Pneumocystis carinii: a deadly opportunist.

Abstract:

:Pneumocystis carinii pneumonia is a life-threatening complication of diseases and therapies associated with immunosuppression. Approximately 80 percent of patients with acquired immunodeficiency syndrome will develop pneumocystis pneumonia. Diagnosis is important, because effective therapy is available. In most cases, diagnosis can be made by sputum analysis. Bronchoalveolar lavage will yield a diagnosis in 85 to 90 percent of patients with pneumocystis pneumonia, and is used when sputum induction and analysis is unproductive, unavailable or negative. Transbronchial biopsy and, rarely, open lung biopsy will yield the etiology of pneumonia in the remaining patients. Pentamidine or trimethoprim-sulfamethoxazole is the treatment of choice. Toxicity often occurs, including hypoglycemia, nephrotoxicity, neutropenia and rash. Corticosteroids are helpful in moderate to severe disease. Mortality for the first episode of P. carinii pneumonia averages 20 percent. Prophylaxis effectively prevents and reduces the incidence of future episodes.

journal_name

Am Fam Physician

authors

Zackrison LH,Tsou E

subject

Has Abstract

pub_date

1991-08-01 00:00:00

pages

528-41

issue

2

eissn

0002-838X

issn

1532-0650

journal_volume

44

pub_type

杂志文章,评审
  • Evaluating hoarseness: keeping your patient's voice healthy.

    abstract::Hoarseness is the term often used by patients to describe changes in their voice quality. The causes of hoarseness are determined after obtaining a detailed medical history of the circumstances preceding the onset of hoarseness and performing a thorough physical examination. The latter may include visualization of the...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Rosen CA,Anderson D,Murry T

    更新日期:1998-06-01 00:00:00

  • Thermoregulation of the newborn.

    abstract::The classic modes of heat loss affecting the newborn are conduction, convection, radiation and evaporation. The disproportionate ratio of surface area to body weight (SA/BW) of the premature infant is the basis of inefficient heat conservation, combined with a blunted metabolic response. Hypothermia leads to hypoxemia...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Kanto WP Jr,Calvert LJ

    更新日期:1977-11-01 00:00:00

  • Phenobarbital vs. phenytoin for grand mal epilepsy.

    abstract::The chief side effect of phenobarbital is drowsiness, which is usually associated with overdosage. Phenytoin, on the other hand, causes gingival hyperplasia in many patients, irreversible hypertrichosis in some patients and lethal reactions, such as Stevens-Johnson syndrome, in a few patients. Antiepileptic therapy sh...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Livingston S,Pauli LL,Pruce I,Kramer II

    更新日期:1980-08-01 00:00:00

  • Treating acute hypertensive crisis with sodium nitroprusside.

    abstract::In patients with dangerously elevated diastolic blood pressures, the titrated intravenous administration of sodium nitroprusside usually reduces blood pressure to near-normal levels in less than an hour. This rapid reduction of pressure is well tolerated by hypertensive patients and probably diminishes the morbidity f...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Kohli RK,Elwood CM

    更新日期:1977-01-01 00:00:00

  • Scaphoid (navicular) fracture of the wrist.

    abstract::This common fracture most frequently affects young males. In most cases, the fracture is found on initial examination. Occasionally, it is missed on the initial radiographic evaluation but becomes apparent on follow-up films. Although most scaphoid fractures respond to conservative therapy, some fail to heal. Nonunion...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: O'Dell ML,Moore JB

    更新日期:1984-04-01 00:00:00

  • Eating Disorders in Primary Care: Diagnosis and Management.

    abstract::Eating disorders are potentially life-threatening conditions characterized by disordered eating and weight-control behaviors that impair physical health and psychosocial functioning. Early intervention may decrease the risk of long-term pathology and disability. Clinicians should interpret disordered eating and body i...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Klein DA,Sylvester JE,Schvey NA

    更新日期:2021-01-01 00:00:00

  • Management of status epilepticus.

    abstract::Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of the patient. Treatment is evolving...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Sirven JI,Waterhouse E

    更新日期:2003-08-01 00:00:00

  • Prison medicine.

    abstract::Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Greenberg MJ

    更新日期:1988-07-01 00:00:00

  • Neck Pain: Initial Evaluation and Management.

    abstract::Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and treatment of more concerning diagnoses,...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Childress MA,Stuek SJ

    更新日期:2020-08-01 00:00:00

  • Benign pulmonary tumors.

    abstract::Benign pulmonary neoplasms are relatively uncommon. The symptoms vary, depending on the location of the tumor. Specific diagnosis can be a time-consuming process and requires an orderly plan. Polytomography or computed tomographic scan, bronchoscopy, percutaneous biopsy or thoracotomy may be required. Tissue diagnosis...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Houston TP,Macklin JE

    更新日期:1984-01-01 00:00:00

  • Marine envenomations and aquatic dermatology.

    abstract::Jellyfish stings are usually mild except those caused by species in the South Pacific. The box jellyfish can produce a severe cardiorespiratory insult. The sting of the Portuguese man-of-war is more potent than that of the common jellyfish. The Indo-Pacific area is the source of the most venomous bony fish. Many injur...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Soppe GG

    更新日期:1989-08-01 00:00:00

  • Therapeutic endoscopy for gastrointestinal bleeding.

    abstract::Patients with variceal or other gastrointestinal hemorrhage require aggressive resuscitative measures and early diagnosis for optimal therapy. A number of nonsurgical endoscopic modalities, such as laser therapy, sclerotherapy, heater probe and electrocoagulation (monopolar or bipolar), are available to arrest and som...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Thatcher BS

    更新日期:1986-10-01 00:00:00

  • Prevention of health care-associated infections.

    abstract::Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, an...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Hsu V

    更新日期:2014-09-15 00:00:00

  • Congestive heart failure.

    abstract::Causes of congestive heart failure include hypertension, coronary artery disease, alcohol abuse and valvular heart disease. Two-dimensional echocardiography with Doppler examination is excellent for identifying valvular heart disease. While noninvasive screening for coronary artery disease may seem cost-effective, the...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Vine DL

    更新日期:1990-09-01 00:00:00

  • The patient with excessive worry.

    abstract::Worry is a normal response to uncertainty. Education, empathetic support, reassurance, and passage of time usually ameliorate ordinary worries. However, these common-sense strategies for dealing with transient worries often prove ineffective for patients with excessive worry, many of whom meet the criteria for disorde...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Shearer S,Gordon L

    更新日期:2006-03-15 00:00:00

  • Evaluation and treatment of orthostatic hypotension.

    abstract::Orthostatic hypotension is defined as a decrease of at least 20 mm Hg in systolic blood pressure when an individual moves from a supine position to a standing position. Nonneurogenic causes of orthostatic hypotension are related to cardiac pump failure, reduced intravascular volume, venous pooling or a medication side...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Engstrom JW,Aminoff MJ

    更新日期:1997-10-01 00:00:00

  • Perioperative management of the alcohol-dependent patient.

    abstract::Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Chiang PP

    更新日期:1995-12-01 00:00:00

  • Topical antifungal agents: an update.

    abstract::So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet,...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Diehl KB

    更新日期:1996-10-01 00:00:00

  • Lumbar disk disease: pathophysiology, management and prevention.

    abstract::Patients with symptomatic lumbar disk disease may present with back pain, referred leg pain, radicular leg pain, sensory changes and leg weakness. Because neurologic deficits are commonly localized to the L5 or S1 nerve roots, evaluation of patients with such symptoms should focus on these dermatomes and muscle groups...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Gilmer HS,Papadopoulos SM,Tuite GF

    更新日期:1993-04-01 00:00:00

  • Zidovudine for the treatment of HIV infection.

    abstract::Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Pepe R,Molavi A

    更新日期:1990-08-01 00:00:00

  • Current drug therapy for agoraphobia.

    abstract::The hallmark of agoraphobia is the spontaneous panic attack, a reaction of extreme fearfulness and impending doom with cardiorespiratory symptoms. The end result can be a patient who is housebound. The basic therapeutic principle is confrontation with the avoided object or activity. Controlled clinical experiments dem...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Ravaris CL

    更新日期:1981-01-01 00:00:00

  • Hepatitis A.

    abstract::Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources. Young children are usua...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Matheny SC,Kingery JE

    更新日期:2012-12-01 00:00:00

  • Surgical options in the management of groin hernias.

    abstract::Inguinal and femoral hernias are the most common conditions for which primary care physicians refer patients for surgical management. Hernias usually present as swelling accompanied by pain or a dragging sensation in the groin. Most hernias can be diagnosed based on the history and clinical examination, but ultrasonog...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Bax T,Sheppard BC,Crass RA

    更新日期:1999-01-01 00:00:00

  • Hyperparathyroidism.

    abstract::Hyperparathyroidism is a common cause of hypercalcemia. The hypercalcemia usually is discovered during a routine serum chemistry profile. Often, there has been no previous suspicion of this disorder. In most patients initially believed to be asymptomatic, previously unrecognized symptoms resolve with surgical correcti...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Allerheiligen DA,Schoeber J,Houston RE,Mohl VK,Wildman KM

    更新日期:1998-04-15 00:00:00

  • Pediatric advanced life support: Part I. Airway, circulation and intravascular access.

    abstract::Effective management of life-threatening emergencies in infants and children demands a high level of technical skill. The Pediatric Advanced Life Support (PALS) provider course, developed jointly by the American Academy of Pediatrics and the American Heart Association, is highly recommended to help physicians prepare ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Rockney RM,Alario AJ,Lewander WJ

    更新日期:1991-04-01 00:00:00

  • Traveler's diarrhea.

    abstract::Traveler's diarrhea is the most common health problem in persons who visit developing countries. Dietary precautions are the mainstay of prevention. Since bacteria are responsible for 50 to 80 percent of cases of traveler's diarrhea, antibiotics are the drugs of choice for empiric therapy. Because bacteria are becomin...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Heck JE,Cohen MB

    更新日期:1993-10-01 00:00:00

  • The serum digoxin concentration: ten questions to ask.

    abstract::Although the role of digoxin therapy has been the subject of debate, the drug is generally accepted as effective in the treatment of heart failure due to systolic dysfunction and as therapy for atrial fibrillation and supraventricular tachyarrhythmias. Serum digoxin concentrations are commonly used to gauge patient re...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Cauffield JS,Gums JG,Grauer K

    更新日期:1997-08-01 00:00:00

  • Hemochromatosis in a family.

    abstract::A 56-year-old man, who had previously been treated for arthritis of the hands, was admitted to the hospital because of abdominal pain and fever. Physical examination, laboratory tests and liver biopsy led to the diagnosis of hemochromatosis. The patient's brother, who had also been treated for arthritis, was then foun...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Holcombe DJ

    更新日期:1987-06-01 00:00:00

  • Early management of spinal injuries.

    abstract::Traumatic spinal injuries are a major health problem. Any accident victim suspected of having a spinal injury must be immobilized immediately to prevent further damage to the spine. Management is directed toward achieving the most favorable environment for spinal cord recovery. This includes maintaining adequate oxyge...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Sypert GW

    更新日期:1984-05-01 00:00:00

  • Disorders of Puberty: An Approach to Diagnosis and Management.

    abstract::Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome neurologic symptoms typically have a ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Klein DA,Emerick JE,Sylvester JE,Vogt KS

    更新日期:2017-11-01 00:00:00