摘要:

Throughout the world pneumonia remains an important infectious disease among all age groups, ranking high in terms of mortality, morbidity, and use of medical resources. However, the introduction of antibiotics has had a major impact on the management and mortality of pneumonia. As a clinical syndrome it is constantly changing with the emergence of new pathogens and the rising prominence of opportunistic pathogens in the immunocompromised patient. Developments in science have resulted in a greater understanding of microbial virulence and host defenses as well as new chemothera peutic agents. However, the single most common pathogen responsible for pneumonia remainsStreptococcus pneumoniae,an organism for which there is a vaccine. This review highlights some recent advances in the epidemiology, etiology, pathogenesis, management, and prevention of pneumonia.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Tuberculosis is an increasing problem around the world, including the United States. The human immunodeficiency virus epidemic has dramatically and adversely influenced the control of tuberculosis. Effective chemotherapy is available to prevent and treat disease. Recent public health guidelines support a 6-month regimen of isoniazid and rifampin for 4 months to treat uncomplicated tuberculosis. Patients who are human immunodeficiency virus- or acquired immunodeficiency syndrome-positive should be treated for longer periods, usually 9 months. Tuberculosis is a contagious disease. Increased risk of transmission occurs in certain settings such as health care facilities and correctional institutions. There may be racial differences in susceptibility to infection with tuberculosis, but close contact with an infectious case is the chief risk factor. New technologies promise the possibility of 1− or 2-day diagnosis. Two- or 3-month preventative therapy for tuberculosis may be possible using rifampin and pyrazinamide based upon results in a laboratory animal model.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Cystic fibrosis is characterized by progressive pulmonary deterioration associated with chronic infection withPseudomonas aeruginosa.In the past year, researchers have attempted to elucidate the pathogenesis of cystic fibrosis lung disease and to develop new therapeutic strategies. Early identification of infection by use of cultures, flagellar antigens, or blood spot antibody titers toP. aeruginosamay alter the course of progression. The bacteria and their effects on the lungs appear to be unique in cystic fibrosis. Inflammation associated with chronic infection and immune complex-mediated reactions exacerbate the lung damage. Treatment with anti-inflammatory agents and new antipseudomonal antibiotics appears promising.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Respiratory infections are a major cause of morbidity and mortality in children. Prevention must be the ultimate aim, but this will prove difficult. Eliminating environmental exposure to tobacco smoke has great potential for reducing morbidity from lower respiratory infections. Sore throats are one of the most common manifestations of respiratory infection and there has been increasing interest in rapid diagnosis due to β-hemolytic streptococci. However, currently available techniques are not sufficiently sensitive to be used by parents at home. New evidence has been published suggesting that one dose of dexamethasone will favorably alter the course of laryngotracheitis. New evaluation of older data and recent studies demonstrated clearly that there are no serious long-term neurologic complications with pertussis immunization. This needs to be widely recognized by the medical community and by parents. It is likely that the current killed cell vaccine will be replaced over the next few years by an acellular vaccine that has fewer local systemic reactions. Interesting data have been published suggesting that the A subtype of respiratory syncytial virus is responsible for more serious illness. Cyanosis and inability to feed have been demonstrated as markers of pneumonia likely to be fatal in infants in the Third World. It is recommended that such infants be treated in hospitals with chloramphenicol.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

During recent years, some new techniques have emerged that allow rapid diagnosis of the etiology of respiratory infections caused by viruses, mycoplasmas, and problem bacteria such asMycobacterium, Legionella,andBordetellaspecies. These new techniques are based on antigen detection by enzyme-linked immunosorbent assay or immunofluorescence microscopy, detection of specific microbial products by means of gas chromatography and mass spectrometry, and detection of specific microbial nucleic acids by means of oligonucleotide probes, sometimes after amplification by the polymerase chain reaction. This article reviews some of the recent publications within this field and emphasizes results obtained with clinical samples.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Awareness is growing about the importance of invasive and semi-invasive fungal lung disease. Diagnostic methods are still underemphasized, and this may be a factor in the often late recognition of fungal disease. Allergic bronchopulmonary mycoses are important causes of respiratory disease because of their chronic destructive nature. New antifungal agents are needed and must be subject to trial in precisely defined clinical groups.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Infections of the airways are common. The bacteria that cause them are usually relatively nonvirulent and are often commensals of the upper respiratory tract. In health, dissemination of bacteria from the nasopharynx throughout the respiratory tract (sinuses, eustachian tubes, lower respiratory tract) occurs constantly, for example by inhalation, but airway defense, such as mucociliary clearance and local antibodies, clear the organisms efficiently. In order to understand the pathogenesis of airways infection, attention must be paid not only to the virulence properties of the pathogen involved but also to the host. For example, viral infection or cigarette smoking may impair host defenses, permitting spread of the bacteria from the nasopharynx into other areas of the respiratory tract. The pathogenesis of airways infection involves complex interactions between bacteria and the mucosal surface, local host defenses, and various aspects of the immune system. The immune response can either support local host defenses in clearing the infection or, in some circumstances, disadvantage the host by causing damage or contributing to symptoms. Investigation and therapy must take into account these complex interactions and must also pay attention to the likely pathogens and their antibiotic sensitivities.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Knowledge regarding thein vivoandin vitroproperties of human immunodeficiency virus replication is rapidly expanding. In particular, studies into the mechanism of action of three genes essential for virus growth, thegaggene encoding the p24 viral core protein, therevgene required for the export of human immunodeficiency virus envelope RNA from the nucleus to the cytoplasm of infected cells, and thetatgene responsible for transcriptional and translational viral activation, have led to the discovery of mutations capable of dominantly disrupting the function of each of these three genes. Culturing the plasma of human immunodeficiency virus-infected individuals for transmissible virus has emerged as a sensitive and potentially predictive assay for disease progression. Both primate and murine models have been refined by the isolation of molecular clones capable of inducing acquired immunodeficiency syndrome in rhesus monkeys and by the demonstration that human immunodeficiency virus-infected mice treated with zidovudine exhibit retardation of viral spread.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID