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Query: UMLS:C0032285 (pneumonia)
54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Proliferative responses by human peripheral blood mononuclear cells and rat spleen cells were measured to Pneumocystis carinii in a blastogenic assay using organisms obtained from rat lungs and propagated in tissue culture as the antigen. Responses occurred only in subjects with known prior exposure to P. carinii and the magnitude of the response varied with the number of organisms present in the antigen preparation and days in culture. Healthy human adults showed higher proliferative responses to P. carinii than did patients with Class II (asymptomatic) or Class III (lymphadenopathy) human immunodeficiency virus (HIV) infection. No responses to the preparation were found among Class IV HIV patients with the acquired immunodeficiency syndrome, including those with prior episodes of P. carinii pneumonia or those receiving azidothymidine. Overall, the blastogenic responses obtained with P. carinii were similar to those obtained with tetanus toxoid and phytohemagglutinin, and correlated well with the number of circulating CD4 cells. The data suggest that the blastogenic assay using tissue culture-derived rat P. carinii is specific for the organism and should be helpful in studying the cellular immune responses in pneumocystosis among different human patient populations.
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PMID:Blastogenic responses to Pneumocystis carinii among patients with human immunodeficiency (HIV) infection. 297 40

We used the commercially available Multitest (R) CMI to assess the response of 100 adults hospitalized with community-acquired pneumonia to the following seven antigens: tetanus toxoid, diphtheria toxoid, Streptococcus, Proteus, tuberculin, Candida, and trichophyton. Thirty-one of the patients responded to one or more of these antigens and survived their acute illness. Of the Multitest (R) CMI negative patients, 49 lived and 20 died. A comparison of the three groups revealed that the 31 patients with positive tests were significantly younger and had a higher mean serum albumin than did those with negative tests who died. Multivariate analysis revealed that a positive Multitest (R) CMI and the albumin level were independent predictors of survival. A positive Multitest (R) CMI identified a less seriously ill group of patients as evidenced by 100% survival, by a very low rate of complications (0.18/patient), and by less utilization of resources (fewer hemograms and chest radiographs). Thus a positive Multitest (R) CMI may identify patients who could be discharged earlier, and a negative test should target its patients for more aggressive therapy.
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PMID:A positive response to any of seven intradermal antigens predicts favorable outcome in patients hospitalized with community-acquired pneumonia. 328 71

An analysis of the causes of death in the neonatal nursery of the Port Moresby General Hospital in Papua New Guinea from 1982-1985 is presented, and conclusions were enumerated. The nursery has beds for 24 babies, subdivided into intensive care, infection and growing areas. Dormitory space for 12 mothers is available, and breast feeding is encouraged, whether by sucking, cup or tube: no bottle feeding is done. Up to 9 sisters staff the unit. A total of 2948 infants were admitted, including 831 cesarean births. 343 deaths occurred. 80 deaths were previable babies less than 1000 g. The neonatal mortality was 10/1000. The most common causes of death were septicemia or meningitis (24%), perinatal asphyxia (20%), respiratory distress syndrome (15%), congenital abnormalities (12%), meconium aspiration 7%, apnea of prematurity (7%). Other causes included pneumonia, hypothermia, intrauterine infection syndrome, cerebral hemorrhage and kernicterus. Note that hypothermia can occur in tiny babies, even in the tropics. Both respiratory distress and jaundice appear to be rare in melanesians compared to caucasians. Infections were due to tetanus, E. coli, S. aureus a Strep. faecalis, rather than the Group B hemolytic Strep. more often seen in the West. It was concluded that several inexpensive measures can be put in place to markedly enhance survival: train birth attendants to prevent perinatal asphyxia; maintain body temperature by available means; feed adequately, using expressed breast milk if necessary; maintain oxygenation properly using simple equipment such as a nasal catheter or perspex head box; prevent infection by scrupulous hand washing, cord care and overall cleanliness; manage neonatal jaundice.
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PMID:Neonatal care in perspective: results of neonatal care at Port Moresby. 347 16

Tolerance, clinical effects and kinetics of an unmodified immunoglobulin preparation for intravenous use were investigated in 4 patients with advanced chronic lymphocytic leukemia. Previously, good tolerance of the preparation had been found in 49 immunologically normal patients. The four patients with secondary humoral immunodeficiency received doses of 140-360 mg IgG/kg per infusion as outpatients at monthly intervals. With one exception, no acute infections (pneumonitis), as commonly seen before, were observed during the observation time of 24 to 68 weeks, and the pre-existing chronic infections (bronchitis, sinusitis etc.) remained compensated without antibiotics. In all four patients tolerance of the preparation was good. In all cases of hypogammaglobulinemia a dose-dependent increase in the serum IgG concentration was observed immediately after the infusion. However, persistence of the serum IgG increase showed considerable interindividual differences. The half life of the tetanus and HBs antibodies (21.7 to 34.4 and 19.7 to 25.7 days respectively) found in 4 healthy volunteers is within the biological range. This indicates an unmodified structure of the antibodies of the IgG class contained in the preparation used.
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PMID:[Tolerability and pharmacokinetics of an intravenous immunoglobulin preparation in immunologically normal subjects and tolerability in patients with hypogammaglobulinemia resulting from chronic lymphatic leukemia]. 351 30

Patient visits to the primary care physician are prompted most often by an infectious disease. The clinician must be aware of the common and serious infections present in the community and must institute proper diagnostic and therapeutic measures. Diagnosis and treatment of streptococcal infections, staphylococcal infections, pneumonia and upper respiratory tract infection, bone and joint infections, sinusitis, clostridial infections, and tetanus are discussed.
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PMID:Infectious disease emergencies. 363 85

An analysis is presented of data on all 30 129 inpatient admissions to a mission hospital in the West Nile District of Uganda in the 27 year period from July 1951 to August 1978. For most of this period the hospital was staffed by the same two doctors. For each patient admitted, a record was made of their age (adult or child), sex, place of residence, duration of stay in hospital, diagnosis and vital status at discharge. The annual number of admissions increased steadily from around 300 in 1952 to over 1600 in 1966 and subsequently declined to about 900 in 1977. Sixty-five per cent of admissions were medical, 12% surgical, 11% obstetric and 9% gynaecological. Thirty per cent of admissions were children (aged 0-9 years). Forty-five per cent of admissions were from those resident in the same county as the hospital and another 20% were from an immediately adjacent county. Infective and parasitic conditions (including respiratory diseases) accounted for over 60% of admissions among children and over 38% of admissions among adults (excluding obstetric patients). The six most common causes of admission were: uncomplicated delivery (2308 admissions), pneumonia (2020), hookworm (1999), malaria (1806), schistosomiasis (1742) and diarrhoea (1041). In total 1960 deaths were recorded (6.5% of all admissions). High case fatality rates were observed for tetanus (61%), immaturity (54%), meningitis (38%), kwashiorkor (21%), other malnutrition (19%) and anaemia (19%). A striking increase in the number of admissions for measles was observed in the period 1976 to 1978. Admission rates for schistosomiasis (S. mansoni) appeared to be highest from counties adjacent to the Nile and 104 deaths were recorded among the 1742 patients with this as the primary diagnosis. Admissions for diabetes, as a percentage of all admissions increased from 0.2% in 1951-54 to 1.5% at the end of the study period. Marked seasonal variations in admission patterns were found for diarrhoea, measles, meningitis and respiratory infections, the last two, but not diarrhoea, being most common in the wettest months. Admissions for malaria showed no strong seasonal associations. Despite the limitations of hospital-based data, it is argued that the data analysed provide a reasonable indication of the important causes of severe morbidity and mortality in the district. Furthermore, some of the changes in admission patterns over time are likely to represent true changes in disease rates rather than artefacts of diagnosis or referral. The analyses presented indicate the value of simple record systems, carefully maintained.
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PMID:Admissions to a rural hospital in the West Nile District of Uganda over a 27 year period. 378 13

Many changes occur in the immune system with age. The involution of the thymus plays a major role in immune senescence. Related to this event are the altered ratio of helper to suppressor T-lymphocyte subsets, decrease in immune response by both cell-mediated and humoral branches of the immune system, and increase in autoimmune activity. The clinical implications of these changes are the elderly person's increased susceptibility to infections such as pneumococcal pneumonia, influenza A, and tetanus as well as increased autoimmune activity, reflected by pernicious anemia. Other changes may be increased susceptibility to neoplasms and perhaps acceleration of the aging process. A high index of suspicion should be present for the diagnosis of pernicious anemia in the elderly population. Knowledge of the many autoantibodies that might be present without illness is important when evaluating for disease processes. The relationship of the senescent immune system to the aging process is still unknown. Investigations of this matter, as well as of the function of immune system components and their relationship to disease processes, are continuing. Most methods proposed for enhancing the immune system are still experimental. However, immunizations have been proved to be an effective means of reducing morbidity and mortality from certain infectious diseases in the elderly. Therefore, it is strongly recommended that all elderly persons who are at risk for pneumococcal pneumonia, influenza, and tetanus receive the proper immunizations.
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PMID:Immune function, autoimmunity, and selective immunoprophylaxis in the aged. 389 87

A paper by Hazlett et al. is of particular importance because it addresses the question of the role of acute respiratory infections (ARI) as a cause of morbidity and especially mortality in 3rd world children. Diarrheal disease and malnutrition are generally thought to be the major killers of these children, and until recently little attention was paid to ARI. Recent data suggest that ARI are more important than realized previously and almost certainly are the leading cause of death in children in developing countries. It is estimated that each year more than 15 million children less than 5 years old die, obviously most in socially and economically deprived countries. Since death usually is due to a combination of social, economic, and medical factors, it is impossible to obtain precise data on the causes of death. It has been estimated that 5 million of the deaths are due to diarrhea, over 3 million due to pneumonia, 2 million to measles, 1.5 million to pertussis, 1 million to tetanus, and the other 2.5 million or less to other causes. Since pertussis is an acute respiratory infection and measles deaths frequently are due to infections of the respiratory tract, it is becoming clear that ARI are associated with more deaths than any other single cause. The significance of this is emphasized when the mortality rates from ARI in developed and underdeveloped nations are compared. Depending on the countries compared, age group, and other factors, increases of 5-10-fold have been reported. These factors raise the question of why respiratory infections are so lethal for 3rd world children. The severity of pneumonia, which is the cause of most ARI deaths, seems to be the big difference. Data are accumulating which show that bacterial infections are associated with the majority of severe infections and "Streptococcus pneumoniae" and "Haemophilus influenzae," infrequent causes of pneumonia in developed world children, are the microorganisms incriminated in a large proportion of cases. The increase in severity of ARI in 3rd world children has been associated, at least in port, with malnutrition, diarrheal diseases, an increased parasite load, and more recently with air pollution. Crowding and other factors associated with poverty doubtless also play a role. How these various factors contribute to increased severity and lethality is not well understood. The increasing recognition of the important role played by ARI as causes of mortality in 3rd world children is encouraging. The UN International Children's Emergency Fund (UNICEF) has joined the World Health Organization in the battle against ARI in developing countries, and the 2 organizations recently issued a joint statement on the subject in which they pledged to collaborate to integrate an ARI component into the primary health care program.
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PMID:Acute respiratory infections are the leading cause of death in children in developing countries. 394 32

The antibody response to a variety of antigens has been shown to diminish with age. We investigated the capacity for Thymosin Alpha One (T alpha 1) treatment to augment antibody production in tetanus toxoid (TT) and pneumococcal capsular polysaccharide (PN) inoculated young and old mice. We also measured survival of these immunized mice after aerosol exposure to Streptococcus pneumoniae. As predicted antibody response to TT, but not PN, was significantly reduced in the old animals and T alpha 1 augmented antitetanus antibody in both young and old mice. T alpha 1 did not have an effect on anti pneumococcal antibody production. All mice that had received PN did have an antibody response, yet survival after exposure to the organism was strikingly less in the old animals. Our data support the contention that antibody response to T-dependent antigens (such as tetanus toxoid) falls with aging but can be reconstituted somewhat by thymic factors. Furthermore, for T-independent antigen (such as pneumococcal capsular antigens) the age-related changes are less evident. In the latter situation, the presence of a brisk antibody response after vaccination was not sufficient to prevent pneumonia and death in old animals.
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PMID:Effect of thymosin alpha one on specific antibody response and susceptibility to infection in young and aged mice. 404 90

Registered deaths from the vital statistics registration system of Lagos City, a system that was judged to be 60% complete, were analyzed for the year 1977. Nearly 40% of total registered deaths were from infections, parasitic diseases, and motor vehicle accidents. Of the reported deaths, 17.3% were from ill-defined conditions. Deaths from neoplasms, diseases of the nervous and sense organs, diseases of the digestive and genitourinary systems as well as those from congenital anomalies are relatively less frequent. Maternal mortality appears to be very high. The age pattern of mortality is different from that in the developed countries, a high proportion of the deaths in Lagos being those of children aged under 5 years. Infant mortality is dominated by perinatal causes which constituted a huge 38.4% of deaths of infants under 1 year, the other important causes being dysentery and diarrhea, pneumonia, and tetanus. Among adults, death from motor vehicle accidents is the most important cause accounting for more than 26% of deaths in the age group 15 years and above. Other important causes of adult deaths are cerebrovascular disease, hypertensive disease, heart disease, pneumonia, dysentery and diarrhea, and complications of pregnancy. Well organized health services stressing antenatal care, preventive and health education services are needed to effect a reduction in mortality and bring about a general improvement in the health of the people. (author's)
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PMID:Causes of mortality in an African city. 628 60


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