Gene/Protein Disease Symptom Drug Enzyme Compound
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 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To understand recent temporal trends in acquired immunodeficiency syndrome (AIDS) mortality in the era of highly active antiretroviral therapy (HAART), trends in causes of death among persons with AIDS in San Francisco who died between 1994 and 1998 were analyzed. Among 5234 deaths, the mortality rate for human immunodeficiency virus (HIV)-related or AIDS-related deaths declined after 1995 (P<.01), whereas the mortality rate for non-HIV- or non-AIDS-related deaths remained stable. The proportion of deaths of persons with AIDS associated with septicemia, non-AIDS-defining malignancy, chronic liver disease, viral hepatitis, overdose, obstructive lung disease, coronary artery disease, and pancreatitis increased (P<.05). The standardized mortality ratio was high for these causes in both pre- and post-HAART periods, except for pancreatitis, a possible complication of HAART, which demonstrated an increasing standardized mortality ratio trend after 1996. With increasing AIDS survival, prevention of chronic diseases, assessment of long-term toxicity from HAART, and surveillance for additional causes of mortality will become increasingly important.
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PMID:Trends in causes of death among persons with acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy, San Francisco, 1994-1998. 1223 45

Eosinophilia is common in the neonatal period. However, its causes, pathomechanism and clinical significance are still unknown. Previous reports have described that eosinophilia may be associated with numerous conditions (establishment of an anabolic state, drug reactions, response to foreign antigens, chronic lung disease, erythropoietin treatment and infections). The aim of this study was to evaluate the possible association of various conditions, especially infection, with eosinophilia and to clarify whether recognition of increase in eosinophil count is of any clinical significance in the management of a sick neonate. Fifty-six neonates with eosinophilia (absolute eosinophil count > 700/mm3) and 55 control neonates matched for gestational age, birth weight and hospitalization days were included in the study. A significant difference between the two groups was found only in blood transfusions, immuno-globulin treatment, specific antibiotic treatment and infectious disease. However, neonates who develop sepsis and are treated with antibiotics and immuno-globulin are more often transfused. It can thus be concluded that the main relationship observed is between eosinophilia and infection whereas the other associations are secondary. The relative risk factor for infection when the absolute eosinophil count is > 700/mm3, is 1.58, with a confidence interval 1.30-1.91. Eosinophilia seems to be a reliable indicator of sepsis while normal absolute eosinophil count does not exclude infection. Infection should be strongly considered in the evaluation of a sick neonate with eosinophilia.
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PMID:Eosinophilia in sick neonates. 1224 53

The seminar on maternal morbidity and mortality in the Philippines held in 1991 is described. The objective of the meeting was to define the status of women's health in the country and to prepare for a more comprehensive and developed implementation of local reproductive health services. The seminar honored the International Day of Action for Women's Health. Maternal mortality statistics show a rate of 1.1.1000 live births since 1988 vs. 2.1/1000 live births in 1980. Maternal mortality is greater among young 1st time mothers, among those with 5 children, and among those 40 years regardless of the number of children. Obstetric deaths account for 85% of all maternal deaths. The common causes in 1985-89 were hemorrhage, infection, and hypertensive disorders. Pulmonary disease and acute hepatitis account for indirect obstetric mortality. The prior period from 1984 to 1985 in Manila showed the leading causes to be puerpural sepsis, septic induced abortion, postpartum hemorrhage, and eclampsia. In Manila 33% deliver at home. 65% of hospital emergency cases involve women without prenatal care, and 1 out of 4 are dying upon admission and 1 out of 5 die within 5-6 hours. 58% died within 2 days after admission. 80% of these deaths were preventable. Lack of health education and inadequate diet due to poverty account for a major predisposing role. Confounding factors are anemia, tuberculosis, and parasitism. Broad risk factors are the inadequacy of health services and socioeconomic conditions. Proposals to reduce maternal mortality by 50% include focusing health programs on both mother and child, improving knowledge about prenatal care, improving the quality of prenatal care, and improving the quality of family planning (FP) services. Medical institutions need to maintain adequate supplies of equipment and supplies. Statistics and research are needed. Contraception for the health of the child was proposed as the appropriate tool for acceptance of FP. Competition for funds was a problem. Problems were also identified as the power imbalance between the sexes. High risk screening was recommended at the local level by the health worker. Workshops were formed and issues were identified, recommendations made, activities described, and the government and nongovernmental responses given.
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PMID:The perils of motherhood. 1228 38

The fetus and the neonate are particularly vulnerable to injury caused directly by immunologic mechanisms or inflicted by infectious agents that take advantage of their relatively immature and inexperienced immune system. With increasing survival of high-risk neonates in the surfactant era, prevention/treatment of sepsis and chronic lung disease (CLD) has emerged as an area of priority in neonatal research. Considering the role of inflammatory mediators in the pathogenesis of sepsis and CLD, the clinical application of immunomodulator therapy to neonatology is perhaps more important at present than ever. Advances in molecular biology and immunology have led to development of newer immune modulator therapies that are directed towards specific cells or cytokines rather than resulting in a general suppression of the immune response. Failure of promising, newer immunomodulator therapies in sepsis trials in adults has, however, clearly documented the difficulties in diagnosing/correcting the imbalance between pro- and anti-inflammatory responses. As in the case of sepsis, development of a single magic bullet for prevention/management of a multi-factorial illness like CLD may be difficult, as prevention of prematurity - the single most important high-risk factor for CLD - is an unachievable goal at present. As new frontiers are being explored, older, well-established therapies like antenatal anti-D immunoglobulin prophylaxis continue to emphasize the tremendous potential of immunomodulator therapy in neonatology/perinatology. The current immunomodulators/immunotherapeutic agents with established/potential clinical applications in the perinatal period are reviewed.
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PMID:Perinatal immunomodulation. 1238 69

Granulocyte colony-stimulating factor (G-CSF) increases the concentration and activation of neutrophils in the peripheral blood and has been used to prevent late-onset infection in premature infants. However, if G-CSF also augmented the inflammatory response in the lung, the incidence and severity of acute and chronic lung injury might be expected to increase. Using a newborn piglet model of acute lung injury, we examined the effects of rhG-CSF (recombinant-metHuG-CSF) on lung injury. Thirty-three newborn piglets were studied as follows: 1). Unventilated controls; 2). normally ventilated (PaCO2 = 35-45 torr) with room air(RA) for 48 h; 3). normally ventilated with RA for 48 h and received rhG-CSF (10 mg/kg/dose IV) at 0, 12, 24, and 36 h; 4). hyperventilated (PaCO2 = 15-25 torr) with 100% O2 for 48 h; 5) hyperventilated with 100% O2 for 48 h and received rhG-CSF (10 mg/kg/dose IV) at 0, 12, 24 and 36 h. Complete blood counts and and differentials were performed at 0, 24, and 48 h. Animals were sacrificed at 48 h, lungs were removed en bloc, and bronchoalveolar lavage (BAL) was performed. Total blood white blood cells and neutrophil counts increased significantly over 48 h in animals who received rhG-CSF either with normoventilation (p <0.0001) or hyperventilation with 100% O2 (p <0.003), and did not change significantly in the other experimental groups. However, there were no significant differences in BAL total cell counts, neutrophil chemotaxis activity, total protein, or albumin concentrations among the groups. Despite significantly increasing peripheral neutrophil counts, rhG-CSF did not potentiate acute lung injury or inflammation. This suggests that prophylactic administration strategies using rhG-CSF to prevent sepsis in premature infants should not increase the risk for developing acute and chronic lung disease.
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PMID:Effects of granulocyte colony-stimulating factor on hyperoxia-induced lung injury in newborn piglets. 1239 13

To clarify the relationship between chorioamnionitis and chronic lung disease (CLD) in very low birth weight (VLBW) infants, we performed a retrospective cohort study of all inborn patients between 1995-1997 with gestational age (GA) less than 32 wk, birth weight less than 1.5 kg, survival to 36 wk adjusted GA, and placentas submitted to pathology (n = 371). Racial distribution as defined by the mother was 40% white/60% nonwhite. Prevalence of CLD, defined as O(2) dependence at 36 wk adjusted GA, was 30%. In a preliminary analysis GA and birth weight for GA (standard deviations from the mean, Z-score), considered together, were inversely related to CLD. After adjustment for GA and Z-score, other risk factors for CLD were white race, acute respiratory distress, pulmonary air leak, patent ductus arteriosus, and septicemia. Two placental lesions were inversely related to CLD: histologic chorioamnionitis and acute atherosis (a placental indicator of preeclampsia). Following multivariate analysis, independent risk factors for CLD were GA (OR, 0.6; 95% CI = 0.5, 0.7), birthweight for GA (OR, 0.4; 95% CI = 0.3, 0.6), white race (OR, 1.9; 95% CI = 1.0, 3.3), patent ductus arteriosus (OR, 2.0; 95% CI = 1.0, 3.5), and pulmonary air leak (OR, 3.0; 95% CI = 1.3, 7.1). Acute atherosis was inversely related to CLD (OR, 0.2; 95% CI = 0.1, 0.8). Chorioamnionitis was stratified by subtype and again no association with CLD was seen in the population as a whole. Finally, chorioamnionitis of all subtypes tended to be increased in white infants and decreased in black infants with CLD. This dichotomy was not explained by differences in death rates, acute respiratory distress, intubation on d 2 of life, or total duration of assisted ventilation. We conclude that while chorioamnionitis was not a risk factor for CLD in our total population, racial differences in its relationship to CLD are worthy of further study.
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PMID:Placental and other perinatal risk factors for chronic lung disease in very low birth weight infants. 1240 18

The survival rate for extremely preterm or extremely low-birth-weight (LBW) newborns born at the threshold of viability (25 or fewer completed weeks of gestation) improved in the early 1990s, largely as the result of a greater use of assisted ventilation in the delivery room and surfactant therapy. Increased use of antenatal and neonatal corticosteroids also may have influenced survival rates. However, this improvement in survival has not been associated with an equal improvement in morbidity. The incidence of chronic lung disease, sepsis, and poor growth remains high and may even have increased. There is concern that the treatment of extremely preterm and extremely LBW newborns may result in unforeseen effects into adulthood, and that the neurodevelopmental outcome and cognitive function of extremely preterm and extremely LBW infants may be suboptimal. The purpose of this document is to describe the potential consequences of extremely preterm birth and to provide clinical management guidelines based on the best available data.
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PMID:ACOG practice bulletin. Perinatal care at the threshold of viability. Number 38, September 2002. American College of Obstetrics and Gynecology. 1248 56

In this prospective longitudinal study, birth weight and neonatal morbidities were evaluated relative to a broad range of school age outcomes. Fully 188 infants, 151 who were preterm, were recruited at birth, stratified by birth weight and socioeconomic status, and were followed until age 8 with a 97% retention rate. A gradient relationship was found among birth groups, with full-term children earning the highest scores. The very low birth weight and extremely low birth weight groups were equivocal in all scores except visual perception. The findings also were consistent with a pattern of nonverbal learning disability (Rourke, 1995) in which there is evidence of math underachievement and adequate performance in verbal, reading, and spelling scores. Children who had bronchopulmonary dysplasia, chronic lung disease, intraventricular hemorrhage, and sepsis differed from children without these neonatal morbidities, with an average of 10-20 points below the mean.
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PMID:Birth weight, neonatal morbidities, and school age outcomes in full-term and preterm infants. 1254 85

Oxidative modifications of enzymes and structural proteins play a significant role in the aetiology and/or progression of several human diseases. Protein carbonyl content is the most general and well-used biomarker of severe oxidative protein damage. Human diseases associated with protein carbonylation include Alzheimer's disease, chronic lung disease, chronic renal failure, diabetes and sepsis. Rapid recent progress in the identification of carbonylated proteins should provide new diagnostic (possibly pre-symptomatic) biomarkers for oxidative damage, and yield basic information to aid the establishment an efficacious antioxidant therapy.
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PMID:Protein carbonylation in human diseases. 1272 43

An 82 year old woman was found unexpectedly dead in bed on the day of admission to hospital for the investigation of difficulty breathing. During a barium swallow examination after admission she was thought to have aspirated contrast material. At autopsy a large posterior lingual abscess was found, with barium in the airways. Death was attributed to a combination of upper airway narrowing associated with the abscess, chronic lung disease and possible aspiration of barium. This case demonstrates an unusual sequence of events associated with localised upper airway sepsis. It also confirms the importance of careful examination of the upper aerodigestive tract at autopsy in individuals of all ages.
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PMID:Unexpected death in association with an occult posterior lingual abscess. 1293 10


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