance decrement than a placebo. I.M. promethazine is adsorbed slowly and consequently may provoke drowsiness.

  6. Motion Sickness Treatment Apparatus and Method

    NASA Technical Reports Server (NTRS)

    Reschke, Millard F. (Inventor); Somers, Jeffrey T. (Inventor); Ford, George A. (Inventor)

    2005-01-01

    Methods and apparatus are disclosed for treating motion sickness. In a preferred embodiment a method of the invention comprises operating eyewear having shutter lenses to open said shutter lenses at a selected operating frequency ranging from within about 3 Hz to about 50 Hz. The shutter lenses are opened for a short duration at the selected operating frequency wherein the duration is selected to prevent retinal slip. The shutter lenses may be operated at a relatively slow frequency of about 4 Hz when the user is in passive activity such as riding in a boat or car or in limited motion situations in a spacecraft. The shutter lenses may be operated at faster frequencies related to motion of the user's head when the user is active.

  7. Side effects of antimotion sickness drugs

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Manno, J. E.; Manno, B. R.; Redetzki, H. M.; Wood, M. D.; Vekovius, W. A.

    1984-01-01

    The effects on operational proficiency of the antimotion sickness drugs scopolamine, promethazine and d-amphetamine are tested using a computerized pursuit meter. Proficiency is not significantly affected by oral doses of 0.25 mg or 0.50 mg scopolamine but is descreased by oral or I.M. doses of 25 mg promethazine. The performance decrement associated with 25 mg oral promethazine is prevented when combined with 10 mg oral d-amphetamine. The combination of 25 mg I.M. promethazine, 25 mg oral promethazine and 10 mg d-amphetamine produces less performance decrement than oral or I.M. doses of promethazine alone, though more performance decrement than a placebo. I.M. promethazine is adsorbed slowly and consequently may provoke drowsiness.

  8. Threshold altitude resulting in decompression sickness

    NASA Technical Reports Server (NTRS)

    Kumar, K. V.; Waligora, James M.; Calkins, Dick S.

    1990-01-01

    A review of case reports, hypobaric chamber training data, and experimental evidence indicated that the threshold for incidence of altitude decompression sickness (DCS) was influenced by various factors such as prior denitrogenation, exercise or rest, and period of exposure, in addition to individual susceptibility. Fitting these data with appropriate statistical models makes it possible to examine the influence of various factors on the threshold for DCS. This approach was illustrated by logistic regression analysis on the incidence of DCS below 9144 m. Estimations using these regressions showed that, under a noprebreathe, 6-h exposure, simulated EVA profile, the threshold for symptoms occurred at approximately 3353 m; while under a noprebreathe, 2-h exposure profile with knee-bends exercise, the threshold occurred at 7925 m.

  9. Motion sickness history, food neophobia, and sensation seeking.

    PubMed

    Alley, Thomas R; Willet, Kathleen A; Muth, Eric R

    2006-06-01

    Motion sickness is believed to be caused by conflicting sensory signals, a situation that mimics the effects of ingesting certain toxins. Thus, one might suspect that individuals who have experienced a relatively high frequency of motion sickness may be particularly vigilant about avoiding anything that produces nausea, induding potentially nauseating toxins. Consequently, they may be more resistant to trying new foods, i.e., be more food neophobic, since unfamiliar foods can have unexpected adverse effects due to toxins or allergens. Likewise, many highly stimulating experiences can trigger motion sickness, so individuals who are more susceptible may be more prone to avoid such experiences, i.e., be less sensation seeking. Finally, it was expected that food neophobia would be more frequent in individuals low on sensation seeking tendencies. Self-reported motion sickness history in 308 adults (M= 18.8 yr.; SD = 1.6) was correlated with scores on the Arnett Inventory of Sensation Seeking and the Food Neophobia Scale. As predicted, greater history of motion sickness was associated with lower Sensation Seeking scores. Food Neophobia was not correlated with motion sickness history but, as expected, was negatively correlated (r = -.42) with scores on Sensation Seeking. Further research is recommended that measures actual sensitivity to motion sickness.

  10. Psychosocial work characteristics and sickness absence in Japanese employees.

    PubMed

    Ishizaki, Masao; Kawakami, Norito; Honda, Ryumon; Nakagawa, Hideaki; Morikawa, Yuko; Yamada, Yuichi

    2006-09-01

    This study was undertaken to examine the association between sickness absence in Japanese employees and job demand/control and occupational class as psychosocial work characteristics. The study was cross-sectional in design with data collected from 20,464 male and 3,617 female employees, whose mean age was 40.9 years (SD +/- 9.1 years) and 36.9 years (SD +/- 10.8 years), respectively. The participants were asked to write the total number of sick leaves they had taken during the past year, and a comparison was made between the group with more than 6 days of sickness absence and the group with 0-6 days as a reference group. Job demands, job control, and worksite support from supervisors and colleagues were analyzed by the Job Content Questionnaire, and likewise by the Generic Job Stress Questionnaire of the National Institute for Occupational Safety and Health. Both low job control and low support at the worksite were associated with a high frequency of sickness absence. But there was no clear relationship between job demands and sickness absence. The lowest sickness absence rate was found in male managers and the highest in male and female laborers. This is the first report of a large-scale survey of Japanese employees to show a high frequency of sickness absence associated with increased work stress and a socioeconomically low occupational class.

  11. Advances in Pharmacotherapeutics of Space Motion Sickness

    NASA Technical Reports Server (NTRS)

    Putcha, Lakshmi

    2006-01-01

    Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

  12. Advances in Pharmacotherapeutics of Space Motion Sickness

    NASA Technical Reports Server (NTRS)

    Putcha, Lakshmi

    2006-01-01

    Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

  13. Is adiposopathy (sick fat) an endocrine disease?

    PubMed Central

    Bays, H E; González-Campoy, J M; Henry, R R; Bergman, D A; Kitabchi, A E; Schorr, A B; Rodbard, H W

    2008-01-01

    Objective To review current consensus and controversy regarding whether obesity is a ‘disease’, examine the pathogenic potential of adipose tissue to promote metabolic disease and explore the merits of ‘adiposopathy’ and ‘sick fat’ as scientifically and clinically useful terms in defining when excessive body fat may represent a ‘disease’. Methods A group of clinicians and researchers, all with a background in endocrinology, assembled to evaluate the medical literature, as it pertains to the pathologic and pathogenic potential of adipose tissue, with an emphasis on metabolic diseases that are often promoted by excessive body weight. Results The data support pathogenic adipose tissue as a disease. Challenges exist to convince many clinicians, patients, healthcare entities and the public that excessive body fat is often no less a ‘disease’ than the pathophysiological consequences related to anatomical abnormalities of other body tissues. ‘Adiposopathy’ has the potential to scientifically define adipose tissue anatomic and physiologic abnormalities, and their adverse consequences to patient health. Adiposopathy acknowledges that when positive caloric balance leads to adipocyte hypertrophy and visceral adiposity, then this may lead to pathogenic adipose tissue metabolic and immune responses that promote metabolic disease. From a patient perspective, explaining how excessive caloric intake might cause fat to become ‘sick’ also helps provide a rationale for patients to avoid weight gain. Adiposopathy also better justifies recommendations of weight loss as an effective therapeutic modality to improve metabolic disease in overweight and obese patients. Conclusion Adiposopathy (sick fat) is an endocrine disease. PMID:18681905

  14. Measuring sickness behavior in the context of pancreatic cancer.

    PubMed

    Tobias, Kristen; Rosenfeld, Barry; Pessin, Hayley; Breitbart, William

    2015-03-01

    Sickness behavior has been widely recognized as a symptom cluster that is associated with pro-inflammatory cytokine activation resulting from diverse conditions. The symptoms that comprise sickness behavior overlap substantially with major depressive disorder (MDD), which raises questions about the relationship between these two constructs, both of which occur frequently in patients with cancer. The construct of sickness behavior, while well-established in animal research, has rarely been applied to studies examining cytokines and depression in