Pneumocystis is primarily an opportunistic pulmonary pathogen, causing PCP. Extrapulmonary pneumocystosis is very rare.
PCP was an uncommon disease occurring in immuno-compromised patient populations until the beginning of the 1980s, when it emerged as a significant cause of morbidity and mortality among human immunodeficiency virus (HlV)-infected patients. PCP remains one of the most common acquired immunodeficiency syndrome (AIDS)-defining events, despite the use of prophylaxis and highly active antiretroviral therapy (HAART).
The major presenting symptoms of PCP are shortness of breath, fever, and nonproductive cough. Immunosup-pressed, HIV-uninfected patients are typically sick for days to 2 weeks before seeking medical attention, whereas PCP in HIV-infected patients typically has a more insidious onset, with symptoms lasting several weeks. The organism burden is higher, but the lung damage less severe in HIV-infected patients.
On physical examination, tachypnea and tachycardia are found in acutely ill patients. Although lung auscultation is usually not helpful, the chest radiograph classically exhibits diffuse bilateral interstitial infiltrates. Atypical findings range from normal examination to unilateral localized findings.
The magnitude of impaired arterial oxygenation is used to evaluate the severity of the disease, with a paO2 of 70 mmHg discriminating between mild to moderate disease and severe disease. In addition, serum lactic dehydrogenase levels can be of some help in evaluating the severity of lung injury, but the analysis is nonspecific for PCP and lung injury.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.