Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A randomized double-blind, placebo-controlled, multicenter investigation assessed the usefulness of acyclovir in the treatment of immunosuppressed children with chickenpox. Twelve patients received placebo and eight received acyclovir. If the event of clinical deterioration, patients could be removed from the study to receive acyclovir. Eighteen patients had skin lesions within 96 hours of admission to the study. Nineteen patients had malignancies. The two groups of patients were similar in age, in concomitant or preceding immunosuppressive therapy, in status of malignancy, and in presenting granulocyte and lymphocyte counts. Zoster immune globulin or plasma had been given to 50% of the placebo group but to only 25% of the acyclovir group. One patient in each group had pneumonitis at entry. Of the patients without pneumonitis at entry, five of the 11 placebo patients compared with none of the seven acyclovir patients developed pneumonitis during treatment (P = 0.054). No evidence of toxicity related to acyclovir was observed.
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PMID:Acyclovir therapy of chickenpox in immunosuppressed children--a collaborative study. 675 68

Patients with granulocytopenia (granulocyte count less than 0.5 x 10(9)/L) and a documented infection were randomized to receive or not to receive daily granulocyte transfusions in addition to antimicrobial therapy. Thirty-four of 47 control patients responded to therapy compared to 30 of 48 transfused patients (type 2 error, pneumonia, or a soft tissue infection, respective response rates for the control and transfused patients were 11 of 11 and 11 of 16 (Yates' corrected chi-squared test, p = 0.12). Response rates for patients with gram-negative septicemia were lower but were influenced by recovery of bone marrow function. Eleven of 12 control patients and seven of seven transfused patients with recovery of marrow function survived the gram-negative septicemia. In contrast, 12 of 24 control patients and 12 of 25 transfused patients survived gram-negative septicemia and persistent granulocytopenia (type 2 error p = 0.13). Two thirds of all fatal infections were associated with an underlying disease refractory to medical therapy. Therapeutic granulocyte transfusions had no substantial benefit over optimal antimicrobial therapy alone in managing infected patients with granulocytopenia.
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PMID:Therapeutic granulocyte transfusions for documented infections. A controlled trial in ninety-five infectious granulocytopenic episodes. 675 Nov 83

We used a portable horizontal laminar-air-flow clean bed and an open horizontal laminar-air-flow fan (clean wall unit) for treating patients with acute leukemia. The level of cleanliness as shown in the nonviable and viable particle counts was class 100 and class 1,000 at the head and foot, respectively, of the bed in the clean-bed rooms, while it was class 100 and class 10,000 respectively, in the clean-wall-unit rooms. The level of cleanliness in the open wards, on the other hand, was class 1,000,000. The incidence of infectious complications in the clean-bed rooms was 3.1/100 days when the granulocyte count was 1,000/mm3 or less, 3.9/100 days when the count was 500/mm3 or less and 6.1/100 days when it was 100/mm3 or less. In the clean-wall-unit rooms, these values were 3.1, 3.7 and 7.1, respectively, while in the open wards they were 4.6, 6.1 and 15.0. Thus, it was ascertained that, as the granulocyte count decreased, the incidence of infectious complications became significantly higher in the open wards than in the clean-bed rooms or the clean-wall-unit rooms. No complication of pneumonia was found in 37 patients with acute leukemia in the clean-bed rooms or in 40 in the clean-wall-unit rooms. Among 36 patients treated in the open wards, on the other hand, the complication of pneumonia was found in four. From the above results, it is believed that the use of clean-bed rooms or clean-wall-unit rooms is an extremely effective supplementary treatment method for preventing respiratory tract infection complications in patients with acute leukemia.
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PMID:Application of simplified bioclean apparatuses for treatment of acute leukemia. 683 56

Out of 26 patients with acute pancreatitis, 8 had several signs of bacterial infection such as high nitroblue tetrazolium (NBT) reduction of granulocytes, fever, elevated ESR and leukocytosis with granulocytosis. 2 patients had a high NBT-value without all other clinical signs of infection and 6 had such signs without a high NBT-value. --An NBT-value lower than normal was found in 6 patients, 3 of whom also had other signs of infection. The level of serum lipids, determined in only 3 of the 6, demonstrated concomitant hypertriglyceridemia. Hyperlipidemia is known to decrease granulocyte activity and might have prevented a stimulation to increased NBT-reduction otherwise brought about by bacterial infection. Further, 3 of the 6 patients with low NBT-reductions suffered from a very severe type of pancreatitis and two of them developed pneumonia. --Bacterial infection may thus contribute to a severe clinical course of pancreatitis, especially in patients with hypertriglyceridemia in whom the granulocyte function is depressed.
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PMID:Granulocyte-function in pancreatitis. Nitroblue tetrazolium-test related to clinical signs of bacterial infection and to hypertriglyceridemia. 693 88

We studied the effects of pulmonary infection with type III pneumococcus in dogs on the degree of granulocyte elastase-like esterase activity and on the degree of antiproteases in peripheral blood and lung lavage fluid. In 9 infected dogs the peripheral blood granulocyte esterase activity increased from a preinfection level of 361.3 +/- 51 units/10(8) leukocytes to 593.8 +/- 80 units/10(8) leukocytes (mean +/- SE) 24 h after pneumonia had been induced (p less than .02). Parallel changes were measured in granulocytes obtained from bronchial lavage fluid. The antitrypsin activity and esterase inhibitory activity of peripheral blood increased by 15% after infection was induced. The esterase inhibitory activity of lung lavage fluid increased from a preinfection level of 776 +/- 160 units/mg of lavage protein to 1,390 +/- 200 units/mg of lavage protein (p less than .05). These findings indicate that whereas both circulating and lung lavage granulocytes contain increased concentrations of proteolytic activity during infection, serum antiproteases and, to a larger extent, lung antiproteases, also are increased.
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PMID:Protease and antiprotease responses in lung and peripheral blood in experimental canine pneumococcal pneumonia. 699 61

Neutral proteases can be released from PMN neutrophils in blood smears from healthy subjects by incubation with NaCl-borate buffer. The activity of the PMN proteases can be revealed by the degradation of erythrocytes and plasma within ring-shaped areas centered around each neutrophil (halo effect). During the acute stage of various inflammatory diseases (pneumonia, meningitis, cholecystitis, etc.) the activity of neutral PMN proteases is substantially reduced, as reflected by reduced halo formation. After recovery, halo formation returns to normal. Temporary lowering of neutral PMN proteases is thus one of a series of functional defects of PMN neutrophils which are detectable in the course of acute infectious diseases. These include reduced phagocytosis, altered chemotaxis and reduced bactericidal function. The cytochemical test for neutrophilic granulocyte function used in the present investigation is especially practical by comparison with the other techniques: it saves time and is simple to perform.
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PMID:Cytochemical investigation of neutral proteases in polymorphonuclear (PMN) neutrophils in acute inflammatory diseases. 700 88

One hundred and ninety-five series of granulocyte transfusions in 144 patients were evaluated with respect to possible severe pulmonary toxicity from concomitant administration of granulocytes and amphotericin B. Dyspnea as a side effect of granulocyte transfusion was equally common among patients receiving amphotericin B and those in a matched control group not receiving amphotericin B. Granulocyte transfusions and amphotericin B were given simultaneously in 35 transfusion series, involving 32 patients. Respiratory deterioration, defined as the appearance of new pulmonary infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients developing respiratory deterioration were similar to those not developing respiratory deterioration in age, diagnosis, disease status, duration of concomitant therapy, and outcome, but more often had positive fungal cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8 patients, the episodes of respiratory deterioration were readily explained by congestive heart failure, by simultaneous bacteremia or fungemia, or by fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin reaction (responsive to steroids) and the other 2 had unexplained, but reversible respiratory deterioration. We concluded that concomitant administration of granulocyte transfusions and amphotericin B is not associated with unexpected or rapidly fatal pulmonary toxicity and when appropriate, can be safely accomplished.
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PMID:Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity. 700 33

A patient undergoing examination for moderately severe renal insufficiency had fulminant five-lobed pneumonia caused by Legionella pneumophila. Her clinical course was complicated by granulocytopenia. Bone marrow aspiration showed notable inhibition of myelopoiesis, involving all stages of maturation. The presence of a serum inhibitor of granulopoiesis was demonstrated by in vitro bone marrow culture. Normal bone marrow cultured in the presence of serum from two normal control subjects yielded 69 +/- 5.2 (mean +/- SE) and 61 +/- 5 granulocyte colonies. When the patient's serum was substituted for normal human serum only 14.3 +/- 2.3 colonies were formed. Each of the drugs to which she had been exposed was tested in the in vitro system, using therapeutic concentrations, and none showed significant suppression of granulocyte colony formation. These observations indicate that legionnaires' disease was associated with a serum factor that notably inhibited the growth of granulocyte colonies in this patient.
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PMID:Myelosuppression in Legionnaires' disease. 709 51

Among 245 cases of chronic granulomatous disease which were evaluated, fungal infection occurred in 20.4 percent. Fungi encountered include Aspergillus, Torulopsis and Candida. In 18 percent of the patients with fungal infection, the disease was limited to soft tissue or bone; all did well. Most of the patients had fungal pneumonia and/or widely disseminated disease; diagnosis was usually confirmed by open lung biopsy. Patients with pneumonia or disseminated disease who received no therapy succumbed to infection, whereas more than half the patients who received antifungal therapy were cured. Modalities of treatment included antifungal chemotherapy, surgical removal of infected tissue and granulocyte transfusion. Although several patients showed dramatic improvement during granulocyte transfusions given in combination with antifungal chemotherapy, the improvement achieved was not statistically significant when compared with that achieved with chemotherapy alone. These results emphasized the importance of phagocytic cells in defense against fungi and the need for further evaluation of granulocyte transfusion therapy in compromised hosts in whom fungal infections develop.
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PMID:Fungal infection in chronic granulomatous disease. The importance of the phagocyte in defense against fungi. 719 47

Records of 133 infections occurring in 73 of 125 patients with late-stage non-Hodgkin's lymphoma on intensive chemotherapy programs for a median of 23 months were reviewed. Granulocytopenia, usually related to chemotherapy, was the major predisposing factor, association with 51% of infections. The incidence of infection in chemotherapy courses associated with less than 500 granulocytes/microL was higher than those with 500 or more granulocytes/microL (p = 0.0004). Splenectomized patients tended to have a higher incidence of chemotherapy courses with an infection (p = 0.06); marrow involvement was not a significant predisposing factor to infection. The commonest sites of infection were lung, skin, and alimentary canal. Gram-negative organisms and Staphylococcus aureus caused 83% of documented infections; Pseudomonas aeruginosa was the major cause of pneumonia and bacteremia; and herpes zoster and fungi each caused only 3% of infections. Other infections associated with impaired cellular or humoral immunity were uncommon. Poor prognosis was associated with infections in granulocytopenic patients with stable or falling granulocyte counts, infection at multiple sites, and bacteremia, especially polymicrobial bacteremia.
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PMID:Infections during intensive chemotherapy for non-Hodgkin's lymphoma. 729 44


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