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Query: UMLS:C0024530 (
malaria
)
44,886
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Neuropathologic examination of 19 fatal cases of cerebral
malaria
and a review of the literature showed that the epidemiologic, clinical, and pathologic features of this entity suggest consideration of cerebral
malaria
as a form of disseminated vasculomyelinopathy, a hyperegic reaction of the CNS to the antigenic challenge of
Plasmodium falciparum infection
. Experimental evidence also substantiates this view The initial event seems to be vasculopathy, with alteration of the endothelial permeability, followed by brain edema, perivascular infiltrates and ring hemorrhages, perivascular demyelination, and gliosis (malarial granuloma) in the late stages. This chain of events could be interrupted early in its course by corticosteroids. Parenteral dexamethasone should then be seriously considered at the first signs of involvement of the CNS during P falciparum
malaria
along with the standard forms of antimalarial therapy.
...
PMID:Cerebral malaria. A disseminated vasculomyelinopathy. 34 69
The activities of Mannich base antimalarials, including pyronaridine, have been explored against drug-sensitive (Plasmodium berghei N) and chloroquine-resistant (Plasmodium yoelii NS) rodent
malaria
parasites in vivo. Lines of these parasites have been developed with resistance to pyronaridine, amodiaquine, or WR 228,258. The responses and patterns of cross-resistance of these lines to Mannich bases and other blood schizontocides are inconsistent. It is concluded that some Mannich bases may prove still to be of value inthe treatment of chloroquine-resistant
Plasmodium falciparum infection
.
...
PMID:The chemotherapy of rodent malaria. XLVII. Studies on pyronaridine and other Mannich base antimalarials. 128 26
Recently we have shown that two hybrid proteins expressed in Escherichia coli confer protective immunity to Aotus monkeys against an experimental
Plasmodium falciparum infection
(Knapp et al., 1992). Both hybrid proteins carry a sequence containing amino acids 631 to 764 of the serine stretch protein SERP (Knapp et al., 1989b). We have studied the diversity of this SERP region in field isolates of P. falciparum. Genomic DNA was extracted from the blood of six donors from different endemic areas of Brazil and West Africa. The SERP region encoding amino acids 630 to 781 was amplified by polymerase chain reaction (PCR) and sequenced. Only conserved amino acid substitutions in maximally two positions of the analyzed SERP fragment could be detected which supports the suitability of this SERP region as a component of an anti-blood stage
malaria
vaccine.
...
PMID:A recombinant hybrid protein as antigen for an anti-blood stage malaria vaccine: a study on the conservation of a protective component. 134 88
Reactivation of latent infection is the principal mechanism relating Toxoplasma gondii and Pneumocystis carinii to HIV. Less common is reactivation in Leishmania donovani, Trypanosoma cruzi, and microsporidian infections. An impaired primary immune response occurs in all these infections, and also with Cryptosporidium and Isospora belli. Association of HIV infection with gut parasites including Giardia lamblia and Entamoeba histolytica, and also with Trichomonas vaginalis infection is likely to be related to sexual modes of contact that favour both HIV and the parasite. The severity of
malaria
is not definitely associated with HIV, but
Plasmodium falciparum infection
may favour more rapid evolution of the HIV infection. Both
malaria
and trichomoniasis favour HIV transmission; the former by necessitating blood transfusion, and the latter by enhancing viral transmission during sexual contact.
...
PMID:Protozoan infections and HIV-1 infection: a review. 139 92
Cerebral malaria is a severe complication of
Plasmodium falciparum infection
in children, with a mortality rate of 15-50% despite antimalarial therapy. In order to determine whether combining iron chelation with quinine therapy speeds recovery of consciousness, the authors conducted a randomized, double-blind, placebo-controlled trial of the iron chelator deferoxamine in 83 Zambian children with cerebral
malaria
. To be enrolled, patients had to be under age 6, have P. falciparum parasitemia, have normal cerebrospinal fluid without evidence of bacterial infection, and be in a coma from which they cannot be aroused. Deferoxamine (100 mg/kg of body weight/day, infused intravenously for 72 hours) or placebo was added to standard therapy with quinine and sulfadoxine-pryimethamine. The time to recovery of full consciousness, time to parasite clearance, and mortality were examined with Cox proportional-hazards regression analysis. The rate of recovery of full consciousness among the 42 patients given deferoxamine was 1.3 time that among the 41 who received the placebo (95% confidence interval [CI], 0.7-2.3; the median time to recovery was 20.2 hours in the deferoxamine group, and 43.1 hours in the placebo group (p=0.38). Among 50 patients in deep coma, the rate of recovery of full consciousness was increased 2.2-fold with deferoxamine (95% CI, 1.1-4-7), decreasing the median recovery time from 68.2 to 24.1 hours (p=0.03). Among 69 patients for whom data on parasite clearance were available, the rate of clearance with deferoxamine was 2.0 times that with placebo (95% CI, 1.2-3.6). Among all 83 patients, mortality was 17% in the deferoxamine group and 22% in the placebo group (p=0.52). It is concluded that iron chelation therapy may speed the clearance of parasitemia and enhance recovery from deep coma in cerebral
malaria
.
...
PMID:Effect of iron chelation therapy on recovery from deep coma in children with cerebral malaria. 845 79
At the antenatal clinic of Kilifi District Hospital in the Coast Province of Kenya, researchers enrolled 300 pregnant volunteers 15-32 years olds, living in the district to screen and treat then for
Plasmodium falciparum infection
and to follow those with parasitemia on days 0, 1, 2, 14, 17, 21, and 28. They also conducted in vitro studies to determine resistance to chloroquine. They combined in vivo and in vitro study took place between November 20, 1988 and January 17, 1989. 65 women (21.7%) had P. falciparum in their peripheral blood smear. Primigravidae were more likely to be parasitemia than were multigravidae (41.8% vs. 17.1%; p .001). Their mean parasite density was also higher but not significantly so. Parasite density fell consistently with rising parity.
Malaria
infections in 54.1% of the women responded to 25 mg/kg chloroquine. the remaining 45.9% (28) of cases exhibited in vivo resistance, especially at RI an RII levels (36.1% and 8.2%, respectively). Primigravidae were more likely to experience failure to clear parasites by day 7 than multigravidae. Further, among women experiencing a parasitemia on day 7, parasites tended to reappear on day 14 and 21 in primigravidae. Initial parasite density did not affect clearance of parasites. Primigravidae continued to have a higher level of parasitemia throughout treatment than did multigravidae. It took at least 24 hours for the chloroquine to be completely absorbed thus the mean level of parasitemia decreased sharply between 0-2 days. Amodiaquine induced a parasitemia in 89.3% (25 cases) of the chloroquine resistant infections. Even though the 3 remaining cases with parasitemia received amodiaquine treatment, clinicians administered Fansidar, resulting in a clearing of parasitemia in 7 days. 34.8% of in vitro parasite cultures were resistant to chloroquine. The reduced ability of pregnant women to clear parasitemia likely explained the lower level of in vitro resistance.
...
PMID:In vivo and in vitro response of Plasmodium falciparum to chloroquine in pregnant women in Kilifi district, Kenya. 150 11
A randomized, double-blind, field trial was carried out to compare the effectiveness of permethrin-treated bed nets with that of untreated nets as a method of
malaria
control for migrant workers in eastern Thailand. The study was conducted using 261 subjects in eastern rural areas that are known to be highly endemic for multidrug-resistant
Plasmodium falciparum infection
. One hundred twenty-six subjects used treated nets, while 135 used untreated nets. During the 35 weeks of observation, 23 subjects using treated nets and 33 workers using untreated nets developed 28 and 51 episodes of
malaria
, respectively (P = 0.029). The reduction in risk per subject due to treated nets was 0.06. The residual effects of permethrin were tested using a World Health Organization standard bioassay. Anti-mosquito activity was found to be present in the nets for more than 16 months. We conclude that because of the failure of the development of safe, effective, long-lasting prophylactic agents, integrating the use of impregnated nets with large-scale primary health care programs may be a partially effective method for controlling
malaria
in eastern Thailand.
...
PMID:The effectiveness of permethrin-impregnated bed nets against malaria for migrant workers in eastern Thailand. 152 43
Irregular peaks of
P.falciparum
malaria
incidence were monitored in Suriname during 1982-86. An attempt is made to correlate these fluctuations of
malaria
rates with rainfall and river level in relation to the periodic availability of breeding habitats for the
malaria
vector Anopheles darlingi Root. Densities of adult female An.darlingi were recorded in the Upper-Marowijne region of Suriname, in a focus of
malaria
along the Marowijne River. Peaks in biting densities correlated well with periods of (i) high water level in the long rainy season, (ii) low water level in the long dry season, and (iii) abundant rainfall in the short rainy season. Critical levels of river-height and rainfall were defined which could explain most of the monthly fluctuations in
malaria
parasite incidence observed in this area.
...
PMID:Relations between Anopheles darlingi breeding habitats, rainfall, river level and malaria transmission rates in the rain forest of Suriname. 160 Feb 21
Cerebral malaria is the most important manifestation of severe
Plasmodium falciparum infection
. The clinical picture in South East Asian adults differs from that in African children. The children are more likely to have abnormal brain stem reflexes, signs suggestive of cerebral herniation, and raised CSF opening pressure, and to suffer persistent neurological sequelae. The mortality remains high at about 20%. The diagnosis must be considered in all patients with fever and impaired consciousness who may have been exposed to the infection. The pathophysiology of cerebral
malaria
may involve mechanical obstruction of the cerebral circulation by parasitized erythrocytes which have adhered to the vascular endothelium. Cytokines such as tumor necrosis factor may also contribute. The most important element of treatment is early, optimal chemotherapy with quinine, but artemisinine derivatives may prove even more effective.
...
PMID:Cerebral malaria. 161 97
Mefloquine was introduced into Thailand in 1985 for the treatment of
Plasmodium falciparum infection
. Recently, clinical failure of mefloquine was observed in southeastern Thailand, where an epidemic of falciparum
malaria
occurred. Beginning in 1984 and continuing until 1989, in vitro monitoring of P. falciparum isolates from Borai, a border district in the southeastern part of the country, showed a progressive decrease in mefloquine sensitivity until 1989; in 1990, the degree and prevalence of resistance accelerated. A similar pattern of resistance was observed for halofantrine, an antimalarial drug not yet commercially available in Thailand. In vitro sensitivity patterns of mefloquine and halofantrine elsewhere in the country remained relatively unchanged. These observations suggest a serious deterioration in available drugs for the treatment of falciparum
malaria
in southeastern Thailand that is predicted to spread throughout the country and Southeast Asia.
...
PMID:Emergence of multidrug-resistant Plasmodium falciparum in Thailand: in vitro tracking. 163 77
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