Avaliação do desconforto sensorial causado por estimulação com realidade virtual em voluntários com e sem cinetose / Evaluation of sensory discomfort caused by stimulation with virtual reality in volunteers with and without kinetosis

RESUMO Objetivo comparar os sintomas da cinetose provocados por estímulo de realidade virtual, em voluntários com e sem histórico da doença. Métodos estudo analítico qualitativo e quantitativo, observacional transversal, prospectivo, realizado com voluntários com e sem histórico de cinetose, submetidos à imersão em realidade virtual com o uso de óculos de realidade aumentada. Antes e após a estimulação sensorial, o participante tinha a frequência respiratória (FR), a frequência cardíaca (FC) e pressão arterial sistólica (PAs) e diastólica (PAd) medidas. No primeiro dia, o voluntário foi exposto a um vídeo que simulava uma pessoa dentro de um carro, com predomínio de fluxo visual lateral. Após uma semana, uma animação de montanha russa, com predomínio de fluxo visual frontal. Durante a estimulação sensorial de dez minutos, uma nota de 0 a 10 era dada a cada 30 segundos para a intensidade do desconforto sentido pelo participante. Após, um questionário foi realizado para avaliação dos sintomas de cinetose. Resultados indivíduos com cinetose apresentaram maior intensidade de sintomas, tanto no experimento do carro (p=0,026), como na montanha russa (p=0,035). Não houve correlação entre cinetose e as variáveis FC, FR e PA. Os pacientes com cinetose atribuíram maiores notas de desconforto no curso das experiências, principalmente na experiência da montanha russa. Conclusão indivíduos com cinetose apresentam sintomas mais intensos quando submetidos a estímulos por realidade virtual, se comparados a indivíduos sem a doença.

ABSCTRACT Purpose to compare the symptoms of motion sickness caused by virtual reality stimulation in volunteers with and without history of the disease. Methods qualitative and analytical, observational, cross-sectional, and prospective study, approved by Research Ethics Committee, 3.443.429/19, with volunteers with and without history of motion sickness who were subjected to immersion in VR with the use of virtual reality glasses. Before and after sensory stimulation, the participant had respiratory rate (RF), heart rate (HR) and systolic blood pressure (PAs) and diastolic blood pressure (PAd) measured. On the first day, the volunteer was exposed to a video that simulated a person in a car, with a predominance of lateral visual flow. A week later, an animation of a roller coaster, with a predominance of frontal visual flow. During the 10-minute experiment, a score from 0 to 10 was given every 30 seconds for the intensity of the discomfort felt by the volunteer. A post-questionnaire was conducted to assess motion sickness symptoms. Results individuals with motion sickness history had a higher intensity of symptoms in the car (p = 0.026) and roller coaster experiment (p = 0.035). There was no correlation between motion sickness and the variables HR,FR,PA. Patients with motion sickness gave higher scores of discomfort throughout the experiments, mainly in the roller coaster experience. Conclusion individuals with motion sickness present more intense symptoms when subjected to stimuli by VR compared to controls without disease.

Mal de desembarque / Mal de debarquement

Resumen El síndrome de mal de desembarque es un cuadro clínico de mareo y oscilaciones corporales persistente, descrito siglos atrás cuando los marineros llegaban a tierra después de navegar. Actualmente, se sabe que este cuadro clínico ocurre también al bajarse de cualquier medio de transporte, ya sea marítimo, aéreo o terrestre. Cuando el cuadro clínico tiene una duración de tres o más días, se denomina mal de desembarque persistente, y se asocia a cefalea y mayores niveles de ansiedad y síntomas depresivos. A continuación, presentamos el cuadro clínico de un paciente que consultó por mareo persistente posterior a un paseo en bote en el mar. Se discute diagnóstico y manejo terapéutico.

Abstract Mal de Debarquement is a clinical syndrome characterized by persistent self-motion dizziness and increased oscillatory body sway, that was described centuries ago after sailors landed in port. Nowadays, it is known that mal de debarquement could appear after any travel in a motion vehicle, including airplanes, ships and cars. When the duration of the symptoms lasts longer than three days, a persistent mal de debarquement is diagnosed, and it is associated with headache and higher levels of anxiety and depressive symptoms. Here, we present a clinical case of a persistent mal de debarquement that attended to the Otolaryngology clinics at the Clinical Hospital of the University of Chile after a boat trip in the sea. We discuss diagnosis and clinical management.

Adaptación transcultural del cuestionario motion sickness susceptibility questionnaire form short (MSSQ-SHORT) para la población adulta chilena / Cross-cultural adaptation of the motion sickness susceptibility questionnaire form short (MSSQ-SHORT) for the chilean adult population

Resumen Introducción: La cinetosis se relaciona con la presencia de una serie de síntomas que comúnmente son inducidos por situaciones cotidianas de viajes en medios de transporte. Una forma utilizada por décadas para determinar el grado de susceptibilidad a la cinetosis ha sido con la aplicación del cuestionario en su versión acortada Motion Sickness Suscep-tibility-short (MSSQ-short). Objetivo: Adaptar lingüística y transculturalmente al español el cuestionario MSSQ-short. Material y Método: Se llevaron a cabo cuatro etapas: Traducción directa, traducción inversa (retrotraducción), consolidación por un comité de expertos y pretest (aplicabilidad/viabilidad). En la etapa de pre-test 51 personas respondieron el cuestionario. Resultados: La discrepancias encontradas en las primeras etapas fueron resueltas por un tercer traductor, el cual concluyó en un documento final en español que fue analizado y revisado por el comité de expertos. Se determinaron los percentiles del 0 al 100, percentil 50 con 9,0 puntos, percentil 25 con 2,13 puntos y el percentil 75 con 17,4 puntos. La consistencia interna del cuestionario fue de 0,889. Conclusión: La traducción y adaptación transcultural fue aceptada por un comité de expertos y participantes con distintas características demográficas y educacionales. El cuestionario obtuvo buena consistencia interna y resultados concordantes con la versión original.

Abstract Introduction: Motion sickness is related to the presence of a series of symptoms that are typically induced by everyday situations of travel in means of transport. A way used for decades to determine the degree of susceptibility to motion sickness has been with the application of the questionnaire in its shortened version Motion Sickness Susceptibility-short (MSSQ-short). Aim: Linguistically and cross-culturally adapt the MSSQ-short questionnaire to Spanish. Material and Method: Four stages were carried out: direct translation, reverse translation (back translation), consolidation by a committee of experts, and pretest (applicability/feasibility). In the pre-test stage, 51 people answered the questionnaire. Results: The discrepancies found in the early stages were resolved by a third translator, which concluded in a final document in Spanish that was analyzed and reviewed by the expert committee. The percentiles from 0 to 100 were determined, 50th percentile with 9.0 points, 25th percentile with 2.13 points, and 75th percentile with 17.4 points. The internal consistency of the questionnaire was 0.889. Conclusion: The cross-cultural translation and adaptation were accepted by a committee of experts and participants with different demographic and educational characteristics. The questionnaire obtained good internal consistency and results consistent with the original version.

Cumulative incidence and risks factors for postoperative nausea and vomiting in adult patients undergoing cholecystectomy under balanced general anesthesia: a prospective cohort study / Incidencia acumulada y factores de riesgo para náuseas y vómitos posoperatorios en pacientes adultos sometidos a colecistectomía bajo anestesia general balanceada: estudio prospectivo de cohorte

Abstract Introduction: Postoperative nausea and vomiting (PONV) are common issues arising after general anesthesia, for which several independent risk factors (RF) have been described. Objective: To determine the accumulated incidence of PONV during the first 24hours of the postoperative period. Methods: A cohort observational, prospective study was conducted that included all the adults undergoing cholecystectomy under balanced general anesthesia at the EsSalud Talara Hospital from October 2014 until December 2016. The presence of PONV during the first 24hours after surgery was assessed, and univariate, bivariate, and logistic regression analyses were conducted. Results: A total of 244 patients were included, most of them with 2 RFs in the Apfel scale, that represented an accumulated incidence of PONV of 0.51 (95% confidence interval [CI] 0.45-0.57) during the observation period, notwithstanding the fact that 85.25% received antiemetic prophylaxis. The logistic regression analysis identified that being a female (odds ratio [OR] 3.30,95% CI 1.66-6.55, P = 0.0007) and previous PONV or motion sickness (OR 2.67, 95% CI 1.25-5.68, P = 0.011) were independent RFs for PONV. The administration of antiemetic prophylaxis and the presence of PONV (P = 0.92) were found to be independent. Conclusion: The high cumulative incidence of PONV could be the result of the type of surgery, the use of volatile anesthetic agents, and errors in the antiemetic pharmacological prophylaxis.

Resumen Introducción: Las náuseas y vómitos posoperatorios (NVPO) son problemas comunes que aparecen luego de la anestesia general, para los que se han descrito varios factores independientes de riesgo. Objetivo: Determinar la incidencia acumulada de NVPO durante las primeras 24 horas del periodo posoperatorio. Métodos: Se realizó un estudio observacional prospectivo de cohorte que incluyó a todos los adultos sometidos a colecistectomía bajo anestesia general balanceada en el Hospital EsSalud Talara desde octubre de 2014 hasta diciembre de 2016. Se evaluó la presencia de NVPO durante las primeras 24 horas posoperatorias y se ejecutaron análisis univariado, bivariado y de regresión logística. Resultados: Se incluyeron 244 pacientes, la mayoría con dos factores de riesgo en la escala de Apfel, que presentaron una incidencia acumulada de NVPO de 0.51 (IC 95% 0.45-0.57) en el periodo de observación, a pesar de que el 85.25% recibió profilaxis antiemética. El análisis de regresión logística identificó la presencia de sexo femenino (OR 3.30, IC 95% 1.66-6.55, p = 0.0007) y la historia de NVPO previos o cinetosis (OR 2.67, IC 95% 1.25-5.68, p = 0.011) como factores de riesgo independientes para NVPO. Se halló independencia entre la presencia de profilaxis antiemética y la presencia de NVPO (p=0.92). Conclusiones: La alta incidencia acumulada de NVPO pudiera ser ocasionada por el tipo de cirugía, uso de anestésicos volátiles y falencias en la profilaxis farmacológica antiemética.

Dependencia visual en otoneurología: consideraciones clínicas para la rehabilitación vestibular / Visual dependence in otoneurology: clinical considerations for vestibular rehabilitation

RESUMEN Los sistemas vestibular, visual y somatosensorial coordinan el control postural y se adaptan a las actividades cotidianas en diferentes contextos, sin embargo, cuando existe un cuadro clínico con sintomatología vestibular, las ponderaciones de estos sistemas cambian mayoritariamente al sistema visual, creando una dependencia visual. El cerebelo, que es el principal encargado de generar una compensación vestibular en casos de hipofunción vestibular, juega un rol destacado en el aprendizaje motor generando comportamientos adaptativos que se transforman en puntos claves en la rehabilitación vestibular. Este artículo pretende exponer lo que la literatura informa en relación a la dependencia visual en pacientes con hipofunción vestibular.

ABSTRACT The vestibular, visual and somatosensory systems coordinate postural control and adapt to daily activities in different contexts, however, when there is a clinical picture with vestibular symptoms, the weights of these systems change mainly to the visual system, creating a visual dependence. The cerebellum, which is the main responsible for generating vestibular compensation in cases of vestibular hypofunction, plays a prominent role in motor learning generating adaptive behaviors that become key points in vestibular rehabilitation. This article aims to expose what the literature reports in relation to visual dependence in patients with vestibular hypofunction.

Introduction of Cybersickness / 대한이비인후과학회지

With an introduce of virtual reality (VR) technology, the issue of unpleasant side effect of VR immersion has been raised as “cybersickness.” Although exact mechanism of cybersickness is still elusive, sensory conflict theory has been generally accepted as in classic motion sickness. The absence of expected correlated vestibulo-proprioceptive sensory information during VR experience causes sensory conflict, which leads to dizziness, disorientation, nausea and fatigue. Herein, we review the recent literature to build the conceptual scheme for understanding cybersickness. From the brief description of motions sickness, assessment and management of cybersickness is also outlined.

Dizziness after Traumatic Brain Injury: Neurological Aspects / 대한평형의학회지

Vertigo, dizziness, and disequilibrium are common symptoms following concussion or traumatic brain injury. Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine preventative medications. This paper reviews the neurological causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

Aprepitant prophylaxis effectively reduces preventing postoperative nausea and vomiting in patients receiving opioid based intravenous patient-controlled analgesia

BACKGROUND: Aprepitant is effective in prevention of chemotherapy-induced nausea and vomiting, when administrated with other antiemetics. We compared the effectiveness of aprepitant to ondansetron for prevention of post-operative nausea and vomiting (PONV) in patients who received a patient-controlled analgesia (PCA) containing opioids. METHODS: 198 patients were randomized into two groups. The treatment group was received an aprepitant, 80 mg, and the control group received a placebo. General anesthesia with inhalational anesthetics–N2O was performed, and PCA was supplied, which contained opioids-NSAIDs-ondansetron. The primary end-point was the incidence of PONV for postoperative 48 hours, and the secondary end-point was the changes in the relationship between PONV incidence and risk factors. RESULTS: PONV incidence in the treatment group was lower than in the control group (18.6% [95% CI: 10.8–26.3], 33.3% [95% CI: 23.6–43.1], respectively, P = 0.021). Relative risk of PONV in the control group was 1.80 (95% CI: 1.08–3.00, P = 0.010). PONV scores peaked at around postoperative 6 hours, then gradually decreased in the control group but not in the treatment group, which showed lower values than the control group (P = 0.001), and no changing patterns were observed (P < 0.001). Risk factors analyzed were sex, surgery type, history of motion sickness or PONV, and smoking habits. Their effects of all risk factors except sex were abolished in the treatment group. CONCLUSIONS: Prophylactic aprepitant with ondansetron was more effective than ondansetron-only regimen in preventing PONV after volatile anesthesia with opioid-containing PCA. Aprepitant abolished the effects of most of risk factors, so it could be efficacious in a high-risk PONV group.

Revisión bibliográfica y propuesta de guía de manejo para la prevención y rehabilitación de pilotos con predisposición a la aparición de cinetosis / Bibliographic review and guide proposal for the prevention and rehabilitation of pilots predisposed to the appearance of motion sickness

Introducción: La aerocinetosis se caracteriza por la aparición de una sintomatología variada que incluye náuseas y vómitos, mareos, palidez, sudoración, malestar gástrico y en casos más graves alteraciones de la conciencia. Dichos síntomas pueden mantenerse a lo largo de los días aun habiendo acabado la exposición, si la misma fue mantenida en el tiempo. Cuando se presenta en tripulantes puede resultar inhabilitante para la actividad. Objetivos: Se trata de una revisión bibliográfica que cuenta con información obtenida de múltiples fuentes siendo la más importante la que se obtuvo a través de la experiencia personal no solo del autor sino de los especialistas consultados. Material y Método: Describir los aspectos generales del equilibrio en los seres humanos. Describir las principales características de la aerocinetosis. Proponer una guía de manejo para la prevención y rehabilitación de pilotos con predisposición a la aparición de cinetosis. Conclusión: Se realizó en este trabajo una revisión exhaustiva del tema y se aborda la actitud preventiva y terapéutica a seguir, la cual está orientada a brindar información, identificar los síntomas y/o signos y llevar a cabo estrategias de entrenamiento y adaptación al movimiento que le permitirá al piloto que se ve afectado continuar con su actividad de forma adecuada

Introduction: Kinetosis is characterized by the appearance of a varied symptomatology including nausea and vomiting, dizziness, paleness, sweating, gastric discomfort and in more severe cases alterations of consciousness. These symptoms can be maintained throughout the days even if the exposure is finished, if the same was maintained in the time. When it occurs in crew members it can be disabling for the activity. Objectives: To describe the general aspects of balance in humans. Describe the main characteristics of aerocinetosis. To propose a management guide for the prevention and rehabilitation of pilots with predisposition to the onset of motion sickness. Material and method: This is a bibliographical review that has information obtained from multiple sources, the most important of which was obtained through the personal experience of the specialists consulted. Conclusions: A comprehensive review of the topic was carried out and the preventive and therapeutic attitude to be followed, which is aimed at providing information, identifying symptoms and signs and carrying out strategies of training and adaptation to the movement will allow the pilot who is affected to continue his activity properly.

Postoperative nausea and vomiting after general anesthesia for oral and maxillofacial surgery

BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Despite this, few papers have reported the incidence and independent risk factors associated with PONV in the context of oral and maxillofacial surgery (OMFS). Therefore, we sought to determine the incidence of PONV, as well as to identify risk factors for the condition in patients who had undergone OMFS under general anesthesia. METHODS: A total of 372 patients' charts were reviewed, and the following potential risk factors for PONV were analyzed: age, sex, body mass index, smoking status, history of PONV and/or motion sickness, duration of anesthesia, amount of blood loss, nasogastric tube insertion and retention and postoperative opioid used. Univariate analysis was performed, and variables with a P-value less than 0.1 were entered into a multiple logistic regression analysis, wherein P-values 4 h. Furthermore, the number of risk factors was proportional to the incidence of PONV. CONCLUSIONS: The incidence of PONV in patients who have undergone OMFS varies from center to center depending on patient characteristics, as well as on anesthetic and surgical practice. Identifying the independent risk factors for PONV will allow physicians to optimize prophylactic, antiemetic regimens.

2000 CDC or 2007 WHO – What is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6–10 years?

Objective To compare the two anthropometric standards for screening of overweight and cardio-metabolic risk in 6–10-year-old children.Subjects and methods This cross-sectional study included 175 subjects attending the Referral Center for the Treatment of Children and Adolescents in Campos, Rio de Janeiro. They were classified according to CDC and WHO BMI z scores as normal-weight (z-score > –1 and < 1), overweight (z-score ≥ 1 and < 2) or obese (z-score ≥ 2). Sensitivities and specificities in predicting systolic (SBP), diastolic (DBP) blood pressure and homeostatic model assessment insulin resistance index (HOMA-IR) alterations were calculated.Results There was a major difference in 11 children who rated overweight by the CDC but were reclassified as obese by the WHO. Their mean z-scores for SBP (1.71 ± 1.54), DBP (2.64 ± 1.83) and HOMA-IR (1.84 ± 0.98) were higher than those classified as overweight by both references (SBP = 0.49 ± 1.34, p < 0.023, DBP = 1.45 ± 0.97, p < 0.04 and HOMA = 1.24 ± 0.67, p < 0.04), but were similar to those classified as obese by both criteria (SBP = 1.25 ± 2.04, p = 0.60, DBP = 1.94 ± 1.19, p = 0.50 and HOMA = 2.09 ± 1.12, p = 0.76).Conclusion the 2007 WHO reference was the most sensitive in screening for overweight and alterations in blood pressure and HOMA-IR in 6–10-year-old children. Arch Endocrinol Metab. 2015;59(3):220-5.

Therapeutic Properties of Zingiber officinale Roscoe: A Review.

Aims: Ginger, a rhizome of Zingiber officinale Roscoe (Fam. Zingiberaceae), has been widely used as a spice to enhance the flavor of food and beverages and for medical purposes in various diseases. Methodology: The review covers the databases and articles published between 2002- 2013 via Medline and published papers on the Internet from Scientific Information Database, MagIran and Irandoc. Literature searches were performed to identify all the researches on ginger for treatment properties. Results: The researchers conducted on ginger in medical field were about nausea and vomiting in pregnancy, contraceptive pills nausea, dysmenorrhea, motion sickness, cough, ventilator associated pneumonia, rheumatic diseases, antibacterial and antiviral effects, nausea and vomiting due to chemotherapy, spermatogenesis, anti-hyperlipidemia anti-inflammatory, diabetes nephropathy and postoperative nausea and vomiting. Clinical trials about ginger were mostly to prevent and treat nausea and vomiting during pregnancy. Conclusion: According to the published articles, ginger is an extraordinary herb and more detailed clinical trials using ginger are recommended for further studies in future.

Galvanic vestibular stimulation: a novel modulatory countermeasure for vestibular-associated movement disorders / Estimulacao galvanica vestibular para corrigir transtornos neurologicos associados a disfuncao vestibular

Motion sickness or kinetosis is the result of the abnormal neural output originated by visual, proprioceptive and vestibular mismatch, which reverses once the dysfunctional sensory information becomes coherent. The space adaptation syndrome or space sickness relates to motion sickness; it is considered to be due to yaw, pith, and roll coordinates mismatch. Several behavioural and pharmacological measures have been proposed to control these vestibular-associated movement disorders with no success. Galvanic vestibular stimulation has the potential of up-regulating disturbed sensory-motor mismatch originated by kinetosis and space sickness by modulating the GABA-related ion channels neural transmission in the inner ear. It improves the signal-to-noise ratio of the afferent proprioceptive volleys, which would ultimately modulate the motor output restoring the disordered gait, balance and human locomotion due to kinetosis, as well as the spatial disorientation generated by gravity transition.

A cinetose ou doença do movimento resulta de uma resposta neural anormal originada do desequilíbrio entre estímulos visuais, proprioceptivos e vestibulares, que melhora quando esse desequilíbrio é corrigido. A síndrome de adaptação espacial ou doença do espaço está relacionada à doença do movimento e é desencadeada por mudanças bruscas de direção, inclinação e rotação da cabeça. Têm sido propostas várias medidas comportamentais e farmacológicas para controlar esses transtornos do movimento associados com o sistema vestibular, mas sem sucesso. A estimulação galvânica vestibular pode regular o desequilíbrio sensitivo-motor causado pela cinetose e pela doença do espaço modulando os canais iônicos GABA, relacionados à transmissão de impulsos nervosos no ouvido interno. Essa estimulação melhora a relação sinal-ruído dos impulsos proprioceptivos que acabam modulando a resposta motora, restabelecendo o equilíbrio e a marcha, recuperando a desorientação espacial causada pelos diversos gradientes de gravidade.

A randomized controlled trial: acclimatization training on the prevention of motion sickness in hot-humid environment / 中国应用生理学杂志

<p><b>OBJECTIVE</b>Incidence and severity of motion sickness (MS) in hot-humid environment are extremely high. We tried to know the effect of two-stage training for reducing incidence and severity of ms.</p><p><b>METHODS</b>Sixty male subjects were divided into experimental group and control group randomly. Subjects in experimental group received: (2) adaptation training including sitting, walking and running in hot lab. After adaptation confirmation based on subjective feeling, rectal temperature, heart rate, blood Pressure, sweat rates and sweat salt concentration, we tested both groups by Coriolis acceleration revolving chair test and recorded Graybiel's score and grading of severity to evaluate whether adaptation training was useful; (2) Anti-dizzy training 3m later of deacclimatization contained revolving chair training for 10 times. Then we did the same test as mentioned above to evaluate effect of anti-dizzy training. RESULST: Graybiel' s score and grading of severity had no difference between two groups through acclimatization training (P > 0.05). While they had difference through anti-dizzy training (P < 0.01).</p><p><b>CONCLUSION</b>Adaptation training seems useless for reducing incidence and severity of MS in hot-humid environment, but anti-dizzy training is useful.</p>

Controlled observation of the efficacy on motion sickness in the prevention and treatment with jianpixingnao needling therapy / 中国针灸

<p><b>OBJECTIVE</b>To verify the efficacy of Jianpi-xingniao needling therapy on prevention and treatment of motion sickness.</p><p><b>METHODS</b>Sixty volunteers of motion sickness were randomized into an acupuncture group and a delayed acupuncture group, 30 cases in each one. In the acupuncture group, acupuncture was given at Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36) and Hegu (LI 4). The needles were retained for 20 min. The treatment was given twice a week and 10 treatments were required. In the delayed acupuncture group, acupuncture was postponed, meaning no acupuncture during observation stage. Graybel scale was adopted to observe the score of symptoms and physical signs of the subjects of motion sickness before and after intervention. The efficacy was compared between the two groups.</p><p><b>RESULTS</b>Twenty-five cases in the acupuncture group and 22 cases in the delayed acupuncture group were included in the statistical analysis. The score of symptoms and physical signs of motion sickness was reduced significantly after treatment in the acupuncture group as compared with that before treatment (10.12 +/- 3.37 vs 0.92 +/- 0.40, P < 0.05). The score in the acupuncture group was lower apparently than that in the delayed acupuncture group (0.92 +/- 0.40 vs 9.86 +/- 2.53, P < 0.05). The difference was not significant before and after treatment in the self-comparison of the delayed acupuncture group (P > 0.05). The total effective rate was 96.0% (24/25) in the acupuncture group, which was significantly better than 0.0% (0/22) in the delayed acupuncture group (P < 0.01).</p><p><b>CONCLUSION</b>Jianpixingniao needling therapy relieves the symptoms of motion sickness in the patients and achieves a better clinical efficacy.</p>

Systematic review of the effect of dried ginger powder on improvement of nausea and vomiting associated with early pregnancy or motion sickness / 한국영양학회지

PURPOSE: Ginger (Zingiber officinale) has been widely used as an antiemetic agent. This systematic review was aimed at evaluation of the effect of dried ginger powder supplementation on improvement of nausea and vomiting associated with early pregnancy or motion sickness. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) using keywords such as ginger or Zingiber officinale in combination with nausea, vomiting, motion sickness, or pregnancy, published in March 2013. RESULTS: The strength of the evidence was evaluated on the selected 12 RCTs (randomized controlled trials). Eleven trials including 2,630 subjects showed that supplementation with dried ginger powder resulted in significant improvement of nausea or vomiting related to early pregnancy or motion sickness. Among the nine studies including 809 women in early pregnancy before 20 weeks of gestation, ginger supplementation was superior to placebo in five studies (n = 305), and as effective as positive control (vitamin B6 or dimenhydrinate) in four studies (n = 504). Ginger intake significantly reduced the episodes or severity of vomiting related to motion sickness compared to placebo or showed the same effect as several antiemetic drugs in two studies (n = 1,821). CONCLUSION: Our findings added evidence indicating that ginger powder supplements might improve the symptoms of nausea or vomiting related to early pregnancy or motion sickness without significant adverse events.

Habituation of seasickness in adult during a long voyage / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the habituation of seasickness in non marine subjects during a long voyage.</p><p><b>METHODS</b>A crew of 106 staffs of the Hospital Ship Ark Peace was included in this study. There were 59 male and 47 female with an age ranged from 23 to 53 years (mean 37.2 years). They all took part in the Mission Harmony 2011 for medical service in four countries around the Caribbean Sea. Questionnaires and visual analogue scales (VAS) were used to investigate the prevalence and degree of the seasickness in different periods.</p><p><b>RESULTS</b>The prevalence of seasickness was 72.64% in the initial period of voyage. The prevalence and degree of seasickness in female and in staff with motion sickness history were higher and more severe than that in male and in staff without motion sickness history(P < 0.05). After two weeks, the prevalence and degree of seasickness decreased, which meant habituation of seasickness occurred. With the voyage going longer, the prevalence and degree of seasickness were further decreased, but the severe sea condition make the prevalence and degree of seasickness worse. The rate of habituation of seasickness was 62.33%, and the habituation rate of seasickness in male (76.92%) was higher than that in female (47.37%) (χ(2) = 7.161, P = 0.007).</p><p><b>CONCLUSIONS</b>The habituation of the seasickness occurred after two weeks in a long voyage. Male are easier to get habituation of seasickness than female. The severe sea condition influences the prevalence and degree of seasickness.</p>

Pathophysiology of Vestibular Migraine / 대한평형의학회지

Vestibular migraine (VM) is an increasingly recognized cause of episodic recurrent vertigo. However, the pathophysiology of VM is still a matter of speculation. An understanding of the relationship between migraine and the vestibular system increases knowledge of the pathogenesis of both migraine and vertigo. The pathophysiology of VM has been known to be related to cortical spreading depression, neurotransmitters (i.e., serotonin, noradrenaline, dopamine, calcitonin gene-related peptide) and calcium ion channel disorder. Moreover, VM is related with Meniere's disease, benign paroxysmal positional vertigo, motion sickness, cerebellar dysfunction, or comorbid psychotic disorder. This review refines recently proposed pathophysiological concept for VM and relationships between migraine and other related disorders.

Anti-motion sickness efficacy of the extracted mixture of Chinese medical herbs and its influence on the blood level of hormones / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the anti-motion sickness efficacy and influence on the blood level of some hormones of a Chinese prescription composed of 10 herbs such as spina date seed.</p><p><b>METHODS</b>According to the report by Cramptom and Lucot, SD rats and Beagle dogs were rotated around a horizontal axis, and the rat behavior of pica for Kaolin and the latency to vomit in dog were observed. In addition, guinea pigs were rotated around a vertical axis, and the nystagmus was recorded. Blood levels of corticosterone, adrenocorticotrophic hormone (ACTH), corticotropin releasing hormone (CRH) and arginine vasopressin (AVP) in rats were measured with radioimmunoassay. The influences of the extracted mixture of herbs on these variables were simultaneously investigated.</p><p><b>RESULTS</b>Compared with control group, oral administration of the extracted mixture of herbs: (1) significantly inhibited the rat behavior of pica for Kaolin and prolonged the latency to vomit in dog dose-dependently; (2) decreased the frequency of nystagmus and mean slow phase speed in rat; (3) reduced the elevation of corticosterone, ACTH, CRH and AVP in rat blood induced by rotatory stimulation; and (4) these effects of the extracted mixture of herbs were almost identical to dimenhydrinate.</p><p><b>CONCLUSION</b>(1) The extracted mixture of Chinese Medicinal Herbs we used could inhibit motion sickness effectively. (2) This drug could reduce the blood levels of hormones of hypothalamic-pituitary-adrenocortical axis and AVP elevated by provocative rotatory stimulation.</p>