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Fluid distribution during spaceflight and impact on brain and vision health is an emerging field of high-priority research in the NASA human space program. International Space Station astronauts have developed ocular refraction changes during prolonged spaceflight. Within this book, experts review current data related to fluid shifts during microgravity exposure and the impact of fluid shifts on astronaut health.This work also compares current astronaut health problems with Earth-based health conditions such as elevated intracranial pressure and glaucoma. Chapters include discussion of altered fluid distribution, including intracellular and extracellular fluid shifts, eye morphology and vision disturbances, and intraocular pressure. In addition, chapters will include a discussion of advanced non-invasive technologies to investigate the abovementioned fluid volume and pressure variables.As such, the book aims to bridge health professionals, researchers, and science professionals by a presentation of ophthalmology topics critical to future human space exploration, thus providing new perspectives to solve emerging brain and eye disease on Earth and in Space.
"Fluid distribution during spaceflight and impact on brain and vision health is an emerging field of high-priority research in the NASA human space program. International Space Station astronauts have developed ocular refraction changes during prolonged spaceflight. Within this book, experts review current data related to fluid shifts during microgravity exposure and the impact of fluid shifts on astronaut health.This work also compares current astronaut health problems with Earth-based health conditions such as elevated intracranial pressure and glaucoma. Chapters include discussion of altered fluid distribution, including intracellular and extracellular fluid shifts, eye morphology and vision disturbances, and intraocular pressure. In addition, chapters will include a discussion of advanced non-invasive technologies to investigate the abovementioned fluid volume and pressure variables.As such, the book aims to bridge health professionals, researchers, and science professionals by a presentation of ophthalmology topics critical to future human space exploration, thus providing new perspectives to solve emerging brain and eye disease on Earth and in Space"--
Recent missions on board the International Space Station have revealed previously unreported physiological consequences of long duration space flight, particularly in eyesight, and in this Brief Dr. Seedhouse reviews the existing theories on what causes this degeneration and how long it will last. Notably, 60% of long-duration crews have reported subjective degradation in vision, a clear indication that further study is necessary before astronauts embark on even longer-term space missions. Decreased near-visual acuity was reported in 46% of ISS/Mir crewmembers, resulting in a change of up to 2 dioptres in their refractive correction. It is possible that ophthalmic changes have been present since the first days of spaceflight, but had been attributed to other causes; this approach to the issue as well as other hypotheses are all presented in full to give a broad foundation of the existing knowledge on the topic. The changes have occurred at various times during a mission with varying degrees of visual degradation. Some cases resolved on return to Earth, but several crewmembers have not regained pre-flight visual acuity, indicating the damage may be permanent. One explanation of the syndrome has been attributed to hyperopic shift due to aging, but onboard analysis techniques, including visual acuity assessments, retinal imagery, and ultrasound examination of the eye, has led to the acceptance of a wider syndrome. In addition to vision changes, studies have reported flattening of the globe, swelling of the optic disc (papilledema), choroidal folds in the retina, swelling of the optic nerve sheath, and visual field defects. It is widely hypothesized that this spectrum of symptoms may be explained by an elevation of intracranial pressure (ICP). Establishing the provenance of this medical problem, monitoring its occurrence and resolving the symptoms for future long term space missions is a key challenge for space medicine. With this book, readers have an entry point for understanding the full scope of the problem and its possible origins.
Prolonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuro-ophthalmic findings in astronauts. These microgravity-associated findings collectively define the Spaceflight Associated Neuro-ocular Syndrome (SANS). In this book, the editors compare and contrast prior published work on SANS by the National Aeronautics and Space Administration’s (NASA) Space Medicine Operations Division with retrospective and prospective studies from other research groups. The book describes the possible mechanisms and potential etiologies for SANS, and provides an update and review on the clinical manifestations of SANS including: unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and focal areas of ischemic retina (i.e., cotton wool spots). The ocular imaging findings (e.g., retinal nerve fiber layer, optic disc, and choroidal changes on optical coherence tomography) of SANS is also described, including the intraorbital and intracranial findings on orbital ultrasound and magnetic resonance imaging. The knowledge gaps for in-flight and terrestrial human research including potential countermeasures for future stud is also explored, including reports on the in-flight and terrestrial human and animal research being investigated by NASA and its partners to study SANS both prospectively and longitudinally and in preparation for future long duration manned missions to space including the moon, the asteroid belt, or Mars. We think this is a unique topic and hope that NASA and its research partners continue to study SANS in preparation for future longer duration manned space missions. Written in an easy-to-read manner, the book adopts a translational approach and explores the science and the clinical manifestations of Space flight associated neuro-ocular syndrome. It is also multi-disciplinary and suitable for both clinicians and researchers in ophthalmology, neurology, and aerospace medicine interested in SANS SANS is a unique space flight disorder that has no terrestrial equivalent. The book involves contributions from international experts across multiple disciplines to tackle the problem of SANS Summarizes and reviews the current findings of SANS, including possible mechanisms and potential etiologies, clinical manifestations, current reports on the in-flight and terrestrial human and animal research, and ocular imaging findings
The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan. The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health. Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.
This book consolidates the current knowledge of how short and long-duration spaceflight affects the anatomy and physiology of the central nervous system. It also incorporates the methodology and constraints of studying the central nervous system in space. Chapters detail advances in imaging techniques available to assess intracranial and intraocular pathology as well as translational medicine with an emphasis on brain cancer and neurodegenerative disease in spaceflight. Additionally, the book offers theoretical background information, tested laboratory protocols, and step-by-step methods for reproducible lab experiments to aid neuroscientists and neurobiologists in laboratory testing and experimentation. Spaceflight and the Central Nervous System is the first to comprehensively include all aspects of spaceflight-induced changes in the central nervous system. It is an invaluable resource for basic and clinical laboratory trainees and researchers in aerospace medicine and physiology or for those looking to gain specific knowledge in spaceflight neuroscience.
Although once a widely speculated about and largely theoretical topic, spaceflightinduced intracranial hypertension is more accepted as a distinct clinical phenomenon; yet, the underlying physiological mechanisms are still poorly understood. In the past, many terms were used to describe the symptoms of malaise, nausea, vomiting, and vertigo though longer duration spaceflights have increased the prevalence of overlapping symptoms of headache and visual disturbance. Spaceflight-induced visual pathology is thought to be a manifestation of increased intracranial pressure (ICP) because of its similar presentation to cases of known intracranial hypertension on Earth as well as the documentation of increased ICP by lumbar puncture in symptomatic astronauts upon return to gravity. The most likely mechanisms of spaceflight-induced increased ICP include a cephalad shift of body fluids, venous outflow obstruction, blood-brain barrier breakdown, and disruption to CSF flow. The relative contribution of increased ICP to the symptoms experienced during spaceflight is currently unknown though as other factors recently posited to contribute include local effects on ocular structures, individual differences in metabolism, and the vasodilator effects of carbon dioxide. Spaceflight-induced intracranial hypertension must be distinguished from other pathologies with similar symptomatology. The following chapter discusses the proposed physiologic causes and the pathological manifestations of increased ICP in the spaceflight environment and provides considerations for future long-term space travel.
Traumatic brain injury (TBI) syndrome has emerged as a serious health concern worldwide due to the severity of outcomes and growing socioeconomic impacts of the diseases, e.g., high cost of long-term medical care and loss of quality of life. This book focuses on the TBI pathobiology as well as on the recent developments in advanced diagnostics and acute management. The presented topics encompass personal experience and visions of the chapter contributors as well as an extensive analysis of the TBI literature. The book is addressed to a broad audience of readers from students to practicing clinicians.