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)

Severe falciparum malaria complicated by acute renal failure resulted in very high mortality. Ten patients with acute renal failure from falciparum malaria (infected rbc up to 80%) were continuously dialysed using Tenckhoff peritoneal catheter. Five were oliguric and BUN was maintained between 60 to 80 mg/dl (21.4 to 28.6 mmol/l) by hourly 1 to 1.5 liter dialysate exchange during the acute phase. The peritoneal urea clearance (mean +/- SD) was 12.1 +/- 1.2 ml/min with urea nitrogen removal of 13.4 +/- 2.3 g/day. In nonoliguric cases dialysis was also needed for additional removal of waste products since the remaining renal function could not cope with the hypercatabolic state. Peritoneal glucose absorption (135 to 565 g/day) gave considerable caloric supply without volume load and also contributed to the prevention of hypoglycemia. Varying degree of acute respiratory failure developed in all patients with 5 cases (2 oliguric and 3 nonoliguric) progressing to pulmonary edema. Swan-Ganz catheterization and hemodynamic study suggested the role of increased capillary permeability and volume overload from endogenous water formation in the development of pulmonary complication. Continuous removal of fluid and waste products minimized these problems and may prevent the progression of respiratory failure. One patient died of severe sepsis and the other nine survived. This study showed the beneficial contribution of continuous peritoneal dialysis in the management of acute renal failure from severe falciparum malaria.
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PMID:Continuous peritoneal dialysis in acute renal failure from severe falciparum malaria. 312 24

One hundred and ninety-two male malaria patients admitted to two different hospitals within 1 year, were studied. There were 74 malaria cases with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and 118 G-6-PD normal malaria cases, randomly selected as a control group. History of dark urine, and the presence of jaundice, haematocrit, total bilirubin and parasite count on day of admission were not significantly different comparing both groups. The number of observed complications did not differ either. Distinctions were detected in abnormal symptoms and in some laboratory parameters in patients with Plasmodium falciparum infection. G-6-PD deficient patients had significantly less gastrointestinal disturbances (P = 0.006), higher serum glutamic oxalacetic transaminase (P = 0.009) and significantly lower blood urea nitrogen (P = 0.007) when compared with the control group. These findings indicate that G-6-PD deficiency when the variants are aggregated, in male adult patients has no significant influence on the clinical presentation of malaria.
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PMID:Glucose-6-phosphate dehydrogenase deficiency in Thailand: the influence on the clinical presentation of malaria in male adult patients. 329 88

The herb Artemisia annua has been used for many centuries in Chinese traditional medicine as a treatment for fever and malaria. In 1971, Chinese chemists isolated from the leafy portions of the plant the substance responsible for its reputed medicinal action. This compound, called qinghaosu (QHS, artemisinin), is a sesquiterpene lactone that bears a peroxide grouping and, unlike most other antimalarials, lacks a nitrogen-containing heterocyclic ring system. The compound has been used successfully in several thousand malaria patients in China, including those with both chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum. Derivatives of QHS, such as dihydroqinghaosu, artemether, and the water-soluble sodium artesunate, appear to be more potent than QHS itself. Sodium artesunate acts rapidly in restoring to consciousness comatose patients with cerebral malaria. Thus QHS and its derivatives offer promise as a totally new class of antimalarials.
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PMID:Qinghaosu (artemisinin): an antimalarial drug from China. 388 71

Numerous exoerythrocytic forms of Plasmodium falciparum ( PFEEF ) were obtained from the liver of the South American monkey, Cebus apella, for analysis of the antigens on this stage. As antigen for the fluorescent assay, 5-micron sections of liver fragments collected on day 5 following sporozoite inoculation and fixed in Carnoy's solution or kept in liquid nitrogen were used. Two types of fluorescent labeling of the PFEEF were identified: diffuse and peripheral. Each of 23 sera from individuals with P. falciparum infection acquired naturally by mosquito bite showed the diffuse and peripheral patterns of fluorescence at low serum dilutions (i.e., 1:10-1:100), but only peripheral staining at higher serum dilutions (i.e., 1:200-1:1,600). All other polyclonal sera tested showed only the diffuse pattern of fluorescence whatever the serum dilution used; this was true for P. falciparum infections acquired accidentally by blood transfusion, heterologous human infections with P. vivax, P. ovale, P. malariae or P. cynomolgi, and experimental animal infections with P. berghei, P. gallinaceum, or P. cynomolgi. Fluorescent antibody titers on PFEEF were generally 1-4 dilutions lower than on blood stages. No age-dependent pattern of fluorescence titers was found in 30 sera from individuals ranging in age from 2-78 years living in a malaria-endemic area. Twenty-six monoclonal antibodies directed to P. falciparum blood stages which reacted at high titers with rings, schizonts, merozoites, and gametocytes did not react with PFEEF antigen even when using the undiluted ascitic fluid.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Species- and stage-specific antigens in exoerythrocytic stages of Plasmodium falciparum. 620 18

Camp and Smith strains of the human malaria parasite Plasmodium falciparum became resistant to mefloquine after continuous cultivation in the presence of the drug. The 50% inhibitory dose (ID(50)) values for mefloquine, as assessed by [(3)H]hypoxanthine incorporation, were found to have increased 4-fold, from 3 mug/l to 12 mug/l. The ID(50) values obtained by morphological examination of the cultures increased 10-fold. Resistance was stable in both strains either when grown in a drug-free medium or when kept frozen in liquid nitrogen. The mefloquine-resistant Camp strain remained sensitive to chloroquine and amodiaquine, and became slightly more resistant to quinine; there was increased sensitivity to pyrimethamine. The mefloquine-resistant Smith strain remained sensitive to amodiaquine and resistant to pyrimethamine; there was increased resistance to quinine, and an increase in sensitivity to chloroquine.
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PMID:Plasmodium falciparum: mefloquine resistance produced in vitro. 638 Jul 85

The present study was to evaluate the soluble antigen prepared from the in-vitro cultured P. falciparum (FCR3) as an alternative source of antigen to those obtained from in-vivo models for enzyme linked immunosorbent assay (ELISA) in serology of malaria. Results obtained on known positive and negative reference sera revealed good correlation between the ELISA and the indirect fluorescent antibody (IFA) technique (rs = 0.797; p less than 0.001). However such close correlation was not observed on six local sera from patients whose peripheral blood smear showed ring stage of P. falciparum (rs = 0.43; p greater than 0.05), though all the six sera were positive by the IFA and ELISA tests. Test was repeated to establish its reproducibility. The results indicate that antigen prepared from in vitro culture and stored in liquid nitrogen was found sensitive in ELISA for serology of malaria.
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PMID:Evaluation of a crude soluble antigen from in-vitro culture of Plasmodium falciparum for ELISA. 676 15

The anthropometric (body weight, height, upper arm circumference, triceps and subescapular skinfolds; Quetelet index and arm muscle circumference) and blood biochemistry (proteins and lipids) parameters were evaluated in 93 males and 27 females, 17-72 years old voluntaries living in the malarial endemic area of Humaita city (southwest Amazon). According to their malarial history they were assembled in four different groups: G1--controls without malarial history (n:30); G2--controls with malarial history but without actual manifestation of the disease (n:40); G3--patients with Plasmodium vivax (n:19) and G4--patients with Plasmodium falciparum (n:31). The malarial status was stablished by clinical and laboratory findings. The overall data of anthropometry and blood biochemistry discriminated the groups differently. The anthropometric data were low sensitive and contrasted only the two extremes (G1 > G4) whereas the biochemistry differentiated two big groups, the healthy (G1 + G2) and the patients (G3 + G4). The nutritional status of the P. falciparum patients was highly depressed for most of the studied indices but none was sensitive enough to differentiate this group from the P. vivax group (G3). On the other hand the two healthy groups could be differentiated through the levels of ceruloplasmin (G1 < G2) and alpha nitrogen (G1 > G2). Thus it seems that the malaria-malnourishment state exists and the results could be framed either as a consequence of nutrient sink and/or the infection stress both motivated by the parasite.
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PMID:The malarial impact on the nutritional status of Amazonian adult subjects. 756 36

Mefloquine is currently the drug-of-choice for malaria prophylaxis among military personnel. Four active duty military personnel receiving 250 mg mefloquine per week were killed in the line of duty under combat conditions. Samples of blood, bile, liver, kidney, muscle, brain, spleen and lung were submitted to the Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, for routine toxicologic analysis. Qualitative screening revealed only the presence of ethanol (< 25 mg/dl, probably attributable to postmortem formation) and mefloquine. Quantitation of mefloquine was performed using an HP 5880 gas chromatograph equipped with a nitrogen/phosphorus detector. The column was an HP-5 cross-linked 5% phenyl methyl silicone fused silica capillary column (15 m x 0.25 mm i.d. x 0.25 microns film thickness). The temperature program began at 110 degrees C, was held for 1 min and ramped at 20 degrees C/min to 200 degrees C, held for 1 min and then ramped at 10 degrees C/min to 280 degrees C and held for 10 min. Mefloquine elutes with a relative retention time similar to that of the tricyclic antidepressants. No postmortem data concerning mefloquine concentrations or tissue distribution was available. Quantitated blood concentrations in the presented cases were greater than the expected therapeutic values indicating the possibility of postmortem redistribution of this drug. No mefloquine overdoses were identified in the literature making comparison to the postmortem therapeutic concentrations impossible at this time.
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PMID:Mefloquine distribution in postmortem cases. 795 78

A selective and sensitive high-performance liquid chromatographic method with electrochemical detection is described for the simultaneous quantitation of primaquine and carboxyprimaquine, its primary metabolite, in plasma. After addition of internal standard, plasma was deproteinized by addition of acetonitrile. Nitrogen-dried supernatants, resuspended in mobile phase were analyzed on a C8 reversed-phase column. Limits of detection for primaquine and carboxyprimaquine were 2 and 5 ng/ml with quantitation limits of 5 and 20 ng/ml, respectively. None of 47 tested antimicrobial agents interfered. In contrast to previously reported methods, the assay sensitivity and specificity are sufficient to permit quantitation of primaquine in plasma for pharmacokinetics following low dose (30 mg, base) oral administration of primaquine, typically used in the treatment of malaria and Pneumocystis carinii pneumonia.
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PMID:Simultaneous determination of primaquine and carboxyprimaquine in plasma using high-performance liquid chromatography with electrochemical detection. 806 37

We have tested the hypothesis that nitric oxide may be responsible for the immunosuppression reported during malaria infections. We first showed that reactive nitrogen intermediates, which indicate nitric oxide generation, were increased in the plasma of Plasmodium vinckei-infected mice. We next found that Concanavalin A-induced proliferation of spleen cells from these mice was reduced compared with that observed in uninfected animals. The addition of NG-methyl-L-arginine (L-NMMA) for the duration of the cultures restored the malarial proliferative response to normal. We then tested the effect of oral L-NMMA on the proliferative response of P. chabaudi-infected mice to a human red blood cell lysate. The secondary response to this antigen, measured as spleen cell proliferation in vitro ten days after immunization and when there was no discernible parasitaemia, remained normal in L-NMMA-treated P. chabaudi mice, but was decreased in the untreated infected mice. These results suggest a role for nitric oxide in malarial immunosuppression.
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PMID:Possible role of nitric oxide in malarial immunosuppression. 807 68


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