Blood and bone marrow changes in malaria

ContextMany US clinicians and laboratory personnel are unfamiliar with the diagnosis and treatment of malaria.ObjectivesTo examine the evidence base for management of uncomplicated and severe malaria and to provide clinicians with practical recommendations for the diagnosis and treatment of malaria in the United States.Evidence AcquisitionSystematic MEDLINE search from 1966 to 2006 using the search term malaria (with the subheadings congenital, diagnosis, drug therapy, epidemiology, and therapy). Additional references were obtained from searching the bibliographies of pertinent articles and by reviewing articles suggested by experts in the treatment of malaria in North America.Evidence SynthesisImportant measures to reduce morbidity and mortality from malaria in the United States include the following: obtaining a travel history, considering malaria in the differential diagnosis of fever based on the travel history, and prompt and accurate diagnosis and treatment. Chloroquine remains the treatment of choice for Plasmodium falciparum acquired in areas without chloroquine-resistant strains. In areas with chloroquine resistance, a combination of atovaquone and proguanil or quinine plus tetracycline or doxycycline or clindamycin are the best treatment options. Chloroquine remains the treatment of choice for all other malaria species, with the exception of P vivax acquired in Indonesia or Papua New Guinea, in which case atovaquone-proguanil is best, with mefloquine or quinine plus tetracycline or doxycycline as alternatives. Quinidine is currently the recommended treatment for severe malaria in the United States because the artemisinins are not yet available. Severe malaria occurs when a patient with asexual malaria parasitemia, and no other confirmed cause of symptoms, has 1 or more designated clinical or laboratory findings. The only adjunctive measure recommended in severe malaria is exchange transfusion.ConclusionsMalaria remains a diagnostic and treatment challenge for US clinicians as increasing numbers of persons travel to and emigrate from malarious areas. A strong evidence base exists to help clinicians rapidly initiate appropriate therapy and minimize the major mortality and morbidity burdens caused by this disease.

https://jamanetwork.com/journals/jama/articlepdf/207162/jcr70004_2264_2277.pdf

Treatment of Malaria in the United States: A Systematic Review

Malaria remains a highly prevalent disease in more than 90 countries and accounts for at least 1 million deaths every year. Plasmodium falciparum infection is often associated with a procoagulant t...

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Blood Coagulation, Inflammation, and Malaria

Purpose of review Nephrolithiasis is a prominent public health issue. It imposes a substantial burden on human health and is a considerable financial expenditure for the nation. Numerous epidemiologic studies have shown a significant association between nephrolithiasis, obesity, hypertension and chronic kidney disease. The review highlights many of those emerging studies and sheds light on the importance of our recognition of kidney stones as a systemic illness. Recent findings Several cross-sectional retrospective studies have investigated the relationship between kidney stones and the metabolic syndrome. The various silent features of the metabolic syndrome, including type 2 diabetes, increased BMI, hypertension and dyslipidemia, are becoming progressively more recognized and independently associated with an increased risk of kidney stone formation. Summary Our further understanding of the underlying mechanisms in the connection between nephrolithiasis and the metabolic syndrome will stimulate the development of more effective preventive and therapeutic measures.

Thomas W. Butler

Papers

Blood coagulation studies in Plasmodium falciparum malaria.

Radioimmunometric Quantification of Surface Lactoferrin in Blood Mononuclear Cells