Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.16.2 (PCP)
 3,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abnormalities in local coagulation may explain alveolar fibrin deposition which often accompanies human lung injuries. The purpose of this study was to investigate the generation of procoagulant activity (PCA) and tissue factor pathway inhibitor (TFPI) in selected bronchoalveolar lavage fluids (BAL) from controls (n = 7) and from patients with interstitial lung diseases (n = 9), Pneumocystis carinii (PCP) pneumonia (n = 11) and bacterial pneumonia (n = 8). As compared with controls a significant increase of PCA was observed in the three groups with lung diseases. PCA in BAL from patients with untreated interstitial lung diseases (PC Units mean of 162 +/- 48) was significantly higher than PCA of treated patients (PC Units 36 +/- 10; p less than 0.05). Increases of PCA paralleled protein levels in BAL and the protein/albumin ratios were comparable in the four groups. TFPI was significantly increased in PCP (p less than 0.02) and bacterial pneumonia (p less than 0.03), but only marginally increased in interstitial lung diseases when compared with controls. No correlation was found between TFPI and PCA in any of the four groups. These data indicate that increased procoagulant activity observed in various lung diseases is not counterbalanced by TFPI.
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PMID:Procoagulant activity in bronchoalveolar fluids: no relationship with tissue factor pathway inhibitor activity. 161 94

A rapid diagnostic team was formed to facilitate the diagnosis of pulmonary infections in solid organ transplant recipients. Seventy-seven renal and three liver transplant recipients developed 86 episodes of pneumonitis between 6 and 2,410 days posttransplant (median, 117 days). A diagnosis was established in all but seven patients. More than one diagnosis was established in 25. Cytomegalovirus (CMV) occurred in 51 episodes, bacterial pneumonia in 16 episodes, Pneumocystis carinii (PCP) in 11 episodes, fungal or Nocardia in 10 episodes, and Legionellosis in six episodes. Over half of the episodes of pneumonitis occurred in the period 1 to 4 months posttransplant. Bacterial pneumonia occurred significantly later than pneumonitis caused by PCP, Legionella, or CMV. Death occurred in 24 transplant recipients (31%) including 19 of 49 patients (39%) with CMV. Diffuse disease was the most common abnormality noted on initial chest roentgenogram (79 of 111, 71%). Interstitial infiltrates were the most common type of radiographic lesion observed, accounting for 62 of 111 (56%). Fiberoptic bronchoscopy was performed in 69 transplant recipients. Thirty-six of the 65 diagnoses made were established early, within 24 hours after bronchoscopy. Of the remaining diagnoses established later than 24 hours, all but one case of CMV was included. Bronchial alveolar lavage alone established 31 of the diagnoses. Bronchial brushings alone established only six cases, including five episodes of bacterial pneumonia and one case of CMV. We conclude that a team approach relying on fiberoptic bronchoscopy is useful in establishing the diagnosis of pulmonary infections in solid organ transplant recipients.
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PMID:The rapid diagnosis of pulmonary infections in solid organ transplant recipients. 216 Jul 17

The AIDS epidemic continues to spread in Georgia. Almost every medical specialty is affected in some manner by the increased number of patients being diagnosed and treated with AIDS or the AIDS-related complex. Radiology has a pivotal role in documenting various opportunistic complications so that further testing and therapy may be instituted. Because of the large number of AIDS patients that develop thoracic disease, we have reviewed many of the potential pulmonary complications and their radiographic findings. Certain patterns of disease may suggest etiologies, though admittedly the chest radiograph is nonspecific. Diagnosis must be confirmed with sputum culture, bronchial lavage, and biopsy or open lung biopsy. There are key features that should be kept in mind. P. carinii, the most common pathogen, and several other opportunistic agents usually present with a fine bilateral interstitial or ground glass appearance. The presence of mediastinal adenopathy and/or pleural effusion suggests an etiology other than PCP. These findings are indicative of mycobacterial infection, KS, or lymphoma. PCP can present as a focal pulmonary consolidation, but this is unusual, and bacterial pneumonia must be considered. Finally, a small percentage of persons will present with a normal chest x-ray despite the presence of pulmonary infection or neoplasm. In those cases gallium lung scanning can help identify the affected individuals.
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PMID:Pulmonary complications in AIDS: the radiographic manifestations. 271 44

Because AIDS patients frequently present with minimal symptomatology, radionuclide imaging with its ability to survey the entire body, is especially valuable. Gallium-67 citrate, the most commonly performed radionuclide study for localizing infection in these patients, is most useful for detecting opportunistic infections, especially in the thorax. A negative gallium scan, particularly when the chest X-ray is unremarkable, rules strongly against pulmonary disease. A negative gallium scan in a patient with an abnormal chest X-ray and Kaposi's sarcoma, suggests that the patient's respiratory distress is related to the neoplasm. Diffuse pulmonary parenchymal uptake of gallium in the HIV (+) patient is most often associated with PCP. While there are other causes of diffuse pulmonary uptake, the more intense or heterogeneous the uptake, the more likely the patient is to have PCP. Focal pulmonary uptake is usually associated with bacterial pneumonia although PCP may occasionally present in this fashion. Lymph node uptake of gallium is usually associated with Mycobacterium avium complex, tuberculosis, or lymphoma. When corresponding abnormalities are present on thallium scintigraphy lymphoma is likely. Gallium positive, thallium negative, studies suggest mycobacterial disease. Labeled leukocyte imaging is not useful for detecting opportunistic infections probably because of the inflammatory response incited by these organisms. Leukocyte imaging is, however, more sensitive for detecting bacterial pneumonia. In the abdomen, gallium imaging is most useful for identifying lymphadenopathy, while labeled leukocyte imaging is superior for detecting AIDS-associated colitides. In summary, radionuclide studies are valuable diagnostic modalities in AIDS. Their success can be maximized by tailoring the study to the individual's needs.
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PMID:The role of gallium and labeled leukocyte scintigraphy in the AIDS patient. 755 45

The epidemiologic shift in HIV-infected populations from homosexual men to intravenous drug users and their sexual partners, together with the wide application of antipneumocystis prophylaxis and a better understanding of the broad range of HIV-associated illnesses, has changed our concept of the spectrum of lung infections that occur in patients with HIV infection. Bacterial pneumonia, not PCP, is the most common lower respiratory infection. Newer therapies of mild-to-moderate PCP increase the treatment options. The worldwide increase in tuberculosis cases is attributable to coinfection with HIV, and multidrug-resistant tuberculosis is now a serious threat, especially in the inner cities. Fungal pneumonias occur with increased frequency in patients with HIV infection, depending on the geographic factors and the severity of immunodeficiency.
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PMID:Pneumonia in patients with HIV infection. 807 69

The aim of this retrospective study is to evaluate the correlation between T-cell immunity and pulmonary disorders in a group of Italian subjects with HIV infection. HIV-infected patients seen at the Institute of Infectious Diseases, University of Verona, were included in this study if they had a specific acute pneumonia, a CD4+ cell count and a CD4+/CD8+ ratio during the 60 days immediately before the onset of pulmonary disease. Cases receiving any antimicrobial prophylaxis were excluded. Pneumonia was recognized by usual clinical and radiologic abnormalities. The diagnostic procedure included sputum examination, bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. The specimens were processed for bacterial, mycobacterial and fungal stains and cultures. Ziehl-Neelsen, periodic acid-Schiff and silver methenamine stains were performed on the transbronchial biopsy specimens in addition to usual pathologic examinations mononuclear. Determination of percentage of peripheral blood mononuclear cells bearing CD4+ and CD8+ markers was done by conventional fluorescent antibody cell-sorter analysis of the mononuclear cell population. Absolute number of CD4+ lymphocytes was determined by multiplying the total lymphocyte count by the percent of mononuclear cells bearing CD4+ marker. From October 1987 to August 1991, 61 patients, 50 males and 11 females, had 65 episodes of specific pneumonia. The average age of patients was 31.4 years (range 29-59 years). The risk factors for HIV infection included intravenous drug abuse (47 patients), homosexuality (6 patients), bisexuality (3 patients) and heterosexual contact (5 patients). Before the onset of pulmonary disorders, patients were classified in the following clinical HIV-related stages: asymptomatic state (22 episodes), ARC (22 episodes) and AIDS (21 episodes). In decreasing order of frequency diagnosis of pneumonias were PCP (29 episodes), community-acquired bacterial pneumonia (16 episodes), pulmonary tuberculosis (8 episodes), nonspecific interstitial pneumonia (4 episodes), PCP and pulmonary tuberculosis (3 episodes), cytomegalovirus pneumonia (2 episodes), and one of each episode of PCP and pulmonary cryptococcosis, pulmonary candidiasis, pulmonary Kaposi's sarcoma. The mean and the standard deviation of immunologic values regarding the four primary diagnostic groups were: PCP CD4+/CD8+ 0.50 +/- 0.42, CD4+/mm3 196 +/- 190; bacterial pneumonia CD4+/CD8+ 0.53 +/- 0.44, CD4+/mm3 247 +/- 139; pulmonary tuberculosis CD4+/CD8+ 0.62 +/- 0.38, CD4+/mm3 260 +/- 170; nonspecific interstitial pneumonia CD4+/CD8 + 0.57 +/- 0.48, CD4+/mm3 240 +/- 189. No significant statistical differences with respect to CD4+/CD8 ratios and CD4+ cell counts among these diagnostic groups were found by standard analysis of variance.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Acute pneumonia and cell-mediated immunity in patients with HIV infection]. 849 71

Respiratory symptoms are common in HIV-infected persons. The challenge facing clinicians is to determine whether these respiratory symptoms are due to an opportunistic infection or to a chronic process, such as asthma, chronic bronchitis, bronchiectasis, or emphysema. This article reviewed the clinical presentation, diagnosis, and treatment of two important opportunistic infections, PCP and bacterial pneumonia. It also reviewed the current data on obstructive lung diseases as they relate to HIV.
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PMID:AIDS and the lung. 867 14

We examined the effects of travel on the health of a group of HIV-infected adults (n = 89) cared for in a public hospital HIV clinic. In a period of 2 years, 45% travelled to a median of 3 US destinations for at least one week and 20% travelled to at least one international destination for a mean duration of 20 days. At the time of completion of the survey, the majority of these patients were severely immunosuppressed (median CD4+ count, 120/mm3). A physician was consulted concerning travel before 53% of the trips, but only one person consulted a travel medicine expert. All but one patient (98%) who was receiving medical therapy carried sufficient supplies of medication; 95% estimated their compliance with medication at 75% or better. None of the travellers to developing countries received gamma globulin, but one received yellow fever vaccine. Fifteen travellers (43%) became ill either during their trip or immediately thereafter; 3 required hospitalization. While most illnesses were not severe, 4 patients developed potentially life-threatening infections including coccidioidomycosis, cryptococcosis, PCP, and bacterial pneumonia. This survey provides information by which the clinician can anticipate the health care needs of HIV-infected patients who travel. HIV-infected patients should be more aware of the necessity for medical counsel prior to travel.
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PMID:Travels with HIV: the compliance and health of HIV-infected adults who travel. 904 81

Three studies that are highlighted suggest that PCP-causing microbes are developing resistance to Bactrim/Septra (B/S), the drug of choice for preventing the life-threatening complications caused by PCP, toxoplasmosis, and bacterial pneumonia. While resistance does not appear to be happening on a large scale, it is a concern because no other drug has the same beneficial effects of B/S. Research is needed for simple, low-toxicity treatments and prophylactic drugs for PCP, before resistance becomes a common problem.
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PMID:PCP prevention--more cases of resistance to sulfa drugs. 1136 81

A prospective study was conducted at Bamrasnaradura Hospital, Nonthaburi Province, Thailand from November 11, 2002 to January 5, 2003. A total of 59 HIV/AIDS patients with interstitial infiltrates on chest radiographs were included in the study. The objectives of this study were to describe the clinical manifestations and determine the etiologies of interstitial pneumonitis, assess the short-term outcomes and determine the accuracy of the clinical diagnosis of the etiologies of interstitial pneumonitis in HIV/AIDS patients at Bamrasnaradura Hospital, Nonthaburi, Thailand. Tuberculosis was the most common diagnosis (44%), followed by Pneumocystis carinii pneumonia (25.4%), bacterial pneumonia (20.3%) and fungal pneumonia (10.2%). In tuberculosis, compared to other diagnoses, a mild cough (p = 0.031), pallor (p = 0.021), lymphadenopathy (p < 0.001), absence of skin lesions (p = 0.003), higher mean body temperature (p = 0.004) and an absence of dyspnoea on exertion (p = 0.042) were significant findings. On multivariate analysis, however, only an absence of skin lesions (p = 0.023) remained a statistically significant predictor of TB. In Pneumocystis carinii pneumonia compared to other diagnoses, dyspnea on exertion (p = 0.014), non-purulent sputum production (p = 0.047), a higher mean respiratory rate (p < 0.001), absence of lymphadenopathy (p < 0.001) and lack of purulent sputum (p = 0.030) were significant factors. By multivariate analysis, only an absence of lymphadenopathy were shown to be independently and statistically significantly associated (p = 0.040). In bacterial pneumonia, compared to other diagnoses, production of purulent sputum (p = 0.014), hemoptysis (p = 0.006), pallor (p = 0), skin lesions (p = 0.002) and a severe cough (p = 0.020) were significantly associated factors. On multivariate analysis, none of these factors were statistically significant. In fungal pneumonia, compared to other diagnoses, headache and papulonecrotic skin lesions were common findings, but no factor had a significant association. After four weeks, 59.3% of the patients were alive, 13.6% died and 27.1% were lost to follow-up. Among the alive patients 88.6% had clinically improved. On multivariate analysis, no factor was shown to be a statistically significant predictor of death. The cumulative survival after 28 days was highest among PCP patients, followed by bacterial pneumonia, tuberculosis and fungal pneumonia, but this difference was not statistically significant (p = 0.0453).
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PMID:Clinical features, etiology and short term outcomes of interstitial pneumonitis in HIV/AIDS patients. 1661 Jun 49


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