Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026916 (MAC)
 5,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Evolution of bronchial reactivity was examined in a sample of aluminium potroom workers exposed to a variety of respiratory irritants in concentrations below the MAC values for Yugoslavia (hydrogen fluoride, particulate fluorides, sulphur dioxide). Lung function indices and bronchial reactivity were measured in 24 workers continuously employed in an aluminium plant and in nine workers who had ceased to work in the plant. Measurements took place over a two-year interval. A sustained level of bronchial reactivity was recorded in both examined groups regardless of occupational practice. Even in workers with dyspnoea and airway obstruction bronchial reactivity did not worsen in spite of continuous exposure. Avoidance of exposure to potroom fumes did not bring about any significant improvement of reactivity, moreover, bronchial reactivity deteriorated in one worker. Owing to discordance between spirometric values and bronchial reactivity, a follow-up of workers removed from harmful occupational exposure is suggested.
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PMID:[Bronchial reactivity during continuous and interrupted exposure to respiratory irritants]. 228 61

To data there have been 130 cases of the acquired immune deficiency syndrome (AIDS) in Britain. AIDS is though to be caused by the retrovirus human T cell lymphotropic virus III/lymphadenopathy associated virus (HTLV-III/LAV). The presenting feature of AIDS may be and acute pneumonic illness with cough, breathlessness, and fever. Nearly always, however, there is a preceding history of several months' ill health characterized by loss of weight, intermittent of prolonged fever, and malaise. The organism most commonly responsible for AIDS related pneumonia is the multiflagellate protozoa Pneumocystis carinii. Pneumonia caused by this organism is usually associated with an insidious but progressive dry cough and increasing breathlessness. Other organisms associated with AIDS related pneumonia in the US include Mycobacterium avium intracellulare and cytomegalovirus. In patients suspected of having AIDS the diagnosis may not be possible until an opportunistic organism has been identified. P carinii may be identified morphologically only in stained specimens of bronchoalveolar lavage or of alveolar tissue obtained by transbronchial, percutaneous needle, or open lung biopsy. Clinicians disagree as to whether agressive investigation is really necessary. Most will probably choose the most likely pathogen on clinical and radiological grounds and treat accordingly, reserving transbronchial biopsy and bronchoalveolar lavage for patients who fail to respond. The initial choice of antibiotics is likely to be difficult since many patients may have multiple infecting organisms. Conventional pneumonia should be treated with oxygen, physiotherapy, and broad spectrum antibiotics. The mortality from a 1st attack of P carinni pneumonia is about 1/3.
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PMID:Pneumonia in the acquired immune deficiency syndrome. 392 66

"Kalkstickstoff" (calcium cyanamide) is extensively used as a fertilizer and a herbicide and also as a chemical intermediate. Its main compounds are calcium cyanamide (CaCN2) (60%) and calcium oxide (15%). In earlier times cauterized damages of the skin and the mucous membranes caused by the content of calcium oxide were common. A certain effect of CaCN2 is the reaction of intolerance after alcohol intake, which expresses as a so-called burning, a flush with redness and feeling of heat of the head, the neck and the upper part of the body often combined with tachycardia and dyspnea. Further health impairments, sometimes with fatal end, were reported repeatedly in the older literature. Convincing evidences for the causal connections between the exposure to CaCN2 and these damages are missed. They exclusively concerned farmers but not workers in the production of CaCN2. Except of the damages of the skin also diseases of the respiratory and gastrointestinal tract, the kidneys, the nervous and circulatory system as well as favoring of infectious complications and goitrogenic effects are in discussion. Furthermore it was suggested that CaCN2 causes a lack of reduced glutathione in the organism. On the occasion of establishing a preliminary MAC-value for CaCN2 in the F.R.G. an occupationally medical field study was performed on 65 workers of a calcium cyanamide factory with long-term exposure to CaCN2. The maximal CaCN2 concentration measured at the working places was 8.3 mg/m3. No signs of diseases or health impairments, which are possibly caused by CaCN2, were found with the medical examination in the above mentioned organs and organ systems. There also was no decrease of the glutathione content of the total blood detectable. With an alcohol load of 22 voluntary workers 1 till 7 hours after the working shift in 6 cases modest and in 7 cases weak flush reactions were observed. As result of the study an elevation of the MAC-value from 1 to at least 2.5 mg/m3 is proposed.
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PMID:[Field study of workers with longterm exposure to calcium cyanamide (author's transl)]. 726 62

We present a patient with a very large pericardial effusion due to disseminated Mycobacterium avium complex (MAC) infection with associated bacteraemia and gastroenteritis. He was HIV antibody-positive with a CD4+ lymphocyte count of 10 x 10(6)/l. He complained of fevers, diarrhoea and dyspnoea and an echocardiogram showed a pericardial effusion. Chest X-ray showed progressive enlargement of the cardiac silhouette over a 3-month period. The effusion was drained surgically and antimycobacterial therapy (clarithromycin, clofazamine, rifampicin, ciprofloxacin, amikacin) was initiated. The patient had complete resolution of his pericardial effusion both clinically and radiologically. Three other AIDS patients with pericardial effusions caused by MAC are described in the medical literature, two died of cardiac dysfunction shortly after diagnosis. There is a case described of MAC-related pericardial effusion in a HIV-negative immunocompetent patient which resolved antimycobacterial therapy. MAC should be included in the differential diagnosis of pericardial effusions in AIDS patients. A combination of medical therapy and surgical intervention may give rise to considerable clinical benefit especially if initiated early.
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PMID:Mycobacterium avium: a potentially treatable cause of pericardial effusions. 775 68

A 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. His condition had been diagnosed as AIDS 1 1/2 years before presentation. Multiple blood cultures and serological tests failed to yield an infective etiology. Bronchoscopy with transbronchial biopsy, both performed twice, also failed to reveal an etiology. Empirical treatment for infection with the Mycobacterium avium complex yielded no response; empirical treatment, based on abnormalities revealed by gallium scanning, for Pneumocystis carinii pneumonia led to some clinical improvement. Because of rapid respiratory deterioration at the end of this treatment course, a thoracoscopic lung biopsy was performed; this procedure demonstrated classic bronchiolitis obliterans organizing pneumonia. Corticosteroid therapy resulted in a rapid salutary response. It is important to aggressively pursue a definitive diagnosis for selected patients with a nonidentifiable infectious cause so that patients receive the correct treatment.
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PMID:Bronchiolitis obliterans organizing pneumonia in a patient with AIDS. 808 53

A 33-yr-old homosexual man with acquired immune deficiency syndrome (AIDS) and Mycobacterium avium intracellulare (MAI) infection presented with fever, sweats, lethargy and dyspnea. A chest radiograph showed cardiomegaly and an echocardiograph revealed a large pericardial effusion. After pericardial aspiration, which confirmed T cell non-Hodgkin's lymphoma, he remained dyspneic. Gallium-67 imaging was performed to determine whether the patient's residual dyspnea was related to pulmonary MAI infection or lymphomatous infiltration of the heart. Planar 67Ga scintigraphy revealed intense tracer uptake in two areas within the mediastinum and surrounding the entire heart shadow but no evidence of pulmonary MAI infection. SPECT 67Ga scintigraphy precisely localized the two mediastinal abnormalities and demonstrated the tracer uptake around the heart to be pericardial rather than myocardial. Gallium-67 scintigraphy suggested that pericardial lymphoma was the likely basis of the patient's dyspnea.
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PMID:Gallium-67 imaging of pericardial lymphoma in AIDS. 868 31

A 46-year old man was admitted to a hospital because of cough and dyspnea. He was diagnosed as interstitial pneumonia and was treated with prednisolone (PSL) and antibiotics. The symptoms improved temporarily but he soon developed acute respiratory failure and was transferred to our hospital. Chest X-ray and CT revealed ground-glass opacities in both lung fields. He was treated with methyl PSL, antibiotics, and antimycobacterial drugs but he died on the fourth hospital day. Retrospectively, hematologic laboratory examinations revealed that CD4+ cell count was 0/microliter and serological tests for HIV were positive by both EIA and Western blot methods. The culture of the bone marrow specimens was positive for mycobacteria other than M. tuberculosis, and the bacilli were identified as Mycobacterium avium. Thus, his disease was eventually diagnosed as disseminated Mycobacterium avium complex (MAC) infection. In the past reports, the diagnosis of disseminated MAC infection was most often made by blood cultures, however, the isolation of MAC from bone marrow is another sensitive and specific method for the diagnosis of this infection. In some cases, bone marrow examination would be useful to diagnose disseminated MAC infection.
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PMID:[A case of acquired immunodeficiency syndrome with disseminated Mycobacterium avium complex infection in which M. avium was isolated from bone marrow]. 907 Oct 89

We studied retrospectively 132 episodes of infectious pneumonias in 89 patients examined from 1990 to 1995. Pneumocystis carinii was found to be the most common cause of pneumonia (33 patients). The other causes were: Streptococcus pneumoniae (15), Mycobacterium tuberculosis (14), Pseudomonas aeruginosa (8), Staphylococcus aureus (5), Cytomegalovirus (4), Haemophilus influentiae (4), Mycobacterium avium intracellulare (2), Klebsiella pneumoniae (2), E. coli (2), Serratia marcescens (1). No etiologic agent was found in 40 cases. We stress the need of a more frequent use of invasive diagnostic procedures in the study of focal lung consolidations because this radiologic sign is highly aspecific and may be caused by too many different pathogenic agents, needing different therapies-i.e., Streptococcus pneumoniae (15 cases), Pseudomonas aeruginosa (8), Staphylococcus aureus (5), Klebsiella pneumoniae (2), Escherichia coli (2), Pneumocystis carinii, Serratia marcescens and Haemophilus influentiae (1). Since there is an increase in mortality among patients treated with empiric antibiotic therapy, we stress the need of the routinary use of bronchoalveolar lavage in HIV+ patients with lung consolidation to perform specific therapy. Moreover, Pneumocystis carinii is by far the most frequent cause of diffuse interstitial infiltrates, and PCP has very suggestive clinical (dyspnea), radiologic (diffuse perihilar interstitial infiltrates; ground glass opacities; pneumatoceles) and laboratory (CD3+CD4 < 200/mcl; LDH > 600 UI/dl; PO2 < 70 mmHg) patterns, always related to the discovery of Pneumocystis carinii in escreatum. Thus, we decided to treat 15 patients with specific therapy for Pneumocystis carinii pneumonia with the above diagnostic algorithm, obtaining in all of them complete clinical and radiologic recovery. To conclude, in critical patients, invasive procedures should be performed only in the cases in which PCP is clinically improbable.
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PMID:[Diagnostic imaging and therapeutic implications in lung infections in patients with HIV-1 infection]. 928 Sep 34

Pulmonary mycobacteriosis is usually caused by Mycobacterium tuberculosis, Mycobacterium avium complex, or Mycobacterium kansasii. There are, however, other slow-growing mycobacteria which can cause pulmonary infection. Mycobacterium szulgai, first reported in 1972, is a scotochromogenic species which can affect human lungs, although human-to-human spread of infection is thought to be unlikely. We have recently treated three cases of middle-aged to elderly persons (45-87 year-old), two of them had underlying diseases (one with intrapulmonary and the other with extrapulmonary). All patients had constitutional symptoms (cough, sputum, dyspnea), and chest roentgenograms demonstrated either cavitation with scattered nodules or peripheral infiltrates predominantly in upper lobes, resembling pulmonary tuberculosis. In two cases, M. szulgai was identified by using DNA-DNA hybridization method. The in vitro susceptibility of M. szulgai to antimycobacterial drugs was better than that of M. avium complex, and it was resistant only to paraaminosalicylate, cycloserine, and partially to isoniazid. Pulmonary disease of three patients were successfully treated with a combination of multiple antimycobacterial agents including rifampin, ethambutol, isoniazid, or streptomycin.
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PMID:[Clinicopathological study of cases with Mycobacterium szulgai infection]. 984 45

This study examines the relation of QT dispersion (QTd) on a surface electrocardiogram (ECG) to clinical features and established risk factors of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HC). One hundred fifty-six consecutive patients with HC (91 men, mean age 41+/-15 years, range 7 to 79) and 72 normal subjects (41 men, mean age 39+/-9 years, range 20 to 60) were studied. Standard 12-lead ECGs were recorded from each subject using a MAC VU electrocardiograph. Patients with nonsinus rhythm, atrioventricular conduction block, QRS duration > 120 ms, age < 15 years, and low amplitude T waves were excluded from the analysis (n=51). Another 22 patients who were receiving amiodarone and/or sotalol therapy were also excluded. QT interval and QTd were measured using automated analysis in the remaining 83 patients (46 men, age 40+/-14 years, range 16 to 76). QT interval (406+/-38 ms), QTc interval (432+/-27 ms), and QTd (43+/-25 ms) were significantly greater in patients with HC than in normal controls (386+/-31 ms, 404+/-16 ms, 26+/-16 ms, respectively) (p <0.0001). QTd was significantly greater in patients with HC with chest pain compared with asymptomatic or mildly symptomatic patients (50+/-28 ms vs 37+/-20 ms, p=0.02). Increased QTd was found in patients with dyspnea New York Heart Association functional classes II/III than in those with dyspnea New York Heart Association functional class I (50+/-27 ms vs 38+/-22 ms, p=0.04). QTd was weakly correlated with maximum left ventricular wall thickness (r=0.228, p=0.038). No significant association was found between QTd and any risk factors for SCD. Thus, patients with HC have increased QTd. The QTd correlates with symptomatic status. Assessment of QTd might provide complementary clinical characterization of patients with HC but its relation to SCD remains uncertain.
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PMID:QT dispersion and risk factors for sudden cardiac death in patients with hypertrophic cardiomyopathy. 987 57


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