Publications

mycobacterium xenopi infection in patients with human immunodeficiency virus infection.	mycobacterium xenopi is one of the most frequently isolated nontuberculous mycobacteria in ontario, canada. we reviewed the records of 28 human immunodeficiency virus (hiv)-infected patients from whom m. xenopi was isolated between 1982 and 1995. m. xenopi was recovered from respiratory specimens from 24 patients, most of whom had clinical and radiographic evidence of pulmonary disease. however, coexistent pulmonary infection due to other pathogens was found in 17 patients: pneumocystis carinii ...	1997	9332511
pneumocystis carinii pneumonia in patients receiving chemotherapy for breast cancer.	pneumocystis carinii pneumonia (pcp) is uncommon in patients undergoing chemotherapy for breast cancer. most previously described patients with breast cancer and pcp received treatment with corticosteroids, a known risk factor for pcp. we describe two patients with metastatic breast cancer who developed pcp after receiving therapy with high doses of cyclophosphamide with peripheral blood stem cell support. both patients developed fevers of unclear etiology in the setting of recovery of the neutr ...	1997	9332513
pneumocystis carinii pneumonia in patients without human immunodeficiency virus infection.		1997	9332514
[the epidemiology and laboratory diagnosis of pneumocystis carinii infections].		1997	9333858
[drug hypersensitivity in aids patients: report of a case].	drug allergy is a common symptom in hiv infected patients, with higher prevalence that in general population. we describe a child with aids and adverse reactions to several drugs indicated for pneumocystis carinii prophylaxis and antibiotics. reaction to intravenous pentamidine was present in this case and it is not an usual findings in hiv infected children. alternative therapy and desensitization to tmp-smx are also discussed.	1997	9334468
preventing and treating major opportunistic infections in aids. what's new and what's still true.	new highly active antiretroviral therapies are boosting the blood absolute cd4+ counts of many patients with aids and are decreasing the prevalence of aids-related opportunistic infections. nevertheless, the prevention, diagnosis, and treatment of opportunistic infections remain important features of management of hiv infection. in recent years, significant advances have been made in the prevention and treatment of opportunistic diseases such as pneumocystis carinii pneumonia, cytomegalovirus re ...	1997	9336601
current issues in the treatment and prophylaxis of pneumocystis carinii pneumonia in hiv infection.		1997	9338481
the influence of mt-2 tropism on the prognostic implications of the delta32 deletion in the ccr-5 gene.	long-term non-progression in hiv-1-infected patients has been reported to be associated with a 32 base-pair deletion (delta32) in one ccr-5 allele. the normal gene product acts as a coreceptor for hiv cell entry and is essential for infection of cells by non-syncytium-inducing and mt-2-negative hiv-1 strains.	1997	9342063
methemoglobinemia associated with dapsone treatment in solid organ transplant recipients: a two-case report and review.	dapsone, a sulfone antibiotic, has been increasingly used in solid-organ transplant recipients for the primary prevention of pneumocystis carinii pneumonia, especially in patients with documented sulfa allergy. a known side effect of dapsone therapy, however, is methemoglobinemia, a condition leading to impaired tissue oxygen delivery. this report documents two cases of dapsone-induced methemoglobinemia in patients after solid organ transplantation with emphasis on the importance of clinical rec ...	1997	9346728
sequences of pneumocystis carinii f. sp. hominis strains associated with recurrent pneumonia vary at multiple loci.	the sequences of the internal transcribed spacer (its) of pneumocystis carinii f. sp. hominis strains from 7 of 15 aids patients were found to vary during discrete episodes of p. carinii pneumonia. changes in the its sequence correlated with changes in the mitochondrial large-subunit rrna sequence. the coincidence of changes in the sequences of the its, which is located in the nucleus, with changes in a mitochondrial gene excludes mutation as the cause of the genetic differences between p. carin ...	1997	9350725
rapid detection of pneumocystis carinii in bronchoalveolar lavage specimens from human immunodeficiency virus-infected patients: use of a simple dna extraction procedure and nested pcr.	we report on the development of a rapid nested pcr protocol for the detection of pneumocystis carinii dna in bronchoalveolar lavage (bal) specimens in which the protocol included the use of a commercially available dna extraction kit (genereleaser). genereleaser enabled us to obtain amplification-ready dna within 20 min without requiring the purification of the dna. the nested pcr was performed with the primers paz102-e, paz102-h, and paz102-l2 (a. e. wakefield, f. j. pixley, s. banerji, k. sinc ...	1997	9350726
the major surface glycoprotein of pneumocystis carinii induces release and gene expression of interleukin-8 and tumor necrosis factor alpha in monocytes.	recent studies suggest that interleukin-8 (il-8) and tumor necrosis factor alpha (tnf-alpha) may play a central role in host defense and pathogenesis during pneumocystis carinii pneumonia. in order to investigate whether the major surface antigen (msg) of human p. carinii is capable of eliciting the release of il-8 and tnf-alpha, human monocytes were cultured in the presence of purified msg. msg-stimulated cells released significant amounts of il-8 within 4 h, and at 20 h, cells stimulated with ...	1997	9353066
mediastinal emphysema with pneumocystis carinii pneumonia in aids.		1997	9353489
n-acetylcysteine treatment and the risk of toxic reactions to trimethoprim-sulphamethoxazole in primary pneumocystis carinii prophylaxis in hiv-infected patients.	in a randomized double blind placebo controlled trial, hiv sero-positive patients with cd4+ cell count less than 200 x 10(6)/l or an aids diagnosis were evaluated for drug reactions to trimethoprim-sulphamethoxazole (tmp-smx) during treatment, including pretreatment, with n-acetylcysteine (nac) 800 mg daily or placebo. tmp-smx (one double-strength tablet containing 160 mg of trimethoprim and 800 mg of sulphamethoxazole) was given three times weekly as primary pneumocystis carinii (pcp) prophylax ...	1997	9354348
comparative evaluation of naturally occurring pneumocystis carinii pneumonia (pcp) and pcp despite primary chemoprophylaxis in patients with aids.		1997	9354363
the role of tracheostomy in acquired immunodeficiency syndrome.	tracheostomy tube (tt) insertion for respiratory failure in patients with acquired immunodeficiency syndrome has been associated with an early mortality rate of 100%. we have reviewed our experience with tracheostomy to determine if there is a role for this procedure among certain subgroups.	1997	9354514
pneumocystis carinii pneumonia in pediatric acquired immunodeficiency syndrome.		1997	9357214
2,4-diaminothieno[2,3-d]pyrimidine lipophilic antifolates as inhibitors of pneumocystis carinii and toxoplasma gondii dihydrofolate reductase.	ten previously unreported 2,4-diaminothieno[2,3-d]pyrimidine lipophilic dihydrofolate reductase inhibitors were synthesized as potential inhibitors of pneumocystis carinii and toxoplasma gondii dihydrofolate reductase. pivaloylation of 2,4-diamino-5-methylthieno[2,3-d]pyrimidine followed by dibromination with n-bromosuccinimide in the presence of benzoyl peroxide gave 2,4-bis(pivaloylamino)-6-bromo-5-(bromomethyl)thieno[2,3-d]pyrimid ine, which after condensation with substituted anilines or n-m ...	1997	9357537
ancillary benefits of mycobacterium avium-intracellulare complex prophylaxis with clarithromycin in hiv-infected patients.	because of the significant morbidity and mortality associated with opportunistic infections, prophylaxis has become routine practice in the management of immunocompromised patients such as those with aids. clarithromycin, an antimicrobial agent with a broad spectrum of activity against most common respiratory pathogens as well as many protozoa, has proven to be effective for both treatment and prophylaxis of mycobacterium avium-intracellulare complex (mac) infection in aids patients. results of ...	1997	9358196
pneumocystis carinii host origin defines the antibody specificity and protective response induced by immunization.	to determine how the known host species-specific antigenic variation of pneumocystis carinii would affect immune recognition, mice were immunized with either mouse- or ferret-derived p. carinii, with subsequent analysis of the immune response and the ability of the mice to resist infection after immunosuppression and challenge. immunization with mouse-derived p. carinii produced a strong immune response to mouse but not ferret p. carinii. these mice were completely protected from p. carinii pneu ...	1997	9359734
neutrophil chemotactic activity in bronchoalveolar lavage fluid of patients with aids-associated pneumocystis carinii pneumonia.	pneumocystis carinii pneumonia (pcp) is accompanied by an acute inflammatory infiltration of the lung parenchyma. the cellular infiltrate is characterized by inflammatory cells including neutrophils, lymphocytes and macrophages. furthermore, neutrophilia in bronchoalveolar lavage (bal) fluid has been shown to confer a poor prognosis in pcp. we therefore investigated the potential of bal fluid from 17 patients with pcp to induce neutrophil chemotaxis. bal fluid from patients induced considerable ...	1997	9360251
graft-versus-host disease after liver and small bowel transplantation in a child.	an 8-month-old child with an immunodeficiency disorder characterized by abnormal lymphocyte function and by low igg and iga levels had combined liver and small bowel transplantation under tacrolimus and steroid immunosuppression for the treatment of short gut syndrome and hepatic cirrhosis. the patient developed an early postoperative episode of pneumocystis carinii pneumonia, and a subsequent surgical complication, prompting discontinuance of tacrolimus. a skin rash eventually shown to be graft ...	1997	9361921
study of prevalence, severity, and etiological factors associated with acute pancreatitis in patients infected with human immunodeficiency virus.	patients with the human immunodeficiency virus (hiv) disease can develop pancreatic gland inflammation from hiv infection and related causes, or from factors totally independent of it. the incidence and severity acute pancreatitis in patients with hiv diseases and the frequency of associated etiological factors have not been examined in any detail. the purpose of this study was to (a) determine the prevalence of acute pancreatitis, (b) evaluate severity of pancreatic gland inflammation, (c) iden ...	1997	9362189
pneumocystis carinii pneumonia in two cavalier king charles spaniels.		1997	9133724
cytokine profiles in bronchoalveolar lavage fluid and blood in hiv-seropositive patients with pneumocystis carinii pneumonia.	concentrations and ex vivo production of interleukin 1 beta (il-1), tumour necrosis alpha (tnf), interleukin 6 (il-6), interleukin-1 receptor antagonist (il-1ra) and tnf soluble receptors (stnf-receptors, p55 and p75) were measured in bronchoalveolar lavage (bal) fluid and blood in 23 hiv-seropositive (hiv+) patients with pneumocystis carinii pneumonia (pcp) and compared with values found in healthy hiv-seronegative (hiv-) controls and asymptomatic hiv+ subjects. concentrations of the proinflamm ...	1997	9134383
a 5-year retrospective review of adverse drug reactions and their risk factors in human immunodeficiency virus-infected patients who were receiving intravenous pentamidine therapy for pneumocystis carinii pneumonia.	the incidence and severity of adverse drug reactions (adrs) in human immunodeficiency virus-infected persons receiving intravenous pentamidine for pneumocystis carinii pneumonia during a 5-year period were reviewed retrospectively. predisposing risk factors for adrs were identified. adrs were included if they occurred during or within 1 week following the discontinuation of pentamidine treatment. nephrotoxicity, dysglycemia, hepatotoxicity, hyperkalemia, and hyperamylasemia accounted for 80% of ...	1997	9142782
etiology of solitary pulmonary nodules in patients with human immunodeficiency virus infection.	we assessed 10 patients with human immunodeficiency virus (hiv) infection (nine of whom had aids) and solitary pulmonary nodules (spns) that were detected on roentgenograms. five of the patients presented with respiratory symptoms. the etiology of the spn was determined for eight of these patients: six had infections (hydatidosis, mucormycosis, or infection with nocardia asteroides, cryptococcus neoformans, cytomegalovirus, or pneumocystis carinii), one had non-hodgkin's lymphoma, and the remain ...	1997	9142791
rapid disease progression in human immunodeficiency virus type 1-infected individuals with adverse reactions to trimethoprim-sulfamethoxazole prophylaxis.	we studied the relation between the occurrence of adverse reactions to trimethoprim-sulfamethoxazole (tmp-smz) prophylaxis and the subsequent course of human immunodeficiency virus (hiv) infection in a cohort of homosexual men. adverse reactions to tmp-smz were associated with a more rapid progression to aids (p < .001) and death (p < .001) and with a more rapid decline in cd4+ cell counts (p = .001). the median time to progression to aids was 14.9 months in subjects with adverse reactions to tm ...	1997	9142796
reducing the incidence of pneumocystis carinii pneumonia: a persisting challenge.		1997	9143626
penetration of dapsone into pulmonary lining fluid of human immunodeficiency virus type 1-infected patients.	we studied the penetration of dapsone into the epithelial lining fluid (elf) of sixteen human immunodeficiency virus type 1-infected patients who had received the drug at a dose of 100 mg twice weekly as primary prophylaxis for pneumocystis carinii pneumonia. bronchoscopy, bronchoalveolar lavage (bal), and venipuncture were performed for each patient at a specific time after administration of the last dose of dapsone. dapsone concentrations in plasma and bal were determined by high-performance l ...	1997	9145873
clinical features and outcomes of hiv-related cytomegalovirus pneumonia.	to describe the characteristics and outcomes of hiv-infected patients with biopsy-proven cytomegalovirus (cmv) pneumonia.	1997	9147423
empiric treatments impair the diagnostic yield of bal in hiv-positive patients.	to investigate the influence of empiric treatments prior to fiberoptic bronchoscopy (fob) on the diagnostic yield of bal in hiv-positive patients with respiratory symptoms.	1997	9149567
utility of lactate dehydrogenase vs radiographic severity in the differential diagnosis of pneumocystis carinii pneumonia.	in patients with hiv infection, serum lactate dehydrogenase (ldh) level is commonly stated to be more elevated in pneumocystis carinii pneumonia (pcp) than in non-pcp. we hypothesized that ldh level reflects radiographic extent and severity of pneumonia rather than p carinii infection specifically and therefore is not useful in the differential diagnosis of lung infections in aids.	1997	9149568
alveolar damage in aids-related pneumocystis carinii pneumonia.	pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of aids. despite this, many basic aspects in the pathogenesis of hiv-associated p carinii pneumonia are unknown. we therefore undertook a light and electron microscopic study of transbronchial biopsy specimens to compare pathologic features of p carinii pneumonia and other hiv-related lung diseases.	1997	9149569
the role of alveolar macrophages in pneumocystis carinii degradation and clearance from the lung.	although studies indicate that alveolar macrophages participate in host defense against pneumocystis carinii, their role in organism degradation and clearance from the lung has not yet been established. we, therefore, quantified the uptake and degradation of 35s-labeled p. carinii by cultured macrophages, demonstrating significant degradation of p. carinii over 6 h. we further evaluated the role of macrophages in elimination of p. carinii from the living host. rats received either intratracheal ...	1997	9151783
survival and treatment of aids patients 1984-1993: experience of a smaller east london hiv centre.	to assess changes in survival from diagnosis of aids for patients managed in a small east london hiv clinic and the impact of therapeutic interventions on these survival patterns.	1997	9155555
pcr detection of pneumocystis carinii in bronchoalveolar lavage specimens: analysis of sensitivity and specificity.	although pcr detection of pneumocystis carinii dna has been described, little is known about the sensitivity or specificity of the assay in routine laboratory practice. we had the unique opportunity to use a bronchoalveolar lavage (bal) specimen bank with samples for which the direct examination results for p. carinii were known. dna purified from 129 selected specimens was amplified by using the primers described previously (a. e. wakefield, f. j. pixley, s. banerji, k. sinclair, r. f. miller, ...	1997	9157136
pneumocystis carinii pneumonia after renal transplantation.		1997	9158038
survival benefits of pulmonary cellular activation in aids patients with pneumocystis infection.	pneumocystis carinii pneumonia (pcp) is the most common life-threatening, opportunistic infection in patients with acquired immunodeficiency syndrome. between 1984 and 1987, patients infected with human immunodeficiency virus (hiv) received bronchoalveolar lavages to confirm pcp diagnosis. unstained slides containing bronchoalveolar cells from 20 of these patients were stored. eight years after the last diagnostic bronchoalveolar lavage, blinded investigators immunohistochemically analyzed the u ...	1997	9160074
usefulness of pcr for diagnosis of pneumocystis carinii pneumonia in different patient groups.	pneumocystis carinii pneumonia (pcp) is one of the most predominant opportunistic infectious diseases in patients with aids. nested pcr has been described as a sensitive and specific tool for detecting p. carinii dna in clinical specimens. little is known about the correlation of positive pcr results and clinical evidence of pcp in patients with different forms of immunosuppression. one hundred and thirty-six sputum samples, 26 tracheal-bronchial aspirate samples, 35 bronchoalveolar lavage sampl ...	1997	9163459
detection of pneumocystis carinii in respiratory specimens by pcr-solution hybridization enzyme-linked immunoassay.	by using a recently developed pcr-solution hybridization enzyme-linked assay (pcr-shela), we investigated pneumocystis carinii in bronchoalveolar lavage fluid samples and induced sputa of patients with pneumocystosis. in detecting p. carinii, pcr-shela proved more sensitive than immunofluorescence staining or a single pcr and significantly more diagnostically specific than a nested pcr. our data suggest that pcr-shela could be used to detect p. carinii organisms in respiratory samples, particula ...	1997	9163489
a single-tube nested pcr for pneumocystis carinii f. sp. hominis.	a single-tube nested pcr which amplifies the internal transcribed spacer (its) regions of the rrna genes of human pneumocystis carinii was developed. the outer primers for the first pcr, which anneal to the 18s and the 26s rrna genes of p. carinii, were made to have a midpoint temperature (tm) of 74 degrees c. the inner primers for the second pcr have a tm of 56 to 58 degrees c and are specific for human p. carinii; they anneal to an area close to the beginning of its1 and the junction of its2 a ...	1997	9163492
pneumocystis carinii pneumonia in a hiv-seronegative patient with untreated rheumatoid arthritis and cd4+ t-lymphocytopenia.	pneumocystis carinii pneumonia (pcp) usually occurs in immunocompromised patients, and it is a life-threatening infection. we report the case of a human immunodeficiency virus (hiv)-seronegative patient with untreated rheumatoid arthritis (ra), who developed fatal pcp related to uncommon cd4+ t-lymphocytopenia. although extremely rare and of uncertain aetiology, suppression of cellular immunity and subsequent opportunistic infections should be suspected in such patients.	1997	9163666
[usefulness of chest ct in diagnosing pneumonia].	the usefulness of chest ct in diagnosing pneumonia was evaluated by a retrospective review of 110 pneumonia cases in which both plain chest radiograph and ct were obtained. detection of abnormal opacities on chest radiograph was difficult or impossible in 9 cases (8.2%), requiring ct to detect them. the opacities which appeared consolidative, nodular, small nodular or cavitary on chest radiograph were shown as opacities of similar character on ct. on the other hand, many opacities of patchy, gro ...	1997	9164115
identification of porcine pneumocystis carinii as a genetically distinct organism by dna amplification.	dna was amplified from lung samples from three piglets infected with pneumocystis carinii, using oligonucleotide primers designed to the p. carinii mitochondrial large subunit ribosomal rna gene. the nucleotide sequence of the amplification product was determined and indicated lack of sequence variation among these pig-derived p. carinii samples at this locus. the data showed that porcine p. carinii was genetically distinct from p. carinii isolated from other mammalian host species.	1997	9164476
listeriosis after fludarabine treatment for chronic lymphocytic leukemia.	the authors report a case of listeria monocytogenes septicemia in a patient with advanced cll after a single course of fludarabine, without any other immunosuppressive therapy e.g. corticosteroids. the immunosuppressive action of fludarabine in patients who are already severely immunosuppressed must be considered from a diagnostic and therapeutic point of view. listeriosis and other opportunistic infections, like pneumocystis carinii pneumonia, have been reported during and after treatment with ...	1997	9168306
intermittent infusion of cladribine (cda) in previously treated patients with low-grade non-hodgkin's lymphoma.	thirty-six patients with previously treated low-grade non-hodgkin's lymphoma (lg-nhl) were included in a phase ii study between august 1990 and february 1994 and treated with 0.12 mg/kg cda as a 2 h.i.v. infusion daily x v, q 28 days up to 6 courses. twenty-three were refractory to previous chemotherapy while 13 were relapsed. four patients had mantle cell lymphoma, 17 follicle centre cell derived lymphoma, 7 lymphoplasmacytoid lymphomas and, 8 had small lymphocytic lymphoma. the response rate w ...	1997	9168441
effect of smoking on the clinical progression of hiv-1 infection.	cigarette smoking as a risk factor in progression of hiv-1 disease was investigated in the multicenter aids cohort study of homosexual men. longitudinal data for t-cell subsets, hiv-related clinical symptoms, smoking behavior, and aids medication use were collected semiannually from 2,499 hiv-1-seropositive men for up to 9 years. survival methods, including kaplan-meier analysis and multivariate cox regression models, were used to assess the effect of cigarette smoking on development of pneumocy ...	1997	9170420
[hiv infection and acquired immunodeficiency syndrome].	on june 4, 1981, mmwr published a report about pneumocystis carinii pneumonia in homosexual men in los angeles. this was the first published report. a years later, this disease was named acquired immunodeficiency syndrome (aids). in the following year, montangier et al in france discovered the causative agent, which they called lymphadenopathy virus (lav), now known as human immunodeficiency virus (hiv). in 1985, solid-phase enzymeimmunoassay for the detection of the antibody to hiv was develope ...	1997	9170967
[the aids patient in anesthesia].	treatment of a patient with acquired immune deficiency syndrome (aids) is very challenging, and makes great demands on the anaesthesiologist. any of an aids patient's vital organ systems may be compromised, either by the human immunodeficiency virus (hiv) itself, opportunistic infections, by tumours, or as a result of aids-related drug therapies. infections of the lungs (e.g., pneumocystis carinii pneumonia) are prevalent, and cardiac impairment can be found in as many as 50% of aids patients. i ...	1997	9172723
how successful are we in administering prophylaxis against pneumocystis carinii pneumonia (pcp) in patients with hiv infection?		1997	9175661
transmission of pneumocystis carinii from patients to hospital staff.	an extrahuman reservoir of human pathogenic pneumocystis carinii remains unknown. host to host transmission has been described in animal studies and in cluster cases among immunodeficient patients. p carinii dna has recently been detected in air filters from inpatient and outpatient rooms in departments of infectious diseases managing patients with p carinii pneumonia (pcp), suggesting the airborne route of transmission. exposure of staff to p carinii may occur in hospital departments treating p ...	1997	9176532
interleukin-8 and leukotriene b4 in bronchoalveolar lavage fluid from hiv-infected patients with bacterial pneumonia.	human immunodeficiency virus (hiv)-infected patients are at increased risk of contracting bacterial infections, mainly pneumonia. despite this, little is known about immunopathogenic mechanisms in hiv-related bacterial pneumonia. this paper investigates the presence of the neutrophil chemotactic mediators, interleukin-8 (il_8) and leukotriene b4 (ltb4), in bronchoalveolar lavage (bal) fluid from 27 hiv-infected patients with bacterial pneumonia. significantly elevated levels of il-8 were found i ...	1997	9176651
present status of purine analogs in the therapy of chronic lymphocytic leukemias.	chronic lymphocytic leukemia (cll) is considered an incurable disease and therefore the management is palliative and more disease-related symptoms directed. recently, the high activity of nucleoside analogs as fludarabine (famp), 2-chlorodeoxyadenosine (2-cda) and 2-deoxycoformycin (dcf) in low-grade nhls has caused a new reawakening interest in cll concerning new treatment strategies, the biology and prognostic factors of this disease. predominantly famp has widely been studied in cll with impr ...	1997	9178835
prophylactic strategies to meet infectious complications in fludarabine-treated cll.	fludarabine has emerged as salvage therapy in chlorambucil-resistant cll. however, encouraging response rates have been compromised by a high incidence of serious infectious complications. prophylactic measures to reduce the frequency of infections are needed, but up to now, there are no established standards for supportive therapy in fludarabine-treated cll. clinicians have observed an increasing frequency of life-threatening opportunistic infections but only some of these may be explained by f ...	1997	9178837
serum pcr of pneumocystis carinii dna in immunocompromised patients.	the detection of pneumocystis carinii dna in serum, a potentially useful and attractive tool for the diagnosis of p. carinii infection and for monitoring the success of therapeutic interventions, remains a controversial issue. in a prospective study of 29 immunocompromised patients, including 16 with hiv infection undergoing bronchoscopy and bronchoalveolar lavage, we examined 32 bronchoalveolar lavage fluids and multiple serum samples for the presence of p. carinii dna by using mitochondrial rr ...	1997	9181652
inhalatory pentamidine therapy and the duration of the qt interval in hiv-infected patients.	we evaluated the effect of chronic pneumocystis carinii pneumonia (pcp) prophylaxis, with a once a month dose of 300 mg of inhalatory pentamidine isethionate, on qt interval duration. we included 22 human immunodeficiency virus (hiv)-infected patients: 11 were on this medication and 11 were not. the two groups were matched for age, sex and hiv infection stage. no patient had any clinical condition or was under any medication known to affect the duration of the qt interval. the heart rate-correct ...	1997	9183045
crystal structure of the anti-bacterial sulfonamide drug target dihydropteroate synthase.	sulfonamides were amongst the first clinically useful antibacterial agents to be discovered. the identification of sulfanilamide as the active component of the dye prontosil rubrum led to the synthesis of clinically useful analogues. today sulfamethoxazole (in combination with trimethoprim), is used to treat urinary tract infections caused by bacteria such as escherichia coli and is also a first-line treatment for pneumonia caused by the fungus pneumocystis carinii, a common condition in aids pa ...	1997	9187658
macrophages as a source of hiv during opportunistic infections.	the source of increasing viremia that characterizes the latter stages of human immunodeficiency virus (hiv) disease has remained a paradox because it occurs at a time when lymphoid tissue is quantitatively and qualitatively impaired, and the patients' cd4 t lymphocytes are steadily declining. here, macrophages, both infected and uninfected with common opportunistic pathogens of hiv disease such as mycobacterium avium complex and pneumocystis carinii, were identified as highly productive sources ...	1997	9188531
evaluation and medical treatment of the hiv-exposed infant. american academy of pediatrics. committee on pediatric aids.	as a result of the expanding human immunodeficiency virus (hiv) infection epidemic and recently published recommendations for routine hiv testing with consent for all pregnant women in the united states, pediatricians are becoming increasingly involved in providing care to infants born to hiv-infected women. this article provides guidelines about counseling the parent or care giver of the infant, use of antiretroviral therapy to reduce the risk of infection in the infant, medical treatment of th ...	1997	9190556
structural studies on bioactive compounds. 28. selective activity of triazenyl-substituted pyrimethamine derivatives against pneumocystis carinii dihydrofolate reductase.	triazenyl-substituted pyrimethamine derivatives 10a-s have been prepared by coupling diazotized 2,4-diamino-5-(3-amino-4-chlorophenyl)-6-ethyl pyrimidine (1c) with a series of secondary amines in aqueous sodium carbonate solution. the triazenes which are stable and poorly soluble as free bases form more soluble, but unstable, salts with alkanesulfonic acids. the lead dimethyltriazene 2,4-diamino-5[4-chloro-3-(3,3-dimethyltriazen-1-yl)phenyl]-6-et hylpyrimidine (4a) forms a crystalline ethanesulf ...	1997	9191966
synthesis and biological activities of conformationally restricted, tricyclic nonclassical antifolates as inhibitors of dihydrofolate reductases.	seven novel tricyclic pyrimido[4,5-c][2,7]naphthyridones 5-8 and the corresponding naphthyridines 9-11 were synthesized as conformationally restricted inhibitors of dihydrofolate reductase (dhfr) and as antitumor and/or antiinfectious agents. the analogues were designed to orient the side chain trimethoxyphenyl group in different conformationally defined positions in order to explore the effect of the side chain orientation on binding affinity and selectivity for dhfr from various species. the s ...	1997	9191971
pneumothorax in hiv-infected patients: role of pneumocystis carinii pneumonia and pulmonary tuberculosis.	patients with acquired immune deficiency syndrome (aids) are at increased risk for pneumothorax, which usually occurs in the setting of pneumocystis carinii pneumonia. the rationale of the present study was based on the hypothesis that the increased incidence of pulmonary tuberculosis in human immunodeficiency virus (hiv)-infected patients could favour the development of pneumothorax in such patients. a case-control study was performed comprising 140 hiv-infected patients grouped as follows: 35 ...	1997	9192938
species-specific trna recognition in relation to trna synthetase contact residues.	in spite of variations in the sequences of trnas, the genetic code (anticodon trinucleotides) is conserved in evolution. however, non-anticodon nucleotides which are species specific are known to prevent a given trna from functioning in all organisms. conversely, species-specific trna contact residues in synthetases should also prevent cross-species acylation in a predictable way. to address this question, we investigated the relatively small tyrosine trna synthetase where contacts of escherichi ...	1997	9192996
pulmonary complications of hiv infection.	with changes in epidemiology and the application of newer treatment and prophylactic regimens, the types of pulmonary diseases that occur in hiv-infected persons are changing. new ways to assess the progression of hiv disease and new antiretroviral treatments are available. increased survival is often coupled with worsening immunosuppression. overall mortality from pneumocystis carinii pneumonia is declining, but mortality from bacterial pneumonia and mycobacterial disease is increasing. infecti ...	1997	9193862
nocardiosis after bone marrow transplantation: a retrospective study.	to evaluate the spectrum of nocardiosis after marrow transplantation, we reviewed the medical records of 27 patients with nocardiosis who were treated at three centers, and we reviewed the findings of three cases reported in the literature. nocardial involvement was defined as invasive nocardiosis (n = 25), colonization (n = 4), or contamination (n = 1). the median time to the diagnosis of nocardiosis after marrow transplantation was 210 days. nocardia asteroides complex accounted for 96% of iso ...	1997	9195074
pneumocystis carinii pneumonia in asians and pacific islanders.		1997	9195100
diagnostic strategies for pneumocystis carinii pneumonia.	pneumocystis carinii is an opportunistic organism that is a common cause of pneumonia in immunocompromised patients. its life cycle begins when cysts rupture and release sporozoites, which mature into trophozoites that eventually form cysts. the diagnostic methods for p. carinii pneumonia (pcp) have progressed from open lung biopsy to bronchoalveolar lavage (bal) and induced sputum analysis (isa). detection of p. carinii organisms is done with various stains that highlight sporozoites, trophozoi ...	1997	9195672
treatment of pneumocystis carinii pneumonia in adults with aids.	trimethoprim-sulfamethoxazole remains the treatment of choice in patients with pneumocystis carinii pneumonia (pcp) requiring intravenous therapy. those patients who require intravenous therapy who cannot tolerate or who fall therapy with trimethoprim-sulfamethoxazole may be treated with either pentamidine or trimetrexate (plus folinic acid), with or without orally administered dapsone. the toxicity of the former drug makes trimetrexate-based therapy the preferred second choice for parenteral us ...	1997	9195673
study of internal transcribed spacer and mitochondrial large-subunit genes of pneumocystis carinii hominis isolated by repeated bronchoalveolar lavage from human immunodeficiency virus-infected patients during one or several episodes of pneumonia.	the objective of this study was to type, analyze, and compare pneumocystis carinii hominis strains obtained from different samples during a given or recurrent episodes of p. carinii pneumonia (pcp) for epidemiologic purposes. we studied 36 bronchoalveolar lavage (bal) or induced sputum (is) samples from 16 human immunodeficiency virus-infected patients with one or several episodes of pcp. pcr amplification and direct sequencing were performed on the two internal transcribed spacers (its1 and its ...	1997	9196174
simplified sample processing combined with a sensitive one-tube nested pcr assay for detection of pneumocystis carinii in respiratory specimens.	early diagnosis of pneumocystis carinii pneumonia, a life-threatening complication in immunosuppressed patients, may lower morbidity and mortality. we have developed a one-tube nested pcr assay for the detection of p. carinii in respiratory specimens. four primers were selected from the sequence of the small-subunit rrna gene of p. carinii to amplify a 265-bp fragment, and their specificities for p. carinii were confirmed by both theoretical evaluations (by computer-assisted comparison with the ...	1997	9196175
[pneumocystis carinii pneumonia in a, until now, healthy 46-year-old hiv-negative man].	a 46-year-old male patient was referred from a peripheral hospital with a 5 days history of high fever, dyspnea and respiratory deterioration. direct immunofluorescence examination of bronchoalveolar fluid repeatedly showed clusters of pneumocystis carinii. high-dose sulfamethoxazole-trimethoprim therapy was initiated and the patient recovered promptly during the following days. this otherwise healthy patient's past history was unremarkable in terms of prior infectious diseases. there was no evi ...	1997	9198889
detection of pneumocystis carinii in tracheal aspirates of intubated patients using calcofluor-white (fungi-fluor) and immunofluorescence antibody (genetic systems) stains.	to compare the detection rate of pneumocystis carinii in endotracheal aspirates with that rate in bronchoalveolar lavage fluid, using calcofluor-white (fungi-fluor) and immunofluorescence antibody (genetic systems) staining methods.	1997	9201045
the carbohydrate recognition domain of surfactant protein a mediates binding to the major surface glycoprotein of pneumocystis carinii.	pneumocystis carinii is a common cause of life-threatening pneumonia in immunodeficient patients. pulmonary surfactant protein a (sp-a), an alveolar glycoprotein containing collagen-like and carbohydrate recognition domains (crd), binds p. carinii and enhances adherence to alveolar macrophages. in this study, we examined the structural basis of the interaction between sp-a and the major surface glycoprotein of p. carinii (msg). rat sp-a bound to purified rat p. carinii-derived msg in a saturable ...	1997	9201957
dihydropteroate synthase polymorphisms in pneumocystis carinii.	sulfa drugs are widely used in the treatment and prophylaxis of pneumocystis carinii pneumonia. the nucleotide sequences of the sulfa target enzyme, dihydropteroate synthase (dhps), differed substantially in human-, rat-, and mouse-derived p. carinii. sequence variation also existed in the dhpss from human-derived isolates. six nucleotide changes were found in 6 human isolates; each was nonsynonymous and resulted in an amino acid change. several of these changes were in highly conserved regions ...	1997	9203679
[pulmonary complications of human immunodeficiency virus infection in sub-saharan africa].	based on a selection of articles published in the literature and reports from international aids conferences, we present the main pulmonary complications of hiv-infection observed in sub-saharan africa. the different clinical studies demonstrate the predominance of infectious complications, mainly tuberculosis (29 to 44%) and bacterial pneumonia (21 to 35%). the frequency of pneumocystis carinii pneumonia remains low (5 to 19%). other complications (mycobacterial infection, cytomegalovirus, toxo ...	1997	9205686
inhibitors of delta24(25) sterol methyltransferase block sterol synthesis and cell proliferation in pneumocystis carinii.	detailed analysis of the endogenous sterol content of purified pneumocystis carinii preparations by gas-liquid chromatography coupled to mass spectrometry suggested that this parasite can both synthesize de novo steroid skeletons (to produce delta7 sterols) and take them from the infected host (leading to delta5 sterols). in both cases the final products are 24-alkyl sterols, resulting from the action of delta24(25) and delta24(24') sterol methyltransferases, enzymes not present in vertebrates. ...	1997	9210660
pharmacokinetics of hyperimmune anti-human immunodeficiency virus immunoglobulin in persons with aids.	hyperimmune anti-human immunodeficiency virus immunoglobulin (hivig) is an intravenous immunoglobulin prepared from hiv-infected asymptomatic donors with a cd4 cell count greater than 400 cells/microl and a high titer of antibody to hiv-1 p24 protein. twelve persons with aids received four doses of hmg (two at 50 mg/kg of body weight and then two at 200 mg/kg) every 28 days. pharmacokinetics were evaluated by measurement of anti-p24 antibody. hivig was well tolerated, and all participants comple ...	1997	9210687
opportunistic infections in pediatric hiv infection: a study of 74 autopsy cases from latin america. the latin american aids pathology study group.	the present report describes opportunistic infections found at 74 autopsies of pediatric hiv/aids patients performed at several hospitals in latin american countries. fungal infections were the most common (53 cases), candida sp. (39.18%) and pneumocystis carinii (20.27%) being the most frequently recognized. other fungal diseases included histoplasmosis, aspergillosis, and cryptococcosis. viral infections were present in 31 cases, 38.7% being due to cytomegalovirus. other viruses recognized inc ...	1997	9211549
comparison of nursing interventions classification and current procedural terminology codes for categorizing nursing activities.	to compare the frequency with which nursing activity terms could be categorized using nursing interventions classification (nic) and current procedural terminology (cpt) codes.	1997	9212508
how to interpret an overview: a meta-analysis of the relative efficacy and toxicity of pneumocystis carinii prophylactic regimens.		1997	9215100
rapid diagnosis of acute eosinophilic pneumonia (aep) in a patient with respiratory failure using bronchoalveolar lavage (bal) with calcofluor white (cw) staining.	a diagnosis of exclusion, acute eosinophilic pneumonia (aep) is an acute febrile illness with respiratory impairment, diffuse pulmonary infiltrates, and bronchoalveolar lavage (bal) fluid eosinophilia. whether pulmonary eosinophilia in aep is primary or secondary remains undetermined. we report here a 22-year-old auto mechanic with severe aep and acute respiratory failure who required intubation and ventilatory support. the patient's bronchoalveolar lavage (bal) fluid was analyzed using cultures ...	1997	9219061
survival of adults with aids in the united kingdom.	accurate estimates of expected survival times and survival rates of aids patients are important both for estimating the prognosis of individuals and for monitoring the progress of the hiv/aids epidemic as new treatments are introduced. they are also needed for projecting future numbers of aids cases. data on reported aids cases held at the phls aids centre at the communicable disease surveillance centre and the scottish centre for infection and environmental health confirmed the time, age, and r ...	1997	9219423
aseptic meningitis from trimethoprim-sulfamethoxazole in an hiv-infected adolescent.	adolescents infected with the human immunodeficiency virus (hiv) often confront the clinician with difficult medical problems. besides the host of opportunistic infections, which can affect these patients, side effects from medications can be frequent and, at times, life-threatening. we report a case of aseptic meningitis secondary to trimethoprim-sulfamethoxazole therapy for prophylaxis against pneumocystis carinii in an hiv-infected adolescent.	1997	9220510
discovery of selective, small-molecule inhibitors of rna complexes--ii. self-splicing group i intron ribozyme.	self-splicing group i intron rna was chosen as a potential therapeutic target for small-molecule intervention. high-throughput screening methodologies have been developed to identify small organic molecules that regulate the activities of these catalytic introns. group introns derived from pathogenic pneumocystis carinii and phage t4 were used as model systems. inhibitors identified from a library of approximately equal to 150,000 compounds were shown to regulate biochemical reactions including ...	1997	9222512
impact of treatment changes on the interpretation of the concorde trial.	the concorde trial compared two policies of therapy with zidovudine (zvd) in individuals with asymptomatic hiv infection: immediate or deferred zdv. participants in both groups could stop their blinded trial therapy for several reasons and/or could start open-label zdv. the difference in survival and disease progression between the two groups was estimated allowing for treatment changes.	1997	9223734
fulminant pneumocystis carinii pneumonia in 4 patients with dermatomyositis.	between 1989 and 1996, 4 cases of pneumocystis carinii pneumonia (pcp) were observed in patients seronegative for the human immunodeficiency virus who were receiving corticosteroid therapy for dermatomyositis in our institution. these cases were considered unusual in light of the short delay of their onset after initiation of immunosuppressive therapy and their fulminant course: 3 of these patients died of pcp occurring during the first month of treatment with prednisone. in all 4 patients lymph ...	1997	9224230
opportunistic infections and psychosocial stress in hiv.	persons infected with the human immunodeficiency virus (hiv) are susceptible to both opportunistic infections and psychosocial crises at varying stages of their disease. many interventions, including lifestyle changes and chemoprophylaxis, may help prevent, delay or lessen the extent of the morbidities associated with immunodeficiency. in appropriate patients, prophylaxis for infections with pneumocystis carinii, mycobacterium avium complex and toxoplasma helps to reduce morbidity.	1997	9225668
extrapulmonary pneumocystosis.	extrapulmonary pneumocystosis is an exceedingly rare complication of pneumocystis carinii pneumonia (pcp). prior to the advent of the human immunodeficiency virus type 1 (hiv-1) epidemic, only 16 cases of extrapulmonary pneumocystosis in individuals who were immunocompromised by a variety of underlying diseases had been reported. since the beginning of the hiv-1 and related pcp epidemic, at least 90 cases of extrapulmonary pneumocystosis have been reported. this review briefly presents a history ...	1997	9227859
the activity of triple combinations of antifolate biguanides, with and without folinic acid, against plasmodium falciparum in vitro.	at least two triple combinations of biguanides, proguanil-atovaquone-dapsone and ps-15-atovaquone-dapsone, may be useful in treating drug-resistant infections of falciparum malaria. each of these triple combinations can be considered as two synergistic combinations: proguanil-atovaquone and cycloguanil-dapsone, and ps-15-atovaquone and wr99210-dapsone, respectively. since folinic acid might mitigate the possible side-effects produced by such drug combinations, both combinations were administered ...	1997	9229018
temporal trends and factors associated with survival after pneumocystis carinii pneumonia in california, 1983-1992.	the authors investigated quarterly trends in survival after the diagnosis of pneumocystis carinii pneumonia for 19,607 patients in california in the decade from january 1, 1983, through december 31, 1992. subjects included all cases for whom p. carinii pneumonia was the initial (and only) acquired immunodeficiency syndrome (aids)-defining diagnosis as reported to the california human immunodeficiency virus/aids surveillance registry. there was a period of rapidly improving survival from approxim ...	1997	9230773
pneumocystis carinii pneumonia in malawian children.	sixty children aged between 1 and 23 months admitted to queen elizabeth central hospital in blantyre, malawi for diagnosis of acute lower respiratory tract infections (alri) were investigated for laboratory diagnosis of pneumocystis carinii pneumonia (pcp) by indirect immunofluorescence assay on nasopharyngeal secretions. p. carinii was found in five of the 60 children. three pcp cases had aids. the clinical presentation of children with pcp was of little diagnostic value and all the children we ...	1997	9230974
care for the patient with aids in the icu: outcomes and ethics.	hiv infection and aids are common diagnoses in many intensive care units (icus) in the united states. although pneumocystis carinii currently represents only one quarter of all diagnoses for which hiv-infected persons are admitted to the icu, it is the disease with the most clinically applicable outcome data and, therefore, is a model for ethical decision-making regarding patients with hiv infection in the icu. despite advances in diagnosis and treatment of hiv-related p. carinii, recent studies ...	1997	9233138
[pulmonary alveolar proteinosis: ultrastructural study of 4 cases].	pulmonary alveolar proteinosis (pap) is a rare and diffuse lung disease characterized by the abnormal deposition of pas positive, lipoproteinaceous material in the alveolar spaces. it has been related, mainly, to alterations in the immune state and to secondary infections. we studied four cases of pap diagnosed by light microscopy. in two cases we were able to demonstrate disseminated histoplasmosis related to immunodeficiency states (aids and malnutrition), one case with pneumocystis carinii in ...	1997	9235071
[radiographic findings in pneumocystis carinii pneumonia and its complications in hiv patients].	we have performed a retrospective study of 61 cases of pneumocystis carinii pneumonia (pcp) among the human immunodeficiency virus (hiv) seropositive population at the 11th health area of the comunidad de madrid with microbiological diagnosis until january 1994. we made an epidemiologic analysis of this pcp group and compared it with the epidemiologic data of the general hiv population in madrid. besides, we studied the radiologic manifestations and their possible associations with several facto ...	1997	9235078
infection and pathogenicity of chimeric simian-human immunodeficiency viruses in macaques: determinants of high virus loads and cd4 cell killing.	chimeric simian-human immunodeficiency viruses (shivs) carrying envelope glycoproteins derived from a t cell-macrophage dual-tropic primary isolate (human immunodeficiency virus type 1 [hiv-1] strain dh12) were constructed. when inoculated into macaque monkeys, shiv(md14) carrying simian immunodeficiency virus-derived nef established significantly higher virus loads than did shiv(md1), which contains the hiv-1 nef gene. three patterns of cd4 cell depletion were observed in infected monkeys: expo ...	1997	9237701
[extrapulmonary and disseminated pneumocystosis in aids. a review of the literature].	we present a literature review about extrapulmonary and disseminated pneumocystosis in aids. the prevalence of such infections seems low but is probably under-estimated. disseminated pneumocystosis occurs in patients with profound immunosuppression, who do not receive prophylaxis against pneumocystis carinii pneumonia or are treated with aerolized pentamidine. the lack of specificity of symptoms may delay the diagnosis. most organs may be involved. three different presentations may be individual ...	1997	9238445
cd8+ t lymphocyte counts as an adjunctive predictor of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome.	we encountered a case of cytomegalovirus (cmv) retinitis with spontaneous regression in association with an increased number of cd8+ but not cd4+ t lymphocytes in a patient with acquired immunodeficiency syndrome (aids). thus, we examined the number of cd4 and cd8 counts at the diagnosis of cmv retinitis and compared with those of pneumocystis carinii pneumonia (pcp). all 21 patients with a confirmed diagnosis of pcp (22 episodes) and 14 cmv retinitis patients were included in this study. althou ...	1997	9240493
lobar or segmental consolidation on chest radiographs of patients with hiv infection.	to correlate chest radiographic abnormalities with diagnoses in hiv infected patients presenting with acute respiratory symptoms and lobar or segmental consolidation.	1997	9240708
epidemiology of hiv/aids in women and children in the usa.	in the usa, the aids epidemic has shown dramatic increases among women and children in the past decade with more than 70,000 cases in women and 7000 cases in children reported. acquired immunodeficiency syndrome is the seventh leading cause of death in children aged 1-4 years and the fourth leading cause of death among women aged 25-44 years. data from the national survey of childbearing women, a blinded serosurvey of blood specimens left over from routine metabolic screening of most infants bor ...	1997	9240851