RESUMO
A 2-year-old Omani child with hyperimmunoglobulin E syndrome (HIES) had a 5-week illness characterized by fever, heart failure and acute mitral regurgitation. Echocardiographic studies showed the evolution of an apical left ventricular aneurysm during this illness.
Assuntos
Aneurisma/etiologia , Ventrículos do Coração , Síndrome de Job/complicações , Miocardite/etiologia , Aneurisma/diagnóstico por imagem , Aneurisma/terapia , Pré-Escolar , Ecocardiografia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Síndrome de Job/terapia , Masculino , Miocardite/diagnóstico por imagem , Miocardite/terapiaRESUMO
The cases of 51 patients with malaria seen at the Albert Einstein College of Medicine hospitals from January 1986 to June 1991 are reviewed. Thirty-five patients acquired infection on journeys to their country of origin. Of these 35 patients, 83% of whom had lived in the United States for > or = 2 years, only 17% received antimalarial prophylaxis. Ten of the 51 patients were born and raised in the United States, and 70% received prophylaxis (P < .01). Six of the 51 patients were visitors to the United States from areas endemic for malaria. Overall, 64% of patients acquired malaria in West Africa, south of the Sahara; 20% in Asia; 8% in Ecuador; 6% in Haiti; and 4% in the Middle East. The majority of infections were due to Plasmodium falciparum. Six patients traveled to a zone endemic for malaria while pregnant, and none received prophylaxis. In nine of 13 patients who received prophylaxis, there was inadequate dosing or poor compliance. Individuals born in regions endemic for malaria are at high risk of acquiring malaria on return to their countries of origin and are less aware of the need for malaria prophylaxis than are other travelers.
Assuntos
Malária/tratamento farmacológico , Malária/epidemiologia , Cooperação do Paciente , Viagem , Adolescente , Adulto , África Ocidental/epidemiologia , África Ocidental/etnologia , Animais , Antimaláricos , Ásia Ocidental/epidemiologia , Ásia Ocidental/etnologia , Distribuição de Qui-Quadrado , Criança , Cloroquina , Resistência a Medicamentos , Equador/epidemiologia , Equador/etnologia , Feminino , Humanos , Malária/prevenção & controle , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Plasmodium falciparum/isolamento & purificação , Plasmodium malariae , Plasmodium vivax/isolamento & purificação , Gravidez , Complicações Parasitárias na Gravidez , Recidiva , Estudos Retrospectivos , Fatores de Risco , Índias Ocidentais/epidemiologia , Índias Ocidentais/etnologiaAssuntos
Doenças Autoimunes/etiologia , Proteínas da Membrana Bacteriana Externa , Proteínas de Transporte , Infecções Estreptocócicas/imunologia , Streptococcus pyogenes/imunologia , Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Membrana Celular/imunologia , Reações Cruzadas , Glomerulonefrite/imunologia , Glomerulonefrite/microbiologia , Humanos , Ácido Hialurônico/imunologia , Febre Reumática/imunologia , Febre Reumática/microbiologia , Infecções Estreptocócicas/complicaçõesRESUMO
The incidence of cat or dog ownership was similar in 64 multiple sclerosis (MS) patients in south-east England and age- and sex-matched controls. 86% of both groups had owned a cat or dog before the date of onset of MS in the index case so that it would be difficult to detect an association between pet ownership and MS. The titres of neutralising antibody to canine distemper virus were higher in the MS patients (mean 48 +/- 68) than the controls (32 +/- 35), a significant difference (P < 0.05). This difference is not necessarily explained by a cross-reaction with measles antibody of which the titre was much higher in MS (610 +/- 560) than in the controls (320 +/- 330, P < 0.001).
Assuntos
Animais Domésticos , Anticorpos Antivirais/análise , Vírus da Cinomose Canina/imunologia , Esclerose Múltipla/imunologia , Animais , Gatos , Cães , Humanos , Sarampo/imunologiaRESUMO
The pattern of heart disease in 404 patients seen prospectively from the guinea savanna region of Africa is presented. Over 90% presented with cardiac failure. Hypertension, Peripartal Cardiac Failure (PPCF), Congestive Cardiomyopathy and Rheumatic Heart Disease are major problems. The highest incidence of PPCF in the world probably occurs in this area but the prognosis is good. The reasons for this and the possible interrelationship of hypertension with cardiomyopathy and PPCF are discussed. In contrast to the tropical rainforests, no case of endomyocardial fibrosis was seen. During the period of study, vascular thrombosis is uncommon and coronary heart disease is non-existent in Zaria.
