Malaria in travelers in Rhode Island: a review of 26 cases
Article Abstract:
Malaria is the infection of red blood cells with the parasitic microorganism Plasmodium. It is characterized by attacks of chills, fever, sweats, anemia, enlargement of the spleen, and the deposition of a pigment called melanin in several organs. This infectious disease affects 200 million persons living in underdeveloped countries and causes death in one to two million persons each year. Cases of malaria in the United States are usually found in persons who visited or immigrated from areas where malaria is endemic, or prevalent. The incidence (number of new cases) of malaria is increasing in the United States and Canada, possibly due to resistance of the parasite to the antimalarial agent chloroquine, which is used to protect travelers to endemic countries from acquiring malaria. The incidence of malaria reported at two community hospitals in Rhode Island between 1986 and 1990 was assessed. These hospitals serve as the major regional centers for tropical medicine and the largest travel clinics in the state. There were 26 cases of malaria, including 15 immigrants who contracted the disease while visiting West Africa, their country of origin. Symptoms included fever in 67 percent of cases and gastrointestinal complaints in 26 percent. Patients with a history of malaria were able to differentiate between recurrent malarial disease and other diseases associated with fever. In two cases, malaria affected the brain, and 77 percent of cases were caused by Plasmodium falciparum. Thus, malaria should be considered in travelers returning from endemic countries, particularly East Africa, where the incidence of P. falciparum infection is increasing. This disease should be detected and treated early to prevent the occurrence of complications, such as infection of the brain. The antimalarial drug mefloquine is recommended by the Centers for Disease Control to prevent malaria in travelers to countries where Plasmodium is resistant to the conventional antimalarial agent chloroquine. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Prevention of irradiation-induced bowel discomfort by sucralfate: a double-blind, placebo-controlled study when treated localized pelvic cancer
Article Abstract:
Sucralfate is well established as an effective medication in the treatment of peptic ulcers. It appears to work predominantly by providing protection for the lining of the stomach and intestines and by strengthening the natural mucus protection of these linings. It might be possible, therefore, to use sucralfate to protect the intestines of patients being treated for pelvic cancers, as well. Radiotherapy is commonly used in the treatment of cancers in the pelvic region. Even when the affected organ is successfully removed, radiation is used to destroy any cancer cells that may have migrated within the local region. Unfortunately, the lining of the intestines is especially sensitive to the effects of radiation, and patients who receive such radiotherapy usually suffer through serious diarrhea and bowel discomfort. In a study of 66 patients with prostate cancer or bladder cancer, the effectiveness of sucralfate in reducing intestinal symptoms was examined. Thirty-two patients were treated with sucralfate and 34 received only placebo treatment. Diarrhea was common among both groups, but 18 of the sucralfate patients were free of diarrhea during the observation period, in contrast with only 7 of the patients who received placebo. Studies of the action of sucralfate on stomach ulcers have shown that this anti-ulcer agent tends to bind to damaged areas of the stomach. It seems reasonable to suppose that sucralfate binds to regions of the intestines damaged by the radiation and helps protect them from further damage by the intestinal contents. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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