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prevention of pneumocystis carinii pneumonia and of cerebral toxoplasmosis by roxithromycin in hiv-infected patients.the prevention of cerebral toxoplasmosis and of pneumocystis carinii pneumonia is an essential objective in the management of patients infected with hiv. given that roxithromycin is active in vitro against toxoplasma gondii and that in 1989 dolermann reported the effective treatment of p. carinii respiratory infections with erythromycin, a randomized pilot study was undertaken in 52 patients infected with hiv. patients were treated with either: a monthly dose of pentamidine aerosol (300 mg); rox ...19957782114
novel 2,4-diamino-5-substituted-pyrrolo[2,3-d]pyrimidines as classical and nonclassical antifolate inhibitors of dihydrofolate reductases.eight novel, nonclassical, antifolate 2,4-diamino-5-(anilinomethyl)pyrrolo[2,3-d]pyrimidines, 1-8, with 3',4',5'-trimethoxyphenyl, 3',4'-dimethoxyphenyl, 2',5'-dimethoxyphenyl, 4'-methoxyphenyl, 2',5'-diethoxyphenyl, 3',4'-dichlorophenyl, 1'naphthyl, and phenyl substituents were synthesized as potential inhibitors of dihydrofolate reductases (dhfrs). the classical analogue n-[4-[n-[(2,4-diaminopyrrolo[2,3-d]pyrimidin- 5-yl)methyl]amino]benzoyl]-l-glutamic acid (9) was also synthesized as an inhi ...19957783147
[changes in the natural history of aids in patients from mallorca and ibiza: 1986-1992].longitudinal follow-up studies in patients with human immunodeficiency virus (hiv) infection and aids, which are fundamental for the knowledge of variations the natural history of this disease, have generally been carried out by public health departments and in populations in which homosexual males predominate. the aim of the present study was to analyze the changes in the natural history of the patients diagnosed with aids in the islands of mallorca and ibiza.19957783469
analysis of cellular response and gamma interferon synthesis in bronchoalveolar lavage fluid and lung homogenate of mice infected with pneumocystis carinii.the cellular and cytokine responses in the lungs of mice infected with pneumocystis carinii were examined on both lung homogenates and bronchoalveolar lavage (bal) fluids. in the lungs of infected mice, the number of p. carinii cysts rapidly decreased by day 7, then started to increase with a peak on day 14, and thereafter decreased gradually. when the presence of p. carinii was examined at the dna level by dot blot hybridization, a similar clearance curve was obtained, and the organisms were sh ...19957783677
disseminated toxoplasmosis in aids patients--report of 16 cases.between june 1986 and october 1992, disseminated toxoplasmosis was diagnosed in 16 aids patients. 13 cases were diagnosed at autopsy where multiple organ involvement was documented in all 13. three patients were diagnosed intra vitam. all 3 survived with appropriate treatment. clinical features indicative of disseminated toxoplasmosis were: fever of unknown origin between 39 degrees and 40 degrees c in 16 cases, clinical signs suggestive of sepsis or septic shock in 15, with progression to multi ...19957784818
ct-guided automated needle biopsy of the chest.the purpose of this study was to determine the diagnostic accuracy and frequency of complications of ct-guided transthoracic needle biopsy done with an automated biopsy system.19957785631
effect of atovaquone and atovaquone drug combinations on prophylaxis of pneumocystis carinii pneumonia in scid mice.the prophylactic efficacies of atovaquone (atq) alone and in combination with azithromycin, clarithromycin, rifabutin, proguanil, ps-15, trimethoprim, co-trimoxazole, or dapsone were investigated in a scid mouse model of pneumocystis carinii pneumonia (pcp). atq alone was shown to have a significant dose-related effect, and at 200 mg/kg of body weight per day administered orally, the efficacy of atq was comparable to that of septrin (co-trimoxazole). of the drugs investigated orally in combinati ...19957785975
treatment of experimental endocarditis due to methicillin-susceptible or methicillin-resistant staphylococcus aureus with trimethoprim-sulfamethoxazole and antibiotics that inhibit cell wall synthesis.using two strains of staphylococcus aureus, one susceptible and one heterogeneously resistant to methicillin, for which mics and mbcs of trimethoprim-sulfamethoxazole (tmp-smx) were 0.06 and 0.06 micrograms/ml and 0.06 and 0.25 microgram/ml, respectively (concentrations are those of tmp), we studied the efficacies of tmp-smx and cloxacillin, teicoplanin, and vancomycin for treatment of experimental staphylococcal endocarditis. rabbits were treated with dosages of tmp-smx selected to achieve conc ...19957786002
clinical experience with atovaquone on a treatment investigational new drug protocol for pneumocystis carinii pneumonia.the clinical experience of human immunodeficiency virus (hiv) + patients treated with oral atovaquone for acute pneumocytstis carinii pneumonia (pcp) under a treatment investigational new drug (ind) protocol (mild or moderate pcp) and an open-label study protocol (severe pcp) was evaluated. a total of 940 patients intolerant of or unresponsive to trimethoprimsulfamethoxazole were enrolled from private practices, clinics, and institutional hiv treatment centers in the united states. demographics ...19957788426
trimetrexate. a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the treatment of pneumocystis carinii pneumonia.trimetrexate is a folinic acid analogue structurally related to methotrexate, whose primary mechanism of action is believed to be inhibition of dihydrofolate reductase. this reduces the production of dna and rna precursors and leads to cell death. trimetrexate is lipophilic and can passively diffuse across cell membranes including those of pneumocystis carinii and its mammalian host. to minimise toxicity, trimetrexate must be coadministered with calcium folinate (leucovorin calcium), a reduced f ...19957789290
active immunity to pneumocystis carinii reinfection in t-cell-depleted mice.immunocompetent c.b-17 mice were immunized against pneumocystis carinii by several intratracheal inoculations with infective p. carinii. these mice and another group of c.b-17 mice naive to p. carinii were then depleted of cd4+ cells by treatment with both anti-cd4 and anti-thy1 monoclonal antibodies. both groups of mice were then challenged with an infective inoculum containing 10(7) p. carinii organisms by intratracheal instillation. the mean log10 counts of p. carinii nuclei in the lungs of t ...19957790048
collagenases and the serine proteinases elastase and cathepsin g in steroid-induced pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) is characterized by the formation of leaky alveoli and a foamy alveolar exudate. to induce pcp, male wistar rats were immunosuppressed by oral dexamethasone treatment for 12 weeks, during which time all rats developed pcp. bronchoalveolar lavage fluid (balf) was analyzed at that time and at 1, 2, and 4 weeks after the cessation of dexamethasone treatment, during which time the rats were recovering from pcp and immunosuppression (and was compared with the balf ...19957790446
surfactant adjunctive therapy for pneumocystis carinii pneumonitis in an infant with acute lymphoblastic leukaemia. 19957790617
evidence of pneumocystis carinii in cell line cultures infected with peripheral blood mononuclear cells isolated from aids patients with p. carinii pneumonia.the detection of pneumocystis carinii was investigated in an in-vitro system consisting of a human lung epithelial cell line (a-549) inoculated with infected peripheral blood mononuclear cells (pmbc) from hiv-infected patients with proven or suspected p. carinii pneumonia (pcp), and from hiv-negative patients with other lung infections. supernates from cultures were sampled daily and evaluated for the presence of p. carinii by giemsa and immunofluorescence staining. p. carinii was isolated from ...19957791202
successful treatment of pneumocystis carinii pneumonia in mice with benanomicin a (me1451).benanomicin a (bnm-a) has antimycotic activities via binding to mannan in the cell walls of fungi. anti-pneumocystis carinii activity of the agent was examined in the p. carinii-infected balb/c nu/nu female mouse model because p. carinii also possesses mannan in the membranes. the infected mice were treated with intraperitoneal injections of six doses of bnm-a (1, 2.5, 5, 10, 30, and 100 mg/kg of body weight), 4 mg of pentamidine isethionate per kg, 100 mg of sulfamethoxazole per kg combined wit ...19957793879
cytomegalovirus infections of the nervous system in patients with aids.retinitis due to cytomegalovirus (cmv) infection is a widely recognized complication of advanced disease due to human immunodeficiency virus type 1 (hiv-1). less appreciated are other neurological manifestations of cmv infection in persons with aids. dr. j. allen mccutchan has comprehensively reviewed the various clinical presentations of cmv neurological disease as well as the methods of diagnosis, the neuropharmacology of available antiviral agents, the results of therapy, and the potential fo ...19957795068
rapid oral desensitization to trimethoprim-sulfamethoxazole (tmp-smz): use in prophylaxis for pneumocystis carinii pneumonia in patients with aids who were previously intolerant to tmp-smz.trimethoprim-sulfamethoxazole (tmp-smz) is the drug of choice as prophylaxis for pneumocystis carinii pneumonia in patients with aids. however, adverse reactions ascribed to tmp-smz are common in such patients. we previously described a rapid method of oral tmp-smz desensitization in patients with aids and varying degrees of intolerance to the drug. to assess the feasibility, safety, and long-term clinical utility of our desensitization protocol, we retrospectively studied 22 consecutive patient ...19957795084
[atypical presentation of pneumocystis carinii pneumonia]. 19957795126
empirically treated pneumocystis carinii pneumonia in los angeles, chicago, and miami: 1987-1990.many patients infected with the human immunodeficiency virus (hiv) with symptoms suggestive of pneumonia are treated empirically for pneumocystis carinii pneumonia (pcp), although other bacterial infections (e.g., tuberculosis) and pulmonary kaposi's sarcoma may cause identical symptoms. empiric treatment for pcp may result in misdiagnosis and mistreatment. when the outcomes of cytologically confirmed versus empirically treated pcp cases were evaluated, the most important predictors of in-hospit ...19957797940
cost and outcome of intensive care for patients with aids, pneumocystis carinii pneumonia, and severe respiratory failure.to determine the costs and outcomes associated with intensive care unit (icu) admission for patients with acquired immunodeficiency syndrome (aids)-related pneumocystis carinii pneumonia (pcp), and severe respiratory failure.19957807663
cryptococcal pneumonia in aids: is cryptococcal meningitis preceded by clinically recognizable pneumonia?identification of cryptococcal infection while it is still in its pulmonary phase might improve the prognosis for patients with aids who contract cryptococcosis. since cryptococcal pneumonia is infrequently diagnosed in the aids patient, especially compared with the frequency of diagnosis of cryptococcal meningitis, this retrospective study was designed to investigate the frequency of pulmonary complaints in the months before diagnosis of cryptococcal meningitis. the medical records of 18 patien ...19957749794
profile of opportunistic infections among hiv-1 infected people in hong kong.to determine the spectrum of opportunistic infections in patients with human immunodeficiency virus (hiv-1) infection in hong kong.19957750052
111-indium-dtpa-igg lung imaging in patients with pulmonary and hiv infection.111-indium-dtpa-igg (111in-igg) is a new radiopharmaceutical that has been evaluated for the detection of infection without the need for in vitro cell labeling. we prospectively studied this agent in 33 patients suspected of having lung infections, most of whom also had hiv infection, and three patients with hiv infection and diarrhea without lung disease. anterior and posterior lung images in the upright position were obtained within 24 h after intravenous administration of 2 mci of 111in-igg a ...19957750328
pathological lesions in hiv positive patients.pathomorphological features of 10 hiv positive individuals studied at autopsy and biopsy are described. nine patients had evidence of neuro-aids and eight of them succumbed to various opportunistic infections. one surviving patient underwent a diagnostic lymph node biopsy which revealed tuberculous lymphadenopathy. cryptococcal meningitis was the commonest cns opportunistic infection, seen in five cases, with disseminated systemic cryptococcosis in two. the other opportunistic infections include ...19957751041
use of semiquantitative pcr to assess onset and treatment of pneumocystis carinii infection in rat model.the use of semiquantitative pcr (sqpcr) to assess pneumocystis carinii pneumonia (pcp) infection and its response to treatment was studied with rats. groups of eight rats were immunosuppressed with steroids for 3 to 12 weeks. untreated controls were maintained for the same periods. three groups of rats were treated with pentamidine, three groups were treated with trimethoprim-sulfamethoxazole, and three groups of rats were tapered from steroids. at various times during suppression, rats from the ...19957751383
mortality and survival trends in patients with aids in north east england from 1984-1992.to study trends in mortality and survival in patients with aids attending an id unit.19957751661
adverse events associated with trimethoprim-sulfamethoxazole and atovaquone during the treatment of aids-related pneumocystis carinii pneumonia.atovaquone was compared to trimethoprim-sulfamethoxazole (tmp-smz) for the relationship of time receiving therapy, plasma drug concentrations, and incidence of adverse reactions in patients with aids-associated pneumocystis carinii pneumonia. treatment-limiting adverse events occurred in 9% of atovaquone-treated patients and 24% of tmp-smz-treated patients. adverse events usually did not occur before day 7 for either treatment. only the incidence of rash increased with increasing plasma concentr ...19957751706
[clinico-pathological aspect of hiv-sero positive inpatients].to describe the clinico-pathological aspect of hiv/aids inpatients, we reviewed hiv/aids inpatients in our hospital since 1988. we evaluated risk factors, cd4 counts, cd4/8 ratio, cause of death and the survival time after diagnosis of aids. a total of 13 hiv sero-positive subjects were admitted to our hospital, including 11 cases (85%) with aids. one patient was a foreigner. all cases were male; age range 18-70 years. hemophiliacs and sexually transmitted patients account for 62% and 38% of cas ...19957751747
encephalopathy in children with perinatally acquired human immunodeficiency virus infection. pediatric spectrum of disease clinical consortium.to define the incidence, characteristics, and survival of children with perinatally acquired human immunodeficiency virus (hiv) infection and encephalopathy.19957751993
effect of corticosteroids on survival of children with acquired immunodeficiency syndrome and pneumocystis carinii-related respiratory failure.the medical records of patients with acquired immunodeficiency syndrome were reviewed to evaluate the effect of our adoption to the pediatric population of the national institutes of health recommendation for adjunctive corticosteroid therapy in adults with pneumocystis carinii pneumonia. in 21 episodes of p. carinii-related respiratory failure, only adjunctive corticosteroids were associated with a significant improvement in survival to successful removal of the tracheal tube, from a historical ...19957752016
6-substituted 2,4-diamino-5-methylpyrido[2,3-d]pyrimidines as inhibitors of dihydrofolate reductases from pneumocystis carinii and toxoplasma gondii and as antitumor agents.the synthesis and biological activity of 15 6-substituted 2,4-diamino-5-methylpyrido[2,3-d]-pyrimidines are reported. these compounds were synthesized in improved yields by modifications of procedures previously reported by us. specifically, dimethoxyphenyl-substituted compounds with h and ch3 at the n-10 position and trimethoxyphenyl-substituted compounds with n-10 ethyl, isopropyl, and propargyl moieties were synthesized. these compounds were evaluated as inhibitors of dihydrofolate reductases ...19957752201
complete remission of intractable sle after trimethoprim-sulphamethoxazole therapy for pneumocystis carinii infection. 19957753465
bidirectional effectors of a group i intron ribozyme.the group i self-splicing introns found in many organisms are competitively inhibited by l-arginine. we have found that l-arginine acts stereoselectively on the pc1. lsu nuclear group i intron of pneumocystis carinii, competitively inhibiting the first (cleavage) step of the splicing reaction and stimulating the second (ligation) step. stimulation of the second step is most clearly demonstrated in reactions whose first step is blocked after 15 min by addition of pentamidine. the guanidine moiety ...19957753618
[hyperpotassemia during the treatment of pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole]. 19957754158
[a case from practice (324). hiv infection, stage c3 cdc-classification. visceral leishmaniasis and pneumocystis-carinii pneumonia. recurrent candidiasis stomatitis]. 19957754274
does the choice of pneumocystis carinii prophylaxis influence the prevalence of enterocytozoon bieneusi microsporidiosis in aids patients? 19957755923
infectious complications following pancreatic transplantation: incidence, microbiological and clinical characteristics, and outcome.the infectious complications following pancreatic transplantation in 34 consecutive recipients were analyzed during a mean follow-up of 39 months. twenty-seven recipients (79%) developed a mean of 2.1 serious infectious complications. three of the six deaths (overall mortality, 18%) were infection related. thirty-three percent of severe infectious episodes were caused by bacteria (72% by gram-positive cocci) and 26% by fungi (87% by candida species); severe cytomegalovirus (cmv) infection accoun ...19957756469
once-weekly administration of dapsone/pyrimethamine vs. aerosolized pentamidine as combined prophylaxis for pneumocystis carinii pneumonia and toxoplasmic encephalitis in human immunodeficiency virus-infected patients.to evaluate combined prophylaxis for pneumocystis carinii pneumonia (pcp) and toxoplasmic encephalitis, 533 patients with symptomatic human immunodeficiency virus infection and/or cd4 lymphocyte counts of < 200/microl were randomized to receive dapsone/pyrimethamine (200/75 mg once weekly) or aerosolized pentamidine (300 mg every 4 weeks). the median cd4 lymphocyte count was 110/microl; 47.5% were seropositive for toxoplasma antibodies. the median duration of follow-up was 483 days. in the inten ...19957756472
administration of pyrimethamine/sulfadoxine for prevention of pneumocystis carinii pneumonia in patients with aids. 19957756514
cloning and identification of arp1, an actin-related protein from pneumocystis carinii.the complete pneumocystis carinii arp1 gene has been sequenced from two cdna clones. the gene encodes a protein 385 bp in length with an estimated size of 45,000 kd. the a + t% for the arp1 gene and a 900-bp sequence upstream of the gene were 63.7% and 70.3%, respectively. these values are consistent with a + t codon preference displayed by p. carinii and are similar to values reported for other p. carinii genes. the predicted amino acid sequence of the p. carinii arp1 protein had a similarity o ...19957757056
receipt of recommended medical care in hiv-infected and at-risk persons.the authors evaluated receipt of recommended medical care for 133 hiv-infected and 101 at-risk san francisco public health clinic patients. fewer than half the patients received syphilis and tuberculosis screening, hepatitis b immunity testing or vaccination, and tetanus boosters. the hiv-infected persons were significantly (p < or = 0.01) more likely than the at-risk persons to receive preventive care, except for interventions specific to women. more than 80% of the hiv-infected persons receive ...19957730946
[airway continuous positive pressure in acute respiratory failure caused by pneumocystis carinii pneumonia].to evaluate the efficiency of continuous positive airway pressure through a face mask in acute respiratory insufficiency (ari) secondary to pneumocystis carinii pneumonia.19957732189
pneumonia due to staphylococcus aureus in a patient with aids: review of incidence and report of an atypical roentgenographic presentation.multiple defects in host defense mechanisms produce an increased incidence of community-acquired bacterial pneumonia in individuals infected with the human immunodeficiency virus. clinical studies suggest that staphylococcus aureus is an uncommon cause of such infections, though its incidence is increased in the setting of intravenous drug use, indwelling vascular catheter, and coexistent pulmonary kaposi's sarcoma or pneumonia due to pneumocystis carinii. the significantly higher incidence of s ...19957732454
transcription factor genes from rat pneumocystis carinii.genes encoding the tfiid tata-box binding protein (tbp) from two probable species of rat pneumocystis carinii (prototype and variant) were sequenced. the two p. carinii tbp gene sequences were 91% identical to each other, and 65-77% identical to tbp genes from other species. a cdna from one of the two p. carinii tbp genes was sequenced, which showed that four small introns resided in identical positions within the tbp genes from the prototype and variant rat p. carinii. conservation of the 180 a ...19957728137
polymorphism of the thymidylate synthase gene of pneumocystis carinii from different host species.pneumocystis carinii is an opportunistic agent found in the lung of various mammals which often causes severe pneumonia in immunocompromised humans, especially in aids patients. in the past several years significant additions have been made to the collection of knowledge we have concerning the genetic diversity of p. carinii. these additions provide new understanding of pneumocystis transmission and the effect of possible reservoirs of pneumocystis in the various species. in this study, a 400-bp ...19957728138
comparison of coding and spacer region sequences of chromosomal rrna-coding genes of two sequevars of pneumocystis carinii.two distinct sequevars, denoted pc1 and pc2, of the opportunistic pathogen pneumocystis carinii have been previously identified based on the sequence of their 26s rrna genes, the location of group i self-splicing introns and pulsed field electrophoretic patterns of chromosomal dna. this study shows that the sequences of 16s and 5.8s rrna genes also vary between these sequevars, and that greater variation was seen in the internal transcribed spacer regions. polymerase chain reaction and restricti ...19957728139
a histological basis for the 'sonographic snowstorm' in opportunistic infection of the liver and spleen.we report 3 cases of opportunistic infection of the liver and spleen due to pneumocystis carinii, candida albicans and aspergillus with an unusual but similar sonographic appearance. in the patient with pneumocystis we report for the first time this same appearance in the bowel and pleura. histology showed either extensive fibrosis or focal fibrinous exudates as the underlying cause. calcification, though present, was scanty and was not thought to be the likely explanation for the appearances.19957729117
outbreak of pneumocystis carinii pneumonia in a renal transplant unit.the charts for seven renal transplant recipients who developed pneumocystis carinii pneumonia were reviewed. they included six men and one woman transplanted a mean of 150 days before the diagnosis of this infection. six presented at least one episode of acute graft rejection. cytomegalovirus pneumonia was diagnosed in six of the patients. all patients were treated with cotrimoxazole. global mortality was 43%. in additional to the classic hypothesis of latent pneumocystis carinii reactivation in ...19957758477
pneumocystis carinii pneumonia without acquired immunodeficiency syndrome. more patients, same risk. 19957763117
suspected pneumocystis carinii pneumonia with a negative induced sputum examination. is early bronchoscopy useful?in u.s. patients with the acquired immunodeficiency syndrome (aids), pneumocystis carinii pneumonia is the most frequent aids-defining opportunistic infection. sputum induction and bronchoscopy are effective techniques for obtaining specimens used to identify p. carinii although debate continues over their optimal use, specifically whether to perform bronchoscopy after a negative induced sputum examination for p. carinii. to evaluate the usefulness of bronchoscopy in this situation, we reviewed ...19957767533
adoptive transfer of lymphocytes sensitized to the major surface glycoprotein of pneumocystis carinii confers protection in the rat.pneumocystis carinii is a major opportunistic pathogen and a leading cause of morbidity in patients with aids. cd4+ cells have been shown to be important in host defenses against p. carinii, but the antigen(s) involved with this response have not been identified. we undertook the present study to determine whether the major surface glycoprotein (msg) of p. carinii contains epitopes that can elicit a protective cellular immune response. spleen cells and purified cd4+ cells isolated from lewis rat ...19957769101
surfactant protein d interacts with pneumocystis carinii and mediates organism adherence to alveolar macrophages.pneumocystis carinii interacts with glycoproteins present in the lower respiratory tract through its mannose-rich surface antigen complex termed gpa. surfactant protein d (sp-d) is a recently described component of the airspace lining material that possesses a calcium-dependent lectin domain capable of interacting with glycoconjugates present on microorganisms and leukocytes. accordingly, we evaluated the extent and localization of sp-d in the lower respiratory tract during pneumocystis pneumoni ...19957769109
antigenic variation by positional control of major surface glycoprotein gene expression in pneumocystis carinii.major cell surface glycoproteins (msgs) of pneumocystis carinii play a crucial role in host-parasite interactions during p. carinii pneumocystosis in aids patients. genes encoding msgs are repeated and dispersed throughout the genome and are highly polymorphic. msg gene expression was found to be mediated by a dna element that was termed the upstream conserved sequence (ucs). the ucs element maps to a single chromosome, is attached to expressed msg genes, and encodes the sequence found at the 5' ...19957769293
efficacy and toxicity of two doses of trimethoprim-sulfamethoxazole as primary prophylaxis against pneumocystis carinii pneumonia in patients with human immunodeficiency virus. dutch aids treatment group.the efficacy and toxicity of trimethoprim-sulfamethoxazole (tmp-smz) as primary prophylaxis against pneumocystis carinii pneumonia (pcp) for patients with human immunodeficiency virus (hiv) infection was assessed by comparing the effects of two dosages (480 or 960 mg once a day) of the drug. the multicenter trial involved 260 hiv-infected patients with cd4 cell counts < 0.2 x 10(9)/l and no history of pcp. patients were randomly assigned to the treatment groups. after a median follow-up of 376 d ...19957769306
opportunistic pulmonary infections with fludarabine in previously treated patients with low-grade lymphoid malignancies: a role for pneumocystis carinii pneumonia prophylaxis.the high incidence of opportunistic pulmonary infections in fludarabine-treated patients at walter reed army medical center (wramc) and in the literature are described. a cancerlit search of fludarabine from june 1983-april 1994 with subsequent cross referencing and a retrospective review of all patients receiving fludarabine at wramc was performed. a total of 2,269 patients with low-grade lymphoid malignancies who received 7,547 + cycles of fludarabine were identified from the literature. seven ...19957771465
causes of death in renal transplant recipients: a study of 102 autopsies from 1968 to 1991.a study was conducted on 102 patients submitted to renal transplant who died and were autopsied at the university hospital, faculty of medicine of ribeirão preto, brazil, from 1968 to 1991. the cause of death, based on a review of medical records and autopsy reports, was assigned to one of the following categories: infectious (69.6%); cardiovascular (12.7%); gastrointestinal (7.8%); graft rejection (6.9%); tumoral (2.0%); and undetermined (1.0%). among the 71 cases of death caused by infection, ...19957884765
the use of a nested polymerase chain reaction for detecting pneumocystis carinii from lung and blood in rat and human infection.a nested polymerase chain reaction (pcr) assay was developed to detect both rat- and human-derived pneumocystis carinii dna. the nested pcr product was 125 bp long and was representative of part of the gene coding for the large subunit of mitochondrial ribosomal rna. twenty serial blood samples and 24 tissues from six immunosuppressed sprague-dawley rats were examined by nested pcr. all lung samples were positive by pcr and toluidine blue o staining. buffy coat samples and all the other tissues ...19957884803
pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with wegener's granulomatosis.the risk factors and clinical and laboratory parameters in pneumocystis carinii pneumonia in patients with wegener's granulomatosis have not been well characterized. we undertook a retrospective chart review of all patients with a diagnosis of wegener's granulomatosis and p. carinii pneumonia who were followed at the national institute of allergy and infectious diseases of the national institutes of health. the chart review focused on clinical, laboratory, and roentgenologic evidence of p. carin ...19957881673
a multicenter randomized double-blind placebo-controlled trial of adjunctive corticosteroids in the treatment of pneumocystis carinii pneumonia complicating the acquired immune deficiency syndrome.a multicenter placebo-controlled trial of early short-term high-dose methylprednisolone enrolled 78 patients with moderate to severe pneumocystis carinii pneumonia (pcp) complicating hiv infection. the mean pressure of oxygen (po2) at study entry was 55 mm hg for the 71 patients who had blood gases monitored while breathing room air. patients were randomized to receive methylprednisolone (40 mg) or placebo parenterally twice daily for 10 days, and the first dose of study medication was given wit ...19957882099
the learning curve for aids-related pneumocystis carinii pneumonia: experience from 3,981 cases in veterans affairs hospitals 1987-1991.previous studies have found lower mortality rates for aids-related pneumocystis carinii pneumonia (pcp) in hospitals with higher levels of experience with pcp. it is not known if patients are selectively referred to better hospitals or if there is a learning curve whereby outcomes improve as physicians gain experience in treating pcp. we assessed cases of pcp at 140 veterans administration (va) medical centers in the united states. during 1987-1991, 3,981 patients were hospitalized with first-ep ...19957882102
2,4-diamino-5-substituted-quinazolines as inhibitors of a human dihydrofolate reductase with a site-directed mutation at position 22 and of the dihydrofolate reductases from pneumocystis carinii and toxoplasma gondii.2,4-diaminoquinazoline antifolates with a lipophilic side chain at the 5-position, and in one case with a classical (p-aminobenzoyl)-l-glutamate side chain, were synthesized as potentially selective inhibitors of a site-directed mutant of human dihydrofolate reductase (dhfr) containing phenylalanine instead of leucine at position 22. this mutant enzyme is approximately 100-fold more resistant than native enzyme to the classical antifolate methotrexate (mtx), yet shows minimal cross resistance to ...19957877140
[anticardiolipin antibodies in parenteral drug addicts: relationship with hiv].the igg isotype of anticardiolipin antibodies (acl) and its possible relationship with the immunodeficiency virus (hiv) were studied in 65 parenteral drug addicts (pda). thirty-seven patients were infected in the present study. nineteen (51%) fulfilled diagnostic criteria of aids. thirty-two of these 37 hiv-positive patients (86%) were igg-acl positive. fourteen (50%) of the 28 hiv-negative patients were igg-acl positive. our study reveals a lack of correlation between acl and thrombocytopenia. ...19957878276
associating poor outcome with the presence of cytomegalovirus in bronchoalveolar lavage from hiv patients with pneumocystis carinii pneumonia. 19957874921
the relationship between cytomegalovirus retrieved by bronchoalveolar lavage and mortality in patients with hiv.to evaluate mortality over 6 months of patients with hiv with cytomegalovirus (cmv) cultured from bronchoalveolar lavage (bal) compared with those without cmv and to assess the significance of cmv cytologic study, cd4+ counts, and coexistent pneumocystis carinii pneumonia.19957874946
pneumocystis carinii glycoprotein a binds macrophage mannose receptors.pneumocystis carinii causes life-threatening pneumonia in patients with impaired immunity. recent studies suggest that alveolar macrophages interact with p. carinii through macrophage mannose receptors. however, the ligand(s) on p. carinii that is recognized by these receptors has not been fully defined. p. carinii contains a major mannose-rich surface antigen complex termed glycoprotein a (gpa). it was therefore hypothesized that gpa binds directly to macrophage mannose receptors and mediates o ...19957868247
differences exist in the immunoblotting profiles of cyst and trophozoite antigens of pneumocystis carinii.the antigenic profiles of pneumocystis carinii trophozoites and cysts were compared by immunoblotting with hyperimmune rat sera against cyst and trophozoite antigens. strong bands corresponding to proteins of 50-60 kda and 104 kda were demonstrated in cyst and trophozoite antigens by all antisera. additional prominent proteins of 81 and 63 kda and less prominent proteins of 88, 73, 69 and 37 kda were found only in trophozoite antigen. the latter proteins were recognised by anti-trophozoite and a ...19957869347
prophylaxis against pneumocystis carinii pneumonia at higher cd4+ t-cell counts. 19957869553
[induced sputum. indication for examination in pneumocystis carinii pneumonia?].induced sputum is a simple, rapid, and non-invasive technique for detection of pneumocystis carinii in patients with pneumocystis carinii pneumonia. in this study 31 patients were examined both with induced sputum and bronchoalveolar lavage. p. carinii was found in 24 patients. in 68% of the samples obtained by the induced sputum method the microorganism was found after giemsa or methenamine silver staining. in 32% the diagnosis was established in the lavage fluid only. induced sputum is indicat ...19957871505
the role of atovaquone tablets in treating pneumocystis carinii pneumonia.at the start of the aids epidemic, the only agents licensed for treatment of pneumocystis carinii pneumonia (pcp) were trimethoprim-sulfamethoxazole (tmp-smx) and pentamidine. both are effective against pcp, but their use has been compromised by adverse reactions that necessitate discontinuing therapy in < or = 54% of patients. as a result of the limitations in the use of these therapies, research efforts have been directed toward the development of effective agents with an improved safety profi ...19957859136
outpatient supportive therapy after induction to remission therapy in adult acute myelogenous leukaemia (aml) is feasible: a multicentre study.twenty-four adult patients with aml were treated with standard "7 + 3" chemotherapy. after administering the myeloablative drugs in the hospital, patients were instructed to continue their supportive treatment on an outpatient basis; they received ciprofloxacin, cotrimoxasole and itraconazole vo until the absolute granulocyte count rose above 1 x 10(9)/l. platelet concentrates were given every other day until the platelet count rose above 20 x 10(9)/l. complete remission (cr) was obtained in 87% ...19957859871
prophylaxis against pneumocystis carinii pneumonia among children with perinatally acquired human immunodeficiency virus infection in the united states. pneumocystis carinii pneumonia prophylaxis evaluation working group.pneumocystis carinii pneumonia (pcp) remains a common and often fatal opportunistic infection among children infected with the human immunodeficiency virus (hiv). hiv-infected infants between three and six months of age are particularly vulnerable. current guidelines recommend prophylaxis in children from birth to 11 months old who have cd4+ counts below 1500 cells per cubic millimeter.19957862183
maternal-fetal transmission of pneumocystis carinii in human immunodeficiency virus infection. 19957862196
a historical review of pneumocystis carinii. 19957853636
a randomized trial of three antipneumocystis agents in patients with advanced human immunodeficiency virus infection. niaid aids clinical trials group.we evaluated the effectiveness of three treatment strategies for the prevention of a first episode of pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus (hiv).19957854375
a randomized trial comparing fluconazole with clotrimazole troches for the prevention of fungal infections in patients with advanced human immunodeficiency virus infection. niaid aids clinical trials group.cryptococcal meningitis and other serious fungal infections are common complications in patients infected with the human immunodeficiency virus (hiv). fluconazole is effective for long-term suppression of many fungal infections, but its effectiveness as primary prophylaxis had not been adequately evaluated.19957854376
phospholipid composition of pneumocystis carinii carinii and effects of methylprednisolone immunosuppression on rat lung lipids.the phospholipid class composition of pneumocystis carinii carinii freshly isolated from infected lungs generally resembled that of the host lung, suggesting that the parasite scavenges lung alveolar lipids. however, subtle quantitative differences were demonstrated, indicating that the pathogen has the metabolic capacity to de novo synthesize, or at least tailor, its lipids. the concentration of phosphatidylcholine, the major lung surfactant lipid, in the organism was lower than that in lungs o ...19957890386
aids in india.the first case of aids in india was reported in 1986. it is now estimated, however, that more than 1.5 million people in the country are infected with hiv, with current projections indicating that india will have more cases of aids than any other country in the world by the year 2000. the hiv epidemic in india is similar in many ways to the epidemics in sub-saharan africa and thailand. heterosexual intercourse is the main mode of viral transmission, with prostitution and an high prevalence of ...19957891543
pneumocystis carinii pneumonia in hiv-negative immunocompromised adults.to identify patient populations at risk of pneumocystis carinii pneumonia (pcp) and assess the potential role of chemoprophylaxis.19957891601
pneumocystis carinii pneumonia prophylaxis remains unchallenged. 19957893433
the role of initial aids-defining illness in survival following aids.to examine the role of initial aids-defining illness in survival following aids and survival trends over time.19957893442
a population-based comparison of the clinical course of children and adults with aids.to examine the association of clinical complications and age at diagnosis with survival for a cohort of children and adults with aids.19957893443
bronchogenic carcinoma in hiv-positive patients: findings on chest radiographs and ct scans.the radiographic manifestations of bronchogenic carcinoma in hiv-positive individuals may resemble or accompany changes of inflammatory disease. to provide information that is useful in the differential diagnosis, we studied the findings on plain radiographs and chest ct scans in 30 hiv-positive patients with proven bronchogenic carcinoma and correlated the radiographic features with the presence or absence of thoracic opportunistic infection.19957998569
frequencies of opportunistic diseases prior to death among hiv-infected persons. community programs for clinical research on aids.to describe the complete history of major opportunistic events experienced by 1883 hiv-infected persons prior to and specifically within 6 months of death, and to determine whether the frequency of specific events varies according to demographic characteristics, risk behaviors or geographic location.19958519450
the art of parasite survival.parasites develop and survive in an environment which is often hostile to them. when facing aggressive conditions parasites are able to use various and complex strategies. echinococcus granulosus, toxocara canis, pneumocystis carinii, entamoeba or toxoplasma gondii are able to seclude from the environment when stressed by surrounding (immunologic or non-immunologic) aggressive factors. specific antigens which exert a functional activity during a short period of time appear to be concealed from t ...19958520537
uptake and metabolism of l-serine by pneumocystis carinii carinii.serine is an important amino acid that is utilized in the biosyntheses of proteins and lipids. it is directly incorporated into the head group of phosphatidylserine, which in turn can be converted to other phospholipids. also, it is required for the formation of long chain bases, precursors of sphingolipids. uptake and incorporation of radiolabeled serine into both lipids and acid-precipitable material were demonstrated in pneumocystis carinii carinii organism preparations freshly isolated from ...19958520579
analysis of genetic diversity at the arom locus in isolates of pneumocystis carinii.the dna sequences of a portion of the 5-enolpyruvyl shikimate phosphate synthase domain of the arom gene, encoding the pentafunctional arom protein, were determined from isolates of pneumocystis carinii from five mammalian host species (rat, human, ferret, rabbit and mouse). high levels of genetic divergence were found among p. carinii derived from different host species, 7-22% at the dna sequence level, and 7-26% at the derived amino acid sequence level. two separate and distinct sequences were ...19958520580
pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with wegener's granulomatosis. 19958520798
[two cases of sensory neural hearing loss as a manifestation of hiv infection].in patients with hiv infection, oral and pharyngeal pathology frequently occurs, but there have been no reports on cases of deafness in japan. herein, the authors report two cases of sensory neural hearing loss in hemophilia a patients infected with hiv through factor viii concentrates. case 1 was a 16-year-old male with hemophilia a. he had been administered factor viii concentrates starting at 6 months after birth. at 8 years of age, hiv antibodies were positive. he was diagnosed as having aid ...19958523168
pneumocystis carinii pneumonia associated with inhaled corticosteroids in an immunocompetent child with asthma. 19958523172
corticosteroid therapy for pneumocystis carinii pneumonia. 19958523175
impairment of antigen-specific t-cell priming in mice lacking cd40 ligand.lack of functional expression of cd40 ligand (cd40l) on t cells results in hyper-igm syndrome (higm1), a human immunodeficiency associated with a severely impaired humoral immune response that is consistent with defects in b-cell responses. patients also succumb to recurrent opportunistic infections such as pneumocystis carinii and cryptosporidial diarrhoea, suggesting that t-cell functions are also compromised in these individuals, but so far this has not been explained. we have previously show ...19958524395
[infections following bone marrow transplantation].recent years have witnessed a reduction in the frequency of infectious complications both in allogeneic and in autologous bone marrow transplantation (bmt). with a frequency of 30-40 percent, septicaemia is the predominant problem during the aplastic phase. owing to the introduction of prophylaxis with quinolones, there has been a shift in the aetiological spectrum toward gram-positive infections, and gram-negative infections now account for less than 10 percent of all cases. in turn, this has b ...19958524635
steroids do not enhance the risk of developing tuberculosis or other aids-related diseases in hiv-infected patients treated for pneumocystis carinii pneumonia.to evaluate the risk of developing tuberculosis or other aids-related diseases (ard) in hiv-infected patients treated with corticosteroids as adjunctive therapy for pneumocystis carinii pneumonia (pcp).19958527075
clinical experience with fludarabine and its immunosuppressive effects in pretreated chronic lymphocytic leukemias and low-grade lymphomas.fludarabine monophosphate (famp) is a new adenine nucleoside analogue with a promising efficacy in b-cell chronic lymphocytic leukemia (b-cll) and low-grade non-hodgkin lymphomas (nhls). here, the clinical experience and side effects with famp are reported in 77 patients with pretreated cll (59 b-cll, 2 t-cll) and low-grade nhls (9 immunocytic lymphomas including 5 waldenström's macroglobulinaemia, 2 centrocytic (cc) and 5 centroblastic-centrocytic (cb-cc) nhls). 70/77 patients are evaluable for ...19958528057
immunoblot analysis for serum antibodies to pneumocystis carinii by age and intensity of infection in rats.the present study aims to observe changing patterns of serum antibody to pneumocystis carinii in normal rats of different ages and in immunosuppressed rats. the serum igg antibody was observed by immunoblotting with crude antigen of p. carinii which were purified from the lungs of infected rats. the crude antigens separated in sds-page resolved more than 20 protein bands from 20 to 200 kda. of them, 40-45, 50-55, 116 and 200 kda bands were major antigens of p. carinii. most of the normal rats of ...19958528625
mycobacterium genavense invasive infection in two children with aids: long-term followup.mycobacterium genavense is a rare cause of opportunistic infection in immunocompromised hosts. follow up of two cases of m. genavense invasive infection in children with haemophilia a and aids are presented. one patient died 18 months after diagnosis of m. genavense infection of an indirectly related cause, probably of pneumocystis carinii pneumonia. the second patient still attends our outpatient clinic and the infection is under control. both presented with abdominal lymphomas and pain and a w ...19958529716
polymerase chain reaction is more sensitive than standard cytologic stains in detecting pneumocystis carinii in bronchoalveolar lavages from human immunodeficiency virus type 1-infected infants and children with pneumonia. 19958532434
successful bone marrow transplantation in patients with recent pneumocystis carinii pneumonia: report of two cases. 19958535327
the scid mouse as an experimental model for the evaluation of anti-pneumocystis carinii therapy.the usefulness of scid mice bearing endogenous pneumocystis carinii infection as a model for experimental chemotherapy was examined using standard compounds known to be effective against p. carinii. trimethoprim/sulphamethoxazole was able to reduce pulmonary p. carinii cysts in a dose-dependent manner within the dose range studied (10/50 to 100/500 tmp/smx mg/kg/d, bd, po, 5 days per week for 30 treatments). however, alterations in associated symptoms of infection (reduced body weight, increased ...19958537261
acute hepatic and renal failure caused by pneumocystis carinii in patients with aids.clinical and pathological findings are described in two aids patients with pneumocystis carinii infection who received prophylactic treatment with nebulised pentamidine and developed unusual hepatic and renal failure. histological examination showed clumps of p carinii massively obstructing hepatic sinuses and portal vessels in the first patient, and merular and intertubular capillaries in the second. these findings could explain the unusual clinical features, characterised by acute hepatic and ...19958537506
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