Publications

modification of the fungi-fluor and the genetic systems fluorescent antibody methods for detection of pneumocystis carinii in bronchoalveolar lavage specimens.	four hundred forty-five bronchoalveolar lavage specimens from patients with the human immunodeficiency virus were preserved in saccomano's fixative and stained for pneumocystis carinii cysts by a modified method with fungi-fluor solution a (polysciences, warrington, pa) and the genetic systems pneumocystis carinii immunofluorescence antibody (genetic systems corp, seattle, wash). the majority of patients had been treated for suspected p carinii pneumonia for a few days prior to collection of bro ...	1995	7531427
analysis of pneumocystis carinii organism burden, viability and antigens in bronchoalveolar lavage fluid in aids patients with pneumocystosis: correlation with disease severity.	we examined 96 bronchoalveolar lavage fluid (balf) specimens from aids patients with proven pneumocystis carinii pneumonia (pcp) in order to compare the relationship of organism burden, viability and antigen expression with disease severity at the time of clinical presentation.	1994	7531457
genetic diversity in human-derived pneumocystis carinii isolates from four geographical locations shown by analysis of mitochondrial rrna gene sequences.	the opportunistic fungal pathogen pneumocystis carinii is a frequent cause of pneumonia in immunocompromised hosts. in this study, we have compared the dna sequences of a portion of the mitochondrial large-subunit rrna gene of p. carinii (an informative locus showing up to 27% differences among isolates of p. carinii from human-, rat-, mouse-, ferret-, rabbit-, and horse-infected lungs) obtained from human-derived isolates from widely disparate geographical areas, including britain, the united s ...	1994	7533779
a novel in situ model to study pneumocystis carinii adhesion to lung alveolar epithelial cells.	pneumocystis carinii, an extracellular parasite thriving in the lungs of immunosuppressed mammals, is a major cause of death in aids patients in the usa. as a prelude to growth, the parasite adheres mostly to type i pneumocytes lining the alveolar spaces. the mechanism of adherence remains unknown, largely because of difficulties in isolating type i pneumocytes and maintaining them in vitro. as a first step to understand p. carinii adherence to its natural substrate, we developed an in situ meth ...	1994	7508475
evaluation of the sensitivity, specificity, and predictive value of monoclonal antibody 3f6 for the detection of pneumocystis carinii pneumonia in bronchoalveolar lavage specimens and induced sputum.	the sensitivity and specificity of different staining procedures for the detection of pneumocystis carinii organisms were compared. three conventional stains (papanicolaou, giemsa and grocott's) and one immunocytochemical stain using 3f6 antibody were used on smears prepared from the same specimen. bronchoalveolar lavage (bal) and induced sputum (is) specimens were used for this purpose. one hundred and sixty-five episodes from 142 patients were investigated by the four different staining techni ...	1994	7518707
molecular characterization of clustered variants of genes encoding major surface antigens of human pneumocystis carinii.	a 13-kb genomic fragment from human pneumocystis carinii was cloned as repetitive dna. the fragment contains a cluster of three related genes, each 3 kb in size, and the 5' end of a fourth gene. the predicted polypeptide of the first gene in the cluster comprises 1,030 amino acid residues with a total molecular mass of 116 kda. the gene's predicted amino acid sequence bears 32% identity to predicted sequences of recently described gene fragments of ferret p. carinii, which encode an immunodomina ...	1994	7518806
safety profile of didanosine among patients with advanced hiv disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program.	the aim of this study was to ascertain the safety profile of didanosine (videx; ddi) within the canadian open treatment program. symptomatic hiv+ subjects with aids or arc or cd4 < 200/mm3 were eligible to receive didanosine if they were either (a) intolerant to zidovudine (retrovir, zdv) or (b) deteriorating despite zdv therapy. the dose of didanosine (powder formulation) was based on body weight as follows: > or = 75 kg, 375 mg b.i.d.; 50-74 kg, 250 mg b.i.d.; 35-49 kg, 167 mg b.i.d. participa ...	1994	7519674
gene for an extracellular matrix receptor protein from pneumocystis carinii.	an initial and crucial step in the establishment of many microbial infections is the attachment of the pathogen to the host cells. thus, adherence of pneumocystis carinii (pc) to type i pneumocytes is believed to be important in the induction of pc pneumonia. little is known about the nature of the attachment of pc to type i cells, although extracellular matrix (ecm) proteins, such as fibronectin and laminin, have been implicated in the process. we report here the isolation of a pc gene encoding ...	1994	7519777
pneumocystis carinii: recognition of the infection in albino rats using different stains.	pneumocystis carinii is a commensal protozoan which may cause pneumonia in hosts with compromised immune status and may end fatally. since effective management of pneumocystic pneumonia depends on rapid and accurate recognition of the disease, so, the present study aims to throw lights on the best staining method for cytodiagnosis of this organism with the sequential pathological changes in the infected lungs. an immunosuppression state was induced in albino rats for 6-8 weeks then rats were sac ...	1994	7521380
comparison of pneumocystis carinii detection by toluidine blue o staining, direct immunofluorescence and dna amplification in sputum specimens from hiv positive patients.	pneumocystis carinii pneumonia (pcp) is the commonest opportunistic infection in aids patients. by using the polymerase chain reaction (pcr), specific dna sequences can be amplified and used in diagnosis of infections such as pcp where the causative pathogen is both difficult to grow and present in low numbers. twenty hiv positive patients were investigated for pcp. twenty sputa (15 induced and 5 expectorated) had toluidine blue o staining, direct immunofluorescence and pcr performed for pneumoc ...	1994	7522318
pneumocystis carinii: antigenic, immunological, and molecular characterization.		1994	7523034
utility of gomori methenamine silver stains in bronchoalveolar lavage specimens.	bronchoalveolar lavage (bal) with gomori methenamine silver (gms) stain is commonly used to detect pneumocystis carinii and fungal organisms as causes of infectious pulmonic disease in immunosuppressed patients. however, several reports have indicated that gms stains are not any more sensitive than conventional cytologic stains in detecting pneumocystis organisms in select patient populations, such as those with acquired immunodeficiency syndrome (aids). to examine the utility of gms stains in o ...	1994	7524071
an evaluation of four methods for the detection of pneumocystis carinii in clinical specimens.	we undertook a prospective evaluation of 4 methods for the detection of pneumocystis carinii in clinical specimens and compared an indirect immunofluorescence assay (ifa) (diagnostics pasteur), and a fluorescent whitening agent (fwa) (blankophor ba 267%, bayer, australia) with our standard methenamine silver (meag) and toluidine blue o (tb) stains. two hundred and two specimens were received from 162 patients (133 hiv infected, 19 heart or heart-lung transplant recipients, and 10 "miscellaneous" ...	1994	7527514
attitudes to prevention among hiv-infected patients: the case of specific prophylaxis for pneumocystis carinii pneumonia.	despite a consensus on the need for pneumocystis carinii pneumonia (pcp) prophylaxis for hiv-infected patients with fewer than 200 cd4+ lymphocytes/mm3, the number of cases of pcp has remained stable, and about 70% involve patients who are not receiving prophylaxis. the aim of this study was to determine why these patients are not covered by prophylaxis. it was based on a retrospective analysis of semidirective interviews with 32 patients who developed pcp while not receiving prophylaxis. the re ...	1994	10134582
the changing clinical features of hiv-1 infection in the united kingdom.	despite advances in antimicrobial and anti-retroviral treatment in the past decade, the natural history of hiv-1 infection remains largely unchanged. clinical monitoring has led to the introduction of effective prophylaxis of pneumocystis carinii pneumonia and has facilitated the early detection and treatment of opportunistic infections. pneumocystis carinii pneumonia now makes up a smaller proportion of first aids defining diagnoses than before prophylaxis was introduced. the proportion made up ...	1994	10884858
changes in insurance status and access to care for persons with aids in the boston health study.	the purpose of this study was to measure unmet needs and changes in insurance status for persons with acquired immunodeficiency syndrome (aids). thirty-six percent of the study's boston-area respondents (n = 305) had a change in insurance coverage between aids diagnosis and interview. medicaid coverage increased from 14% to 41%. pneumocystis carinii pneumonia prophylaxis was nearly universal. only 5% did not receive zidovudine, and intravenous drug users were at higher risk. approximately 14% to ...	1994	7998646
a survey of birds in denmark for the presence of pneumocystis carinii.	one hundred eighty-three toluidine blue o-stained necropsy lung imprint smears from different avian species were examined microscopically for pneumocystis carinii. no cyst forms of the organism could be identified. seventy-eight serum samples from a total of 155 chickens were examined by a competition enzyme-linked immunosorbent assay (elisa) for antibodies to p. carinii; 53 serum samples were from individual chickens, and 25 samples were pools of sera from two to five chickens. diluted 1:50, th ...	1994	8002876
pulmonary disease associated with the human immunodeficiency virus in kigali, rwanda. a fiberoptic bronchoscopic study of 111 cases of undetermined etiology.	all human immunodeficiency virus type 1 (hiv-1) infected adult patients referred to the division of pulmonary diseases of the centre hospitalier de kigali, rwanda for evaluation of a pulmonary disease of undetermined etiology (pdue) were investigated by fiberoptic bronchoscopy using both bronchoalveolar lavage (bal) and transbronchial biopsy (tbb). during a 10-mo period 111 hiv-1 infected patients with pdue were examined, of whom 47 (42%) fulfilled the world health organization (who) clinical ca ...	1994	8004318
diffuse thallium lung uptake in pneumocystis carinii pneumonia.	five patients with aids with pneumocystis carinii pneumonia (pcp) showed diffuse bilateral lung uptake on sequential thallium and gallium scans. this creates a problem in the sequential use of these tests for the differentiation of kaposi's sarcoma from acute inflammatory or other malignant diseases. in kaposi's sarcoma, thallium uptake is usually focal and not diffuse unless associated with other pathology. however, in pcp the diffuse thallium lung uptake may be due to congestion, increased vas ...	1994	8004857
local antibodies against pneumocystis carinii in bronchoalveolar lavage fluid.	pneumocystis carinii pneumonia (pcp) is a frequent cause of pneumonia among human immunodeficiency virus (hiv)-infected patients. little is known, however, about the role played by humoral immunity to control the infection. this study was undertaken to elucidate the role played by local antibodies. bronchoalveolar lavage (bal) fluids from 18 acquired immune deficiency syndrome (aids) patients with pcp, 20 hiv-antibody positive patients without pcp, and 20 lung cancer patients were examined for a ...	1994	8005248
[scintigraphy with gallium-67 citrate in patients with aids: pathologic extrapulmonary uptake].	67gallium citrate can accumulate in different inflammatory and neoplastic lesions. the mechanisms of 67gallium uptake in abnormal tissue are still partially unknown and the tracer is considered a nonspecific indicator of disease. in aids patients, 67gallium citrate is used in the diagnosis and characterization of opportunistic pulmonary infections and especially of pneumocystis carinii pneumonia. from june 1989 through december 1992 in our department 140 67gallium scans were performed on 103 aid ...	1994	8008901
[pneumococcal endocarditis and pneumocystis carinii pneumonia in a patient with hiv infection].		1994	8008937
impairment of exercise capacity in various groups of hiv-infected patients.	it is known that pulmonary function is impaired during the course of hiv infection even in early stages. in order to estimate the resulting reduction of exercise capacity, different groups of hiv patients were investigated. group 1 consisted of 20 patients without a history of respiratory disease and without actual lung disease, group 2 of 18 patients with a former episode of pneumocystis carinii pneumonia (pcp) without actual lung disease, and group iii of 37 patients with different broncho-pul ...	1994	8008992
higher socioeconomic status is associated with slower progression of hiv infection independent of access to health care.	in order to identify socioeconomic characteristics associated with slower progression of hiv infection, we conducted a nested case-control study within a cohort of 729 homosexual men. the study compared non-progressors (defined as subjects who, at a follow-up visit during the period october 1989-december 1990, had been hiv positive for at least 5 years, had a cd4 count > 0.5 x 10(9)/l, had a karnofsky score of 100%, were at centers for disease control (cdc) stage iii or less, and had never recei ...	1994	7904296
[pneumocystis carinii pneumonia during therapy with 2-chlorodeoxyadenosine (2-cda)].	we report the case of a 70-year-old patient with b-cell chronic lymphocytic leukemia. during therapy with the new purine analog 2-chloro-deoxyadenosine (2-cda) the patient developed pneumocystis carinii pneumonia (pcp). although the mechanism of action of 2-cda suggests the incidence of opportunistic infections and therefore pneumocystis pneumonia, this is the first case of pcp among 140 patients of the swiss study of 2-cda. the mechanism of action of 2-cda is described and the occurrence of pcp ...	1994	7905206
severity and outcome of pneumocystis carinii pneumonia (pcp) in patients of known and unknown hiv status.	of 170 western australian patients who had their first aids-defining illness between 1 january 1983 and 31 december 1991, 61 (36%) were of unknown hiv antibody status (aids presenters), while 109 (64%) were of known hiv antibody status (hiv presenters). pneumocystis carinii pneumonia (pcp) was less common as the aids-defining illness in hiv presenters (41% versus 62%, p = 0.005). in this study of 70 patients with pcp as the index aids diagnosis, 36 were hiv presenters and 34 were aids presenters ...	1994	7905524
cd4 t cell count as predictor of pneumocystis carinii pneumonia in children born to mothers infected with hiv. european collaborative study group.	to assess the value of cd4 t cell count in predicting pneumocystis carinii pneumonia in infants born to mothers infected with hiv, with reference to the guidelines from the centers for disease control on prophylaxis against pneumocystis.	1994	7907246
changes in aids survival time in two san francisco cohorts of homosexual men, 1983 to 1993.	during the first decade since the recognition of the acquired immunodeficiency syndrome (aids), new therapies have been introduced and the frequency of clinical manifestations has changed. the impact of these changes on aids survival, however, has not been well characterized.	1994	7908703
nih conference. recent advances in the management of aids-related opportunistic infections.	secondary infections remain the leading cause of death in patients with the acquired immunodeficiency syndrome (aids). dealing with the rapidly evolving spectrum of infectious problems seen in patients with aids requires knowledge of current therapeutic and prophylactic strategies. through an extensive preclinical trials network supported by both industry and government, an increasing number of new agents are being identified and rapidly moved into clinical trials. several agents are now availab ...	1994	7909657
preventive care among hiv-positive patients in a general medicine practice.	we randomly selected a cohort of human immunodeficiency virus (hiv)-positive patients from a large university-based general medicine practice to determine how often recommended disease prevention services are received. we used a standardized medical record review protocol to gather data from the records of 159 randomly selected hiv-positive adults followed in a university general medicine practice. we set 80% as the minimum acceptable rate of receipt of each recommended preventive service. withi ...	1994	7909673
survival differences in european patients with aids, 1979-89. the aids in europe study group.	to examine the pattern of survival and factors associated with the outcome of disease in patients with aids.	1994	7909698
tuberculosis in patients with hiv infection who receive corticosteroids for presumed pneumocystis carinii pneumonia.	to determine if the use of corticosteroids for presumed pneumocystis carinii pneumonia exacerbated undiagnosed tuberculosis or increased the likelihood of reactivation tuberculosis, we reviewed medical records of 144 hospitalized hiv-infected patients who received antipneumocystis therapy. ninety-four patients (group c) received corticosteroids and 50 patients (group nc) did not. one hundred and thirty-seven patients (97%) had acid-fast stains and mycobacterial cultures performed. group c and gr ...	1994	7911709
pneumocystis carinii pneumonia and tuberculosis in an human immunodeficiency virus-seronegative patient without evidence of the idiopathic cd4+ t lymphopenia syndrome.		1994	7912115
prophylaxis of opportunistic infections in persons with hiv infection.	morbidity and mortality associated with human immunodeficiency virus infection and the acquired immunodeficiency syndrome is most often related to associated opportunistic infections.	1994	7913002
efficacy of primary chemoprophylaxis against pneumocystis carinii pneumonia during the first year of life in infants infected with human immunodeficiency virus type 1.	to evaluate the efficacy of primary chemoprophylaxis in preventing pneumocystis carinii pneumonia (pcp) in infants with perinatal human immunodeficiency virus-1 infection during the first year of life, we conducted a retrospective chart review of infants with human immunodeficiency virus-1 infection born at new york university medical center-bellevue hospital center, in new york. between march 1989 and march 1993, 24 infants received primary chemoprophylaxis with trimethoprim-sulfamethoxazole in ...	1994	7915306
the aids epidemic.	the nature of the clinical presentation of hiv infection continues to evolve over time. new cutaneous (e.g., seborrheic dermatitis, onychomycosis, and tinea pedis) and systemic (e.g., aspergillus fumigatus and penicillium marneffei) opportunistic fungal infections can now be added to the classic clinical markers for progressive hiv infection, such as kaposi's sarcoma, pneumocystis carinii pneumonia, mycobacterium avium intercellulare infections, and cryptococcal meningitis. the fact that the app ...	1994	7915731
use of cd4 lymphocyte count to predict long-term survival free of aids after hiv infection.	to estimate the probability of remaining free of aids for up to 25 years after infection with hiv by extrapolation of changes in cd4 lymphocyte count.	1994	7916226
pneumocystis carinii pneumonia associated with concurrent cryptococcosis or toxoplasmosis in patients with aids.		1994	8054420
toxoplasma gondii infection in marrow transplant recipients: a 20 year experience.	twelve of 3803 consecutive marrow allograft patients treated at this center over the past 20 years have had a post-transplant tissue diagnosis of toxoplasmosis: 10 at autopsy and 2 by brain biopsy. this infection was identified in none of 509 autologous marrow recipients. occurrence of toxoplasmosis was 0.31 cases per 100 allogeneic transplants and 1.0 per 100 autopsies. an estimated 15% of allogeneic transplant recipients were seropositive for toxoplasma gondii and 2% of seropositive patients d ...	1994	8054907
plasma pentamidine concentrations vary between individuals with pneumocystis carinii pneumonia and the drug is actively secreted by the kidney.	the multiple-dose pharmacokinetics of pentamidine were studied in six aids patients with acute pneumocystis carinii pneumonia given infusions of pentamidine isethionate 3.7-4 mg/kg/day i.v. plasma and urine concentrations of pentamidine of repeated samples taken on days 1, 4 and 7 of treatment were assayed by hplc. creatinine clearance clcr was also determined. on day 7, the area under the plasma concentration versus time curve (auc) varied fourfold (3263 to 12776 nmol.h/l) between individuals. ...	1994	8056699
[risk of nosocomial pneumocystis carinii pneumonia in immunosuppressed patients non-infected by human immunodeficiency viruses].	we report four cases of pneumocystis carinii pneumonia (pcp) in human immunodeficiency virus (hiv)-seronegative patients. two of them had been hospitalized for polymyositis treatment near aids patients, respectively 1 and 4 months before pcp. the two others suffered from localized cancer. their evolution was complicated by respiratory distress and death in two of them. a telephone survey among 19 hospital units yielded nine cases of similar patients. they were only observed in wards caring for a ...	1994	8059128
laboratory diagnosis and occurrence of pneumocystis carinii.	pneumocystis carinii is an opportunistic pathogen causing life threatening pneumonia (pcp) in immunosuppressed patients and particularly among aids patients. whether the infection results from reactivation or reinfection is debated. since methods for in vitro cultivation still are not successful, the diagnosis is dependent on direct demonstration of the organism in respiratory specimen. in this thesis laboratory diagnostic methods in terms of staining, sampling, antibody detection and dna amplif ...	1994	8059227
the aids epidemic among scandinavian women: 1980-1990.	to describe trends and patterns in the aids epidemic among scandinavian women with aids.	1994	8060549
the changing spectrum of aids index diseases in canada.	to describe the changing spectrum of aids index diseases in canada over a 10-year period from 1981 to 1991.	1994	8060550
the role of bronchoscopy in patients with hiv disease.	pulmonary involvement is a frequent feature of patients infected with the human immunodeficiency virus (hiv). pneumocystis carinii pneumonia (pcp) is still the commonest aids defining diagnosis despite the advent of effective prophylaxis and antiretroviral treatment. other pulmonary manifestations of aids, including tuberculosis, may pose a greater problem in the future. the clinical manifestations of hiv-disease are many and varied, and changing as the disease is modified by therapeutic interve ...	1994	8061087
simultaneous determination of primaquine and carboxyprimaquine in plasma using high-performance liquid chromatography with electrochemical detection.	a selective and sensitive high-performance liquid chromatographic method with electrochemical detection is described for the simultaneous quantitation of primaquine and carboxyprimaquine, its primary metabolite, in plasma. after addition of internal standard, plasma was deproteinized by addition of acetonitrile. nitrogen-dried supernatants, resuspended in mobile phase were analyzed on a c8 reversed-phase column. limits of detection for primaquine and carboxyprimaquine were 2 and 5 ng/ml with qua ...	1994	8061837
pulmonary deposition of aerosolised pentamidine using a new nebuliser: efficiency measurements in vitro and in vivo.	the therapeutic efficacy of nebulised pentamidine in the prophylaxis of pneumocystis carinii pneumonia (pcp) depends on the absolute pulmonary deposition of the drug. we studied the performance of a new nebuliser (pentasave) by comparison both in vitro and in vivo with a standard nebuliser (respirgard ii). in vitro, deposition of pentamidine labelled with technetium-99m human serum albumin was measured indirectly by capturing inhaled particles on an absolute filter and measuring radioactivity wi ...	1994	8062844
a molecular model of the folate binding site of pneumocystis carinii dihydrofolate reductase.	the inhibition of pneumocystis carinii dihydrofolate reductase (dhfr) continues to be the major treatment strategy for p. carinii pneumonia (pcp). the design of new anti-pneumocystis agents would be significantly enhanced by the availability of a 3d model of the methotrexate (mtx) binding site of the p. carinii dhfr. however, an x-ray crystal structure of the p. carinii dhfr is not yet available. alignment of the amino acid sequences of p. carinii and lactobacillus casei dhfrs indicates that the ...	1994	8064329
ultrastructural demonstration of a pore in the cyst wall of pneumocystis carinii.	the proposed life cycle of the opportunistic organism pneumocystis carinii (pc) includes the formation of a thick-walled cyst containing haploid progeny. the progeny cells mature within the cyst and are somehow released, leaving a collapsed empty cyst behind. pneumocystis carinii cysts containing 8 intracystic bodies (icb) as well as empty collapsed cysts have been commonly observed. in this study a single pore in the cyst walls of pc was observed by transmission electron microscopy in infected ...	1994	8064534
[pneumocystis carinii pneumonia in hiv-infected patients examined by bronchoscopy during the period 1989-1991].	we analyzed prospectively collected data from 211 hiv-infected patients who underwent bronchoscopy because of pulmonary symptoms during the period 1989-1991. we found an improvement in survival for patients diagnosed with pneumocystis carinii pneumonia (pcp) in 1991 as compared to 1989 and 1990 (log rank test: p = 0.07). a significant decline in po2 and cd4 cell count was observed in patients with pcp in the same period (p < 0.05 and 0.005 respectively). we suggest that the decline in cd4 cell c ...	1994	8066923
levels of dapsone and pyrimethamine in serum during once-weekly dosing for prophylaxis of pneumocystis carinii pneumonia and toxoplasmic encephalitis.	concentrations of dapsone, monoacetyldapsone, and pyrimethamine were determined in 36 serum samples from human immunodeficiency virus-infected patients on prophylaxis with once-weekly administration of dapsone-pyrimethamine (200 mg of dapsone-75 mg of pyrimethamine). during day 1 after ingestion, median levels of 1,038 ng of dapsone per ml and 356 ng of pyrimethamine per ml were found. during days 6 to 7, the dapsone level fell to < 20 ng/ml in five of nine serum samples, but the pyrimethamine l ...	1994	8067765
iron chelators as therapeutic agents against pneumocystis carinii.	iron plays a critical role in host-parasite interactions, and iron chelators have been demonstrated to serve as effective adjunct therapeutic agents against malaria. the effects of the parenteral iron chelator deferoxamine (dfo) on the growth of rat-derived pneumocystis carinii were studied in a human fibroblast cell culture model and in two in vivo models of experimental infection. in addition, the effects of the investigational oral iron chelator cp20 and its 3-hydroxypyridin-4-one analogs cp5 ...	1994	8067783
prevention of pneumocystis carinii pneumonia in children with cancer.		1994	8068112
pneumocandin d0, a new antifungal agent and potent inhibitor of pneumocystis carinii.	pneumocandin d0 (9), a new member of the echinocandin class of antifungal agents, has been isolated as a minor constituent from fermentation broths of the filamentous fungi zalerion arboricola (atcc 20957). the structure of 9 has been determined mainly on the basis of spectroscopic analysis and by comparison with published data for similar compounds. to date, pneumocandin d0 has been found to be the most potent inhibitor of pneumocystis carinii development in vivo within the natural-occurring ec ...	1994	8071120
limitations of and indications for the use of co-trimoxazole.	co-trimoxazole is still widely used for indications where trimethoprim alone is equally effective. microbiological and pharmacokinetic considerations reveal that trimethoprim alone provides adequate anti-microbial activity for treatment of conditions for which co-trimoxazole is often given. synergy may be shown in vitro, but in clinical practice is an unusual occurrence. there is no evidence from clinical studies that the sulphonamide moiety fo co-trimoxazole prevents the development of resistan ...	1994	8071675
[heart and aids].	although pulmonary and central nervous symptoms prevail before death, autopsy often reveals marked myocardial alterations in aids patients. this discrepancy prompted us to systematically study cardiac alterations in 100 sequential autopsies of patients who died of aids. we appraised the results in relation to changes noted in other organ systems, and compared our data with the aids-associated cardiac alterations described in the literature. cardiac lesions were present in more than 50% of our pa ...	1994	8073231
[sputum examination in the diagnosis of pneumocystis carinii pneumonia in hiv-infected patients].	to assess the sensitivity and negative predictive value of sputum examination for pneumocystis carinii in hiv-positive patients, follow-ups were performed in hiv-infected patients who had been investigated for the presence of pneumocystis carinii (376 examinations of sputum and 71 bronchoalveolar lavages). pneumocystis carinii pneumonia was diagnosed 65 times in 64 patients (57 male and 7 female, median age 35 [23-67]years). in 52% of the cases (n = 34) the pathogen was identified in the sputum, ...	1994	8076502
experimental evaluation of combined prophylaxis against murine pneumocystosis and toxoplasmosis.	prophylactic efficacy of antimicrobial agents against pneumocystosis and toxoplasmosis was examined in a model of concurrent pneumocystis carinii and toxoplasma gondii infections in rats. corticosteroid-treated rats naturally infected by p. carinii were challenged with the rh strain of t. gondii. infection was assessed by counting p. carinii cysts in lung and by titration of t. gondii in tissues by tissue culture. untreated rats died after challenge, with p. carinii infection in lungs and t. gon ...	1994	8077724
appropriate and inappropriate prescribing of narcotics for ambulatory hiv-positive patients.	to assess the appropriateness of narcotic-prescribing practices in an ambulatory clinic for patients infected with hiv.	1994	8077993
sequence-selective binding to dna of cis- and trans- butamidine analogues of the anti-pneumocystis carinii pneumonia drug pentamidine.	footprinting experiments using both dnase i and methidium propyl-edta.fe(ii) have been used to investigate the sequence selectivity in binding to dna of pentamidine and four butamidine analogues active against the pneumocystis carinii pathogen, which afflicts patients with acquired immunodeficiency syndrome. in common with pentamidine, the butamidine drugs, which contain cis- or trans-1,4-but-2-ene linkers and either bis(amidine) or bis(imidazolidine) terminal groups, bind selectively to dna seq ...	1994	8078493
crossover of placebo patients to intravenous immunoglobulin confirms efficacy for prophylaxis of bacterial infections and reduction of hospitalizations in human immunodeficiency virus-infected children. the national institute of child health and human development intravenous immunoglobulin clinical trial study group.	after completion of a placebo-controlled trial of intravenous immunoglobulin (ivig) infection prophylaxis, patients were offered open label ivig and optional participation in a follow-up study. the purpose of the follow-up study was to evaluate the ivig effect in original placebo recipients and longevity of ivig benefit in original ivig recipients. of 212 human immunodeficiency virus-infected children on study at trial closure, 148 (67 of 98 (68%) placebo and 81 of 114 (71%) ivig patients) recei ...	1994	8078734
evolving trends revealed by autopsies of patients with the acquired immunodeficiency syndrome. 565 autopsies in adults with the acquired immunodeficiency syndrome, los angeles, calif, 1982-1993 [corrected].	to determine changes in causes of death, survival, and organ system distribution of major opportunistic infections and neoplasms in adults dying with the acquired immunodeficiency syndrome (aids) following the widespread use of antiretroviral therapy and prophylaxis for opportunistic infections since 1988.	1994	8080357
soluble cd8 and cd25 in serum of patients after heart transplantation.	to evaluate the diagnostic value of serum cytokine levels and cytokine receptor levels in the diagnosis of acute rejection after heart transplantation, we measured soluble cd8 and soluble cd25 in the serum of heart transplant recipients. the results were compared with endomyocardial biopsy (emb) histopathology, lymphocyte activation by morphologic inspection of peripheral blood cells (cytoimmunologic monitoring), clinically manifested infections, and the maintenance immunosuppressive therapy. si ...	1994	8082307
transthoracic needle aspiration in the study of pulmonary infections in patients with hiv.	to evaluate the safety and efficacy of transthoracic aspiration with an ultrathin needle in the microbiologic diagnosis of pulmonary infections in hiv-infected patients.	1994	8082342
[polymerase chain reaction assay for the diagnosis of pneumocystis carinii and cytomegalovirus pneumonia].	we evaluated the utility of the polymerase chain reaction (pcr) method in detecting pneumocystis carinii (pc) and cytomegalovirus (cmv) in bronchoalveolar lavage (bal) specimens from patients suspected of having opportunistic infection of the lung. we evaluated bal samples obtained from 41 immunosuppressed patients who had signs and symptoms of acute lower respiratory tract infection. in addition, we studied 16 immunocompetent patients. pc-dna was detected in 19 cases and cmv-dna was detected in ...	1994	8084099
early onset of pneumocystis carinii pneumonia in a patient receiving bone marrow transplantation from a matched unrelated donor.		1994	8019447
the relationship between type of care planning system and patient outcomes in hospitalized aids patients.	the purpose of this study was to describe the problems of hiv-infected patients, hospitalized for pneumocystis carinii pneumonia (pcp), as documented in the nursing care plan and to examine differences in the number and type of activated patient problems and patient outcomes between manually generated, computer-supported, and standardized care planning systems. of the sample, 22% had no care plan. in the computer-supported care planning system the fewest number of care plans were completed. the ...	1994	8021390
cystic pulmonary lesions in pneumocystis carinii infection.	thick-walled pulmonary cavities are an uncommon manifestation of pneumocystis carinii pneumonia (pcp). a case of pcp in a man with acquired immunodeficiency syndrome (aids) presenting with a thick-walled pulmonary cavity and multiple smaller pulmonary air cysts is described. all of these lesions showed dramatic healing with therapy. a brief review of the recent literature is also presented.	1994	8024510
opportunistic infection during treatment with low dose methotrexate.	two patients receiving low dose methotrexate, one with rheumatoid arthritis and the other with pityriasis rubra pilaris, developed disseminated histoplasmosis and mycobacterium avium intracellulare pneumonia, respectively. twenty-three cases of opportunistic infection in patients receiving low dose methotrexate have been reported previously, with pneumocystis carinii pneumonia being the most common infection (10 of 23, 43%). patients receiving low dose methotrexate are at risk for opportunistic ...	1994	8025760
[neutrophilia in the bronchoalveolar lavage of patients with aids and pneumocystis carinii pneumonia. reflections on its prognostic value in the spanish setting].	the prognostic value of neutrophilia (> 5%) in bronchoalveolar lavage (bal) in our context is studied in 21 patients with aids and pneumocystis carinii pneumonia. neutrophilia does not seem to be a good prognostic indicator in our context. we have found this condition, with a mean of 6 +/- 4%, in only 33% of our sample. the sensitivity of this parameter with respect to risk of death was very low (25%), while specificity was moderate (65%). in contrast with what has been reported in studies done ...	1994	8025785
cd4+ lymphocytopenia due to common variable immunodeficiency mimicking aids.	there are an increasing number of published reports of patients with acquired immunodeficiency without evidence of hiv infection, who have been labelled as having "idiopathic cd4+ lymphocytopenia". the case is reported here of a young man who presented with pneumocystis carinii pneumonia (pcp), cd4+ lymphopenia, and hypogammaglobulinaemia attributable to common variable immunodeficiency (cvid). the presentation of this condition, with many of the clinical and laboratory features of aids, highlig ...	1994	8027379
cytomegalovirus pneumonitis: spectrum of parenchymal ct findings with pathologic correlation in 21 aids patients.	to identify characteristic features of cytomegalovirus (cmv) pneumonitis at computed tomography (ct), particularly markers that may help differentiate cmv from pneumocystis carinii pneumonia.	1994	8029414
what is the role of t-lymphocytes with gamma/delta receptors in pneumocystis carinii pneumonia in aids patients?		1994	8031525
administration of aerosol pentamidine: a program design.	aerosol pentamidine (ap) is an fda-approved prophylaxis against pneumocystis carinii pneumonia (pcp) in hiv-infected individuals who have a cd4+ lymphocyte count less than 200/mm3, constitutional symptoms, or a previous history of the pneumonia. the university of washington medical center, a 450-bed tertiary care center, established a successful aerosol pentamidine treatment program, providing treatment in its special procedure nit. the authors present an overview of ap and discuss the role of i ...	1994	8032012
invasive pulmonary aspergillosis associated with low dose methotrexate therapy for rheumatoid arthritis: a case report of treatment with itraconazole.	opportunistic infections complicating low dose methotrexate therapy are rare, consisting predominantly of pneumocystis carinii pneumonia. we report a case of invasive pulmonary aspergillosis which developed in a patient being treated for seropositive rheumatoid arthritis with low dose methotrexate (5-7.5 mg weekly) for 8 years. the patient was successfully treated with itraconazole 200 mg daily for 6 months. this case adds to the growing evidence implicating low dose methotrexate with opportunis ...	1994	8032050
[thoracoscopic treatment of recurrent pneumothorax].	spontaneous pneumothorax (pno) is usually due to rupture of a small subpleural bleb into the pleural cavity and affects mainly young men. after simple drainage, recurrence occurs in about 50% of cases. the risk of recurrence increases after each new pno. secondary pno complicates an underlying pulmonary disease, especially chronic obstructive pulmonary disease with emphysema. a new form of secondary pno has emerged in the recent years in aids patients with pneumocystis carinii pneumonia. we have ...	1994	8034519
close association of pneumocystis carinii from infected rat lung with culture cells as shown by light and electron microscopy.	studies of the association of rat-origin pneumocystis carinii with culture cells were performed both to learn more about the role of cells in p. carinii culture and to evaluate additional cell lines in an effort to improve culture methods. proliferation of trophozoites of p. carinii from rat lung in cultures with six lung cell lines was demonstrated by light microscopic evaluations of both giemsa-stained and immune-specific-stained culture samples. scanning electron microscopy and transmission e ...	1994	8036234
a highly unusual combination of pulmonary pathogens in an hiv infected patient.	we report on a case with an unusual combination of pulmonary pathogens including pneumocystis carinii, rhodococcus equi and toxoplasma gondii in an hiv infected patient. the multiple microbiological procedures required to ascertain the etiological diagnoses of pneumonitis in hiv-seropositive subjects are discussed.	1994	8036478
spontaneous pneumocystis carinii infection in the dog with naturally acquired generalised demodicosis.		1994	8036776
adverse reactions to dapsone in persons infected with human immunodeficiency virus.	dapsone is used in prophylaxis for and treatment of pneumocystis carinii pneumonia. we present a case of stevens-johnson syndrome that was likely induced by administration of dapsone. a review of charts at the hiv treatment center of northwestern university (chicago) revealed that 40.3% of patients treated with trimethoprim-sulfamethoxazole could not tolerate the medication, while 25.2% of those treated with dapsone were intolerant of the drug. we also found a higher rate of adverse reactions to ...	1994	8038322
pneumocystis carinii pneumonia: relationship between cyst size and response to treatment.	pneumocystis carinii pneumonia is a common cause of death in patients with aids. diagnosis is based on cytological examination of smears prepared from induced sputum samples and bronchoalveolar lavage (bal) specimens which have been stained with methenamine silver. we have examined 46 bal/induced sputum specimens from patients who had clinical symptoms and signs suggestive of p. carinii pneumonia and measured the diameter of a minimum 100 cysts in each specimen. we found that cyst size correlate ...	1994	8038427
[spontaneous and iatrogenic pneumothorax in the adult. 217 personal cases].	this study is dedicated to the epidemiology of pneumothoraces (217 cases) during the last 8 years in an intensive care department where most patients were admitted for respiratory diseases. cases resulting from road-injury or surgery were excluded. spontaneous pneumothoraces accounted for 61.8% of the cases. among them, the most current etiology was idiopathic pneumothorax owing to small subpleural blebs, rarely leading to tension pneumothorax or hemapneumothorax. other causes were pulmonary emp ...	1994	8039003
gallium-avid painless thyroiditis in a patient with aids.	intense thyroidal ga-67 accumulation was seen in a man with aids imaged for suspected pneumocystis carinii pneumonia. concurrent tc-99m pertechnetate thyroid scanning demonstrated absent trapping, helping establish the diagnosis of painless thyroiditis. occult hyperthyroidism, and not pulmonary infection, may have been responsible for the patient's original presenting symptoms.	1994	8039315
cellular responses to a 55-kilodalton recombinant pneumocystis carinii antigen.	the host-parasite interaction in pneumocystis carinii pneumonia is poorly understood. in recent years, two major groups of p. carinii antigens have been identified. one class of antigens is characterized by a broad band of immunoreactivity between 45 and 55 kda in p. carinii derived from rats. this antigen complex is the p. carinii antigen most commonly found in respiratory tract specimens and most frequently recognized by the host immune response. the availability of a recombinant antigen has p ...	1994	8039919
the acquired immune deficiency syndrome: an overview for the emergency physician, part 1.	the acquired immune deficiency syndrome (aids) was recognized as a distinct entity in 1981. it began as a medical curiosity affecting only several dozen individuals in a restricted segment of the u.s. population. in the 12 years since its description, aids has become a pandemic affecting tens of millions with cases reported from all major countries. the illness is caused by a retrovirus, termed human immunodeficiency virus (hiv). it is a blood-borne disease with sexual, parenteral, and perinatal ...	1994	8040596
[a case of adult t cell leukemia complicated with strongyloidiasis and amplification of pneumocystis carinii dna in bronchoalveolar lavage fluid].	the patient was a 75-year-old male, who simultaneously showed symptoms of bacterial meningitis during steroid treatment for erythroderma and symptoms of respiratory failure. based on ground-glass shadows in both lungs on chest x ray, bronchoalveolar lavage (bal) was carried out and strongyloides was detected. in addition to strongyloidiasis, the patient was shown to have the complication of pneumocystis carinii (pc) pneumonia after pc dna was detected in bal fluid using a pcr assay. when other c ...	1994	8041045
[atypical radiological images in pneumocystis carinii infection in hiv-positive patients].	to assess the prevalence of atypical pcp patterns in aids patients, the chest films of 300 patients with clinical and laboratory diagnosis of pcp were reviewed. we considered as atypical patterns the finding of an asymmetric lesion, the involvement of apical regions, pleural effusion, hilar and/or mediastinal lymphadenopathy, parenchymal nodules and pneumatoceles. in some patients more than one of these patterns was found. atypical patterns were observed in 32% of cases and consisted of: unilate ...	1994	8041929
cytologic diagnosis of extrapulmonary pneumocystis carinii infection in pleural and ascitic fluid. report of a case in a patient with the acquired immunodeficiency syndrome.	we present a case of an extrapulmonary pneumocystis carinii infection in a human immunodeficiency virus-positive patient undergoing prophylactic treatment with pentamidine. the diagnosis was established in pleural and ascitic fluid, and the patient died before starting specific systemic treatment. we discuss the cytologic differences between pulmonary and extrapulmonary infections and the importance of careful screening for this pathogen in immunosuppressed patients.	1994	8042433
four different regimens for prevention of pneumocystis carinii pneumonia and toxoplasma encephalitis in hiv-infected patients.		1994	8043236
failure of pentamidine as prophylaxis for pneumocystis carinii pneumonia in hiv-infected children.		1994	8044270
the role of flexible bronchoscopy in children with aids: an update of the new york university experience.	the clinical courses of children with acquired immunodeficiency syndrome (aids) who underwent diagnostic flexible bronchoscopy at bellevue hospital from 1987-1992 were reviewed to determine the value of the procedure in patient management. twenty-eight children (age 13 days to 12 years) underwent 31 bronchoscopies for indications including respiratory distress, fever and abnormal chest radiograph. procedures were well tolerated. complications were limited to transient hypoxia and epistaxis. alth ...	1994	8045694
[effects of the 1987 revision of the definition for an aids case in switzerland].	aids cases diagnosed in switzerland after the revision of 1987 and reported to the swiss federal office of public health until 31.12.1992 were categorised according to whether they conformed to the diagnostic criteria valid before the revision (= "pre-87"-group) or only to the new criteria introduced with the revision (= "post-87"-group). compared to the "pre-87"-group, the proportion of injecting drug users was higher, the proportion of homosexual men was lower, the patients were younger and pn ...	1994	8048273
genetic diversity of pneumocystis carinii derived from infected rats, mice, ferrets, and cell cultures.	the degree of strain and/or species diversity among pneumocystis carinii isolates is unknown. as a first approach to the study of p. carinii genetic relatedness, we compared the pulsed field gel electrophoretic karyotypes of p. carinii derived from lung homogenates of three immunosuppressed host animals: rats transtracheally inoculated with p. carinii-infected mouse lung; and ferrets which developed reactivated latent p. carinii pneumonia. rat p. carinii propagated on hel299 cells was also exami ...	1994	8049685
a tandem repeat of rat-derived pneumocystis carinii genes encoding the major surface glycoprotein.	a fragment from the genome of rat-derived pneumocystis carinii was found to contain two msg genes arranged as a direct repeat. the sequences from one gene (msg b), the region between the two genes, and part of the second gene (msg a) were determined. the two msg genes were not identical in sequence. the open reading frames of msg a and msg b encode non-identical proteins, both of which are similar to that encoded by a previously published cdna. the msg b gene sequence showed no evidence of intro ...	1994	8049690
[usefulness of polymerase chain reaction method in the early diagnosis of pneumocystis carinii pneumonia].	we evaluated the sensitivity and specificity of polymerase chain reaction (pcr) method in the detection of pneumocystis carinii, and compared its clinical usefulness with that of a previous method, toluidine blue-o (tbo) staining in diagnosis of p. carinii pneumonia (pcp) using clinical samples such as sputum and bronchoalveolar lavage fluid (balf). using p. carinii obtained from balf of the infected rats, we showed that pcr showed 100 fold more sensitivity than tbo staining as indicated by the ...	1994	8051442
[antiphospholipid antibodies in human immunodeficiency virus infection].	the frequency, clinical significance and prognosis of the lupic anticoagulant and the anticardiolipin antibodies were analyzed in patients with the human immunodeficiency virus infection.	1994	8051959
[polycystic and cavernous course of pneumocystis carinii pneumonia in aids].	we observed a polycystic and cavitating presentation of pneumocystis carinii pneumonia as primary manifestation of aids in a patient with previously unknown hiv-infection. pneumocystis carinii was histologically proved by transbronchial biopsy but not by bronchoalveolar lavage. a nearly complete resolution of all pulmonary lesions could be achieved with cotrimoxazole. pneumocystis carinii must be considered in differential diagnosis of cystic and cavitating pulmonary disease in patients with unk ...	1994	8052588
morphogenesis in chronic pneumocystis carinii infection--discussion of three cases.	the clinical and histological features of three hiv1-positive patients are reported of whom two showed persistent focal lesions on serial chest x-rays without any demonstrable lesion on repeated bronchoscopies. the third patient presented with recurrent pneumothorax. by thoracoscopy peripheral lung tissue was obtained in all cases, showing localized histomorphological findings compatible with a prolonged interstitial reaction around pneumocystis carinii (pc) organisms and their breakdown product ...	1994	7893975
non-specific interstitial pneumonia (nip): immunohistologic screening of etiologic agents.	non-specific interstitial pneumonia (nip) occurs frequently in patients with hiv-infection. to elucidate the etiology of this pulmonary disorder, we searched for 13 different microorganisms in transbronchial biopsies from 15 patients with nip, 15 patients with pneumocystis carinii pneumonia (pcp) and 20 patients with lung diseases not related to hiv-infection using monoclonal antibodies and the apaap- or pap-technique for immunostaining. chlamydia trachomatis and parainfluenza iii were detected ...	1994	7893990
[the inhalational therapy of respiratory pathology].	the inhalation of aerosolized drugs for therapeutic purpose has been used for many years in respiratory diseases as asthma, chronic bronchitis, cystic fibrosis. therapeutic aerosols have the advantages to deliver active substances directly to the site of disease, without systemic side effects, to produce a more rapid clinical response, to avoid barriers to the absorption of drugs such as the gastrointestinal tract. we review the mechanisms and the site of lung deposition and the range of devices ...	1994	7885949