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superiority of promace-cytabom over promace-mopp in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial.one hundred ninety-three patients with stage ii, iii, or iv follicular large-cell, diffuse large-cell, diffuse mixed, immunoblastic, or diffuse small noncleaved-cell (non-burkitt's) lymphoma were randomized to receive either cyclophosphamide 650 mg/m2 intravenously (iv), doxorubicin 25 mg/m2 iv, etoposide 120 mg/m2 iv on day 1, mechlorethamine 6 mg/m2 iv, vincristine 1.4 mg/m2 (no cap at 2 mg total dose) iv on day 8, prednisone 60 mg/m2 orally daily days 1 through 14, procarbazine 100 mg/m2 oral ...19911702144
pneumocystis carinii pneumonia in patients with aids: evaluation of lavage and staining techniques in diagnosis.the diagnostic yield of unilateral vs. bilateral bronchoalveolar lavage (bal) was prospectively evaluated in 65 consecutive patients suspected of having pneumocystis carinii pneumonia (pcp) complicating acquired immune deficiency syndrome (aids). gram-weigert (gw), papanicolaou (pap), and gomori's methenamine silver (gms) stains were used for identification of p. carinii in all cases. forty-eight patients had pcp that was identified by gw staining of bal in 47/48 patients followed by pap/gms sta ...19911704061
monoclonal immunofluorescence compared with silver stain for investigating pneumocystis carinii pneumonia.two hundred and eighty two specimens from 220 patients positive for hiv with respiratory tract symptoms, or febrile illness, or both, were examined for the presence of pneumocystis carinii. specimens were either induced sputum samples or bronchoalveolar lavage fluids. to establish the optimal method for laboratory diagnosis a comparison was made of detection of the organism by use of monoclonal antibody and immunofluorescence with conventional silver staining methods. three commercially availabl ...19911705263
cytomegalovirus pneumonitis after cardiac transplantation.to evaluate the incidence and clinical features of cytomegalovirus (cmv) pneumonitis after cardiac transplantation, we identified 27 (16%) of 171 consecutive recipients in whom cmv pneumonitis was confirmed by strict diagnostic criteria. cytomegalovirus pneumonitis occurred in 6 (30%) of 20 patients treated with azathioprine and prednisone, and 8 (25%) of 32 patients treated with azathioprine, cyclosporine, and prednisone, but only 13 (11%) of 119 patients treated with cyclosporine and prednison ...19911645949
morbidity and mortality of patients with aids and first-episode pneumocystis carinii pneumonia unaffected by concomitant pulmonary cytomegalovirus infection.to determine the significance of cytomegalovirus (cmv) pulmonary coinfection with pneumocystis carinii pneumonia in aids, we examined the association of long- and short-term survival and morbidity (as defined by length of hospital stay) with recovery of cmv from bronchoscopy specimens and an indirect measure of virus titer in bronchoalveolar lavage fluid (the time to develop cmv cytopathology in culture) in 111 patients diagnosed with a first episode of p. carinii pneumonia. compared with 57 ind ...19911648316
[detection of human cytomegalovirus dna by in situ hybridization].a biotin labelled human cytomegalovirus (hcmv) dna probe of ecori d fragment (17kb) from hcmv ad 169 strain was prepared. in situ hybridization of hcmv was performed in paraffin section of tissues collected from an autopsy case of congenital and combined immunodeficiency syndrome associated with systemic hcmv and pneumocystis carinii infections. the pathological lesions of hcmv infection showed three different patterns: 1, necrotic granuloma type, 2, diffuse type, and 3, scattered type. hcmv dna ...19911648456
autopsy pathology and disease patterns in shiraz, iran, 1960-1974.the impact of 4300 serial autopsies performed in shiraz, iran, on scientific and clinical medicine is discussed. these studies in geographic pathology led to the recognition of the importance in disease patterns of persistent, life-long changes in the human immune response brought about by serious perinatal infection and/or malnutrition. elucidation of the pathogenesis of primary upper small intestinal lymphoma serves as an example of the importance of the field of geographic pathology for the u ...19911649795
infections following orthotopic liver transplantation.the epidemiology of infections associated with orthotopic liver transplantation is summarized herein, and approaches to prophylaxis are outlined. infection is a major complication following orthotopic liver transplantation, and more than half of transplant recipients develop at least one infection. the risk of infection is highest in the first month after transplantation, and the most common pathogens are bacteria and cytomegalovirus (cmv). bacterial infections usually occur in the first month, ...19911650245
surgical pathology of the liver in hiv infection.in the 6-year period 1984-1989, 101 liver biopsies or 'needle necropsies' from human immunodeficiency virus positive patients were examined histologically. of these, only nine showed no abnormality whatsoever. the commonest histological findings were either fatty change or changes related to co-existent chronic viral hepatitis. granulomas were seen in 15 cases, four of which were positive for acid-fast bacilli. a range of organisms were recorded: cytomegalovirus (4); histoplasma capsulatum (1); ...19911653181
disseminated histoplasmosis in an aids patient treated with itraconazole.a patient with aids presented with a fever, shortness of breath and a productive cough. a provisional diagnosis of pneumocystis carinii pneumonia was made; however, blood cultures and bone marrow examination revealed disseminated infection with histoplasmosis capsulatum. this was treated by itraconazole with initial success, but the patient relapsed while on maintenance therapy.19911655628
the causes of death in patients with human immunodeficiency virus infection: a clinical and pathologic study with emphasis on the role of pulmonary diseases.the clinical records and autopsy data of 75 patients dying with aids were reviewed to determine the frequency of individual diseases diagnosed premortem and postmortem, the significance of pulmonary processes found in the lungs at autopsy, and the clinical and pathologic causes of death. cytomegalovirus (cmv) infection was identified histologically either premortem or postmortem in 81% of patients. the lungs and adrenal glands were infected most commonly. only one-half of cmv infections were rec ...19911656164
[progress and problems in hospital infections: exemplified by pneumonia].nosocomial pneumonias have various etiologies and their development depends mainly on the underlying condition of the patients. intubated patients are prone to development of bacterial pneumonia from the oropharyngeal or gastric flora. prevention relies on reducing exogenous as well as endogenous colonization of the bronchotracheal tree: avoidance of cross-contamination, maintenance of a physiological gastric ph and, possibly, selective digestive decontamination. neutropenic patients may develop ...19911656522
clinical and serologic features of herpes simplex virus infection in patients with aids.we studied the natural history of herpes simplex virus (hsv) infection and its association with specific serum antibody in a sample of 68 hiv-infected patients with a first episode of pneumocystis carinii pneumonia at san francisco general hospital in 1986. seroprevalence was 66 and 77% for hsv-1 and hsv-2 antibody, respectively, by immunoblot assay. twenty-seven patients had 45 hsv outbreaks diagnosed during 739 patient-months of follow-up. median frequency of recurrence resulting in a medical ...19911657040
bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections.to further improve the diagnostic value of bronchoscopy in the immunosuppressed population presenting with diffuse pulmonary infiltrates, we prospectively investigated the utility of bilateral bronchoalveolar lavage (bal). we performed 62 bronchoscopies on 52 immunosuppressed patients. of the 52 patients, 33 had pulmonary infections. the yield for pneumocystis carinii pneumonia on bilateral bal was 94 percent (31/33), compared to the 84 percent (51/61) previously obtained with unilateral bal in ...19911657538
modulation of pneumocystis carinii adherence to cultured lung cells by a mannose-dependent mechanism.pneumocystis carinii is an opportunistic parasite that attaches to the alveolar epithelium during the initiation of pneumonia. it is unknown whether p. carinii recognizes specific receptors on the surface of lung cells. our study indicates that concanavalin a (con a), a lectin that recognizes mannose-containing glycoproteins, binds to p. carinii organisms in a saturable manner with a binding affinity of kd = 11 x 10(-6) mol/l and with 18.5 x 10(6) con a binding sites per p. carinii organism. con ...19911658169
spectrum of activity of azithromycin.in recent years, a number of newer macrolides have been developed. one such antibiotic is azithromycin, which has a 15-membered ring structure and is classed as an azalide. the limitations of erythromycin and the discovery of pathogenic bacteria such as campylobacter, legionella and chlamydia species provide incentives to study the usefulness of newer antibiotics of this class. azithromycin has good activity against staphylococci, streptococci, moraxella catarrhalis and other rapidly growing pyo ...19911662624
coexisting pneumocystis carinii pneumonia, cytomegalovirus pneumonitis and salmonellosis in systemic lupus erythematosus.infection with opportunistic organisms, either singly or in combination, is known to occur in immunocompromised patients. a patient with systemic lupus erythematosus who developed pneumocystis carinii pneumonia, cytomegalovirus pneumonitis, and salmonellosis is reported. she responded to early treatment with intravenous trimethoprim-sulphamethoxazole (20 mg/kg).19911663329
a comparison of several agents with two delivery systems for the prevention of airway narrowing induced by nebulised pentamidine isethionate.bronchial narrowing is the major side effect of inhaled nebulised pentamidine isethionate, used for the prophylaxis and treatment of pneumocystis carinii pneumonia. several agents and delivery systems were assessed for prophylaxis of bronchial narrowing in hiv-positive males receiving regular nebulised pentamidine isethionate. in a previous study we found the mean maximum fall in fev1 with nebulised pentamidine alone to be 21%. fev1 was measured before and after inhaling nebulised pentamidine, p ...19911663642
mitochondrial gene sequences show fungal homology for pneumocystis carinii.a 6.8 kilobase fragment of mitochondrial dna from pneumocystis carinii encodes for apocytochrome b, nadh dehydrogenase subunits 1, 2, 3, and 6, cytochrome oxidase subunit ii, and the small subunit of ribosomal rna. comparative sequence analysis with a series of organisms representative of the fungal and protozoan groups shows that p. carinii has, consistently, an average similarity of 60% with the fungi but only 20% with the protozoa. the data indicate homology with the fungi for this opportunis ...19911664905
[a case of smoldering adult t-cell leukemia complicated by various pulmonary infections].a 46-year-old man was admitted to oita medical college hospital on october 16, 1987, because of cough and sputum. chest x-ray and chest ct films showed diffuse reticulonodular shadow. the specimens obtained by transbronchial lung biopsy revealed cysts of pneumocystis carinii. abnormal lymphocytes with lobulated nuclei were found 2-7% of peripheral leucocytes. the anti htlv-i antibody was positive. according to these data, we diagnosed the patient as smoldering adult t cell leukemia with pneumocy ...19911665167
a survey of pneumocystis carinii infection in research mouse colonies in japan.to determine the frequency of pneumocystis carinii infection in mouse colonies maintained for biomedical research in medical colleges or medical faculties in universities in japan, 409 nu/nu mice were sent to 43 animal facilities from a p. carinii-free colony. the animals were housed for 6 months in groups of 3 to 10 animals per room, and examined for the presence of parasites and infection. colonies in 10 (24.4%) of 41 facilities were positive for the infection. of 383 animals in 69 rooms, the ...19911666138
the prognosis in hiv-infected patients with pneumonia. relation to microbiological diagnoses.ninety consecutive first-time fiberoptic bronchoscopies (fb) were performed on hiv-infected patients with pulmonary symptoms and radiographic evidence of active pneumonitis. microbiological data were analysed for acute and long-term prognostic significance. 56/90 (63%) patients had one type of microbiological agent recovered from fb, 22/90 (24%) patients had more types recovered, and 12/90 (13%) patients had no types recovered. nine patients (10%) died during the acute episode of pneumonia. a pr ...19911666357
[pneumocystis carinii pneumonia].the paper reports on a theme of important pediatric interest, pneumonia with pneumocystis carinii (pc), a more widespread affection lately, due to the progress in pediatric reanimation, on the one hand (that allowed the survival for a long time of several biologically handicapped infants) and as a consequence of the more and more common use of immunosuppressing therapy, on the other hand (malignant diseases, transplant of organs, etc.); another important role in the increase of the pc pneumonia ...19911667601
the impact of concomitant viral pathogens on the course of pneumocystis carinii pneumonia.a large retrospective study was conducted to evaluate the impact of culturing cytomegalovirus from the respiratory secretions of aids patients with pneumocystis carinii pneumonia. pneumocystis carinii was found in 220 (67%) of 327 episodes and cytomegalovirus was found in 106 (48%) of the p. carinii-positive patients. cytomegalovirus-positive and -negative patients were similar at baseline and had a similar number of hospital days, but had a lower incidence of early deterioration in oxygenation, ...19911667929
inhibition of topoisomerases from pneumocystis carinii by aromatic dicationic molecules.pentamidine and related derivatives inhibit an atp-dependent topoisomerase activity from pneumocystis carinii extracts. since it would be extremely difficult to purify ample quantities of the organisms to allow characterization of the enzyme and carry out drug binding experiments, we have begun the cloning of the topoisomerase genes with a goal towards expression of each gene in a heterologous system. following construction of genomic libraries in the vectors lambda dash and lambda zap, oligonuc ...19911667935
[diagnosis of pulmonary infections by specific etiologic agents in secondary immunocompromised patients].ten cases of pulmonary infections by the specific etiologic agents in immunocompromised patients secondary to diseases and/or drugs were reported. their infections included 5 tuberculosis, 4 pulmonary aspergillosis, 1 pneumocystis carinii and cytomegalovirus pneumonia. the early revelation of pulmonary abnormality, the sampling of non-contaminated diagnostic materials, the improvement of laboratory techniques, and a feasible scheme of clinical management for pulmonary infections in immunocomprom ...19911668066
prophylaxis against pneumocystis carinii pneumonia in children infected with human immunodeficiency virus. 19911669802
[respiratory complications in 44 patients with acquired immunodeficiency syndrome].observation was carried out of 44 patients affected with pulmonary pathology during the course of aids, each of whom presented a severe respiratory insufficiency, admitted to the clinic of infectious diseases between may 1987 and march 1989. in the patients suffering from their first respiratory infection, a lower mortality rate was observed (11/28, 39.2%) compared with the patients suffering from a second or successive infection (10/16, 62.5%). in sixteen cases, the etiological agent was pneumo ...19911670052
cigarette smoking: a modifier of human immunodeficiency virus type 1 infection?two hundred and two homosexual men enrolled in a prospective cohort study of aids risk were assessed for differences in the occurrence and progression of human immunodeficiency virus type 1 (hiv-1) infection with respect to cigarette smoking. among subjects who were initially seronegative, smokers were more likely than nonsmokers to become hiv-1 seropositive (p = 0.03). after seroconversion, serum beta 2-microglobulin and cd4+ lymphocyte levels were elevated in cigarette smokers relative to nons ...19911670588
pulmonary complications of combination therapy with cyclophosphamide and prednisone.oral cyclophosphamide and prednisone are standard treatment for some neoplasms and necrotizing systemic vasculitis and are advocated with increasing frequency for idiopathic interstitial lung disease. during a 15-month period, we observed four cases of acute respiratory failure from pneumocystis carinii pneumonia (pcp) in patients treated with oral cyclophosphamide and prednisone. one patient each had polyarteritis nodosa, wegener's granulomatosis, bronchiolitis obliterans with organizing pneumo ...19911670629
low-dose co-trimoxazole for prevention of pneumocystis carinii pneumonia in human immunodeficiency virus disease.the efficacy and tolerability of low, intermittent doses of co-trimoxazole (160 mg trimethoprim and 800 mg sulfamethoxazole given monday, wednesday, friday) for prophylaxis against pneumocystis carinii pneumonia (pcp) was assessed retrospectively in 116 patients with the acquired immunodeficiency syndrome (aids) and aids-related complex at high risk of pcp. 92% were receiving concomitant zidovudine. 71 with previous episode(s) of pcp were followed a mean of 18.5 months (range 3-42). 45 without p ...19911671479
[relationship between t-subsets and clinical aspects of hiv-associated diseases].hiv predominantly infects the cd4+ t cells, which during the progression of the disease are eliminated, causing an immune deficiency which renders the patients more susceptible to infections. to evaluate the relevance of the cd4+ t cell elimination and thus the clinical usefulness of cd4/cd8 subset determinations in hiv infected persons, we investigated whether analyses of 667 subset determinations of 365 patients correlated with clinical stages of hiv-infection (cdc classification). progress of ...19911671535
ditiocarb sodium (diethyldithiocarbamate) therapy in patients with symptomatic hiv infection and aids. a randomized, double-blind, placebo-controlled, multicenter study.we randomized 389 symptomatic patients with human immunodeficiency virus (hiv) infection to ditiocarb sodium (400 mg/m2 orally for 24 weeks) or a placebo. patients were well balanced according to centers for disease control (cdc) group, cd4+ cell number, and duration of disease prior to entry. ten new acquired immunodeficiency syndrome (aids)-defining opportunistic infections occurred in the treated patients and 21 in the controls. reduction of new opportunistic infections in the ditiocarb group ...19911671884
guidelines for prophylaxis against pneumocystis carinii pneumonia for children infected with human immunodeficiency virus.although guidelines have been established for prophylaxis against pneumocystis carinii pneumonia (pcp) for adults with human immunodeficiency virus (hiv) infection, they have not been available for children (1). experts in pediatric hiv infection (convened by the pediatric hiv resource center) independently reviewed recent data and provided recommendations to the u.s. public health service for pcp prophylaxis for hiv-infected or -exposed children. this report summarizes these deliberations and d ...19911672036
from the centers for disease control. guidelines for prophylaxis against pneumocystis carinii pneumonia for children infected with human immunodeficiency virus. 19911672167
clinical and laboratory correlates of pneumocystis carinii pneumonia in children infected with hiv.the case histories of 27 children with pneumocystis carinii pneumonia (pcp) who were followed up in the aids program at the children's hospital of new jersey, newark, are reviewed. the mean and median age at pcp diagnosis were 10.8 and 7.7 months, respectively. all of the children had other clinical evidence of infection with the human immunodeficiency virus that was documented prior to the diagnosis of pcp or found at the time of pcp diagnosis. most patients who presented to the hospital were a ...19911672168
cd4 t-lymphocyte counts and pneumocystis carinii pneumonia in pediatric hiv infection.the relationship between cd4 t-lymphocyte counts and infection with the human immunodeficiency virus (hiv) is retrospectively investigated for 266 hiv-infected and uninfected children who were born to infected women, including 39 with pneumocystis carinii pneumonia (pcp), in a population-based surveillance study. of 21 perinatally hiv-infected children with pcp only 10 (48%) had cd4 t-lymphocyte counts that were less than 500 x 10(6) cells/l (500 cells/mm3), compared with all 18 who were infecte ...19911672169
[pneumocystis carinii pneumonia in hiv infection. diagnosis, prognostic factors and curative treatment].the diagnosis of pneumocystis carinii pneumonia (pcp) rests on the isolation of this micro-organism in patients whose latest blood count, less than 2 months old, shows less than 250 cd4 lymphocytes per cubic mm and who present with signs of impaired lung function. bronchoalveolar lavage (bal) is the reference diagnostic method, but induced expectoration may be the initial examination, in which case bal is performed only when the latter fails or gives negative results. prognostic factors are thos ...19911672560
pneumocystis carinii pneumonia complicating somatostatin therapy of cushing's syndrome in a patient with metastatic pancreatic islet cell carcinoma and zollinger-ellison syndrome.described is the case of a 73-yr-old woman with metastatic pancreatic islet carcinoma that manifested initially as zollinger-ellison syndrome followed by onset of endogenous cushing's syndrome, who developed pneumocystis carinii pneumonia while on therapy with a long-acting somatostatin analog. although p. carinii pneumonia has been observed in patients with cushing's syndrome associated with other conditions, this is the first reported case in a patient with zollinger-ellison syndrome. heighten ...19911672788
primary prophylaxis for pneumocystis carinii pneumonia in hiv-infected people with cd4 counts below 200/mm3: a cost-effectiveness analysis.we developed a decision-analytic model to assess the effectiveness and costs of dapsone, trimethoprim-sulfamethoxazole, or aerosolized pentamidine as initial prophylaxis for pneumocystis carinii pneumonia in human immunodeficiency virus-infected people without prior symptoms aids and with cd4 counts less than 200/mm3. each strategy increased life expectancy by about 18% compared with no prophylaxis; annual per-person costs were $440, $700, and $1,680 for dapsone, trimethoprim-sulfamethoxazole, a ...19911673157
unexplained cd4-positive t-cell deficiency in non-hiv patients presenting as a pneumocystis carinii pneumonia.three cases of pneumocystis carinii pneumonia occurring in adults with unexplained t-cell defects are reported. no hiv markers were found during the follow up, and neither was any immunosuppressive disease. the authors emphasize the possibility that pneumocystis pneumonia may occur and may be treated successfully in previously healthy subjects.19911673634
effect of prophylaxis against pneumocystis carinii on toxoplasma encephalitis. 19911673776
low-dose co-trimoxazole, aerosolised pentamidine, or dapsone plus pyrimethamine for prevention of pneumocystis carinii pneumonia. 19911674036
prophylaxis against pneumocystis carinii pneumonia in children infected with hiv. 19911674037
dna amplification on induced sputum samples for diagnosis of pneumocystis carinii pneumonia.dna amplification and silver staining were used to identify pneumocystis carinii in bronchoscopic lavage and induced sputum samples during 51 episodes of respiratory illness in 47 subjects with hiv infection. in 20 episodes, in which the clinical diagnosis was pneumocystis pneumonia (pcp), silver stain was positive in 14 lavage samples (70%) and 7 sputum samples (35%), whereas dna amplification was positive in 19 lavage samples (95%) and 18 sputum samples (90%). dna amplification was positive in ...19911674765
prophylaxis and treatment of pneumocystis carinii pneumonia.although pneumocystis carinii pneumonia (pcp) can occur in any patient with severe impairment of immunity, there has been a sharp rise in incidence with the spread of human immunodeficiency virus through the usa and western europe, where nearly 80% of patients with hiv infection have at least one episode of pcp during their lifetime (murray et al, 1984).19911676607
effect of zidovudine and pneumocystis carinii pneumonia prophylaxis on progression of hiv-1 infection to aids. the multicenter aids cohort study.although used widely, the effectiveness of zidovudine therapy and primary prophylaxis for pneumocystis carinii pneumonia (pcp) in hiv-1-infected individuals, has not been assessed in a large cohort. we have done an observational study between october, 1986, and october, 1990, of a cohort of 2145 hiv-1-seropositive men and 371 who seroconverted during the study. a markov chain transitional analysis was used to examine the effect of zidovudine and pcp prophylaxis on the probability of progression ...19911677108
predictive value of cd4 lymphocyte numbers for the development of opportunistic infections and malignancies in hiv-infected persons.infection with the human immunodeficiency virus (hiv) results in progressive depletion of the cd4 subset t-lymphocytes and the development of opportunistic infections and certain malignancies. charts were reviewed for 185 hiv-infected individuals with 265 aids-defining illnesses (adis) who had t-lymphocyte subset analyses performed within 2 months prior to or 1 month following the diagnosis. also included were 22 hiv-infected patients with oral candidiasis and 20 with asymptomatic infection. sig ...19911677419
predicting risk of pneumocystis carinii pneumonia in human immunodeficiency virus-infected children.effective prophylaxis exists against pneumocystis carinii pneumonia, a major cause of illness and death among human immunodeficiency virus-infected children and adults. while adults with cd4 counts less than 0.2 x 10(9)/l are at highest risk for pneumocystis carinii, clinical or laboratory markers of high risk in children infected with the human immunodeficiency virus have not yet been established. a chart review of 13 infants with perinatally acquired human immunodeficiency virus infection and ...19911677526
primary care intervention and management for adults with early hiv infection.recent clinical drug trials have demonstrated that early intervention with zidovudine will delay disease progression in asymptomatic or minimally symptomatic hiv-infected individuals. these trials will encourage larger numbers of seropositive persons to seek access to primary care, overloading specialized clinics for aids and hiv care. the care of early hiv-infected individuals will need to be delivered by mainstream primary care providers. this article discusses the initiation and management of ...19911677748
repeated dna in pneumocystis carinii.a 16-kb dna fragment designated rp3-1 and cloned from the genome of rat-derived pneumocystis carinii was found to contain sequences that were repeated approximately 70 times per genome. the repeated sequences in rp3-1 spanned at least 10.4 kb. sequences in rp3-1 were present on each of the 16 p. carinii chromosomes resolved by field inversion gel electrophoresis. most of the p. carinii genomic sequences homologous to those in the rp3-1 clone appeared to be as long as those in the rp3-1 clone but ...19911677941
inflammatory responses to pneumocystis carinii in mice selectively depleted of helper t lymphocytes.pneumocystis carinii is the most important pulmonary pathogen in patients with the acquired immunodeficiency syndrome, but host defenses against p. carinii are not well characterized. we recently reported an experimental model of p. carinii infection, in which mice selectively depleted of cd4+ lymphocytes develop pulmonary infection after inoculation with p. carinii. in the current study, we compared lung inflammatory responses to p. carinii inoculation in cd4-depleted mice and in normal mice in ...19911679991
pneumocystis carinii pneumonia and high-dose dexamethasone to prevent emesis of chemotherapy. 19911681289
[purpura fulminans and c7 deficiency complicated by pneumocystis carinii pneumonia].a case of meningococcal purpura fulminans is reported in a 22-year-old woman who also suffered from a congenital deficiency in the seventh component of the complement system. this was her third episode of recurrent meningitis. in the course of her treatment in intensive care, the septic shock was cured, but she developed pneumocystis carinii pneumonia. histological investigations revealed abnormalities in her t-cell population, with a very low t-helper (cd4) to t-suppressor (cd8) ratio. laborato ...19911681768
the selective toxicity of medications used in the treatment of aids on the cem human leukemic cd4+ t-cell line.eleven medications used in the treatment of the human immunodeficiency virus or subsequent opportunistic infections were tested to determine their toxicity to the growth of the cem line of transformed cd4+ t-cells. a selectivity ratio (ic50/ec50) for each agent against its target pathogen was calculated as an in vitro indication of the therapeutic value of that agent. among the anti-hiv agents tested in this study, 2',3'-dideoxyinosine (ddi) had the highest in vitro selectivity ratio, 2.5 times ...19911682133
reduction in intensity of pneumocystis carinii pneumonia in mice by aerosol administration of gamma interferon.pneumocystis carinii pneumonia in patients with aids may result from impaired local release of gamma interferon from lung lymphocytes and subsequent failure of macrophage activation. we tested this hypothesis with mice rendered immunodeficient by selective depletion of cd4+ lymphocytes and inoculated intratracheally with p. carinii. after aerosol administration of recombinant murine gamma interferon, the intensity of p. carinii infection in these mice was reduced in comparison with that in mice ...19911682252
natural history of disseminated mycobacterium avium complex infection in aids.this study sought to better characterize the natural history of aids-associated disseminated mycobacterium avium complex (mac) infection. towards that end two retrospective studies were done: a case-control survival study and a mac respiratory colonization study. among 137 consecutive patients who had a sterile body site cultured for mycobacteria within 3 months of their first aids-defining episode of pneumocystis carinii pneumonia, median survival was significantly shorter in those with dissemi ...19911682396
application of atp measurement to evaluation of the growth of parasitic protozoa in vitro with a special reference to pneumocystis carinii.1. there was a significant correlation between the increase in the number of entamoeba histolytica, trichomonas vaginalis, giardia lamblia and leishmania donovani in culture, and their atp contents determined by luciferase reaction. 2. the similar correlation was also demonstrated between the decreased number of e. histolytica in the presence of an anti-amebic quassinoid and the nucleotide content in vitro. 3. in the case of pneumocystis carinii, the numbers of the organism remained relatively c ...19911685366
t cells are not sufficient for resistance to pneumocystis carinii pneumonia in mice.severe combined immunodeficient (scid) mice given spleen cells from immunocompetent donors resolve their pre-existing pneumocystis carinii pneumonia (pcp). however, scid mice given infusions of thymus cells or spleen cells depleted of cells positive for either immunoglobulin or immune response-associated antigen did not resolve their pcp. immunofluorescence staining and mitogen responses of spleen cells from the recipient scid mice confirmed that all groups of mice contained functional t cells b ...19911687826
trimethoprim-sulfamethoxazole oral desensitization in hemophiliacs infected with human immunodeficiency virus with a history of hypersensitivity reactions.hemophiliacs infected with human immunodeficiency virus with a history of hypersensitivity reaction to a combination product of trimethoprim and sulfamethoxazole were desensitized orally. six of the seven patients included in the study successfully completed the desensitization protocol and received trimethoprim-sulfamethoxazole for 5 to 7 months after desensitization (mean length of treatment, 5.7 months) for prophylaxis of pneumocystis carinii pneumonia. the small number of patients and the sh ...19911688295
pneumocystis carinii: a review of an important opportunistic pathogen in aids.since the first report of human infection with pneumocystis carinii in 1942, cases of pneumonia due to this opportunistic pathogen have become increasingly common. animal studies and clinical observations show that a significant depletion or dysfunction of t helper lymphocytes predisposes to clinical disease. individuals with damaged t helper cells secondary to malignancies (eg, hodgkin's lymphoma), drugs (eg, cyclosporine, steroids), or certain infections (eg, human immunodeficiency virus) are ...199122451747
pneumocystis carinii pneumonia: the pathogen, the diagnosis and recent advances in management. 199118611495
[a patient with aids: infection associated with pneumocystis carinii and cryptococcus neoformans].a patient with aids developed pulmonary infiltrates typical of infection by p. carinii. however, therapy for this agent was unsuccessful. further studies including blood cultures revealed the presence of c neoformans. specific therapy for this agent led to recovery. concomitant opportunistic infections may cause diagnostic and therapeutic problems in patients with aids.19919723082
pneumocystosis.in much of the world, pneumocystosis remains the most common life-threatening opportunistic infection among patients with hiv disease. the infection is caused by pneumocystis carinii--an organism whose identity as a fungus or parasite is still debated. what is no longer debated, after a decade of aids, is that pneumocystosis is almost entirely preventable and eminently treatable. understanding has improved concerning when prophylaxis should be initiated. it is also recognized that, at least with ...19921727534
quality of life in persons with human immunodeficiency virus infection: measurement by the medical outcomes study instrument.to assess the reliability and validity of the medical outcomes study (mos) short form health survey as an indicator for quality of life in patients infected with the human immunodeficiency virus (hiv).19921727616
chest manifestations of aids.chest radiographs, computed tomography and gallium scanning are useful in diagnosing the pulmonary manifestations of acquired immunodeficiency syndrome. most opportunistic infections in patients with aids affect the lung as the primary target organ. bilateral perihilar or basilar interstitial infiltrates, which may progress to the ground-glass appearance of adult respiratory distress syndrome, are commonly seen in cases of pneumocystis carinii pneumonia. unilateral or miliary infiltrates and cav ...19921728087
upper lobe pulmonary parenchymal calcification in a patient with aids and pneumocystis carinii pneumonia receiving aerosolized pentamidine.in patients with aids-related pneumocystis carinii infection occurring during aerosolized pentamidine prophylaxis, roentgenographic findings may be atypical. pulmonary parenchymal calcification due to p carinii is rare. in this case, extensive upper lobe pulmonary parenchymal, splenic, and nodal calcifications occurred after two years of monthly treatments with aerosolized pentamidine.19921729082
eflornithine treatment of refractory pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome.eflornithine was offered as compassionate treatment of 33 episodes of pneumocystis carinii pneumonia in 31 patients with acquired immunodeficiency syndrome who were intolerant of and/or unresponsive to conventional trimethoprim-sulfamethoxazole or pentamidine therapy. a full course of eflornithine consisted of ten days at 400 mg/kg/d but no more than 30 g/d in four divided intravenous doses, four days at 300 mg/kg/d in four divided intravenous doses, and then up to six weeks at 300 mg/kg/d in fo ...19921729113
high incidence of bronchospasm with regular administration of aerosolized pentamidine.a systematic evaluation of changes in pulmonary status by objective spirometric assessment and subjective rating using visual analog scale was performed in a cohort of 134 patients receiving aerosolized pentamidine (ap) for the prevention of pneumocystis carinii pneumonia. significant bronchospasm defined as greater than or equal to 15 percent reduction in the forced expiratory volume in 1 s was noted in 26 of 100 (26 percent) of patients receiving ap alone. despite the use of salbutamol (albute ...19921729115
deposition of aerosolized pentamidine and failure of pneumocystis prophylaxis.to determine if outcome of pneumocystis carinii prophylaxis is related to total lung dose of aerosolized pentamidine.19921729117
pneumocystis carinii induces an oxidative burst in alveolar macrophages.there is evidence that alveolar macrophages (am) play a role in the clearing of pneumocystis carinii from the lungs. to investigate the mechanisms involved in this process, we studied in vitro the induction of an oxidative burst by p. carinii in a cell line of macrophages (nr8383) and am from normal rats. p. carinii was added to macrophage monolayers (10(6) cells), and the h2o2 produced after 4 h of incubation was measured. both nr8383 macrophages and normal rat am produced h2o2 in response to p ...19921729174
critical care of patients with aids.we sought to review the clinical and ethical issues surrounding critical care for patients with the acquired immunodeficiency syndrome (aids).19921729577
pneumonia. patient profiles, choice of empiric therapy, and the place of third-generation cephalosporins.choosing appropriate antimicrobial therapy for patients with pneumonia requires knowledge of the etiologic agents seen in specific kinds of patients at specific times and places. for community-acquired pneumonia, there is an important difference in the agents seen in the normal and the compromised host. the normal host most often presents with viral, mycoplasmal, or pneumococcal pneumonia. the exact place of chlamydia pneumoniae is still under study. a normal host who aspirates is at risk of ana ...19921730186
host species-specific antigenic variation of a mannosylated surface glycoprotein of pneumocystis carinii.all pneumocystis carinii, irrespective of their host of origin, express an abundant mannosylated surface glycoprotein. while this molecule is commonly referred to as gp120, some variation in the size of this molecule has been noted. monoclonal antibodies produced to this molecule from ferret, mouse, rat, and human p. carinii made it possible to distinguish the glycoprotein from p. carinii of each host by immunoblot and indirect immunofluorescence assays. the glycoprotein varied in size (approxim ...19921730900
technetium-99m-dtpa aerosol and gallium-67 scanning in pulmonary complications of human immunodeficiency virus infection.we retrospectively compared the results of 67ga chest scans and 99mtc-dtpa aerosol clearance measurements with those of fiberoptic bronchoscopy in 88 patients infected with the human immunodeficiency virus. of 100 investigations, a pulmonary infection was diagnosed in 39, mainly pneumocystis carinii pneumonia and a noninfectious disorder was found in 42, mainly kaposi's sarcoma and lymphocytic alveolitis. gallium scans and dtpa clearance were abnormal respectively in 74% and 92% of infectious co ...19921731002
the effect of antiviral therapy on the natural history of human immunodeficiency virus infection in a cohort of hemophiliacs.the antiviral drug zidovudine (zdv) slows progression to aids and improves survival after aids diagnosis. although clinical trials have demonstrated early improvement in cd4 lymphocyte number with zdv, long-term effects of zdv on cd4 in advanced and asymptomatic disease are not well known. the purpose of this study was to quantitate the effect of zdv on the natural history of hiv infection, specifically the type and frequency of new aids cases, aids-free survival, survival after aids, and long-t ...19921732503
autopsy findings in hiv-infected inner-city patients.to assess the importance of the autopsy in hiv-1 infection, we retrospectively reviewed the autopsy reports of 70 hiv-1-seropositive patients at howard university hospital. of the 58 patients with aids, the diagnosis of aids was made after autopsy in 24 (41%) cases. the lung was the most common site of aids-diagnostic diseases, and was affected in 90% of patients. pneumocystis carinii infection was the most common aids-diagnostic disease, and was present in 50% of the aids patients. thirty-eight ...19921732504
synthesis, stability, and biological evaluation of water-soluble prodrugs of a new echinocandin lipopeptide. discovery of a potential clinical agent for the treatment of systemic candidiasis and pneumocystis carinii pneumonia (pcp). 19921732529
pneumocystis carinii pneumonia among patients without aids at a cancer hospital.to determine the predisposing factors, attack rate by underlying disease, and outcome of pneumocystis carinii pneumonia among patients without the acquired immunodeficiency syndrome (aids) at a cancer center.19921732656
[pneumocystis carinii pneumonia in hiv-negative immunosuppressed patients].during a period of 10 years 129 immunosuppressed hiv-negative patients were evaluated for pulmonary complications. a definite diagnosis could be established in 72 cases (56%): pneumocystis carinii pneumonia (pcp) (25), pulmonary involvement of underlying disease (10), drug toxicity (8), mycobacterioses (6), bacterial pneumonias (5), aspergillosis (5), others (13). the underlying conditions in patients with pcp were: lymphatic neoplasias (11), immunosuppression after solid organ (9) and after bon ...19921733012
pathology of pentamidine-induced pancreatitis.extensive acute necrotizing pancreatitis occurred in three patients with the acquired immunodeficiency syndrome who had received both aerosolized pentamidine as prophylaxis and intravenous pentamidine for pneumocystis carinii pneumonia. the clinical manifestations along with gross and microscopic pathologic findings at autopsy are presented.19921733411
[taenia crassiceps infection in aids].a 33-year-old patient with aids, and a history of episodes of pneumocystis carinii pneumonia and cerebral toxoplasmosis, developed a subcutaneous paravertebral infiltrate, which at first resembled a haematoma. over a period of several weeks, the lesion spread to cover almost the entire back. initially, numerous investigations failed to reveal the aetiology. his general condition worsened progressively, and intermittent bleeding into the soft tissue of the back occurred, requiring transfusion. th ...19921733697
high-resolution ct of parenchymal lung disease: precise correlation with histologic findings.to provide a precise correlation between high-resolution computed tomographic (ct) findings and histologic studies of various parenchymal lung diseases, 20 fixed and inflated lungs were studied as follows: (a) every lung was cut at the corresponding ct level into 1.5-mm-thick sections, (b) selected slices were cut into small blocks to prepare histologic slides, (c) each slide was photographed, and (d) the image of the entire lung section was reconstituted with the enlarged photographs (assembled ...19921734481
pneumocystis carinii pneumonia due to corticosteroids.a patient receiving long-term corticosteroid therapy for asthma had two episodes of pneumocystis carinii pneumonia (pcp) 8 years apart. she had no other causes of immunosuppression. experimental evidence indicates that corticosteroid administration causes a reduction in t lymphocytes mediated by suppression of cytokines. corticosteroid therapy is a rare but possible independent predisposition to pcp.19921734541
thoracic magnetic resonance imaging in the evaluation of hiv-1/aids pneumonitis.magnetic resonance imaging of the thorax was performed on ten occasions in eight hiv-positive patients with a clinical picture suggestive of pneumocystis carinii pneumonia. the diagnosis of pcp was subsequently confirmed on six occasions. patients without pcp had low mri profusion scores, while four of six patients with pcp had mri profusion scores greater than 6/21. neither the chest roentgenogram appearance nor computer-generated t1 and t2 relaxation times could reliably distinguish between th ...19921735257
pneumocystis carinii pneumonia in patients with connective tissue disease.four patients with pcp complicating a ctd are described. rising serum lactate dehydrogenase levels were documented during an asymptomatic period associated with corticosteroid dosage tapering, weeks prior to the development of acute pulmonary symptoms. the diagnosis of pcp was established by fob in each patient.19921735258
transmission of tuberculosis to hospital workers by a patient with aids.a patient with acquired immunodeficiency syndrome (aids) was admitted to a hospital with cough and fever and after 29 days was transferred to a hospice. he was eventually shown to have active pulmonary tuberculosis. this diagnosis was obscured clinically by simultaneous infection with pneumocystis carinii and mycobacterium avium complex (mac). laboratory recognition of mycobacterium tuberculosis was delayed because of overgrowth of cultures by mac but was later established using dna probe techni ...19921735302
multiplication of human-derived pneumocystis carinii in severe combined immunodeficient (scid) mice.clinically healthy scid mice were infected intratracheally with pneumocystis carinii (pc) of human origin. the data obtained provides unambiguous evidence that progressive multiplication of pc organisms of human origin takes place in the lungs of experimentally infected animals. scid mice that were infected with human-derived pc also revealed a markedly greater number of mouse pc organisms in their lungs than the controls. all the scid recipients of human pc died by day 65 post infection, wherea ...19921737579
human immunodeficiency virus infection in pregnant women under care at aids clinical trials centers in the united states.the federal government supports a nationwide network of medical centers to evaluate promising therapies against the human immunodeficiency virus (hiv) and the opportunistic infections and cancers that characterize aids. forty-five obstetricians from the 49 medical centers receiving federal research support for the conduct of aids-related clinical trials, in preparation for a meeting, provided summary information about the number and clinical status of the known hiv-infected pregnant women under ...19921738515
treatment options for human immunodeficiency virus-infected pregnant women. obstetric-gynecologic working group of the aids clinical trials group of the national institute of allergy and infectious diseases.the increasing seroprevalence of human immunodeficiency virus (hiv) among women of reproductive age and the risks of vertical transmission of hiv have led to recommendations for routine prenatal hiv counseling and testing. the incentive to undergo such testing is related not only to fetal concerns, but also to the potential benefit of early and comprehensive therapy for women. treatments that should be considered for use during pregnancy include the antiretroviral agent zidovudine and prophylact ...19921738529
[glucocorticoids and infection].glucocorticosteroids are the most commonly used immunosuppressive agents. in the following review important mechanisms of action of glucocorticoids on the immunological network are summarized, the relationship between duration of therapy, daily dose and incidence of infections is analysed, and evidence is presented that in some infectious diseases glucocorticoids may even be beneficial. the association between corticosteroid therapy and subsequent infections was calculated by pooling the data fr ...19921738819
why give corticosteroids for pneumocystis carinii pneumonia? 19921739112
computer-supported versus manually-generated nursing care plans: a comparison of patient problems, nursing interventions, and aids patient outcomes.the number and type of activated patient problems and the number of nursing interventions in computer-supported and manually-generated nursing care plans for human immunodeficiency virus (hiv) infected patients hospitalized for pneumocystis carinii pneumonia (pcp) were compared. there were significantly more activated patient problems (p = 0.005) and nursing interventions (p = 0.002) listed using the computer-supported care planning system. the top ranked problems in both systems were reflective ...19921739883
[laboratory diagnosis of pneumocystis carinii: comparison of cytological, immunofluorescent and immunocytochemical staining].authors review several methods for diagnosis of pneumocystis carinii on bal fluid in aids patients aiming to identify ideal routine technic. giemsa, gomori and toluidine blue staining. direct and indirect immunofluorescence. immunocytochemical methods were tested and advantages/disadvantages compared on bal fluid from aids patients. pneumocystis carinii was detected in 7 out 21 cases (33%). gomori staining and toluidine blue staining were chosen for routine pneumocystis carinii detection while i ...19921279508
phenotypic analysis of bronchoalveolar lavage lymphocytes from acquired immunodeficiency patients with and without pneumocystis carinii pneumonia.a study was performed to reveal possible differences in lymphocyte subpopulations from bronchoalveolar lavage (bal) of acquired immunodeficiency patients with and without pneumocystis carinii pneumonia. forty-one consecutive human immunodeficiency virus-seropositive patients were studied. pneumocystis carinii infection was detected in the bal fluid from 18 patients. the bal lymphocyte subpopulations were determined by surface marker analysis with the immunoperoxidase slide assay. no significant ...19921280389
purification of pneumocystis carinii trophozoites and identification of their circulating antigens.we have developed a new method to isolate pneumocystis carinii trophozoites from experimental rat bronchoalveolar lavage specimens by using a percoll discontinuous gradient and have identified the circulating antigens in experimental rat p. carinii pneumonia. the antigenic components of the trophozoites were compared with those of cysts by immunoblotting. a major immunoreactive band of 90,000 da and some others of lower molecular mass were found in trophozoites. on the other hand, bands of 110,0 ...19921280653
identification of a lectin activity in pneumocystis carinii.pneumocystitis carinii is known to adhere to pulmonary alveolar epithelial cells in vivo and to epithelial cell lines in vitro by a mechanism unknown at the molecular level. p. carinii is now found to adhere to rabbit and human red blood cells leading to rosette formation and hemagglutination. p. carinii erythrocyte-adherence was best inhibited by bovine submaxillary mucin and by a polysaccharide from the wall of group a streptococcus, and to a lesser extent by streptococcus group c polysacchari ...19921281927
treatment of aids-related non-hodgkin's lymphoma with a twelve week chemotherapy program.current treatment options for acquired-immunodeficiency syndrome (aids)-related non-hodgkin's lymphoma (nhl) are unsatisfactory because of excessive toxicity rates and frequent recurrence of lymphoma. in this phase ii study, we evaluated a novel 12 week chemotherapy program with respect to feasibility, toxicity and therapeutic results. thirty hiv-seropositive patients with intermediate grade or small non-cleaved cell nhl received a 12 week program of weekly intravenous and oral chemotherapy cons ...19921283356
[hiv infection: a case of progressive encephalopathy and pneumocystis carinii pneumonia in a child]. 19921283713
[pneumocystis carinii infection in a hiv infection department].to determine the prevalence of pneumocystis carinii in the hiv-infection department, a simultaneous survey was made of 33 hiv-infected patients at various stages of the disease, of close relatives that were nursing the patients in the unit (n-7), and of medical staff of the department (n-20). patients with toxic infections who were on another floor of the same hospital and medical students were examined as a control group. for detection of p. carinii antigen, smears from the deep airways were te ...19921283714
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