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small airways dysfunction in patients with aids and pneumocystis carinii pneumonia.abnormalities of small airways function may have clinical relevance in aids patients with pneumocystis carinii pneumonia (pcp) since obstructive dysfunction at alveolar levels may impede delivery of aerosolized medication. this study was designed to determine if small airways dysfunction is present in aids patients with pcp despite normal standard spirometric results.199611361652
current management practices in the treatment of pneumocystis carinii pneumonia (pcp). 199611361688
twice-weekly dapsone for primary prophylaxis against pneumocystis carinii pneumonia in hiv-1 infection: efficacy, safety and pharmacokinetic data.objectives: in this study we evaluated the pharmacokinetics, efficacy and safety of dapsone given 100 mg twice weekly as primary prophylaxis against pneumocystis carinii pneumonia (pcp) in patients with hiv-1 infection. methods: this was a prospective open trial, evaluating a total of 55 hiv-1-infected patients with cd4 cell counts below 200/mm3 and without previous episodes of pcp. plasma concentrations of dapsone were determined with high-performance liquid chromatography (hplc). after a mean ...199611866808
study questions increasing cost of intensive care of pneumocystis.according to a new study, intensive care for aids patients with severe pneumonia is becoming so expensive that policy makers may decide to ration or refuse treatments. researchers at the university of california-san francisco (ucsf) found that it costs an average of $215,000 to extend by one year the life of an aids patient who is treated for pneumocystis carinii pneumonia (pcp) in a hospital's intensive care unit. this is twice as much as comparable care cost in 1988. aids patients are survivin ...199511362220
management of late-stage aids grows more complex.the question of what to do for patients with late-stage aids becomes more complicated as new research reinforces the value of early treatment and prophylaxis for hiv patients. decisions ranging from cost and quality of life to toxicity and multiple drug interactions all must be taken into account. pneumocystis carinii pneumonia (pcp) still is the most common adverse event in the last six months of life, with wasting syndrome being second, followed closely by mycobacterium avium complex (mac) and ...199511362247
preventing opportunistic infections.as more drugs are approved for the prevention of opportunistic infections, concerns regarding the benefits and potential risks of these therapies are arising. a synopsis of the data for prophylaxis against opportunistic infections is provided for the following: pneumocystis carinii pneumonia, fungal infections, mycobacterium avium complex, cytomegalovirus infections, and toxoplasmosis. general precautions in using preventive medications for people with fewer than 100 cd4 plus cells are highlight ...199511362422
[opportunistic infections--prevention and treatment].many people are exposed to opportunistic infections which can only be controlled by a healthy immune system. the hiv virus limits the development of the immune system. the prevention, diagnosis, and treatment of many opportunistic infections are described. pneumocystis carinii, mycobacterium avium complex infections (mai or mac), toxoplasmosis, cryptococcal meningitis, cytomeglovirus infections (cmv), tuberculosis, kaposi's sarcoma (ks), crytosporidiosis, aids dementia complex, and progressive m ...199511362439
opportunistic infections studies update.studies being conducted on opportunistic infections among people with hiv are presented in list form. the list includes new studies, those still in development, and those slated to begin in 1995. areas of interest include candidiasis, cryptosporidiosis/microsporidiosis, cytomegalovirus (cmv), mycobacterium avium complex (mac) infection, pneumocystis carinii pneumonia (pcp), toxoplasmosis, and tuberculosis (tb). enrollment information can be obtained by calling 1-(800)-trials-a (tdd 1- 800-448-04 ...199511362449
atovaquone (mepron) suspension approved by fda. food and drug administration.the newly approved use of an atovaquone (mepron) suspension for treating mild to moderate pneumocystis carinii (pcp) in patients unable to tolerate trimethoprim-sulfamethoxazole (tmp-smx), has shown that it is twice as bioavailable compared with the previously licensed tablet formulation. however, atovaquone use has produced more deaths than tmp-smx, a problem that may in part be due to its lack of a broad antibacterial spectrum.199511362554
pcp prevention for children.pneumocystis carinii pneumonia (pcp) is common in children and adults who are hiv-positive. more than half of the babies who have pcp never received preventive drugs. it is suggested that a greater number of hiv-exposed infants must be identified at an earlier stage, and preventive medication should be prescribed. it is further recommended that hiv testing and monitoring be made more available to infants at risk so that preventive pcp medication can be given at four to six weeks of age, regardle ...199511362597
fda approves new pcp drug. food and drug administration.the u.s. food and drug administration (fda) recently approved a suspension formulation of atovaquone (mepron) for treating mild to moderate cases of pneumocystis carinii pneumonia (pcp) in patients intolerant of trimethoprim/sulfamethoxazole (tmp-smx). the liquid form offers better bioavailability and convenient dosing. at least one study has shown that the drug is less toxic than intravenous pentamidine and may have possible action against microsporidiosis. the use of the suspension formulation ...199511362680
phs guidelines map out prevention routes through terrain of infections. public health service.interaction between health agencies, community groups, aids patients, and the u.s public health service has finally resulted in the creation of the first comprehensive guide for preventing aids-related opportunistic infections. hundreds of drug studies were sorted through to assess which drugs prevented opportunistic infections the best. other suggestions in the guidelines involved quality-of-life decisions, such as owning pets and drinking tap water. the top priorities in the guidelines were pr ...199511362773
physician's aggressive preventive therapy differs.dr. bernard bihari, an aids specialist practicing in new york city, and other members of the community programs for clinical research on aids (cpcra), have determined that some of the public health services's recommendations for preventing opportunistic infections do not match the standards of care that the cpcra developed nearly five years ago. the basic treatments provided by bihari include using 1) tmp-smz and fluconazole to prevent, respectively, pneumocystis carinii pneumonia (pcp) and cryp ...199511362774
a difficult case of pcp.a case history is presented of an hiv-infected female patient with a recurrence of pneumocystis carinii pneumonia (pcp) and contraindications to use of most drugs for pcp, including pentamidine, trimethoprim-sulfamethoxazole (tmp-smx), clindamycin, primaquine, and dapsone. treatment alternatives discussed address risk-benefit analyses of using different drugs. the final treatment decision was to use escalating doses of tmp-smx, since her previous adverse effects (fever and rash) are not an absol ...199511362780
drug developed by ncddg-oi to enter clinical trials. national cooperative drug discovery group program for opportunistic infections.phase i clinical trials on a new drug developed to treat patients with pneumocystis carinii pneumonia (pcp) are expected to begin in the fall of 1995. the drug is designated rg-201 and has been developed by the national cooperative drug discovery group program for opportunistic infections. the mechanism of action is not yet known, but there is hope that it will be effective and have few side effects.199511362804
pneumocystis carinii pneumonia: a pediatric perspective. 199511361390
[prevention of pneumonia related to hiv--pneumocystis carinii pneumonia (pcp)].pneumocystis carinii pneumonia (pcp) is a principal cause of death in aids patients. symptoms include breathing difficulty, dry cough, and fever. medications such as bactrim, septra, dapsone, or nebupent may prevent or reduce pcp's symptoms. if a person is hiv-positive, a t-cell level blood test can alert a physician to prescribe medication to prevent pcp. telephone numbers for a spanish health forum in florida are listed.199511363204
[self-detection of symptoms].hiv-positive patients are prone to many illnesses due to their weakened immune systems. pneumocystis carinii pneumonia (pcp) and tuberculosis (tb) both cause respiratory difficulties, as well as fatigue, scratchy throat and weight loss. cytomegalovirus (cmv) causes changes in vision. cryptococcal meningitis and toxoplasmosis share symptoms of acute headaches, confusion and memory loss. kaposi's sarcoma (ks) causes red and purple skin legions to appear. candidiasis symptoms reveal themselves in o ...199511363215
the role of a nested polymerase chain reaction in the diagnosis of pneumocystis carinii pneumonia.aim-to compare the techniques and results of a nested pcr and an immunofluorescence assay (ifa) for the detection of pneumocystis carinii infection; to consider the role of the nested pcr in the diagnosis of p carinii pneumonia (pcp).methods-serial dilutions of two known p carinii positive samples were tested by ifa and pcr to determine their relative sensitivities. seventy eight respiratory samples (15 from 11 patients with hiv infection/acquired immunodeficiency syndrome (aids) and 63 from 42 ...199516696036
pneumonia in pregnancy.pneumonia complicating pregnancy requires a prompt diagnosis and the institution of adequate supportive and antimicrobial therapy. in a patient with a classic presentation of pneumonia, the most likely pathogens are streptococcus pneumoniae and haemophilus influenzae. in a patient with an atypical presentation of pneumonia, mycoplasma pneumoniae and chlamydia pneumoniae are frequently encountered. in a patient suffering from acquired immunodeficiency syndrome (aids), pneumocystis carinii is the ...199518475411
fever and cough in methotrexate-treated patients: an approach.the prevalence of acute methotrexate pneumonitis is up to 5.5%. its presentation is often difficult to distinguish from opportunistic infections such as pneumocystis carinii, nocardia, and cryptococcus or from interstitial infiltrates from the underlying rheumatic disease. its recognition rests on the presence of cough, dyspnea, fever, new pulmonary function test abnormalities, and acute infiltrates on chest radiograph. the diagnosis ultimately rests on histologic confirmation and exclusion of i ...199519077998
community acquired, nursing home acquired and hospital acquired pneumonia: a five-year review of the clinical, bacteriological and radiological characteristics.to assess the contemporary clinical, bacteriological and radiographic features of hospitalized patients with community acquired (ca), nursing home acquired (na) and hospital acquired pneumonia (ha) and to examine patient outcome.199522550412
pcp pneumonia with bilateral pneumothoraces in a haemophiliac with factor viii inhibitors.pneumocystis carinii pneumonia (pcp) infection is a well-recognized feature of advanced hiv infection in all risk groups. this serious opportunistic parasitic infection is almost invariably fatal if left untreated. when associated with bilateral pneumo-thoraces in a patient with severe haemophilia a and factor viii inhibitors, it poses a critical management problem and can be life-threatening. we report the case of a young man with severe haemophilia a with factor viii inhibitors presenting with ...199527214542
prophylaxis for pneumocystis carinii pneumonia: its impact on the natural history of hiv infection in men with haemophilia.it has been suggested that the range of aids-defining conditions witnessed in patients with hiv infection has changed since the early years of the hiv epidemic. in this paper we consider the range of aids-defining conditions in a cohort of 111 hiv-positive men with haemophilia registered at the royal free hospital haemophilia centre. in particular we assess whether the incidence of pneumocystis carinii pneumonia (pcp) has changed over time. the men were all infected between 1979 and 1985 after t ...199527214220
impact of primary prophylaxis for pneumocystis carinii pneumonia and toxoplasmic encephalitis in a cohort of 1000 patients with aids. 19958904150
100% mortality of non-aids patients with pneumocystis carinii pneumonia (pcp) requiring mechanical ventilation (mv) 19958847436
[thoracotomy as treatment for pneumothorax associated with pneumocystic carinii pneumonia in a patient with hemophilia a and the acquired immunodeficiency syndrome].pneumocystis carinii pneumonia is the most common respiratory infection in patients with the acquired immunodeficiency syndrome, and inhalation of pentamidine aerosol is currently used for secondary prophylaxis. a 16-year-old patient with hemophilia a and the acquired immunodeficiency syndrome had a spontaneous pneumothorax during inhalation of pentamidine aerosol for secondary prophylaxis of pneumocystis carinii pneumonia. tube thoracostomy and pleurodesis were done without success. thoracotomy ...19958822005
[pneumocystis carinii pneumonia. complications of cytotoxic treatment in a systemic vasculitis].we report a patient with systemic vasculitis who developed a pneumocystis carinii pneumonia whilst he was on steroid n cyclophosphamide treatment. severe lymphopenia was noted with a cd4 count of 0.023 x10(9)/1 with no evidence of human immunodeficiency virus infection. a literature review of recent reports about this particular topic reveals that the development of lymphopenia in patients under immunosuppressor treatment is a fact of a paramount importance. in that sense, a periodic monitorizat ...19958804172
differential characteristics of aids patients with a history of imprisonment.aids is among the leading causes of death in prisons, but there is little information about aids patients with a history of imprisonment.19958824862
[intolerance to trimethoprim-sulfamethoxazole in pneumocystis carinii pneumonia in aids. search for predictive factors].the treatment and the prevention of pneumocystis carinii pneumonia (pcp) is based on trimethoprim-sulfamethoxazole. however, hypersensitivity reactions occur often in hiv-infected patients. in this study, clinical and biological parameters of 27 pcp-patients treated by this drug association were analyzed. we divided the drug reactions into two groups according to the severity. a drug reaction occurred in 59.2% of the patients and was note as a mild reaction in 18.5% of the cases and as a severe ...19958787293
morphological study of bacteria of the respiratory system using fluorescence microscopy of papanicolaou-stained smears with special regard to the identification of mycobacteria sp.in papanicolaou-stained smears certain structures such as nucleoli, pneumocystis carinii, charcot-leyden crystals, bacteria and fungi show a brilliant fluorescence. the morphological characteristics of microorganisms which can be detected by this system, especially mycobacteria, are described. this screening method offers the possibility of providing the clinician with a provisional diagnosis within hours. proof of the nature of the organisms should be obtained by culture.19958770540
better efficacy of twice-monthly than monthly aerosolised pentamidine for secondary prophylaxis of pneumocystis carinii pneumonia in patients with aids. an italian multicentric randomised controlled trial. the italian pcp study group.the aim of this multicentric randomised controlled trial was to evaluate long-term efficacy and safety of once-monthly versus twice-monthly 300 mg aerosolized pentamidine (ap) as secondary prophylaxis of pneumocystis carinii pneumonia (pcp). we randomised 205 patients with a previous confirmed episode of pcp (107 treated with 300 mg once-monthly ap, and 98 with 300 mg twice monthly ap); the median review period was 232 days. kaplan-meier method and cox's hazard regression model were used for ana ...19958666860
persistent reduction in lung function after pneumocystis carinii pneumonia in aids patients.by means of serial lung function tests we examined the changes in lung function and possible pulmonary long-term sequelae in aids patients with a primary episode of pneumocystis carinii pneumonia (pcp). a total of 19 patients had lung function tests performed prospectively from the time of pcp diagnosis, at 7 days, 14 days, 1, 2, 3, 4.5, 6 and 9 months after pcp. forced vital capacity (fvc) and forced expiratory volume in 1 second (fev1) were both reduced to a median of 61% of predicted at pcp d ...19958658069
rapid simple and nested polymerase chain reaction for the diagnosis of pneumocystis carinii pneumonia.we have developed a rapid and easy extraction procedure for polymerase chain reaction (pcr) protocols. using this simplified step, we evaluated the sensitivity and the specificity of a simple pcr using the primers of wakefield et al, and of a nested pcr, using new internal primers selected by us, in a total of 89 bronochoalveolar lavage (bal) fluid samples from 43 immunosuppressed patients. in 13 patients, pneumocystis carinii pneumonia (pcp) was diagnosed by immunofluorescent antibody (ifa) sta ...19958658070
pneumocystis carinii in bronchoalveolar lavage and induced sputum: detection with a nested polymerase chain reaction.to evaluate polymerase chain reaction (pcr) for detection of pneumocystis carinii, 117 bronchoalveolar lavage (bal) specimens, from hiv-infected patients undergoing a diagnostic bronchoscopy, were processed and a nested pcr, followed by southern blot and hybridization with a p32-labelled probe was performed. the sensitivity and specificity were 85 and 100% 934/40 and 77/77) respectively. a non-radioactive labelling system blugene was evaluated on all specimens, and found to be as effective as p3 ...19958658071
[aids: infections of the retina and choroid].various viral, bacterial, parasitic and fungal agents have been found to cause infections of retina and choroidea in hiv-infected patients. usually these infections are opportunistic infections caused by the profound immunodeficiency, which is a result of the decay of lymphocytes by hiv. before the hiv epidemic only rare cases of cytomegalovirus (cmv) retinitis were known in the literature. now cmv retinitis has become the most common infection of the eye in aids patients. ocular toxoplasmosis i ...19958653001
[differential radiologic diagnosis of hiv-associated lung diseases].in 1993 in germany an estimated number of 50,000-70,000 individuals were infected with the human immunodeficiency virus (hiv), who estimations ranged up to 14 million hiv-positive individuals including 1 million children. aids-related diseases frequently occur in the lung. 65% of all aids-defining illnesses begin with life-threatening pulmonary infections. most frequently hiv-positive patients present with pneumocystis carinii pneumonia, followed by atypical mycobacteriosis, bacterial infections ...19958653002
aetiology and prognostic factors of patients with aids presenting life-threatening acute respiratory failure.respiratory failure is a significant contributor to morbidity and mortality in patients with the acquired immune deficiency syndrome (aids). we performed a study to investigate the aetiology, prognostic factors, and short- and long-term outcome of aids patients with life-threatening respiratory failure and pulmonary infiltrates. forty-two aids patients (29 of whom required mechanical ventilation), admitted to a respiratory intensive care unit (icu) from 1985 to 1992 because of severe respiratory ...19958620963
hyperkalemia associated with high-dose trimethoprim-sulfamethoxazole in a patient with the acquired immunodeficiency syndrome.when given in standard dosages to treat bacterial respiratory and urinary tract infections, trimethoprim-sulfamethoxazole (tmp-smx) is not commonly associated with hyperkalemia. however, the emergence of the acquired immunodeficiency syndrome has led to increased numbers of patients with pneumocystis carinii pneumonia (pcp) who require high-dose tmp-smx therapy. a 25-year-old man with human immunodeficiency virus infection developed hyperkalemia while receiving high-dose tmp-smx for pcp. his bas ...19958602391
pneumocystis carinii and parasitic infections in transplantation.pneumocystis carinii remains an important pathogen in organ transplantation. new therapeutic options have been developed for the prevention and treatment of p. carinii pneumonia. parasitic infections are recognized more frequently in potential organ donors or recipients as travel and technology for transplantation extend into endemic regions. parasites important to transplantation are largely those that can replicate in humans and that cause infection, the intensity of which is regulated by immu ...19958747777
intrapulmonary and systemic pharmacokinetics of aerosolized pentamidine used for prophylaxis of pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus.a study was conducted to determine the intrapulmonary and systemic pharmacokinetics of aerosolized pentamidine prophylaxis (app) in patients infected with human immunodeficiency virus (hiv). 151 patients received high-dose (300 mg twice a month or 600 mg once a month) app as part of a previously published clinical trial, and 29 additional patients received standard-dose (300 mg once a month) app. serial blood samples were obtained from the first cohort: 577 samples were obtained from 76 patients ...19958750367
infections in patients with chronic adult t-cell leukemia/lymphoma: case report and review.adult t-cell leukemia/lymphoma (atll) is caused by the human t-cell lymphotropic virus type i (htlv-i). atll is classified into the smoldering, chronic, lymphoma, and acute subtypes. we describe a north american woman with chronic atll who presented with pneumonia caused by pneumocystis carinii, cryptococcus neoformans, mycoplasma pneumoniae, and mycobacterium avium complex. although opportunistic infections have been documented in patients with atll, there are few case reports detailing infecti ...19958645790
cholecystectomy in patients with aids: clinicopathologic correlations in 107 cases.the etiologic and clinical features of cholecystisis in infection due to human immunodeficiency virus (hiv) were studies retrospectively. the charts and histopathologic specimens of 136 hiv-infected patients who underwent cholecystectomy between february 1987 and may 1993 at a large tertiary care center were reviewed. opportunistic pathogens infecting the 107 patients with aids included microsporidia (eight cases-- enterocytozoon bieneusi in six and septata intestinalis in two); cytomegalovirus ...19958645829
antipneumocystis activity of 17c91, a prodrug of atovaquone.the prophylactic efficacy of 17c91, a carbamate prodrug of atovaquone (atq), was investigated in a severe combined immunodeficient mouse model of pneumocystis carinii pneumonia (pcp). at an oral dosage equivalent to 100 mg of atq per kg of body weight per day, 17c91 protected 9 of 10 mice from pcp and had a prophylactic efficacy comparable to that of co-trimoxazole (at 250 mg of sulfamethoxazole plus 50 mg of trimethoprim per kg per day orally). the intensity of p. carinii infection (infection s ...19958619570
aerosolized pentamidine, cotrimoxazole and dapsone-pyrimethamine for primary prophylaxis of pneumocystis carinii pneumonia and toxoplasmic encephalitis.to investigate the efficacy and safety of three regimens for primary prophylaxis of pneumocystis carinii pneumonia (pcp) and toxoplasmic encephalitis (te) and to evaluate their effect on survival in patients with hiv infection.19958605054
survival after aids among italian haemophiliacs with hiv infection. the italian group on congenital coagulopathies.to estimate survival trends for persons with haemophilia and hiv/aids.19958605055
[generalized molluscum contagiosum in an african child with aids].a 12-year-old girl from zaire with aids (cdc: p2 d1) presented with a generalized molluscum contagiosum infection. she had suffered from systemic cryptococcosis and from cryptosporidiosis several months before admission. while molluscum contagiousum infection is usually a self-limiting disease in immunocompetent persons, a fulminant appearance and persistence of giant mollusca occurs with advanced immunodeficiency. histological and immunohistological examinations showed a severe diminution of la ...19958641888
[care for the hiv-infected person].early medical intervention in patients with hiv infection is beneficial even in asymptomatic individuals. medical care in these patients consists of the use of antiretroviral drugs, drugs to prevent opportunistic infections, vaccines and comprehensive psychosocial support. it is important to determine the stage of the natural history of the disease at any given moment. besides clinical data, the determination of cd4+ t-lymphocytes is useful to make decisions related to the institution of antiret ...19958599125
carbon-laden macrophages in pleural fluid of crack smokers.carbon-laden macrophages in bronchoalveolar lavage have been noted to be associated with a history of crack smoking. we report herein the finding of carbon-laden macrophages in four cytological preparations of pleural fluid from two crack smokers. the etiology of the two patients' pleural effusions differed; neither had a bronchopleural fistula. patient 1 had aids, pneumocystis carinii pneumonia, and kaposi's sarcoma of the right lung with an associated bilateral pleural effusion. patient 2 was ...19958599915
liver transplantation: current status, complications and prevention.the results of liver transplantation have improved dramatically over the past 15 years and this has produced a marked increase in demand for the procedure. perioperative problems due to haemorrhage have been largely solved by surgical experience, the use of veno-venous bypass and careful control of coagulation parameters. developments in graft preservation with the introduction of university of wisconsin solution led to improved early graft function as well as allowing day-time surgery. the numb ...19958601542
infections in children with human immunodeficiency virus/acquired immunodeficiency syndrome: an autopsy study of 30 cases in south florida, 1990-1993.thirty autopsies performed on infants and children with hiv infection and/or aids were reviewed for the presence and type of infection. twenty-six (87%) demonstrated evidence of infection in addition to hiv at the time of postmortem examination. pathogenic bacterial infectious were the most frequently encountered, seen in 15 of the cases. nine of the 15 (60%) were due to gram-negative rods, most commonly pseudomonas aeruginosa. infections with gram-negative organisms often involved multiple orga ...19958597814
predicting in-hospital outcome in hiv-associated pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) in hiv-infected patients remains a life-threatening complication in the course of hiv infection. despite effective treatment, mortality may still be as high as 10%. the identification of risk factors associated with a lethal outcome might be helpful as a guide to therapy for patients at risk and in the evaluation of new drugs with anti-pneumocystic activity. in a retrospective study 58 first episodes of hiv-associated pcp without prophylaxis were analyzed. va ...19958557384
pneumocystis carinii pneumonia in preterm infants: report of two cases successfully diagnosed by non-bronchoscopic bronchoalveolar lavage.we present two cases of pneumocystis carinii pneumonia in apparently immunocompetent preterm infants presenting with unexplained respiratory distress associated with a predominantly interstitial process on the chest radiograph. definite diagnosis was promptly established on the detection of cyst forms in the lung fluid obtained by non-bronchoscopic bronchoalveolar lavage, and a favourable outcome was achieved.19958580633
benefit of oral zinc supplementation as an adjunct to zidovudine (azt) therapy against opportunistic infections in aids.zinc is perhaps the most important trace element for immune function. congenital or acquired zinc deficiencies are associated with immune abnormalities and increased susceptibility to infectious diseases. aids subjects suffer from reduced zinc bioavailability, more severe in stage iv than in stage iii. such zinc deficiency causes, among other effects, a profound reduction in the biological activity of one of the thymic hormones, thymulin (zinc-facteur-timique-serique, znfts). with these premises ...19958582783
characterization of pneumocystis carinii infection in sorex araneus from southern finland.histologic and quantitative techniques were compared in an evaluation of the intensity of pneumocystis carinii infection in common shrews (sorex araneus) at espoo, southern finland, from september 1992 to may 1993. the histological scores were comparable to the results of the cyst count technique. the number of p. carinii cysts found in common shrews was low compared to those reported by others in clinically ill laboratory rats. the inflammatory changes detected in the lung sections had no signi ...19958583642
[pulmonary involvement in immunoblastic lymphadenopathy: case reports and review of literature published in japan].to investigate pulmonary involvement in immunoblastic lymphadenopathy (ibl), we report five cases of ibl and 21 other reports from the literature published in japan. three of the present patients had respiratory symptoms and showed hypoxemia on admission. radiographic findings in the present cases showed bilateral mediastinal and hilar lymphadenopathy (la: 4/5), pleural effusion (pe: 5/5), interstitial shadow (int s: 1/5), alveolar shadow (a1s: 2/5), and atelectasis (1/5). in the present cases a ...19958583721
disseminated penicillium marneffei infection in human immunodeficiency virus-infected children.disseminated infection with the fungus penicillium marneffei is one of the most common opportunistic infections in human immunodeficiency virus (hiv) disease in northern thailand. we report the clinical, laboratory and therapeutic features of 21 human immunodeficiency virus-infected children with disseminated p. marneffei who were prospectively followed. significant clinical and laboratory features included generalized lymphadenopathy (90%), hepatomegaly (90%), body temperature > 38.5 degrees c ...19958584358
comparison of a rapid nonisotopic polymerase chain reaction assay with four commonly used methods for the early diagnosis of human immunodeficiency virus type 1 infection in neonates and children.to initiate antiretroviral therapy and prophylaxis for pneumocystis carinii pneumonia, it is important to identify human immunodeficiency virus (hiv-1)-infected infants as soon after birth as possible. this study was undertaken to evaluate a novel 5-hour nonisotopic (ni) polymerase chain reaction (pcr) assay (amplicor pcr; roche molecular systems) and four other commonly used hiv-1 diagnostic tests including culture, oligonucleotide hybridization pcr, p24 antigen and immune complex-dissociated ( ...19958584360
[diagnostic value of protected bronchoalveolar lavage in hiv-associated pneumonia].the concept of the protected bronchoalveolar lavage (pbal) is to improve the diagnostic yield in bacterial pneumonia by unifying the high sensitivity of bronchoalveolar lavage (bal) and specificity of the protected specimen brush (psb). hiv-infected patients have been shown to have a high incidence of bacterial pneumonia as well as bacterial colonisation of the tracheobronchial tree. we therefore studied the value of pbal in this population.19958584525
evaluation of potent inhibitors of dihydrofolate reductase in a culture model for growth of pneumocystis carinii.many antifolates are known to inhibit dihydrofolate reductase from murine pneumocystis carinii, with 50% inhibitory concentrations (ic50s) ranging from 10(-4) to 10(-11) m. the relationship of the potency against isolated enzyme to the potency against intact murine p. carinii cells was explored with 17 compounds that had proven selectivity for or potency against p. carinii dihydrofolate reductase. pyrimethamine and one analog were inhibitory to p. carinii in culture at concentrations two to seve ...19958585722
pteroylpolyglutamate synthesis by lung- and culture-derived pneumocystis carinii.pneumocystis carinii synthesizes folates de novo from exogenous p-aminobenzoic acid (paba). lung-derived organisms take up [3h]paba in vitro except in the presence of sulfamethoxazole. supernatants from spinner-flask cultures take up [3h]paba if they were inoculated with lungs from infected rats, but not if they were inoculated with lungs from uninfected rats. p. carinii folates consist primarily of pteroylpentaglutamates. plasmodium falciparum, in contrast, contains primarily pteroyltetraglutam ...19958586276
sinusitis in children infected with human immunodeficiency virus: clinical characteristics, risk factors, and prophylaxis. national institute of child health and human development intravenous immunoglobulin clinical trial study group.the clinical presentation, radiological and laboratory evaluation, treatment, and risk factors of sinusitis in a cohort of 376 human immunodeficiency virus (hiv)-infected children from a placebo-controlled clinical trial of intravenous immunoglobulin (ivig) as prophylaxis for infections were examined. ninety-five episodes of sinusitis were described in 60 patients; one-third of the patients had two or more episodes. sinusitis episodes were commonly associated with nonspecific, chronic symptoms ( ...19958589139
paracoccidioidomycosis and aids: an overview.the scarcity of reported cases of paracoccidioidomycosis and aids remains unexplained. we review the details of the 27 cases reported in the medical literature. paracoccidioidomycosis occurs in patients with advanced aids who are not receiving prophylaxis for pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole, which is also effective against paracoccidioides brasiliensis. clinical manifestations include prolonged fever, weight loss, generalized lymphadenopathy, splenomegaly, hepat ...19958589154
case report: fulminating pneumocystis carinii pneumonia. 19958591644
in-vitro activity of terbinafine, atovaquone and co-trimoxazole against pneumocystis carinii. 19958591953
monitoring of co-trimoxazole concentrations in serum during treatment of pneumocystis carinii pneumonia.the purpose of this prospective randomized open trial was to investigate the impact of monitoring concentrations in serum on the efficacy and side effects of high-dose co-trimoxazole therapy. forty consecutive patients with microscopically confirmed pneumocystis carinii pneumonia were enrolled. therapy was started with 5 and 25 mg of trimethoprim and sulfamethoxazole, respectively, per kg of body weight given every 6 h for 2 days and continued every 8 h either with (group a) or without (group b) ...19958592998
[effect of primary prevention of pneumocystis carinii pneumonia on the inaugural clinical and biological presentation of aids: 624 cases (aquitaine cohort, 1985-1994)].in a cohort of hiv-infected patients, this study compares the clinical and immunological features at the time of aids diagnosis of patients who either received primary pneumocystis carinii prophylaxis (p+; n = 335) or who did not (p-; n = 289). frequency of p carinii pneumonia was lower in p+ than in p- patients (14.9% vs 26.0%; p < 0.001). conversely, toxoplasmic encephalitis, esophageal candidiasis, cytomegalovirus disease and m avium complex disease were more frequent in p+ patients. cd4+ cou ...19958570937
clinical characteristics and outcome of pneumocystis carinii pneumonia in hiv-infected and otherwise immunosuppressed patients.the factors contributing to unequal mortality rates following pneumocystis carinii pneumonia (pcp) in different groups at risk are poorly understood. we therefore compared the first episodes of pcp without prophylaxis in human immunodeficiency virus infected (hiv) and otherwise immunosuppressed patients in this retrospective study. a total of 58 hiv-infected and 16 otherwise immunosuppressed patients were analysed. the comparison included epidemiological, clinical, laboratory, radiological and m ...19958575583
cost-analysis of four diagnostic strategies for pneumocystis carinii pneumonia in hiv-infected subjects.the aim of this study was to analyse the cost-effectiveness ratio of four diagnostic strategies for pneumocystis carinii pneumonia (pcp) in patients infected with human immunodeficiency virus (hiv). two hundred and ten hiv-infected patients with suspected pcp underwent induced-sputum (is) followed, if negative, by bronchoalveolar lavage (bal); 85 of these patients were able to undergo an exercise test (et), prior to induced sputum and bal. the following strategies were analysed: bal strategy (ba ...19958575584
typing of pneumocystis carinii strains with type-specific oligonucleotide probes derived from nucleotide sequences of internal transcribed spacers of rrna genes.we have recently developed a method for typing pneumocystis carinii strains that infect humans. the method takes advantage of nucleotide sequence variations in internal transcribed spacers (itss) of the rrna genes of p. carinii. to date, two types of nucleotide sequences (designated types a and b) have been found in the its1 region, and three types of nucleotide sequences (designated types a, b and c) have been found in the its2 region. of the six potential combination types, we have detected fo ...19958576356
comparison of pcr and standard cytological staining for detection of pneumocystis carinii from respiratory specimens from patients with or at high risk for infection by human immunodeficiency virus.the detection of pneumocystis carinii dna by pcr was compared with routine cytologic staining techniques (cyt). a total of 284 clinical respiratory specimens, including 137 bronchoalveolar lavage (bal), 63 bronchoalveolar washing, 63 sputum, and 21 induced sputum samples, obtained from patients with or at high risk for human immunodeficiency virus infection were evaluated. eighty specimens were positive by pcr, and 69 were positive by cyt. pcr was able to detect p. carinii in more bronchoalveola ...19958576362
clinical significance of resolution of chest x-ray findings in hiv-infected children with lymphocytic interstitial pneumonitis (lip).lymphocytic interstitial pneumonitis (lip) in hiv-infected children is generally associated with better prognosis as compared with children with pneumocystis carinii pneumonia (pcp). we prospectively studied 12 cases of hiv-infected children with lip over a 4-year period in an effort to document one aspect of the natural history of this clinical entity. severe cd4 lymphocytopenia was associated with complete resolution of the chest x-ray findings in five patients, one of whom died of disseminate ...19958577544
[successful prevention of pneumocystis carinii infection with 1,920 mg of trimethoprim-sulfamethoxazole daily in patients with malignant hematopoietic diseases].during 1991-94 we treated 51 patients with acute myeloid leukaemias and 3 patients with a myelodysplastic syndrome of refractory anaemia with excess of blasts in transformation. the patients received trimethoprim-sulphamethoxazole (tmp-smx) 1,920 mg daily as a prophylaxis of pneumocystis carinii infections and selective decontamination of gastrointestinal tract. the majority of patients received tmp-smx in their first course of chemotherapy with daunorubicin and cytosine arabinoside. only one of ...19958578700
bacterial pneumonia in adult patients with hiv infection.patients with hiv infection are at increased risk for community-acquired bacterial pneumonias, due in part to their defects in b-cell function. streptococcus pneumoniae is the commonest cause of community-acquired pneumonia, with the second most common bacterial agent being haemophilus influenzae. these two organisms account for about two-thirds of community-acquired bacterial pneumonias. frequently bacterial pneumonias appear difficult to distinguish from pneumocystis carinii pneumonia or other ...19958568541
variable efficiency of three primer pairs for the diagnosis of pneumocystis carinii pneumonia by the polymerase chain reaction.the efficiency of three different primer pairs, complementary to different pneumocystis carinii dna regions, was compared in the polymerase chain reaction (pcr) for the diagnosis of pneumocystis carinii pneumonia (pcp) on bronchoalveolar fluid (balf) from patients with aids. pcr coupled with dot-blot hybridization (blot) using primers and probe from the mitochondrial 23srdna region showed the highest sensitivity, with a lower detection limit of 0.5-1 organisms microliter-1. when testing 47 balf, ...19958569774
immunoscintigraphy with a 99tcm-labelled anti-granulocyte monoclonal antibody in patients with human immunodeficiency virus infection and aids.the value of immunoscintigraphy with technetium-99m (99tcm) labelled anti-granulocyte monoclonal antibody (bw250/183) was studied prospectively in human immunodeficiency virus (hiv-1) antibody-positive patients presenting with fever without localizing symptoms or signs. twenty-three studies were performed in 23 patients and the results of 99tcm-anti-granulocyte imaging were compared with the definitive microbiological or cytological diagnosis. twenty-one patients had an infective cause of pyrexi ...19958570114
the utility of annual surveillance bronchoscopy in heart-lung transplant recipients.bronchoscopy with transbronchial biopsy (tbbx) and bronchoalveolar lavage (bal) has an appreciable yield in detecting asymptomatic abnormalities in heart-lung transplant recipients (hltr) during the early postoperative period. the utility of annual surveillance procedures has not been critically evaluated. we reviewed all annual bronchoscopies performed on 29 hltr to determine the frequency of asymptomatic abnormalities. surveillance bronchoscopies (sb) were performed on asymptomatic subjects wi ...19958545874
factors associated with pneumocystis carinii pneumonia in wegener's granulomatosis.to determine the factors associated with the occurrence of pneumocystis carinii pneumonia (pcp) in wegener's granulomatosis (wg).19958546533
the scid mouse as an experimental model for the evaluation of anti-pneumocystis carinii therapy.the usefulness of scid mice bearing endogenous pneumocystis carinii infection as a model for experimental chemotherapy was examined using standard compounds known to be effective against p. carinii. trimethoprim/sulphamethoxazole was able to reduce pulmonary p. carinii cysts in a dose-dependent manner within the dose range studied (10/50 to 100/500 tmp/smx mg/kg/d, bd, po, 5 days per week for 30 treatments). however, alterations in associated symptoms of infection (reduced body weight, increased ...19958537261
acute hepatic and renal failure caused by pneumocystis carinii in patients with aids.clinical and pathological findings are described in two aids patients with pneumocystis carinii infection who received prophylactic treatment with nebulised pentamidine and developed unusual hepatic and renal failure. histological examination showed clumps of p carinii massively obstructing hepatic sinuses and portal vessels in the first patient, and merular and intertubular capillaries in the second. these findings could explain the unusual clinical features, characterised by acute hepatic and ...19958537506
epidemiology of isosporiasis among persons with acquired immunodeficiency syndrome in los angeles county.to determine factors associated with isosporiasis in persons with acquired immunodeficiency syndrome (aids) in los angeles county, data from the aids surveillance registry were analyzed for the eight-year period 1985-1992. isosporiasis was reported in 127 (1.0%) of 16,351 persons with aids during the study period. prevalence of infection was highest among foreign-born patients (3.2%), especially those from el salvador (7.4%) and mexico (5.4%), and in all persons of hispanic ethnicity (2.9%). per ...19958561272
alcohol ingestion impairs host defenses predisposing otherwise healthy mice to pneumocystis carinii infection.pulmonary infection with pneumocystis carinii, an opportunistic pathogen, is associated with a variety of immunosuppressive states, including human immunodeficiency virus infection. we hypothesized that alcohol ingestion might compromise host defenses against this pathogen and, in an immunocompromised host, increase the severity of infection. this hypothesis was tested in both acute and chronic ethanol-treated normal and cd4+ t-cell-depleted mice challenged with p. carinii organisms. normal and ...19958561294
autopsy-proven causes of death in hiv-infected patients treated for tuberculosis in abidjan, côte d'ivoire.to determine autopsy-proven causes of death in hiv-infected patients treated for tuberculosis in abidjan, côte d'ivoire.19958561978
detection of pneumocystis carinii, mycobacterium tuberculosis, and cytomegalovirus in human immunodeficiency virus (hiv)-infected patients with hemophilia by polymerase chain reaction of induced sputum samples.the purpose of this study was to diagnose the initial stage of acute pulmonary infections due to pneumocystis carinii (p. carinii), mycobacterium tuberculosis (m. tuberculosis), and cytomegalovirus (cmv) by polymerase chain reaction (pcr) combined with the induced sputum method in hemophilia patients infected with human immunodeficiency virus (hiv). induced sputum and pcr were obtained at each outpatient visit or when any respiratory symptoms were present during a one-year period. all patients w ...19958563099
a comparison of problem lists generated by physicians, nurses, and patients: implications for cpr systems.using a sample of 201 patients hospitalized for pneumocystis carinii pneumonia, this study describes problem lists generated by physicians and examines the overlap among problem lists generated by physicians, nurses, and patients. the findings indicate that the majority of patients in this sample had at least one problem that occurred in more than one problem list. problems that most frequently appeared in more than one problem list were those related to the medical diagnosis of pneumocystis car ...19958563307
cloning and characterization of a conserved region of human and rhesus macaque pneumocystis carinii gpa.although the genes encoding pneumocystis carinii (pc) glycoprotein a (gpa) display a high degree of host species-specific genotypic diversity, the pc gpa derived from different host species share defined regions of significant homology in their primary amino acid (aa) structure. using two degenerate oligodeoxyribonucleotide (oligo) primers corresponding to a conserved cys region (cys-primers) of the ferret (f), rat (r) and mouse (m) pcgpa, a 306-bp portion of the human (h) pcgpa was amplified fr ...19958566775
aids in africans living in london.to investigate the presentation of hiv infection and aids amongst africans diagnosed with aids living in london.19958566973
[therapy and prevention of pneumocystis carinii pneumonia]. 19958567220
comparison of six different pcr methods for detection of pneumocystis carinii.we have recently developed a nested pcr method which amplifies internal transcribed spacers (its) of the ribosomal rna genes of pneumocystis carinii. to determine whether this pcr method can be used to diagnose p. carinii infections, we examined 30 bronchoalveolar lavage (bal) specimens that were shown microscopically to contain p. carinii organisms by the p. carinii its pcr (pc-its-pcr) and five other pcr methods that have been described for detecting p. carinii in clinical specimens. the targe ...19958567928
quality standard for the prophylaxis of pneumocystis carinii pneumonia in adults and adolescents infected with human immunodeficiency virus. 19958547504
quality standard for the prophylaxis of pneumocystis carinii pneumonia in infants and children born to women infected with human immunodeficiency virus. 19958547506
preventing pneumocystis carinii pneumonia in persons infected with human immunodeficiency virus.although the incidence of pneumocystis carinii pneumonia (pcp) among adults infected with human immunodeficiency virus (hiv) has declined, no decline in pcp incidence has been observed among hiv-infected children, and pcp remains the most common serious opportunistic infection among both adults and children in the united states. some evidence of airborne transmission of p. carinii exists, and some clusters of cases of pcp have been reported; however, data are insufficient to recommend that perso ...19958547511
topical fumagillin in the treatment of microsporidial keratoconjunctivitis in aids.to report microsporidial keratoconjunctivitis in a patient infected with hiv who was treated with topical fumagillin.19958547736
fatal pneumopathy in children after bone marrow transplantation--report from the italian registry. italian association of pediatric hematology-oncology bmt group.we have examined data reported in the aieop-bmt registry in order to determine the incidence, causes and risk factors for fatal pneumopathy after bone marrow transplantation in a pediatric population. overall, in the registry 1134 children are reported, 531 of whom received an autologous bmt, 468 allomatched bmt, eight syngeneic, 75 mismatched, 29 unrelated and 23 peripheral blood progenitor cells as rescue after myeloablative therapy in the period 1983-1993. 198 patients out of 1134 (17%) died ...19958547864
massive reversible pulmonary cysts in a patient with aids.we report the case of a patient with aids who presented with bilateral, massive pulmonary cystic disease and pneumothorax presumably caused by pneumocystis carinii which responded to treatment with cotrimoxazole. follow-up with sequential chest x-rays and computed tomography scans showed a progressive improvement in the lung cysts which had resolved almost completely 11 months later. several theories have been proposed to explain the cavitary lesions in this infection. the course observed in our ...19958552545
paclitaxel and simultaneous radiation in the treatment of stage iii a/b non-small cell lung cancer.in a clinical phase ii trial, radiotherapy and escalating doses of paclitaxel (taxol; bristol-myers squibb company, princeton, nj) were given concurrently to patients with stage iiia/b non-small cell lung cancer. radiotherapy was given in daily doses of 2 gy, 5 days a week, in weeks 1 to 3 and 6 to 8 for a total dose of 56 gy. paclitaxel was given in 3-hour infusions on day 1, also in weeks 1 to 3 and 6 to 8. the starting dose level was 50 mg/m2; the subsequent dose levels were 60, 72, 86, and 1 ...19958553078
interstitial pneumonitis in patients infected with the human immunodeficiency virus.a study was performed to identify the clinical, radiographic, and histopathological features of interstitial pneumonitis in patients infected with the human immunodeficiency virus.19958553268
aids and the lung: update 1995. 1. pneumocystis carinii pneumonia. 19958553289
pulmonary complications of hiv disease: 10 year retrospective evaluation of yields from bronchoalveolar lavage, 1983-93.pulmonary disease is a major contributor to morbidity and mortality in patients with hiv infection and aids. the aim of this study was to describe bronchoscopic findings and the spectrum of pulmonary pathogens in hiv seropositive patients undergoing investigation of respiratory disease over a 10 year period in a major uk referral centre.19958553294
[pneumocystis carinii infection in aids patients. current prognosis of the respiratory insufficiency]. 19958555301
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