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)

Despite the recognition of Mycobacterium avium complex (MAC) infection as a common complication of AIDS, the specific clinical features, significance, and need for treatment have been difficult to assess. We reviewed the clinical records and autopsy material of 68 patients dying with AIDS, 32 (47 percent) of whom had MAC isolated from autopsy tissue. All had postmortem evidence of systemic infection. Eleven (34 percent) had MAC isolated from lung tissue. Little, if any, local tissue inflammation and destruction were associated with MAC infection. Patients with autopsy evidence of MAC infection had a longer time interval from diagnosis of AIDS to death. The infection was detected antemortem in 14 (44 percent), blood culture being the most sensitive means (86 percent yield). Although recurrent fever was noted among both MAC infected and uninfected patients, weight loss greater than 20 lb, weakness, anorexia, abdominal pain, and diarrhea were more frequent among infected patients. Severe anemia, thrombocytopenia, lymphopenia, and reduced mean CD-4 percentages and CD-4/CD-8 ratios were associated with MAC infection. Of eight patients who had MAC cultured antemortem and received multidrug antituberculosis therapy, none responded clinically, and all but one had MAC isolated at autopsy. Because MAC is associated with significant discomfort and disability, development of more effective treatment regimens could be beneficial for some affected AIDS patients.
 ...
PMID:Mycobacterium avium complex infection in patients with the acquired immunodeficiency syndrome. A clinicopathologic study. 335 47

Three patients with the acquired immune deficiency syndrome (AIDS) or AIDS-related complex and lymphocytic interstitial pneumonia are reported. All patients presented with progressive dyspnea, nonproductive cough, fever, anorexia, weight loss, and arterial hypoxemia. Chest roentgenograms exhibited bilateral diffuse reticular-nodular densities. The diagnosis of lymphocytic interstitial pneumonia was made by fiberoptic bronchoscopy or open lung biopsy. Two patients were treated with corticosteroids, with significant improvement. The third patient died of pneumonia due to Pneumocystis carinii six months after the diagnosis of lymphocytic interstitial pneumonia was established. Serum antibodies to human immunodeficiency virus (HIV) were demonstrable in the two patients in whom the test was performed. Lymphocytic interstitial pneumonia is probably another pulmonary manifestation of AIDS or AIDS-related complex. Although the clinical presentation may be identical to the more common opportunistic infections, the treatment differs, and the prognosis may be better.
 ...
PMID:Lymphocytic interstitial pneumonia in patients at risk for the acquired immune deficiency syndrome. 349 42

A case of cryptosporidiosis in a male homosexual man with AIDS is reported. The clinical manifestations were anorexia, mild fever, abdominal pain and profuse watery diarrhea. The diagnosis was made in fecal smears by using a modified Ziehl-Neelsen method and a safranin-methylene blue staining technique.
 ...
PMID:Cryptosporidiosis in the acquired immunodeficiency syndrome: a case report. 369 52

Acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) is more virulent than previously reported cases of KS and affects a much younger population. The cell of origin is lymphatic endothelium, with the histopathology characterized by a proliferation of small vessels with abnormal endothelial cells, extravasated erythrocytes, and spindle-shaped-cell infiltration. Clinical manifestations are pigmented, nodular lesions affecting the skin, mucous membranes, lymph nodes, and/or visceral organs. The head and oral cavity, uncommon sites in other KS populations, are frequently involved. Pain is not an early part of the clinical picture. AIDS-related KS is often widespread and rapidly progressive. However, the cause of death in most cases is attributed to opportunistic infection, which is believed to increase as a result of conventional cytotoxic chemotherapy. Recombinant interferon alpha has been the most thoroughly tested of immune-stimulating or nonimmunosuppressive drugs for the treatment of AIDS-related KS. An objective antineoplastic response rate (25% to 60%) comparable to single-agent chemotherapy with vinblastine or VP-16 has been demonstrated in several trials. Response rates to interferon alpha may be enhanced by such factors as absence of lymphoma-like B symptoms, low levels of circulating acid-labile interferon alpha, and absent history of recent serious infection. Varied drug dose, schedule, and route of administration have been employed; doses equal to or greater than 30 million U/day administered intravenously or intramuscularly appear to give the best results. Daily dosing regimens may induce tolerance for subjective toxicities (eg, fever, asthenia, and anorexia), which are often dose limiting. Direct immune stimulation following treatment with interferon alpha has not been conclusively established, but evidence suggests that respondents have low rates of opportunistic infection. Other recent studies demonstrate interferon alpha inhibiting activity against the AIDS-associated retrovirus in vitro and trials in vivo are in progress to define the clinical relevance of this observation.
 ...
PMID:Recombinant interferon alpha in the treatment of acquired immune deficiency syndrome-related Kaposi's sarcoma. 390 16

29 patients (19 males and 10 females) in Haiti were diagnosed as having acquired immunodeficiency syndrome. Their clinical presentation was characterised by unexplained chronic diarrhoea, prolonged fever, extreme weight loss, anorexia, and severe infections. The infectious agents included: Candida albicans (27 patients), Mycobacterium tuberculosis (7 patients), Cryptosporidium (11 patients), Pneumocystis carinii (2 patients), cytomegalovirus (4 patients), and herpes virus (3 patients). In 1 woman Kaposi's sarcoma developed during the course of her disease. Immunological studies of 20 patients revealed profound cell-mediated immune deficiency with cutaneous anergy, marked decrease in the number of T helper cells, and impairment of lymphocyte proliferation. 18 patients died.
 ...
PMID:Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti. 613 96

Ten patients were identified at Jackson Memorial hospital/University of Miami Hospitals and Clinics with enteric coccidial infection due to Cryptosporidium spp. or Isospora belli. All had the acquired immunodeficiency syndrome as manifested by Kaposi's sarcoma or multiple opportunistic infections, or both. They presented with profuse diarrhea associated with weakness, anorexia, and weight loss. Routine examinations of stools for eggs and parasites as performed by the hospital laboratory were negative in all patients. Sugar flotation and modified acid fast techniques were used in the Tropical Disease Laboratory to identify oocysts of Cryptosporidium spp. in stools of seven patients. Malabsorption, characterized by a low 5-hour D-xylose and positive fecal fat, was observed in 6/6 of these patients. In three other patients Isospora belli oocysts were identified in stool specimens or via a duodenal string test. Spiramycin was the only drug found to be effective in treating patients with cryptosporidiosis. Patients with Isospora belli responded to a prolonged course of trimethoprim-sulfamethoxazole.
 ...
PMID:Enteric coccidiosis among patients with the acquired immunodeficiency syndrome. 633 48

This paper presents a case in which treatment of acquired immunodeficiency syndrome (AIDS) was attempted with thymic humoral factor (THF). The capacity of THF for immunoenhancement and modulation of the immune response has been demonstrated in other conditions. The patient, a 24-year old black male homosexual from San Francisco, had experienced fever spikes, malaise, fatigue, anorexia, gradual vision loss, and weight loss over an 8-month period. Lymphopenia, T cell deficiencies, and imbalances in T cell subpopulations established the diagnosis of AIDS. Treatment with arabinoside A and fibroblast interferon was not effective. THF was then administered by daily injections for 3 weeks. At the end of the 2nd week of treatment, increased alertness and appetite were noted. Also documented was a transient increase in circulating lymphocytes, T cells, and helper cells. However, at the end of the 3rd week, the patient developed bronchopneumonia followed by renal failure and died in an acute encephalopathic state. Only 1 other (unsuccessful) attempt to treat an advanced case of AIDS with a thymic hormone has been reported. It is suggested that THF treatment might be more effective if offered at a very early stage of AIDS. It is hypothesized that a sufficient pool of precursor T cells is required to serve as target cells for immune modifiers such as THF. This precursor pool probably shrinks beyond rescue in the advanced stages of AIDS. The authors are currently involved in trials of immunomodulation with THF at early stages of immune impairment in pre-AIDS patients.
 ...
PMID:Attempted treatment of acquired immunodeficiency syndrome (AIDS) with thymic humoral factor. 654 6

Weight loss is a potent stimulus to food intake in normal individuals. The persistence of anorexia in wasting disorders, therefore, implies a failure of this adaptive feeding response. We describe a model for the normal hypothalamic response to starvation composed of the stimulation of neuronal pathways that promote energy intake and storage coupled with the inhibition of pathways that exert opposing effects. This model provides a framework for investigating disturbances of the normal hypothalamic response to weight loss and suggests a specific mechanism by which cytokines contribute to wasting in acquired immune deficiency syndrome and other cachexic disorders.
 ...
PMID:Hypothalamic response to starvation: implications for the study of wasting disorders. 750 22

Mycobacterium genavense is a recently defined fastidious organism that has been identified as a cause of disseminated infection in patients with AIDS. We report the cases of two patients who had advanced AIDS and a clinical syndrome of fever, anorexia, abdominal pain, diarrhea, and weight loss. In addition, splenomegaly and lymphadenopathy were prominent in both cases, and in one patient's case radiographic findings were suggestive of splenic abscesses. Mycobacteria isolated from specimens of blood and bone marrow grew in liquid media but not on solid media. The results of DNA probe tests for Mycobacterium tuberculosis and Mycobacterium avium complex were false-positive for both patients. After treatment of the broth cultures to lyse red blood cells, the results of DNA probe tests were negative for these pathogens. Amplification and sequencing of 16S rRNA with use of the polymerase chain reaction indicated that the mycobacterial isolates from both patients had sequences identical to those previously reported for M. genavense. One patient survived 5 months after diagnosis, the other 2 months after diagnosis; only one patient responded (transiently) to antimycobacterial chemotherapy.
 ...
PMID:Disseminated Mycobacterium genavense infection in two patients with AIDS. 751 19

A brief visual analogue instrument was developed and tested in the context of a multicentre randomized double-blinded four-dose trial of megestrol acetate for the treatment of AIDS-related anorexia/cachexia. This nine-item instrument, the Bristol-Myers Anorexia/Cachexia Recovery Instrument (BACRI), was administered every 4 weeks after initiation of study drug (placebo vs 100 mg, 400 mg or 800 mg of drug). The purpose of the instrument was to quantify patient perception of benefit in areas such as decreased concern over weight, decreased concern over appearance, increased pleasure in eating and increase in global perception of quality of life. Post-trial psychometric evaluation of the instrument strongly supported the use of a seven-item index of subjective recovery from symptoms of anorexia/cachexia (BACRI-7) and a single criterion item depicting patient perception of benefit (BACRI-1). The BACRI-7 and BACRI-1 scales showed significant improvement over 12 weeks in patients who received higher dose active drug (400 and 800 mg) compared with the placebo and 100 mg doses. Further differentiation of 400 vs 800 mg arms was seen in the BACRI-7 results, consistent with dose-response improvements in weight and lean body mass changes. Quadratic trends over time in lean body mass change and provider-rated appetite grade suggested peak therapeutic effect at 8 weeks for these endpoints, whereas the absence of these trends in overall weight and patient-reported BACRI scores suggested that these benefits are more persistent. Although subjective (patient-reported) benefit is strongly associated with objective indicators of improvement, there remains the possibility that there is some added, independent benefit of megestrol acetate to subjective well-being.
 ...
PMID:The Bristol-Myers Anorexia/Cachexia Recovery Instrument (BACRI): a brief assessment of patients' subjective response to treatment for anorexia/cachexia. 761 32


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