Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The increased use of immunosuppressive regimens in organ transplantation and in the treatment of malignant lesions and the epidemic of acquired immunodeficiency syndrome (AIDS) are major reasons for the greater prevalence of fungal infections seen in clinical practice during the past decade. The traditional cornerstone of antifungal treatment, amphotericin B, continues to play a major role in deep-seated mycotic infections. The indications for intravenously administered miconazole have become limited. Orally administered flucytosine remains useful in certain infections, particularly cryptococcal meningitis. The new orally administered antifungal agents ketoconazole and fluconazole have been approved for clinical use and have supplanted amphotericin B in certain situations. Investigational antifungal agents, including liposomal amphotericin B, itraconazole, and saperconazole, hold promise for the future. Active investigation in the development of new antifungal agents is expected to continue.
 ...
PMID:Antifungal agents used for deep-seated mycotic infections. 173 94

Three patients with AIDS who had cryptococcal meningitis were treated with liposomal amphotericin B after unsuccessful treatment with fluconazole and conventional amphotericin B. One patient responded but relapsed nine weeks later; he responded to a second course of treatment but again relapsed and subsequently died. Another patient deteriorated despite an improvement in cryptococcal antigen titres. The third patient was found to have culture negative CSF and treatment was therefore stopped. None of the patients suffered any adverse effects and renal function improved in all after conventional amphotericin was stopped and liposomal amphotericin B commenced.
 ...
PMID:Experience with liposomal amphotericin B (AmBisome) in cryptococcal meningitis in AIDS. 177 87

Cryptococcus neoformans infection occurs frequently in patients with the acquired immune deficiency syndrome (AIDS). Cryptococcal meningitis can result in optic neuropathy. Improvement in afferent visual system dysfunction has not been documented. We report three patients with AIDS who developed either unilateral (1) or bilateral (2) afferent visual system dysfunction. The bilaterally affected patients had visual field deficits compatible with chiasmal involvement. All patients had improvement in their vision following appropriate treatment with amphotericin B. Reactivation of cryptococcal infection was heralded by neuro-ophthalmic manifestations in two patients, in spite of maintenance therapy. Despite the poor overall prognosis, AIDS patients with presumed cryptococcal optic neuropathy can benefit from optimal therapy.
 ...
PMID:Cryptococcal optic neuropathy in the acquired immune deficiency syndrome. 183 92

A 35-year-old male homosexual with AIDS presented with headache and fever and was found to have cryptococcal meningitis. During the patient's hospital course, his hemodynamic status deteriorated as a result of pericardial tamponade. Antemortem analysis of the fluid was unrevealing; however, postmortem examination of the pericardium revealed typical intranuclear inclusions of cytomegalovirus infection. Cytomegalovirus should be included in the differential diagnosis of pericardial effusion in patients with AIDS.
 ...
PMID:Pericarditis with tamponade due to cytomegalovirus in the acquired immunodeficiency syndrome. 184 26

A patient with a positive human immunodeficiency virus (HIV) titer and cryptococcal meningitis suffered bilateral epithelial keratopathy caused by Encephalitozoon, which did not respond to sulfas, erythromycin, bacitracin, tobramycin, neomycin, polymyxin B, or fluconazole. Eventual administration of itraconazole for the meningitis apparently produced resolution of the long-lasting (2-month) ocular infection. This new oral triazole antifungal may be valuable against the increasingly prevalent microsporidial infections in patients with acquired immune deficiency syndrome. Debulking of the infection by corneal scraping may have contributed to the authors' success.
 ...
PMID:Resolution of microsporidial epithelial keratopathy in a patient with AIDS. 184 25

Sixteen patients with AIDS (6% of the total AIDS patients) who had infection by Cryptococcus neoformans were studied. Most of these patients (94%) had cryptococcal meningitis. Only 50% of the cases showed clinical manifestations of neurological involvement. Blood cultures and antigen level measurement were the diagnostic techniques with best results due to their high percentage of positivity. Sixty nine percent of patients survived the acute phase of the infection and only 3 of those who died in this period showed evidence of active infection patients by the fungus.
 ...
PMID:[16 cases of infection by Cryptococcosis neoformans in patients with AIDS]. 185 56

The extra demands placed upon health care resources by management of AIDS patients have increased the focus on cost implications of therapeutic alternatives. Cryptococcal meningitis is a common life-threatening infection in AIDS patients, usually treated with amphotericin B, often in combination with flucytosine. Administered intravenously, this therapy is associated with frequent and often severe side effects. Fluconazole is a new alternative which can be given orally once daily and has fewer such side effects. The purpose of this study was to examine the cost implications of these different therapies for both primary and maintenance treatment of cryptococcal meningitis. Comparison of these two therapies in recent clinical trials has indicated that fluconazole is at least as effective as amphotericin B, and therefore cost-minimisation analysis is an appropriate method to study the economic consequences of the alternative treatments. Patient management and resource-use information for both treatments was obtained using a modified Delphi technique with a panel of European physicians experienced in the treatment of this disease, and three models were developed to reflect the variability of practice evident among the panel members. U.K. health care costs were used to value these resources. The results indicated that, despite the higher cost of the drug itself, the costs associated with fluconazole were likely to be markedly less than those for amphotericin B for primary treatment, and similar or slightly cheaper for maintenance treatment. Over 1 year of treatment, the saving from the use of fluconazole would be in the range of 4000-14,000 pounds.
 ...
PMID:Cost implications of alternative treatments for AIDS patients with cryptococcal meningitis. Comparison of fluconazole and amphotericin B-based therapies. 149 15

Increased intracranial pressure has been a noteworthy problem in some of our patients with cryptococcal meningitis and acquired immunodeficiency syndrome (AIDS), and this appears to be a feature observed in patients with cryptococcal meningitis reported in the literature. Whereas most attention of clinicians is presently focused on optimizing the antifungal regimen, so as to improve on high failure rates in cryptococcal meningitis in AIDS, little attention has been paid to the problem of intracranial hypertension. We argue that visual loss and some of the cases of death early after the onset of chemotherapy may be related to high cerebrospinal fluid (CSF) pressure, regardless of antifungal therapy. The possible pathophysiologic mechanisms are discussed, and we postulate that the mechanism is reduced CSF outflow possibly due to increased outflow resistance, not necessarily accompanied by prominent cerebral edema. Optimal therapy of this complication is not yet established, but some measures that may be helpful are ventricular shunting, frequent high-volume lumbar punctures, and possibly glucocorticoids.
 ...
PMID:Elevated cerebrospinal fluid pressures in patients with cryptococcal meningitis and acquired immunodeficiency syndrome. 189 47

Fluconazole is a recently approved agent for the treatment of certain fungal infections. Based on available studies, the drug is clearly effective in oropharyngeal candidiasis in immunosuppressed hosts. Current evidence suggests it may be more efficacious than other azole drugs for oropharyngeal disease. It is probably also effective in other infections due to Candida species, but controlled studies are lacking. Fluconazole is also efficacious in the treatment of cryptococcal meningitis, but recent reports question its use as initial therapy in HIV-infected patients with this illness. The drug, however, is clearly more effective than amphotericin B in the suppression of cryptococcal meningitis in AIDS patients and is the treatment of choice in this situation.
 ...
PMID:Fluconazole: a new triazole antifungal agent. 189 59

We have presented the clinical history and temporal bone findings in a patient who manifested sudden hearing loss, and who subsequently was found to have cryptococcal meningitis associated with AIDS. The histopathologic findings are similar to earlier reports in patients without AIDS. Because cryptococcal infection is so much more common in AIDS patients than in the general population, it must be considered a causative factor when presented with an AIDS patient with progressive or sudden hearing loss. This offers the patient a chance for timely and effective treatment.
 ...
PMID:Sudden hearing loss due to AIDS-related cryptococcal meningitis--a temporal bone study. 190 Nov 59


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>