RESUMEN
A double-blind clinical trial of mitoxantrone versus methylprednisolone was performed in 49 patients with relapsing, secondary multiple sclerosis. Patients were randomized to receive 13 infusions of mitoxantrone 12 mg/m2 (n = 28), or 13 infusions of 1 g of methylprednisolone (n = 21), over 32 months. Twenty-four patients completed the trial. There were no statistical differences between the two groups of patients at study entry. A significant improvement in the Expanded Disability Scale Score (EDSS) was observed in the mitoxantrone group after one year of treatment (p < 0.0022). The total number of relapses, the mean number of relapses/patient/year, and the total number of gadolinium-enhanced lesions on bi-annual MRI scans were significantly decreased in the mitoxantrone group throughout the study period. Nausea, vomiting, and alopecia were more frequent in the mitoxantrone-treated patients. Mitoxantrone has a role in the treatment of MS patients with frequent exacerbations and rapid disease progression.
Asunto(s)
Inmunosupresores/uso terapéutico , Metilprednisolona/uso terapéutico , Mitoxantrona/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Adulto , Alopecia/inducido químicamente , Medios de Contraste , Método Doble Ciego , Femenino , Estudios de Seguimiento , Gadolinio , Humanos , Inmunosupresores/efectos adversos , Recuento de Linfocitos , Imagen por Resonancia Magnética , Masculino , Azul de Metileno/uso terapéutico , Metilprednisolona/efectos adversos , Mitoxantrona/efectos adversos , Esclerosis Múltiple/patología , Náusea/inducido químicamente , Náusea/prevención & control , Pacientes Desistentes del Tratamiento , Flebitis/inducido químicamente , Flebitis/complicaciones , Embolia Pulmonar/etiología , Pirrolidinas/uso terapéutico , Recurrencia , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Vómitos/inducido químicamente , Vómitos/prevención & controlRESUMEN
Hypothermia, defined as a core temperature less than 35 degrees C has multiple causes and several neurological consequences. The cases of three patients with definite multiple sclerosis since more than a decade are reported, who presented with several episodes of coma and hypothermia. Systematic neuropathologic examination of the hypothalamus in one case did not reveal any abnormality.
Asunto(s)
Hipotermia/complicaciones , Esclerosis Múltiple/complicaciones , Adulto , Enfermedad Crónica , Femenino , Humanos , Hipotermia/fisiopatología , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/fisiopatologíaRESUMEN
One hundred five patients with MS were divided into three groups matched for age, sex, and disability, and treated with either placebo, transfer factor prepared from leukocytes of random donors, or transfer factor from leukocytes of family members living with the patients. There were no differences in the three treatment groups for changes in disability, activities of daily living, or evoked potentials. Eighteen months of transfer factor therapy had no effect on gamma-interferon production or natural killer cell activities.
Asunto(s)
Esclerosis Múltiple/tratamiento farmacológico , Factor de Transferencia/uso terapéutico , Actividades Cotidianas , Ensayos Clínicos como Asunto , Método Doble Ciego , Potenciales Evocados , Femenino , Humanos , Interferón gamma/metabolismo , Células Asesinas Naturales/inmunología , Leucocitos/metabolismo , Masculino , Esclerosis Múltiple/fisiopatología , Estudios ProspectivosRESUMEN
The effect of short-term intensive cyclophosphamide therapy upon 21 patients with moderately advanced multiple sclerosis is compared with a non-treated control group of 21 patients retrospectively matched for global disability. The progression of the disease was evaluated by regular disability scoring, and the results were analyzed by non-parametric statistical tests. No significant differences in the progression of the disability could be detected during a follow-up period of 2 years.
Asunto(s)
Ciclofosfamida/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Adulto , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
Lymphocyte stimulation tests with human basic protein of myelin were performed on patients with multiple sclerosis, with other neurological diseases and on normal subjects. In both MS and OND group, a hypersensitization to basic protein was seen in about one third of the cases. All normal subjects, except one, had negative responses. In the MS group, a positive correlation could be found with some features of the disease: significantly more positive responses were found in independent patients with a short duration of illness and in those with an oligoclonal distribution in the CSF. The authors compare their results with those of the literature. The possible role of BP in pathogeny of MS and OND is discussed.
Asunto(s)
Activación de Linfocitos , Esclerosis Múltiple/inmunología , Proteínas del Tejido Nervioso/farmacología , Histocitoquímica , Humanos , Inmunidad Celular , Inmunoglobulinas/análisis , Esclerosis Múltiple/metabolismo , Vaina de MielinaRESUMEN
Disseminated cryptococcal infection is described in eight patients, seven of them with verified meningeal involvement. Six of the eight patients were recipients of a renal homograft and submitted to the classical immunosuppressive treatment. Consideration is given to predisposing factors and to problems in the clinical, biological and mycological diagnosis. Some comments are presented on the often disappointing results of antifungal therapy of cryptococcal meningitis.
