PubMed Health⌕ Search

Biomedical subjects

A P Hall

Publications and source records attributed to A P Hall.

At least 19 recordsLinked to original sources
PubMed1992

Severity of imported falciparum malaria: effect of taking antimalarial prophylaxis.

OBJECTIVE: To investigate the effects of antimalarial chemoprophylaxis and other variables on the severity of falciparum malaria. DESIGN: Review of consecutive malaria cases between 1987 and 1991. SETTING: The Hospital for Tropical Diseases, London. SUBJECTS: 250 consecutive cases of mild and 51 consecutive cases of severe falciparum malaria. RESULTS: Prophylaxis was taken in 52.4% (131/250) of the cases of mild malaria and 21.6% (11/51) of cases of severe malaria. Severe malaria was more common in white patients than in those of African origin and was also seen more commonly in people returning from central, southern, and east Africa than in those returning from west Africa. Patients with severe malaria presented sooner than patients with mild malaria. CONCLUSIONS: Prior chemoprophylaxis led to a reduction in the severity of falciparum malaria. Ethnic origin, time to presentation, and sex were also associated with the severity of malaria.

Adult↗
PubMed1990

A questionnaire survey of the prevalence of scrapie in sheep in Britain.

An anonymous, self-administered questionnaire has been used in two independent surveys to try to determine the prevalence of scrapie in the national sheep flock. The disease was recorded in 35 counties in England and Wales. About a third (26.5 and 37.3 percent) of respondents owning 100 or more sheep indicated that they had seen sheep with scrapie in their flocks. The incidences of clinical cases recorded in affected flocks in the two surveys were 0.5 and 1.1 cases/100 ewes/year. At present there is no control over the disposal of these animals. If as has been suggested, an increase in the prevalence of scrapie was a contributory factor in the emergence of bovine spongiform encephalopathy, it would seem logical that measures should be introduced to monitor the prevalence and incidence of scrapie and to control the disposal of clinical cases.

Animals↗
PubMed1990

Intestinal helminthiasis in ex-patriates returning to Britain from the tropics. A controlled study.

A retrospective study was performed of clinical features in expatriates attending the Hospital for Tropical Diseases, London, with a sole diagnosis of ascariasis (100), trichuriasis (100), hookworm (75), and strongyloidiasis (36). Results were compared with a control group of 100 ex-patriates attending the same hospital in whom no diagnosis was made and in whom stool microscopy and peripheral blood eosinophil counts were normal. Almost one half of all patients with intestinal helminthiasis were asymptomatic. Of those with symptoms specific clinical features were no different from controls with the exception of a transient itch or rash in patients with strongyloidiasis. The presence of eosinophilia was not a reliable indicator of infection. This study suggests that it may be worth while performing stool microscopy in ex-patriates returning from the tropics even if they are asymptomatic.

Adult↗
PubMed1989

Plasma and urine electrolyte concentrations and vasopressin levels in patients admitted to hospital for falciparum malaria.

Vasopressin levels, together with plasma and urinary electrolytes, were measured in the acute and convalescent stages of 17 patients with malaria and 11 patients with other febrile illnesses. There was a significantly lower serum sodium in the acute stages of both groups (p less than 0.01 and p less than 0.02). There was no significant difference between the malaria and control groups. There were no significant changes in the vasopressin levels, although one patient with malaria showed evidence of inappropriate vasopressin secretion which returned to normal after treatment. This study suggests the mild hyponatraemia sometimes seen in the acute stages of malaria is not related to inappropriate secretion of vasopressin, although this condition may be of importance in more severe cases of hyponatraemia.

Adolescent↗
PubMed1986

Chloroquine-resistant falciparum malaria from East Africa.

Seven patients (one black African and six white Europeans) developed chloroquine-resistant falciparum malaria in East Africa. In vitro studies confirmed chloroquine resistance in three patients, but the parasites failed to grow in the other four patients. Six patients were cured by sequential quinine and Fansidar, one by sequential quinine and mefloquine.

Adult↗
PubMed1978

Preventing deaths from malaria.

To reduce the number of avoidable deaths from malaria in Britain the following five points are recommended. Parliament should pass a Malaria Prevention Act that compels travel agents and airlines to give written and verbal advice on prevention and diagnosis of malaria to people travelling to countries where the disease occurs. To improve diagnostic and therapeutic efficiency for all diseases the Department of Health and Social Security should prepare a procedure manual for the NHS that gives guidance for doctors and other medical staff. Avoidable deaths from all diseases should be the subject of open inquiries at district medical committees, with recorded evidence. Failure to perform diagnostic tests such as blood films for malaria in cases of sickness in people returning from the tropics should automatically be considered negligent. Compensation should be offered by the State to the next of kin of people who have died because of medical negligence from malaria or other diseases.

Coroners and Medical Examiners↗
PubMed1977

Sequential treatment with quinine and mefloquine or quinine and pyrimethamine-sulfadoxine for falciparum malaria.

Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.

Adolescent↗
PubMed1977

The treatment of severe falciparum malaria.

In severe falciparum malaria there is a pathophysiological cascade beginning with changes in the parasitized red blood cells which induce intermediate effects, in turn contributing to dysfunction of several organs. A low serum albumin is a common but often unrecognized finding which may contribute to oedema especially in the lung and brain. The only irreversible complication in falciparum malaria is the acute respiratory distress syndrome, manifested by cyanosis and rapid breathing, basically distinct from acute pulmonary oedema caused by therapeutic overhydration. The pathophysiology of falciparum malaria may be complex but the treatment is simple. Drugs, other than antimalarials, are rarely needed. Guidelines for cholorquine or quinine dosage in severe disease are proposed; each drug is given at a dose of 5 to 10 mg/kg in 10 ml/kg of fluid as an intravenous infusion in four hours at a frequency of dosing every 12 to 24 hours. When the disease has been brought under control the treatment should be changed from the intravenous to the oral route.

Adult↗