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

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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)

We studied the sensitivity of ISA for diagnosis of second-episode PCP in AIDS patients. We induced sputum in 218 patients who had known or suspected AIDS and who had a presentation suggestive of PCP. All patients with negative sputum smear for PCP underwent BAL. Twenty-five patients were identified who had second-episode PCP at least 30 days after initial diagnosis. Chest roentgenographic infiltrate patterns for these 25 patients were blindly scored as normal, diffuse, upper lobe or focal non-upper lobe. The sensitivity of ISA was 72 percent for the first episode of PCP, 72 percent for the second episode of PCP, 72 percent for patients with second-episode PCP who had initial PCP detected by ISA and 71 percent for patients with second-episode PCP whose first episode of PCP was missed by ISA. Of the ten patients who were treated with AP, only one had a false-negative sputum analysis. A comparison of patients who had second-episode PCP diagnosed by ISA with those who had false-negative sputum analysis showed no difference in time to relapse, chest x-ray film pattern (all diffuse) or use of AP.
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PMID:Analysis of induced sputum for the diagnosis of recurrent Pneumocystis carinii pneumonia. 139 59

We report the experience with Pneumocystis carinii lung infections in the 109 children undergoing liver transplantation at our hospital between August, 1985 and May, 1989. PCP developed in 9 of the 86 patients (10%) surviving > or = 6 weeks after transplantation and not receiving P carinii chemoprophylaxis. Of the 59 patients undergoing BAL 2 or more weeks after transplantation there were 16 specimens from 14 patients (24%) positive for P carinii. These patients had a spectrum of illness ranging from asymptomatic to severe pneumonia requiring mechanical ventilation. The mean interval from first transplantation to bronchoalveolar lavage positive for P carinii was 24.9 weeks and the mean interval to first PCP was 28.0 weeks. The earliest and latest occurrences of PCP were 7 weeks and 73 weeks, respectively, after transplantation. There were no complications attributed to BAL.
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PMID:The spectrum of Pneumocystis carinii infection after liver transplantation in children. 141 53

Pulmonary surfactant is altered in experimental Pneumocystis carinii pneumonia. Although P carinii is a major causative agent of pneumonia in immunocompromised patients, the pathophysiology of lung injury caused by this organism is poorly understood. Therefore, we studied bronchoalveolar lavage specimens obtained from 19 HIV-infected subjects with PCP compared with specimens from ten healthy control subjects. As iterative BAL was performed, 37 BAL specimens were analyzed for protein and phospholipid. The BAL samples were divided into two groups as follows: 22 BAL samples with the presence of P carinii and 15 BAL samples without P carinii. Compared to control subjects, HIV+ BAL presented a significant increase of PR and a decrease of total PL in both P carinii+ and P carinii- BAL, but in P carinii+ BAL, the fall of PL/PR ratio was significantly more pronounced compared to P carinii- (0.09 +/- 0.02 vs 0.19 +/- 0.04, p less than 0.02). The BAL performed during the recovery of PCP showed an improvement of initial biochemical abnormalities. Surfactant composition was also altered, with a phosphatidylcholine and phosphatidylglycerol drop and a sphingomyelin and lysophosphatidylcholine increase. The presence, even in P carinii- BAL, of less polar compounds of undetermined nature, was revealed. We concluded that in HIV+ patients, abnormalities of pulmonary surfactant were present before PCP, and that the development of PCP enhances these abnormalities. These surfactant alterations may contribute to the saprophyte-pathogen transformation of P carinii, but this hypothesis requires further investigation that is presently in progress.
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PMID:Surfactant analysis during Pneumocystis carinii pneumonia in HIV-infected patients. 160 Jul 73

We correlated bronchoalveolar lavage findings with the clinical course and outcome of Pneumocystis pneumonia. Forty-eight patients with AIDS and a confirmed diagnosis of P carinii pneumonia were studied. Patients with additional pulmonary infections were excluded. On the basis of BAL findings, they were divided into those with a low neutrophil count (less than 5 percent) and those with a high neutrophil count (greater than or equal to 5 percent). Sixteen patients with AIDS but without PCP served as a control group. All BAL fluid samples from the control group showed a low neutrophil count. The group with PCP and a high neutrophil count had more severe respiratory compromise and greater morbidity than the group with PCP and a low neutrophil count. Mortality rate was not different. The group showing a high BALF neutrophil count also showed a higher BALF protein concentration, a higher ratio of BALF protein concentration to plasma protein concentration, and the presence of alpha 2-globulins compared with other groups. These findings suggest that increased alveolar-capillary permeability occurs during severe PCP.
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PMID:Correlation of bronchoalveolar lavage findings to severity of Pneumocystis carinii pneumonia in AIDS. Evidence for the development of high-permeability pulmonary edema. 162 98

To determine if urine pentamidine was reflective of lung pentamidine, we compared levels of the drug in bronchoalveolar lavage fluid and simultaneously obtained urine. Thirty-one patients who were receiving aerosolized pentamidine either as treatment or as prophylaxis underwent BAL and submitted urine samples for pentamidine analysis. Pentamidine was analyzed in both phases of BAL fluid (supernatant and cell pellet) and in urine using high performance liquid chromatography. Urine results were normalized for creatinine. Patients were categorized as prophylaxis failures (active Pneumocystis carinii pneumonia on prophylaxis), electives (free from PCP on prophylaxis), treatment (daily AP in treatment doses for active PCP, or miscellaneous (single dose of AP). Levels in BAL fluid and urine varied widely over several orders of magnitude. However, for all patients, we found a highly significant relationship between BAL supernatant and urine (r = 0.97, p less than 0.0001). No statistical differences were found when comparing levels of pentamidine between failures and electives; however, the number of failures was small. We conclude that urine pentamidine is related to lung pentamidine and can be used as a clinical indicator in patients receiving aerosolized therapy.
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PMID:Urine pentamidine as an indicator of lung pentamidine in patients receiving aerosol therapy. 193 74

A broad spectrum of lung disease occurs in association with HIV infection. Included are both infectious and neoplastic processes and idiopathic disorders. To insure prompt, accurate, and efficient diagnosis, a logical, staged sequence of tests should be applied. Chest films and, in some instances, pulmonary function tests and gallium-67 citrate lung scans serve to provide objective indications of lung disease. Each of these tests is sensitive but nonspecific. Specific infecting organisms, particularly P. carinii, can be identified by examining sputum induced by inhalation of 3 per cent saline. Bronchoscopic procedures, including BAL and TBB, are highly sensitive and should be performed in patients having nondiagnostic sputum examinations. Tests involving antigen and antibody detection are of little use in the evaluation of individual patients. Detection of recurrent episodes of PCP is difficult because abnormalities in the usual screening tests may be residual from previous episodes. Finding P. carinii in sputum or bronchoscopic specimens soon (within 2 to 3 months) after a confirmed episode of PCP likely represents residual organisms rather than recrudescence of the infection. Empiric diagnosis of P. carinii should be employed only in limited circumstances when specific diagnostic studies are not available, are contraindicated, or are refused.
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PMID:Diagnosis of pulmonary diseases. 304 85

Based on our experience, we would like to offer a few pragmatic suggestions for the practicing clinician. These recommendations are summarized in Tables 1 and 2. The first encounter with most patients gives the impression of either a dramatic acute infection, usually in the lungs, central nervous system, or gastrointestinal tract (in this order of frequency), or that of a chronic wasting disease. The former is frequently superimposed on the latter. The exploration of AIDS risk factors and a few easily detectable physical signs are the most important clues to the correct clinical diagnosis. Once AIDS is suspected, an aggressive and rapid approach for diagnosis is justified. Selected individually for each patient, the most commonly successful tests include bronchoscopy with BAL and/or transbronchial lung biopsy; bone marrow, lymph node, or liver biopsy with both microbiologic and pathologic processing of the material; blood (and often spinal fluid) cultures for fungal organisms; cranial computerized tomographic scan; and toxoplasma serology. Other tests, while potentially useful, are less important in immediate decision-making and treatment. In all cases of respiratory compromise or symptoms related to the chest, PCP has to be ruled out by invasive methods if the suspicion of AIDS is sufficiently strong. The diagnosis of one opportunistic infection should not be interpreted as a final answer. Rather, it should stimulate more vigilant efforts to uncover additional infections and other AIDS-related diseases if any abnormalities remain unexplained or persist despite treatment. Chest radiology should not be the main tool to diagnose or monitor lung infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pulmonary infections in AIDS. 354 59

The presence of P. carinii DNA in serum and in Peripheral Blood Mononuclear Cells (PBMC) during acute phase of PCP in AIDS patients was previously demonstrated by several authors using different specific primers. Amplification by ITSs nested PCR followed by TSO hybridization of P. carinii isolates derived from BAL and blood samples allows to compare genotypes involved in the disease and genotype-related dynamics of Pc-DNA clearance from blood during therapy. Different virulence characteristics among P. carinii genotypes could explain the various spectrum of clinical presentation (pulmonary and extrapulmonary) and susceptibility to classic antipneumocystic drugs during PCP.
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PMID:ITSs genotypes and blood dissemination during acute PCP. 950 17

We have evaluated a PCR technique using primers based on Pneumocystis carinii major surface glycoprotein (MSG) genes, a multicopy gene family, for utility in detection of P. carinii in BAL and oropharyngeal samples obtained from immunosuppressed patients. These primers were able to detect P. carinii DNA in as little as 16 fg of genomic DNA. PCR using MSG primers detected P. carinii DNA in 7 smear-positive BAL samples (100% sensitivity), and found no P. carinii DNA in 12 smear-negative BAL samples (100% specificity). Mitochondrial ribosomal RNA (mrRNA) primers, commonly used in PCR studies of PCP, detected P. carinii in six of seven positive samples (85.7% sensitivity) and none of 12 were negative samples (100% specificity). Diagnosis of PCP by amplification of 81 oropharyngeal samples using MSG primers had a 50% sensitivity (4/8) and 96% specificity (70/73). PCR with mrRNA primers was 37.5% sensitive (3/8) and 100% specific (73/73). All three false-positive MSG results showed a very low intensity on Southern hybridization. PCR using MSG gene primers should prove valuable in the diagnosis of PCP.
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PMID:Development of a PCR assay for diagnosis of Pneumocystis carinii pneumonia based on amplification of the multicopy major surface glycoprotein gene family. 1052 78

A method of collecting pharyngeal and oral swabs from humans and laboratory rats, to be examined later for Pneumocystis infection with simple and nested PCR, was developed. The swabs were obtained from 15 HIV-infected patients, including 5 suffering from PCP, and from 10 immunocompetent children aged 2 to 6 years. Furthermore, the swabs were taken from 30 healthy laboratory rats and 23 animals subjected to immunosuppressive treatment. DNA of Pneumocystis was detected in all the examined rats with nPCR method, but only in 47% of healthy animals when simple PCR was used. Nested PCR examination of swabs collected from human subjects revealed the infection with Pneumocystis in all HIV-infected patients with PCP, and in 8 out of 10 symptomless carriers of Pneumocystis; moreover, the examination was positive in 2 out of 10 immunocompetent children. It was concluded, that noninvasive method of collecting pharyngeal and oral swabs in conjunction with very sensitive method of amplification DNA by nPCR is suitable for measuring the prevalence of Pneumocystis infection in the populations of humans and laboratory animals. The developed method offers a possibility of safe diagnosis of pneumocystosis in patients whose clinical status precludes collection of BAL through bronchoscopy.
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PMID:[An evaluation of the occurrence of pneumocystis infection through examination of pharyngeal and oral swabs using the nested PCR method]. 1764 15


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