Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

150 patients admitted in medical coma at Muhimbili Medical Centre were studied prospectively to determine the causes and early prognosis. 89 (60%) patients had potentially treatable causes (60 cerebral malaria, 16 meningitis, 7 diabetic ketoacidosis and 6 drug over dosage). Other causes were 20 (13%) with cerebrovascular diseases, 30 (20%) hepatic failure and 11 (8%) were of miscellaneous and obscure causes. The cause of coma was an important indicator of prognosis. Good recovery was achieved in 42 (70%) with cerebral malaria, 4 (57%) diabetic ketoacidosis, 4 (25%) meningitis and 1 (16%) drug overdosage. Other indicators were the Glasgow Coma Score on admission and subsequent scores, early neurological signs and complications that arose. The Glasgow Coma Scale was found useful and easy to perform. Further studies are needed to confirm its usefulness in developing countries.
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PMID:Causes and early prognosis of non-traumatic coma in Tanzania. Muhimbili Medical Centre experience. 345 7

Evidence of immune mediated haemolysis was sought in 83 patients with P. falciparum malaria in eastern Thailand. Amongst 73 patients with uncomplicated infection 12 (16.4%) had a weakly positive direct antiglobulin test (DAT). The incidence in 32 children aged 8-16 years was similar to that in adults. Of 10 patients with cerebral malaria, six adults, all of whom were in unrousable coma, had a positive DAT. Erythrocyte-bound IgG1 accounted for the positive DAT in all cases; sensitization with complement or other IgG subclasses was not found. Patients with uncomplicated malaria had a median value of 70 IgG molecules per erythrocyte compared with 65 molecules per cell in 67 healthy controls. This difference was not statistically significant but could account for the lower incidence of a positive DAT in control subjects (4.5%). There was no correlation between the number of IgG molecules per cell and the degree of anaemia during the acute or convalescent phases of the infection. There is no evidence from this study that an immunohaemolytic process contributes to the anaemia of falciparum malaria in eastern Thailand.
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PMID:Evidence against immune haemolysis in falciparum malaria in Thailand. 353 Mar 15

The chloroquine-resistant strains P. falciparum are widely spread in the countries of South-East Asia, Latin America. Since the middle of the 70s the strains also occurred in Eastern Africa. The given paper is concerned with 4 patients suffering from imported chloroquine-resistant tropical malaria. Of these, 3 patients come from Africa, and one from Vietnam. In the latter patient, the disease ran a grave course and was attended by coma, acute renal insufficiency, hepatitis, and hemolytic anemia. The patient was registered as having grade III resistance of P. falciparum to chloroquine. The schedules of the disease treatment including quinine with fansidar, metakelphin (or with sulphalene and chloridine), mafloquine or tetracycline are presented.
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PMID:[Treatment of imported tropical malaria caused by chloroquine-resistant strains of P. falciparum]. 355 Nov 76

To receive actual information about the clinical course of falciparum malaria case history of 373 patients hospitalized in Chemin de Fer Hospital in Phnom Penh from May 1 till October 1, 1985 were evaluated. No patients were infected in Phnom Penh. We estimated that only 8.3% of patients had higher parasitaemia than 100,000 or more asexual parasites in microliter of peripheral blood which is considered as a heavy infection. Complicated malaria was found in 39 patients (10.4%). The most frequent complications were cerebral complications (80.0%), renal failure (23.3%), and liver failure (16.6%). Ten patients had multiple organ complications and they represented 25.6% of patients with complications. The 100% mortality was observed in those in coma stage III; with haemoglobinuria, epistaxis and melena. Only coma stage III as a single symptom caused the death. In other cases death resulted from multiple organ complications.
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PMID:Malaria in Kampuchea: clinical course of falciparum malaria in Chemin de Fer Hospital, Phnom Penh. 355 50

The death of a 23-year-old female patient is reported. She was being treated for porphyria cutanea tarda (p.c.t.) and was mistakenly given a single dose of 1250 mg chloroquine (instead of the intended dose of 125 mg). The course differed from the typical course of chloroquine toxification, which involves cardiac arrhythmias as the main complication (reported in adults only after much higher doses); in spite of intensive care, this patient died 13 days after the ingestion of chloroquine, in a coma caused by irreversible, acute decompensation of the liver. Forensic autopsy and histological and toxicological investigations confirmed the clinical findings. Starting from the chloroquine's pharmacological mechanism of effect in p.c.t., the severe hepatotoxic effect of this drug in the present case is explained. The authors give a serious warning against exceeding the dose of chloroquine now usually recommended for the treatment of the p.c.t., which is 125-250 mg twice weekly. The presence of chronic porphyria hepatica, at least in its clinically manifest form, (= p.c.t.), should be considered a contraindication for chloroquine in prophylaxis and treatment of other illnesses (e.g. malaria and rheumatism).
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PMID:[Death following administration of 1,250 mg chloroquine in porphyria cutanea tarda]. 357 36

The herb Artemisia annua has been used for many centuries in Chinese traditional medicine as a treatment for fever and malaria. In 1971, Chinese chemists isolated from the leafy portions of the plant the substance responsible for its reputed medicinal action. This compound, called qinghaosu (QHS, artemisinin), is a sesquiterpene lactone that bears a peroxide grouping and, unlike most other antimalarials, lacks a nitrogen-containing heterocyclic ring system. The compound has been used successfully in several thousand malaria patients in China, including those with both chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum. Derivatives of QHS, such as dihydroqinghaosu, artemether, and the water-soluble sodium artesunate, appear to be more potent than QHS itself. Sodium artesunate acts rapidly in restoring to consciousness comatose patients with cerebral malaria. Thus QHS and its derivatives offer promise as a totally new class of antimalarials.
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PMID:Qinghaosu (artemisinin): an antimalarial drug from China. 388 71

Of 140 patients with malignant tertian malaria seen during 1956 to 1967 10 died. Death was caused by cerebral malaria in all cases. Since 1968 more intensified treatment has resulted in the complete recovery of three patients and the partial recovery of one, all of whom had been in a cerebral malaria coma for various periods of time before admission and in whom a fatal outcome was expected. In these cases a polypragmatic therapeutic approach using intravenous low molecular weight dextran, besides the usual quinine and fluids, corticosteroids, heparin and urea, separately or combined, was adopted.
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PMID:New concepts in treatment of malignant tertian malaria with cerebral involvement. 555 Dec 49

In a man who had been in a coma for 24 hours with cerebral malaria dexamethasone had a dramatic, and probably life-saving, effect. We believe dexamethasone should be given routinely, together with antimalarial therapy, to patients with cerebral malaria.
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PMID:Use of dexamethasone in cerebral malaria. 566 9

Computed tomography of the brain in 10 patients with severe cerebral malaria, 5 of whom died, showed evidence of cerebral oedema in only 2 fatal cases. Small areas of altered density were seen in 4 cases; these were not associated with focal neurological signs and were still visible in convalescent scans in 2 survivors. 4 patients, including 1 of the fatalities, had completely normal scans. Cerebral oedema may occur in severe cerebral malaria but is not a consistent feature of living patients and cannot, therefore, always be the cause of their coma.
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PMID:Do patients with cerebral malaria have cerebral oedema? A computed tomography study. 613 Nov 65

A review was undertaken of sixty-eight children admitted with cerebral malaria to Madang Hospital, Madang, Papua New Guinea (PNG) in 1980. Children with cerebral malaria were significantly older than those with uncomplicated malaria, and older than children admitted with other conditions causing fits or coma. The nutritional status of children with cerebral malaria did not differ from that of children admitted with other diagnoses. The cerebrospinal fluid was normal in 80% of children with cerebral malaria, and in 20% mildly elevated protein or leukocytes were noted. Of the 68 children with cerebral malaria, four died (5.9%). This is a low mortality rate in comparison wih other centres in PNG and with reports from other countries.
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PMID:Cerebral malaria in children: a retrospective study of admissions to Madang Hospital, 1980. 676 75


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