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Biomedical subjects

P L Andersen

Publications and source records attributed to P L Andersen.

At least 55 records · Page 3Linked to original sources

Phagocytosis and stimulation of the respiratory burst in neutrophils by Pneumocystis carinii.

Phagocytosis and superoxide production of neutrophils stimulated with Pneumocystis carinii were studied using P. carinii obtained from rats and neutrophils and serum from healthy blood donors. Superoxide generation increased in a dose-related way to the number of pneumocysts added and was significantly higher when the parasites were opsonized. The use of heat-inactivated serum for opsonization reduced superoxide production somewhat, but not significantly. Preincubation of neutrophils with recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) increased superoxide production in neutrophils stimulated with pneumocysts from 7.0 to 9.6 fmol/cell/20 min; however, the production in unstimulated cells increased by the same amount. Activation of the respiratory burst was paralleled by phagocytosis, and very few phagocytic vacuoles were found in neutrophils stimulated with unopsonized pneumocysts. By electron microscopy, various stages of cyst degradation were seen.

Animals↗

Etiology of community-acquired pneumonia. Evaluation by transtracheal aspiration, blood culture, or serology.

In a 5-year period, 254 patients with community-acquired pneumonia were attended to. Transtracheal aspiration (TTA) could be performed on 119 patients, blood cultures were performed on 201 patients, and 74 patients underwent serologic examinations. By use of these procedures, an etiologic diagnosis was established in 93 cases. Streptococcus pneumoniae was the most common pathogen as it was found in 35 cases. Eleven of these 35 patients (31.4 percent) had pneumococcemia, and the mortality in this group was 27.3 percent. None of the patients with pneumococcal pneumonia and negative blood culture died. Haemophilus influenzae was the only isolated pathogen from transtracheal aspirated sputum in 16 cases and accounted for 17.5 percent of pneumonias in previous healthy individuals under 50 years of age. Mycoplasma pneumonia infections, Legionella pneumophila infections, and Chlamydia infections were found in ten, eight, and three cases, respectively. The overall agreement between microscopy and culture of respiratory secretions obtained by TTA was 58.8 percent, and microscopy can be a guide when choosing the initial antibiotic treatment. No statistically significant difference in the rate of isolating bacteria among patients treated with antibiotics prior to TTA and patients not previously treated with antibiotics was seen. When contraindications were respected, we found TTA to be a safe procedure.

Adolescent↗

The C-reactive protein responses in HIV-infected patients with pneumonia.

The acute phase C-reactive protein (CRP) was measured in serum of HIV-infected patients suffering from Pneumocystis carinii pneumonia (PCP) (32 patients), bacterial pneumonia (10 patients), and in 19 immunocompetent patients with bacterial pneumonia. The HIV-infected patients with bacterial pneumonia had a significantly lower CRP level than the immunocompetent patients (50% versus 95% had an s-CRP level > 80 mg/l). No significant difference was found in the CRP response to P. carinii or bacteria in HIV-infected patients with pneumonia due to these microorganisms (20% versus 50% had s-CRP > 80 mg/l). In the group of PCP patients, a significantly lower CRP level was found in those with CD4 positive lymphocyte counts below 50 x 10(6)/l. There was no correlation between the CRP response and the severity of the PCP as estimated by the degree of hypoxia. We conclude that the CRP level cannot be used to discriminate between PCP and bacterial pneumonia in HIV-infected patients.

Acquired Immunodeficiency Syndrome↗

Antibodies to Pneumocystis carinii in Danish blood donors and AIDS patients with and without Pneumocystis carinii pneumonia.

Sera from 1) 8 AIDS patients with Pneumocystitis carinii pneumonia, 2) 13 HIV antibody-positive patients, 9 with AIDS and 4 with AIDS-related symptoms, all 13 without Pneumocystis carinii pneumonia, and 3) 36 healthy male blood donors, all HIV antibody negative, were examined for antibodies against Pneumocystis carinii using the indirect immunofluorescence antibody technique. Seven (87%) out of eight sera from group 1, 12 (92%) out of 13 sera from group 2, and 35 (97%) out of 36 sera from group 3 were positive. There was no significant difference between group 1 and 2, and group 2 and 3. The difference between group 1 and group 3 was significant (p = 0.03).

AIDS-Related Opportunistic Infections↗

[Chronic meningococcemia. A review and a report of 4 cases].

Four cases of chronic meningococcacemia (CM) are described. The diagnosis was based on recurring fever, exanthema, arthralgia/arthritis and positive blood culture with Neisseria meningitidis. The meningococcal antibody-test (MAT) was positive in all of the three patients tested. None of the patients had positive throat culture for Neisseria meningitidis. All patients had leucocytosis during the febrile periods. The symptoms lasted for 5-150 days before the diagnosis was made. These findings are discussed in relation to the literature.

Adult↗

[Pneumocystitis carinii pneumonia in adult patients with AIDS].

Pneumocystis carinii pneumonia continues to be the commonest opportunistic infection seen in AIDS patients. Early diagnosis and treatment have caused the one-year survival in AIDS-patients with PCP to increase steadily. However, PCP is still the cause of death in 25% of the AIDS-patients. Secondary prophylaxis with pentamidine-isethionate inhalations has reduced the risk of PCP relapse considerably. The risk of PCP is markedly increased at CD4-cell counts below 200 mio/l. Therefore, inhalations of pentamidine twice monthly, as a primary prophylaxis against PCP, can be recommended in HIV-positive patients with CD4-cell counts below this level.

Acquired Immunodeficiency Syndrome↗

Acute oral candidiasis during febrile episodes in immunocompromised patients with haematologic malignancies.

To estimate clinical, pathogenic and serological aspects of acute oral candidiasis (AOC) during febril episodes in patients with haematologic malignancies, 23 consecutive patients who developed AOC within 7 days from start of fever were compared with 23 consecutive patients who did not develop AOC. The duration of fever and severe granulocytopenia (less than 0.5 x 10(9)/l) was significantly longer in patients with AOC than in patients without AOC, the median differences between the patients with and without AOC being 4 and 3 days, respectively. Development of AOC could not be correlated to a change in the qualitative composition of the oral microflora. The thrombocyte count was lower in patients with AOC on day 4, whereas no differences were found in leukocyte counts. The prevalences of Candida albicans agglutinin titres greater than or equal to 5 were similar in patients with (24%) and without AOC (33%), and in controls (29%). Seroconversion or a significant increase in the agglutinin titre occurred in 4 patients with AOC and long-lasting fever, who became afebrile after systemic antifungal therapy. It is concluded that AOC is associated with long-lasting fever and decreased bone marrow function as judged by low thrombocyte counts, but not related to specific bacteria in the oral cavity or to an increased occurrence of C. albicans antibodies in the serum.

Acute Disease↗

Anti-corticosteroid antibodies in AIDS patients.

Patients suffering from AIDS tend to have symptoms that resemble those encountered in adrenocortical insufficiency. Serum sodium concentrations and blood pressure values were monitored and found to be subnormal, despite the fact that renin activity and aldosterone levels were either normal or elevated. We report the presence of autoantibodies directed against hydrocortisone among such AIDS patients. Indirect immunofluorescence technique using patients' sera and adrenal glands from AIDS patients as antigen showed antibodies to adrenocortical cells in sera from 9 of the 12 AIDS patients and in none from patients with autoimmune diseases and viral diseases or healthy blood donors. No similar reaction was seen in normal human or monkey adrenal glands. An ELISA technique was developed using hydrocortisone as antigen and using this technique 45% of the AIDS patients were found to have antibodies to hydrocortisone. It is possible that anti-corticosteroid antibodies (ACSA) may play a role in the pathophysiology of the Addison's like syndrome seen in terminal phases of AIDS.

Acquired Immunodeficiency Syndrome↗

Screening for complement deficiencies in unselected patients with meningitis.

Two hundred and nine patients consecutively admitted to hospital with a tentative diagnosis of meningitis were screened for complement deficiency by measuring classical and alternative pathway serum haemolytic complement activity and the plasma concentration of C3d. Abnormal test results were followed up by quantitative immunochemical measurements of individual complement components. No patients with homozygous complement deficiency were found in our material. One patient with pneumococcal meningitis with probable heterozygous C2-deficiency was identified. Patients with purulent meningitis of various etiologies or meningococcal disease had significantly increased plasma C3d concentration at admission compared to patients with serous meningitis or without meningitis. Furthermore, increased plasma level of C3d at admission in patients with purulent meningitis or meningococcal disease was associated with an increased lethality. Our findings do not support the hypothesis that complement deficiency is commonly associated with sporadically occurring meningococcal disease or purulent meningitis.

Adolescent↗

Autoantibodies and vascular events in essential hypertension: a five-year longitudinal study.

The relationship between serum autoantibodies and vascular events was investigated in 140 patients with essential hypertension during a five-year period. The influence of time upon incidence of autoantibodies was assessed in 55 normotensive controls of roughly the same distribution of age and sex. Thirty-four patients experienced a vascular event, which was fatal in 10 cases (7.1%). Eight of these 10 patients had autoantibodies in serum before the events, and the presence of autoantibodies at entry to the study tripled the five-year relative risk for vascular events. Antinuclear antibodies (ANA) and smooth muscle antibodies (SMA) especially contributed to this increased risk. The vascular events were followed by a significantly increased occurrence of ANA. In the control subjects no events occurred and no significant increases in the presence of autoantibodies were found during the five years. ANA and SMA positive sera showed no significant complement fixing properties, and the autoantibodies studied seemed to be secondary to tissue damage. Despite this, they seemed to reflect an ongoing injury of the vascular bed.

Adult↗

Herpesvirus antibodies and vascular complications in essential hypertension.

Antibodies against herpes simplex virus (HSV) and cytomegalovirus (CMV) were examined in sera from 132 patients with essential hypertension and 54 normotensive healthy subjects of the same age and sex. Prevalences of HSV and CMV antibodies (titre greater than or equal to 4) were equal in patients and controls. A HSV antibody tire greater than or equal to 64 was found in 39.5% (17/53) of patients with WHO stage III hypertension, in 26.2% (22/85) of patients with stage I-II hypertension, and in only 9.4% (5/54) of normotensive subjects (p less than 0.0005). The HSV antibodies were mainly of type 1. No association between CMV antibodies and vascular complications could be demonstrated.

Adult↗

Autoantibodies in untreated and treated essential hypertension. I.

Using the indirect immunofluorescence method, autoantibodies (AB) of IgG and IgM classes were investigated in sera from 161 consecutive patients with essential hypertension and compared with those from 78 healthy normotensive subjects of the same composition by age and sex, and without any family history of hypertension. The frequency of one or more AB was as high in 78 untreated (15.3%) as in 83 treated patients (13.0%) and was in the controls 9.0% (n.s.). In the treated patients, the AB were associated with heart involvement (p less than 0.02). In the untreated patients, antinuclear antibodies of IgG class were associated with BP (p less than 0.01) and fundus grading (p less than 0.005). A family history of hypertension was found in 23.5% of the hypertensive males with AB and in 9.0% of the normotensive males (p less than 0.10). These results are discussed in relation to reports of an association of AB with cardiovascular diseases. It is concluded that the presence of AB in essential hypertension is not necessarily due to drug induction.

Adult↗

HLA antigens in essential hypertension. Relation to familiar disposition and serum immunoglobulins.

HLA-typing was performed in 149 patients with essential hypertension, 86 males and 63 females. In 66 patients with significantly elevated serum levels of immunoglobulins, HLA-B27 was increased to 18%, from 8% in the controls (P less than 0.007). This was not significant when correcting the P-value for the number of antigens analyzed, but confirms reports of an association of this antigen with serum levels of immunoglobulins. HLA-Bw15 was found to be increased two-fold in patients with a family history of hypertension (P corrected less than 0.05) and in patients with autoantibodies (not significant). This is discussed in relation to the increase of Bw15 in juvenile diabetes and in Systemic Lupus Erythematosus, diseases in which vascular damage also occurs.

Epitopes↗