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Barr body. How does it work?

Barr body. How does it work?


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Barr's body is a spiral X chromosome. If I'm not mistaken, one random chromosome (a healthy woman) is inactivated in each cell. Which X chromosome is inactivated in a given cell is random. I've heard the example of a tricolor cat. The patched coloring is caused by the fact that cells responsible for the color of each patch contain another inactivated X chromosome.

But what if a girl is a carrier of the Daltonism gene, why isn't she sick if a chromosome with this gene can be inactivated in some cells?


Like you said the sexual X chromosome inactivation is random in each different cell, this means women have some cells with the maternal x chromosome active and others with the paternal x chromosome active. Now if a woman carries the daltonism gene mutation (heterozygous for color blindness) she can actually manifest signs of the disease if the retinal cells randomly silenced the healthy x chromosome instead of the mutated one in more cells compared to the opposite pattern of silencing (meaning she can present daltonism out of pure bad luck).

It is worth mentioning that the magnitude of this disease will never be as strong as it presents itself in males since women (even the unlucky ones who present signs of daltonism) will always have the protection of a certain percentage of retinal cells with the healthy x chromosome active. The only way a woman could have classic daltonism to the same extent as a male is if she presents the color-blindness gene mutation in combination with Turner syndrome.

In conclusion recessive X-linked diseases aren't "everything or nothing" since woman could present signs in function to the number of cells that randomly inactivated the healthy X chromosome. They will fully express themselves in males all the time though.

References:

Scitable by nature education - Q&A

X chromosome inactivation - Nature education


Ballet-Inspired Barre Classes

Pliés, relevés, and sauté jumps don’t just look graceful, the ballet moves also lengthen and strengthen muscles and burn calories.

Ballet-inspired classes like Pure Barre, Bar Method, and Balletone are a popular workout trend that incorporates moves from ballet, Pilates, and yoga to upbeat music.

Many gyms offer ballet-inspired fitness classes, and barre studios offer classes for overall conditioning as well as targeted workouts for abs, thighs, or glutes. There are even “barre light” classes for beginners.

You don’t need a tutu or ballet slippers. Instead, dress in comfortable workout clothes and show up to the 60-minute classes prepared to use the ballet barre to do the movements your teacher shows you.

Some classes also use small balls, resistance bands, and hand weights to do floor work. The low-impact workout focuses on proper alignment.

The classes blend cardio, strength training, flexibility, balance and core conditioning in a total body workout that targets the hips, glutes, abs, and arms.


The information provided on this website (including the Blogs, Community pages, Program Materials and all other content) was originally intended for a US audience. Regulations in your country may vary.

+Results vary depending on starting point, goals and effort. Exercise and proper diet are necessary to achieve and maintain weight loss and muscle definition. The testimonials featured may have used more than one Beachbody product or extended the program to achieve their maximum results.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

Consult your physician and follow all safety instructions before beginning any exercise program or using any supplement or meal replacement product, especially if you have any unique medical conditions or needs. The contents on our website are for informational purposes only, and are not intended to diagnose any medical condition, replace the advice of a healthcare professional, or provide any medical advice, diagnosis, or treatment.

© 2021 Beachbody, LLC. All rights reserved. Beachbody, LLC is the owner of the Beachbody and Team Beachbody trademarks, and all related designs, trademarks, copyrights, and other intellectual property.


The information provided on this website (including the Blogs, Community pages, Program Materials and all other content) was originally intended for a US audience. Regulations in your country may vary.

+Results vary depending on starting point, goals and effort. Exercise and proper diet are necessary to achieve and maintain weight loss and muscle definition. The testimonials featured may have used more than one Beachbody product or extended the program to achieve their maximum results.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

Consult your physician and follow all safety instructions before beginning any exercise program or using any supplement or meal replacement product, especially if you have any unique medical conditions or needs. The contents on our website are for informational purposes only, and are not intended to diagnose any medical condition, replace the advice of a healthcare professional, or provide any medical advice, diagnosis, or treatment.

© 2021 Beachbody, LLC. All rights reserved. Beachbody, LLC is the owner of the Beachbody and Team Beachbody trademarks, and all related designs, trademarks, copyrights, and other intellectual property.


Herpes 101

What do you think of when you see the word "herpes"? Painful blisters on the genital area, right? You probably know that there's no cure and that you can get it through sexual contact. Often, though, that's the extent of the average person's knowledge when it comes to herpes.

Have you ever gotten a painful, tingling fever blister on your lip? If you get cold sores, then you have herpes. If you haven't gotten cold sores, you're still not home free -- if you've had chicken pox, you're carrying a different type of herpes.

Herpes is actually a family of eight different viruses known as Herpesviridae. It's a DNA virus, which means that its genetic material is made of DNA and it replicates through RNA in the nucleus of a cell. The blisters are just the physical symptoms of the virus. If you "have" herpes, that means that you've been infected by one of these viruses at some point and it's living in your cells. Exactly where it lives depends on the type of herpes virus. Most of them are transmitted through exchange of fluids, such as semen, mucus or saliva. Some of the viruses can be passed from mother to child during pregnancy.

Most herpes viruses are cyclic. When the virus is active, an infected person experiences symptoms and associated illnesses. There's also an increased risk of passing the virus on to someone else. During the shedding stage of the cycle, the virus replicates itself, which can occur even when the virus is inactive. Even without symptoms, there is still a risk of infecting others. Many people have no idea that they have a herpes virus because they've never had any symptoms. Some types of herpes are especially prevalent it's estimated that as many as 60 percent of adults in the United States carry the oral herpes virus and 20 percent carry the genital herpes virus [source: CDC].

Now that you know a little about herpes in general, let's start with learning about these two most well-known types.

­Although oral herpes is typically known as cold sores or fever blisters, while genital herpes gets the distinction of the name "herpes," they're actually quite similar. Fifty percent of their DNA is the same [source: HHV-6 Foundation]. Oral herpes is herpes simplex 1 (HSV-1), while genital herpes is herpes simplex 2 (HSV-2).

Both HSV-1 and HSV-2 cause fluid-filled blisters or lesions, which carry virions, or infectious particles. These blisters last from a week to a month, becoming open sores that crust over with scabs. The outbreak following the initial infection (usually a few days to a few weeks afterward) is usually the worst -- the ones after that are less painful. Some people actually confuse their mild outbreaks with other skin conditions. Early after infection, some people experience prodrome, a tingling, itching feeling that occurs in an area where blisters will shortly develop.

The main difference between HSV-1 and HSV-2 is their preferred sites of transmission and infection. HSV-1 generally results from oral contact, and the blister outbreaks are contained to the lips, mouth and face. The infection lies in a cluster of nerve cells near the ear called the trigeminal ganglion. HSV-2 generally results from genital contact with blisters in the genitals, anus and inner thighs, and it lives in nerve cells in the sacral ganglion, near the base of the spine.

Many people believe that HSV-2 is more dangerous than HSV-1, but that's not true. In fact, some researchers argue that HSV-1 is more dangerous because it's more prevalent. Both types of herpes can cause fevers and swollen lymph nodes. Urinating can be extremely painful when having an outbreak of HSV-2 as the urine hits the open sores. HSV-1 infections can also spread to the eyes (herpes keratitis), face and chest (herpes gladiatorum), and fingers and thumbs (herpetic Whitlow). In rare cases, it can spread to the brain and cause herpes encephalitis or Molliet's meningitis, types of brain inflammation that can result in death. There has been some research associating herpes simplex viruses with Alzheimer's and Bell's palsy, although definitive links haven't yet been proved.

Next, we'll look at how the herpes simplex viruses are spread and how their symptoms can be treated.


Symptoms Symptoms

The following list includes the most common signs and symptoms in people with chronic active Epstein-Barr virus infection (CAEBV). These features may be different from person to person. Some people may have more symptoms than others and symptoms can range from mild to severe. This list does not include every symptom or feature that has been described in this condition. [1] [2] [3]

  • Fever
  • Swollen lymph nodes
  • Enlarged liver (hepatomegaly)
  • Enlarged spleen (splenomegaly)
  • Anemia
  • Nerve damage
  • Liver failure
  • Pneumonia

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.


The Pros And Cons Of Doing Pure Barre

By now, you’ve probably caught wind of Pure Barre, a hot new fitness trend that is spreading like wildfire. It’s a ballet-inspired fitness regimen mostly centered around the handrail used in ballet training — the barre — with some Pilates influences tossed in the mix. Not only does Pure Barre burn fat and tone muscles, but it also helps with your balance and posture. Carrie Rezabek Dorr, a dancer and choreographer, designed the technique and opened her first studio in a basement in Birmingham, MI in 2001. It became a franchise in 2009 and is now the most successful barre establishment in the United States.

It was hard for me to forget the image of Natalie Portman’s svelte ballet bod in Black Swan , so when I heard that similar results could be found through Pure Barre, I decided to give it a shot. Since I’m short (5’2 on a good day) but broader than most petite women, I was looking for a new workout that would help me slim down and — dare I say — look a bit taller. To my surprise, I got hooked I was going four or five times a week for a few months and saw some amazing results.

But, as a yoga teacher, I also had an opinion or two about what could be improved. Because, let’s face it, no workout is perfect. So before you head to your first Pure Barre class, read up on these pros and cons.

Pro #1: You Get Lean And Toned Everywhere

It’s a full-body workout that produces incredible results — fast. Their motto is “Lift, Tone, Burn,” and it focuses on isometric movements. This helps you work into the small muscles, producing a slender, rather than bulky, look. You start with a warm-up, and move into upper body strengthening, where small weights are optional. The barre is used to target hips, thighs, and butt, then comes the abdominal work (the most effective I’ve ever encountered). Class ends with a cool-down/stretch session to work on flexibility. The technique is effective and it lives up to the hype if you keep going regularly.

Con #1: It’s Expensive

I was shocked by the prices at first, especially coming from the yoga world where I already thought some of the vinyasa class packages were getting a bit too pricey. For example, one month of unlimited classes is around $200. Eek! Obviously, you’ll get the most bang for your buck if you sink your teeth into an annual pass, but not all of us have that kind of cash to drop at once. Also, the more you get addicted, the more clothes you’ll buy in the lobby, which are specifically made for the workout and prey on you when you're full of endorphins. Be prepared to drop over $100 for a pair of pants.

Pro #2: There's A Low Risk Of Injury

It’s a low-impact workout that puts zero pressure on the joints. Their shtick is all about lifting and toning by using your own body or weights as small as 1lb. None of the movements are sudden or unnatural, so if you’ve got some knee or shoulder or back issues, this could be a great option for you. It’s even completely safe for pregnant women to do (always check with your doc first, though!). The instructors are attentive, so they will correct you if you’re doing it in a way that might be harmful.

Con #2: You Might Get Bored

There is certainly good to be had from a systemized workout — you know what you’re going to get and it’s proven to work. But if you crave a fitness regimen that mixes it up a lot, to keep you and your body guessing, like the cross training in Crossfit, Pure Barre probably isn’t for you. Every session is structured the same way, even though the movements may vary. Muscle memory happens fast, so you could reach a plateau if you’re just going through the motions.

Pro #3: You Can Lose Weight Quickly (If That's Your Goal)

OK, so shedding pounds definitely isn’t the most important thing we look for in a exercise regimen, but for some, it’s a welcomed addition. Pure Barre revs up your metabolism it may not look like a tough workout, but, trust me, your heart rate gets up there. It also burns fat and builds lean muscle (which also burns fat while you’re in resting mode). I was shocked to see the extra layer of pudge on my tummy slowly disappear — and I hadn’t even changed my diet in an attempt to lose weight.

Con #3: There Isn’t Much Diversity

To be honest, I initially felt uncomfortable walking into my first few Pure Barre establishments because I was the only non-white person in the whole place. The class prices and marketing schemes tend to attract a certain demographic of folks. The yoga industry had this same problem for many years, but there are tons of studios that have been working hard to diversify their clientele base as a response. I’m hoping Pure Barre will eventually move in that direction too.

Pro #4: It’s A Fun Workout

As my instructor said before my first class, “This will be the fastest 55 minutes of your life.” She. Was. So. Right. It went by so quickly. They play fun, dancey music you can’t help but bob you head to, like Beyonce and Ellie Goulding. I found myself singing along to the songs and grinning like an idiot. Every teacher I’ve encountered is engaging and friendly, qualities the franchise looks for when hiring, and they create the kind of environment you want to be in when you’re a novice.


WTF Are Barre Workouts and Are They Actually Worth Doing?

Visit any barre studio&rsquos website and you&rsquoll find plenty of appealing promises: &ldquoDevelop long, lean muscles without bulk.&rdquo &ldquoSculpt a ballerina&rsquos body.&rdquo &ldquoEnhance flexibility and improve balance.&rdquo Many say that after only five classes, you&rsquoll see changes in your body, gain strength, and tone those hard-to-target muscles in your core, arms, and legs. And the best part: Anyone&mdashno matter their age, weight, or fitness level&mdashcan hit the bar and get results. With claims like these, who wouldn&rsquot want to plié their way to a stronger body?

As with anything that sounds too good to be true, we had to investigate. Here, we dig into the science behind the the ballet-inspired workout to find out exactly how (and if) it can actually transform your physique.

The History

Considering that the basic equipment (ahem, a ballet barre) and many of the moves are based on classic ballet positions, it&rsquos no surprise barre was developed by a ballerina. After injuring her back, Lotte Berk, a German dancer living in London, came up with the idea to combine her dance conditioning routine with her rehabilitative therapy. She opened her first studio in 1959 in her London basement, where famous faces such as Joan Collins and Barbara Streisand regularly came to lift, tuck, and curl.

Lydia Bach, an American student of Berk&rsquos, brought the workout back to the states in 1971, when she opened the first Lotte Berk Method studio in New York City. Over time instructors began branching off to create their own variations of the workout, such as Physique 57, The Bar Method, and Core Fusion, among others. In fact, so many teachers eventually left the original Lotte Berk Method studio that it ended up closing its doors in 2005.

To say the barre trend has heated up in the last 10 years is an understatement. Barre has morphed from a class for nimble dancer-types to become the workout of choice for fitness fiends everywhere&mdashand studios are springing up in droves across the U.S. (and internationally). In fact, Pure Barre has almost 300 locations, while The Bar Method just opened its 82nd studio. Several brands, including Barre3, Beyond Barre, and Physique 57 also offer online streaming and on-demand videos. Basically if your neighborhood doesn&rsquot have a barre studio, it&rsquos safe to assume it will soon.

The Workout

While barre has origins in dance, the rhythmically challenged shouldn&rsquot worry: No tapshoes, leotards, or any fancy footwork are required. &ldquoYou don&rsquot need any dance experience&mdashyou&rsquore not going to be doing pirouettes,&rdquo says Nicole Bushong, DPT, a former dancer and physical therapist at the Center for Advanced Orthopedics and Advanced Medicine in Auburn Hills, MI.

Instead, most barre classes follow the same basic structure: You&rsquoll start with a mat-based warm-up full of planks and push-ups, do a series of arm exercises, and continue at the bar with a lower-body section to work your thighs and glutes. Finally, you&rsquoll finish with a series of core-focused moves at the bar or a short session on the mat.

As for gear, the moves are typically bodyweight only, but you can use light hand weights (usually two or three pounds) or resistance bands to level up your arm exercises. For lower-body work, a soft exercise ball is often used to help engage leg muscles. And while most studios recommend wearing socks with sticky grips on the bottom, others let you go barefoot.

So what&rsquos the difference between barre and a typical strength training class? Rather than larger, compound movements (think squats and shoulder presses), you&rsquoll perform tiny, one-inch increments called isometric movements, says Burr Leonard, fitness expert and founder of The Bar Method. That&rsquos why you&rsquoll often hear, &ldquoDown an inch, up an inch,&rdquo repeated by barre teachers.

For someone who&rsquos used to HIIT or CrossFit, it may seem like you&rsquore not working hard enough. But that&rsquos absolutely not the case, Leonard says. &ldquoIn fact, you&rsquore getting a killer workout because the one-inch increments are enough to fire up the muscle and make it more elastic, but not too big to tear the muscle.&rdquo

The Benefits

So really, can the $20 to $30 spent on each class truly help lift your rear, tone your thighs, improve posture, and deliver a dancer&rsquos body? Here&rsquos what the experts say:

1. Those tiny movements can help you get stronger.

The isometric contractions that make up the bulk of a barre class occur when the muscle tenses without changing length. Think of these movements as the opposite of typical strength training moves (or concentric and eccentric contractions), which occur when a muscle stretches then shortens (as in a biceps curl). Isometric exercise is a great way to maintain muscle strength.

&ldquoWhat&rsquos wonderful about the one-inch movements is that you can hold a posture and benefit from continuously engaging the muscle, but you also get a mini-recovery with each pulse, so you can stay in the hold longer,&rdquo says Sadie Lincoln, fitness expert and founder of Barre3.

Bushong agrees that there&rsquos a physical payoff from these tiny pulses. &ldquoIsometric movements help isolate specific muscles,&rdquo she says. &ldquoYou can do more reps with smaller movements like these, which fatigue your muscles in a different way.&rdquo These higher-rep, low-weight exercises target slow-twitch muscles, which help increase endurance. In contrast, larger, compound movements target fast-twitch muscles, which help with power and speed (think running a marathon vs. sprinting). Plus, isometric movements can help strengthen muscles without straining tendons or ligaments, so there&rsquos less risk of injury compared to more traditional strength training.

2. You&rsquoll target multiple muscle groups at once.

&ldquoIt&rsquos a highly efficient workout since you&rsquore doing two to four movements&mdashholding, pulsing, stretching, for example&mdashat a time in each move,&rdquo Leonard says. For example, in Bar Method classes, you&rsquoll practice the &ldquodiamond waterski.&rdquo While holding onto the bar with one hand, your legs are in a diamond-shape, heels raised, while the torso is angled (think of a water-skier leaning back). This move mainly targets your quads, but at the same time you&rsquore also challenging the calves, hamstrings, glutes, abs, and upper-back muscles. Bonus: &ldquoWorking all these areas at once also helps raise the heart rate,&rdquo Leonard says.

3. You&rsquore going to see your body shake like a bowl of JELL-O.

&ldquoThis happens most commonly in thigh work at the barre, as you&rsquore spending an extended period of time in a muscle (quad) contraction, while performing an isometric hold to intensify the work,&rdquo says Kira Stokes, trainer and creator of the Stoked Series and StokedC3BarreMAX. Shaking is a sign of muscle fatigue&mdashyour muscles are telling you they are feeling it. If taught and done correctly, this is a good thing. You may be tempted to pop out of the hold if you start to shake, but try to embrace the shake! &ldquoAlso, if you worked your lower body the day before or you&rsquore dehydrated, this can increase the likelihood of muscles trembling,&rdquo Stokes adds.

4. You&rsquoll improve your mind-body connection.

The smaller movements in a barre class can bring a new level of awareness to the body that you don&rsquot get in regular strength workouts, says Greatist Expert Jessi Kneeland, founder of Remodel Fitness. &ldquoIn this way, barre can improve muscular activation for frequently underused muscles by strengthening the neuro-muscular (mind-body) connection,&rdquo she says.

5. You may lose weight.

&ldquoWe&rsquove had students who have lost 100 pounds or more doing The Bar Method, but it&rsquos so individual,&rdquo Leonard says. &ldquoYou just have to be aware of your body and figure out what&rsquos best for you to lose weight.&rdquo And it&rsquos important to remember that what you eat can have a bigger impact on weight loss than what you do: &ldquoNinety percent of losing weight is about what you eat and how much you eat,&rdquo Leonard says. (Hint: as little sugar as possible.)

Plus, as with any exercise, barre affects different body types in different ways. &ldquoWhile a trained ballerina or 6&rsquo2&rdquo model can come in and see results in a few classes, someone struggling with their weight may not see change as quickly,&rdquo Stokes says.

Depending on your body type and fitness level, you&rsquoll see and feel changes in three weeks to three months, Leonard says&mdashthough making a major change in your body and losing a significant amount of weight could take more than a year. All that hard work will pay off, though: &ldquoOur students develop a natural youthfulness, power, and grace, and wonderful, natural posture and a lifted derriere,&rdquo Leonard says.

The Real Deal

Other fitness experts, however, aren&rsquot so sure that barre is the end-all, be-all fitness miracle it&rsquos touted to be. &ldquoOf course anything that gets people moving is fantastic,&rdquo says Adam Rosante, founder of The People&rsquos Bootcamp and author of The 30-Second Body. &ldquoAnd barre classes can help improve postural alignment, core strength, and enhance mobility&mdashespecially if you spend most of your time sitting at a desk.&rdquo On the other hand, there are a few downsides:

1. You may not gain functional strength.

&ldquoYou&rsquore not going to build great functional strength through the methods employed in barre classes alone,&rdquo Rosante says. Barre classes can lack compound movements, like squats, lunges, bent-over rows, or clean-and-presses, which involve multiple muscle groups and joints. These functional exercises help you gain strength for moves you&rsquore likely to encounter in everyday life, like walking up stairs, picking up boxes, or carrying groceries. &ldquoPlus, compound movements recruit maximum muscle fibers, which in turn drive your heart rate through the roof. This translates into greater fat loss,&rdquo Rosante says.

Many brands, including Barre3 and The Bar Method, are adding functional, aerobic movements to their repertoire. After fatiguing the muscles in isometric holds, Barre3 students, for example, follow with functional movements (think full-range squats following small pulses at the bar), which also add in some cardio. &ldquoWe don&rsquot want to train your body to dance&mdashwe want to train your body for life,&rdquo Lincoln says.

2. You&rsquore not challenging your heart enough.

The cardio you&rsquoll do in typical barre classes isn&rsquot enough for cardiovascular health and post-exercise calorie burn, Stokes says. Even though you do some low-level cardio in barre, Stokes estimates you&rsquore only working at 40 to 50 percent of your maximum heart rate in a typical barre class, as evidenced by the fact you can often head straight to dinner after class (without needing to shower).

Translation: If your goal is to burn fat, you need to consider the lack of excess post-exercise oxygen consumption (EPOC)&mdashwhat&rsquos commonly known as afterburn&mdashwhen it comes to barre, Rosante says. &ldquoAny calorie burn that&rsquos happening in class is going to end when it&rsquos over.&rdquo

3. You may plateau.

Your body will get used to barre class, and without hefting heavier weights (barre class weights typically max out at five pounds), you&rsquoll tap out your potential to get stronger, Kneeland says. &ldquoSince consistent progressive overload and challenging your body is the key to consistent progress, you&rsquoll most likely see results for a little while, then plateau.&rdquo

The Takeaway

If you find barre classes fun and motivating, go for it! After all, you&rsquore more likely to stick with an exercise regimen if you enjoy it. Consider it &ldquofine-tuning for your body,&rdquo Stokes suggests. If you&rsquore doing a lot of strength training and spinning, for example, it&rsquos a good idea to incorporate the high-reps, bodyweight-only exercises of a barre class once a week. &ldquoA combination of classes together creates the leanest, best body possible,&rdquo she says.

Adding barre to your routine? On another two to three days a week, do some cardio to get your heart rate up, and add in two to three strength training sessions, Kneeland suggests. (We like to make our workouts super efficient with metabolic strength training like this high-intensity workout you can do at home.)

To quote the cereal commercials of your childhood, &ldquoIt&rsquos all part of a balanced breakfast,&rdquo Rosante says. &ldquoLift, run, jump, do yoga, swim, take a barre class, dance. Mix up your routine and keep your body moving while focusing the majority of your efforts on work that increases overall strength and endurance. Do that and you&rsquoll be fit as a fiddle for life.&rdquo


How is Guillain-Barré treated?

There is no known cure for Guillain-Barré syndrome. However, some therapies can lessen the severity of the illness and shorten recovery time. There are also several ways to treat the complications of the disease.

Because of possible complications of muscle weakness, problems that can affect any paralyzed person (such as pneumonia or bed sores) and the need for sophisticated medical equipment, individuals with Guillain-Barré syndrome are usually admitted and treated in a hospital&rsquos intensive care unit.

There are currently two treatments commonly used to interrupt immune-related nerve damage. One is plasma exchange (PE, also called plasmapheresis) the other is high-dose immunoglobulin therapy (IVIg). Both treatments are equally effective if started within two weeks of onset of GBS symptoms, but immunoglobulin is easier to administer. Using both treatments in the same person has no proven benefit.

In the process of plasma exchange, a plastic tube called a catheter is inserted into the person&rsquos veins, through which some blood is removed. The blood cells from the liquid part of the blood (plasma) are extracted and returned to the person. This technique seems to reduce the severity and duration of the Guillain-Barré episode. Plasma contains antibodies and PE removes some plasma PE may work by removing the bad antibodies that have been damaging the nerves.

Immunoglobulins are proteins that the immune system naturally makes to attack infecting organisms. IVIg therapy involves intravenous injections of these immunoglobulins. The immunoglobulins are developed from a pool of thousands of normal donors. When IVIg is given to people with GBS, the result can be a lessening of the immune attack on the nervous system. The IVIg can also shorten recovery time. Investigators believe this treatment also lowers the levels or effectiveness of antibodies that attack the nerves by both &ldquodiluting&rdquo them with non-specific antibodies and providing antibodies that bind to the harmful antibodies and take them out of commission.

Miller-Fisher syndrome is also treated with plasmapheresis and IVIg.

Anti-inflammatory steroid hormones called corticosteroids have also been tried to reduce the severity of Guillain-Barré syndrome. However, controlled clinical trials have demonstrated that this treatment is not effective.

Supportive care is very important to address the many complications of paralysis as the body recovers and damaged nerves begin to heal. Respiratory failure can occur in GBS, so close monitoring of a person&rsquos breathing should be instituted initially. Sometimes a mechanical ventilator is used to help support or control breathing. The autonomic nervous system (that regulates the functions of internal organs and some of the muscles in the body) can also be disturbed, causing changes in heart rate, blood pressure, toileting, or sweating. Therefore, the person should be put on a heart monitor or equipment that measures and tracks body function. Occasionally GBS-related nerve damage can lead to difficulty handling secretions in the mouth and throat. In addition to the person choking and/or drooling, secretions can fall into the airway and cause pneumonia.

Rehabilitative care

As individuals begin to improve, they are usually transferred from the acute care hospital to a rehabilitation setting. Here, they can regain strength, receive physical rehabilitation and other therapy to resume activities of daily living, and prepare to return to their pre-illness life.

Complications in GBS can affect several parts of the body. Often, even before recovery begins, caregivers may use several methods to prevent or treat complications. For example, a therapist may be instructed to manually move and position the person&rsquos limbs to help keep the muscles flexible and prevent muscle shortening. Injections of blood thinners can help prevent dangerous blood clots from forming in leg veins. Inflatable cuffs may also be placed around the legs to provide intermittent compression. All or any of these methods helps prevent blood stagnation and sludging (the buildup of red blood cells in veins, which could lead to reduced blood flow) in the leg veins. Muscle strength may not return uniformly some muscles that get stronger faster may tend to take over a function that weaker muscles normally perform&mdashcalled substitution. The therapist should select specific exercises to improve the strength of the weaker muscles so their original function can be regained.

Occupational and vocational therapy help individuals learn new ways to handle everyday functions that may be affected by the disease, as well as work demands and the need for assistive devices and other adaptive equipment and technology.


Outlook

MS is a lifelong disease. Although its symptoms can come and go, there is no cure. Some people have more frequent and severe attacks of symptoms. The future for people with MS has improved a lot, thanks to new medicines. Today, most people with MS are still able to walk 20 years after they're diagnosed.

People with GBS can have severe symptoms, but they usually make a full recovery. GBS often gets better after a few weeks, but the weakness it causes can continue for years. Sometimes, the numbness and tingling will come back years after the first attack of symptoms. Early recognition is key to halting the progression of CIDP. Up to 30% of CIDP patients will progress to wheelchair dependence.

Sources

Capello, E. European Journal of Neurology, March 2000.

CDC: "Guillain-Barrè Syndrome and Flu Vaccine" and "Zika and Guillain-Barrè Syndrome."

Etemadifar M. Autoimmune Diseases, 2012.

Multiple Sclerosis Association of America: "Long-Term Treatments" and "Treating Multiple Sclerosis Relapses."

National Institute of Neurological Disorders and Stroke: "Guillain-Barrè Syndrome Fact Sheet" and "Multiple Sclerosis: Hope Through Research."

National MS Society: "Medications" "Multiple Sclerosis FAQs" "MS Symptoms" "Numbness or Tingling" and "What Causes MS?"