Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

Query: EC:3.4.16.2 (PCP)
3,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the development of a reduced DLCO in patients with HIV-related disease, we studied 474 HIV-seropositive patients and performed serial lung function measurements over 18 months. The mean values of DLCO at presentation were lower in patients with more advanced HIV disease compared with asymptomatic HIV-seropositive patients (DLCO 88% of predicted). When compared with the DLCO in asymptomatic HIV-seropositive patients, the DLCO had reduced values in patients with persistent generalized lymphadenopathy (PGL) (82% of predicted, p less than 0.05), acquired deficiency syndrome-related complex (ARC) (73% predicted, p less than 0.001), nonpulmonary Kaposi's sarcoma (KS) (72% of predicted, p less than 0.001), nonpulmonary complications of AIDS excluding KS (73% of predicted, p less than 0.001), pulmonary KS (63% of predicted, p less than 0.001), pulmonary mycobacterial infection (68% of predicted, p less than 0.05), pyogenic infection (70%, p less than 0.05), acute Pneumocystis carinii pneumonia (PCP; 49%, p less than 0.001), and following recovery from PCP (71%, p less than 0.001). Serial lung function measurements over 18 months revealed no change in DLCO within any patient group, and in particular there was no tendency for a gradual decline. Clinical deterioration due to the development of PCP was associated with a reduction in DLCO. Conversely, in patients recovering from PCP, there was a partial improvement in DLCO over 3 months. Zidovudine (AZT) use did not affect DLCO within any diagnostic group or the recovery in DLCO following PCP. However, cigarette smoking was associated with further reductions in DLCO in all patient groups and with an impaired recovery of DLCO following acute PCP.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Pulmonary function in human immunodeficiency virus infection. A prospective 18-month study of serial lung function in 474 patients. 151 57

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.
...
PMID:Pulmonary complications in AIDS: the radiographic manifestations. 271 44

The most frequent radiographic presentation of (PCP) is bilateral interstitial or alveolar infiltrates. Atypical features include lobar distribution, pleural effusions, hilar adenopathy, cyst formation and spontaneous pneumothorax. A diffuse miliary pattern has not been described previously for PCP. A 30-year-old male intravenous drug abuser, with AIDS, presented to our institution complaining of fever and productive cough. Admission chest x-ray film revealed a "classic" miliary pattern. Sputum smears were negative for acid-fast bacilli and both bronchoalveolar lavage and transbronchial biopsy revealed only PCP. Repeat bronchoscopy one month later was unrevealing and marked x-ray resolution occurred after treatment with pentamidine alone. The incidence of atypical roentgenographic features of PCP in AIDS is approximately 10 percent. Given the frequency of this infection in AIDS, knowledge of the unusual presentations is imperative. Based on this report, PCP must be included in the differential diagnosis of a miliary x-ray pattern.
...
PMID:Miliary PCP in AIDS. 278 60

The clinical features of our cases demonstrated some of the already known characteristics of the variable spectrum of HIV infection. DA are the most important risk category in Italy. 10% of the ARC cases evolved into AIDS during a 12-month follow-up, on average. The most frequent OI in our AIDS cases were PCP, C. albicans esophagitis and chronic mucocutaneous ulcers. An high percentage of neurologic involvement from HIV was observed, and malignancies were encountered in AIDS (3 KS and 1 undifferentiated B lymphoma) as well as in ARC (1 Hodgkin's lymphoma). Statistically, significant worsening of the immunologic situation is evident as the disease progresses from LAS to AIDS. Activated B lymphocytes represent most of the cells of the germinal center during the hyperplastic stage of lymphadenopathy. Reversal of the T4/T8 ratio appears early during the initial stage of lymphadenopathy and is due to a decrease of CD4 and a relative increase of CD8. Also, destruction of the follicular dendritic cells is an early feature which becomes more evident as the disease advances and the lymph node evolves toward progressive involution. Activated B-lymphocyte augmentation with polyclonal Ig secretion appears to be related to T-independent B stimulation by coinfection such as CMV, EBV and HBV. The increase of cytotoxic/suppressor lymphocytes seems to be partly related to the excessive activation of B lymphocytes and partially directed to the cells infected by HIV or coated with its proteins (6,7,8,9). The destruction of follicular dendritic cells has been interpreted not only as a killer effect of the virus but also as a result of the intervention of CTL sensitized to the cells containing the virus (10,11). Their destruction may contribute to the impaired recognition of soluble antigen which is one of the main features of the immune deficiency of HIV infection (9,13,16).
...
PMID:A clinical-immunological evaluation of AIDS cases and related syndromes. 348 82

The data suggest that: The recent outbreak of KS and PCP is a single epidemic, that of immunosuppression among homosexual men and drug abusers. The public health significance of this epidemic is probably underestimated, and clinicians should be alert to more subtle indications of immunosuppression, such as nonfatal opportunistic infections, unexplained lymphadenopathy, or other tumors. Opportunities to clarify the relationships between the environment, immunology, cancer, and infections make this outbreak scientifically important. The sudden and highly focal occurrence of these illnesses among homosexual men and drug addicts suggests a potential for their prevention if risk factors or etiologic agent(s) can be identified. The staggering morbidity and mortality associated with this outbreak dictate immediate concerted efforts to identify risk factors.
...
PMID:The current outbreak of Kaposi's sarcoma and opportunistic infections. 681 92

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.
...
PMID:The role of gallium and labeled leukocyte scintigraphy in the AIDS patient. 755 45

A 49-year-old Japanese male who had been imprisoned for five years then lived with other men complained of fever, constitutional symptoms and a 12 kg weight loss over four-month period. He was referred to us as his gastric washings were positive for acid-fast bacilli (AFB). Chest X-ray showed patchy, infiltrative small shadows primarily in the right upper lung field without hilar adenopathy. Before transfer to our hospital, tuberculosis chemotherapy composed of SM, INH, RFP and PZA was initiated. Over the next three weeks, fever dropped, and the above described abnormal shadows on the chest X-ray improved, leaving small cystic lesions. Although a sputum smear was negative for AFB, M. tuberculosis was isolated from cultured samples and sensitive to all standard anti-tuberculous drugs. AFB were also demonstrated on a touch imprint of biopsied cervical lymph nodes. Sputum samples turned negative one month later both on smear and culture. Moreover, high fever developed and another abnormal shadow indicative of Pneumocystis carinii (PCP) appeared in the left lung field one month after the admission. White plaque was noted in the oral cavity. Dark red nodules were observed on the upper extremities and chest wall, and diagnosed histologically as Kaposi's sarcoma. Serologic testing for HIV was positive both by PA and Western blot methods, thus AIDS was diagnosed according to the CDC surveillance case definition for AIDS with the diagnosis of tuberculosis. The patient died of wasting syndrome on the 90th hospital day. On autopsy, small thin-walled cavities were observed in the right upper lung, correlating with earlier X-ray and CT findings.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[A case report of the atypical tuberculosis associated with AIDS]. 756 52

To assess the prevalence of atypical PCP patterns in AIDS patients, the chest films of 300 patients with clinical and laboratory diagnosis of PCP were reviewed. We considered as atypical patterns the finding of an asymmetric lesion, the involvement of apical regions, pleural effusion, hilar and/or mediastinal lymphadenopathy, parenchymal nodules and pneumatoceles. In some patients more than one of these patterns was found. Atypical patterns were observed in 32% of cases and consisted of: unilateral involvement in 11% of cases, apical involvement in 6%, pleural effusion in 9%, hilar and/or mediastinal lymph nodes in 4%, parenchymal nodules in 6% and finally pneumatocele in 12% of cases.
...
PMID:[Atypical radiological images in Pneumocystis carinii infection in HIV-positive patients]. 804 29

A 27-year-old woman, who is being successfully treated for HIV, has mostly normal results from physical examinations and feels well. Yet she had a chest X-ray that showed prominent perihilar adenopathy and a miliary pattern in all lung fields. Medical records from an open lung biopsy, photographs taken during the biopsy, and the pathology reports reveal histoplasma capsulatum infection, a rare occurrence in late-stage HIV infection, especially without concurrent symptoms including fever, wasting, cytopenias, and oral and intestinal ulcerations. It is not known whether the patient's highly active antiretroviral therapy allowed her to react to this organism as immunocompetent persons do, which is with well-formed granulomas. Her travel history was evaluated and showed that she had briefly passed through histoplasma-endemic areas of the southern United States. However, tests for histoplasma antigens returned negative, as did tests for serum histoplasma antibodies. Two immunohistochemical stainings for PCP were also both negative. The patient is being treated with Itraconazole, and may also be treated with a 3-week course of atovaquone for recurrent PCP.
...
PMID:An alarming x-ray in a patient who feels well. 1136 83

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).
...
PMID:Clinical features, etiology and short term outcomes of interstitial pneumonitis in HIV/AIDS patients. 1661 Jun 49


1 2 Next >>

---