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)

CRP level was determined in the cerebrospinal fluid in 40 cases of bacterial meningitis. Similar determination in serum was done in 32 of these patients. Aetiological verification was possible in 90% of cases. Meningitis caused by Str. pneumonia and Neisseria meningitides prevailed (52.5% and 27.5% respectively). The control group comprised 20 subjects. For CRP demonstration immunochemical and turbidimetric methods were used. CRP in CSF was raised in 62.5% of the study cases while in the serum it was raised in all of them. CRP detection in serum in acute phase of central nervous system infection is diagnostically important since CRP increase suggests a purulent process.
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PMID:[C-reactive protein (CRP) and its significance in purulent meningitis]. 858 95

We studied the effects of inhibiting and augmenting neutrophil function by using an immunocompetent rat model of infectious and hyperoxic lung injury. After intrabronchial Escherichia coli challenge at all fractional inspired O2 (FIO2) values studied (FIO2 = 0.21, 0.60, and 0.95) and after lethal O2 exposure alone (FIO2 = 0.90), lung injury, as measured by histological and physiological changes, was reduced by a CD11b/CD18-directed monoclonal antibody (MAb 1B6, P < 0.05 vs. controls) but was increased by recombinant granulocyte colony-stimulating factor (rG-CSF; P < 0.05 vs. control; MAb 1B6 vs. rG-CSF, P < 0.004). Pulmonary neutrophil counts were reduced by MAb 1B6 (P < 0.04) and increased by rG-CSF (P < 0.0004) compared with control animals. However, despite antibiotics, MAb 1B6 and rG-CSF both significantly increased the relative risk of death, independent of O2 concentration, during E. coli pneumonia (1.74 [symbol: see text] 1.20 and 2.39 [symbol: see text] 1.19, respectively, each P < 0.01). During lethal hyperoxia, MAb 1B6 increased the relative risk of death (1.76 [symbol: see text] 1.28, P < 0.16), whereas rG-CSF had no effect on survival (0.97 [symbol: see text] 1.28, P = 0.89). Thus inhibition of neutrophil function attenuated and enhancement worsened lung injury in response to infectious and hyperoxic challenges, supporting a pathophysiological role of the neutrophil in these processes. However, it is problematic that MAb 1B6 therapy, despite preventing lung damage, ultimately worsened host defenses and survival. Furthermore, rG-CSF also adversely affected survival during infectious lung injury, demonstrating the inherent risks of inhibiting or augmenting neutrophil function in an immunocompetent host during infection.
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PMID:Controlled trials of rG-CSF and CD11b-directed MAb during hyperoxia and E. coli pneumonia in rats. 880 15

In order to assess the efficacy and safety of recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) in the treatment of HIV-associated leukopenia, 35 subjects suffering from severe leukopenia/neutropenia (24 with a previous diagnosis of AIDS, 11 with AIDS-related complex), received rHuGM-CSF at 0.5-3 micrograms/Kg/day subcutaneously for a mean period of 9.7 +/- 12.5 weeks (range 2-43 weeks). Five patients have been treated continuously for more than 6 months. rHuGM-CSF administration led to a significant (at least two-fold; P < .001) increase in total leukocyte, neutrophil and monocyte count by the second week of treatment, subsequently maintained through the entire course of therapy. No considerable effects on other hematological, immunological and virological parameters have been detected. Patients treated with rHuGM-CSF did not suffer from novel opportunistic diseases, while bacterial infections occurred in only 3 cases (pneumonia in 2, otitis/mastoiditis in 1). Long-term treatment with rHuGM-CSF allowed continuation or resumption of potentially myelotoxic drugs in 22 patients out of 35. A self-limited flu-like syndrome represented the most common adverse event (observed in 15 patients), while no other significant clinical or laboratory abnormalities were found. In conclusion, long-term rHuGM-CSF therapy showed a good efficacy and safety profile in the treatment of HIV-related leukopenia, also increasing tolerability to potentially myelosuppressive drugs, and leading to a significant reduction in morbidity due to secondary infections.
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PMID:Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) in leukopenic patients with advanced HIV disease. 880 19

This study describes bronchoalveolar lavage (BAL), histological and immunohistochemical features in a series of 10 patients with cryptogenic organizing pneumonia (COP). The histological diagnosis was performed by transbronchial biopsy in seven cases and by open lung biopsy in three cases. All patients showed a marked increase in lymphocytes and a mild increase in neutrophils and eosinophils in BAL fluid. The number of T-lymphocytes expressing human leucocyte antigen-DR (HLA-DR) surface antigen was increased (p < 0.002). The majority of lymphocytes expressed the CD8 phenotype, so that the CD4/CD8 ratio was markedly decreased. Masson bodies were present in the lung specimens of all patients. Most of the epithelial cells surrounding the Masson bodies were immunoreactive with an anti-granulocyte/macrophage colony-stimulating factor (GM-CSF) monoclonal antibody. The great majority of mononuclear cells in the lung specimens showed immunoreactivity with anti-CD3, anti-CD8 and anti-CD45R0 monoclonal antibodies. In the Masson bodies, spindle cells were immunoreactive with anti-alpha smooth muscle (alpha-sm) actin monoclonal antibody. Glucocorticoid treatment (the therapy of choice in COP) downregulated GM-CSF messenger ribonucleic acid (mRNA) expression in lung epithelial cell lines. These findings indicate that the combination of bronchoalveolar lavage cell profile with histological evidence is a valuable means of corroborating a clinical diagnosis of cryptogenic organizing pneumonia, and that granulocyte/macrophage colony-stimulating factor may be one of the cytokines involved in the pathogenesis.
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PMID:Bronchoalveolar lavage, histological and immunohistochemical features in cryptogenic organizing pneumonia. 890 12

A newborn with symptoms of congenital cytomegalovirus infection (interuterine dystrophy, thrombocytopenia, leukopenia, hepatosplenomegaly, chronic pneumonia, pleocytosis in CSF) is described in whom tests for specific anti- CMV-IgM antibodies were negative. Changes typical for cytomegaloviral infection were found on autopsy. The authors discuss the difficulties in interpreting various serologic tests (CFT, anti-CMV IgM) in congenital infections, suggesting the necessity of introducing new diagnostic methods for better diagnosis and treatment.
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PMID:[Suppression of immunological response in a newborn with congenital cytomegalovirus infection: diagnostic difficulties]. 897 25

Adenovirus infections are very common diseases, especially upper respiratory infections and diarrhea in infants. Moreover, adenoviruses can occasionally produce CNS infections. The common causative adenovirus is type 7 for them, and they have been associated with pneumonia and epidemics of adenovirus in family outbreaks. Reye-like syndrome has rarely been reported. As AIDS and other immunocompromised patients have increased, new reports of adenovirus CNS infections have also increased. Of course the immunosuppressed conditions have included lymphoma, transplant etc. In the near future, long term care for immunocompromised patients will have a crisis of adenovirus CNS infection. On the other hand, adenovirus CNS infections are difficult to diagnose precisely without special facilities, due to the need for adenovirus cultivation from CSF. In addition, the diagnosis may have limitations due to the many subtypes of adenovirus. Despite the benefits of PCR methods, standard laboratory testing procedures are still not established for diagnosis.
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PMID:[Adenovirus CNS infections]. 910 87

The surveillance of pneumococcal resistance in nasopharyngeal isolates is a practical way to determine the prevalence of resistant strains and is a reasonable predictor of resistance in systemic isolates. The increasing prevalence of resistance is shifting the distribution of invasive pneumococcal serotypes toward those included in conjugate vaccines. If these vaccines reduce carriage, they may eliminate or greatly reduce the prevalence of resistant strains. Meningitis is the most important infection caused by PRP for which penicillin or ampicillin therapy is inappropriate. Although the extended spectrum cephalosporins will be effective for most cases of PRP meningitis, it is clear that such therapy is not foolproof. It is important for the laboratory to test CSF isolates not only for penicillin resistance but also for resistance to the cephalosporins. beta-Lactam antibiotics can still be considered appropriate empiric therapy for otitis media, pneumonia, or sepsis. However, occasional treatment failures with these agents may necessitate use of alternative therapeutic strategies.
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PMID:Antibiotic-resistant pneumococci in pediatric disease. 915 79

Streptococcus pneumoniae (SPN) is the most common cause of invasive infections in children, with high levels of mortality in developing countries. An increase in frequency of penicillin-resistant strains is reported in most parts of the world. A study was undertaken in Argentina and 5 other countries of the region, to determine the type distribution and penicillin resistance rate of SPN isolated from invasive infections in children less than 5 years old. Between June 1994 and March 1996, a total of 505 SPN isolated from sterile sites were collected from 15 hospitals located in 9 cities of different geographic areas. Clinical and epidemiological data from 443 children were analyzed. Sixty five percent SPN were isolated from children less than 2 years old. Pneumonia was the clinical diagnosis in 58% of the cases, meningitis in 22%, and sepsis in 10.6%. Isolates were recovered from blood (51.2%), pleural fluid (22.7%), CSF (20.7%), and other sterile sites (5.4%). Thirty different pneumococcal capsular types were identified and the 10 most frequent in descending order were: 14, 5, 1, 6A/6B, 7F, 9V, 19F, 19A, 16F y 23F, representing 89.3% of the total. Overall, 13.1% of isolates showed intermediate resistance to penicillin while 11.3% showed high resistance. Lethality was 8.8%, without correlation with penicillin-resistance and/or type. These result should be used in selecting the optimal combination of specific types for a conjugate vaccine, useful in children less than 2 years old and for considering therapeutic strategies for invasive pneumococcal infections.
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PMID:Distribution of capsular types and penicillin-resistance of strains of Streptococcus pneumoniae causing systemic infections in Argentinian children under 5 years of age. Streptococcus pneumoniae Working Group. 918 40

Colony-Stimulating Factors (CSFs) are a family of glycoproteins that are required for the proliferation and differentiation of hematopoietic progenitor cells. Among these factors, G-CSF and GM-CSF are principally involved in the production of neutrophils. They have been demonstrated to be effective in correcting neutropenia during cytotoxic chemotherapy or bone marrow transplantations. Beside their hematopoietic action, recent data indicate that G-CSF and GM-CSF also have stimulatory effects on mature neutrophils function. The functional properties of neutrophils that are enhanced by G-CSF and GM-CSF are those related primarily to the host's defense against microorganisms. For Gm-CSF those stimulatory effects also concern the macrophages. Investigations of several animal models of severe bacterial infection and specially pneumonia have indicated that exogenous recombinant G-CSF or GM-CSF can significantly enhance host defenses and improve rates of survival. Trials of recombinant G-CSF in combination with antibiotics for the treatment of severe pneumonia in noneutropenic patients have recently been initiated. First results confirm the good tolerance of recombinant G-CSF. Further prospective studies are required to determine the effectiveness and the conditions of administration of G-CSF and GM-CSF in this indication.
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PMID:[Hematopoietic growth factors and anti-infective respiratory defenses]. 919 45

In a multi-centre phase I study we investigated the possibility of reducing the interval between courses of standard CHOP (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 2 mgs day 1, and prednisolone 40 mg/m2 days 1-8) from 21 days to 15 days and then 10 days using granulocyte colony stimulating factor (r-MetHuG-CSF (Amgen)-filgrastim) to accelerate neutrophil recovery. Patients received CHOP followed by G-CSF 5 micrograms/kg s.c. from day 2 to the day before the next course (e.g. days 2-14 for the 15-day interval). A total of 28 patients with newly diagnosed intermediate grade or high grade NHL were studied. Four patients were studied at a 21-day interval, six patients were treated at a 15-day interval and subsequently six patients at a 10-day interval. Following analysis of this initial cohort, a further 12 patients were evaluated; four at the 15-day interval, and eight at the 10-day interval. No dose-limiting toxicity was seen in the four patients receiving 21-day CHOP. Dose-limiting toxicity was seen in 4/10 patients treated at the 15-day interval (M:F 7:3, median age 55.5, range 39-67 years). This consisted of infection in two patients, recurrent infection and debility in a third, and mucositis in a fourth. Seven patients experienced one or more infectious episodes requiring antibiotics (median number of episodes: 2, range 1-4). Fourteen patients (M:F 4:3, median age 47.5, range 25-63 years) were treated at the 10-day interval. Dose-limiting toxicity was seen in six patients. This consisted of severe mucositis in three patients, neutropenia and thrombocytopenia on two separate occasions in one patient, and steroid-induced gastritis in two patients. Nine patients had one or more documented infections (median: 2, range 1-3) requiring antibiotics, of which six were severe (WHO grade 3 or 4). One patient died of Pneumocystis carinii (PCP) pneumonia. In summary, G-CSF (filgrastim) will facilitate the shortening of the dosage interval between cycles of CHOP chemotherapy due to accelerated hematological recovery. However, non-hematological toxicity due to the shorter dosage interval is increased and infective episodes are frequent.
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PMID:A phase I trial to assess the value of recombinant human granulocyte colony stimulating factor (R-MeTHuG-CSF, filgrastim) in accelerating the dose rate of chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma (NHL). The Central Lymphoma Group. 926 65


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