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1.
J Neurol Neurosurg Psychiatry ; 87(8): 821-30, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27093948

RESUMO

While the past 2 decades have witnessed an increasing understanding of amyotrophic lateral sclerosis (ALS) arising from East Asia, particularly Japan, South Korea, Taiwan and China, knowledge of ALS throughout the whole of Asia remains limited. Asia represents >50% of the world population, making it host to the largest patient cohort of ALS. Furthermore, Asia represents a diverse population in terms of ethnic, social and cultural backgrounds. In this review, an overview is presented that covers what is currently known of ALS in Asia from basic epidemiology and genetic influences, through to disease characteristics including atypical phenotypes which manifest a predilection for Asians. With the recent establishment of the Pan-Asian Consortium for Treatment and Research in ALS to facilitate collaborations between clinicians and researchers across the region, it is anticipated that Asia and the Pacific will contribute to unravelling the uncertainties in ALS.


Assuntos
Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/epidemiologia , Doença dos Neurônios Motores/complicações , Doença dos Neurônios Motores/epidemiologia , Esclerose Lateral Amiotrófica/genética , Esclerose Lateral Amiotrófica/mortalidade , Ásia/epidemiologia , Progressão da Doença , Humanos , Doença dos Neurônios Motores/genética , Doença dos Neurônios Motores/mortalidade , Fenótipo , Síndrome
2.
Lupus ; 24(3): 248-55, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25253567

RESUMO

OBJECTIVE: Peripheral neuropathy in systemic lupus erythematosus (SLE) is heterogeneous and its commonest pattern is symmetrical polyneuropathy. The aim of this study was to describe the prevalence, clinical and electrophysiological features, disease associations and effects on function and quality of life of polyneuropathy in SLE patients, defined using combined clinical and electrophysiological diagnostic criteria. METHODS: Consecutive SLE patients seen at the University of Malaya Medical Centre were included. Patients with medication and other disorders known to cause neuropathy were excluded. Demographic, clinical and laboratory data were obtained using a pre-defined questionnaire. Function and health-related quality of life was assessed using the modified Rankin scale and the SF-36 scores. Nerve conduction studies (NCS) were carried out in both upper and lower limbs. Polyneuropathy was defined as the presence of bilateral clinical symptoms and/or signs and bilateral abnormal NCS parameters. RESULTS: Of 150 patients, 23 (15.3%) had polyneuropathy. SLE-related polyneuropathy was mainly characterized by sensory symptoms of numbness/tingling and pain with mild signs of absent ankle reflexes and reduced pain sensation. Function was minimally affected and there were no differences in quality of life scores. NCS abnormalities suggested mild length-dependent axonal neuropathy, primarily in the distal lower limbs. Compared to those without polyneuropathy, SLE-related polyneuropathy patients were significantly older but had no other significant demographic or disease associations. CONCLUSIONS: SLE-related polyneuropathy is a chronic, axonal and predominantly sensory neuropathy, associated with older age. Its underlying pathogenetic mechanisms are unknown, although a possibility could be an increased susceptibility of peripheral nerves in SLE patients to effects of aging.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Polineuropatias/etiologia , Adolescente , Adulto , Idoso , Criança , Estudos de Coortes , Feminino , Humanos , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Condução Nervosa , Polineuropatias/epidemiologia , Polineuropatias/fisiopatologia , Adulto Jovem
3.
Lupus ; 22(9): 967-71, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23846232

RESUMO

OBJECTIVES: Ethnic differences in systemic lupus erythematosus (SLE) have been previously described in the multiethnic Malaysian population. However, there have since been many demographic and socioeconomic changes in the country. The aim of this study is to re-examine the clinical and immunological profiles of Malaysian SLE patients of different ethnic backgrounds. METHODS: Consecutive follow-up patients at the University Malaya Medical Centre (UMMC) from July 2010 until March 2011 were included in the study. RESULTS: The most common clinical manifestations were malar rash (61.3%), arthritis (52.3%), haematological disease (51.6%), oral ulcers (51%) and renal disease (40.6%). Ethnic Indians had fewer malar and discoid rashes but were at higher risk of arthritis, serositis, renal and neuropsychiatric disease compared to Malays and Chinese Malaysians. Antiphospholipid syndrome (APS) was less common in Chinese. A longer duration of SLE correlated with a lower SLEDAI score. CONCLUSION: Overall, the spectrum disease expression was similar to the earlier Malaysian study but the frequency of the more severe disease manifestations, viz. renal, haematological, neuropsychiatric involvements and serositis, were lower. This study further emphasises differences primarily between ethnic Indians and the other races in Malaysia.


Assuntos
Síndrome Antifosfolipídica/epidemiologia , Lúpus Eritematoso Sistêmico/epidemiologia , Centros Médicos Acadêmicos , Adolescente , Adulto , Síndrome Antifosfolipídica/etnologia , Estudos Transversais , Feminino , Humanos , Lúpus Eritematoso Sistêmico/etnologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Malásia/epidemiologia , Masculino , Índice de Gravidade de Doença , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
4.
Lupus ; 21(10): 1119-23, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22433918

RESUMO

Peripheral neuropathy is a known manifestation of systemic lupus erythematosus. However, the association of primary autoimmune inflammatory neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP) with SLE is uncommon. We report a 26-year-old man who simultaneously presented with severe CIDP and photosensitive rash, but was unresponsive to intravenous immunoglobulin infusion and continued to progress. He was found to have underlying SLE and improved with combined corticosteroid and immunosuppressive therapy with oral cyclophosphamide. CIDP with underlying SLE may be more resistant to conventional therapy with IVIG, requiring the addition of other immunosuppressive agents.


Assuntos
Ciclofosfamida/uso terapêutico , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/complicações , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/tratamento farmacológico , Administração Oral , Corticosteroides/administração & dosagem , Adulto , Ciclofosfamida/administração & dosagem , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/administração & dosagem , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/fisiopatologia , Resultado do Tratamento
5.
Mycologia ; 114(6): 947-963, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36239960

RESUMO

Ganoderma boninense, the causal agent of basal stem rot (BSR) disease, has been recognized as a major economic threat to commercial plantings of oil palm (Elaeis guineensis Jacq.) in Southeast Asia, which supplies 86% of the world's palm oil. High genetic diversity and gene flow among regional populations of 417 G. boninense isolates collected from Sabah, Sarawak, and Peninsular Malaysia (Malaysia) and Sumatra (Indonesia) were demonstrated using 16 microsatellite loci. Three genetic clusters and different admixed populations of G. boninense across regions were detected, and they appeared to follow the spread of the fungus from the oldest (Peninsular Malaysia and Sumatra) to younger generations of oil palm plantings (Sabah and Sarawak). Low spatial genetic differentiation of G. boninense (FST = 0.05) among the sampling regions revealed geographically nonrestricted gene dispersal, but isolation by distance was still evident. Analysis of molecular variance (AMOVA) confirmed the little to no genetic differentiation among the pathogen populations and the three genetic clusters defined by STRUCTURE and minimum spanning network. Despite G. boninense being highly outcrossing and spread by sexual spores, linkage disequilibrium was detected in 7 of the 14 populations. Linkage disequilibrium indicated that the reproduction of the fungus was not entirely by random mating and genetic drift could be an important structuring factor. Furthermore, evidence of population bottleneck was indicated in the oldest oil palm plantations as detected in genetic clusters 2 and 3, which consisted mainly of Peninsular Malaysia and Sumatra isolates. The population bottleneck or founding event could have arisen from either new planting or replanting after the removal of large number of palm hosts. The present study also demonstrated that migration and nonrandom mating of G. boninense could be important for survival and adaptation to new palm hosts.


Assuntos
Arecaceae , Fluxo Gênico , Malásia , Indonésia , Doenças das Plantas/microbiologia , Arecaceae/microbiologia , Reprodução
6.
Mycologia ; 113(5): 902-917, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34161196

RESUMO

In 1911 and 1917, the first commercial plantings of African oil palm (Elaeis guineensis Jacq.) were made in Indonesia and Malaysia in Southeast Asia. In less than 15 years, basal stem rot (BSR) was reported in Malaysia. It took nearly another seven decades to identify the main causal agent of BSR as the fungus, Ganoderma boninense. Since then, research efforts have focused on understanding G. boninense disease epidemiology, biology, and etiology, but limited progress was made to characterize pathogen genetic diversity, spatial structure, pathogenicity, and virulence. This study describes pathogen variability, gene flow, population differentiation, and genetic structure of G. boninense in Sarawak (Malaysia), Peninsular Malaysia, and Sumatra (Indonesia) inferred by 16 highly polymorphic cDNA-SSR (simple sequence repeat) markers. Marker-inferred genotypic diversity indicated a high level of pathogen variability among individuals within a population and among different populations. This genetic variability is clearly the result of outcrossing between basidiospores to produce recombinant genotypes. Although our results indicated high gene flow among the populations, there was no significant genetic differentiation among G. boninense populations on a regional scale. It suggested that G. boninense genetic makeup is similar across a wide region. Furthermore, our results revealed the existence of three admixed genetic clusters of G. boninense associated with BSR-diseased oil palms sampled throughout Sarawak, Peninsular Malaysia, and Sumatra. We postulate that the population structure is likely a reflection of the high genetic variability of G. boninense populations. This, in turn, could be explained by highly successful outcrossing between basidiospores of G. boninense from Southeast Asia and introduced genetic sources from various regions of the world, as well as regional adaptation of various pathogen genotypes to different palm hosts. Pathogen variability and population structure could be employed to deduce the epidemiology of G. boninense, as well as the implications of plantation cultural practices on BSR disease control in different regions.


Assuntos
Arecaceae , Ganoderma , Ganoderma/genética , Fluxo Gênico , Variação Genética , Humanos , Indonésia , Malásia , Doenças das Plantas
7.
Neurology ; 57(3): 529-31, 2001 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-11502928

RESUMO

In a hospital series of 70 patients on follow-up after radiotherapy for nasopharyngeal carcinoma, 14 patients (20%) developed delayed post-irradiation bulbar palsy 1 to 18 years after radiotherapy (mean 5.5 years). Functional disability was moderate to severe. Three patients had aspiration pneumonia with one mortality. Post-irradiation bulbar palsy was a common complication and probably resulted from direct neuronal damage.


Assuntos
Paralisia Bulbar Progressiva/etiologia , Irradiação Craniana/efeitos adversos , Neoplasias Nasofaríngeas/radioterapia , Adulto , Paralisia Bulbar Progressiva/fisiopatologia , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/fisiopatologia , Fatores de Tempo
8.
J Infect ; 42(1): 40-3, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11243752

RESUMO

OBJECTIVES: To study the excretion of Nipah virus in the upper respiratory secretions and urine of infected patients in relation to other clinical features. METHODS: Isolation of Nipah virus from the respiratory secretions and urine was made in Vero cells and identified by indirect immunofluorescence assay using anti-Hendra specific hyperimmune mouse ascitic fluid and FITC-conjugated goat anti-mouse IgG. RESULTS: During the peak outbreak of Nipah virus encephalitis in Malaysia, Nipah virus was isolated from the upper respiratory secretions and urine in eight of 20 patients who were virologically and/or serologically confirmed to be infected with the virus. From these eight patients, Nipah virus was isolated from six throat swab specimens, three urine specimens and only one nasal swab specimen. The positive virus isolation rate was related to the collection of these specimens during the early phase of the illness (P = 0.068). The presence of serum anti-Nipah specific IgM appeared to reduce the chance of isolating the virus (P = 0.049). There was no significant difference in the isolation rate with respect to the age, gender, ethnic group and clinical features associated with grave prognosis and mortality outcome of the patients. CONCLUSION: This study shows that it is possible to be infected from secretions of infected patients, but epidemiological survey on close contacts so far did not suggest that human-to-human transmission is common.


Assuntos
Encefalite Viral/virologia , Infecções por Paramyxoviridae/virologia , Paramyxovirinae/isolamento & purificação , Sistema Respiratório/virologia , Adolescente , Adulto , Animais , Ascite , Surtos de Doenças , Encefalite Viral/epidemiologia , Encefalite Viral/urina , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulina G , Malásia/epidemiologia , Masculino , Camundongos , Pessoa de Meia-Idade , Mucosa Nasal/virologia , Infecções por Paramyxoviridae/epidemiologia , Infecções por Paramyxoviridae/urina , Faringe/virologia , Prognóstico , Sistema Respiratório/metabolismo , Eliminação de Partículas Virais
9.
J Clin Neurosci ; 7(4): 334-6, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10938615

RESUMO

We report two patients with myopathic dropped head syndrome, a rare and interesting neuromuscular syndrome characterised by a predominant weakness of the neck extensor muscles. The first patient, a middle aged Chinese man, presented with progressive weakness of neck extension but his clinical course later stabilised despite a lack of response to corticosteroids. Muscle biopsy revealed a necrotising myopathy with no evidence of inflammation. This patient supports the existence of an idiopathic restricted non-inflammatory myopathy, a so called isolated neck extensor myopathy syndrome which is recognised to pursue a less progressive, more benign course. Our second patient had histopathological evidence for polymyositis; there was a favourable response to steroids. Our cases underscore the fact that there may be a spectrum of pathological processes associated with the myopathic dropped head syndrome ranging from non-inflammatory muscle necrosis to a full blown inflammatory myositis.


Assuntos
Debilidade Muscular/etiologia , Debilidade Muscular/patologia , Doenças Musculares/complicações , Doenças Musculares/patologia , Músculos do Pescoço/patologia , Adulto , Movimentos da Cabeça/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/fisiopatologia , Doenças Musculares/fisiopatologia , Músculos do Pescoço/fisiopatologia
10.
Ann Acad Med Singap ; 25(4): 566-9, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8893932

RESUMO

Sciatic neuropathy is an uncommonly diagnosed focal mononeuropathy. We reviewed the aetiology and electrodiagnostic features of 29 patients studied at the Neurodiagnostic Laboratory, Tan Tock Seng Hospital from January 1989 to April 1995. External nerve compression was the most common cause (38%) followed by trauma (21%). Other rare causes in this series included intragluteal injections, hip surgery and diabetic mononeuropathy while 24% had uncertain aetiology. Electrodiagnostic studies showed preferential involvement of the peroneal division in 51%. Axonal loss was found in 97%. We conclude that sciatic neuropathy often mimics distal peroneal nerve dysfunction and neurophysiological studies are essential for diagnosis. Furthermore, these studies are necessary for assessing prognosis in relation to axonal loss.


Assuntos
Nervo Isquiático , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Eletrodiagnóstico , Eletrofisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Estudos Retrospectivos , Nervo Isquiático/lesões
12.
AJR Am J Roentgenol ; 175(2): 437-42, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10915690

RESUMO

OBJECTIVE: The newly discovered Nipah virus causes an acute febrile encephalitic illness in humans that is associated with a high mortality. The purpose of this study is to describe the MR imaging findings of Nipah encephalitis. MATERIALS AND METHODS: MR imaging of the brain was performed in 31 patients with Nipah encephalitis divided into three groups. The first group (14 patients) underwent MR imaging during the acute phase of the illness and the second group (10 patients) during the later phase of the acute illness. The third group consisted of six patients who underwent MR imaging because they experienced neurologic relapse and one patient who had late-onset encephalitis. Spin-echo T1- and T2-weighted sequences and T2-weighted fluid attenuated inversion recovery (FLAIR) sequences were performed. Contrast-enhanced MR imaging was performed in four patients. RESULTS: The FLAIR sequences revealed abnormalities in all patients studied. MR imaging findings in both the acute and later phases of encephalitis were similar; the main feature of both phases was the presence of discrete high-signal-intensity lesions, measuring 2-7 mm, disseminated throughout the brain, mainly in the subcortical and deep white matter of the cerebral hemispheres. Neither mass effect nor cerebral edema was seen. There was no correlation with the focal neurologic signs, depth of coma, and outcome of the patients. The lesions were attributed to widespread microinfarctions from underlying vasculitis of cerebral small vessels. Features found on MR imaging in relapsed and late-onset encephalitis differed from the features in acute encephalitis in that confluent cortical involvement was the prominent finding in the former, as opposed to discrete focal lesions in the subcortical and deep white matter in the latter. CONCLUSION: MR imaging is a sensitive and specific diagnostic tool for evaluating Nipah encephalitis.


Assuntos
Encefalite Viral/patologia , Imageamento por Ressonância Magnética , Infecções por Paramyxoviridae/patologia , Paramyxovirinae , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Ann Neurol ; 49(6): 810-3, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11409437

RESUMO

Nipah virus, a newly identified paramyxovirus caused a severe outbreak of encephalitis in Malaysia with high fatalities. We report an open-label trial of ribavirin in 140 patients, with 54 patients who were managed prior to the availability of ribavirin or refused treatment as control. There were 45 deaths (32%) in the ribavirin arm; 29 deaths (54%) occurred in the control arm. This represents a 36% reduction in mortality (p = 0.011). There was no associated serious side effect. This study suggests that ribavirin is able to reduce the mortality of acute Nipah encephalitis.


Assuntos
Encefalite Viral/tratamento farmacológico , Paramyxovirinae/fisiologia , Ribavirina/uso terapêutico , Adulto , Povo Asiático , China/etnologia , Encefalite Viral/mortalidade , Encefalite Viral/fisiopatologia , Encefalite Viral/virologia , Feminino , Humanos , Malásia , Masculino , Paramyxovirinae/classificação , Paramyxovirinae/isolamento & purificação , Estudos Retrospectivos , Ribavirina/efeitos adversos , Resultado do Tratamento , Recusa do Paciente ao Tratamento
14.
N Engl J Med ; 342(17): 1229-35, 2000 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-10781618

RESUMO

BACKGROUND: Between September 1998 and June 1999, there was an outbreak of severe viral encephalitis due to Nipah virus, a newly discovered paramyxovirus, in Malaysia. METHODS: We studied the clinical features of the patients with Nipah virus encephalitis who were admitted to a medical center in Kuala Lumpur. The case definition was based on epidemiologic, clinical, cerebrospinal fluid, and neuroimaging findings. RESULTS: Ninety-four patients with Nipah virus infection were seen from February to June 1999 (mean age, 37 years; ratio of male patients to female patients, 4.5 to 1). Ninety-three percent had had direct contact with pigs, usually in the two weeks before the onset of illness, suggesting that there was direct viral transmission from pigs to humans and a short incubation period. The main presenting features were fever, headache, dizziness, and vomiting. Fifty-two patients (55 percent) had a reduced level of consciousness and prominent brain-stem dysfunction. Distinctive clinical signs included segmental myoclonus, areflexia and hypotonia, hypertension, and tachycardia and thus suggest the involvement of the brain stem and the upper cervical spinal cord. The initial cerebrospinal fluid findings were abnormal in 75 percent of patients. Antibodies against Hendra virus were detected in serum or cerebrospinal fluid in 76 percent of 83 patients tested. Thirty patients (32 percent) died after rapid deterioration in their condition. An abnormal doll's-eye reflex and tachycardia were factors associated with a poor prognosis. Death was probably due to severe brain-stem involvement. Neurologic relapse occurred after initially mild disease in three patients. Fifty patients (53 percent) recovered fully, and 14 (15 percent) had persistent neurologic deficits. CONCLUSIONS: Nipah virus causes a severe, rapidly progressive encephalitis with a high mortality rate and features that suggest involvement of the brain stem. The infection is associated with recent contact with pigs.


Assuntos
Surtos de Doenças , Encefalite Viral/virologia , Infecções por Paramyxoviridae/fisiopatologia , Paramyxovirinae , Adulto , Criação de Animais Domésticos , Animais , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/imunologia , Surtos de Doenças/estatística & dados numéricos , Eletroencefalografia , Encefalite Viral/epidemiologia , Encefalite Viral/mortalidade , Encefalite Viral/fisiopatologia , Feminino , Humanos , Modelos Logísticos , Imageamento por Ressonância Magnética , Malásia/epidemiologia , Masculino , Doenças do Sistema Nervoso/etiologia , Infecções por Paramyxoviridae/complicações , Infecções por Paramyxoviridae/epidemiologia , Infecções por Paramyxoviridae/mortalidade , Paramyxovirinae/imunologia , Recidiva , Suínos
15.
Lancet ; 354(9186): 1257-9, 1999 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-10520635

RESUMO

BACKGROUND: Between February and April, 1999, an outbreak of viral encephalitis occurred among pig-farmers in Malaysia. We report findings for the first three patients who died. METHODS: Samples of tissue were taken at necropsy. Blood and cerebrospinal-fluid (CSF) samples taken before death were cultured for viruses, and tested for antibodies to viruses. FINDINGS: The three pig-farmers presented with fever, headache, and altered level of consciousness. Myoclonus was present in two patients. There were signs of brainstem dysfunction with hypertension and tachycardia. Rapid deterioration led to irreversible hypotension and death. A virus causing syncytial formation of vero cells was cultured from the CSF of two patients after 5 days; the virus stained positively with antibodies against Hendra virus by indirect immunofluorescence. IgM capture ELISA showed that all three patients had IgM antibodies in CSF against Hendra viral antigens. Necropsy showed widespread microinfarction in the central nervous system and other organs resulting from vasculitis-induced thrombosis. There was no clinical evidence of pulmonary involvement. Inclusion bodies likely to be of viral origin were noted in neurons near vasculitic blood vessels. INTERPRETATION: The causative agent was a previously undescribed paramyxovirus related to the Hendra virus. Close contact with infected pigs may be the source of the viral transmission. Clinically and epidemiologically the infection is distinct from infection by the Hendra virus. We propose that this Hendra-like virus was the cause of the outbreak of encephalitis in Malaysia.


Assuntos
Doenças dos Trabalhadores Agrícolas/microbiologia , Surtos de Doenças , Encefalite Viral , Infecções por Paramyxoviridae , Paramyxovirinae/isolamento & purificação , Adulto , Doenças dos Trabalhadores Agrícolas/epidemiologia , Doenças dos Trabalhadores Agrícolas/patologia , Animais , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Encefalite Viral/epidemiologia , Encefalite Viral/microbiologia , Encefalite Viral/patologia , Encefalite Viral/transmissão , Evolução Fatal , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Paramyxoviridae/epidemiologia , Infecções por Paramyxoviridae/patologia , Infecções por Paramyxoviridae/transmissão , Paramyxovirinae/imunologia , Suínos
16.
Ann Neurol ; 48(5): 802-5, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11079547

RESUMO

During the outbreak of Nipah virus encephalitis in Malaysia, stored cerebrospinal fluid (CSF) samples from 84 patients (27 fatal and 57 nonfatal cases) were cultured for the virus. The virus was isolated from 17 fatal cases and 1 nonfatal case. There were significant associations between CSF virus isolation and mortality as well as clinical features associated with poor prognosis. In addition, there was a positive linear correlation of CSF virus isolation with age. There was no significant association between CSF virus isolation and the character of the CSF, presence of Nipah-specific antibody in the serum or CSF, duration of illness before collection of samples, or sex or ethnicity of the patients. This study suggests that high viral replication in the central nervous system may be an important factor for high mortality.


Assuntos
Encefalite/líquido cefalorraquidiano , Encefalite/virologia , Infecções por Paramyxoviridae/líquido cefalorraquidiano , Paramyxovirinae/química , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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