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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The article includes a historical review of therapeutic procedures. Two patients with suppurative arthritis are described, one newborn child with delayed diagnosis resulting in necrosis of the femoral head and luxation. This child was in very good health all the time with no signs reflecting the severity of the infection; a fact which explains the failure to diagnose the condition. Immunodeficiency during the first year of life is probably responsible for the subdued clinical findings. Another patient, a 14 year-old boy, had a typical septic coxitis, which was treated early with arthrotomy and antibiotics with good result. Penicillinase-producing staphylococcus aureus was the causative organism in both patients. Osteomyelitis in the metaphysis was also present in the first patient. The most important factors affecting prognosis seem to be delayed diagnosis and arthrotomy. Associated osteomyelitis and penicillinase-producing staphylococcus aureus are also factors having an adverse influence on prognosis. The diagnostic aspects of transient synovitis and the pathogenetic correlation between this and Perthes' disease are discussed. In this field, ultrasonography and bone scintigraphy are essential for planning the strategy of therapy. The high risk of femoral head destruction is obvious.
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PMID:[Coxitis in children]. 152 30

Pretreatment sinus puncture was performed on 339 patients with acute community-acquired sinusitis (ACAS) between 1975 and 1990. Bacterial species recovered in titers of greater than or equal to 10(4) colony-forming units per milliliter (CFU/ml) from 383 sinus aspirates included Streptococcus pneumoniae, 92 (41%); Haemophilus influenzae, 79 (35%); anaerobes, 17 (7%); streptococcal species, 16 (7%); Moraxella catarrhalis, 8 (4%); Staphylococcus aureus, 7 (33%); and other, 8 (4%). Viruses (rhinovirus, parainfluenza virus, and influenza virus) and fungi (Aspergillus, zygomycoses, Phaeohyphomycis, Pseudallescheria, and Hyalohyphomycis) have also been reported to cause ACAS. Posttreatment sinus puncture was performed on 220 of the 339 patients in six studies to evaluate efficacy of selected antimicrobial agents in producing bacteriologic cure. Ampicillin, 500 mg four times daily; amoxicillin, 500 mg three times daily; trimethoprim-sulfamethoxazole, twice a day; cefaclor, 500 mg four times daily; bacampicillin, 800 mg twice a day; cyclacillin, 500 mg three times a day; cefuroxime axetil, 250 mg twice daily; amoxicillin-clavulanate, 500/125 three times daily; and loracarbef 400 mg twice daily, given in 10-day courses, produced bacteriologic cure in more than 90% of patients. Early studies were done before beta-lactamase-producing strains of H. influenzae were a frequent cause of ACAS in Charlottesville. Management of therapeutic failures is a difficult problem for which diagnostic and therapeutic sinus puncture and lavage, prolonged antimicrobial therapy, steroid therapy, and evaluation of allergy, immunodeficiency, and surgically correctable lesions of the osteomeatal complex are recommended.
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PMID:The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. 152 37

Based on a variety of independent assays, the expression of HIV (human immunodeficiency virus type 1) protease in living bacterial cells results in their loss of viability. Although the mechanism is not proven, we have observed degradation of cellular proteins in E. coli expressing large amounts of active HIV protease. In order to avoid the loss of viability, we devised an expression system in which the viral protease is fused to beta-lactamase and is rapidly secreted to the periplasmic space, thus reducing its duration in the cytosol. Furthermore, we find the periplasmic form of the protease is soluble and enzymatically is several-fold more active than enzyme recovered from intracellular aggregates. The question of whether the viral protease may be toxic to infected cells is discussed.
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PMID:An E. coli expression system which detoxifies the HIV protease. 180 36

Neisseria gonorrhoeae strains resistant to treatment with penicillin, tetracycline, and/or spectinomycin are increasing in prevalence in many parts of the world. In Zambia, 52% of N. gonorrhoeae isolates produced beta-lactamase in 1986. Few oral regimens have proven effective for treatment of resistant N. gonorrhoeae. We conducted a prospective, double-blind, randomized clinical trial of 250 mg of ciprofloxacin given orally versus 250 mg of ceftriaxone given intramuscularly for treatment of uncomplicated gonococcal urethritis in adult males. Two hundred men were enrolled and treated. The two groups were comparable in age (27.5 years), prevalence of latent syphilis (14 and 10%), and human immunodeficiency virus infection (32 and 38%). Of 165 patients with cultures positive for N. gonorrhoeae who returned for follow-up, ciprofloxacin cured 83 of 83 (100%), including 26 with penicillinase-producing N. gonorrhoeae (PPNG) and 21 with N. gonorrhoeae with chromosomally mediated resistance to multiple antibiotics (CMRNG), and ceftriaxone cured 81 of 82 (98.7%), including 30 with PPNG and 19 with CMRNG. Both treatment regimens were well tolerated. Chlamydia trachomatis in urethral exudate was found by direct fluorescent-antibody microscopic examination or by culture in 10 (5%) participants. All N. gonorrhoeae isolates were inhibited by ceftriaxone at 0.06 micrograms/ml, except one which was inhibited at 0.125 micrograms/ml, while ciprofloxacin inhibited all isolates at 0.03 micrograms/ml. Ciprofloxacin is a safe and effective therapy for uncomplicated gonococcal urethritis, including that caused by PPNG and CMRNG in human immunodeficiency virus-infected men.
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PMID:Oral ciprofloxacin versus ceftriaxone for the treatment of urethritis from resistant Neisseria gonorrhoeae in Zambia. 211 96

89 prostitutes and 45 men attending the sexually transmitted disease (STD) clinic in Mogadishu, Somalia, were tested for HIV (human immunodeficiency virus) with the Abbott ELISA (enzyme-linked immuno-sorbent assay) test, cultured for gonorrhea, and screened for syphilis. There were no sera positive for HIV. 11% of the prostitutes and 7% of the men had positive gonorrhea cultures; 28% of the prostitutes and 4% of the men were positive for syphilis; 1 of the men had penicillin-resistant N. gonorrhoea with a beta-lactamase test. An epidemiological questionnaire was administered to the subjects. Most were aged 20-29; 67% were married; 80% of the men and 22.5% of the women were soldiers. 40% of the men reported use of prostitutes. Stated numbers of sexual contacts were 1.87/week for the prostitutes, and 1.51/week for the men. Data were also reported on occupations, recent injections, immunizations, intravenous drug use, surgery, blood transfusions and scarification.
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PMID:HIV infection surveillance in Mogadishu, Somalia. 222 25

The prevalence of sexually transmitted pathogens in two groups of women was studied: 50 women with clinical diagnoses of acute pelvic inflammatory disease (PID) and 50 asymptomatic women attending a family planning clinic (FPC). Genital specimens, collected by non-invasive procedures, were examined. Endocervical Neisseria gonorrhoeae was present in 62% of the PID group and 10% of the FPC group (P less than 0.0001). One-third of N. gonorrhoeae isolates were penicillinase-producing strains. Chlamydia trachomatis was isolated from the endocervix in 30% of the PID group and 26% of the FPC group (P = 0.8240 NS). Mycoplasma hominis was more prevalent in the vaginas and endocervices of the PID group than the FPC group (84% and 72% v. 50% and 42%; P = 0.0006 and 0.0047 respectively). Trichomonas vaginalis was present in 56% of the PID group and 20% of the FPC group (P = 0.0004). Syphilis serology was positive in 34% of the PID group and 10% of the FPC group (P = 0.0026). In the PID group of patients, 8% were positive for HBsAg. Antibody to the human immunodeficiency virus was not detected in any of the 100 women. The high prevalence of recognised sexually transmitted pathogens underlines the need for appropriate antimicrobial agent(s) active against N. gonorrhoeae, C. trachomatis and M. hominis in patients with PID. In view of the high prevalence of penicillinase-producing strains of N. gonorrhoeae, routine use of an antibiotic active against such strains is desirable.
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PMID:Sexually transmitted pathogens in acute pelvic inflammatory disease. 250 53

HIV-infected children are more likely than other children to develop pneumonia, which in these children is often recurrent or persistent. The main reservoir of the major pathogens is the nasopharynx, but to date no data has been published on the frequency and biologic characteristics of S.pneumoniae, H.influenzae and respiratory viruses found in the upper respiratory tract of children born to human immunodeficiency virus-infected mothers. To document these aspects, 105 children was monitored by pharyngeal swab (PS) and nasopahryngeal aspirates (NPA) who attended an outpatient clinic for HIV-infection evaluation. Bacterial identification was performed by standard procedures. Serotype, biotype and beta-lactamase production was investigated in H.influenzae isolates. S.pneumoniae serotypes were recognized by "quellung" and the susceptibility to 4 antibiotics was assessed. Respiratory syncytial viruses, parainfluenza, influenza A and B, and adenoviruses were diagnosed by indirect immunofluorescence and/or viral isolation in cell cultures. Twenty-nine children were identified as infected by HIV as a result of maternal-child transmission. Seventy children born to HIV-positive mothers but who were not HIV-infected served as controls. Of 269 PS, 110 110 S. pneumoniae and 92 H.influenzae were identified. Also 31 viruses were detected in 188 NPA. After stratifying by age no differences were observed in the frequency of bacterial colonization or in the presence of viruses in the upper respiratory tract of the two groups. Some biologic characteristics of the agents were noteworthy such as the frequency of colonization by S.pneumoniae serotype 14, the predominance of H.influenzae biotype I and the high frequency of viruses in NPA of asymptomatic children. Of note, although colonization frequencies were similar, children presenting with acute respiratory illness (ARI) were more likely to have bacteria isolated if they also had HIV-infection than if they were HIV-negative. It is concluded that HIV-infection in infants as a result of maternal virus transmission have a similar frequency of bacteria and virus colonization of their respiratory tract, but a higher frequency of ARI and perhaps a higher frequency of types of bacteria with special characteristics.
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PMID:Frequency, Type and Associated Diseases of Bacteria and Virus in The Oropharynx of Children Born to Human Immunodeficiency Virus-Infected Mothers. 1110

Although nonhuman primates are genetically close to humans, their T cells do not support productive replication of HIV-1. In contrast, HIV-1 replicates in activated human CD4(+) T cells, monocytes, and metabolically active human cells of a variety of cell types become permissive for HIV-1 replication when transduced to express CD4 and CCR5 or CXCR4. The molecular basis of this species restriction to HIV-1 replication was investigated by using African green monkey and rhesus macaque cell lines that were stably transduced to express human CD4 and CCR5. The cells supported replication of cognate viruses [simian immunodeficiency virus from African green monkeys (SIV-AGM) and macaques (SIVmac239)] but did not support replication of an R5-tropic cytopathic HIV-1. A beta-lactamase-based HIV-1 entry assay was used to show that the virus efficiently entered the nonhuman primate cells. Provirus formation was reduced 50-fold compared with similarly infected human cells. Real-time PCR quantitation demonstrated that reverse transcription failed to initiate efficiently in the simian cells. The block to reverse transcription was overridden at multiplicity of infection >1 or by preincubation of the nonhuman primate cells with virus, a feature reminiscent of the Friend virus resistance gene-1 (FV-1), restriction to murine leukemia virus replication in mouse cells. Heterokaryon analysis in which human and simian cells were fused demonstrated that the block was dominant. These findings suggested that the primate cells contain a dominant inhibitor that prevents HIV-1 reverse transcription.
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PMID:A dominant block to HIV-1 replication at reverse transcription in simian cells. 1236 68

V(D)J recombination constitutes a critical checkpoint in the development of the immune system as shown in several animal models as well as severe combined immune deficiency (SCID) condition in humans. We recently cloned the Artemis gene, whose mutations are responsible for RS-SCID, a condition characterized by an absence of both B and T lymphocytes and associated with increased sensitivity to ionizing radiations. Artemis is ubiquitously expressed and is localized in the nucleus. Artemis belongs to the metallo-beta-lactamase superfamily and defines a new group, beta-CASP, within this family. beta-CASP proteins are beta-lactamases acting on nucleic acids. While RS-SCID patients harbor Artemis loss-of-function mutations, we identified four patients with a combined immunodeficiency characterized by a low but detectable number of both B and T lymphocytes caused by hypomorphic mutations in the Artemis gene. Two of these patients developed aggressive B cell lymphomas, a condition that suggests Artemis may be considered a "caretaker" factor, similarly to the other V(D)J recombination/DNA repair actors.
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PMID:The V(D)J recombination/DNA repair factor artemis belongs to the metallo-beta-lactamase family and constitutes a critical developmental checkpoint of the lymphoid system. 1272 34

Chronic viral hepatitis is a common co-morbidity in Italian HIV-infected patients. It represents an important emergent associated risk of mortality in patients with HIV infection whose survival has increasingly improved by highly active antiretroviral therapy. In such patients further infectious predisposing factors, related to hepatic failure and esophageal haemorrhage, worsen the immunodeficiency due to HIV infection. Bacterial peritonitis has been reported in 3% of patients after esophageal endoscopic injection sclerotherapy emergency and in 0,5% of elective procedure. Combined antibiotic prophylaxis with aminopenicillins beta-lactamase inhibitor and fluoroquinolone should be regularly given to AIDS patients with decompensated liver cirrhosis who have esophageal variceal bleeding. A case of a pneumococcal bacterial peritonitis following emergency esophageal endoscopic sclerotherapy for variceal bleeding in patient with AIDS and liver cirrhosis with ascites is reported.
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PMID:Pneumococcal bacterial peritonitis in an AIDS patient following esophageal endoscopic variceal sclerotherapy: case report and recommendations for antibiotic prophylaxis. 1532 31


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