Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
Mais filtros

Bases de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Science ; 273(5272): 236-8, 1996 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-8662506

RESUMO

An inheritable muscular hypertrophy was recently described in sheep and shown to be determined by the callipyge gene mapped to ovine chromosome 18. Here, the callipyge phenotype was found to be characterized by a nonmendelian inheritance pattern, referred to as polar overdominance, where only heterozygous individuals having inherited the callipyge mutation from their sire express the phenotype. The possible role of parental imprinting in the determinism of polar overdominance is envisaged.


Assuntos
Genes Dominantes , Impressão Genômica , Músculo Esquelético/anatomia & histologia , Ovinos/anatomia & histologia , Ovinos/genética , Animais , Mapeamento Cromossômico , Cruzamentos Genéticos , Feminino , Genótipo , Heterozigoto , Escore Lod , Masculino , Modelos Genéticos , Mutação , Fenótipo
2.
J Vet Intern Med ; 31(4): 1132-1139, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28556454

RESUMO

BACKGROUND: Scottish Terriers have a high incidence of juvenile onset hereditary ataxia primarily affecting the Purkinje neuron of the cerebellar cortex and causing slowly progressive cerebellar dysfunction. OBJECTIVE: To identify chromosomal regions associated with hereditary ataxia in Scottish Terriers. ANIMALS: One hundred and fifty-three Scottish Terriers were recruited through the Scottish Terrier Club of America. MATERIALS AND METHODS: Prospective study. Dogs were classified as affected if they had slowly progressive cerebellar signs. When possible, magnetic resonance imaging and histopathological evaluation of the brain were completed as diagnostic aids. To identify genomic regions connected with the disease, genome-wide mapping was performed using both linkage- and association-based approaches. Pedigree evaluation and homozygosity mapping were also performed to examine mode of inheritance and to investigate the region of interest, respectively. RESULTS: Linkage and genome-wide association studies in a cohort of Scottish Terriers both identified a region on CFA X strongly associated with the disease trait. Homozygosity mapping revealed a 4 Mb region of interest. Pedigree evaluation failed to identify the possible mode of inheritance due to the lack of complete litter information. CONCLUSION AND CLINICAL IMPORTANCE: This finding suggests that further genetic investigation of the potential region of interest on CFA X should be considered in order to identify the causal mutation as well as develop a genetic test to eliminate the disease from this breed.


Assuntos
Doenças do Cão/genética , Degenerações Espinocerebelares/veterinária , Animais , Encéfalo/diagnóstico por imagem , Doenças do Cão/diagnóstico por imagem , Cães , Feminino , Ligação Genética/genética , Estudo de Associação Genômica Ampla/veterinária , Homozigoto , Imageamento por Ressonância Magnética/veterinária , Masculino , Neuroimagem/veterinária , Linhagem , Degenerações Espinocerebelares/diagnóstico por imagem , Degenerações Espinocerebelares/genética
3.
Am J Med ; 93(1): 97-101, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1626579

RESUMO

Granulomatous mastitis is a benign inflammatory breast disease of unknown etiology. Although it is rare, it frequently presents in a manner similar to that of breast carcinoma. Surgical resection of the affected tissue has often been the method of treatment, but many patients have experienced recurrences. Corticosteroids have also been used, but the initiation of this therapy is often limited by concerns related to the presence of an infectious etiology. Presented here are two cases that demonstrate the efficacy of corticosteroids in this condition after appropriate evaluation is performed.


Assuntos
Mastite/patologia , Adulto , Diagnóstico Diferencial , Feminino , Granuloma/patologia , Humanos , Úlcera/patologia
4.
Expert Rev Mol Diagn ; 1(3): 334-42, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11901839

RESUMO

This paper provides a review of recent work in the area of marker-phenotype association studies, specifically as used for localizing--or mapping--genes affecting a trait of interest. We describe the basis of association mapping and discuss a number of the commonly used techniques. We have also included references to various papers that have evaluated the use of these methods.


Assuntos
Marcadores Genéticos , Técnicas de Diagnóstico Molecular , Fenótipo , Análise de Variância , Estudos de Casos e Controles , Mapeamento Cromossômico , Saúde da Família , Genótipo , Haplótipos , Humanos , Desequilíbrio de Ligação , Característica Quantitativa Herdável
5.
Brain Res ; 823(1-2): 59-66, 1999 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-10095012

RESUMO

Dopaminergic projections to the medial prefrontal cortex (mPFC) were unilaterally lesioned with 6-hydroxydopamine (6-OHDA) to examine how dopamine (DA) asymmetry in the mPFC influences voluntary ethanol consumption. Differences in nucleus accumbens (NAS) DA neurotransmission have been related to individual differences in locomotor activity and in the rewarding efficacy of ethanol. Therefore, differences in locomotor activity were used to further characterize the effects of unilateral mPFC 6-OHDA lesions on ethanol consumption. Male Long Evans rats were assessed for high versus low levels of spontaneous locomotor activity. DA terminals in the left or right mPFC were unilaterally lesioned with 6-OHDA, resulting in an average DA depletion of 54% and 50%, respectively. After a minimum seven-day recovery period, preference for a 10% ethanol solution vs. water was determined in a 24-h 2-bottle home-cage free-choice paradigm. Left mPFC 6-OHDA lesions increased and right lesions decreased ethanol consumption. These differential effects of left and right lesions were primarily attributable to rats exhibiting low locomotor activity prior to surgery. The present data suggest that right greater than left cortical DA asymmetry in combination with low endogenous NAS DA (predicted by low locomotor activity levels) may increase the vulnerability to abuse ethanol.


Assuntos
Consumo de Bebidas Alcoólicas/fisiopatologia , Dominância Cerebral/fisiologia , Córtex Pré-Frontal/fisiologia , Animais , Comportamento Animal/fisiologia , Masculino , Atividade Motora/fisiologia , Oxidopamina/farmacologia , Córtex Pré-Frontal/efeitos dos fármacos , Ratos , Ratos Long-Evans
6.
Brain Res ; 823(1-2): 80-7, 1999 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-10095014

RESUMO

Spontaneous turning behavior and locomotor activity were evaluated for their ability to predict differences in the voluntary consumption of ethanol in male Long-Evans rats. Animals were assessed for their preferred direction of turning behavior and for high vs. low levels of spontaneous locomotor activity, as determined during nocturnal testing in a rotometer. Subsequently, preference for a 10% ethanol solution vs. water was determined in a 24-h two-bottle home-cage free-choice paradigm. Rats exhibiting a right-turning preference consumed more ethanol than rats showing a left-turning preference. While locomotor activity alone did not predict differences in drinking, turning and locomotor activity together predicted differences in ethanol consumption. Low-activity right-turning rats consumed more ethanol than all the other groups of rats. Previous studies from this laboratory have shown that individual differences in turning behavior are accompanied by different asymmetries in dopamine (DA) function in the medial prefrontal cortex (mPFC). Individual differences in locomotor activity are associated with differences in nucleus accumbens (NAS) DA function. The present data suggest that variations in mPFC DA asymmetry and NAS DA function may underlie differences in the voluntary consumption of ethanol.


Assuntos
Consumo de Bebidas Alcoólicas/fisiopatologia , Atividade Motora/fisiologia , Comportamento Estereotipado/fisiologia , Animais , Comportamento de Escolha/fisiologia , Lateralidade Funcional/fisiologia , Individualidade , Masculino , Ratos , Ratos Long-Evans
7.
Brain Res ; 823(1-2): 207-12, 1999 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-10095029

RESUMO

Ethanol (0.5 g/kg i.p.) 15 min prior to sacrifice increased homovanillic acid (HVA) levels in the left medial prefrontal cortex (mPFC) of left-turning rats and in the right mPFC of right-turning rats. In the nucleus accumbens (NAS), ethanol decreased dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), and HVA levels in rats that exhibited low levels of locomotor activity but not in rats that exhibited high levels of locomotor activity. This laboratory has previously shown that rats exhibiting differences in turning and locomotor activity behavior display different preferences for ethanol. The present results suggest that ethanol-induced differences in mPFC and NAS DA activity may be related to individual differences in the susceptibility to abuse ethanol.


Assuntos
Dopamina/metabolismo , Etanol/farmacologia , Lateralidade Funcional/fisiologia , Núcleo Accumbens/metabolismo , Córtex Pré-Frontal/metabolismo , Comportamento Estereotipado/fisiologia , Ácido 3,4-Di-Hidroxifenilacético/metabolismo , Animais , Ácido Homovanílico/metabolismo , Masculino , Ratos , Ratos Long-Evans , Distribuição Tecidual
8.
Brain Res ; 707(1): 122-6, 1996 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-8866721

RESUMO

The effects of chronic administration of the antidepressant drugs desipramine, nortryptiline and paroxetine (PAR) (10 mg/kg/day, 21 days) on changes in turning (circling) behavior and on norepinephrine (NE), dopamine (DA) and serotonin and their metabolites 3,4-dihydroxyphenylacetic acid and 5-hydroxyindole acetic acid (5-HIAA) in the medial prefrontal cortex (PFC), nucleus accumbens and striatum were evaluated in rats. All three drugs eliminated turning biases in right turning rats. All drugs increased DA concentrations in the PFC while PAR increased NE in the PFC and reduced 5-HIAA in all three structures. The results are discussed with reference to previous findings involving brain asymmetry in depression.


Assuntos
Antidepressivos/farmacologia , Comportamento Animal/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , Animais , Corpo Estriado/efeitos dos fármacos , Desipramina/farmacologia , Dopamina/metabolismo , Masculino , Núcleo Accumbens/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Ratos , Serotonina/metabolismo
9.
Physiol Behav ; 61(4): 525-35, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9108571

RESUMO

Mice have paw preferences that are consistent upon repeated measurement. The Collins HI and LO strains are two populations of mice that have been selectively bred to differ markedly in the degree of paw preference. They represent a unique genetic model of functional cerebral lateralization. Rotation (or circling) behavior in normal unlesioned animals reflects an endogenous lateralization of the functioning brain dopamine (DA) systems. In the present study, rotational behavior and lateralized brain DA neurochemistry were assessed in the Collins HI and LO strain mice. Confirming Collins findings, HI strain mice exhibited stronger paw preferences than LO strain mice. HI strain mice also showed stronger percent directional preferences during nocturnal tests of spontaneous rotation. Neurochemical differences were also apparent between the strains. DA and its metabolites were measured in the medial prefrontal cortex (PFC), nucleus accumbens (NAS), and striatum. Degrees of rotational and paw preference in HI, but not LO, mice were correlated with PFC asymmetries in DA and the DA metabolite dihydroxyphenyl acetic acid (DOPAC), respectively. Hemisphere, paw preference, turning preference, and strain interacted in a complex way to determine measures of DA utilization in the NAS and striatum. Even though the directions of paw preference and rotation were not correlated, HI and LO mice of differing paw and rotational directional preferences showed differences in DA neurochemistry in the NAS and striatum.


Assuntos
Comportamento Animal/fisiologia , Encéfalo/metabolismo , Dopamina/metabolismo , Lateralidade Funcional/fisiologia , Rotação , Animais , Feminino , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Análise e Desempenho de Tarefas
10.
Can J Public Health ; 91(2): 129-32, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10832179

RESUMO

OBJECTIVES: To determine the demographic characteristics, risk behaviours and prevalence of HIV-1 among injection drug users (IDU) attending Calgary's needle exchange program (NEP). METHODS: A survey was conducted from June through September 1998 among IDU attending Calgary's NEP. Demographic and behaviour characteristics were determined by personal interview and saliva was tested for HIV antibody. RESULTS: There were 278 participants providing 272 saliva specimens. Nine were positive for HIV-1 (3.3%, 95% C.I. 1.6-6.4%). Sexual and injecting practices, cities where drugs had been used, incarceration, addiction treatment and demographic characteristics were described, and a subanalysis for women, youth and Aboriginals was carried out. CONCLUSIONS: HIV prevalence remains low among NEP attenders in Calgary, although high-risk behaviours are common. Women, youth and Aboriginals have unique risk behaviour profiles. Many IDU want to participate in addiction treatment, and strategies should be made to provide accessible, appropriate treatment services.


Assuntos
Infecções por HIV/epidemiologia , Programas de Troca de Agulhas , Adolescente , Adulto , Alberta/epidemiologia , Feminino , Infecções por HIV/transmissão , Soroprevalência de HIV , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Programas de Troca de Agulhas/normas , Assunção de Riscos , Comportamento Sexual , Abuso de Substâncias por Via Intravenosa/epidemiologia
11.
Adolescence ; 29(115): 525-42, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7832019

RESUMO

This study investigated the relationships between multiple dimensions of self-esteem and adolescents' perceptions of parental behaviors using nonclinical (n = 119) and clinical (n = 30) samples of adolescents. The Rosenberg Self-Esteem Scale (RSES), a modified version of Osgood's Semantic Differential (OSD), Schaefer's Children's Report of Parental Behavior Inventory (CRPBI) short form), and a demographic questionnaire were administered to participants. Scores from the self-esteem measures were empirically combined and factor analyzed, yielding four dimensions of self-esteem. Multivariate analysis of variance were used to compare self-esteem dimension scores for males and females within both samples. Correlations and partial correlations were conducted to determine the nature of the relationships between each dimension of self-esteem and perceptions of parental behaviors. Nonclinical adolescents scored higher than did clinical adolescents on all self-esteem dimensions. Males scored higher than females only on the dimension of Self-Esteem Competence. Perceptions of parental behaviors were consistently unrelated to dimensions of self-esteem among adolescents in the clinical sample. Among adolescents in the nonclinical sample, perceptions of parental support and autonomy granting were related to multiple dimensions of self-esteem. Perceptions of parental discipline were inconsistently related to dimensions of nonclinical self-esteem.


Assuntos
Transtornos Mentais/psicologia , Relações Pais-Filho , Desenvolvimento da Personalidade , Autoimagem , Adolescente , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Admissão do Paciente , Inventário de Personalidade/estatística & dados numéricos , Psicometria , Apoio Social
14.
Appl Microbiol Biotechnol ; 76(5): 1107-18, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17646985

RESUMO

The aflatoxin-producing fungi, Aspergillus flavus and A. parasiticus, form structures called sclerotia that allow for survival under adverse conditions. Deletion of the veA gene in A. flavus and A. parasiticus blocks production of aflatoxin as well as sclerotial formation. We used microarray technology to identify genes differentially expressed in wild-type veA and veA mutant strains that could be involved in aflatoxin production and sclerotial development in A. flavus. The DNA microarray analysis revealed 684 genes whose expression changed significantly over time; 136 of these were differentially expressed between the two strains including 27 genes that demonstrated a significant difference in expression both between strains and over time. A group of 115 genes showed greater expression in the wild-type than in the veA mutant strain. We identified a subgroup of veA-dependent genes that exhibited time-dependent expression profiles similar to those of known aflatoxin biosynthetic genes or that were candidates for involvement in sclerotial production in the wild type.


Assuntos
Aflatoxinas/biossíntese , Antraquinonas/metabolismo , Aspergillus flavus/crescimento & desenvolvimento , Proteínas Fúngicas/metabolismo , Perfilação da Expressão Gênica , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Aspergillus flavus/genética , Aspergillus flavus/metabolismo , Proteínas Fúngicas/genética , Regulação Fúngica da Expressão Gênica , Biblioteca Gênica , Genômica
15.
Jt Comm J Qual Improv ; 19(12): 566-75, 1993 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8118525

RESUMO

The cornerstone of HEDIS 2.0 is measurement. Only by measuring how a plan performs with respect to defined measures will an employer be able to assess a plan's value and also hold a plan accountable for its performance. Because of time and resource constraints, there are many issues related to the development and use of the performance measures contained within HEDIS 2.0 that have been incompletely addressed or not addressed at all. Following are some of the issues that warrant further consideration. Selection of performance measures. The present set of performance measures represents only a first attempt to define measures that document health plan performance in a number of areas of health care delivery. The resulting measures constitute a core data and information set and should not be considered to be an optimum set. Many other areas and measures of health plan performance were considered, including costs of specific episodes of care, age-specific utilization of defined services, patients receiving appropriate follow-up care for identified preventive health services, stage of cancer at time of diagnosis in relationship to preventive services screening, and functional outcome assessment. These measures were not included in this revision of HEDIS because of difficulties in developing specifications for the measure and/or in obtaining reliable data. It will be important to address these areas in the future. Risk adjustment of performance measures. To minimize the effects of population differences, most of the recommended performance measures assess discrete aspects of the process of care delivery (for example, percentage of pregnant women with first-trimester visit) rather than outcomes. However, interpretation of certain measures (for example, low birthweight, hospital readmission rate) will be affected by the specific member characteristics of the health plan population. Health plans and employers need to be aware of this limitation when interpreting and comparing certain performance measures, and further refinements will be needed in future ierations.(ABSTRACT TRUNCATED AT 400 WORDS)


Assuntos
Planos de Assistência de Saúde para Empregados/organização & administração , Programas de Assistência Gerenciada/normas , Comportamento do Consumidor , Coleta de Dados/normas , Acessibilidade aos Serviços de Saúde , Sistemas de Informação , Garantia da Qualidade dos Cuidados de Saúde/normas , Qualidade da Assistência à Saúde/organização & administração , Estados Unidos
16.
Theor Popul Biol ; 60(3): 253-63, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11855959

RESUMO

There is great expectation that the levels of association found between genetic markers and disease status will play a role in the location of disease genes. This expectation follows from regarding association as being proportional to linkage disequilibrium and therefore inversely related to recombination value. For disease genes with more than two alleles, the association measure is instead a weighted average of linkage disequilibria, with the weights depending on allele frequencies and genotype susceptibilities at the disease loci. There is no longer a simple relationship, even in expectation, with recombination. We adopt a general framework to examine association mapping methods which helps to clarify the nature of case-control and transmission/disequilibrium-type tests and reveals the relationship between measures of association and coefficients of linkage disequilibrium. In particular, we can show the consequences of additive and nonadditive effects at the trait locus on the behavior of these tests. These concepts have a natural extension to marker haplotypes. The association of two-locus marker haplotypes with disease phenotype depends on a weighted average of three-locus disequilibria (two markers with each disease locus). It is likely that these two-marker analyses will provide additional information in association mapping studies.


Assuntos
Mapeamento Cromossômico/métodos , Marcadores Genéticos , Predisposição Genética para Doença , Desequilíbrio de Ligação , Modelos Genéticos , Alelos , Apolipoproteínas E/genética , Citocromo P-450 CYP2D6/genética , Genótipo , Haplótipos , Humanos , Fenótipo
17.
Genet Res ; 74(3): 271-7, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10689804

RESUMO

We examine the relationships between a genetic marker and a locus affecting a quantitative trait by decomposing the genetic effects of the marker locus into additive and dominance effects under a classical genetic model. We discuss the structure of the associations between the marker and the trait locus, paying attention to non-random union of gametes, multiple alleles at the marker and trait loci, and non-additivity of allelic effects at the trait locus. We consider that this greater-than-usual level of generality leads to additional insights, in a way reminiscent of Cockerham's decomposition of genetic variance into five terms: three terms in addition to the usual additive and dominance terms. Using our framework, we examine several common tests of association between a marker and a trait.


Assuntos
Modelos Genéticos , Característica Quantitativa Herdável , Animais , Marcadores Genéticos , Humanos , Computação Matemática
18.
J Automat Chem ; 20(6): 199-203, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-18924836

RESUMO

An automated Cobas Fara method was developed determining the activity of recombinant M. thermophila laccase (rMtL). The chromogenic substrate used was syringaldazine. Under aerobic conditions, rMtL catalyses the oxidation of syringaldazine forming tetrametoxy-azo bis methylene quinone. The developed violet colour was measured kinetically at 530 nm as an expression of the enzyme activity, rMtL is a very sensitive oxidoreductase, therefore many factors had to be carefully controlled in order to get a robust analytical assay. In order to stabilize rMtL, PEG 6000 was added to the enzyme dilution medium. Furthermore, Triton X-I00 was included in the enzyme incubation solution.The analytical as well as technical conditions have been optimized, resulting in a method with good precision, sensitivity and speed of analysis. The Michaelis-Menten constant, K(m), was determined to be 22muM syringaldazine. LOQ was determined to be 0.010 Uml(-1), LOD to be 0.0002 Uml(-1) The analytical range of the enzyme dilution curve was from 0.01 to 0.044 Uml(-1) The repeatability was 1.9%, the reproducibility 3.1%. Testing the robustness of the method showed that the most sensible factors in the rMtL analysis in decreasing range were: incubation temperature, concentration of Triton X-I00, molarity and pH of the incubation buffer, and finally the concentration of syringaldazine.

19.
Am J Hum Genet ; 63(5): 1531-40, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9867708

RESUMO

We review and extend a recent suggestion that fine-scale localization of a disease-susceptibility locus for a complex disease be done on the basis of deviations from Hardy-Weinberg equilibrium among affected individuals. This deviation is driven by linkage disequilibrium between disease and marker loci in the whole population and requires a heterogeneous genetic basis for the disease. A finding of marker-locus Hardy-Weinberg disequilibrium therefore implies disease heterogeneity and marker-disease linkage disequilibrium. Although a lack of departure of Hardy-Weinberg disequilibrium at marker loci implies that disease susceptibilityweighted linkage disequilibria are zero, given disease heterogeneity, it does not follow that the usual measures of linkage disequilibrium are zero. For disease-susceptibility loci with more than two alleles, therefore, care is needed in the drawing of inferences from marker Hardy-Weinberg disequilibria.


Assuntos
Doenças Genéticas Inatas/genética , Marcadores Genéticos , Desequilíbrio de Ligação , Modelos Genéticos , Modelos Estatísticos , Alelos , Genes Recessivos , Predisposição Genética para Doença , Heterozigoto , Humanos
20.
Ann Intern Med ; 109(4): 280-7, 1988 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-3260759

RESUMO

STUDY OBJECTIVE: To ascertain the efficacy and toxicity of trimethoprim-sulfamethoxazole or pentamidine when either is given alone during the entire treatment period for Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). DESIGN: Prospective, randomized, noncrossover comparison of trimethoprim-sulfamethoxazole with pentamidine. Trimethoprim-sulfamethoxazole dosage was adjusted to maintain serum trimethoprim at 5 to 8 micrograms/mL. Pentamidine dosage was reduced by 30% to 50% for an absolute rise in serum creatinine of more than 88 mumol/L (1 mg/dL). SETTING: Tertiary care hospital and AIDS clinic. PATIENTS: Thirty-six patients were treated with trimethoprim-sulfamethoxazole and 34 with pentamidine. Pretreatment clinical features and laboratory test results were similar in the two groups. MEASUREMENTS AND MAIN RESULTS: Thirty-six recipients of trimethoprim-sulfamethoxazole and 33 recipients of pentamidine completed therapy without crossover. Trimethoprim-sulfamethoxazole caused a rash (44%) and anemia (39%) more frequently (P less than or equal to 0.03, whereas pentamidine caused nephrotoxicity (64%), hypotension (27%), or hypoglycemia (21%) more frequently (P less than or equal to 0.01). The (A - a)DO2 improved by greater than 1.3 kPa (10 mmHg) 8 days earlier for trimethoprim-sulfamethoxazole recipients (95% CI for the difference in response, -1 to 17; P = 0.04). Thirty-one (86%) patients treated with trimethoprim-sulfamethoxazole and 20 (61%) with pentamidine survived and were without respiratory support at completion of treatment (95% CI for the difference in response, 5% to 45%; P = 0.03). CONCLUSIONS: For most patients with AIDS and P. carinii pneumonia, successful treatment with a single agent is possible. Toxicity associated with the two standard treatments is rarely life-threatening and may be diminished if the trimethoprim-sulfamethoxazole dosage is modified by pharmacokinetic monitoring and the pentamidine dosage is reduced for nephrotoxicity. Oxygenation improved more quickly and survival was better with trimethoprim-sulfamethoxazole.


Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Amidinas/uso terapêutico , Pentamidina/uso terapêutico , Pneumonia por Pneumocystis/tratamento farmacológico , Sulfametoxazol/uso terapêutico , Trimetoprima/uso terapêutico , Adulto , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/efeitos adversos , Combinação de Medicamentos/uso terapêutico , Doenças Hematológicas/induzido quimicamente , Humanos , Nefropatias/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Pentamidina/administração & dosagem , Pentamidina/efeitos adversos , Pneumonia por Pneumocystis/etiologia , Estudos Prospectivos , Distribuição Aleatória , Sulfametoxazol/administração & dosagem , Sulfametoxazol/efeitos adversos , Trimetoprima/administração & dosagem , Trimetoprima/efeitos adversos , Trimetoprima/sangue , Combinação Trimetoprima e Sulfametoxazol
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA