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)

The clinical characteristics of falciparum malaria were studied among 61 children, aged 0 to 14 treated at a reference center in Manaus, from October to December 1997. The symptoms observed were fever (98.4%), headache (80.3%), chills (68.9%), perspiration (65. 6%), myalgia (59.0%), nausea (54.1%), lumbar pain (49.2%), vomiting (49.2%), cough (45.9%), arthralgia (31.1%), diarrhea (34.4%), dyspnea (8.2%), convulsions (8.2%) and dizziness (4.9%). Pallor and anaemia were found more frequently in children under five years old. Anaemia was associated with high levels of parasitaemia. Fifty-eight (91.5%) patients had uncomplicated malaria, 3 (4.9%) had severe malaria and the lethality was 1.6%.
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PMID:[Clinical study of falciparum malaria in children in Manaus, AM, Brazil]. 1088 Nov 32

The pattern of acute illness was determined in 102 adolescents and adults with sickle cell anaemia who presented to the emergency unit of a Lagos hospital. The patients had a mean age of 20.5 years (SD 13.1) and a male-female ratio of 1.5. The symptoms included fever (72%), fatigue and weakness (59%), anorexia (59%) and pain (57.5%) while major clinical signs were pallor (100%), jaundice (71%) and hepatomegaly (68%). Sixty-eight per cent of patients had sickle cell crises, including one with hemiplegic stroke, 10% with combined anaemia and pain crises, 33% with anaemia crises only and 23.5% with pain crises only. Sixty-three per cent had infection which was malaria in 24.5%, bacterial in 17% and viral in 6%. Of 16 patients with pyrexia of unknown origin, seven responded to treatment with chloroquine and eight to antibiotics. Infection was detected in 50% of the patients with sickle cell crises. The association between anaemia crises and malaria was significant (P < 0.05). Of the eight deaths, seven (88%) had anaemia crises. In contrast to studies conducted two decades ago in the same hospital, the prevalence of anaemia crises now exceeds that of pain crises and malaria now exceeds that of bacterial infection. Severe symptomatic anaemia (anaemia crisis) was more frequently associated with infection (mostly malaria) than was bone pain crisis. The Girdle pain crisis more frequently resulted in a fatal outcome than the uncomplicated bone pain crisis.
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PMID:Acute sickle cell syndromes in Nigerian adults. 1093 Nov 63

Man has been fighting rheumatism for thousands of years. Early therapy began with the use around the world of decoctions or extracts of herbs or plants such as willow bark or leaves. Most or all of these turned out to contain salicylates. The first record was about 3,500 years ago in the Ebers papyrus. Hippocrates, Celsus, Pliny the Elder, Dioscorides and Galen all recommended decoctions containing salicylate for rheumatic pain. A country parson, the Reverend Edward Stone of Chipping Norton in Oxfordshire, made the first "clinical trial" of willow bark (1). He was surprised by its bitter taste, which reminded him of cinchona bark (containing quinine), then being used to treat malaria. He harvested a pound of willow bark, dried it, pulverized it and dispersed it in tea, small beer or water. He found in 50 patients that doses of 1 dram (1.8g) cured their fever. He concluded "I have no other motives for publishing this valuable specific, than that it may have a fair and full trial in all its variety of circumstances and situations, and that the world may reap the benefits accruing from it". Salicylic acid was chemically synthesised in 1860 by Kolbe in Germany and its ready supply led to even more extended usage as an external antiseptic, as an antipyretic and in the treatment of rheumatism.
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PMID:The fight against rheumatism: from willow bark to COX-1 sparing drugs. 1119 32

A truncated history of the contribution of plants to medicine is given with reference to some of the less well known ancestors of the Harborne family. Six of the top 20 prescriptions dispensed in 1996 were natural products and the clinical use of drugs such as artemisinin, etoposide and taxol has once more focussed attention on plants as sources of novel drug entities. High through-put robotic screens have been developed by industry and it is possible to carry out 50,000 tests per day in the search for compounds which have specificity of action against a key enzyme or a subset of receptors. Bioassay-guided fractionation of plant extracts linked to chromatographic separation techniques leads to the isolation of biologically active molecules whose chemical structures can readily be determined by modern spectroscopic methods. The role of academics in the search for new drugs is discussed by reference to some of our research into natural products with activity on the central nervous system, on pain receptors, the malaria parasite Plasmodium falciparum, the wound healing properties of the sap of species of Croton (Dragon's blood), and a traditional Chinese medicine used to treat eczema. Expertise in phytochemistry has been essential for this research and the strong lead shown by Professor Jeffrey Harborne is gratefully acknowledged.
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PMID:Phytochemistry and medicinal plants. 1124 50

After a spending three weeks in Cameroon, a 19-year-old woman presented in the emergency room with sudden lancinating pain in the lower abdomen, predominantly on the right side. A blood smear tested for presumed malaria showed subperiodic microfilariae of the species Mansonella perstans. The patient was treated with mebendazole (Vermox).
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PMID:[Mansonella perstans filariasis after stay in Cameroon. A 19-year-old patient born in Cameroon, in Switzerland for the last 10 years]. 1184 14

The intramuscular (i.m.) route is generally used for treatment of childhood falciparum malaria in outlying health care units in Togo. The purpose of this randomized therapeutic trial was to compare the efficacy and tolerance of diluted injectable quinine administered by the i.m. versus intrarectal (IR) route. A total of 64 children ranging in age from 8 months to 15 years were treated, i.e. 32 for each administration route. All children presented uncomplicated falciparum malaria in association with vomiting in 30 cases, a single unrecurring seizure with postictal coma lasting less than 30 minutes in 25 patients, or prostration without neurological manifestations in 9. Injectable quinimax (an association of cinchona alkaloids) was diluted to a concentration of 60 mg base/ml for i.m. injection into the thigh and 30 mg base/ml for use by the IR route. Administration was performed every 12 hours for 72 hours at a dose of 12.5 mg/kg for patients in the i.m. group or at a dose of 15 mg/kg in the IR group. The anus and lower rectal mucosa were examined using an anal valve before and after treatment using the IR route. Analysis of mean temperature curves demonstrated no significant difference between the clinical effectiveness of quinimax administered by the i.m. versus IR route (p > 0.05). Similar effect were also observed on parasitemia which disappeared completely in all patients by the end of the 72-hour treatment. The main problems were insufficient product retention requiring re-administration in 25% of patients in IR group and residual pain at the injection site in 12.5% of patients in the i.m. group. Endoscopic examination revealed no evidence of ulceration or necrosis of the anorectal mucosa. These findings indicate that administration of diluted injectable quinine by IR route is an effective, well-tolerated alternative for treatment of childhood falciparum malaria. It should be used preferentially in outlying health care units in patients presenting severe malaria pending transfer to an hospital, or signs of "intermediate severity" such as hyperpyrexia, hyperparasitemia, unrepeated seizure, or intensive vomiting.
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PMID:[Diluted injectable quinine in the intramuscular and intrarectal route: comparative efficacity and tolerance in malaria treatment for children ]. 1219 13

Severe or complicated malaria is defined by infestation by Plasmodium falciparum into all red blood cells, especially those in the brain, causing coma and repeated convulsions; severe anemia (6 g/dl hemoglobin, 20% hematocrit); renal insufficiency (265 mcmol/l creatinine, 400 ml/day diuresis); pulmonary edema; hypoglycemia (2.2 ml/l or 0.4 g/l); shock; diffuse hemorrhaging; massive hemoglobinuria; and blood acidosis. Other possible symptoms of severe malaria are clouded thinking, changes in behavior, and inability to focus. It is most common in people with no immunity to malaria (children aged 4 and travelers in endemic zones). Pregnancy, splenectomy, corticotherapy, or poorly maintained immunity status favor severe anemia in adults. Sources of chloroquine-resistant P. falciparum have existed since 1960. Resistance has since expanded from Southeast Asia and South America to Africa, posing treatment problems. Malaria usually begins with fever (40 or more degrees Celsius), headaches, muscular pain, digestive troubles (e.g., diarrhea, nausea, or vomiting), and abdominal pain. In suspected cases of malaria, a blood sample or a thick blood smear as well as treatment (even in the absence of parasitological proof) needs to be done as soon as possible. Intravenous quinine diluted in a 5-10% glucose solution should be delivered at a rate of 24 mg/kg/day. In the case of severe jaundice, the dose should be cut in half beginning 8 hours after treatment began. If intravenous delivery is impossible, intramuscular delivery should be done. Corticosteroids, anticoagulants, and aspirin are contraindicated. In 2-4 days, oral administration (chloroquine, halofantrine, or mefloquine) is warranted. 20% of malaria-related deaths among patients who receive treatment are due to complications of the central nervous system. Protection against mosquito bites prevents malaria. Chemoprophylaxis in endemic zones should be limited to short trips to malaria zones or to pregnant women.
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PMID:[Severe malaria]. 1229 Jan 83

We tested the clinical reactions to a synthetic, Plasmodium falciparum, circumsporozoite multiple antigen peptide (MAP) vaccine in 39 volunteers immunized two to three times over 2-8 months using a dose escalation design. Immediate pain at the injection site was associated with the adjuvant QS-21 (P<0.001), and delayed local inflammatory reactions were associated with high-titered circulating IgG anti-MAP antibody (P=0.03). Because two volunteers developed acute, systemic urticaria after the third immunization associated with development of serum IgE MAP antibody, we employed immediate-type hypersensitivity skin tests (ITH-STs) using intradermal injections of diluted MAP vaccine to identify persons sensitized to the vaccine. ITH-STs were negative in seven volunteers tested 27 days after the first vaccination, but six of these individuals developed positive wheal and flare reactions when tested 14 or 83 days after the second vaccination; IgE MAP antibody was detected in only one of them. Another cohort of 16 volunteers, including the 2 allergic individuals, were ITH-ST negative when first tested late after their second or third vaccination at 6-7 months. Five of five non-immunized persons were also ITH-ST negative. ITH-STs may help identify individuals sensitized to malaria peptides and at potential risk of developing systemic allergic reactions after re-vaccination.
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PMID:Immediate-type hypersensitivity and other clinical reactions in volunteers immunized with a synthetic multi-antigen peptide vaccine (PfCS-MAP1NYU) against Plasmodium falciparum sporozoites. 1245 Jul 2

Investigation has been made on the folk medicine and health care in Jingning Autonomous Prefecture of She ethnic group, the only of its kind in China. It is demonstrated that since the living condition is bad, the hygienic environment is very poor, epidemics like measle, malaria and venereal diseases are very prevalent, and a high incident area of hyperthyroidism. Since there are no special writing characters, She ethnic group spread their medical know - how by oral transmission. Collection of herbs and compounding of recipes are mainly through the family. Medicine of the She ethnic group has a long history, and the treatment of bone - injury, snake - bites and wind - pain are very unique. It has been found that there are 599 genuses, 199 families of herbs in She medicine with 1043 species; among them, 214 herbs are in common use, falling under 126 genuses. In addition, 7 new herbal plants are found, and 332 recipes collected. Currently, over 40 She physicians are practicing in the prefecture.
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PMID:[Investigation on folk medicine and health care of She ethnic group in Zhejiang province]. 1263 31

Typhoid fever is an acute infectious disease caused by Salmonella enterica serotype typhi. The infection is responsible for endemic or epidemic outbreaks in tropical and subtropical countries, especially in Indian subcontinent, Southeast Asia, Central and South Africa. Latin America, and it occurs sporadically in Poland. We reported two cases of imported typhoid fever after travelling to India and Nepal. In the tourists returning from the area hyperendemic for malaria, visceral leishmaniosis, amoebiasis and haemorrhagic fevers and not following tropical hygiene measures, persistent fever was a source of difficulties in differential diagnosis. In the first case, lack of anti-malarial chemoprophylaxis in the presence of anaemia and thrombocytopenia strongly suggested Plasmodium spp. infection. Two daily peaks of fever with splenomegaly, lymphadenopathy, leucopenia, high transaminases levels and co-existing positive serology for L. donovani pointed to visceral leishmaniosis. Late occurrence of specific anti-S. typhi agglutinins in the Widal test, cross-reactivity with S. paratyphi A and negative urine bacteriological culture were observed. In the second case, gastrointestinal disturbances, including pain, abdominal tenderness and diarrhoea gave a suspicion of amoebic colitis. Stool and urine cultures were negative for S. typhi and cross reactions with S. paratyphi A and C were reported. Typhoid fever was finally confirmed in both patients by an isolation of S. typhi from peripheral blood cultures. The effectiveness of treatment of choice with ciprofloxacin or ceftriaxone in a case of multidrug-resistant (MDR) strain of S. typhi was documented.
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PMID:[Diagnostic difficulties in febrile travellers returning from the tropics. Two cases of typhoid fever imported from India]. 1266 54


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