scholarly journals High prevalence of malaria in a non-endemic setting among febrile episodes in travellers and migrants coming from endemic areas: a retrospective analysis of a 2013–2018 cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alejandro Garcia-Ruiz de Morales ◽  
Covadonga Morcate ◽  
Elena Isaba-Ares ◽  
Ramon Perez-Tanoira ◽  
Jose A. Perez-Molina

Abstract Background The study aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain. Methods Observational retrospective study that consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR). Results Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by Plasmodium falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs. 65%), were older (34 vs. 24 years), sought medical attention earlier (17d vs. 32d), had a greater number of previous malaria episodes (74% vs. 60%), lower levels of platelets (110,500µL vs. 250,000µL), and higher of bilirubin (0.6 mg/dL vs. 0.5 mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusions Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitic infection. Prompt diagnosis is crucial to avoid severe cases and deaths.

2021 ◽  
Author(s):  
Alejandro Garcia-Ruiz de Morales ◽  
Covadonga Morcate ◽  
Elena Isaba-Ares ◽  
Ramon Perez-Tanoira ◽  
Jose A. Perez-Molina

Abstract Objectives: We aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain.Methods: This retrospective study consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR).Results: Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by P. falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs 65%), were older (34 vs 24 years), sought medical attention earlier (17d vs 32d), had a greater number of previous malaria episodes (74% vs 60%), lower levels of platelets (110,500µL vs 250,000µL), and higher of bilirubin (0.6mg/dL vs 0.5mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusion: Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitosis. Prompt diagnosis is crucial to avoid severe cases and deaths. We suggest a proportion around 30% of positive samples as a potential adequate index of suspicion for malaria diagnosis.


Parasitology ◽  
1993 ◽  
Vol 107 (S1) ◽  
pp. S159-S167 ◽  
Author(s):  
P. S. Shetty ◽  
N. Shetty

Interactions between infection and nutrition have been well recognized for several years now since they contribute directly to the health of individuals and communities. Malnourished individuals are specially prone to developing infections while infections themselves can lead to profound changes in the nutritional status of the individual. Health workers in developing countries in the tropics have long recognized the mutually aggravating interactions of malnutrition and infection. The importance of this synergistic relationship between infection and nu-tritional status has been studied extensively in the case of young children. The nutritional status of a young child is a critical determinant of both c morbidity and mortality resulting from a wide range of infections: bacterial, viral, or parasitic. Chandra (1983), in his review on the relationship of nutrition, immunity and infection has categorized the wide range of infectious agents (bacterial, viral, fungal and parasitic) into those that are definitely, variably or minimally influenced by the nutritional status of the child.


2018 ◽  
Author(s):  
Andrey Chetverikov ◽  
Gianluca Campana ◽  
Arni Kristjansson

Our interactions with the visual world are guided by attention and visual working memory. Things that we look for and those we ignore are stored as templates that reflect our goals and the tasks at hand. The nature of such templates has been widely debated. A recent proposal is that these templates can be thought of as probabilistic representations of task-relevant features. Crucially, such probabilistic templates should accurately reflect feature probabilities in the environment. Here we ask whether observers can quickly form a correct internal model of a complex (bimodal) distribution of distractor features. We assessed observers’ representations by measuring the slowing of visual search when target features unexpectedly match a distractor template. Distractor stimuli were heterogeneous, randomly drawn on each trial from a bimodal probability distribution. Using two targets on each trial, we tested whether observers encode the full distribution, only one peak of it, or the average of the two peaks. Search was slower when the two targets corresponded to the two modes of a previous distractor distribution than when one target was at one of the modes and another between them or outside the distribution range. Furthermore, targets on the modes were reported later than targets between the modes that, in turn, were reported later than targets outside this range. This shows that observers use a correct internal model, representing both distribution modes using templates based on the full probability distribution rather than just one peak or simple summary statistics. The findings further confirm that performance in odd-one out search with repeated distractors cannot be described by a simple decision rule. Our findings indicate that probabilistic visual working memory templates guiding attention, dynamically adapt to task requirements, accurately reflecting the probabilistic nature of the input.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Borhanpour ◽  
Seyed Saeed Sekhavatizadeh ◽  
Saeid Hosseinzadeh ◽  
Mahboobeh Hasanzadeh ◽  
Mohammad-Taghi Golmakani ◽  
...  

Abstract Chavil (Ferulago angulata) extract (CE) and microencapsulated chavil extract (MCE) were added to UF- Feta-type Cheese. The aim of this study was to comprising CE and MCE on physicochemical and microbiological properties in cheese. The scanning electron microscope images demonstrate the MCE had elliptical shape. The average size diameter curve of the MCE revealed bimodal distribution with two peaks (1541 and 2222 nm) separately. The hardness value of MCE cheese (212.83 ± 17.63 g) was lower than that of CE (343.67 ± 25.53 g) because of canola oil used in the microencapsulation process. The MCE-cheese showed lower values of acidity (1.67%) in comparison with CE-cheese (1.87%). The viable numbers of Streptococcus thermophilus and Lactococcus lactis were equal among the samples (4.6–4.9 log10 CFU/g respectively). The acid degree value of MCE (2.07 ± 0.21%) and CE (1.83 ± 0.25%) cheese were nearly equal at the end of storage time.


2018 ◽  
Vol 148 (8) ◽  
pp. 1300-1308 ◽  
Author(s):  
Szimonetta Lohner ◽  
Viktória Jakobik ◽  
Krisztina Mihályi ◽  
Sara Soldi ◽  
Sotirios Vasileiadis ◽  
...  

2011 ◽  
Vol 20 (supp01) ◽  
pp. 203-207 ◽  
Author(s):  
RODOLFO VALENTIM ◽  
JORGE E. HORVATH ◽  
ERALDO M. RANGEL

The distribution of masses for neutron stars is analyzed using the Bayesian statistical inference, evaluating the likelihood of two a priori gaussian peaks distribution by using fifty-five measured points obtained in a variety of systems. The results strongly suggest the existence of a bimodal distribution of the masses, with the first peak around 1.35M⊙ ± 0.06 M ⊙ and a much wider second peak at 1.73M⊙ ± 0.36 M ⊙. We compared the two gaussian's model centered at 1.35M⊙ and 1.55M⊙ against a "single gaussian" model with 1.50M⊙ ± 0.11 M ⊙ using 3σ that provided a wide peak covering objects the full range of observed of masses. In order to compare models, BIC (Baysesian Information Criterion) can be used and a strong evidence for two distributions model against one peak model was found. The results support earlier views related to the different evolutionary histories of the members for the first two peaks, which produces a natural separation (in spite that no attempt to "label" the systems has been made). However, the recently claimed low-mass group, possibly related to O - Mg - Ne core collapse events, has a monotonically decreasing likelihood and has not been identified within this sample.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S294-S294
Author(s):  
Kaj Svedberg ◽  
William Hancox ◽  
Hugh Grant-Peterkin

AimsWith the advent of the COVID-19 Pandemic the NHS long term Plan commitments of January 2019 to improve crisis care nationwide became all the more pressing. The aim of this study was to thematically investigate what mental health crisis presentations might be diverted from the Emergency department to external crisis hubs in order to reduce the COVID-19 contamination risks.MethodAll referrals made to the Homerton University Hospital (HUH) mental health liaison service were looked at between 1/3/20-11/6/20 (n = 846), coinciding with the first peak of the COVID-19 Pandemic.Referral data was anonymised and sorted independently into naturally emerging thematic classes by two junior liaison doctors.Cases that did not clearly fit any of the 14 themes generated were further looked into to determine outcome of referral and discussed to try and match to an appropriate class.Result14 frequent themes for mental health crisis referrals were identified. The distribution of these ranged from most common (suicidality) to neurocognitive presentation and identified shifts in themes over the course of the pandemic peak such as increases of low mood, anxiety and intoxication requiring medical attention over the three month period.ConclusionAlthough themes for presentations may be identified in acute referrals to mental health liaison services it is problematic determining how these may be parsed safely to crisis hubs without risking overlooking cases that may require medical attention. The most common theme that was identified and remained throughout the first wave of the COVID-19 Pandemic was acute suicidal presentation. The remaining themes would require careful consideration around risk thresholds for what a service may wish to accept in devolving the emergency department liaison and balance these against future risks of repeat COVID-19 waves.


2020 ◽  
Vol 35 (6) ◽  
pp. e191-e191
Author(s):  
Mohammed S. Al-Rashdi ◽  
Bakathir Abdulaziz ◽  
Khalid A. Al Balushi

Objectives: We sought to assess medications prescribed to patients attending the Dental and Maxillofacial Surgery (DMS) clinic at Sultan Qaboos University Hospital (SQUH), Oman. Methods: This was a retrospective cross-sectional study covering a six-month period from January to June 2018 including a sample of patients attending the DMS clinic. Drug utilization data like drug name, type, administration route, dosage frequency, and anatomical and therapeutic class were assessed. Results: The study included 400 patients, of which 190 (47.5%) were males and 210 (52.5%) were females. A total of 88 different drugs were prescribed. Only 140 (35.0%) patients were prescribed drugs for their dental conditions or other comorbidities per visit, and the rest 260 (65.0%) were not prescribed any drugs. The dentists prescribed drugs only in 116 (29.0%) patients. The most common diagnosis was dental caries (n = 177, 44.3%) followed by chronic gingivitis (n = 15, 3.8%). The most common comorbidities in patients were anemia (n = 45, 11.3%) and diabetes (n = 21, 5.3%). The most common drugs prescribed were chlorhexidine mouthwash (n = 43, 37.1%) and paracetamol (n = 36, 31.0%) followed by ibuprofen (n = 10, 8.6%) and amoxicillin/clavulanate (n = 5, 4.3%). Conclusions: Drugs prescribing pattern was within the international norms. Sixty-five percent of the patients were not prescribed any drug by the dentist. Oral antiseptics, analgesics, and antibiotics were the most common drugs prescribed by dentists.


el–Hayah ◽  
2015 ◽  
Vol 5 (2) ◽  
pp. 73 ◽  
Author(s):  
Eko Budi Minarno

<p class="Default"><em>Carica  pubescens Lenne &amp; K. Koch is one of the species in the tropics, which adapt to the plateau environment and low temperatures. In Indonesia, this plant is found at Cangar, Bromo, and Dieng Plateau. This study aims to determine the results of phytochemical screening and total flavonoids in fruit samples were taken from the third place. Qualitative and quantitative tests carried out in the Laboratory of Department of Biology and Chemistry, </em><em>Faculty of </em><em>Science and Technology</em><em>, </em><em>Maulana Malik Ibrahim State Islamic University, Malang</em><em>. Analysis of total flavonoids using a spectrophotometer at λ = 510 nm. The results of qualitative phytochemical screening tests on samples of C. pubescens fruits at Cangar, Bromo, and Dieng Plateau shows that the positive sample contains flavonoids, polyphenols, tannins, and triterpenoids. Quantitative test results show that the C. pubescens at Cangar contains  total flavonoids quercetin equivalent with value 800 mg / L, Bromo with value 816.65 mg / L, and Dieng Plateau with value 633.35 mg / L, respectively.</em></p>


2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Maria A. Roinwowan ◽  
Janno B. B. Bernadus ◽  
Angle M. H. Sorisi

Abstract: Malaria is a parasitic infection that attacks the erythrocytes. This disease remains a global health problem, especially in developing countries in the tropics and subtropics. Symptomatic malaria infection include fever, chills, anemia and splenomegaly. Malaria infection can progress without any complications but can also develop systemic complications known as severe malaria. The cause of malaria is plasmodium infection, Plasmodium in humans infected erythrocytes (red blood cells) and asexual breeding experience in liver tissue and erythrocytes. In this research, the microscopic examination of blood samples for counting malaria parasites in the blood and then measured the levels of TNF-α by ELISA. This analytical study using 40 samples taken by simple random sampling. The results showed that there is a significant relationship between the amount of TNF-α levels plasmodium with.  Conclusions: There were significant correlation between the levels of TNF-α with a density of plasmodium malaria in blood samples. Keywords: Malaria, TNF-α, ELISA, plasmodium    Abstrak: Malaria adalah penyakit infeksi parasit yang menyerang eritrosit. Penyakit ini masih merupakan masalah kesehatan dunia terutama di negara sedang berkembang pada kawasan tropik dan subtropik. Infeksi malaria memberikan gejala berupa demam, menggigil, anemia dan splenomegali. Infeksi malaria dapat berlangsung tanpa adanya komplikasi namun dapat juga menyebabkan komplikasi sistemik yang dikenal sebagai malaria berat. Penyebab infeksi malaria ialah plasmodium,Plasmodium ini pada manusia menginfeksi eritrosit (sel darah merah) dan mengalami pembiakan aseksual di jaringan hati dan eritrosit. Dalam penelitian ini dilakukan pemeriksaan mikroskopis pada sampel darah penderita malaria untuk menghitung parasit dalam darah dan selanjutnya dilakukan pengukuran kadar TNF-α dengan metode ELISA. Penelitian analisis ini menggunakan 40 sampel yang diambil secara simple random sampling. Hasil penelitian memperlihatkan bahwa terdapat hubungan yang bermakna antara jumlah plasmodium dengan  kadar TNF- α. Kesimpulan : Didapatkan korelasi yang signifikan antara kadar TNF- α dengan densitas plasmodium pada sampel darah penderita malaria. Kata Kunci : Malaria, TNF- α, ELISA, plasmodium


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