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)

Eight (14 per cent) out of 57 consecutive cerebral malaria patients (all < 5 years old) were malnourished, including one with marasmus and another recovering from kwashiorkor. This was significantly lower than among other paediatric patients in the same children's emergency ward (112/319, i.e. 35 per cent, P < 0.01). Poor outcomes (death or recovery with neurological deficits) were commoner in the malnourished group (4/8) than the well nourished group (7/49) (P = 0.037, Fisher's exact test). Malnourished children should receive malaria chemoprophylaxis during nutritional rehabilitation.
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PMID:Protein energy malnutrition and cerebral malaria in Nigerian children. 928 24

Marasmus and kwashiorkor are clinically distinct manifestations of severe malnutrition. This study tested the hypothesis that rates of whole-body protein synthesis and breakdown are higher in marasmus than in kwashiorkor during acute infection. We measured whole-body protein kinetics using stable isotope tracers in eight children with marasmus and acute infection (pneumonia or malaria) to determine the rate of appearance of urea and leucine in plasma. Serum concentrations of total protein, albumin, and C-reactive protein were also measured. These findings were compared with those reported previously for 13 children with kwashiorkor (including marasmic kwashiorkor) and acute infection who were studied with the same methods. HIV infection was present in 10 of 21 children. Rates of protein breakdown and synthesis were higher in marasmus than in kwashiorkor (227 +/- 59 compared with 103 +/- 30 micromol leucine x kg(-1) x h(-1) and 216 +/- 60 compared with 97 +/- 30 micromol leucine x kg(-1) x h(-1), P < 0.001). The concentration of globulin (total protein minus albumin) was higher in marasmus than kwashiorkor (40 +/- 17 compared with 25 +/- 7 g/L, P < or = 0.01), but C-reactive protein was not different (73 +/- 79 compared with 83 +/- 89 mg/L). HIV infection and body composition did not explain the differences between marasmus and kwashiorkor. The accelerated rate of protein turnover in children with marasmus and acute infection requires further investigation.
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PMID:Whole-body protein kinetics in marasmus and kwashiorkor during acute infection. 962 94

In a combined retrospective and prospective 4-year study of 6412 children consecutively admitted to St Paul's Hospital, Nchelenge, north-east Zambia, the clinical epidemiology of paediatric disease was described. One diagnosis per admission was noted. Protein-energy malnutrition (PEM) was diagnosed clinically and by means of a modified Wellcome scheme using weight-for-height and Z scores. Correlation coefficients were calculated between monthly admission rates and relative humidity, rainfall and temperature. The age distribution of admitted children showed several distinct groups. Type I (malaria, acute gastro-enteritis, pneumonia and meningitis) had its peak in the 1st 7 months of age, type II (burn wounds and measles) had its main prevalence between the ages of 2 and 4 years, and type III (trauma, typhoid fever, snake bite and tropical ulcer) occurred mainly between 4 and 14 years of age. Admission rates for PEM, PEM subtypes, pneumonia, trauma and snake bite correlated with wet season variables. Malaria and acute gastro-enteritis were extremely common throughout the year. A measles epidemic in the dry season was initially followed by an increase in marasmus, whereas oedematous malnutrition only assumed epidemic proportions associated with a post-measles rise in admission rates of pneumonia. Clinical epidemiological data at the district level is a powerful tool for understanding the pattern of serious paediatric disease in the community.
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PMID:Clinical epidemiology of paediatric disease at Nchelenge, north-east Zambia. 992 74

Malnutrition is the fourth commonest reason for hospital admission to the paediatric department of the Central Hospital, Maputo and has the second highest death rate (20 per cent). A study from 1995 into mortality at this paediatric department, suggested an increase in severe malnutrition. Recent studies have shown that the global burden of undernutrition in the world is declining; however, data for Eastern Africa shows a deterioration. The current study was aimed at describing and comparing the patients on the malnutrition ward, in 2001 and 1983. The study gathered indices of nutritional status and secondary diagnoses from the notes of all children (aged between 6 months and 5 years) discharged from the malnutrition ward for a period of l year (January-December 2001), and from data (collected in January-December 1983) for the malnutrition ward. Data was entered and analysed using Epi-Info 6 and SPSS statistics package. The ethics committee of the hospital approved the study. Data was collected for 558 children in 2001 and 833 in 1983. There was no gender difference, average age was 21.7 months in 2001 and 23.8 months in 1983 and the average hospital stay was 13.1 and 14.3 days, respectively. In 2001, 33 per cent had kwashiorkor, 26 per cent marasmus, and 28 per cent marasmic kwashiorkor. Three hundred and twenty children (82 per cent) were <2 Z-scores below the median weight-for-age and 252 children (65 per cent) were <3 Z-scores. Forty per cent had malaria, 65 per cent anaemia, 53 per cent bronchopneumonia, 14 per cent TB, 36 per cent diarrhoea, and 12 per cent HIV/AIDS. In 1983, 49 per cent had kwashiorkor, 17 per cent marasmus, and 11 per cent had marasmic kwashiorkor. A total of 494 children (81 per cent) were <2 Z-scores below the median weight-for-age and 335 children (55 per cent) were <3 Z-scores. Eighteen per cent had malaria, 37 per cent anaemia, 28 per cent bronchopneumonia, 6 per cent TB, 8 per cent diarrhoea, and 4.4 per cent measles/post-measles. A comparison between the clinical status of 1983 with that of 2001 shows little difference in age, gender or length of stay. There were fewer admissions in 2001, although a higher percentage of severely underweight children and the 2001 group had more secondary infections, especially malaria, bronchopneumonia and anaemia. Clinical malnutrition at a referral hospital level, in spite of the remarkable Mozambican economic growth, shows signs of following the depressing pattern for much of Eastern Africa. A prospective study including HIV tests and anthropometric data for this and the city's other hospitals is warranted. Discussion needs to be prompted on a local level about malnutrition and the use of guidelines.
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PMID:Nutritional and clinical status of children admitted to the malnutrition ward, Maputo central hospital: a comparison of data from 2001 and 1983. 1567 69

The family of the Medici has dominated the city of Florence from the 15th to the 18th century. With the fortune accumulated by their bank, their trade and industry, they made Florence the European capital of the Renaissance and one of the world centres of culture. However, the Medici got a lot of health problems that have often influenced the destiny of the city and its citizens. During the 15th century, the Medici of Cafaggiolo branch of the family were the uncrowned masters of the Florence republic. All got major "rheumatic" complaints, who often interfered with a normal professional activity. The tradition called their disease "gout" and one of the Medici even received the nickname "the gouty" (Piero il Gottoso). Radiological and pathological exploration of the bones, the study of documents from ocular witnesses and the icon pathological study of paintings of the family could however not confirm this diagnosis. On the contrary, 2 other osteo-articular syndromes could be disclosed in the family. During the 16th century, the Medici became Grandukes of Tuscany with absolute political power, abandoning their classical jobs as bankers and traders. Their luxurious life with feasts and lewdness induces their progressive fall that will be accelerated by illness. Malaria, the plague, venereal diseases, madness and cardiovascular disease decimate the family as well as murders, poisonings and other criminal acts. Moreover, the physical resistance of the family decreased due to some underlying, hereditary pathologies that were recently discovered. In 1737, the last Granduke died in a state of complete marasmus and Florence is taken over by the house of Lorraine.
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PMID:[Medical history of a Florentine dynasty: the Medici]. 2012 Feb 55

An outbreak of kwashiorkor of epidemic proportions occurred among Baluba refugees in the South Kasai in late 1960, and all degrees of severity of the disease were seen among both children and adults. Among the associated conditions were anaemia, malaria, dysentery and, in one child, smallpox. Marasmus was observed in only 3% of hospitalized patients.Rapid control of the emergency was made possible through the relief action of the United Nations and co-operating agencies. Except for those most severely affected, who required special fluid and antibiotic therapy, the treatment was mainly dietary (skin milk powder, starchy gruel, fish and palm oil). This treatment brought about a dramatic improvement in the clinical condition of hospitalized persons.The author considers that, to achieve lasting improvement, a long-range educational programme in nutrition is required in addition to emergency control measures.
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PMID:An epidemic of kwashiorkor in the South Kasai, Congo. 2060 26

This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition in children less than five years admitted to Omdurman Paediatric Hospital during the period January 2014 to December 2014. Data was collected from patient's hospital records during the study period. Ethical approval and permission to access patients' record were obtained. A total of 593 children with severe malnutrition were identified; 305 of cases were male (51.4%) with a male: female ratio of 1:0.9. The mean age these children was 22.3 months. Children 36-59 months were least affected. 35.4% were classified as low socioeconomic class, 22.9% classified as an average class and there were no sufficient data to classify the remaining. The overall prevalence of severe malnutrition was 6.5%, and the general mortality rate was 2.4% while mortality rate among children with severe malnutrition was 9.3%. Among the 593 admitted children with malnutrition, 407 (68.6%) had marasmus, 141 (23.8%) had kwashiorkor and 45 (7.6%) had marasmic-kwashiorkor. The highest prevalence and mortality rate occurred in September. The most common clinical presentations were gastroenteritis, malaria, urinary tract infections, giardiasis, tuberculosis and AIDS. Only 10.8% of the admitted children were exclusively breast fed for the first three months. 33% were fully vaccinated. Overall 75.7% improved and discharged, 15% discharged against medical advice and 9.3% died. We concluded that prevalence and mortality among children with acute severe malnutrition at Omdurman paediatrics hospital were high, and the current management strategies require review to identify the causes. We recommended adopting policies to manage malnutrition in the community and hospitals.
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PMID:Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan. 2765 50


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