| pharmacokinetics of dapsone administered daily and weekly in human immunodeficiency virus-infected children. | although dapsone is a commonly used alternative agent for prophylaxis against pneumocystis carinii pneumonia in children intolerant to trimethoprim-sulfamethoxazole, there are few data that describe dapsone pharmacokinetics in children. we studied dapsone pharmacokinetics in 30 children (median age, 2.8 years; age range, 0. 3 to 12 years) receiving a new proprietary liquid preparation by three dosing regimens (1 mg/kg of body weight daily, 2 mg/kg daily, or 4 mg/kg weekly). dosing of children wi ... | 1999 | 10543733 |
| immune-mediated inflammation directly impairs pulmonary function, contributing to the pathogenesis of pneumocystis carinii pneumonia. | the clinical severity of pneumocystis carinii pneumonia (pcp) correlates closely with the appearance of pulmonary markers of inflammation. therefore, a model system was developed whereby physiological studies could be performed on live mice to determine the extent to which pulmonary inflammation contributes to respiratory impairment during pcp. p. carinii-infected severe combined immunodeficient mice displayed little evidence of pulmonary inflammation and exhibited normal oxygenation and dynamic ... | 1999 | 10545529 |
| sterols of pneumocystis carinii hominis organisms isolated from human lungs. | the opportunistic pathogen pneumocystis carinii causes pneumonia (p. carinii pneumonia, or pcp) in immunocompromised individuals such as aids patients. rat-derived p. carinii carinii organisms have distinct sterols which are not synthesized by mammals and not found in other microbes infecting mammalian lungs. the dominant sterol present in the organism is cholesterol (which is believed to be scavenged from the host), but other sterols in p. carinii carinii have an alkyl group at c-24 of the ster ... | 1999 | 10548595 |
| experimental corticosteroid induction of pneumocystis carinii pneumonia in piglets. | animal models of pneumocystis carinii (pc) pneumonia (pcp) play a central role in research on the pc microorganism itself and the disease, especially the pathogenesis and the host defence. the classic rat model with corticosteroid-induced reactivation of a latent infection has been most widely used. in our search for alternative non-rodent models, six 31/2-week-old piglets were injected intramuscularly with methylprednisolone acetate, at 18 mg/kg body weight, once a week for 6 weeks. six litterm ... | 1999 | 10549589 |
| vertical transmission rates for hiv in the british isles: estimates based on surveillance data. | to estimate and interpret time trends in vertical transmission rates for hiv using data from national obstetric and paediatric surveillance registers. | 1999 | 10550082 |
| in-vitro activity of rifabutin and albendazole singly and in combination with other clinically used antimicrobial agents against pneumocystis carinii. | the in-vitro activity of rifabutin and albendazole alone and in combination with clarithromycin, etoposide, minocycline and pyrimethamine was investigated against four clinical isolates of pneumocystis carinii. the susceptibility tests were performed by inoculation of the isolates on to cell monolayers and by determining the parasite count after 72 h incubation at 37 degrees c. the culture medium was supplemented with serial dilutions of each agent. albendazole tested alone was more active than ... | 1999 | 10552982 |
| emergence of trimethoprim-sulfamethoxazole resistance in the aids era. | trimethoprim-sulfamethoxazole (tmp-smx) is widely used for pneumocystis carinii pneumonia prophylaxis in human immunodeficiency virus (hiv)-infected patients, but little is known about the effects of this practice on the emergence of tmp-smx-resistant bacteria. a serial cross-sectional study of resistance to tmp-smx among all clinical isolates of staphylococcus aureus and 7 genera of enterobacteriaceae was performed at san francisco general hospital. resistance among all isolates was <5.5% from ... | 1999 | 10558935 |
| pneumocystis carinii dihydropteroate synthase but not dihydrofolate reductase gene mutations correlate with prior trimethoprim-sulfamethoxazole or dapsone use. | recent studies of the human pneumocystis carinii dihydropteroate synthase (dhps) gene suggest that p. carinii is developing resistance to sulfamethoxazole (smx) and dapsone. to explore whether p. carinii is also developing resistance to trimethoprim (tmp), the human p. carinii dihydrofolate reductase (dhfr) gene was cloned, dhfr and dhps genes in 37 p. carinii isolates from 35 patients were sequenced, and the relationship between tmp-smx or dapsone use and gene mutations was analyzed. the dhfr g ... | 1999 | 10558954 |
| [bone marrow involvement by pneumocystis carinii in an aids patient]. | | 1999 | 10563098 |
| mitogen-activated protein kinase mkp1 of pneumocystis carinii complements the slt2delta defect in the cell integrity pathway of saccharomyces cerevisiae. | signal transduction pathways are important in the adaptive response of microbes to their environment. a pneumocystis carinii extracellular signal-regulated protein kinase (mapk) homologue, mkp1, has been isolated by sequence similarity screening of p. carinii genomic dna. the mkp1 of p. carinii shows closest homology to other fungal map kinases involved in cell integrity signal transduction cascades, including slt2p/mpk1p of saccharomyces cerevisiae, mkc1 of candida albicans and mps1 of magnapor ... | 1999 | 10564487 |
| inhaled antimicrobial therapy. | although antimicrobial therapy has been administered through the inhaled route for decades, it has always been controversial. there are relatively few accepted indications for this mode of administration. well-controlled studies of aerosolized antibiotics in cystic fibrosis demonstrate that tobramycin on a cyclical basis may reduce sputum volume, bacterial counts, and improve pulmonary function. preliminary data indicate that inhaled antibiotic therapy of ventilator-associated tracheobronchitis ... | 1999 | 10565884 |
| a case of interstitial pneumonia associated with pneumocystis carinii in a foal. | subacute interstitial pneumonia with diffuse alveolar damage, marked macrophage infiltration, and intracellular pneumocystis carinii cysts is described in a 3-month-old swiss warmblood foal. clinically, the disease was characterized by sudden onset of respiratory distress with fatal outcome. based on serum immunoglobulin g (igg), iga, and igm values, no humoral immunosuppression was detected. spleen, thymus, and bronchial lymph nodes did not reveal lymphoid depletion, as assessed by immunohistoc ... | 1999 | 10568448 |
| successful management of pulmonary tuberculosis in renal allograft recipients in a single center. | pulmonary infections, especially tuberculosis, are responsible for significant mortality and morbidity among renal transplant recipients in developing countries. conventional diagnostic modalities are associated with a low yield, delaying specific therapy. | 1999 | 10571806 |
| structure-based design of selective inhibitors of dihydrofolate reductase: synthesis and antiparasitic activity of 2, 4-diaminopteridine analogues with a bridged diarylamine side chain. | as part of a larger search for potent as well as selective inhibitors of dihydrofolate reductase (dhfr) enzymes from opportunistic pathogens found in patients with aids and other immune disorders, n-[(2,4-diaminopteridin-6-yl)methyl]dibenz[b,f]azepine (4a) and the corresponding dihydrodibenz[b,f]azepine, dihydroacridine, phenoxazine, phenothiazine, carbazole, and diphenylamine analogues were synthesized from 2, 4-diamino-6-(bromomethyl)pteridine in 50-75% yield by reaction with the sodium salts ... | 1999 | 10579848 |
| synthetic dna minor groove-binding drugs. | in this review, both cationic and neutral synthetic ligands that bind in the minor groove of dna are discussed. certain bis-distamycins and related lexitropsins show activities against human immunodeficiency virus (hiv)-1 and hiv-2 at low nanomolar concentrations. dapi binds strongly to at-containing polymers and is located in the minor groove of dna. dapi intercalates in dna sequences that do not contain at least three consecutive at bp. berenil can also exhibit intercalative, as well as minor ... | 1999 | 10580832 |
| nosocomial infections in patients with hiv disease. | throughout the aids epidemic, nosocomial infection in the patient with hiv disease has presented a constant problem--not only for the hospitalized patient but also for the clinic attender. the nosocomial spread of multidrug-resistant tuberculosis has emphasized the need for effective control of infection measures in dealing with the immunodeficient. increased recognition of nosocomial bacterial pneumonias has raised questions about the place, if any, of antimicrobial prophylaxis in preventing gr ... | 1999 | 10582184 |
| pneumocystis carinii pneumonia in patients receiving immunosuppressive drugs for dermatological diseases. | in recent years, pneumocystis carinii pneumonia (pcp) has been increasingly reported in patients without human immunodeficiency virus (hiv) infection. the increased occurrence of pcp in non-hiv-immunocompromised subjects has been attributed to several factors: use of stronger immunosuppressive regimens, higher awareness of pcp, advanced diagnostic technology and nosocomial spread of p. carinii. appearance of pcp subsequent to the use of immunosuppressive drugs has been noticed in many inflammato ... | 1999 | 10583061 |
| the growth and the control of human immunodeficiency virus in the lung: implications for highly active antiretroviral therapy. | in recent years, it has become apparent that the lung is an important niche for the proliferation of human immunodeficiency virus (hiv), which may have implications for highly active antiretroviral therapy (haart). the lung itself is a major site for the opportunistic infections associated with the progression to acquired immune deficiency syndrome (aids), specifically pneumocystis carinii, myobacterium tuberculosis and pyogenic bacteria. these cases of active pulmonary complications are direct ... | 1999 | 10583442 |
| a comparison of three strategies for risk-adjustment of outcomes for aids patients hospitalized for pneumocystis carinii pneumonia. | the need for risk-adjustment of patient outcomes has been driven by the competitive health care market and the subsequent increase in comparative outcome reporting among health care institutions, among managed care plans, and among individual providers for some procedures (e.g. coronary artery bypass graft surgery). however, if the outcomes reported do not take into account patient characteristics that can be considered dimensions of risk for poor clinical outcomes or increased utilization of se ... | 1999 | 10583654 |
| high rates of pneumocystis carinii pneumonia in allogeneic blood and marrow transplant recipients receiving dapsone prophylaxis. | chemoprophylaxis for pneumocystis carinii pneumonia (pcp) is routinely given after allogeneic blood or marrow transplantation. we evaluated the effectiveness of dapsone prophylaxis (50 mg orally twice daily, 3 times per week) compared with twice-weekly trimethoprim-sulfamethoxazole (tmp-smz) in preventing pcp after allogeneic blood or marrow transplantation. patients included all (n=646) who received allogeneic blood or marrow transplants between 1 september 1993 and 31 december 1996 who survive ... | 1999 | 10585797 |
| association of primary pneumocystis carinii infection and sudden infant death syndrome. | to delineate clinical and histological features of the first pneumocystis carinii infection affecting the immunocompetent host, p. carinii-specific histological stains were performed on autopsy lung specimens from 534 consecutive pediatric patients (those with aids and malignancies were excluded) in santiago, chile. p. carinii clusters were found in 4 (25%) of 16 infants who died of no apparent cause at arrival to the emergency department, and in 10 (2.9%) of 342 infants who died of multiple con ... | 1999 | 10585801 |
| pneumocystis carinii pneumonia in human immunodeficiency virus (hiv)-positive and hiv-negative immunocompromised patients. | for 89 human immunodeficiency virus (hiv)-positive and 32 hiv-negative immunocompromised patients who had 121 episodes of pneumocystis carinii pneumonia (pcp), clinical features and changes over time were compared. hiv-infected patients characteristically had a longer duration of symptoms (23 vs. 13 days; p<.005); were younger (39 vs. 48 years; p<.001); had a higher frequency of sweating, weight loss, and thoracic pain; and had fewer admissions to the intensive care unit (16% vs. 31%; p<.05). in ... | 1999 | 10585806 |
| spectrum of opportunistic infections and malignancies in patients with human immunodeficiency virus infection in south korea. | to determine the frequency and types of major opportunistic diseases in patients with hiv infection in south korea, we reviewed the medical records of 173 hiv-infected patients. the patients were seen from 1985 to 1998 at a referral hospital for aids in south korea. most patients (85%) were male, and 107 (62%) were infected by heterosexual contacts. cd4+ lymphocyte counts at presentation were <200/microl in 27% of the patients. tuberculosis was the most frequent opportunistic infection (25% of p ... | 1999 | 10585807 |
| imaging-guided percutaneous biopsy of focal splenic lesions: update on safety and effectiveness. | the purpose of this study is to determine the safety and effectiveness of percutaneous imaging-guided biopsy in the diagnosis of focal splenic lesions. | 1999 | 10587123 |
| enhanced in vivo human immunodeficiency virus-1 replication in the lungs of human immunodeficiency virus-infected persons with pneumocystis carinii pneumonia. | the relationship of serum human immunodeficiency virus-1 (hiv-1) rna levels to hiv-1 rna levels in other compartments, such as the lungs, is not well characterized. the purpose of this study was to determine the viral burden of hiv-1 in the lungs by comparing hiv-1 rna in cell-free bronchoalveolar lavage fluid (balf) with that in serum. specimens were examined from 77 hiv-seropositive adults (cd4(+) cell counts: 0 to 700 cells/mm(3); 48% receiving prescribed antiretroviral agents), comprising 43 ... | 1999 | 10588627 |
| randomized trial of weekly sulfadoxine/pyrimethamine vs. daily low-dose trimethoprim-sulfamethoxazole for the prophylaxis of pneumocystis carinii pneumonia after liver transplantation. | we conducted a prospective, randomized clinical trial among liver transplant patients to assess the efficacy and safety of weekly sulfadoxine/pyrimethamine compared with daily trimethoprim-sulfamethoxazole in the prevention of pneumocystis carinii pneumonia. the studied drugs were given during 6 months after transplantation. one hundred twenty patients were included. none of the 60 patients receiving weekly sulfadoxine/pyrimethamine developed pneumocystis carinii pneumonia, whereas two cases (3% ... | 1999 | 10589886 |
| a randomized trial of daily and thrice-weekly trimethoprim-sulfamethoxazole for the prevention of pneumocystis carinii pneumonia in human immunodeficiency virus-infected persons. terry beirn community programs for clinical research on aids (cpcra) | we enrolled 2,625 human immunodeficiency virus-infected patients into a randomized trial to assess the efficacy and tolerability of daily vs. thrice-weekly trimethoprim-sulfamethoxazole (160 mg/800 mg) for prophylaxis of pneumocystis carinii pneumonia (pcp). the rate of pcp was 3.5 and 4.1 per 100 person-years in the daily and thrice-weekly groups, respectively, with a relative risk (rr) of 0.82 (95% confidence interval [ci], 0.61-1.09; p = .16) (rr of <1.0 favors daily trimethoprim-sulfamethoxa ... | 1999 | 10589887 |
| editorial response: prophylaxis for pneumocystis carinii pneumonia--an evolving tale of two populations. | | 1999 | 10589888 |
| detection of pneumocystis carinii dna in the air filter of a ventilated patient with aids. | | 1999 | 10589930 |
| blood eosinophilia in tacrolimus-treated patients: an indicator of pneumocystis carinii pneumonia. | pneumocystis carinii pneumonia (pcp) in immunocompromised patients is suggested if the following symptoms develop: dyspnea, fever, and interstitial infiltrates on chest x-ray. we observed a significant blood eosinophilia in kidney recipients with pcp under immunosuppressive treatment with tacrolimus. | 1999 | 10589963 |
| clinical experience of hiv/aids in a municipal hospital in taiwan. | to describe the spectrum of epidemiological and major clinical manifestations of patients infected by human immunodeficiency virus type 1 (hiv-1) in a municipal hospital, a retrospective review was done of 53 hiv-1-infected patients who had been admitted to taipei municipal jen-ai hospital between january 1990, and july 1996. the majority (94.3%) of the patients in the cohort were male. peak incidence was found in the fourth decade (28.3%). forty-four (83%) patients presented in the first hospit ... | 1997 | 10592814 |
| autopsy findings on patients with aids in taiwan. | at national taiwan university hospital, from 1986 to 1996, autopsies were performed on 16 patients with acquired immunodeficiency syndrome. there were 15 men and 1 woman. fourteen of these male patients had contracted the disease as a result of sexual practice, among which 9 were homosexual, 1 was bisexual and 4 were heterosexual. one of the patients had become infected by sharing a syringe during intravenous drug use. the female was a sex worker. among these patients, only 2 had been tested for ... | 1997 | 10592820 |
| persistent high bal fluid granulocyte activation marker levels as early indicators of bronchiolitis obliterans after lung transplant. | the major cause of mortality in the long-term in lung transplant recipients is chronic rejection. this is a fibroproliferative process in the small airways leading to obliterative bronchiolitis and progressive loss of lung function, both constituting the clinical entity bronchiolitis obliterans syndrome (bos). granulocyte activation has been implicated as one factor behind bos. granulocyte markers in bronchoalveolar lavage (bal) fluid were prospectively and longitudinally studied in order to ide ... | 1999 | 10596701 |
| occurrence of pneumocystis carinii pneumonia in hiv-1-infected patients responding to haart: is prophylaxis discontinuation a safe tool? | | 1999 | 10597798 |
| the spectrum of aids-defining diseases: temporal trends in italy prior to the use of highly active anti-retroviral therapies, 1982-1996. | to evaluate time trends of the spectrum of aids-defining diseases in italy, 1982-1996. | 1999 | 10597999 |
| the impact of competing subsistence needs and barriers on access to medical care for persons with human immunodeficiency virus receiving care in the united states. | to examine whether competing subsistence needs and other barriers are associated with poorer access to medical care among persons infected with human immunodeficiency virus (hiv), using self-reported data. | 1999 | 10599608 |
| thermodynamics of rna-rna duplexes with 2- or 4-thiouridines: implications for antisense design and targeting a group i intron. | antisense compounds are designed to optimize selective hybridization of an exogenous oligonucleotide to a cellular target. typically, watson-crick base pairing between the antisense compound and target provides the key recognition element. uridine (u), however, not only stably base pairs with adenosine (a) but also with guanosine (g), thus reducing specificity. studies of duplex formation by oligonucleotides with either an internal or a terminal 2- or 4-thiouridine (s(2)u or s(4)u) show that s(2 ... | 1999 | 10600128 |
| clinical and laboratory findings of disseminated mycobacterium avium complex infection (dmac) in a pair matched case-control study. | a pair matched case/control study was conducted from january 1991 to 30 june 1992 in order to define clinical and laboratory findings associated with dmac infection in aids patients. since dmac infection is usually associated with advanced immunodeficiency, and therefore also with other opportunistic illnesses, in addition to the number of cd4+ lymphocytes, cases and controls were matched using the following criteria: date of aids diagnosis and antiretroviral therapy, number and severity of asso ... | 1999 | 10602540 |
| effects of atovaquone and diospyrin-based drugs on ubiquinone biosynthesis in pneumocystis carinii organisms. | the naphthoquinone atovaquone is effective against plasmodium and pneumocystis carinii carinii. in plasmodium, the primary mechanism of drug action is an irreversible binding to the mitochondrial cytochrome bc(1) complex as an analog of ubiquinone. blockage of the electron transport chain ultimately inhibits de novo pyrimidine biosynthesis since dihydroorotate dehydrogenase, a key enzyme in pyrimidine biosynthesis, is unable to transfer electrons to ubiquinone. in the present study, the effect o ... | 2000 | 10602716 |
| an unusual case of pneumocystis carinii presenting as an aural mass. | extrapulmonary involvement of organs with the protozoan pneumocystis carinii is rare. we describe a case of pneumocystis carinii presenting as an erosive aural mass in a young male patient with acquired immunodeficiency syndrome. as far as the authors are aware such an example has never been described in a british journal and is the first case worldwide where otic pneumocystosis has extended into the middle cranial fossa. we also present a review of the literature on otological manifestations of ... | 1999 | 10605587 |
| risk factors for community-acquired pneumonia among persons infected with human immunodeficiency virus. | two hundred eleven adults with human immunodeficiency virus (hiv) infection hospitalized for community-acquired pneumonia, including pneumocystis carinii pneumonia (pcp; patients), and 192 matched hiv-infected hospitalized patients without pneumonia (controls) were interviewed to determine risk factors for pneumonia. multivariate logistic regression showed that patients were less likely than controls to have used trimethoprim-sulfamethoxazole (tmp-smz) prophylaxis (odds ratio [or], 0.22; 95% con ... | 2000 | 10608762 |
| atovaquone suspension in hiv-infected volunteers: pharmacokinetics, pharmacodynamics, and tmp-smx interaction study. | to evaluate the pharmacokinetics and safety of atovaquone suspension in volunteers infected with the human immunodeficiency virus ((hiv). | 1999 | 10610011 |
| antimicrobial activity of polycationic peptides. | the in vitro activity of six polycationic peptides, buforin ii, cecropin p1, indolicidin, magainin ii, nisin, and ranalexin, were evaluated against several clinical isolates of gram-positive and gram-negative aerobic bacteria, yeasts, pneumocystis carinii and cryptosporidium parvum, by using microbroth dilution methods. the peptides exhibited different antibacterial activities and rapid time-dependent killing. the gram-negative organisms were more susceptible to buforin ii and cecropin p1, where ... | 1999 | 10612440 |
| [pathogenesis of pneumocystis carinii pneumonia]. | pneumocystis carinii is a ubiquitous fungus and opportunistic resident of the bronchoalveolar lumen of men and a variety of other mammalian species. this microorganism replicates under immunosuppressive conditions, ultimately resulting in lethal pneumonia (pcp) if left untreated. in the past decade, considerable progress has been made concerning the understanding of the underlying pathogenic mechanisms of this infection, mostly with the help of animal models such as scid (severe combined immunod ... | 1999 | 10613069 |
| pneumocystis carinii infection presents as common bile duct mass biopsied by fine-needle aspiration. | this paper describes a case of pneumocystis carinii (pc) presenting as a common bile duct intraluminal mass in an hiv-infected 30-yr-old homosexual man. in fine-needle aspiration smears, exuberant vascular proliferation associated with multinucleated giant-cell reactions was found within the granular exudate of pc. | 2000 | 10613968 |
| survival and progression of hiv disease in women attending gum/hiv clinics in britain and ireland. study group for the mrc collaborative study of hiv infection in women. | to describe the pattern of clinical disease in women with hiv infection and to examine the effect of potential cofactors, including oral contraceptive use, alcohol and smoking, ethnic group, and route of hiv transmission, on progression to aids and death. | 1999 | 10615311 |
| diagnosis of pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients with polymerase chain reaction: a blinded comparison to standard methods. | pneumocystis carinii pneumonia (pcp) is an important cause of morbidity and death among persons with human immunodeficiency virus (hiv) infection. polymerase chain reaction (pcr) analysis of respiratory specimens has been investigated as a rapid diagnostic method. we have previously reported on the utility of this technique for diagnosing pcp in hiv-infected patients. in this report we evaluate pcr used in a blinded study design to avoid biases inherent to retrospective and nonblinded studies. t ... | 2000 | 10619742 |
| efficacy of sulfamethoxazole-trimethoprim administration in the prevention of pneumocystis carinii pneumonia in patients with connective tissue disease. | the efficacy and adverse effects of prophylactic administration of sulfamethoxazole-trimethoprim (st) for pneumocystis carinii pneumonia (pcp) were assessed in patients with connective tissue diseases (ctd). eighty-four patients who were receiving more than 40 mg/day of prednisolone were entried in the present study. patients with at least one of the two pcp risk factors (interstitial pulmonary fibrosis and lymphopenia), were administered either one (11 patients) or two (26 patients) st tablets/ ... | 1999 | 10624092 |
| antimicrobial prophylaxis in adults. | antimicrobial prophylaxis is used by clinicians for the prevention of numerous infections, including sexually transmitted diseases, human immunodeficiency virus infection, tuberculosis, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract infections in women, spontaneous bacterial peritonitis in patients with cirrhosis, influenza, malaria, infective endocarditis, pertussis, plague, anthrax, early-onset group b streptococcal disease in neonates, and ... | 2000 | 10630764 |
| delays in tuberculosis isolation and suspicion among persons hospitalized with hiv-related pneumonia. | despite awareness of hiv-related tuberculosis (tb), nosocomial outbreaks of multidrug-resistant tb among hiv-infected individuals occur. | 2000 | 10631207 |
| karyotypes of pneumocystis carinii derived from several mammals. | pneumocystis carinii is the most important opportunistic pathogen of humans in the world. pneumocystis carinii is experimentally detected in the lungs of rats, mice, rabbits, and monkeys, however, the organisms from different mammals are identical in microscopic morphology. the present study tried to find out more mammalian hosts of p. carinii and also to differentiate the organisms from different mammals by karyotyping. rats, mice, hamsters, rabbits, cats, and dogs were successfully infected by ... | 1999 | 10634044 |
| epidemiology and risk of pulmonary disease. | although pulmonary diseases are important causes of illness and death in patients with human immunodeficiency virus (hiv) infection, advances in treatment and the demographics of hiv-infected populations are changing their incidence and manifestations. the rates of acquires immune deficiency syndrome (aids)- related mortality and opportunistic infections have fallen drastically since the introduction of highly active antiretroviral therapy (haart) in 1996. the risk of developing specific disorde ... | 1999 | 10638509 |
| screening and noninvasive testing for pulmonary disease. | although detection of preclinical disease using screening tests is desirable if earlier treatment improves outcome, the available data show no morbidity or mortality benefit using chest radiography, sputum analysis for pneumocystis carinii and acid-fast bacilli, or serial measurements of single-breath carbon monoxide diffusing capacity to detect pulmonary disease in asymptomatic persons with hiv. it seems prudent to evaluate asymptomatic patients periodically with a careful history and focused p ... | 1999 | 10638510 |
| bronchoscopic techniques for the diagnosis of pulmonary complications of hiv infection. | bronchoscopy has played the central role in defining the spectrum of pulmonary disorders that occur in patients with hiv infection. transbronchial biopsy (tbb) and bronchoalveolar lavage (bal) both have high yields in the diagnosis of pneumocystis carinii pneumonia (pcp) and other infections. paradoxically, despite our knowledge and experience using bronchoscopy, controversy still exists regarding whether to attempt to make a bronchoscopic diagnosis in most patients with suspected pcp who have n ... | 1999 | 10638511 |
| bacterial pneumonia. | bacterial pneumonia is significantly more common in persons who are hiv-infected than in the general population and is most common among injection drug users and in persons with advanced hiv disease and immunosuppression. the clinical features of bacterial pneumonia are similar to those in hiv-seronegative persons, but bacteremia is more common. when a pathogen is identified, streptococcus pneumoniae is consistently the most common, occurring in 20% to 70% of cases. haemophilus influenzae, staph ... | 1999 | 10638512 |
| pneumocystis carinii pneumonia. | throughout the epidemic, pneumocystis carinii pneumonia (pcp) has been the most common aids-defining opportunistic infection in the united states. with the widespread use of highly active antiretroviral therapy (haart) and prophylaxis in patients known to be at risk, the incidence of pcp in patients with aids has declined dramatically. however, it is still seen regularly in patients with previously undiagnosed human immunodeficiency virus (hiv) infection, those who do not comply with prophylacti ... | 1999 | 10638513 |
| cytomegalovirus pneumonia. | cytomegalovirus (cmv) pneumonia is a major cause of morbidity and mortality in allogeneic bone marrow transplant and lung transplant recipients. however, its role as a cause of lung disease in patients with the human immunodeficiency virus (hiv) is controversial. although cmv can be isolated from lung specimens in patients with hiv-associated respiratory illness, it is rarely the causative pathogen. most adults with hiv infection have latent cmv infection of many tissues including the lung, and ... | 1999 | 10638515 |
| thoracic surgical spectrum of hiv infection. | the thoracic surgeon is often called on to diagnose or treat a variety of disorders associated with human immunodeficiency virus (hiv) infection. surgical mediastinal exploration through cervical and anterior approaches is a safe and valuable modality in appropriately selected patients with unexplained mediastinal lymphadenopathy. open lung biopsy is used in a small subset of hiv-infected patients with undiagnosed diffuse or multifocal pulmonary disease, with an anticipated diagnostic yield of m ... | 1999 | 10638516 |
| intensive care of patients with hiv infection. | despite the improvements in the prognosis associated with the development of highly active antiretroviral therapy (haart), more than 410,000 people in the united states were reported to have died from acquired immune deficiency syndrome (aids) by the end of 1998. the number of people living with human immunodeficiency virus (hiv) infection and aids in the united states continues to increase, estimated at more than 370,000 in 1998, and there is good reason for optimism that hiv infection may be a ... | 1999 | 10638517 |
| a retrospective study of the addition of ciprofloxacin to clarithromycin and ethambutol in the treatment of disseminated mycobacterium avium complex infection. | disseminated mycobacterium avium complex (dmac) infection is associated with increased morbidity and mortality in hiv-infected individuals. the combination antibiotic regimens containing clarithromycin can decrease symptoms and improve survival in patients with dmac, however, optimal therapy remains to be defined. quinolones have been widely used in the treatment of dmac but their utility has not been established. a retrospective cohort study of dmac infection was established in a metropolitan h ... | 1999 | 10639059 |
| effect of a bis-benzyl polyamine analogue on pneumocystis carinii. | pneumocystis carinii is the causative agent of p. carinii pneumonia (pcp), an opportunistic infection associated with aids and other immunosuppressed conditions. although polyamine metabolism of this fungus has been shown to be a chemotherapeutic target, this metabolism has not been thoroughly investigated. reported here is the effect of one polyamine analogue, n, n'-bis[3-[(phenylmethyl)amino]propyl]-1,7-diaminoheptane (bbs), on p. carinii. bbs inhibits the growth of p. carinii in culture, but ... | 2000 | 10639359 |
| [the cause of infection as the main or additional cause of death in patients treated for small cell lung cancer]. | in 116 out of 845 patients treated for small cell lung cancer (sclc) in the institute of tuberculosis and chest disease in warsaw in the years 1980-1994 infection was the main or coexistent cause of death. in 4.1% infection was proved of bacterial origin and in further 6.5% of probable bacterial origin (in the later group cultures were negative or not done but fungal infection, pneumocystosis pneumonia and tuberculosis were excluded on autopsy). in 1.54% infection was of fungal origin, 1.2% pati ... | 1999 | 10647287 |
| unsuspected pneumocystis carinii pneumonia at presentation of severe primary immunodeficiency. | pneumocystis carinii is an important pathogen in immunodeficiency but may be an unrecognised cause of respiratory compromise. | 2000 | 10648370 |
| diagnosis of pulmonary embolus by spiral ct: a case study. | a thirty-eight-year old immunosuppressed woman presented with respiratory distress and was diagnosed with pneumocystis carinii pneumonia. pulmonary embolism was also suspected on clinical grounds. a ventilation-perfusion scan was indeterminate. contrast-enhanced spiral computed tomography of the chest confirmed the presence of a central pulmonary embolus and helped to avoid pulmonary angiography in this critically ill patient. | 1999 | 10650776 |
| protists as opportunistic pathogens: public health impact in the 1990s and beyond. | protist organisms (protozoa and fungi) have become increasingly prominent as opportunistic pathogens among persons infected with human immunodeficiency virus (hiv) and among organ transplant recipients--two immunocompromised populations that have increased dramatically in the past two decades. pneumocystis carinii pneumonia continues to be the most common serious opportunistic infection (oi) among hiv-infected persons in the united states, occurring frequently among persons not previously receiv ... | 2000 | 10651290 |
| clinical presentation and significance of emerging opportunistic infections. | in recent years the clinical face of the acquired immune deficiency syndrome has changed significantly as a consequence of use of prophylaxis against pneumocystis carinii pneumonia and combination antiretroviral therapy. in this context several opportunistic pathogens have emerged as causes of clinically important disease. many of these infective agents have previously been defined by specific geographical locations. their clinical presentation frequently mimics other (non) opportunistic infecti ... | 2000 | 10651291 |
| discontinuation of chemoprophylaxis against pneumocystis carinii pneumonia in patients with hiv infection. hiv outpatient study (hops) investigators. | hiv-infected patients with sustained immunologic improvement from antiretroviral therapy may be able to discontinue chemoprophylaxis against pneumocystis carinii pneumonia (pcp). | 2000 | 10651600 |
| cell type-specific regulation of fibrinogen expression in lung epithelial cells by dexamethasone and interleukin-1beta. | our recent studies demonstrating the expression of fibrinogen (fbg) by an alveolar type ii cell line stimulated with proinflammatory mediators and also in the inflamed pulmonary epithelium of animals with pneumocystis carinii pneumonia suggest that extrahepatic fbg participates in the local acute phase response (apr) to infection and subsequent wound repair. however, the mechanisms that regulate extrahepatic fbg expression are poorly understood. this study compares the regulation of hepatic and ... | 2000 | 10657942 |
| variable use of therapeutic interventions for children with human immunodeficiency virus type 1 infection in europe. | although a range of antiretroviral drugs are available for use in children, the appropriate paediatric regimen remains unclear. in a survey to investigate policies and practices relating to the therapeutic management of children infected by the human immunodeficiency virus (hiv), a postal questionnaire was sent to a named paediatrician in 70 major hiv centres in 13 european countries in early 1998. a total of 64 paediatricians (91%) responded. pneumocystis carinii pneumonia prophylaxis was found ... | 2000 | 10664230 |
| clinical presentation and outcome of pneumocystis carinii pneumonia in malawian children. | necropsy studies from africa have shown that pneumocystis carinii pneumonia (pcp) is common in infants with hiv infection. we aimed to describe the rate, clinical presentation, and outcome of pcp in young malawian children with acute severe pneumonia. | 2000 | 10665557 |
| pneumocystis carinii pneumonia following discontinuation of primary prophylaxis despite highly active antiretroviral therapy. | | 2000 | 10667904 |
| major surface glycoprotein genes from pneumocystis carinii f. sp. ratti. | pneumocystis carinii occurs in a variety of mammals, each of which harbors one or more genetically distinct "special forms" of the microbe. laboratory rats can be infected by two special forms, p. carinii f. sp. ratti and p. carinii f. sp. carinii. p. carinii f. sp. carinii has a variable antigen, the major surface glycoprotein (msg), the expression of which is controlled by genetic recombination. recombination may involve the crje, a 23-bp dna sequence element invariant among p. carinii f. sp. ... | 1999 | 10669586 |
| nosocomial tuberculosis prevention measures among two groups of us hospitals, 1992 to 1996. | to compare trends in nosocomial tuberculosis (tb) prevention measures and health-care worker (hcw) tuberculin skin test (tst) conversion of hospitals with hiv-related pneumocystis carinii pneumonia (pcp) patients and other us hospitals from 1992 through 1996. design and setting: surveys in 1992 and 1996 of 38 hospitals with pcp patients in four high-hiv-incidence cities and 136 other us hospitals from the american hospital association membership list. | 2000 | 10669678 |
| disease patterns in field and bank vole populations during a cyclic decline in central finland. | declining field vole (microtus agrestis) and bank vole (clethrionomys glareolus) populations were sampled (117 field voles and 34 bank voles) in south-central finland during the winter of 1988-89. the last surviving field voles were caught in april and bank voles in february. a subsample (16) of the april field voles were taken live to the laboratory for immunosuppression. the histopathology of the main internal organs and the presence of aerobic bacteria and certain parasites were studied. in t ... | 2000 | 10670697 |
| efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study. | this study was designed to evaluate the efficacy of therapeutic intensification with autologous stem cell transplantation (asct) for mantle cell lymphomas (mcl) in terms of response rate, duration of response, and event-free and overall survivals. twenty-four patients with confirmed mcl responding to chemotherapy received a high-dose chemo-radiotherapy regimen followed by asct. transplantation was performed during first-line therapy in nine cases, second-line in 13 cases and third-line in two ca ... | 2000 | 10673695 |
| regulation of the plasma membrane potential in pneumocystis carinii. | many protists use a h(+) gradient across the plasma membrane, the proton motive force, to drive nutrient uptake. this force is generated in part by the plasma membrane potential (deltapsi). we investigated the regulation of the deltapsi in pneumocystis carinii using the potentiometric fluorescent dye bisoxonol. the steady state deltapsi in a buffer containing na(+) and k(+) (standard buffer) was found to be -78+/-8 mv. in the absence of na(+) and k(+) (nmg buffer) or cl(-) (gluconate buffer), de ... | 2000 | 10675605 |
| microbiologically proven pneumocystis carinii pneumonia (pcp) at ga-rankuwa hospital. | | 1999 | 10678196 |
| granulomatous pneumocystis carinii pneumonia in wegener's granulomatosis. | this study reports on a first case of granulomatous pneumocystis carinii pneumonia (pcp) in a human immunodeficiency virus-negative patient with antineutrophil cytoplasmic antibody-positive wegener's granulomatosis whilst receiving immunosuppressive treatment. the patient presented with diffuse alveolar haemorrhage, pauci-immune rapid progressive glomerulonephritis and leukocytoclastic vasculitis of the skin. granulomatous pneumocystis carinii pneumonia developed under immunosuppressive treatmen ... | 2000 | 10678649 |
| decreased production of local immunoglobulin a to pneumocystis carinii in bronchoalveolar lavage fluid from human immunodeficiency virus-positive patients. | an enzyme-linked immunosorbent assay and a western blot analysis were developed to study the antibody response to pneumocystis carinii in serum and bronchoalveolar lavage fluid from 27 human immunodeficiency virus 27 (hiv)-infected patients with p. carinii pneumonia (pcp), 32 patients without pcp, and 51 hiv-negative controls. urea was used for the correct dilution of epithelial lining fluid, and albumin was used to evaluate transudation from plasma for the assessment of local production of anti ... | 2000 | 10678907 |
| granulocyte-macrophage colony-stimulating factor in the innate immune response to pneumocystis carinii pneumonia in mice. | innate immunity plays an important role in pulmonary host defense against pneumocystis carinii, an important pathogen in individuals with impaired cell-mediated immunity. we investigated the role of gm-csf in host defense in a model of p. carinii pneumonia induced by intratracheal inoculation of cd4-depleted mice. lung gm-csf levels increased progressively during the infection and were significantly greater than those in uninfected controls 3, 4, and 5 wk after inoculation. when gm-csf gene-targ ... | 2000 | 10679099 |
| effects of atovaquone and diospyrin-based drugs on the cellular atp of pneumocystis carinii f. sp. carinii. | atovaquone (also called mepron, or 566c80) is a napthoquinone used for the treatment of infections caused by pathogens such as plasmodium spp. and pneumocystis carinii. the mechanism of action against the malarial parasite is the inhibition of dihydroorotate dehydrogenase (dhod), a consequence of blocking electron transport by the drug. as an analog of ubiquinone (coenzyme q [coq]), atovaquone irreversibly binds to the mitochondrial cytochrome bc(1) complex; thus, electrons are not able to pass ... | 2000 | 10681344 |
| opportunistic infections shortly after beginning highly active antiretroviral therapy. | the clinical benefit of highly active antiretroviral therapy (haart) has been attributed to its suppression of viral replication and improvement in the cd4 lymphocyte count. however, the development of clinical symptoms secondary to previously silent opportunistic pathogens shortly after beginning haart has been reported as a distinct clinical syndrome and seems to be associated with inflammatory phenomena surrounding a rapid restoration of the immune system in previously immunosuppressed patien ... | 1998 | 10682143 |
| immunoassays for pentamidine and related compounds: development of a facile inhibitory elisa suitable for clinical use. | aromatic dicationic drugs have a broad spectrum of activity against protozoal and fungal pathogens including pneumocystis carinii, leishmania mexicana amazonensis, cryptosporidium parvum and cryptococcus neoformans. pentamidine serves as the exemplar for an extensive collection of newly synthesized related compounds, which have reduced toxicity and a wider range of target organisms. assays of pentamidine and related compounds have depended on hplc-tandem mass spectrometry (hplc-tms) for the quan ... | 2000 | 10683618 |
| pneumocystis carinii isolated from lung lavage fluid in an infant with cystic fibrosis. | pneumocystis carinii (p. carinii) cysts were identified in bronchoalveolar lavage fluid from a 15-week-old child newly diagnosed with cystic fibrosis who presented with bronchitis, pneumonia, and weight loss. the child was not infected with human immunodeficiency virus (hiv), and there was no evidence of impaired immunity or exposure to individuals with known or suspected p. carinii disease. culture of the lavage fluid also revealed pathogens typical of lung disease associated with cystic fibros ... | 2000 | 10686045 |
| common variable immunodeficiency in miniature dachshunds affected with pneumonocystis carinii pneumonia. | seven miniature dachshunds, all under the age of 1 year, were presented with polypnea, tachypnea, and exercise intolerance as a result of pneumocystis carinii pneumonia, which was diagnosed on transtracheal aspirate cytology. in all of the dogs, historical and clinical signs were suggestive of immune incompetence. immunological studies undertaken were leukogram parameters, serum immunoglobulin fraction quantification, lymphocyte transformation assay. cd3 and cd79a lymphocyte markers on lymphoid ... | 2000 | 10690774 |
| pneumocystis carinii infection in young non-immunosuppressed rabbits. kinetics of infection and of the primary specific immune response. | the aim of this study was to determine the kinetics, the dissemination of the infection and the immunological response to pneumocystis carinii primary infection in a non-immunosuppressed rabbit model. for this purpose, we developed a nested pcr that amplified a portion of the mitochondrial large-subunit rrna gene of rabbit-derived p. carinii. the pcr detected p. carinii dna in lung and bronchoalveolar lavage fluids from 14- to 45-day-old rabbits but not in their serum. no p. carinii dna was dete ... | 1999 | 10691087 |
| a review of the diagnosis and treatment of smear-negative pulmonary tuberculosis. | recommendations on the management of smear-negative pulmonary tuberculosis (tb) are still based on the behaviour of this disease in populations unaffected by the human immunodeficiency virus (hiv). studies prior to the hiv epidemic estimated that there were 1.22 cases of smear-negative and extra-pulmonary tb for each smear-positive case. patients with smear-negative pulmonary tb were found to be less infectious and to have a lower mortality, but a significant proportion (50%-71%) progressed to a ... | 2000 | 10694086 |
| outcomes of intensive care for patients with human immunodeficiency virus infection. | intensive care for patients with human immunodeficiency virus is common, costly, and associated with high morbidity. accurate and up-to-date outcome and prognostic data are needed to effectively counsel patients and to make difficult decisions regarding admission to the intensive care unit. | 2000 | 10695695 |
| hiv & aids in older adults. | many americans mistakenly believe that older adults are not at risk for hiv/aids. older people do not perceive themselves to be at risk for hiv infection, either. in reality, approximately 10% of aids cases are among people older than 50. many health care providers lack an awareness of the risk of hiv/aids in the elderly population, and as a result, many older people with these conditions are misdiagnosed with other ailments. major manifestations of hiv/aids in elderly adults include pneumocysti ... | 1999 | 10703354 |
| aerosolized pentamidine as pneumocystis prophylaxis after bone marrow transplantation is inferior to other regimens and is associated with decreased survival and an increased risk of other infections. | pneumocystis carinii pneumonia (pcp) is a life-threatening but preventable infection that may occur after bone marrow transplantation (bmt). although various prophylactic regimens have been used in this setting to prevent active infection, their efficacy, toxicity profile, and impact on outcomes are poorly described in this patient group. we undertook a retrospective cohort study in which we reviewed the records of 451 adult patients who underwent bmt for hematologic malignancies, aplastic anemi ... | 2000 | 10707997 |
| p. carinii induces selective alterations in component expression and biophysical activity of lung surfactant. | studies of pneumocystis carinii pneumonia (pcp) suggest an important role for the surfactant system in the pathogenesis of the hypoxemic respiratory insufficiency associated with this infection. we hypothesized that pcp induces selective alterations in alveolar surfactant component expression and resultant biophysical properties. pcp was induced by intratracheal inoculation of 2 x 10(5) p. carinii organisms into c.b-17 scid/scid mice. six weeks after inoculation, large (la)- and small (sa)-aggre ... | 2000 | 10710533 |
| biochemical characterization of endogenously formed eosinophilic crystals in the lungs of mice. | crystals seldom form spontaneously within tissues of mammals, except in the urinary tract or in association with eosinophil-rich diseases in humans (charcot-leyden crystals). endogenously formed eosinophilic crystals have been reported in respiratory tract and other tissues of several strains of mice, but the biochemical characterization of these crystals has not been reported. in this study, eosinophilic crystal formation was examined in homozygous c57bl/6j viable motheaten mice, lung-specific ... | 2000 | 10713123 |
| changes in pathological findings at autopsy in aids cases for the last 15 years. | to analyze changes in frequency of systemic aids pathology over time and its relationship to central nervous system pathology. | 2000 | 10714569 |
| nosocomial transmission of pneumocystis carinii in renal transplantation. | | 2000 | 10715474 |
| pneumocystis carinii mutations associated with sulfa and sulfone prophylaxis failures in immunocompromised patients. | recent studies have shown that mutations in two amino acid positions of the pneumocystis carinii dihydropteroate synthase gene are significantly more common in immunocompromised patients with p. carinii pneumonia who fail sulfa or sulfone prophylaxis. this paper reviews the studies that suggest that these mutations may be responsible for some failures of prophylaxis in p. carinii. | 2000 | 10717542 |
| molecular characterization of kex1, a kexin-like protease in mouse pneumocystis carinii. | expression screening of a pneumocystis carinii-infected mouse lung cdna library with specific monoclonal antibodies (mabs) led to the identification of a p. carinii cdna with extensive homology to subtilisin-like proteases, particularly fungal kexins and mammalian prohormone convertases. the 3.1 kb cdna contains a single open reading frame encoding 1011 amino acids. structural similarities to fungal kexins in the deduced primary amino acid sequence include a putative proenzyme domain delineated ... | 2000 | 10721706 |
| pentamidine inhibition of group i intron splicing in candida albicans correlates with growth inhibition. | we previously demonstrated that pentamidine, which has been clinically used against pneumocystis carinii, inhibits in vitro a group i intron ribozyme from that organism. another fungal pathogen, candida albicans, also harbors a group i intron ribozyme (ca.lsu) in the essential rrna genes in almost half of the clinical isolates analyzed. to determine whether pentamidine inhibits ca.lsu in vitro and in cells, phylogenetically closely related intron-containing (4-1) and intronless (62-1) strains we ... | 2000 | 10722497 |
| identification of cryptosporidium parvum dihydrofolate reductase inhibitors by complementation in saccharomyces cerevisiae. | there is a pressing need for drugs effective against the opportunistic protozoan pathogen cryptosporidium parvum. folate metabolic enzymes and enzymes of the thymidylate cycle, particularly dihydrofolate reductase (dhfr), have been widely exploited as chemotherapeutic targets. although many dhfr inhibitors have been synthesized, only a few have been tested against c. parvum. to expedite and facilitate the discovery of effective anti-cryptosporidium antifolates, we have developed a rapid and faci ... | 2000 | 10722506 |
| isolated pneumocystis carinii cell wall glucan provokes lower respiratory tract inflammatory responses. | macrophage-induced lung inflammation contributes substantially to respiratory failure during pneumocystis carinii pneumonia. we isolated a p. carinii cell wall fraction rich in glucan carbohydrate, which potently induces tnf-alpha and macrophage-inflammatory protein-2 generation from alveolar macrophages. instillation of this purified p. carinii carbohydrate cell wall fraction into healthy rodents is accompanied by substantial increases in whole lung tnf-alpha generation and is associated with n ... | 2000 | 10725735 |
| therapeutic potential of terbinafine in subcutaneous and systemic mycoses. | mycoses vary widely in severity, and may present as superficial, subcutaneous and/or systemic infection. effective treatments for most superficial mycoses now exist, but new agents with convenient dosing regimens and a low level of adverse events are still needed to reduce morbidity and mortality from serious subcutaneous and systemic fungal infections. in vitro, terbinafine exhibits a broad spectrum of activity against the pathogenic fungi responsible for deep mycoses. clinical data, while not ... | 1999 | 10730913 |