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Query: UMLS:C0032285 (
pneumonia
)
54,520
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
From May 1987 to July 1990, 45 cases of Hodgkin's disease (HD) were recorded by the French Registry of HIV-associated tumors. Thirty-nine patients were male and median age was 30 years. Twenty-two cases had mixed cellularity type (MC), 18 nodular sclerosis, two lymphocyte depletion and three were not classified. Thirty-four patients had advanced HD clinical stages (CS III and IV). Thirty-six patients (80%) presented with B symptoms. Bone marrow involvement was diagnosed in 12 patients. Mediastinal involvement was present in only 4/30 patients (12%). Risk groups for AIDS were homosexuality in 18 cases, intravenous drug abuse in 17, both in one, and other in nine cases. In 40 cases (89%), HD occurred before any AIDS-related episode. Median CD4 cell count at HD diagnosis was 304 cells/microliters. Seventy-nine percent of the patients achieved complete remission with standard therapy, but hematological and infectious complications were very frequent. The rate of progression to AIDS was 71% at three years and opportunistic infections (mainly pneumocystis carinii
pneumonia
) were the most frequent cause of death. Overall two-year survival was 41% (78% for patients with initial CD4 cell count higher than 300 cell/microliters and 0% for those with CD4 cell count lower than 300/microliters). HD-HIV has a specific clinical profile as compared to primary HD, with a predominance of MC type and advanced clinical stage, without mediastinal involvement (88%). This study provides a basis for future clinical trials on HD-HIV: intensity of chemotherapy should be adapted to CD4 cell count; pneumocystis carinii prophylaxis is mandatory in all cases.
Zidovudine
should be included during and after HD treatment; the potential role of hematological growth factors has still to be evaluated.
...
PMID:[Hodgkin's disease associated with HIV infection: clinical characteristics and development. French registry of tumors associated with HIV infection]. 148 23
Infection with HIV is a problem of growing magnitude among women and children in the United States. During 1991, AIDS will be among the five leading causes of death for women of childbearing age. Over 80% of children with HIV have acquired the infection vertically, and AIDS is now a leading cause of death of children in many urban areas of the United States. Gender and age have important influences on the progression of HIV disease and on the occurrence of complicating illnesses.
Zidovudine
can slow HIV disease progression, and several regimens of prophylaxis are effective against P. carinii
pneumonia
, which is the leading cause of death among adults and children with AIDS. Intravenous immunoglobulin may be effective for prevention of serious infections in some children with symptomatic HIV infection. Ultimately, prevention of HIV infection among women and children depends on targeted education and, possibly, the development of medical strategies for interruption of vertical transmission.
...
PMID:Impact of human immunodeficiency virus infection on women and infants. 157 10
Tissue macrophages are recognized as a cellular target for infection with the human immunodeficiency virus type 1 (HIV-1). To characterize the nature of this cell-retrovirus interaction within the lower respiratory tract we analyzed fluid and cells obtained by bronchoalveolar lavage (BAL) of eight individuals with acquired immunodeficiency syndrome (AIDS) who were undergoing diagnostic fiberoptic bronchoscopy. Of these eight individuals, seven had active infection with Pneumocystis carinii; one had suspected cytomegalovirus
pneumonitis
. At the time of study two were receiving the antiretroviral drug zidovudine (azidothymidine [
AZT
]). HIV-1 could not be isolated from any of the eight samples of BAL fluid concentrated by ultracentrifugation through 20% sucrose. HIV-1 antigen (p24) was detected in one of eight samples of concentrated BAL fluid but could not be found in eight samples of media conditioned by overnight incubation with adherent BAL cells. Despite the infrequent detection of HIV-1 antigen it was possible to identify HIV-1 genomic sequences by the use of a DNA amplification technique, the polymerase chain reaction, in all eight BAL cell preparations. In BAL cells adherent for up to 5 days in culture this method detected retroviral DNA that hybridized to a complementary pair of primers located in the env and gag gene regions of HIV-1. These studies demonstrate the uniform presence of HIV-1 harboring cells within the airways of the lung in individuals with AIDS and active respiratory infection and may have implications for local organ defense.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Frequent identification of HIV-1 DNA in bronchoalveolar lavage cells obtained from individuals with the acquired immunodeficiency syndrome. 184 69
Zidovudine
(azidothymidine, Retrovir) and ddI (di-deoxy-inosine, Videx) interfere with the multiplication of HIV by incorporation into nascent DNA chains and interruption of the further linking of nucleotides.
Zidovudine
lowers early mortality in patients with Aids and pneumocystis carinii
pneumonia
. However, much of the effectiveness of zidovudine is lost later on; the average prolongation of life in treated patients is estimated to be about 1 year. About two thirds of patients with Aids can be treated with zidovudine; in the others, the drug is ineffective or contraindicated. Frequent blood counts are necessary to monitor myelotoxicity, even at relatively low doses of 500 mg/day. In contrast, zidovudine is well tolerated by asymptomatic patients with 200 to 500 CD4 lymphocytes/mm3, in whom it diminishes the incidence of Aids from about 7 to 3% during the first year of treatment, with less than 2% severe anemia or leukopenia. For patients who do not tolerate zidovudine, ddI is an alternative. It is not myelotoxic but can cause neuritis and pancreatitis, especially at doses in excess of 10 mg/kg/day. Although its antiviral effect is excellent both in vitro and in vivo, there is still a lack of firm data on its clinical value, such as the decrease in opportunistic infections and increase in survival.
...
PMID:[Antiretroviral therapy in Switzerland 1991]. 192 47
AIDS is one of the most perplexing diseases to confront modern medicine today. AIDS will rank just behind accidents, heart disease and cancer as a major cause of potential life lost in the USA by 1991. Over half million AIDS cases are predicted by 1993 in the United States alone. There has been a great improvement in the understanding and treatment of opportunistic infections in AIDS. The most important concept is prophylactic treatment of the most common infectious complications as the immune system deteriorates. The major advance has been the prophylactic treatment of Pneumocystic Carinii
Pneumonia
(PCP) with either aerosolized Pentamidine or low dose Bactrim. Some experts advocate a low dose antibiotic prophylaxis for latent toxoplasma and cryptococcal infection in those patients whose immune systems are deteriorating. Prophylaxis would be instituted as the T4 helper lymphocyte count decreases. Finally, any patient found to be lately infected with either tuberculosis or syphilis, while HIV positive, must be thoroughly treated for these infections prior to any immunocompromise. The minimum follow-up of HIV positive individuals should include T4 lymphocyte counts and perhaps P24 antigen levels as well as beta 2-microglobulin levels. As these parameters worsen, patients should be directed to explore safe available treatments such as Antabuse, Naltrexone and Dextran sulfate. Any healthy patient with T4 helper counts under 400 should be directed to AIDS treatment evaluation units for enrolment in research protocols. At present over 100 drugs are being tested for the treatment of AIDS. However, researchers predict that no more than one or two drugs will be discovered over the next three years that will be helpful in the treatment of AIDS. If ever there was a more powerful argument to institute a new way of evaluating research drugs, it is this prediction. Due to the epidemic proportions of this disease, it seems reasonable to test epidemic proportions of this disease, it seems reasonable to test drugs shown to have some effect in groups of three of four drugs per patient. It is well demonstrated that
AZT
(
Zidovudine
) loses its anti-retroviral effect at about twelve to eighteen months. Drug resistance is seen in the treatment of a similar infectious agent, M. tuberculosis. Acute infection of MTB necessitates the use of three antibacterial agents. In AIDS infection, it seems logical to test two or three anti-retrovirals combined with one immunostimulant.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Acquired immunodeficiency syndrome: molecular biology and its therapeutic intervention (review). 251 41
Current evidence indicates that the length of survival for patients with the acquired immunodeficiency syndrome (AIDS) is increasing, thereby affording a greater opportunity for strategies designed to prevent the infectious diseases that mark the syndrome. Because these infections may occur at different stages of immunosuppression caused by the human immunodeficiency virus (HIV), effective application of preventive measures depends not only on detection of HIV infection but also on the use of staging indicators. The diseases that serve to define AIDS, such as Pneumocystis carinii pneumonia, tend to occur late in the course of HIV infection and often when the T helper lymphocyte (CD4+ cells) count is less than 0.2 x 10(9)/l. Other infections, such as tuberculosis and pyogenic bacterial pneumonia, may develop at any point after HIV infection has occurred. Given this relation between the degree of immunosuppression and the occurrence of particular pulmonary infections, different preventive interventions should be applied at different times. It is now known that the incidence of several of the pulmonary infections that are common in patients with HIV infection can be reduced by prophylactic measures. Pneumocystis pneumonia is decreased in frequency by any one of several prophylactic agents, the best established being pentamidine administered as an inhaled aerosol. The role of isoniazid in the chemoprophylaxis of tuberculosis in patients not infected with HIV is well established. Although there is little evidence of benefit so far from isoniazid in HIV infected patients with a positive tuberculin skin test response, it is logical to assume that there could be some effect. The use of pneumococcal polysaccharide vaccine may also be of some benefit in reducing the frequency of pneumococcal
pneumonia
in patients with AIDS. In addition to these specific measures, the antiretroviral agent zidovudine decreases both the frequency and the severity of opportunist infections, at least during the first few months of treatment. A comprehensive strategy for prevention of HIV associated lung infection first requires detection of HIV seropositivity, staging the immunosuppression by the CD4+ cell count, and determining whether tuberculous infection is present by a tuberculin skin test. All seropositive individuals should be given pneumococcal vaccine and those with evidence of tuberculosis infection should be treated with isoniazid for one year.
Zidovudine
should probably be started when CD4+ cell counts are in the range 0.4-0.5 x 10(9)/l and prophylaxis against pneumocystis infection when CD4+ cell counts are in the range 0.2-0.3 x 10(9)/l.
...
PMID:Prevention of lung infections associated with human immunodeficiency virus infection. 257 1
Acyclovir (Zovirax) and zidovudine (Retrovir) dominate antiviral therapy. They interfere with the multiplication of herpes viruses (acyclovir) and HIV (zidovudine) by incorporation into nascent DNA chains and interruption of the further linking of nucleotides. All types of infection caused by herpes simplex virus are potentially treatable by acyclovir, but treatment has to start to be effective. It is especially important to treat immunosuppressed patients because their infections are more prolonged and severe. A typical attack of herpes zoster in an immunocompetent patient is shortened by about 2 days if high doses of acyclovir are given within 3 days of the start of the skin lesions, but unfortunately the incidence of post-herpetic neuralgia is not diminished.
Zidovudine
lowers early mortality in patients with AIDS and pneumocystis carinii
pneumonia
. However, much of the effectiveness of zidovudine is lost later; the average prolongation of life in treated patients is estimated to be about 1 year. Some two thirds of patients with AIDS can be treated with zidovudine; in the others the drug is ineffective (Kaposi's sarcoma) or contraindicated. Frequent blood counts are necessary to monitor myelotoxicity.
...
PMID:[Antiviral drugs--1988]. 285 Nov 67
AIDS is a syndrome that represents the most severe form of infection with the retrovirus HIV. Opportunistic infections, uncommon malignant neoplasms, and intractable immunologic deficiency are hallmarks of AIDS. To date, the syndrome in the U.S. is seen mainly in epidemiologically restricted populations. It appears to be transmitted in a manner analogous to hepatitis B. There is no available means of reversing the immune deficit. Therapy is restricted to treating the complicating infections and tumors. Those having been diagnosed with P. carinii
pneumonia
may benefit from therapy with
AZT
. The spread of HIV and the syndrome can only be reduced by preventive measures until an effective and safe vaccine can be developed.
...
PMID:AIDS. 327 64
Serum and urinary concentrations and recovery rates of aztreonam (SQ26,776,
AZT
), a newly developed antibiotic, were studied for a total of 20 pediatric cases by one-shot intravenous injections of 10, 20 and 40 mg/kg to 3, 4 and 3 cases, respectively, and by intravenous drip infusion of 10, 20 and 40 mg/kg to 3, 4 and 3 cases for 1 hour, respectively. Clinical and bacterial effects of
AZT
were studied by administering 76.7 mg/kg per day on average for a total of 36 cases of tonsillitis (6),
pneumonia
(13), otitis media and
pneumonia
complication (1), pleurisy (1), sinusitis (1) and UTI (14). The above daily dose was given t.i.d. (9 cases) or q.i.d. (27 cases), by intravenous drip infusion for 30 minutes for one t.i.d. case and by one-shot intravenous injection for 7 days for the remaining 35 cases. Also, side effect and laboratory values were examined for 43 cases including 7 dropouts. Serum concentration of
AZT
in 10 pediatric cases were measured by dosing 10, 20 and 40 mg/kg by one-shot intravenous injection to 3, 4 and 3 cases, respectively. In every dosage group, the serum concentrations were highest 5 minutes after the intravenous injection with average values of 91.0, 174.0 and 175.3 mcg/ml, respectively. Dose response was observed between 10 mg/kg dose group and 20, 40 mg/kg dose groups, but it was not between 20 mg/kg group and 40 mg/kg group. This was considered to be attributable to the individual case-fluctuations in the 2 groups and to a high concentration case of 240.0 mcg/ml in the 20 mg/kg group. Half-life of each dosage group was 1.55, 1.65 and 1.93 hours. Serum concentrations of
AZT
in 10 pediatric cases at the dosage level of 10, 20 and 40 mg/kg for 3, 4 and 3 cases, respectively, by 1 hour intravenous drip infusion were highest at the end of the administration with average values of 95.7, 126.0 and 170.7 mcg/ml, respectively. There was a dose response among the 3 groups and the half-life of them were 1.02, 1.41 and 2.48 hours, respectively. A longer half-life of the 3rd group with 40 mg/kg administration than the other 2 groups was due to 1 particular case of 4.44 hours with unknown cause of such an exceptional extension.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[Basic and clinical trials of aztreonam in the field of pediatrics]. 391 25
Aztreonam (E-0734,
AZT
) was administered to
pneumonia
and chronic respiratory tract infections. The results were as follows:
AZT
was administered to 29 patients. Twenty-six cases were evaluable and 3 cases were excluded from evaluation of efficacy because 1 was Gram-positive infection, 2 were unclear symptom of infection.
Pneumonia
was 4 cases. Chronic respiratory tract infections were 22 cases. Clinical efficacy was judged as follows; excellent in 7 cases, good in 10 cases, fair in 5 cases and poor in 4 cases, then the efficacy rate was 65.4%. Efficacy rate in
pneumonia
, acute aggravation of diffuse panbronchiolitis and bronchiectasis with infection was 50%, 67% and 83%, respectively. Bacteriological response was judged on 21 cases with eradication rate was 66.7%. Bacteriological response classified by pathogen was as follows: All 6 isolates of H. influenzae, 2 in 6 isolates of P. aeruginosa, 4 in 5 isolates of H. parainfluenzae and all 3 isolates of K. pneumoniae were cleared. Total eradicated rate was 74.1%. Eruption was observed in 1 case as side effect. Abnormal laboratory findings were observed in 4 cases. Elevation of GOT and GPT was in 3 cases. Increase of eosinophil and basophil was in 1 case.
AZT
was considered to be a useful antibiotic for the treatment of respiratory tract infections, especially chronic respiratory tract infections, caused by Gram-negative pathogens.
...
PMID:[Clinical study of aztreonam on respiratory tract infections caused by gram-negative pathogens]. 391 26
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