Publications

ultrastructural localization of monoclonal antibodies against pneumocystis carinii. differentiation between developmental stage and host origin.	the ultrastructural immunolocalization of target antigens recognized by two monoclonal antibodies against pneumocystis carinii was investigated using both human- and rat-derived organism. labelling was seen using both cryo electron microscopy and postembedding in epon after fixation in glutaraldehyde. the antibodies showed different host species- and developmental stage specificity. one of the antibodies reacted with the outer membrane of all developmental stages of human-derived but not rat-der ...	1994	7888158
dysregulation of interleukin 8, interleukin 10, and interleukin 12 release by alveolar macrophages from hiv type 1-infected subjects.	we examined the in vitro release of interleukin 8 (il-8), interleukin 10 (il-10), and interleukin 12 (il-12) by alveolar macrophages from normal volunteers and hiv-1-infected subjects. normal volunteers had very low levels of il-8 and il-10 and undetectable il-12 in the cell-free bronchoalveolar lavage fluid (balf). asymptomatic hiv-1-infected subjects had elevated levels of il-8 and il-10 in their balf, and hiv-1-infected subjects with nonspecific interstitial pneumonitis (nip) or infected with ...	1994	7888221
typing of pneumocystis carinii strains that infect humans based on nucleotide sequence variations of internal transcribed spacers of rrna genes.	small portions of the 18s and the 26s rrna genes, the entire 5.8s rrna gene, and internal transcribed spacers its1 and its2 (located between the 18s and 5.8s rrna genes and between the 5.8s and 26s rrna genes, respectively) of pneumocystis carinii that infect humans were cloned and sequenced. the nucleotide sequences of the 18s, 5.8s, and 26s rrna genes determined in the study were approximately 90% homologous to those of p. carinii that infect rats, while the sequences of its1 and its2 of p. ca ...	1994	7883876
preliminary results of pneumocystis carinii strain differentiation by using molecular biology.	the mode of pneumocystis carinii transmission is controversial. recent studies point to exogenous inoculation rather than reactivation, and person-to-person transmission has also been suggested. comparison of nucleotide sequences of the large-subunit mitochondrial rrna gene of p. carinii from human immunodeficiency virus-seropositive patients showed strain differences.	1994	7883899
outcome of toxoplasma gondii mismatches in heart transplant recipients over a period of 8 years.	donor-related infection due to toxoplasma gondii is a well-recorded complication of cardiac transplantation. in order to assess the efficacy of co-trimoxazole in small doses as prophylaxis for primary toxoplasma gondii infection in seronegative heart and heart-lung transplant recipients receiving organs from seropositive donors, we reviewed the serostatus and clinical outcome of all such mismatched transplants performed at our unit over a period of 8 years. of 310 transplants performed between m ...	1994	7884217
thrush and fever as measures of immunocompetence in hiv-1-infected men.	the occurrence of pneumocystis carinii pneumonia (pcp) in human immunodeficiency virus type 1 (hiv-1)-infected individuals with high cd4+ counts indicates poor immunologic function. thrush and persistent fever, easily recognized clinically, are potential measures of immunocompetence. this analysis establishes the complex interactions of cd4+ count, thrush, and persistent fever to predict the occurrence of pcp. analyses used 20,632 person visits from 2,568 hiv-1-seropositive homosexual or bisexua ...	1994	7965635
health care delivery, zidovudine use, and survival of women and men with aids.	the aim of this study was to define predictors of survival for women and men after aids diagnosis. we examined health care delivery and drug therapy in the year before aids diagnosis for continuously enrolled new york state medicaid beneficiaries with aids in 1988-1990. we examined the association of these factors with survival after aids diagnosis. of 1,077 women and 1,871 men, 60% of both gender groups were drug users. in both risk groups, women had more outpatient visits than men but were equ ...	1994	7965636
infections in bone marrow transplant recipients in south india--a post-mortem study.	a study of post-mortem material obtained from ten patients who had undergone bone marrow transplantation is presented. the cause of death in all patients was infection. six patients had fungal infection, two had bacterial infection and three had cytomegalovirus infection. pneumocystis carinii and tuberculous infections were not detected.	1994	7966537
clinicopathologic correlations of hiv-1-associated vacuolar myelopathy: an autopsy-based case-control study.	to determine the clinical correlates of hiv-1-associated vacuolar myelopathy (vm), we designed a case-control study based on 215 aids autopsies in which we examined the spinal cord. we defined a case as an individual dying with aids and with vm present at autopsy; we defined a control as an individual dying with aids without vm. vm was found in 100 of 215 (46.5%) autopsies, with no apparent temporal trends. a higher number of aids-defining illnesses was strongly associated with the likelihood of ...	1994	7969977
improved outcome for young children with aids, pneumocystis carinii pneumonia, and acute respiratory failure.	to describe the clinical course of children with acquired immunodeficiency syndrome, requiring mechanical ventilation secondary to pneumocystis carinii pneumonia, with respect to intensive care unit outcome, long-term survival after intensive care unit discharge, and possible predictors of outcome.	1994	7970917
pulmonary pathology in aids: atypical pneumocystis carinii infection and lymphoid interstitial pneumonia.		1994	7974327
[pulmonary infection with pneumocystis carinii in patients with malignant hematologic diseases].	the authors describe their experience with the diagnosis of pulmonary infection with pneumocystis carinii in patients with malignant diseases. in the course of three years they recorded a total of 16 such cases. all cases were diagnosed by bronchoalveolar lavage. the authors analyze in detail the clinical symptoms and radiological picture. attention is drawn to the fact that no finding is specific for the disease. the infection of pneumocystis carinii was combined in 13 cases with another infect ...	1994	7975363
[pulmonary infection with pneumocystis carinii].	the author present extensive review on pulmonary infection with pneumocystis carinii. he deals with the following aspects: history, pathophysiology, clinical picture and diagnosis. diagnostic methods used at present are described in great detail. therapy and prevention are not discussed.	1994	7975365
fulminant reexpansion pulmonary edema in a patient with aids.	a 23-year-old man with aids presented to the emergency department with recurrent spontaneous pneumothoraces secondary to recent pneumocystis carinii pneumonia. shortly after placement of bilateral pigtail catheters for chest reexpansion, he developed fatal unilateral reexpansion pulmonary edema. the association between p carinii pneumonia and pneumothorax, and the risk factors and pathophysiology of reexpansion pulmonary edema are reviewed. emergency physicians should recognize that reexpansion ...	1994	7978577
adverse cutaneous reactions to trimethoprim-sulfamethoxazole in patients with the acquired immunodeficiency syndrome and pneumocystis carinii pneumonia.	patients with the acquired immunodeficiency syndrome are predisposed to cutaneous drug reactions. the reasons are poorly understood and the circumstances in which such patients can be treated through hypersensitivity are a matter of discussion. we assessed the value of clinical and laboratory parameters for predicting trimethoprim-sulfamethoxazole-induced skin reactions and the effects of continued trimethoprim-sulfamethoxazole therapy in such patients. we retrospectively studied all episodes of ...	1994	7979438
detection of pneumocystis dna in nasopharyngeal aspirates of leukaemic infants with pneumonia.	the technique of polymerase chain reaction was used to detect pneumocystis carinii dna in nasopharyngeal secretions of three infants with leukaemia who had the clinical features of p carinii pneumonia. the use of this non-invasive technique allowed the early diagnosis and treatment of these infants whose protocols did not include the use of prophylactic co-trimoxazole.	1994	7979502
management of adverse reactions to trimethoprim-sulfamethoxazole in human immunodeficiency virus-infected patients.	trimethoprim-sulfamethoxazole is an important medication for the treatment and prevention of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. use of this medication has been limited by the high frequency of adverse reactions that occur in patients with human immunodeficiency virus disease. this article reviews the incidence and spectrum of adverse reactions and options for continuing therapy with trimethoprim-sulfamethoxazole in human immunodeficiency virus ...	1994	7979835
the continuing utility of bronchoalveolar lavage to diagnose opportunistic infection in aids patients.	to determine whether bronchoalveolar lavage (bal) remains a useful technique in assessing human immunodeficiency virus (hiv)-infected patients with pulmonary symptoms.	1994	7985710
albendazole inhibits pneumocystis carinii proliferation in inoculated immunosuppressed mice.	albendazole, a benzimidazole derivative widely used for treating helminth infections, was successfully used to treat and prevent development of pneumocystis carinii pneumonia in transtracheally inoculated immunosuppressed mice. for treatment, 3 weeks postinoculation, albendazole at 300 and 600 mg/kg of body weight per day was administered in food for 3 weeks. for prophylaxis, albendazole was begun on the same day as inoculation at 300 mg/kg/day for 7 days, and then the dose was reduced to 150 mg ...	1994	7986016
pneumocystis carinii is resistant to imidazole antifungal agents.	because pneumocystis carinii is closely related to fungi, drugs useful for treating mycoses have been considered for use in the treatment of p. carinii pneumonia. six antifungal imidazole drugs were tested for their activities against p. carinii in a short-term culture screen and in animals. none of the imidazoles tested was effective in inoculated infected rats, and only miconazole showed slight effects in culture at the high concentration of 10 micrograms/ml. analysis of cell membranes from cu ...	1994	7986021
[cytomegalovirus pneumopathies in pediatric intensive care units].	cytomegalovirus (cmv) infection can result in major complications in immunocompromised infants and children. cmv pneumonia may be difficult to diagnose and the true pathogenic role of the virus in the disease is not always clear. this report describes a cohort of 20 children who suffered from cmv pneumonia.	1994	7987439
comparison of ballard catheter bronchoalveolar lavage with bronchoscopic bronchoalveolar lavage.	bronchoscopic bronchoalveolar lavage (bal) in mechanically ventilated patients requires a large endotracheal tube, physician expertise, expensive equipment, and support staff.	1994	7988195
geographical pathology profile of aids in puerto rico: the first decade.	postmortem histopathological changes in 100 adult patients with aids who died in puerto rico from 1982 to 1991 were studied and tabulated. modes of hiv transmission were reviewed. patient ages ranged from 21 to 60 yr. gender composition for the patient group was 83 men (average age, 35 yr) and 17 women (average age, 39 yr). sixty-eight of the patients were injecting-drug users, 20 were homosexual and bisexual men, seven were women who had had heterosexual contact with men at risk for hiv, and on ...	1994	7991523
prophylaxis of toxoplasmosis infection with pyrimethamine/sulfadoxine (fansidar) in bone marrow transplant recipients.	prophylaxis against toxoplasmosis with weekly administration of pyrimethamine/sulfadoxine (fansidar) was assessed for efficacy and toxicity in bone marrow transplant (bmt) recipients over a 21 month period. sixty-nine of 90 consecutive seropositive patients were evaluable. fansidar was administered from the time of established engraftment (median day 40, range days 13-100). medication was scheduled to be continued until 6 months or longer in cases of continued immunosuppression (median 10 months ...	1994	7994239
[current alternatives in the treatment of pneumocystis carinii pneumonia in patients with aids].		1994	7996899
update of the rapid diagnosis of infectious diseases. i: bacteria, fungi and parasites.	the application of monoclonal antibodies and dna probes in the clinical microbiology laboratory has resulted in an array of rapid diagnostic tests. the immunofluorescent assay or enzyme-linked immunoassay is widely used in the rapid diagnosis of bacteria eg group a streptococcus, legionella pneumophila, mycoplasma pneumoniae, bordetella pertussis; parasites eg chlamydia tachomatis, cryptosporidium species; and fungi eg pneumocystis carinii. the bactec system was first introduced to detect bacter ...	1994	7997914
adverse effects of drugs used in the management of opportunistic infections associated with hiv infection.	pneumocystis carinii pneumonia (pcp) is one of the most common aids-defining diagnoses. first-line therapy is cotrimoxazole (trimethoprim-sulfamethoxazole), despite a high incidence of toxic effects, and a greater incidence of hypersensitivity reactions among hiv-positive patients compared with the seronegative population. alternative agents such as intravenous pentamidine, or clindamycin with primaquine, and trimethoprim with dapsone, also have a wide range of serious adverse effects, but remai ...	1994	7917073
amplification of pneumocystis carinii dna on specimens scraped from slides.	a method for the detection of pneumocystis carinii by polymerase chain reaction using specimens obtained by scraping bronchoalveolar lavage or tissue impression smears is described. the smears were scraped into water and then absorbed onto a glass-fiber filter. after fixing with methanol, the specimen on the filter was digested with proteinase k. the digestion mixture was then clarified, and a portion of the clarified supernatant was used as a template for the amplification of a portion of the m ...	1994	7924213
generalized air cysts complicated by fatal bilateral pneumothoraces in a patient with aids-related pneumocystis carinii pneumonia.	we describe a case of air cyst lesions in an aids patient suffering from pneumocystis carinii pneumonia. this case is unique because these lesions were generalized to both lungs and initially well tolerated. pathologic examination revealed extensive tissue invasion by p carinii. the prognosis was complicated by bilateral pneumothoraces. surgical right pleurodesis allowed lung re-expansion but did not prevent recurrence of fatal contralateral pneumothorax.	1994	7924511
changes in serum neopterin and serum beta 2-microglobulin in subjects with lung infections.	our aim was to investigate whether serum neopterin and beta 2-microglobulin have any value in the distinction between pneumocystis carinii pneumonia (pcp) and pneumonia due to extracellular bacteria. also, to study whether neopterin and beta 2-microglobulin would correlate with the clinical course of lung infections in human immunodeficiency virus (hiv)-positive and hiv-negative patients. thirty hiv-positive subjects with pcp, 9 hiv-positive patients with bacterial pneumonia, and 16 hiv-negative ...	1994	7925900
magnetic resonance imaging findings in pulmonary kaposi's sarcoma: a series of 10 cases.	since chest x-ray and ct scan features of kaposi's sarcoma (ks) are nonspecific, we wanted to test the hypothesis that the histological components of this tumour and/or the associated haemorrhagic component, may result in a characteristic signal pattern on magnetic resonance imaging (mri). thoracic mri was performed in a prospective manner in ten patients with acquired immune deficiency syndrome (aids) and pulmonary ks. mri examinations (1.5 tesla) included spin-echo t1 (se-t1), before and after ...	1994	7925908
acquired immunodeficiency syndrome and its ocular complications.	human immunodeficiency virus infection is the first major pandemic of the 20th century. at present, almost 10 million people are known to be infected with this virus, and it is estimated that by the year 2000, approximately 40 million people will be infected. transmission of this deadly infection is predominantly by sexual contact. individuals infected with this virus pass through several predictable stages with progressive decrease in circulating cd4+ t cells. during the advanced stage, these p ...	1994	7927632
use of anti-cd4+ hybridoma cells to induce pneumocystis carinii in mice.	a reduction of peripheral cd4+ cell levels has been correlated with the onset of pneumocystis carinii pneumonia in aids patients. most in vivo drug discovery and development for p. carinii have been conducted in corticosteroid-treated rats. there is need for the development of new small animal models with more selective methods of immunosuppression. this study outlines a new mouse model in which specific depletion of the cd4+ t-lymphocyte population was achieved by subcutaneous injection of g.k1 ...	1994	7927769
development and evaluation of a rapid and simple procedure for detection of pneumocystis carinii by pcr.	we report the development of a simplified pcr-based assay for the detection of pneumocystis carinii dna in clinical specimens. the adoption of a rapid dna extraction procedure and the introduction of a type of enzyme-linked immunosorbent assay for pcr product detection enabled this procedure to be carried out in a single working day in a clinical microbiology laboratory. the pcr assay was prospectively compared with an immunofluorescent-antibody (fa) staining method for the detection of p. carin ...	1994	7929749
relative potency of 10 drugs with anti-pneumocystis carinii activity in an animal model.	several drugs have been shown to have anti-pneumocystis carinii activity in clinical trials. because of the large number of patients required, no more than 3 drugs can be compared for efficacy in human studies. however, the experimental animal model for p. carinii pneumonitis is remarkably similar to the human disease and was used to compare 10 drugs for the relative potency against this infection. all drugs were compared at doses known to prevent the pneumonitis in > 80% of animals and at one-t ...	1994	7930735
adjunctive folinic acid with trimethoprim-sulfamethoxazole for pneumocystis carinii pneumonia in aids patients is associated with an increased risk of therapeutic failure and death.	ninety-two aids patients with pneumocystis carinii pneumonia (pcp) were randomized to receive folinic acid or matching placebo in conjunction with trimethoprim-sulfamethoxazole in a prospective, double-blind trial. neither frequency of dose-limiting toxicity (26% vs. 37%; p = .4) nor time to occurrence (p = .7) was associated with folinic acid use. although incidence of neutropenia was lower in patients receiving folinic acid (23% vs. 47%; p = .03), time to occurrence of neutropenia did not diff ...	1994	7930736
phase ii trial of fludarabine phosphate and interferon alfa-2a in advanced mycosis fungoides/sézary syndrome.	this phase ii study was undertaken to assess the efficacy and toxicity of the addition of continuous low-dose interferon alfa-2a (ifn) to fludarabine in patients with advanced or refractory mycosis fungoides (mf) or the sézary syndrome (ss).	1994	7931473
natural history of hiv infection in filipino female commercial sex workers.	a prospective follow-up study of the progression of hiv infection, from seroconversion to onset of opportunistic infections (oi) indicative of immune deficiency and to death, was performed in a cohort of 54 hiv-1 antibody positive filipino female commercial sex workers (fcsw). the cumulative probability of having a cd4+ t cell count of < 200/mm3 and/or an oi indicative of severe immune deficiency was 52.9% within 5 years and 73.8% within 6 years after seroconversion. the cumulative probability o ...	1994	7932083
lower socioeconomic status and shorter survival following hiv infection.	we studied the association between socioeconomic status and survival in a prospective study of 364 hiv-infected homosexual men who were recruited during 1982-84. the participants were divided by annual income; those earning above canadian $10,000 (high-income; n = 274) and those below $10,000 (low-income; n = 90) at recruitment. the latter threshold closely approximated to the poverty level for this population. low income men were significantly younger than high income men but the groups were si ...	1994	7934494
[pneumocystis carinii: pathogen of opportunistic infections for 40 years. plasma cell interstitial pneumonia: the "plague" of premature infants and week infants].		1994	7935227
pneumocystis carinii pneumonia prophylaxis during pregnancy.	the frequency of human immunodeficiency virus (hiv) infection among pregnant women is increasing. pneumocystis carinii pneumonia (pcp) is the most common opportunistic infection in hiv-infected patients, and prophylaxis is an important part of decreasing morbidity. trimethoprim-sulfamethoxazole (tmp-smx), pentamidine, and dapsone, alone or in combination with pyrimethamine, are the most commonly used drugs for pcp prophylaxis in the nonpregnant hiv-infected population. trimethoprim-sulfamethoxaz ...	1994	7937279
[rapidly evolving pulmonary bullous degeneration in hiv-infected patients. description of 4 cases and review of the literature].	cavitary lung lesions are common in intravenous drug-addicts (ivda) and in aids patients. four cases are reported of ivda patients with hiv positive serology who developed an initially thick-walled lesion, which grew rapidly and evolved into bullous lesions. the negative results in microbiological investigations for pneumocystis carinii, nocardia spp., staphylococci; the topographic superposition on a previous tuberculous lesion; a prolonged asymptomatic period; and a particularly rapid evolutio ...	1994	7938824
[thoracic imaging in aids].	chest complications were the first known in aids; even, pneumocystis carinii pneumonia was the initial warning light. at the present time lung complications remain the major cause of death in such patients. a better knowledge of these pathologies often allows to pass an acute episode and perhaps to prevent infectious pathologies, so, leading to the observation of extra-thoracic pathologies. preventive treatments and increasing survival time allow the appearance of some atypical aspects of pneumo ...	1994	7939323
cytomegalovirus infection rate among heart transplant patients in relation to anti-thymocyte immunoglobulin induction therapy. copenhagen heart transplant group.	during a 2-year period, 49 patients underwent heart transplantation at rigshospitalet, copenhagen. nine (18%) were females and the mean age for all patients was 44 years (range 14-56 years). immunosuppressive therapy included cyclosporin, azathioprine and steroids in all patients. 43 patients received in addition short-term (approx. 4 days) induction treatment with antithymocyte immunoglobulin (atg). 17 patients received atg fresenius, 2.5 mg/kg/day or atgam, 12.5 mg/kg/day, whereas the remainin ...	1994	7939422
severe opportunistic infections in aids patients with late-stage disease.	clinicians caring for patients who have acquired immunodeficiency syndrome (aids) need to be aware of the wide variety of infectious diseases that can occur. although pneumocystis carinii pneumonia (pcp) is the most common aids-defining infection, other opportunistic infections associated with advanced immunodeficiency can develop after an initial diagnosis.	1994	7942097
determinants of hiv disease progression among homosexual men registered in the tricontinental seroconverter study.	data on 403 homosexual/bisexual men with documented dates of human immunodeficiency virus (hiv) seroconversion were merged. all subjects originated from cohort studies that started between 1982 and 1984 in amsterdam, the netherlands; san francisco, california; sydney, australia; and vancouver, british columbia, canada. with respect to the four geographic locations, no statistically significant differences in progression time from hiv seroconversion to acquired immunodeficiency syndrome (aids) an ...	1994	7942776
hypogammaglobulinaemia associated with normal or increased igm (the hyper igm syndrome): a case series review.	the clinical and immunological aspects of 16 children with the syndrome of hypogammaglobulinaemia associated with normal or increased igm (the hyper igm syndrome) and their responses to treatment are reviewed. increased concentrations of igm, neutropenia, and recurrent infections could usually be controlled by antimicrobial and intravenous immunoglobulin treatment. together with the bacterial infections characteristic of hypogammaglobulinaemia, these patients often developed opportunistic infect ...	1994	7944538
aerosolized pentamidine as primary prophylaxis for pneumocystis carinii pneumonia: efficacy, mortality and morbidity.	primary prophylaxis against pneumocystis carinii pneumonia (pcp) for patients with hiv infection has been recommended by the centers for disease control and prevention. we evaluated alternatives to routine primary pcp prophylaxis with aerosolized pentamidine.	1994	7946102
survival and medical intervention in southern brazilian aids patients.	the aim of the study was to describe survival patterns of southern brazilian aids patients: 224 predominantly working class aids patients were treated in an aids referral centre in porto alegre between october 1986 and september 1991. the caseload increased progressively, as did the number of female aids cases treated at the hospital during the study period. self-referred patients were more likely to present with an aids defining condition (p < 0.03) and they (n = 106) had significantly worse su ...	1994	7948159
increased survival of young infants with pneumocystis carinii pneumonia and acute respiratory failure with early steroid administration.		1994	7948541
pyrimethamine/sulfadoxine for prevention of pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus.		1994	7948546
delayed-type hypersensitivity anergy in human immunodeficiency virus-infected persons screened for infection with mycobacterium tuberculosis.	a total of 479 human immunodeficiency virus (hiv)-infected persons at an hiv clinic in florida and a tuberculosis clinic in new jersey were skin-tested with tuberculin, tetanus toxoid, mumps antigen, and candida antigen in a study of the prevalence of delayed-type hypersensitivity (dth) anergy and the usefulness of two-step tuberculin testing in this population. of the patients tested, 12% had a positive (> or = 5-mm) response to tuberculin; 57%, 45%, and 35% had a positive (> or = 3-mm) respons ...	1994	7948554
phylogenetic spectrum of fungi that are pathogenic to humans.	recent phylogenetic studies based on ribosomal rna sequences have confirmed that the organisms traditionally treated as fungi include those that have evolved from several different lines (multiphyletic organisms), as has been suspected. even organisms causing disease in humans represent at least two evolutional lines. pythium insidiosum and prototheca species are both believed to have evolved from one line, while the rest of the pathogens have evolved from another line. p. insidiosum is more clo ...	1994	7948565
the value of direct fluorescent antibody (dfa) testing for the detection of pneumocystis carinii in cytological specimens.	a direct fluorescent antibody (dfa) method was compared with methenamine silver staining (mss) for the detection of pneumocystis carinii in 384 cytological specimens. dfa testing was more sensitive than the mss, with p. carinii detected in 31 specimens with dfa and 24 with the mss. results of the two methods disagreed in 17 specimens, all of which were sputa. twelve sputum specimens were dfa positive/mss negative and five were mss positive/dfa negative. it is concluded that the dfa technique, al ...	1994	7948760
can snomed international represent patients' perceptions of health-related problems for the computer-based patient record?	as the united states moves towards a computer-based patient record, there is much discussion related to the contents of such a record and the manner in which the data elements will be represented. recent health care reform has emphasized the need for increased patient involvement in health care decision making, however, there has been little discussion about including the patient perspective in the computer-based patient record. using an existing data set of 201 patients who were hospitalized fo ...	1994	7949916
the hydroxymethyldihydropterin pyrophosphokinase domain of the multifunctional folic acid synthesis fas protein of pneumocystis carinii expressed as an independent enzyme in escherichia coli: refolding and characterization of the recombinant enzyme.	the folic acid synthesis (fas) protein of pneumocystis carinii is a multifunctional enzyme containing dihydroneopterin aldolase, 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (pppk), and dihydropteroate synthase activities. isolation of the stretch of fas cdna shown by amino acid similarity to the bacterial counterparts to code for pppk activity (fasc domain) is described. fasc was expressed to high levels in escherichia coli inclusion bodies using an inducible tac promoter expression syst ...	1994	7950384
changing use of intensive care for hiv-infected patients with pneumocystis carinii pneumonia.	clinicians' approach to acute respiratory failure from pneumocystis carinii pneumonia (pcp) is hypothesized to have gone through three phases: aggressive management due to an absence of data on prognosis (1981-84), withholding of intensive care based on a few small studies showing high case fatality (1985-87), and an increase in intensive care to an intermediate level (1988 forward). unfortunately, studies of survival from acute respiratory failure among such patients have been small and have be ...	1994	7952557
persistence of pneumocystis carinii in patients with aids receiving chemoprophylaxis.	pneumocystis carinii organisms have been shown to persist throughout therapy in the majority of patients with pneumocystis carinii pneumonia (pcp). this study evaluated the relationship between persistence of organisms and recurrence of disease, and the effect of chemoprophylaxis on bronchoalveolar lavage specimens. seven patients receiving pcp chemoprophylaxis underwent serial bronchoalveolar lavage (bal) examinations at 1, 4, and 7 mo after recovery from a first episode of pcp. specimens were ...	1994	7952576
drug smoking, pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.	to examine the risk factors for the first episode of bacterial pneumonia among human immunodeficiency virus (hiv)-seropositive injection drug users (idus), medical record review was performed on idus participating in a cohort study from january 1988 to june 30, 1992. hiv-seropositive idus with a first episode of bacterial pneumonia (n = 40) were matched with up to five hiv-seropositive control subjects without bacterial pneumonia (n = 197) by date of entry (+/- 3 mo) and length of follow-up. odd ...	1994	7952605
a rapid preadmission method for predicting inpatient course of disease for patients with hiv-related pneumocystis carinii pneumonia.	pneumocystis carinii pneumonia (pcp) has been the most common reason for hospitalization and the most common cause of death for persons with hiv infection. hospital mortality rates for pcp range from 10 to 60%. studies that evaluate differences in hospital mortality rates must control for differences in patient severity of illness. we developed a simple staging system for categorizing severity of illness in patients with pcp. we analyzed the relation between clinical factors and in-hospital mort ...	1994	7952607
relation of cyst counts with numbers of total nuclei of pneumocystis carinii in rats.	wistar rats were induced of pneumocystis carinii infection by injection with methyl-prednisolone to correlate the cyst counts and numbers of nuclei. seven sections of the lungs were examined by impression smears and also whole lung homogenates were screened for nucleus counting for each rat. at the first week of the experiment, all of the impression smears except one were cyst negative but trophic forms were counted around 10(6). at the third week, the cysts appeared one per 20 immersion oil len ...	1994	7953242
[laboratory and clinical study on pneumocystis carinii. ii. immunoblot analysis for detection of anti-pneumocystis carinii antibodies in the sera from healthy blood donors].	rat pneumocystis carinii cyst soluble antigen (csa) was analysed by sds-page, and more than 20 polypeptide bands were found. the molecular weights of the major bands were > 100kda, 85-94kda, 67kda, 52kda and 34kda, respectively. the specific igg antibodies in the sera from healthy blood donors recognizing the 110kda, 105kda, 85kda, 67kda, 52kda and 46kda polypeptide antigens were identified by immunoblot analysis. the total positive rate of igg specific antibodies was 56.7% (59/104). the 85kda p ...	1994	7955159
infections and immunizations in organ transplant recipients: a preventive approach.	infections after organ transplantation can be devastating in immunocompromised patients.	1994	7955311
pneumocystis carinii-induced activation of the respiratory burst in human monocytes and macrophages.	human monocytes and monocyte-derived macrophages were studied for their ability to phagocytose pneumocystis carinii and produce superoxide (o2-) during the process. one x 10(6) freshly isolated monocytes, incubated with 0.1-3.75 x 10(6) p. carinii cysts, increased o2- production in a dose-related way. antibodies were essential for the process since opsonized, but not unopsonized, pneumocysts induced o2- production significantly above the response obtained by lung tissue from rats (10.7 and 4.9 v ...	1994	7955522
respiratory failure from severe pneumocystis carinii pneumonia. entering the third era.		1994	7956373
decreasing frequency but worsening mortality of acute respiratory failure secondary to aids-related pneumocystis carinii pneumonia.	to describe changes in incidence and outcome of acute respiratory failure (arf) due to aids-related pneumocystis carinii pneumonia (pcp) at a tertiary care center over the 4-year period starting april 1, 1987 with reference to previously reported data from the preceding 6 years.	1994	7956401
estimation of fetal risk from aerosolized pentamidine in pregnant healthcare workers.	inhaled pentamidine is used to treat pneumocystis carinii pneumonia. its potential effects on dna have raised concerns about its safety for pregnant healthcare workers. we used a pharmacokinetic approach to estimate the fetal risks, based on the published data of pentamidine renal clearance and of urinary pentamidine concentrations in healthcare workers exposed to aerosolized pentamidine. the maximum pentamidine doses (intravenous equivalent) that healthcare workers were exposed to were calculat ...	1994	7956402
thoracoscopic findings in spontaneous pneumothorax in aids.	six patients with the acquired immunodeficiency syndrome (aids) who suffered eight spontaneous pneumothoraces between january 1990 and january 1993 underwent videothoracoscopy. the predominant macroscopic findings, found in four patients on five occasions, were white-yellow nodules dispersed throughout the lung surface. in addition, in one patient, these lesions were associated with multiple small apical bullae and, in another, a large reddish nodule with several smaller white satellite nodules ...	1994	7956424
[minimally invasive surgery in persistent pneumothorax and pneumocystis carinii infection].	the most frequent pulmological complication of aids is pneumocystis carinii pneumonia (pcp), which in 2% of cases will cause a spontaneous pneumothorax. every aids patient who develops a pneumothorax is highly suspicious for a pneumocystis carinii pneumonia too. we describe the case of an aids patient who suffered from pneumothorax caused by pcp. conventional tube thoracostomy with continuous suction and tetracycline pleurodesis were unsuccessful. the patient recovered however after resection of ...	1994	7956543
successful treatment of toxoplasma gondii myocarditis in an aids patient.	central nervous system disease due to toxoplasma gondii is a common cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. cardiac toxoplasmosis, however, has been described in only a limited number of cases. in a 45-year-old patient with symptoms suggestive of myocarditis, toxoplasma gondii was detected in myocardial tissue obtained by biopsy. after the institution of appropriate antiprotozoal therapy, the patient recovered. this patient is believed to be the ...	1994	7957272
[intravenous immunoglobulin substitution in patients with arc and aids (wr 3-6)].	hiv-infected patients acquire a profound dysfunction in humoral and cellular immunity. this immunological impairment causes a markedly increased incidence of recurrent infections. while effective prophylaxis of pneumocystis carinii pneumonia is available, infections with other microorganisms still cause a high rate of morbidity and mortality. preliminary results of our randomized outpatient trial to evaluate the efficacy of intravenous immunoglobulin (ivig) in adults demonstrate that ivig reduce ...	1994	7959860
pneumocystis carinii attachment increases expression of fibronectin-binding integrins on cultured lung cells.	pneumocystis carinii is an extracellular pathogen which requires attachment to alveolar epithelial cells for growth and replication. previous studies have demonstrated that the extracellular matrix protein fibronectin (fn) facilitates attachment of p. carinii to lung cells. this study addresses the role of cell surface fn receptors (integrins) as mediators of p. carinii attachment and demonstrates the effect of p. carinii attachment on integrin expression on cultured lung cells. to determine the ...	1994	7960127
incidence of clinical aids conditions in a cohort of homosexual men with cd4+ cell counts < 100/mm3. multicenter aids cohort study.	incidence rates of aids illnesses are described among patients with < or = 100 cd4 cells/mm3 grouped by use of antiretrovirals and chemoprophylaxis. data were obtained from 2646 homosexual men infected with human immunodeficiency virus type 1. participants were in the multicenter aids cohort study during 1985-1993. the incidence rates per 100 person-years for pneumocystis carinii pneumonia were 47.4 without treatment, 21.5 with antiretrovirals alone, and 12.8 with antiretrovirals combined with c ...	1994	7963728
[infections likely to develop in immunocompromised hosts: pneumocystis carinii pneumonia].		1994	7964074
[pneumonia caused by pneumocystis carinii in immunodepressed patients: clinical picture, treatment, and prognosis].	pneumocystis carinii pneumonia is frequent in patients with cellular immunity impairments, specially those with aids. we communicate our experience in 20 patients (15 with aids) with pneumocystis carinii pneumonia confirmed by the finding of trophozoites or cysts. clinical manifestations were cough in 75% of cases, dyspnea in 70% and fever in 65%. eighty five percent of cases had diffuse reticular and nodular radiological densities. nineteen patients had an increased alveolar-arterial o2 gradien ...	1994	8085078
isolation of pneumocystis carinii gp120 by fibronectin affinity: evidence for manganese dependence.	pneumocystis carinii is a major opportunistic lung pathogen and a leading cause of death among patients with the human immunodeficiency virus. adherence of p. carinii to type i alveolar epithelial cells is essential for growth and replication and has been shown to be mediated in part by fibronectin (fn). to better understand the mechanisms underlying this attachment, p. carinii-fn interaction was characterized with respect to divalent and monovalent ion concentration and ph using an 125i-fn bind ...	1994	8086164
once-a-month administration of intravenous pentamidine to patients infected with human immunodeficiency virus as prophylaxis for pneumocystis carinii pneumonia.	we reviewed the charts of 52 patients infected with human immunodeficiency virus (hiv) who received at least three consecutive doses of intravenous pentamidine as prophylaxis for pneumocystis carinii infections. pentamidine isethionate was administered intravenously over 60-90 minutes once a month, at a dosage of 4 mg/kg, in 250 ml of 5% dextrose in water. during 387 months of administration of primary prophylaxis to 37 patients, no cases of p. carinii pneumonia were observed. during 200 months ...	1994	8086550
clindamycin and primaquine therapy for mild-to-moderate episodes of pneumocystis carinii pneumonia in patients with aids: aids clinical trials group 044.	the objective of this prospective, noncomparative study was to assess the safety and efficacy of clindamycin and primaquine therapy for mild-to-moderate pneumocystis pneumonia (defined as a difference of < 40 mm hg between the alveolar and the arterial oxygen determinations) in patients with aids. in the first part of the study, 22 patients were treated with iv clindamycin (900 mg every 8 hours) for the first 10 days, and then their therapy was switched to oral clindamycin (450 mg every 6 hours) ...	1994	8086551
bronchiolitis obliterans organizing pneumonia in a patient with aids.	a 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. his condition had been diagnosed as aids 1 1/2 years before presentation. multiple blood cultures and serological tests failed to yield an infective etiology. bronchoscopy with transbronchial biopsy, both performed twice, also failed to reveal an etiology. empirical treatment for infection with the mycobacteriu ...	1994	8086553
structure, expression and phylogenetic analysis of the gene encoding actin i in pneumocystis carinii.	actin is a major component of the cytoskeleton and one of the most abundant proteins found in eukaryotic cells. comparative sequence analysis shows that this essential gene has been highly conserved throughout eukaryotic evolution making it useful for phylogenetic analysis. complete cdna clones for the actin-encoding gene were isolated and characterized from pneumocystis carinii purified from immunosuppressed rat lungs. the nucleotide sequence encodes a protein of 376 amino acids. the predicted ...	1994	8088520
the spectrum of pathological changes in the lung in children with the acquired immunodeficiency syndrome: an autopsy study of 36 cases.	we present the pulmonary findings in 36 autopsies of children affected by the acquired immunodeficiency syndrome (aids). twenty-three patients were male and 13 were female, ranging in age between 3 days and 13 years. twenty children had human immunodeficiency virus (hiv)-positive parents or parents who were at high risk of exposure (intravenous drug abusers and prostitutes), five had a history of transfusion, and one had a history of renal transplantation and blood transfusion. clinically, the p ...	1994	8088762
granulomatous pneumocystis carinii pneumonia: dna amplification studies on bronchoscopic alveolar lavage samples.	three hiv positive subjects presented with symptoms and radiographic changes suggestive of pneumocystis carinii pneumonia. methenamine silver staining of bronchoscopic alveolar lavage (bal) fluid was negative (from one sample in one patient and two samples in the other two patients). open lung biopsy was performed because of uncertain clinical progress and diagnosis; all three patients were found to have multiple pulmonary granulomata encasing numerous p carinii organisms. dna amplification, usi ...	1994	8089227
pneumocystis carinii infection in the hiv-seropositive patient.	in this article, pneumocystis carinii pneumonia (pcp) in persons with aids is described with regard to its epidemiology, pathogenesis, presentation, treatment, and prophylaxis. the changing epidemiologic patterns of pcp from 1981 to 1993 are diagrammed. atypical and classical presentations of pre-aids, including extrapulmonary pneumocystis, are discussed. diagnostic strategies are outlined, giving algorithms for the most efficient means of diagnosing pcp. various intravenous and oral treatment o ...	1994	8089464
[pulmonary nocardiosis concurrent with pneumocystis carinii pneumonia in a case of smoldering adult t-cell leukemia].	a 76-year-old man, with concomitant pulmonary nocardiosis and pneumocystis carinii (pc) pneumonia, is described. he suffered from smoldering type adult t-cell leukemia and strongyloidiasis. chest x-rays showed bilateral infiltrative shadows. nocardia asteroides was isolated from sputum and bronchofiberscopic aspirates. pc was not detected, however, despite the chest x-ray raising the suspicion of pc pneumonia. since pc antigen was detected by immunoelectrophoresis in the absence of other clinica ...	1994	8089947
[nasal pressure support ventilation (npsv) in a case of pneumocystis carinii pneumonia in single-lung transplantation].	in patients who underwent lung transplantation one of the primary determinants of patient survival is infection. contributing factors in the development of pneumonia include immunosuppression and alterations in the natural lung defense mechanism induced by transplantation. we describe a case of a pneumocystis carinii pneumonia occurring in the recipient of single lung transplantation for interstitial lung disease four months after surgery. the patient developed severe acute respiratory failure ( ...	1994	8090305
aerosolized l-693,989 for pneumocystis carinii prophylaxis in rats.	water-soluble pneumocandin l-693,989, a potent antipneumocystis agent in the rat model for pneumocystis carinii pneumonia (pcp), inhibits p. carinii cyst development and effectively prevents the development of pcp when used as a prophylactic agent (d. m. schmatz, m. a. powles, d. c. mcfadden, l. pittarelli, j. balkovec, m. hammond, r. zambias, p. liberator, and j. anderson, antimicrob. agents chemother. 36:1964-1970, 1992). however, because of limited oral bioavailability, this compound would li ...	1994	8092844
clinical experience with atovaquone: a new drug for treating pneumocystis carinii pneumonia.	atovaquone is a new hydroxynapthoquinone antiprotozoal agent active against pneumocystis carinii in vitro and in animal models. the authors report an experience using atovaquone to treat 25 patients with mild to moderate p. carinii pneumonia. eligible patients were treated for 21 days with 750 mg of atovaquone orally three times daily. prednisone was added when the p(a-a)o2 gradient was between 35-45 mm hg. patients were treated under three treatment protocols. patients in group 1 participated i ...	1994	8010339
rapid and sensitive diagnosis of cytomegalovirus and pneumocystis carinii pneumonia in patients with haematological neoplasia by using capillary polymerase chain reaction.	we attempted the simultaneous detection of cytomegalovirus dna (cmv-dna) and pneumocystis carinii (carinii-dna) in sputum samples obtained from 20 patients with haematological neoplasm with pneumonia, using rapid cycle dna amplification (capillary pcr). we used a thermal cycler for capillary pcr which featured recirculation of hot air for rapid temperature control of 10 microliters reaction samples in thin glass capillary tubes. we extracted dna from patients' sputa using a simple method. a comp ...	1994	8011522
[clindamycin-primaquine in the treatment of pneumocystis carinii pneumonia].	the efficacy of clindamycin-primaquine as treatment of pneumocystis carinii pneumonia (pcp) is similar to that of trimethoprim-sulfamethoxazol and endovenous pentamidine. the untoward effects of this combination are scarce and of mild degree.	1994	8011723
effect of corticosteroids on the incidence of adverse cutaneous reactions to trimethoprim-sulfamethoxazole during treatment of aids-associated pneumocystis carinii pneumonia.	we retrospectively studied all courses of treatment with trimethoprim-sulfamethoxazole (tmp-smz) alone and with adjuvant corticosteroids for aids-associated pneumocystis carinii pneumonia. the corticosteroids were administered for 8-21 days (mean, 14 days) because of hypoxemia. we evaluated the influence of corticosteroids on the incidence of cutaneous adverse reactions to tmp-smz and on the course of aids during 3 months of follow-up. of 38 patients treated with tmp-smz alone, 18 (47%) develope ...	1994	8011811
detection of pneumocystis carinii in urinary samples from a patient with aids despite prophylactic treatment with aerosolized pentamidine.		1994	8011843
imaging of hiv infection in the prenatal and postnatal period.	prenatal diagnosis of maternal diseases common to hiv infection may alert the clinician to potential hiv infection in the infant, with resultant early diagnosis and treatment. although of limited value in the first months of life, imaging studies can be beneficial in selected cases and may be the first clue to the diagnosis of aids. the multisystem involvement frequently seen in aids necessitates multiple imaging modalities. recurrent pneumonia, particularly pneumocystis carinii pneumonia, may b ...	1994	8013181
effect of sputum induction on arterial oxygen saturation and spirometry in hiv-infected patients.	we wanted to study the effect of sputum induction on forced expiratory volume in one second (fev1) and on oxygen saturation in normal controls, asymptomatic human immunodeficiency virus (hiv)-seropositive individuals, and hiv-seropositive patients under investigation for suspected pneumocystis carinii pneumonia (pcp). over a five month period, sputum induction with ultrasonically nebulized 3% saline was performed on 110 hiv-seropositive patients with suspected pcp, 10 asymptomatic hiv-seropositi ...	1994	8013601
trimetrexate with leucovorin versus trimethoprim-sulfamethoxazole for moderate to severe episodes of pneumocystis carinii pneumonia in patients with aids: a prospective, controlled multicenter investigation of the aids clinical trials group protocol 029/031.	trimetrexate is a powerful inhibitor of the dihydrofolate reductase of pneumocystis carinii. aids patients (n = 215) with moderate to severe p. carinii pneumonia were enrolled in a double-blind study of trimetrexate plus leucovorin versus trimethoprim-sulfamethoxazole (tmp-smz) for 21 days. by study day 10, study therapy failed because of lack of efficacy in 16% of patients assigned to tmp-smz and 27% assigned to trimetrexate (p = .064), and the pao2-pao2 improved significantly faster with tmp-s ...	1994	8014493
temporal trends of opportunistic infections and malignancies in homosexual men with aids.	temporal changes in the lifetime occurrence of opportunistic infections and malignancies among 1115 homosexual men diagnosed with aids were examined. information from the aids surveillance registry, hospital pathology and microbiology logs, patient chart reviews, cancer registries, and death certificates was used to calculate the frequency of specific opportunistic infections and malignancies as lifetime (initial or subsequent) diagnoses. the most common lifetime diagnoses were pneumocystis cari ...	1994	8014498
primary prophylaxis with pyrimethamine for toxoplasmic encephalitis in patients with advanced human immunodeficiency virus disease: results of a randomized trial. terry beirn community programs for clinical research on aids.	pyrimethamine, 25 mg thrice weekly, was evaluated as primary prophylaxis for toxoplasmic encephalitis (te) in a double-blind, randomized clinical trial in patients with human immunodeficiency virus (hiv) disease, absolute cd4 lymphocyte count of < 200/microl (or prior aids-defining opportunistic infection), and the presence of serum igg to toxoplasma gondii. leucovorin was coadministered only for hematologic toxicity. there was a significantly higher death rate among patients receiving pyrimetha ...	1994	8106772
interaction of pneumocystis carinii dihydropteroate synthase with sulfonamides and diaminodiphenyl sulfone (dapsone).	dihydropteroate synthase is the target enzyme for the sulfonamide compounds, which are the mainstay of therapy for pneumocystis carinii pneumonia, a common infection in patients with impaired immunity. the stability of this enzyme, its kinetic constants with respect to substrates, and the 50% inhibitory concentration (ic50) of several sulfonamides and the sulfone dapsone have been characterized using both cell-free and intact organism assay systems. stability of the enzyme is dependent on storag ...	1994	8106784
factors influencing survival after aids: report from the multicenter aids cohort study (macs).	the objective of this study was to determine if clinical signs, symptoms, laboratory variables, and use of therapeutic or prophylactic agents have prognostic associations with survival after diagnosis of clinical aids. a total of 2,168 homosexual men, seropositive for human immunodeficiency virus type 1 (hiv-1) participated in a longitudinal cohort study of the greater metropolitan areas of baltimore, maryland, washington, d.c., chicago, illinois, pittsburgh, pennsylvania, and los angeles, calif ...	1994	8106968
australia's first case of aids? pneumocystis carinii pneumonia and hiv in 1981.	to present the earliest australian case of the acquired immunodeficiency syndrome (aids) reported to date.	1994	8107624
racial differences in the use of drug therapy for hiv disease in an urban community.	guidelines for drug therapy in human immunodeficiency virus (hiv) disease are based primarily on the stage of the disease. to determine whether sociodemographic characteristics of patients influence drug therapy in practice, we analyzed the use of antiretroviral therapy and prophylactic therapy for pneumocystis carinii pneumonia (pcp) in an urban population infected with hiv.	1994	8107743