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maternal and fetal infections.acquired immunodeficiency virus infections had recently been the leading cause of death in minority women of reproductive age in several urban cities in the united states. in addition, more than 80% of infants with human immunodeficiency virus type 1 infection acquired the infection perinatally. these alarming data have spawned a prodigious body of information about perinatal human immunodeficiency virus type 1 infection. some of the most recent advances are highlighted in this review. revolutio ...19921543830
prophylaxis against pneumocystis carinii pneumonia. 19921545462
antiparasitic agents.in recent years, introduction of new and more effective agents has improved the overall therapy for parasitic infections. this field, however, is still plagued by numerous problems, including the development of resistance to antimicrobial agents (especially with malaria), unavailability of agents in the united states or lack of approval by the food and drug administration, and major toxicities or lack of experience in pregnant women and children, which limits use in these groups of patients. wid ...19921545596
[aids in germany: clinical manifestations of aids].since 1982, voluntary anonymous reports that meet the criteria of the who/cdc-aids definition are being collected by the federal health office. by december 31st, 1989 a total of 4,306 aids cases has been registered. more than 80% of the reported cases are homo- and bisexual men and injection drug-users. the remaining cases are divided between hemophiliacs, persons who get infected by heterosexual contacts, blood transfusion recipients, and children infected pre- or perinatally. in 16% of all cas ...19921545764
pneumocystis carinii osteomyelitis in a patient with common variable immunodeficiency. 19921545853
[spontaneous pneumothorax and pneumocystis carinii pneumonia. something more than a casual association?].the association of spontaneous pneumothorax and pneumocystis pneumonia is not frequent. the medical literature reports a ratio between 0 and 5.7%. in 18 patients admitted in our hospital, in the last two years, and diagnosed of aids and pneumocystis pneumonia, we observed two cases of pneumothorax spontaneous. they represent the 11%. in one of them spontaneous pneumothorax was the first manifestation and in the other a complication of the illness. it was not possible to isolate an agent differen ...19921546199
spontaneous pneumothorax in pneumocystis carinii pneumonia: common or uncommon? 19921546615
a comparison of the effectiveness of three regimens in the prevention of pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients.pneumocystis carinii pneumonia (pcp) is a major cause of morbidity and the leading cause of death in patients with the acquired immunodeficiency syndrome. the prevention of the occurrence and recurrence of pcp is a cornerstone in the treatment of patients infected with the human immunodeficiency virus. there are few studies comparing pcp prophylactic regimens.19921546914
clinical prediction of pneumocystis pneumonia.pneumocystis carinii pneumonia is often difficult to diagnose in an ambulatory care setting. previous reports have identified elements of the clinical history, physical examination, and clinical testing that are useful predictors of p carinii pneumonia. we analyzed published data on these predictors and measured them against methodologic standards for clinical prediction rules. variables with high negative or positive predictive value for p carinii pneumonia, low error rates, or compelling biolo ...19921546926
importance of endogenous tumor necrosis factor alpha and gamma interferon in host resistance against pneumocystis carinii infection.c.b-17 scid/scid (scid) mice that have acquired natural pulmonary infection with pneumocystis carinii clear these organisms by 19 days after reconstitution with spleen cells from immunocompetent mice and therefore serve as a model for studying the pathogenesis of and immunity to p. carinii pneumonia. the present study examined the importance of endogenous tumor necrosis factor alpha (tnf-alpha) and gamma interferon (ifn-gamma) in the clearance of p. carinii by treatment of reconstituted scid mic ...19921548057
mouse model for pneumocystis carinii pneumonia that uses natural transmission to initiate infection.animal models for pneumocystis carinii, for the most part, have been limited to immunosuppressed rats and ferrets, while a dependable mouse model has been more difficult to develop. a p. carinii mouse model has now been established with several strains of mice, including c3heb/fej, c3hen, balb/c, dba/2n, and balb/c nu/nu (athymic). in lieu of using invasive methods for initiating p. carinii infections, mice harboring p. carinii transmitted the disease to mice without latent infection via short-t ...19921548065
improved rat model of pneumocystis carinii pneumonia: induced laboratory infections in pneumocystis-free animals.an immunosuppressed rat model of pneumocystis carinii pneumonia is described that utilizes simple, noninvasive intratracheal (i.t.) inoculation of cryopreserved parasites and results in development of severe p. carinii pneumonia within 5 weeks. this is an improvement over the most commonly used models of p. carinii pneumonia that rely on immune suppression to activate latent p. carinii infections and that often require 8 to 12 weeks to produce heavy infections of p. carinii. it is also less labo ...19921548080
elisa of complement c3a in bronchoalveolar lavage fluid.activated complement factors within the lung may induce several local biological effects. in order to investigate local complement activation we have developed non-competitive two-site elisas of c3a and total c3 in bronchoalveolar lavage fluid (balf). for the assay of c3a, both c3 and c3(h2o) were removed from the samples by precipitation with polyethylene glycol. it was necessary to add carrier proteins to balf to remove c3 and c3(h2o) fully. the elisa of c3a has the lowest limit of detection r ...19921548406
the spectrum of chest infections in hiv positive patients in edinburgh.in a retrospective analysis of all known hiv-positive patients admitted to the city hospital before november 1989, 208 patients accounted for 612 admissions, 72% being injection drug users (idus). one hundred and eighty admissions (29%) were for chest-related disorders, and this was the commonest reason for admission. unlike other u.k. centres where more than 50% chest problems are due to pneumocystis carinii pneumonia (pcp), only 27% of our chest admissions were for pcp. fifty-four percent of c ...19921548416
comparative trial of dapsone versus trimethoprim/sulfamethoxazole for primary prophylaxis of pneumocystis carinii pneumonia.the purpose of this study was to compare the efficacy and safety of dapsone and trimethoprim/sulfamethoxazole in the primary prophylaxis of pneumocystis carinii pneumonia (pcp) in patients infected with the human immunodeficiency virus (hiv) and having less than 200 cd4-positive cells per ml. this was a prospective, randomized, open-label study, using dapsone (100 mg p.o.) or trimethoprim/sulfamethoxazole (160 mg/800 mg p.o.) daily. patients who developed toxicity requiring discontinuation were ...19921548570
trends in survival for children reported with maternally transmitted acquired immunodeficiency syndrome in new york city, 1982 to 1989.to better understand the natural history of severe pediatric human immunodeficiency virus infection, reported cases of perinatally acquired pediatric acquired immunodeficiency syndrome (aids) in new york city were examined for differences in survival and age at diagnosis before and after implementation of an expanded case definition in 1987. one hundred ninety-six children reported through august, 1987, and 333 children reported between september, 1987, and february, 1990, and diagnosed through ...19921549406
diagnostic value of lung clearance of 99mtc dtpa compared with other non-invasive investigations in pneumocystis carinii pneumonia in aids. 19921549824
trimethoprim-sulfamethoxazole prophylaxis for pneumocystis carinii infections in heart-lung and lung transplantation--how effective and for how long?pneumocystis carinii pneumonia (pcp) is a common clinical problem in the setting of organ transplantation, particularly in heart-lung and lung allograft recipients. without prophylactic measurements, the incidence of p carinii pneumonia can reach up to 88% of heart-lung transplant recipients. we conducted a retrospective analysis of the stanford heart-lung and lung transplant experience in order to assess the efficacy of the prophylactic therapy and to try to define the duration of therapy neces ...19921549851
accumulation of pneumocystis carinii pneumonia in patients after kidney transplantation. 19921551249
treatment ind protocol announced for pneumocystis carinii pneumonia. 19921551304
pulmonary disposition of gallium-67 in patients with pneumocystis pneumonia: an analysis using bronchoalveolar lavage.gallium-67 localizes to the cellular fraction of bronchoalveolar lavage (bal) fluid in patients with sarcoidosis, idiopathic pulmonary fibrosis, as well as normal subjects. to further study 67ga disposition in bal fluid, 11 patients with pneumocystis carinii pneumonia (pcp) and 8 patients with a variety of other lung diseases, underwent bal 24 hr after 67ga injection. compared to the non-pcp patients, pcp patients had high uptake gallium scans at 24 and 72 hr, and showed significantly increased ...19921552333
survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for aids other than hemophilia.between january 1, 1981, and june 30, 1990, 1,514 hemophilia-associated acquired immunodeficiency syndrome (aids) cases in males were diagnosed in the united states. in 1,394, hemophilia was reported as the sole risk factor. for an additional 120, other risk factors were reported: of 101 of these, 40 had homosexual/bisexual activity, 53 had a history of intravenous drug use, and 8 had both of these risk factors. we examined the demographic data and the survival data of two principal groups: male ...19921553956
the biology of pneumocystis carinii. 19921554424
pneumocystis carinii infection in the middle ear.pneumocystis carinii is the opportunistic pathogen frequently causing pneumonitis in the acquired immunodeficiency syndrome. extrapulmonic manifestation of p carinii is unusual and is commonly associated with severe systemic illness, other immune deficiency status, malignancy, or immune suppression. we describe a case of acquired immunodeficiency syndrome with manifestations of p carinii otitis media with severe otalgia and conductive hearing loss.19921554446
case report: disseminated pneumocystis carinii infection in a patient with the acquired immune deficiency syndrome causing thyroid gland calcification and hypothyroidism.we present the case of a homosexual male patient with the acquired immune deficiency syndrome (aids) who developed disseminated infection with pneumocystis carinii. he presented with symptoms and signs of thyroid disease, and developed thyroid gland calcification. this was later histologically proven to be due to p. carinii infection. disseminated p. carinii infection is rare, and this case represents the first report to our knowledge of thyroid gland involvement causing both hypothyroidism and ...19921555379
spontaneous pneumothorax associated with pneumocystis carinii pneumonia. successful treatment with talc pleurodesis.spontaneous pneumothoraces occur in patients with acquired immunodeficiency syndrome and pneumocystis carinii pneumonia. however, treatment with tube insertion and tetracycline sclerosis often fails to prevent recurrence. we present a single case of such a patient successfully treated with talc sclerosis.19921555449
flow cytometric analyses of lectin binding to pneumocystis carinii surface carbohydrates.pneumocystis carinii obtained from infected rat lung homogenates was incubated with fluorescein isothiocyanate-conjugated lectins, counterstained with the nuclear stain, propidium iodide (pi), and analyzed by dual parameter histograms for lectin-associated green and pi-associated red fluorescence using a fluorescence-activated cell sorter. the presence of glucose/mannose moieties was evidenced by the binding of all organisms to concanavalin a and wisteria floribunda. from the lectin group specif ...19921556643
characteristics and outcome variables of hiv cases at a university-based medical practice.an increasing number of aids cases occur each year in west virginia despite its small urban population. from january 1984 to march 1991 at the marshall university based multispecialty internal medicine group (the university physicians in internal medicine), 66 hiv-infected persons were treated, most of whom are native west virginians and always resided in the state. the study group consisted of 61 men and 5 women; four-fifths of the men are homosexual/bisexual and one-seventh used intravenous il ...19921557906
pneumocystis carinii peritonitis. antemortem confirmation of disseminated pneumocystosis by cytologic examination of body fluids.histologic confirmation of extrapulmonary pneumocystis carinii infection in the acquired immunodeficiency syndrome has usually required organ biopsy when the diagnosis was made antemortem. three cases of pneumocystis peritonitis were studied in which confirmation of extrapulmonary dissemination was achieved by cytologic examination of ascitic fluid. patients presented with characteristic choroidal lesions, transudative ascites, profound hypoalbuminemia, and hepatic dysfunction. cytologic examina ...19921558450
trimethoprim-sulphamethoxazole appears more effective than aerosolized pentamidine as secondary prophylaxis against pneumocystis carinii pneumonia in patients with aids.we compared the efficacies of low-dose trimethoprim-sulphamethoxazole (tmp-smx; one tablet: tmp, 160 mg, smx, 800 mg, twice daily, twice a week) and aerosolized pentamidine (300 mg every 4 weeks) as secondary prophylaxis against pneumocystis carinii pneumonia (pcp) in patients with hiv infection.19921558714
prospective randomized comparison of toxicity of two prophylactic regimens of cotrimoxazole in leukemic children.cotrimoxazole is currently used for pneumocystis carinii pneumonia prophylaxis in leukemic children. the former regimen of continuous administration was recently replaced by intermittent administration. the antifolic activity of cotrimoxazole could theoretically enhance that of methotrexate, also administered to leukemic children. we report on a prospective, randomized study to compare two different regimens--continuous vs. 3 days a week--of cotrimoxazole prophylaxis. the aim of the study was to ...19921558774
increasing impact of hiv infection on hospitalizations in the united states, 1983-1988.during 1983-1988, hospitalizations of patients with a diagnosis of human immunodeficiency virus (hiv) infection increased from 1.3 to 33.7 per 100,000 persons. we used the national hospital discharge survey, which is based on a representative sample of discharges from nonfederal short-stay hospitals, to describe illnesses among hospitalized patients with hiv infection. of 222,200 such hospitalizations during 1983-1988, most occurred among persons who were 25-44 years of age (79%), white (66%), a ...19921560347
opsonophagocytosis of pneumocystis carinii.the interaction of pneumocystis carinii purified from rat lungs with rat peritoneal macrophages and human circulating polymorphonuclear leucocytes was studied by amplified chemiluminescence and examination of stained cytospin preparations. a polyclonal rat antiserum to p. carinii was opsonic with both types of phagocyte. complement had no opsonic properties alone but produced a synergic effect in combination with antibody.19921560444
[pneumatocele and pneumonia caused by pneumocystis carinii]. 19921560726
[pneumocystis carinii pneumonia in a hiv-positive patient].the authors publish a case report of a young man, who have got a severe pneumonia, which did not recover after antibiotics treatment. when the cause of the immunosuppression was investigated, hiv positivity was found, and pneumocystis carinii was recognised in the bronchoalveolar lavage fluid. the diagnosis of the lung complications and the possibilities of the treatment are discussed.19921560972
the gene coding for small ribosomal subunit rna in the basidiomycete ustilago maydis contains a group i intron.the nucleotide sequence of the gene coding for small ribosomal subunit rna in the basidiomycete ustilago maydis was determined. it revealed the presence of a group i intron with a length of 411 nucleotides. this is the third occurrence of such an intron discovered in a small subunit rrna gene encoded by a eukaryotic nuclear genome. the other two occurrences are in pneumocystis carinii, a fungus of uncertain taxonomic status, and ankistrodesmus stipitatus, a green alga. the nucleotides of the con ...19921561081
immunodeficiency in methylmalonic acidaemia.three chinese infants with methylmalonic acidaemia were described. they presented in the neonatal period with recurrent episodes of poor feeding, lethargy, apnoea and severe acidosis. the diagnosis was established by increased methylmalonic acid concentration in the plasma and/or urine. pancytopenia was a prominent feature in all three patients. only patient three had assessment of lymphocyte subsets and it showed diminished population of b-lymphocytes and a reversed cd4/cd8 ratio. all three pat ...19921562372
procoagulant and fibrinolytic activities in bronchoalveolar fluid of hiv-positive and hiv-negative patients.imbalance between intra-alveolar procoagulant activity (pca) and fibrinolytic activity may lead to fibrin deposition, as described in several pneumopathies, and may eventually contribute to fibrotic changes as observed in pneumocystis carinii pneumonia (pcp). the aim of our study was to compare these activities in bronchoalveolar lavages of human immunodeficiency virus (hiv)-positive and hiv-negative patients. the material comprised: a) controls (n = 7); b) hiv-positive patients subdivided into ...19921563500
aerosolized pentamidine: a well-tolerated mode of prophylaxis against pneumocystis carinii pneumonia in older children with human immunodeficiency virus infection.aerosolized pentamidine has been recommended as an alternative mode of antipneumocystis prophylaxis in human immunodeficiency virus-infected children with trimethoprim-sulfamethoxazole intolerance. however, there have been no definitive data concerning the most appropriate dose and the tolerance of aerosolized pentamidine in children. in the present study, we assessed the tolerance of aerosolized pentamidine in older children using a regimen similar to the one recommended in adults. a 300-mg dos ...19921565553
diagnosis of pulmonary tuberculosis complicating hiv infection: superiority of sputum smear over bronchoalveolar lavage.tuberculosis should be prominently considered in the differential diagnosis when an hiv-infected patient has respiratory symptoms. sputum smears and culture for acid-fast organisms should always be obtained. fiberoptic bronchoscopy to exclude other concurrent opportunistic infections is appropriate because pneumocystis carinii complicates as many as 25% of the cases of pulmonary tb, but acid-fast sputum smears should always be obtained. it should not be assumed that bronchoalveolar lavage is sup ...19921566155
trimethoprim-sulfamethoxazole versus pentamidine for pneumocystis carinii pneumonia in aids patients: results of a large prospective randomized treatment trial.to compare the clinical efficacy and safety of trimethoprim-sulfamethoxazole (tmp-smx) with pentamidine in the therapy of pneumocystis carinii pneumonia (pcp) in patients with aids.19921567574
the prevalence of invasive amebiasis is not increased in patients with aids.to determine whether the frequency or severity of invasive amebiasis is increased in patients with aids.19921567575
a simple scoring system to diagnose pneumocystis carinii pneumonia in high-risk individuals. 19921567583
[a case of new type scrub typhus (tsutsugamushi disease) presenting with acute respiratory failure and hemophagocytic syndrome].a 47-year-old male was referred to our hospital with persistent high fever. he had received antibiotics (aspc) for the diagnosis of acute infectious disease, which failed to respond, and subsequently developed marked lymphocytopenia and thrombocytopenia. during his hospitalization, hypoxic respiratory failure rapidly developed. a bone marrow aspiration revealed marked hemophagocytosis, leading to the tentative diagnosis of opportunistic respiratory infection associated with malignant histiocytos ...19921569724
decision analysis: treatment of pneumocystis carinii pneumonia in patients with aids.controversy exists as to the most appropriate drug for the initial treatment of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. decision analysis can be used to evaluate the choice between parenteral pentamidine and trimethoprim-sulfamethoxazole. sensitivity and threshold analyses illustrate how the choice is affected by the probabilities of success and adverse reactions, as well as by the values placed by the patient and practitioner on treatment outcomes ...19921570229
thoracic disease in the immunocompromised patient.thoracic disease in the hiv negative immunocompromised host is most frequently caused by infection. patterns of involvement produced on the chest radiograph include (1) lobar or segmental consolidation, (2) nodules with rapid growth and/or cavitation, and (3) diffuse lung disease. the lung also may be directly involved by lymphoma, metastases, drug reactions, radiation pneumonitis, or nonspecific interstitial pneumonitis. the lung is a frequent target organ for opportunistic infections in aids p ...19921570394
salvage therapy with clindamycin/primaquine for pneumocystis carinii pneumonia.clindamycin/primaquine is effective for treating mild-to-moderate cases of pneumocystis carinii pneumonia (pcp) in patients with aids. we retrospectively reviewed our experience with this combination among patients in whom conventional therapy had failed or was not tolerated. twenty-six patients who experienced 28 episodes of pcp received salvage therapy with clindamycin/primaquine at two university-affiliated medical centers. clindamycin was administered intravenously, (usually 900 mg every 8 h ...19921571426
the long-term effects of aerosol pentamidine on pulmonary function. the toronto aerosolized pentamidine study (taps) group.aerosolized pentamidine (ap) has been widely used for prophylaxis of pneumocystis carinii pneumonia (pcp) since 1988. the objective of this study was to evaluate the long-term effects of ap on pulmonary function. of 36 patients with aids who were receiving ap for secondary prophylaxis of pcp, 13 patients had been using ap continuously for more than 52 weeks. ap was given using a fisoneb ultrasonic nebulizer with five loading doses of 60 mg over two weeks, followed by one dose of 60 mg every two ...19921572106
inoculated mouse model of pneumocystis carinii infection.a transtracheally inoculated mouse model of pneumocystis carinii has been developed using balb/c mice. the advantage of this strain of mice include that they are widely available, inexpensive, and were not infected with pneumocystis before inoculation. inoculated mice that were not treated had a mean infectivity score of 4.1 compared with inoculated mice treated with the effective anti-pneumocystis drug combination of trimethoprim plus sulfamethoxazole, which had a mean infectivity score of 0.1, ...19921572137
detection of antibodies to pneumocystis carinii in bronchoalveolar lavage fluid by immunoreactivity to pneumocystis carinii within alveoli, granulomas, and disseminated sites.although pneumocystis carinii pneumonia (pcp) is the most common major opportunistic infection in the acquired immunodeficiency syndrome (aids), its immunopathogenesis is not fully understood. it is known that anti-pneumocystis antibodies are present in the sera of individuals with and without pcp. in order to determine whether anti-pneumocystis antibodies are also present in bronchoalveolar lavage fluid (bal), we looked for them, by immunoreactivity with tissue sections of intra-alveolar p. car ...19921574487
pneumocystis carinii of the orbit. 19921575242
[pneumocystis carinii pneumonia in aids and prolonged fever].pneumonia by pneumocystis carinii (npc) presents a high incidence in the evolution of patients infected by the human immunodeficiency virus (hiv). common clinical signs include fever, dry cough and dyspnea, in the presence of pulmonar interstitial affection with several degrees of hypoxemia. one hundred and sixteen patients with npc and infection by hiv were diagnosed between december 1986 and january 1990. criteria of persistent fever was established in 10 of them (8.7%), with normal thoracic r ...19921576315
radiology of aids in the pediatric patient.the acquired immunodeficiency syndrome (aids) has involved the pediatric age group and is especially prevalent in babies born of mothers who are intravenous drug abusers or prostitutes. approximately 30% of children born to mothers who are seropositive for the human immunodeficiency virus (hiv) will develop hiv infection. there are several important differences in children and adults with aids. the incubation period of the disease is shorter, and initial clinical manifestations occur earlier in ...19921576831
disseminated penicillium marneffei infection in hiv-infected subject.penicillium marneffei is a rare human pathogen predominantly affecting residents of south-east asia. we report four fatal cases from hong kong in human immunodeficiency virus-infected patients. the diagnosis was established by histological examination and confirmed by isolation of the fungus. the infection was disseminated with involvement of lymph nodes, liver, spleen, lung, intestine and bone marrow. the involved organs showed an exclusively anergic tissue reaction characterized by a diffuse i ...19921577408
cytology of extrapulmonary pneumocystis carinii infection in the acquired immunodeficiency syndrome.rare cases of extrapulmonary pneumocystis carinii (eppc) have been seen in patients with acquired immunodeficiency syndrome (aids). we report seven such diagnoses of nonpulmonary p carinii (pc) from four aids patients between 1986 and 1989. the specimens included fine needle aspirate of liver, spleen, periarticular tissue and pleura as well as ankle fluid, pleural fluid and ascites. in some, but not all, cases the patients had concurrent or previous episodes of pc pneumonia. in all cases the typ ...19921580133
a new drug (566c80) for the treatment of pneumocystis carinii pneumonia. 19921580456
t cell immunodeficiency in dyskeratosis congenita.dyskeratosis congenita has been found to be associated with abnormal immune function. in this study we report a patient with this association. he developed pneumocystis carinii interstitial pneumonia, and impaired cell mediated immunity was confirmed by the presence of depressed lymphoproliferative responses to in vitro stimulation with mitogen. enumeration of t cell subsets showed a severely depressed cd4:cd8 ratio (0.38), which is the likely cause for impaired cell mediated immunity. the t cel ...19921580685
otic and ophthalmic pneumocystosis in acquired immunodeficiency syndrome. report of a case and review of the literature.a case of primary pneumocystis carinii infection involving the left middle ear of a patient with acquired immunodeficiency syndrome is described, and the literature on the otic and ophthalmic pneumocystosis is reviewed. otic pneumocystosis typically presents as a unilateral polypoid mass, and it is clinically manifested as otalgia, hearing loss, or, sometimes, otorrhea without evidence of current respiratory disease or previous pneumocystis pneumonia. in contrast, choroidal pneumocystosis usuall ...19921580753
ultrasonic findings in visceral pneumocystis carinii infection in aids. 19921581799
concurrent bacterial lung infection in patients with aids, pcp, and respiratory failure.to determine and compare the incidence of concurrent bacterial lung infection in intubated and nonintubated patients with the acquired immunodeficiency syndrome (aids) and pneumocystis carinii pneumonia (pcp) requiring medical intensive care unit (micu) admission for support of their respiratory function.19921582304
length of stay and survival after intensive care for severe pneumocystis carinii pneumonia. a prospective study. california collaborative treatment group.survival rates for persons receiving intensive care for pneumocystis carinii pneumonia have improved. however, the utility of prolonged intensive care for patients who do not show initial improvement remains unclear. we assessed survival in a nested cohort study of patients receiving intensive care while participating in a randomized trial of early adjunctive corticosteroids for pneumocystis pneumonia. twenty-eight of 251 (11 percent) participants were admitted to an intensive care unit. fourtee ...19921582305
spontaneous pneumothorax in aids patients not receiving prophylaxis against pneumocystis carinii pneumonia. 19921582330
antibody responses to a major pneumocystis carinii antigen in human immunodeficiency virus-infected patients with and without p. carinii pneumonia.antibody responses to a major purified human pneumocystis carinii surface antigen (gp95) were determined by elisa in human immunodeficiency virus (hiv)-infected patients. serum igg directed against gp95 was measured in 129 consecutive hiv-infected patients who underwent bronchoscopy for evaluation of pulmonary symptoms. significantly more patients with p. carinii pneumonia (pcp) had detectable antibodies compared with hiv-infected patients without pcp and with hiv-negative controls (50 [66%] of ...19921583338
cloning and sequence of a beta-tubulin cdna from pneumocystis carinii: possible implications for drug therapy.this work describes the isolation and characterization of a full-length cdna clone encoding beta-tubulin from the pathogen pneumocystis carinii. p. carinii contains a single gene encoding beta-tubulin. the complete sequence of this cdna has been determined and its inferred amino acid sequence compared with the beta-tubulins from other organisms. this analysis augments the data indicating that p. carinii should be classified as a fungal organism. further comparisons between the p. carinii beta-tu ...19921584027
cloning and characterization of a repetitive sequence from pneumocystis carinii.four repetitive sequence clones measuring 10.9-23.4 kb in length were isolated from the genomic library of pneumocystis carinii. restriction enzymes mapping and cross-hybridization studies revealed that these clones are interrelated and that they derive from the common repeat unit, which is specific for p. carinii. dot-blot analysis suggested that the copy number of the repeat sequence is about 100, assuming that the genome size is 1.5 x 10(7) bp. interestingly, the repetition unit extended over ...19921584742
aids and the lung: update 1992. 1. pneumocystis carinii pneumonia. 19921585297
evolving epidemiology of hiv infection among adults.whereas new, or changes in existing, routes of transmission of hiv have not been identified in the 11 years since aids was identified as a clinical syndrome, changes in the epidemiology of hiv infection in the us have been identified during that period. the role of injection drug use as a risk for both parenteral and sexual transmission of hiv has increased substantially during this period. heterosexual transmission is becoming more prominent as the epidemic continues to "mature" in the us. the ...19921586001
ga-67 scintigraphy and computed tomography in the diagnosis of pneumocystis carinii pneumonia in patients with aids. a prospective comparison.a prospective evaluation of ga-67 scintigraphy and transmission computed tomography was performed in 70 consecutive patients with aids who were suspected of having pneumocystis carinii pneumonia. studies were evaluated independently by two observers. receiver operating characteristic curves were plotted. although scintigraphy had a higher true-positive ratio at any false-positive ratio, statistically the areas under the two receiver operating characteristic curves were not significantly differen ...19921587045
isolation of pneumocystis carinii cysts by flow cytometry.pneumocystis carinii cysts were separated as enriched populations from suspensions of lung homogenate obtained from infected rats containing all developmental stages of this organism. isolation of cyst populations was achieved by incubating filtered lung homogenate with the fluorescent phospholipid analog 1-palmitoyl-2-c6-nbd-phosphatidylcholine. whereas cysts did not fluorescence as a result of outer-wall restraint of lipid integration, trophozoites and young intermediate stages readily incorpo ...19921589425
infection with mycobacterium bovis in a patient with aids: a late complication of bcg vaccination.we present a 28-year-old hiv-infected man with a 2-year delayed complication of bcg immunization. when immunized the man was healthy, with an unknown hiv status, but 2 years later he was diagnosed with aids because of a pneumocystis carinii pneumonia. he was successfully treated and discharged in a state of good health. a few months later he presented with an enlarged lymph node and mycobacterium bovis, bcg strain, was cultured. no sign of dissemination was found. we discuss the indications for ...19921589715
cardiac arrest during treatment of pneumocystis carinii pneumonia with intravenous pentamidine isethionate.a 27-year-old man, hiv-positive for 4 years, developed ventricular fibrillation and cardiac arrest during treatment of pneumocystis carinii pneumonia with intravenous pentamidine isethionate. the dosage was 4 mg/kg/day for 18 days. nephrotoxicity occurred and raised serum potassium. the plasma concentration of pentamidine was 580 nmol/l. careful monitoring of renal and cardiac functions is recommended during intravenous therapy with pentamidine isethionate.19921589716
pneumocystis colitis in a patient with the acquired immunodeficiency syndrome.we report a case of colonic pneumocystosis in a human immunodeficiency virus (hiv)-positive homosexual male who presented with fever and diarrhea. stool cultures for bacterial pathogens and examinations for ova and parasites were negative. the diagnosis was made by colonoscopic biopsy which revealed pneumocystis carinii organisms in the lamina propria of the cecum, descending colon, and sigmoid colon. the patient subsequently developed pulmonary and ocular abnormalities consistent with p. carini ...19921590316
correlation of pneumocystis carinii cyst density with mortality in patients with acquired immunodeficiency syndrome and pneumocystis pneumonia.fifteen percent to 20% of patients with the acquired immunodeficiency syndrome and pneumocystis pneumonia do poorly despite early intervention. it is not known what distinguishes those who die, despite early intervention and aggressive therapy, from those who readily respond to therapy. we used image analysis to determine the relative abundance of cysts within aggregates of pneumocystis carinii found in induced sputa (21 patients) and bronchoalveolar lavage fluid (14 patients) from 35 patients w ...19921592383
critical care management of the patient with hiv infection who has pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) is the most frequently occurring opportunistic infection in individuals infected with the human immunodeficiency virus. improved methods of diagnosing and treating pcp have resulted in increased survival rates. nurses are more frequently faced with treatment of the critical care patient with pcp. knowledge about the mechanisms and manifestations of pcp as well as its diagnosis and treatment provides a baseline for the nursing management of pcp. nursing care f ...19921592614
pneumocystis carinii pneumonia (pcp) and your child: a parent information booklet.a parent education booklet describing pneumocystis carinii pneumonia (pcp) was prepared by the pediatric branch of the national cancer institute. in addition to information about prophylaxis and treatment of pcp, the booklet discusses overall care of children infected with human immunodeficiency virus.19921594471
the sulfone syndrome in a patient receiving dapsone prophylaxis for pneumocystis carinii pneumonia. 19921595261
cost reduction in diagnosing pneumocystis carinii pneumonia. sputum induction versus bronchoalveolar lavage as the initial diagnostic procedure.sputum induction (si) is a sensitive and specific method for diagnosing pneumocystis carinii pneumonia (pcp) in patients with aids. although less expensive than bronchoscopy with bronchoalveolar lavage (bal), si followed by bal does not necessarily reduce costs compared with bal alone. cost analysis demonstrates that the cost of diagnosing pcp is dependent on the prevalence of pcp (pcpprevalence) in the studied population, the sensitivity of si (sisensitivity) for diagnosing pcp, and the relativ ...19921596013
cutaneous pneumocystis carinii infection mimicking kaposi sarcoma. 19921596046
fibreoptic bronchoscopy and bronchoalveolar lavage in the investigation of the immunocompromised lung.the records of 18 immunocompromised patients with recent onset of pulmonary disease who had fibreoptic bronchoscopy and bronchoalveolar lavage over a two year period (1989-90) were reviewed. the underlying diseases were human immunodeficiency virus (hiv) infection (n = 7), organ transplantation (n = 9), and chemotherapy for malignancy (n = 2). four patients were receiving prophylactic therapy and 12 had been started on empirical therapy for infection. patients proceeded to bronchoscopy either be ...19921598142
surfactant analysis during pneumocystis carinii pneumonia in hiv-infected patients.pulmonary surfactant is altered in experimental pneumocystis carinii pneumonia. although p carinii is a major causative agent of pneumonia in immunocompromised patients, the pathophysiology of lung injury caused by this organism is poorly understood. therefore, we studied bronchoalveolar lavage specimens obtained from 19 hiv-infected subjects with pcp compared with specimens from ten healthy control subjects. as iterative bal was performed, 37 bal specimens were analyzed for protein and phosphol ...19921600773
pneumocystis carinii in aids patients. 19921602420
clinical apnea as an early manifestation of pneumocystis carinii pneumonia in an infant with perinatal hiv-1 infection.this article describes the first case of pneumocystis carinii pneumonia in a human immunodeficiency virus (hiv) seropositive infant in whom apnea was the earliest presenting clinical finding. pediatricians treating infants with hiv infection need to be aware of this unusual clinical presentation of p carinii pneumonia to avoid a delay in diagnosis and management of this disease.19921602505
comparison of aids in women in rural and urban georgia.through 1990, 308 cases of aids had been reported in female residents of georgia (aged 13 years and older); 77 (25%) were white and 228 (75%) black. the mean age of the white women (43.8 years) was greater than that of the black women (34.5 years). one hundred sixty-six women were from atlanta (metro atl), the major metropolitan center in georgia, and 142 (46%) from other regions of the state (other areas). blacks represented 74% and 76% of all cases in women in metro atl and other areas respect ...19921604384
cerebral toxoplasmosis and prophylaxis for pneumocystis carinii pneumonia. 19921605434
use of fluoroquinolones for prophylaxis of murine pneumocystis carinii pneumonia.we compared the prophylactic activities of six fluoroquinolones against pneumocystis carinii pneumonia in immunosuppressed rats. pefloxacin was the only agent which was as effective as the reference drug trimethoprim-sulfamethoxazole. clinical trials with pefloxacin in patients at risk for p. carinii pneumonia appear to be justified.19921605613
prognostic indicators for development of aids among intravenous drug users.a cohort of 544 human immunodeficiency virus-1 (hiv-1) seropositive intravenous drug users (ivdus) was recruited in 1988 and early 1989; data on laboratory markers, clinical symptoms, intravenous drug use, and demographics were collected. forty-one ivdus developed aids within 2 years of enrollment. data were analyzed using methods of survival analysis. none of the individuals reported use of antiviral agents or pneumocystis carinii prophylaxis at baseline. a very strong (p less than 0.001) dose- ...19921613668
adjunctive corticosteroid therapy for pneumocystis carinii pneumonia in aids: a randomized european multicenter open label study.fifty-nine human immunodeficiency virus type-1-infected patients with a microscopically proven first episode of moderate to severe pneumocystis carinii pneumonia (pcp) were enrolled into a randomized european multicenter study. the effect of adjunctive corticosteroid (cs) therapy was assessed on (a) survival to discharge, (b) need for mechanical ventilation, and (c) survival at day 90. cs was given within 24 h of standard therapy as intravenous methylprednisolone 2 mg/kg body weight daily for 10 ...19921613673
procoagulant activity in bronchoalveolar fluids: no relationship with tissue factor pathway inhibitor activity.abnormalities in local coagulation may explain alveolar fibrin deposition which often accompanies human lung injuries. the purpose of this study was to investigate the generation of procoagulant activity (pca) and tissue factor pathway inhibitor (tfpi) in selected bronchoalveolar lavage fluids (bal) from controls (n = 7) and from patients with interstitial lung diseases (n = 9), pneumocystis carinii (pcp) pneumonia (n = 11) and bacterial pneumonia (n = 8). as compared with controls a significant ...19921615494
detection of pneumocystis carinii. comparative study of monoclonal antibody and silver staining.the sensitivity of pneumocystis carinii detection using silver stain (grocott method) was compared to that using the avidin-biotin-complex immunoperoxidase (ip) staining method with anti-p. carinii monoclonal antibody. silver stain detected only cyst wall, whereas ip stained both cyst wall and trophozoites. serial sections of formalin-fixed, paraffin-embedded autopsy lung specimens from 41 acquired immune deficiency syndrome patients in three disease categories were stained: i--premortem or auto ...19921615917
the spectrum of clinical and pathological manifestations of aids in a consecutive series of autopsied patients in mexico.little is known about the clinical profile of aids in latin american populations. this study characterizes the clinical and pathological manifestations of aids in a representative series of mexican aids patients at autopsy.19921616652
improved outcome of pneumocystis carinii pneumonia in aids patients: a multifactorial treatment effect.factors determining the outcome of an episode of pneumocystis carinii pneumonia (pcp) in 149 aids patients treated at st mary's hospital were identified and their importance on improved survival evaluated between 1984 and 1989. the proportion of fatal episodes of pcp decreased over time. fatal compared with nonfatal episodes had lower mean alveolar-arterial oxygen gradient (82.5 mmhg vs 53.8 mmhg, p less than 0.001), mean haemoglobin level (11.2 g/dl vs 12.1 g/dl, p = 0.01), mean lymphocyte coun ...19921616964
emergence of unusual opportunistic pathogens in aids: a review.opportunistic infections are a major cause of morbidity and death among patients infected with the human immunodeficiency virus (hiv), particularly late in the disease, when immunosuppression is severe. some pathogens, such as pneumocystis carinii and toxoplasma gondii, are extremely common in this population and are readily recognized by clinicians caring for these patients. however, many other organisms occasionally cause conditions that clinically mimic the more commonly encountered pathogens ...19921617054
[diagnosis and course of patients with hiv infections and exclusion of pneumocystis carinii pneumonia].30 patients infected with hiv (20 men, 10 women; mean age 34 [26-54] years), suspected of having pneumocystis carinii (pc) pneumonia, had undergone bronchoalveolar lavage which proved negative for pc. they were then kept under observation for 5 months. no transbronchial biopsy was performed. 27 patients were in stage iv of the hiv infection, and 14 had been on pentamidine prophylaxis. the most frequent diagnosis with the bronchial lavage was bacterial infection (19 patients), next most frequent ...19921618118
[acute nonbacterial bronchopneumopathies in the 1st years of life. diagnostic strategies and clinico-epidemiological peculiarities].the authors summarise diagnostic strategies an clinical epidemiologic peculiarities of non-bacterial bronchopneumopathies in children. the role of classic viral agents (virus influenzal a-b, virus parainfluenza 2-3, rvs) is stressed without neglecting the role of other etiologic agents such as chlamydia trachomatis, mycoplasma pneumoniae and pneumocystis carinii. the authors point out the necessity of direct investigation (viral cultures, direct investigation in if and elisa, investigation with ...19921620072
[pulmonary cavity caused by pneumocystis carinii in an hiv+ patient]. 19921620930
[survival in hiv infection and aids].duration of the aids-free period after hiv-infection and survival time vary to a wide extent. about 50 percent of the patients develop aids within 10 years. the most important prognostic factor is the cd4-lymphocyte count. the risk of aids increases significantly after cd4-lymphocyte counts drop below 400/microliters. another prognostic factor is age. in older patients disease progresses more rapidly. aids often is preceded by an aids-related-complex characterized for example by oral candidiasis ...19921621324
detection of fc receptors for iga on rat alveolar and peritoneal macrophages.the presence of fc receptors for iga on alveolar macrophages was determined by rosette assay and immunogold labeling. iga-mediated phagocytosis by alveolar macrophages was observed. results of these assays were compared between rats receiving no treatment and those receiving long-term cortisone administration. sheep erythrocytes coated with dextran and an iga monoclonal antibody specific for the alpha 1,3 linkages of dextran bound to 16% of alveolar macrophages. however, peritoneal macrophages d ...19921623549
clinical usefulness of high-pressure liquid chromatographic determination of serum pentamidine in aids patients.we have developed a reproducible hplc method to determine serum pentamidine, which demonstrates good chromatographic performance, and is sensitive enough to measure therapeutic doses. pentamidine is first extracted from serum by passage through a c-18 extraction cartridge. potential interfering substances are then removed by washing with 100% methanol. pentamidine is eluted from the extraction cartridge with 1-heptanesulfonic acid. the extract is chromatographed on a highly deactivated column fo ...19921623582
correlation of bronchoalveolar lavage findings to severity of pneumocystis carinii pneumonia in aids. evidence for the development of high-permeability pulmonary edema.we correlated bronchoalveolar lavage findings with the clinical course and outcome of pneumocystis pneumonia. forty-eight patients with aids and a confirmed diagnosis of p carinii pneumonia were studied. patients with additional pulmonary infections were excluded. on the basis of bal findings, they were divided into those with a low neutrophil count (less than 5 percent) and those with a high neutrophil count (greater than or equal to 5 percent). sixteen patients with aids but without pcp served ...19921623798
modulation of tumor necrosis factor release from alveolar macrophages treated with pentamidine isethionate.alveolar macrophages in aids patients have a marked increase in tumor necrosis factor release in active pneumocystis carinii pneumonia. we have demonstrated that pentamidine, an aromatic diamidine currently used to treat aids-related p. carinii pneumonia, is an effective inhibitor of cellular tumor necrosis factor release from lipopolysaccharide-stimulated rat alveolar macrophages at concentrations greater than 10(-8) m. inhibition of release is not dependent upon the continued presence of penta ...19921624213
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