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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A parainfluenza type 1 virus (6/94) recovered from brain cell cultures of two patients with multiple sclerosis (MS) was inoculated into newborn chimpanzees by the intranasal (IN) or intracerebral (IC) routes. Four of the five animals receiving the virus IN developed clinical signs ranging from mild fever, with or without rhinorrhea, to severe respiratory disease. Two of the chimpanzees died as a result of pneumonia. Virus could be recovered from respiratory tracts for as long as 9 days after exposure and was followed by development of specific neutralizing antibody to the 6/94 virus but not to the HA2 strain of parainfluenza type 1. Brain examination showed astrocytosis, especially of posterior fossa structures, activation of microgliacytes and, in one animal, round cell infiltration of leptomeninges. Of thse three animals receiving virus IC, two developed recurrent seizures beginning 14 months after inoculation. One of these was sacrificed at 23 months of age after progressive neurologic disease, with electroencephalographic abnormalities, developed. The third animal died at 3 months of age of intercurrent pneumonia. No virus was recovered from these animals, although all showed antibody conversion to 6/94 but not HA2 virus. A variety of pathologic lesions were seen in the brains of both animals coming to necropsy particularly in the sacrificed chimpanzee. These included subacute encephalitis, extensive cortical and subcortical degeneration, vascular sclerosis, white matter gliosis and axonal dystrophy.
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PMID:Infection and disease induced in chimpanzees with 6/94, a parainfluenza type 1 virus isolated from human multiple sclerosis brain. 18 66

6 patients with severe chronic progressive multiple sclerosis were subjected to total lymphoid irradiation (TLI) to assess clinical efficacy and side effects. During a 4 year follow-up the disability progression was continuous. Side effects during TLI were well tolerated; side effects after TLI brought about a worsening of the quality of life. One patient died of pneumonia. In this preliminary study TLI did not reduce the worsening of disability in MS patients.
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PMID:Total lymphoid irradiation in chronic progressive multiple sclerosis. 159 73

In England and Wales there is a strong geographical relation between current mortality from chronic bronchitis and emphysema in adults and infant mortality from bronchitis and pneumonia 50 years ago. Follow-up studies of infants and children show that certain pulmonary infections cause persisting abnormalities of lung function. This suggests that infection of an organ system during a period of rapid growth may have permanent deleterious effects. Long-term consequences of infection may also depend on age-related differences in the host response. The relationship between age of infection with hepatitis B virus and the likelihood of becoming a chronic HBsAg carrier is an example of this. Evidence that the common communicable diseases of childhood tend to have occurred late in cases of multiple sclerosis hints at similar mechanisms in this disease. The current patterns of motor neuron disease mirror the epidemiology of poliovirus infection 40 years ago both in geographical distribution and in changes over time. The same neuronal populations are affected in both these conditions; is there a causal link?
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PMID:Childhood infection and adult disease. 185 18

Although chemical immunosuppression has been shown to benefit patients with chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an appreciable oncogenic potential in patients with multiple sclerosis. Accordingly, we developed a modified total lymphoid irradiation (TLI) regimen designed to reduce toxicity and applied it to a randomized double blind trial of TLI or sham irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980 rad, lowering the superior mantle margin to midway between the thyroid cartilage and angle of the mandible (to avert xerostomia) and the lower margin of the mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by dividing abdominal radiation between mantle and inverted Y), limiting spinal cord dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of inverted Y fields, and also protecting the left kidney even if part of the spleen were shielded. Clinical efficacy was documented by the less frequent functional scale deterioration of 20 TLI treated patients with chronic progressive MS compared to to 20 sham-irradiated progressive MS patients after 12 months (16% versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up was related to the reduction in lymphocyte count 3 months post-irradiation (p less than 0.02). Toxicity was generally mild and transient, with no instance of xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI patients. However, menopause was induced in 2 patients and staphylococcal pneumonia in one. Our data suggest that this modified TLI regimen has clinical efficacy and sufficiently low toxicity to make it suitable for investigative immunosuppressive treatment of patients with progressive MS or other non-malignant conditions.
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PMID:Total lymphoid irradiation for multiple sclerosis. 327 1

A 38 year-old wife, of belgian origin and residency, suffered from a left retrobulbar optic neuritis in 1973, with as only sequel dyschromatopsia and central scotoma enlargement. In 1985, 12 years later, she complained of a progressive weakness of the right hand, and developed a spastic tetraplegia within four months. The C.T. Scan showed white matter hypodensities, without mass effect or contrast enhancement, first limited to the left centrum semiovale and later on with multifocal character. Somatosensory evoked potentials after stimulation of the right median nerve demonstrated only lemniscus medialis response. Multiple sclerosis was initially suspected. Analysis of lymphocytes subsets however showed a markedly reduced helper population with as a result a very low H/S ratio, and the serology was found positive for HTLV-III-LAV, thus demonstrating the diagnosis of acquired immune deficiency syndrome (AIDS). Visceral autopsy demonstrated only a CMV pneumonia. Autopsy of the brain showed typical lesions of progressive multifocal leukoencephalopathy (PML). This case is compared with 20 previously published observations of PML associated with AIDS and appears rather unusual due to the association of unfrequent clinical peculiarities: previous, probably coincidental, retrobulbar optic neuritis, female patient, lack of risk factor and clinical symptoms of AIDS. The diagnostic difficulties in the present case are emphasized.
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PMID:[Progressive multifocal leukoencephalopathy mimicking multiple sclerosis as the sole clinical manifestation of acquired immunodeficiency syndrome]. 381 29

The role of measles virus in persistent infections has been reviewed. Measles, normally a benign disease of children can give rise directly to complications (encephalitis, pneumonia) or after a period of months or years lead to a slow neurological infection (subacute sclerosing panencephalitis). The models, both "in vitro" and "in vivo", which have been developed to study the factors involved in measles virus persistence, are compared and related to the parameters observed in the human disease. The evidence that measles virus is associated with other long term diseases (multiple sclerosis, Paget'b bone disease) is discussed.
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PMID:Measles virus and chronic infections. 702 50

This study explored the prevalence of comorbid conditions in hospitalized patients with multiple sclerosis (MS) who were 65 years of age or older. Using 1989 data from the Quality of Care Medicare Provider Analysis and Review (MEDPAR) file, hospitalized MS patients were compared with respect to discharge diagnoses to an age- and sex-matched group of hospitalized patients without MS. As expected, the following discharge diagnoses were more common (P < 0.05) for MS patients: urinary tract infection, pneumonia, septicemia and cellulitus. In contrast, MS patients were less likely (P < 0.05) to have discharge diagnoses of acute myocardial infarction, heart failure, hypertension, angina pectoris, cerebrovascular disease, diabetes mellitus and chronic obstructive pulmonary disease. Possible explanations include under-reporting of certain comorbid conditions on discharge records of MS patients, a protective effect of MS or its treatment, reduced prevalence of risk factors, disproportionate mortality in younger MS patients with comorbidity and the benefits of medical surveillance.
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PMID:Patterns of comorbidity in elderly patients with multiple sclerosis. 772 46

Immunosuppressive treatments of neuro-immunologic diseases: myasthenia gravis, polymyositis, chronic inflammatory demyelinating polyneuropathy and multiple sclerosis were reviewed. The treatments need to be planned in terms of 2-5 years. Cautions must be taken for adverse effects of short and long terms. Corticosteroids were the most well used and were studied medication of the first choice among immunosuppressants in these diseases except for CIDP in which large amounts of IV-Ig or plasmapheresis are the first choice. Pulse treatment of very high doses of steroids are used in refractory or severe cases. As for immunosuppressants, in polymyositis iv MTX is the choice since its response is quicker than AZ. CsA is used in cases with pneumonitis. In MS, pulse treatments of steroids followed by gradual decreasing doses of steroids are used for 2-3 months in each relapse. Recently, IFN-alpha 2a and IFN-beta significantly reduced the number of relapses and improved MRI findings. Chronic applications of AZ, CY, Cs or MTX have possibilities of reducing relapses, and new drugs like mizoribine and mitoxantrone etc. are in trials.
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PMID:[Treatment of neuro-immunologic diseases by immunosuppressants]. 799 8

A case-control study on multiple sclerosis was conducted in Western Norway during the years 1986-1988. Included were 155 persons with multiple sclerosis and 200 controls, marginally matched according to age, sex and area of residence. The mean age at measles infection was for the cases 6.6 years and for the controls 5.7 years (p = 0.06). The cases had more frequently experienced bronchitis and/or pneumonia in the age group 11-15 years (OR = 3.20, 95% confidence interval 0.96-10.63). Tonsillectomies were reported more frequently by the cases. The odds ratio was especially high for those treated at age 0-6 years (OR = 3.44, 95% confidence interval 1.63-7.27). The results are consistent with the idea of MS as an age-dependent, host-immune response to infection during childhood or adolescence.
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PMID:Infections in childhood and adolescence in multiple sclerosis. A case-control study. 823 5

Respiratory complications are common in the terminal stages of multiple sclerosis and contribute to mortality in these patients. When respiratory motor pathways are involved, respiratory muscle weakness frequently occurs. Although it is well established that weakness of the respiratory muscles produces a restrictive ventilatory defect, the degree of muscle weakness and pulmonary function are poorly related. Respiratory muscle weakness was observed in patients with normal or near normal pulmonary function. Expiratory muscle weakness is more prominent than inspiratory muscle weakness and may impair performance of coughing. Subsequently, in addition to bulbar dysfunction, respiratory muscle weakness may contribute to ineffective coughing, pneumonia, and sometimes even acute ventilatory failure may ensue. Respiratory muscle weakness may also occur early in the course of the disease. Recent studies suggest that the respiratory muscles can be trained for both strength and endurance in multiple sclerosis patients. Whether respiratory muscle training delays the development of respiratory dysfunction and subsequently improves exercise capacity and cough efficacy, prevents pulmonary complications or prolongs survival in the long-term remains to be determined.
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PMID:Respiratory muscle involvement in multiple sclerosis. 1006 97


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