Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol

Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilot study is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features.

Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy

Children with cerebral palsy (CP) have difficulty controlling and coordinating voluntary muscle, which results in poor selective control of muscle activity. Children with spastic CP completed ankle selective motor control exercises using a virtual reality (VR) exercise system and conventional (Conv) exercises. Ankle movements were recorded with an electrogoniometer. Children and their parents were asked to comment on their interest in the exercise programs. Greater fun and enjoyment were expressed during the VR exercises. Children completed more repetitions of the Conv exercises, but the range of motion and hold time in the stretched position were greater during VR exercises. These data suggest that using VR to elicit or guide exercise may improve exercise compliance and enhance exercise effectiveness.

Antibody response to Actinobacillus pleuropneumoniae antigens after vaccination of pigs bred for high and low immune response

To enhance inherent general resistance to infectious diseases an indirect strategy of selective breeding for multiple immune response traits representing both antibody and cell-mediated immune response has been pursued over several generations in pigs. High and low response lines differ significantly not only in response to antigens included in the estimated breeding values upon which the selection was based, but also to other antigens. To test whether or not the lines also differed in antibody response to vaccination, high and low response pigs were given a commercial Actinobacillus pleuropneumoniae vaccine, and their serum antibody to three constituent antigens, carbohydrates (CHO) 1 and 5 and lipopolysaccharide (LPS) 1 was measured by enzyme immunoassay. The high line had significantly (P < or = 0.05) more antibody to all antigens except at day 28 to CHO antigen 5. The frequency of non-response to vaccination was also less in the high response pigs to CHO antigen 1 (P < or = 0.01) and to the LPS antigen (P < or = 0.06) but not to the CHO antigen 5. Based upon these observation it is concluded that the high immune response pigs are more responsive to the commercial vaccine than are the low response pigs and that the strategy of altering population immune response by multi-trait selective breeding may be useful in facilitating vaccine-based health management programs for livestock.

Simultaneous screening of bovine sera for antibodies to bluetongue and epizootic hemorrhagic disease of deer viruses by enzyme-linked immunosorbent assay

An indirect enzyme-linked immunosorbent assay (I-ELISA) is described for simultaneous screening of bovine sera for detection of antibodies to bluetongue (BT) and epizootic hemorrhagic disease of deer (EHD) viruses (V). Optimal dilutions of BTV and EHDV antigens were combined and allowed to absorb on to the wells of microtiter plates. Appropriately diluted (1:100) bovine sera were allowed to incubate and the bound antibodies were detected by a murine monoclonal antibody (MAb) to bovine immunoglobulin (H-Chain) conjugated with horseradish peroxidase. The performance of the combined (C) I-ELISA in detecting antibodies to BTV and EHDV in sequential serum samples from calves experimentally inoculated with BTV, serotype 10, EHDV, serotype 1 (New Jersey) or EHDV serotype 2 (Alberta) was evaluated. Comparable antibody profiles were demonstrable by the CI-ELISA and separate I-ELISAs using either BTV or EHDV antigens. The results suggest that the CI-ELISA offers many advantages over the standard agar gel immunodiffusion (AGID) test and has potential application as a rapid, sensitive, inter-group-specific and inexpensive test for simultaneous screening of bovine sera for antibodies to BTV and/or EHDV.

Cyclic nucleotides of lung lavage following acute antigen exposure in chronically exposed sheep

In the sheep model of chronic allergic airway disease, we measured sequentially for 7 h following antigen exposure (Ascaris suum) histamine and the cyclic nucleotides cAMP and cGMP in bronchoalveolar lavage (BAL) fluids. Results in the six sheep with chronic allergic airway disease (reactive sheep) were compared to those of three sheep chronically exposed to antigen but without acute or chronic airway response (nonreactive sheep). Histamine levels in BAL fluids were not modified after antigen exposure in reactive and nonreactive groups. Before acute challenge, cAMP in BAL was 10.4 +/- 1.0 pmol/ml in reactive sheep and 16.4 +/- 1.0 in nonreactive sheep; cGMP was 0.16 +/- 0.01 pmol/ml in reactive sheep and 0.18 +/- 0.06 in nonreactive sheep. Antigen exposure did not change the lung lavage levels of cAMP or cGMP for up to 7 h in the nonreactive sheep. In the reactive sheep, antigen exposure induced a significant gradual fall in cAMP to 49% of the preexposure level and a rapid and sustained increase of cGMP to 200% of the preexposure level (P less than 0.05). Prechallenge lung resistance was increased in reactive sheep compared to nonreactive sheep. Antigen challenge further increased lung resistance in reactive sheep during the first hour without any change in nonreactive sheep. Reactive sheep BAL eosinophils increased to 900% of the values of nonreactive sheep at 4 and 7 h following challenge. These observations suggest that histamine does not have a major role in allergic response in the chronic sheep asthmatic model; furthermore, cyclic nucleotide modifications could reflect sympathoadrenergic imbalance and/or increase of inflammatory reaction following antigen exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic allergic airway disease in the sheep model: functional and lung-lavage features

We developed an animal model of chronic allergic airway disease by repeatedly exposing nine sheep to tracheal instillation of ascaris antigen until stable increase in lung resistance at three times control in six reactive sheep (group C) was obtained. They were then compared to the three nonreactive sheep (group B) and a control group of eight sheep exposed to saline only (group A) in terms of pulmonary function tests and bronchoalveolar lavage (BAL) analyses. Lung resistance was 1.5 +/- 0.3 cm H2O/L/sec in group A, 1.8 +/- 0.3 in group B, and 5.9 +/- 1.3 in group C. Trapping volume (functional residual capacity by plethysmography and by helium rebreathing technique) was 0 +/- 0.1 L in group A, 0.05 +/- 0.1 in group B, and 0.51 +/- 0.17 in group C. Upstream resistance at peak flow did not differ between any two groups, but upstream resistance near residual volume was 1.8 +/- 0.3 cm H2O/L/sec in A, 6.2 +/- 1.0 in B, and 28 +/- 6 in C. In BAL, total cells were 25 +/- 5 X 10(4)/ml in A, 35 +/- 8 in B, and 31 +/- 6 in C. Macrophages in BAL were 16 +/- 2 in A, 27 +/- 9 in B, and 24 +/- 4 in C. Neutrophils were 0.5 +/- 0.2 in A, 3.4 +/- 2.5 in B, 2.8 +/- 1.5 in C. Eosinophils were 0.1 +/- 0.1 in A, 0.5 +/- 0.2 in B, and 0.9 +/- 0.3 in C (p less than 0.05 group C versus group A). Total proteins, albumin, alkaline phosphatase, and fibronectin did not differ between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Sustained efficacy of aluminum to reduce quartz toxicity in the lung

In a recent study of the sheep tracheal lobe model, we have demonstrated that surface chemistry modification of quartz by aluminum lactate significantly alters the biological activity of quartz for at least 2 months after exposure. In the present study, we have extended our observations of the biological reaction of the lung tissue to aluminum treated quartz and to untreated quartz, added lung lavage analyses of surfactant and glycosaminoglycans as additional indicators of activity of the quartz-induced lung injury and analyzed lung lavage and tissue retention of the minerals. The tracheal lobe of 8 sheep was exposed to either 11 mg of aluminum lactate in 100 ml saline (Al group), 100 mg of quartz (Minusil-5) in 100 ml saline (Si group) or 100 mg of quartz treated with 11 mg of Al lactate in 100 ml saline (Si-Al group). The 24 sheep were studied by lung lavage at month 9, 0.13, 1, 2, 3, 5, 7, 9, and 10 and by autopsy at month 10. In the Al group, we found no significant change over time, the pathologic score was 0.38 +/- 0.15 and Si undetectable. In the Si group, we found significant sustained increases in total lavage cells, macrophages, lymphocytes, neutrophils, glycosaminoglycans, lactate dehydrogenase, phosphatidylcholine and phosphatidylglycerol. Histologically we found a macrophagic lymphocytic alveolitis with early nodular silicotic lesions; the pathological score was 3.0 +/- 0.8 at month 10 with an average quartz tissue level of 1.4 +/- 0.4 micrograms/mg. In the Si-Al group, all these changes were significantly reduced early and remained so up to 10 months after exposure; the pathological score was 1.1 +/- 0.4 and lung levels of quartz were undetectable. The data thus demonstrated that Al treatment of quartz significantly reduces the biological activity of quartz and increases its clearance with essentially no detectable particle retention in the lung 10 months after exposure.

Asbestos exposure and retention as determinants of airway disease and asbestos alveolitis

To evaluate the relationships of asbestos exposure, retention, airway response, and the asbestos alveolitis, we exposed 2 groups of sheep every 2 wk for 3 yr to either 100 ml phosphate-buffered saline (PBS) or 100 mg UICC chrysotile fibers in 100 ml PBS. The sheep were evaluated periodically by pulmonary function tests (PFT), chest radiograph (CR), bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TLB). At Month 24 of the study, all asbestos-exposed sheep had significant increases in lung resistance and upstream resistance. However, only 9 of the 16 asbestos-exposed sheep had significant changes in TLB, CR, Cst, and VC, which clearly separated them from the other 6 sheep in these parameters. The 2 groups, however, had similar air-flow limitation. At lung biopsy, all asbestos-exposed sheep had significant peribronchiolar fibrosis, with significant alveolitis only in the group of 9 sheep with radiographic and functional changes of early asbestosis. The 9 sheep also had significant changes in BAL cellularity and biochemical profile, which differentiated them from the other 6 asbestos-exposed sheep. Analysis of BAL fiber content at that point revealed that despite identical exposure, the group with interstitial lung disease had significantly more fiber retention (p less than 0.01). The data demonstrate that whereas asbestos airway disease appears to be primarily an exposure-dose-related response, the lung response appears to be more closely related to alveolar retention of the dust.