Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

78 children with acute lymphoblastic leukemia or non-Hodgkin-lymphoma were treated at the Children's Hospital of the University of Heidelberg from December 1971 to April 1979. Following cytostatic treatment and irradiation of the skull 11 children developed CNS-symptoms (mainly seizures and paresis) which were caused by intracerebral hemorrhage, infectious or degenerative CNS-diseases. Cranial axial tomography (CAT) was helpful in finding the cause of the CNS-complication. We recommend routine CAT in the beginning and during the course of treatment of leukemia to document CNS-changes as early as possible and to prevent further damage by alterations of therapy.
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PMID:[ZNS complications in children with acute lymphatic leukemia. Computer tomographic studies]. 29 67

Four patients with chronic lymphatic leukaemia, M. Hodgkin and metastatic breast carcinoma developed particularly severe generalised herpes zoster, with complications of herpes zoster pneumonia, signs of encephalitis and phrenic nerve paresis. Virus specific complement-fixing antibodies increased regularly or delayed, without strict correlation to the clinical course. However, in all these cases there was a relative or absolute deficiency of T-lymphocytes in the peripheral blood, as a result of the underlying illness and of treatment with cytostatic agents. Because of the vital role of cell-mediated immunity in the control of the varicella-zoster virus (VZV), the observed T-cell deficiency seems to be an important pre-condition for the development of severe generalised herpes zoster.
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PMID:[Severe generalized courses of zoster due to cellular immunologic defects. Importance of an absolute or relative T-cell deficiency]. 30 13

Twelve patients who developed radiation-induced brachial plexopathy (RIBP) after receiving radiation therapy for breast carcinoma (7 patients) or Hodgkin's lymphoma (5 patients) were followed for 12 or more years, with a mean follow-up time of 20 years. Tingling and numbness of the fingers as well as weakness of the hand or arm were the most prominent presenting symptoms of RIBP. Whereas pain in most patients evolved only later in the course, it became a predominant feature in only 2. In 8 of the 12 patients, the plexopathy was surgically treated, either by neurolysis only or by neurolysis plus omental grafting in order to stop progression or paresis and/or pain. In 8 patients, including 6 of the operated group, there was slow and steady progression of RIBP over time, with the final outcome being almost complete paralysis of the arm (2 patients) or severe sensorimotor paresis rendering the hand useless (6 patients). In only 4 patients, including 2 of the non-operated group, was there absence of progression and stabilization of the paresis with only slight functional loss of the affected arm in 3 patients and severe palsy in 1. None of the 12 patients had any clear long-lasting improvement of their sensorimotor impairment. It is concluded from this study that RIBP, irrespective of surgery (neurolysis and/or omentum transplant), left two-thirds of the patients with severe or total paresis of the arm. However, the almost complete relief of severe pain (6 of 8 patients), both immediately and in follow-up patients treated with neurolysis and/or omental transplant, indicates that surgical treatment has a beneficial effect on pain relief.
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PMID:Natural history of radiation-induced brachial plexopathy compared with surgically treated patients. 239 47

Clinical charts and biopsies of 32 children with thyroid nodules were reviewed at the National Children's Hospital from 1970 to 1988. The classification between benign and malignant types was only possible by surgery and biopsy. Twenty three (72%) were found to be benign forms and nine (28%) were carcinomas (8 papillary and one follicular). Two of the carcinomas had been irradiated previously because of neuroblastoma, as well as one of the benign type who received radiation to the neck and mediastinum because of a Hodgkin's disease. No patients showed alteration in thyroid functional test (T4 and TSH). Twenty two per cent of the carcinomas and 16% of the benign forms presented higher retention in the gammagram test. Seventy eight per cent of the carcinomas and 70% of the benign types showed a normal gammagram test. Surgery in the benign cases included 10 hemithyroidectomy, 7 sub-total thyroidectomy, 3 total thyroidectomy and 3 node resection. Carcinoma cases included 6 patients with total thyroidectomy with ganglionar modified dissection in three patients; 2 hemithyroidectomy and one with sub-total thyroidectomy. Complications included 3 hypoparathyroidisms, one of them permanent, 3 transitory recurrent paresis and only one child died because of pulmonary metastasis. All carcinoma patients were treated with levothyroxine and three of them also received 1131 in order to control ganglionar metastasis. Total survival rate for carcinoma patients was 83% at 90 months. It is concluded that only with surgery it is possible to classify correctly the histological type of children with thyroid nodes. Clinical evaluation and laboratory tests are useless. However, it has not been defined how big the surgery must be.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Thyroid nodules in children. Experience at the National Children Hospital of Costa Rica]. 260 73

Hodgkin's disease (HD) has been reported in association with the acquired immunodeficiency syndrome (AIDS) only occasionally, and these patients seemed to have aggressive unusual HD. We report an additional case of HD in a 50-year-old homosexual man with a marked change of his clinical course after the development of seropositivity to human immunodeficiency virus (HIV). In 1978, HD stage IIIA, nodular sclerosing type, was diagnosed and treated with splenectomy and total nodal radiotherapy, which led to a complete response lasting till 1985. The patient then reported to our clinic with generalized lymphadenopathy and paresis of the m. biceps and m. triceps due to an infiltration of C6/C7 by HD. Laboratory findings revealed a T4/T8 ratio of 0.5 and HIV antibodies. He was given chemotherapy (COPP), but after a good initial response he developed pulmonary infiltration of HD. Therapy was changed to ABVD, but the patient did not respond to treatment and died of progressive HD in 1986. We therefore conclude that the natural history of HD in patients at risk for AIDS may be altered to a higher malignant form, and treatment modalities used in these patients must be further evaluated.
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PMID:Atypical presentation of Hodgkin's disease in a patient at risk for the acquired immunodeficiency syndrome. 318 Jan 29

In a group of 241 patients with non-Hodgkin lymphoma investigated retrospectively, CNS manifestations occurred in 8%, mainly as meningeosis lymphoblastomatosa. Lymphoblastic and immunoblastic NHL showed the highest risk of CNS infiltration (40.7% and 12.5% respectively). Further risk factors were disseminated stage of the disease, prior involvement of the bone marrow and juvenile age. Characteristic symptoms were eye muscle paresis, paresthesias and pareses of peripheral muscles. The most fruitful diagnostic measure was lumbar puncture. More than 80% of the patients observed with CNS manifestations died within one year. The factor limiting life was less the CNS infiltration itself than the systemic progression. CNS prophylaxis should be incorporated in the treatment plan in patients with lymphoblastic and immunoblastic non-Hodgkin lymphoma at an early stage. In contrast CNS prophylaxis is not justified in uncontrollable systemic non-Hodgkin lymphoma spread.
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PMID:CNS manifestations in non-Hodgkin lymphomas (NHL). 663 30

Since the majority of children with acute leukemia and lymphoma are long-term survivors, more attention is directed towards late sequelae of therapy. Intracerebral hemorrhage after treatment of central nervous system (CNS) neoplasia in childhood is a very rare event. A seven and a half-year-old boy was admitted to our hospital because of acute third nerve palsy. Three years and eight months before the patient had been treated for a mediastinal T-cell non Hodgkin's lymphoma (T-NHL) with CNS involvement by combined chemo-radiotherapy. Recurrent disease was excluded, but intracerebral hemorrhage in the tectal area was demonstrated by repeated magnetic resonance imaging. Symptoms of incomplete oculomotor paresis improved spontaneously with conservative therapy. Intracerebral hemorrhage may occur as a rare complication in children with malignant CNS disease even years after treatment with combined chemo-radiotherapy.
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PMID:Intracerebral hemorrhage as a late complication after CNS treatment of childhood lymphoma. 987 96

Epidural involvement is analyzed retrospectively in 512 patients with primary treatment and follow up for Hodgkin's disease (HD) between 1970 and 1999. In one case (0.2%) epidural manifestation was the first symptom and in six cases (1.2%) it occurred later, at a disseminated, advanced stage. All seven patients were male: three had mixed cellularity and four nodular sclerosis histological subtype. The thoracic segment was involved in four cases, the lumbar in two and the cervical segment in one case. The most frequent symptoms were back pain, limb weakness, paresis/plegia, incontinence. Computer tomography, magnetic resonance imaging and myelography were used as diagnostic procedures and in planning the treatment. Functional recovery was achieved by laminectomy, loco-regional irradiation and adjuvant polychemotherapy with remission of HD for 6-100 months. Later, however, six patients died due mainly to relapse/progression of HD. We emphasize the importance of an interdisciplinary approach in the treatment of HD with this relatively rare appearance, which requires close co-operation among oncohematologists, neurologists, radiologists, neurosurgeons, radiotherapists and physiotherapists.
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PMID:Epidural involvement in Hodgkin's disease. 1241 30

Highly active antiretroviral treatment (HAART), which has been available for most AIDS patients in France since 1996, has resulted in a dramatic improvement of the progression of the disease. From the survey of our series of 343 brains with acquired immunodeficiency syndrome (AIDS) from patients who died between 1985 and 2002, we found both quantitative and qualitative changes in the pattern of human immunodeficiency virus (HIV) neuropathology. Quantitatively, despite a dramatic decrease in the number of autopsies, brain involvement remained a major cause of death. There was an overall decrease in incidence of cerebral toxoplasmosis, cytomegalovirus encephalitis (CMVE), and HIV encephalitis (HIVE), for which successful treatment is available. This contrasted with the unchanged incidence of progressive multifocal leukoencephalopathy (PML) and malignant non-Hodgkin lymphomas (MNHL). However, when looking closer at the 3 last years, the incidence of diseases affecting patients with severe immunodepression (CMVE, PML, and MNHL) decreased between 2000 and 2002, whereas infections occurring in patients with milder immunodeficiency, toxoplasmosis, varicella-zoster encephalitis (VZVE), or herpes simplex virus encephalitis (HSVE) became more frequent. In addition, we found uncommon types of brain infection such as BK virus encephalitis or general paresis. Finally, we described new variants of HIVE: severe leukoencephalopathy with intense perivascular macrophage and lymphocyte infiltration, possibly due to an exaggerated response from a newly reconstituted immune system, and chronic "burnt out" forms of HIVE as VZVE, toxoplasmosis, or PML, possibly associated with prolonged survival, in which neither inflammation nor organisms could be detected. These findings are compared with those reported in other neuropathological studies from different developed countries.
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PMID:The changing pattern of HIV neuropathology in the HAART era. 1276 83

Introduction of Highly Active Antiretroviral Treatment (HAART) which is available for most AIDS patients in France since 1996, has resulted in a dramatic improvement of the disease course. From the survey of our autopsy series of (AIDS) cases and the review of other neuropathological studies from different developed countries, we found quantitative and qualitative changes in the pattern of human immunodeficiency virus (HIV) neuropathology. Quantitatively, there was a dramatic decrease in the number of autopsy cases but brain involvement remained a major cause of death in AIDS patients. There was an overall decrease of cerebral toxoplasmosis, cytomegalovirus encephalitis (CMVE) and HIV encephalitis (HIVE) for which successful treatment is available. This contrasted with the unchanged incidence of progressive multifocal leucoencephalopathy (PML) and primary malignant non Hodgkin brain lymphomas (PMBL). However, when looking closer at the last three years, the incidence of diseases affecting patients with severe immunodepression (CMVE, PML, PMBL) decreased in 2000-2002, whereas infections occurring in patients with milder immunodeficiency (toxoplasmosis, varicella-zoster encephalitis (VZVE) or herpes simplex virus encephalitis (HSVE) became more frequent. Qualitatively, there were uncommon types of brain infections, such as BK virus encephalitis or general paresis. Finally, new forms of HIVE were reported: severe leukoencephalopathy with intense perivascular macrophage and lymphocyte infiltration possibly due to an exaggerated response from a newly reconstituted immune system; and also chronic "burnt out" forms of HIVE as VZVE, toxoplasmosis, or PML in which no inflammation and no infectious agent could be detected, likely due to prolonged survival.
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PMID:[The neuropathology of HIV infection in the era of highly active antiretroviral therapy]. 1475 84


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