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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a nineteen-year-old women with the cerebral form of malaria tropica is reported. She showed hyperpyrexia, abdominal manifestations, haemolysis and disseminated intravascular coagulation. Cerebral symptoms amounting to grade IV encephalopathy occurred. The patient responded rapidly to the administration of chloroquine, anticonvulsants, dextran, corticosteroids, antipyretics, blood and antithrombin III and her symptoms had almost completely vanished one week after the onset of therapy.
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PMID:[Course and intensive treatment of acute falciparum malaria (author's transl)]. 37 59

Chloroquine is considered essentially nontoxic when used for the chemosuppression of malaria, but gastrointestinal upsets, headache, blurring of vision, pruritus, and uritcaria may occur during chloroquine therapy. Recently, Bhargava et al. and Eronini and Eronini have reported the extrapyramidal syndrome (EPS) following chloroquine therapy in adults. The clinical manifestations included upward rolling of the eyeballs, retraction of neck and back, trismus with marked difficulty in speech, and coarse tremors. Observations of 4 instances of EPS in children following chloroquine therapy for malaria are reported. A 2-1/2 year old girl was admitted to the All India Institute of Medical Sciences Hospital with a 4 day history of intermittent high grade pyrexia with chills and rigors. Following treatment with oral chloroquine in the recommended therapeutic dosage, the fever responded, but the child became drowsy and developed paroxysms of involuntary movements of the tongue, torticollis, torsion dystonia of the limbs, and parosysms of tonic muscular spasms. She completely recovered spontaneously within 48 hours. The 2nd case was that of a 12-year old female brought to the hospital with a 15-day history of intermittent high grade fever with chills and rigors. The patient was started on chloroquine sulfate in the recommended therapeutic dose. After an interval of 4 days she developed coarse tremors of the hands, upward rolling of the eyeballs, episodic deviation of the angle of the mouth towards the left, and trismus. These symptoms disappeared spontaneously within 8 hours. A 6-year old girl, the 3rd case, developed episodes of opisthotonous, upward rolling of the eyeballs, protrusions of the tongue, intermittent writhing movements of the upper limbs, and drowsiness following the ingestion of 6 tablets of chloroquine sulfate for suspected diagnosis of malaria. She spontaneously recovered from EPS over a period of about 48 hours. The 4th case, a 7-year old boy, gave a history of high grade fever with chills and rigors of 1 day's duration. He developed drowsiness, tonic spasms of the neck, upward rolling of the eyeballs, and writhing contortions of all limbs about 2 hours following intravenous administration of 100 mg of chloroquine. 8 hours later an additional 100 mg chloroquine was given intravenously for the mistaken diagnosis of cerebral malaria. On examination the child was drowsy, had generalized stiffness, torticollis, and trismus. He recovered gradually over a 48-hour period without any specific therapy. The exact mechanism of production of EPS remains uncertain.
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PMID:Extrapyramidal syndrome following chloroquine therapy. 45 22

4 cases from the authors' experiences are added to the list of women who became pregnant during oral contraception while taking other drugs. 2 were 24- and 28-year-old epileptics taking Stediril and Mysoline, or primidone, a deoxybarbiturate. The 3rd was a 32-year-old woman who had forgotten 1 Stediril pill and taken 2 the next day, while taking 75 mg phenobarbital for a homeopathic regime. The 4th had been using Stediril for 5 years and had stopped for 2 months, and conceived during her 1st cycle after resuming the pill. She was taking drugs for migraine headaches, Nivaprine to prevent malaria, tetracyclines and trisulfazine for diarrhea. It is emphasized that when the usual pill side effects or regular withdrawal bleeding are absent in women on other medications, physicians should be alerted that the contraceptive action of the pill may be compromised.
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PMID:[Letter: Influence of certain drugs on the action of contraceptive pills]. 94 Jul 60

There is a constant increase of new malaria cases in Brazil; 98% from the Amazon region, mainly in prospecting areas and new settlements. Available disease control strategies are inadequate in the face of this complex problem. The multiple and interrelated causality factors instead demand a transdisciplinary approach. The author used interviews, open agenda investigative meetings, field observations, photography, tape recordings, a field diary, and other methods to document and understand the challenges malaria poses in recently opened human settlement areas in rural Brazil. She lived with the people, visited their workplaces, talked to groups about life, interviewed men who work in the area, and spent time with pastoral agents of the Roman Catholic Church. Study findings are presented with direct citations from her subjects. The ethical dimensions of research practice are also considered.
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PMID:Every day life in new settlement areas and malaria control strategies. 134 Jun 34

A young women was treated with intravenous quinine and chloramphenicol for suspected severe malaria and/or typhoid fever. On the second day of quinine therapy (after 2.25 g of quinine) she suddenly developed total bilateral loss of vision. Both drugs were stopped and cyclandelate therapy was started. She showed slight improvement in vision but on referral her visual acuity was limited to seeing waving hand movement only; visual fields were constricted and colour vision was absent. Both pupils were fixed and dilated. The fundi showed macular oedema and attenuated retinal arteries. She was treated with dexamethasone, cyclandelate, vitamin B complex and vitamin C. Colour vision was completely recovered after 5 days of treatment. Full recovery of the direct light reflex occurred after 10 days. Visual acuity improved slowly over a period of one month to 6/15 vision in both eyes. At this time macular oedema and retinal arteriolar attenuation were still present but less severe. In the context of this case report the condition of quinine blindness is briefly reviewed and the management discussed.
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PMID:Quinine blindness. 134 Oct 94

A 25 year-old primigravid woman developed chronic falciparum malaria at 23 weeks' gestation. Diagnosis was suspected on splenomegaly and haemolytic anaemia but without fever and confirmed by thin smears (Plasmodium falciparum) and serologic tests. She was successfully cured with chloroquine therapy. One week after her return from Cameroon, a 28 year-old woman was seen for malaria at 32 weeks' gestation. In spite of chloroquine therapy, foetal troubles appeared and a caesarean was performed. The newborn had an APGAR coefficient of 3 points and examination both of his blood films and the placenta revealed numerous trophozoites of P. falciparum. Chloroquine resulted in a rapid cure of the child. In endemic areas, parasitaemia is more frequent and dense during pregnancy, and especially in primigravidae. However, clinical symptoms remain rare because of acquired immunity. In case of no or loss of immunity, malarial infections are heavy and abortions are frequent. Congenital malaria is probably due to transplacental transfer of infected red blood cells of the mother. In endemic areas, the incidence is low due to the simultaneously transferred immunity. Emergency treatment is necessary because of life-threatening to both mother and child.
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PMID:[Malaria of the pregnant woman and the newborn]. 181 95

A British nurse was the 1st health visitor in the village of Keneba in the Gambia. She was at a nutritional research center which provided basic medical services. In addition to visiting mothers in their homes to talk about health education, such as oral rehydration and advice on hand washing, she would also encourage them to bring their children to the infant welfare clinic for immunizations. She told the mothers that the health staff would check the growth and nutritional status of their children and why these activities were important. Staff at the clinic aimed to see all the children 2 years 9 times the 1st year and 4 times the 2nd year. All anthropometric data were forwarded to Cambridge, England to be included in a continuing study on the growth of the population. The clinic referred children with serious illnesses to the pediatrician or, if necessary, took them to a hospital on the coast. Children that came to the clinic with a fever 37.4 degrees Celsius during the wet season had a blood film taken to check for malaria parasites. Indeed cerebral malaria contributed greatly to child deaths in the Gambia. If malaria was present, children received their 1st dose of chloroquine immediately so the staff could determine tolerance. 3 doses followed this dose. The health visitor also organized the health education component of the clinic. The clinic dresser interpreted the British nurse's presentations to eventually conduct them alone. The nurse divided the mothers and fathers into 2 groups. In the future, she would evaluate the 2 groups to determine if weekly education on hand washing and skin hygiene would reduce diarrheal and cutaneous disease incidence in children 3 years old. The other group learned about family planning. Both groups learned about immunization, detection of illness, safety, sanitation, nutritional advice, dental care, and food preparation.
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PMID:Health visiting in rural Gambia. 199 1

In this article, Candace Kugel, a family nurse practitioner in Pennsylvania who visited Nicaragua as part of an exchange program, describes her impressions of the country's health care system. Kugel is a member of the Project Gettysburg/Leon, a sister-city program that promotes cultural exchanges. She arrived in Nicaragua less than 2 weeks after the newly elected UNO government assumed power. In Leon, Kugel visited seven rural and urban clinics, the city's hospital, the health education organization, and the medical, dental, and nursing schools. In all health facilities, she discovered politically energized and committed health care workers. It is this determination that allows then to continue working in spite of perpetual shortages of even the most basic supplies. The hospital was out of insulin, and was having to reuse bulb syringes for newborns. One clinic lacked water supply. Kugel also found nurses to be in short supply. As she explains, the physicians outnumber professional nurse 3-1. Because of low salaries, 1 6-day work schedule, and staffing shortages, few are interested in becoming nurses. Furthermore, the nursing school is severely ill-equipped. Nonetheless, Nicaragua's health care system has accomplished health: immunization, family planning, prenatal care, well-child screening, health education, and treating open water for malaria and dengue-bearing mosquitoes. From 1979-88, infant mortality dropped from 93/1000-62/1000, and life expectancy increased from 56-63.3 years. Additionally, Nicaraguans now consider health care a right, not a privilege. Kugel hopes that with the end of the US embargo and the renewal of US aid, Nicaragua will accomplish even more.
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PMID:Learning from the Third World: health care in Nicaragua. 200 63

This is a case report of a 24 year-old woman who is HIV-infected since three years (stage III B, CDC). She developed malaria tropica during her touristic stay in the Cameroons, Africa. No clinical complications were detectable even though she had a high parasitemia of 18% blood cells infected with Plasmodium falciparum. After quinine therapy defervescence occurred and blood smears were continuously free of malaria parasites. P. falciparum infection may increase HIV-related immunosuppression which favours the earlier occurrence of AIDS indicative opportunistic infections. Malaria in combination with HIV-infection can lead to a higher parasitemia; this does not necessarily lead to a higher rate of complications.
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PMID:[Malaria tropica in HIV infection]. 219 95

A 24-year-old woman presented with retinal hemorrhages, back from a travel in Cameroon. She took a chloroquine chemoprophylaxis. We diagnosed a malaria due to Plasmodium falciparum with anemia, splenomegaly and low parasitemia. A speedy clinical and ophthalmological recovery was obtained with mefloquine therapy. We discuss physiopathology of such uncommon retinal damage during malaria.
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PMID:[Malaria and retinal hemorrhages]. 220 Sep 39


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