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

Although cerebral angiography should be approached with caution in the diagnosis of inflammatory cerebro-vascular disease there are some characteristic angiographic findings which may be helpful for classification and differential diagnosis. The proximal cerebral arteries are favourably affected by basal meningitis and thrombangiitis obliterans with resulting stenoses and occlusions. Whereas those inflammations originating from neighbouring skull structures mostly involve the intracavernous parts of the carotid artery, the tuberculous and mycotic arteritis prefer the supraclinoid carotid siphon. Peripheral vascular changes are found in luetic endangiitis, necrotizing and toxic angiitis and in collagenoses. Simultaneous involvement of the temporal arteries is of great diagnostic importance demonstrating the systemic character of the inflammatory process; in Horton's arteritis it can be a pathognomonic finding. Infectious endocarditis, some mycoses and malaria may lead to embolic occlusion of cerebral vessels. Mycotic aneurysms mostly have a broad base or a fusiform shape and do not prefer the localizations of congenital aneurysms. Angiographically, abscesses, tuberculomas and viral encephalitis may result in circumscribed hypervascularized areas. The characteristic angiographic findings are exemplified and discussed on the basis of 8 cases of inflammatory cerebro-vascular disease (tuberculosis, pneumococcal and unspecific bacterial meningitis, syphilis, mycosis, Takayasu-syndrome, panarteritis nodosa, temporal arteritis).
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PMID:[Inflammatory cerebro-vascular disease: angiographic findings and distribution patterns (author's transl)]. 0 27

The maternal deaths occurring in the Kilimanjaro Christian Medical Center (KCMC), which serves as a supraregional reference hospital for the 5 regions of Northern and Central Tanzania, are reviewed for the 1971-1977 period and avoidable factors are discussed. All deaths occurring within the hospital during pregnancy or the first 6 weeks of the puerperium were included in this survey. Postmortem examination was performed in 35% of the cases. In the remaining cases the diagnosis was made on clinical grounds. During the period under review, there were 10 deaths among 83 cases, a mortality of 12%. The major cause of rupture was obstructed labor associated with a contracted pelvis or abnormal lie. 25% of the patients had had a previous cesarean section scar give way. 2 other deaths were attributed to anesthetic accidents and 1 was probably due to pulmonary embolism. The primary cause of death in the 7 remaining cases was hemorrhage (4) and sepsis (3). If deaths from ruptured uterus are to be avoided, early diagnosis is essential. 1044 cases of moderate and severe EPH gestosis (preeclampsia) were treated in KCMC during the period under review together with 54 cases of eclampsia. There were 5 deaths among the patients with eclampsia, a mortality of 9%. In addition to the 11 sepsis deaths there were 3 others included among the cases of ruptured uterus. There were 4 cases of septic abortion and 3 of those admitted to criminal interference. Preexisting anemia was a complicating factor in 5 cases, all of whom died within 15 minutes of arrival. There were 4 deaths among 251 cases of ruptured ectopic pregnancy. There were 10 deaths associated with cesarean section among 1271 sections peformed during the period under review. Deaths from associated diseases included the following: enterocolitis (12 deaths); renal and hypertensive disease (4 deaths); cardiac disease (2 deaths); anemia (2 deaths); malaria (2 deaths); tuberculous meningitis (2 deaths); and miscellaneous associated conditions (11 deaths).
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PMID:Maternal deaths in the Kilimanjaro region of Tanzania. 47 24

The frequency of infectious diseases in 6543 children hospitalised in the year 1974-75 in Arthur Davidson Hospital is analysed. Airborne infections including pneumonias and bronchopneumonias were found in 53.7% of the children and in 79.4% of those who died. Measles was found in 1112 children with a mortality rate of 15.6%. Measles and Malaria were among the top five killer diseases in Arthur Davidson Hospital. Of the airborne infections, measles, tuberculosis, laryngotracheobronchitis and pyogenic meningitis are the worst. Some problems concerning prevention and diagnosis are stressed. Improvement in the diagnosis of infectious diseases will depend on improvement in laboratory facilities.
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PMID:Analysis of admissions to the Arthur Davidson Children's Hospital, Ndola. 72 49

This article describes the major activities carried out since 1959 in the field of pediatrics and child care in Cuba. In particular, it notes the improvements made through establishment of a national health system and through the participation of community organizations (the Federation of Cuban Women, Committees for the Defense of the Revolution, associations of small farmers, and trade unions) and shows how perinatal, infant, and childhood mortality have been significantly reduced. As of 1973 perinatal mortality had fallen to 27.9 deaths per 1,000 live births, infant mortality to 27.4 deaths per 1,000 live births, preschool mortality to 1.2 per 1,000 children, and school-age mortality, to 0.4 per 1,000 children. This report also cites data on available physical and manpower resources, and outlines a large range of activities linked to a Comprehensive Child Care Program undertaken in 1967. This program, in which newborns are enrolled upon leaving the maternity, seeks to encourage breast-feeding, to promote the activities of well-baby clinics, to provide special examinations for malnourished infants, to provide health care for preschool and school-age children, to promote pediatric medical visits to the home, to assist with camps for asthmatic and diabetic children, to provide pediatric services at pioneer and other camps for schoolchildren, to carry out health education activities, and to combat communicable disease. In particular, activites to prevent communicable disease appear responsible for a good part of the progress achieved to date. As a result of these activities malaria and diphtheria have been eradicated, poliomyelitis has been overcome, and the incidences of tuberculosis, tuberculous meningitis, tetanus (among both newborns and children under 15), and acute diarrheal disease have been substantially reduced.
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PMID:Advances in pediatrics and child care in Cuba, 1959-1974. 77 91

The verbal autopsy (VA) is an epidemiological tool that is widely used to ascribe causes of death by interviewing bereaved relatives of children who were not under medical supervision at the time of death. This technique was assessed by comparison with a prospective survey of 303 childhood deaths at a district hospital in Kenya where medically confirmed diagnoses were available. Common causes of death were detected by VA with specificities greater than 80%. Sensitivity of the VA technique was greater than 75% for measles, neonatal tetanus, malnutrition, and trauma-related deaths; however, malaria, anaemia, acute respiratory-tract infection, gastroenteritis, and meningitis were detected with sensitivities of less than 50%. There may have been unwarranted optimism in the ability of VAs to detect some of the major causes of death, such as malaria, in African children. VA used in malaria-specific intervention trials should be interpreted with caution and only in the light of known sensitivities and specificities.
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PMID:Childhood deaths in Africa: uses and limitations of verbal autopsies. 135 14

Changes in the cerebral microvasculature such as breakdown of the blood-brain barrier, petechial hemorrhages, congestion, and edema are observed in the later stages of murine cerebral malaria. These changes have been described from histologic sections of brain, but the need to section the material makes direct observation of the microvasculature in situ difficult. The retinal vasculature, in contrast, offers a unique opportunity to study rheologic, barrier, and functional properties of the microvasculature as a wholemount preparation with normal spatial relationship with other tissues and as an intact vascular plexus. A combination of techniques, including intravascular perfusion of Evan's Blue, Bisbenzimide and Monastral Blue, and fluorescence and transmitted light observation of retinal wholemounts, were developed to examine the progressive microvascular changes in murine cerebral malaria. These techniques allowed detection of phenomena such as monocyte adherence to endothelial cells, congestion, small hemorrhages, and breakdown of the blood-retinal barrier, with details of the location of this leakage, earlier than was possible by studying brain sections. Because the retina is intact, the phenomena were seen in greater detail and some, such as occlusion of vessel segments, were detectable only in retinal wholemounts. In addition, the covisualization of the blood elements, barrier properties, and vascular endothelial integrity that are possible with retinal wholemounts allowed detailed analysis of the interaction of different cellular elements in the pathogenesis of cerebral malaria. Except for detection of edema, the retinal wholemount technique offers a more powerful and less time-consuming technique for detecting early microvascular changes in murine cerebral malaria. This technique could find wider application in the study of other diseases that affect the microvasculature of the central nervous system, such as experimental allergic encephalitis and meningitis.
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PMID:Early microvascular changes in murine cerebral malaria detected in retinal wholemounts. 137 93

Ninety-one consecutive cases of coma were identified among gravidas at Maputo Central Hospital. The commonest causes were eclampsia (70 cases), cerebral malaria (six cases), and meningitis (five cases). Fetal mortality in eclampsia was 23 per cent and maternal mortality 10 per cent. There was a markedly higher incidence of eclampsia during the colder months.
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PMID:Coma in Mozambican gravidas: causes and perinatal outcome. 150

Classification, management and prevention of seizures in children are summarized for clinicians in Papua New Guinea. Seizures are classified as febrile with or without underlying brain pathology, and afebrile, including neonatal fits, infantile spasms, myoclonic jerks, akinetic seizures, tonic clonic fits, petit mal, benign focal, and psychomotor seizures. In all cases the first step is to secure the airway, then do a fingerstick and treat hypoglycemia, and finally stop the fit if it is prolonged with paraldehyde, diazepam, phenobarbitone or phenytoin. A cause for the seizure should be sought: physical exam, especially tympanic membranes and throat, blood slide for malaria, lumbar puncture for signs of meningitis, blood culture, serum calcium, and other chemistries. Some empirical treatments to use for negative findings include: dextrose, calcium gluconate, magnesium SO4, pyridoxine, quinine and Fansidar. Hyperthermia in a febrile child can be reversed with cool sponging. The author recommends prescribing phenobarbitone to prevent subsequent simple febrile seizures if the child has 3 or more, then slowly withdrawing the drug if the child is seizure free for a year. Drug therapy for the various other types of seizures available in Papua New Guinea include sodium valproate by special order, and phenobarbitone, phenytoin, carbamazepine, nitrazepam, ethosuximide, and prednisolone. A table is provided to help select the drug for each seizure type, e.g. ethosuximide for petit mal, prednisolone for infantile spasms, and carbamazepine for various types of focal and psychomotor seizures.
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PMID:Convulsions in children. 150 14

Fever is the cardinal symptom of many infections in travellers returning from the tropics and is second in place only to infectious diarrhea. Once the obvious causes of fever in an individual patient have been eliminated, it may be very difficult to find the cause of fever. Fevers can be distinguished by their length of duration and divided into acute fevers i.e. up to 3 weeks duration and chronic fevers i.e. more than 3 weeks duration. Whether fever goes along with leucopenia or a normal white blood cell count on the one hand or with leucocytosis on the other hand is of differential diagnostic value. A schedule based on these two parameters will be presented to simplify differential diagnostic considerations. Two rules of thumb will be stressed: (1) Each febrile illness, even febrile diarrhea, jaundice or meningitis, is to be considered a malaria until it is excluded. (2) Patients returning from tropical areas might suffer from banal infections such as pneumonia, urinary tract infections, cholangitis, etc. as well.
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PMID:[Differential diagnosis of fever after returning from the tropics]. 150 60

During the period April 1985 to November 1986 (18 months), 196 children (of age greater than 1 month) admitted to the Children's Emergency Hospital in Khartoum, Sudan, with clinical suspicion of meningitis/meningoencephalitis were followed up prospectively. Bacterial meningitis was diagnosed by culture, direct microscopy and/or antigen-detecting assays (co-agglutination and enzyme immunoassay) in 44 infants (25 Haemophilus influenzae type b, 8 Neisseria meningitidis, 7 Streptococcus pneumoniae, 3 enterobacteria and one mixed infection), aseptic meningitis in 52, cerebral malaria in 4 and febrile convulsions in 96. The majority of cases of bacterial meningitis were boys and 57% of those in whom H. influenzae was the commonest isolate were less than 1 year old. The presenting signs and symptoms are described as well as the transient and permanent short-term sequelae. The total mortality from bacterial meningitis was 19%, permanent neurological sequelae were seen in 26% of survivors. Prospective follow-up, including audiometry, of 35 children 1-2 months after discharge showed that 11% had hemiplegia and 20% had hearing impairment. The potential impact of vaccination against invasive H. influenzae infections is discussed.
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PMID:Endemic bacterial meningitis in Sudanese children: aetiology, clinical findings, treatment and short-term outcome. 169 86


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