Prognostic value of interleukin-8 in AIDS-associated Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Benfield, T L; Vestbo, Jørgen; Junge, Jette

1995-01-01

Interleukin-8 (IL-8) is a potent neutrophil chemoattractant and activator. Pneumocystis carinii pneumonia is associated with an accumulation of neutrophils in bronchoalveolar lavage (BAL) fluid. Thus, we hypothesized that IL-8 is involved in the pathogenesis of P. carinii pneumonia. BAL fluid...... and serum were prospectively collected in 76 consecutive HIV-infected patients with a primary episode of P. carinii pneumonia, as well as in 10 healthy control subjects. Patients were found to have elevated levels of IL-8 in BAL fluid compared with control subjects (p ... the course of P. carinii pneumonia. Comparing survivors with nonsurvivors, the median IL-8 level in BAL fluid was 127 (0 to 3,900) versus 584 (127 to 6,100) pg/ml (p

Isolation and expression of the Pneumocystis carinii thymidylate synthase gene

DEFF Research Database (Denmark)

Edman, U; Edman, J C; Lundgren, B

1989-01-01

The thymidylate synthase (TS) gene from Pneumocystis carinii has been isolated from complementary and genomic DNA libraries and expressed in Escherichia coli. The coding sequence of TS is 891 nucleotides, encoding a 297-amino acid protein of Mr 34,269. The deduced amino acid sequence is similar...

Radiographic aspects of Pneumocystis carinii pneumonia in the miniature dachshund

International Nuclear Information System (INIS)

Kirberger, R.M.; Lobetti, R.G.

1998-01-01

The thoracic radiographic changes of Pneumocystis carinii in 7 miniature Dachshunds were reviewed, The dogs were 7-12 months old and presented with polypnea, exercise intolerance and clinical signs suggestive of immune-incompetence. P. carinii pneumonia was diagnosed in all the dogs using transtracheal aspirate cytology and confirmed at postmortemin 3 dogs that died. Radiographically, diffuse pulmonary changes we represent and varied from a mild interstitial and bronchial pattern to an alveolar pattern. Radiographic evidence of cor pulmonale was present in 1 dog. The most severe radiographic changes were seen in 2 of the dogs that died

Use of Terbinafine in Mouse and Rat Models of Pneumocystis carinii Pneumonia

Science.gov (United States)

Walzer, Peter D.; Ashbaugh, Alan

2002-01-01

Terbinafine, an allylamine used to treat onychomycosis, has been reported to be active against rat Pneumocystis carinii in vitro and in vivo. By contrast, our in vitro data showed that the 50% inhibitory concentration of terbinafine against rat P. carinii is 3.7 μg/ml, a level that cannot be clinically achieved in serum. In the present study, terbinafine administered orally at doses of 20 to 400 mg/kg/day and 50 to 250 mg/kg/day was ineffective therapy for mouse and rat models of pneumocystosis, respectively. These results emphasize the complexities of P. carinii drug testing and the need for caution before considering studies in humans. PMID:11796365

Effect of folic and folinic acid on cytopenia occurring during co-trimoxazole treatment of Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Bygbjerg, Ib Christian; Lund, J T; Hørding, M

1988-01-01

12 AIDS/ARC patients with or suspected of Pneumocystis carinii pneumonia were treated with co-trimoxazole and received supplementary folic or folinic acid to avoid peripheral blood cytopenia. Most patients developed decreased numbers of neutrophils and hemoglobin while receiving co-trimoxazole. S......12 AIDS/ARC patients with or suspected of Pneumocystis carinii pneumonia were treated with co-trimoxazole and received supplementary folic or folinic acid to avoid peripheral blood cytopenia. Most patients developed decreased numbers of neutrophils and hemoglobin while receiving co...

Non-typical radiological finding in pneumonia caused by pneumocystis carinii organisms

International Nuclear Information System (INIS)

Moellmann, D.; Jablonowski, H.

1990-01-01

To distinguish between individual forms of pneumonia computed tomograhy appears to be a more reliable diagnostic tool than is conventional survey radiography. As a general rule, any pictures apparently suggestive of tuberculosis must be thoroughly examined in order to exclude Pneumocystis-carinii-induced pneumonia. (orig.) [de

Prognostic markers of short-term mortality in AIDS-associated Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Benfield, T L; Helweg-Larsen, J; Bang, D

2001-01-01

BACKGROUND: Since 1990, corticosteroids have been recommended as adjunctive therapy for patients with AIDS-associated Pneumocystis carinii pneumonia (PCP) and respiratory failure. We hypothesized that the natural course of AIDS-associated PCP has changed in the era of adjunctive corticosteroid...

The outcome of Pneumocystis carinii pneumonia in Danish patients with AIDS

DEFF Research Database (Denmark)

Pedersen, C; Lundgren, Jens Dilling; Nielsen, T

1989-01-01

A total of 100 consecutive patients with AIDS were evaluated for efficacy and safety of treatment and secondary prophylaxis directed against Pneumocystis carinii pneumonia (PCP). 89 episodes of PCP were recorded in 75 patients. 63 of the 75 patients (84%) with a first episode of PCP were discharged...

Pneumocystis carinii in bronchoalveolar lavage and induced sputum: detection with a nested polymerase chain reaction

DEFF Research Database (Denmark)

Skøt, J; Lerche, A G; Kolmos, H J

1995-01-01

To evaluate polymerase chain reaction (PCR) for detection of Pneumocystis carinii, 117 bronchoalveolar lavage (BAL) specimens, from HIV-infected patients undergoing a diagnostic bronchoscopy, were processed and a nested PCR, followed by Southern blot and hybridization with a P32-labelled probe......, but sensitivity dropped markedly with this system. A further 33 patients had both induced sputum and bronchoalveolar lavage performed and the induced sputum was analysed using PCR and routine microbiological methods. The PCR sensitivity on induced sputum was equal to that of routine methods. At present...... the evaluated PCR cannot replace routine microbiological methods for detection of Pneumocystis carinii, on either BAL fluid or induced sputum....

Guanylhydrazones in therapy of Pneumocystis carinii pneumonia in immunosuppressed rats.

Science.gov (United States)

Walzer, P D; Foy, J; Runck, J; Steele, P; White, M; Klein, R S; Otter, B A; Sundberg, R J

1994-01-01

Guanylhydrazones are cationic heteroaromatic drugs similar to the diamidines which are effective in the treatment of African trypanosomiasis and pneumocystosis. On the basis of their antitrypanosomal activity, different guanylhydrazones were selected for evaluation in a rat model of Pneumocystis carinii pneumonia. The most active compounds were the 2-(4'-formylphenyl)-1-methylimidazo-[1,2-a] pyridinium guanylhydrazones which, at a dose of 2 mg/kg/day, were about as effective as trimethoprim-sulfamethoxazole at a dose of 50 mg of trimethoprim per kg/day plus 250 mg of sulfamethoxazole per kg/day. The anti-P. carinii activity of these guanylhydrazone derivatives was found with parenteral but not with oral administration. The 1,3-arylene diketone bis(guanylhydrazones) were generally ineffective, although a triacetyl derivative showed some anti-P. carinii activity. Nitroimidazole guanylhydrazone derivatives were also ineffective. Attempts to improve the therapeutic efficacy of the different guanylhydrazones were limited by problems of toxicity. We conclude that some guanylhydrazone derivatives are potent anti-P. carinii drugs and that further studies should be pursued to develop safer compounds and investigate structure-activity relationships. PMID:7872750

Pneumocystis carinii and specific fungi have a common epitope, identified by a monoclonal antibody

DEFF Research Database (Denmark)

Lundgren, B; Kovacs, J A; Nelson, N N

1992-01-01

Because Pneumocystis carinii may be related to fungi, we evaluated the reactivities of monoclonal antibodies raised against P. carinii with a variety of fungi. Fifty-two fungi and six protozoa were evaluated by immunofluorescence. One of three monoclonal antibodies (MAbs) tested (MAb 7D7) reacted...... with 15 fungi but no protozoa. Saccharomyces cerevisiae showed the strongest reactivity by immunofluorescence. The reactive antigen was characterized for four fungi by the immunoblot technique. In all cases the antigen that was reactive with MAb 7D7 was larger than the P. carinii antigens that reacted...

Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Orholm, M; Lundgren, Jens Dilling; Nielsen, T L

1990-01-01

During a six-month period, 40 consecutive fiberoptic bronchoscopic procedures including bronchoalveolar lavage, bronchial brushing and forceps biopsy were performed in local anaesthesia on 34 HIV-infected males presenting symptoms compatible with Pneumocystis carinii pneumonia. In 23 examinations...... did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed...

Cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate

DEFF Research Database (Denmark)

Balslev, U; Berild, D; Nielsen, T L

1992-01-01

A 27-year-old man, HIV-positive for 4 years, developed ventricular fibrillation and cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate. The dosage was 4 mg/kg/day for 18 days. Nephrotoxicity occurred and raised serum potassium. The plasma...

Pneumocystis carinii in bronchoalveolar lavage and induced sputum: detection with a nested polymerase chain reaction

DEFF Research Database (Denmark)

Skøt, J; Lerche, A G; Kolmos, H J

1995-01-01

was performed. The sensitivity and specificity were 85 and 100% 934/40 and 77/77) respectively. A non-radioactive labelling system BluGENE was evaluated on all specimens, and found to be as effective as P32-labelling. To increase the speed and convenience of detection, a dot blot system was tested......To evaluate polymerase chain reaction (PCR) for detection of Pneumocystis carinii, 117 bronchoalveolar lavage (BAL) specimens, from HIV-infected patients undergoing a diagnostic bronchoscopy, were processed and a nested PCR, followed by Southern blot and hybridization with a P32-labelled probe...... the evaluated PCR cannot replace routine microbiological methods for detection of Pneumocystis carinii, on either BAL fluid or induced sputum....

IgM response to a human Pneumocystis carinii surface antigen in HIV-infected patients with pulmonary symptoms

DEFF Research Database (Denmark)

Lundgren, Bettina; Kovacs, J A; Mathiesen, Lars Reinhardt

1993-01-01

We have developed an ELISA to detect IgM antibodies to a major human Pneumocystis carinii surface antigen (gp95), and investigated the IgM response in 128 HIV-infected patients who underwent bronchoscopy for evaluation of pulmonary symptoms. Only 5 (4%) patients had IgM antibodies to P. carinii g...

Albendazole inhibits Pneumocystis carinii proliferation in inoculated immunosuppressed mice.

OpenAIRE

Bartlett, M S; Edlind, T D; Lee, C H; Dean, R; Queener, S F; Shaw, M M; Smith, J W

1994-01-01

Albendazole, a benzimidazole derivative widely used for treating helminth infections, was successfully used to treat and prevent development of Pneumocystis carinii pneumonia in transtracheally inoculated immunosuppressed mice. For treatment, 3 weeks postinoculation, albendazole at 300 and 600 mg/kg of body weight per day was administered in food for 3 weeks. For prophylaxis, albendazole was begun on the same day as inoculation at 300 mg/kg/day for 7 days, and then the dose was reduced to 150...

Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis.

LENUS (Irish Health Repository)

Lahiff, C

2007-12-01

Pneumocystis carinii pneumonia (PCP) is a rare form of pneumonia associated with immune-suppression. It is common in patients with AIDS and with a CD4 count of less than 200 cells\\/mm(3). We report a case of PCP secondary to immune-suppression in a 41-year-old man with psoriatic arthritis being treated with the immune-modulatory agent etanercept.

Aerosolised pentamidine for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome Aerosol de pentamidina no tratamento da pneumonia por Pneumocystis carinii em pacientes com a síndrome da imunodeficiência adquirida

Directory of Open Access Journals (Sweden)

Adriana Weinberg

1990-08-01

Full Text Available The goal of this study was to evaluate inhaled pentamidine for the treatment of patients with mild and moderate Pneumocystis carinii pneumonitis. Eight adults with AIDS and pneumocystis pneumonia (4 with a first episode and 4 with a repeat pneumocystosis received daily inhalations of aerosol pentamidine isethionate for 21 days. Six patients were treated with doses of 300 mg of pentamidine and the remaining 2 received 600 mg every day. In the 300 mg treatment group, 2 individuals showed discrete and transient neutropenia. However, both subjects that received 600 mg of aerosol pentamidine daily developed leukopenia. One of them had major toxicity (overall severe intolerance of 12.5% that required drug discontinuation and did not allow any analysis of the treatment efficacy. Of the 7 evaluable patients, 6 (88% completed the treatment successfuly. One subject of the 300 mg regimen experienced an early recurrence. In conclusion, inhaled pentamidine is an effective treatment for mild and moderate cases of P. carinii pneumonia. It is less toxic than standard anti-pneumocystis therapy and is suitable for outpatient use.O objetivo deste estudo consistiu em avaliar pentamidina inalatória para o tratamento de pneumonia leve a moderada, causada por Pneumocystis carinii. Oito adultos com a síndrome da imunodeficiência humana e pneumocistose (4 apresentando o primeiro episódio e 4 na vigência de pneumocistose de repetição receberam inalações diárias de isetionato de pentamidina por 21 dias. Seis pacientes foram tratados com doses de 300 mg de pentamidina e os 2 restantes receberam 600 mg diariamente. No grupo de 300 mg, 2 indivíduos desenvolveram neutropenia leve e transitória. Porém, ambos os pacientes recebendo 600 mg de pentamidina aerosol apresentaram leucopenia. Um deles teve toxicidade importante (intolerância global de 12,5%, que levou a suspensão da droga e impediu a avaliação da sua eficácia. Entre os 7 pacientes que puderam ser

Multiple genes encode the major surface glycoprotein of Pneumocystis carinii

DEFF Research Database (Denmark)

Kovacs, J A; Powell, F; Edman, J C

1993-01-01

hydrophobic region at the carboxyl terminus. The presence of multiple related msg genes encoding the major surface glycoprotein of P. carinii suggests that antigenic variation is a possible mechanism for evading host defenses. Further characterization of this family of genes should allow the development......The major surface antigen of Pneumocystis carinii, a life-threatening opportunistic pathogen in human immunodeficiency virus-infected patients, is an abundant glycoprotein that functions in host-organism interactions. A monoclonal antibody to this antigen is protective in animals, and thus...... blot studies using chromosomal or restricted DNA, the major surface glycoproteins are the products of a multicopy family of genes. The predicted protein has an M(r) of approximately 123,000, is relatively rich in cysteine residues (5.5%) that are very strongly conserved, and contains a well conserved...

Recognition of Pneumocystis carinii in foals with respiratory distress

International Nuclear Information System (INIS)

Ainsworth, D.M.; Weldon, A.D.; Beck, K.A.; Rowland, P.H.

1993-01-01

Five 3-month-old foals presenting with fever and respiratory disease were found to have pulmonary abscesses with patchy to diffuse alveolar and interstitial pneumonia on post-mortem examination. All affected foals had evidence of Rhodococcus equi infection and had few to abundant Pneumocystis carinii cysts in the sections of affected lung. Of the 5 foals examined radiographically, 3 had a distinct reticulonodular (miliary) pattern which may aid in the ante-mortem diagnosis of P. carinii pneumonia (PCP). Leukocyte counts of foals with PCP were significantly greater than in the control group of foals with uncomplicated bacterial pneumonia. Foals with PCP tended to be more tachypnoeic than the control foals and 4 of the 5 PCP+ foals appeared dyspnoeic before death. The ante-mortem recognition of PCP may be expedited by bronchoalveolar lavage and successful treatment of foals with PCP may require the administration of adequate levels of potentiated sulphonamides

Pneumocystis carinii in the miniature dachshund: case report and literature review

International Nuclear Information System (INIS)

Lobetti, R.G.; Leisewitz, A.L.; Spencer, J.A.

1996-01-01

This article reviews Pneumocystis carinii and presents four cases in the miniature dachshund. The cases presented with hyperpnoea, tachypnoea and exercise intolerance. There were also clinical signs suggestive of immune incompetence in all the dogs. P carinii pneumonia was diagnosed in all four cases on transtracheal aspirate cytology. Immunological studies showed low globulin levels on serum electrophoresis, decreased lymphoblast transformation response (in the two cases that were tested) and a deficiency of immunoglobulins A, G and M. Light and electron microscopy as well as anti-canine immunoglobulin G immunoperoxidase staining studies were performed on one case which had died because of the disease. From these four cases, it appears that P carinii pneumonia in the miniature dachshund may be the result of an immunodeficiency. It does not, however, appear to be a classic primary severe combined immunodeficiency syndrome as the dogs appeared to respond to treatment, did not show growth failure and did not manifest overwhelming commensurate bacterial infections

Humoral and cellular responses to Pneumocystis carinii, CMV, and herpes simplex in patients with AIDS and in controls

DEFF Research Database (Denmark)

Hofmann, B; Nielsen, P B; Ødum, Niels

1988-01-01

The titers of IgG and IgA to Pneumocystis carinii in 36 AIDS patients did not differ significantly from those in 31 controls. Only 2/15 patients (13%) with P. carinii pneumonia (PCP) had titers of IgM antibodies greater than or equal to 5, which is significantly less frequent than in 32 controls...

Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

International Nuclear Information System (INIS)

Reiss, T.F.; Golden, J.

1990-01-01

Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population

Imaging of pneumocystic carinii pneumonia in AIDS

International Nuclear Information System (INIS)

Zhao Dawei; Zhang Ke; Ma Daqing; Jia Cuiyu

2002-01-01

Objective: To study the X-ray and CT findings of pneumocystis carinii pneumonia in AIDS. Methods: Five AIDS patients who had chest abnormalities were analyzed. Results: Pneumocystis carinii pneumonia appeared as diffuse infiltrative and interstitial fine nodules. Conclusion: If the diffuse and infiltrative interstitial fine nodule are the appearances in patients with AIDS, the pneumocystic carinii pneumonia should be considered

Heterogeneity and compartmentalization of Pneumocystis carinii f. sp. hominis genotypes in autopsy lungs

DEFF Research Database (Denmark)

Helweg-Larsen, J; Lundgren, Bettina; Lundgren, Jens Dilling

2001-01-01

The extent and importance of genotype heterogeneity of Pneumocystis carinii f. sp. hominis within lungs have not previously been investigated. Two hundred forty PCR clones obtained from respiratory specimens and lung segments from three patients with fatal P. carinii pneumonia were investigated....... Not all genotypes present in the lungs at autopsy were detected in the diagnostic respiratory samples. Compartmentalization of specific ITS and mtLSU rRNA sequence types was observed in different lung segments. In conclusion, the interpretation of genotype data and in particular ITS sequence types...... in the assessment of epidemiological questions should be cautious since genotyping done on respiratory samples cannot a priori be assumed to represent all genotypes present within the lung....

Pneumocystis carinii pneumonia in systemic lupus erythematosus: a report of two cases.

Science.gov (United States)

Tsai, H C; Lee, S S; Lin, H H; Lu, L Y; Liu, Y C

2001-10-01

Patients with systemic lupus erythematosus (SLE) have increased susceptibility to infection by Pneumocystis carinii, but this condition has rarely been reported in Taiwan. Here, we describe two cases of patients with SLE who developed Pneumocystis carinii pneumonia (PCP). The first patient was a 39-year-old woman presenting with fever and dyspnea that had lasted 2 weeks. Chest roentgenography disclosed bilateral interstitial and alveolar infiltrates. The second patient was a 22-year-old woman presenting with a 4-day history of malaise, cough, dyspnea, and fever. She had concomitant Mycobacterium tuberculosis infection. Both patients had been treated with varying doses of corticosteroids and/or cytotoxic drugs within 4 months before presentation. Diagnosis was established based on the findings of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB). Both patients received trimethoprim-sulfamethoxazole (20 mg.kg-1.d-1 trimethoprim), but finally died of nosocomial septicemia (Acinetobacter baumanni and Pseudomonas aeruginosa bacteremia in one, P. aeruginosa bacteremia in the other). These two cases demonstrate that PCP should be included in the differential diagnosis of patients with SLE presenting with pneumonic processes. In addition, a second opportunistic pathogen should be suspected. Bronchoscopic examination should be performed if the diagnosis is not clear and should include TBLB and BAL.

Aerosolized pentamidine: Effect on diagnosis and presentation of Pneumocystis carinii pneumonia

International Nuclear Information System (INIS)

Jules-Elysee, K.M.; Stover, D.E.; Zaman, M.B.; Bernard, E.M.; White, D.A.

1990-01-01

The objective of this study was to determine the effect of previous aerosolized pentamidine therapy on diagnosis and presentation of Pneumocystis carinii pneumonia. This was a retrospective study of fifty-two consecutive patients with P. carinii pneumonia and underlying infection with the human immunodeficiency virus (HIV) who had bronchoscopy. Twenty-one patients who were on aerosolized pentamidine therapy served as the study group. Thirty-one patients who had not received the drug served as the control group. The yield of bronchoalveolar lavage for P. carinii pneumonia was 62% for the study group and 100% for the control group (P less than 0.05). This lower yield was significant for the subset of patients having their first episode of P. carinii pneumonia. The yield of transbronchial biopsy was similar for both groups of patients (81% compared with 84%). The yield of bronchoscopy was not influenced by use of zidovudine. Review of lavage specimen slides suggested that there may be fewer organisms present in patients receiving aerosolized pentamidine. An atypical roentgenographic presentation of upper lobe predominant infiltrates was seen in 38% of the study patients and 7% of the control patients. In addition, pneumothoraces and cystic changes were also frequently seen in the study patients. Gallium scans, when done, were also atypical in the study group. Markers of the severity of disease, however, were similar in both groups. The yield of bronchoalveolar lavage for P. carinii pneumonia in HIV-infected patients is lower in patients receiving aerosolized pentamidine. Unusual roentgenographic presentations and atypical gallium scans are also found in this setting

Altered distribution of Pneumocystis carinii pneumonia during radiation therapy

International Nuclear Information System (INIS)

Kim, H.H.; Park, S.H.; Kim, S.C.; Kim, Y.S.

1999-01-01

The radiographic findings of Pneumocystis carinii pneumonia (PCP) are various. The typical findings are diffuse, bilateral, symmetric, finely granular, or reticular infiltrates. In patients taking aerosol pentamidine, atypical findings may be the first manifestation. One interesting radiologic finding of PCP is that the pneumonia may spare the irradiated lung. We report PCP developed in a patient undergoing irradiation for lung cancer. High-resolution CT revealed diffuse, bilateral, and symmetric ground-glass opacities with septal thickening in both lungs; however, the radiation port was spared and appeared as the ''photographic negative of post-radiation pneumonia.'' The distribution of the pneumonic infiltrates was altered by radiotherapy. (orig.)

Pneumocystis carinii: its incidence in rodents and enhancement of the infection by corticosteroids

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Helly A. Lage

1973-01-01

Full Text Available A survey was made on the incidence of Pneumocystis carinii in 361 rodents including sewer rats, albino rats, albino mice, guinea-pigs and rabbits. P. carinii was found in 4 of the 215 Rattus norvegicus examined (1,8%. These results accord with recent observations but disagree with investigations made by the researchers who first studied this parasite in the past when high indexes of infection were found. However, in 20 albino rats treated with corticosteroids (betamethazone we found 8 positive (40% and in 20 albino mice treated by the same way, 9 were positive for P. carinii (45%. These results confirm the opportunistic character of P. carinii in rodents already well demonstrated in man.Foi feita uma investigação sobre a ocorrência de P. carinii em 361 roedores, incluindo ratos de esgoto, ratos albinos, camundongos albinos, cobaios e coelhos. Só foram encontrados positivos 4 Rattus norvegicus em 215 examinados (1.8%. Estes resultados estão de acordo com observações feitas nos últimos anos, os quais constrastam com as verificações feitas nos primeiros anos, os quais contrastam com as verificações feitas nos primeiros anos de estudo do P. carinii, quando foram assinalados altos índices infecciosos. Entretanto, em 20 ratos albinos tratados com corticosteróides (betametasona foram encontrados 8 positivos (40%; e em 20 camundongos albinos, tratados do mesmo modo, foram encontrados 9 positivos (45%. Estes resultados confirmaram o caráter oportunístico do P. carinii no roedores, do mesmo modo como acontece no homem.

Improved detection of Pneumocystis carinii by an immunofluorescence technique using monoclonal antibodies

DEFF Research Database (Denmark)

Orholm, M; Holten-Andersen, W; Lundgren, Jens Dilling

1990-01-01

To assess whether a recently developed indirect immunofluorescent stain using monoclonal antibodies was more sensitive in detecting Pneumocystis carinii than the combination of Giemsa and methenamine silver nitrate stains which has routinely been used in the laboratory, 88 lavage fluid specimens...... silver nitrate and toluidine blue O. Immunofluorescence using the monoclonal antibodies from the NIH was significantly more sensitive than any other single staining method and than the combination of Giemsa and methenamine silver nitrate staining. The study also showed that the cytospin centrifuge...

Antibody responses to a major Pneumocystis carinii antigen in human immunodeficiency virus-infected patients with and without P. carinii pneumonia

DEFF Research Database (Denmark)

Lundgren, Bettina; Lundgren, Jens Dilling; Nielsen, T

1992-01-01

of pulmonary symptoms. Significantly more patients with P. carinii pneumonia (PCP) had detectable antibodies compared with HIV-infected patients without PCP and with HIV-negative controls (50 [66%] of 76 vs. 18 [34%] of 53 and 7 [35%] of 20, respectively; P less than .001), and the level of antibody response......Antibody responses to a major purified human Pneumocystis carinii surface antigen (gp95) were determined by ELISA in human immunodeficiency virus (HIV)-infected patients. Serum IgG directed against gp95 was measured in 129 consecutive HIV-infected patients who underwent bronchoscopy for evaluation...... response, compared with only 1 (3%) of 31 patients without PCP (P less than .001). This patient had PCP on the basis of clinical criteria, including response to therapy. Thus, despite severe immunosuppression, a proportion of HIV-infected patients with PCP can mount a specific IgG-mediated antibody...

Scintigraphic pattern of pneumothorax complicating Pneumocystis carinii pneumonia in patients with AIDS

International Nuclear Information System (INIS)

Finestone, H.; Goldfarb, C.R.; Ongseng, F.; Wasserman, I.; Garcia, H.

1990-01-01

Spontaneous pneumothorax is a serious though infrequently reported pulmonary complication of AIDS. An unsuspected lung collapse was discovered via gallium scintigraphy for the study of Pneumocystis carinii pneumonia. Neither the pneumonia nor the pneumothorax were apparent on the most recent chest roentgenogram. In evaluating gallium images during the work-up of AIDS patients with associated pulmonary pathology, the possible complication of lung collapse should be considered. If pneumothorax is suspected on gallium imaging, a chest roentgenogram in expiration must be obtained for prompt delineation of this serious, yet correctable, condition

Gallium accumulation in early pulmonary Pneumocystis carinii infection

International Nuclear Information System (INIS)

Stevens, D.A.; Allegra, J.C.

1986-01-01

The accumulation of gallium 67 citrate in pulmonary Pneumocystis carinii is well known. The sensitivity of gallium uptake in detecting early inflammatory processes, even when conventional roentgenograms are normal, would seem to make it possible in immunocompromised patients to make a presumptive diagnosis of this serious infection early in its course without using invasive techniques to demonstrate the organism. However, the presence of gallium uptake in radiation pneumonitis, pulmonary drug toxicity, and other processes that also occur in this group limit its usefulness. In our two patients--a young woman with Hodgkin's disease and an elderly woman with small cell lung cancer--this technique proved helpful. Although the latter patient was successfully treated empirically, such empiric treatment should be reserved for patients unable or unwilling to undergo invasive tests. Pulmonary gallium uptake in patients with respiratory symptoms, even with a normal chest film, should prompt attempts to directly demonstrate the organism

IgM response to a human Pneumocystis carinii surface antigen in HIV-infected patients with pulmonary symptoms

DEFF Research Database (Denmark)

Lundgren, Bettina; Kovacs, J A; Mathiesen, Lars Reinhardt

1993-01-01

We have developed an ELISA to detect IgM antibodies to a major human Pneumocystis carinii surface antigen (gp95), and investigated the IgM response in 128 HIV-infected patients who underwent bronchoscopy for evaluation of pulmonary symptoms. Only 5 (4%) patients had IgM antibodies to P. carinii gp...... response to gp95. These patients also showed an increase in IgG antibodies to gp95 and had microbiologically proven PCP. Prior to the development of the IgM response, IgG antibodies to gp95 were detectable in all 3 patients. Thus, HIV-infected patients with PCP seldom produce IgM antibodies to the major...

Clusters of Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Helweg-Larsen, J; Tsolaki, A G; Miller, Raymonde

1998-01-01

Genotyping at the internal transcribed spacer (ITS) regions of the nuclear rRNA operon was performed on isolates of P. carinii sp. f. hominis from three clusters of P. carinii pneumonia among eight patients with haematological malignancies and six with HIV infection. Nine different ITS sequence...

Comparison of methenamine silver nitrate and Giemsa stain for detection of Pneumocystis carinii in bronchoalveolar lavage specimens from HIV infected patients

DEFF Research Database (Denmark)

Holten-Andersen, W; Kolmos, H J

1989-01-01

Seventy-seven bronchoalveolar lavages from human immunosuppressive virus infected patients with pulmonary symptoms were examined routinely for the presence of Pneumocystis carinii, using Giemsa stain to detect trophozoites and methenamine silver nitrate to detect cysts. Thirty-seven samples were...

Transcriptome of Pneumocystis carinii during fulminate infection: carbohydrate metabolism and the concept of a compatible parasite.

Directory of Open Access Journals (Sweden)

Melanie T Cushion

2007-05-01

Full Text Available Members of the genus Pneumocystis are fungal pathogens that cause pneumonia in a wide variety of mammals with debilitated immune systems. Little is known about their basic biological functions, including life cycle, since no species can be cultured continuously outside the mammalian lung. To better understand the pathological process, about 4500 ESTS derived from sequencing of the poly(A tail ends of P. carinii mRNAs during fulminate infection were annotated and functionally characterized as unassembled reads, and then clustered and reduced to a unigene set with 1042 members. Because of the presence of sequences from other microbial genomes and the rat host, the analysis and compression to a unigene set was necessarily an iterative process. BLASTx analysis of the unassembled reads (UR vs. the Uni-Prot and TREMBL databases revealed 56% had similarities to existing polypeptides at E values ofcarinii gene products. In contrast, similarities to proteins of the yeast-like fungi, Schizosaccharomyces pombe and Saccharomyces cerevisiae, predominated in the unigene set. Gene Ontology analysis using BLAST2GO revealed P. carinii dedicated most of its transcripts to cellular and physiological processes ( approximately 80%, molecular binding and catalytic activities (approximately 70%, and were primarily derived from cell and organellar compartments (approximately 80%. KEGG Pathway mapping showed the putative P. carinii genes represented most standard metabolic pathways and cellular processes, including the tricarboxylic acid cycle, glycolysis, amino acid biosynthesis, cell cycle and mitochondrial function. Several gene homologs associated with mating

Common variable immune deficiency in a Pomeranian with Pneumocystis carinii pneumonia.

Science.gov (United States)

Kanemoto, Hideyuki; Morikawa, Rei; Chambers, James Kenn; Kasahara, Koichi; Hanafusa, Yasuko; Uchida, Kazuyuki; Ohno, Koichi; Nakayama, Hiroyuki

2015-06-01

A Pomeranian dog, 1 year- and 8 month-old neutered female, was presented with persistent respiratory distress and recurrent generalized demodicosis. Physical examination revealed cyanosis, rough respiratory sounds, multifocal alopecia and dermal erosions on the dorsal side of the forelimbs, perineal area and skin around the eyes. A severe diffuse interstitial lung pattern was observed on thoracic radiographs. The blood examination revealed neutrophilia and hypoglobulinemia. Serum immunoglobulin concentrations of IgG and IgA were low. Histopathological examination revealed severe diffuse interstitial pneumonia with Pneumocystis carinii infection. Severe lymphoid depletion was observed in the spleen and other organs with lymphoid follicles consisted mainly of CD3-positive T cells and few cells of B-cell lineage. B-cell hypoplasia with subsequent antibody deficiency was suspected.

Utility of 67Ga scintigraphy and bronchial washings in the diagnosis and treatment of Pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome

International Nuclear Information System (INIS)

Tuazon, C.U.; Delaney, M.D.; Simon, G.L.; Witorsch, P.; Varma, V.M.

1985-01-01

Twenty patients with the acquired immune deficiency syndrome (AIDS) and suspected Pneumocystis carinii pneumonia were evaluated by 67 Ga scintigraphy and fiberoptic bronchoscopy for initial diagnosis and response to therapy. Lung uptake of 67 Ga was demonstrated in 100% of AIDS patients with P. carinii pneumonia, including those with subclinical infection. Fiberoptic bronchoscopy identified P. carinii in the bronchial washings of 100% of cases (19 patients), whereas only 13 of 16 (81%) patients had P. carinii in lung tissue obtained by transbronchial biopsy. Repeat fiberoptic bronchoscopy was performed in 16 of 20 patients. After 2 to 4 wk of therapy, P. carinii was identified in bronchial washings in 8 of 16 (50%) patients and in transbronchial biopsy in 1 of 10 (10%) patients examined. Bronchial washing has a higher yield than transbronchial biopsy in demonstrating P. carinii in patients with AIDS and may evolve as the procedure of choice in such patients. Based on the clinical course and results of 67 Ga scintigraphy and fiberoptic bronchoscopy in AIDS patients with P. carinii pneumonia, optimal therapy may require at least 3 wk of treatment

The outcome of Pneumocystis carinii pneumonia in Danish patients with AIDS

DEFF Research Database (Denmark)

Pedersen, C; Lundgren, Jens Dilling; Nielsen, T

1989-01-01

A total of 100 consecutive patients with AIDS were evaluated for efficacy and safety of treatment and secondary prophylaxis directed against Pneumocystis carinii pneumonia (PCP). 89 episodes of PCP were recorded in 75 patients. 63 of the 75 patients (84%) with a first episode of PCP were discharged....... Of 72 patients with a first episode of PCP who were initially treated with trimethoprim-sulfamethoxazole. 76% completed therapy successfully. Side effects were common, but generally mild and tolerated during continued treatment. 7/11 patients (64%) with a first episode of PCP who required mechanical....../16 (69%) patients who were not receiving prophylaxis (p less than 0.00001). No patients discontinued prophylaxis because of side effects. It is concluded that for most patients with AIDS and PCP, treatment and secondary prophylaxis with TMP-SMZ is safe and effective....

Pneumocystis carinii pneumonia in AIDS patients: clinical course in relation to the parasite number found in routine specimens obtained by fiberoptic bronchoscopy

DEFF Research Database (Denmark)

Orholm, M; Nielsen, T L; Holten-Andersen, W

1992-01-01

The aim of this study was to evaluate whether the amount of Pneumocystis carinii organisms found at fiberoptic bronchoscopy (FB) performed on HIV-positive patients correlated to the character of the P. carinii pneumonia (PCP). A consecutive series of 105 patients presented with 131 episodes...... of pulmonary symptoms requiring FB, and in 75 of these episodes a diagnosis of PCP was made. Specimens were stained with Giemsa and methenamine silver nitrate and the number of parasites found was given as: numerous, many, few or none. The following signs and symptoms were registered: cough, dyspnoea, fever......, loss of weight, chest radiograph, haemoglobin, WBC, CD4 cell count, PO2 and HIV p24 antigen. The PCP was characterized by the clinical course: mild, moderate, severe, and by the outcome: pulmonary healthy, pulmonary insufficiency and death. No correlations between the number of P. carinii organisms...

sup 67 Ga citrate imaging in AIDS-related pneumocystis carinii pneumonia in Japan

Energy Technology Data Exchange (ETDEWEB)

Kosuda, Shigeru; Shioyama, Yasukazu; Kutsukake, Yasumichi; Tanaka, Junji; Asumi, Masahiko; Ito, Kiyonobu; Kamata, Noriko; Suzuki, Kenzo (Tokyo Metropolitan Komagome Hospital, Tokyo (Japan))

1991-01-01

Six AIDS patients with Pneumocystis carinii pneumonia (PCP) underwent {sup 67}Ga scan as part of their evaluation. Only one patient of them showed the characteristic {sup 67}Ga distribution pattern for PCP, that is, diffuse, increased, bilateral lung activity greater than liver activity. Two patients who were receiving therapy for PCP and one patient with recurrent PCP showed focal or uneven {sup 67}Ga lung uptake. In the four patients, the scan showed more extensive lesion than the chest radiograph. The other two patients who died 2 months later of cellular immunodeficiency showed no or very slight lung uptake of {sup 67}Ga. In summary, {sup 67}Ga scanning is useful diagnostic procedure in evaluation of PCP in patients with AIDS. (author).

Transmission of Pneumocystis carinii from patients to hospital staff

DEFF Research Database (Denmark)

Lundgren, Bettina; Elvin, K; Rothman, L P

1997-01-01

rooms in departments of infectious diseases managing patients with P carinii pneumonia (PCP), suggesting the airborne route of transmission. Exposure of staff to P carinii may occur in hospital departments treating patients with PCP. METHODS: Exposure to P carinii was detected by serological responses...... to human P carinii by ELISA, Western blotting, and indirect immunofluorescence in 64 hospital staff with and 79 staff without exposure to patients with PCP from Denmark and Sweden. DNA amplification of oropharyngeal washings was performed on 20 Danish staff with and 20 staff without exposure to patients...... with PCP. RESULTS: There was no significant difference in the frequency or level of antibodies to P carinii between staff exposed and those unexposed to patients with PCP. None of the hospital staff had detectable P carinii DNA in oropharyngeal washings. CONCLUSIONS: There is no difference in antibodies...

Development of a Rapid Real-Time PCR Assay for Quantitation of Pneumocystis carinii f. sp. Carinii

DEFF Research Database (Denmark)

Larsen, Hans Henrik; Kovacs, Joseph A; Stock, Frida

2002-01-01

) PCR assay for detecting P. carinii f. sp. carinii, the subspecies of P. carinii commonly used in research models of PCP. The assay was based on the single-copy dihydrofolate reductase gene and was able to detect r = 0.99) over...... 6 log values for standards containing > or =5 copies/tube. Application of the assay to a series of 10-fold dilutions of P. carinii organisms isolated from rat lung demonstrated that it was reproducibly quantitative over 5 log values (r = 0.99). The assay was applied to a recently reported in vitro....... In conclusion, a rapid, sensitive, and reproducible quantitative PCR assay for P. carinii f. sp. carinii has been developed and is applicable to in vivo as well as in vitro systems. The assay should prove useful for conducting studies in which quantification of organism burden or growth assessment is critical...

Purification and characterization of a major human Pneumocystis carinii surface antigen

DEFF Research Database (Denmark)

Lundgren, B; Lipschik, G Y; Kovacs, J A

1991-01-01

. To evaluate humoral immune responses to the human P. carinii protein, an enzyme-linked immunosorbent assay using purified protein was developed. Some, but not all, patients who subsequently developed P. carinii pneumonia demonstrated a serum antibody response to the surface antigen. Nearly all subjects...... without a history of P. carinii pneumonia had no detectable antibodies. Purified P. carinii proteins will greatly facilitate the investigation of host-P. carinii interactions....

Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia

DEFF Research Database (Denmark)

Bang, D.; Emborg, J.; Elkjaer, J.

2001-01-01

The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory......%). In a logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short......-term mortality remained high after the introduction of adjunctive corticosteroid therapy. BAL neutrophilia may be a useful prognostic marker to identify patients at high risk of requiring mechanical ventilation Udgivelsesdato: 2001/8...

Sterols of Pneumocystis carinii hominis organisms isolated from human lungs

DEFF Research Database (Denmark)

Kaneshiro, E S; Amit, Z; Chandra, Jan Suresh

1999-01-01

in conjunction with analyses of chemically synthesized authentic standards. The sterol composition of isolated P. carinii hominis organisms has yet to be reported. If P. carinii from animal models is to be used for identifying potential drug targets and for developing chemotherapeutic approaches to clear human...... infections, it is important to determine whether the 24-alkylsterols of organisms found in rats are also present in organisms in humans. In the present study, sterol analyses of P. carinii hominis organisms isolated from cryopreserved human P. carinii-infected lungs and from bronchoalveolar lavage fluid were...

Strain typing methods and molecular epidemiology of Pneumocystis pneumonia

DEFF Research Database (Denmark)

Beard, Charles Ben; Roux, Patricia; Nevez, Gilles

2004-01-01

Pneumocystis pneumonia (PCP) caused by the opportunistic fungal agent Pneumocystis jirovecii (formerly P. carinii) continues to cause illness and death in HIV-infected patients. In the absence of a culture system to isolate and maintain live organisms, efforts to type and characterize the organism...

Pneumocystis carinii pneumonia in acquired immunodeficiency syndrome - correlation of high-resolution computed tomography and anatomopathology

International Nuclear Information System (INIS)

Marchiori, Edson; Moreira, Luiza Beatriz; Capone, Domenico; Moraes, Heleno Pinto de; Pereira, Cyntia Inez Guedes Soares

2001-01-01

We present the main findings observed on the high-resolution computed tomography examinations of 15 patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia. The high-resolution computed tomography and autopsy findings of 5 patients were also compared. The most frequently observed high-resolution computed tomography patterns were ground-glass attenuation, consolidation areas, crazy-paving pattern and cysts. Nodules and intralobular reticulation were less frequently observed. Ground-glass attenuation and consolidation areas corresponded to alveolar filling with inflammatory exudate. Thickening of the interlobular septa was due to cell infiltration and edema. One patient presented interlobular reticulation, and the pathology study revealed alveolar septa thickening due to cell infiltration and fibrosis. Nodules observed in one of the patients corresponded to a patchy intra alveolar accumulation of microorganisms and inflammatory cells forming a 'granulomatous' pattern. (author)

Update on Pneumocystis carinii f. sp. hominis Typing Based on Nucleotide Sequence Variations in Internal Transcribed Spacer Regions of rRNA Genes

Science.gov (United States)

Lee, Chao-Hung; Helweg-Larsen, Jannik; Tang, Xing; Jin, Shaoling; Li, Baozheng; Bartlett, Marilyn S.; Lu, Jang-Jih; Lundgren, Bettina; Lundgren, Jens D.; Olsson, Mats; Lucas, Sebastian B.; Roux, Patricia; Cargnel, Antonietta; Atzori, Chiara; Matos, Olga; Smith, James W.

1998-01-01

Pneumocystis carinii f. sp. hominis isolates from 207 clinical specimens from nine countries were typed based on nucleotide sequence variations in the internal transcribed spacer regions I and II (ITS1 and ITS2, respectively) of rRNA genes. The number of ITS1 nucleotides has been revised from the previously reported 157 bp to 161 bp. Likewise, the number of ITS2 nucleotides has been changed from 177 to 192 bp. The number of ITS1 sequence types has increased from 2 to 15, and that of ITS2 has increased from 3 to 14. The 15 ITS1 sequence types are designated types A through O, and the 14 ITS2 types are named types a through n. A total of 59 types of P. carinii f. sp. hominis were found in this study. PMID:9508304

Adverse effects associated with intravenous pentamidine isethionate as treatment of Pneumocystis carinii pneumonia in AIDS patients

DEFF Research Database (Denmark)

Balslev, U; Nielsen, T L

1992-01-01

To evaluate the adverse effects of intravenous pentamidine isethionate, a retrospective study was carried out over a four-year period. Twenty-one acquired immunodeficiency syndrome (AIDS) patients received intravenous pentamidine as treatment of Pneumocystis carinii pneumonia (PCP). This was 13......% of the total number of patients with PCP in the department during that period. Four patients died during treatment and were not evaluated for side effects. Thirteen patients (13/17 = 76%) suffered from one or more minor side effects. The most common of these were gastrointestinal discomfort, pancreatitis......, nephro- and hepatotoxicity. Five patients (5/17 = 29%) experienced a major adverse effect. These were cardiac arrest (one patient), severe hypoglycaemia (one patient) and severe pancreatitis (three patients). In two patients, discontinuation of treatment was necessary due to adverse reactions. As long...

Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient

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Antonio Carlos Toledo Jr.

Full Text Available This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be considered and alternate causes of immunosuppression sought.

The major surface glycoprotein of Pneumocystis carinii induces release and gene expression of interleukin-8 and tumor necrosis factor alpha in monocytes

DEFF Research Database (Denmark)

Benfield, T L; Lundgren, Bettina; Levine, S J

1997-01-01

Recent studies suggest that interleukin-8 (IL-8) and tumor necrosis factor alpha (TNF-alpha) may play a central role in host defense and pathogenesis during Pneumocystis carinii pneumonia. In order to investigate whether the major surface antigen (MSG) of human P. carinii is capable of eliciting...... the release of IL-8 and TNF-alpha, human monocytes were cultured in the presence of purified MSG. MSG-stimulated cells released significant amounts of IL-8 within 4 h, and at 20 h, cells stimulated with MSG released 45.5 +/- 9.3 ng of IL-8/ml versus 3.7 +/- 1.1 ng/ml for control cultures (P = 0.......01). In a similar fashion, MSG elicited release of TNF-alpha. Initial increases were also seen at 4 h, and at 20 h, TNF-alpha levels reached 6.4 +/- 1.1 ng/ml, compared to 0.08 +/- 0.01 ng/ml for control cultures (P alpha secretion was observed at 20 h...

Effects of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of AIDS-associated P. carinii pneumonia

DEFF Research Database (Denmark)

Helweg-Larsen, J; Benfield, Thomas; Eugen-Olsen, Jesper

1999-01-01

for folate biosynthesis. We assessed whether mutations in the DHPS gene of P. carinii were associated with exposure to sulpha drugs and influenced outcome from PCP. METHODS: We studied bronchoalveolar samples collected in 1989-99 from a prospective cohort of HIV-1-infected patients who had PCP. In 144...... patients with 152 episodes of PCP, we analysed portions of DHPS using PCR and direct sequencing. The relation between survival, P. carinii DHPS mutations, and other predictors of treatment failure was assessed by Kaplan-Meier and multivariate Cox regression analysis. FINDINGS: P. carinii DHPS mutations...

SYTO-13, a Viability Marker as a New Tool to Monitor In Vitro Pharmacodynamic Parameters of Anti-Pneumocystis Drugs.

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Annie Standaert-Vitse

Full Text Available While Pneumocystis pneumonia (PcP still impacts the AIDS patients, it has a growing importance in immunosuppressed HIV-negative patients. To determine the anti-Pneumocystis therapeutic efficacy of new compounds, animal and in vitro models have been developed. Indeed, well-designed mouse or rat experimental models of pneumocystosis can be used to describe the in vivo anti-Pneumocystis activity of new drugs. In vitro models, which enable the screening of a large panel of new molecules, have been developed using axenic cultures or co-culture with feeder cells; but no universally accepted standard method is currently available to evaluate anti-Pneumocystis molecules in vitro. Thus, we chose to explore the use of the SYTO-13 dye, as a new indicator of Pneumocystis viability. In the present work, we established the experimental conditions to define the in vitro pharmacodynamic parameters (EC50, Emax of marketed compounds (trimethoprim/sulfamethoxazole, pentamidine, atovaquone in order to specifically measure the intrinsic activity of these anti-P. carinii molecules using the SYTO-13 dye for the first time. Co-labelling the fungal organisms with anti-P. carinii specific antibodies enabled the measurement of viability of Pneumocystis organisms while excluding host debris from the analysis. Moreover, contrary to microscopic observation, large numbers of fungal cells can be analyzed by flow cytometry, thus increasing statistical significance and avoiding misreading during fastidious quantitation of stained organisms. In conclusion, the SYTO-13 dye allowed us to show a reproducible dose/effect relationship for the tested anti-Pneumocystis drugs.

Detection of Pneumocystis DNA in samples from patients suspected of bacterial pneumonia--a case-control study

DEFF Research Database (Denmark)

Helweg-Larsen, Jannik; Jensen, Jørgen Skov; Dohn, Birthe

2002-01-01

Pneumocystis jiroveci (formerly known as P. carinii f.sp. hominis) is an opportunistic fungus that causes Pneumocystis pneumonia (PCP) in immunocompromised individuals. Pneumocystis jiroveci can be detected by polymerase chain reaction (PCR). To investigate the clinical importance of a positive P...... Pneumocystis-PCR among HIV-uninfected patients suspected of bacterial pneumonia, a retrospective matched case-control study was conducted....

Serum type III procollagen peptide in patients with Pneumocystis carinii infection. The Copenhagen-Amsterdam PCP-Prednisolone Study Group

DEFF Research Database (Denmark)

Bentsen, K D; Nielsen, T L; Eaftinck Schattenkerk, J K

1993-01-01

Inflammation may play a central role in the pathogenesis of HIV-related Pneumocystis carinii pneumonia (PCP). Serum levels of the amino-terminal propeptide of Type III procollagen (PIIINP) reflect inflammatory activity in granulation tissue and in chronic rheumatic and liver disorders....... To investigate changes in PIIINP serum levels during an episode of HIV-related PCP, consecutive serum samples were taken from 48 HIV-infected patients with PCP in a randomized, placebo-controlled study of the effect of adjunctive methylprednisolone therapy (26 in corticosteroid [CS] group and 22 in control group......). All patients were treated with co-trimoxazole. In the control group, PIIINP serum levels at day of initiation of therapy (Day 0) were significantly higher in patients requiring mechanical ventilation and/or dying during the course of the pneumonia, and serum levels of PIIINP higher than 5 ng/ml were...

Evidence for a Pneumocystis carinii Flo8-like transcription factor: insights into organism adhesion.

Science.gov (United States)

Kottom, Theodore J; Limper, Andrew H

2016-02-01

Pneumocystis carinii (Pc) adhesion to alveolar epithelial cells is well established and is thought to be a prerequisite for the initiation of Pneumocystis pneumonia. Pc binding events occur in part through the major Pc surface glycoprotein Msg, as well as an integrin-like molecule termed PcInt1. Recent data from the Pc sequencing project also demonstrate DNA sequences homologous to other genes important in Candida spp. binding to mammalian host cells, as well as organism binding to polystyrene surfaces and in biofilm formation. One of these genes, flo8, a transcription factor needed for downstream cAMP/PKA-pathway-mediated activation of the major adhesion/flocculin Flo11 in yeast, was cloned from a Pc cDNA library utilizing a partial sequence available in the Pc genome database. A CHEF blot of Pc genomic DNA yielded a single band providing evidence this gene is present in the organism. BLASTP analysis of the predicted protein demonstrated 41 % homology to the Saccharomyces cerevisiae Flo8. Northern blotting demonstrated greatest expression at pH 6.0-8.0, pH comparable to reported fungal biofilm milieu. Western blot and immunoprecipitation assays of PcFlo8 protein in isolated cyst and tropic life forms confirmed the presence of the cognate protein in these Pc life forms. Heterologous expression of Pcflo8 cDNA in flo8Δ-deficient yeast strains demonstrated that the Pcflo8 was able to restore yeast binding to polystyrene and invasive growth of yeast flo8Δ cells. Furthermore, Pcflo8 promoted yeast binding to HEK293 human epithelial cells, strengthening its functional classification as a Flo8 transcription factor. Taken together, these data suggest that PcFlo8 is expressed by Pc and may exert activity in organism adhesion and biofilm formation.

Pneumocystis carinii Pneumonia in Acute Lymphatic Leukaemia ...

African Journals Online (AJOL)

A case report of a patient who developed fatal pneumocystis pneumonia while in remission from acute lymphatic leukaemia is presented. Clinical and aetiological aspects of this rare infection are discussed. Attention is drawn to diagnostic pitfalls encountered in leukaemia.

Pneumocystis pneumonia: importance of gallium scan for early diagnosis and description of a new immunoperoxidase technique to demonstrate Pneumocystis carinii

International Nuclear Information System (INIS)

Levin, M.; McLeod, R.; Young, Q.; Abrahams, C.; Chambliss, M.; Walzer, P.; Kabins, S.A.

1983-01-01

Pneumocystis pneumonia presented in a homosexual with fever, a normal chest radiograph, and pulmonary gallium uptake. Bronchial washings yielded Mycobaterium tuberculosis, but despite antituberculosis therapy he remained febrile, and gallium uptake in the lung increased. Subsequently, silver stain of transbronchial lung biopsy obtained 2 months earlier at the time that tuberculosis was diagnosed showed many Pneumocystis cysts in alveolar spaces. In contrast to Pneumocystis cysts in infected lung tissue from other humans, our patient's Pneumocystis cysts reacted more avidly with antiserum to rat Pneumocystis than with antiserum to human pneumocystis, raising the possibility that organisms that infect humans may have varied surface antigenic properties

Comparative Genomics of Pneumocystis Species Suggests the Absence of Genes for myo-Inositol Synthesis and Reliance on Inositol Transport and Metabolism

Science.gov (United States)

Sesterhenn, Thomas M.; Collins, Margaret S.; Welge, Jeffrey A.

2014-01-01

ABSTRACT In the context of deciphering the metabolic strategies of the obligate pathogenic fungi in the genus Pneumocystis, the genomes of three species (P. carinii, P. murina, and P. jirovecii) were compared among themselves and with the free-living, phylogenetically related fission yeast (Schizosaccharomyces pombe). The underrepresentation of amino acid metabolism pathways compared to those in S. pombe, as well as the incomplete steroid biosynthesis pathway, were confirmed for P. carinii and P. jirovecii and extended to P. murina. All three Pneumocystis species showed overrepresentation of the inositol phosphate metabolism pathway compared to that in the fission yeast. In addition to those known in S. pombe, four genes, encoding inositol-polyphosphate multikinase (EC 2.7.1.151), inositol-pentakisphosphate 2-kinase (EC 2.7.1.158), phosphoinositide 5-phosphatase (EC 3.1.3.36), and inositol-1,4-bisphosphate 1-phosphatase (EC 3.1.3.57), were identified in the two rodent Pneumocystis genomes, P. carinii and P. murina. The P. jirovecii genome appeared to contain three of these genes but lacked phosphoinositide 5-phosphatase. Notably, two genes encoding enzymes essential for myo-inositol synthesis, inositol-1-phosphate synthase (INO1) and inositol monophosphatase (INM1), were absent from all three genomes, suggesting that Pneumocystis species are inositol auxotrophs. In keeping with the need to acquire exogenous inositol, two genes with products homologous to fungal inositol transporters, ITR1 and ITR2, were identified in P. carinii and P. murina, while P. jirovecii contained only the ITR1 homolog. The ITR and inositol metabolism genes in P. murina and P. carinii were expressed during fulminant infection as determined by reverse transcriptase real-time PCR of cDNA from infected lung tissue. Supplementation of in vitro culture with inositol yielded significant improvement of the viability of P. carinii for days 7 through 14. PMID:25370490

Biochemical research elucidating metabolic pathways in Pneumocystis*

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Kaneshiro E.S.

2010-12-01

Full Text Available Advances in sequencing the Pneumocystis carinii genome have helped identify potential metabolic pathways operative in the organism. Also, data from characterizing the biochemical and physiological nature of these organisms now allow elucidation of metabolic pathways as well as pose new challenges and questions that require additional experiments. These experiments are being performed despite the difficulty in doing experiments directly on this pathogen that has yet to be subcultured indefinitely and produce mass numbers of cells in vitro. This article reviews biochemical approaches that have provided insights into several Pneumocystis metabolic pathways. It focuses on 1 S-adenosyl-L-methionine (AdoMet; SAM, which is a ubiquitous participant in numerous cellular reactions; 2 sterols: focusing on oxidosqualene cyclase that forms lanosterol in P. carinii; SAM:sterol C-24 methyltransferase that adds methyl groups at the C-24 position of the sterol side chain; and sterol 14α-demethylase that removes a methyl group at the C-14 position of the sterol nucleus; and 3 synthesis of ubiquinone homologs, which play a pivotal role in mitochondrial inner membrane and other cellular membrane electron transport.

Radiographic imaging study of pneumocystis carinii pneumonia in renal transplantation recipient

International Nuclear Information System (INIS)

Chen Chengshui; Li Yuping; Ye Min; Zhang Dongqing; Zheng Shaoling; Xing Lingling; Chen Shaoxian

2005-01-01

Objective: To improve the understanding of the imaging features of pneumocystis carinii pneumonia (PCP) in renal transplantation recipient. Methods: Twenty-four renal transplantation recipients suffered from PCP. There were 19 males and 5 females, the age ranged from 23 to 62 years (mean 39.2 years). The mean time duration from renal transplantation to onset of illness was 5.6 months, and the mean time from onset of illness to consultation was 5.5 days. All patients had fever and dyspnea. The chest radiographic imaging was reviewed and the dynamic imaging changes were followed up. Results: Pathology showed alveolar exudation, inflammation in the interstitium and alveolar lumen, fibrosis in lung interstitium, and erosion of alveolar epithelium. Initial chest X-ray demonstrated diffuse changes in only 10 patients. Of the 10 patients, 3 showed ground-glass changes, 2 showed ground-glass and reticular changes, and 4 showed consolidation. But all patients had abnormal ill-defined ground-glass findings on thoracic CT images, 9 of them showed reticulum among ground-glass changes, and 12 of them showed consolidation among ground-glass changes. Among patients with clinical deterioration, chest radiographs and CT showed progression of pulmonary infiltrations, and it reached the top level within 1 to 2 weeks. With successful response to therapy, chest radiographs and CT showed resolution of the lung opacities, but the resolution was retarded for about 1 week, complete resolution would need 4 weeks. Conclusion: The radiographic imaging features of PCP in renal transplantation recipient were diffuse interstitial alterations and consolidations, and with fast progression. With successful response to therapy, it showed resolution of the lung opacities, but the resolution was retarded for about 1 week, and complete resolution would need 4 weeks. Chest CT was more sensitive than radiographs. (authors)

Factors associated with the development of Pneumocystis carinii pneumonia in 5,025 European patients with AIDS. AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Barton, S E; Lazzarin, A

1995-01-01

This study examined the factors associated with the development of a first episode of Pneumocystis carinii pneumonia (PCP) in 5,025 patients with AIDS, including 1,976 patients with primary PCP at the time of AIDS diagnosis and 635 with primary PCP occurring subsequently. Compared with untreated...... patients, patients treated with zidovudine were at similar risk of developing PCP during the first year of therapy but were at greater risk after longer intervals of treatment. The following factors were associated with an increased risk of PCP (either at the time of AIDS diagnosis or thereafter): lack...... of primary PCP prophylaxis, male homosexuality/bisexuality, diagnosis of AIDS in northern Europe, and CD4 cell count below 200 x 10(6)/L at the time of AIDS diagnosis. Patients with severe weight loss had a 60% higher risk of developing PCP during follow-up than those without such weight loss. Thus...

Pneumocystis carinii pneumonia in HIV/AIDS patients at an urban ...

African Journals Online (AJOL)

Background: Pneumocytis carinii pneumonia has generally been regarded to be an uncommon opportunistic infection in HIV infected individuals in sub-Saharan Africa. The reason for this has not been clear but postulates included a lack of suitable pathogenic types in the African environment, diagnostic difficulties and the ...

Extra-pulmonary Pneumocystis jiroveci infection: a case report

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Mehrdad Bakhshayesh Karam

2014-11-01

Full Text Available In physical examination abdominal tenderness, gate disturbance and penile herpetic lesions were detected. Decreased disc height at T11-T12 level was detected in chest X-ray. Abdominal sonography and CT scan revealed hypo dense lesions in Lt left Lobe of liver and multiple hypo dense splenic and pancreatic lesions, ascitis, Lt left sided pleural effusion, thickening of jejuneal mucosa and edema of bowel wall. Vertebral body lesion and paravertebral abscess, bony calvarial involvement and adjacent extra axial brain lesion were observed in imaging were other findings. RNA analysis for HIV was positive. Vertebral lesion biopsy and aspiration of splenic lesion were performed and pathology revealed Pneumocystis jirovecii suggestive of extra pulmonary Pneumocystis carinii infection.

XX. Animal models of pneumocystosis

DEFF Research Database (Denmark)

Dei-Cas, E.; Brun-Pascaud, M.; Bille-Hansen, Vivi

1998-01-01

As in vitro culture systems allowing to isolate Pneumocystis samples from patients or other mammal hosts are still not available, animal models have critical importance in Pneumocystis research. The parasite was reported in numerous mammals but P. carinii pneumonia (PCP) experimental models were...... a source of parasites taxonomically related to P. carinii sp. f hominis. Moreover, primates might be used as experimental hosts to human Pneumocystis. A marked variability of parasite levels among corticosteroid-treated animals and the fact that the origin of the parasite strain remains unknown......, are important drawbacks of the corticosteroid-treated models. For these reasons, inoculated animal models of PCP were developed. The intratracheal inoculation of lung homogenates containing viable parasites in corticosteroid-treated non-latently infected rats resulted in extensive, reproducible Pneumocystis...

Adult cytomegalic inclusion disease in leukemia and malignant lymphoma. Report of two cases with concomitant pneumocystis infection

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Nakamura, R M; Ichimaru, Michito; Izeki, Tetsuya

1961-01-01

Two cases of cytomegalic inclusion disease complicating chronic granulocytic leukemia and subacute lymphocytic leukemia in adult Japanese males in Nagasaki, Japan are reported. Both cases had concomitant pulmonary infection by pneumocystis carinii and both were exposed to the atomic bomb in 1945. It is believed these are the first reported autopsy cases of adult cytomegalic inclusion disease in which typical cytomegalic inclusion bodies were seen in the parenchymal cells of the salivary glands. Previously reported cases of adult cytomegalic inclusion disease complicating leukemia and malignant lymphoma are briefly summarized. Present knowledge of the relationship between cytomegalic and pneumocystis infections and association with lymphoma and leukemia is reviewed. The possible roles of chemotherapeutic agents and of radiation in the development of the cytomegalic and pneumocystis infections are also briefly discussed. 43 references, 4 figures, 2 tables.

Functional and Expression Analyses of the Pneumocystis MAT Genes Suggest Obligate Sexuality through Primary Homothallism within Host Lungs

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S. Richard

2018-02-01

Full Text Available Fungi of the genus Pneumocystis are obligate parasites that colonize mammals’ lungs and are host species specific. Pneumocystis jirovecii and Pneumocystis carinii infect, respectively, humans and rats. They can turn into opportunistic pathogens in immunosuppressed hosts, causing severe pneumonia. Their cell cycle is poorly known, mainly because of the absence of an established method of culture in vitro. It is thought to include both asexual and sexual phases. Comparative genomic analysis suggested that their mode of sexual reproduction is primary homothallism involving a single mating type (MAT locus encompassing plus and minus genes (matMc, matMi, and matPi; Almeida et al., mBio 6:e02250-14, 2015. Thus, each strain would be capable of sexual reproduction alone (self-fertility. However, this is a working hypothesis derived from computational analyses that is, in addition, based on the genome sequences of single isolates. Here, we tested this hypothesis in the wet laboratory. The function of the P. jirovecii and P. carinii matMc genes was ascertained by restoration of sporulation in the corresponding mutant of fission yeast. Using PCR, we found the same single MAT locus in all P. jirovecii isolates and showed that all three MAT genes are often concomitantly expressed during pneumonia. Extensive homology searches did not identify other types of MAT transcription factors in the genomes or cis-acting motifs flanking the MAT locus that could have been involved in MAT switching or silencing. Our observations suggest that Pneumocystis sexuality through primary homothallism is obligate within host lungs to complete the cell cycle, i.e., produce asci necessary for airborne transmission to new hosts.

Pneumocystis carinii pneumonia in acquired immunodeficiency syndrome - correlation of high-resolution computed tomography and anatomopathology; Pneumocistose na sindrome da imunodeficiencia adquirida: correlacao da tomografia computadorizada de alta resolucao com a anatomopatologia

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Marchiori, Edson; Moreira, Luiza Beatriz [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br; Capone, Domenico [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Moraes, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia; Pereira, Cyntia Inez Guedes Soares

2001-12-01

We present the main findings observed on the high-resolution computed tomography examinations of 15 patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia. The high-resolution computed tomography and autopsy findings of 5 patients were also compared. The most frequently observed high-resolution computed tomography patterns were ground-glass attenuation, consolidation areas, crazy-paving pattern and cysts. Nodules and intralobular reticulation were less frequently observed. Ground-glass attenuation and consolidation areas corresponded to alveolar filling with inflammatory exudate. Thickening of the interlobular septa was due to cell infiltration and edema. One patient presented interlobular reticulation, and the pathology study revealed alveolar septa thickening due to cell infiltration and fibrosis. Nodules observed in one of the patients corresponded to a patchy intra alveolar accumulation of microorganisms and inflammatory cells forming a 'granulomatous' pattern. (author)

Diamidines versus Monoamidines as Anti-Pneumocystis Agents: An in Vivo Study

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El-Moukhtar Aliouat

2013-07-01

Full Text Available Some compounds articulated around a piperazine or an ethylenediamine linker have been evaluated in vitro to determine their activity in the presence of a 3T6 fibroblast cell line and an axenic culture of Pneumocystis carinii, respectively. The most efficient antifungal derivatives, namely N,N′-bis(benzamidine-4-ylethane-1,2-diamine (compound 6, a diamidine and N-(benzamidine-4-yl-N′-phenylethane-1,2-diamine (compound 7, a monoamidine, exhibited no cytotoxicity and were evaluated in vivo in a rat model. Only the diamidine 6 emerged as a promising hit for further studies.

Substrate analysis of the Pneumocystis carinii protein kinases PcCbk1 and PcSte20 using yeast proteome microarrays provides a novel method for Pneumocystis signalling biology.

Science.gov (United States)

Kottom, Theodore J; Limper, Andrew H

2011-10-01

Pneumocystis carinii (Pc) undergoes morphological transitions between cysts and trophic forms. We have previously described two Pc serine/threonine kinases, termed PcCbk1 and PcSte20, with PcSte20 belonging to a family of kinases involved in yeast mating, while PcCbk1 is a member of a group of protein kinases involved in regulation of cell cycle, shape, and proliferation. As Pc remains genetically intractable, knowledge on specific substrates phosphorylated by these kinases remains limited. Utilizing the phylogenetic relatedness of Pc to Saccharomyces cerevisiae, we interrogated a yeast proteome microarray containing >4000 purified protein based peptides, leading to the identification of 18 potential PcCbk1 and 15 PcSte20 substrates (Z-score > 3.0). A number of these potential protein substrates are involved in bud site selection, polarized growth, and response to mating α factor and pseudohyphal and invasive growth. Full-length open reading frames suggested by the PcCbk1 and PcSte20 protoarrays were amplified and expressed. These five proteins were used as substrates for PcCbk1 or PcSte20, with each being highly phosphorylated by the respective kinase. Finally, to demonstrate the utility of this method to identify novel PcCbk1 and PcSte20 substrates, we analysed DNA sequence data from the partially complete Pc genome database and detected partial sequence information of potential PcCbk1 kinase substrates PcPxl1 and PcInt1. We additionally identified the potential PcSte20 kinase substrate PcBdf2. Full-length Pc substrates were cloned and expressed in yeast, and shown to be phosphorylated by the respective Pc kinases. In conclusion, the yeast protein microarray represents a novel crossover technique for identifying unique potential Pc kinase substrates. Copyright © 2011 John Wiley & Sons, Ltd.

Pneumocystis jiroveci Pneumonia in Patients with Non-Hodgkin's Lymphoma Receiving Chemotherapy Containing Rituximab

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Hung Chang

2008-11-01

Full Text Available Rituximab enhances treatment efficacy of B-lineage lymphoma by targeting CD20+ B-cells. Such target therapies may compromise the immune system and render patients susceptible to opportunistic infections. We report 2 cases of lymphoma complicated with Pneumocystis jiroveci (previously known as P. carinii pneumonia (PCP while being treated with rituximab-containing chemotherapy regimens. In both cases, PCP developed during the neutropenic period. With timely diagnosis and proper management, both were treated successfully. We searched the literature and found that such opportunistic infection occurred only infrequently in lymphoma patients, and it has not been reported in the large-scale clinical trials of rituximab. Such cases demonstrate the importance of taking PCP into diagnostic consideration in lymphoma patients receiving similar therapies.

Lung complications in AIDS

International Nuclear Information System (INIS)

Weiske, R.; Buck, J.; Schneider, R.; Hannemann, T.; Krauss, B.

1986-01-01

A short description of epidemiologic and clinical facts correlated with the acquired immunodeficiency syndrome (AIDS) is followed by a report on the manifestation of pulmonary infections mostly effected by pneumocystis carinii. Two examples out of four cases will demonstrate the radiographic appearance of the pneumocystis carinii pneumonia and clinical data. Only in rare cases does it seem possible to reduce the fatal outcome by early diagnosis. (orig.) [de

Characterizing Pneumocystis in the Lungs of Bats: Understanding Pneumocystis Evolution and the Spread of Pneumocystis Organisms in Mammal Populations

Science.gov (United States)

Akbar, Haroon; Pinçon, Claire; Aliouat-Denis, Cecile-Marie; Derouiche, Sandra; Taylor, Maria-Lucia; Pottier, Muriel; Carreto-Binaghi, Laura-Helena; González-González, Antonio E.; Courpon, Aurore; Barriel, Véronique; Guillot, Jacques; Chabé, Magali; Suarez-Alvarez, Roberto O.; Aliouat, El Moukhtar; Dei-Cas, Eduardo

2012-01-01

Bats belong to a wide variety of species and occupy diversified habitats, from cities to the countryside. Their different diets (i.e., nectarivore, frugivore, insectivore, hematophage) lead Chiroptera to colonize a range of ecological niches. These flying mammals exert an undisputable impact on both ecosystems and circulation of pathogens that they harbor. Pneumocystis species are recognized as major opportunistic fungal pathogens which cause life-threatening pneumonia in severely immunocompromised or weakened mammals. Pneumocystis consists of a heterogeneous group of highly adapted host-specific fungal parasites that colonize a wide range of mammalian hosts. In the present study, 216 lungs of 19 bat species, sampled from diverse biotopes in the New and Old Worlds, were examined. Each bat species may be harboring a specific Pneumocystis species. We report 32.9% of Pneumocystis carriage in wild bats (41.9% in Microchiroptera). Ecological and behavioral factors (elevation, crowding, migration) seemed to influence the Pneumocystis carriage. This study suggests that Pneumocystis-host association may yield much information on Pneumocystis transmission, phylogeny, and biology in mammals. Moreover, the link between genetic variability of Pneumocystis isolated from populations of the same bat species and their geographic area could be exploited in terms of phylogeography. PMID:23001662

Pneumocystis Pneumonia

Science.gov (United States)

... among 16 patients after kidney transplantation. Journal of clinical microbiology 2008;46:966-71. Pifer LL, Hughes WT, ... diagnosis of Pneumocystis jirovecii pneumonia: a meta-analysis. Clinical microbiology and infection 2013;19:39-49. CDC. Pneumocystis ...

Pneumonia: high-resolution CT findings in 114 patients

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Reittner, Pia [Department of Radiology, Vancouver Hospital and Health Sciences Center, 855 W. 12th Ave., Vancouver, BC (Canada); Department of Radiology, Karl Franzens University and University Hospital Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Ward, Suzanne; Heyneman, Laura; Mueller, Nestor L. [Department of Radiology, Vancouver Hospital and Health Sciences Center, 855 W. 12th Ave., Vancouver, BC (Canada); Johkoh, Takeshi [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565-0825 (Japan)

2003-03-01

The objective of the present study was to assess the high-resolution CT appearances of different types of pneumonia. The high-resolution CT scans obtained in 114 patients (58 immunocompetent, 59 immunocompromised) with bacterial, Mycoplasma pneumoniae, viral, fungal, and Pneumocystis carinii pneumonias were analyzed retrospectively by two independent observers for presence, pattern, and distribution of abnormalities. Areas of air-space consolidation were not detected in patients with viral pneumonia and were less frequently seen in patients with Pneumocystis carinii pneumonia (2 of 22 patients, 9%) than in bacterial (30 of 35, 85%), Mycoplasma pneumoniae (22 of 28, 79%), and fungal pneumonias (15 of 20, 75%; p<0.01). There was no significant difference in the prevalence or distribution of consolidation between bacterial, Mycoplasma pneumoniae, and fungal pneumonias. Extensive symmetric bilateral areas of ground-glass attenuation were present in 21 of 22 (95%) patients with Pneumocystis carinii pneumonia and were not seen in other pneumonias except in association with areas of consolidation and nodules. Centrilobular nodules were present less commonly in bacterial pneumonia (6 of 35 patients, 17%) than in Mycoplasma pneumoniae (24 of 28, 96%), viral (7 of 9, 78%), or fungal (12 of 20, 92%) pneumonia (p<0.01). Except for Pneumocystis carinii pneumonia and Mycoplasma pneumoniae pneumonia, which often have a characteristic appearance, high-resolution CT is of limited value in the differential diagnosis of the various types of infective pneumonia. (orig.)

Pneumonia: high-resolution CT findings in 114 patients

International Nuclear Information System (INIS)

Reittner, Pia; Ward, Suzanne; Heyneman, Laura; Mueller, Nestor L.; Johkoh, Takeshi

2003-01-01

The objective of the present study was to assess the high-resolution CT appearances of different types of pneumonia. The high-resolution CT scans obtained in 114 patients (58 immunocompetent, 59 immunocompromised) with bacterial, Mycoplasma pneumoniae, viral, fungal, and Pneumocystis carinii pneumonias were analyzed retrospectively by two independent observers for presence, pattern, and distribution of abnormalities. Areas of air-space consolidation were not detected in patients with viral pneumonia and were less frequently seen in patients with Pneumocystis carinii pneumonia (2 of 22 patients, 9%) than in bacterial (30 of 35, 85%), Mycoplasma pneumoniae (22 of 28, 79%), and fungal pneumonias (15 of 20, 75%; p<0.01). There was no significant difference in the prevalence or distribution of consolidation between bacterial, Mycoplasma pneumoniae, and fungal pneumonias. Extensive symmetric bilateral areas of ground-glass attenuation were present in 21 of 22 (95%) patients with Pneumocystis carinii pneumonia and were not seen in other pneumonias except in association with areas of consolidation and nodules. Centrilobular nodules were present less commonly in bacterial pneumonia (6 of 35 patients, 17%) than in Mycoplasma pneumoniae (24 of 28, 96%), viral (7 of 9, 78%), or fungal (12 of 20, 92%) pneumonia (p<0.01). Except for Pneumocystis carinii pneumonia and Mycoplasma pneumoniae pneumonia, which often have a characteristic appearance, high-resolution CT is of limited value in the differential diagnosis of the various types of infective pneumonia. (orig.)

FlindersTechnology Associates (FTA) filter paper-based DNA extraction with polymerase chain reaction (PCR) for detection of Pneumocystis jirovecii from respiratory specimens of immunocompromised patients.

Science.gov (United States)

Nuchprayoon, Surang; Saksirisampant, Wilai; Jaijakul, Siraya; Nuchprayoon, Issarang

2007-01-01

We evaluated the diagnostic value of Flinders Technology Associates (FTA) filter paper together with polymerase chain reaction (PCR) for detection of Pneumocystis jirovecii (carinii) from induced sputum (IS) and bronchoalveolar lavage fluid (BALF) samples. The study involved 162 patients with clinical diagnosis of pneumocystis pneumonia (PcP) of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients and other immunocompromised patients. P. jirovecii cysts or trophozoites were detected in IS and BALF by cytological method. The mitochondrial 5S ribosomal ribonucleic acid (rRNA) gene of P. jirovecii was amplified from these samples by using FTA filters together with a one-step PCR method (FTA-PCR). With the FTA-PCR method, the sensitivity and specificity of the test compared to microscopic examination were 67% and 90% for IS, while they were 67% and 91% for BALF, respectively. The sensitivity and specificity of the FTA-PCR test was also comparable to PCR with the conventional deoxyribonucleic acid (DNA) extraction method. We concluded that FTA-PCR is useful to detect P. jirovecii in noninvasive IS.

Role of flexible bronchoscopy and bronchoalveolar lavage in the diagnosis of pediatric acquired immunodeficiency syndrome-related pulmonary disease.

Science.gov (United States)

Birriel, J A; Adams, J A; Saldana, M A; Mavunda, K; Goldfinger, S; Vernon, D; Holzman, B; McKey, R M

1991-06-01

Flexible fiberoptic bronchoscopy with bronchoalveolar lavage was performed in 16 pediatric patients with the acquired immunodeficiency syndrome (AIDS) and deterioration in pulmonary function suggestive of opportunistic infection. In 62% of the patients Pneumocystis carinii was identified. Culture results showed a pure growth of Pseudomonas aeruginosa for one patient in addition to the Pneumocystis carinii. Bronchoscopy with lavage was well tolerated, with few complications even among patients with significant tachypnea and hypoxia. Because of its relative safety and effectiveness, this procedure should be considered the first invasive measurement used for evaluation of parenchymal lung disease in this population of patients.

Pneumocystis Infections: MedlinePlus Health Topic

Science.gov (United States)

... Pneumocystis jiroveci pneumonia (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Pneumocystis Infections updates ... GO MEDICAL ENCYCLOPEDIA Pneumocystis jiroveci pneumonia Related Health Topics HIV/AIDS HIV/AIDS and Infections Pneumonia National ...

Differentiating pneumocystis cysts from Candida Sp. yeasts in pulmonary specimens using methenamine silver

International Nuclear Information System (INIS)

Chantiziantoniou, N.

1996-01-01

Pneumocystis carinii (PC) pneumonia in the immunocompromised patient requires therapeutic intervention; therefore, rapid identification of PC organisms in cytopathologic specimens is essential. Conclusive diagnoses of PC are achievable using Grocott's methenamine silver (GMS), the gold standard stain for PC cyst visualization. However, non-budding Candida sp. yeasts can stimulate PC cysts with GMS and thus pose significant diagnostic challenges. After qualitative and semi-quantitative analysis of 49 cytopulmonary cases, this study aimed to establish morphologic criteria that differentiate these organisms using GMS. The results showed that spherical/demilune PC cysts (4 to 7 microns in diameter) are monomorphic and mainly transparent, with intracyst densities being commonly evident. Demilune cysts typically display wall wrinkling with longitudinal clefts. Relative to cysts, Candida sp. yeasts reveal increased argyrophilia, range 4 to 10 microns in diameter, are mainly oval and budding, polymorphic and exhibit wall deformation with variable internal structure. Differentiating criteria are (a) budding; (b) cyst transparency, demilune shape; (c) longitudinal cyst clefts; (d) paired common-alike intracyst densities; (e) cyst monomprphism; (f) alveolar cast formations; (g) overall cystomorphologic presentation; and (h)relative argyrophilia. (author)

Pneumocystis diversity as a phylogeographic tool

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S Derouiche

2009-02-01

Full Text Available Parasites are increasingly used to complement the evolutionary and ecological adaptation history of their hosts. Pneumocystis pathogenic fungi, which are transmitted from host-to-host via an airborne route, have been shown to constitute genuine host markers of evolution. These parasites can also provide valuable information about their host ecology. Here, we suggest that parasites can be used as phylogeographic markers to understand the geographical distribution of intra-specific host genetic variants. To test our hypothesis, we characterised Pneumocystis isolates from wild bats living in different areas. Bats comprise a wide variety of species; some of them are able to migrate. Thus, bat chorology and migration behaviour can be approached using Pneumocystis as phylogeographic markers. In the present work, we find that the genetic polymorphisms of bat-derived Pneumocystis are structured by host chorology. Therefore, Pneumocystis intra-specific genetic diversity may constitute a useful and relevant phylogeographic tool.

Diffuse pulmonary gallium accumulation with a normal chest radiogram in a homosexual man with pneumocystis carinii pneumonia. A case report

International Nuclear Information System (INIS)

Moses, S.C.; Baker, S.R.; Seldin, M.F.

1983-01-01

A homosexual man with A.I.D.S. (acquired immunologic deficiency syndrome) and pneumocystis infestation was found to have diffuse Ga-67 uptake in the lungs with a coincident negative chest x-ray. While Ga-67 accumulates diffusely in the lungs in a variety of conditions, the present case is the first described in a patient with A.I.D.S. in which Ga-67 was positive before roentgenographic abnormalities were demonstrated. Thus, the use of Ga-67 scan, when A.I.D.S. is suspected, could help establish a diagnosis more promptly

Pulmonary complications of AIDS: radiologic features

International Nuclear Information System (INIS)

Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

1984-01-01

Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed

Pharmacokinetics of trimethoprim-sulfamethoxazole in critically ill and non-critically ill AIDS patients.

OpenAIRE

Chin, T W; Vandenbroucke, A; Fong, I W

1995-01-01

Current dosage regimens of trimethoprim-sulfamethoxazole used to treat Pneumocystis carinii pneumonia in AIDS patients have been based on data from healthy subjects or patients without AIDS. The clearance and absorption characteristics of the drugs may potentially be different between patients with and without AIDS. This study was conducted to assess the pharmacokinetics of trimethoprim-sulfamethoxazole in critically ill and non-critically ill AIDS patients treated for P. carinii pneumonia. P...

Management of HIV-associated focal brain lesions in developing coun

African Journals Online (AJOL)

TB is endemic in developing countries.11. This therefore implies that if the AAN ..... CSF = cerebrospinal fluid, TB = tuberculosis, PTB = pulmonary tuberculosis, PCP = Pneumocystis carinii .... ulations from Mexico and the United States. J.

Cushing's syndrome complicated by multiple opportunistic infections

NARCIS (Netherlands)

Bakker, R. C.; Gallas, P. R.; Romijn, J. A.; Wiersinga, W. M.

1998-01-01

The case history of a 56-year-old man is described who suffered from severe adrenocorticotrophic hormone (ACTH)-dependent Cushing's syndrome. The clinical course was complicated by simultaneous infections with Pneumocystis carinii, Staphylococcus aureus, Candida albicans, Aspergillus fumigatus and

Thoracic imaging in AIDS

Energy Technology Data Exchange (ETDEWEB)

Barneveld Binkhuysen, F H [Eemland Hospital, Dept. of Radiology, Amersfoort (Netherlands)

1996-12-31

The contents are infectious diseases i.e. pneumocystis carinii, mycobacterium tuberculosis, atypical mycobacteria, fungal infections, viral infections ; Malignant diseases : kaposi`s sarcoma (KS), malignant lymphoma and other disorders i.e. lymphocytic interstitial pneumonitis, hypersensitivity reactions, bullous changes, pericardial abnormalities (15 refs.).

Yield of diagnostic tests for opportunistic infections in AIDS: a survey of 33 patients

DEFF Research Database (Denmark)

Gøtzsche, P C; Bygbjerg, Ib Christian; Olesen, B

1988-01-01

/7 disseminated infections with atypical mycobacteria were only revealed at autopsy, despite numerous cultures in vivo. Liver biopsies were not helpful. Diagnostic procedures for Pneumocystis carinii pneumonia by lung biopsy caused pneumothorax in 3/15 patients; bronchoalveolar lavage or treatment...

Thoracic imaging in AIDS

International Nuclear Information System (INIS)

Barneveld Binkhuysen, F.H.

1995-01-01

The contents are infectious diseases i.e. pneumocystis carinii, mycobacterium tuberculosis, atypical mycobacteria, fungal infections, viral infections ; Malignant diseases : kaposi's sarcoma (KS), malignant lymphoma and other disorders i.e. lymphocytic interstitial pneumonitis, hypersensitivity reactions, bullous changes, pericardial abnormalities (15 refs.)

ffi••";;

African Journals Online (AJOL)

pneumoniast more nonspecific presentations of LIPI bronchiectasis, Pneumocystis carinii pneumonia and other lung conditions may add to the diagnostic dilemma. We have observed a very high prevalence of significant paratracheal adenopathy (52%), hilar adenopathy. (67%), and bronchial compression (30%), the latter.

Pneumocystis jirovecii colonization in chronic pulmonary disease

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Gutiérrez S.

2011-05-01

Full Text Available Pneumocystis jirovecii causes pneumonia in immunosuppressed individuals. However, it has been reported the detection of low levels of Pneumocystis DNA in patients without signs and symptoms of pneumonia, which likely represents colonization. Several studies performed in animals models and in humans have demonstrated that Pneumocystis induces a local and a systemic response in the host. Since P. jirovecii colonization has been found in patients with chronic pulmonary diseases it has been suggested that P. jirovecii may play a role in the physiopathology and progression of those diseases. In this report we revise P. jirovecii colonization in different chronic pulmonary diseases such us, chronic obstructive pulmonary disease, interstitial lung diseases, cystic fibrosis and lung cancer.

Investigation of the Role of the Cytomegalovirus as a Respiratory Pathogen in HIV-Infected Patients

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Rafael E de la Hoz

1996-01-01

Full Text Available OBJECTIVE: To investigate the occurrence of cytomegalovirus (CMV pneumonitis in the setting of human immunodeficiency virus (HIV infection and whether the presence of CMV as copathogen is associated with increased clinical severity or short term mortality in patients with Pneumocystis carinii pneumonia.

pneumocytis carinii pneumonia in hiv/aids patients at an urban

African Journals Online (AJOL)

hi-tech

2003-01-01

Jan 1, 2003 ... common non-opportunistic pathogens before severe degrees of immunosuppression ... Methods: Patients presenting with a sub-acute onset of cough and dyspnoea ..... of community acquired Pneumocytis carinii Pneumonia:.

Pneumocystis Pneumonia Presenting as an Enlarging Solitary Pulmonary Nodule

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Krunal Bharat Patel

2016-01-01

Full Text Available Pneumocystis pneumonia is a life threatening infection that usually presents with diffuse bilateral ground-glass infiltrates in immunocompromised patients. We report a case of a single nodular granulomatous Pneumocystis pneumonia in a male with diffuse large B-cell lymphoma after R-CHOP therapy. He presented with symptoms of productive cough, dyspnea, and right-sided pleuritic chest pain that failed to resolve despite treatment with multiple antibiotics. Chest X-ray revealed right lower lobe atelectasis and CT of chest showed development of 2 cm nodular opacity with ground-glass opacities. Patient underwent bronchoscopy and biopsy that revealed granulomatous inflammation in a background of organizing pneumonia pattern with negative cultures. Respiratory symptoms resolved but the solitary nodular opacity increased in size prompting a surgical wedge resection which revealed granulomatous Pneumocystis pneumonia infection. This case is the third documented report of Pneumocystis pneumonia infection within a solitary pulmonary nodule in an individual with hematologic neoplasm. Although Pneumocystis pneumonia most commonly occurs in patients with HIV/acquired immunodeficiency syndrome and with diffuse infiltrates, the diagnosis should not be overlooked when only a solitary nodule is present.

Pneumocystis PCR: It Is Time to Make PCR the Test of Choice.

Science.gov (United States)

Doyle, Laura; Vogel, Sherilynn; Procop, Gary W

2017-01-01

The testing strategy for Pneumocystis at the Cleveland Clinic changed from toluidine blue staining to polymerase chain reaction (PCR). We studied the differences in positivity rates for these assays and compared each with the detection of Pneumocystis in companion specimens by cytology and surgical pathology. We reviewed the results of all Pneumocystis test orders 1 year before and 1 year after the implementation of a Pneumocystis -specific PCR. We also reviewed the corresponding cytology and surgical pathology results, if performed. Finally, we reviewed the medical records of patients with rare Pneumocystis detected by PCR in an effort to differentiate colonization vs true disease. Toluidine blue staining and surgical pathology had similar sensitivities and negative predictive values, both of which were superior to cytology. There was a >4-fold increase in the annual detection of Pneumocystis by PCR compared with toluidine blue staining (toluidine blue staining: 11/1583 [0.69%] vs PCR: 44/1457 [3.0%]; chi-square P < .001). PCR detected 1 more case than surgical pathology and was far more sensitive than cytology. Chart review demonstrated that the vast majority of patients with rare Pneumocystis detected were immunosuppressed, had radiologic findings supportive of this infection, had no other pathogens detected, and were treated for pneumocystosis by the clinical team. PCR was the most sensitive method for the detection of Pneumocystis and should be considered the diagnostic test of choice. Correlation with clinical and radiologic findings affords discrimination of early true disease from the far rarer instances of colonization.

Novel Pneumocystis Antigen Discovery Using Fungal Surface Proteomics

OpenAIRE

Zheng, Mingquan; Cai, Yang; Eddens, Taylor; Ricks, David M.; Kolls, Jay K.

2014-01-01

Pneumonia due to the fungus Pneumocystis jirovecii is a life-threatening infection that occurs in immunocompromised patients. The inability to culture the organism as well as the lack of an annotated genome has hindered antigen discovery that could be useful in developing novel vaccine- or antibody-based therapies as well as diagnostics for this infection. Here we report a novel method of surface proteomics analysis of Pneumocystis murina that reliably detected putative surface proteins that ...

Inflammatory/granulomatous diseases of the lung

International Nuclear Information System (INIS)

Ivancevic, V.; Munz, D.L.

1998-01-01

The term 'inflammatory' and 'granulomatous' lung disease represents a pool of many etiologically different diseases, the pathologic mechanisms of which are characterized by inflammatory reactions of varying intensity and cell composition. In sarcoidosis and other granulomatous diseases as well as in lung fibroses, gallium scintigraphy allows reliable non-invasive estimation of alveolitis activity and is suitable for therapy monitoring. Granulomatous diseases seem to be detectable sensitively by means of somatostatin receptor scintigraphy as well. It is yet uncertain, whether positron emission tomography with F-18 fluordeoxyglucose will play a role in quantitative assessment of disease activity in sarcoidosis. Gallium scintigraphy is very useful in the early detection of pulmonary complications in AIDS patients. Pneumocystis carinii pneumonia, which is important in this patient population, can also be detected by both Tc-99m and In-111 labelled polyclonal human immunoglobulin, and in future possibly with a monoclonal antibody fragment against Pneumocystis carinii as well. The significance of primary bacterial pneumonias has decreased and nuclear medicine procedures for diagnosing inflammation are needed only exceptionally in this indication. (orig.) [de

Chest x-ray findings of opportunistic infections

International Nuclear Information System (INIS)

Lee, Yul; Jeon, Suk Chul; Lim, Jeong Ki; Park, Jae Hyung; Kim, Chu Wan

1983-01-01

The chest x-ray findings of 20 cases of pulmonary opportunistic infection were analyzed according to causative agents. The results were as follows: 1. Final diagnoses of 20 cases of opportunistic infections were tuberculosis in 6 cases, pneumocystis carinii pneumonia in 5 cases, bacterial infection in 7 cases, and fungal infection in 2 cases. 2. The underlying diseases were leukemia in 6 cases, kidney transplantation in 6 cases, lymphoma in 3 cases, nephrotic syndrome in 1 case, nasopharyngeal cancer in 1 case, multiple myeloma in 1 case, agranulocytosis in 1 case, and hypogammaglobulinemia in 1 case. 3. In tuberculosis, all the 6 cases showed severe manifestations such as military tuberculosis, tuberculous pneumonia, moderately advanced tuberculosis and tuberculous pericarditis. 4. In pneumocystis carinii pneumonia, the most frequent findings were bilateral alveolar densities and peripheral field of the lung was saved in most cases. 5. In 2 cases of fungal infections bilateral multiple cavity nodules were noted. 6. In cases of bacterial infection there was more cases of gram negative infection than gram positive and 2 cases of pseudomonas revealed bilateral multiple cavitary nodules

Pneumocystis jirovecii colonisation in HIV-positive and HIV-negative subjects in Cameroon.

Science.gov (United States)

Riebold, D; Enoh, D O; Kinge, T N; Akam, W; Bumah, M K; Russow, K; Klammt, S; Loebermann, M; Fritzsche, C; Eyong, J E; Eppel, G; Kundt, G; Hemmer, C J; Reisinger, E C

2014-06-01

To determine the prevalence of Pneumocystis pneumonia (PCP), a major opportunistic infection in AIDS patients in Europe and the USA, in Cameroon. Induced sputum samples from 237 patients without pulmonary symptoms (126 HIV-positive and 111 HIV-negative outpatients) treated at a regional hospital in Cameroon were examined for the prevalence of Pneumocystis jirovecii by specific nested polymerase chain reaction (nPCR) and staining methods. CD 4 counts and the history of antiretroviral therapy of the subjects were obtained through the ESOPE database system. Seventy-five of 237 study participants (31.6%) were colonised with Pneumocystis, but none showed active PCP. The Pneumocystis colonisation rate in HIV-positive subjects was more than double that of HIV-negative subjects (42.9% vs. 18.9%, P 500 cells/μl were colonised at a rate of 20.0%, subjects with CD 4 counts between 200 and 500 cells/μl of 42.5%, and subjects with CD 4 counts <200 cells/μl of 57.1%. Colonisation with Pneumocystis in Cameroon seems to be comparable to rates found in Western Europe. Prophylactic and therapeutic measures against Pneumocystis should be taken into account in HIV care in western Africa. © 2014 John Wiley & Sons Ltd.

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

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Afessa Bekele

2001-09-01

Full Text Available Abstract Background A prospective observational study was done to describe nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus (HIV infection. Methods The study included 1,225 consecutive hospital admissions of 599 HIV-infected patients treated from April 1995 through March 1998. Data included demographics, risk factors for HIV infection, Acute Physiology and Chronic Health Evaluation (APACHE II score, pulmonary complications, CD4+ lymphocyte count, hospital stay and case-fatality rate. Results Patient age (mean ± SD was 38.2 ± 8.9 years, 62% were men, and 84% were African American. The median APACHE II score was 14, and median CD4+ lymphocyte count was 60/μL. Pulmonary complications were Pneumocystis carinii pneumonia (85 in 78 patients, Mycobacterium avium complex (51 in 38, Mycobacterium tuberculosis (40 in 35, Mycobacterium gordonae (11 in 11, Mycobacterium kansasii (10 in 9, Cytomegalovirus (10 in 10, Nocardia asteroides (3 in 3, fungus ball (2 in 2, respiratory syncytial virus (1, herpes simplex virus (1, Histoplasma capsulatum (1, lymphoma (3 in 3, bronchogenic carcinoma (2 in 2, and Kaposi sarcoma (1. The case-fatality rate of patients was 11% with Pneumocystis carinii pneumonia; 5%, Mycobacterium tuberculosis; 6%, Mycobacterium avium complex; and 7%, noninfectious pulmonary complications. Conclusion Most pulmonary complications in hospitalized patients with HIV are from Pneumocystis and mycobacterial infection.

Pneumonia Pneumosistis

OpenAIRE

I Wayan Gustawan; BNP Arhana; Putu Siadi Purniti; IB Subanada; K Dewi Kumara Wati

2016-01-01

Pneumonia pnemosistis merupakan penyebab kesakitan yang serius dan kematian pada kasus gangguan sistem imun. Pneumonia pnemosistis merupakan infeksi oportunistik tersering pada kasus yang terinfeksi HIV, leukemia dan anak yang menerima transplantasi organ. Organisme penyebab adalah Pneumocystis carinii. Manifestasi klinis berupa gangguan pernapasan disertai penyakit dasarnya. Diagnosis pasti ditegakkan dengan ditemukannya organisme dalam pemeriksaan mikroskopis. Pengobatan secara ...

Update on the diagnosis and treatment of Pneumocystis pneumonia.

Science.gov (United States)

Carmona, Eva M; Limper, Andrew H

2011-02-01

Pneumocystis is an opportunistic fungal pathogen that causes an often-lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystis pneumonia in humans were initially recognized in Central Europe after the Second World War in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960-1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystis pneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, Pneumocystis prevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystis pneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ

Pulmonary diseases in children with AIDS

Energy Technology Data Exchange (ETDEWEB)

Stoever, B.; Cammann, U.

1988-03-01

The opportunistic infections evident in children with AIDS are similar to those reported in adults. However malignant lymphoma or sarcoma are seen in only 4%. Pneumocystis carinii pneumonia is frequently seen. CMV infections, streptococcus pneumonia and lung infections causes by gram negative bacterial infections occur as well. In cases with lymhoid interstitial pneumonia evidence of Epstein-Barr virus infection is common in children.

The acquired immunodeficiency syndrome (AIDS). 4

International Nuclear Information System (INIS)

Witt, C.

1987-01-01

The diagnostic relevance of bronchological examination methods in addition to lung function and X-ray thorax diagnostics as well as 67 Ga thorax scintigraphy in AIDS patients suffering from pneumocystis carinii pneumonia are discussed. Data on the diagnostic strategy regarding pneumological conditions as well as in the out-patient care of HIV-infected and of AIDS patients are presented. (author)

Low prevalence of Pneumocystis pneumonia in hospitalized patients with systemic lupus erythematosus: review of a clinical data warehouse.

Science.gov (United States)

Kapoor, T M; Mahadeshwar, P; Nguyen, S; Li, J; Kapoor, S; Bathon, J; Giles, J; Askanase, A

2017-12-01

Objective In the era of powerful immunosuppression, opportunistic infections are an increasing concern in systemic lupus erythematosus. One of the best-studied opportunistic infections is Pneumocystis pneumonia; however, the prevalence of Pneumocystis pneumonia in systemic lupus erythematosus is not clearly defined. This study evaluates the prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, with a focus on validating the Pneumocystis pneumonia and systemic lupus erythematosus diagnoses with clinical information. Methods This retrospective cohort study evaluates the prevalence of Pneumocystis pneumonia in all systemic lupus erythematosus patients treated at Columbia University Medical Center-New York Presbyterian Hospital between January 2000 and September 2014, using electronic medical record data. Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and patients with renal transplants (including both early and late post-transplant patients) represented immunocompromised control groups. Patients with systemic lupus erythematosus, Pneumocystis pneumonia, HIV/AIDS, or renal transplant were identified using diagnostic codes from the International Classification of Diseases, Ninth Revision (ICD-9). Results Out of 2013 hospitalized systemic lupus erythematosus patients, nine had presumed Pneumocystis pneumonia, yielding a low prevalence of Pneumocystis pneumonia in systemic lupus erythematosus of 0.45%. Three of the nine Pneumocystis pneumonia cases were patients with concomitant systemic lupus erythematosus and HIV/AIDS. Only one of these nine cases was histologically confirmed as Pneumocystis pneumonia, in a patient with concomitant systemic lupus erythematosus and HIV/AIDS and a CD4 count of 13 cells/mm 3 . The prevalence of Pneumocystis pneumonia in renal transplant patients and HIV/AIDS patients was 0.61% and 5.98%, respectively. Conclusion Given the reported high rate of adverse effects

Pneumocystis-Driven Inducible Bronchus-Associated Lymphoid Tissue Formation Requires Th2 and Th17 Immunity.

Science.gov (United States)

Eddens, Taylor; Elsegeiny, Waleed; Garcia-Hernadez, Maria de la Luz; Castillo, Patricia; Trevejo-Nunez, Giraldina; Serody, Katelin; Campfield, Brian T; Khader, Shabaana A; Chen, Kong; Rangel-Moreno, Javier; Kolls, Jay K

2017-03-28

Inducible bronchus-associated lymphoid tissue (iBALT) is an ectopic lymphoid structure composed of highly organized T cell and B cell zones that forms in the lung in response to infectious or inflammatory stimuli. Here, we develop a model for fungal-mediated iBALT formation, using infection with Pneumocystis that induces development of pulmonary lymphoid follicles. Pneumocystis-dependent iBALT structure formation and organization required CXCL13 signaling. Cxcl13 expression was regulated by interleukin (IL)-17 family members, as Il17ra -/- , Il17rb -/- , and Il17rc -/- mice failed to develop iBALT. Interestingly, Il17rb -/- mice have intact Th17 responses, but failed to generate an anti-Pneumocystis Th2 response. Given a role for Th2 and Th17 immunity in iBALT formation, we demonstrated that primary pulmonary fibroblasts synergistically upregulated Cxcl13 transcription following dual stimulation with IL-13 and IL-17A in a STAT3/GATA3-dependent manner. Together, these findings uncover a role for Th2/Th17 cells in regulating Cxcl13 expression and provide an experimental model for fungal-driven iBALT formation. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Pulmonary diseases in children with AIDS

International Nuclear Information System (INIS)

Stoever, B.; Cammann, U.

1988-01-01

The opportunistic infections evident in children with AIDS are similar to those reported in adults. However malignant lymphoma or sarcoma are seen in only 4%. Pneumocystis carinii pneumonia is frequently seen. CMV infections, streptococcus pneumonia and lung infections causes by gram negative bacterial infections occur as well. In cases with lymhoid interstitial pneumonia evidence of Epstein-Barr virus infection is common in children. (orig./MG) [de

In vitro systems in pneumocystis research

DEFF Research Database (Denmark)

Dei-Cas, E; Cailliez, J C; Lundgren, Bettina

1996-01-01

as well as elimination of host cell debris from parasite extracts. In other investigations, such as transmission, infectivity, life cycle, biochemical, in vitro culture or drug-screening studies, viable and infectious Pneumocystis organisms are urgently required. However, there is no generally accepted...

Phylogenetic analysis of Pneumocystis from pig lungs obtained from slaughterhouses in southern and midwestern regions of Brazil

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E.M.C Sanches

2011-10-01

Full Text Available The Pneumocystis genus is comprised of pathogens dwelling in the lungs of terrestrial, aerial, and aquatic mammals. Occasionally they induce severe pneumonitis, particularly in hosts with severe impairment of the immune system and progressively may fill pulmonary alveolar cavities causing respiratory failure. Molecular genetic studies revealed that Pneumocystis gene sequences present a marked divergence with the host species concerned. In the present study, the genetic diversity of Pneumocystis obtained from lungs of swines was examined by analyzing mitochondrial large subunit (mtLSU and small subunit (mtSSU rRNA sequences. The samples were obtained from two slaughterhouses located in two Brazilian states. Phylogenetic analysis demonstrated that genetic groupings within Pneumocystis organisms were in accordance with those of the corresponding hosts and that two clusters were formed. In conclusion, these data show that there are genetically distinct porcine Pneumocystis genotypes with at least two separate clusters in Brazil.

HRCT in AIDS patients presenting with acute pulmonary conditions

International Nuclear Information System (INIS)

Diehl, S.J.; Lehmann, K.J.; Georgi, M.; Thienel, F.

1997-01-01

Purpose: The purpose of this study was to assess the clinical value of HRCT of the lung in patients with known HIV-infection and acute lung disease. In a prospective study a HRCT was performed in 31 patients infected with the HIV-1 virus, mainly stage C (CDC), who had acute pulmonary symptoms. Precondition for the HRCT examination was a normal or non-specific chest radiograph. A provoked sputum as well as bronchoscopy with bronchoalveolar lavage and/or transbronchial biopsy were performed concurrently. In 24 out of 31 cases a pathogenic organism was identified. 19 of these 24 patients showed abnormal HRCT findings. The most frequent pathogenic organism was Pneumocystis carinii (n=12). 9 out of these 12 patients (75%) showed pathological HRCT findings consisting of ground-glass opacity. Specific patterns of attenuation could not be worked out except for Pneumocystis carinii infection. Compared to bronchoalveolar lavage, the diagnostic value of HRCT is inferior; it is however helpful in the early stage of disease, when the pathogenic organism has not yet been identified, HRCT may demonstrate parenchymal abnormalities in patients with normal radiographic findings. Compared to bronchoalveolar lavage and induced sputum, HRCT can provide conclusive results within a short time. (orig.) [de

Ventilação mecânica não-invasiva em paciente com provável pneumonia por pneumocystis jirovecii: relato de caso Noninvasive mechanical ventilation in patient with pneumocystis jirovecii pneumonia: case report

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Élida Mara Carneiro

2008-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A pneumonia por Pneumocystis jirovecii tem sido uma das doenças mais comuns e uma complicação infecciosa fatal em pacientes com síndrome da imunodeficiência adquirida. O objetivo deste estudo foi apresentar uma paciente com provável diagnóstico de pneumonia por Pneumocystis jirovecii que recebeu ventilação não-invasiva com pressão positiva. RELATO DO CASO: Paciente do sexo feminino, 25 anos, com diagnóstico provável de pneumonia por Pneumocystis jirovecii grave, recebeu ventilação mecânica não-invasiva com pressão positiva. CONCLUSÕES: Todos os parâmetros melhoraram progressivamente nos primeiros cinco dias. Os resultados sugeriram a eficácia desta medida para otimizar a oxigenação, reverter a hipoxemia e prevenir a intubação traqueal.BACKGROUND AND OBJECTIVES: Pneumocystis jirovecii pneumonia has been one of the most common diseases and life-threatening infectious complications in acquired immunodeficiency syndrome patients. The objective of the case report was to present a patient with probable diagnosis of Pneumocystis jirovecii pneumonia who received noninvasive positive pressure ventilation. CASE REPORT: A female patient, 25 years old, with probable diagnosis of Pneumocystis jirovecii pneumonia received noninvasive positive pressure ventilation. CONCLUSIONS: All respiratory parameters progressively improved in the first five days. Results suggest the efficacy of this support to improve oxygenation, to revert hypoxemia and to prevent orotracheal intubation.

Survival after Pneumocystis jirovecii pneumonia requiring ventilation ...

African Journals Online (AJOL)

Pneumocystis pneumonia (PCP) in patients with the human immunodeficiency virus (HIV) is associated with a high mortality rate, which increases substantially with the need for mechanical ventilation. Local experience of patients with PCP admitted to the intensive care unit has revealed mortality rates close to 100%.

Pulmonary manifestation of AIDS

International Nuclear Information System (INIS)

Blum, U.; Dinkel, E.; Laaff, H.; Wuertemberger, G.; Senn, H.; Vaith, P.; Kroepelin, T.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.

1989-01-01

We reviewed retrospectively the clinical records of 28 patients with AIDS staged group IV according to CDC-criteria. Among these, 19 had pulmonary disease: most of them (n=17) had pneumocystis carinii pneumonia (Pcp). 12/17 patients with proven Pcp displayed typical X-ray findings with diffuse perihilar interstitial infiltration sparing lung periphery. 3/17 had atypical features and 2 normal chest x-ray findings. These data are important to identify patients with pulmonary complications of AIDS. (orig.) [de

Radiological features of pulmonary complications in patients with AIDS

International Nuclear Information System (INIS)

Ruebesam, D.; Fuchs, H.F.

1988-01-01

Our experience with over 200 AIDS-patients emphasizes the good knowledge in radiological features of pulmonary complications in patients with AIDS for early diagnosis. We show the radiological appearance of the most frequent opportunistic infection of the lung, pneumocystis carinii pneumonia, and the different appearance of the other most frequently seen pulmonary complications as Kaposisarkoma, cytomegaly-virus-pneumonia, non-typical-mycobacteria-infection and tuberculosis. A synopsis over the most important symptoms is made for easier differential diagnosis. (orig.) [de

Acquired immunodeficiency syndrome associated with blood-product transfusions

International Nuclear Information System (INIS)

Jett, J.R.; Kuritsky, J.N.; Katzmann, J.A.; Homburger, H.A.

1983-01-01

A 53-year-old white man had fever, malaise, and dyspnea on exertion. His chest roentgenogram was normal, but pulmonary function tests showed impaired diffusion capacity and a gallium scan showed marked uptake in the lungs. Results of an open-lung biopsy documented Pneumocystis carinii pneumonia. Immunologic test results were consistent with the acquired immunodeficiency syndrome. The patient denied having homosexual contact or using intravenous drugs. Twenty-nine months before the diagnosis of pneumocystis pneumonia was made, the patient had had 16 transfusions of whole blood, platelets, and fresh-frozen plasma during coronary artery bypass surgery at another medical center. This patient is not a member of any currently recognized high-risk group and is believed to have contracted the acquired immunodeficiency syndrome from blood and blood-product transfusions

Virtual Screening of Phytochemicals to Novel Target (HAT) Rtt109 in Pneumocystis Jirovecii using Bioinformatics Tools.

Science.gov (United States)

Sugumar, Ramya; Adithavarman, Abhinand Ponneri; Dakshinamoorthi, Anusha; David, Darling Chellathai; Ragunath, Padmavathi Kannan

2016-03-01

Pneumocystis jirovecii is a fungus that causes Pneumocystis pneumonia in HIV and other immunosuppressed patients. Treatment of Pneumocystis pneumonia with the currently available antifungals is challenging and associated with considerable adverse effects. There is a need to develop drugs against novel targets with minimal human toxicities. Histone Acetyl Transferase (HAT) Rtt109 is a potential therapeutic target in Pneumocystis jirovecii species. HAT is linked to transcription and is required to acetylate conserved lysine residues on histone proteins by transferring an acetyl group from acetyl CoA to form e-N-acetyl lysine. Therefore, inhibitors of HAT can be useful therapeutic options in Pneumocystis pneumonia. To screen phytochemicals against (HAT) Rtt109 using bioinformatics tool. The tertiary structure of Pneumocystis jirovecii (HAT) Rtt109 was modeled by Homology Modeling. The ideal template for modeling was obtained by performing Psi BLAST of the protein sequence. Rtt109-AcCoA/Vps75 protein from Saccharomyces cerevisiae (PDB structure 3Q35) was chosen as the template. The target protein was modeled using Swiss Modeler and validated using Ramachandran plot and Errat 2. Comprehensive text mining was performed to identify phytochemical compounds with antipneumonia and fungicidal properties and these compounds were filtered based on Lipinski's Rule of 5. The chosen compounds were subjected to virtual screening against the target protein (HAT) Rtt109 using Molegro Virtual Docker 4.5. Osiris Property Explorer and Open Tox Server were used to predict ADME-T properties of the chosen phytochemicals. Tertiary structure model of HAT Rtt 109 had a ProSA score of -6.57 and Errat 2 score of 87.34. Structure validation analysis by Ramachandran plot for the model revealed 97% of amino acids were in the favoured region. Of all the phytochemicals subjected to virtual screening against the target protein (HAT) Rtt109, baicalin exhibited highest binding affinity towards the

Childhood AIDS: pulmonary involvement. Clinico radiological correlation

International Nuclear Information System (INIS)

Cinta, C.; Muro, D.; Perez, A.; Otero, M.C.

1997-01-01

To determine the different radiological findings in the lung of children presenting human ummunodeficiency virus (HIV) infection. We assess the different radiological patterns and their prevalence. The study deals with 58 children presenting HIV infection. All underwent plain chest radiography at some time during the course of their disease to determine the cause of different respiratory symptoms (dyspnea, fever, cough, etc.).Bronchial lavage was performed in all the children who required intubation due to severe respiratory distress. The results of chest X-ray were normal in 29 children despite the existence of pulmonary symptomatology. The other 29 patients presented pulmonary, including 21 cases of pneumonia (36,2%) in 16 patients, in seven of whom the pathogen was determined by blood culture. Four cases of Pneumocystis carinii (6.89%) were diagnosed by means of bronchial lavage. There were nine children with interstitial pneumonitis, five of the lym-phoid variant (8.62%) and four of unknown origin (6.89%). In contrast to the findings in adults, we have had no cases of pulmonary tuberculosis among our patients The rates of morbidity and mortality among HIV-infected children are associated with lung involvement. However, the prevalence has decreased progressively since the introduction of antiviral agents. Recurrent bacterial pneumonia and opportunistic Pneumocystis carinii infection are the most common types of acute pulmonary involvement. Interstitial pneumonitis usually develops a chronic course. (Author) 15 refs

Radiological diagnosis of immunologically mediated disorders of the bronchopulmonary system in children and adolescents

International Nuclear Information System (INIS)

Ball, F.

1990-01-01

After coverage of pathophysiological mechanisms, radiological symptoms and differential diagnosis of bacterial and opportunistic infections of the bronchopulmonary system are discussed as they occur in humoral, cellular and combined congenital and acquired immune deficiencies. The discussion is based on case reports. Humoral deficiences cause recurrent and chronic bacterial infections of the bronchopulmonary system, frequently with bronchiectasis. In the case of cellular and combined immune deficiencies, not only bacterial infections but also the very serious opportunistic infections occur. Opportunistic infections of the lung are predominantly caused by Pneumocystis carinii, by the cytomegaly virus, and by fungi such as Candida, Aspergillus and Mucor. Pneumocystis is also the most frequent cause of opportunistic infections of the lungs in children with AIDS. In contrast to the situation in adults, in children a relatively low-grade lymphocytic interstitial pneumonitis occasionally precedes the typical opportunistic infections. Lymphocytic interstitial pneumonitis and Pneumocystis pneumonia can be differentiated from each other easily in children because of their relatively characteristic appearances. Fungal infections, on the other hand, sometimes pose severe diagnostic problems. Radiological chest findings in autoimmune diseases are discussed. (orig.)

Pneumocystis jirovecii dihydropteroate synthase (DHPS) genotypes in non-HIV-immunocompromised patients: a tertiary care reference health centre study.

Science.gov (United States)

Tyagi, A K; Mirdha, B R; Luthra, K; Guleria, R; Mohan, A; Singh, U B; Samantaray, J C; Dar, L; Iyer, V K; Sreenivas, V

2011-02-01

Studies on Pneumocystis jirovecii dihydropteroate synthase (DHPS) genotypes among non-HIV immunocompromised patients from developing countries are rare. In the present prospective investigation, 24 (11.8%) cases were found to be positive for Pneumocystis jirovecii out of 203 non-HIV patients with a clinical suspicion of Pneumocystis pneumonia (PCP). Dihydropteroate synthase (DHPS) genotype 1 (Thr55+Pro57) was noted in 95.8% P. jirovecii isolates in the present study in contrast to only 4.1% of patients with DHPS genotype 4 (Thr55Ala + Pro57Ser).

Opportunistic infections and malignancies in 231 Danish AIDS patients

DEFF Research Database (Denmark)

Pedersen, C; Gerstoft, J; Tauris, P

1990-01-01

diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion......We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...

Computed tomography in opportunistic lung infections

International Nuclear Information System (INIS)

Hartelius, H.

1988-01-01

Chest radiography in two teenage boys, one with Wiscott-Aldrich's syndrome and one with acute lymphatic leucemia in remission showed increased interstitial pattern. In both computed tomography (CT) of the lungs showed heavy interstitial pneumonia, rather different in appearance but in both cases equal to the CT findings in opportunistic lung infections known from immunoincompetent patients with for instance pneumocystis carinii and/or cytomegalo virus infections. In both patients the CT findings led to lung biopsy establishing the etiologic agent. (orig.)

Pulmonary scintigraphy by citrate of Ga67 for HIV(+) patients or AIDS

International Nuclear Information System (INIS)

Daumal, J.; Pena, C.; Mata, F.; Paternostro, C.; Penafiel, A.

1993-01-01

Pulmonary scintigraphy with citrate of gallium 67 is useful when combined with a thorax radiography to establish the presence of an infection. When the two examinations are negative we can conclude there is no infection, but if the radiography is positive with a scintiscanning negative the most possible diagnosis is tuberculosis. If the scintiscanning is positive with a diffuse model we can envisage a pneumonia by Pneumocystis Carinii and if the model is ganglionic we can think to tuberculosis. 4 tabs

Pulmonary scintigraphy by citrate of Ga67 for HIV(+) patients or AIDS. Scintigraphie pulmonaire au citrate de Ga67 chez des patients VIH(+) ou sida

Energy Technology Data Exchange (ETDEWEB)

Daumal, J.; Pena, C.; Mata, F.; Paternostro, C.; Penafiel, A. (Hopital Son Dureta, Palma de Mallorca (Spain))

1993-04-01

Pulmonary scintigraphy with citrate of gallium 67 is useful when combined with a thorax radiography to establish the presence of an infection. When the two examinations are negative we can conclude there is no infection, but if the radiography is positive with a scintiscanning negative the most possible diagnosis is tuberculosis. If the scintiscanning is positive with a diffuse model we can envisage a pneumonia by Pneumocystis Carinii and if the model is ganglionic we can think to tuberculosis. 4 tabs.

What do Pneumocystis organisms tell us about the phylogeography of their hosts? The case of the woodmouse Apodemus sylvaticus in continental Europe and western Mediterranean islands.

Directory of Open Access Journals (Sweden)

Christine Demanche

Full Text Available Pneumocystis fungi represent a highly diversified biological group with numerous species, which display a strong host-specificity suggesting a long co-speciation process. In the present study, the presence and genetic diversity of Pneumocystis organisms was investigated in 203 lung samples from woodmice (Apodemus sylvaticus collected on western continental Europe and Mediterranean islands. The presence of Pneumocystis DNA was assessed by nested PCR at both large and small mitochondrial subunit (mtLSU and mtSSU rRNA loci. Direct sequencing of nested PCR products demonstrated a very high variability among woodmouse-derived Pneumocystis organisms with a total number of 30 distinct combined mtLSU and mtSSU sequence types. However, the genetic divergence among these sequence types was very low (up to 3.87% and the presence of several Pneumocystis species within Apodemus sylvaticus was considered unlikely. The analysis of the genetic structure of woodmouse-derived Pneumocystis revealed two distinct groups. The first one comprised Pneumocystis from woodmice collected in continental Spain, France and Balearic islands. The second one included Pneumocystis from woodmice collected in continental Italy, Corsica and Sicily. These two genetic groups were in accordance with the two lineages currently described within the host species Apodemus sylvaticus. Pneumocystis organisms are emerging as powerful tools for phylogeographic studies in mammals.

Diagnosis and management of Pneumocystis jirovecii infection.

Science.gov (United States)

White, P Lewis; Backx, Matthijs; Barnes, Rosemary A

2017-05-01

Pneumocystis jirovecii is a ubiquitous fungus, which causes pneumonia in humans. Diagnosis was hampered by the inability to culture the organism, and based on microscopic examination of respiratory samples or clinical presentation. New assays can assist in the diagnosis and even aid with the emergence of resistant infections. Areas covered: This manuscript will provide background information on Pneumocystis pneumonia (PcP). Diagnosis, from radiological to non-microbiological (e.g. Lactate dehydrogenase) and microbiological investigations (Microscopy, PCR, β-D-Glucan) will be discussed. Recommendations on prophylactic and therapeutic management will be covered. Expert commentary: PcP diagnosis using microscopy is far from optimal and false negatives will occur. With an incidence of 1% or less, the pre-test probability of not having PcP is 99% and testing is suited to excluding disease. Microscopy provides a high degree of diagnostic confidence but it is not infallible, and its lower sensitivity limits its application. Newer diagnostics (PCR, β-D-Glucan) can aid management and improve performance when testing less invasive specimens, such as upper respiratory samples or blood, alleviating clinical pressure. Combination testing may allow PcP to be both diagnosed and excluded, and molecular testing can assist in the detection of emerging resistant PcP.

Haemophilia, AIDS and lung epithelial permeability

Energy Technology Data Exchange (ETDEWEB)

O' Doherty, M.J.; Page, C.J.; Harrington, C.; Nunan, T.; Savidge, G. (Haemophilia Centre and Coagulation Research Unit, Department of Nuclear Medicine, Rayne Institute, St. Thomas' Hospital, London (United Kingdom))

1990-01-01

Lung {sup 99m}Tc DTPA transfer was measured in HIV antibodypositive haemophiliacs (11 smokers, 26 nonsmokers, 5 patients with Pneumocystis carinii pneumonia (PCP)). Lung {sup 99m}Tc DTPA transfer as a marker of lung epithelial permeability was measured as the half time of transfer (from airspace into blood). This half time was faster in smokers compred to nonsmokers and the transfer curve was monoexponential. In nonsmokers no difference was observed between asymptomatic HIV-positive haemophiliacs and normal subjects, with the exception of the lung bases. At the lung basis in HIV-positive haemophiliac nonsmokers the transfer was faster than in normal individuals, implying increased alveolar permeability. Pneumocystis carinii pneumonia resulted in a rapid transfer of {sup 99m}Tc DTPA (mean T50 of 2 minutes) and the transfer curve was biphasic, confirming previous observations in homosexual HIV antibody-positive patients with PCP. These changes returned to a monoexponential profile by 6 weeks following successful treatment. The DTPA lung transfer study may enable clinicians to instigate therapy for PCP without the need for initial bronchoscopy and provide a noninvasive method for the reassessment of patients should further respiratory signs or symptoms develop. This method is considered to be highly cost-effective in that it obviates the use of factor VIII concentrates required to cover bronchoscopic procedures and, with its early application and ease of use as a follow-up investigation, permits the evaluation of patients on an outpatient basis, thus reducing hospital costs. (au).

Haemophilia, AIDS and lung epithelial permeability

International Nuclear Information System (INIS)

O'Doherty, M.J.; Page, C.J.; Harrington, C.; Nunan, T.; Savidge, G.

1990-01-01

Lung 99m Tc DTPA transfer was measured in HIV antibodypositive haemophiliacs (11 smokers, 26 nonsmokers, 5 patients with Pneumocystis carinii pneumonia (PCP)). Lung 99m Tc DTPA transfer as a marker of lung epithelial permeability was measured as the half time of transfer (from airspace into blood). This half time was faster in smokers compred to nonsmokers and the transfer curve was monoexponential. In nonsmokers no difference was observed between asymptomatic HIV-positive haemophiliacs and normal subjects, with the exception of the lung bases. At the lung basis in HIV-positive haemophiliac nonsmokers the transfer was faster than in normal individuals, implying increased alveolar permeability. Pneumocystis carinii pneumonia resulted in a rapid transfer of 99m Tc DTPA (mean T50 of 2 minutes) and the transfer curve was biphasic, confirming previous observations in homosexual HIV antibody-positive patients with PCP. These changes returned to a monoexponential profile by 6 weeks following successful treatment. The DTPA lung transfer study may enable clinicians to instigate therapy for PCP without the need for initial bronchoscopy and provide a noninvasive method for the reassessment of patients should further respiratory signs or symptoms develop. This method is considered to be highly cost-effective in that it obviates the use of factor VIII concentrates required to cover bronchoscopic procedures and, with its early application and ease of use as a follow-up investigation, permits the evaluation of patients on an outpatient basis, thus reducing hospital costs. (au)

Glycosylation of the major human Pneumocystis carinii surface antigen

DEFF Research Database (Denmark)

Lundgren, Bettina; Koch, C; Mathiesen, Lars Reinhardt

1993-01-01

-mannose and bisected complex-type glycans. Using a polyclonal antibody raised against purified gp95 and crossed affinoimmunoelectrophoresis and the lectins Con A and WGA, gp95 exhibited carbohydrate-dependent microheterogeneity. We therefore suggest that gp95 is composed of subtypes which differ in N...

AIDS: radiologic findings in the thorax and abdomen

International Nuclear Information System (INIS)

Langer, M.; Langer, R.

1993-01-01

Thoracic manifestation of AIDS are initially diagnosed on plain film studies. Pneumocystis carinii infections are characterised by bi-hilar streaky, interstitial and diffuse micronodular infiltrations. These findings are best seen on thoracic CT examinations. Thoracic Kaposi sarcoma is characterized by larger, rounded interstitial infiltrations. In abdominal AIDS ultrasound is the first screening method. It detects equally well lymph nodes in Kaposi sarcoma as in all lymphomas and opportunistic infections. CT can differentiate between mycobacterium tuberculosis and mycobacterium avium intracellulare infections, because of the central low-density lymphoma in tuberculosis. (orig.)

Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

1994-01-01

. The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

Legionellosis in patients with HIV infection

DEFF Research Database (Denmark)

Bangsborg, Jette Marie; Jensen, B N; Friis-Møller, A

1990-01-01

During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from...... specimens additionally for Pneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P...

Cotrimoxazole-Induced Hypoglycemia in an HIV-Infected Patient

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Christine A Hughes

2001-01-01

Full Text Available A case of cotrimoxazole-induced hypoglycemia is described in a male patient infected with HIV. Ten days after initiating high dose cotrimoxazole for suspected Pneumocystis carinii pneumonia, the patient developed neuroglycopenic symptoms and diaphoresis. Blood glucose levels were repeatedly low, with elevated insulin and C-peptide levels despite multiple intravenous bolus doses and infusions of dextrose. Hypoglycemia resolved after approximately 36 h of treatment with dextrose and discontinuation of cotrimoxazole. A review of reported cases of hypoglycemia associated with cotrimoxazole is provided, including information about onset, risk factors and possible mechanism.

Pneumocystis jirovecii pneumonia in patients with end-stage renal disease

DEFF Research Database (Denmark)

Leth, Steffen; Jensen-Fangel, Søren; Østergaard, Lars Jørgen

2014-01-01

Background: Data on occurrence and risk factors for pneumocystis pneumonia (PCP) in patients with end-stage renal disease (ESRD) are sparse. Methods: This was a nationwide population-based study assessing occurrence and risk factors for PCP among patients with ESRD and population controls over a 21...

Life-threatening Pneumocystis jiroveci pneumonia following treatment of severe Cushing's syndrome

NARCIS (Netherlands)

Oosterhuis, J. K.; van den Berg, G.; Monteban-Kooistra, W. E.; Ligtenberg, J. J. M.; Tulleken, J. E.; Zijlstra, J. G.; Meertens, John

We describe two patients with a severe Cushing's syndrome due to ectopic production of ACTH. Both patients developed a life-threatening Pneumocystis jiroveci pneumonia (PCP) shortly after treatment of the hypercortisolism was started by means of inhibition of production of glucocorticoids and

Low genetic diversity of Pneumocystis jirovecii among Cuban population based on two-locus mitochondrial typing.

Science.gov (United States)

de Armas, Yaxsier; Friaza, Vicente; Capó, Virginia; Durand-Joly, Isabelle; Govín, Anamays; de la Horra, Carmen; Dei-Cas, Eduardo; Calderón, Enrique J

2012-05-01

Genotypes of two different loci of the Pneumocystis jirovecii mitochondrial gene were studied in specimens from a total of 75 Pneumocystis pneumonia patients in Spain, France and Cuba. A new genotype of the mitochondrial small subunit rRNA gene of P. jirovecii (160A/196T) was identified, which was revealed to be the most common in these three countries, especially in Cuba where its proportion reached 93.8%. Our data imply that the new genotype might be circulating worldwide and also suggests that the distribution of P. jirovecii genotypes could be narrower in islands such as Cuba.

Genotyping and phylogenetic analysis of Pneumocystis jirovecii isolates from India.

Science.gov (United States)

Gupta, Rashmi; Mirdha, Bijay Ranjan; Guleria, Randeep; Agarwal, Sanjay Kumar; Samantaray, Jyotish Chandra; Kumar, Lalit; Kabra, Sushil Kumar; Luthra, Kalpana; Sreenivas, Vishnubhatla

2010-08-01

Pneumocystis jirovecii is the cause of Pneumocystis pneumonia (PCP) in immuno-compromised individuals. The aim of this study was to describe the genotypes/haplotypes of P. jirovecii in immuno-compromised individuals with positive polymerase chain reaction (PCR) result for PCP. The typing was based on sequence polymorphism at internal transcribed spacer (ITS) regions of rRNA operon. Phylogenetic relationship between Indian and global haplotypes was also studied. Between January 2005 to October 2008, 43 patients were found to be positive for Pneumocystis using PCR targeting mitochondrial large subunit rRNA (mt LSU rRNA) and ITS region. Genotyping of all the positive samples was performed at the ITS locus by direct sequencing. Nine ITS1 alleles (all previously known) and 11 ITS2 alleles (nine previously defined and two new) were observed. A total of 19 ITS haplotypes, including five novel haplotypes (DEL1r, Edel2, Hr, Adel3 and SYD1a), were observed. The most prevalent type was SYD1g (16.3%), followed by types Ea (11.6%), Ec (9.3%), Eg (6.9%), DEL1r (6.9%), Ne (6.9%) and Ai (6.9%). To detect mixed infection, 30% of the positive isolates were cloned and 4-5 clones were sequenced from each specimen. Cloning and sequencing identified two more haplotypes in addition to the 19 types. Mixed infection was identified in 3 of the 13 cloned samples (23.1%). Upon construction of a haplotype network of 21 haplotypes, type Eg was identified as the most probable ancestral type. The present study is the first study that describes the haplotypes of P. jirovecii based on the ITS gene from India. The study suggests a high diversity of P. jirovecii haplotypes in the population. Copyright 2010 Elsevier B.V. All rights reserved.

Amount of Pneumocystis carinii and degree of acute lung inflammation in HIV-associated P carinii pneumonia

DEFF Research Database (Denmark)

Vestbo, Jørgen; Nielsen, T L; Junge, Jette

1993-01-01

) was examined. In the TBB the amount of PC correlated strongly with overall inflammation in the interstitium (Kendall correlation coefficient [Kcc] = 0.59; p type 2 pneumocyte proliferation, and edema formation. The amount of PC in the TBB also correlated with interstitial accumulation of neutrophils...... (Kcc = 0.54; p = 0.0001), lymphocytes, and macrophages. In BALF the amount of PC correlated with edema formation and type 2 pneumocyte proliferation in the TBB but not with the percentage of neutrophils, lymphocytes, or macrophages in BALF. The amount of PC in the BALF and the percentage of neutrophils...

Cutaneous gallium uptake in patients with AIDS with mycobacterium avium-intracellulare septicemia

International Nuclear Information System (INIS)

Allwright, S.J.; Chapman, P.R.; Antico, V.F.; Gruenewald, S.M.

1988-01-01

Gallium imaging is increasingly being used for the early detection of complications in patients with AIDS. A 26-year-old homosexual man who was HIV antibody positive underwent gallium imaging for investigation of possible Pneumocystis carinii pneumonia. Widespread cutaneous focal uptake was seen, which was subsequently shown to be due to mycobacterium avium-intracellulare (MAI) septicemia. This case demonstrates the importance of whole body imaging rather than imaging target areas only, the utility of gallium imaging in aiding the early detection of clinically unsuspected disease, and shows a new pattern of gallium uptake in disseminated MAI infection

Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome.

LENUS (Irish Health Repository)

Garvey, J P

2009-11-01

Acute interstitial nephritis (AIN) secondary to trimethoprim-sulfamethoxazole (TMP-SMX) is well documented as a cause of acute renal failure in native kidneys. TMP-SMX is the standard prophylactic agent against pneumocystis carinii (PCP) used in the early post-transplant period, however, it has to date only been indirectly associated with AIN in renal allografts. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We describe eleven renal transplant patients with acute allograft dysfunction in whom a transplant biopsy demonstrated primary histopathologic features of allergic AIN, all of whom were receiving TMP-SMX in addition to other medications known to cause AIN.

Tuberculose como doença definidora de síndrome da imunodeficiência adquirida: dez anos de evolução na Cidade do Rio de Janeiro Tuberculosis as a disease defining acquired immunodeficiency syndrome: ten years of surveillance in Rio de Janeiro, Brazil

Directory of Open Access Journals (Sweden)

Elizabeth Cristina Coelho Soares

2006-10-01

Full Text Available OBJETIVO: Analisar a freqüência da tuberculose e das outras principais doenças oportunistas definidoras de síndrome da imunodeficiência adquirida, no momento em que estes casos são notificados, no Município do Rio de Janeiro. MÉTODOS: Análise do banco de dados do Sistema de Vigilância Epidemiológica do Programa de Doenças Sexualmente Transmissíveis e Síndrome da Imunodeficiência Adquirida da Cidade do Rio de Janeiro, no período de 1993 a 2002. RESULTADOS: A expansão da definição de casos de síndrome da imunodeficiência adquirida ocorrida em 1998 criou um aumento substancial no número de casos notificados de síndrome da imunodeficiência adquirida, principalmente por aqueles que passaram a ser definidos pelo critério imunológico. Dentre os casos de síndrome da imunodeficiência adquirida que foram definidos apenas por doença, a candidíase em suas diversas formas manteve-se como a doença oportunista de maior freqüência no momento da notificação. Embora a pneumonia por Pneumocystis carinii se apresentasse como a segunda doença mais freqüente na maioria dos anos observados, a partir de 2001, a tuberculose ultrapassou-a em freqüência, tornando-se a segunda doença mais freqüente no momento da notificação dos casos de síndrome da imunodeficiência adquirida. CONCLUSÃO: Apesar da diminuição do número de casos de síndrome da imunodeficiência adquirida definidos por doença, a tuberculose manteve-se como um importante evento definidor dessa síndrome, sendo atualmente de ocorrência mais freqüente do que a pneumonia por Pneumocystis carinii e a toxoplasmose, provavelmente por sua alta taxa de prevalência na cidade.OBJECTIVE: To analyze the frequency of tuberculosis and of the other principal opportunistic infections defining acquired immunodeficiency syndrome at the time such cases were reported in the city of Rio de Janeiro, Brazil. METHODS: Analysis of the data compiled in the Rio de Janeiro Municipal

Treatment of infectious complications of acquired immunodeficiency syndrome.

Science.gov (United States)

Furio, M M; Wordell, C J

1985-01-01

The infectious complications of the acquired immunodeficiency syndrome (AIDS) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. The infections most commonly encountered in patients with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). Pneumocystis carinii pneumonia is the most common life-threatening process in these patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis often indicates the progression to AIDS in the high-risk populations of homosexual or bisexual men, intravenous drug abusers, and individuals with hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis most commonly manifests itself in patients with AIDS as a cerebral mass lesion. The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients frequently experience protozoal invasion of the intestinal tract with Giardia lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ, and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs, gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these disseminated CMV infections with antiviral agents, including acyclovir, have not been successful. However, acyclovir has been found beneficial in the treatment of herpes-simplex virus infections. Multiple infectious complications may occur in patients with AIDS as a result of the cellular-immune deficiency associated with this disease. Until more research is done with AIDS patients, therapy must be based on the data available from the treatment of these infections in immunosuppressed patients without AIDS.

Coinfection pulmonaire par pneumocystis jirovecii et pseudomonas aeruginosa au cours du SIDA: à propos de deux cas

Science.gov (United States)

Mamoudou, Savadogo; Bellaud, Guillaume; Ana, Canestri; Gilles, Pialoux

2015-01-01

Rapporter deux cas cliniques de coinfections pulmonaires par Pneumocystis jirovecii et par Pseudomonas aeruginosa chez des patients vivant avec le VIH. Les deux patients étaient âgés respectivement de 32 ans et 46 ans. Un patient a été pris en charge à l'hôpital Yalgado Ouédraogo de Ouagadougou au Burkina Faso et l'autre a été pris en charge à l'hôpital Ténon de Paris, en France. Les deux souffraient de pneumopathie confirmée à la radiographie et à la tomodensitométrie. L'un des patients était sévèrement immuno déprimé, contrairement à l'autre. L'examen bactériologique dans les crachats avait permis d'isoler Pseudomonas aeruginosa et Pneumocystis jirovecii chez les deux patients. Sous traitement, l’évolution a été favorable. Les coinfections morbides sont relativement fréquentes chez les patients vivant avec le VIH. Devant une symptomatologie respiratoire du sujet vivant avec le VIH, il faut savoir rechercher en plus du Bacille de Koch, Pneumocystis jirovecii et Pseudomonas aeruginosa par un lavage broncho alvéolaire. PMID:26516396

Sloth biology: an update on their physiological ecology, behavior and role as vectors of arthropods and arboviruses

Directory of Open Access Journals (Sweden)

Gilmore D.P.

2001-01-01

Full Text Available This is a review of the research undertaken since 1971 on the behavior and physiological ecology of sloths. The animals exhibit numerous fascinating features. Sloth hair is extremely specialized for a wet tropical environment and contains symbiotic algae. Activity shows circadian and seasonal variation. Nutrients derived from the food, particularly in Bradypus, only barely match the requirements for energy expenditure. Sloths are hosts to a fascinating array of commensal and parasitic arthropods and are carriers of various arthropod-borne viruses. Sloths are known reservoirs of the flagellate protozoan which causes leishmaniasis in humans, and may also carry trypanosomes and the protozoan Pneumocystis carinii.

Lung Surfactant Protein D (SP-D) Response and Regulation During Acute and Chronic Lung Injury

DEFF Research Database (Denmark)

Gaunsbaek, Maria Quisgaard; Rasmussen, Karina Juhl; Beers, Michael F.

2013-01-01

in three murine models of lung injury, using a validated ELISA technology for estimation of SP-D levels. METHODS: Mice were exposed to lipopolysaccharide, bleomycin, or Pneumocystis carinii (Pc) and sacrificed at different time points. RESULTS: In lipopolysaccharide-challenged mice, the level of SP...... injury, with a sustained increment during chronic inflammation compared with acute inflammation. A quick upregulation of SP-D in serum in response to acute airway inflammation supports the notion that SP-D translocates from the airways into the vascular system, in favor of being synthesized systemically....... The study also confirms the concept of using increased SP-D serum levels as a biomarker of especially chronic airway inflammation....

ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients

DEFF Research Database (Denmark)

Maschmeyer, Georg; Helweg-Larsen, Jannik; Pagano, Livio

2016-01-01

The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay th...

Clinical features of Pneumocystis pneumonia in patients with systemic lupus erythematosus

International Nuclear Information System (INIS)

Tasaka, Sadatomo; Hasegawa, Naoki; Yamada, Wakako; Saito, Fumitake; Nishimura, Tomoyasu; Ishizaka, Akitoshi

2006-01-01

Systemic lupus erythematosus (SLE) is often associated with various opportunistic infections, particularly during treatment with corticosteroids or immunosuppressants. We studied the clinical characteristics of 15 patients with SLE who underwent diagnostic bronchoalveolar lavage (BAL) and compared 6 patients with confirmed Pneumocystis pneumonia (PcP+), with 9 patients without Pneumocystis pneumonia (PcP-). The serum concentrations of β-D-glucan and KL-6 were significantly higher in PcP+ than in PcP- patients, whereas serum LDH was similar in both groups. The serum concentrations of complement, a marker of SLE activity, and of IgG did not predict the presence of PcP. In all patients, the overall cell and lymphocyte counts were increased in the BAL fluid, without any significant difference between the PcP+ and PcP- groups. Ground-glass opacities on chest computed tomography, and oxygenation impairment (PaO2/FiO2<200 Torr) were more common in PcP+ than PcP- patients. We concluded that, in patients with SLE, serum β-D-glucan and KL-6 might be useful in the diagnosis of PcP, particularly when severe hypoxemia precludes BAL. (author)

Modulation of inflammasome-mediated pulmonary immune activation by type I IFNs protects bone marrow homeostasis during systemic responses to Pneumocystis lung infection.

Science.gov (United States)

Searles, Steve; Gauss, Katherine; Wilkison, Michelle; Hoyt, Teri R; Dobrinen, Erin; Meissner, Nicole

2013-10-01

Although acquired bone marrow failure (BMF) is considered a T cell-mediated autoimmune disease, possible innate immune defects as a cause for systemic immune deviations in response to otherwise innocuous infections have not been extensively explored. In this regard, we recently demonstrated an important role of type I IFNs in protecting hematopoiesis during systemic stress responses to the opportunistic fungal pathogen Pneumocystis in lymphocyte-deficient mice. Mice deficient in both lymphocytes and type I IFN receptor (IFrag(-/-) mice) develop rapidly progressing BMF due to accelerated bone marrow (BM) cell apoptosis associated with innate immune deviations in the BM in response to Pneumocystis lung infection. However, the communication pathway between lung and BM eliciting the induction of BMF in response to this strictly pulmonary infection has been unclear. In this study, we report that absence of an intact type I IFN system during Pneumocystis lung infection not only causes BMF in lymphocyte-deficient mice but also transient BM stress in lymphocyte-competent mice. This is associated with an exuberant systemic IFN-γ response. IFN-γ neutralization prevented Pneumocystis lung infection-induced BM depression in type I IFN receptor-deficient mice and prolonged neutrophil survival time in BM from IFrag(-/-) mice. IL-1β and upstream regulators of IFN-γ, IL-12, and IL-18 were also upregulated in lung and serum of IFrag(-/-) mice. In conjunction, there was exuberant inflammasome-mediated caspase-1 activation in pulmonary innate immune cells required for processing of IL-18 and IL-1β. Thus, absence of type I IFN signaling during Pneumocystis lung infection may result in deregulation of inflammasome-mediated pulmonary immune activation, causing systemic immune deviations triggering BMF in this model.

Radiographic features of paediatric pneumocystis pneumonia - a historical perspective

International Nuclear Information System (INIS)

Pitcher, R.D.; Zar, H.J.

2008-01-01

Aim: To determine differences between the plain radiographic features of paediatric pneumocystis pneumonia (PCP) recorded before the emergence of human immunodeficiency virus (HIV) in 1982 and those documented in the HIV era. To establish differences in the radiographic features of PCP documented in HIV-infected children in developed and developing countries. Method: A Medline search of articles was conducted from 1950 to 2006, using the terms 'pneumocystis pneumonia in children' and 'chest radiographic features' or 'bilateral opacification' or 'lobar consolidation' or 'asymmetrical opacification' or 'pneumatocoeles' or 'cavities' or 'pneumothorax' or 'pneumomediastinum' or 'pleural effusion' or 'mediastinal adenopathy' or 'nodules' or 'normal chest radiography'. Appropriate articles were retrieved, radiological data extracted, reference lists examined and hand searches of referenced articles conducted. Results: Diffuse bilateral 'ground-glass' or alveolar pulmonary opacification, which may show some asymmetry, has been consistently documented as the commonest radiographic finding in childhood PCP throughout the period under review. The less common radiological features of PCP in children are similar to those in adults. In developed countries, PCP-related pulmonary air cysts have been reported at an earlier age in HIV-infected children, compared with uninfected children. PCP-related air cysts, pneumothorax, and pneumomediastinum have been reported in children in developed but not in developing countries. Conclusion: The radiological features of paediatric PCP documented before the HIV epidemic are similar to those recorded in the HIV era. Further study of the determinants of the uncommon radiographic features in children is warranted

Common variable immune deficiency in a Pomeranian with Pneumocystis carinii pneumonia

OpenAIRE

KANEMOTO, Hideyuki; MORIKAWA, Rei; CHAMBERS, James Kenn; KASAHARA, Koichi; HANAFUSA, Yasuko; UCHIDA, Kazuyuki; OHNO, Koichi; NAKAYAMA, Hiroyuki

2015-01-01

A Pomeranian dog, 1 year- and 8 month-old neutered female, was presented with persistent respiratory distress and recurrent generalized demodicosis. Physical examination revealed cyanosis, rough respiratory sounds, multifocal alopecia and dermal erosions on the dorsal side of the forelimbs, perineal area and skin around the eyes. A severe diffuse interstitial lung pattern was observed on thoracic radiographs. The blood examination revealed neutrophilia and hypoglobulinemia. Serum immunoglobul...

Regressão de psoríase em paciente HIV-positivo após terapia anti-retroviral Regression of psoriasis in HIV patient after antiretroviral therapy

Directory of Open Access Journals (Sweden)

Maria de Fátima Amorin Ruiz

2003-12-01

Full Text Available A síndrome da imunodeficiência adquirida foi reconhecida pela primeira vez como nova doença em 1981 devido à associação atípica de sarcoma de Kaposi e pneumonia por Pneumocystis carinii em homens. A pele é sede freqüente de doenças conseqüentes a essa infecção. A psoríase é dermatose crônica que afeta proporção que varia de 1,3 a 5% dos pacientes infectados com HIV. Portadores de psoríase que apresentem formas clínicas exacerbadas e dificuldade de resposta terapêutica devem ser investigados para possível infecção pelo HIV. É relatado caso de paciente do sexo masculino, de 44 anos, que iniciou com lesões eritêmato-escamosas no couro cabeludo, nos cotovelos, joelhos, palma das mãos, planta dos pés, além de comprometimento ungueal, após infecção pelo HIV. Confirmado o diagnóstico de psoríase e introduzida a terapia anti-retroviral, houve melhora significativa das lesões.Immunodeficiency syndrome was first described as a new disease in 1981 because an unusual association of Kaposi's Sarcoma and Pneumocystis carinii pneumonia in men. The skin is a frequent site of diseases due to this infection. Psoriasis is a chronic dermatitis that affects 1.3-5% of HIV-positive patients. The case is described of a 44-year-old man with onset of erythematous scaly lesions in scalp, elbows, knees, hands, feet and nails following HIV infection. After diagnosis of psoriasis was confirmed and antiretroviral therapy instigated, he presented improvement of the psoriasis lesions.

Pulmonary disease in patients with human immunodeficiency virus infection

DEFF Research Database (Denmark)

Lundgren, J D; Orholm, Marianne; Lundgren, B

1989-01-01

cause pulmonary disease alone or in combination. Bilateral interstitial infiltrates are the most frequent chest x-ray abnormality and are most frequently caused by infection with Pneumocystis carinii. Cytomegalovirus, Mycobacterium tuberculosis, nonspecific interstitial pneumonitis and pulmonary Kaposi......Pulmonary disease is the most important cause of morbidity and mortality in patients infected with human immunodeficiency virus (HIV). All parts of the hospital system are expected to be involved in the diagnosis and treatment of HIV infected patients in the coming years. Many different processes......'s sarcoma are the most important parts of the differential diagnosis. An aggressive approach to the diagnosis of pulmonary disease in this patient population is indicated in order to provide optimal care and assess new therapies....

An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant

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Ravinder Kaur

2016-01-01

Full Text Available Pneumocystis jiroveci pneumonia (PJP is one of the major infections in patients with impaired immunity. The entity is common in HIV-seropositive individuals but quite very rare in HIV-seronegative individuals especially children. We report here a case of 16-week-old HIV-seronegative infant with chief complaint of chronic cough of one month of evolution. Sweat chloride test for diagnosis of cystic fibrosis was positive. Bronchoalveolar lavage (BAL fluid was collected and Pseudomonas aeruginosa was isolated on culture. Empirical antibiotic regimen comprising ceftriaxone and azithromycin was initiated that was switched to meropenem as per antimicrobial susceptibility report, but the patient did not improve. Subsequently, an immunofluorescence staining of BAL fluid was performed and P. jiroveci cysts were detected. Following a laboratory confirmation of Pneumocystis pneumonia, cotrimoxazole was added and the clinical condition of the patient significantly improved. This is an unusual case wherein unsuspected PJP occurred and since signs and symptoms of the patient persisted even after the initiation of antimicrobial therapy for Pseudomonas infection and resolved only after treatment for PJP was started, it suggests a causative role of P. jiroveci rather than colonization/contamination.

Radiographic features of paediatric pneumocystis pneumonia - a historical perspective

Energy Technology Data Exchange (ETDEWEB)

Pitcher, R.D. [Division of Paediatric Radiology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town (South Africa)], E-mail: pitcher@iafrica.com; Zar, H.J. [Department of Paediatric Pulmonology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town (South Africa)

2008-06-15

Aim: To determine differences between the plain radiographic features of paediatric pneumocystis pneumonia (PCP) recorded before the emergence of human immunodeficiency virus (HIV) in 1982 and those documented in the HIV era. To establish differences in the radiographic features of PCP documented in HIV-infected children in developed and developing countries. Method: A Medline search of articles was conducted from 1950 to 2006, using the terms 'pneumocystis pneumonia in children' and 'chest radiographic features' or 'bilateral opacification' or 'lobar consolidation' or 'asymmetrical opacification' or 'pneumatocoeles' or 'cavities' or 'pneumothorax' or 'pneumomediastinum' or 'pleural effusion' or 'mediastinal adenopathy' or 'nodules' or 'normal chest radiography'. Appropriate articles were retrieved, radiological data extracted, reference lists examined and hand searches of referenced articles conducted. Results: Diffuse bilateral 'ground-glass' or alveolar pulmonary opacification, which may show some asymmetry, has been consistently documented as the commonest radiographic finding in childhood PCP throughout the period under review. The less common radiological features of PCP in children are similar to those in adults. In developed countries, PCP-related pulmonary air cysts have been reported at an earlier age in HIV-infected children, compared with uninfected children. PCP-related air cysts, pneumothorax, and pneumomediastinum have been reported in children in developed but not in developing countries. Conclusion: The radiological features of paediatric PCP documented before the HIV epidemic are similar to those recorded in the HIV era. Further study of the determinants of the uncommon radiographic features in children is warranted.

Unusual coexistence of opportunistic lung infections in a human immunodeficiency virus positive patient suffering from persistent Pneumocystis jirovecii pneumonia: A case report

Directory of Open Access Journals (Sweden)

D. Ponces Bento

2013-05-01

Full Text Available It is well-established that HIV patients are at high risk of opportunistic infections (OI, like the ones caused by Pneumocystis jirovecii, a worldwide pathogen implicated in interstitial pneumonia (PcP. We present a case of a newly diagnosed HIV-1 patient with multiple OI, including a persistent form of PcP, an invasive aspergillosis (IA, cytomegalovirus and Mycobacterium xenopi lung infection. We describe the combination of laboratorial screening, surgery and antimicrobial therapy which were crucial for patient recovery. Resumo: Como é sabido, nos doentes com infeção por vírus da imunodeficiência humana (VIH existe um alto risco de ocorrência de infeções oportunistas (IO, tais como as infeções por Pneumocystis jirovecii, um agente patogénico com distribuição mundial, que provoca pneumonia intersticial (PPc. Apresentamos um caso de um doente recém-diagnosticado com infeção por VIH-1 e múltiplas IO pulmonares, incluindo uma forma persistente de PPc, aspergilose invasiva (AI, e infeções por citomegalovírus e por Mycobacterium xenopi. Descrevemos a combinação de fatores cruciais para a recuperação do doente, que incluíram a obtenção de dados laboratoriais, intervenção cirúrgica e múltipla terapêutica antimicrobiana. Keywords: Human immunodeficiency virus (HIV, Pneumocystis jirovecii Pneumonia (PcP, Opportunistic infections, Lungs, Palavras-chave: Vírus da imunodeficiência humana (VIH, Pneumonia por Pneumocystis jirovecii (PPc, Infeções oportunistas, Pulmões

ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

DEFF Research Database (Denmark)

Maertens, Johan; Cesaro, Simone; Maschmeyer, Georg

2016-01-01

The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. R...

Crystallographic Analysis Reveals a Novel Second Binding Site for Trimethoprim in Active Site Double Mutants of Human Dihydrofolate Reductase†,‡

Science.gov (United States)

Cody, Vivian; Pace, Jim; Piraino, Jennifer; Queener, Sherry F.

2011-01-01

In order to produce a more potent replacement for trimethoprim (TMP) used as a therapy for Pneumocystis pneumonia and targets dihydrofolate reductase from Pneumocystis jirovecii (pjDHFR), it is necessary to understand the determinants of potency and selectivity against DHFR from the mammalian host and fungal pathogen cells. To this end, active site residues in human (h)DHFR were replaced with those from pjDHFR. Structural data are reported for two complexes of TMP with the double mutants Gln35Ser/Asn64Phe (Q35S/N64F) and Gln35Lys/Asn64Phe (Q35K/N64F) of hDHFR that unexpectedly show evidence for the binding of two molecules of TMP: one molecule that binds in the normal folate binding site and the second molecule that binds in a novel subpocket site such that the mutated residue Phe64 is involved in van der Waals contacts to the trimethoxyphenyl ring of the second TMP molecule. Kinetic data for the binding of TMP to hDHFR and pjDHFR reveal an 84-fold selectivity of TMP against pjDHFR (Ki 49 nM) compared to hDHFR (Ki 4093 nM). Two mutants that contain one substitution from pj- and one from the closely related Pneumocystis carinii DHFR (pcDHFR) (Q35K/N64F and Q35S/N64F) show Ki values of 593 and 617 nM, respectively; these Ki values are well above both the Ki for pjDHFR and are similar to pcDHFR (Q35K/N64F) and Q35S/N64F) (305 nM). These results suggest that active site residues 35 and 64 play key roles in determining selectivity for pneumocystis DHFR, but that other residues contribute to the unique binding of inhibitors to these enzymes. PMID:21684339

Life-Threatening Hypercalcemia During Prodrome of Pneumocystis jiroveci Pneumonia in an Immunocompetent Infant

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Judith Sebestyen VanSickle MD

2017-04-01

Full Text Available Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL. Serum 1,25(OH2-vitamin D (1,25(OH2-D level was elevated and parathyroid hormone undetectable. Evaluation for genetic mutations and malignant etiologies of hypercalcemia was negative. Treatment with intravenous hydration, loop diuretic, and calcitonin failed to correct the hypercalcemia, which was subsequently controlled with bisphosphonate therapy. Due to progressive respiratory deterioration, a bronchopulmonary lavage was done on day 17 of her hospitalization disclosing Pneumocystis jiroveci infection. The subsequent immunological investigation showed no abnormalities. She was treated with trimethoprim/sulfamethoxazole resulting in gradual clearing of her lungs and normalization of serum 1,25(OH2-D level. A year later, she remains healthy with normal biochemical parameters of mineral metabolism. We conclude that in a child with hypercalcemia with suppressed parathyroid hormone and elevated 1,25(OH2-D, once the genetic etiology for elevated 1,25(OH2-D and malignancy are ruled out, one should investigate closely for a chronic granulomatous disease. Among the latter Pneumocystis jiroveci pneumonia infection should be considered even in an immunocompetent child.

Diagnosis of pulmonary infections with HIV (+) patients. Brought of aerosol DTPA-Tc99m and of Ga67 citrate

International Nuclear Information System (INIS)

Banzo, I.; Quirce, R.; Serrano, J.; Jimenez, J.; Tabuenca, O.; Carril, J.M.

1993-01-01

The pulmonary clearance of aerosol DTPA-Tc99m is a technology easy to use, well support by patients with immediate results. With the pneumonia at Pneumocystis Carinii (PPC), the clearance is more sensitive and more specific than the thoracic scintigraphy with Ga67. Used with a thorax radiography, results will lead to three directions: High probability of PPC, di phasic curve and very fast T50, equal inferior to 5,10 mn. Low probability of PPC, monoexponential curve and abnormal thorax radiography or di phasic curve with a value T50 superior to 5,10 mn. With these patients other explorations will be made (Ga67, biopsy) and if possible search pulmonary tuberculosis. Extra pulmonary pathology: monoexponential curve associated with a normal thoracic radiography. 2 figs

Opportunistic infections and malignancies in 231 Danish AIDS patients

DEFF Research Database (Denmark)

Pedersen, C; Gerstoft, J; Tauris, P

1990-01-01

We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...... diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion...... of patients who developed particular diseases changed with calendar time. Most striking was a three to fourfold decrease in diseases caused by cytomegalovirus. In conclusion, the study showed that disease frequencies in patients with AIDS may vary with the patients risk behaviour and duration of AIDS...

Early detection of interstitial pneumonia by WXGa-citrate scintigraphy. Cases of abnormal pulmonary WXGa uptake with normal chest radiographs

Energy Technology Data Exchange (ETDEWEB)

Ito, Shinsaku; Mikami, Riichiro; Ryujin, Yoshitada

1985-04-01

In this paper we report our recent experience indicating usefulness of WXGa-citrate scintigraphy in 4 cases with inflammatory pulmonary diseases. These cases showed abnormal pulmonary WXGa uptake with normal chest radiographs. The first case with malignant lymphoma and the second one with lung cancer suffered from pulmonary infection following secondary immuno-insufficiency due to radiotherapy and chemotherapy. Pneumocystis carinii was suspected as causative agent in the first case, and gram negative bacilli in the second case. The third case with lung cancer developed radiation pneumonia after radiotherapy. The fourth case with acute bronchitis developed drug induced interstitial pneumonia presumably due to minocycline administration. It is concluded that WXGa-citrate scintigraphy is more sensitive for early detection of interstitial pneumonia than routine chest radiography.

Doença pleural e síndroma de imunodeficiência adquirida

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Adelina Amorim

2004-05-01

Full Text Available RESUMO: As infecções respiratórias estão entre as infecções mais comuns nos doentes infectados pelo vírus da imunodeficiência humana (VIH, podendo ocorrer com qualquer valor de CD4. As complicações pleurais não são frequentes, mas têm algumas características distintas das dos doentes VIH negativos.A ocorrência de pneumotórax (PTX em doentes com infecção VIH foi descrito pela primeira vez em 1984. A incidência total de PTX nos doentes com síndroma da imunodeficiência adquirida (SIDA varia entre os 2,7% e 4,9%. A maioria dos casos ocorre em doentes com infecção por Pneumocystis carinii prévia ou actual, que apresentam cavidades pulmonares subpleurais, associadas a necrose. O tratamento do PTX nos doentes com SIDA é difícil, verificando-se uma maior tendência para a persistência de fístulas broncopleurais. O uso de drenagem por toracostomia, com ou sem esclerose pleural, pode não ser suficiente para resolver o PTX. Outras opções terapêuticas são a colocação de uma válvula de Heimlich ou o recurso à cirurgia.A prevalência e a etiologia do derrame pleural (DP em doentes hospitalizados com SIDA é muito variável. Uma das causas que pode contribuir para esta variabilidade é a diferença nos factores de risco associados à infecção VIH na população estudada. Os derrames parapneumónicos, a tuberculose e o sarcoma de Kaposi são as causas mais comuns. Os empiemas são uma complicação pleural rara. Apesar de a pneumonia por Pneumocystis carinii ser uma causa comum de pneumonia nos doentes com SIDA, raramente é causa de derrame pleural. Outras causas possíveis de derrame pleural são os linfomas não-Hodgkin, nomeadamente o linfoma das cavidades corporais.REV PORT PNEUMOL 2004; X (3: 217-225 ABSTRACT: Respiratory infections are among the most common complications in patients infected with human

Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients.

Science.gov (United States)

Stern, Anat; Green, Hefziba; Paul, Mical; Vidal, Liat; Leibovici, Leonard

2014-10-01

Pneumocystis pneumonia (PCP) is a disease affecting immunocompromised patients. PCP among these patients is associated with significant morbidity and mortality. To assess the effectiveness of PCP prophylaxis among non-HIV immunocompromised patients; and to define the type of immunocompromised patient for whom evidence suggests a benefit for PCP prophylaxis. Electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE and EMBASE (to March 2014), LILACS (to March 2014), relevant conference proceedings; and references of identified trials. Randomised controlled trials (RCTs) or quasi-RCTs comparing prophylaxis with an antibiotic effective against PCP versus placebo, no intervention, or antibiotic(s) with no activity against PCP; and trials comparing different antibiotics effective against PCP among immunocompromised non-HIV patients. We only included trials in which Pneumocystis infections were available as an outcome. Two review authors independently assessed risk of bias in each trial and extracted data from the included trials. We contacted authors of the included trials to obtain missing data. The primary outcome was documented PCP infections. Risk ratios (RR) with 95% confidence intervals (CI) were estimated and pooled using the random-effects model. Thirteen trials performed between the years 1974 and 2008 were included, involving 1412 patients. Four trials included 520 children with acute lymphoblastic leukemia and the remaining trials included adults with acute leukemia, solid organ transplantation or autologous bone marrow transplantation. Compared to no treatment or treatment with fluoroquinolones (inactive against Pneumocystis), there was an 85% reduction in the occurrence of PCP in patients receiving prophylaxis with trimethoprim/sulfamethoxazole, RR of 0.15 (95% CI 0.04 to 0.62; 10 trials, 1000 patients). The evidence was graded as moderate due to possible risk of bias. PCP

Bacterial and Pneumocystis Infections in the Lungs of Gene-Knockout Rabbits with Severe Combined Immunodeficiency

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Jun Song

2018-03-01

Full Text Available Using the CRISPR/Cas9 gene-editing technology, we recently produced a number of rabbits with mutations in immune function genes, including FOXN1, PRKDC, RAG1, RAG2, and IL2RG. Seven founder knockout rabbits (F0 and three male IL2RG null (−/y F1 animals demonstrated severe combined immunodeficiency (SCID, characterized by absence or pronounced hypoplasia of the thymus and splenic white pulp, and absence of immature and mature T and B-lymphocytes in peripheral blood. Complete blood count analysis showed severe leukopenia and lymphocytopenia accompanied by severe neutrophilia. Without prophylactic antibiotics, the SCID rabbits universally succumbed to lung infections following weaning. Pathology examination revealed severe heterophilic bronchopneumonia caused by Bordetella bronchiseptica in several animals, but a consistent feature of lung lesions in all animals was a severe interstitial pneumonia caused by Pneumocystis oryctolagi, as confirmed by histological examination and PCR analysis of Pneumocystis genes. The results of this study suggest that these SCID rabbits could serve as a useful model for human SCID to investigate the disease pathogenesis and the development of gene and drug therapies.

Bacterial and Pneumocystis Infections in the Lungs of Gene-Knockout Rabbits with Severe Combined Immunodeficiency

Science.gov (United States)

Song, Jun; Wang, Guoshun; Hoenerhoff, Mark J.; Ruan, Jinxue; Yang, Dongshan; Zhang, Jifeng; Yang, Jibing; Lester, Patrick A.; Sigler, Robert; Bradley, Michael; Eckley, Samantha; Cornelius, Kelsey; Chen, Kong; Kolls, Jay K.; Peng, Li; Ma, Liang; Chen, Yuqing Eugene; Sun, Fei; Xu, Jie

2018-01-01

Using the CRISPR/Cas9 gene-editing technology, we recently produced a number of rabbits with mutations in immune function genes, including FOXN1, PRKDC, RAG1, RAG2, and IL2RG. Seven founder knockout rabbits (F0) and three male IL2RG null (−/y) F1 animals demonstrated severe combined immunodeficiency (SCID), characterized by absence or pronounced hypoplasia of the thymus and splenic white pulp, and absence of immature and mature T and B-lymphocytes in peripheral blood. Complete blood count analysis showed severe leukopenia and lymphocytopenia accompanied by severe neutrophilia. Without prophylactic antibiotics, the SCID rabbits universally succumbed to lung infections following weaning. Pathology examination revealed severe heterophilic bronchopneumonia caused by Bordetella bronchiseptica in several animals, but a consistent feature of lung lesions in all animals was a severe interstitial pneumonia caused by Pneumocystis oryctolagi, as confirmed by histological examination and PCR analysis of Pneumocystis genes. The results of this study suggest that these SCID rabbits could serve as a useful model for human SCID to investigate the disease pathogenesis and the development of gene and drug therapies. PMID:29593714

Ambient air pollution associated with suppressed serologic responses to Pneumocystis jirovecii in a prospective cohort of HIV-infected patients with Pneumocystis pneumonia.

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Robert J Blount

Full Text Available Ambient air pollution (AAP may be associated with increased risk for Pneumocystis pneumonia (PCP. The mechanisms underlying this association remain uncertain.To determine if real-life exposures to AAP are associated with suppressed IgM antibody responses to P. jirovecii in HIV-infected (HIV+ patients with active PCP, and to determine if AAP, mediated by suppressed serologic responses to Pneumocystis, is associated with adverse clinical outcomes.We conducted a prospective cohort study in HIV+ patients residing in San Francisco and admitted to San Francisco General Hospital with microscopically confirmed PCP. Our AAP predictors were ambient air concentrations of particulate matter of < 10 µm in diameter (PM10 and < 2.5 µm in diameter (PM2.5, nitrogen dioxide (NO2, ozone (O3, and sulfur dioxide (SO2 measured immediately prior to hospital admission and 2 weeks prior to admission. Our primary outcomes were the IgM serologic responses to four recombinant P. jirovecii major surface glycoprotein (Msg constructs: MsgC1, MsgC3, MsgC8, and MsgC9.Elevated PM10 and NO2 exposures immediately prior to and two weeks prior to hospital admission were associated with decreased IgM antibody responses to P. jirovecii Msg. For exposures immediately prior to admission, every 10 µg/m(3 increase in PM10 was associated with a 25 to 35% decrease in IgM responses to Msg (statistically significant for all the Msg constructs, and every 10 ppb increase in NO2 was associated with a 19-45% decrease in IgM responses to Msg (statistically significant for MsgC8 and MsgC9. Similar findings were seen with exposures two weeks prior to admission, but for fewer of the Msg constructs.Real life exposures to PM10 and NO2 were associated with suppressed IgM responses to P. jirovecii Msg in HIV+ patients admitted with PCP, suggesting a mechanism of immunotoxicity by which AAP increases host susceptibility to pulmonary infection.

Single Nodula opacity of granulomatous Pneumocystis jirovecii pneumoniain an asymptomatic lymphoma patient

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Soo; Shin, Kyung Eun; Lee, Ju Hie [Kyung Hee University Hospital, Seoul (Korea, Republic of)

2015-04-15

The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.

Defining Moments in MMWR History: The AIDS Epidemic, Pneumocystis Pneumonia --- Los Angeles 1981

Centers for Disease Control (CDC) Podcasts

On June 5, 1981, MMWR published a report of Pneumocystis pneumonia in five previously healthy young gay men in Los Angeles, California. This report was later acknowledged as the first published account of what would become known as human immunodeficiency virus, or HIV, and acquired immunodeficiency syndrome, or AIDS. It was the first of many MMWR reports that led to a better understanding of this new condition. In this podcast, Dr. Harold Jaffe recalls CDC's investigation and response to the AIDS Epidemic.

Pulmonary infection in AIDS

International Nuclear Information System (INIS)

Kim, Seog Joon; Im, Jung Gi; Seong, Chang Kyu; Yeon, Kyung Mo; Han, Man Chung; Song, Jae Woo

1998-01-01

To analyze the clinical and radiological manifestations of pulmonary infection in patients with AIDS. We reviewed the medical records and analyzed retrospectively analysed the chest radiographs(n=3D24) and CT scans(n=3D11) of 26 patients with AIDS who had been followed up at our institute from 1987 to June 1998. Pulmonary infections were confirmed by sputum smear and culture(n=3D18), pleural examination(n=3D3), bronchoalveolar lavage(n=3D3), autopsy(n=3D4), transbronchial lung biopsy(n=3D1) or clinical history(n=3D9). The study group included 23 men and three women aged 25-54(average 35.2) years. We correlated the radiologic findings with CD4 lymphocyte counts. Pulmonary infections included tuberculosis(n=3D22), pneumocystis carinii pneumonia(n=3D9), cytomegalovirus(n=3D3), and unidentified bacterial pneumonia(n=3D2). Radiologically pulmonary tuberculosis was classified as primary tuberculosis(n=3D11;mean CD4 counts:41.3 cells/mm 3 ) and post-primary tuberculosis(n=3D11;mean CD4 counts:251.3cells/mm 3 ). CT findings of tuberculosis included lymphadenitis(n=3D6), bronchogenic spread(n=3D5), large consolidation(n=3D4), esophago-mediastinal fistula(n=3D2), and cavity(n=3D1). Tuberculosis in AIDS responded rapidly to anti-TB medication with complete or marked resolution of lesions within three months. Radiologic findings of Pneumocystis carinii pneumonia included diffuse ground glass opacities, cysts, and reticular opacities. Tuberculosis was the most common infection in patients with AIDS in Korea, and this is attributed to the high prevalence of tuberculosis. Radiological findings varied with CD4+cell count, showing those of primary tuberculosis as a patient's CD4+ cell count decreased. Pulmonary tuberculosis in AIDS responded rapidly to anti-Tb medication. =20

Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

1994-01-01

OBJECTIVES--To examine the pattern of survival and factors associated with the outcome of disease in patients with AIDS. DESIGN--Inception cohort. Data collected retrospectively from patients' charts. SETTING--52 clinical centres in 17 European countries. SUBJECTS--6578 adults diagnosed with AIDS....... The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

Early detection of interstitial pneumonia by 67Ga-citrate scintigraphy

International Nuclear Information System (INIS)

Ito, Shinsaku; Mikami, Riichiro; Ryujin, Yoshitada

1985-01-01

In this paper we report our recent experience indicating usefulness of 67 Ga-citrate scintigraphy in 4 cases with inflammatory pulmonary diseases. These cases showed abnormal pulmonary 67 Ga uptake with normal chest radiographs. The first case with malignant lymphoma and the second one with lung cancer suffered from pulmonary infection following secondary immuno-insufficiency due to radiotherapy and chemotherapy. Pneumocystis carinii was suspected as causative agent in the first case, and gram negative bacilli in the second case. The third case with lung cancer developed radiation pneumonia after radiotherapy. The fourth case with acute bronchitis developed drug induced interstitial pneumonia presumably due to minocycline administration. It is concluded that 67 Ga-citrate scintigraphy is more sensitive for early detection of interstitial pneumonia than routine chest radiography. (author)

Cytogenetic evaluation of Fansidar on human lymphocyte chromosomes in vitro.

Science.gov (United States)

Praveen, Nuzhat; Saifi, Muheet Alam; Shadab, G G H A

2011-01-01

Fansidar is a fixed combination of two antimalarial agents a diaminopyrimidine (Pyrimethamine) and a sulphonamide (Sulphadoxine) in the ratio 1:20- that have been used extensively worldwide for the treatment of Chloroquine resistant Plasmodium falciparum malaria, toxoplasmosis and Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. This study examined the effect of Fansidar on chromosomes in human lymphocyte culture. Fansidar was added to peripheral blood lymphocyte cultures in vitro at four different concentrations: 5,15, 25 and 50 microl in the ratio 1:20, 3:60, 5:100 and 10:200 microg ml(-1). Result shows that this drug induces moderate increase in the frequency of gaps, breaks and rearrangements. Therefore it can be concluded that Fansidar has moderate clastogenic effect on human chromosomes in vitro.

Platypnea and orthodeoxia associated with Pneumocystis jiroveci and Cytomegalovirus pneumonia: a case report

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Bikas Christoforos

2009-12-01

Full Text Available Abstract Introduction Platypnea-orthodeoxia is an uncommon syndrome characterized by dyspnea and deoxygenation accompanying a change to a sitting or standing posture from a recumbent position. It is usually related to interatrial communications, although several other disorders associated with platypnea-orthodeoxia syndrome have been reported. However, the precise mechanisms are unknown. Case presentation We present the case of a 75-year-old Caucasian woman with chronic renal failure due to vasculitis who was admitted with fever and respiratory failure. She was found to have both Pneumocystis jiroveci and Cytomegalovirus pneumonia. She was HIV negative. Severe platypnea and orthodeoxia were major features of her illness with no history of respiratory, liver or cardiac disease. Further investigation with contrast echocardiography revealed no intracardiac or intrapulmonary shunts. Although one case involving Pneumocystis jiroveci pneumonia and platypnea has been previously reported, to the best of our knowledge, this is the first time that two opportunistic pathogens have been accompanied by platypnea and orthodeoxia. As both lung bases were predominantly affected and no obvious explanation was found, platypnea and orthodeoxia were attributed to significant areas of low or zero ventilation/perfusion (V/Q ratio. Conclusion Platypnea-orthodeoxia is a rare and usually underestimated syndrome. Intracardiac shunts and anatomic pulmonary vascular shunts are the most common etiologic associations. However, if a detailed examination reveals no obvious intracardiac or intrapulmonary shunting combined with extensive pulmonary lesions, then severe V/Q mismatching should be considered as the probable explanation.

Cryptosporidium,Giardia, Cryptococcus, Pneumocystis genetic variability: cryptic biological species or clonal near-clades?

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Michel Tibayrenc

2014-04-01

Full Text Available An abundant literature dealing with the population genetics and taxonomy of Giardia duodenalis, Cryptosporidium spp., Pneumocystis spp., and Cryptococcus spp., pathogens of high medical and veterinary relevance, has been produced in recent years. We have analyzed these data in the light of new population genetic concepts dealing with predominant clonal evolution (PCE recently proposed by us. In spite of the considerable phylogenetic diversity that exists among these pathogens, we have found striking similarities among them. The two main PCE features described by us, namely highly significant linkage disequilibrium and near-clading (stable phylogenetic clustering clouded by occasional recombination, are clearly observed in Cryptococcus and Giardia, and more limited indication of them is also present in Cryptosporidium and Pneumocystis. Moreover, in several cases, these features still obtain when the near-clades that subdivide the species are analyzed separately ("Russian doll pattern". Lastly, several sets of data undermine the notion that certain microbes form clonal lineages simply owing to a lack of opportunity to outcross due to low transmission rates leading to lack of multiclonal infections ("starving sex hypothesis". We propose that the divergent taxonomic and population genetic inferences advanced by various authors about these pathogens may not correspond to true evolutionary differences and could be, rather, the reflection of idiosyncratic practices among compartmentalized scientific communities. The PCE model provides an opportunity to revise the taxonomy and applied research dealing with these pathogens and others, such as viruses, bacteria, parasitic protozoa, and fungi.

Heterogeneity and compartmentalization of Pneumocystis carinii f. sp. hominis genotypes in autopsy lungs

DEFF Research Database (Denmark)

Helweg-Larsen, J; Lundgren, Bettina; Lundgren, Jens Dilling

2001-01-01

. Not all genotypes present in the lungs at autopsy were detected in the diagnostic respiratory samples. Compartmentalization of specific ITS and mtLSU rRNA sequence types was observed in different lung segments. In conclusion, the interpretation of genotype data and in particular ITS sequence types...

Characteristics and Mortality of Pneumocystis Pneumonia in Patients With Cushing’s Syndrome: A Plea for Timely Initiation of Chemoprophylaxis

Science.gov (United States)

van Halem, Karlijn; Vrolijk, Lucia; Pereira, Alberto Martin

2017-01-01

Abstract In patients with Cushing’s syndrome, development of Pneumocystis pneumonia (PCP) is associated with extreme cortisol production levels. In this setting, immune reconstitution after abrogation of cortisol excess appears to induce development of symptomatic PCP. The high mortality rate warrants timely initiation of chemoprophylaxis or even preemptive treatment of PCP. PMID:28480275

Defining Moments in MMWR History: The AIDS Epidemic, Pneumocystis Pneumonia --- Los Angeles 1981

Centers for Disease Control (CDC) Podcasts

2017-12-01

On June 5, 1981, MMWR published a report of Pneumocystis pneumonia in five previously healthy young gay men in Los Angeles, California. This report was later acknowledged as the first published account of what would become known as human immunodeficiency virus, or HIV, and acquired immunodeficiency syndrome, or AIDS. It was the first of many MMWR reports that led to a better understanding of this new condition. In this podcast, Dr. Harold Jaffe recalls CDC’s investigation and response to the AIDS Epidemic.  Created: 12/1/2017 by MMWR.   Date Released: 12/1/2017.

Percutaneous transcatheter drainage of intrathoracic air and fluid collections

International Nuclear Information System (INIS)

Klein, J.S.; Salmon, C.J.

1991-01-01

In this paper, the authors review their experience with radiologically guided percutaneous, small-bore catheter drainage of 89 intrathoraic air or fluid collections in 81 patients to determine the effect of various clinical and radiographic features and fluid characteristics on successful treatment of the collections. The majority of patients underwent drainage for malignant pleural effusion. Patients with pneumothorax, complicated parapneumonic effusion or empyema, hemothorax, chylothorax, and lung abscess were included. Each patient's diagnosis and symptoms; the size, position, and characteristics of the fluid collection; catheter type and size, and use of urokinase were recorded; their effect on clinical and radiographic resolution was determined with logistic regression analysis. The vast majority of malignant effusions were successfully drained and sclerosed with small bore (8-F) pigtail catheters. In patients with pneumothorax, those from Pneumocystis carinii pneumonia required prolonged suction and pleurodesis

Zidovudine treatment of AIDS and ARC in Denmark 1987

DEFF Research Database (Denmark)

Teglbjaerg, L L; Mathiesen, Lars Reinhardt; Søeberg, B

1989-01-01

In 1987, a total of 138 Danish patients (94 AIDS and 44 ARC) received treatment with zidovudine, a total observation period of 572 treatment months. 15 AIDS and 1 ARC patient died after a median of 70 days (range 2-295). In the ARC group 4 patients developed AIDS (3 Pneumocystis carinii pneumonia......, 1 Kaposi's sarcoma). Among the AIDS patients 38 new opportunistic infections were reported. 24 of these opportunistic infections occurred within 6 weeks after treatment initiation. 79 patients were observed for more than 3 months, 25 of these had their daily dose zidovudine reduced, usually from 1...... on 94 occasions and 19 (14%) patients required multiple transfusions. The mortality among the AIDS patients was significantly lower compared to historical controls. In our experience zidovudine treatment is reasonably well tolerated and the side effects are manageable....

Cerebral toxoplasmosis in Danish AIDS patients

DEFF Research Database (Denmark)

Smith, E; Pers, C; Aschow, C

1991-01-01

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... was 83% (10/12 patients) while among patients diagnosed in 1987 or earlier the accuracy was 41% (7/17 patients). Four patients were diagnosed with Pneumocystis carinii pneumonia (PCP) prior to the diagnosis of CNS toxoplasmosis, while among patients with toxoplasmosis as the AIDS-defining diagnosis, 3...

Pathogenesis and role of nuclear medicine

International Nuclear Information System (INIS)

Freedman, P. N; Korowlay, N. A

2002-01-01

The means by which replication of viruses takes place is explained, as it helps in the understanding of how viruses spread in the blood and how antiretroviral drugs work. The most important viruses, from a health care workers point of view, are hepatitis B and C and human immunodefiency virus (HIV). Whether nuclear medicine has a role to play in the diagnosis of these viruses, and the oportunistic infections that go with them, is debatable. Several radiopharmaceuticals are extremely sensitive for infection and tumor imaging but lack specificity. Patients' treatment is often not based on the outcome of the investigation but rather on preset protocols. AIDS patients are put on prophylactic antibiotic treatment as protection against infections such as toxoplasmosis and pneumocystis carinii pneumonia and there is a poor prognosis for AIDS patients with tumors (Au)

Description of Eimeria motelo sp. n. (Apicomplexa: Eimeriidae from the yellow footed tortoise, Geochelone denticulata (Chelonia: Testudinidae, and replacement of Eimeria carinii Lainson, Costa & Shaw, 1990 by Eimeria lainsoni nom. nov.

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Lada Hurková

2000-12-01

Full Text Available Eimeria motelo sp. n. is described from faeces of the yellow-footed tortoise, Geochelone denticulata (L.. Oocysts are irregularly ellipsoidal or cylindrical, with slightly expressed lobed protrusions and irregularities at the poles, possibly caused by wrinkling of the oocyst wall, 17 (15-19 × 9.4 (8.5-11 µm, shape index (length/width being 1.81 (1.45-2. The oocyst wall is smooth, single-layered, 0.5 µm thick with no micropyle. There are no polar bodies. Sporocysts are ellipsoidal, 8.9 (7.5-10 × 4.4 (4-5 µm, shape index 2.03 (1.7-2.5. A sporocyst residuum is present, composed of many granules of irregular size. The sporozoites are elongate, lying lengthwise in the sporocysts. Comparison with other species of the genus Eimeria parasitising members of family Testudinidae indicates that the presently described coccidium represents a new species. The name of Eimeria carinii Lainson, Costa & Shaw, 1990 is found to be preoccupied by a homonym, Eimeria carinii Pinto 1928 given to a coccidium from Rattus norvegicus. Therefore, it is replaced by Eimeria lainsoni nom. nov.

Usefulness of FTA® cards as a Pneumocystis-DNA extraction method in bronchoalveolar lavage samples.

Science.gov (United States)

Rodiño, Jenniffer M; Aguilar, Yudy A; Rueda, Zulma Vanessa; Vélez, Lázaro A

2016-01-01

FTA® cards (Fast Technology for Analysis of Nucleic Acids) are an alternative DNA extraction method in bronchoalveolar lavage (BAL) samples for Pneumocystis jirovecii molecular analyses. The goal was to evaluate the usefulness of FTA® cards to detect P. jirovecii-DNA by PCR in BAL samples compared to silica adsorption chromatography (SAC). This study used 134 BAL samples from immunocompromised patients previously studied to establish microbiological aetiology of pneumonia, among them 15 cases of Pneumocystis pneumonia (PCP) documented by staining and 119 with other alternative diagnoses. The FTA® system and SAC were used for DNA extraction and then amplified by nested PCR to detect P. jirovecii. Performance and concordance of the two DNA extraction methods compared to P. jirovecii microscopy were calculated. The influence of the macroscopic characteristics, transportation of samples and the duration of the FTA® card storage (1, 7, 10 or 12 months) were also evaluated. Among 134 BAL samples, 56% were positive for P. jirovecii-DNA by SAC and 27% by FTA®. All 15 diagnosed by microscopy were detected by FTA® and SAC. Specificity of the FTA® system and SAC were 82.4% and 49.6%, respectively. Compared to SAC, positivity by FTA® decreased with the presence of blood in BAL (62% vs 13.5%). The agreement between samples at 7, 10 and 12 months was 92.5% for FTA®. Positive cases by FTA® remained the same after shipment by mail. Results suggest that FTA® is a practical, safe and economical method to preserve P. jirovecii-DNA in BAL samples for molecular studies.

Estudo temporal das doenças associadas à AIDS no Brasil, 1980-1999 Temporal trends in AIDS-associated opportunistic infections in Brazil, 1980-1999

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Mark Drew Crosland Guimarães

2000-01-01

Full Text Available Neste trabalho foram estimadas as incidências de condições associadas (CA à AIDS/100 casos de AIDS em adultos (> 12 anos, a nível nacional, de 1980 a maio de 1999. A análise incluiu qui-quadrado e regressão linear simples. As CA analisadas foram candidíase (CD, tuberculose (TB, pneumonia por Pneumocystis carinii (PCP, neurotoxoplasmose(NT, Herpes, Sarcoma de Kaposi (SK, meningite criptocócica (MC e infecções por protozoários (IP. As incidências acumuladas/100 casos de AIDS foram: CD = 59, TB = 26, PCP = 23, NT = 15, Herpes = 12, SK = 5, MC = 4 e IP = 4. A tendência anual indicou queda estatisticamente significativa em todas as CA. Entretando, houve aumento na incidência de TB (b = 0,39 e NT (b = 0,20, para as regiões Nordeste e Centro-Oeste, respectivamente. TB apresentou maior incidência entre aqueles com baixa escolaridade (Trends in annual incidence of reported AIDS-associated opportunistic infections (OI/100 adults > 12 years old among AIDS cases were estimated at the national level in Brazil from 1980 through May 1999. The analysis included chi-square and linear regression modeling. The opportunistic infections included: candidiasis (CD, tuberculosis (TB, Pneumocystis carinii pneumonia (PCP, neurotoxoplasmosis (NT, Kaposi sarcoma (KS, cryptococcal meningitis (CM, and protozoa infections (PI. The overall cumulative incidence rates/100 reported AIDS cases were: CD = 59, TB = 26, PCP = 23, NT = 15, KS = 5, CM = 4, and PI = 4. Annual trends indicated a statistically significant decline in all OIs. However, in the Northeast and Central-West regions there were increases in TB (b = 0.39 and NT (b = 0.20, respectively. TB showed a higher incidence among individuals with less schooling (< 8 years, while PCP and KS had higher incidence rates among those with 8 or more years of schooling, despite similar downward trends. Access to antiretroviral therapy and OI prophylaxis may partially explain these results. However, data reliability

Pulmonary infections in immunocompromised patients

International Nuclear Information System (INIS)

Choneva, I.; Abadjieva, D.; Kirilov, R.

2013-01-01

Full text: Introduction: The lung is one of the most commonly affected organs in immunocompromised patients. Primary complication is pulmonary infection which is associated with high morbidity and mortality. Although radiography and CT, as main diagnostic tools are reliable and credible methods, often there is difficulty with the correct diagnose. The reasons for this are that immunocompromised patients are potentially susceptible to infection by various microorganisms and that the radiographic findings are rarely specific for detecting a particular pathogen. What you will learn : Our objective is to present general nosological classification of pulmonary infections in immunocompromised patients, and to evaluate and analyze new imaging methods and discuss their correlation with the clinical setting, which aims to facilitate the diagnosis and to take a decision for the treatment. The experience indicates that a clinical environment conducive the immunocompromised patients to infection with certain pathogens, thereby changing the frequency of their occurrence. The most commonly cited fungal infections, cytomegalovirus infections, Pneumocystis carinii pneumonia and Pulmonary tuberculosis (PTB) of which convincing is the Imaging diagnosis primarily in fungal infections, and Pneumocystis carinii pneumonia and less accurate - in bacterial and viral infections. Discussion: The term 'immunocompromised' describes a subject with an increased risk for life-threatening infection as a result of congenital or acquired abnormalities of the immune system. Over the past few decades, the number of immunocompromised patients has grown considerably, reflecting the increased use of immunosuppressive drugs, and the syndrome of acquired immunodeficiency. Given the high incidence of pulmonary infections in immunocompromised patients (lung is one of the most commonly affected organs, such as lung infection is about 75% of pulmonary complications), rapid and accurate diagnosis is important

Zidovudine treatment of AIDS and ARC in Denmark 1987

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Teglbjærg, Lars Stubbe; Mathiesen, L R; Søeberg, B

1989-01-01

In 1987, a total of 138 Danish patients (94 AIDS and 44 ARC) received treatment with zidovudine, a total observation period of 572 treatment months. 15 AIDS and 1 ARC patient died after a median of 70 days (range 2-295). In the ARC group 4 patients developed AIDS (3 Pneumocystis carinii pneumonia......, 1 Kaposi's sarcoma). Among the AIDS patients 38 new opportunistic infections were reported. 24 of these opportunistic infections occurred within 6 weeks after treatment initiation. 79 patients were observed for more than 3 months, 25 of these had their daily dose zidovudine reduced, usually from 1......,200 mg to 600 mg, 9 others were temporarily off drug. HIV antigen was analyzed in serum samples from 93 patients. Of these, 28 (52%) of 54 initially HIV antigen-positive became antigen-negative, 7 (18%) of 39 initially HIV antigen-negative became antigen-positive within the first 8 weeks of zidovudine...

New approach to imaging HIV-positive patients with pyrexia of undetermined origin

International Nuclear Information System (INIS)

Buscombe, J.; Miller, R.; Lui, D.; Ell, P.J.

1990-01-01

This paper established if imaging with Tc-99m human immunoglobulin (HIG) in addition to Ga-67 citrate increased the diagnostic sensitivity in patients who have pyrexia of unknown origin (PUO) and who have tested positive for human immunodeficiency virus (HIV). The authors studied 18 HIV-positive patients with PUO for 3 or more weeks. Imaging was performed 4 and 20 hours after administration of 200 MBq of Tc-99m HIG and 24, 48, and (if indicated) 72 hours after administration of 300 MBq of Ga-67. Anterior whole body and relevant spot view were obtained for both agents. Twenty-four sites of infection were confirmed microbiologically in 12 patients. Ga-67 scan results were positive in 22 of these sites, and Tc-99m HIG results were positive in 13; the nine Ga-positive sites that were Tc-negative were intrathoracic (one Pneumocystis carinii, eight Mycobacterium intracellulare)

Pneumocystosis in wild small mammals from California

Science.gov (United States)

Laakkonen, Juha; Fisher, Robert N.; Case, Ted J.

2001-01-01

Cyst forms of the opportunistic fungal parasite Pneumocystis carinii were found in the lungs of 34% of the desert shrew, Notiosorex crawfordi (n = 59), 13% of the ornate shrew, Sorex ornatus (n = 55), 6% of the dusky-footed wood rat, Neotoma fuscipes (n = 16), 2.5% of the California meadow vole,Microtus californicus (n = 40), and 50% of the California pocket mouse, Chaetodipus californicus (n= 2) caught from southern California between February 1998 and February 2000. Cysts were not found in any of the harvest mouse, Reithrodontomys megalotis (n = 21), California mouse,Peromyscus californicus (n = 20), brush mouse, Peromyscus boylii (n = 7) or deer mouse, Peromyscus maniculatus (n = 4) examined. All infections were mild; extrapulmonary infections were not observed. Other lung parasites detected were Hepatozoon sp./spp. from M. californicus andNotiosorex crawfordi, Chrysosporium sp. (Emmonsia) from M. californicus, and a nematode from S. ornatus.

Late Onset Combined Immunodeficiency Presenting with Recurrent Pneumocystis jiroveci Pneumonia

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Ilias Papakonstantinou

2014-01-01

Full Text Available Late onset combined immunodeficiency (LOCID is a recently described variant of common variable immunodeficiency (CVID, involving adult patients presenting with opportunistic infections and/or low CD4+ lymphocyte counts. A 36-year-old male with unremarkable past medical history presented with fever, respiratory failure, and lymphocytopenia. He was found to have Pneumocystis jiroveci pneumonia (PJP, subsequently complicated by recurrent hospital-acquired Pseudomonas aeruginosa pneumonia and immune reconstitution phenomena, attributed to restoration of immunoglobulin levels. Clinicians should be aware of LOCID, which could be confused with HIV infection/AIDS or idiopathic CD4 lymphocytopenia. In the English bibliography there is only one case report, where PJP was the initial presentation of CVID (that case would probably be classified as LOCID. Phenomena of immune reconstitution are described in various settings, including primary immunodeficiency, manifesting as temporary clinical and radiologic deterioration and leading to misperceptions of therapeutic failure and/or presence of alternative/additional diagnoses.

Value of Tc99m-DTPA alveolar permeability in lung involvement detection of patients with HIV infection

International Nuclear Information System (INIS)

Massardo Vega, Teresa; Jofre Manieu, Maria Josefina; Cabello Araya, Hernan; Sepulveda Carvajal, Cecilia; Ruiz Carmona, Mauricio; Moyano Schlegel, Leonor; Fica Cubillos, Alberto; Alay Perez, Rita

2001-01-01

We studied 35 HIV patients in order to know the value of Tc99mDTPA in the assessment of pulmonary lung involvement, especially pneumocystis carinii (PC) infection. Lung DTPA clearance measures increased alveolar permeability. Twenty patients with respiratory symptoms were included, 4 with systemic symptoms and also 11 asymptomatics, with similar immune condition (CD4 lymphocytes <400) as a control group. Smoking habit was suspended prior the test. Clinical follow up, chest film, induced sputum and/or fibrobronchoscopy were obtained. There was histological confirmation of PC presence or absence in 16 symptomatics and 3 asymptomatics. DTPA sensitivity for PC detection was 78%, specificity 40% and accuracy 58%; the values were 85%, 60% and 79%, respectively, for inflammatory lung processes. There were 4/6 cases false positive for PC detection with respiratory features explaining DTPA abnormalities. Concluding, Tc99m-DTPA is sensitive but not specific for detecting PC pneumonia but its value is higher for pulmonary inflammatory processes (Au)

Contribution of chest x-ray to the diagnosis of HIV virus infection

International Nuclear Information System (INIS)

Monti, C.; Sabbarani, S.

1987-01-01

After revising literature concerning Pneumocystis Carinii Pneumoniae (PCP), the authors undertook a close examination of the immunological system of the HIVab-positive patients that suffered opportunistic pneumopathy from PCP. Hundred-forty-three cases of HIVab-positive (mean age of 29), prevalently heroine drugusers, were studied. There were 13 AIDS, 26 ARC, 91 LAS cases and 13 patients with only Ab positivity for HIV. Four hundred chest radiographs were examined without previous knowledge of case histories. A small number of hilum and/or mediastinal lymphoadenopathies was observed. Moreover, percentage increase in acute lung inflammatory diseases, mainly interstitial, was seen. These data were correlated to the worsening of the HIV infection and to the developing of LAS, ARC and ADIS. In a number of cases there was radiological evidence of pregressed inflammatory episodes. The clinical pattern of PCP patients is dramatic and often fatal. Clinical-radiological cases with special reference to acute interstitial disease, caused by opportunistic agents, are presented

Coexistência de infeções oportunistas pulmonares num doente com infeção por vírus da imunodeficiência humana e uma forma persistente de pneumonia por Pneumocystis jirovecii: caso clínico

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D. Ponces Bento

2013-05-01

Full Text Available Resumo: Como é sabido, nos doentes com infeção por vírus da imunodeficiência humana (VIH existe um alto risco de ocorrência de infeções oportunistas (IO, tais como as infeções por Pneumocystis jirovecii, um agente patogénico com distribuição mundial, que provoca pneumonia intersticial (PPc. Apresentamos um caso de um doente recém-diagnosticado com infeção por VIH-1 e múltiplas IO pulmonares, incluindo uma forma persistente de PPc, aspergilose invasiva (AI, e infeções por citomegalovírus e por Mycobacterium xenopi. Descrevemos a combinação de fatores cruciais para a recuperação do doente, que incluíram a obtenção de dados laboratoriais, intervenção cirúrgica e múltipla terapêutica antimicrobiana. Abstract: It is well established that HIV patients are at high risk of opportunistic infections (OI, like the ones caused by Pneumocystis jirovecii, a worldwide pathogen implicated in interstitial pneumonia (PcP. We present a case of a newly diagnosed HIV-1 patient with multiple OI, including a persistent form of PcP, an invasive aspergillosis (IA, cytomegalovirus and Mycobacterium xenopi lung infection. We describe the combination of laboratorial screening, surgery and antimicrobial therapy that were crucial for patient recovery. Palavras-chave: Vírus da imunodeficiência humana, Pneumonia por Pneumocystis jirovecii, Infeções oportunistas, Keywords: Human immunodeficiency virus, Pneumocystis jirovecii pneumonia, Opportunistic lung infections

Primary pneumocystis infection in infants hospitalized with acute respiratory tract infection

DEFF Research Database (Denmark)

Larsen, Hans Henrik; von Linstow, Marie-Louise; Lundgren, Bettina

2007-01-01

with 431 episodes of acute respiratory tract infection (RTI) by using a real-time PCR assay. In 68 episodes in 67 infants, P. jirovecii was identified. The odds ratio (95% confidence interval) of a positive signal compared with the first quartile of age (7-49 days) was 47.4 (11.0-203), 8.7 (1......Acquisition of Pneumocystis jirovecii infection early in life has been confirmed by serologic studies. However, no evidence of clinical illness correlated with the primary infection has been found in immunocompetent children. We analyzed 458 nasopharyngeal aspirates from 422 patients hospitalized.......9-39.7), and 0.6 (0.1-6.7) for infants in the second (50-112 days), third (113-265 days), and fourth (268-4,430 days) age quartiles, respectively. Infants with an episode of upper RTI (URTI) were 2.0 (1.05-3.82) times more likely to harbor P. jirovecii than infants with a lower RTI. P. jirovecii may manifest...

Neutrophil chemotactic activity in bronchoalveolar lavage fluid of patients with AIDS-associated Pneumocystis carinii pneumonia

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Benfield, T L; Kharazmi, A; Larsen, C G

1997-01-01

been shown to confer a poor prognosis in PCP. We therefore investigated the potential of BAL fluid from 17 patients with PCP to induce neutrophil chemotaxis. BAL fluid from patients induced considerable neutrophil chemotactic activity compared to normal controls. Elevated levels of IL-8 were detected...... in patient samples as compared to controls. A specific anti-IL-8 antibody significantly reduced chemotactic activity of patient samples by more than 50%. In conclusion, IL-8 appears to be a significant participant of neutrophil chemotaxis in AIDS-associated PCP, and may participate in the recruitment...

Performance of 2 commercial real-time polymerase chain reaction assays for the detection of Aspergillus and Pneumocystis DNA in bronchoalveolar lavage fluid samples from critical care patients.

Science.gov (United States)

Orsi, Carlotta Francesca; Gennari, William; Venturelli, Claudia; La Regina, Annunziata; Pecorari, Monica; Righi, Elena; Machetti, Marco; Blasi, Elisabetta

2012-06-01

This article investigates the performance of 2 commercial real-time polymerase chain reaction (PCR) assays, MycAssay™ Aspergillus (Myc(Asp)Assay) and MycAssay™ Pneumocystis (Myc(PCP)Assay), on the ABI 7300 platform for the detection of Aspergillus (Asp) or Pneumocystis jirovecii (Pj) DNA in bronchoalveolar lavage (BAL) samples from 20 patients. Operationally, patients enrolled were clustered into 3 groups: invasive aspergillosis group (IA, 7 patients), Pj pneumonia group (PCP, 8 patients), and negative control group (5 patients). All the IA patients were Myc(Asp)Assay positive, whereas 12 non-IA patients returned negative PCR results. Furthermore, 7 of 8 PCP patients were Myc(PCP)Assay positive, while 9 non-PCP patients were PCR negative. In conclusion, these data provide an early indication of the effectiveness of both the Myc(Asp)Assay and Myc(PCP)Assay on the ABI 7300 platform for the detection of either Asp or Pj DNA in BAL from patients with deep fungal infections. Copyright © 2012 Elsevier Inc. All rights reserved.

Investigation of outbreaks of Pneumocystis jirovecii pneumonia in two Scottish renal units.

Science.gov (United States)

Inkster, T; Dodd, S; Gunson, R; Imrie, L; Spalding, E; Packer, S; Deighan, C; Daly, C; Coia, J; Imtiaz, T; McGuffie, C; Wilson, R; Bal, A M

2017-06-01

Pneumocystis jirovecii is recognized as an opportunistic pathogen. In recent years, human-to-human transmission of P. jirovecii has been demonstrated. However, outbreaks of P. jirovecii infections are not well defined because the epidemiological setting that facilitates transmission is not fully understood. This article describes two outbreaks of P. jirovecii pneumonia (PCP) in renal transplant patients in the West of Scotland. In total, 25 patients in two geographically contiguous locations were affected. Allele B was identified as the dominant type, along with allele A3. It was not possible to determine the exact reason for clustering of cases, although the outpatient clinic setting featured in one of the outbreaks. The outbreaks ceased with the use of trimethoprim-sulphamethoxazole prophylaxis; the target populations that received prophylaxis were different in the two outbreaks. Infection control teams should be alert to the possibility of outbreaks of PCP. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Pneumocystis jirovecii detection in asymptomatic patients: what does its natural history tell us? [version 1; referees: 3 approved

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Alexandre Alanio

2017-05-01

Full Text Available Pneumocystis jirovecii is an unusual ascomycetous fungus that can be detected in the lungs of healthy individuals. Transmission from human to human is one of its main characteristics in comparison with other fungi responsible for invasive infections. P. jirovecii is transmitted through the air between healthy individuals, who are considered to be the natural reservoir, at least transiently. In immunocompromised patients, P. jirovecii multiplies, leading to subacute infections and acute life-threatening pneumonia, called Pneumocystis pneumonia [PCP]. PCP is caused by genotypically distinct mixtures of organisms in more than 90% of cases, reinforcing the hypothesis that there is constant inhalation of P. jirovecii from different contacts over time, although reactivation of latent organisms from previous exposures may be possible. Detection of P. jirovecii DNA without any symptoms or related radiological signs has been called “colonization”. This situation could be considered as the result of recent exposure to P. jirovecii that could evolve towards PCP, raising the issue of cotrimoxazole prophylaxis for at-risk quantitative polymerase chain reaction (qPCR-positive immunocompromised patients. The more accurate way to diagnose PCP is the use of real-time quantitative PCR, which prevents amplicon contamination and allows determination of the fungal load that is mandatory to interpret the qPCR results and manage the patient appropriately. The detection of P. jirovecii in respiratory samples of immunocompromised patients should be considered for potential risk of developing PCP. Many challenges still need to be addressed, including a better description of transmission, characterization of organisms present at low level, and prevention of environmental exposure during immunodepression.

The Prevalence of Pneumocystis jiroveci in Bronchoalveolar Lavage Specimens of Lung Transplant Recipients Examined by the Nested PCR.

Science.gov (United States)

Izadi, Morteza; Jonaidi Jafari, Nematollah; Sadraei, Javid; Mahmoodzadeh Poornaki, Abbas; Rezavand, Babak; Zarrinfar, Hossein; Abdi, Jahangir; Mohammadi, Younes

2014-12-01

The use of immune suppressive drugs for organ transplant recipients predisposes them to opportunistic infections, especially by fungal agents. Pneumocystis jiroveci, as an opportunistic pathogen, endangers the patients' life in those with immune system disorders. Early detection of latent Pneumocystis infection in susceptible patients may help choose the optimal treatment for these patients. The aim of this study was to identify and determine the colonization of latent P. jiroveci infection among lung transplant recipients. This cross-sectional descriptive study was conducted on lung transplant recipients. Bronchoalveolar lavage (BAL) specimens were collected from 32 patients undergoing bronchoscopy. The samples were aseptically homogenized by 10 mM dithiothreitol, and their DNA was extracted. The mtLSUrRNA gene of P. jiroveci was amplified using nested PCR in two stages. Nested PCR was performed using external primers of pAZ-102-E and pAZ102-H followed by using the PCR product of the first stage and internal primers of pAZ-102-E and pAZ102-L2. The genome of P. jiroveci was revealed by a 346 bp PCR product in the initial amplification and a 120 bp product in the nested PCR. The results showed that seven BAL specimens (21.9%) from lung transplant recipients were positive for P. jiroveci. In molecular epidemiology studies, nested PCR has higher sensitivity than PCR. Results of this study support the colonization of P. jiroveci in patients receiving lung transplantation. Patients who are carriers of P. jiroveci are at a higher risk of P. jiroveci pneumonia.

Unusual Radiographic Presentation of Pneumocystis Pneumonia in a Patient with AIDS

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Brian L. Block

2017-01-01

Full Text Available Pneumocystis jirovecii pneumonia (PCP typically presents as an interstitial and alveolar process with ground glass opacities on chest computed tomography (CT. The absence of ground glass opacities on chest CT is thought to have a high negative predictive value for PCP in individuals with AIDS. Here, we report a case of PCP in a man with AIDS who presented to our hospital with subacute shortness of breath and a nonproductive cough. While his chest CT revealed diffuse nodular rather than ground glass opacities, bronchoscopy with bronchoalveolar lavage and transbronchial biopsies confirmed the diagnosis of PCP and did not identify additional pathogens. PCP was not the expected diagnosis based on chest CT, but it otherwise fit well with the patient’s clinical and laboratory presentation. In the era of combination antiretroviral therapy, routine prophylaxis for PCP, and increased use of computed tomography, it may be that PCP will increasingly present with nonclassical chest radiographic patterns. Clinicians should be aware of this presentation when selecting diagnostic and management strategies.

Circulation of Pneumocystis dihydropteroate synthase mutants in France.

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Le Gal, Solène; Damiani, Céline; Perrot, Maëla; Rouillé, Amélie; Virmaux, Michèle; Quinio, Dorothée; Moalic, Elodie; Saliou, Philippe; Berthou, Christian; Le Meur, Yann; Totet, Anne; Nevez, Gilles

2012-10-01

Data on the prevalence of Pneumocystis jirovecii (P. jirovecii) dihydropteroate synthase (DHPS) mutants in France are still limited. In this study, mutant prevalence in the Brest region (western France) was determined. Archival pulmonary specimens from 85 patients infected with P. jirovecii and admitted to our institution (University Hospital, Brest) from October 2007 to February 2010 were retrospectively typed at the DHPS locus using a polymerase chain reaction-restriction fragment length polymorphism assay. Type identification was successful in 66 of 85 patients. Sixty-four patients were infected with a wild type, whereas mutants were found in 2 patients (2/66, 3%). Medical chart analysis revealed that these 2 patients usually lived in Paris. Another patient usually lived on the French Riviera, whereas 63 patients were from the city of Brest. Thus, the corrected prevalence of mutants in patients who effectively lived in our geographic area was 0% (0/63). Taking into account that i) Paris is characterized by a high prevalence of mutants from 18.5% to 40%, ii) infection diagnoses were performed in the 2 Parisians during their vacation Paris to Brest through infected vacationers. The study shows that the usual city of patient residence, rather than the city of infection diagnosis, is a predictor of mutants and that P. jirovecii infections involving mutants do not represent a public health issue in western France. Copyright © 2012 Elsevier Inc. All rights reserved.

Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos

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Sofia Lourenço

2008-01-01

Full Text Available Resumo: Nos doentes com infecção pelo vírus da imunodeficiência humana (VIH o citomegalovírus torna-se um agente de doença importante quando existe imunossupressão avançada. O seu papel como agente de doença pulmonar neste contexto tem sido amplamente debatido. Nos doentes com pneumocistose, a presença do citomegalovírus no pulmão não parece conferir pior prognóstico, excepto nos que recebem terapêutica adjuvante com corticóides.Os autores apresentam dois casos de doentes com infecção VIH e imunossupressão avançada, admitidos na unidade de cuidados intensivos por insuficiência respiratória. Em ambos houve isolamento de Pneumocystis jirovecii no lavado broncoalveolar. Apesar da terapêutica instituída ambos vieram a falecer. A biópsia pulmonar post mortem mostrou, nos dois casos, a presença de Pneumocystis e inclusões por citomegalovírus. Perante este achado tecem-se algumas considerações sobre o papel do citomegalovírus como agente de pneumonia na SIDA e sobre o seu significado como co-infectante na pneumocistose, sobretudo nos casos de falência terapêutica.Rev Port Pneumol 2008; XIV (1: 151-157 Abstract: Cytomegalovirus is capable of causing disease in immunocompromised patients. In people infected by the Human Immunodeficiency Virus (HIV it becomes an important agent when there is advanced immunosupression. Its role as a pulmonary pathogen in these patients has been questioned. In the case of pneumocystosis the presence of Cytomegalovirus doesn’t seem to worsen prognosis, except in cases where corticosteroids are used.Authors present two cases of patients with HIV infection and advanced immunosupression who were admitted in the intensive care unit for respiratory failure. In both Pneumocystis jirovecii was isolated from bronco-alveolar lavage. Despite of therapy both patients died from refractory hypoxemia. Pulmonary biopsies performed post

Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos

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Sofia Lourenço

2008-01-01

Full Text Available Resumo: Nos doentes com infecção pelo vírus da imunodeficiência humana (VIH o citomegalovírus torna-se um agente de doença importante quando existe imunossupressão avançada. O seu papel como agente de doença pulmonar neste contexto tem sido amplamente debatido. Nos doentes com pneumocistose, a presença do citomegalovírus no pulmão não parece conferir pior prognóstico, excepto nos que recebem terapêutica adjuvante com corticóides.Os autores apresentam dois casos de doentes com infecção VIH e imunossupressão avançada, admitidos na unidade de cuidados intensivos por insuficiência respiratória. Em ambos houve isolamento de Pneumocystis jirovecii no lavado broncoalveolar. Apesar da terapêutica instituída ambos vieram a falecer. A biópsia pulmonar post mortem mostrou, nos dois casos, a presença de Pneumocystis e inclusões por citomegalovírus. Perante este achado tecem-se algumas considerações sobre o papel do citomegalovírus como agente de pneumonia na SIDA e sobre o seu significado como co-infectante na pneumocistose, sobretudo nos casos de falência terapêutica. Abstract: Cytomegalovirus is capable of causing disease in immunocompromised patients. In people infected by the Human Immunodeficiency Virus (HIV it becomes an important agent when there is advanced immunosupression. Its role as a pulmonary pathogen in these patients has been questioned. In the case of pneumocystosis the presence of Cytomegalovirus doesn’t seem to worsen prognosis, except in cases where corticosteroids are used.Authors present two cases of patients with HIV infection and advanced immunosupression who were admitted in the intensive care unit for respiratory failure. In both Pneumocystis jirovecii was isolated from bronco-alveolar lavage. Despite of therapy both patients died from refractory hypoxemia. Pulmonary biopsies performed post mortem revealed presence of

Nuclear medicine and AIDS

International Nuclear Information System (INIS)

O'Doherty, M.J.; Kent and Canterbury Hospital, Canterbury; Nunan, T.O.

1993-01-01

The human immunodeficiency virus (HIV) infection and its associated illnesses in a relatively young population of patients provides an expanding role for nuclear medicine. The disease enforces a review of each department's infection control procedures. It has also resulted in an increase in the number of patients presenting with diseases such as Pneumocystis carinii pneumonia, Kaposi's sarcoma etc. which prior to the HIV epidemic were extremely rare. Thus in high risk patients the interpretation of abnormalities in nuclear medicine scans needs to include the spectrum of opportunistic infections and unusual tumours. The presence of opportunistic infections in the severely immunocompromised patient has led to the development of techniques not normally used, i.e. lung 99 Tc m -diethylenetriamine pentaacetate (DTPA) transfer/clearance, donor leukocyte scanning to allow rapid diagnosis of an abnormality. Radionuclide techniques are also used to monitor the effect of therapy directed at the HIV itself or against opportunistic infections. This review covers aspects of infection control as well as the use of radionuclides to investigate specific problems related to HIV infection and therapy of the associated disease processes. (author)

Rapid detection of dihydropteroate polymorphism in AIDS-related Pneumocystis carinii pneumonia by restriction fragment length polymorphism

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Helweg-Larsen, J; Eugen-Olsen, Jesper; Lundgren, B

2000-01-01

are associated with failure of sulpha prophylaxis and increased mortality in HIV-1 positive patients with PCP, suggesting that DHPS mutations may cause sulpha resistance. To facilitate detection of DHPS mutations we developed a restriction fragment length polymorphism (RFLP) assay, detecting mutations at codon...

Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a randomized European multicenter open label study

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Nielsen, T L; Eeftinck Schattenkerk, J K; Jensen, B N

1992-01-01

.0 kPa (67.5 mm Hg) and/or a PaCO2 less than 4.0 kPa (30.0 mm Hg) while breathing room air. During the acute episode of PCP, 9 (31%) of the 29 control patients died versus 3 (10%) of the 30 CS patients; p = 0.01. Mechanical ventilation was necessary in 15 patients; 12 (41%) in the control group and 3...

Acometimento pulmonar em crianças com a síndrome da imunodeficiência humana (AIDS: estudo clínico e de necrópsia de 14 casos Necroscopic study of 14 children with AIDS and pneumonia

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I.T.R. YPARRAGUIRRE

2001-06-01

Full Text Available OBJETIVOS: Descrever os aspectos clínicos, laboratoriais, radiológicos e anatomopatológicos encontrados em tecidos pulmonares de necrópsias de crianças com Aids e acometimento pulmonar. MÉTODOS: Foram revisados, retrospectivamente, prontuários, radiografias simples de tórax e laudos de necrópsias de 14 crianças com Aids e acometimento pulmonar. RESULTADOS: Oito casos eram do sexo masculino e seis do feminino. As idades variaram de três meses a nove anos, mediana de 1,2, sendo nove deles menores de dois anos. A transmissão foi vertical em 10 pacientes, dos quais cinco mães tinham história de contaminação por relação heterossexual; três, por hemotransfusão e em duas, ignorada. Pneumonia (n=8, candidíase oral (n=8 e diarréia (n=5 foram as doenças prévias mais referidas. Os sinais e sintomas observados à internação foram febre (n=12, dispnéia (n=10, tosse (n=11, linfoadenomegalia (n=11, hepato e/ou esplenomegalia (n=10, desnutrição (n=9, palidez (n=8, cianose (n=5 e baqueteamento digital (n=2. Os achados radiológicos mais comuns foram infiltrados difusos (n=6 e condensações (n=5. As alterações histológicas pulmonares foram compatíveis com pneumonia pelo citomegalovírus (n=9, por bactérias (n=8, por Pneumocystis carinii (n=3, por Hystoplasma capsulatum (n=1, por Toxoplasma gondii (n=1 e pneumonia intersticial linfocítica (n=1. A associação CMV e bactéria foi observada em seis casos. CONCLUSÕES: Houve predomínio de menores de dois anos, de transmissão vertical, de quadro clínico inespecífico de doença pulmonar e de infiltrados e condensações à radiografia. Citomegalovírus e bactérias foram os agentes mais comuns, sendo freqüente a sua associação. Pneumonia Intersticial Linfocítica e Pneumonia pelo P. carinii não foram causas freqüentes de doenças pulmonares.BACKGROUND: To describe clinical, laboratorial, radiological, and histopathological lung findings from necroscopy of aidetic children

Mechanisms of Surface Antigenic Variation in the Human Pathogenic Fungus Pneumocystis jirovecii.

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Schmid-Siegert, Emanuel; Richard, Sophie; Luraschi, Amanda; Mühlethaler, Konrad; Pagni, Marco; Hauser, Philippe M

2017-11-07

Microbial pathogens commonly escape the human immune system by varying surface proteins. We investigated the mechanisms used for that purpose by Pneumocystis jirovecii This uncultivable fungus is an obligate pulmonary pathogen that in immunocompromised individuals causes pneumonia, a major life-threatening infection. Long-read PacBio sequencing was used to assemble a core of subtelomeres of a single P. jirovecii strain from a bronchoalveolar lavage fluid specimen from a single patient. A total of 113 genes encoding surface proteins were identified, including 28 pseudogenes. These genes formed a subtelomeric gene superfamily, which included five families encoding adhesive glycosylphosphatidylinositol (GPI)-anchored glycoproteins and one family encoding excreted glycoproteins. Numerical analyses suggested that diversification of the glycoproteins relies on mosaic genes created by ectopic recombination and occurs only within each family. DNA motifs suggested that all genes are expressed independently, except those of the family encoding the most abundant surface glycoproteins, which are subject to mutually exclusive expression. PCR analyses showed that exchange of the expressed gene of the latter family occurs frequently, possibly favored by the location of the genes proximal to the telomere because this allows concomitant telomere exchange. Our observations suggest that (i) the P. jirovecii cell surface is made of a complex mixture of different surface proteins, with a majority of a single isoform of the most abundant glycoprotein, (ii) genetic mosaicism within each family ensures variation of the glycoproteins, and (iii) the strategy of the fungus consists of the continuous production of new subpopulations composed of cells that are antigenically different. IMPORTANCE Pneumocystis jirovecii is a fungus causing severe pneumonia in immunocompromised individuals. It is the second most frequent life-threatening invasive fungal infection. We have studied the mechanisms

Echinocandin treatment of pneumocystis pneumonia in rodent models depletes cysts leaving trophic burdens that cannot transmit the infection.

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Melanie T Cushion

2010-01-01

Full Text Available Fungi in the genus Pneumocystis cause pneumonia (PCP in hosts with debilitated immune systems and are emerging as co-morbidity factors associated with chronic diseases such as COPD. Limited therapeutic choices and poor understanding of the life cycle are a result of the inability of these fungi to grow outside the mammalian lung. Within the alveolar lumen, Pneumocystis spp., appear to have a bi-phasic life cycle consisting of an asexual phase characterized by binary fission of trophic forms and a sexual cycle resulting in formation of cysts, but the life cycle stage that transmits the infection is not known. The cysts, but not the trophic forms, express beta -1,3-D-glucan synthetase and contain abundant beta -1,3-D-glucan. Here we show that therapeutic and prophylactic treatment of PCP with echinocandins, compounds which inhibit the synthesis of beta -1,3-D-glucan, depleted cysts in rodent models of PCP, while sparing the trophic forms which remained in significant numbers. Survival was enhanced in the echincandin treated mice, likely due to the decreased beta -1,3-D-glucan content in the lungs of treated mice and rats which coincided with reductions of cyst numbers, and dramatic remodeling of organism morphology. Strong evidence for the cyst as the agent of transmission was provided by the failure of anidulafungin-treated mice to transmit the infection. We show for the first time that withdrawal of anidulafungin treatment with continued immunosuppression permitted the repopulation of cyst forms. Treatment of PCP with an echinocandin alone will not likely result in eradication of infection and cessation of echinocandin treatment while the patient remains immunosuppressed could result in relapse. Importantly, the echinocandins provide novel and powerful chemical tools to probe the still poorly understood bi-phasic life cycle of this genus of fungal pathogens.

ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

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Alanio, Alexandre; Hauser, Philippe M; Lagrou, Katrien

2016-01-01

The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidence-based recommendations for using tests to diagnose Pneumocystis jirovecii pneumonia (PCP) in adult patients with haematological malignancies. Immunofluorescence assays are recommended...... a positive test result may indicate other fungal infections. Genotyping using multilocus sequence markers can be used to investigate suspected outbreaks ( A-II: ). The routine detection of dihydropteroate synthase mutations in cases of treatment failure is not recommended ( B-II: ) since these mutations do...... not affect response to high-dose co-trimoxazole. The clinical utility of these diagnostic tests for the early management of PCP should be further assessed in prospective, randomized interventional studies....

[Case Report: Clindamycin with Primaquine Therapy for Severe Pneumocystis Pneumonia].

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Yoshimura, Yukihiro; Sakamoto, Youhei; Amano, Yuichiro; Tachikawa, Natsuo

2015-09-01

A Japanese female in her 60's on 5 years' treatment with prednisolone 5 mg for ulcetarive colitis developed severe bloody stools and diarrhea and was admitted. A total colectomy was performed because leukocytapheresis with intravenous corticosteroid administration (prednisolone 70 mg/day) relieved her symptoms partially. Pneumocystis pneumonia (PCP) prophylaxis was not introduced then. She developed acute respiratory failure on postoperative day (POD) 8, and was intubated and moved to our intensive care unit. PCP was suspected and sulfamethoxazole/trimethoprim (ST) was started with methylprednisolone 40 mg/day. The pneumonia initially improved but got worse around POD 27 and pulse corticosteroid therapy was administered. Antibiotics were first changed to pentamidine and finally changed to clindamycin/primaquine because of adverse reactions due to both of the medications. She recovered fully and experienced no exacerbation after discontinuation of the secondary prophylaxis. This is the first report of primaquine administration for PCP in Japan. Clindamycin/primaquine are second-line drugs but very important because the first-line medications such as ST and pentamidine cause adverse reactions and frequently result in discontinuation, as was the case in our present patient. Nowadays immunosuppresive therapy for malingnancies and autoimmune diseases has been introduced more frequently than before, PCP has attracted more attention. Therefore primaquine should be approved for appropriate use without delay in Japan.

Clinical and epidemiological analysis of patients with HIV/AIDS admitted to a reference hospital in the northeast region of Brazil Análise clínica e epidemiológica dos pacientes com HIV/AIDS internados em um Hospital de Referência na Região Nordeste do Brasil

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Vítor Yamashiro Rocha Soares

2008-12-01

Full Text Available The AIDS epidemic has become a worldwide phenomenon of enormous magnitude and extension, deeply transforming medical practices and public health initiatives. This retrospective survey aimed to analyze clinical and epidemiological characteristics of patients with HIV/AIDS admitted to the Institute of Tropical Diseases Natan Portella, Teresina, Piauí, Brazil, from January, 2001 through December, 2004. Of the 828 patients, 43% were from other states and 71.3% were men. Average patient age was 35.4 ± 11.5 years-old and 85.5% were illiterate or had primary education. The main form of exposure to HIV was heterosexual behavior (54.1%, while injectable drug use was confirmed by only 2.7% of registered cases. The most frequent infectious complications were candidiasis (42.4% and pneumocystosis (22.2%. Sixty-eight cases (8.2% of visceral leishmaniasis were registered. Using multivariate analysis, individuals aged over 40 years-old, patients with active tuberculosis, Pneumocystis carinii pneumonia and central nervous system cryptococcosis showed increased risk of death. In this study, young male adults with low educational levels predominated and the most frequent opportunistic infections were candidiasis and pneumocystosis.A epidemia de AIDS tornou-se um fenômeno mundial de grande magnitude e extensão, transformando profundamente a prática médica e as iniciativas em saúde pública. O estudo retrospectivo analisou as características clínicas e epidemiológicas dos pacientes com HIV/AIDS internados no Instituto de Doenças Tropicais Natan Portella, Teresina, Piauí, Brasil, de janeiro de 2001 a dezembro de 2004 . Dos 828 pacientes, 43% eram provenientes de outros estados e 71,3% eram do sexo masculino. A idade média foi 35,4 ± 11,5 anos. Eram analfabetos ou cursaram até o ensino fundamental 85,5%. A principal via de exposição ao HIV foi o comportamento heterossexual (54,1%, enquanto o uso de drogas injetáveis foi observado em apenas 2,7% dos

Primary brain tumors treated with steroids and radiotherapy: Low CD4 counts and risk of infection

International Nuclear Information System (INIS)

Hughes, Michael A.; Parisi, Michele; Grossman, Stuart; Kleinberg, Lawrence

2005-01-01

Purpose: Patients with primary brain tumors are often treated with high doses of corticosteroids for prolonged periods to reduce intracranial swelling and alleviate symptoms such as headaches. This treatment may lead to immunosuppression, placing the patient at risk of life-threatening opportunistic infections, such as Pneumocystis carinii pneumonia. The risk of contracting some types of infection may be reduced with prophylactic antibiotics. The purpose of this study was to determine the occurrence of low CD4 counts and whether monitoring CD4 counts during and after radiotherapy (RT) is warranted. Methods and Materials: CD4 counts were measured during RT in 70 of 76 consecutive patients with newly diagnosed Grade III and IV astrocytoma and anaplastic oligodendroglioma treated with corticosteroids and seen at the Johns Hopkins Hospital. Weekly CD4 measurements were taken in the most recent 25 patients. Prophylactic trimethoprim-sulfamethoxazole (160 mg/800 mg p.o. every Monday, Wednesday, and Friday) or dapsone (100 mg p.o. daily) in those with sulfa allergy was prescribed only if patients developed a low CD4 count. Carmustine chemotherapy wafers were placed at surgery in 23% of patients, evenly distributed between the groups. No patient received any other chemotherapy concurrent with RT. Results: CD4 counts decreased to 3 in 17 (24%) of 70 patients. For the 25 patients with weekly CD4 counts, all CD4 counts were >450/mm 3 before RT, but 6 (24%) of 25 fell to 3 during RT. Patients with counts 3 were significantly more likely to be hospitalized (41% vs. 9%, p <0.01) and be hospitalized for infection (23% vs. 4%, p <0.05) during RT. Overall survival was not significantly different between the groups. All patients with low CD4 counts were treated with prophylactic antibiotics, and no patient developed Pneumocystis carinii pneumonia. No patients developed a serious adverse reaction to antibiotic therapy. The mean dose of steroids, mean minimal white blood cell count

Retrospective Analysis of Bacterial and Viral Co-Infections in Pneumocystis spp. Positive Lung Samples of Austrian Pigs with Pneumonia.

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Christiane Weissenbacher-Lang

Full Text Available Aim of this study was the retrospective investigation of viral (porcine circovirus type 2 (PCV2, porcine reproductive and respiratory syndrome virus (PRRSV, torque teno sus virus type 1 and 2 (TTSuV1, TTSuV2 and bacterial (Bordetella bronchiseptica (B. b., Mycoplasma hyopneumoniae (M. h., and Pasteurella multocida (P. m. co-infections in 110 Pneumocystis spp. positive lung samples of Austrian pigs with pneumonia. Fifty-one % were positive for PCV2, 7% for PRRSV, 22% for TTSuV1, 48% for TTSuV2, 6% for B. b., 29% for M. h., and 21% for P. m. In 38.2% only viral, in 3.6% only bacterial and in 40.0% both, viral and bacterial pathogens were detected. In 29.1% of the cases a co-infection with 1 pathogen, in 28.2% with 2, in 17.3% with 3, and in 7.3% with 4 different infectious agents were observed. The exposure to Pneumocystis significantly decreased the risk of a co-infection with PRRSV in weaning piglets; all other odds ratios were not significant. Four categories of results were compared: I = P. spp. + only viral co-infectants, II = P. spp. + both viral and bacterial co-infectants, III = P. spp. + only bacterial co-infectants, and IV = P. spp. single infection. The evaluation of all samples and the age class of the weaning piglets resulted in a predomination of the categories I and II. In contrast, the suckling piglets showed more samples of category I and IV. In the group of fattening pigs, category II predominated. Suckling piglets can be infected with P. spp. early in life. With increasing age this single infections can be complicated by co-infections with other respiratory diseases.

Second-line salvage treatment of AIDS-associated Pneumocystis jirovecii pneumonia: a case series and systematic review

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Benfield, T.; Atzori, C.; Miller, R.F.

2008-01-01

BACKGROUND: Limited clinical data exist to guide the choice of second-line salvage treatment for AIDS-associated Pneumocystis jirovecii pneumonia (PCP). METHODS: We did a systematic search of MEDLINE for all randomized and observational studies of PCP treatment published up to August 2007...... and included individual treatment data of AIDS-associated PCP from a tricenter study. We calculated pooled estimates of reported outcome of second-line treatment using averaged odds ratios (ORs). RESULTS: Twenty-nine studies with sufficient detail of second-line treatment and outcome, including data from 82...... individual cases from the tricenter study, yielded a total of 468 PCP second-line treatment episodes. Response rates to second-line treatment were comparable for trimethoprim-sulfamethoxazole (TMP-SMX; 68%) and clindamycin-primaquine (73%) (OR for response = 2.1 [95% confidence interval (CI): 1.1 to 3...

Genetic characterization of UCS region of Pneumocystis jirovecii and construction of allelic profiles of Indian isolates based on sequence typing at three regions.

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Gupta, Rashmi; Mirdha, Bijay Ranjan; Guleria, Randeep; Kumar, Lalit; Luthra, Kalpana; Agarwal, Sanjay Kumar; Sreenivas, Vishnubhatla

2013-01-01

Pneumocystis jirovecii is an opportunistic pathogen that causes severe pneumonia in immunocompromised patients. To study the genetic diversity of P. jirovecii in India the upstream conserved sequence (UCS) region of Pneumocystis genome was amplified, sequenced and genotyped from a set of respiratory specimens obtained from 50 patients with a positive result for nested mitochondrial large subunit ribosomal RNA (mtLSU rRNA) PCR during the years 2005-2008. Of these 50 cases, 45 showed a positive PCR for UCS region. Variations in the tandem repeats in UCS region were characterized by sequencing all the positive cases. Of the 45 cases, one case showed five repeats, 11 cases showed four repeats, 29 cases showed three repeats and four cases showed two repeats. By running amplified DNA from all these cases on a high-resolution gel, mixed infection was observed in 12 cases (26.7%, 12/45). Forty three of 45 cases included in this study had previously been typed at mtLSU rRNA and internal transcribed spacer (ITS) region by our group. In the present study, the genotypes at those two regions were combined with UCS repeat patterns to construct allelic profiles of 43 cases. A total of 36 allelic profiles were observed in 43 isolates indicating high genetic variability. A statistically significant association was observed between mtLSU rRNA genotype 1, ITS type Ea and UCS repeat pattern 4. Copyright © 2012 Elsevier B.V. All rights reserved.

Infrequent detection of Pneumocystis jirovecii by PCR in oral wash specimens from TB patients with or without HIV and healthy contacts in Tanzania

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Jensen, Lotte; Jensen, Andreas V.; Praygod, George

2010-01-01

In tuberculosis (TB) endemic parts of the world, patients with pulmonary symptoms are managed as "smear-negative TB patients" if they do not improve on a two-week presumptive, broad-spectrum course of antibiotic treatment even if they are TB microscopy smear negative. These patients are frequently...... HIV positive and have a higher mortality than smear-positive TB patients. Lack of access to diagnose Pneumocystis jirovecii pneumonia might be a contributing reason. We therefore assessed the prevalence of P. jirovecii by PCR in oral wash specimens among TB patients and healthy individuals in an HIV...

Does cytomegalovirus predict a poor prognosis in Pneumocystis carinii pneumonia treated with corticosteroids? A note for caution

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Jensen, A M; Lundgren, Jens Dilling; Benfield, T

1995-01-01

treated with adjunctive CS who had CMV cultured from BAL fluid had a two times higher mortality within 3 months from bronchoscopy than others (p = 0.08). This difference could not be explained by differences in CD4 count, PO2 or PCO2 at time of bronchoscopy. CONCLUSION: With the accepted usage...... of adjunctive CS in severe PCP, the role of CMV as a pulmonary copathogen may have changed. Active CMV infection may be an important cause of failing treatment of severe PCP in those treated with adjunctive CS....

Extreme Tetralogy of Fallot With Polycythemia in a Ferret (Mustela putorius furo).

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Dias, Sara; Planellas, Marta; Canturri, Albert; Martorell, Jaume

2017-06-01

A 5-month-old, intact male ferret (Mustela putorius furo) was presented with apathy, tachypnea and exercise intolerance. On initial physical examination, tachypnea and cyanosis were the two primary clinical signs detected. The complete blood count also revealed a severe polycythemia, with lymphopenia, neutrophilia and eosinophilia. Further diagnostic imaging tests were performed. The thoracic radiographs revealed cardiomegaly and a diffuse alveolar pulmonary pattern. Consequently, an echocardiography was performed and showed an interventricular septal defect, pulmonic artery occlusion, overriding of the aorta and right ventricle hypertrophy. All abnormalities were compatible with a tetralogy of Fallot (TOF). As a treatment plan, a phlebotomy was performed and the ferret was posteriorly maintained with oxygen and fluid therapy. The following day, the hematocrit decreased 11% and the respiratory distress improved. Four days later, the ferret got clinically worse and was euthanized. A necropsy was performed and confirmed the presence of an extreme TOF with a diffused interstitial pneumonia secondary to Pneumocystis carinii. To the author's knowledge, this is the first report of an extreme tetralogy of Fallot with polycythemia in a ferret. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevention of bone marrow cell apoptosis and regulation of hematopoiesis by type I IFNs during systemic responses to pneumocystis lung infection.

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Taylor, David; Wilkison, Michelle; Voyich, Jovanka; Meissner, Nicole

2011-05-15

We recently demonstrated that lack of type I IFN signaling (IFNAR knockout) in lymphocyte-deficient mice (IFrag(-/-)) results in bone marrow (BM) failure after Pneumocystis lung infection, whereas lymphocyte-deficient mice with intact IFNAR (RAG(-/-)) had normal hematopoiesis. In the current work, we performed studies to define further the mechanisms involved in the induction of BM failure in this system. BM chimera experiments revealed that IFNAR expression was required on BM-derived but not stroma-derived cells to prevent BM failure. Signals elicited after day 7 postinfection appeared critical in determining BM cell fate. We observed caspase-8- and caspase-9-mediated apoptotic cell death, beginning with neutrophils. Death of myeloid precursors was associated with secondary oxidative stress, and decreasing colony-forming activity in BM cell cultures. Treatment with N-acetylcysteine could slow the progression of, but not prevent, BM failure. Type I IFN signaling has previously been shown to expand the neutrophil life span and regulate the expression of some antiapoptotic factors. Quantitative RT-PCR demonstrated reduced mRNA abundance for the antiapoptotic factors BCL-2, IAP2, MCL-1, and others in BM cells from IFrag(-/-) compared with that in BM cells from RAG(-/-) mice at day 7. mRNA and protein for the proapoptotic cytokine TNF-α was increased, whereas mRNA for the growth factors G-CSF and GM-CSF was reduced. In vivo anti-TNF-α treatment improved precursor cell survival and activity in culture. Thus, we propose that lack of type I IFN signaling results in decreased resistance to inflammation-induced proapoptotic stressors and impaired replenishment by precursors after systemic responses to Pneumocystis lung infection. Our finding may have implications in understanding mechanisms underlying regenerative BM depression/failure during complex immune deficiencies such as AIDS.

Pneumocystis Pneumonia in Non-HIV Pregnant Women Receiving Chemotherapy for Malignant Lymphoma: Two Case Reports

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Yuki Fukutani

2017-01-01

Full Text Available Pneumocystis pneumonia (PCP is a life-threatening opportunistic infection that sometimes occurs in immunocompromised patients with human immunodeficiency virus (HIV. Here, we report two extremely rare cases of PCP in non-HIV pregnant women who underwent chemotherapy for malignant lymphoma. Case  1 is a 34-year-old primigravida who was diagnosed with Hodgkin’s lymphoma. She received ABVD chemotherapy and developed PCP at 37 weeks of gestation. After the onset of PCP, emergent cesarean section was performed due to a nonreassuring fetal status. Case  2 is a 31-year-old multigravida with diffuse large B-cell lymphoma who was administered R-CHOP chemotherapy. At 34 weeks of gestation, she complained of dyspnea and developed PCP. She delivered her baby vaginally immediately after the onset of symptoms. Both patients were treated with sulfamethoxazole-trimethoprim (ST and recovered shortly thereafter. The babies’ courses were also uneventful. PCP remains a serious cause of death, especially in non-HIV patients, and, therefore, appropriate prophylaxis and a prompt diagnosis are imperative.

Nonadherence to primary prophylaxis against Pneumocystis jirovecii pneumonia.

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James D Heffelfinger

Full Text Available Despite the effectiveness of prophylaxis, Pneumocystis jirovecii pneumonia (PCP continues to be the most common serious opportunistic infection among HIV-infected persons. We describe factors associated with nonadherence to primary PCP prophylaxis.We used 2000-2004 data from the Supplement to HIV/AIDS Surveillance (SHAS project, a cross-sectional interview project of HIV-infected persons >or=18 years conducted in 18 states. We limited the analysis to persons who denied having prior PCP, reported having a current prescription to prevent PCP, and answered the question "In the past 30 days, how often were you able to take the PCP medication(s exactly the way your doctor told you to take them?" We used multivariable logistic regression to describe factors associated with nonadherence. Of 1,666 subjects prescribed PCP prophylaxis, 305 (18.3% were nonadherent. Persons were more likely to be nonadherent if they reported using marijuana (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI] = 1.1-2.4, non-injection drugs other than marijuana (aOR = 1.5, 95% CI = 1.0-2.1, or injection drugs (aOR = 2.3, 95% CI = 1.3-4.1 in the past year; their mental health was "not good" for >or=1 day during the past month (aOR = 1.6, 95% CI = 1.2-2.2; their most recent CD4 count was <200 cells/microL (aOR = 1.6, 95% CI = 1.1-2.2; or taking ART usually (aOR = 9.6, 95% CI = 6.7-13.7 or sometimes/rarely/never (aOR = 18.4, 95% CI = 11.1-30.4, compared with always, as prescribed.Providers should inquire about and promote strategies to improve adherence to PCP prophylaxis, particularly among persons who use illicit drugs, have mental health issues, and who are not compliant with ART to reduce the occurrence of PCP.

Atovaquone versus trimethoprim-sulfamethoxazole as Pneumocystis jirovecii pneumonia prophylaxis following renal transplantation.

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Gabardi, Steven; Millen, Peter; Hurwitz, Shelley; Martin, Spencer; Roberts, Keri; Chandraker, Anil

2012-01-01

Pneumocystis pneumonia (PCP) is associated with significant morbidity and mortality in renal transplant recipients (RTR). Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the prophylactic agent-of-choice. Some patients require an alternative owing to TMP-SMZ intolerance. This is the first evaluation of full-dose atovaquone vs. TMP-SMZ for PCP prevention in RTR. One hundred and eighty-five RTR were evaluated in this single-center, retrospective analysis. Patients received either single-strength TMP-SMZ daily (group I; n = 160) or 1500 mg/d of atovaquone and of a fluoroquinolone for one month (group II; n = 25). The primary endpoint was the incidence of PCP at 12 months post-transplant. There were no cases of PCP in either group. There were comparable rates of infections from bacterial pathogens and cytomegalovirus, but rates of BK viremia were significantly higher in group I (22.5%) vs. group II (4%; p = 0.03). The incidence of leukopenia was similar in both groups. Higher mean potassium levels were seen in group I at three months post-transplant but were comparable at all other time points. The need for dose reduction and/or premature discontinuation of therapy secondary to adverse events was more prevalent in TMP-SMZ-treated patients. In our experience, atovaquone appears to be effective in preventing PCP post-renal transplant and also demonstrates good tolerability. © 2012 John Wiley & Sons A/S.

Lung fibrosis in deceased HIV-infected patients with Pneumocystis pneumonia

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Erica J Shaddock

2012-06-01

Full Text Available Background. Pneumocystis pneumonia (PcP is one of the most common opportunistic infections found in patients with HIV. The prognosis if ventilation is required is poor, with mortality of 36 - 80%. Although more recent studies have shown improved survival, our experience has been that close to 100% of such patients die, and we therefore decided to investigate further. Methods. All patients with confirmed or suspected PcP who died owing to respiratory failure were eligible for the study. Where consent was obtained, trucut lung biopsies were performed post mortem, stored in formalin and sent for histopathological assessment. Results. Twelve adequate lung biopsies were obtained from 1 July 2008 to 28 February 2011 – 3 from men and 9 from women. The mean age was 34.7 years (range 24 - 46, and the mean admission CD4 count was 20.8 (range 1 - 68 cells/μl and median 18.5 cells/μl. All specimens demonstrated typical PcP histopathology; in addition, 9 showed significant interstitial fibrosis. Three had co-infection with cytomegalovirus (CMV, two of which had fibrosis present. There was no evidence of TB or other fungal infections. Conclusion. The high mortality seen in this cohort of PcP patients was due to intractable respiratory failure from interstitial lung fibrosis. whereas the differential includes ventilator induced lung injury, drug resistance or co-infections, we suggest that this is part of the disease progression in certain individuals. Further studies are required to identify interventions that could modify this process and improve outcomes in patients with PcP who require mechanical ventilation. S Afr J HIV Med 2012;13(2:64-67.

Immune reconstitution inflammatory syndrome in HIV-infected patients with Pneumocystis jirovecii pneumonia.

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Roade Tato, Luisa; Burgos Cibrian, Joaquín; Curran Fábregas, Adrià; Navarro Mercadé, Jordi; Willekens, Rein; Martín Gómez, María Teresa; Ribera Pascuet, Esteban; Falcó Ferrer, Vicenç

2017-11-26

The incidence of immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients after an episode of Pneumocystis jirovecii pneumonia (PJP) seems to be lower than with other opportunistic infections. We conducted an observational study in order to determine the incidence, clinical characteristics and outcome of patients diagnosed with PJP-related IRIS. We conducted an observational study of HIV patients diagnosed with PJP-related IRIS from January 2000 to November 2015. We analyzed epidemiological and clinical characteristics as well as laboratory findings. We also carried out a systematic review of published cases. Six cases of IRIS out of 123 (4.9%) HIV-infected patients with PJP who started ART were diagnosed. All six cases were men with a median age of 34 (IQR: 8) years. The six patients developed paradoxical IRIS. Subjects younger than 40 years old (p=0.084) and with an HIV-RNA viral load >100000 copies/ml (p=0.081) at diagnosis showed a tendency to develop IRIS. Thirty-seven published cases of PJP-related IRIS were identified. Although 51% of cases involved respiratory failure, no deaths were reported. PJP-related IRIS is rare condition compared to other opportunistic infections. It can lead to a severe respiratory failure in a significant proportion of cases, although no deaths have been reported. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Interleukin-8 and eicosanoid production in the lung during moderate to severe Pneumocystis carinii pneumonia in AIDS: a role of interleukin-8 in the pathogenesis of P. carinii pneumonia

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Benfield, T L; van Steenwijk, R; Nielsen, T L

1995-01-01

(PG) and leukotrienes (LT)] are pro-inflammatory mediators released from arachidonic acid by action of phospholipase A2 (PLA2) and have been implicated in the host response to micro-organisms. Bronchoalveolar lavage (BAL) was performed on patients with PCP as part of a randomized study of adjuvant...... of IL-8 as a mediator in the pathogenesis of PCP, whereas the role of eicosanoids seems less clear....

Detection of Pneumocystis jirovecii by nested PCR in HIV-negative patients with pulmonary disease.

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Santos, Cristina Rodrigues; de Assis, Ângela M; Luz, Edson A; Lyra, Luzia; Toro, Ivan F; Seabra, José Claudio C; Daldin, Dira H; Marcalto, Tathiane U; Galasso, Marcos T; Macedo, Ronaldo F; Schreiber, Angélica Z; Aoki, Francisco H

Nested PCR can be used to determine the status of Pneumocystis jirovecii infection in other lung diseases. This study sought to detect a target DNA fragment (mitochondrial large subunit rRNA or mtL SUrRNA) of P. jirovecii in patients with lung disease who underwent bronchoscopy with collection of bronchoalveolar lavage (BAL). The results from toluidine blue staining were compared with those obtained using molecular methods that included an "in house" DNA extraction procedure, PCR and nested PCR. Fifty-five BAL samples from patients with atypical chest X-rays were screened for P. jirovecii. None of the samples was positive for P. jirovecii using toluidine blue staining. In contrast, P. jirovecii DNA was detected by nested PCR in BAL samples from 36 of 55 patients (65.5%). The lung diseases in the patients included cancer, pneumonia, tuberculosis, and chronic obstructive pulmonary disease (COPD). Other chronic problems in the patients included hypertension, diabetes, smoking, and alcoholism. Nested PCR showed high sensitivity for detecting P. jirovecii, especially when compared with toluidine blue staining. Using this method, P. jirovecii infection was detected in HIV-negative patients with lung disease. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

[Immunohistochemistry diagnosis of fungal infections].

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Rocha, D C; Duarte, M I; Pagliari, C; de Oliveira, M S

1998-01-01

Because the mycosis incidence has increased a lot with the appearing of AIDS, the Immunohistochemistry study among fungus shows the importance of fast methods for their identification that have advantage of been a durable method in comparison with immunofluorescence and the possibility of making retrospective studies in material embedded in paraffin. The Immunohistochemistry reaction with Histoplasma capsulatum, Pneumocystis carinii; and Criptococcus neoformans antibodies were sensitive, specifics, and intensely positive in all the cases previously diagnosed as Histoplasmosis, Pneumocystosis and Cryptococcosis, without cross-reaction with other fungus; while the anti-Candida albicans antibody showed weak positiveness in four Histoplasmosis cases, in one of Paracoccidioidomycosis cases and Sporotrichosis case; and the reactions with the antibody anti-P. brasiliensis were intensely positive in all the Paracoccidioidomycosis cases and weakly positive in two Histoplasmosis and two of the four Candidiasis cases. The previous identification of each fungi on tissue sample was made by Grocott method. This preliminary study showed that it is necessary to use other kinds of antibody and fungus, in order to get more details about the possible occurrence of cross-reactions. We suggest the use of new antibodies, with new standardizations in order to find the best titles for each reaction and eliminate the cross-reactions.

S-adenosylmethionine decarboxylase inhibitors: new aryl and heteroaryl analogues of methylglyoxal bis(guanylhydrazone).

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Stanek, J; Caravatti, G; Capraro, H G; Furet, P; Mett, H; Schneider, P; Regenass, U

1993-01-08

A series of 3-acylbenzamidine (amidino)hydrazones 7a-h, the corresponding (hetero)aromatic congeners 7i-p, and 3,3'-bis-amidino-biaryls 25a-e were synthesized. The hydrazones 7a-p were prepared by conversion of the corresponding acyl nitriles 1a,c-d,i,n-p to the imido esters 3a,c-d,i and the amidines 5a,c-d,h-i, followed by a reaction with aminoguanidine, or vice versa. Similarly, the biaryl 3,3'-dinitriles 23a-e were converted, via the imino esters 24a-c or the imino thioesters 27d-e, to the diamidines 25a-e. These new products are conformationally constrained analogues of methylglyoxal bis(guanylhydrazone) (MGBG). They are up to 100 times more potent as inhibitors of rat liver S-adenosylmethionine decarboxylase (SMDC) and generally less potent inhibitors of rat small intestine diamine oxidase (DAO) than MGBG. Some of these SAMDC inhibitors, e.g., compounds 7a, 7e, 7i, 25a, and 25d, have shown antiproliferative effects against T24 human bladder carcinoma cells. These products, whose structure-activity relationships are discussed, are of interest as potential anticancer agents and drugs for the treatment of protozoal and Pneumocystis carinii infections.

Negative role of malnutrition in cell-mediated immune response: Pneumocystis jirovecii pneumonia (PCP) in a severely malnourished, HIV-negative patient with anorexia nervosa.

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Hanachi, Mouna; Bohem, Vanessa; Bemer, Pauline; Kayser, Nadja; de Truchis, Pierre; Melchior, Jean-Claude

2018-06-01

It is generally acknowledged that malnutrition is a propensity factor for secondary infections in different clinical situations (malnutrition-associated infections in hospitalized patients and malnourished children in developing countries). However, it is not clear how malnutrition might facilitate the development of opportunistic infections in human immunodeficiency virus (HIV)-negative patients without a definite etiology (disease or treatment) of impaired cell-mediated immune response. We report here on a case of Pneumocystis jirovecii pneumonia in an HIV-negative patient suffering from anorexia nervosa with extreme malnutrition, which had a favorable outcome despite the severity of her respiratory failure. This report indicates the need for the early screening of nutritional status and rapid treatment initiation in patients with malnutrition, as well as the determination of opportunistic infections in the event of a low lymphocyte count. Copyright © 2018. Published by Elsevier Ltd.

Pneumocystis jirovecii pneumonia in systemic autoimmune rheumatic disease: A case-control study.

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Tadros, Susan; Teichtahl, Andrew J; Ciciriello, Sabina; Wicks, Ian P

2017-06-01

Pneumocystis jirovecii pneumonia (PJP) is an opportunistic fungal infection that affects the immunocompromised. Patients with systemic autoimmune rheumatic disease are increasingly recognised as an at-risk clinical population with a high mortality. This case-control study examined differences in the characteristics and peripheral blood parameters between patients with systemic autoimmune rheumatic disease who developed PJP and gender, age and disease-matched controls. Historical data collected between 2002 and 2013 at the Royal Melbourne Hospital, Australia were reviewed. Cases were defined by having a systemic autoimmune rheumatic disease and a diagnosis of PJP (either a positive toluidine blue O stain or P. jirovecii PCR, with a concurrent respiratory illness that was clinically consistent with PJP). Controls were matched for age, gender and disease in a 4:1 ratio. Peripheral blood results were retrieved from an in-house pathology database. Clinical information including glucocorticoid exposure, PJP prophylaxis, comorbidities and month of admission were retrieved from medical notes. After adjustment for corticosteroid exposure and C-reactive protein, lymphocyte count on admission (0.4 vs. 1.3; p = 0.04) and at nadir (0.2 vs. 0.8 × 10 9 /L; p = 0.05) was significantly lower in cases than in controls. Cases (n = 11) were more frequently Caucasian rather than non-Caucasian (81.8% vs. 65.9%; p = 0.04). In addition, cases more commonly presented in autumn (March to May) than in other seasons (OR = 7.3; 95% CI: 1.4-38.7; p = 0.02). These data demonstrate that patients with systemic autoimmune rheumatic disease who develop PJP have significantly greater lymphopenia than age, gender and disease-matched controls, independent of corticosteroid exposure, as well as a potential ethnicity and seasonal predilection to PJP. This may help to inform prophylactic guidelines for PJP in these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-term outcomes of liver transplant patients with human immunodeficiency virus infection and end-stage-liver-disease: single center experience

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Vernadakis S

2011-08-01

Full Text Available Abstract Objective Orthotopic-liver-transplantation (OLT in patients with Human-Immunodeficiency-Virus infection (HIV and end-stage-liver-disease (ESDL is rarely reported. The purpose of this study is to describe our institutional experience on OLT for HIV positive patients. Material and methods This is a retrospective study of all HIV-infected patients who underwent OLT at the University Hospital of Essen, from January 1996 to December 2009. Age, sex, HIV transmission-way, CDC-stage, etiology of ESDL, concomitant liver disease, last CD4cell count and HIV-viral load prior to OLT were collected and analysed. Standard calcineurin-inhibitors-based immunosuppression was applied. All patients received anti-fungal and anti-pneumocystis carinii pneumonia prophylaxis post-OLT. Results Eight transplanted HIV-infected patients with a median age of 46 years (range 35-61 years were included. OLT indications were HCV (n = 5, HBV (n = 2, HCV/HBV/HDV-related cirrhosis (n = 1 and acute liver-failure (n = 1. At OLT, CD4 cell-counts ranged from 113-621 cells/μl, and HIV viral-loads from Conclusions OLT in HIV-infected patients and ESLD is an acceptable therapeutic option in selected patients. Long-term survival can be achieved without HIV disease-progression under antiretroviral therapy and management of the viral hepatitis co-infection.

Technetium-99m DTPA aerosol and gallium scanning in acquired immune deficiency syndrome

International Nuclear Information System (INIS)

Picard, C.; Meignan, M.; Rosso, J.; Cinotti, L.; Mayaud, C.; Revuz, J.

1987-01-01

In 11 non-smoking AIDS patients suspected of pneumocystis carinii pneumonia (PCP), the results of Tc-99m DTPA aerosol clearances, gallium scans, and arterial blood gases were compared with those of bronchoalveolar lavage (BAL). Nine patients had PCP. All had increased clearances five times higher than the normal (5.6 +/- 2.3% X min-1 vs 1.1 +/- 0.34% X min-1, N = 10, P less than 0.001), suggesting an increased alveolar permeability. Gallium scans were abnormal in six patients but normal or slightly abnormal in the three others. Four of these nine patients had normal chest x-rays. In two of these the gallium scan was abnormal, but in the two others, only the increased Tc-99m DTPA clearances showed evidence of lung disease. Two patients had normal BAL, with normal clearances and gallium scans. Four out of the nine patients with PCP were studied after treatment. Three recovered and had normal clearance and gallium scans. One still had PCP with increased clearance but normal gallium scan. Gallium scanning and Tc-99m DTPA clearance are useful for detecting lung disease in AIDS patients with suspected PCP and for prompting BAL when chest x-rays and PaO 2 levels are normal. Due to its high sensitivity, a normal Tc-99m DTPA clearance could avoid BAL

Measles mimicking HIV seroconversion syndrome: a case report

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Brook Gary

2010-02-01

Full Text Available Abstract Introduction Measles is on the rise in the United Kingdom and must be considered in the differential diagnosis of any patient presenting with fever and rash. As a highly infectious disease, identified patients must be isolated in the hospital setting. Case presentation A 28-year-old Polish woman presented ill to the accident and emergency department of a district general hospital. She had painful genital ulceration, oral soreness, fever, and a facial rash. She became hypoxic within 24 hours of presentation and began to tire, thus requiring noninvasive ventilation. Her respiratory symptoms were out of proportion to the findings of her chest radiograph, which remained virtually normal. Human immunodeficiency virus seroconversion syndrome complicated by Pneumocystis carinii pneumonia was high among the differential diagnoses. She was given cotrimoxazole, high-dose steroids, broad spectrum antibiotics, and anti fungal cover. Human immunodeficiency virus polymerase chain reaction came back as negative and her symptoms resolved within 10 days of presentation. She was taken off all treatment and discharged home feeling well. Serological measles was confirmed as part of a viral screen, but its clinical suspicion was low. Conclusion The presentation of measles in this patient was unique and atypical. With its incidence rising in the United Kingdom, measles must be increasingly considered as a differential diagnosis in patients presenting with fever and rash.

111In-labeled nonspecific immunoglobulin scanning in the detection of focal infection

International Nuclear Information System (INIS)

Rubin, R.H.; Fischman, A.J.; Callahan, R.J.; Khaw, B.A.; Keech, F.; Ahmad, M.; Wilkinson, R.; Strauss, H.W.

1989-01-01

We performed radionuclide scanning after the intravenous injection of human IgG labeled with indium-111 in 128 patients with suspected focal sites of inflammation. Localization of 111In-labeled IgG correlated with clinical findings in 51 infected patients (21 with abdominal or pelvic infections, 11 with intravascular infections, 7 with pulmonary infections, and 12 with skeletal infections). Infecting organisms included gram-positive bacteria, gram-negative bacteria, Pneumocystis carinii, Mycoplasma pneumoniae, and Candida albicans. No focal localization of 111In-labeled IgG was observed in 63 patients without infection. There were five false negative results, and nine results were unusable. Serial scans were carried out in eight patients: continued localization correctly predicted relapse in six, and the absence of localization indicated resolution in two. To determine whether 111In-labeled IgG localization was specific for inflammation, we studied 16 patients with cancer. Focal localization occurred in 13 of these patients (5 with melanomas, 5 with gynecologic cancers, and 1 each with lymphoma, prostate cancer, and malignant fibrous histiocytoma). No localization was seen in patients with renal or colon cancer or metastatic medullary carcinoma of the thyroid. We conclude that 111In-labeled IgG imaging is effective for the detection of focal infection and that serial scans may be useful in assessing therapeutic efficacy. This technique may also be helpful in the evaluation of certain cancers

Diagnostic performance of the (1-3-β-D-glucan assay in patients with Pneumocystis jirovecii compared with those with candidiasis, aspergillosis, mucormycosis, and tuberculosis, and healthy volunteers.

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Hyo-Ju Son

Full Text Available Diagnosis of pneumocystis pneumonia (PCP relies on microscopic visualization of P. jirovecii, or detection of Pneumocystis DNA in respiratory specimens, which involves invasive procedures such as bronchoalveolar lavage. The (1-3-β-D-glucan (BG assay has been proposed as a less invasive and less expensive diagnostic test to rule out PCP. We therefore compared blood levels of BG in patients with PCP with those of patients with candidemia, chronic disseminated candidiasis (CDC, invasive aspergillosis, mucormycosis, and tuberculosis and those of healthy volunteers.Adult patients who were diagnosed with PCP, candidemia, CDC, invasive aspergillosis, mucormycosis, and tuberculosis whose blood samples were available, and healthy volunteers were enrolled in a tertiary hospital in Seoul, South Korea, during a 21-month period. The blood samples were assayed with the Goldstream Fungus (1-3-β-D-glucan test (Gold Mountain River Tech Development, Beijing, China.A total of 136 individuals including 50 patients P. jirovecii,15 candidemia, 6 CDC, 15 invasive aspergillosis, 10 mucormycosis, and 40 controls (20 TB and 20 healthy volunteers were included. The mean±SD of the concentration of 1-3-β-D-glucan in the patients with PCP (290.08 pg/mL±199.98 were similar to those of patients with candidemia (314.14 pg/mL±205.60, p = 0.90 at an α = 0.005 and CDC (129.74 pg/mL±182.79, p = 0.03 at an α = 0.005, but higher than those of patients with invasive aspergillosis (131.62 pg/mL±161.67, p = 0.002 at an α = 0.005, mucormycosis (95.08 pg/mL±146.80, p 31.25 pg/mL, which is highly sensitive for PCP versus tuberculosis plus healthy volunteers at the expense of specificity, the BG assay had a sensitivity of 92% (95% CI 81%-98% and a specificity of 55% (95% CI 39%-71%.The BG assay appears to be a useful adjunct test for PCP.

[Pneumocystis jiroveci pneumonia: Clinical characteristics and mortality risk factors in an Intensive Care Unit].

Science.gov (United States)

Solano L, M F; Alvarez Lerma, F; Grau, S; Segura, C; Aguilar, A

2015-01-01

To describe the epidemiological characteristics of the population with Pneumocystis jiroveci (P. jiroveci) pneumonia, analyzing risk factors associated with the disease, predisposing factors for admission to an intensive care unit (ICU), and prognostic factors of mortality. A retrospective observational study was carried out, involving a cohort of patients consecutively admitted to a hospital in Spain from 1 January 2007 to 31 December 2011, with a final diagnosis of P. jiroveci pneumonia. The ICU and hospitalization service of Hospital del Mar, Barcelona (Spain). We included 36 patients with pneumonia due to P. jiroveci. Of these subjects, 16 required ICU admission (44.4%). The average age of the patients was 41.3 ± 12 years, and 23 were men (63.9%). A total of 86.1% had a history of human immunodeficiency virus (HIV) infection, and the remaining 13.9% presented immune-based disease subjected to immunosuppressive therapy. Risk factors associated to hospital mortality were age (51.8 vs. 37.3 years, P=.002), a higher APACHE score upon admission (17 vs. 13 points, P=.009), the need for invasive mechanical ventilation (27.8% vs. 11.1%, P=.000), requirement of vasoactive drugs (25.0% vs. 11.1%, P=.000), fungal coinfection (22.2% vs. 11.1%, P=.001), pneumothorax (16.7% vs. 83.3%, P=.000) and admission to the ICU (27.8% vs. 72.2% P=.000). The high requirement of mechanical ventilation and vasoactive drugs associated with fungal coinfection and pneumothorax in patients admitted to the ICU remain as risk factors associated with mortality in patients with P. jiroveci pneumonia. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Clinical Course, Radiological Manifestations, and Outcome of Pneumocystis jirovecii Pneumonia in HIV Patients and Renal Transplant Recipients.

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Lukas Ebner

Full Text Available Pneumocystis jirovecii pneumonia (PCP is a frequent opportunistic infection in immunocompromised patients. In literature, presentation and outcome of PCP differs between patients with human immunodeficiency virus (HIV infection and renal transplant recipients (RTRs.We conducted a cross-sectional study of patients with PCP based on the HIV and renal transplant registries at our institution. Radiological and clinical data from all confirmed PCP cases between 2005 and 2012 were compared.Forty patients were included: 16 with HIV and 24 RTRs. Radiologically, HIV patients had significantly more areas of diffuse lung affection (81% HIV vs. 25% RTR; p = 0.02, more ground glass nodules 5-10 mm (69% vs. 4%; p = 80% in both groups. Duration from illness onset to hospital presentation was longer in the HIV patients (median of 18 vs. 10 days (p = 0.02, implying a less fulminant clinical course. Sixty percent of PCP cases in RTRs occurred >12 months after transplantation. Lengths of hospitalization, admission rates to the intensive care unit, and requirements for mechanical ventilation were similar. Outcome in both groups was favourable.While important differences in radiological presentation of PCP between HIV patients and RTRs were found, clinical presentation was similar. PCP only rarely presented with fulminant respiratory symptoms requiring ICU admission, with similar results and outcomes for HIV patients and RTRs. Early diagnosis and treatment is mandatory for clinical success.

Prevalence and Genotype Distribution of Pneumocystis jirovecii in Cuban Infants and Toddlers with Whooping Cough

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Monroy-Vaca, Ernesto X.; de Armas, Yaxsier; Illnait-Zaragozí, María T.; Toraño, Gilda; Diaz, Raúl; Vega, Dania; Alvarez-Lam, Ileana; Calderón, Enrique J.

2014-01-01

This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P = 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P = 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii. PMID:24131683

Sensitivity and specificity of Ga-67 pulmonary scans for the detection of p. carinii pneumonitis in patients with the acquired immunodefficiency syndrome and pulmonary symptoms

International Nuclear Information System (INIS)

Hattner, R.S.; Sollitto, R.A.; Golden, J.A.; Coleman, D.L.; Okerlund, M.D.

1984-01-01

Acquired immunodeficiency syndrome (AIDS) is a severe disorder of cellular immunity of obscure etiology. Since its original recognition in 1981 the incidence of AIDS has doubled in each of the succeeding six months. The most common causes of death in AIDS are Kaposi's sarcoma and p. carinii pneumonia (PCP). The latter is treatable if diagnosed early, and AIDS patients (pts) may suffer recurrent episodes of PCP. Since the invasive technique of fiberoptic bronchoscopy with transbronchial biopsy, brushing, and bronchialveolar lavage are necessary for diagnosis and follow-up a noninvasive method of categorizing which AIDS pts require this procedure would be most welcome. Twenty-one pts with the syndrome of AIDS and pulmonary symptoms underwent Ga-67 scans of the thoracic region, and fibroptic bronchoscopy with washings, and brush and transbronchial biopsy. Pulmonary activity was graded in a blinded fashion by three experienced observers as follows: 1, less than, or equal to adjacent soft tissues; 2, greater than adjacent soft tissues, but less than liver; 3, equal to liver; 4, greater than liver. Eleven pts had documented PCP, and the remaining ten had non-specific pulmonary inflammation, or other, in some cases, putative, infections. The sensitivity and specificity of Ga-67 scans ≥ grade 3 was 100% and 90% respectively. These results suggests a useful role for graded Ga-67 scans in AIDS pts with pulmonary symptoms, permitting selection of pts with a high risk of PCP for further mandatory invasive investigation of this otherwise usually fatal disease

Estudo temporal das doenças associadas à AIDS no Brasil, 1980-1999

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Mark Drew Crosland Guimarães

Full Text Available Neste trabalho foram estimadas as incidências de condições associadas (CA à AIDS/100 casos de AIDS em adultos (> 12 anos, a nível nacional, de 1980 a maio de 1999. A análise incluiu qui-quadrado e regressão linear simples. As CA analisadas foram candidíase (CD, tuberculose (TB, pneumonia por Pneumocystis carinii (PCP, neurotoxoplasmose(NT, Herpes, Sarcoma de Kaposi (SK, meningite criptocócica (MC e infecções por protozoários (IP. As incidências acumuladas/100 casos de AIDS foram: CD = 59, TB = 26, PCP = 23, NT = 15, Herpes = 12, SK = 5, MC = 4 e IP = 4. A tendência anual indicou queda estatisticamente significativa em todas as CA. Entretando, houve aumento na incidência de TB (b = 0,39 e NT (b = 0,20, para as regiões Nordeste e Centro-Oeste, respectivamente. TB apresentou maior incidência entre aqueles com baixa escolaridade (< 8 anos, enquanto que PCP e SK tiveram maiores incidências entre aqueles com melhor escolaridade (8+ anos, apesar de declínios semelhantes. Acesso à terapia anti-retroviral e profilaxias para as CA explicam parcialmente estes resultados. Entretanto, a confiabilidade dos dados, o atraso na notificação, a incidência de CA pós-AIDS, bem como os critérios de notificação e diagnóstico, são fatores que devem ser avaliados.

Estudo temporal das doenças associadas à AIDS no Brasil, 1980-1999

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Guimarães Mark Drew Crosland

2000-01-01

Full Text Available Neste trabalho foram estimadas as incidências de condições associadas (CA à AIDS/100 casos de AIDS em adultos (> 12 anos, a nível nacional, de 1980 a maio de 1999. A análise incluiu qui-quadrado e regressão linear simples. As CA analisadas foram candidíase (CD, tuberculose (TB, pneumonia por Pneumocystis carinii (PCP, neurotoxoplasmose(NT, Herpes, Sarcoma de Kaposi (SK, meningite criptocócica (MC e infecções por protozoários (IP. As incidências acumuladas/100 casos de AIDS foram: CD = 59, TB = 26, PCP = 23, NT = 15, Herpes = 12, SK = 5, MC = 4 e IP = 4. A tendência anual indicou queda estatisticamente significativa em todas as CA. Entretando, houve aumento na incidência de TB (b = 0,39 e NT (b = 0,20, para as regiões Nordeste e Centro-Oeste, respectivamente. TB apresentou maior incidência entre aqueles com baixa escolaridade (< 8 anos, enquanto que PCP e SK tiveram maiores incidências entre aqueles com melhor escolaridade (8+ anos, apesar de declínios semelhantes. Acesso à terapia anti-retroviral e profilaxias para as CA explicam parcialmente estes resultados. Entretanto, a confiabilidade dos dados, o atraso na notificação, a incidência de CA pós-AIDS, bem como os critérios de notificação e diagnóstico, são fatores que devem ser avaliados.

Ground-glass opacity at high resolution CT: an approach for differential diagnosis

International Nuclear Information System (INIS)

Spina, Juan C.; Rogondino, Jose; Vidales, Valeria; Rolnik, Maria C.; Montanari, Mariano; Salazar, Santiago N.

2004-01-01

Purpose: To evaluate the Ground-Glass Opacity in high resolution computed tomography (HRCT) with its underlying abnormality and anatomic distribution and its correlation with different etiologies. Methods: A 38 patients series, (32 men, 16 women, mean age 54,6 years, range 20-28) was retrospectively analyzed. They were evaluated with high resolution computed tomography, 2 mm thick sections and 10 mm of interval. Contrast intravenous iodinated contrast (no-ionic) was injected in 11 patients. The final diagnosis was made with sputum analysis, bronchioalveolar lavage, trans bronchial biopsy and open lung biopsy. Results: The differential diagnosis of ground glass opacity is based on analyzing their anatomic resolution and the underlying pathology in the lung parenchyma. Centrilobular distribution indicated early air-spaces pathology produced in our series by 21 infections, 4 pulmonary hemorrhages, 1 hypersensitivity pneumonitis and 1 descamative interstitial pneumonitis. Panlobular distribution, alveolar proteinosis (1 case) sarcoidosis (1 case) drug toxicity 1 case and one case of pneumocystis carinii. Peripherical distribution typical of early idiopathic fibrosis (1). Bronchiolitis obliterans with organizing pneumonia (1). Structural alterations of the lung parenchyma with bronchiectasias was seen in 16 cases, cystic lesions in 3 cases, sub pleural linear opacities 4 cases, peribronchovascular interstitial thickening or nodularity and emphysema in 10 cases. Conclusion: HRCT is useful to evaluate ground glass opacities pattern with the anatomic distribution and the underlying structural pathology. These findings under some clinical circumstances can suggest a specific diagnosis in most cases, indicating a potentially treatable disease. (author)

Abnormal chest shadow on CT in immunosuppressed patients

International Nuclear Information System (INIS)

Tanaka, Nobuyuki; Matsumoto, Tsuneo; Nakamura, Hiroshi

1992-01-01

An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients. (author)

Pulmonary infection in patients with cyclosporine, azathioprine, and corticosteroids after cardiac transplantation; Clinical and radiographic assessment

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Murayama, Sadayuki; Ikezoe, Junpei; Godwin, J.D.; Marglin, S.I.; Allen, M.D. (University of Washington Medical Center, Seattle, WA (United States))

1991-07-01

Between November 1985 and November 1989, 54 patients have undergone 55 cardiac transplants, 5 of whom died during operation or one week after transplantation. The remaining 49 patients with a minimum follow-up of 5 months were studied to examine pulmonary infection clinically and radiologically while receiving triple drug immunosuppression consisting of cyclosporine, azathioprine, and prednisolone. Pulmonary infection occurred in 14 patients (29%) with a total of 21 occasions. Causative organisms were identified in 9 occasions, with the most common organism being Cytomegalovirus (CMV). One patient died of pulmonary infection with Aspergillus. Causative organisms occurring in the remaining 12 occasions of pulmonary infection were unknown, which did not lead to death. Because pulmonary infection of unknown organisms rapidly responded to convensional antibiotics, it seemed to have been caused by bacteria. Pulmonary infection of unknown organism occurred 13.2{+-}3.2 months after transplantation, as compared with 3.3{+-}1.0 months in pulmonary infection of known organisms. Chest plain radiographic features fell into four types: (1) interstitial shadow seen in pulmonary infection of CMV, Pneumocystis carinii, or Hemophilia influenza, (2) patchy, and basilar and lobular consolidation shadows in bacterial pneumonia, (3) localized nodular shadow in aspergillosis, and (4) multiple patchy and confluent opacity patterns occurring in herpes simplex viral infection. Pulmonary infection of influenza bacteria for one patient and pulmonary infection of unknown organisms for 4 patients were difficult to identify from pulmonary infection of CMV. (N.K.).

Pulmonary infection in patients with cyclosporine, azathioprine, and corticosteroids after cardiac transplantation

International Nuclear Information System (INIS)

Murayama, Sadayuki; Ikezoe, Junpei; Godwin, J.D.; Marglin, S.I.; Allen, M.D.

1991-01-01

Between November 1985 and November 1989, 54 patients have undergone 55 cardiac transplants, 5 of whom died during operation or one week after transplantation. The remaining 49 patients with a minimum follow-up of 5 months were studied to examine pulmonary infection clinically and radiologically while receiving triple drug immunosuppression consisting of cyclosporine, azathioprine, and prednisolone. Pulmonary infection occurred in 14 patients (29%) with a total of 21 occasions. Causative organisms were identified in 9 occasions, with the most common organism being Cytomegalovirus (CMV). One patient died of pulmonary infection with Aspergillus. Causative organisms occurring in the remaining 12 occasions of pulmonary infection were unknown, which did not lead to death. Because pulmonary infection of unknown organisms rapidly responded to convensional antibiotics, it seemed to have been caused by bacteria. Pulmonary infection of unknown organism occurred 13.2±3.2 months after transplantation, as compared with 3.3±1.0 months in pulmonary infection of known organisms. Chest plain radiographic features fell into four types: (1) interstitial shadow seen in pulmonary infection of CMV, Pneumocystis carinii, or Hemophilia influenza, (2) patchy, and basilar and lobular consolidation shadows in bacterial pneumonia, (3) localized nodular shadow in aspergillosis, and (4) multiple patchy and confluent opacity patterns occurring in herpes simplex viral infection. Pulmonary infection of influenza bacteria for one patient and pulmonary infection of unknown organisms for 4 patients were difficult to identify from pulmonary infection of CMV. (N.K.)

Acquired immunodeficiency syndrome and its ocular complications

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Rao Narsing

1994-01-01

Full Text Available Human immunodeficiency virus infection is the first major pandemic of the 20th century. At present, almost 10 million people are known to be infected with this virus, and it is estimated that by the year 2000, approximately 40 million people will be infected. Transmission of this deadly infection is predominantly by sexual contact. Individuals infected with this virus pass through several predictable stages with progressive decrease in circulating CD4+ T cells. During the advanced stage, these patients develop various opportunistic infections or malignancies, or both. It is this advanced stage that was first recognized as AIDS, which has a 100% mortality rate. The opportunistic organisms that can involve the eye in patients with AIDS include cytomegalovirus, herpes zoster, Toxoplasma gondii, Mycobacterium tuberculosis, Cryptococcus neoformans, Mycobacterium avium-intracellulare, Pneumocystis carinii, Histoplasma capsulatum, Candida, and others. Intraocular lesions from these agents often represent disseminated infections. Visual morbidity occurs secondary to retinitis due to cytomegalovirus, herpes zoster, or Toxoplasma gondii. Anti-viral agents such as ganciclovir or foscarnet are effective against cytomegalovirus infection. The role of the ophthalmologist in the diagnosis and management of AIDS is becoming increasingly important. Not only does the eye reflect systemic disease, but ocular involvement may often precede systemic manifestations. In the AIDS patient, the ophthalmologist thus has an opportunity to make not only a slight-saving, but also life-saving diagnosis of disseminated opportunistic infections.

HRCT-features of Pneumocystis jiroveci pneumonia and their evolution before and after treatment in non-HIV immunocompromised patients

International Nuclear Information System (INIS)

Vogel, M.N.; Vatlach, M.; Weissgerber, P.; Goeppert, B.; Claussen, C.D.; Hetzel, J.; Horger, M.

2012-01-01

Objective: This study retrospectively analyzes the characteristics and kinetics of pulmonary changes in Pneumocystis jiroveci pneumonia (PJP) before and after treatment as depicted by thin-section-CT in HIV-negative patients. Materials and methods: Serial CT scans of 84 consecutive HIV-negative PJP patients were reviewed retrospectively encompassing a median follow-up of 76 (range, 37–506) days. Along with underlying disease and time span between the onset of symptoms and specific antimicrobial therapy, early and late pulmonary CT-findings were evaluated. Results: Imaging findings at initial diagnosis differed from those in the posttherapeutic setting. In the acute (initial) PJP-phase, most frequent finding was symmetric, apically distributed ground glass opacities (GGO) with peripheral sparing 43% (n = 36). These initial changes resolved up to 1st follow-up-examination in 57% (n = 48), and finally in all except for two patients after a median period of 13 (mean 26, range 1–58) days following application of specific therapy. In 42% (n = 35) architectural distortions occurred, but they resolved after a median period of 27 (mean 60, range 11–302) days. Only in 9 patients, complete resolution could not be documented. Significant correlations of the underlying disease or the time span between the onset of symptoms and specific antibiotic therapy and morphologic kinetic could not be found. Conclusion: Thin-section CT-findings of PJP usually resolve soon after onset of specific therapy. Postinfectious fibrosis rarely occurs following PJP in HIV-negative patients.

Non-HIV Pneumocystis pneumonia: do conventional community-acquired pneumonia guidelines under estimate its severity?

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Asai, Nobuhiro; Motojima, Shinji; Ohkuni, Yoshihiro; Matsunuma, Ryo; Nakasima, Kei; Iwasaki, Takuya; Nakashita, Tamao; Otsuka, Yoshihito; Kaneko, Norihiro

2012-06-11

Non-HIV Pneumocystis pneumonia (PCP) can occur in immunosuppressed patients having malignancy or on immunosuppressive agents. To classify severity, the A-DROP scale proposed by the Japanese Respiratory Society (JRS), the CURB-65 score of the British Respiratory Society (BTS) and the Pneumonia Severity Index (PSI) of the Infectious Diseases Society of America (IDSA) are widely used in patients with community-acquired pneumonia (CAP) in Japan. To evaluate how correctly these conventional prognostic guidelines for CAP reflect the severity of non-HIV PCP, we retrospectively analyzed 21 patients with non-HIV PCP. A total of 21 patients were diagnosed by conventional staining and polymerase chain reaction (PCR) for respiratory samples with chest x-ray and computed tomography (CT) findings. We compared the severity of 21 patients with PCP classified by A-DROP, CURB-65, and PSI. Also, patients' characteristics, clinical pictures, laboratory results at first visit or admission and intervals from diagnosis to start of specific-PCP therapy were evaluated in both survivor and non-survivor groups. Based on A-DROP, 18 patients were classified as mild or moderate; respiratory failure developed in 15 of these 18 (83.3%), and 7/15 (46.7%) died. Based on CURB-65, 19 patients were classified as mild or moderate; respiratory failure developed in 16/19 (84.2%), and 8 of the 16 (50%) died. In contrast, PSI classified 14 as severe or extremely severe; all of the 14 (100%) developed respiratory failure and 8/14 (57.1%) died. There were no significant differences in laboratory results in these groups. The time between the initial visit and diagnosis, and the time between the initial visit and starting of specific-PCP therapy were statistically shorter in the survivor group than in the non-survivor group. Conventional prognostic guidelines for CAP could underestimate the severity of non-HIV PCP, resulting in a therapeutic delay resulting in high mortality. The most important factor to

[Causes of death in patients with HIV infection in two Tunisian medical centers].

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Chelli, Jihène; Bellazreg, Foued; Aouem, Abir; Hattab, Zouhour; Mesmia, Hèla; Lasfar, Nadia Ben; Hachfi, Wissem; Masmoudi, Tasnim; Chakroun, Mohamed; Letaief, Amel

2016-01-01

Antiretroviral tritherapy has contributed to a considerable reduction in HIV-related mortality. The causes of death are dominated by opportunistic infections in developing countries and by cardiovascular diseases and cancer in developed countries. To determine the causes and risk factors associated with death in HIV-infected patients in two Tunisian medical centers. cross-sectional study of HIV-infected patients over 15 years treated at Sousse and Monastir medical centers between 2000 and 2014. Death was considered related to HIV if its primary cause was AIDS-defining illness or if it was due to an opportunistic infection of unknown etiology with CD4 cause wasn't an AIDS defining illness or if it was due to an unknown cause if no information was available. Two hundred thirteen patients, 130 men (61%) and 83 women (39%), average age 40 ± 11 years were enrolled in the study. Fifty four patients died, the mortality rate was 5.4/100 patients/year. Annual mortality rate decreased from 5.8% in 2000-2003 to 2.3% in 2012-2014. Survival was 72% at 5 years and 67% at 10 years. Death events were associated with HIV in 70.4% of cases. The leading causes of death were pneumocystis carinii pneumonia and cryptococcal meningitis in 6 cases (11%) each. Mortality risk factors were a personal history of opportunistic infections, duration of antiretroviral therapy < 12 months and smoking. Strengthening screening, early initiation of antiretroviral therapy and fight against tobacco are needed to reduce mortality in patients infected with HIV in Tunisia.

Antibody response to a major human Pneumocystis carinii surface antigen in patients without evidence of immunosuppression and in patients with suspected atypical pneumonia

DEFF Research Database (Denmark)

Lundgren, Bettina; Lebech, M; Lind, K

1993-01-01

under evaluation due to atypical pneumonia, 76 patients showed no change in the titre of antibodies to Legionella spp. or Mycoplasma pneumoniae in two consecutive serum samples. Three of these 76 patients (4%) demonstrated an increase in the level of IgG antibodies to gp95 in the paired samples. One...

Non-HIV Pneumocystis pneumonia: do conventional community-acquired pneumonia guidelines under estimate its severity?

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Asai Nobuhiro

2012-06-01

Full Text Available Abstract Background Non-HIV Pneumocystis pneumonia (PCP can occur in immunosuppressed patients having malignancy or on immunosuppressive agents. To classify severity, the A-DROP scale proposed by the Japanese Respiratory Society (JRS, the CURB-65 score of the British Respiratory Society (BTS and the Pneumonia Severity Index (PSI of the Infectious Diseases Society of America (IDSA are widely used in patients with community-acquired pneumonia (CAP in Japan. To evaluate how correctly these conventional prognostic guidelines for CAP reflect the severity of non-HIV PCP, we retrospectively analyzed 21 patients with non-HIV PCP. Methods A total of 21 patients were diagnosed by conventional staining and polymerase chain reaction (PCR for respiratory samples with chest x-ray and computed tomography (CT findings. We compared the severity of 21 patients with PCP classified by A-DROP, CURB-65, and PSI. Also, patients’ characteristics, clinical pictures, laboratory results at first visit or admission and intervals from diagnosis to start of specific-PCP therapy were evaluated in both survivor and non-survivor groups. Results Based on A-DROP, 18 patients were classified as mild or moderate; respiratory failure developed in 15 of these 18 (83.3%, and 7/15 (46.7% died. Based on CURB-65, 19 patients were classified as mild or moderate; respiratory failure developed in 16/19 (84.2%, and 8 of the 16 (50% died. In contrast, PSI classified 14 as severe or extremely severe; all of the 14 (100% developed respiratory failure and 8/14 (57.1% died. There were no significant differences in laboratory results in these groups. The time between the initial visit and diagnosis, and the time between the initial visit and starting of specific-PCP therapy were statistically shorter in the survivor group than in the non-survivor group. Conclusions Conventional prognostic guidelines for CAP could underestimate the severity of non-HIV PCP, resulting in a therapeutic delay

[Cause of death after liver transplantation: an analysis of 41 cases in 382 patients].

Science.gov (United States)

Rayes, N; Bechstein, W O; Keck, H; Blumhardt, G; Lohmann, R; Neuhaus, P

1995-01-01

The aim of this study was to analyse the causes of death after liver transplantation in order to find and to avoid preventable fatal complications if possible. Between September 1988 and September 1993 415 orthotopic liver transplantations in 382 patients were performed at the Rudolf Virchow University Hospital in Berlin. During the same interval 41 (10.7%) of these patients died. Their clinical records were reviewed. The main cause of death was infection (29.3%), followed by recurrent malignancy (21.9%). Less patients died because of hepatitis B-reinfection (14.6%), chronic rejection (7.3%), hemorrhage (7.3%), cardiac failure (7.3%), trauma (4.8%), hypoxia (4.8%) and recurrence of alcoholic liver disease (4.8%). There was a wide spectrum of opportunistic infectious agents with CMV and Pneumocystis carinii being the most important pathogenic organisms. Only one isolated bacterial infection as principle cause of death was found. In all fatal infections the lung was the primary site of infection, 7 patients additionally developed sepsis. Altogether 75 patients (19.6%) with hepatitis B-cirrhosis were transplanted. Six of them (8%) developed a fatal hepatitis B-reinfection. Malignancy was the indication for OLT in 41 patients (10.7%). Six of these patients (14.6%) died because of recurrent tumor. Regarding the whole series, most deaths occurred four to twelve months (58.5%) and only five (12.2%) during the first month after OLT. Recurrence of primary disease is an important factor regarding total mortality. Therefore it is necessary to practise a careful selection of liver transplant recipients. In the future more attention needs to be drawn towards prevention, identification and management of opportunistic infections.

Gallium and imaging studies

International Nuclear Information System (INIS)

Vogel, H.C.

1982-01-01

The indications for the use of 67 Gallium imaging studies of the lungs are discussed. In spite of localization of 67 Ga in a large variety of neoplastic and inflammatory tissues, there is only limited application of the lung study in the differential diagnosis of pulmonary diseases. The chest radiograph will continue to be the principal tool for evaluation of pulmonary diseases. The 67 Ga-citrate scan serves as a study complementary to the chest radiograph, as it indicates the localization, extent and degree of activity of lung disease with greater accuracy than radiography. Gallium-67 scanning may be used in the evaluation of patients with lymphoreticular neoplasms, especially Hodgkin-disease and malignant lymphoma both during initial staging and in evaluation of the response to therapy. The 67 Ga-citrate scan is useful in the pre-operative evaluation of patients with lung cancer. Hilar and mediastinal lymphadenopathy are accurately revealed. The lung study is non-invasive and complementary to mediastinoscopy by showing from which glands a biopsy might be taken. Unsuspected extrathoracic secondaries may be shown up, as well as pulmonary metastases from malignancies elsewhere, although the metastases must be at least 1,5 cm in size. The 67 Ga lung scan is valuable in the evaluation of pulmonary infiltrates of suspicious infective etiology, the differentiation between pulmonary infection and pneumonia in selected cases, follow-up of sarcoid patients on corticosteroid therapy, evaluation of inflammatory activity of idiopathic pulmonary fibrosis and the early detection of neo-plastic or inflammatory diseases before the chest radiograph reveals abnormality, e.g. in diffuse carcinomatosis or Pneumocystis carinii-infection. The sensitivity of tumors to radiation or chemotherapy may be shown

The shape of the HIV/AIDS epidemic in Puerto Rico El estado de la epidemia de VIH/SIDA en Puerto Rico

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Maria A. Gomez

2000-06-01

Full Text Available This study presents information on AIDS patients in Puerto Rico, including their general sociodemographic profile, some risk-related parameters, characteristics of vulnerable groups, and elements of the clinical spectrum of the disease. Data were analyzed from the Puerto Rico AIDS Surveillance Program and available studies about the HIV/AIDS epidemic in Puerto Rico. A total of 23 089 AIDS cases was reported to the Puerto Rico AIDS Surveillance Program from January 1981 through February 1999. The HIV/AIDS epidemic has affected mostly males and females between the ages of 30 and 49, though cases have also been reported for other age groups. The cumulative proportion of persons with AIDS who are women has increased tremendously, from 11.4% for the 1981-1986 period to 21.6% for the entire 1981-1999 period. In Puerto Rico the category of injecting drug users (IDUs accounts for the majority of the AIDS cases (52%, followed by heterosexual contact (22%, and men who have sex with men (17%. The three main diagnoses for AIDS on the island are wasting syndrome (30.7%; esophageal, bronchial, and lung candidiasis (29.4%; and Pneumocystis carinii pneumonia (26.8%. According to 1994 vital statistics for Puerto Rico, AIDS was the fourth-leading cause of death. The overall reported AIDS mortality rate was 42.0 per 100 000 persons, with the rate for males, 67.8, much higher than it was for females, 17.4. AIDS is the first cause of death among persons between 30 and 39 years old. Intense efforts are needed to better understand the epidemic in Puerto Rico and its biology, social and family impacts, and financial costs.Este estudio presenta información sobre los pacientes con sida en Puerto Rico, como su perfil sociodemográfico general, los factores de riesgo, las características de los grupos vulnerables y los elementos del espectro clínico de la enfermedad. Los datos analizados procedían del Programa de Vigilancia del sida en Puerto Rico y de estudios sobre

Papel da fibrobroncoscopia no diagnóstico de pacientes com suspeita de tuberculose pulmonar Role of the fiberoptic bronchoscopy in the diagnosis of patients with suspected pulmonary

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Anna Luiza Summers Caymmi

2004-02-01

Full Text Available INTRODUÇÃO: A tuberculose pulmonar é uma doença infectocontagiosa de elevadas incidência e prevalência. O diagnóstico é feito de maneira rápida e segura através da baciloscopia do escarro. Entretanto, dos portadores de tuberculose pulmonar, 30% a 50% têm baciloscopia do escarro negativa ou não têm escarro, o que faz com que a fibrobroncoscopia adquira especial importância nesses casos. OBJETIVO: Avaliar a sensibilidade de espécimes colhidos, através da fibrobroncoscopia (lavado broncoalveolar e biópsia transbrônquica, para o diagnóstico de pacientes com suspeita de tuberculose pulmonar, sem confirmação diagnóstica através da baciloscopia do escarro. MÉTODO: Através da revisão dos livros de registro das fibrobroncoscopias realizadas no Hospital Universitário Professor Edgard Santos e no Hospital São Rafael, entre março de 1997 e março de 2001, foram identificados e incluídos no estudo os pacientes maiores de 18 anos, e encaminhados devido a suspeita de tuberculose com, no mínimo, três baciloscopias do escarro negativas. Foram coletados dados referentes a idade, sexo, alteração radiológica e alterações encontradas durante o exame endoscópico. RESULTADOS: Foram identificados 52 pacientes, com idade variando de 19 a 77 anos (mediana de 39, sendo 58% do sexo masculino e 37% atendidos pelo SUS. A apresentação radiológica predominante foi o infiltrado alveolar (80%. Tuberculose foi o diagnóstico final em 35 pacientes (1 com neoplasia associada, e a broncoscopia foi diagnóstica em 28 pacientes (80%. Outros diagnósticos obtidos pela broncoscopia foram: neoplasia, histoplasmose, alveolite crônica eosinofilica, pneumonia por Pneumocystis carinii e fibrose pulmonar. CONCLUSÃO: Os resultados deste estudo indicam a realização da fibrobroncoscopia em pacientes com suspeita de tuberculose não confirmada através da baciloscopia do escarro para determinação diagnóstica, não só desta doença, como de todas as

Discontinuation of Pneumocystis jirovecii pneumonia prophylaxis with CD4 count <200 cells/µL and virologic suppression: a systematic review.

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Cecilia T Costiniuk

Full Text Available HIV viral load (VL is currently not part of the criteria for Pneumocystis jirovecii pneumonia (PCP prophylaxis discontinuation, but suppression of plasma viremia with antiretroviral therapy may allow for discontinuation of PCP prophylaxis even with CD4 count <200 cells/µL.A systematic review was performed to determine the incidence of PCP in HIV-infected individuals with CD4 count <200 cells/µL and fully suppressed VL on antiretroviral therapy but not receiving PCP prophylaxis.Four articles examined individuals who discontinued PCP prophylaxis with CD4 count <200 cells/µL in the context of fully suppressed VL on antiretroviral therapy. The overall incidence of PCP was 0.48 cases per 100 person-years (PY (95% confidence interval (CI (0.06-0.89. This was lower than the incidence of PCP in untreated HIV infection (5.30 cases/100 PY, 95% CI 4.1-6.8 and lower than the incidence in persons with CD4 count <200 cells/µL, before the availability of highly active antiretroviral therapy (HAART, who continued prophylaxis (4.85/100 PY, 95% CI 0.92-8.78. In one study in which individuals were stratified according to CD4 count <200 cells/µL, there was a greater risk of PCP with CD4 count ≤100 cells/µL compared to 101-200 cells/µL.Primary PCP prophylaxis may be safely discontinued in HIV-infected individuals with CD4 count between 101-200 cells/µL provided the VL is fully suppressed on antiretroviral therapy. However, there are inadequate data available to make this recommendation when the CD4 count is ≤100 cells/µL. A revision of guidelines on primary PCP prophylaxis to include consideration of the VL is merited.

[Mycoses in domestic animals].

Science.gov (United States)

García, M E; Blanco, J L

2000-03-01

In the present paper we will present a general view of the main mycoses affecting domestic animals. In the dog, we show the importance of the dermatophytoses, increased by its zoonosic character and the problem of the false negatives in the traditional microbiological culture. Under the general term of systemic mycoses we include a series of conditions considered usually as aspergillosis, bat with more and more fungal species implicated as possible etiological agents. In addition, fungi, especially yeasts, are being implicated in canine otitis; in our laboratory 86 % of canine chronic otitis involve a yeast etiology, alone or in collaboration with bacteria. In the cat, dermatophytes are more common than in the dog, and are the main source of infection in man, with the description of a high percentage of healthy carrier animals. Cryptococcosis is a severe disease, usually secondary to other process, especially feline immunodeficiency. In cows we refer to fungal abortion, with three main fungi implicated: Aspergillus, Candida and Zygomycetes. In some areas of our country the percentage of fungal abortion is around 10 %. A consequence of the multiple use of antibiotics in mastitis is selection of yeasts, especially those included in the genera Candida and Cryptococcus. Bovine dermatophytoses is an extensively disseminated disease in our country, with a commercial specific vaccine available. In small ruminants, Cryptococcus causes severe pneumonic processes that could be confused clinically with other conditions. An additional important question is the description of isolation of this fungus from tree leaves. In poultry, aspergillosis is a known and controlled disease, but with more importance in captive wild birds with an ecological value. In horses, we emphasize the lung infections by different fungi, specially Pneumocystis carinii, and arthritis by yeasts as consequence of wound contamination or surgery.

Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

International Nuclear Information System (INIS)

Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

1985-01-01

Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases

Estimation of CD4+ and CD8+ T-lymphocytes in human immunodeficiency virus infection and acquired immunodeficiency syndrome patients in Manipur

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Singh H

2007-01-01

Full Text Available Purpose : To estimate and stratify CD4 + and CD8 + T-lymphocyte levels in human immunodeficiency virus (HIV infected (asymptomatic and acquired immunodeficiency syndrome (AIDS patients (symptomatic and correlate the clinical features of the patients with CD4+ and CD8+ lymphocyte level. Methods : Between April 2002 and September 2003, a total of 415 HIV seropositive adult patients (297 males and 118 females attending Regional Institute of Medical Sciences (RIMS hospitals were tested for CD4+ and CD8+ T-lymphocytes by fluorescent activated cell sorter (FACS counter (Becton Dickinson. Symptomatic patients were diagnosed as per NACO clinical case definition. Results : Ranges of 0-50, 51-100, 101-200, 201-300, 301-400, 401-500 and above 500 CD4+ T-lymphocyte per microlitre were seen in 68, 52, 101, 73, 47, 31 and 43 patients respectively whereas CD8+ T-lymphocyte ranges of 0-300, 301-600, 601-900, 901-1500, 1501-2000, 2001-3500 per microlitre were seen in 29, 84, 92, 145, 40 and 25 patients respectively. One hundred and fifty patients were asymptomatic and 265 were symptomatic. CD4/CD8 ratio in asymptomatics and symptomatics were 0.13-1.69 and 0.01-0.93 respectively. Tuberculosis and candidiasis occurred in CD4+ T-lymphocyte categories between 0-400 cells per mL in symptomatics. However, cryptosporidiosis, toxoplasmosis, herpes zoster, cryptococcal meningitis, Pneumocystis carinii pneumonia, penicilliosis and cytomegalovirus retinitis were seen in patients having CD4+ T-lymphocyte less than 200 per mL. Conclusions : CD4+ T-lymphocyte was decreased in both asymptomatic and symptomatic HIV patients, The decrease was greater in symptomatics while CD8+ T-lymphocyte was increased in both except advanced stage symptomatics. CD4:CD8 ratio was reversed in both groups. Opportunistic infections correlated with different CD4+ T-lymphocyte categories.

US hospital care for patients with HIV infection and pneumonia: the role of public, private, and Veterans Affairs hospitals in the early highly active antiretroviral therapy era.

Science.gov (United States)

Uphold, Constance R; Deloria-Knoll, Maria; Palella, Frank J; Parada, Jorge P; Chmiel, Joan S; Phan, Laura; Bennett, Charles L

2004-02-01

We evaluated differences in processes and outcomes of HIV-related pneumonia care among patients in Veterans Affairs (VA), public, and for-profit and not-for-profit private hospitals in the United States. We compared the results of our current study (1995 to 1997) with those of our previous study that included a sample of patients receiving care during the years 1987 to 1990 to determine how HIV-related pneumonia care had evolved over the last decade. The sample consisted of 1,231 patients with HIV infection who received care for Pneumocystis carinii pneumonia (PCP) and 750 patients with HIV infection who received care for community-acquired pneumonia (CAP) during the years 1995 to 1997. We conducted a retrospective medical record review and evaluated patient and hospital characteristics, HIV-related processes of care (timely use of anti-PCP medications, adjunctive corticosteroids), non-HIV-related processes of care (timely use of CAP treatment medications, diagnostic testing, ICU utilization, rates of endotracheal ventilation, placement on respiratory isolation), length of inpatient hospital stay, and inpatient mortality. Rates of timely use of antibiotics and adjunctive corticosteroids for treating PCP were high and improved dramatically from the prior decade. However, compliance with consensus guidelines that recommend public, private not-for-profit hospitals, and for-profit hospitals. This study provides the first overview of HIV-related pneumonia care in the early highly active antiretroviral therapy era, and contrasts current findings with those of a similarly conducted study from a decade earlier. Quality of care for patients with PCP improved, but further efforts are needed to facilitate the appropriate management of CAP. In the third decade of the epidemic, it will be important to monitor whether variations in processes of care for various HIV-related clinical diagnoses among different types of hospitals persist.

Trends in overall opportunistic illnesses, Pneumocystis carinii pneumonia, cerebral toxoplasmosis and Mycobacterium avium complex incidence rates over the 30 years of the HIV epidemic: a systematic review

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Lara Coelho

2014-03-01

Conclusions: Opportunistic illnesses remain an important public health problem. To better guide health policies in low/middle-income settings, multicenter cohort studies should be encouraged. Studies from Brazil are urgently needed to assess the current burden of opportunistic illnesses in our population and to support the planning of HIV/AIDS health care services organization.

Low Risk of Pneumonia From Pneumocystis jirovecii Infection in Patients With Inflammatory Bowel Disease Receiving Immune Suppression.

Science.gov (United States)

Cotter, Thomas G; Gathaiya, Nicola; Catania, Jelena; Loftus, Edward V; Tremaine, William J; Baddour, Larry M; Harmsen, W Scott; Zinsmeister, Alan R; Sandborn, William J; Limper, Andrew H; Pardi, Darrell S

2017-06-01

Use of immunosuppressants and inflammatory bowel disease (IBD) may increase the risk of pneumonia caused by Pneumocystis jirovecii (PJP). We assessed the risk of PJP in a population-based cohort of patients with IBD treated with corticosteroids, immune-suppressive medications, and biologics. We performed a population-based cohort study of residents of Olmsted County, Minnesota, diagnosed with Crohn's disease (n = 427) or ulcerative colitis (n = 510) from 1970 through 2011. Records of patients were reviewed to identify all episodes of immunosuppressive therapies and concomitant PJP prophylaxis through February 2016. We reviewed charts to identify cases of PJP, cross-referenced with the Rochester Epidemiology Project database (using diagnostic codes for PJP) and the Mayo Clinic and Olmsted Medical Center databases. The primary outcome was risk of PJP associated with the use of corticosteroids, immune-suppressive medications, and biologics by patients with IBD. Our analysis included 937 patients and 6066 patient-years of follow-up evaluation (median, 14.8 y per patient). Medications used included corticosteroids (520 patients; 55.5%; 555.4 patient-years of exposure), immunosuppressants (304 patients; 32.4%; 1555.7 patient-years of exposure), and biologics (193 patients; 20.5%; 670 patient-years of exposure). Double therapy (corticosteroids and either immunosuppressants and biologics) was used by 236 patients (25.2%), with 173 patient-years of exposure. Triple therapy (corticosteroids, immunosuppressants, and biologics) was used by 70 patients (7.5%) with 18.9 patient-years of exposure. There were 3 cases of PJP, conferring a risk of 0.2 (95% CI, 0.01-1.0) to corticosteroids, 0.1 (95% CI, 0.02-0.5) cases per 100 patient-years of exposure to immunosuppressants, 0.3 (95% CI, 0.04-1.1) cases per 100 patient-years of exposure to biologics, 0.6 (95% CI, 0.01-3.2) cases per 100 patient-years of exposure to double therapy, and 0 (95% CI, 0.0-19.5) cases per 100 patient

Frecuencia de la colonización por Pneumocystis jirovecii en pacientes con Enfermedad Pulmonar Obstructiva Crónica en Bogotá, Colombia

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Juan Felipe Burbano-Gutiérrez

2017-04-01

Full Text Available Antecedentes: la colonización por Pneumocystis jirovecci (P. jirovecii se ha postulado como causa de deterioro de la función pulmonar en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC. Se desconocía la frecuencia de aparición de la colonización por P. jirovencii en esa población en Colombia. Objetivo: documentar la frecuencia de colonización por P. jirovecii en mayores de 40 años con EPOC excluyendo a los pacientes que requirieran manejo inmunosupresor y a las personas infectadas por el Virus de la Inmunodeficiencia Humana (VIH. Materiales y métodos: se trató de un estudio de corte transversal, que contó con muestreo no probabilístico por conveniencia y selección continua de pacientes. Se realizó PCR (reacción en cadena de polimerasa en tiempo real (rt-PCR del esputo inducido con el Kit LighMix de P. jirovecii (Roche®-Suiza amplificándose un fragmento de 244 pares de bases a partir del gen de la glicoproteína de superficie del hongo. Resultados: para una muestra de 52 pacientes en total, se documentó una frecuencia de colonización del 15,4% en todos los participantes mayores de 65 años, quienes además presentaron altos índices de sintomatología según la escala modificada Medical Research Council (MR Cm y el cuestionario de evaluación de la EPOC (CAT. La mayoría de pacientes analizados se clasificó como GOLD D (63% en la clasificación por la Iniciativa Global para la EPOC. Conclusiones: la frecuencia de colonización por P. jirovecii en pacientes con EPOC detectada por rt-PCR en el esputo inducido fue del 15,4%. Este constituye el primer estudio colombiano que evalúa la frecuencia de colonización del hongo.

Kaposi's sarcoma-associated herpesvirus-like DNA sequences (KSHV/HHV-8) in oral AIDS-Kaposi's sarcoma: a PCR and clinicopathologic study.

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Flaitz, C M; Jin, Y T; Hicks, M J; Nichols, C M; Wang, Y W; Su, I J

1997-02-01

Recently, a new human herpesvirus (KSHV/HHV-8) has been identified in classic, transplant, endemic, and AIDS Kaposi's sarcoma that may be involved in the pathogenesis of Kaposi's sarcoma. The purpose of this study was to evaluate oral AIDS-Kaposi's sarcoma for detection of KSHV/HHV-8 DNA. DNA extracted from 54 oral AIDS-Kaposi's sarcoma lesions (47 initial, 7 postvinblastine treated), 5 non-Kaposi's sarcoma HIV-positive lesions, and 3 non-Kaposi's sarcoma HIV-negative lesions was evaluated by polymerase chain reaction (KS330(233bp)amplicon) for KSHV/HHV-8. The AIDS-Kaposi's sarcoma study population consisted of 52 patients (51:1, men:woman; 92% men having sex with men, 8% heterosexual; mean age, 38 years; mean, CD4 59/mm3) Opportunistic infections occurred in 88% (candidiasis, 65%; Pneumocystis carinii pneumonia, 31%; nonoral Kaposi's sarcoma, 25%; mycobacterium avium-intracellulare (MAI), 16%; cytomegalovirus, 14%; herpes simplex virus, 14%). Sexually transmitted diseases occurred in 73% (gonorrhea, 37%; syphilis, 23%; condyloma, 22%; HSV, 16%). Most frequent lesion sites were palate (74%) and gingiva (17%). Most common lesion types were purple nodular (48%) and macular (42%). Histopathologic subtypes were nodular (71%), plaque (27%), and patch (2%). Polymerase chain reaction analysis detected KSHV/HHV-8 DNA in 53 of 54 AIDS-Kaposi's sarcoma lesions (47 of 47 initial, 6 of 7 postvinblastine treatment). KSHV/HHV-8 DNA was not detected in non-Kaposi's sarcoma lesions in HIV-positive or HIV-negative persons. KSHV/HHV-8 DNA sequence is present in a high proportion of oral AIDS-Kaposi's sarcoma lesions. Whether KSHV/HHV-8 is an etiologic agent or a cofactor in the development of this vascular neoplasm is uncertain and remains to be proven. Polymerase chain reaction analysis for KSHV/HHV-8 DNA sequence detection may be helpful in identifying Kaposi's sarcoma in early vascular proliferations, when the characteristic histopathologic features are not present.

Post-transplantation Infections in Bolivia.

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Arze, S; Arze, L; Abecia, C

2016-03-01

Over 26 years, we found 46 infectious episodes in 350 kidney transplant recipients. Fifteen were urinary tract infections, recurrent in 4 patients. There were 8 cytomegalovirus infections, three of them fatal when intravenous (IV) ganciclovir was not available. Seven patients had a reactivation of tuberculosis (TB) in the pleura, cervical spine, lumbar spine, knee, ankle, skin and peritoneum, respectively, and were all resolved satisfactorily with conventional anti-TB therapy. Three patients transplanted before routine prophylaxis with the use of acyclovir developed an extensive herpes zoster infection in the 1st 6 months after transplantation, which was resolved with the use of oral acyclovir, and 1 had a disseminated herpes simplex infection resolved with the use of IV acyclovir. Three patients transplanted before routine prophylaxis with trimethoprim sulfa developed Pneumocystis carinii pneumonia in the 1st 6 months after transplantation, which was fatal in one of them. In 2 patients, we found a Nocardia infection, confined to the lung, which was cured in one of the cases and systemic and fatal in the other. Two patients transplanted before routine prophylaxis with the use of nystatin developed esophageal candidiasis in the 1st 6 months after transplantation. One patient developed infective endocarditis in a stenotic bicuspid aortic valve and died 10 years later after another incident of infective endocarditis at the prosthetic aortic valve. Two patients developed an extensive condyloma at the penis, perianal region, and perineum owing to human papillomavirus, requiring extensive surgical resection and podophyllin applications. Another patient developed fatal post-transplantation lymphoproliferative disease due to Epstein-Barr virus infection 15 years after transplantation. One patient developed a severe and fatal mucocutaneous leishmaniasis with no response to conventional antimonial therapy. It is interesting to note that despite Chagas disease being endemic

Pneumocystis jirovecii pneumonia

DEFF Research Database (Denmark)

Cordonnier, Catherine; Cesaro, Simone; Maschmeyer, Georg

2016-01-01

and monoclonal antibodies in various haematological diseases, justifies constant vigilance in order to identify new at-risk populations and give prophylaxis accordingly. The fifth and sixth European Conferences on Infections in Leukaemia (ECIL-5 and ECIL-6) aimed to review risk factors for PCP in haematology...

Pneumocystis jiroveci pneumonia

Science.gov (United States)

... symptoms. Tests that may be ordered include: Blood gases Bronchoscopy (with lavage) Lung biopsy X-ray of ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

Pneumonia por Rhodococcus equi em doente VIH (+: A propósito de uma associação rara

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Paula Esteves

2007-09-01

Full Text Available Resumo: A infecção humana por Rhodococcus equi, mesmo no contexto da infecção pelo VIH, é relativamente rara. Os autores apresentam o caso clínico de um indivíduo, infectado pelo VIH, que apresentava um quadro clínico e imagiológico compatível com pneumonia, cujos exames iniciais revelaram a presença de Pneumocystis jiroveci. Após realização de terapêutica específica, perante a manutenção do quadro clínico-imagiológico, procedeu-se à realização de novos exames complementares, tendo sido identificado a presença de Rhodococcus equi no lavado broncoalveolar. Com instituição de terapêutica dirigida a este agente, verificou--se progressiva melhoria clínica e imagiológica. Os autores efectuam uma revisão bibliográfica da pneumonia por Rhodococcus equi, salientando a raridade desta associação e a elevada sobrevida observada. Abstract: The human infection by Rhodococcus equi, even in the presence of HIV infection, remains a rare disease. The authors present a case report of pneumonia, occurring in a HIV (+ man. After identifying Pneumocystis jiroveci in the BAL, despite proper medication, the patient didn’t improve. Another BAL was performed and a Rhodoccus equi isolated. The therapeutic regimen was changed according to this finding and the patient improved. The authors make a review of the literature, focusing on the rarity of this association and the high survival observed. Palavras-chave: Rhodococcus equi, Pneumocystis jiroveci, VIH, Key-words: Rhodococcus equi, Pneumocystis jiroveci, HIV

[Professor Adam Nowosławski (1925-2012)--founder of the Polish School of Immunopathology].

Science.gov (United States)

Madaliński, Kazimierz

2012-01-01

Professor dr med. Adam Nowosławski, has died at age of 87, on February 3, 2012, the founder of the Polish school of immunopathology, member of Polish Academy of Sciences and of Polish Academy of Art and Sciences. Professor was born on April 30, 1925 in Rzeszów (SE Poland). During the Second World War he took part in the anti-nazi resistance movement; he was the soldier of the 'Baszta' regiment of the Home Army. Subsequently, he was imprisoned in the Pawiak and concentration camps: Majdanek and Buchenwald. The medical studies he has completed at Warsaw Medical Academy between 1946-1951. The degree of doctor of medicine Prof. Adam Nowosławski has obtained in 1963, habilitation degree in the field of immunopathology--in 1966; the title of Professor he has obtained in 1980. His scientific achievements consist of 170 publications, including 101 original papers. His publications were quoted in several American books for students and physicians. Topics of his early papers concerned the immunopatogenesis ofPneumocystis carinii--induced pneumonia in premature babies, immunopatogenesis of rheumatoid arthritis, and the origin of rheumatoid factor. The enormous role in the field of hepatology played research on the virus of hepatitis B. These studies dealt with the discovery of HB core antigen which had the cellular localization different from HB surface antigen and with the parameters of the immune response to infection. Papers published on this topic were the mostly quoted in the literature and earned him national awards. The activity of Prof. Adam Nowosławski in the field of HIV/AIDS prevention was honored by the special prize of the Minister of Health. Professor was the honorary member of the two Societies: Polish Society of Pathologists and Polish Society of Hepatology. He was also the member of International Association for the Study of the Liver and International Academy of Pathology. Prof. Adam Nowosławski received the national medals: Polonia Restituta Crosses

THE MANY FACES OF PNEUMOMEDIASTINUM: AN OBSERVATIONAL STUDY

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Narendra Kumar Narahari

2016-06-01

Full Text Available Pneumomediastinum is an uncommon condition which is defined by the presence of air in the mediastinum. It may result from a number of causes, but at times the underlying aetiology remains obscure. The present study aims to review the clinical and imaging features in patients who presented with pneumomediastinum alone or in association with other findings in order to establish the aetiological diagnosis. We report here, a series of cases with pneumomediastinum of various unusual aetiologies and also the clinical profile, predisposing factors and outcome of these patients along with the associated complications. METHODS We retrospectively reviewed the records of all patients who presented to the respiratory unit of our hospital with the diagnosis of pneumomediastinum over a period of 2 years from 2013-2015. The cases of pneumomediastinum resulting from trauma and iatrogenic causes were excluded from the study. RESULTS A total of six patients (4 males and 2 females with pneumomediastinum were identified during the study period after applying the exclusion criteria. The most common presenting symptom in these cases was shortness of breath followed by dry cough, chest pain and fever. Subcutaneous emphysema and Hamman sign was identified in one patient each. Of the six cases, preexisting lung disease was identified in 3 patients and these included connective tissue disease related interstitial lung disease in two cases and combined pulmonary fibrosis and emphysema in one case. In the remaining three cases, the causes of pneumomediastinum were Pneumocystis carinii pneumonia (PCP in HIV positive patient, pulmonary tuberculosis in another and spontaneous oesophageal perforation in the third. Coexisting pneumothorax was present in 3 out of 6 cases. The mean duration of hospital stay in these six patients was 8 days. No recurrence of pneumomediastinum was seen in any of the six patients during six months of followup. CONCLUSIONS Pneumomediastinum is a

Risk factors for mortality from acute lower respiratory infections (ALRI in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies.

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Michela Sonego

Full Text Available OBJECTIVE: To evaluate risk factors for death from acute lower respiratory infections (ALRI in children in low- and middle-income countries. DESIGN: Systematic review and meta-analysis. STUDY SELECTION: Observational studies reporting on risk factors for death from ALRI in children below five years in low- and middle income countries. DATA SOURCES: Medline, Embase, Global Health Library, Lilacs, and Web of Science to January 2014. RISK OF BIAS ASSESSMENT: Quality In Prognosis Studies tool with minor adaptations to assess the risk of bias; funnel plots and Egger's test to evaluate publication bias. RESULTS: Out of 10,655 papers retrieved, 77 studies from 39 countries (198,359 children met the inclusion criteria. Host and disease characteristics more strongly associated with ALRI mortality were: diagnosis of very severe pneumonia as per WHO definition (odds ratio 9.42, 95% confidence interval 6.37‒13.92; age below two months (5.22, 1.70‒16.03; diagnosis of Pneumocystis Carinii (4.79, 2.67‒8.61, chronic underlying diseases (4.76, 3.27‒6.93; HIV/AIDS (4.68, 3.72‒5.90; and severe malnutrition (OR 4.27, 3.47‒5.25. Socio-economic and environmental factors significantly associated with increased odds of death from ALRI were: young maternal age (1.84, 1.03‒3.31; low maternal education (1.43, 1.13‒1.82; low socio-economic status (1.62, 1.32‒2.00; second-hand smoke exposure (1.52, 1.20 to 1.93; indoor air pollution (3.02, 2.11‒4.31. Immunisation (0.46, 0.36‒0.58 and good antenatal practices (0.50, 0.31‒0.81 were associated with decreased odds of death. CONCLUSIONS: Host and disease characteristics as well as socio-economic and environmental determinants affect the risk of death from ALRI in children. Together with the prevention and treatment of chronic diseases, interventions to modify underlying risk factors such as poverty, lack of female education, and poor environmental conditions, should be considered among the strategies to

Towards New Antifolates Targeting Eukaryotic Opportunistic Infections

Energy Technology Data Exchange (ETDEWEB)

Liu, J.; Bolstad, D; Bolstad, E; Wright, D; Anderson, A

2009-01-01

Trimethoprim, an antifolate commonly prescribed in combination with sulfamethoxazole, potently inhibits several prokaryotic species of dihydrofolate reductase (DHFR). However, several eukaryotic pathogenic organisms are resistant to trimethoprim, preventing its effective use as a therapeutic for those infections. We have been building a program to reengineer trimethoprim to more potently and selectively inhibit eukaryotic species of DHFR as a viable strategy for new drug discovery targeting several opportunistic pathogens. We have developed a series of compounds that exhibit potent and selective inhibition of DHFR from the parasitic protozoa Cryptosporidium and Toxoplasma as well as the fungus Candida glabrata. A comparison of the structures of DHFR from the fungal species Candida glabrata and Pneumocystis suggests that the compounds may also potently inhibit Pneumocystis DHFR.

Pneumonia - adults (community acquired)

Science.gov (United States)

... Pneumocystis jiroveci can cause pneumonia in people whose immune system is not working well, especially people with advanced HIV infection. Viruses , such as the flu virus, are also a common cause of pneumonia. ...

ORIGINAL ARTICLES Balantidium coli-induced pulmonary ...

African Journals Online (AJOL)

and electrolytes, creatinine, liver functions, thyroid stimulating hormone, brain natriuretic ... for acid-fast bacilli and. Pneumocystis jiroveci, and only mixed oral flora were cultured. ... mucosa and cause ulcers, probably owing to the production.

Pulmonary disease in HIV-infected Patients at the University

African Journals Online (AJOL)

Esem

K.J. Mateyo , S. Lakhi , B. Guffey , B. Chi , A. Mweemba , B. Andrews. 1Department ... 41, No. 2: 50 -58 (2014) ... and Pneumocystis jirovecii by microscopy and culture. ... Baseline characteristics of study participants ... Staphylococcus aureus. 1.

FEATURES OF PNEUMONIA IN HIV-INFECTED PATIENTS

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M. T. Vatutin

2016-01-01

Full Text Available The article presents the clinical, diagnostic and treatment features of pneumocystis pneumonia in HIV-infected patients. The clinical case of diagnosis verification in a patient 58 years old with severe respiratory failure is described.

Disease: H01521 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available pathogen: clinical and diagnostic review. ... JOURNAL ... Parasitol Res 114:3577-85 (2015) DOI:10.1007/s00436-015-4678-6 ...ORS ... Sokulska M, Kicia M, Wesolowska M, Hendrich AB ... TITLE ... Pneumocystis jirovecii--from a commensal to

Challenges Facing Early Infant Diagnosis of HIV among Infants

African Journals Online (AJOL)

AJRH Managing Editor

Department of Community Medicine, College of Health Sciences, Osun State University, Osogbo. *For correspondence: .... are infected with HIV have a better prognosis ... Pneumocystis jiroveci pneumonia is recommended for infants .... addition, NGOs should scale up EID trainings to allow ..... Journal of Acquired Immune.

HIV-associated opportunistic fungal infections: a guide to using the ...

African Journals Online (AJOL)

This review aims to provide a guide for clinicians to using the clinical microbiology laboratory for management of common HIV-associated opportunistic fungal infections, e.g. mucosal candidiasis, cryptococcosis, Pneumocystis jirovecii pneumonia (PCP), histoplasmosis, etc. Laboratory tests provide valuable guidance at ...

Follicular bronchiolitis in an HIV-infected individual on combination antiretroviral therapy with low CD4+ cell count but sustained viral suppression

DEFF Research Database (Denmark)

Rasmussen, Line D; Pedersen, Court; Madsen, Helle D

2017-01-01

A 36-year-old Danish man, living in Asia, was diagnosed with Pneumocystis pneumonia (PCP) and HIV in 2013 (CD4+ count: 6 cells/µL; viral load: 518 000 copies/mL). He initiated combination antiretroviral therapy. Later that year, he was also diagnosed with granulomatosis with polyangiitis and was ......A 36-year-old Danish man, living in Asia, was diagnosed with Pneumocystis pneumonia (PCP) and HIV in 2013 (CD4+ count: 6 cells/µL; viral load: 518 000 copies/mL). He initiated combination antiretroviral therapy. Later that year, he was also diagnosed with granulomatosis with polyangiitis...... tests demonstrated severely reduced lung capacity with an obstructive pattern and a moderately reduced diffusion capacity. High resolution computer tomography revealed minor areas with tree-in-bud pattern and no signs of air trapping on expiratory views. Lung biopsy showed lymphocytic infiltration...

Infecção pelo HIV: descritores de mortalidade em pacientes hospitalizados

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Luiz Claudio Santos Thuler

1998-12-01

Full Text Available OBJETIVO: Estudar os descritores clínico-epidemiológicos da mortalidade em pacientes internados por condições clínicas associadas à infecção pelo HIV. MÉTODO: Estudo retrospectivo de todos os pacientes adultos hospitalizados em 1990, 1992 e 1994 em hospital universitário. Os resultados foram descritos como números absolutos, percentagens e médias, sendo a significância estatística entre as diferenças avaliada pelos testes do qui-quadrado, exato de Fisher ou t de Student, conforme o caso. Um modelo de regressão logística foi elaborado visando a identificar os principais fatores associados ao risco de evolução para o óbito. RESULTADOS: Foram incluídos no estudo 240 pacientes. Entre 1990 e 1994 a idade média dos pacientes aumentou de 35,0 para 36,9 anos, a razão entre os sexos masculino e feminino caiu de 9,8 para 2,0, a proporção de não brancos cresceu de 18,5 para 41,3 e registrou-se um aumento do tempo médio entre a descoberta da infecção pelo HIV e a hospitalização de 0,7 para 2,5 anos. Observou-se a redução do número médio de dias de hospitalização de 31,3 para 25,3 e aumento da proporção de pacientes em acompanhamento ambulatorial de 47,8 para 83,3%. As infecções respiratórias representaram a principal causa de hospitalização (58% e as infecções oportunistas apresentadas com maior freqüência foram: candidíase oral (27,1%, tuberculose (18,3%, pneumonia por Pneumocystis carinii (15,4% e neurotoxoplasmose (10,4%. Na análise multivariada, apenas o tempo de hospitalização menor ou igual a 7 dias (Odds Ratio [OR]=3,88; p=0,02 e a ausência de acompanhamento ambulatorial (OR=3,29; p=0,01 mostraram-se associados a um maior risco de evolução para óbito. CONCLUSÃO: O conhecimento dos fatores associados a um risco aumentado de morte pode ser útil na tomada de decisão frente a pacientes hospitalizados com infecção pelo HIV.

Mujeres con VIH-SIDA en el Hospital Nacional Cayetano Heredia en Lima, Perú

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Lely Solari Zerpa

1999-04-01

Full Text Available Objetivo: Describir las características epidemiológicas y clínicas del grupo de mujeres infectadas con el Virus de la Inmunodeficiencia Humana (VIH que fueron atendidas en el Hospital Nacional Cayetano Heredia de Enero de 1989 a Diciembre de 1996. Material y Métodos: Se hizo una revisión retrospectiva de sus fichas epidemiológicas e historias clínicas. Se utilizó la clasificación de los Centros de Control de Enfermedades (CDC para infección por el VIH (Estadíos I-IV. Resultados: Se incluyó 236 mujeres, de 17 a 60 años, con una edad media de 30.4 años. El número de mujeres diagnosticadas por año aumentó de 5 en 1989 a 63 en 1996. La vía probable de adquirir la infección fue por relaciones heterosexuales en 212 pacientes (90.2%. Refirieron haber tenido una sola pareja sexual en su vida 113 (47.8%. Hubo 4 (1.6% de trabajadoras sexuales y no hubo drogadictas por vía endovenosa. Habían tenido otras Enfermedades de Transmisión Sexual (ETSs el 23.4% y éstas fueron más prevalentes en mujeres que tenían prácticas sexuales riesgosas (p=0.005. Tuvieron diagnóstico de Síndrome de Inmunodeficiencia Adquirida (SIDA 69 mujeres. La Condición Definitoria de SIDA más frecuente Síndrome Consuntivo en 23 mujeres (33.3%. Hubo 19 muertes en los años de estudio. La sobrevida media en estadío SIDA fue de 10.6 meses y la causa de muerte más frecuente fue Tuberculosis y Neumonía por Pneumocystis carinii. Conclusiones: El hecho de tener una transmisión predominantemente heterosexual y de que haya un alto porcentaje de mujeres con pocas parejas sexuales nos hace suponer que es probablemente la conducta sexual riesgosa de sus parejas lo que expone a las mujeres a la infección por el VIH. Debemos resaltar la importancia de una adecuada educación a las mujeres que comienzan a tener relaciones, de los riesgos que esto implica y la difusión del uso de condones para prevenir esta infección. ( Rev Med Hered 1999; 10:62-68 .

[Weekly low-dose methotrexate in rheumatoid arthritis. Review of the literature].

Science.gov (United States)

Manganelli, P; Troise Rioda, W

1993-10-01

Methotrexate (MTX) is an antifolic drug that in recent years has been largely employed in the treatment of Rheumatoid Arthritis (RA). Both short and long term clinical trials have demonstrated its efficacy and good tolerability. It induces a significant improvement of all clinical variables and a decrease in the erythrocyte sedimentation rate and other acute phase reactants with a steroid sparing effect. The probability of continuing MTX therapy for up to 5 years is 46-55% whereas that of continuing gold, hydroxychloroquine, sulfasalazine or D-penicillamine therapy is less than 20%. MTX is a rapidly acting drug with a clinical response within 4 weeks and a plateau phase after 6 months of therapy. Discontinuation of long-term MTX therapy induces a flare-up of the disease so that patients receiving long-term MTX must continue the drug to maintain clinical benefits. In spite of its clinical efficacy, MTX does not seem to have a significant effect on disease progression as determined radiographically. In this respect, MTX appears to have some superiority when compared to azathioprine, but not when compared to gold salts. MTX has been employed in patients with RA unresponsive to other Disease-Modifying Antirheumatic Drugs (DMARDs), but according to some recent views on the therapeutic strategy of RA, it could be used in early RA as a first choice drug. Toxic effects are the main reason in limiting long-term MTX treatment. Hepatic toxicity is one of the more common side-effects of MTX, but the recognition of its "risk factors" such as alcohol abuse, may reduce it. Acute pneumonitis is one of the more severe complications of MTX therapy and may be life-threatening. In RA patients treated with MTX are also reported complications of immunosuppression, such as Pneumocystis carinii pneumonia whose clinical-radiological picture may be similar to that of acute pneumonitis. The mechanism of action of low-dose weekly MTX in RA is still unclear, but it might be more

Studies on the role of irradiated filarial parasites in inducing immunoprophylaxis against experimental filariasis. Part of a coordinated programme on the use of nuclear techniques in the preparation of vaccines against parasitic diseases

International Nuclear Information System (INIS)

Subrahamaniam, D.

1979-01-01

The effect of ionizing radiation at various doses on the growth of Litomosoides carinii infective third stage larvae and on the protection conferred by such larvae against filarial infections was studied in albino rats. At radiation doses of 30 K rads and below the larvae developed into adults in retarded and sterile forms. No such development was seen when the larvae were irradiated at doses of 38 K rads and above. A high degree of protection was observed when the animals were immunized with 3 doses of infective larvae attenuated with 38 or 40 K rads of radiation. This degree of protection was not observed with larvae irradiated at other dose levels nor when the number of immunizations were reduced to two. The concurrent injection with heat killed Coryne-bacterium parva at immunization increased the level of protection. This was not observed when the C. parva organisms were replaced with Freunds Complete Adjuvant. Protection was best demonstrated when the challenge was given more than 30 days following the last immunization. The immunized animals showed the presence of serum dependent cellular adhesion to microfilarial and this correlated well with protection

severe rhabdomyolysis following co-administration of simvastatin ...

African Journals Online (AJOL)

and penile ulcers typical of genital herpes (subsequently confirmed by a polymerase chain reaction test). Other findings were unremarkable. He tested positive for HIV antibodies. The patient was prescribed fluconazole for the oral candidosis and co-trimoxazole for prophylaxis against pneumocystis pneumonia. A follow-up ...

Lesson of the month 1: Lobar pulmonary consolidation in an immunocompromised host.

Science.gov (United States)

Reynolds, Daniel J; Andersen, Carl A; Hoskote, Sumedh S; Lee, Hee Eun; Raghunathan, Aditya; Kalra, Sanjay; Limper, Andrew H

2016-12-01

A 19-year-old male with a history of idiopathic panuveitis, currently taking methotrexate and infliximab, presented to our institution with 6 weeks of cough, dyspnoea and fevers. He had failed outpatient antimicrobial therapy. Computerised tomography (CT) of the chest revealed the presence of a lobar pneumonia and he was treated with broad spectrum antibiotics, which did not improve his symptoms. Bronchoalveolar lavage was performed with a transbronchial lung biopsy because of the diagnostic uncertainty of the patient's presentation. Pathology revealed non-budding yeasts, consistent with Pneumocystis Serological and urine studies were positive for both Histoplasma and Blastomyces The diagnosis of Histoplasma pneumonia was made because of the presentation being inconsistent with Pneumocystis pneumonia, and serology, urine and pathology testing being more consistent with Histoplasma The patient was treated with oral itraconazole and was doing well at follow-up 12 weeks after hospitalisation. © Royal College of Physicians 2016. All rights reserved.

Ventilator induced lung injury (VILI) in acute respiratory distress ...

African Journals Online (AJOL)

The lung protective ventilation strategy- Low tidal volume ventilation has shown some reduction in mortality in patients with ARDS but mortality is still high in patient with severe ARDS secondary to Pneumocystis jiroveci pneumonia (PJP) despite of lung protective ventilation strategy. In patients with Severe ARDS due to PJP ...

ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Intracellular signaling pathways: tyrosine kinase and mTOR inhibitors).

Science.gov (United States)

Reinwald, M; Silva, J T; Mueller, N J; Fortún, J; Garzoni, C; de Fijter, J W; Fernández-Ruiz, M; Grossi, P; Aguado, J M

2018-06-01

The present review is part of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biologic therapies. To review, from an infectious diseases perspective, the safety profile of therapies targeting different intracellular signaling pathways and to suggest preventive recommendations. Computer-based Medline searches with MeSH terms pertaining to each agent or therapeutic family. Although BCR-ABL tyrosine kinase inhibitors modestly increase the overall risk of infection, dasatinib has been associated with cytomegalovirus and hepatitis B virus reactivation. BRAF/MEK kinase inhibitors do not significantly affect infection susceptibility. The effect of Bruton tyrosine kinase inhibitors (ibrutinib) among patients with B-cell malignancies is difficult to distinguish from that of previous immunosuppression. However, cases of Pneumocystis jirovecii pneumonia (PCP), invasive fungal infection and progressive multifocal leukoencephalopathy have been occasionally reported. Because phosphatidylinositol-3-kinase inhibitors (idelalisib) may predispose to opportunistic infections, anti-Pneumocystis prophylaxis and prevention strategies for cytomegalovirus are recommended. No increased rates of infection have been observed with venetoclax (antiapoptotic protein Bcl-2 inhibitor). Therapy with Janus kinase inhibitors markedly increases the incidence of infection. Pretreatment screening for chronic hepatitis B virus and latent tuberculosis infection must be performed, and anti-Pneumocystis prophylaxis should be considered for patients with additional risk factors. Cancer patients receiving mTOR inhibitors face an increased incidence of overall infection, especially those with additional risk factors (prior therapies or delayed wound healing). Specific preventive approaches are warranted in view of the increased risk of infection associated with some of the

Aterosclerose experimental em coelhos Experimental atherosclerosis in rabbits

Directory of Open Access Journals (Sweden)

Waleska C. Dornas

2010-08-01

Full Text Available Numerosas pesquisas têm sido realizadas utilizando modelos experimentais para estudar o desenvolvimento da aterosclerose com dieta induzindo hiperlipidemia. Devido ao fato de que coelhos são muito sensíveis a dietas ricas em colesterol e acumulam grandes quantidades no plasma, a utilização destes animais como modelo experimental para avaliar o desenvolvimento de aterosclerose é de grande relevância, trazendo informação sobre fatores que contribuem para progressão e regressão aplicadas a situações humanas. Sendo assim, nessa revisão a função aterogênica do colesterol é mostrada em trabalhos que incluem o coelho como modelo experimental, uma vez que este animal tornou-se o mais popular modelo experimental de aterosclerose.Many researches have been conducted in experimental models in order to study the development of atherosclerosis from hyperlipidemia-inducing diets. Since rabbits are very sensitive to cholesterol-rich diets and accumulate large amounts of cholesterol in their plasma, their use as experimental models to evaluate the development of atherosclerosis is highly relevant and brings information on factors that contribute to the progression and regression of this condition that can be applied to humans. As such, this review includes studies on the atherogenic function of cholesterol based on rabbits as the experimental model, since they have become the most largely used experimental model of atherosclerosis.

Mutations in the dihydropteroate synthase gene of Pneumocystis jiroveci isolates from Portuguese patients with Pneumocystis pneumonia

DEFF Research Database (Denmark)

Costa, M C; Helweg-Larsen, J; Lundgren, Bettina

2003-01-01

The aim of this study was to evaluate the frequency of mutations of the P. jiroveci dihydropteroate synthase (DHPS) gene in an immunocompromised Portuguese population and to investigate the possible association between DHPS mutations and sulpha exposure. In the studied population, DHPS gene...... mutations were not significantly more frequent in patients exposed to sulpha drugs compared with patients not exposed (P=0.390). The results of this study suggest that DHPS gene mutations are frequent in the Portuguese immunocompromised population but do not seem associated with previous sulpha exposure...

Experimental Engineering: Articulating and Valuing Design Experimentation

DEFF Research Database (Denmark)

Vallgårda, Anna; Grönvall, Erik; Fritsch, Jonas

2017-01-01

In this paper we propose Experimental Engineering as a way to articulate open- ended technological experiments as a legitimate design research practice. Experimental Engineering introduces a move away from an outcome or result driven design process towards an interest in existing technologies and...

Experimental thermodynamics experimental thermodynamics of non-reacting fluids

CERN Document Server

Neindre, B Le

2013-01-01

Experimental Thermodynamics, Volume II: Experimental Thermodynamics of Non-reacting Fluids focuses on experimental methods and procedures in the study of thermophysical properties of fluids. The selection first offers information on methods used in measuring thermodynamic properties and tests, including physical quantities and symbols for physical quantities, thermodynamic definitions, and definition of activities and related quantities. The text also describes reference materials for thermometric fixed points, temperature measurement under pressures, and pressure measurements. The publicatio

[Pulmonary infections in patients with rheumatoid arthritis].

Science.gov (United States)

Takayanagi, Noboru; Tsuchiya, Yutaka; Tokunaga, Daidou; Miyahara, Yousuke; Yamaguchi, Shouzaburo; Saito, Hiroo; Ubukata, Mikio; Kurashima, Kazuyoshi; Yanagisawa, Tsutomu; Sugita, Yutaka

2007-06-01

We studied 149 rheumatoid arthritis (RA) patients (mean age 68.0 years; 68 men, 81 women) with pulmonary infections. The mean age at the onset of RA and the duration of RA was 57.2 +/- 15.2 years and 10.9 +/- 11.5 years, respectively. Pulmonary infections included nontuberculous mycobacteriosis in 59 patients (Mycobacterium avium complex infection, 50 cases : Mycobacterium kansasii infection, 4 cases; others, 5 cases), pneumonia in 46 patients, pulmonary tuberculosis in 28 patients, pulmonary aspergillosis in 12 patients, pulmonary cryptococcosis in 5 patients, Pneumocystis jiroveci pneumonia in 5 patients, lung abscess in 9 patients, exacerbation of bronchiectasis in 7 patients, and empyema in 4 patients. One hundred percent of patients with exacerbation of bronchiectasis, 91.7% of patients with pulmonary aspergillosis, 87% of patients with pneumonia, and 81.4% of patients with nontuberculous mycobacteriosis had underlying lung diseases. The pulmonary infections during therapy with steroids were pulmonary tuberculosis (78.6%), pneumonia (65.2%), and pulmonary aspergillosis (58.3%), while the pulmonary infections during methotrexate treatment were Pneumocystis jiroveci pneumonia (80%), pulmonary cryptococcosis (40%), and pulmonary tuberculosis (28.6%). Pulmonary infections in RA patients who were taking TNFalpha inhibitors included 1 patient each with nontuberculous mycobacteriosis, pneumonia, pulmonary tuberculosis, and Pneumocystis jiroveci pneumonia. Among the RA patients with lung abscess, malignancy was noted in 55.6%, and diabetes mellitus in 22.2%. Pseudomonas aeruginosa was the second-most-common cause of pneumonia and cause of all exacerbations of bronchiectasis. As well as immunosuppressive medications (steroids, methotrexate, TNFalpha inhibitors) and systemic comorbid diseases, underlying lung diseases could be one of the risk factor for pulmonary infections in patients with RA. The dominant risk factor for each pulmonary infection in patients with RA

HIV MARCH MAKE UP 01

African Journals Online (AJOL)

Winnie

He had been diagnosed with HIV infection in 2000. At that time he was asymptomatic and attended the state HIV clinic. His first admission was for Pneumocystis jiroveci pneumonia. (PCP). At the time our unit was screening patients for a clinical trial. This patient was not our 'usual' trial candidate. He had been expelled from ...

Diversity of Pneumocystis jirovecii Across Europe

DEFF Research Database (Denmark)

Alanio, Alexandre; Gits-Muselli, Maud; Guigue, Nicolas

2017-01-01

with France (14/15, pFrance (14/15/16 patients) and in renal transplant patient (13/15). Our study showed the wide population diversity across Europe, with evidence of local clusters of patients harbouring a given...

Convenience experimentation.

Science.gov (United States)

Krohs, Ulrich

2012-03-01

Systems biology aims at explaining life processes by means of detailed models of molecular networks, mainly on the whole-cell scale. The whole cell perspective distinguishes the new field of systems biology from earlier approaches within molecular cell biology. The shift was made possible by the high throughput methods that were developed for gathering 'omic' (genomic, proteomic, etc.) data. These new techniques are made commercially available as semi-automatic analytic equipment, ready-made analytic kits and probe arrays. There is a whole industry of supplies for what may be called convenience experimentation. My paper inquires some epistemic consequences of strong reliance on convenience experimentation in systems biology. In times when experimentation was automated to a lesser degree, modeling and in part even experimentation could be understood fairly well as either being driven by hypotheses, and thus proceed by the testing of hypothesis, or as being performed in an exploratory mode, intended to sharpen concepts or initially vague phenomena. In systems biology, the situation is dramatically different. Data collection became so easy (though not cheap) that experimentation is, to a high degree, driven by convenience equipment, and model building is driven by the vast amount of data that is produced by convenience experimentation. This results in a shift in the mode of science. The paper shows that convenience driven science is not primarily hypothesis-testing, nor is it in an exploratory mode. It rather proceeds in a gathering mode. This shift demands another shift in the mode of evaluation, which now becomes an exploratory endeavor, in response to the superabundance of gathered data. Copyright © 2011 Elsevier Ltd. All rights reserved.

Pulmonary infections and risk of lung cancer among persons with AIDS.

Science.gov (United States)

Shebl, Fatma M; Engels, Eric A; Goedert, James J; Chaturvedi, Anil K

2010-11-01

Lung cancer risk is significantly increased among persons with AIDS (PWA), and increased smoking may not explain all of the elevated risk, suggesting a role for additional cofactors. We investigated whether AIDS-defining pulmonary infections (recurrent pneumonia, Pneumocystis jirovecii pneumonia, and pulmonary tuberculosis) affected the risk of subsequent lung cancer over 10 years after AIDS onset among 322,675 PWA, whose records were linked with cancer registries in 11 US regions. We assessed lung cancer hazard ratios (HRs) using Cox regression and indirectly adjusted HRs for confounding by smoking. Individuals with recurrent pneumonia (n = 5317) were at significantly higher lung cancer risk than those without [HR = 1.63, 95% confidence interval (CI) = 1.08 to 2.46, adjusted for age, race, sex, HIV acquisition mode, CD4 count, and AIDS diagnosis year]. This association was especially strong among young PWA (risk was unrelated to tuberculosis [(n = 13,878) HR = 1.12, 95% CI = 0.82 to 1.53] or Pneumocystis jirovecii pneumonia [(n = 69,771) HR = 0.97, 95% CI = 0.80 to 1.18]. The increased lung cancer risk associated with recurrent pneumonia supports the hypothesis that chronic pulmonary inflammation arising from infections contributes to lung carcinogenesis.

Optimal experimental design with R

CERN Document Server

Rasch, Dieter; Verdooren, L R; Gebhardt, Albrecht

2011-01-01

Experimental design is often overlooked in the literature of applied and mathematical statistics: statistics is taught and understood as merely a collection of methods for analyzing data. Consequently, experimenters seldom think about optimal design, including prerequisites such as the necessary sample size needed for a precise answer for an experimental question. Providing a concise introduction to experimental design theory, Optimal Experimental Design with R: Introduces the philosophy of experimental design Provides an easy process for constructing experimental designs and calculating necessary sample size using R programs Teaches by example using a custom made R program package: OPDOE Consisting of detailed, data-rich examples, this book introduces experimenters to the philosophy of experimentation, experimental design, and data collection. It gives researchers and statisticians guidance in the construction of optimum experimental designs using R programs, including sample size calculations, hypothesis te...

BENSC. Experimental reports 1994

International Nuclear Information System (INIS)

Kirschbaum, Y.; Gast, H.; Michaelsen, R.

1995-05-01

This volume contains the guest groups' experimental reports describing experimental work carried out on the Berlin Scattering Center in 1994. These experimental reports are intended as interim summaries. (HP)

BENSC experimental reports 1993

International Nuclear Information System (INIS)

Kirschbaum, Y.; Michaelsen, R.

1994-05-01

This volume contains the guest groups' experimental reports describing experimental work carried out on the Berlin Scattering Center in 1993. These experimental reports are intended as interim summaries. (HP)

Is animal experimentation fundamental?

Science.gov (United States)

d'Acampora, Armando José; Rossi, Lucas Félix; Ely, Jorge Bins; de Vasconcellos, Zulmar Acciolli

2009-01-01

The understanding about the utilization of experimental animals in scientific research and in teaching is many times a complex issue. Special attention needs to be paid to attain the understanding by the general public of the importance of animal experimentation in experimental research and in undergraduate medical teaching. Experimental teaching and research based on the availability of animals for experimentation is important and necessary for the personal and scientific development of the physician-to-be. The technological arsenal which intends to mimic experimentation animals and thus fully replace their use many times does not prove to be compatible with the reality of the living animal. The purpose of this paper is to discuss aspects concerning this topic, bringing up an issue which is complex and likely to arouse in-depth reflections.

Ethics in Animal Experimentation

Directory of Open Access Journals (Sweden)

Yusuf Ergun

2010-08-01

Full Text Available Experimental animals are frequently used to obtain information for primarily scientific reasons. In the present review, ethics in animal experimentation is examined. At first, the history of animal experimentation and animal rights is outlined. Thereafter, the terms in relation with the topic are defined. Finally, prominent aspects of 3Rs constituting scientific and ethical basis in animal experimentation are underlined. [Archives Medical Review Journal 2010; 19(4.000: 220-235

Experimental Object-Oriented Modelling

DEFF Research Database (Denmark)

Hansen, Klaus Marius

through, e.g., technical prototyping and active user involvement. We introduce and examine “experimental object-oriented modelling” as the intersection of these practices. The contributions of this thesis are expected to be within three perspectives on models and modelling in experimental system...... development: Grounding We develop an empirically based conceptualization of modelling and use of models in system development projects characterized by a high degree of uncertainty in requirements and point to implications for tools and techniques for modelling in such a setting. Techniques We introduce......This thesis examines object-oriented modelling in experimental system development. Object-oriented modelling aims at representing concepts and phenomena of a problem domain in terms of classes and objects. Experimental system development seeks active experimentation in a system development project...

A broncofibroscopia no diagnóstico etiológico de afecções pulmonares em pacientes com síndrome da imunodeficiência adquirida

Directory of Open Access Journals (Sweden)

Silva R.M. da

2000-01-01

Full Text Available OBJETIVO: Avaliar o papel da broncofibroscopia no diagnóstico etiológico de pneumopatias em pacientes positivos ao vírus da imunodeficência humana. MÉTODOS: O presente estudo analisa um grupo de 49 pacientes com diagnóstico de síndrome da imunodeficiência adquirida, admitidos no Hospital Nereu Ramos - Florianópolis -SC. Foram selecionados pacientes sintomáticos respiratórios com lesão simples ao exame radiográfico do tórax, sem diagnóstico etiológico confirmado por exame de escarro. Tais pacientes foram submetidos à broncofibroscopia com realização de lavado broncoalveolar, escovado brônquico e biópsia pulmonar transbrônquica. As amostras foram analisados com bacterioscopia pelo Gram, pesquisa de BAAR, citomegalovírus, P. carinii e outros fungos. RESULTADOS: A broncofibroscopia foi efetiva na realização do diagnóstico etiológico em 71,43% dos casos. A biópsia pulmonar transbrônquica foi a técnica com maior positividade, firmando o diagnóstico em 59,18% dos casos. A técnica com menor positividade foi o escovado brônquico, com diagnóstico em 4,08% dos casos. O agente etiológico mais freqüente foi o P. carinii (42,8%, seguido pelo M. tuberculosis (22,86%. Nenhuma complicação foi observada nos procedimentos realizados. CONCLUSÃO: Concluímos no presente estudo que neste grupo de pacientes a broncofibroscopia foi um procedimento seguro e efetivo para o diagnóstico etiológico de afecções pulmonares.

Experimental atomic physics

International Nuclear Information System (INIS)

Anon.

1985-01-01

The experimental atomic physics program within the physics division is carried out by two groups, whose reports are given in this section. Work of the accelerator atomic physics group is centered around the 6.5-MV EN tandem accelerator; consequently, most of its research is concerned with atomic processes occurring to, or initiated by, few MeV/amu heavy ions. Other activities of this group include higher energy experiments at the Holifield Heavy Ion Research Facility (HHIRF), studies of electron and positron channeling radiation, and collaborative experiments at other institutions. The second experimental group concerns itself with lower energy atomic collision physics in support of the Fusion Energy Program. During the past year, the new Electron Cyclotron Resonance Source has been completed and some of the first data from this facility is presented. In addition to these two activities in experimental atomic physics, other chapters of this report describe progress in theoretical atomic physics, experimental plasma diagnostic development, and atomic data center compilation activities

Atovaquone for Prophylaxis of Toxoplasmosis after Allogeneic Hematopoietic Stem Cell Transplantation.

Science.gov (United States)

Mendorf, Alexander; Klyuchnikov, Evgeny; Langebrake, Claudia; Rohde, Holger; Ayuk, Francis; Regier, Marc; Christopeit, Maximilian; Zabelina, Tatjana; Bacher, Adelbert; Stübig, Thomas; Wolschke, Christine; Bacher, Ulrike; Kröger, Nicolaus

2015-01-01

Toxoplasmosis and infections by other opportunistic agents such as Pneumocystis jirovecii constitute life-threatening risks for patients after allogeneic hematopoietic stem cell transplantation. Trimethoprim/sulfamethoxazole (TMP-SMX) has been well established for post-transplant toxoplasmosis and pneumocystis prophylaxis, but treatment may be limited due to toxicity. We explored atovaquone as an alternative and compared it with TMP-SMX regarding toxicity and efficacy during the first 100 days after transplantation in 155 consecutive adult stem cell recipients. Eight patients with a prior history of TMP-SMX intolerance received atovaquone as first-line prophylaxis. TMP-SMX was used for 141 patients as first-line strategy, but 13 patients (9.2%) were later switched to atovaquone due to TMP-SMX toxicity or gastrointestinal symptoms. No active toxoplasmosis or active P. jirovecii infection developed under continued prophylaxis with either TMP-SMX or atovaquone. However, for reasons of TMP-SMX and/or atovaquone toxicity, 7 patients were unable to tolerate any efficacious toxoplasmosis prophylaxis and therefore obtained inhalative pentamidine as P. jirovecii prophylaxis but no toxoplasmosis prophylaxis. Importantly, 2 of these patients developed severe toxoplasmosis. In summary, atovaquone appears as a valid alternative for at least some post-transplant patients who cannot tolerate TMP-SMX. This should be further confirmed by multicenter trials. © 2015 S. Karger AG, Basel.

Experimental halls workshop summary

International Nuclear Information System (INIS)

Thorndike, A.

1976-01-01

At the experimental halls workshop, discussions were held on: (1) open areas as compared with enclosed halls; (2) the needs of ep, anti pp, and other options; (3) the hall for the lepton detector; and (4) the hall for the hadron spectrometer. The value of different possibilities for the future experimental program was explored. A number of suggestions emerged which will be used as the design of the experimental halls progresses

Experimental Volcanology: 2010 and 2020

Science.gov (United States)

Dingwell, D. B.

2010-12-01

The advent of an experimental approach to volcanology has its roots in decades-old laboratory based approaches to characterising the properties of magmas and analog materials, together with the attempts at simulating volcanic processes in the lab. A little over ten years ago many new thrusts of experimental advance led to a new dawn for experimental science applied to volcanic eruptions. Along with that, new expectations, new goals and new strategies emerged about ten years ago. Ten years later, in 2010, many fruits have been born of this labour, and new frontiers are being unfolded as we meet here. Here are some of the youngest captivating themes being explored in experimental programs today: 1) interfacing volcanic monitoring systems to experimentally generated eruptions. 2) elucidating the physicochemical behavior of experimentally generated volcanic ash as an agent in the earth system. 3) blending experimental rock deformation and magmatology studies to understand the strength and stability of volcanic materials and volcanic structures 4) exploiting the kinematics of experimentally-generated versus natural volcanic products to understand flow style and strain history. The past ten years of experimental developments in volcanology have prepared us for great advances in the future, most of which were not perceived as likely avenues of investigation as little as ten years ago! The situation is likely to repeat itself in 2020.

Ansiedade experimental humana Human experimental anxiety

Directory of Open Access Journals (Sweden)

Frederico Guilherme Graeff

2007-01-01

Full Text Available CONTEXTO: A ansiedade experimental no ser humano constitui-se em ponte entre os modelos animais e os ensaios clínicos. OBJETIVO: Este artigo focaliza métodos químicos e psicológicos utilizados para provocar ansiedade experimental em seres humanos. MÉTODOS: Realizou-se revisão seletiva da literatura. RESULTADOS: Os desafios farmacológicos têm sido usados principalmente para induzir ataques de pânico em pacientes com transtorno de pânico, os quais são mais sensíveis a eles que indivíduos normais ou pacientes portadores de outros transtornos psiquiátricos. Uma das mais importantes contribuições deste método é a de ter mostrado que os agentes panicogênicos mais seletivos, como o lactato ou a inalação de CO2, não ativam o eixo hormonal do estresse. Entre os métodos psicológicos, destacam-se o condicionamento de respostas elétricas da condutância da pele, cujo perfil farmacológico se aproxima daquele do transtorno de ansiedade generalizada, e o teste da simulação do falar em público, cuja farmacologia é semelhante à do transtorno de pânico. CONCLUSÕES: Tais resultados salientam a diferença entre a neurobiologia da ansiedade e a do pânico.BACKGROUND: Human experimental anxiety methods bridge the gap between animal models and clinical assays. OBJECTIVE: This article is focused on chemical and psychological procedures used to generate experimental anxiety in human beings. METHODS: A selective review of the literature has been carried out. RESULTS: Pharmacological challenges have been mainly used to induce panic attacks in panic disorder patients, who are more susceptible than normal individuals or patients with other psychiatric disorders. One of the most important contributions of this method is to have shown that the most selective panicogenic agents, such as lactate or CO2 inhalation, do not activate the hormonal stress axis. Among the psychological methods stand the conditioning of the electrical skin conductance

The experimental watersheds in Slovenia

International Nuclear Information System (INIS)

Sraj, M; Rusjan, S; Petan, S; Vidmar, A; Mikos, M; Globevnik, L; Brilly, M

2008-01-01

Experimental watersheds are critical to the advancement of hydrological science. By setting up three experimental watersheds, Slovenia also obtained its grounds for further development of the science and discipline. In the Dragonja experimental watershed the studies are focused on the afforestation of the watershed in a mediterranean climate, on the Reka river the water balance in a partly karstic area is examined, and on the case of the Glinscica stream the implications of the urban environment are studied. We have obtained valuable experience and tested new measuring equipment on all three experimental watersheds. Measurements and analysis on the experimental watersheds improved the current understanding of hydrological processes. They resulted in several PhD Theses, Master Theses and scientific articles. At the same time the experimental watersheds provide support to the teaching and studying process.

Respiratory complications in Brazilian patients infected with human immunodeficiency virus Complicações respiratórias em pacientes brasileiros infectados pelo vírus da imunodeficiência humana

Directory of Open Access Journals (Sweden)

Adriana Weinberg

1993-04-01

Full Text Available PURPOSE: To determine how often and by what means an indentifiable pulmonary pathogen can be recognized in human immunodeficiency virus (HIV infected patients with respiratory disorders in Brazil, which are the most frequently observed microorganisms and what impact specific therapy has on these agents. PATIENTS AND METHODS: Thirty-five HIV seroposiüve subjects with respiratory complaints were studied. All patients had a complete history, physical examination and blood counts. The pulmonary assessment included chest radiograms; sputum examination for bacterial and fungal pathogens; bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. Patients with treatable complications received standard antimicrobial therapy. RESULTS: One or more microorganisms were found in 24 subjects and another 3 individuals showed nonspecific interstitial pneumonitis. The sputum examination identified the pulmonary pathogens in 7 cases. The bronchoalveolar lavage and the histopathologic examination were diagnostic in 14% and 83%, respectively, of the 28 individuals that were submitted to bronchoscopy. The most frequently identified microorganism was P. carinii (55%, followed by M. tuberculosis (41% and cytomegalovirus (8%. The clinical, laboratory and radiographic findings failed to distinguish the specific pulmonary pathogens. Twenty-three individuals with P. carinii pneumonitis and/or tuberculosis received specific therapy; among the evaluable patients the therapeutic response rates were 79% for PCP and 100% for TB. CONCLUSIONS: We have determined that tuberculosis, P. carinii and cytomegalovirus pneumonitis are the most common respiratory opportunistic diseases in Brazilian patients infected with HIV. The histologic evaluation was crucial in order to identify the pulmonary pathogens. Tuberculosis in AIDS individuals displayed clinical and radiographic findings atypical for reactivation disease. However, most of the features observed in HIV infected

Experimental heavy quarkonium physics

International Nuclear Information System (INIS)

Bugge, L.

1986-08-01

Following some brief arguments on why heavy quarkonium spectroscopy is an important field of particle physics, some points on experimental techniques are discussed. Parts of the basic quarkonium phenomenology, including discussions of various items related to potensial models, are then presented. An up-to-date presentation is given of the state-of-the-art of experimental charmonium and bottomonium spectroscopy below open flavour threshold, including the confrontation of experimental results to representative theoretical predictions

NEUMOCISTOSIS EN EL SERVICIO DE MEDICINA INTERNA, COMPLEJO HOSPITALARIO UNIVERSITARIO “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012 I PNEUMOCYSTOSIS IN THE INTERNAL MEDICINE SERVICE, UNIVERSITY HOSPITAL COMPLEX “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012

OpenAIRE

Fadi Wahab-El-Fatairi; Ignacio Sigona-Giangreco; Isabel Ortiz-Vielma; María Teresa Maniscalchi-Badaoui; Duvric Lemus-Espinoza

2015-01-01

In Venezuela and in the state Anzoátegui, the pneumocystosis, is little studied. To weigh that it is an infection opportunist caused by Pneumocystis jirovecii, it causes pneumonia of high morbility and mortality. The inmunocompromised patient is those that present bigger risks of acquiring this infection. The objectives of this investigation were to determine the infection frequency for P. jirovecii in patient with breathing symptoms and immunocompromised hospitalized in the Service of Intern...

Experimentation with PEC channel prototype

International Nuclear Information System (INIS)

Caponetti, R.; Iacovelli, M.

1984-01-01

Experimentation on prototypes of PEC components is presently being carried out at Casaccia CRE. This report shows the results of the first cycle of experimentation of the central channel, concerning the aspects of sodium removal after experimentation

Experimental philosophy.

Science.gov (United States)

Knobe, Joshua; Buckwalter, Wesley; Nichols, Shaun; Robbins, Philip; Sarkissian, Hagop; Sommers, Tamler

2012-01-01

Experimental philosophy is a new interdisciplinary field that uses methods normally associated with psychology to investigate questions normally associated with philosophy. The present review focuses on research in experimental philosophy on four central questions. First, why is it that people's moral judgments appear to influence their intuitions about seemingly nonmoral questions? Second, do people think that moral questions have objective answers, or do they see morality as fundamentally relative? Third, do people believe in free will, and do they see free will as compatible with determinism? Fourth, how do people determine whether an entity is conscious?

Administrative Aspects of Human Experimentation.

Science.gov (United States)

Irvine, George W.

1992-01-01

The following administrative aspects of scientific experimentation with human subjects are discussed: the definition of human experimentation; the distinction between experimentation and treatment; investigator responsibility; documentation; the elements and principles of informed consent; and the administrator's role in establishing and…

Reconstruction of dynamic structures of experimental setups based on measurable experimental data only

Science.gov (United States)

Chen, Tian-Yu; Chen, Yang; Yang, Hu-Jiang; Xiao, Jing-Hua; Hu, Gang

2018-03-01

Nowadays, massive amounts of data have been accumulated in various and wide fields, it has become today one of the central issues in interdisciplinary fields to analyze existing data and extract as much useful information as possible from data. It is often that the output data of systems are measurable while dynamic structures producing these data are hidden, and thus studies to reveal system structures by analyzing available data, i.e., reconstructions of systems become one of the most important tasks of information extractions. In the past, most of the works in this respect were based on theoretical analyses and numerical verifications. Direct analyses of experimental data are very rare. In physical science, most of the analyses of experimental setups were based on the first principles of physics laws, i.e., so-called top-down analyses. In this paper, we conducted an experiment of “Boer resonant instrument for forced vibration” (BRIFV) and inferred the dynamic structure of the experimental set purely from the analysis of the measurable experimental data, i.e., by applying the bottom-up strategy. Dynamics of the experimental set is strongly nonlinear and chaotic, and itʼs subjects to inevitable noises. We proposed to use high-order correlation computations to treat nonlinear dynamics; use two-time correlations to treat noise effects. By applying these approaches, we have successfully reconstructed the structure of the experimental setup, and the dynamic system reconstructed with the measured data reproduces good experimental results in a wide range of parameters.

Experimental program at Fermilab

International Nuclear Information System (INIS)

Jovanovic, D.

1974-01-01

The experimental program at Fermilab is briefly surveyed: accelerators and experimental areas, current experiments such as elastic scattering of π +- , K +- , p +- , on proton and deuteron total cross sections, neutrino physics, high transverse momentum [fr

Experimental technique of neutron reflection

International Nuclear Information System (INIS)

Chen Bo; Huang Chaoqiang; Li Xinxi

2006-12-01

It is presented that the classifications, structures and components of neutron reflectometer (NR), as well s functions and parameters of each components, detailed characters of NR facility 'PRN-2M'. Based on the practical experiments, the basic experimental techniques, the measurement and the related experimental settings are described, including the choice of experimental conditions, adjustments of polarized neutron beam line, basic experimental technique and approach of measurement. The above can be an instruction for NR experiments and a reference for NR construction. (authors)

Animal experimentation.

Science.gov (United States)

Kolar, Roman

2006-01-01

Millions of animals are used every year in often times extremely painful and distressing scientific procedures. Legislation of animal experimentation in modern societies is based on the supposition that this is ethically acceptable when certain more or less defined formal (e.g. logistical, technical) demands and ethical principles are met. The main parameters in this context correspond to the "3Rs" concept as defined by Russel and Burch in 1959, i.e. that all efforts to replace, reduce and refine experiments must be undertaken. The licensing of animal experiments normally requires an ethical evaluation process, often times undertaken by ethics committees. The serious problems in putting this idea into practice include inter alia unclear conditions and standards for ethical decisions, insufficient management of experiments undertaken for specific (e.g. regulatory) purposes, and conflicts of interest of ethics committees' members. There is an ongoing societal debate about ethical issues of animal use in science. Existing EU legislation on animal experimentation for cosmetics testing is an example of both the public will for setting clear limits to animal experiments and the need to further critically examine other fields and aspects of animal experimentation.

Experimental approaches and applications

CERN Document Server

Crasemann, Bernd

1975-01-01

Atomic Inner-Shell Processes, Volume II: Experimental Approaches and Applications focuses on the physics of atomic inner shells, with emphasis on experimental aspects including the use of radioactive atoms for studies of atomic transition probabilities. Surveys of modern techniques of electron and photon spectrometry are also presented, and selected practical applications of inner-shell processes are outlined. Comprised of six chapters, this volume begins with an overview of the general principles underlying the experimental techniques that make use of radioactive isotopes for inner-sh

Ice condenser experimental plan

International Nuclear Information System (INIS)

Kannberg, L.D.; Piepel, G.F.; Owczarski, P.C.; Liebetrau, A.M.

1986-01-01

An experimental plan is being developed to validate the computer code ICEDF. The code was developed to estimate the extent of aerosol retention in the ice compartments of pressurized water reactor ice condenser containment systems during severe accidents. The development of the experimental plan began with review of available information on the conditions under which the code will be applied. Computer-generated estimates of thermohydraulic and aerosol conditions entering the ice condenser were evaluated and along with other information, used to generate design criteria. The design criteria have been used for preliminary test assembly design and for generation of statistical test designs. Consideration of the phenomena to be evaluated in the testing program, as well as equipment and measurement limitations, have led to changes in the design criteria and to subsequent changes in the test assembly design and statistical test design. The overall strategy in developing the experimental plan includes iterative generation and evaluation of candidate test designs using computer codes for statistical test design and ICEDF for estimation of experimental results. Estimates of experimental variability made prior to actual testing will be verified by replicate testing at preselected design points

Experimental semiotics: a review.

Science.gov (United States)

Galantucci, Bruno; Garrod, Simon

2011-01-01

In the last few years a new line of research has appeared in the literature. This line of research, which may be referred to as experimental semiotics (ES; Galantucci, 2009; Galantucci and Garrod, 2010), focuses on the experimental investigation of novel forms of human communication. In this review we will (a) situate ES in its conceptual context, (b) illustrate the main varieties of studies thus far conducted by experimental semioticians, (c) illustrate three main themes of investigation which have emerged within this line of research, and (d) consider implications of this work for cognitive neuroscience.

Theory-laden experimentation

DEFF Research Database (Denmark)

Schindler, Samuel

2013-01-01

light bending in 1919 by Eddington and others) to show that TDRs are used by scientists to resolve data conflicts. I argue that the rationality of the practices which employ TDRs can be saved if the independent support of the theories driving TDRs is construed in a particular way.......The thesis of theory-ladenness of observations, in its various guises, is widely considered as either ill-conceived or harmless to the rationality of science. The latter view rests partly on the work of the proponents of New Experimentalism who have argued, among other things, that experimental...... practices are efficient in guarding against any epistemological threat posed by theory-ladenness. In this paper I show that one can generate a thesis of theory-ladenness for experimental practices from an influential New Experimentalist account. The notion I introduce for this purpose is the concept...

The philosophy of scientific experimentation: a review

Science.gov (United States)

2009-01-01

Practicing and studying automated experimentation may benefit from philosophical reflection on experimental science in general. This paper reviews the relevant literature and discusses central issues in the philosophy of scientific experimentation. The first two sections present brief accounts of the rise of experimental science and of its philosophical study. The next sections discuss three central issues of scientific experimentation: the scientific and philosophical significance of intervention and production, the relationship between experimental science and technology, and the interactions between experimental and theoretical work. The concluding section identifies three issues for further research: the role of computing and, more specifically, automating, in experimental research, the nature of experimentation in the social and human sciences, and the significance of normative, including ethical, problems in experimental science. PMID:20098589

New experimental model for training in videosurgery Novo modelo experimental para treinamento em videocirurgia

Directory of Open Access Journals (Sweden)

Danilo Malta Batista

2012-10-01

Full Text Available PURPOSE: To develop a new experimental model of lower cost for training in videosurgery. METHODS: This project was performed at the Nucleus of Experimental Surgery of the Bahiana School of Medicine and Public Health, based on previous models described in the literature and under the supervision of the full professor of Operative Technique and Experimental Surgery II. It was made a model cube-shaped, made of wood, with holes distributed in various locations, rubber stoppers for the holes and lined externally with carpet, and internally with laminate. RESULTS: The new experimental model is of low cost and reproduces quite faithfully several videosurgical procedures. CONCLUSION: Medical schools interested in the subject may adopt the new model for training in videosurgery without the need of high costs for making and using these models.OBJETIVO: Desenvolver um novo modelo experimental de baixo custo para treinamento em videocirurgia MÉTODOS: Este projeto foi conduzido no Núcleo de Cirurgia Experimental da Escola Bahiana de Medicina e Saúde Pública, baseado em modelos prévios descritos na literatura e sob a supervisão do professor titular de Técnica Operatória e Cirurgia Experimental II. Foi feito um modelo em formato de cubo, de madeira, com furos distribuídos em vários locais, tampas de borracha para os orifícios e forrado externamente com carpete e internamente com laminado. RESULTADOS: O novo modelo experimental desenvolvido é de baixo custo e reproduz de forma bastante fiel diversos procedimentos videocirúrgicos. CONCLUSÃO: Faculdades médicas interessadas no tema poderão adotar o novo modelo para o treinamento em videocirurgia sem que sejam necessários gastos elevados para a confecção e o uso desses modelos.

Nuclear Test-Experimental Science

International Nuclear Information System (INIS)

Struble, G.L.; Donohue, M.L.; Bucciarelli, G.; Hymer, J.D.; Kirvel, R.D.; Middleton, C.; Prono, J.; Reid, S.; Strack, B.

1988-01-01

Fiscal year 1988 has been a significant, rewarding, and exciting period for Lawrence Livermore National Laboratory's nuclear testing program. It was significant in that the Laboratory's new director chose to focus strongly on the program's activities and to commit to a revitalized emphasis on testing and the experimental science that underlies it. It was rewarding in that revolutionary new measurement techniques were fielded on recent important and highly complicated underground nuclear tests with truly incredible results. And it was exciting in that the sophisticated and fundamental problems of weapons science that are now being addressed experimentally are yielding new challenges and understanding in ways that stimulate and reward the brightest and best of scientists. During FY88 the program was reorganized to emphasize our commitment to experimental science. The name of the program was changed to reflect this commitment, becoming the Nuclear Test-Experimental Science (NTES) Program

H.J. Andrews Experimental Forest.

Science.gov (United States)

Art McKee; Pamela. Druliner

1998-01-01

The H.J. Andrews Experimental Forest is a world renowned center for research and education about the ecology and management of forests and streams. Located about 50 miles (80 km) east of Eugene, Oregon, the Andrews Experimental Forest lies in the Blue River Ranger District of the Willamette National Forest. Established in 1948, the Experimental Forest is administered...

Experimental facility of innovative types as the laboratory analog of research reactor experimental device

International Nuclear Information System (INIS)

Androsenko, A.A.; Androsenko, P.A.; Zabud'ko, A.N.; Kremenetskij, A.K.; Nikolaev, A.N.; Trykov, L.A.

1991-01-01

The paper analyses capability of creating laboratory analogs of complex experimental facilities at research reactors utilizing power radionuclide neutron sources fabricated in industrial conditions. Some experimental and calculational investigations of neutron-physical characteristics are presented, which have been attained at the RIZ research reactor laboratory analog. Experimental results are supplemented by calculational investigations, fulfilled by means of the BRAND three-dimensional computational complex and the ROZ-6 one-dimensional program. 4 refs.; 3 figs

Experimental halls workshop summary

International Nuclear Information System (INIS)

Thorndike, A.

1976-01-01

On May 26 and 27, 1976, approximately 50 people met for an informal workshop on plans for experimental halls for ISABELLE. Plans as they exist in the May 1976 version of the ISABELLE proposal were presented. Discussions were held on the following four general topics by separate working groups: (1) pros and cons of open areas as compared with enclosed halls; (2) experimental hall needs of ep, anti pp, and other options; (3) hall for the lepton detector; and (4) hall for the hadron spectrometer. The planning for experimental halls at PEP, the hall for the lepton detector, the hadron spectrometer, and open areas are discussed

Report of experimental hall subworking group

International Nuclear Information System (INIS)

Miyake, K.; Ohama, T.; Takahashi, K.

1982-01-01

The general plan of constructing the TRISTAN e + e - colliding beam experimental halls may be divided into two parts. The first step is to construct two test-experimental halls associated with the 6.5 GeV x 6.5 GeV e + e - accumulator ring, and the second step is to build four experimental halls at the 30 GeV x 30 GeV e + e - TRISTAN main ring. At this workshop, extensive discussions on the detailed design of the four main ring experimental halls have been made. Four experimental areas will be built at the main ring, and two test-experimental halls at the accumulating ring. Among the four areas at the main ring, two will be used for electron-proton possible as well as electron-positron colliding beam experiment. The other two will be used exclusively for e + e - colliding experiments. Only a preliminary design has been made for these four experimental areas. A tentative plan of a larger experimental hall includes a counting and data processing room, a utility room, and a radiation safety control room. Two smaller halls have simpler structure. The figures of the experimental halls are presented. The two test-experimental halls at the accumulator ring will be used to test the detectors for e + e - colliding experiments before the final installation. The utility rooms designed for the halls are used to supply coolant and electric power of superconducting magnets. At the workshop, various ideas concerning the preliminary plan are presented. (Kato, T.)

Children's Understanding of Experimental Contrast and Experimental Control: An Inventory for Primary School

Science.gov (United States)

Osterhaus, Christopher; Koerber, Susanne; Sodian, Beate

2015-01-01

Experimentation skills are a central component of scientific thinking, and many studies have investigated whether and when primary-school children develop adequate experimentation strategies. However, the answers to these questions vary substantially depending on the type of task that is used: while discovery tasks, which require children to…

The 14th International Workshops on Opportunistic Protists (IWOP 14).

Science.gov (United States)

Cushion, Melanie T; Limper, Andrew H; Porollo, Aleksey; Saper, Vivian E; Sinai, Anthony P; Weiss, Louis M

2018-05-03

The 14th International Workshops on Opportunistic Protists (IWOP-14) was held August 10-12, 2017 in Cincinnati, OH, USA. The IWOP meetings focus on opportunistic protists (OIs); for example, free-living amoebae, Pneumocystis spp., Cryptosporidium spp., Toxoplasma, the Microsporidia, and kinetoplastid flagellates. The highlights of Pneumocystis spp. research included the reports of primary homothallism for mating; a potential requirement for sexual replication in its life cycle; a new antigen on the surface of small asci; roles for CLRs, Dectin-1, and Mincle in host responses; and identification of MSG families and mechanisms used for surface variation. Studies of Cryptosporidia spp. included comparative genomics, a new cryopreservation method; the role of mucin in attachment and invasion, and epidemiological surveys illustrating species diversity in animals. One of the five identified proteins in the polar tube of Microsporidia, PTP4, was shown to play a role in host infection. Zebrafish were used as a low cost vertebrate animal model for an evaluation of potential anti-toxoplasma drugs. Folk medicine compounds with anti-toxoplasma activity were presented, and reports on the chronic toxoplasma infection provided evidence for increased tractability for the study of this difficult life cycle stage. Escape from the parasitophorus vacuole and cell cycle regulation were the topics of the study in the acute phase. © 2018 International Society of Protistologists.

Computer system for Monte Carlo experimentation

International Nuclear Information System (INIS)

Grier, D.A.

1986-01-01

A new computer system for Monte Carlo Experimentation is presented. The new system speeds and simplifies the process of coding and preparing a Monte Carlo Experiment; it also encourages the proper design of Monte Carlo Experiments, and the careful analysis of the experimental results. A new functional language is the core of this system. Monte Carlo Experiments, and their experimental designs, are programmed in this new language; those programs are compiled into Fortran output. The Fortran output is then compiled and executed. The experimental results are analyzed with a standard statistics package such as Si, Isp, or Minitab or with a user-supplied program. Both the experimental results and the experimental design may be directly loaded into the workspace of those packages. The new functional language frees programmers from many of the details of programming an experiment. Experimental designs such as factorial, fractional factorial, or latin square are easily described by the control structures and expressions of the language. Specific mathematical modes are generated by the routines of the language

Experimenter gender and replicability in science.

Science.gov (United States)

Chapman, Colin D; Benedict, Christian; Schiöth, Helgi B

2018-01-01

There is a replication crisis spreading through the annals of scientific inquiry. Although some work has been carried out to uncover the roots of this issue, much remains unanswered. With this in mind, this paper investigates how the gender of the experimenter may affect experimental findings. Clinical trials are regularly carried out without any report of the experimenter's gender and with dubious knowledge of its influence. Consequently, significant biases caused by the experimenter's gender may lead researchers to conclude that therapeutics or other interventions are either overtreating or undertreating a variety of conditions. Bearing this in mind, this policy paper emphasizes the importance of reporting and controlling for experimenter gender in future research. As backdrop, it explores what we know about the role of experimenter gender in influencing laboratory results, suggests possible mechanisms, and suggests future areas of inquiry.

Strength of Experimental Grouts

DEFF Research Database (Denmark)

Sørensen, Eigil V.

 The present report describes tests carried out on 5 experimental grouts developed by BASF Construction Materials and designed for use in grouted connections of offshore windmill foundations....... The present report describes tests carried out on 5 experimental grouts developed by BASF Construction Materials and designed for use in grouted connections of offshore windmill foundations....

Introduction: Experimental Green Strategies

DEFF Research Database (Denmark)

Peters, Terri

2011-01-01

Defining new ways in which archietcts are responding to the challenge of creating sustainable architecture , Experimental Green Strategies present a state of the art in applied ecological architectural research.......Defining new ways in which archietcts are responding to the challenge of creating sustainable architecture , Experimental Green Strategies present a state of the art in applied ecological architectural research....

Pneumocystis jirovecii infection of the external auditory canal

African Journals Online (AJOL)

nonspecific symptoms of otorrhoea, otalgia, hearing loss, vertigo and tinnitus. Clinical findings include a mass in the external auditory canal and occasional otitis media. Destruction of the ossicles and sclerosis of the mastoid air cells, extensive bony erosion, and extension into the middle cranial fossa are rare complications.

Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock

Directory of Open Access Journals (Sweden)

Sneha Nandy

2015-01-01

Full Text Available Human immunodeficiency virus (HIV-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles, Cryptococcus neoformans, Kaposi′s sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis.

The '3Is' of animal experimentation.

Science.gov (United States)

2012-05-29

Animal experimentation in scientific research is a good thing: important, increasing and often irreplaceable. Careful experimental design and reporting are at least as important as attention to welfare in ensuring that the knowledge we gain justifies using live animals as experimental tools.

2016 International Symposium on Experimental Robotics

CERN Document Server

Nakamura, Yoshihiko; Khatib, Oussama; Venture, Gentiane

2017-01-01

Experimental Robotics XV is the collection of papers presented at the International Symposium on Experimental Robotics, Roppongi, Tokyo, Japan on October 3-6, 2016. 73 scientific papers were selected and presented after peer review. The papers span a broad range of sub-fields in robotics including aerial robots, mobile robots, actuation, grasping, manipulation, planning and control and human-robot interaction, but shared cutting-edge approaches and paradigms to experimental robotics. The readers will find a breadth of new directions of experimental robotics. The International Symposium on Experimental Robotics is a series of bi-annual symposia sponsored by the International Foundation of Robotics Research, whose goal is to provide a forum dedicated to experimental robotics research. Robotics has been widening its scientific scope, deepening its methodologies and expanding its applications. However, the significance of experiments remains and will remain at the center of the discipline. The ISER gatherings are...

Experimental Research in Marketing

Directory of Open Access Journals (Sweden)

Jose Mauro Hernandez

2014-05-01

Full Text Available Considering the growing number of scientific studies published in the marketing field and the development of unique theories of the area (Hunt, 2010, using experimental designs seems increasingly appropriate to investigate marketing phenomena. This article aims to discuss the main elements in conducting experimental studies and also to stimulate researchers to adopt this research method. Several international journals (e.g., JCR, JCP, JMR, JR, JBR have been publishing articles based on experiments that not only demonstrate a relationship between two events, but also elucidate how they occur by means of mediation and moderation analyses. This article intents to be a roadmap for novice researchers on how to conduct experiments and to offer new perspectives in experimental research for experienced researchers.  

Shielding in experimental areas

International Nuclear Information System (INIS)

Stevens, A.; Tarnopolsky, G.; Thorndike, A.; White, S.

1979-01-01

The amount of shielding necessary to protect experimental detectors from various sources of background radiation is discussed. As illustrated an experiment has line of sight to sources extending approx. 90 m upstream from the intersection point. Packing a significant fraction of this space with shielding blocks would in general be unacceptable because primary access to the ring tunnel is from the experimental halls. (1) From basic machine design considerations and the inherent necessity to protect superconducting magnets it is expected that experimental areas in general will be cleaner than at any existing accelerator. (2) Even so, it will likely be necessary to have some shielding blocks available to protect experimental apparatus, and it may well be necessary to have a large amount of shielding available in the WAH. (3) Scraping will likely have some influence on all halls, and retractable apparatus may sometimes be necessary. (4) If access to any tunnel is needed to replace a magnet, one has 96 h (4 days) available to move shielding away to permit access without additional downtime. This (the amount of shielding one can shuffle about in 96 h) is a reasonable upper limit to shielding necessary in a hall

The Experimental Art School

DEFF Research Database (Denmark)

Ørum, Tania

2014-01-01

The article describes the Experimental Art School from its early beginnings, its development from formal experiments to political action, the question of gender and politics, and the power of the self-organised......The article describes the Experimental Art School from its early beginnings, its development from formal experiments to political action, the question of gender and politics, and the power of the self-organised...

Experimental work on drift chambers

International Nuclear Information System (INIS)

Alcaraz, J.; Duran, I.; Gonzalez, E.; Martinez-Laso, L.; Olmos, P.

1989-01-01

An experimental work made on drift chambers is described in two chapters. In the firt chapter we present the description of the experimental installation used, as well as some details on the data adquisition systems and the characteristics on three ways used for calibration proposes (cosmic muons, β radiation and test beam using SPS at CERN facilities). The second chapter describes the defferent prototypes studied. The experimental set up and the analysis are given. Some results are discussed. The magnetic field effect is also studied. (Author)

Experimental plasma research project summaries

International Nuclear Information System (INIS)

1982-10-01

The experimental plasma Research Branch has responsibility for developing a broad range of experimental data and new experimental techniques that are required for operating and interpreting present large-scale confinement experiments, and for designing future deuterium-tritium burining facilities. The Branch pursued these objectives by supporting research in DOE laboratories, other Federal laboratories, other Federal laboratories, universities, and private industry. Initiation and renewal of research projects are primarily through submission of unsolicited proposals by these institutions to DOE. Summaries of these projects are given

Experimental intrauterine growth retardation.

Science.gov (United States)

van Marthens, E; Harel, S; Zamenshof, S

1975-01-01

The effects of experimental intrauterine growth retardation on subsequent fetal development, especially with respect to brain development, were studied in a new animal model. The rabbit was chosen since it has a perinatal pattern of brain development similar to that of the human. Experimental ischemia was induced during the last trimester by ligation of spiral arterioles and the differential effects on fetal development at term (30th gestational day) are reported. Specific brain regions were examined for wet weight, total cell number (DNA) and total protein content. Highly significant decreases in all these parameters were found in both the cortex and cerebellum following experimental intrauterine growth retardation; these two organs were differentially affected. The prospects and advantages of using this animal model for the study of the postnatal "catch-up growth" are discussed.

Experimental design a chemometric approach

CERN Document Server

Deming, SN

1987-01-01

Now available in a paperback edition is a book which has been described as ``...an exceptionally lucid, easy-to-read presentation... would be an excellent addition to the collection of every analytical chemist. I recommend it with great enthusiasm.'' (Analytical Chemistry). Unlike most current textbooks, it approaches experimental design from the point of view of the experimenter, rather than that of the statistician. As the reviewer in `Analytical Chemistry' went on to say: ``Deming and Morgan should be given high praise for bringing the principles of experimental design to the level of the p

Summary of experimental insertions workshop

International Nuclear Information System (INIS)

Sandweiss, J.; Month, M.

1976-01-01

The last ISABELLE workshop of the summer 1976 series, which was held at Brookhaven, August 16-20, focused on the design and utilization of the experimental insertions. The goals of the workshop, which were somewhat more general than might be suggested by the title, are: (1) review the ISABELLE proposal from the point of view of experimental use; (2) contribute useful information on the ''open questions'' in the ISABELLE design; (3) develop data for experimental equipment and operating cost estimates; and (4) project a first approximation to ISABELLE operating modes

Experimental study of Coal Pyrolysis 1.: Review of the experimental information from the literature

International Nuclear Information System (INIS)

Hugony, F.; Migliavacca, G.

2007-01-01

A brief analysis of some of the main experimental works published in the past decades about coal pyrolysis is here reported. In particular the results of some series of experiments are cited and reported in details, coming from the activity of some important international research teams; they supply a survey wide and complete enough of the different operating and experimental conditions proposed in this field. With the aim of giving a comparison benchmark for the original experimental data published in the companion paper of this series and in order to grant a good support to the validation of the predictive models of coal devolatilization [it

Color and experimental physics

International Nuclear Information System (INIS)

Chanowitz, M.S.

1975-01-01

After a brief review of the color hypothesis and the motivations for its introduction, the experimental tests arare discussed. It is assumed that colored states have not been produced at present energies and only experimental tests which apply below the color threshold, when color is a ''hidden symmetry,'' are discussed. Some of these tests offer the possibility of distinguishing between quark models with fractional and integral quark charges. (auth)

Surface physics : experimental

International Nuclear Information System (INIS)

Padalia, B.D.

1978-01-01

In this report, discussion is confined to some important ultra high vacuum surface techniques such as ultra-violet photoelectron spectroscopy (UPS), X-ray photoelectron spectroscopy (XPS), Auger electron spectroscopy (AES) and the low energy electron diffraction (LEED). An attempt is made to cover the basic principles and the experimental details of XPS and AES. Selected examples illustrating the potentialities of the above techniques to solve the important basic as well as applied problems relating to surfaces are presented. Salient features of the available commercial machines in which UPS, AES and LEED are combined to facilitate surface examination sequentially or simultaneously under identical experimental conditions are indicated. (auth.)

Threats to the Internal Validity of Experimental and Quasi-Experimental Research in Healthcare.

Science.gov (United States)

Flannelly, Kevin J; Flannelly, Laura T; Jankowski, Katherine R B

2018-01-24

The article defines, describes, and discusses the seven threats to the internal validity of experiments discussed by Donald T. Campbell in his classic 1957 article: history, maturation, testing, instrument decay, statistical regression, selection, and mortality. These concepts are said to be threats to the internal validity of experiments because they pose alternate explanations for the apparent causal relationship between the independent variable and dependent variable of an experiment if they are not adequately controlled. A series of simple diagrams illustrate three pre-experimental designs and three true experimental designs discussed by Campbell in 1957 and several quasi-experimental designs described in his book written with Julian C. Stanley in 1966. The current article explains why each design controls for or fails to control for these seven threats to internal validity.

Experimental Methods in Media Research

NARCIS (Netherlands)

C.W. Handke (Christian); C. Herzog (Christian)

2017-01-01

textabstractCausal effects are a prime concern in media policy research, and experimental research designs are widely regarded as the most effective way to identify and gauge causality. Nevertheless, explicit applications of experimental methods are rare in media policy research. This chapter

Online Experimentation in Education and Training

Directory of Open Access Journals (Sweden)

Maria Teresa Restivo

2014-03-01

Full Text Available The increasing use of emergent technologies in industry, medicine, research, training and education attests to the relevance of their integration in teaching/learning approaches. Online experimentation comprises remote and virtual experimentation also supported and complemented by other online tools that incorporate necessarily the use of emergent technologies. The present work synthesizes the final outcomes of a project aiming to develop, use and disseminate Online Experimentation, funded by the Calouste Gulbenkian Foundation. Some application examples are given to illustrate the use of online experimentation on different contexts, such as secondary and higher education (STEM, lifelong learning or industrial training.

Toward a Holistic Federated Future Internet Experimentation Environment: The Experience of NOVI Research and Experimentation

NARCIS (Netherlands)

Maglaris, V.; Papagianni, C.; Androulidakis, G.; Grammatikou, M.; Grosso, P.; van der Ham, J.; de Laat, C.; Pietrzak, B.; Belter, B.; Steger, J.; Laki, S.; Campanella, M.; Sallent, S.

This article presents the design and pilot implementation of a suite of intelligent methods, algorithms, and tools for federating heterogeneous experimental platforms (domains) toward a holistic Future Internet experimentation ecosystem. The proposed framework developed within the NOVI research and

Experimental Research in Marketing

OpenAIRE

Jose Mauro Hernandez; Kenny Basso; Marcelo Moll Brandão

2014-01-01

Considering the growing number of scientific studies published in the marketing field and the development of unique theories of the area (Hunt, 2010), using experimental designs seems increasingly appropriate to investigate marketing phenomena. This article aims to discuss the main elements in conducting experimental studies and also to stimulate researchers to adopt this research method. Several international journals (e.g., JCR, JCP, JMR, JR, JBR) have been publishing articles based on expe...

Experimental guidelines

International Nuclear Information System (INIS)

1997-01-01

The paper proposes a model experimental design to study the effects of pesticides on particular ecosystem. It takes maize as a model crop and an alternative crop while studying the adverse effects on untargeted arthropods, residues in the soil and other plants. 5 refs, 7 figs

Experimental approach to explosive nucleosynthesis

International Nuclear Information System (INIS)

Kubono, S.

1991-07-01

Recent development of experimental studies on explosive nucleosynthesis, especially the rapid proton process and the primordial nucleosynthesis were discussed with a stress on unstable nuclei. New development in the experimental methods for the nuclear astrophysics is also discussed which use unstable nuclear beams. (author)

Open source in Experimental Psychology

OpenAIRE

Dalmaijer, Edwin

2015-01-01

Talk on using open-source software in experimental psychology. Presented on 3 March 2015, at the Attention, Brain and Cognitive Development group (http://www.psy.ox.ac.uk/research/attention-brain-and-cognitive-development-group) at the University of Oxford's Department of Experimental Psychology.

Cameroon Journal of Experimental Biology

African Journals Online (AJOL)

The Cameroon Journal of Experimental Biology is the official journal of the Cameroon Forum for Biological Sciences (CAFOBIOS). It is an interdisciplinary journal for the publication of original research papers, short communications and review articles in all fields of experimental biology including biochemistry, physiology, ...

Spectrum Of Opportunistic Infections In Aids Cases In A Tertiary Care Hospital In Nepal

Directory of Open Access Journals (Sweden)

Hari Shanker Joshi

2006-12-01

Full Text Available A retrospective study was carried out, 404 clinically suspected cases attending AIDS clinic at Manipal Teaching Hospital, Pokhara, Nepal to assess an occurance of opportunistic infections in AIDS cases. Study reveals that Tuberculosis (60%, Cryptospridiosis (13.33% and candidasis (11.11% are the predominant opportunistic infection in HIV/AIDS patients in the Pokharo village. Next common pathogen was found an ubiquitous yeast. Candida obtained from skin, oral cavity, oesophagus, sputum and stool. The least common documented documented infection was pneumocystis carini pneumonia (2.22%.

Problems of the experimental implementation of MTJ

International Nuclear Information System (INIS)

Mazaletskiy, L A; Rudy, A S; Trushin, O S; Naumov, V V; Mironenko, A A; Vasilev, S V

2015-01-01

The results of experimental studies of MRAM technology based on standard magnetic tunneling junctions are presented. Basic steps of experimental fabrication of MRAM cell are considered. Experimental samples of MTJ with variable lateral sizes are fabricated. Current-voltage characteristics of the tunnel barriers are investigated. Main parameters of the tunnel barriers are estimated from comparison of the experimental data with the theory. (paper)

Experimental tests of gauge theories

International Nuclear Information System (INIS)

Haidt, D.

1984-11-01

This series of five lectures is intended to provide the experimental basis to the theoretical courses on gauge symmetries delivered by C. Jarlskog and R. Petronzio. The framework is the standard model. The experimental material is taken mainly from lepton-hadron and e + e - -experiments. (orig./HSI)

A proposal for experimental homework

Science.gov (United States)

Rodríguez, Eduardo E.

1998-10-01

Homework in Physics courses usually deal with conceptual inquiries or numerical solution of theoretical problems. However, experimental homework is rather uncommon. I propose that certain physical situations properly simulated may be useful to encourage students to seek a solution behind the steps of the "experimental method."

Strongly correlated systems experimental techniques

CERN Document Server

Mancini, Ferdinando

2015-01-01

The continuous evolution and development of experimental techniques is at the basis of any fundamental achievement in modern physics. Strongly correlated systems (SCS), more than any other, need to be investigated through the greatest variety of experimental techniques in order to unveil and crosscheck the numerous and puzzling anomalous behaviors characterizing them. The study of SCS fostered the improvement of many old experimental techniques, but also the advent of many new ones just invented in order to analyze the complex behaviors of these systems. Many novel materials, with functional properties emerging from macroscopic quantum behaviors at the frontier of modern research in physics, chemistry and materials science, belong to this class of systems. The volume presents a representative collection of the modern experimental techniques specifically tailored for the analysis of strongly correlated systems. Any technique is presented in great detail by its own inventor or by one of the world-wide recognize...

Los Alamos Experimental Engineering Waste Burial Facility: design considerations and preliminary experimental plan

International Nuclear Information System (INIS)

DePoorter, G.L.

1981-01-01

The Experimental Engineered Waste Burial Facility is a field test site where generic experiments can be performed on several scales to get the basic information necessary to understand the processes occurring in low-level waste disposal facilities. The experiments include hydrological, chemical, mechanical, and biological factors. In order to separate these various factors in the experiments and to extrapolate the experimental results to actual facilities, experiments will be performed on several different scales

The experimental nuclear reactor: AQUILON; Le reacteur nucleaire experimental: AQUILON

Energy Technology Data Exchange (ETDEWEB)

Girard, Y; Koechlin, J C; Moreau, J M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1958-07-01

'Aquilon' is an experimental reactor specially designed for the neutronic study of heterogeneous multiplying media with solid fuel and liquid moderator. Since this study is in general incompatible with energy production, the power of the reactor has been limited to a minimum so as to be able to obtain a simple and compact structure, easy access, good handling and great flexibility of operation and utilisation. (author) [French] 'Aquilon' est un reacteur experimental specialement concu pour l'etude neutronique de milieux multiplicateurs heterogenes a combustible solide et ralentisseur liquide. Cette etude etant en general incompatible avec la production d'energie, on a limite au minimum la puissance du reacteur pour pouvoir obtenir une structure simple et peu encombrante, un acces facile, une bonne maniabilite et une grande souplesse de fonctionnement et d'utilisation. (auteur)

Experimental test of magnetic photons

International Nuclear Information System (INIS)

Lakes, R.S.

2004-01-01

A 'magnetic' photon hypothesis associated with magnetic monopoles is tested experimentally. These photons are predicted to easily penetrate metal. Experimentally the optical transmittance T of a metal foil was less than 2x10-17. The hypothesis is not supported since it predicts T=2x10-12

Preclinical electrogastrography in experimental pigs

Science.gov (United States)

Květina, Jaroslav; Varayil, Jithinraj Edakkanambeth; Ali, Shahzad Marghoob; Kuneš, Martin; Bureš, Jan; Tachecí, Ilja; Rejchrt, Stanislav; Kopáčová, Marcela

2010-01-01

Surface electrogastrography (EGG) is a non-invasive means of recording gastric myoelectric activity or slow waves from cutaneous leads placed over the stomach. This paper provides a comprehensive review of preclinical EGG. Our group recently set up and worked out the methods for EGG in experimental pigs. We gained our initial experience in the use of EGG in assessment of porcine gastric myoelectric activity after volume challenge and after intragastric administration of itopride and erythromycin. The mean dominant frequency in pigs is comparable with that found in humans. EGG in experimental pigs is feasible. Experimental EGG is an important basis for further preclinical projects in pharmacology and toxicology. PMID:21217873

Experimental Learning Enhancing Improvisation Skills

Science.gov (United States)

Pereira Christopoulos, Tania; Wilner, Adriana; Trindade Bestetti, Maria Luisa

2016-01-01

Purpose: This study aims to present improvisation training and experimentation as an alternative method to deal with unexpected events in which structured processes do not seem to work. Design/Methodology/Approach: Based on the literature of sensemaking and improvisation, the study designs a framework and process model of experimental learning…

BENSC. Experimental reports 1995

International Nuclear Information System (INIS)

Kirschbaum, Y.; Gast, H.; Michaelsen, R.

1996-06-01

The present volume contains a collection of BENSC Experimental Reports. The reports present an overview on the experimental work carried out on BENSC in 1995. About 70 percent of the beam time is available to external users. A qualitative step is the start of user operation of the new advanced Time-of-Flight Spectrometer V3 (NEAT). The increase of SANS project for the Double Crystal Diffractometer V12 is noticed. The current list of instruments and instrument responsibles is given. (DG)

An experimenter's history of neutral currents

International Nuclear Information System (INIS)

Sciulli, F.

1979-01-01

The history of the experimental study of neutral currents, defined as the class of weak interactions engaged in by lepton pairs of net zero charge, is traced under the headings; historical motivations, experimental searches, first positive indications, neutral currents corroborated, neutrino experiments on neutral currents and some general experimental comments. It is concluded that the neutral current does exist and predicted on the basis of gauge theory ideas, and though to connect the weak and electromagnetic interactions, its very general experimental properties are quite consistent with those ideas. Among these are flavor conserving complicated isospin structure, complicated V, A structure and a structure which depends on the type (or quantum numbers) of the target. 50 references. (UK)

Experimental studies

International Nuclear Information System (INIS)

Cowser, K.E.; Stansbury, P.S.; Poston, J.W.; Deus, S.F.; Chen, W.L.; Roswell, R.L.; Goans, R.E.; Cantrell, J.H. Jr.

1978-01-01

Spectral fluence measurements in an adult phantom are reported. A NaI(Tl) probe was used in various locations within the phantom and pulse-height spectra were obtained for seven beam configurations and three generating potentials. Some typical spectra results are presented. A comparison of calculated dose to experimental measurements is presented

Simultaneous estimation of experimental and material parameters

CSIR Research Space (South Africa)

Jansen van Rensburg, GJ

2012-07-01

Full Text Available to the experimental data. An inverse analysis is performed that determines material properties and boundary conditions simultaneously. This idea is investigated using virtual experimental data. The virtual experimental data is obtained by performing a finite element...

MEASUREMENT AND PRECISION, EXPERIMENTAL VERSION.

Science.gov (United States)

Harvard Univ., Cambridge, MA. Harvard Project Physics.

THIS DOCUMENT IS AN EXPERIMENTAL VERSION OF A PROGRAMED TEXT ON MEASUREMENT AND PRECISION. PART I CONTAINS 24 FRAMES DEALING WITH PRECISION AND SIGNIFICANT FIGURES ENCOUNTERED IN VARIOUS MATHEMATICAL COMPUTATIONS AND MEASUREMENTS. PART II BEGINS WITH A BRIEF SECTION ON EXPERIMENTAL DATA, COVERING SUCH POINTS AS (1) ESTABLISHING THE ZERO POINT, (2)…

Experimental Mathematics and Computational Statistics

Energy Technology Data Exchange (ETDEWEB)

Bailey, David H.; Borwein, Jonathan M.

2009-04-30

The field of statistics has long been noted for techniques to detect patterns and regularities in numerical data. In this article we explore connections between statistics and the emerging field of 'experimental mathematics'. These includes both applications of experimental mathematics in statistics, as well as statistical methods applied to computational mathematics.

Safety Research and Experimental Coal Mines

Data.gov (United States)

Federal Laboratory Consortium — Safety Research and Experimental Coal MinesLocation: Pittsburgh SiteThe Safety Research Coal Mine and Experimental Mine complex is a multi-purpose underground mine...

REBA experimenters' manual

International Nuclear Information System (INIS)

Schuch, R.L.

1977-04-01

The REBA is a high-energy, pulsed electron beam or bremsstrahlung x-ray generator whose operational purpose is to provide an energy source of short duration for conducting experiments, primarily to determine material responses to rapid surface and in-depth deposition of energy. The purpose of this manual is to serve as a basic source of information for prospective users of REBA. Included is a brief discussion of the design and operation of the facility as well as a summary of output characteristics for electron beam modes and environmental data for x-ray operation. The manual also contains a description of the REBA experimental facilities, including geometry of the test cell, instrumentation and data collection capabilities, and services and support available to experimenters

Access to Experimental Cancer Drugs

Science.gov (United States)

An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

Knockout reactions: experimental aspects

Energy Technology Data Exchange (ETDEWEB)

Cortina Gil, D. [Santiago de Compostela Univ. (Spain)

2007-07-01

The availability of radioactive beams has given rise to intense activity in the field of direct reactions. The removal of one(two)-nucleon (referred to as nucleon knockout in this text) from a fast exotic projectile has been extensively investigated. This lecture provides a general overview of the experimental results achieved using this technique. The sensitivity of the method to different experimental aspects is illustrated with a few examples. Special attention is given to the application of nucleon-knockout reactions as a general purpose spectroscopic tool. (author)

Knockout reactions: experimental aspects

International Nuclear Information System (INIS)

Cortina Gil, D.

2007-01-01

The availability of radioactive beams has given rise to intense activity in the field of direct reactions. The removal of one(two)-nucleon (referred to as nucleon knockout in this text) from a fast exotic projectile has been extensively investigated. This lecture provides a general overview of the experimental results achieved using this technique. The sensitivity of the method to different experimental aspects is illustrated with a few examples. Special attention is given to the application of nucleon-knockout reactions as a general purpose spectroscopic tool. (author)

Quasi experimental designs in pharmacist intervention research.

Science.gov (United States)

Krass, Ines

2016-06-01

Background In the field of pharmacist intervention research it is often difficult to conform to the rigorous requirements of the "true experimental" models, especially the requirement of randomization. When randomization is not feasible, a practice based researcher can choose from a range of "quasi-experimental designs" i.e., non-randomised and at time non controlled. Objective The aim of this article was to provide an overview of quasi-experimental designs, discuss their strengths and weaknesses and to investigate their application in pharmacist intervention research over the previous decade. Results In the literature quasi experimental studies may be classified into five broad categories: quasi-experimental design without control groups; quasi-experimental design that use control groups with no pre-test; quasi-experimental design that use control groups and pre-tests; interrupted time series and stepped wedge designs. Quasi-experimental study design has consistently featured in the evolution of pharmacist intervention research. The most commonly applied of all quasi experimental designs in the practice based research literature are the one group pre-post-test design and the non-equivalent control group design i.e., (untreated control group with dependent pre-tests and post-tests) and have been used to test the impact of pharmacist interventions in general medications management as well as in specific disease states. Conclusion Quasi experimental studies have a role to play as proof of concept, in the pilot phases of interventions when testing different intervention components, especially in complex interventions. They serve to develop an understanding of possible intervention effects: while in isolation they yield weak evidence of clinical efficacy, taken collectively, they help build a body of evidence in support of the value of pharmacist interventions across different practice settings and countries. However, when a traditional RCT is not feasible for

Establishment for quality control of experimental animal

International Nuclear Information System (INIS)

Kim, Tae Hwan; Kim, Soo Kwan; Kim, Tae Kyoung

1999-06-01

Until now, because we have imported experimental animal from foreign experimental animal corporation, we could have saved money by establishing the quality control of animal in barrier system. In order to improve the quality of animal experiment and efficiency of biomedical study, it is indispensable to control many factors that effect in the experiment. Therefore, it is essential to organize the system of laboratory animal care for enhancing reliability and revivability of experimental results. The purpose of the present investigation was to establish the quality control system of experimental animals that we can provide good quality animals according to the experimental condition of each investigator although the exact quality control system to estimate the infection of bacteria and virus easily remains ill-defined yet. Accordingly, we established the useful quality control system for microbiologic monitoring and environmental monitoring to protect experimental animal from harmful bacteria and virus

Establishment for quality control of experimental animal

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae Hwan; Kim, Soo Kwan; Kim, Tae Kyoung

1999-06-01

Until now, because we have imported experimental animal from foreign experimental animal corporation, we could have saved money by establishing the quality control of animal in barrier system. In order to improve the quality of animal experiment and efficiency of biomedical study, it is indispensable to control many factors that effect in the experiment. Therefore, it is essential to organize the system of laboratory animal care for enhancing reliability and revivability of experimental results. The purpose of the present investigation was to establish the quality control system of experimental animals that we can provide good quality animals according to the experimental condition of each investigator although the exact quality control system to estimate the infection of bacteria and virus easily remains ill-defined yet. Accordingly, we established the useful quality control system for microbiologic monitoring and environmental monitoring to protect experimental animal from harmful bacteria and virus.

Experimental overview

International Nuclear Information System (INIS)

Nagamiya, Shoji

1992-01-01

Five years ago the first heavy-ion beams were accelerated at both the BNL-AGS and the CERN-SPS. This conference is the 5th anniversary in the experimental field. Currently, four experimental groups (E802/E859, E810, E814, E858) are taking data at BNL and eight groups (NA34-3, NA44, NA45, NA35, NA36, NA38, WA80/WA93, WA85) at CERN. Au and Pb beams are about to come, and a lot of activities are going on for RHIC and LHC. The purpose of this talk is to overview where we are, in particular, by looking at the past data. In this talk, the data of proton rapidity distributions are reviewed first to study nuclear transparency, then, the data of energy spectra and slopes, HBT and anti d production are discussed in connection with the evolution of the collision. Third, the data of strangeness production are described. Finally, the status of J/ψ and that of soft photons and electron pairs are briefly overviewed. (orig.)

Optimal Bayesian Experimental Design for Combustion Kinetics

KAUST Repository

Huan, Xun

2011-01-04

Experimental diagnostics play an essential role in the development and refinement of chemical kinetic models, whether for the combustion of common complex hydrocarbons or of emerging alternative fuels. Questions of experimental design—e.g., which variables or species to interrogate, at what resolution and under what conditions—are extremely important in this context, particularly when experimental resources are limited. This paper attempts to answer such questions in a rigorous and systematic way. We propose a Bayesian framework for optimal experimental design with nonlinear simulation-based models. While the framework is broadly applicable, we use it to infer rate parameters in a combustion system with detailed kinetics. The framework introduces a utility function that reflects the expected information gain from a particular experiment. Straightforward evaluation (and maximization) of this utility function requires Monte Carlo sampling, which is infeasible with computationally intensive models. Instead, we construct a polynomial surrogate for the dependence of experimental observables on model parameters and design conditions, with the help of dimension-adaptive sparse quadrature. Results demonstrate the efficiency and accuracy of the surrogate, as well as the considerable effectiveness of the experimental design framework in choosing informative experimental conditions.

13th International Symposium on Experimental Robotics

CERN Document Server

Dudek, Gregory; Khatib, Oussama; Kumar, Vijay

2013-01-01

The International Symposium on Experimental Robotics (ISER) is a series of bi-annual meetings which are organized in a rotating fashion around North America, Europe and Asia/Oceania. The goal of  ISER is to provide a forum for research in robotics that focuses on novelty of theoretical contributions validated by experimental results. The meetings are conceived to bring together, in a small group setting, researchers from around the world who are in the forefront of experimental robotics research. This unique reference presents the latest advances across the various fields of robotics, with ideas that are not only conceived conceptually but also explored experimentally. It collects robotics contributions on the current developments and new directions in the field of experimental robotics, which are based on the papers presented at the 13th ISER held held in Québec City, Canada, at the Fairmont Le Château Frontenac, on June 18-21, 2012. This present thirteenth edition of Experimental Robotics edited by Jayd...

12th International Symposium on Experimental Robotics

CERN Document Server

Kumar, Vijay; Sukhatme, Gaurav

2014-01-01

The International Symposium on Experimental Robotics (ISER) is a series of bi-annual meetings which are organized in a rotating fashion around North America, Europe and Asia/Oceania. The goal of  ISER is to provide a forum for research in robotics that focuses on novelty of theoretical contributions validated by experimental results. The meetings are conceived to bring together, in a small group setting, researchers from around the world who are in the forefront of experimental robotics research. This unique reference presents the latest advances across the various fields of robotics, with ideas that are not only conceived conceptually but also explored experimentally. It collects robotics contributions on the current developments and new directions in the field of experimental robotics, which are based on the papers presented at the 12th ISER held on December 18-21, 2010 in New Delhi and Agra, India.This present twelfth edition of Experimental Robotics edited by Oussama Khatib, Vijay Kumar and Gaurav Sukha...

14th International Symposium on Experimental Robotics

CERN Document Server

Khatib, Oussama; Kumar, Vijay

2016-01-01

The International Symposium on Experimental Robotics (ISER) is a series of bi-annual meetings which are organized in a rotating fashion around North America, Europe and Asia/Oceania. The goal of  ISER is to provide a forum for research in robotics that focuses on novelty of theoretical contributions validated by experimental results. The meetings are conceived to bring together, in a small group setting, researchers from around the world who are in the forefront of experimental robotics research. This unique reference presents the latest advances across the various fields of robotics, with ideas that are not only conceived conceptually but also explored experimentally. It collects robotics contributions on the current developments and new directions in the field of experimental robotics, which are based on the papers presented at the 14th ISER held on June 15-18, 2014 in Marrakech and Essaouira, Morocco.  This present fourteenth edition of Experimental Robotics edited by M. Ani Hsieh, Oussama Khatib, and Vi...

SPHINX experimenters information package

International Nuclear Information System (INIS)

Zarick, T.A.

1996-08-01

This information package was prepared for both new and experienced users of the SPHINX (Short Pulse High Intensity Nanosecond X-radiator) flash X-Ray facility. It was compiled to help facilitate experiment design and preparation for both the experimenter(s) and the SPHINX operational staff. The major areas covered include: Recording Systems Capabilities,Recording System Cable Plant, Physical Dimensions of SPHINX and the SPHINX Test cell, SPHINX Operating Parameters and Modes, Dose Rate Map, Experiment Safety Approval Form, and a Feedback Questionnaire. This package will be updated as the SPHINX facilities and capabilities are enhanced

Diagnosis and treatment of invasive fungal diseases in patients with severe liver diseases

Directory of Open Access Journals (Sweden)

ZANG Hong

2016-09-01

Full Text Available Invasive fungal diseases (IFDs are an important factor affecting the prognosis of patients with severe liver diseases, and their early diagnosis remains a challenge for clinicians. The four most commonly seen IFDs are candidiasis, aspergillosis, cryptococcosis, and pneumocystis pneumonia. We should pay attention to the risk of developing IFDs in patients with severe liver diseases during clinical management. Particularly, early diagnosis and proper treatment of IFDs are important in high-risk patients. These are vital to improving the prognosis of patients with severe liver diseases.

Are 1-K display systems suitable for primary diagnosis from radiographic images in picture archiving and communications systems

International Nuclear Information System (INIS)

Dawood, R.M.; Todd-Pokropek, A.; Highman, J.H.; Porter, A.; Craig, J.O.M.C.

1990-01-01

The authors of this paper performed a formal clinical evaluation of a commercially available high-resolution (1,280-line) picture archiving and communications system workstation. Diagnostic accuracy with plain radiographs was compared with that with laser-digitized images, with the use of receiver operating characteristic (ROC) curve methods. Four major clinical groups were studied: hand films of patients with renal osteodystrophy, chest films of patients with pneumocystis pneumonia, mammograms of patients with breast carcinoma, and skull films of patients with fractures. More than 13,000 observations were recorded

Pneumothorax in human immunodeficiency virus infection

Directory of Open Access Journals (Sweden)

Sibes Kumar Das

2015-01-01

Full Text Available Pneumothorax occurs more frequently in people with Human immunodeficiency virus infection in comparison with the general population. In most cases it is secondary the underlying pulmonary disorder, especially pulmonary infections. Though Pneumocystis jiroveci pneumonia is most common pulmonary infection associated with pneumothorax, other infections, non-infective etiology and iatrogenic causes are also encountered. Pneumothorax in these patients are associated with persistent bronchopleural fistula, prolonged hospital stay, poor success with intercostal tube drain, frequent requirement of surgical intervention and increased mortality. Optimal therapeutic approach in these patients is still not well-defined.

Using semantics for representing experimental protocols.

Science.gov (United States)

Giraldo, Olga; García, Alexander; López, Federico; Corcho, Oscar

2017-11-13

An experimental protocol is a sequence of tasks and operations executed to perform experimental research in biological and biomedical areas, e.g. biology, genetics, immunology, neurosciences, virology. Protocols often include references to equipment, reagents, descriptions of critical steps, troubleshooting and tips, as well as any other information that researchers deem important for facilitating the reusability of the protocol. Although experimental protocols are central to reproducibility, the descriptions are often cursory. There is the need for a unified framework with respect to the syntactic structure and the semantics for representing experimental protocols. In this paper we present "SMART Protocols ontology", an ontology for representing experimental protocols. Our ontology represents the protocol as a workflow with domain specific knowledge embedded within a document. We also present the S ample I nstrument R eagent O bjective (SIRO) model, which represents the minimal common information shared across experimental protocols. SIRO was conceived in the same realm as the Patient Intervention Comparison Outcome (PICO) model that supports search, retrieval and classification purposes in evidence based medicine. We evaluate our approach against a set of competency questions modeled as SPARQL queries and processed against a set of published and unpublished protocols modeled with the SP Ontology and the SIRO model. Our approach makes it possible to answer queries such as Which protocols use tumor tissue as a sample. Improving reporting structures for experimental protocols requires collective efforts from authors, peer reviewers, editors and funding bodies. The SP Ontology is a contribution towards this goal. We build upon previous experiences and bringing together the view of researchers managing protocols in their laboratory work. Website: https://smartprotocols.github.io/ .

Experimental effects of exposure to pornography

DEFF Research Database (Denmark)

Hald, Gert Martin; Malamuth, Neil N

2015-01-01

Using a randomly selected community sample of 200 Danish young adult men and women in a randomized experimental design, the study investigated the effects of a personality trait (agreeableness), past pornography consumption, and experimental exposure to non-violent pornography on attitudes...... supporting violence against women (ASV). We found that lower levels of agreeableness and higher levels of past pornography consumption significantly predicted ASV. In addition, experimental exposure to pornography increased ASV but only among men low in agreeableness. This relationship was found...

An experimental system for thermoluminescent dosimetry

International Nuclear Information System (INIS)

Perry, K.E.G.; George, E.

1965-08-01

A thermoluminescent dosimeter (T.L.D.) reader has been developed for experimental investigations on the use of lithium fluoride for 'finger tip' dosimetry. The design of the reader is based on the maximum use of standard electronic units in the A.E.R.E. Type 2000 series but some new unit development has been necessary. The reader gives improved experimental facilities over present commercially-available designs. The technique for 'finger-tip' dosimetry is described and the initial experimental results are given. (author)

On the metaphysics of experimental physics

CERN Document Server

Rogers, K

2005-01-01

This provocative and critical work addresses the question of why scientific realists and positivists consider experimental physics to be a natural and empirical science. Taking insights from contemporary science studies, continental philosophy, and the history of physics, this book describes and analyses the metaphysical presuppositions that underwrite the technological use of experimental apparatus and instruments to explore, model, and understand nature. By revealing this metaphysical foundation, the author questions whether experimental physics is a natural and empirical science at all.

Experimental Design Research

DEFF Research Database (Denmark)

This book presents a new, multidisciplinary perspective on and paradigm for integrative experimental design research. It addresses various perspectives on methods, analysis and overall research approach, and how they can be synthesized to advance understanding of design. It explores the foundations...... of experimental approaches and their utility in this domain, and brings together analytical approaches to promote an integrated understanding. The book also investigates where these approaches lead to and how they link design research more fully with other disciplines (e.g. psychology, cognition, sociology......, computer science, management). Above all, the book emphasizes the integrative nature of design research in terms of the methods, theories, and units of study—from the individual to the organizational level. Although this approach offers many advantages, it has inherently led to a situation in current...

Experimental facilities and simulation means

International Nuclear Information System (INIS)

Thomas, J.B.

2009-01-01

This paper and its associated series of slides review the experimental facilities and the simulation means used for the development of nuclear reactors in France. These experimental facilities include installations used for the measurement and qualification of nuclear data (mainly cross-sections) like EOLE reactor and Minerve zero power reactor, installations like material testing reactors, installations dedicated to reactor safety experiments like Cabri reactor, and other installations like accelerators (Jannus accelerator, GANIL for instance) that are complementary to neutron irradiations in experimental reactors. The simulation means rely on a series of advanced computer codes: Tripoli-Apollo for neutron transport, Numodis for irradiation impact on materials, Neptune and Cathare for 2-phase fluid dynamics, Europlexus for mechanical structures, and Pleiades (with Alcyone) for nuclear fuels. (A.C.)

Experimental Spaces and Institutional Innovation

DEFF Research Database (Denmark)

Cartel, Melodie; Boxenbaum, Eva

and procedures that connect the prototype to the organizational field, hence increasing the likelihood of institutional innovation. We develop a process model of institutional institutionalization that, through temporal interactions between distancing work and anchoring work, enables the generation......This paper examines processes involved in designing experimental spaces for institutional innovation. Through a qualitative, process-oriented analysis of an experimental space related to the institutional innovation of carbon markets in Europe, we show how key actors in the European electricity...... sector deliberately designed an experimental space and engaged a range of stakeholders in experimenting incognito with a carbon market model. A mirror image of their prototype later appeared as European policy. Our findings show that the key actors engaged in two forms of institutional work, distancing...

EXPERIMENTAL LIPOSOMAL VIRAL VACCINE SAFETY

Directory of Open Access Journals (Sweden)

Romanova OA

2016-12-01

Full Text Available Introduction. With the transport links development there is rather important issue respiratory viral infections spread, especially influenza. The only method controlling influenza is vaccination. Search and development effective and safe vaccines is important. Material and methods. In base SO "Mechnikov Institute Microbiology and Immunology National Ukrainian Academy Medical Sciences" in the scientific theme "Developing new approaches to creating viral vaccines and study specific activity depending of type and degree component`s modification" was created several experimental influenza vaccine with subsequent component`s modification for selecting the most optimal pattern of safety and immunogenicity. In assessing the influenza vaccine safety is using a few criteria, including, reactivity, as measured by the frequency of local and systemic adverse (negative effects, which due to its introduction, and for lipid content drugs, ability to influence oxidation processes. At present study phase was determined: a systemic reaction and local reaction of delayed-type hypersensitivity (foot pad swelling assay;b lipids and proteins peroxidation processes after administration officinal and experimental vaccines (content protein’s carbonyl groups, lipid’s hydroperoxides, activity of glutathione-peroxidase.Study objects were trivalent seasonal influenza vaccine, "Vaxigrip" (Sanofi Pasteur, S.A., France, "Inflexal V" (Biotech Ltd. Berne, Switzerland and experimental vaccine samples. Highest immunogenicity vaccines had undergone improvements and modifications using adjuvant systems and acylation influenza proteins. Liposomes 2 – the experimental influenza vaccine with a liposome negative charge and antigenic composition like split vaccines "Vaksihryp". Liposomes 2.1 - the adjuvantexperimental influenza vaccine with modifications liposomal components (etoniy and chlorophyllipt molecules embedded in liposomal membrane. Liposomes 2.2 - the adjuvant

Considering RNAi experimental design in parasitic helminths.

Science.gov (United States)

Dalzell, Johnathan J; Warnock, Neil D; McVeigh, Paul; Marks, Nikki J; Mousley, Angela; Atkinson, Louise; Maule, Aaron G

2012-04-01

Almost a decade has passed since the first report of RNA interference (RNAi) in a parasitic helminth. Whilst much progress has been made with RNAi informing gene function studies in disparate nematode and flatworm parasites, substantial and seemingly prohibitive difficulties have been encountered in some species, hindering progress. An appraisal of current practices, trends and ideals of RNAi experimental design in parasitic helminths is both timely and necessary for a number of reasons: firstly, the increasing availability of parasitic helminth genome/transcriptome resources means there is a growing need for gene function tools such as RNAi; secondly, fundamental differences and unique challenges exist for parasite species which do not apply to model organisms; thirdly, the inherent variation in experimental design, and reported difficulties with reproducibility undermine confidence. Ideally, RNAi studies of gene function should adopt standardised experimental design to aid reproducibility, interpretation and comparative analyses. Although the huge variations in parasite biology and experimental endpoints make RNAi experimental design standardization difficult or impractical, we must strive to validate RNAi experimentation in helminth parasites. To aid this process we identify multiple approaches to RNAi experimental validation and highlight those which we deem to be critical for gene function studies in helminth parasites.

Reform of experimental teaching based on quality cultivation

Science.gov (United States)

Wang, Wei; Yan, Xingwei; Liu, Wei; Yao, Tianfu; Shi, Jianhua; Lei, Bing; Hu, Haojun

2017-08-01

Experimental teaching plays an import part in quality education which devotes to cultivating students with innovative spirit, strong technological talents and practical ability. However, in the traditional experimental teaching mode, the experiments are treated as a vassal or supplementary mean of theoretical teaching, and students prefer focus on theory to practice. Therefore, the traditional experimental teaching mode is difficult to meet the requirements of quality education. To address this issue, the reform of experimental teaching is introduced in this paper taking the photoelectric detector experiment as the example. The new experimental teaching mode is designed from such aspects as experimental content, teaching method and experimental evaluation. With the purpose of cultivating students' practical ability, two different-level experimental content is designed. Not only the basic experiments used to verify the theory are set to consolidate the students' learned theoretical knowledge, but also comprehensive experiments are designed to encourage the students to apply their learned knowledge to solve practical problems. In the teaching process, heuristic teaching thought is adopt and the traditional `teacher-centered' teaching form is replaced by `student-centered' form, which aims to encourage students to design the experimental systems by their own with the teacher's guidance. In addition to depending on stimulating the students' interest of science research, experimental evaluation is necessary to urge students to complete the experiments efficiently. Multifaceted evaluation method is proposed to test the students' mastery of theoretical knowledge, practice ability, troubleshooting and problem solving skills, and innovation capability comprehensively. Practices demonstrated the satisfying effect of our experimental teaching mode.

Experimental pseudo-symmetric trap EPSILON

International Nuclear Information System (INIS)

Skovoroda, A.A.; Arsenin, V.V.; Dlougach, E.D.; Kulygin, V.M.; Kuyanov, A.Yu.; Timofeev, A.V.; Zhil'tsov, V.A.; Zvonkov, A.V.

2001-01-01

Within the framework of the conceptual project 'Adaptive Plasma EXperiment' a trap with the closed magnetic field lines 'Experimental Pseudo-Symmetric trap' is examined. The project APEX is directed at the theoretical and experimental development of physical foundations for stationary thermonuclear reactor on the basis of an alternative magnetic trap with tokamak-level confinement of high β plasma. The fundamental principle of magnetic field pseudosymmetry that should be satisfied for plasma to have tokamak-like confinement is discussed. The calculated in paraxial approximation examples of pseudosymmetric curvilinear elements with poloidal direction of B isolines are adduced. The EPSILON trap consisting of two straight axisymmetric mirrors linked by two curvilinear pseudosymmetric elements is considered. The plasma currents are short-circuited within the curvilinear element what increases the equilibrium β. The untraditional scheme of MHD stabilization of a trap with the closed field lines by the use of divertor inserted into axisymmetric mirror is analyzed. The experimental installation EPSILON-OME that is under construction for experimental check of divertor stabilization is discussed. The possibility of ECR plasma production in EPSILON-OME under conditions of high density and small magnetic field is examined. (author)

[The ethics of animal experimentation].

Science.gov (United States)

Goffi, Jean-Yves

2013-01-01

The paper starts with a short definition of animal experimentation, then three main approaches to the practice are considered: unconditional approval (as advocated by Claude Bernard), conditional and restricted approval (as advocated by Peter Singer) and strict prohibition (as advocated by Tom Regan and Gary Francione). It is argued that what is actually approved or condemned in animal experimentation is the value of the scientific enterprise.

Reflections on experimental science Martin Perl

CERN Document Server

Perl, Martin Lewis

1996-01-01

This is a collection of important lecture and original articles and commentaries by Martin Perl, discoverer of the tau lepton and the third generation of elementary particles, and this year's Nobel Prize winner. This book contains a fascinating and realistic picture of experimental science based on the high energy physics research work carried out by him. Using reprints of his articles with his commentaries, the author presents the various aspects of experimental research in science: the pleasures and risks of experimental work; the pain and frustration with experiments that are useless or fai

Experimental modal analysis

Energy Technology Data Exchange (ETDEWEB)

Ibsen, Lars Bo; Liingaard, M.

2006-12-15

This technical report concerns the basic theory and principles for experimental modal analysis. The sections within the report are: Output-only modal analysis software, general digital analysis, basics of structural dynamics and modal analysis and system identification. (au)

Experimental status of quantum electrodynamics

International Nuclear Information System (INIS)

Drell, S.D.

1980-01-01

The speech of Drell S. on the symposium dedicated to 60th anniversary of Schwinger J. is presented. The fundamental status of the hero of the day in quantum field theory, which turned into quantum electrodynamics, are stated. The theory has been perfectly experimentally confirmed and now is the main model permitting to explain weak and strong interactions. The attention is paid on the difference between theoretical and experimental values of the electron anomalous magnetic moment (asub(e)) obtained in the sixth order of perturbation theory. It is necessary to carry out calculations in the octic order of the perturbation theory in order to obtain more precise value of asub(e). The theory and the experimental difference is demonstrated on the example of estimation of fine and hyperfine structure of hydrogen, muonium, and positronium

Experimental results for an experimental condensation heat exchanger with a spiral minichanel tube. Comparison to numerical imulations

Directory of Open Access Journals (Sweden)

Hrubý J.

2013-04-01

Full Text Available The paper describes new results for an experimental heat exchanger equipped with a single corrugated capillary tube, basic information about the measurements and the experimental setup. Some of the results were compared with numerical simulations.

Experimental insertions

International Nuclear Information System (INIS)

Sandweiss, J.; Kycia, T.F.

1975-01-01

A discussion is given of the eight identical experimental insertions for the planned ISABELLE storage rings. Four sets of quadrupole doublets are used to match the β functions in the insertions to the values in the cells, and the total free space available at the crossing point is 40 meters. An asymmetric beam energy operation is planned, which will be useful in a number of experiments

Experimental rigs for MHD studies

International Nuclear Information System (INIS)

Venkataramani, N.; Jayakumar, R.; Iyer, D.R.; Dixit, N.S.

1976-01-01

An MHD experimental rig is a miniature MHD installation consisting of basic equipments necessary for specific investigations. Some of the experimental rigs used in the investigations being carried out at the Bhabha Atomic Research Centre, Bombay (India) are dealt with. The experiments included diagnostics and evaluation of materials in seeded combustion plasmas and argon plasmas. The design specifications, schematics and some of the results of the investigations are also mentioned. (author)

Quasi-Experimental Designs for Causal Inference

Science.gov (United States)

Kim, Yongnam; Steiner, Peter

2016-01-01

When randomized experiments are infeasible, quasi-experimental designs can be exploited to evaluate causal treatment effects. The strongest quasi-experimental designs for causal inference are regression discontinuity designs, instrumental variable designs, matching and propensity score designs, and comparative interrupted time series designs. This…

Experimental plasma research project summaries

International Nuclear Information System (INIS)

1992-06-01

This is the latest in a series of Project Summary books going back to 1976 and is the first after a hiatus of several years. They are published to provide a short description of each project supported by the Experimental Plasma Research Branch of the Division of Applied Plasma Physics in the Office of Fusion Energy. The Experimental Plasma Research Branch seeks to provide a broad range of experimental data, physics understanding, and new experimental techniques that contribute to operation, interpretation, and improvement of high temperature plasma as a source of fusion energy. In pursuit of these objectives, the branch supports research at universities, DOE laboratories, other federal laboratories and industry. About 70 percent of the funds expended are spent at universities and a significant function of this program is the training of students in fusion physics. The branch supports small- and medium-scale experimental studies directly related to specific critical plasma issues of the magnetic fusion program. Plasma physics experiments are conducted on transport of particles and energy within plasma and innovative approaches for operating, controlling, and heating plasma are evaluated for application to the larger confinement devices of the magnetic fusion program. New diagnostic approaches to measuring the properties of high temperature plasmas are developed to the point where they can be applied with confidence on the large-scale confinement experiments. Atomic data necessary for impurity control, interpretation of diagnostic data, development of heating devices, and analysis of cooling by impurity ion radiation are obtained. The project summaries are grouped into these three categories of plasma physics, diagnostic development and atomic physics

Experimental and numerical study of the British Experimental Rotor Programme blade

Science.gov (United States)

Brocklehurst, Alan; Duque, Earl P. N.

1990-01-01

Wind-tunnel tests on the British Experimental Rotor Programme (BERP) tip are described, and the results are compared with computational fluid dynamics (CFD) results. The test model was molded using the Lynx-BERP blade tooling to provide a semispan, cantilever wing comprising the outboard 30 percent of the rotor blade. The tests included both surface-pressure measurements and flow visualization to obtain detailed information of the flow over the BERP tip for a range of angles of attack. It was observed that, outboard of the notch, favorable pressure gradients exist which ensure attached flow, and that the tip vortex also remains stable to large angles of attack. On the rotor, these features yield a very gradual break in control loads when the retreating-blade limit is eventually reached. Computational and experimental results were generally found to be in good agreement.

Analysis of DCA experimental data

International Nuclear Information System (INIS)

Min, B. J.; Kim, S. Y.; Ryu, S. J.; Seok, H. C.

2000-01-01

The lattice characteristics of DCA are calculated with WIMS-ATR code to validate WIMS-AECL code for the lattice analysis of CANDU core by using experimental data of DCA at JNC. Analytical studies of some critical experiments had been performed to analyze the effects of fuel composition. Different items of reactor physics such as local power peaking factor (LPF), effective multiplication factor (Keff) and coolant void reactivity were calculated for two coolant void fractions (0% and 100%). LPFs calculated by WIMS-ATR code are in close agreement with the experimental results. LPFs calculated by WIMS-AECL code with WINFRITH and ENDF/B-V libraries have similar values for both libraries but the differences between experimental data and calculated results by WIMS-AECL code are larger than those of WIMS-ATR code. The maximum difference between the values calculated by WIMS-ATR and experimental values of LPFs are within 1.3%. The coupled code systems WIMS-ATR and CITATION used in this analysis predict Keff within 1% ΔK and coolant void reactivity within 4 % ΔK/K in all cases. The coolant void reactivity of uranium fuel is found to be positive. To validate WIMS-AECL code, the core characteristics of DCA shall be calculated by WIMS-AECL and CITATION codes in the future

[Ethical issue in animal experimentation].

Science.gov (United States)

Parodi, André-Laurent

2009-11-01

In the 1970s, under pressure from certain sections of society and thanks to initiatives by several scientific research teams, committees charged with improving the conditions of laboratory animals started to be created, first in the United States and subsequently in Europe. This led to the development of an ethical approach to animal experimentation, taking into account new scientific advances. In addition to the legislation designed to provide a legal framework for animal experimentation and to avoid abuses, this ethical approach, based on the concept that animals are sentient beings, encourages greater respect of laboratory animals and the implementation of measures designed to reduce their suffering. Now, all animal experiments must first receive ethical approval--from in-house committees in the private sector and from regional committees for public institutions. Very recently, under the impetus of the French ministries of research and agriculture, the National committee for ethical animal experimentation published a national ethical charter on animal experimentation, setting the basis for responsible use of animals for scientific research and providing guidelines for the composition and functioning of ethics committees. Inspired by the scientific community itself this ethical standardization should help to assuage--but not eliminate--the reticence and hostility expressed by several sections of society.

Computations for a condenser. Experimental results

International Nuclear Information System (INIS)

Walden, Jean.

1975-01-01

Computations for condensers are presented with experimental results. The computations are concerned with the steam flux at the condenser input, and inside the tube bundle. Experimental results are given for the flux inside the condenser sleeve and the flow passing through the tube bundle [fr

Data base of reactor physics experimental results in Kyoto University critical assembly experimental facilities

International Nuclear Information System (INIS)

Ichihara, Chihiro; Fujine, Shigenori; Hayashi, Masatoshi

1986-01-01

The Kyoto University critical assembly experimental facilities belong to the Kyoto University Research Reactor Institute, and are the versatile critical assembly constructed for experimentally studying reactor physics and reactor engineering. The facilities are those for common utilization by universities in whole Japan. During more than ten years since the initial criticality in 1974, various experiments on reactor physics and reactor engineering have been carried out using many experimental facilities such as two solidmoderated cores, a light water-moderated core and a neutron generator. The kinds of the experiment carried out were diverse, and to find out the required data from them is very troublesome, accordingly it has become necessary to make a data base which can be processed by a computer with the data accumulated during the past more than ten years. The outline of the data base, the data base CAEX using personal computers, the data base supported by a large computer and so on are reported. (Kako, I.)

Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance

DEFF Research Database (Denmark)

Huang, Laurence; Crothers, Kristina; Atzori, Chiara

2004-01-01

in the dihydropteroate synthase (DHPS) gene. Similar mutations have been observed in P. jirovecii. Studies have consistently demonstrated a significant association between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim...

Updates on Aspergillus, Pneumocystis and other opportunistic pulmonary mycoses.

Science.gov (United States)

Curbelo, Jose; Galván, Jose María; Aspa, Javier

2015-12-01

Mycoses are serious diseases with potentially fatal outcome. The introduction of immunosuppressive treatments and life support techniques has led to a growing prevalence of different degrees of immunosuppression. Compromised immune response is the primary risk factor for the development of opportunistic mycoses. Early diagnosis and treatment are crucial for improving prognosis. However, isolation in cultures or identification using antigen detection techniques cannot distinguish between colonization and invasive infection, and the clinical status of the patient often prevents biopsy sampling. Clinicians thus find themselves in an uncertain position, requiring them to quickly recognize clinical and radiological signs and interpret microbiological results in context. The aim of this review is to provide a general overview of the profile of patients susceptible to these infections, the role of the immune system and, in more detail, the major diagnostic developments that have gained most acceptance and recognition among the scientific community. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Radiological findings of pulmonary Kaposi's sarcoma. Manifestaciones radiologicas del sarcoma de Kaposi pulmonar

Energy Technology Data Exchange (ETDEWEB)

Rosello, J A; Hernandez, S; Arranz, M; Jareo, J; Ancoechea, J

1994-01-01

Kaposi's sarcoma (KS) is the most common neoplasm in AIDS patients. The incidence of pulmonary involvement is approximately 20%. The radiological findings are reported in plain chest x-ray and computed tomography (CT) in 15 patients diagnosed as having pulmonary Kaposi's sarcoma, in whom concomitant pulmonary infection was ruled out. The most common radiological pattern was that of bilateral perihilar interstitial involvement (86%), while poorly defined multiple nodules seldom presented (13%). In 40% of cases, the pulmonary parenchymal lesion was accompanied by pleural effusion. This sign is useful in the differential diagnosis involving opportunistic P. carinii pneumonia, a very common process in these patients which rarely presents with pleural effusion. The chest CT finding that was most characteristic of pulmonary Kaposi's sarcoma was bilateral perihilar peribronchovascular enlargement. (Author)

Radiological findings of pulmonary Kaposi's sarcoma. Manifestaciones radiologicas del sarcoma de Kaposi pulmonar

Energy Technology Data Exchange (ETDEWEB)

Rosello, J.A.; Hernandez, S.; Arranz, M.; Jareo, J.; Ancoechea, J.

1994-01-01

Kaposi's sarcoma (KS) is the most common neoplasm in AIDS patients. The incidence of pulmonary involvement is approximately 20%. The radiological findings are reported in plain chest x-ray and computed tomography (CT) in 15 patients diagnosed as having pulmonary Kaposi's sarcoma, in whom concomitant pulmonary infection was ruled out. The most common radiological pattern was that of bilateral perihilar interstitial involvement (86%), while poorly defined multiple nodules seldom presented (13%). In 40% of cases, the pulmonary parenchymal lesion was accompanied by pleural effusion. This sign is useful in the differential diagnosis involving opportunistic P. carinii pneumonia, a very common process in these patients which rarely presents with pleural effusion. The chest CT finding that was most characteristic of pulmonary Kaposi's sarcoma was bilateral perihilar peribronchovascular enlargement. (Author)

Experimental studies of electron capture

International Nuclear Information System (INIS)

Pedersen, E.H.

1983-01-01

This thesis discusses the main results of recent experimental studies of electron capture in asymmetric collisions. Most of the results have been published, but the thesis also contains yet unpublished data, or data presented only in unrefereed conference proceedings. The thesis aims at giving a coherent discussion of the understanding of the experimental results, based first on simple qualitative considerations and subsequently on quantitative comparisons with the best theoretical calculations currently available. (Auth.)

[Experimental studies of micromotor headpieces].

Science.gov (United States)

Kanaev, V F; Repin, V A

1982-01-01

Experimental studies of handpieces for micromotors have been performed to make more precise their operating parameters. The special stand has been used for the measurements of the following data: head temperature, power losses in handpieces at no-load, and operating power required for machining by means of spherical burrs. The experimental results made it possible to specify more exactly the range of handpiece rotational speeds and to select optimum loads under reliability testing.

Control systems for experimental physics

International Nuclear Information System (INIS)

Anon.

1988-01-01

At an international conference last year at Villars-sur-Ollon (Switzerland), scientists from all over the world looked at the problems of controlling complex physics installations, including particle accelerators, nuclear reactors, large telescopes and high energy physics detectors. The meeting, organized by the European Physical Society's Interdivisional Group on Experimental Physics Control Systems, EPCS, brought together 180 scientists from the world's leading experimental physics research laboratories, universities and industries

Evolutionary optimization of an experimental apparatus

DEFF Research Database (Denmark)

Geisel, Ilka; Cordes, Kai; Mahnke, Jan

2013-01-01

algorithm based on differential evolution. We demonstrate that this algorithm optimizes 21 correlated parameters and that it is robust against local maxima and experimental noise. The algorithm is flexible and easy to implement. Thus, the presented scheme can be applied to a wide range of experimental...

Experimental investigation of photoreactions in Bonn

International Nuclear Information System (INIS)

Anton, G.

1988-01-01

In this paper the investigation of nuclear photoreactions in Bonn is reviewed. At the new stretcher ring ELSA considerable experimental improvements are possible with an energy tagged photon beam in conjunction with a large acceptance hadron detector. The future program and the new experimental facilities are described

Experimental facilities of Valduc critical station

International Nuclear Information System (INIS)

Mangin, D.; Maubert, L.

1975-01-01

The critical facility of Valduc and its experimentation possibilities are described. The different experimental programs carried out since 1962 are briefly reviewed. The last program involving a plutonium nitrate solution (18.9wt% 240 Pu) in a large parallelepipedic tank is presented and main results given [fr

27 CFR 24.77 - Experimental wine.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Experimental wine. 24.77... OF THE TREASURY LIQUORS WINE Administrative and Miscellaneous Provisions Tax Exempt Wine § 24.77 Experimental wine. (a) General. Any scientific university, college of learning, or institution of scientific...

Transonic Experimental Research Facility

Data.gov (United States)

Federal Laboratory Consortium — The Transonic Experimental Research Facility evaluates aerodynamics and fluid dynamics of projectiles, smart munitions systems, and sub-munitions dispensing systems;...

FELIX construction status and experimental program

International Nuclear Information System (INIS)

Turner, L.R.; Praeg, W.F.; Knott, M.J.; Lari, R.J.; McGhee, D.G.; Wehrle, R.B.

1983-01-01

FELIX (Fusion Electromagnetic Induction Experiment) is an experimental test facility being constructed at Argonne National Laboratory (ANL) for the study of electromagnetic effects in the first wall/blanket/shield (FWBS) systems of fusion reactors. The facility design, construction status, experimental program, instrumentation, and associated computer-code comparisons are described

Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence.

Science.gov (United States)

Vaiserman, Alexander M

2017-03-05

Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies ('natural experiments'). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed.

Experimental economics for web mining

OpenAIRE

Tagiew, Rustam; Ignatov, Dmitry I.; Amroush, Fadi

2014-01-01

This paper offers a step towards research infrastructure, which makes data from experimental economics efficiently usable for analysis of web data. We believe that regularities of human behavior found in experimental data also emerge in real world web data. A format for data from experiments is suggested, which enables its publication as open data. Once standardized datasets of experiments are available on-line, web mining can take advantages from this data. Further, the questions about the o...

Experimental Economics: Some Methodological Notes

OpenAIRE

Fiore, Annamaria

2009-01-01

The aim of this work is presenting in a self-contained paper some methodological aspects as they are received in the current experimental literature. The purpose has been to make a critical review of some very influential papers dealing with methodological issues. In other words, the idea is to have a single paper where people first approaching experimental economics can find summarised (some) of the most important methodological issues. In particular, the focus is on some methodological prac...

Experimental violation of entropic inequalities

International Nuclear Information System (INIS)

Bovino, F.A.; Castagnoli, G.; Ekert, A.; Horodecki, P.; Alves, C.M.; Sergienko, A.V.

2005-01-01

Full text: We report the experimental evidence that polarization entangled photons violate the inequality based on Renyi entropy. Our experimental method is based on four-photon coincidences in photon bunching and antibunching effects. We introduce an additional 'phase marking' technique, which allow observing the violation of the inequalities even with non-deterministic sources of entangled photons. Our method can be applied to measure selected non-linear properties of bipartite quantum states, such as purity or entanglement. (author)

Experimental economics' inconsistent ban on deception.

Science.gov (United States)

Hersch, Gil

2015-08-01

According to what I call the 'argument from public bads', if a researcher deceived subjects in the past, there is a chance that subjects will discount the information that a subsequent researcher provides, thus compromising the validity of the subsequent researcher's experiment. While this argument is taken to justify an existing informal ban on explicit deception in experimental economics, it can also apply to implicit deception, yet implicit deception is not banned and is sometimes used in experimental economics. Thus, experimental economists are being inconsistent when they appeal to the argument from public bads to justify banning explicit deception but not implicit deception. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experimental Learning in Nursing Literature Education

Directory of Open Access Journals (Sweden)

Eskandar Fathiazar

2015-08-01

Full Text Available ​Experimental learning is a type of discovery learning. This method of learning appears to be suitable for nursing education, but there is not enough evidence about it. As a result, in this non-systematic review article, after explaining experimental learning, its application in nursing will be presented based on literature review and with functional examples. According to the results, in this kind of learning, students practice with experimental cases and learn by failure in. Participants should have the main role and teachers act as mentors or learning facilitators. According to the literature, it seems useful to use this new method in nursing education.

Experimental energy-dependent nuclear spin distributions

International Nuclear Information System (INIS)

Egidy, T. von; Bucurescu, D.

2009-01-01

A new method is proposed to determine the energy-dependent spin distribution in experimental nuclear-level schemes. This method compares various experimental and calculated moments in the energy-spin plane to obtain the spin-cutoff parameter σ as a function of mass A and excitation energy using a total of 7202 levels with spin assignment in 227 nuclei between F and Cf. A simple formula, σ 2 =0.391 A 0.675 (E-0.5Pa ' ) 0.312 , is proposed up to about 10 MeV that is in very good agreement with experimental σ values and is applied to improve the systematics of level-density parameters.

FELIX construction status and experimental program

International Nuclear Information System (INIS)

Turner, L.R.; Peag, W.F.

1983-01-01

FELIX (Fusion Electromagnetic Induction eXperiment) is an experimental test facility being constructed at Argonne National Laboratory (ANL) for the study of electromagnetic effects in the first wall/blanket/shield (FWBS) systems of fusion reactors. The facility design, construction status, experimental program, instrumentation, and associated computer-code comparisons are described

Combined Teaching Method: An Experimental Study

Science.gov (United States)

Kolesnikova, Iryna V.

2016-01-01

The search for the best approach to business education has led educators and researchers to seek many different teaching strategies, ranging from the traditional teaching methods to various experimental approaches such as active learning techniques. The aim of this experimental study was to compare the effects of the traditional and combined…

Acquisition and treatment systems for experimental data

International Nuclear Information System (INIS)

Bouard, E.

1988-01-01

The acquisition and treatment systems for experimental data has been conceived to give a response to experimental requirements in a research reactor such OSIRIS. Its objective is to acquire and treat the ensemble of informations coming from one or many experiences, to archive useful data for an ulterior treatment and to give at the experimentator a tool ensemble for a better track of his experience. Its main characteristics are given in this text [fr

Experimental plant for sludge composting. Plant experimental de compostaje de lodos

Energy Technology Data Exchange (ETDEWEB)

Cadenas, A.; Caellas, N.; Amengual, A.; Calafact, J.

1993-01-01

Results and expertise collected during the first year of exploitation of a compost experimental plant located in Mallorca (Spain): The plant is treating sludge from the biological treatment plant of water at the town of Felanitx and the compost produced is used in agriculture. (Author)

Persuasion in experimental ultimatum games

DEFF Research Database (Denmark)

Andersson, Ola; Galizzi, Matteo M.; Hoppe, Tim

2010-01-01

We study persuasion effects in experimental ultimatum games and find that Proposers' payoffs significantly increase if, along with offers, they can send messages which Responders read before deciding. Higher payoffs are driven by both lower offers and higher acceptance rates.......We study persuasion effects in experimental ultimatum games and find that Proposers' payoffs significantly increase if, along with offers, they can send messages which Responders read before deciding. Higher payoffs are driven by both lower offers and higher acceptance rates....

Characterization of experimental cements with endodontic goal

International Nuclear Information System (INIS)

Dantas, A.M.X.; Sousa, W.J.B.; Oliveira, E.D.C.; Carrodeguas, R.G.; Fook, M.V. Lia; Universidade Estadual da Paraiba

2017-01-01

The present study aimed to characterize experimental endodontic cements using as comparative parameter MTA cement. Two experimental endodontic cements were assessed: one based on 95% tri-strontium aluminate and 5% gypsum (CE1) and another based on 50% Sr_3Al_2O_6 and 50% non-structural white cement (CE2). Experimental cements were manipulated and characterized by scanning electron microscopy (SEM), coupled to EDS mode, X-ray diffractometer (XRD) and Thermogravimetric (TG) analysis. Data analysis demonstrated that the particles of the materials used presented varied shapes and sizes, with similar elements and crystalline behavior. However, CE1 presented increased mass loss. Experimental cements presents similarities to MTA, nevertheless, further studies are encourage to determinate comparative properties with the commercially material. (author)

Experimental design of a waste glass study

International Nuclear Information System (INIS)

Piepel, G.F.; Redgate, P.E.; Hrma, P.

1995-04-01

A Composition Variation Study (CVS) is being performed to support a future high-level waste glass plant at Hanford. A total of 147 glasses, covering a broad region of compositions melting at approximately 1150 degrees C, were tested in five statistically designed experimental phases. This paper focuses on the goals, strategies, and techniques used in designing the five phases. The overall strategy was to investigate glass compositions on the boundary and interior of an experimental region defined by single- component, multiple-component, and property constraints. Statistical optimal experimental design techniques were used to cover various subregions of the experimental region in each phase. Empirical mixture models for glass properties (as functions of glass composition) from previous phases wee used in designing subsequent CVS phases

Great Basin Experimental Range: Annotated bibliography

Science.gov (United States)

E. Durant McArthur; Bryce A. Richardson; Stanley G. Kitchen

2013-01-01

This annotated bibliography documents the research that has been conducted on the Great Basin Experimental Range (GBER, also known as the Utah Experiment Station, Great Basin Station, the Great Basin Branch Experiment Station, Great Basin Experimental Center, and other similar name variants) over the 102 years of its existence. Entries were drawn from the original...

Injury Based on Its Study in Experimental Models

Directory of Open Access Journals (Sweden)

M. Mendes-Braz

2012-01-01

Full Text Available The present review focuses on the numerous experimental models used to study the complexity of hepatic ischemia/reperfusion (I/R injury. Although experimental models of hepatic I/R injury represent a compromise between the clinical reality and experimental simplification, the clinical transfer of experimental results is problematic because of anatomical and physiological differences and the inevitable simplification of experimental work. In this review, the strengths and limitations of the various models of hepatic I/R are discussed. Several strategies to protect the liver from I/R injury have been developed in animal models and, some of these, might find their way into clinical practice. We also attempt to highlight the fact that the mechanisms responsible for hepatic I/R injury depend on the experimental model used, and therefore the therapeutic strategies also differ according to the model used. Thus, the choice of model must therefore be adapted to the clinical question being answered.

Experimental models of demyelination and remyelination.

Science.gov (United States)

Torre-Fuentes, L; Moreno-Jiménez, L; Pytel, V; Matías-Guiu, J A; Gómez-Pinedo, U; Matías-Guiu, J

2017-08-29

Experimental animal models constitute a useful tool to deepen our knowledge of central nervous system disorders. In the case of multiple sclerosis, however, there is no such specific model able to provide an overview of the disease; multiple models covering the different pathophysiological features of the disease are therefore necessary. We reviewed the different in vitro and in vivo experimental models used in multiple sclerosis research. Concerning in vitro models, we analysed cell cultures and slice models. As for in vivo models, we examined such models of autoimmunity and inflammation as experimental allergic encephalitis in different animals and virus-induced demyelinating diseases. Furthermore, we analysed models of demyelination and remyelination, including chemical lesions caused by cuprizone, lysolecithin, and ethidium bromide; zebrafish; and transgenic models. Experimental models provide a deeper understanding of the different pathogenic mechanisms involved in multiple sclerosis. Choosing one model or another depends on the specific aims of the study. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Radiation environment of fusion experimental reactor

International Nuclear Information System (INIS)

Mori, Seiji; Seki, Yasushi

1988-01-01

Next step device (experimental reactor), which is planned to succeed the large plasma experimental devices such as JT-60, JET and TFTR, generates radiation (neutron + gamma ray) during its operation. Radiation (neutronic) properties of the material are basis for the study on neutron utilization (energy recovery and tritium breeding), material selection (irradiation damage and lifetime evaluation) and radiation safety (personnel exposure and radiation waste). It is necessary, therefore, to predict radiation behaviour in the reactor correctly for the engineering design of the reactor. This report describes the outline of the radiation environment of the reactor based on the information obtained by the neutronic and shielding design calculation of the fusion experimental reactor (FER). (author)

Book Review "Cambridge handbook of experimental political science"

NARCIS (Netherlands)

Grimmelikhuijsen, Stephan

2014-01-01

Experimentation has formed the basis for modern scientific discovery. Francis Bacon (1561– 1626), “the father of empiricism,” was one of the first to propose a method of science based on experimentation that results in new theories that can again be tested by experimentation. At first, experiments

Multi-Directional Experimental Facility

Data.gov (United States)

Federal Laboratory Consortium — The ATLSS Multi-directional Experimental Laboratory was constructed in 1987 under funding from the National Science Foundation to be a major facility for large-scale...

The Stephen F. Austin Experimental Forest

Science.gov (United States)

Cary C. Russell; Ronald E. Thill; David L. Kulhavy

2002-01-01

On December 14, 1944, the Seventy-Eighth United States Congress passed a bill that authorized the transfer of 2,560 acres in Nacogdoches County, Texas, to the research branch of the United States Forest Service (USFS). This land became the Stephen F. Austin Experimental Forest (SFAEF) on September 19. 1945. One of eighty-one federal experimental forests and ranges...

Chemotherapy of experimental bovine petechial fever.

Science.gov (United States)

Snodgrass, D R

1976-01-01

A dithiosemicarbazone was compared with two tetracycline formulations in the treatment of bovine petechial fever (BPF) in experimentally infected sheep, and was then used to treat the disease in experimental cattle. The dithiosemicarbazone was found to be more efficacious than either of the other two drugs in treating ovine BPF, and also to be effective against BPF in cattle.

Experimental music for experimental physics

CERN Multimedia

Rosaria Marraffino

2014-01-01

Using the sonification technique, physicist and composer Domenico Vicinanza paid homage to CERN at its 60th anniversary ceremony. After months of hard work, he turned the CERN Convention and LHC data into music.   Click here to download the full score of the "LHChamber music". Every birthday deserves gifts and CERN’s 60th anniversary was no exception. Two gifts were very special, thanks to the hard work of Domenico Vicinanza, a physicist and composer. He created two experimental pieces by applying the sonification technique to the CERN Convention and to data recorded by the four LHC detectors during Run 1. “This technique allows us to ‘hear’ data using an algorithm that translates numbers or letters into notes. It keeps the same information enclosed in a graph or a document, but has a more aesthetic exposition,” explains Domenico Vicinanza. “The result is meant to be a metaphor for scientific cooperation, in which d...

Nuclear test experimental science

International Nuclear Information System (INIS)

Struble, G.L.; Middleton, C.; Bucciarelli, G.; Carter, J.; Cherniak, J.; Donohue, M.L.; Kirvel, R.D.; MacGregor, P.; Reid, S.

1989-01-01

This report discusses research being conducted at Lawrence Livermore Laboratory under the following topics: prompt diagnostics; experimental modeling, design, and analysis; detector development; streak-camera data systems; weapons supporting research

Nuclear test experimental science

Energy Technology Data Exchange (ETDEWEB)

Struble, G.L.; Middleton, C.; Bucciarelli, G.; Carter, J.; Cherniak, J.; Donohue, M.L.; Kirvel, R.D.; MacGregor, P.; Reid, S. (eds.)

1989-01-01

This report discusses research being conducted at Lawrence Livermore Laboratory under the following topics: prompt diagnostics; experimental modeling, design, and analysis; detector development; streak-camera data systems; weapons supporting research.

Storming a Citadel: Mathematical Theory and Experimental Practice

Science.gov (United States)

Sichau, Christian

2006-09-01

Based upon a comparison of the viscosity experiments of James Clerk Maxwell (1831 1879) and Oskar Emil Meyer (1834 1909) in the 1860s, I argue that mathematical theory plays a significant role in both aspects of experimental practice, the design and construction of an experimental apparatus and the transformation of the observed experimental data into the value of a physical quantity. I argue further that Maxwell’s and Meyer’s evaluation of each other’s theoretical and experimental work depended significantly on the mathematical tools they employed in their theories.

Experimental project - Cloud chamber

International Nuclear Information System (INIS)

Nour, Elena; Quinchard, Gregory; Soudon, Paul

2015-01-01

This document reports an academic experimental project dealing with the general concepts of radioactivity and their application to the cloud room experiment. The author first recalls the history of the design and development of a cloud room, and some definitions and characteristics of cosmic radiation, and proposes a description of the principle and physics of a cloud room. The second part is a theoretical one, and addresses the involved particles, the origins of electrons, and issues related to the transfer of energy (Bremsstrahlung effect, Bragg peak). The third part reports the experimental work with the assessment of a cloud droplet radius, the identification of a trace for each particle (alphas and electrons), and the study of the magnetic field deviation

Experimental status QCD

International Nuclear Information System (INIS)

Radyushkin, A.V.; Slepchenko, L.A.

1983-01-01

Analysis of experimental status of quantum chromodynamics (QCD) has been carried out. A short introduction into QCD is given. QCD sum rules are considered. Jets in e + e - annihilation and inclusive processes of lepton-hadron and hadron-hadron scattering are considered. Effect of QCD corrections to perturbation theory on quark count is analyzed

Increased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiation

DEFF Research Database (Denmark)

Pettit, April C; Giganti, Mark J; Ingle, Suzanne M

2018-01-01

) initiation. METHODS: We included HIV treatment-naïve adults from the Antiretroviral Therapy Cohort Collaboration (ART-CC) who initiated ART from 1996 to 2014. Causes of death were assigned using the Coding Causes of Death in HIV (CoDe) protocol. The adjusted hazard ratio (aHR) for overall and cause......-specific non-AIDS mortality among those with an ADE (all ADEs, tuberculosis (TB), Pneumocystis jiroveci pneumonia (PJP), and non-Hodgkin's lymphoma (NHL)) compared to those without an ADE was estimated using a marginal structural model. RESULTS: The adjusted hazard of overall non-AIDS mortality was higher...

Revised experimental program on the nuclear ship 'Mutsu'

International Nuclear Information System (INIS)

Mori, Yuichi

1985-01-01

The experimental program on the nuclear ship ''Mutsu'' has been revised by the Government. And, the responsible organization for n. s. Mutsu was turned to Japan Atomic Energy Research Institute (JAERI) from Japan Nuclear-ship Development Agency. The revised, new experimental program is as follows. (1) Experimental navigation of n. s. Mutsu is made with the already loaded 1st reactor core for about one year. (2) The mooring port for n. s. Mutsu is in a minimum scale. (3) Upon termination of the experimental navigation, n. s. Mutsu is immediately decommissioned. (4) Power-up test and experimental navigation of n. s. Mutsu are made in fiscal 1989 to 1990. The policy of research and development with n. s. Mutsu and the works assigned to JAERI with n. s. Mutsu are described. (Mori, K.)

RIAR experimental base development concept 1. Multi-purpose pyrochemical complex for experimental justification of innovative closed fuel cycle technologies

Energy Technology Data Exchange (ETDEWEB)

Bychkov, A.V.; Kormilitsyn, M.V. [Research Institute of Atomic Reactors, Dimitrovgrad-10, Ulyanovsk region, 433510 (Russian Federation)

2009-06-15

The principles of closed FC arrangement on the basis of non-aqueous methods allow the development of production addressing two tasks simultaneously: production of fresh fuel and reprocessing of irradiated fuel, that makes it possible to achieve the industrial level of implementation of closed FC of fast reactors of new generation in a series variant of standardized process modules on the basis of innovative pyrochemical high-effective compact technologies. For the purpose of experimental justification of innovative closed FC technologies at the RIAR site, the existing experimental base is being updated and a multi-purpose pyrochemical complex is developed: - Experimental complex of pyrochemical molten salt facilities to reprocess all types of spent fuel (MOX, nitride, metallic, IMF) of fast reactors of new generation (BN-800, MBIR, BREST). - Experimental complex of facilities to master a gas-fluoride technology of reprocessing intractable fuel, research reactors fuel and thermal SNF. - Transition of the existing facility of pyro-electrochemical production of MOX fuel into the mode of reprocessing of the BN-800 MOX SNF. - Renovation of the facilities for production of fuel elements from experimental, re-fabricated, innovative and high-active fuel - a complex of heavy and glove boxes - to produce experimental fuel elements and targets with MAs on the basis of oxides (vibro and pellets), mixed nitrides, metal alloys and inert matrices in heavy boxes. - Upgrading of the complex for mastering and demonstration of the processes for radioactive waste management and spent fuel pyrochemical reprocessing. The report covers main concept and design solutions, plans and schedule of the program for development of pyrochemical complex for experimental justification of innovative closed FC technologies. (authors)

Experimental qualification of nuclear components

Energy Technology Data Exchange (ETDEWEB)

Alliot, P; Fronte, T; Genty, F [FRAMATOME - Cedex 16, Paris la Defense (France)

1988-07-01

In the process of showing the adequacy of the seismic design of French PWR reactor, Fermat has repeatedly used dynamic testing on actual nuclear reactor components both on site and in manufacturing shops. The objective and results of a few representative examples of this on-site experimental verification are presented in this paper: the experimental dynamic analysis of a manipulator crane; the investigation of the seismic behaviour of fuel storage racks equipped with aseismic bearing devices. Difficulties to select satisfactory testing methods are also discussed for the particular case of the electrical cabinets. (author)

Experimental application of QCD antennas

Energy Technology Data Exchange (ETDEWEB)

Bobrovskyi, Sergei

2010-02-15

A serious problem in searches for new physics at the LHC is the rejection of QCD induced multijet events. In this thesis the formalism of QCD antenna variables based on the SPHEL approximation of QCD matrix elements is applied for the rst time on experimentally reconstructed jets in order to discriminate QCD from supersymmetric processes. The new observables provide additional information with respect to traditional event shape variables. Albeit correlated with experimentally measured missing transverse energy, the variables can be used to improve the signal to background ratio. (orig.)

Experimental application of QCD antennas

International Nuclear Information System (INIS)

Bobrovskyi, Sergei

2010-02-01

A serious problem in searches for new physics at the LHC is the rejection of QCD induced multijet events. In this thesis the formalism of QCD antenna variables based on the SPHEL approximation of QCD matrix elements is applied for the rst time on experimentally reconstructed jets in order to discriminate QCD from supersymmetric processes. The new observables provide additional information with respect to traditional event shape variables. Albeit correlated with experimentally measured missing transverse energy, the variables can be used to improve the signal to background ratio. (orig.)

EBTS: DESIGN AND EXPERIMENTAL STUDY

International Nuclear Information System (INIS)

PIKIN, A.; ALESSI, J.; BEEBE, E.; KPONOU, A.; PRELEC, K.; KUZNETSOV, G.; TIUNOV, M.

2000-01-01

Experimental study of the BNL Electron Beam Test Stand (EBTS), which is a prototype of the Relativistic Heavy Ion Collider (RHIC) Electron Beam Ion Source (EBIS), is currently underway. The basic physics and engineering aspects of a high current EBIS implemented in EBTS are outlined and construction of its main systems is presented. Efficient transmission of a 10 A electron beam through the ion trap has been achieved. Experimental results on generation of multiply charged ions with both continuous gas and external ion injection confirm stable operation of the ion trap

Qualitative tools and experimental philosophy

Science.gov (United States)

Andow, James

2016-01-01

Abstract Experimental philosophy brings empirical methods to philosophy. These methods are used to probe how people think about philosophically interesting things such as knowledge, morality, and freedom. This paper explores the contribution that qualitative methods have to make in this enterprise. I argue that qualitative methods have the potential to make a much greater contribution than they have so far. Along the way, I acknowledge a few types of resistance that proponents of qualitative methods in experimental philosophy might encounter, and provide reasons to think they are ill-founded. PMID:28392629

Experimental qualification of nuclear components

International Nuclear Information System (INIS)

Alliot, P.; Fronte, T.; Genty, F.

1988-01-01

In the process of showing the adequacy of the seismic design of French PWR reactor, Fermat has repeatedly used dynamic testing on actual nuclear reactor components both on site and in manufacturing shops. The objective and results of a few representative examples of this on-site experimental verification are presented in this paper: the experimental dynamic analysis of a manipulator crane; the investigation of the seismic behaviour of fuel storage racks equipped with aseismic bearing devices. Difficulties to select satisfactory testing methods are also discussed for the particular case of the electrical cabinets. (author)

Experimental toxicology: Issues of statistics, experimental design, and replication.

Science.gov (United States)

Briner, Wayne; Kirwan, Jeral

2017-01-01

The difficulty of replicating experiments has drawn considerable attention. Issues with replication occur for a variety of reasons ranging from experimental design to laboratory errors to inappropriate statistical analysis. Here we review a variety of guidelines for statistical analysis, design, and execution of experiments in toxicology. In general, replication can be improved by using hypothesis driven experiments with adequate sample sizes, randomization, and blind data collection techniques. Copyright © 2016 Elsevier B.V. All rights reserved.

Animal experimentation

OpenAIRE

Laz, Alak; Cholakova, Tanya Stefanova; Vrablova, Sofia; Arshad, Naverawaheed

2016-01-01

Animal experimentation is a crucial part of medical science. One of the ways to define it is any scientific experiment conducted for research purposes that cause any kind of pain or suffering to animals. Over the years, the new discovered drugs or treatments are first applied on animals to test their positive outcomes to be later used by humans. There is a debate about violating ethical considerations by exploiting animals for human benefits. However, different ethical theories have been made...

Experimental site and design

Energy Technology Data Exchange (ETDEWEB)

Guenette, C. C. [SINTEF Applied Cemistry, Trondheim (Norway)

1999-08-01

Design and site selection criteria for the Svalbard oil spill experiments are described. All three experimental sites have coarse and mixed sediment beaches of sand and pebble; within each site wave exposure is very similar; along-shore and across-shore sediment characteristics are also relatively homogeneous. Tidal range is in the order of 0.6 m at neaps, and 1.8 m at springs. All three sites are open to wave action and are ice-free during the experimental period of mid-July to mid-October. Study plots at each site were selected for different treatments from within the continuous stretch of oiled shoreline, with oiled buffer zones between plots and at either end of the oiled zone. Treatments included mixing (tilling), sediment relocation (surf washing) and bioremediation (nutrient enrichment). Measurements and observations were carried out during the summers of 1997 and 1998. The characteristics measured were: wave and wind conditions; beach topography and elevation; sediment grain size distribution; mineral fines size distribution and mineral composition; background hydrocarbons; concentration of oil within experimental plots and the rate of oil loss over time; depth of oil penetration and thickness of the oiled sediment layer; oil concentration and toxicity of near-shore benthic sediments; mineral composition of suspended particulate material captured in sub-tidal sediment traps; and oil-fines interaction in near-shore water samples. 1 fig.

Experimental site and design

Energy Technology Data Exchange (ETDEWEB)

Guenette, C. C. [SINTEF Applied Cemistry, Trondheim (Norway)

1999-07-01

Design and site selection criteria for the Svalbard oil spill experiments are described. All three experimental sites have coarse and mixed sediment beaches of sand and pebble; within each site waveexposure is very similar; along-shore and across-shore sediment characteristics are also relatively homogeneous. Tidal range is in the order of 0.6 m at neaps, and 1.8 m at springs. All three sites are open to wave action and are ice-free during the experimental period of mid-July to mid-October. Study plots at each site were selected for different treatments from within the continuous stretch of oiled shoreline, with oiled buffer zones between plots and at either end of the oiled zone. Treatments included mixing (tilling), sediment relocation (surf washing) and bioremediation (nutrient enrichment). Measurements and observations were carried out during the summers of 1997 and 1998. The characteristics measured were: wave and wind conditions; beach topography and elevation; sediment grain size distribution; mineral fines size distribution and mineral composition; background hydrocarbons; concentration of oil within experimental plots and the rate of oil loss over time; depth of oil penetration and thickness of the oiled sediment layer; oil concentration and toxicity of near-shore benthic sediments; mineral composition of suspended particulate material captured in sub-tidal sediment traps; and oil-fines interaction in near-shore water samples. 1 fig.

Woodward Effect Experimental Verifications

Science.gov (United States)

March, Paul

2004-02-01

The work of J. F. Woodward (1990 1996a; 1996b; 1998; 2002a; 2002b; 2004) on the existence of ``mass fluctuations'' and their use in exotic propulsion schemes was examined for possible application in improving space flight propulsion and power generation. Woodward examined Einstein's General Relativity Theory (GRT) and assumed that if the strong Machian interpretation of GRT as well as gravitational / inertia like Wheeler-Feynman radiation reaction forces hold, then when an elementary particle is accelerated through a potential gradient, its rest mass should fluctuate around its mean value during its acceleration. Woodward also used GRT to clarify the precise experimental conditions necessary for observing and exploiting these mass fluctuations or ``Woodward effect'' (W-E). Later, in collaboration with his ex-graduate student T. Mahood, they also pushed the experimental verification boundaries of these proposals. If these purported mass fluctuations occur as Woodward claims, and his assumption that gravity and inertia are both byproducts of the same GRT based phenomenon per Mach's Principle is correct, then many innovative applications such as propellantless propulsion and gravitational exotic matter generators may be feasible. This paper examines the reality of mass fluctuations and the feasibility of using the W-E to design propellantless propulsion devices in the near to mid-term future. The latest experimental results, utilizing MHD-like force rectification systems, will also be presented.

Heavy quarks - experimental

International Nuclear Information System (INIS)

Hollebeek, R.

1990-01-01

The purpose of these lectures, given at the 1989 SLAC Summer School, was to discuss the experimental aspects of heavy quark production. A companion set of lectures on the theoretical point of view were to be given by Keith Ellis. An experimentalist should gather together the measurements which have been made by various groups, compare, contrast and tabulate them, and if possible point out the ways in which these measurements confirm or contradict current theories. Here the authors has tried to do this, although the reader who expects to find here the latest of all experimental measurements should probably be forewarned that the field is moving extremely rapidly. In some cases, he has added and updated materials where crucial new information became available after or during the summer of 1989, but not in all cases. He has concentrated on trying to select those measurements which are at the moment most crucial in refining our understanding of heavy quarks as opposed to those which merely measure things which are perhaps too complicated to be enlightening at the moment. While theorists worry primarily about production mechanisms, cross sections, QCD corrections, and to some extent about signatures, the experimentalist must determine which measurements he is interested in making, and which signatures for heavy quark production are realistic and likely to produce results which will shed some new light on the underlying production model without undo theoretical complications. Experimentalists also need to evaluate the available experimental equipment, both machines and detectors to find the best way to investigate the properties of heavy quarks. In many cases, the things which we would like to measure are severely restricted by what we can measure. Nevertheless, many properties of heavy quark production and decay can be measured, and the results have already taught us much about the weak interactions and QCD

Experimental tumour treatment

International Nuclear Information System (INIS)

1985-08-01

This report of 1984 is the seventh in a series and presents that year's results of continuous studies in the domain of experimental tumour radiotherapy. In the year under review, more personnel has been available for the studies, and the scientific programmes for the assessment of acute and chronic side effects of radiotherapies have been extended. New models have been developed, among them a first system based on animal experiments, for quantifying the mucositis of the oral and pharyngeal mucosa, a limiting condition in the radiotherapy of head and throat tumours. Another significant advancement is a model for quantification of chronical damage to the ureter, which still is a serious problem in the radiotherapy of gynaecological tumours. The 1984 experimental tumour studies have been mainly devoted to the repopulation and split-dose recovery in various tumours, concentrating on dose fractionation as one of the major problems studies. Particular interest has been attached to the processes involved in treatments over several weeks with a daily effective dose of 2 Gy. (orig./MG) [de

Experimental preparation and verification of quantum money

Science.gov (United States)

Guan, Jian-Yu; Arrazola, Juan Miguel; Amiri, Ryan; Zhang, Weijun; Li, Hao; You, Lixing; Wang, Zhen; Zhang, Qiang; Pan, Jian-Wei

2018-03-01

A quantum money scheme enables a trusted bank to provide untrusted users with verifiable quantum banknotes that cannot be forged. In this work, we report a proof-of-principle experimental demonstration of the preparation and verification of unforgeable quantum banknotes. We employ a security analysis that takes experimental imperfections fully into account. We measure a total of 3.6 ×106 states in one verification round, limiting the forging probability to 10-7 based on the security analysis. Our results demonstrate the feasibility of preparing and verifying quantum banknotes using currently available experimental techniques.

Research Directions for Cyber Experimentation: Workshop Discussion Analysis.

Energy Technology Data Exchange (ETDEWEB)

DeWaard, Elizabeth [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Deccio, Casey [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Fritz, David Jakob [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Tarman, Thomas D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-10-01

Sandia National Laboratories hosted a workshop on August 11, 2017 entitled "Research Directions for Cyber Experimentation," which focused on identifying and addressing research gaps within the field of cyber experimentation , particularly emulation testbeds . This report mainly documents the discussion toward the end of the workshop, which included research gaps such as developing a sustainable research infrastructure, exp anding cyber experimentation, and making the field more accessible to subject matter experts who may not have a background in computer science . Other gaps include methodologies for rigorous experimentation, validation, and uncertainty quantification, which , if addressed, also have the potential to bridge the gap between cyber experimentation and cyber engineering. Workshop attendees presented various ways to overcome these research gaps, however the main conclusion for overcoming these gaps is better commun ication through increased workshops, conferences, email lists, and slack chann els, among other opportunities.

Students' views about the nature of experimental physics

Science.gov (United States)

Wilcox, Bethany R.; Lewandowski, H. J.

2017-12-01

The physics community explores and explains the physical world through a blend of theoretical and experimental studies. The future of physics as a discipline depends on training of students in both the theoretical and experimental aspects of the field. However, while student learning within lecture courses has been the subject of extensive research, lab courses remain relatively under-studied. In particular, there is little, if any, data available that address the effectiveness of physics lab courses at encouraging students to recognize the nature and importance of experimental physics within the discipline as a whole. To address this gap, we present the first large-scale, national study (Ninstitutions=75 and Nstudents=7167 ) of undergraduate physics lab courses through analysis of students' responses to a research-validated assessment designed to investigate students' beliefs about the nature of experimental physics. We find that students often enter and leave physics lab courses with ideas about experimental physics as practiced in their courses that are inconsistent with the views of practicing experimental physicists, and this trend holds at both the introductory and upper-division levels. Despite this inconsistency, we find that both introductory and upper-division students are able to accurately predict the expertlike response even in cases where their views about experimentation in their lab courses disagree. These finding have implications for the recruitment, retention, and adequate preparation of students in physics.