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

A 50-year-old Swiss male died from strongyloidiasis 8 weeks after renal allotransplantation. Past history revealed malaria at age 20 years, when the patient had stayed in tropical and subtropical areas, as well as pulmonary tuberculosis. Hypertension, erythrocyturia, proteinuria and unexplained episodes of blood eosinophilia were first noticed age 45, and 4 years later dialysis was started. A mild acute rejection crisis was successfully treated 4 weeks after transplantation. 2 weeks later, however, bilateral pneumonia developed. Despite vigorous antibiotic and tuberculostatic therapy the patient died in septic shock. Autopsy revealed strongyloidiasis with adult females, eggs and rhabditiform larvae of Strongloides stercoralis in the small intestine. Numerous filariform larvae were detected in the lungs, in the walls of bronchi and trachea, in the brain, in the walls of arteries, and in lymphnodes. Massive granulomatous inflammatory reaction and extensive pulmonary hemorrhage were the main pathological findings.
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PMID:[Strongyloidiasis following kidney transplantation]. 36 Mar 82

The causes of mortality and frequency of diseases were tabulated in 304 autopsies performed at Hopital Mama Yemo, Kinshasa, between July 1973 and December 1974. 78 of these autopsies were performed on subjects who died at Hopital Mama Yemo, 36 encompassed subjects from other hospitals, and 190 were of medicolegal cases in which the cause of death was not apparent from external examination. Men comprised 63.5% of autopsied cases. The mean age was 30.19 +or- 1.31 for men and 19.84 +or- 1.76 for women. 16.8% of deaths were due to homicide, 6.3% to suicide, and 8.9% to accidents, yielding an overall prevalence for trauma of 32%. Cancer accounted for only 3% of deaths, and cardiovascular diseases 8.2%. Bacterial infections (predominantly streptococcal disease, lobar pneumonia, and pulmonary tuberculosis) represented the largest single cause of death (17.4%). Parasitic infections comprised a further 6.3% of mortality and viral infections 7.2%, giving infectious diseases a combined frequency of 30.9%. Metabolic diseases were responsible for an additional 11.8% of deaths. Obstetric causes were identified in 3.9% of fatalities, and 95% of these cases represented hemorrhagic and septic complications of illegal abortion. Neonatal deaths (4.3%) were largely due to pneumonitis from aspirated amniotic fluid. A final 5.9% of deaths were unexplained. Also analyzed were cases of sudden death occurring outside the hospitals. 31.3% of these deaths were attributed to cardiovascular diseases and 46.3% to infection (including 2.5% due to septic abortion). Finally, the frequency of major diseases in this series was tabulated. Malaria was most frequently found (41.8%), followed by intravascular erythrocytic sickling (18.3%) and hypertension (16%). 12% of females in this series (20% of those dying traumatically) showed evidence of pelvic inflammatory disease. This series is considered to overestimate the frequency of trauma because of the large number of medicolegal cases that fall in this category. This selection for trauma further led to an oversampling of adult men. Nonetheless, it represents the 1st and best qualitative estimate of disease mortality and prevalence in Zaire. The trends in mortality and morbidity identified through this study provide a basis for planning health care and health education.
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PMID:Autopsy analysis of disease frequency in Kinshasa, Republic of Zaire. 96 86

Glucocorticosteroids are the most commonly used immunosuppressive agents. In the following review important mechanisms of action of glucocorticoids on the immunological network are summarized, the relationship between duration of therapy, daily dose and incidence of infections is analysed, and evidence is presented that in some infectious diseases glucocorticoids may even be beneficial. The association between corticosteroid therapy and subsequent infections was calculated by pooling the data from 73 controlled clinical trials (meta-analysis). The rate of infectious complications was not increased in patients given a daily dose of less than 10 mg or a cumulative dose of less than 700 mg prednisone. With increasing doses the occurrence rate of infectious complications increased in patients given corticosteroids as well as in patients given placebo, a finding which suggests that not only the corticosteroid but also the underlying disease state accounts for the steroid-associated infectious complications observed in clinical practice. To analyze the effect of glucocorticoids prescribed as adjuvants in patients with infectious diseases, an analysis of the controlled trials was performed. Some patients with pulmonary tuberculosis or constrictive pericarditis have a better outcome when they are given prednisone. On the other hand, there is no evidence that patients with septic shock or ARDS derive advantage from glucocorticoid therapy. At present there is controversy as to whether patients with bacterial meningitis should be treated with glucocorticosteroids. Patients with hepatitis B should not be treated with glucocorticoids, whereas elderly patients less frequently show postherpetic neuralgia when given glucocorticosteroids. Patients with cerebral malaria should not be given glucocorticosteroids. Aids patients with pneumocystis carinii pneumonia have a higher survival rate when treated with glucocorticosteroids than with placebo.
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PMID:[Glucocorticoids and infection]. 173 19

Ninety-nine consecutive patients who received cytotoxic therapy for acute leukemia were retrospectively studied to determine the pattern of infection at the Tata Memorial Hospital, Bombay, India. In all, 224 infective episodes occurred in these patients. Bacterial infection was the commonest type, accounting for 152 (67.9%) of 224 infective episodes, followed by fungal and viral infections (15.6% and 14.3%, respectively). Gram-negative organisms (Pseudomonas and Klebsiella) were the commonest bacterial organisms isolated, constituting 38 (76%) of 50 positive cultures; infection with Staphylococcus was rare (10%). Infective hepatitis, malaria, and systemic tuberculosis were responsible for fever with neutropenia in 20, 4, and 2 patients, respectively. Three hundred fifty-two patients with lymphoproliferative malignancies were also retrospectively studied to determine the pattern of infection. Only 53 infective episodes were recorded. In these patients, in contrast to those with acute leukemia, viral infection (33 [62.3%] of 53) and pulmonary tuberculosis (18 [34%] of 53) were frequently seen. It is interesting that 50% of our patients with hairy cell leukemia also had tuberculosis. Bacterial infection was conspicuous by its absence. Knowledge of the prevailing pattern of infection permits the development of investigative and therapeutic approaches of optimal efficacy.
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PMID:Pattern of infection in hematologic malignancies: an Indian experience. 260 80

Some Nicaraguans living in Costa Rica are in refugee camps. The types and rates of infectious diseases in the Pueblo Nuevo refugee camp were measured by examining medical records for 1985 and performing stool and blood testing. The incidence of infections was 320 episodes per 1000 persons per year. Respiratory infections represented 63% of all illnesses and pulmonary tuberculosis was high. Malaria was not found in blood samples and no childhood illnesses preventable by immunizations were recorded in the records. Intestinal parasites were found in 56% of the persons examined, considerably higher than the 15% prevalence noted in surveys of Costa Rica as a whole. Trichuris trichiura was found in 40% of the positive stool samples. The deficient hygienic conditions and overcrowding in the camp are responsible for the high rates of infections and the continued presence of infections many of which probably were acquired in Nicaragua. Improvement of hygienic conditions can be accomplished by involving the refugees in education, cleaning and identifying problem areas. Adequate sanitation and improved water supply, and reducing overcrowding are also recommended.
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PMID:Infectious diseases in a Nicaraguan refugee camp in Costa Rica. 292 7

Reported causes of death (1899-1911) and of admission to hospital (1884-1910) of Indian migrants to Natal are analysed, and an attempt is made to relate them to the circumstances and way of life of the community. The most frequently reported causes of death were pneumonia, enteritis and pulmonary tuberculosis; the commonest reason for admission was venereal disease. Fluctuations in reported mortality and morbidity from year to year were most marked for malaria, with a formidable epidemic in 1905-1906. Typhoid fever and diphtheria were uncommon, as were diabetes and the sequelae of arteriosclerosis.
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PMID:Nostalgia and alligator bite--morbidity and mortality among Indian migrants to Natal, 1884-1911. 636 94

Some of the characteristics of the process of mortality decline in Latin America were studied for the 1955-73 period. General characteristics of mortality decline were examined and total and cause specific standardized death rates were examined in an effort to uncover the contribution of changes in the incidence of some diseases to the rate of decline in the initial stages of the process. The relationship between socioeconomic factors and total and cause-specific levels of mortality were also examined. Data on deaths by age groups and causes on various Latin American countries were collected from regular publications of the World Health Organization (WHO). Only those countries for which information was available at least at 1 point during the 1950s and at least once during the 1960s were included. Adult deaths (above age 5) were adjusted for completeness using techniques by Brass (1975) and Preston (1979). Causes of deaths were grouped into categories that allowed the comparability of the 6th, 7th, and 8th revisions of the International Classification of Diseases. Death rates specific for 5-year age groups were computed. The analysis supports the idea that the major contributors to the rapid process of mortality decline were, in this order: infectious diseases, influenza-pneumonia-bronchitis, and diarrhea. Respiratory tuberculosis and other diseases of early infancy were responsible for about 12% of the total decline. Of late there has been an apparent increase in deaths due to cardiovascular diseases and neoplasms, but cardiovascular diseases (probably of infectious origin) may have contributed positively to mortality decline, perhaps as much as 28% of the total decline (net of the effects of changes in the category of "ill defined" deaths). The association between the decline in malaria and the concomitant decline in other infectious diseases points to a confirmation of the hypothesis which attributed substantial weight to medical innovations because of the synergism among the diseases themselves. The source of the changes in mortality were found to correspond in almost equal measure to rising standards of living and to the contribution of exogenous factors: about 45% of the changes between 1955-73 were due to rising standards of living. Exogenous factors seemed to have left a more decisive imprint among countries in which malaria was endemic and within categories of such diseases (such as infections) which were most likely to be controlled without imposing the necessity of substantial transformations in standards of living.
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PMID:Mortality decline in Latin America: changes in the structure of causes of deaths, 1950-1975. 734 97

During the past 20 years, millions of people have died in Cambodia as the result of violence, starvation, and preventable diseases. During this period, the public health system was also decimated as health professionals were killed. Efforts to provide health care were further stymied by inadequate training and low salaries that forced doctors to depend upon private practices in urban areas for their income. The health indicators in Cambodia reflect this situation, with life expectancy at 47 years for men and 49 for women, infant mortality at 120/1000 live births, child mortality at 190/1000, and maternal mortality at 9/1000 births. Malaria causes 5000-10,000 deaths each year, and the annual incidence of pulmonary tuberculosis is 250/100,000. The spread of HIV in South East Asia is also posing a major threat to Cambodia, and each month 300-400 people are injured or die as a result of the explosion of 1 of the 13 million land mines (scattered throughout the country of 9 million inhabitants). Many Cambodians suffer mental illness as a result of the decades of violence and displacement. Today Cambodians are struggling to reestablish their public health system with the help of international donor agencies, and there is hope that an appropriate and sustainable system will be in place within 10 years.
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PMID:Cambodian health in transition. 764 May 94

The potential usefulness of ELISA based serological tests to assist in rapid, early and specific diagnosis of tuberculosis was investigated. The materials were selected, based on published data and on our preliminary findings. Initially screening tests were performed using crude antigens such as Purified Protein Derivate (PPD) and a BCG-filtrate. Unfortunately, the results with these antigens were not promising. The specificity of both antigens using sera from 94 healthy controls was 64%. As a consequence of these findings, the crude antigens were excluded from further tests, and the study was continued with purified antigens. The work focused on 2 purified proteins: Antigen 60 (A60), a lipopolysaccharide-protein complex, and P32, a stress protein produced in zinc deprived cultures, identified as Antigen 85 A in the BCG reference system, both isolated from Mycobacterium bovis BCG. The commercial A60 based ELISA and our own P32 based ELISA were used to test a total of 300 sera from HIV positive, negative and unscreened individuals, mainly originating from Burundi. These sera were collected from clinical established cases of pulmonary TB, extrapulmonary TB, and patients with non-tuberculous tropical diseases such as salmonellosis, trypanosomiasis, malaria, etc. and healthy individuals. The A60 based ELISA had a sensitivity of 76.8% for the proven cases of active pulmonary tuberculosis and 61.9% for the extrapulmonary tuberculosis cases. No difference was shown between HIV positive and HIV negative patients. Specificity reached 95.2% for healthy individuals, but dropped to 68.1% when persons with active non-tuberculous tropical diseases were included. Eighty-six percent of the pulmonary cases and 87.7% of the extrapulmonary cases were detected by the ELISA-P32. These findings suggest that this test might be useful as a confirmatory test for the diagnosis of extrapulmonary tuberculosis. Again no difference was noticed between HIV negative and positive patients. The main contraindication for the use of the ELISA-P32 for the diagnosis of tuberculosis is its low specificity: 70.2% with sera from healthy controls and 22.2% for hospitalised patients and persons with non-tuberculous tropical diseases. In a small recent prospective study 4 out of 10 HIV+ persons with no evidence for TB yielded a positive result for the ELISA-P32. Two of them developed pulmonary tuberculosis within 6 months, whereas 2 P32-positives and 6 P32-negatives remained up to now without any manifestations of tuberculosis. The difference was not significant, but the number of cases was limited.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Rapid, early and specific diagnosis of tuberculosis and other mycobacterial diseases in Burundi. 812 78

A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger clubbing, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain. HIV-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.
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PMID:Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report. 851 33


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