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"crazy paving appearance" on high resolution ct in various diseases.the purpose of this work was to demonstrate the variety of causes of crazy-paving appearance (cpa) on high resolution ct (hrct).199910524860
pulmonary colonization with pneumocystis carinii in human immunodeficiency virus-negative patients: assessing risk with blood cd4+ t cell counts. 199910524989
altered distribution of pneumocystis carinii pneumonia during radiation therapy.the radiographic findings of pneumocystis carinii pneumonia (pcp) are various. the typical findings are diffuse, bilateral, symmetric, finely granular, or reticular infiltrates. in patients taking aerosol pentamidine, atypical findings may be the first manifestation. one interesting radiologic finding of pcp is that the pneumonia may spare the irradiated lung. we report pcp developed in a patient undergoing irradiation for lung cancer. high-resolution ct revealed diffuse, bilateral, and symmetri ...199910525868
the structural mechanism for half-the-sites reactivity in an enzyme, thymidylate synthase, involves a relay of changes between subunits.thymidylate synthase (ts), a half-the-sites reactive enzyme, catalyzes the final step in the de novo biosynthesis of deoxythymidine monophosphate, dtmp, required for dna replication. the cocrystal structure of ts from pneumocystis carinii (pcts), a new drug target for an important pathogen, with its substrate, deoxyuridine monophosphate (dump), and a cofactor mimic, cb3717, was determined. the structure, solved at 2.6 a resolution, shows an asymmetric dimer with two molecules of the substrate du ...199910529228
development of a pcr assay for diagnosis of pneumocystis carinii pneumonia based on amplification of the multicopy major surface glycoprotein gene family.we have evaluated a pcr technique using primers based on pneumocystis carinii major surface glycoprotein (msg) genes, a multicopy gene family, for utility in detection of p. carinii in bal and oropharyngeal samples obtained from immunosuppressed patients. these primers were able to detect p. carinii dna in as little as 16 fg of genomic dna. pcr using msg primers detected p. carinii dna in 7 smear-positive bal samples (100% sensitivity), and found no p. carinii dna in 12 smear-negative bal sample ...199910529878
impact of bacterial pneumonia and pneumocystis carinii pneumonia on human immunodeficiency virus disease progression. pulmonary complications of hiv study group.the course of pneumonia caused by pyogenic bacteria and pneumocystis carinii was examined in a multicity cohort study of hiv infection. the median duration of survival among 150 individuals following initial bacterial pneumonia was 24 months, compared with 37 months among 299 human immunodeficiency virus (hiv)-infected control subjects matched by study site and cd4 lymphocyte count (p<.001). for 152 subjects with p. carinii pneumonia, median survival was 23 months, compared with 30 months for 28 ...199910530443
editorial response: do bacterial pneumonia and pneumocystis carinii pneumonia accelerate progression of human immunodeficiency virus disease? 199910530444
corticosteroids as adjunctive therapy for severe pneumocystis carinii pneumonia in non-human immunodeficiency virus-infected patients: retrospective study of 31 patients.the aim of this retrospective study was to assess whether corticosteroid adjunctive therapy (cat) could prevent death in immunocompromised patients with severe pneumocystis carinii pneumonia (pcp) who do not have human immunodeficiency virus (hiv) infection, similarly to what has been demonstrated for hiv-infected patients. the charts of all non-hiv-infected patients who were admitted to two medical intensive care units between 1988 and 1996 because of severe pcp, defined by an arterial oxygen p ...199910530464
analysis of pneumocystis carinii introns.pneumocystis carinii is an ascomycete phylogenetically related to schizosaccharomyces pombe. little is known about gene regulation in p. carinii. the removal of introns from pre-mrna requires spliceosomal recognition of the intron-exon boundary. in s. pombe and higher eukaryotes, this boundary and a branch site within the intron are conserved. we recently demonstrated that p. carinii cdc2 cdna can complement s. pombe containing conditional mutations of cdc2, an essential gene involved in cell cy ...199910531280
drug-resistant pneumocystis carinii. 199910533856
effects of mutations in pneumocystis carinii dihydropteroate synthase gene on outcome of aids-associated p. carinii pneumonia.sulpha drugs are widely used for the treatment and long-term prophylaxis of pneumocystis carinii pneumonia (pcp) in hiv-1-infected individuals. sulpha resistance in many microorganisms is caused by point mutations in dihydropteroate synthase (dhps), an enzyme that is essential for folate biosynthesis. we assessed whether mutations in the dhps gene of p. carinii were associated with exposure to sulpha drugs and influenced outcome from pcp.199910533864
a search for pneumocystis carinii dna by polymerase chain reaction on bronchoalveolar lavage fluids from patients with wegener's granulomatosis. 199910534563
pattern of opportunistic pulmonary infections in hiv sero-positive subjects: observations from pondicherry, india.prospective analysis for a period of six-and-a-half years was done in 190 patients with hiv infection, which showed post-primary tuberculosis with sputum positive for acid-fast bacilli in 65% of cases. extrapulmonary forms of tuberculosis especially lymph nodes infection was more frequent. cervical group of lymph node involvement was the commonest presentation. procedures such as fnac/biopsy of lymph nodes and pleura provided the immediate diagnostic yields. these procedures must be considered e ...199910534938
[pyrimethamine and sulfadoxine as a preventive treatment for pneumocystis carinii and toxoplasma encephalitis].few studies have been reported on the potential usefulness of fansidar combination at a fixed doses of pyrimethamine and sulfadoxine as prophylaxis for pneumonia by pneumocystis carinii and toxoplasmic encephalitis.199910535188
pneumocystis carinii pneumonia: a clinical review.pneumocystis carinii pneumonia (pcp) is an opportunistic infection that occurs in immunosuppressed populations, primarily patients with advanced human immunodeficiency virus infection. the classic presentation of nonproductive cough, shortness of breath, fever, bilateral interstitial infiltrates and hypoxemia does not always appear. diagnostic methods of choice include sputum induction and bronchoalveolar lavage. the drug of choice for treatment and prophylaxis is trimethoprim-sulfamethoxazole, ...199910537385
infectious complications in chronic lymphocytic leukaemia.infections are the major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (cll). predisposition to infection in cll is mediated through various abnormalities including both the immune defects inherent in the primary disease (impairment in humoral and cellular immunity) and in the further immunosuppression related to the management of cll. hypogammaglobulinemia is probably the most important immune defect in terms of risk of severe bacterial infections, its frequency ...199910543369
pharmacokinetics of dapsone administered daily and weekly in human immunodeficiency virus-infected children.although dapsone is a commonly used alternative agent for prophylaxis against pneumocystis carinii pneumonia in children intolerant to trimethoprim-sulfamethoxazole, there are few data that describe dapsone pharmacokinetics in children. we studied dapsone pharmacokinetics in 30 children (median age, 2.8 years; age range, 0. 3 to 12 years) receiving a new proprietary liquid preparation by three dosing regimens (1 mg/kg of body weight daily, 2 mg/kg daily, or 4 mg/kg weekly). dosing of children wi ...199910543733
immune-mediated inflammation directly impairs pulmonary function, contributing to the pathogenesis of pneumocystis carinii pneumonia.the clinical severity of pneumocystis carinii pneumonia (pcp) correlates closely with the appearance of pulmonary markers of inflammation. therefore, a model system was developed whereby physiological studies could be performed on live mice to determine the extent to which pulmonary inflammation contributes to respiratory impairment during pcp. p. carinii-infected severe combined immunodeficient mice displayed little evidence of pulmonary inflammation and exhibited normal oxygenation and dynamic ...199910545529
sterols of pneumocystis carinii hominis organisms isolated from human lungs.the opportunistic pathogen pneumocystis carinii causes pneumonia (p. carinii pneumonia, or pcp) in immunocompromised individuals such as aids patients. rat-derived p. carinii carinii organisms have distinct sterols which are not synthesized by mammals and not found in other microbes infecting mammalian lungs. the dominant sterol present in the organism is cholesterol (which is believed to be scavenged from the host), but other sterols in p. carinii carinii have an alkyl group at c-24 of the ster ...199910548595
experimental corticosteroid induction of pneumocystis carinii pneumonia in piglets.animal models of pneumocystis carinii (pc) pneumonia (pcp) play a central role in research on the pc microorganism itself and the disease, especially the pathogenesis and the host defence. the classic rat model with corticosteroid-induced reactivation of a latent infection has been most widely used. in our search for alternative non-rodent models, six 31/2-week-old piglets were injected intramuscularly with methylprednisolone acetate, at 18 mg/kg body weight, once a week for 6 weeks. six litterm ...199910549589
vertical transmission rates for hiv in the british isles: estimates based on surveillance data.to estimate and interpret time trends in vertical transmission rates for hiv using data from national obstetric and paediatric surveillance registers.199910550082
in-vitro activity of rifabutin and albendazole singly and in combination with other clinically used antimicrobial agents against pneumocystis carinii.the in-vitro activity of rifabutin and albendazole alone and in combination with clarithromycin, etoposide, minocycline and pyrimethamine was investigated against four clinical isolates of pneumocystis carinii. the susceptibility tests were performed by inoculation of the isolates on to cell monolayers and by determining the parasite count after 72 h incubation at 37 degrees c. the culture medium was supplemented with serial dilutions of each agent. albendazole tested alone was more active than ...199910552982
emergence of trimethoprim-sulfamethoxazole resistance in the aids era.trimethoprim-sulfamethoxazole (tmp-smx) is widely used for pneumocystis carinii pneumonia prophylaxis in human immunodeficiency virus (hiv)-infected patients, but little is known about the effects of this practice on the emergence of tmp-smx-resistant bacteria. a serial cross-sectional study of resistance to tmp-smx among all clinical isolates of staphylococcus aureus and 7 genera of enterobacteriaceae was performed at san francisco general hospital. resistance among all isolates was <5.5% from ...199910558935
pneumocystis carinii dihydropteroate synthase but not dihydrofolate reductase gene mutations correlate with prior trimethoprim-sulfamethoxazole or dapsone use.recent studies of the human pneumocystis carinii dihydropteroate synthase (dhps) gene suggest that p. carinii is developing resistance to sulfamethoxazole (smx) and dapsone. to explore whether p. carinii is also developing resistance to trimethoprim (tmp), the human p. carinii dihydrofolate reductase (dhfr) gene was cloned, dhfr and dhps genes in 37 p. carinii isolates from 35 patients were sequenced, and the relationship between tmp-smx or dapsone use and gene mutations was analyzed. the dhfr g ...199910558954
[bone marrow involvement by pneumocystis carinii in an aids patient]. 199910563098
mitogen-activated protein kinase mkp1 of pneumocystis carinii complements the slt2delta defect in the cell integrity pathway of saccharomyces cerevisiae.signal transduction pathways are important in the adaptive response of microbes to their environment. a pneumocystis carinii extracellular signal-regulated protein kinase (mapk) homologue, mkp1, has been isolated by sequence similarity screening of p. carinii genomic dna. the mkp1 of p. carinii shows closest homology to other fungal map kinases involved in cell integrity signal transduction cascades, including slt2p/mpk1p of saccharomyces cerevisiae, mkc1 of candida albicans and mps1 of magnapor ...199910564487
inhaled antimicrobial therapy.although antimicrobial therapy has been administered through the inhaled route for decades, it has always been controversial. there are relatively few accepted indications for this mode of administration. well-controlled studies of aerosolized antibiotics in cystic fibrosis demonstrate that tobramycin on a cyclical basis may reduce sputum volume, bacterial counts, and improve pulmonary function. preliminary data indicate that inhaled antibiotic therapy of ventilator-associated tracheobronchitis ...199910565884
a case of interstitial pneumonia associated with pneumocystis carinii in a foal.subacute interstitial pneumonia with diffuse alveolar damage, marked macrophage infiltration, and intracellular pneumocystis carinii cysts is described in a 3-month-old swiss warmblood foal. clinically, the disease was characterized by sudden onset of respiratory distress with fatal outcome. based on serum immunoglobulin g (igg), iga, and igm values, no humoral immunosuppression was detected. spleen, thymus, and bronchial lymph nodes did not reveal lymphoid depletion, as assessed by immunohistoc ...199910568448
successful management of pulmonary tuberculosis in renal allograft recipients in a single center.pulmonary infections, especially tuberculosis, are responsible for significant mortality and morbidity among renal transplant recipients in developing countries. conventional diagnostic modalities are associated with a low yield, delaying specific therapy.199910571806
structure-based design of selective inhibitors of dihydrofolate reductase: synthesis and antiparasitic activity of 2, 4-diaminopteridine analogues with a bridged diarylamine side chain.as part of a larger search for potent as well as selective inhibitors of dihydrofolate reductase (dhfr) enzymes from opportunistic pathogens found in patients with aids and other immune disorders, n-[(2,4-diaminopteridin-6-yl)methyl]dibenz[b,f]azepine (4a) and the corresponding dihydrodibenz[b,f]azepine, dihydroacridine, phenoxazine, phenothiazine, carbazole, and diphenylamine analogues were synthesized from 2, 4-diamino-6-(bromomethyl)pteridine in 50-75% yield by reaction with the sodium salts ...199910579848
synthetic dna minor groove-binding drugs.in this review, both cationic and neutral synthetic ligands that bind in the minor groove of dna are discussed. certain bis-distamycins and related lexitropsins show activities against human immunodeficiency virus (hiv)-1 and hiv-2 at low nanomolar concentrations. dapi binds strongly to at-containing polymers and is located in the minor groove of dna. dapi intercalates in dna sequences that do not contain at least three consecutive at bp. berenil can also exhibit intercalative, as well as minor ...199910580832
nosocomial infections in patients with hiv disease.throughout the aids epidemic, nosocomial infection in the patient with hiv disease has presented a constant problem--not only for the hospitalized patient but also for the clinic attender. the nosocomial spread of multidrug-resistant tuberculosis has emphasized the need for effective control of infection measures in dealing with the immunodeficient. increased recognition of nosocomial bacterial pneumonias has raised questions about the place, if any, of antimicrobial prophylaxis in preventing gr ...199910582184
pneumocystis carinii pneumonia in patients receiving immunosuppressive drugs for dermatological diseases.in recent years, pneumocystis carinii pneumonia (pcp) has been increasingly reported in patients without human immunodeficiency virus (hiv) infection. the increased occurrence of pcp in non-hiv-immunocompromised subjects has been attributed to several factors: use of stronger immunosuppressive regimens, higher awareness of pcp, advanced diagnostic technology and nosocomial spread of p. carinii. appearance of pcp subsequent to the use of immunosuppressive drugs has been noticed in many inflammato ...199910583061
the growth and the control of human immunodeficiency virus in the lung: implications for highly active antiretroviral therapy.in recent years, it has become apparent that the lung is an important niche for the proliferation of human immunodeficiency virus (hiv), which may have implications for highly active antiretroviral therapy (haart). the lung itself is a major site for the opportunistic infections associated with the progression to acquired immune deficiency syndrome (aids), specifically pneumocystis carinii, myobacterium tuberculosis and pyogenic bacteria. these cases of active pulmonary complications are direct ...199910583442
a comparison of three strategies for risk-adjustment of outcomes for aids patients hospitalized for pneumocystis carinii pneumonia.the need for risk-adjustment of patient outcomes has been driven by the competitive health care market and the subsequent increase in comparative outcome reporting among health care institutions, among managed care plans, and among individual providers for some procedures (e.g. coronary artery bypass graft surgery). however, if the outcomes reported do not take into account patient characteristics that can be considered dimensions of risk for poor clinical outcomes or increased utilization of se ...199910583654
high rates of pneumocystis carinii pneumonia in allogeneic blood and marrow transplant recipients receiving dapsone prophylaxis.chemoprophylaxis for pneumocystis carinii pneumonia (pcp) is routinely given after allogeneic blood or marrow transplantation. we evaluated the effectiveness of dapsone prophylaxis (50 mg orally twice daily, 3 times per week) compared with twice-weekly trimethoprim-sulfamethoxazole (tmp-smz) in preventing pcp after allogeneic blood or marrow transplantation. patients included all (n=646) who received allogeneic blood or marrow transplants between 1 september 1993 and 31 december 1996 who survive ...199910585797
association of primary pneumocystis carinii infection and sudden infant death syndrome.to delineate clinical and histological features of the first pneumocystis carinii infection affecting the immunocompetent host, p. carinii-specific histological stains were performed on autopsy lung specimens from 534 consecutive pediatric patients (those with aids and malignancies were excluded) in santiago, chile. p. carinii clusters were found in 4 (25%) of 16 infants who died of no apparent cause at arrival to the emergency department, and in 10 (2.9%) of 342 infants who died of multiple con ...199910585801
pneumocystis carinii pneumonia in human immunodeficiency virus (hiv)-positive and hiv-negative immunocompromised patients.for 89 human immunodeficiency virus (hiv)-positive and 32 hiv-negative immunocompromised patients who had 121 episodes of pneumocystis carinii pneumonia (pcp), clinical features and changes over time were compared. hiv-infected patients characteristically had a longer duration of symptoms (23 vs. 13 days; p<.005); were younger (39 vs. 48 years; p<.001); had a higher frequency of sweating, weight loss, and thoracic pain; and had fewer admissions to the intensive care unit (16% vs. 31%; p<.05). in ...199910585806
spectrum of opportunistic infections and malignancies in patients with human immunodeficiency virus infection in south korea.to determine the frequency and types of major opportunistic diseases in patients with hiv infection in south korea, we reviewed the medical records of 173 hiv-infected patients. the patients were seen from 1985 to 1998 at a referral hospital for aids in south korea. most patients (85%) were male, and 107 (62%) were infected by heterosexual contacts. cd4+ lymphocyte counts at presentation were <200/microl in 27% of the patients. tuberculosis was the most frequent opportunistic infection (25% of p ...199910585807
imaging-guided percutaneous biopsy of focal splenic lesions: update on safety and effectiveness.the purpose of this study is to determine the safety and effectiveness of percutaneous imaging-guided biopsy in the diagnosis of focal splenic lesions.199910587123
enhanced in vivo human immunodeficiency virus-1 replication in the lungs of human immunodeficiency virus-infected persons with pneumocystis carinii pneumonia.the relationship of serum human immunodeficiency virus-1 (hiv-1) rna levels to hiv-1 rna levels in other compartments, such as the lungs, is not well characterized. the purpose of this study was to determine the viral burden of hiv-1 in the lungs by comparing hiv-1 rna in cell-free bronchoalveolar lavage fluid (balf) with that in serum. specimens were examined from 77 hiv-seropositive adults (cd4(+) cell counts: 0 to 700 cells/mm(3); 48% receiving prescribed antiretroviral agents), comprising 43 ...199910588627
randomized trial of weekly sulfadoxine/pyrimethamine vs. daily low-dose trimethoprim-sulfamethoxazole for the prophylaxis of pneumocystis carinii pneumonia after liver transplantation.we conducted a prospective, randomized clinical trial among liver transplant patients to assess the efficacy and safety of weekly sulfadoxine/pyrimethamine compared with daily trimethoprim-sulfamethoxazole in the prevention of pneumocystis carinii pneumonia. the studied drugs were given during 6 months after transplantation. one hundred twenty patients were included. none of the 60 patients receiving weekly sulfadoxine/pyrimethamine developed pneumocystis carinii pneumonia, whereas two cases (3% ...199910589886
a randomized trial of daily and thrice-weekly trimethoprim-sulfamethoxazole for the prevention of pneumocystis carinii pneumonia in human immunodeficiency virus-infected persons. terry beirn community programs for clinical research on aids (cpcra)we enrolled 2,625 human immunodeficiency virus-infected patients into a randomized trial to assess the efficacy and tolerability of daily vs. thrice-weekly trimethoprim-sulfamethoxazole (160 mg/800 mg) for prophylaxis of pneumocystis carinii pneumonia (pcp). the rate of pcp was 3.5 and 4.1 per 100 person-years in the daily and thrice-weekly groups, respectively, with a relative risk (rr) of 0.82 (95% confidence interval [ci], 0.61-1.09; p = .16) (rr of <1.0 favors daily trimethoprim-sulfamethoxa ...199910589887
editorial response: prophylaxis for pneumocystis carinii pneumonia--an evolving tale of two populations. 199910589888
detection of pneumocystis carinii dna in the air filter of a ventilated patient with aids. 199910589930
blood eosinophilia in tacrolimus-treated patients: an indicator of pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) in immunocompromised patients is suggested if the following symptoms develop: dyspnea, fever, and interstitial infiltrates on chest x-ray. we observed a significant blood eosinophilia in kidney recipients with pcp under immunosuppressive treatment with tacrolimus.199910589963
pulmonary manifestations of pediatric hiv infection.vertically acquired hiv infection is becoming increasingly common in india. the main clinical manifestations of hiv in childhood are growth failure, lymphadenopathy, chronic cough and fever, recurrent pulmonary infections, and persistent diarrhoea. pulmonary disease is the major cause of morbidity and mortality in pediatric aids, manifesting itself in more than 80% of cases. the most common causes are pneumocystis carinii pneumonia (pcp), lymphocytic interstitial pneumonitis (lip), recurrent bac ...199910798157
pneumonia due to unusual organisms in children.generally antimicrobials for treatment of pneumonia are chosen to target the usual bacterial etiological agents. such regimens are unable to cure patients of pneumonia caused by 'unusual organisms' mycoplasma, chlamydia, pneumocystis carinii and legionella pneumophilus). thus, there is a need to anticipate their presence in appropriate cases and to plan the initial antimicrobial therapy accordingly. studies in europe as well as india have shown that such infections form a fairly substantial perc ...199910798161
therapeutic potential of terbinafine in subcutaneous and systemic mycoses.mycoses vary widely in severity, and may present as superficial, subcutaneous and/or systemic infection. effective treatments for most superficial mycoses now exist, but new agents with convenient dosing regimens and a low level of adverse events are still needed to reduce morbidity and mortality from serious subcutaneous and systemic fungal infections. in vitro, terbinafine exhibits a broad spectrum of activity against the pathogenic fungi responsible for deep mycoses. clinical data, while not ...199910730913
hiv & aids in older adults.many americans mistakenly believe that older adults are not at risk for hiv/aids. older people do not perceive themselves to be at risk for hiv infection, either. in reality, approximately 10% of aids cases are among people older than 50. many health care providers lack an awareness of the risk of hiv/aids in the elderly population, and as a result, many older people with these conditions are misdiagnosed with other ailments. major manifestations of hiv/aids in elderly adults include pneumocysti ...199910703354
diagnosis of pulmonary embolus by spiral ct: a case study.a thirty-eight-year old immunosuppressed woman presented with respiratory distress and was diagnosed with pneumocystis carinii pneumonia. pulmonary embolism was also suspected on clinical grounds. a ventilation-perfusion scan was indeterminate. contrast-enhanced spiral computed tomography of the chest confirmed the presence of a central pulmonary embolus and helped to avoid pulmonary angiography in this critically ill patient.199910650776
pneumocystis carinii infection in young non-immunosuppressed rabbits. kinetics of infection and of the primary specific immune response.the aim of this study was to determine the kinetics, the dissemination of the infection and the immunological response to pneumocystis carinii primary infection in a non-immunosuppressed rabbit model. for this purpose, we developed a nested pcr that amplified a portion of the mitochondrial large-subunit rrna gene of rabbit-derived p. carinii. the pcr detected p. carinii dna in lung and bronchoalveolar lavage fluids from 14- to 45-day-old rabbits but not in their serum. no p. carinii dna was dete ...199910691087
microbiologically proven pneumocystis carinii pneumonia (pcp) at ga-rankuwa hospital. 199910678196
major surface glycoprotein genes from pneumocystis carinii f. sp. ratti.pneumocystis carinii occurs in a variety of mammals, each of which harbors one or more genetically distinct "special forms" of the microbe. laboratory rats can be infected by two special forms, p. carinii f. sp. ratti and p. carinii f. sp. carinii. p. carinii f. sp. carinii has a variable antigen, the major surface glycoprotein (msg), the expression of which is controlled by genetic recombination. recombination may involve the crje, a 23-bp dna sequence element invariant among p. carinii f. sp. ...199910669586
[the cause of infection as the main or additional cause of death in patients treated for small cell lung cancer].in 116 out of 845 patients treated for small cell lung cancer (sclc) in the institute of tuberculosis and chest disease in warsaw in the years 1980-1994 infection was the main or coexistent cause of death. in 4.1% infection was proved of bacterial origin and in further 6.5% of probable bacterial origin (in the later group cultures were negative or not done but fungal infection, pneumocystosis pneumonia and tuberculosis were excluded on autopsy). in 1.54% infection was of fungal origin, 1.2% pati ...199910647287
efficacy of sulfamethoxazole-trimethoprim administration in the prevention of pneumocystis carinii pneumonia in patients with connective tissue disease.the efficacy and adverse effects of prophylactic administration of sulfamethoxazole-trimethoprim (st) for pneumocystis carinii pneumonia (pcp) were assessed in patients with connective tissue diseases (ctd). eighty-four patients who were receiving more than 40 mg/day of prednisolone were entried in the present study. patients with at least one of the two pcp risk factors (interstitial pulmonary fibrosis and lymphopenia), were administered either one (11 patients) or two (26 patients) st tablets/ ...199910624092
survival and progression of hiv disease in women attending gum/hiv clinics in britain and ireland. study group for the mrc collaborative study of hiv infection in women.to describe the pattern of clinical disease in women with hiv infection and to examine the effect of potential cofactors, including oral contraceptive use, alcohol and smoking, ethnic group, and route of hiv transmission, on progression to aids and death.199910615311
an unusual case of pneumocystis carinii presenting as an aural mass.extrapulmonary involvement of organs with the protozoan pneumocystis carinii is rare. we describe a case of pneumocystis carinii presenting as an erosive aural mass in a young male patient with acquired immunodeficiency syndrome. as far as the authors are aware such an example has never been described in a british journal and is the first case worldwide where otic pneumocystosis has extended into the middle cranial fossa. we also present a review of the literature on otological manifestations of ...199910605587
karyotypes of pneumocystis carinii derived from several mammals.pneumocystis carinii is the most important opportunistic pathogen of humans in the world. pneumocystis carinii is experimentally detected in the lungs of rats, mice, rabbits, and monkeys, however, the organisms from different mammals are identical in microscopic morphology. the present study tried to find out more mammalian hosts of p. carinii and also to differentiate the organisms from different mammals by karyotyping. rats, mice, hamsters, rabbits, cats, and dogs were successfully infected by ...199910634044
epidemiology and risk of pulmonary disease.although pulmonary diseases are important causes of illness and death in patients with human immunodeficiency virus (hiv) infection, advances in treatment and the demographics of hiv-infected populations are changing their incidence and manifestations. the rates of acquires immune deficiency syndrome (aids)- related mortality and opportunistic infections have fallen drastically since the introduction of highly active antiretroviral therapy (haart) in 1996. the risk of developing specific disorde ...199910638509
screening and noninvasive testing for pulmonary disease.although detection of preclinical disease using screening tests is desirable if earlier treatment improves outcome, the available data show no morbidity or mortality benefit using chest radiography, sputum analysis for pneumocystis carinii and acid-fast bacilli, or serial measurements of single-breath carbon monoxide diffusing capacity to detect pulmonary disease in asymptomatic persons with hiv. it seems prudent to evaluate asymptomatic patients periodically with a careful history and focused p ...199910638510
bronchoscopic techniques for the diagnosis of pulmonary complications of hiv infection.bronchoscopy has played the central role in defining the spectrum of pulmonary disorders that occur in patients with hiv infection. transbronchial biopsy (tbb) and bronchoalveolar lavage (bal) both have high yields in the diagnosis of pneumocystis carinii pneumonia (pcp) and other infections. paradoxically, despite our knowledge and experience using bronchoscopy, controversy still exists regarding whether to attempt to make a bronchoscopic diagnosis in most patients with suspected pcp who have n ...199910638511
bacterial pneumonia.bacterial pneumonia is significantly more common in persons who are hiv-infected than in the general population and is most common among injection drug users and in persons with advanced hiv disease and immunosuppression. the clinical features of bacterial pneumonia are similar to those in hiv-seronegative persons, but bacteremia is more common. when a pathogen is identified, streptococcus pneumoniae is consistently the most common, occurring in 20% to 70% of cases. haemophilus influenzae, staph ...199910638512
pneumocystis carinii pneumonia.throughout the epidemic, pneumocystis carinii pneumonia (pcp) has been the most common aids-defining opportunistic infection in the united states. with the widespread use of highly active antiretroviral therapy (haart) and prophylaxis in patients known to be at risk, the incidence of pcp in patients with aids has declined dramatically. however, it is still seen regularly in patients with previously undiagnosed human immunodeficiency virus (hiv) infection, those who do not comply with prophylacti ...199910638513
cytomegalovirus pneumonia.cytomegalovirus (cmv) pneumonia is a major cause of morbidity and mortality in allogeneic bone marrow transplant and lung transplant recipients. however, its role as a cause of lung disease in patients with the human immunodeficiency virus (hiv) is controversial. although cmv can be isolated from lung specimens in patients with hiv-associated respiratory illness, it is rarely the causative pathogen. most adults with hiv infection have latent cmv infection of many tissues including the lung, and ...199910638515
thoracic surgical spectrum of hiv infection.the thoracic surgeon is often called on to diagnose or treat a variety of disorders associated with human immunodeficiency virus (hiv) infection. surgical mediastinal exploration through cervical and anterior approaches is a safe and valuable modality in appropriately selected patients with unexplained mediastinal lymphadenopathy. open lung biopsy is used in a small subset of hiv-infected patients with undiagnosed diffuse or multifocal pulmonary disease, with an anticipated diagnostic yield of m ...199910638516
intensive care of patients with hiv infection.despite the improvements in the prognosis associated with the development of highly active antiretroviral therapy (haart), more than 410,000 people in the united states were reported to have died from acquired immune deficiency syndrome (aids) by the end of 1998. the number of people living with human immunodeficiency virus (hiv) infection and aids in the united states continues to increase, estimated at more than 370,000 in 1998, and there is good reason for optimism that hiv infection may be a ...199910638517
a retrospective study of the addition of ciprofloxacin to clarithromycin and ethambutol in the treatment of disseminated mycobacterium avium complex infection.disseminated mycobacterium avium complex (dmac) infection is associated with increased morbidity and mortality in hiv-infected individuals. the combination antibiotic regimens containing clarithromycin can decrease symptoms and improve survival in patients with dmac, however, optimal therapy remains to be defined. quinolones have been widely used in the treatment of dmac but their utility has not been established. a retrospective cohort study of dmac infection was established in a metropolitan h ...199910639059
pneumocystis carnii pneumonia in aids--an autopsy report.pneumocystis carinii pneumonia (pcp), the most common presenting manifestation in patients with aids from western countries, holds the distinction for being the first opportunistic infection that was associated with aids. there is marked paucity of clinically diagnosed and pathologically confirmed cases of pcp in india. this case represents the first complete autopsy report of pneumocystis carinii pneumonia inpatient with aids from our country. a high index of clinical suspicion and microscopic ...199910862304
changing spectrum of hiv infection and its associated conditions in spain: the end of the beginning?to evaluate the natural history and the impact that different strategies have had on hiv infection and its associated conditions, a cohort of 970 patients (432 had aids) who had been seen over a period of 13 years were studied. the incidence of new hiv-infected patients had increased steadily since 1985, peaking in 1993 (52.9 cases/100,000 population), to significantly decrease in the subsequent years. the most common aids-defining illnesses (adis) were tuberculosis (52.3% of the patients), pneu ...199910842855
determinants of hiv-related survival among texas prison inmates.research indicates that being incarcerated adversely affects disease progression and overall health status. because hiv infection is a growing problem among prison populations in the united states, understanding how incarceration affects hiv-related survival patterns is critical. the present study examined determinants of hiv-related survival in a cohort of 2380 texas department of criminal justice (tdcj) inmates who were treated for hiv/aids, dating from january 1, 1992 and june 31, 1997. asses ...199910842856
search for agents causing atypical pneumonia in hiv-positive patients by inhibitor-controlled pcr assays.pneumonia is one of the most frequent complications in acquired immunodeficiency syndrome-patients with pneumocystis carinii as the leading cause. the true prevalence of atypical agents such as chlamydia pneumoniae, c. trachomatis, legionella pneumophila and mycoplasma pneumoniae in this population of patients is unknown as the currently used method for diagnosing these agents is measurement of antibody levels. however, this method is of limited value in human immunodeficiency virus (hiv)-positi ...199910836344
factors associated with the time elapsed between the initial detection of hiv-1 antibodies and a diagnosis of aids among patients followed in lyons university hospitals. cisih collaborators.to identify the factors associated with a short period between the initial detection of hiv-1 antibodies and aids diagnosis among patients from lyons, france.199910754941
knowledge of prophylaxis treatment therapy among hiv-positive prisoners.the present study examined the level of knowledge and understanding of pneumocystis carinii pneumonia (pcp) treatment therapy among heterosexual and non-heterosexual inmates (prisoners) with hiv-infection. this study seeks to determine if any differences exist between hiv-positive inmates based on sexual orientation, with reference to pcp treatment therapy. it is our contention that this effort will provide health professionals with valuable insight regarding delivering expanded care for hiv-inf ...199910755030
epidemiology of pediatric aids in puerto rico: 1981-1998.the objective of this study was to describe the aids-defining conditions (adc) and survival experience of pediatric aids cases (< 13 years age) reported in puerto rico. a descriptive analysis of the data gathered by the puerto rico aids surveillance system was performed. data for the 377 pediatric aids cases reported from january 1981 through june 1998 were reviewed. survival curves following aids diagnosis were estimated using the kaplan--meier method and differences between curves were assesse ...199910743510
journal club. hiv-associated bacterial pneumonia.bacterial pneumonia is the most common cause of death from pneumonia in patients with hiv disease, causing greater mortality than pneumocystis carinii pneumonia. the challenge for the clinician evaluating the hiv-infected patient with pneumonia is to quickly distinguish clinically among all possible causes and to initiate therapy based on the most likely diagnosis. while an understanding of typical clinical and radiographic presentations is essential, bronchoscopy is the preferred test for relia ...199911082736
intestinal tuberculosis presenting as fever of unknown origin in a heart transplant patient.patients undergoing transplantation have an increased risk of developing infections such as tuberculosis, pneumocystis carinii pneumonia, candida infections or cytomegalovirus infections because of their immunosuppressive therapy with cyclosporin a, azathioprine and steroids. mycobacterial infection is well recognized as a complication in the immunocompromised host but diagnosis and therapy are very difficult.199910885848
pneumocystis carinii pneumonia (pcp) at ga-rankuwa hospital.pneumocystis carinii is recognized as one of the leading causes of death in aids patients in developed countries but its role in this regard in developing countries appears to be less prominent. sub-saharan african countries, in spite of their high hiv prevalence, have hardly recorded any cases. we report the first microbiologically proven case of pcp in an adult patient at ga-rankuwa hospital. a 37 year old african woman was referred to ga-rankuwa hospital from the local clinic for chest infect ...199910746400
structural changes in rat pneumocystis carinii surface antigens after terbinafine administration in experimental p. carinii pneumonia.terbinafine is a synthetic antifungal agent which has recently been found to be highly effective against pneumocystis carinii. this study evaluated the efficacy of terbinafine on rat p. carinii antigenic profile and the immune response by western blot analysis, in comparison with atovaquone and co-trimoxazole in rats with pneumocystosis. terbinafine was shown to target two specific major antigens, particularly those of 116 and 35-40 kda. antibodies reactive against these moieties were found in a ...199911252340
identification and characterization of novel variant major surface glycoprotein gene families in rat pneumocystis carinii.the major surface glycoprotein (msg) is an abundant, immunodominant protein on the surface of the opportunistic pathogen pneumocystis carinii. the current study identified two novel variant msg (vmsg) gene families in rat p. carinii that are closely related to but distinct from msg. these gene families encode proteins of approximately 90 kda (v1msg) and approximately 115 kda (v2msg). compared with msg, v1msg is characterized by a deletion near the carboxyl terminus. the predicted v1msg and v2msg ...19999841839
detection of pneumocystis carinii dna in blood specimens from human immunodeficiency virus-infected patients by nested pcr.the detection of pneumocystis carinii dna in blood by pcr could be useful for studying the natural history of pneumocystosis and could also be a noninvasive diagnostic method. the results of previous studies are nevertheless conflicting. in our study, we compared three commercially available dna extraction kits (genereleaser, qiaamp tissue kit, and readyamp genomic dna purification system) and proteinase k and proteinase k-phenol-chloroform treatments for the extraction of p. carinii dna from di ...19999854076
[experimental and clinical pulmonary pneumocystosis].rat lungs with hydrocortisone-induced pneumocystosis and a necropsy material from 5 patients with aids were studied light- and electron-microscopically. the identity of basic morphological features of lung pneumocystosis development in experiment and humans is demonstrated. three main periods--latent, pronounced, terminal (pneumocystic pneumonia) are distinguished taking into account the relation of productive and vegetative forms of pneumocystis carinii, state of the surfactants, type i alveolo ...19989854613
[pneumocystis carinii infections in patients with neoplasms and aids--clinical-pathologic changes in the lungs].pneumocystis carinii (pc) has been documented as a cause of pneumonia in a broad range of immunocompromised patients. the presentation of disease will very based on the underlying predisposing condition but a confirmation depends upon the identification of organisms in a bronchial aspiration or lung biopsy specimen. this retrospective study based on autopsies of 15 patients (pts) with aids and 12 non aids pts with neoplastic diseases. pneumocystis carinii pneumonia (pcp) was confirmed by histolo ...19989857666
[latent aids in young children of mothers who were hiv-negative in the first trimester of pregnancy].the authors describe two cases of infants admitted to our unit with respiratory failure caused by a pneumocystis carinii pneumonia (pcp). because their mothers were hiv negative in the first three months of pregnancy. hiv infection was not suspected and the diagnosis was only made after the pcp. based on these examples we discuss the importance of detecting hiv infection during pregnancy.19989859518
[prevention of opportunistic infections in the protease inhibitor era].from the middle of 1996 we are living a striking reduction of incidence of opportunistic infections (ols) associated to human immunodeficiency virus (hiv). the recovery of the immune system, at least partially, is showing up substantial changes of ols after the introduction of highly active antiretroviral therapy (haart): relieves, sometime complete resolutions, of ols that previously did not give any response to the treatment (cryptosporidiosis, microsporidiosis, progressive multifocal leucoenc ...19989859614
[pneumocystis carinii pneumonia and hiv infection: diagnosis and treatment].pneumocystis carinii pneumonia (pcp) is one of the leading complications among hiv-infected patients. recent advances in pcp prophylaxis, diagnosis and treatment have caused a decrease in pcp-related morbidity and mortality. despite these advances, pcp continues to be frequent in patients not known to be hiv-infected and in those patients with poor adherence to prophylactic regimens or severe immunosuppression. in typical cases diagnosis may be suspected by the patient's clinical presentation. c ...19989859618
a randomized trial of n-acetylcysteine for prevention of trimethoprim-sulfamethoxazole hypersensitivity reactions in pneumocystis carinii pneumonia prophylaxis (ctn 057). canadian hiv trials network 057 study group.hydroxylamine derivatives of sulfamethoxazole may be the reactive metabolites that cause adverse reactions to trimethoprim-sulfamethoxazole (tmp-smx). the increased frequency of reactions observed in hiv-positive individuals is hypothesized to be due to systemic glutathione deficiency and a decreased ability to scavenge these metabolites. two hundred and thirty-eight patients were randomized to receive or not receive n-acetylcysteine (3 g of the 20% liquid solution) 1 hour before each dose of tm ...19989859964
accelerated hyperfractionated radiotherapy combined with induction and concomitant chemotherapy for inoperable non-small-cell lung cancer--impact of total treatment time.tumour cell proliferation during conventionally fractionated radiotherapy (rt) can negatively influence the treatment outcome in patients with unresectable non-small-cell lung cancer (nsclc). accelerated and hyperfractionated rt may therefore have an advantage over conventional rt. moreover, earlier studies have suggested improved survival with addition of cisplatin-based chemotherapy (ct). we present here the results of combined treatment with induction and concomitant ct and accelerated hyperf ...19989860311
atovaquone compared with dapsone for the prevention of pneumocystis carinii pneumonia in patients with hiv infection who cannot tolerate trimethoprim, sulfonamides, or both. community program for clinical research on aids and the aids clinical trials group.although trimethoprim-sulfamethoxazole is the drug of choice for the prevention of pneumocystis carinii pneumonia, many patients cannot tolerate it and must switch to an alternative agent.19989862944
nitrated sp-a does not enhance adherence of pneumocystis carinii to alveolar macrophages.we investigated whether nitration of surfactant apoprotein (sp) a alters its ability to bind to mannose-containing saccharides on pneumocystis carinii and its potential role in the mediation of p. carinii adherence to alveolar macrophages. human sp-a was nitrated by incubation with tetranitromethane at ph 8.0 or synthetic peroxynitrite (onoo-) at ph 7.4, which resulted in significant nitration of tyrosines in its carbohydrate recognition domain [0.63 +/- 0.001 (se) and 1.25 +/- 0.02 mol nitrotyr ...19989843839
[pneumonia caused by granulomatous pneumocystis carinii in a patient with the acquired immunodeficiency syndrome].a 54-year-old man was admitted to the hospital because of fever and general fatigue. a chest roentgenogram on admission showed lobular opacities and ill-defined opacities in both lower lobes. the pneumonia was successfully treated with antibiotics. the acquired immunodeficiency syndrome was diagnosed because elisa and pcr tests for antibodies to the human immunodeficiency virus were positive and the cd 4+ lymphocyte count was 39 per cubic millimeter. examination of bronchoalveolar lavage fluid r ...19989844388
[7 new cases of hiv-2 infection recognized in madrid in 1996 and 1997].the infection with human immunodeficiency virus type-2 (hiv-2) is endemic in western africa, where it is responsible for many of aids cases. in spain, 72 cases with hiv-2 until december 1997 had been reported, mainly in african immigrants. seven of these cases (4 males and 3 females) were identified during 1996 and 1997. five came from western africa and other two were spanish, one from alicant and the other from vigo. only one out of the seven patients presented clinical manifestations (pneumoc ...19989844454
six-hour trimethoprim-sulfamethoxazole-graded challenge in hiv-infected patients.hypersensitivity reactions to trimethoprim-sulfamethoxazole (tmp-smx) are very common in hiv-infected patients, leading to drug discontinuation. however, it is the drug of choice as prophylaxis for pneumocystis carinii pneumonia.19989847446
septic shock from mycobacterium tuberculosis after therapy for pneumocystis carinii.septic shock resulting from mycobacterium tuberculosis (tb) occurs only rarely, even among patients infected with human immunodeficiency virus. we report a case of fulminant tb sepsis in the setting of human immunodeficiency virus infection. this case illustrates the hazards of corticosteroid use as a part of empirical treatment of pneumocystis carinii pneumonia, as well as the unique appearance of tb on chest x-ray films.19989588437
prevention of infection due to pneumocystis carinii. 19989593116
drug evaluation of concurrent pneumocystis carinii, toxoplasma gondii, and mycobacterium avium complex infections in a rat model.we present a new experimental model for the simultaneous evaluation of the activities of drugs against pneumocystis carinii, toxoplasma gondii, and mycobacterium avium complex infections. rats latently infected with p. carinii were challenged with the mo-1 strain of m. avium and then immunosuppressed with corticosteroids for 7 weeks. at week 5 the rh strain of t. gondii was intraperitoneally injected. organs were examined for the three pathogens after death or killing of the animals at week 7. w ...19989593128
ocular opportunistic infection incidences among patients who are hiv positive compared to patients who are hiv negative.the purpose of the study was to examine the incidence of ocular opportunistic infections among patients who are human immunodeficiency virus (hiv) positive compared to patients who are hiv negative.19989593394
weight loss as a predictor of survival and disease progression in hiv infection. terry beirn community programs for clinical research on aids.severe weight loss in hiv is associated with decreased length of survival. it is unclear whether mild weight loss is associated with an increased risk of death or opportunistic complications of hiv. participants in four interventional studies (n = 2382) conducted by a community-based clinical trials network were evaluated for percentage change in weight during their first 4 months in the study. proportional hazards models were performed for the occurrence of opportunistic complications and death ...19989593462
typing with internal transcribed spacer regions of pneumocystis carinii from aids patients with recurrent pneumonia. 19989795997
[clinical study on mechanism of pneumocystis carinii pneumonia by polymerase chain reaction].pneumocystis carinii is a human respiratory pathogen which causes fatal pneumonia in patients under immunosuppressed or immune deficient conditions. recent work have documented the usefulness of the polymerase chain reaction (pcr) method in the detection of p. carinii from clinical samples. therefore, we described our experience in using pcr method in the detection of p. carinii from respiratory samples. in our study, bronchial washing or balf were good for diagnosis of p. carinii pneumonia (pcp ...19989796184
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