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

Disturbances in calcium metabolism in acute renal failure (ARF) remain incompletely understood. Most data are from patients with rhabdomyolysis. As renal impairment commonly accompanies severe malaria in the absence of rhabdomyolysis, falciparum malaria provides an alternative model of mineral homoeostasis in ARF. We studied 25 Vietnamese subjects, aged 18-63 yr, with severe malaria and 10 controls. Fourteen patients had a serum creatinine level of 250 mumol/L or less during treatment (group 1), five developed ARF but were not dialyzed (group 2a), and six required dialysis (group 2b). Group 1 patients presented with mild hypocalcemia (mean +/- SD serum ionized calcium, 1.18 +/- 0.05 vs. 1.23 +/- 0.02 mmol/L in controls; P = 0.01) that persisted until discharge in the presence of normal serum phosphate, PTH, and vitamin D metabolite levels. Group 2 patients were more hypocalcemic on admission (1.10 +/- 0.08 mmol/L; P < 0.0001 vs. controls), especially those in group 2b whose serum ionized calcium fell to 0.88 +/- 0.13 mmol/L when renal dysfunction was maximal. In group 2 patients, the admission serum PTH level was raised (5.4 +/- 3.8 vs. 2.7 +/- 0.9 pmol/L in controls; P < 0.02) and changed reciprocally with calcemia. Significant rises in serum phosphate occurred only in group 2b patients who had depressed serum free 1,25-dihydroxyvitamin D levels throughout. Hypercalcemia did not accompany the diuretic phase of ARF. These data suggest that parathyroid gland dysfunction is a cause of hypocalcemia in severe malaria without ARF, as seen in group 1 patients; in patients with ARF, the effect of the combination of phosphate retention and altered vitamin D metabolism on skeletal PTH sensitivity is of prime significance.
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PMID:Mineral homoeostasis in acute renal failure complicating severe falciparum malaria. 767 21

Chloroquine-phosphate was suspended in various lipophilic and hydrophilic suppository bases in an amount of 250 mg/2.0 g. The authors studied the solidity and the disintegration time of the suppositories as well as the in vitro drug liberation with a membrane diffusion method. The effect of the storage time and the storage circumstances on the stability of the suppositories was observed. Tropics-resistance studies were also carried out at a temperature of 45 degrees C and at a relative humidity content of 75%, thus these suppositories may be used for the treatment of malaria. The Witepsol H 15 base was found to be the best in all respect for use in countries with a continental climate. Finally a function relationship was found between the concentration of the pharmacon and the diffusion time with linear regression analysis.
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PMID:[Production technology and in vitro study of rectal suppositories containing chloroquine phosphate]. 779 89

Since September 19, 1994, approximately 20,000 U. S. military personnel have been deployed to Haiti as part of Operation Uphold Democracy. To monitor the occurrence of mosquitoborne illnesses (including dengue fever [DF] and malaria) among deployed military personnel, on September 19 the U. S. Army established a surveillance system for febrile illness. Before deployment, all military personnel were instructed to take antimalarial chemoprophylaxis, either chloroquine phosphate (500 mg weekly) or doxycycline (100 mg daily). This report summarizes surveillance findings for September 19-November 4.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dengue fever among U.S. military personnel--Haiti, September-November, 1994. 796 2

A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatremia and hypokalaemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated.
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PMID:Falciparum malaria treated with a chloroquine suspension administered rectally in Trinidad. 803 15

The antimalaric drug chloroquine is a well known inhibitor of lysosomal proteolysis in vitro. The present study tests the hypothesis that therapeutic doses of the drug decrease proteolysis also in vivo in humans. Leucine kinetics were determined in 20 healthy volunteers given 12 and 1.5 h before the studies 250 and 500 mg, respectively, of chloroquine phosphate (n = 10) or similar tablets of placebo (n = 10). Chloroquine reduced the rates of leucine appearance, a measure of whole body proteolysis, from 2.45 +/- 0.08 to 2.19 +/- 0.08 mumol.kg-1.min-1 (P = 0.038) and those of nonoxidative leucine disposal, an estimate of whole body protein synthesis, from 2.16 +/- 0.08 to 1.95 +/- 0.06 mumol.kg-1.min-1 (P = 0.050). The drug resulted also in a marginally significant (P = 0.051) decrement in the plasma concentrations of glucose. The effects of chloroquine on protein turnover might be potentially useful in counteracting protein wasting complicating several catabolic diseases, whereas those on glucose metabolism can explain the sporadic occurrence of severe hypoglycemic episodes in malaria patients chronically treated with this drug.
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PMID:Chloroquine reduces whole body proteolysis in humans. 804 8

A randomized controlled trial of the effect of chloroquine prophylaxis versus placebo on the occurrence of clinical malaria was carried out in 1988 among children aged 1-14 in the Awash Rift Valley of central Ethiopia. At the time of the study, chloroquine resistance had not been reported from this area. Two thousand children were randomly allocated to either chloroquine phosphate (5 mg base kg-1) or a multivitamin tablet. Treatment and weekly follow-up were carried out for 10 weeks during the peak malaria transmission season. There was no difference between chloroquine and placebo groups in the occurrence of at least one episode of clinical malaria, in smear positivity in those who remained free of attacks until the end of the study period, or in the prevalence of splenomegaly at the end of the study period. It is concluded that chloroquine prophylaxis is ineffective in preventing at least one clinical attack of malaria in children in this area.
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PMID:Chloroquine chemoprophylaxis in children during peak transmission period in Ethiopia. 806 43

To investigate metabolic disturbances in an animal model of human malaria, four rhesus monkeys (Macaca mulatta) were infected with Plasmodium coatneyi, a parasite which induces cytoadherence of infected erythrocytes. When moribund or the parasitaemia had plateaued, the monkeys were sacrificed (3 animals) or treated with chloroquine (1 animal). Blood and cerebrospinal fluid (CSF) were sampled at intervals between inoculation and sacrifice or treatment. Arterial and CSF glucose and lactate rose during infection, indicating evolving insulin resistance. The arteriovenous difference in glucose concentration also increased, consistent with increased glucose consumption by parasitised tissues. Arterial plasma lactate rose but a positive arteriovenous concentration difference suggested tissue lactate uptake. The animal with the highest plasma lactate at sacrifice remained hyperglycaemic but also had the highest CSF lactate, the greatest cerebral sequestration and neurological depression, and biochemical and histological evidence of severe hepatic pathology. Serum cholesterol and corrected serum calcium fell consistently during infection; serum phosphate was also reduced in animals without renal impairment. These preliminary results indicate that lactic acidosis is a late complication of severe malaria and, by implication from this and other studies, hypoglycaemia occurs even later; other metabolic changes during P. coatneyi infection in rhesus monkeys also parallel those of severe falciparum malaria in humans. The model could be used in further studies of malaria-associated metabolic dysfunction and its management.
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PMID:Metabolic disturbances in Plasmodium coatneyi-infected rhesus monkeys. 802 92

In Al Ain District located in the Abu Dhabi Emirate of the United Arab Emirates (UAE), clinicians at the Al Ain General Hospital outpatient clinic conduct a medical examination of and take blood samples from all new immigrants applying for resident or work permits. All persons with malaria receive 600 mg chloroquine phosphate at the clinic (day 0) and a prescription for another 600 mg for day 1 and 300 mg on day 2. The malaria cases are to return to the clinic on day 3. Entomologists record mosquito larval counts at all field sides and conduct susceptibility tests in the laboratory. The malaria control program applies a larvicide on breeding sites and uses pyrethroids to eliminate adult flying insects. In 1981, local transmission of malaria ceased. During 1988-1991, 4.7-9.1% of the population was slide-positive for malaria. This incidence rate is high enough to introduce imported malaria into the local anopheline mosquito population, should malaria control activities be reduced. Pakistanis, UAE nationals, and Omanis comprise most malaria cases (36.3-56.6%, 12.8-21.9%, and 15.7-25.3%, respectively). The immigrants tend to visit their home countries, where they acquire malaria. All UAE nationals acquire it while on holiday in or traveling to endemic areas, especially Oman. In 1991, out of 1150 cases, the leading sources of malaria were clearly Pakistan (576) and Oman (526). Most slide-positive children are either Omanis or part of UAE families with relatives across the border in Oman. Plasmodium falciparum, mostly from Pakistan and Oman, is responsible for 69.5% of malaria cases. The Indian subcontinent is the source of most P. vivax cases. Beginning in 1987, the number of chloroquine-resistant P. falciparum cases increased from 9 to 302. The leading sources of resistant cases originate from Oman (160), Pakistan (100), and Sudan (26). All chloroquine-resistant cases except one responded to Fansidar. Factors that may disturb effective malaria control efforts in this new agriculture area are rapid development of water resources and the undemarcated border with Oman.
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PMID:Status of imported malaria in a control zone of the United Arab Emirates bordering an area of unstable malaria. 829 56

Plasmodium falciparum is the causative agent of malaria tropica in man. Biochemical studies were focused on the asexual, intraerythrocytic stages of P. falciparum, because of their role in the clinical phase of the disease and the possibility of propagation in a cell culture system. In this report, we describe the in-culture labeling of malarial glycolipids and the analysis of their hydrophilic moieties. They were identified as glycosylphosphatidylinositols (GPIs) by: 1) labeling with [3H]mannose, [3H]glucosamine, and [3H]ethanolamine and 2) sensitivity toward glycosylphosphatidylinositol-specific phospholipase D, phospholipase A2, and nitrous acid. Malarial GPIs are shown to be unaffected by treatment with phosphatidylinositol-specific phospholipase C, regardless of prior treatment with mild base commonly used for inositol deacylation. Two candidates for putative GPI-anchor precursors to malarial membrane proteins with the structures ethanolamine-phosphate-6(Man alpha 1-2)Man alpha 1-2Man alpha 1-6Man alpha 1-4 GlcN-PI (Pfg1 alpha) and ethanolamine-phosphate-6Man alpha 1-2Man alpha 1-6Man-alpha 1-4-GlcN-PI (Pfg1 beta) were identified.
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PMID:Glycosylphosphatidylinositols synthesized by asexual erythrocytic stages of the malarial parasite, Plasmodium falciparum. Candidates for plasmodial glycosylphosphatidylinositol membrane anchor precursors and pathogenicity factors. 830 May 89

In 1988, 50 cases each of falciparum malaria were treated by dihydroartemisin (360 mg in 5 days and 480 mg in 7 days respectively), and compared randomly with piperaquine phosphate group. The results showed that the plasmodium of falciparal malaria in Dong Fang County, Hainan province, is much more resistant to piperaquine phosphate, in the 51 cases treated by piperaquine, 33.3% were sensitive, 19.0% were RI, 21.6% were RII, and 25.5% were RIII. The effect of dihydroartemisinin (both 5 days and 7 days therapy) were obviously better than that of pipera quine, fever subsidence time and parasite clearance time were similar and parasite recrudescence rate showed no obvious difference in these two groups too.
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PMID:[Randomised comparison on the treatment of falciparum malaria with dihydroartemisinin and piperaquine]. 831 83


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