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

In experiments carried out in mice, hamsters, guinea pigs and rabbits both dihydroartemisinin and artesunate showed contragestational effect. In mice and rabbits they caused embryo absorption whereas in hamsters and guinea pigs they induced abortion. The contragestational ED50 of dihydroartemisinin given sc on d 7 of pregnancy in mice and d 5 of pregnancy in hamsters were 32.8(27.7-38.9) mg.kg-1 and 6.1(5.6-6.7) mg.kg-1 respectively. The ED50 of this drug given im on d 18 of pregnancy in guinea pigs was 18.3(13.9-24.2) mg.kg-1. Dihydroartemisinin also showed mid-pregnancy terminating effect in hamsters. The contragestational ED50 of artesunate given sc on d 5 of pregnancy in hamsters and the ED50 of sodium artesunate given sc on d 5-8 of pregnancy in hamsters were 12.2(10.3-14.4) mg.kg-1 and 1.0(0.9-1.2) mg.kg-1 daily respectively. Results of light microscopic examination revealed that dihydroartemisinin was selectively toxic to embryo sac. At dose levels sufficient to induce embryo sac necrosis, dihydroartemisinin did not injure the uterus and ovary of the maternal animals. On the ground of the foregoing observations we consider that dihydroartemisinin, artesunate and their analogous drugs should not be used to treat malaria in pregnant women and there is the possibility to exploit intentional abortion agents from artemisinin derivatives.
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PMID:[Contragestational effects of dihydroartemisinin and artesunate]. 986 30

An immunohistochemical method was developed, using a polyclonal antibody, to detect the enzyme indoleamine 2,3-dioxygenase (IDO) in normal and malaria-infected tissue. Plasmodium berghei ANKA, a cerebral malaria (CM) model, and P. berghei K173, a non-cerebral malaria (NCM) model, were used. It was found that vascular endothelial cells were the primary site of IDO expression in both models of malaria infection and that this response was systemic, with the vascular endothelium of brain, heart, lung, spleen and uterus all staining positive. These results suggest that IDO is part of a systemic host response to parasite infection. Although high levels of IDO production alone may not cause pathology, it is possible that when its production is combined with other features of CM, such as breakdown of the blood-brain barrier (BBB), metabolites of the kynurenine pathway may be able to influence the otherwise tightly regulated, immunologically privileged site of the CNS and cause some of the symptoms and pathology observed.
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PMID:Tissue distribution of indoleamine 2,3-dioxygenase in normal and malaria-infected tissue. 1093 86

It is well established that the thymus is an essential organ for the support of T-cell differentiation. However, some T cells, termed extrathymic T cells, have been found to differentiate without such support by the thymus. The major sites of these T cells are the intestine and liver. Subsequent studies have revealed that extrathymic T cells are also present in the uterus and exocrine glands (e.g., the salivary gland). Depending on the sites, extrathymic T cells have some distinct properties as well as some common properties. For example, all extrathymic T cells have a TCR-CD3 complex similar to thymus-derived T cells. Extrathymic T cells comprise both alpha beta T cells and gamma delta T cells. Although extrathymic T cells are very few in number at any extrathymic sites in youth, they increase in number as a function of age. This phenomenon seems to occur in parallel with thymic involution. Even in youth, extrathymic T cells are activated in number and function by stress, in autoimmune diseases, and during pregnancy. Acute thymic atrophy always accompanies this activation. Therefore, reciprocal regulation between extrathymic T cells and thymus-derived T cells might be present. We hypothesize that extrathymic T cells are intimately associated with innate immunity and that the mechanisms underlying autoimmune diseases and intracellular infection (e.g., malaria) cannot be properly understood without introducing the concept of extrathymic T cells.
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PMID:Extrathymic pathways of T-cell differentiation and immunomodulation. 1146 Mar 7

Nearly 25 million infants were born with low birth weight in 1990, according to information from WHO's Safe Motherhood database. This situation is virtually unchanged since the late 1970s when the first estimates were produced. WHO defines low birth weight as weight at birth of less than 2500 gm whatever the gestational age. It is normally caused by either prematurity (birth at less than 37 weeks) or retarded growth in the uterus, or a combination of the two. Low birth weight is most likely to occur in developing countries. Low birth weight babies account for 17% of the world's live births, according to WHO. The region with the highest incidence is Asia where 21% of babies have low birth weight. In Oceania, 20% of babies have low birth weight, followed by Africa (15%). Latin America (11%), North America (7%) and Europe (6%). In southern Asia, where almost a third of the world's births take place, 1 in 3 live newborns have low birth weight. Infants with low birth weight, especially in developing countries, have a higher risk of being malnourished by the time they are 1 year old. By the age of 4 or 5 they have a higher risk of both malnutrition and infection which impairs their growth further. Poor intrauterine growth is most likely when the mother has low calorie intake or low weight gain, if she had low weight before pregnancy, is short of stature, smokes cigarettes, or has malaria. Cigarette smoking and low birth weight of the mother may contribute to premature birth, but the main causes of prematurity are reproductive trace infections and sexually transmitted diseases.
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PMID:One newborn in six weighs less than 2,500 grammes. 1231 26

Thousands of women in developing countries depend on quinacrine as a simple, low cost, nonsurgical sterilization method. Few US reproductive health professionals know about quinacrine's family planning use. Since quinacrine cannot be patented, no pharmaceutical company can protect its financial investments in quinacrine. So none has asked the US Food and Drug Administration to approve it for contraception. US family planners question quinacrine's safety and efficacy, but supporters have access to much data showing that it is safe. Quinacrine is used to treat malaria, giardia, tapeworm, and lung cancer. When quinacrine is inserted into the uterus, it dissolves, migrates to the tube, and creates scar tissue that blocks the tube. 252 mg quinacrine once a month for 2-3 months is enough to induce scarring. None of 80,000 women who have used quinacrine pellets to effect nonsurgical sterilization died from quinacrine. The liquid form of quinacrine used as a sterilizing agent in the 1970s in Chile caused 3 deaths, toxic psychosis (i.e., intense mental irritability), cancer, and a failure rate of 2-6.7%. Researchers are still following the Chilean women to determine whether there is indeed an excess cancer risk. Even though laboratory studies showed that quinacrine is potentially toxic, teratogenic, and mutagenic, researchers in Texas still used it for clinical trials. A gynecologist contends that even if quinacrine proves to be toxic to humans, it benefits may outweigh risks, and thus it should be available in the US. A women's health advocate is concerned about quinacrine's potential carcinogenic risk, yet she is interested in a sterilization procedure without surgery. She also thinks that sterilization is a misnomer because of its high failure rates. Many people think that a population control policy drives proponents to push for quinacrine use. Its proponents say that it will save the lives of women, and that surgical sterilization places women at risk of death.
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PMID:Quinacrine pellets have potential for simple, low-cost female sterilizations. 1231 49

A new female sterilization method, the insertion of quinacrine hydrochloride pellets into the uterus, has created controversy, because of the potential for coercive use. Supporters of quinacrine believe that its ease of insertion and effectiveness make its use ideal for protecting women from unwanted pregnancy. The UN reports that 23% of reproductive age women worldwide have chosen sterilization. Quinacrine was developed during the 1970s by a Chilean gynecologist. Jaime Zipper first used quinacrine as a sterilizing agent in the 1970s in liquid form. The drug was used originally for malaria treatment. Quinacrine is attractive due to its low cost (a dollar for two insertions), the ease of insertion, and the few side effects (minor cramping and fever). The methods appears to be 95-97% effective. Field trials are being conducted in 11 countries. Current clinical trials, undertaken by the Vietnamese Ministry of Health and published in Lancet, reveal that only 818 pregnancies occurred among 32,000 women using quinacrine. No deaths and only eight serious complications occurred compared to 30 deaths and 1800 serious complications from surgical sterilization. Opponents contend that the research methodology is questionable, because there was insufficient follow-up. Results are based on subsets and extrapolation to the entire study population. Critics desire more research on the potential for coercive use. The president of the Boston Women's Book Collective considers that more retrospective research is needed before confirmation of its safety. Another perspective is that the relative risk of having a baby in a rural developing country is much higher than the quinacrine risk. This position is argued by Marie Stopes International. The president of the Center for Research on Population and Security (Dr. Mumford) agrees that many people are being denied a life-saving method, and the process of review, because of the controversy, does nothing for the many women dying each year in childbirth or due to unsafe abortion.
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PMID:Risks and rewards: family planners weigh quinacrine. 1231 52

Quinacrine is a synthetic antimalarial used to treat malaria during the 1930s and 1940s until it was replaced with better drugs such as chloroquine. When quinacrine pellets are introduced via the cervix into the fundus of the uterus during the early proliferative phase of the menstrual cycle, local inflammation results, followed by the development of scar tissue which leads to tubal occlusion and irreversible, nonsurgical sterilization in women. The method was developed in Chile in the 1970s. The most common schedule involves the insertion of 7 pellets of 36 milligrams each either once or twice using a modified copper T IUD inserter. Sterilization using quinacrine requires neither anesthesia nor trained personnel and can be performed in areas with no access to health facilities. Trials of sterilization with quinacrine are being conducted by nongovernmental organizations and private doctors in a range of places in India. Other trials have been conducted in 15 countries, including Chile, Indonesia, Vietnam, and all countries in South Asia. The author discusses the potential for abuse of the method, global trials, concern and resistance, trials in India, and the issues at stake.
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PMID:Surreptitious sterilizations: an endangering process. 1232 Dec 22

The unexpected occurrence of a fever higher than 38 degrees Celsius at least twice in 48 hours after childbirth is a common problem. A well-executed clinical examination of a patient with a high fever is necessary to determine the origin of the infection. It is necessary to remain vigilant because it could be a sign of severe infection threatening a mother's life. The fever can sometimes remain moderate while the infection progresses at lightning speed. This is especially the case in weak patients (e.g., those with tuberculosis, AIDS, or malnutrition); thus it will be necessary to keep an attentive eye on them. Major causes to be familiar with and to recognize include malaria (always to be considered), uterine infection (the most common postpartum infection), kidney infection, tender breasts, pneumonia, meningitis, or appendicitis. Things health workers should consider if they suspect uterine infection are birth history, endometritis, and the fact that, in the absence of treatment, the infection can spread to the Fallopian tubes and eventually to the general circulation (septicemia). Special cases include uterine infections accompanied by retention of placental debris or membranes, fever after abortion, and fever after cesarean section. Health workers must consider all cases of retention, even those without a fever, as a potential infection. They must administer antibiotic treatment within 5 days after emptying the uterus. The treatment of choice for fever following an abortion is 3 g ampicillin for 7 days. In cases of infection after an abortion, health workers should consider uterine perforation and retention. Fever usually occurs 4-5 days after a cesarean section. Antibiotic treatment is usually necessary.
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PMID:[Postpartum infections]. 1234 37

Tanzania's health policy is to improve the health of all Tanzanians with a focus on those most at risk. One of the major objectives is to reduce infant and maternal morbidity and mortality and increase life expectancy. The life expectancy in Tanzania is 49 years for males and 53 years for females. Maternal mortality is recorded at 300-400 deaths per 100,000 women. The main causes are haemorrhage, sepsis, rupture of the uterus, anaemia, and others. The risk factors associated with the above causes include maternal height, age, child spacing, and number of births per woman; malaria and anaemia; imbalance of energy and food intake; HIV/AIDS; women's workload; and female genital mutilation (FGM). To address issues of women's health, the government has put in place many strategies, for example, a ministry to look after women's issues, the safe motherhood initiatives, improvement of the knowledge and skill of health care providers, as well as collaboration with nongovernmental organizations (NGOs) and private agencies. The health sector reform is important because it has negatively affected women's access to health care. To improve the health of women in Tanzania, health and health-related sectors should cooperate and collaborate in order to empower women in the areas of education, social status, and technology. Policies must also address poverty, nutrition, adolescent health, and violence and sexual abuse.
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PMID:Major factors that impact on women's health in Tanzania: the way forward. 1295 70

Chloroquine (CQ) remains the household drug for the treatment of malaria especially among pregnant women. However, there are reports that CQ inhibits the contractile process in non-pregnant rat's uterus. The aim of this study is to compare responses to CQ between non-pregnant and pregnant mice and identify some mechanisms involved. Experiments were carried out in non-pregnant and pregnant mice pretreated 24 hours before with 1.5 mg/kg-body weight stilboesterol given orally. Strips of uterine smooth muscle, approximately 5 mm in diameter, were mounted in a 20 ml organ bath containing De Jalon solution bubbled with a 95% O2-5% CO2 gas mixture. Responses of the strips to graded concentration of acetylcholine (ACh) (10(-9) to 10(-5) mol/L), oxytocin (OXY) (10(-5) to 10(-2) IU/ml) and CQ (10(-6) to 4 x 10(-4) mol/L) were investigated. The strips were then incubated in 4 x 10(-4) mol/L CQ for 15 mins and the cumulative dose responses for OXY were repeated. To investigate mechanism of action, the strips were incubated for 15 mins in N(w)-nitro L-arginine methyl ester (L-NAME) and the cumulative responses to CQ repeated. Each investigation was carried out in fresh tissue mounted on Grass Model FT03 force transducer coupled unto a 4-channel Grass Model 7D Polygraph. CQ (low to moderate level), ACh and OXY led to increases in contractile responses in the uteri. There were greater contractile responses in non-pregnant than pregnant mice to CQ and ACh. At high doses, CQ had an inhibitory effect on the uterine contraction. Incubating in CQ led to abolition of contractile responses to OXY and ACh. In the presence of L-NAME, inhibitory effect of CQ at high doses was attenuated in pregnant mice only. The results suggest that CQ at high doses inhibits contractile responses in non-pregnant and pregnant mice. Enhanced nitric oxide bioactivity attenuated this inhibitory effect.
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PMID:Effect of chloroquine on strips of non-pregnant and pregnant mice uteri in-vitro. 1768 66


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