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 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Centers for Disease Control conducted a case-control study to investigate an outbreak of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men. The occurrence of these diseases was found to be associated with certain aspects of lifestyle, including a greater number of male sex partners per year, exposure to feces during sex, history of syphilis and non-B hepatitis, treatment for enteric parasites, and use of various illicit substances. Laboratory studies reflected both this lifestyle and the probable underlying cause of the Kaposi's sarcoma and P. carinii pneumonia--cellular immune deficiency. Patients were found to have lymphopenia, specifically a deficiency of the T-helper subpopulation, resulting in a reversal of the T-helper to T-suppressor ratio. Levels of IgG and IgA were increased. When compared with controls, patients were also found to have significantly higher titers of antibody to Epstein-Barr virus and cytomegalovirus, a higher prevalence of antibody to hepatitis A virus and Treponema pallidum, a lower prevalence of antibody to varicella zoster virus, and a higher frequency of isolation of cytomegalovirus.
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PMID:National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. 630 49

The acquired immune deficiency syndrome is characterized by the development of multiple recurrent opportunistic infections or unusual neoplasms in individuals with no prior history of immune suppression. This report summarizes the thoracic diseases encountered in such patients before after death and the role of diagnostic techniques currently used in the evaluation of thoracic disease in 15 patients with this syndrome. Efficacy of treatment was determined by correlation with postmortem findings in all patients. Pulmonary disease was present in all 15 patients and necessitated 23 transbronchial biopsies in 11 patients. Pneumocystis carinii pneumonia and cytomegalovirus pneumonia were the most common findings. Nine open lung biopsies in eight patients disclosed either Pneumocystis carinii pneumonia or Kaposi's sarcoma. Esophageal disease was present in four patients, and endoscopic evaluation demonstrated Candida esophagitis (two), esophageal Kaposi's sarcoma (one), and cytomegalovirus esophagitis and Kaposi's sarcoma (one). Mean time to death from diagnosis of acquired immune deficiency syndrome was 7.7 months, with respiratory insufficiency being the most common cause of death (9/15, 60%). Pneumocystis carinii pneumonia was successfully eradicated in 70% of the patients. Candida esophagitis was ameliorated in both patients with the disease. Unsuspected pulmonary Kaposi's sarcoma, cytomegalovirus pneumonitis, and other infectious pathogens were documented at autopsy. These data reveal that Pneumocystis carinii pneumonia and Candida esophagitis can be managed successfully in patients with acquired immune deficiency syndrome if appropriately diagnosed. The major cause of death in this series was pulmonary insufficiency, often the result of severe cytomegalovirus infection. Thoracic surgeons must continue to play an aggressive and important role in the early diagnosis and management of potentially treatable pulmonary and esophageal disease in these patients.
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PMID:Thoracic manifestations of the acquired immune deficiency syndrome. 633 56

This article presents preliminary 24-month findings from a prospective study initiated in San Francisco in 1981 with the following objectives: to refine the clinical definition of the lymphadenopathy syndrome; to compare these patients to patients with Category A acquired immunodeficiency syndrome (AIDS) with regard to epidemiologic, virologic, and immunologic variables; to follow a cohort of these patients to establish the natural history of the syndrome; and to evaluate screening variables for early transformation to more malignant manifestations of AIDS. It was hypothesized that the lymph node syndrome is prodromal AIDS, and that such patients are at risk of developing Kaposi's sarcoma, lymphoma, Pneumocystis carinii pneumonia, and other opportunistic infections. 200 homosexual lymphadenopathy patients, with a mean age of 33 years, have been enrolled in the study. These men have had an average of 800 sexual partners, and have a history of past sexually transmitted diseases. The graph of the year of onset of adenopathy parallels the exponentially increasing number of new AIDS cases over the past 4 years. Systemic symptoms seen in these patients resemble those in patients with Kaposi's sarcoma and P. carinii pneumonia. 1/3 of lymphadenopathy patients give a history of antecedent flu-like illness, often with fever, diarrhea, and upper respiratory symptoms lasting for 1 week, that occurred 1-2 months before the appearance of their nodes. Involvement of inguinal and axillary nodes has been observed in 100% of patients, while 80% have enlarged posterior cervical nodes. The average patient has 10 nodal groups involved. Immunologic testing reveals a reversal of the T-lymphocyte helper:suppressor ratio (mean of 0.7), and 2/3 of patients have both decreased absolute number and percentage of helper cells with increased suppressors. 198 of these patients have remained with persistent generalized lymphadenopathy without transformation to AIDS, yielding a 1% conversion rate. It is concluded that the lymphadenopathy syndrome is a distinct new syndrome most certainly AIDS-related. Further study will reveal whether it is truly prodromal or an alternate phenotypic response to a common inciting insult.
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PMID:Lymphadenopathy: endpoint or prodrome? Update of a 24-month prospective study. 633 51

The acquired immune deficiency syndrome (AIDS), which has recently occurred at increasing rates in homosexual men, intravenous drug users, and others, is characterized by the development of Kaposi's sarcoma and several opportunistic infections including pneumonia caused by Pneumocystis carinii. Serum samples from patients with AIDS and from matched and unmatched control subjects were examined for the presence of antibodies to cell membrane antigens associated with human T-cell leukemia virus. Nineteen of 75 of the AIDS patients had antibodies directed to surface antigens of Hut 102, a reference T lymphoid cell line infected with leukemia virus, as did two of the 336 control subjects.
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PMID:Antibodies to cell membrane antigens associated with human T-cell leukemia virus in patients with AIDS. 634 36

The acquired immune deficiency syndrome (AIDS) has been reported in more than 2800 persons in the United States (70 per cent of whom are homosexually active men). AIDS is manifested by impaired cell-mediated immunity that results in various opportunistic infections (especially pneumonia caused by Pneumocystis carinii) or malignant disease (especially disseminated Kaposi's sarcoma). The cause is unknown, and effective treatment is not yet available. AIDS apparently is not highly infectious for persons outside the acknowledged high-risk groups.
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PMID:Acquired immune deficiency syndrome. 636 4

This paper presents clinical data on 41 patients (29 male and 12 female) from Haiti who presented with acquired immunedeficiency syndrome (AIDS). Their mean age was 32 years (range 17-61 years). 4 of thes cases were homosexual or bisexual; none was an illicit drug user or a hemophiliac. In addition, 3 of the female patients had sexual contact with a male partner with AIDS. 4 patients had received blood transfusions before their illness. The most prominent clinical symptom in this series was chronic diarrhea of 2-33 months' duration, which occurrred in 39 patients (95%). Also reporte were marked weight loss (95%), fatigue (95%), prolonger fever (90%), and nodular or maculopapular skin lesions (54%). Opportunistic infections in this series included oroesophageal candidiasis (88%) and intestinal cryptosporidiosis (31%). Tuberculosis developed in 22% of patients. Immunologic evaluation revealed profoundly depressed T-helper cells and an inverted T-helper/T-suppressor cell ratio. Biologic markers included elevated alpha-1 thymosin and beta-2 microglobulin levels, elevated immune complexes, and the presence of acid-labile interferon. Of interest were differences in the clinical expression of AIDS between this series and cases in the US. The Haitian data suggest a higher incidencs of female cases,a predominance of gastrointestinal symptoms rather than respiratory symptoms and lymphadenopathy, a frequent association with tuberculosis, and a relatively low incidence of Kaposi's sarcoma or P. carinii pneumonia compared to the situation in the US. As in the US, where most AIDS cases are concentrated in New York and California, most AIDS cases in Haiti are found in residents of Port-au-Prince and Carrefour, which are centers for male and female prostitution.
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PMID:Acquired immune deficiency syndrome: specific aspects of the disease in Haiti. 639 48

The occurrence during the last 2 years of 29 cases of AIDS in hemophiliacs (21 in USA and 8 in Europe) suggests possible transmission of this disease by blood products. All these patients had received Factor VIII or IX concentrates and developed pneumocystis carinii pneumonia or other opportunistic infections. Kaposi's sarcoma was not observed in any patient. Recent studies have focused on the frequency of AIDS-related complex in hemophiliacs, which may arise as a crucial problem. However this does not justify at the moment any reduction in the substitutive treatment of hemophiliac patients unless new clues to the understanding of these disorders are provided. Therefore, it is mostly important to clearly define, through research programs and precise follow-up of patients, blood products which can be used safely in hemophiliacs.
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PMID:[Acquired immunodeficiency syndrome and related syndromes in hemophiliacs: status throughout the world]. 643 70

Observations of 12 patients with AIDS at this institution from March 1981 to April 1984 are reported. Ten patients were homosexuals and two were bisexual. The majority had travelled abroad (USA, Haiti) and reported multiple anonymous sexual contracts. Eleven patients reported symptoms and signs, of 2-12 months' duration, frequently seen in pre-AIDS: fatigue (10), weight loss (10), diarrhea (7), night sweats (5), fever (4), and generalized lymphadenopathy (1). Laboratory studies showed anemia (10), lymphopenia (9), leukopenia (7), decreased T-helper/T-suppressor ratio (10) and cutaneous anergy to multiple skin-test antigens (9). P. carinii pneumonia was diagnosed in three patients, P. carinii pneumonia and Kaposi's sarcoma in one patient and Kaposi's sarcoma in six patients. Another patient had a chronic mucocutaneous infection with herpes simplex and another an intestinal cryptosporidiosis and Kaposi's sarcoma. Alpha-A-interferon was used to treat patients with Kaposi's sarcoma and three patients with limited disease showed a favorable response. Six patients with advanced disease died.
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PMID:[Acquired immune deficiency syndrome in the region of Zurich. Report on 12 cases]. 649 67

The acquired immune deficiency syndrome (AIDS) represents a new epidemic of major proportions. Risk factors include homosexuality, intravenous drug abuse, Haitian descent, and multiple transfusion in the presence of hemophilia A. The etiology of AIDS remains unknown, but there is increasing evidence implicating a transmissible infectious agent and/or multiple antigenic exposures inducing a loss of immunoregulation. In a high-risk patient, the features of weight loss, generalized lymphadenopathy, and fever should arouse suspicion of AIDS. Diagnostic confirmation includes demonstration of reduced numbers of T lymphocytes with reversal of helper-suppressor T-lymphocyte ratio, presence of unusual opportunistic infections, and a progressive downhill course. The most common infection in AIDS is Pneumocystis carinii pneumonia. Treatment failures with trimethoprim-sulfamethoxazole (Bactrim, Septra) are common; pentamidine isethionate (Lomidine) may be more effective in eradicating the infection. In spite of initial improvement, recurrences of P carinii pneumonia and other opportunistic infections are common. In addition, other protozoan, viral, fungal, and atypical mycobacterial infections are frequent in patients with AIDS. Finally, rare neoplasms such as Kaposi's sarcoma and B-cell lymphoma, including primary lymphoma of the brain, are also being recognized as complications. At present there is no specific therapy for AIDS, and the disease is usually fatal. Continued research will hopefully result in immunomodulation techniques and specific vaccines to combat this serious epidemic.
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PMID:Acquired immune deficiency syndrome. A deadly new disease. 660 12

A patient with Kaposi's sarcoma and the acquired immune deficiency syndrome became acutely febrile and dyspneic. Although chest roentgenograms and findings from arterial blood oxygenation studies were normal, bronchoscopy disclosed heavy Pneumocystis carinii infection. The patient was treated with trimethoprim-sulfamethoxazole with a rapid clinical response. It has been distinctly unusual to diagnose Pneumocystis without roentgenographic or blood gas abnormalities. Pneumocystis infection probably occurs as a wide spectrum of disease ranging from subclinical infection to frank pneumonitis. In the appropriate clinical setting, clinically significant Pneumocystis infection may be diagnosed despite the absence of an infiltrate or hypoxemia and early treatment may be beneficial.
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PMID:Pneumocystis with normal chest X-ray film and arterial oxygen tension. Early diagnosis in a patient with the acquired immune deficiency syndrome. 660 29


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