Showing papers by "William Borkowsky published in 1990"

Pneumocystis carinii Pneumonia in Infants Infected with the Human Immunodeficiency Virus with More Than 450 CD4 T Lymphocytes per Cubic Millimeter

Abstract: PNEUMOCYSTIS carinii pneumonia (PCP) is the most common illness defining the presence of the acquired immunodeficiency syndrome (AIDS). It occurred in 70 percent of the pediatric patients with the human immunodeficiency virus (HIV) infection whose cases have been reported to the Centers for Disease Control.1 A child's first episode of PCP is frequently fatal; children who survive the initial attack have a mortality rate of approximately 90 percent during a second clinical episode.2 Absolute CD4-lymphocyte counts have been shown to be a clinically useful indicator of immune function in HIV-infected patients. These counts are currently used to stratify HIV-infected adults . . .

Lymphocyte proliferative responses to HIV-1 envelope and core antigens by infected and uninfected adults and children.

Abstract: Lymphocytes derived from children and adults infected with the human immunodeficiency virus (HIV-1), as well as from seronegative children and adults, were tested for their ability to proliferate i...

A Controlled Trial of Bovine Dialyzable Leukocyte Extract for Cryptosporidiosis in Patients with AIDS

Abstract: Cryptosporidial infection causes severe diarrheal disease in patients with AIDS. Fourteen patients with AIDS and symptomatic cryptosporidiosis were treated with a specific bovine dialyzable leukocyte extract (immune DLE) prepared from lymph node lymphocytes of calves immunized with cryptosporidia or a nonspecific (nonimmune) DLE prepared from nonimmunized calves. Six of 7 patients given immune DLE gained weight and had a decrease in bowel movement frequency, with eradication of oocysts from stool in 5 patients. Six of 7 patients given nonimmune DLE showed no decrease in bowel movement and 4, no clearing of oocytes from stool; 5 continued to lose weight. Subsequently, 5 of these 7 were treated with immune DLE; 4 had a decrease in bowel movement frequency and significant weight gain, with eradication of oocytes from stool in 2 patients. Immune DLE produces sustained symptomatic improvement in patients with AIDS and active cryptosporidiosis, but lack of an appropriate cryptosporidial antigen allows only postulation that an augmentation of cellular immunity to Cryptosporidium parvum induced by immune DLE resulted in the microbiologic and clinical improvement observed.

Outcome after assisted ventilation in children with acquired immunodeficiency syndrome.

Abstract: Twenty-two pediatric patients with AIDS required assisted ventilation during 27 pediatric ICU (PICU) admissions. Patients were retrospectively divided on the basis of whether they required assisted ventilation for acute respiratory failure (ARF) or for another reason. Sixteen (59%) courses of assisted ventilation were for ARF. The PICU mortality rate was 81% for the ARF group. Eleven (41%) courses of assisted ventilation were for reasons not involving ARF. The PICU mortality rate for the group without ARF was 9%, significantly lower (p less than .01) than for the ARF group. Pneumocystis carinii pneumonia (PCP) was documented during 48% of admissions. Occurrence of PCP did not affect mortality, nor was it more likely in those with than without ARF. Two patients with ARF survived to discharge from the hospital. Both died within 1 yr of ARF. Thus, the short-term prognosis for pediatric AIDS patients requiring assisted ventilation for ARF is extremely poor.

Pediatric human immunodeficiency virus infection: an otolaryngologist's perspective.

Abstract: Children with human immunodeficiency virus (HIV) frequently have recurrent otitis media, chronic rhinorrhea, parotitis, cough and other common pediatric otolaryngologic problems. As these complaints often occur before more unusual opportunistic infections or pulmonary conditions prompt a diagnosis of acquired immunodeficiency syndrome (AIDS), members of our specialty are liable to see HIV-positive children before infection with the virus has been recognized. Children with HIV infection are also likely to be referred to us after diagnosis, as is any immunosuppressed child with otolaryngologic infections. These children may require procedures such as bronchoscopy, sinus irrigations or tympanocentesis. The subject of this review is the natural history of pediatric HIV infection with special emphasis on otolaryngologic manifestations and recommendations for safe techniques of examination and treatment.