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

The underlying degree of immune suppression is an important consideration in the selection of treatment for AIDS-KS. In general, subjects with CD4+ T lymphocytes greater than 500/mm3 require only local therapy unless there is some specific disability caused by the AIDS-KS lesions. Subjects with CD4+ T lymphocytes between 200 and 500/mm3 may respond to recombinant interferon. This therapy is effective in controlling AIDS-KS, can be combined with zidovudine, and has anti-HIV properties. If interferon-alpha with zidovudine is clinically ineffective, systemic chemotherapy may then be required. Subjects with AIDS-KS and CD4+ T lymphocytes less than 200/mm3 should receive PCP prophylaxis, may require systemic chemotherapy, and should be maintained on antiretroviral therapy. Therapy of AIDS-KS is not curative, and a treatment plan of the underlying immune deficiency is essential for planning and implementing rational therapy. AIDS-KS is rarely life threatening but often cosmetically and functionally disabling. Treatment plans remain focused on palliative goals and include reduction of extremity or facial edema, elimination of painful lesions, relief of gastrointestinal disturbances induced by AIDS-KS lesions (including symptoms of outlet obstruction, diarrhea, and rarely blood loss), and reduction of the pulmonary burden of AIDS-KS to improve oxygenation and relieve obstructive pneumonias.
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PMID:AIDS-associated Kaposi's sarcoma. 160 60

IV phencyclidine (PCP) self-administration was studied in five rhesus monkeys. The animals were given 23 h per day access with each respose producing an injection. For the first seven sessions saline was made contingent on responding. For the next 30 sessions responses produced 0.01 mg/kg PCP and for the next 20 sessions responses produced 0.05 mg/kg PCP. Withdrawal signs and symptoms were evaluated every 4 h during the subsequent saline-access period. All animals responded for 0.01 mg/kg injections at rates higher than their initial saline rates. Response rates decreased but total PCP intake increased during access to the higher dose. The levels of PCP self-administered resulted in severe intoxication. Evidence for physical dependence development was obtained. The symptoms emerged within 4--8 h after access was terminated, peaked at 12--16 h, and subsided by 24--48 h. The syndrome could be reversed by IV PCP administration. The most common symptoms were vocalizations, hyperresponsivity, bruxism, oculomotor hyperactivity, and diarrhea. During withdrawal the animals refused preferred food. In some of the animals piloerection, tremors, ear and facial twitches, and priapism occurred. Rhythmic abdominal contractions and emesis were seen in one subject and convulsive activity was seen in one subject.
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PMID:Continuous-access phencyclidine self-administration by rhesus monkeys leading to physical dependence. 677 35

Two cases concerning newborn infants whose mothers used phencyclidine (PCP) during pregnancy are described. The neonatal symptoms of maternal PCP abuse were jitteriness, hypertonicity, vomiting, and one case of diarrhea. In both infants, PCP was detected in the urine during the first few days of life. Both infants were successfully treated with phenobarbital but they continued to remain jittery and slightly hypertonic following discontinuation of the therapy. In one case the infant was noted to be microcephalic. In the neonate, the symptoms of maternal PCP abuse are similar to the symptoms of narcotic withdrawal. The diagnosis of PCP effects in the neonate can be confirmed by urinalysis for the drug. The teratogenicity of PCP remains a possibility. The metabolism and treatment of PCP effects in the newborn need further clarification.
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PMID:Neonatal manifestations of maternal phencyclidine (PCP) abuse. 732 87

Four hundred and eighty six infected adults (90.7% men) were prospectively followed from 1988 to 1993 at a multiprofessional center in Santiago, Chile. 87.8% of male patients (pts)--84% of them homo/bisexual--and 64.4% of women acquired the infection sexually. At the beginning of the follow up (F/U) 51% of men and 71% of women were asymptomatic and 30% of the total group had AIDS. (AIDS definition: CDC 1993, excluded CD4 lymphocyte count < 200 x mm3). 240/486 (49.4%) had developed AIDS at the end of the study (12/31/93). AIDS defining events (ADE) were: interstitial pneumonia (confirmed or suggestive as caused by P. carinii [PCP]), 25%; tuberculosis (all forms), 22.1%; wasting, 13.8%; Kaposi Sarcoma, 9.2%; esophageal candidiasis, 6.7%; isosporiasis, 5.4%. Of all PCP cases, 72% were ADE, the rest, post.AIDS'. As expected, AIDS pts continued having major complications (mainly bacterial pneumonias, PCPs, esophagitis, tuberculosis and diarrhea due to I. belli and Cryptosporidium. Less frequently, but also observed, were toxoplasmic encephalitis and cryptococcal meningitis). Known mortality (excluded abandonment of F/U) was 27% for the whole group and varied from 5.8%, 51.6% to 69.2% for the first, 4th and 6th year of F/U respectively. For II-III CDC pts the mortality was 5% and 57% and for IV CDC pts it was 38% and 100% during the first and 6th year of F/U respectively. 36%, 53%, 74% and 85% of the pts followed for 1, 3, 5 and 6 years respectively had developed AIDS by the end of 1993. Multifactorial causes with either diarrhea, wasting or both were responsible for the death in half the pts in whom this was known, 15% died of respiratory complications and 5.7% of cryptococcal meningitis. 80% of AIDS pts survived their ADE. This study has provided information about the clinical profile of the HIV infection and natural history of the disease in Chile.
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PMID:[Clinical characteristics and natural history of human immunodeficiency virus infection. Study in a Chilean population served at a multiprofessional pilot center]. 756 47

The acquired immune deficiency syndrome (AIDS) was recognized as a distinct entity in 1981. It began as a medical curiosity affecting only several dozen individuals in a restricted segment of the U.S. population. In the 12 years since its description, AIDS has become a pandemic affecting tens of millions with cases reported from all major countries. The illness is caused by a retrovirus, termed human immunodeficiency virus (HIV). It is a blood-borne disease with sexual, parenteral, and perinatal modes of transmission. Infection with the virus can be determined by a number of serologic techniques as well as viral culture. The pathophysiology of illness is incompletely understood, but is in large part related to destruction of helper, CD4 lymphocytes. This results in immune dysfunction and the development of a variety of opportunistic infections and malignancies. A great deal has been learned over the last decade, with important advances in treatment. Zidovudine (AZT) remains the most important agent in slowing progression of the disease and has resulted in prolonging survival. All organ systems can be affected by HIV, and many clinical manifestations are protein. Fever, weight loss, and diarrhea are often encountered general symptoms. The skin is frequently involved, with Kaposi's Sarcoma the most common malignancy and a variety of fungi and viruses the most frequent cause of infection. The lung is involved in the majority of patients, with Pneumocystis Carinii (PCP) and mycobacteria emerging as the most important pathogens. A variety of treatments have demonstrated efficacy for PCP. The risk of PCP is related to the decay in CD4 lymphocytes so that prophylactic treatment is recommended when CD4 counts fall below 200. Mycobacterial infection with multiresistant organisms has complicated the management of these infections and poses new risks to health care workers. Part 1 of this two-part series on AIDS discusses the pathophysiology and clinical expression, epidemiology, laboratory testing, and the general clinical manifestations of AIDS, as well as dermatologic, pulmonary, and cardiac symptoms. Part 2 will discuss the gastrointestinal, neurologic, and ocular symptoms, as well as the treatment and management of the AIDS patient.
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PMID:The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1. 804 May 96

The first case of AIDS in India was reported in 1986. Subsequently, a surveillance system was developed in 1987. The data from this surveillance activity suggest that the HIV infection has now spread to the general population and to all parts of the country, except Arunachal Pradesh in North-eastern India. With the changing scenario of the AIDS epidemic, a host of opportunistic infections add to the present endemic state of some already existing infections like tuberculosis. This report analyses the AIDS cases in India, reported to the National AIDS Control Organization over the years between 1986 to 1997. A total of 3,551 AIDS cases had been reported till 31st May 1997. Tuberculosis (pulmonary and extrapulmonary) is the major opportunistic infection affecting 62% of the cases followed by candidiasis seen in 57% of the patients. In 1997, of the 390 AIDS cases analysed, tuberculosis (pulmonary and extrapulmonary) accounted for 56.5% of the total cases whereas candidiasis was seen in 61% of the cases. An increasing trend was observed with tuberculosis from 58% in 1986-1992 to 68.5% in 1995. No trend could be established in the case of candidiasis, though, a high prevalence of 66% was seen in the cases between 1986 and 1992. An increase was also observed in cases of PCP, cerebral toxoplasmosis and Kaposi sarcoma. In the AIDS cases, chronic diarrhea (76%), weight loss (87%) and fever (85%) appeared to be the major presenting symptoms. But, of the 390 AIDS cases reported in 1997, only 47% of them were suffering from chronic diarrhea. With increase in the number of AIDS cases, India is burdened with a dual epidemic of HIV/AIDS and tuberculosis. The National AIDS Control Organization in India, is involved in training clinicians and laboratory personnel in the diagnosis and management of the AIDS cases. With better diagnosis of the opportunistic infections, especially diarrhea, in AIDS patients, a better picture will emerge regarding the opportunistic infections which would help clinicians and health planners to tackle the AIDS epidemic in a more effective manner.
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PMID:AIDS in India: recent trends in opportunistic infections. 988 31

Clinicians have had some success in treating or preventing several rarely discussed opportunistic infections. The author discusses seven infections, outlining the disease and possible treatments. Aspergillosis, a fungal infection found in the lungs and sinuses, can be treated with intravenous amphotericin B. However, researchers are studying oral itraconazole as an alternative treatment. B-19 parvovirus is a viral infection that may cause severe anemia, a decrease in red blood cell count or hemoglobin. A small study suggests that IVIG (intravenous immune globulin) was effective in reversing B-19 parvovirus-related anemia in seven HIV-positive patients. Coccidioidomycosis, an uncommon fungal infection usually seen in the lungs, has symptoms closely resembling those of PCP. Treatments include amphotericin B, or ketoconazole or fluconazole for mild cases. Histoplasmosis usually occurs in AIDS patients with fewer than 100 CD4 cells. A fungal infection, histoplasmosis can be treated with amphotericin V and itraconazole. Isosporiasis invades the intestines, causing persistent, watery diarrhea and other symptoms resembling cryptosporidiosis. Sulfadoxine and pyrimethamine combined can prevent the return of the organism. Molluscum contagiosum is a viral infection that produces small, white wart-like bumps on the skin. Bumps can be removed with an electrical charge or with liquid nitrogen. Progressive multifocal leukoencephalopathy (PML) is a life-threatening brain disorder. A very small study suggests that patients who received cytosine arabinoside (ara-C, cytarabine) stabilized and improved after treatment.
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PMID:Out of sight, but not out of mind. 1136 70

Azithromycin (Zithromax) has been used to treat a number of infections, including mycobacterium avium complex (MAC). A study using Azithromycin to prevent MAC shows the drug's effectiveness in reducing the outbreak of MAC and also protecting from other infections, including PCP. This study involved 180 HIV-positive subjects, of which 89 received 1200 mg of Azithromycin once a week, and 91 received a placebo once a week. Fifteen percent of the treated subjects developed MAC infections compared to 30 percent of the placebo group. In addition, more subjects taking the placebo developed PCP than subjects taking the Azithromycin. Diarrhea, nausea, and abdominal pain were the most common side effects from Azithromycin.
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PMID:Azithro once a week for MAC. 1136 25