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At least 379 records · Page 21Linked to original sources
PubMed2003

A case of sporotrichosis treated with itraconazole.

Lymphocutaneous sporotrichosis is caused by Sporothrix schenckii, a dimorphic fungus commonly existing on decaying plants and in the soil. The fungus has a worldwide distribution but is more prevalent in temperate and tropical climates. Infection may result from traumatic inoculation of contaminated material such as soil, hay, moss, plant debris, splinters, thorns and barbs. Inoculation is also possible through some animal scratches and bites. We describe a typical case of lymphocutaneous sporotrichosis, which was confirmed by clinical, histological and microbiological features. The patient was successfully treated with 400 mg daily systemic itraconazole for 4 months.

Adult↗
PubMed2001

Cryptococcosis in India: the awakening of a giant?

The menace of cryptococcosis has assumed global proportions over the years. The tropical climate of the Indian subcontinent offers a suitable environment for Cryptococcus neoformans, and the onslaught of the acquired immune deficiency syndrome (AIDS) pandemic since the early 1990s has substantially influenced the situation. Coupled with that are the advances in laboratory diagnostic techniques that have made accurate diagnosis increasingly available. These factors together have led to a sharp increase in the number of reported cases of cryptococcosis. This review attempts to present an overview of the status of cryptococcosis in India from its first description to the most recent times. The disease has been reported from almost all parts of the country. C. neoformans var. neoformans is predominantly found in clinical samples, while C. n. var. gattii infection has also been reported. An organ commonly involved is the central nervous system, among others. Both immunocompromised and apparently immunocompetent patients have been affected. Laboratory diagnosis is mostly by conventional methods, while effective therapeutic options are limited. Early diagnosis followed by institution of specific therapy, where possible, has effectively reduced mortality. Awareness of the disease and maintenance of a high index of clinical suspicion is required. An integrated approach to patient management with active interaction between the clinicians and the laboratory personnel would be highly beneficial. The wide variety of presentations of the disease seen in India suggests the possibility of occurrence of strain variation which needs to be investigated fully. Introduction of routine testing of antifungal susceptibility of clinical isolates is also important in order to obtain baseline data on susceptibility patterns and to predict in advance any shift in those patterns in the population. To maintain a high standard in all such endeavours, the establishment of an external quality control system is desirable.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Experimental models in drug development for helminthic diseases.

The prevalence and socioeconomic impact of helminthic infections continue to be of global concern, particularly in areas with tropical climates, poor sanitation, low standards of living, and poor health education. Considerable progress has been achieved in the development of anthelmintics, and a number of useful model systems are available. The uses and pharmacologic and clinical features of a number of anthelmintics are reviewed.

Animals↗
PubMed1995

Dermatoses associated with travel to tropical countries: a prospective study of the diagnosis and management of 269 patients presenting to a tropical disease unit.

The full spectrum of skin diseases related to travel in tropical areas is unknown. We prospectively studied 269 consecutive patients with travel-associated dermatosis who presented to our tropical disease unit in Paris during a 2-year period. The median age of these patients was 30 years; 137 patients were male; 76% of the patients were tourists; 38% had visited sub-Saharan Africa; and 85% had been appropriately vaccinated against tetanus. Cutaneous lesions appeared while the patient was still abroad in 61% of cases and after the patient's return to France in 39%. The diagnosis was definite in 260 cases; 137 of these cases (53%) involved an imported tropical disease. The most common diagnoses were cutaneous larva migrans (25%); pyodermas (18%); pruritic arthropod-reactive dermatitis (10%); myiasis (9%); tungiasis (6%); urticaria (5%); fever and rash (4%); and cutaneous leishmaniasis (3%). Hospitalization was necessary in 27 cases (10%), with a median duration of 5 days (range, 2-21 days). Travelers should be advised on how to avoid exposure to the agents and vectors of infectious dermatoses. Travel first-aid kits should include insect repellents and antibiotics effective against bacterial skin infections.

Adolescent↗
PubMedDate not supplied

Peripelvic abscesses: a diagnostic dilemma.

Acute hematogenous peripelvic infections are common in tropical climates. However, in more temperate regions, this is a rare and often overlooked diagnosis. Because of the subtle and subacute nature of the symptoms, the diagnosis is often delayed. We report our experience with nine children treated for a hematogenous peripelvic infection. The hospital and clinic charts were reviewed of nine consecutive patients with the diagnosis of a peripelvic abscess. Patients ranged in age from 2 to 13 years. Symptoms were present from 5 to 20 days. The most consistent symptom was a hip-flexion pseudocontracture (eight patients). The initial diagnosis was correct in only three patients. Computed tomography (CT) scan was diagnostic in all nine patients, providing diagnosis and localization. Seven of the nine patients underwent irrigation and debridement followed by a variable course of intravenous (i.v.) and oral antibiotics. All seven had rapid resolution of their symptoms. Two patients were treated with i.v. antibiotics alone, one of whom had a recurrence of symptoms. All nine patients had microbiologic confirmation of the infecting organisms [seven at surgery, one from blood cultures, one from sacroiliac (SI) joint aspiration]. Eight of the nine were infected by Staphylococcus aureus and one by group A Streptococcus. All had complete resolution of their symptoms at follow-up. Although acute retrofascial abscesses are rare in temperate climates, they should be considered in the differential diagnosis in the child with lower abdominal or hip pain. CT scan was the most helpful diagnostic test in these patients. Surgical drainage resulted in the most consistent results in this small series of patients.

Abscess↗
PubMed1989

Treatment of femoral shaft fractures with the Hoffmann external fixator in prepuberty.

Twenty-two children with femoral shaft fractures, between the age of 10 and 14 years, were treated with the Hoffmann external fixation apparatus from 1980 to 1985. This method of treatment is very simple. It requires less surgical exposure and allows earlier ambulation and easy nursing care. In addition, it makes patients comfortable in multiple trauma conditions. The average time to union and removal of fixators was 72 days (range, 44 to 80 days). There were no deep wound infections, nonunions, or rotationary deformities. On followup, all patients regained the range of motion of knee joints in 3 months without significant leg length discrepancy or radiographic evidence of growth disturbance. The device may serve as an alternative method for femoral shaft fractures in prepuberty, especially in areas of tropical climate.

Adolescent↗
PubMed2006

Seasonal infectious disease epidemiology.

Seasonal change in the incidence of infectious diseases is a common phenomenon in both temperate and tropical climates. However, the mechanisms responsible for seasonal disease incidence, and the epidemiological consequences of seasonality, are poorly understood with rare exception. Standard epidemiological theory and concepts such as the basic reproductive number R0 no longer apply, and the implications for interventions that themselves may be periodic, such as pulse vaccination, have not been formally examined. This paper examines the causes and consequences of seasonality, and in so doing derives several new results concerning vaccination strategy and the interpretation of disease outbreak data. It begins with a brief review of published scientific studies in support of different causes of seasonality in infectious diseases of humans, identifying four principal mechanisms and their association with different routes of transmission. It then describes the consequences of seasonality for R0, disease outbreaks, endemic dynamics and persistence. Finally, a mathematical analysis of routine and pulse vaccination programmes for seasonal infections is presented. The synthesis of seasonal infectious disease epidemiology attempted by this paper highlights the need for further empirical and theoretical work.

Animals↗
PubMed1976

Work capacity, thermal responses and lung function: united kingdom studies in the L.B.P.

Results of physiological studies from some ten U.K. Human Adaptability projects are presented. U.K. investigators made major contributions in developing and adapting techniques for the assussment under field conditions of work capacity, heat tolerance and respiratory function. The various ethnic studies of work capacity revealed the special role of body size and muscularity, as well as training, in determining the observed inter- and intra-population variance. The results on samples from U.K., New Guinea, the Caribbean, Israel, West and East Africa and the Ethiopian highlands gave no indication that genetic difference were significant in determining population differences. Differences in heat tolerance reflect in general the intensity of heat exposure, especially when combined with hard physical work. Indigenous peoples in Africa and New Guinea show some modification in sweating responses which do not appear to be genetically determined but are in some way, as yet not clearly established, attributable to long continued residence in tropical climates. In renal function of some seven ethnic groups were analysed in terms of lung volume bellows function, gas exchange and responses to excercise and carbon dioxide. The relative importance of genetic and non-genetic factors was examined.

Body Temperature Regulation↗
PubMed2004

South American palaeobotany and the origins of neotropical rainforests.

Extant neotropical rainforest biomes are characterized by a high diversity and abundance of angiosperm trees and vines, high proportions of entire-margined leaves, high proportions of large leaves (larger than 4500 mm2), high abundance of drip tips and a suite of characteristic dominant families: Sapotaceae, Lauraceae, Leguminosae (Fabaceae), Melastomataceae and Palmae (Arecaceae). Our aim is to define parameters of extant rainforests that will allow their recognition in the fossil record of South America and to evaluate all known South American plant fossil assemblages for first evidence and continued presence of those parameters. We ask when did these critical rainforest characters arise? When did vegetative parameters reach the level of abundance that we see in neotropical forests? Also, when do specific lineages become common in neotropical forests? Our review indicates that evidence of neotropical rainforest is exceedingly rare and equivocal before the Palaeocene. Even in the Palaeocene, the only evidence for tropical rainforest in South America is the appearance of moderately high pollen diversity. By contrast, North American sites provide evidence that rainforest leaf physiognomy was established early in the Palaeocene. By the Eocene in South America, several lines of evidence suggest that neotropical rainforests were diverse, physiognomically recognizable as rainforest and taxonomically allied to modern neotropical rainforests. A mismatch of evidence regarding the age of origin between sites of palaeobotanical high diversity and sites of predicted tropical climates should be reconciled with intensified collecting efforts in South America. We identify several lines of promising research that will help to coalesce previously disparate approaches to the origin, longevity and maintenance of high diversity floras of South America.

Adaptation, Biological↗
PubMed2004

Miliaria crystallina in an intensive care setting.

Drop-like, transient blisters of miliaria crystallina may develop with focal intensity of heat within the skin, such as occurs in tropical climates or during febrile episodes. Miliaria crystallina develops due to a transient poral closure of the sweat duct opening, resulting in obstruction of free flow of eccrine sweat and retention in a vesicle below the skin surface. Dual cholinergic and adrenergic sweat gland innervation is influenced by a variety of medications used in intensive care patients. We present two febrile intensive care patients in whom enhanced alpha-adrenergic stimulation of sweat gland myoepithelia may have led to miliaria crystallina.

Adrenergic alpha-Agonists↗
PubMed1987

Complications following total inferior turbinectomy: facts or myths?

Various surgical procedures have been described for the relief of chronic nasal obstruction due to inferior turbinate hypertrophy, but none has been consistently satisfactory. We have performed total inferior turbinectomy for this condition for 5 years. Of the 39 patients followed for at least 2 years, 90% were relieved permanently of nasal obstruction. However, only 36% and 61% of patients with rhinorrhoea and anosmia respectively were relieved of these symptoms. Complications were minimal. It is concluded that even in a dry, dusty tropical climate, inferior turbinectomy does not appear to disturb the function of the nasal cavity appreciably.

Airway Obstruction↗
PubMed1997

The place of "the tropics' in Western medical ideas since 1750.

The idea of "the tropics' as a region distinct from the "temperate' world has a long history and derives from European expansion and environmental theories especially from about 1750 onwards. Although the tropics were ascribed some positive attributes, the dominant concept was a negative one and the idea of distinctive tropical disease and the corresponding need for a separate specialty of tropical medicine largely grew out of this.

Brazil↗