RESUMO
The presence of oligoclonal bands of IgG (OCB) in cerebrospinal fluid (CSF) is used to establish a diagnosis of multiple sclerosis (MS), but their specificity has remained an enigma since its first description over forty years ago. We now report that the use of lipid arrays identifies heteromeric complexes of myelin derived lipids as a prominent target for this intrathecal B cell response.
Assuntos
Imunoglobulina G/líquido cefalorraquidiano , Metabolismo dos Lipídeos , Esclerose Múltipla , Bainha de Mielina/metabolismo , Bandas Oligoclonais/imunologia , Análise de Variância , Animais , Linfócitos B/imunologia , Linfócitos B/metabolismo , Células Cultivadas , Embrião de Mamíferos , Humanos , Esclerose Múltipla/líquido cefalorraquidiano , Esclerose Múltipla/imunologia , Esclerose Múltipla/patologia , Proteína Básica da Mielina/metabolismo , Bainha de Mielina/imunologia , Antígenos O/metabolismo , Ratos , Ratos Sprague-Dawley , Medula Espinal/citologiaRESUMO
OBJECTIVE: The purpose of this study was to test the feasibility and validity of a continuous measurement of urinary sensation during cystometry. STUDY DESIGN: Subjects continuously recorded their level of urinary sensation during cystometry with the use of urodynamic diagnoses and responses to the Medical Epidemiologic and Social Aspects of Aging (MESA) and Urinary Distress Inventory (UDI) scales. Trends in urinary sensation recordings by increasing percentage of maximum cystometric capacity (MCC) were captured and compared with the use of growth curves. RESULTS: Fifty-one women participated: 18 patients had detrusor overactivity incontinence (DOI); 15 patients had urodynamic stress incontinence; 9 patients had mixed incontinence, and 9 patients did not demonstrate incontinence. In the volume range between 35% and 75% of MCC, the mean sensation level was higher in the DOI group than the other groups (P < .04). Urge sensation at 50% of MCC correlated with UDI and MESA urge subscales (rho = 0.34, p < .03 and rho = 0.39, p < .02). CONCLUSION: This study demonstrates that the Urgeometer measurement is feasible and correlates with urodynamic diagnosis and the severity and bother from urge incontinence.
Assuntos
Bexiga Urinária/fisiopatologia , Incontinência Urinária/diagnóstico , Urodinâmica , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária de Urgência/diagnósticoRESUMO
Physical guidance is a strategy commonly used for noncompliance. In two experiments, we evaluated reinforcing effects of physical guidance. Experiment 1 include three individuals with developmental disabilities who were noncompliant with tasks. Anecdotal observations indicated physical contact was highly reinforcing, and a functional analysis identified attention as a reinforcer for problem behavior. Two conditions compared physical guidance following noncompliance and no physical guidance following noncompliance. Results showed noncompliance increased for all three participants when physical guidance followed noncompliance. The second experiment empirically evaluated the function of noncompliance prior to examining the effect of physical guidance on noncompliance. A functional analysis, conducted with two participants, indicated noncompliance served an escape function for one and an attention function for the other. Comparisons of physical guidance and no physical guidance indicated physical guidance resulted in decreased noncompliance for the participant with an escape function but increased noncompliance for the participant with an attention function.
