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randomized study of sulfamethoxazole-trimethoprim versus aerosolized pentamidine for secondary prophylaxis of pneumocystis carinii pneumonia in patients with aids.in a prospective, randomized open-label trial, the efficacy of sulfamethoxazole-trimethoprim (smx-tmp) 400/80 mg b.i.d. was compared with the efficacy of aerosolized pentamidine (ap) 60 mg every 2nd week as secondary prophylaxis (sp) against recurrence of pneumocystis carinii pneumonia (pcp) in aids patients. 94 patients participated in the study, 47 in each group. the patients were observed for a mean period of 17.2 months. pcp recurred in the ap group in 8 cases, while 1 relapse occurred in th ...19958539544
clinically achievable plasma deferoxamine concentrations are therapeutic in a rat model of pneumocystis carinii pneumonia.the iron-chelating drug deferoxamine (dfo) has been shown to be active in animal models of pneumocystis carinii pneumonia (pcp), with effective daily intraperitoneal bolus dosages being 400 and 1,000 mg of dfo mesylate kg of body weight-1 in mouse and rat models, respectively. continuous infusion produced a moderately improved response in a rat model. the data reported here demonstrate that the response achieved by continuous infusion of 195 and 335 mg of dfo mesylate kg-1 day-1 in the rat model ...19958540710
primary care of children with hiv infection.as the number of children affected by the hiv epidemic increases, the primary care physician can have an important role in ensuring that these children receive comprehensive health care. clinical aspects of pediatric hiv disease are reviewed, including the recently revised centers for disease control and prevention classification system. important advances include the development and application of techniques for establishing in early infancy whether or not a child is infected. the implications ...19958541949
serial indium-111-labelled igg biodistribution in rat pneumocystis carinii pneumonia: a tool to monitor the course and severity of the infection.to study the effect of new therapeutic strategies, we developed an animal model to monitor the course and severity of experimental pneumocystis carinii pneumonia (pcp) in rats. p. carinii density scores in giemsa-stained impression smears were used to follow p. carinii load. indium-111 labelled igg scintigraphy and biodistribution, histology of paraffin-embedded tissue sections, lung/body weight (l/b wt) ratio and cell count and differentiation of broncho-alveolar lavage (bal) fluid were used as ...19958542896
frequencies of opportunistic diseases prior to death among hiv-infected persons. community programs for clinical research on aids.to describe the complete history of major opportunistic events experienced by 1883 hiv-infected persons prior to and specifically within 6 months of death, and to determine whether the frequency of specific events varies according to demographic characteristics, risk behaviors or geographic location.19958519450
the art of parasite survival.parasites develop and survive in an environment which is often hostile to them. when facing aggressive conditions parasites are able to use various and complex strategies. echinococcus granulosus, toxocara canis, pneumocystis carinii, entamoeba or toxoplasma gondii are able to seclude from the environment when stressed by surrounding (immunologic or non-immunologic) aggressive factors. specific antigens which exert a functional activity during a short period of time appear to be concealed from t ...19958520537
uptake and metabolism of l-serine by pneumocystis carinii carinii.serine is an important amino acid that is utilized in the biosyntheses of proteins and lipids. it is directly incorporated into the head group of phosphatidylserine, which in turn can be converted to other phospholipids. also, it is required for the formation of long chain bases, precursors of sphingolipids. uptake and incorporation of radiolabeled serine into both lipids and acid-precipitable material were demonstrated in pneumocystis carinii carinii organism preparations freshly isolated from ...19958520579
analysis of genetic diversity at the arom locus in isolates of pneumocystis carinii.the dna sequences of a portion of the 5-enolpyruvyl shikimate phosphate synthase domain of the arom gene, encoding the pentafunctional arom protein, were determined from isolates of pneumocystis carinii from five mammalian host species (rat, human, ferret, rabbit and mouse). high levels of genetic divergence were found among p. carinii derived from different host species, 7-22% at the dna sequence level, and 7-26% at the derived amino acid sequence level. two separate and distinct sequences were ...19958520580
pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with wegener's granulomatosis. 19958520798
[two cases of sensory neural hearing loss as a manifestation of hiv infection].in patients with hiv infection, oral and pharyngeal pathology frequently occurs, but there have been no reports on cases of deafness in japan. herein, the authors report two cases of sensory neural hearing loss in hemophilia a patients infected with hiv through factor viii concentrates. case 1 was a 16-year-old male with hemophilia a. he had been administered factor viii concentrates starting at 6 months after birth. at 8 years of age, hiv antibodies were positive. he was diagnosed as having aid ...19958523168
pneumocystis carinii pneumonia associated with inhaled corticosteroids in an immunocompetent child with asthma. 19958523172
corticosteroid therapy for pneumocystis carinii pneumonia. 19958523175
impairment of antigen-specific t-cell priming in mice lacking cd40 ligand.lack of functional expression of cd40 ligand (cd40l) on t cells results in hyper-igm syndrome (higm1), a human immunodeficiency associated with a severely impaired humoral immune response that is consistent with defects in b-cell responses. patients also succumb to recurrent opportunistic infections such as pneumocystis carinii and cryptosporidial diarrhoea, suggesting that t-cell functions are also compromised in these individuals, but so far this has not been explained. we have previously show ...19958524395
[infections following bone marrow transplantation].recent years have witnessed a reduction in the frequency of infectious complications both in allogeneic and in autologous bone marrow transplantation (bmt). with a frequency of 30-40 percent, septicaemia is the predominant problem during the aplastic phase. owing to the introduction of prophylaxis with quinolones, there has been a shift in the aetiological spectrum toward gram-positive infections, and gram-negative infections now account for less than 10 percent of all cases. in turn, this has b ...19958524635
steroids do not enhance the risk of developing tuberculosis or other aids-related diseases in hiv-infected patients treated for pneumocystis carinii pneumonia.to evaluate the risk of developing tuberculosis or other aids-related diseases (ard) in hiv-infected patients treated with corticosteroids as adjunctive therapy for pneumocystis carinii pneumonia (pcp).19958527075
clinical experience with fludarabine and its immunosuppressive effects in pretreated chronic lymphocytic leukemias and low-grade lymphomas.fludarabine monophosphate (famp) is a new adenine nucleoside analogue with a promising efficacy in b-cell chronic lymphocytic leukemia (b-cll) and low-grade non-hodgkin lymphomas (nhls). here, the clinical experience and side effects with famp are reported in 77 patients with pretreated cll (59 b-cll, 2 t-cll) and low-grade nhls (9 immunocytic lymphomas including 5 waldenström's macroglobulinaemia, 2 centrocytic (cc) and 5 centroblastic-centrocytic (cb-cc) nhls). 70/77 patients are evaluable for ...19958528057
immunoblot analysis for serum antibodies to pneumocystis carinii by age and intensity of infection in rats.the present study aims to observe changing patterns of serum antibody to pneumocystis carinii in normal rats of different ages and in immunosuppressed rats. the serum igg antibody was observed by immunoblotting with crude antigen of p. carinii which were purified from the lungs of infected rats. the crude antigens separated in sds-page resolved more than 20 protein bands from 20 to 200 kda. of them, 40-45, 50-55, 116 and 200 kda bands were major antigens of p. carinii. most of the normal rats of ...19958528625
mycobacterium genavense invasive infection in two children with aids: long-term followup.mycobacterium genavense is a rare cause of opportunistic infection in immunocompromised hosts. follow up of two cases of m. genavense invasive infection in children with haemophilia a and aids are presented. one patient died 18 months after diagnosis of m. genavense infection of an indirectly related cause, probably of pneumocystis carinii pneumonia. the second patient still attends our outpatient clinic and the infection is under control. both presented with abdominal lymphomas and pain and a w ...19958529716
polymerase chain reaction is more sensitive than standard cytologic stains in detecting pneumocystis carinii in bronchoalveolar lavages from human immunodeficiency virus type 1-infected infants and children with pneumonia. 19958532434
successful bone marrow transplantation in patients with recent pneumocystis carinii pneumonia: report of two cases. 19958535327
pulmonary complications of bone marrow transplantation: a comparison of total body irradiation and cyclophosphamide to busulfan and cyclophosphamide.to retrospectively compare the acute and long-term pulmonary toxicities of total body irradiation and busulfan in bone marrow transplantation.19957536723
inhibition of constitutive nitric oxide synthase in the brain by pentamidine, a calmodulin antagonist.nitric oxide (no) which is produced by activation of ca2+/calmodulin-dependent no synthase is known to induce neuronal damage. we examined the effects of 3'-azido-2',3'-dideoxythymidine (azt, a reverse transcriptase inhibitor), pentamidine (a therapeutic drug for pneumocystis carinii pneumonia) and calmodulin antagonists such as trifluoperazine and n-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (w-7) on no synthase activation. although azt had no effect on the activity of constitutive neuron ...19957542607
decreased activation of the respiratory burst in neutrophils from aids patients with previous pneumocystis carinii pneumonia.neutrophils from human immunodeficiency virus (hiv)-negative blood donors, asymptomatic hiv-positive patients, aids patients with previous pneumocystis carinii pneumonia (pcp), and aids patients without previous pcp were compared for their ability to activate the respiratory burst, measured as luminol-amplified chemiluminescence. p. carinii, staphylococcus aureus, phorbol-12-myristate-13-acetate, and fmlp were used to stimulate the neutrophils. when stimulated with p. carinii, neutrophils from p ...19957542687
genetic variation among pneumocystis carinii hominis isolates in recurrent pneumocystosis.pneumocystis carinii hominis is a ubiquitous organism that causes pneumonia in immunocompromised persons. paired p. carinii hominis isolates from human immunodeficiency virus-infected persons who had two episodes of pneumocystosis were examined for genetic heterogeneity. genetic variation was detected by sequence comparison of a portion of the mitochondrial ribosomal rna gene. in 5 of 10 patients experiencing two episodes of pneumocystosis, genetically distinct isolates were associated with each ...19957542688
two domains with amino-acid sequence similarity are required for dihydroneopterin aldolase function in the multifunctional folic acid synthesis fas protein of pneumocystis carinii.the folic acid synthesized gene (fas) of pneumocystis carinii (pc) codes for a multifunctional enzyme (fas) known to catalyse three consecutive steps leading to the production of dihydropteroate in the de novo folate synthesis pathway. previously, we predicted that a domain, designated fasb (amino acids (aa) 161-280), of the 740-aa multifunctional protein contains the first of the three enzyme activities in the pathway, namely dihydroneopterin aldolase (dhna), since it shares 23% aa identity wit ...19957543066
species-specific microhelix aminoacylation by a eukaryotic pathogen trna synthetase dependent on a single base pair.we report here that tyrosyl-trna synthetase from the eukaryotic pathogen pneumocystis carinii is a 370 amino acid polypeptide with characteristic elements of a class i aminoacyl-trna synthetase and aligns with the prokaryotic tyrosyl-trna synthetases in the class-defining active site region, including the trna acceptor helix-binding region. the expressed enzyme is a dimer that aminoacylates yeast trna but not escherichia coli trna(tyr). like most trnas, prokaryotic tyrosine trnas have a g1.c72 b ...19957547995
community-acquired pneumonia: impact of immune status.this cross-sectional and prospective one year study evaluated adults admitted to an inner city hospital with community-acquired pneumonia. the study used extensive diagnostic methods to evaluate the etiologies of community-acquired pneumonia in hospitalized patients with differing immunologic status. of 385 study patients, concurrent problems associated with immunosuppression were noted in 221 (57%) patients, 180 of whom were human immunodeficiency virus (hiv)-infected. the five most common caus ...19957551387
pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with wegener's granulomatosis. 19957551403
[serologic response of normal korean children to pneumocystis carinii as observed by immunoblot].soluble protein of purified pneumocystis carinii was prepared from experimentally infected rats. sds-page of the crude antigen resolved about 20 protein bands from 20 to 200 kda. out of them, 116 kda band strongly reacted and 45-55 and 100 kda bands reacted weakly to the positive reference human serum from u.s.a. western blot analysis with sera of 130 normal children and 15 newborns in korea revealed specific igg antibody reaction to 40-55 and 116 kda protein bands. forty percent (40.0%) of the ...19957551800
genetic variability in different pneumocystis isolates from man and rats.to gain further insight into the genetic variability between different isolates of pneumocystis carinii of rat and human origin, we sequenced three dna regions from the mitochondrial rrna gene, the 5s rrna gene and the dihydrofolate reductase gene (dhfr) of microorganisms isolated from three different immunosuppressed rat sources and from one hiv + patient with p. carinii pneumonia. some point mutations and deletions were found among rat isolates in two regions (mitochondrial rrna gene and 5s rr ...19957553373
[experimental and clinical study on pneumocystosis. iv. use of a 4d7 monoclonal antibody to detect pneumocystis carinii by immunoperoxidase staining].this paper reports on the diagnostic utility of the 4d7 monoclonal antibody (mcab) and immunohistochemical (ihc) staining to detect p. carinii. specimens of 30 pathological sections of lung tissues and 1 smear of aspirated bronchial material from confirmed cases, and 12 sputum smears from high risk patients with pneumonia were examined by immunohistochemical method using the 4d7 mcab. the results showed that both the sensitivity and specificity of the 4d7 mcab-ihc staining were 100% (31/31). a c ...19957554163
spontaneous pneumothorax in children with aids.the incidence of pneumothorax in hiv-infected children has not been reported. in adults with aids, pneumothorax has been described exclusively in association with pneumocystis carinii pneumonia (pcp). we report the cases of three children with aids, one with lymphoid interstitial pneumonitis (lip) without evidence of pcp and two with pcp, all of whom developed spontaneous pneumothorax (sp). on presentation, none of the children had any risk factors for the development of pneumothorax, but all ha ...19957555138
aids-related spontaneous pneumothorax. risk factors and treatment.to define risk factors and optimum therapy for aids-related spontaneous pneumothorax (ptx).19957555166
dapsone-induced methemoglobinemia: an anesthetic risk.dapsone is used to treat several systemic inflammatory diseases, many of which have head and neck manifestations, such as leprosy, systemic lupus erythematosus, rhinosporidiosis, relapsing polychondritis, dermatitis herpetiformis, pemphigus vulgaris and bullous pemphigoid. it has also been recently used prophylactically alone or in combination against malaria and in aids patients against pneumocystis carinii infections. this is significant to the otolaryngologist-head and neck surgeon since appr ...19957558644
penicillin-resistant pneumococci--an emerging threat to successful therapy.pneumococci highly resistant to penicillin g [minimum inhibitory concentration (mic) > or = 2 mg l-1] have become prevalent in many parts of the world since their emergence and spread in the late 1970s. in the usa, such organisms are seen primarily in two populations: infants and children, and adults with aids. surveys in both rural and urban areas have revealed presence of these organisms, as well as an increasing frequency of streptococcus pneumoniae strains relatively resistant to penicillin ...19957560986
cd40 ligand is required for resolution of pneumocystis carinii pneumonia in mice.the role of the cd40-cd40 ligand (cd40l) interaction in resolution of pneumocystis carinii (pc) pneumonia (pcp) was assessed in a pc-infected severe combined immunodeficiency (scid) mouse reconstitution model using an anti-cd40l mab to block cd40l. scid mice infected with pc were reconstituted with unfractionated spleen cells from immunocompetent donors and given either anti-cd40l mab or an irrelevant control mab. mice given the control mab resolved the pc infection, whereas those given the anti ...19957561048
translation elongation factor-3 (ef-3): an evolving eukaryotic ribosomal protein?fungi appear to be unique in their requirement for a third soluble translation elongation factor. this factor, designated elongation factor 3 (ef-3), exhibits ribosome-dependent atpase and gtpase activities that are not intrinsic to the fungal ribosome but are nevertheless essential for translation elongation in vivo. the ef-3 polypeptide has been identified in a wide range of fungal species and the gene encoding ef-3 (yef3) has been isolated from four fungal species (saccharomyces cerevisiae, c ...19957563124
[massive and progressive hepatosplenomegaly caused by disseminated nontuberculous mycobacteriosis in a patient with acquired immunodeficiency syndrome].a 28-year-old hemophilia a patient was admitted to our hospital in july, 1991 because of high fever, chronic diarrhea and anemia. the patient had been recognized as a asymptomatic carrier of human immunodeficiency virus (hiv) in 1985 and had developed pneumocystis carinii pneumonia and had been diagnosed as acquired immunodeficiency syndrome (aids) in 1990. hematologic laboratory examinations on admission revealed pancytopenia and a cd4+ cell count of 3/mm3. x-ray findings of chest and abdomen w ...19957564051
[a case report of the atypical tuberculosis associated with aids].a 49-year-old japanese male who had been imprisoned for five years then lived with other men complained of fever, constitutional symptoms and a 12 kg weight loss over four-month period. he was referred to us as his gastric washings were positive for acid-fast bacilli (afb). chest x-ray showed patchy, infiltrative small shadows primarily in the right upper lung field without hilar adenopathy. before transfer to our hospital, tuberculosis chemotherapy composed of sm, inh, rfp and pza was initiated ...19957564052
1995 revised guidelines for prophylaxis against pneumocystis carinii pneumonia for children infected with or perinatally exposed to human immunodeficiency virus. national pediatric and family hiv resource center and national center for infectious diseases, centers for disease control and prevention.pneumocystis carinii pneumonia (pcp) is the most common opportunistic infection in children who have acquired immunodeficiency syndrome (aids). despite the publication of guidelines for prophylaxis against pcp for children infected with human immunodeficiency virus (hiv) in 1991 (1), ongoing aids surveillance has detected no substantial decrease in pcp incidence among hiv-infected infants. studies indicate that this continued incidence is associated with failure to identify hiv-infected children ...19957565543
spectrum of chest radiographic abnormalities in children with aids and pneumocystis carinii pneumonia.this report aims to provide a description of the spectrum of radiographic findings in children with aids and pneumocystis carinii pneumonia (pcp). the chest radiographs of all children with perinatally transmitted hiv infection who had pcp were reviewed. thirty-eight episodes of pcp were noted in 32 children. the age range was 2-17 months. the radiographic findings were characterized as to pattern, severity, presence of pulmonary air cyst, thoracic air leak, thoracic lymphadenopathy, and pleural ...19957567276
application of thin-section low-dose chest ct (tsct) in the management of pediatric aids.the aim of this study was to evaluate the usefulness of thin-section low-dose computed tomography (tsct) in the management of children with aids, as chest radiographs (cxr) often fail to adequately explain the patients' clinical status. we performed 54 noncontrast tscts on 32 children. the patients aged from 3 months to 14.6 years, were diagnosed as having bacterial pneumonia, lumphocytic interstitial pneumonitis (lip), pneumocystis carinii pneumonia (pcp), or mycobacterium avium-intracellulare ...19957567277
[induced expectoration: its role in the diagnosis of pneumocystis carinii pneumonia].the purpose of this retrospective study was to describe the changes and the effect of pneumocystis carinii pneumonia (pcp) prophylaxis on induced sputum sensitivity during these five last years19957567819
[alveolitis and pneumocystis carinii infection in a worker exposed to plaster]. 19957569212
isoform diversity and tandem duplication of the glycoprotein a gene in ferret pneumocystis carinii.two ferret p. carinii gpa cdna clones were identified that reacted identically with a panel of anti-gpa monoclonal antibodies, although their nucleotide sequences were 22% divergent. each clone hybridized to a single mrna species of 3,600 nucleotides only in p. carinii-infected lung mrna, but rt-pcr analysis demonstrated that these cdna clones were derived from two distinct gpa mrna transcripts. further pcr analysis demonstrated that the ferret p. carinii genome contains at least two gpa genes l ...19957584051
an inductive algorithm approach to knowledge acquisition for expert system development. a pilot study.knowledge acquisition, which consists of knowledge elicitation and knowledge representation, often is considered the weakest link in the design of expert systems. systems frequently are built on the knowledge of one expert and require extensive use of knowledge engineering techniques to elicit this knowledge from the expert. inductive algorithms are a potential alternative method of knowledge acquisition for expert system development. the aim of this pilot study was to examine the feasibility of ...19957585305
acute lung disease in the immunocompromised host. diagnostic accuracy of the chest radiograph.to assess the diagnostic accuracy of the chest radiograph in the evaluation of acute pulmonary complications in immunocompromised patients.19957587430
atovaquone. a review of its pharmacological properties and therapeutic efficacy in opportunistic infections.atovaquone has been investigated as an alternative agent for oral use in the treatment of both mild to moderate pneumocystis carinii pneumonia (pcp) and toxoplasmosis, opportunistic infections commonly experienced by patients with aids. in patients with mild to moderate pcp, a dosage of 750mg 3 times daily (administered in tablet form) has similar overall therapeutic efficacy (defined as clinical response without a treatment-limiting adverse event) to the conventional therapies oral cotrimoxazol ...19957588086
combined autoimmune cytopenias.autoimmune neutropenia (ain) can occur in association with autoimmune hemolytic anemia (aiha) and/or immune thrombocytopenic purpura (itp), although these associations have not been studied in detail.19957590498
an appraisal of thoracic procedures performed in patients with hiv-positive serology.patients who have contracted the human immunodeficiency virus (hiv) often require a diagnostic or therapeutic thoracic procedure. to determine the clinical benefits of a noncardiac pulmonary intervention in the treatment of hiv-positive individuals, 82 patients with hiv-positive serology who underwent a thoracic procedure for illnesses related to acquired immunodeficiency syndrome (aids) between 1987 and 1990 were reviewed. pneumocystis carinii pneumonia was the most common opportunistic infecti ...19957593145
therapeutic progress. iv: treatment and prophylaxis of pneumocystis carinii infection.co-trimoxazole presently remains the first choice for prophylaxis and treatment of pneumocystis carinii infections. the high incidence of adverse reactions experienced by patients taking co-trimoxazole has led to a number of trials comparing it with other antipneumocystis agents. adjuvant therapy with corticosteroids may benefit patients with severe p. carinii pneumonia. this paper reviews the standard treatments for p. carinii pneumonia, some of the newer agents such as atovaquone, recently lic ...19957593374
diagnosis of pneumocystis carinii pneumonia in aids patients by using polymerase chain reactions on serum specimens.a polymerase chain reaction (pcr) that amplifies the internal transcribed spacers of rrna genes of pneumocystis carinii (pc-its-pcr) was compared with dihydrofolate reductase (dhfr) gene pcr to determine its usefulness in the diagnosis of pneumocystis carinii pneumonia. all specimens from non-p. carinii pneumonia aids patients were both pc-its-pcr- and dhfr pcr-negative. twenty-six (96%) of 27 bronchoalveolar lavage specimens from p. carinii pneumonia patients were pc-its-pcr-positive, and all 2 ...19957594732
[a case of aids patient who was hard to diagnose from an initial symptom of interstitial pneumonitis].a thirty-six year old male was admitted to the hospital because of fever and dyspnea. on the eighth day the patient turned out to be hiv positive. although aggressive therapy was performed, the patient died of hiv related disease such as pneumocystis carinii pneumonitis and cmv infection which led to multiple organ failure seventeen days after admission. we reported a case of aids patient who was hard to diagnose from an initial symptom of interstitial pneumonitis.19957594792
surfactant protein binding to pneumocystis carinii organisms. 19957595024
surfactant protein-d modulates interaction of pneumocystis carinii with alveolar macrophages. 19957595025
interleukin-8 and eicosanoid production in the lung during moderate to severe pneumocystis carinii pneumonia in aids: a role of interleukin-8 in the pathogenesis of p. carinii pneumonia.pneumocystis carinii pneumonia (pcp) may cause severe respiratory distress. this is believed to be partly caused by the accumulation of neutrophils in the lung. interleukin-8 (il-8) and leukotriene b4 (ltb4) are potent neutrophil chemo-attractants and activators. eicosanoids [i.e. prostaglandins (pg) and leukotrienes (lt)] are pro-inflammatory mediators released from arachidonic acid by action of phospholipase a2 (pla2) and have been implicated in the host response to micro-organisms. bronchoalv ...19957597268
intensive care for patients with aids: clinical and ethical issues.pneumocystis carinii pneumonia (pcp) remains a common and morbid infection among patients with the acquired immunodeficiency syndrome (aids). most patients who die of pcp do so because of respiratory failure. the survival after intubation and mechanical ventilation for pcp and respiratory failure has gone through three eras: era i (1981-85), when the survival rate to hospital discharge was about 10%; era ii (1986-88), when the hospital survival rate rose to about 40%; and era iii (1989-present), ...19957597398
[pneumocystis carinii pneumonia in infants with vertically acquired hiv infection in switzerland].review of incidence, clinical picture, therapy, and outcome of pneumocystis carinii pneumonia (pcp) in infants with vertically-acquired hiv infection in switzerland.19957597404
recovery of pseudomonas aeruginosa in respiratory specimens from hiv positive patients being evaluated for pneumocystis carinii pneumonia.despite the immune suppression, frequent hospital admissions, and many intercurrent illnesses associated with hiv infection, pseudomonas aeruginosa has been cited relatively infrequently as a respiratory pathogen in hiv positive patients.19957597670
twice-weekly maintenance therapy with sulfadiazine-pyrimethamine to prevent recurrent toxoplasmic encephalitis in patients with aids. spanish toxoplasmosis study group.to evaluate the efficacy of twice-weekly maintenance therapy with sulfadiazine-pyrimethamine to prevent toxoplasmic encephalitis relapse in patients with the acquired immunodeficiency syndrome (aids).19957598298
antimicrobial prophylaxis in bone marrow transplantation.to review the efficacy of antimicrobial prophylaxis in bone marrow transplantation.19957598303
dapsone acetylation by human liver arylamine n-acetyltransferases and interaction with antiopportunistic infection drugs.dapsone is used in the treatment of pneumocystis carinii pneumonia, an opportunistic infection that afflicts acquired immunodeficiency syndrome (aids) patients. inhibition of n-acetyltransferase (nat)-dependent acetylation of dapsone could increase peak plasma concentrations of dapsone and shift the biotransformation pathway to the p450-mediated formation of a toxic metabolite of dapsone, the hydroxylamine. therefore, we have determined using human liver cytosol and bacterially expressed nats, t ...19957600914
staging system for clinical aids patients. royal free/chelsea and westminster hospitals collaborative group.although there are wide differences in prognosis between patients with aids they are often thought of as a single homogeneous group. we think a simple staging system that accounts for important prognostic factors including type and number of aids diseases and the cd4 lymphocyte count is required. we followed 363 aids patients at the royal free hospital and reported the occurrence of 680 aids-defining diseases (adds). we measured cd4 counts at approximately monthly intervals. severity of aids dis ...19957603137
hyperferritinemia in reactive hemophagocytic syndrome report of four adult cases.four patients were diagnosed with reactive hemophagocytic syndrome (rhps) during a 7 month period. of these, three patients were diagnosed with acquired immunodeficiency syndrome complicated by disseminated mycobacterium tuberculosis infection, incompletely treated pneumocystis carinii pneumonia and disseminated histoplasmosis respectively. the fourth patient had non-hodgkin's lymphoma of the mature t-cell phenotype. fever, bicytopenia, or pancytopenia, elevated serum lactate dehydrogenase (ldh) ...19957604819
the role of bronchoscopy in the diagnosis and treatment of pulmonary disease in hiv-infected patients.pulmonary disease is the most common reason for presentation and the major cause of death in hiv-infected patients. there has been an evolution in the optimal approach to the investigation of a pulmonary infiltrate in hiv-infected patients since the introduction of induced sputum for the diagnosis of pneumocystis carinii pneumonia (pcp).19957605295
severe accidental dapsone overdose.acute poisoning from excessive dapsone (4,4-diaminodiphenylsulfone) intake in uncommon in the united states; no cases were reported during 1992. however, with the increasing use of dapsone for diseases other than leprosy and dermatitis herpetiformis, such as acne vulgaris, psoriasis, and pneumocystis carinii pneumonia infection in acquired immunodeficiency syndrome, clinicians should be aware of potential toxicities. this report describes a case of accidental dapsone intoxication resulting in se ...19957605525
sequence-dependent drug binding to the minor groove of dna: crystal structure of the dna dodecamer d(cgcaaatttgcg)2 complexed with propamidine.the dna-binding ligand propamidine, an analogue of the drug pentamidine which is used in the treatment of acquired immune deficiency syndrome (aids)-associated pneumocystis carinii, has been cocrystallized with the dna sequence d(cgcaaatttgcg)2, and the crystal structure of the complex has been determined using data from 8 to 2.2 a resolution. the r factor converged to 15.5% with the inclusion of 73 water molecules. the structure shows binding of the propamidine molecule within the at tract of t ...19957608897
use of the polymerase chain reaction technique on induced-sputum samples for the diagnosis of pneumocystis carinii pneumonia in hiv-infected patients. a clinical and cost-analysis study.the purpose of this study was to assess the sensitivity and specificity of the polymerase chain reaction (pcr) on induced sputum (is) for the diagnosis of pneumocystis carinii pneumonia (pcp) in hiv-infected patients, as well as its diagnostic value and cost as a routine clinical tool. forty-nine patients with suspected pcp who had is were studied and if negative, followed by bronchoalveolar lavage (bal). pneumocystis carinii was detected in these samples using standard staining techniques. poly ...19957611187
trophozoite-to-cyst ratio increases during recovery from pneumocystis carinii pneumonia in rats.pneumocystis carinii has two developmental stages: the trophozoite and the cyst. the differential specificity of monoclonal antibodies smoab (cysts only) and cmoab (cysts and trophozoites) was used to analyse the trophozoite-to-cyst (t: c) ratio during recovery from p. carinii pneumonia (pcp) in a dexamethasone model in wistar rats. in tissue homogenates the cysts decreased from week 0 to week 4 (4.10 +/- 1.57 10(6)/g vs 0.069 +/- 0.021 10(6)/g, p < 0.001), whereas the trophozoites decreased muc ...19957612261
pulmonary infection in the immunocompromised patient.pneumonia in the immunocompromised patient remains a significant cause of morbidity and mortality. these patients are susceptible to a wide variety of organisms, but specific infections tend to occur in well defined settings. the type of infection can be predicted based on the nature and severity of the immune defect, past patient exposures, chemotherapy given, radiographic presentation, and acuteness of illness. new treatments, including growth factors, the oral antifungal agents, and antiviral ...19957612759
hiv positive patients first presenting with an aids defining illness: characteristics and survival.to study the presentation and survival of patients who present with their first diagnosis of being hiv positive at the same time as their aids defining illness.19957613426
pcr for detection of pneumocystis carinii in blood cells. 19957615775
human immunodeficiency virus and the skin: selected controversies.acquired immunodeficiency syndrome was first recognized as a new disease in 1981 because of the unusual association of kaposi's sarcoma and pneumocystis carinii pneumonia in young men. the skin remains one of the most important clinical markers for acquired immunodeficiency syndrome, now recognized as the end stage of infection with the human immunodeficiency virus (hiv). indeed, an urticarial viral exanthem appearing during seroconversion may allow early identification of newly infected individ ...19957615989
[high-resolution ct findings of pneumocystis carinii pneumonia].high resolution ct (hrct) was performed on 7 patients with pneumocystis carinii pneumonia (pcp). six cases were proven bacteriologically by bronchoalveolar lavage; one case was proven by autopsy. three patients were re-scanned after specific treatment and symptomatic relief. all the ct scans were abnormal, usually showing bilateral diffuse ground-glass opacity, through which the pulmonary vessels remained visible. chest x-ray, on the other hand, showed a normal pattern in one patient. other chan ...19957617461
racial differences in care among hospitalized patients with pneumocystis carinii pneumonia in chicago, new york, los angeles, miami, and raleigh-durham.while strategies for medical care for human immunodeficiency virus-related pneumocystis carinii pneumonia (pcp) are well established, racial variations in care have not been evaluated.19957618980
physicians' ability to provide initial primary care to an hiv-infected patient.primary care physicians are providing care for an increasing number of persons infected with the human immunodeficiency virus (hiv). this study assesses the ability of primary care physicians to provide initial care for a patient with recently diagnosed hiv infection.19957618984
an epidemiologic analysis of mycobacterium avium complex disease in homosexual men infected with human immunodeficiency virus type 1.cofactors associated with the mycobacterium avium complex (mac) disease and its prognosis in incident cases of aids in homosexuals were studied. we compared 51 men in whom mac disease developed as the initial aids-defining illness (termed aids illness hereafter); 157 men who had mac disease subsequent to another aids illness; and 884 men who had only non-mac aids illnesses. mac disease was the initially diagnosed aids illness more often in baltimore (6.9%) and los angeles (5.6%) than in chicago ...19957620006
fine-needle aspiration diagnosis of extrapulmonary pneumocystis carinii lymphadenitis in a human immunodeficiency virus positive patient.extrapulmonary pneumocystitis carinii is an uncommon and probably underdiagnosed complication of pulmonary p. carinii infections. we report the cytologic diagnosis of a case of p. carinii lymphadenitis which presented, without concurrent or historical pneumonitis, in a human immunodeficiency virus (hiv) positive patient who was taking aerosolized pentamidine. the diagnosis was suggested by abundant granular exudate on the cell block. only scant, fragmented, irregular-shaped granular exudate was ...19957621721
limited persistence in and subsequent elimination of pneumocystis carinii from the lungs after p. carinii pneumonia.the purpose of this study was to determine the period of persistence of pneumocystis carinii in the lungs after p. carinii pneumonitis (pcp). after primary pcp was induced with dexamethasone, experimental rats were moved to a high-efficiency particulate air-filtered isolator to prevent further exposure to environmental p. carinii and allowed to recover. at intervals thereafter, sample groups were transferred to a second isolator and reimmunosuppressed with dexamethasone to provoke pcp if p. cari ...19957622894
a pilot study on the efficacy of epiroprim against developmental stages of toxoplasma gondii and pneumocystis carinii in animal models.the new bacteriocidal drug epiroprim (ro-11-8958) was tested (alone or in combination with dapsone) on its efficacy against toxoplasma gondii and pneumocystis carinii in their hosts: laboratory mice and/or nude mice/rats, and was compared to the curative effects of the recent drugs of choice. the experiments clearly pointed out that epiroprim has significant effects on the reduction of both parasites when given alone. in combination with dapsone epiroprim led to a complete cure of toxoplasmosis ...19957624286
pharmacokinetics of dapsone in human immunodeficiency virus-infected children.dapsone, administered at various doses and schedules, has been proven to be a safe and effective alternative to trimethoprim-sulfamethoxazole for prevention of pneumocystis carinii pneumonia (pcp) in adults with human immunodeficiency virus (hiv) infection. dapsone is also recommended by the centers for disease control for pcp prophylaxis in hiv-infected children. however, the suggested dosage regimen is based upon clinical experience with children with leprosy and dermatitis herpetiformis rathe ...19957625796
[systemic cryptococcosis and pneumocystosis in an hiv-positive patient].cryptococcosis is one of the most common opportunistic infections in aids patients. neurological symptoms are the most frequent clinical presentation of this fungal infection, and pulmonary involvement is clinically much less evident. we report the case of a patient who was treated in the emergency room for acute respiratory failure but who did not survive. microbiologic and histopathologic studies demonstrated simultaneous pulmonary infections with cryptococcus neoformans and pneumocystis carin ...19957627427
pentamidine congeners. 3. crystal structure and molecular modeling studies of trans-1,4-bis(4-amidinophenoxy)-2-butene.x-ray diffraction was used to confirm the geometry of trans-1,4-bis(4-amidinophenoxy)-2-butene dihydrochloride dihydrate (trans-butenamidine). trans-butenamidine is a semirigid analogue of pentamidine that has demonstrated good anti-pneumocystis carinii activity in rats. molecular modeling studies revealed that unlike pentamidine or propamidine, trans-butenamidine does not discriminate between at and ta sequences in its binding to the minor groove of dna. crystal data: [c18h22n4o2(2+)][cl(-)]2[h ...19957629735
2,4-diaminopyrido[3,2-d]pyrimidine inhibitors of dihydrofolate reductase from pneumocystis carinii and toxoplasma gondii.six previously unknown 2,4-diamino-6-(anilinomethyl)- and 2,4-diamino-6-[(n-methylanilino)-methyl]pyrido[3,2-d]pyrimidines (5-10) were synthesized from 2,4-diamino-6-(bromomethyl)-pyrido[3,2-d]pyrimidine hydrobromide (11.hbr) by treatment with the appropriate aniline or n-methylaniline in dimethylformamide at room temperature, with or without nahco3 present. compounds 5-10 were tested as inhibitors of dihydrofolate reductase from pneumocystis carinii, toxoplasma gondii, and rat liver as a part o ...19957629801
patterns of care for and outcomes of pneumocystis carinii pneumonia among persons with transfusion-acquired aids.the most common human immunodeficiency virus (hiv)-related cause of death in persons with transfusion-acquired (ta) aids has been pneumocystis carinii pneumonia (pcp). while better treatment for pcp accounts for improved survival among hiv-infected homosexual or bisexual men, the extent to which others have benefitted from these developments is unknown.19957631408
pleural effusions in human immunodeficiency virus-infected patients. correlation with concomitant pulmonary diseases.the objective of our study was to evaluate the prevalence of pleural effusions in patients with the acquired immunodeficiency syndrome, to correlate these effusions with any concomitant pulmonary diseases and to evaluate the role of cytologic examination in the diagnosis of the effusions. twenty-eight of 389 (7.2%) human immunodeficiency virus-infected patients had pleural effusions and 27 of the 28 were suffering from concomitant pulmonary diseases. those diseases were bacterial pneumonia (9), ...19957631543
case report: vitamin d-mediated hypercalcemia in fungal infections.hypercalcemia has been well described in a variety of neoplastic and granulomatous diseases. one mechanism for this hypercalcemia is via the excess production of 1,25-dihydroxyvitamin d from extra-renal sources. the authors describe an aids patient infected with cryptococcus neoformans who had suggestive evidence of vitamin d-mediated hypercalcemia. he had an elevated serum 1,25-dihydroxyvitamin d value, a normal 25-hydroxyvitamin d value, and low values for parathyroid hormone and parathyroid h ...19957631647
corticosteroid therapy for pneumocystis carinii pneumonia in children with human immunodeficiency virus infection. 19957633553
carboxypeptidase m activity is increased in bronchoalveolar lavage in human lung disease.carboxypeptidase m (cpm) cleaves the c-terminal arginine and lysine of peptides; it is expressed in the lung, especially on the plasma membrane of alveolar type i cells. here, we report on cpm in human bronchoalveolar lavage (bal) collected from 69 patients and analyzed for activity, cell number and type, and protein level. seventy-six percent of cpm activity, measured at ph 7.5 with 5-dimethylamino-naphthalene-1-sulfonyl-alanyl-arginine (dansyl-ala-arg) substrate, was immunoprecipitated with po ...19957633739
does cytomegalovirus predict a poor prognosis in pneumocystis carinii pneumonia treated with corticosteroids? a note for caution.to examine the importance of cytomegalovirus (cmv) in bronchoalveolar lavage (bal) fluid of patients with hiv-associated pneumocystis carinii pneumonia (pcp) treated with adjunctive corticosteroids (cs).19957634876
serum lactate dehydrogenase (ldh) in pneumocystis carinii pneumonia, tuberculosis, and bacterial pneumonia.an increase in serum lactate dehydrogenase (ldh) activity is commonly taken to support the presumptive diagnosis of pneumocystis carinii pneumonia (pcp), although the ldh level may also be increased in other lung infections and in a variety of extrapulmonary disorders. to assess its diagnostic value in patients with fever, lung infiltrates, and a high prevalence of hiv infection, we compared ldh levels in 42 hospitalized patients with pcp, 71 with disseminated tuberculosis (tb), 40 with pulmonar ...19957634877
pulmonary complications associated with illicit drug use. an update.in earlier years, nonopportunistic infectious pulmonary complications of illicit drug use were most common. we designed this study to update the pulmonary complications associated with illicit drug use in the 1990s.19957634884
sociodemographic characteristics of hiv infection in northern india.134 patients testing positive for hiv antibody during the period 1986-1993 were included in the present study. an in-depth analysis of the subjects revealed that the adult males seemed to have the highest propensity for hiv infection in this part of the country. marital status had no bearing on incidence and route of seropositivity. this was not so in females. extramarital heterosexual contact was the mode of hiv acquisition in adults in contrast to blood transfusion in children. clinically, mos ...19957636144
evolution of pulmonary hiv-1 infection in a patient with pneumocystis carinii pneumonia. 19957638374
prognostic factors influencing the outcome in pneumocystis carinii pneumonia in patients with aids.studies attempting to identify the prognostic factors that influence the outcome of pneumocystis carinii pneumonia (pcp) in patients with aids using a multivariate analysis are few. in order to identify those prognostic factors amenable to medical intervention, univariate and multivariate analyses were performed on 102 patients with aids suffering a first episode of pcp.19957638811
pulmonary pathohistological changes in mice in experimental infection with pneumocystis carinii.the infection pneumocystis carinii was activated in mice of closely related balbc/anncr, c57bl/6 and dba/2 strains applying various doses of hydro-cortisone-acetate in combination with hypoprotein or complete food. the males of all investigated strains showed to be more sensitive than the females and the longest survived mice of c57bl/6 strain. the character of pathohistological pulmonary changes varied depending on the duration of survival. the mature cyst forms of pneumocystis carinii were con ...19957638948
[cause of death after liver transplantation: an analysis of 41 cases in 382 patients].the aim of this study was to analyse the causes of death after liver transplantation in order to find and to avoid preventable fatal complications if possible.19957639030
parasitic infections associated with hiv/aids in the caribbean.this review article seeks to highlight the significance for the caribbean of major parasitic infections associated with aids, encourage awareness of these opportunistic parasites, and promote familiarity with appropriate diagnostic techniques and their clinical relevance. specific agents considered include pneumocystis carinii; toxoplasma gondii; the enteric coccidians cryptosporidium spp., isospora belli, and cyclospora cayetanensis; the hemoflagellates leishmania spp. and trypanosoma cruzi; th ...19957640691
human immunodeficiency virus infection in children.the transmission, diagnosis, and clinical manifestations of human immunodeficiency virus (hiv) infection in children up to 13 years of age are reviewed, and maintenance and prophylactic drug therapies for these patients are discussed. hiv can be transmitted from mother to infant in utero, during delivery, or through breast milk. perinatal transmission accounts for almost 90% of all pediatric hiv infections. hiv infection can be diagnosed with hiv culturing, polymerase chain reaction testing, the ...19957641035
respiratory effects of occupational exposure to aerosolized pentamidine.to determine the respiratory effects on health care workers of occupational exposure to aerosolized pentamidine (ap) used for the prophylaxis of pneumocystis carinii pneumonia, we designed a clinical prospective study using subjects as their own controls. sixteen health care workers whose job duties included administration of ap at one or more of nine san francisco bay area medical centers participated in the study. pentamidine concentrations ranged in breathing zone samples from < 0.03 to 62.2 ...19957655955
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