This retrospective investigation of neurological deficits in 95 consecutive patients (77 men, mean age 35 years; 18 women, mean age 28 years) infected by the human immunodeficiency virus showed that ...61% of the female and 47% of the male patients exhibited neurological deficits. In 18% of the total population neurological deficits were the initial sign of acquired immunodeficiency. In addition, we found that a history of headaches and the clinical finding of mental impairment as well as internistic symptoms were significantly correlated with neurological deficits. Patients suffering from cerebral toxoplasmosis developed mental impairment significantly more often than patients with central nervous symptoms of other etiogenesis. Furthermore, it was found that HIV-infected women manifested peripheral neuropathies more often than HIV-infected men. The overall mortality rate over the investigation period of 30 months was 28%. The results of our retrospective investigation indicate that HIV-infected patients have a high risk of developing lesions of the central and peripheral nervous system during the course of the disease. Various reasons might be responsible for these findings: neurotropy and metamorphosis of the human immunodeficiency virus, opportunistic infections and tumors, vitamin deficiencies, and a variety of diseases prior to HIV-infection.
Collisions between prolate uranium nuclei are used to study how particle production and azimuthal anisotropies depend on initial geometry in heavy-ion collisions. We report the two- and four-particle ...cumulants, \(v_2\{2\}\) and \(v_2\{4\}\), for charged hadrons from U+U collisions at \(\sqrt{s_{\rm NN}}\) = 193 GeV and Au+Au collisions at \(\sqrt{s_{\rm NN}}\) = 200 GeV. Nearly fully overlapping collisions are selected based on the amount of energy deposited by spectators in the STAR Zero Degree Calorimeters (ZDCs). Within this sample, the observed dependence of \(v_2\{2\}\) on multiplicity demonstrates that ZDC information combined with multiplicity can preferentially select different overlap configurations in U+U collisions. An initial-state model with gluon saturation describes the slope of \(v_2\{2\}\) as a function of multiplicity in central collisions better than one based on Glauber with a two-component multiplicity model.
Strategies proposed for the treatment of multiple sclerosis are numerous and sometimes contradictory. This review summarizes the most recent studies on the treatment of multiple sclerosis. ...Possibilities of influencing progression of the disease and the degree of disability suffered by patients are discussed. The treatment of acute relapses with high-dose intravenous glucocorticoids is now widely accepted because it has been shown that the duration of the relapse is reduced. Interval therapy between relapses and treatment of the chronic progressive variant of multiple sclerosis are still under debate. Immunosuppression, in particular with azathioprine, appears to have a positive effect on the long-term outcome. Whether other regimens, e.g., treatment with recombinant lymphokines, have a therapeutic effect, is difficult to assess at present since these substances have either never been tested in controlled double blind studies or the results of these studies are not yet available.
The beneficial effects of interferon beta have only been shown for patients in the relapsing-remitting phase of multiple sclerosis (MS). The role of interferon beta in the treatment of patients who ...are in the secondary progressive phase of the disease (SP-MS), and for whom no effective drug treatment is available, has not been assessed.
In this multicentre, double-masked, randomised, placebo-controlled trial, outpatients with SP-MS having scores of 3.0-6.5 on the Expanded Disability Status Scale (EDSS) received either 8 million IU interferon beta-1b every other day subcutaneously, or placebo, for up to 3 years. The primary outcome was the time to confirmed progression in disability as measured by a 1.0 point increase on the EDSS, sustained for at least 3 months, or a 0.5 point increase if the baseline EDSS was 6.0 or 6.5. A prospectively planned interim analysis of safety and efficacy of the intention-to-treat population was done after all patients had been in the study for at least 2 years.
358 patients with SP-MS were allocated placebo and 360 were allocated interferon beta-1b; 57 patients (31 placebo, 26 interferon beta-1b) were lost to follow-up. There was a highly significant difference in time to confirmed progression of disability in favour of interferon beta-1b (p=0.0008). Interferon beta-1b delayed progression for 9-12 months in a study period of 2-3 years. The odds ratio for confirmed progression was 0.65 (95% CI 0.52-0.83). This beneficial effect was seen in patients with superimposed relapses and in patients who had only progressive deterioration without relapses. Positive results were also obtained regarding time to becoming wheelchair-bound, relapse rate and severity, number of steroid treatments and hospital admissions, as well as on magnetic resonance imaging variables. The drug was safe and side effects were in line with previous experience with interferon beta-1b. The study was stopped after the interim results gave clear evidence of efficacy.
Treatment with interferon beta-1b delays sustained neurological deterioration in patients with SP-MS. Interferon beta-1b is the first treatment to show a therapeutic effect in patients with SP-MS.
Seventy-two adult patients suffering spontaneous subarachnoid haemorrhage (SAH) were investigated concerning early mortality. Five patients died within 3 weeks after the onset of clinical symptoms. A ...demonstrable bleeding source and a Hunt-Hess score >2 were found to be powerful predictive factors for early mortality. Sixty-seven survivors of SAH were examined at an average of 85 months after their first bleeding with regard to working capacity. Various clinical variables and different rating scales during the acute and subacute stage of SAH were identified retrospectively, and their prognostic value for working capacity was investigated. We found that all clinical features at the acute stage of SAH were not predictive of limited working capacity. At the time of discharge, however, organic brain syndrome, focal neurological deficits and a low Barthel Index proved to be significantly related to impaired working capacity. A Hunt-Hess score >2 on admission, and a demonstrable bleeding source, were powerful predictors for early death, but not for impaired working capacity of survivors of SAH.
: Common genetic variants have been shown to influence disease susceptibility, disease course, or both in multiple sclerosis (MS). Several studies have suggested a role for tumor necrosis factor‐α ...(TNF‐α) in the pathogenesis of MS. Recently, it has been reported that the TNF receptor (TNFR) II plays an essential role in the pathology and progression of experimental autoimmune encephalomyelitis, an animal model of MS. To investigate whether TNFR II polymorphisms influence susceptibility and/or clinical progression of MS, genomic DNA of 321 samples of the Austrian Genetics in MS study group and DNA of 174 platelet donors, who served as healthy controls, were genotyped for five polymorphic sites in the TNFR II gene: exon 6 nucleotide (nt) 676*T→G, exon 6 nt 783*G→A (both are associated with non‐conserved amino acid substitution), exon 10 nt 1663*G→A, exon 10 nt 1668*T→G, and exon 10 nt 1690*T→C (all of which are located in the 3′ non‐coding region of the gene). We found a significant association between exon 10 nt 1668*T→G polymorphism and susceptibility to MS. The other investigated nucleotide substitutions were not associated with susceptibility to or clinical parameters in MS.
I am the Managing Director of Grant Seebeck International, an online consulting company based in the United States. I am pleased today to be the Chairperson of a session on electronic payment ...services. For the last three days you have had a wonderful time going about looking at the stands and seeing what is happening in the online business and in the Internet. You have seen a lot of great products, but today we hope to answer a question. At the end of a great meal and a great feast you are always presented with a bill, and the question is, how am I going to pay for what I have just seen? Our panel is going to try to answer that question. We have a distinguished panel. All of us have been around the online business for a very long time. We have been here since it was a little business in which we had to convince people, publishers, information providers that they could actually make money in the electronic information business. A lot of people back in the late 70s and early 80s believed that the electronic information business was a business in which they would not make money, and so these people have been around since then. I am happy to introduce to you our panel.
AIDS of the central nervous system Wimberger, D; Kramer, J; Kollegger, H ...
Wiener Klinische Wochenschrift,
1990-Jan-19, Letnik:
102, Številka:
2
Journal Article
Recenzirano
The central nervous system of nearly every HIV-positive patient becomes affected by the AIDS virus itself or by one of the associated diseases during the course of the illness. Early diagnosis of ...lesions which demand therapeutic consequences is of the most importance concerning prolongation of life and improvement in its quality. In spite of the frequent underestimation of cerebral involvement by imaging methods and their unspecific findings they are often the only diagnostic means which permit-timely diagnosis and, at least in some diseases, therapeutic monitoring. Indications for cranial computed tomography (CCT) or magnetic resonance tomography (MRT) are already present with mild or transient neurological or psychiatric symptoms or the extracerebral manifestation of neurotropic organisms or tumours which metastasize to the brain, even in patients without subjective complaints.
In a retrospective study, 56 patients with intracranial meningiomas were investigated. The diagnosis was verified by computer tomography with subsequent selective cerebral angiography in all cases. ...At the time of admission, 62.5% of the patients had functional losses affecting the cranial nerves, 44% functional losses involving the long nerve tracts and 23.2% had cerebellar symptoms. Nonspecific clinical symptoms found comprised headaches in 61% of the patients; these were already present almost three and a half years before the final diagnosis. There was a marked organic psychological disorder in 50% of the patients which had already been present retrospectively for an average of 10 months. Cerebral convulsive attacks were present in 27% of the patients with partial convulsions (mainly of the "temporal lobe type") which had already been present for an average of 40 months before diagnosis; in the general tonic-clonic convulsions, the diagnosis was already made an average of six weeks after the first attack. These data show that nonspecific symptoms such as headaches, organic psychological disorders and cerebral convulsions may be early indicators for the presence of an intracranial space occupation and should be investigated further without delay.
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