Aquagenic pruritus in polycythemia vera: characteristics and influence on quality of life in 441 patients.

Aquagenic pruritus (AP) is a symptom typical for polycythemia vera, but very little is known about its exact frequency, characteristics, influence on quality of life, and proper treatment. Therefore, we investigated these aspects in a large cohort of German patients with polycythemia vera using a patient directed questionnaire. Our analysis revealed that 301 of 441 analyzed patients suffered from AP. In 64.8%, AP occurred on average 2.9 years prior to diagnosis of polycythemia vera. Only in 15.4% did this lead to a hematological investigation. AP occurs primarily on the trunk and proximal parts of the extremities. Most patients complain about itching (71.8%), the remainder about tickling, stinging, or burning sensations. Forty-four patients (14.6%) classified the pruritus as "unbearable." Patients with AP reported reduced global health status and higher fatigue, pain, and dyspnea. Only 24% of patients received pruritus specific treatment for pruritus consisting mostly of histamine antagonists, which ameliorated symptoms in about half of the patients. In 5.6% of patients, polycythemia vera directed therapy (phlebotomy/cytoreduction) resolved the symptoms. In summary, AP is a serious symptom in patients with polycythemia vera, which until recently was difficult to treat. The advent of the novel JAK2 inhibitors, however, may open new ways for therapy.

Omnidirectional Galvanic Vestibular Stimulation in Virtual Reality.

In this paper we propose omnidirectional galvanic vestibular stimulation (GVS) to mitigate cybersickness in virtual reality applications. One of the most accepted theories indicates that Cybersickness is caused by the visually induced impression of ego motion while physically remaining at rest. As a result of this sensory mismatch, people associate negative symptoms with VR and sometimes avoid the technology altogether. To reconcile the two contradicting sensory perceptions, we investigate GVS to stimulate the vestibular canals behind our ears with low-current electrical signals that are specifically attuned to the visually displayed camera motion. We describe how to calibrate and generate the appropriate GVS signals in real-time for pre-recorded omnidirectional videos exhibiting ego-motion in all three spatial directions. For validation, we conduct an experiment presenting real-world 360° videos shot from a moving first-person perspective in a VR head-mounted display. Our findings indicate that GVS is able to significantly reduce discomfort for cybersickness-susceptible VR users, creating a deeper and more enjoyable immersive experience for many people.