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At least 415 records · Page 23Linked to original sources
PubMed2005

The role of the physician in modern military operations: 12 months experience in Southern Iraq.

OBJECTIVES: To examine the profile of medical morbidity and the role of the physician in modern conflict. METHODS: Retrospective survey of admission records at a British Military Field Hospital on operational duty in Southern Iraq. RESULTS: 62.5% of 4870 admissions to the Field Hospital in Shaibah during the first 12 months of military operations in Iraq were under the care of physicians. Of these 1531 (31.4%) were due to diarrhoea and vomiting (D&V) and 764 (15.7%) due to heat illness. The incidence of heat illness rose with ambient temperature, but soldiers were more likely to be admitted with heat illness shortly after arrival in theatre than when fully acclimatised. There was also a steady flow of admissions with a broad spectrum of medical pathology requiring the clinical skills of a general physician. CONCLUSIONS: A general physician is a necessary part of the clinical team in modern conflict. The incidence of D&V and of heat illness on military operations remains high. Planners for any operation in tropical climates should take this into consideration and put preventative measures into place early.

Health Care Surveys↗
PubMed1999

Fungal corneal ulcers of onion harvesters in southern Taiwan.

Fungal corneal ulcers related to agriculture has been reported throughout the world, especially in tropical areas. Most of them were sporadic and had histories of ocular trauma or use of topical corticosteroids and topical antibiotics. Five onion harvesters had fungal corneal ulcers during the same harvest period in Southern Taiwan. The authors think that this is the first report of a group occurrence relating to agricultural workers. Although all of the patients improved after medical and surgical management, their vision was greatly decreased. It is suggested that the tropical climate, the harvest procedure, the characteristic monsoon, and lack of eye protection were involved. Therefore, the importance of the eye protection, hygiene education, and improving medical care to reduce the occurrence of fungal corneal ulcer in agriculture workers must be emphasised.

Adult↗
PubMed1999

Drink composition, voluntary drinking, and fluid balance in exercising, trained, heat-acclimatized boys.

This study examined the effects of beverage composition on the voluntary drinking pattern, body fluid balance, and thermoregulation of heat-acclimatized trained boys exercising intermittently in outdoor conditions (wet bulb globe temperature 30.4 +/- 1.0 degreesC). Twelve boys (age 13.4 +/- 0.4 yr) performed two 3-h sessions, each consisting of four 20-min cycling bouts at 60% maximal aerobic power alternating with 25-min rest. One of two beverages was assigned: unflavored water (W) or flavored water plus 6% carbohydrate and 18 mmol/l Na (CNa). Drinking was ad libitum. Total intake was higher (P < 0.05) during CNa (1,943 +/- 190 g) compared with W (1,470 +/- 143 g). Euhydration was maintained with CNa (+0.18% body wt), but a mild dehydration resulted with W (-0.94% body wt; P < 0.05). Sweat loss, much higher than previously published for children of similar age, was similar between conditions (CNa = 1,644.7 +/- 117.5; W = 1,750.2 +/- 152.7 g). The increase in rectal temperature (CNa = 0.86 +/- 0.3; W = 0.76 +/- 0.1 degreesC), heart rate, and all perceptual variables did not differ between conditions. In conclusion, a flavored carbohydrate-electrolyte drink prevents voluntary dehydration in trained heat-acclimatized boys exercising in a tropical climate despite their large sweat losses. Because hydration changes were minor, the thermoregulatory strain observed was similar between conditions.

Acclimatization↗
PubMed1999

Paederus dermatitis: a report of 46 cases in Aydin, Turkey.

Paederus dermatitis is a specific form of acute irritant contact dermatitis caused by pederin, a secretion of insects of the genus Paederus. The disease is characterized by vesicles, bullae and sometimes small pustules on an erythematous base with sudden onset of a stinging, burning sensation. The dermatitis is most frequently seen in regions with a hot, tropical climate. We present 46 cases from Aydin, Turkey, a province well known for its long hot summers. These are the first cases reported from this region. We would like to point out the possibility of Paederus dermatitis in regions with a similar climate and suggest that 'night burn' be included among other differential diagnoses of a grouped vesicular and/or pustular lesion on an erythematous base.

Adolescent↗
PubMed1998

Analysis of the cross-reactivity between BtM and Der p 5, two group 5 recombinant allergens from Blomia tropicalis and Dermatophagoides pteronyssinus.

BACKGROUND: In tropical climates, sensitization to Bloma tropicalis and Dermatophagoides pteronyssinus is high and mainly directed to species-specific allergens. There is some cross-reactivity between extracts of these mites, probably due to the group 5 allergens that have high sequence homology. OBJECTIVE AND METHODS: We used the radioallergosorbent test (RAST), RAST inhibition and immunoblotting inhibition experiments to investigate the cross-reactivity between the recombinant allergens BtM and Der p 5, expressed as glutathione S-transferase fusion proteins, to detect the epitopes involved and to analyze the importance of this cross-reactivity. RESULTS: Seventy-nine percent of 48 patients sera were RAST positive to both recombinants, with a strong correlation (r = 0.8, p<0.0001). BtM inhibited 25 and 21.1% of IgE-binding to B. tropicalis and D. pteronyssinus extracts respectively and Der p 5 inhibited 22 and 24% of IgE-binding to D. pteronyssinus and B. tropicalis extracts. Furthermore, BtM inhibited 74.5% of IgE binding to Der p 5 and Der p 5 inhibited 72.4% of IgE-binding to BtM. RAST inhibition with BtM-derived synthetic peptides showed that peptide 4 (residues 35-50) and peptide 5 (residues 46-61) inhibited 37 and 16% of IgE-binding to BtM while peptides 5 and 2 (residues 14-30) were able to inhibit the IgE binding (32 and 28%, respectively) to Der p 5. CONCLUSION: There is cross-reactivity between BtM and Der p 5, which explains almost all the cross-reactivity between the two mite extracts. This cross-reactivity seems to be related to epitope(s) at the C-terminal segment of these allergens.

Allergens↗
PubMed2003

Correlates of sensitization to Blomia tropicalis and Dermatophagoides pteronyssinus in asthma in Barbados.

BACKGROUND: Sensitivity to the mite Blomia tropicalis is related to asthma in tropical climates, but correlates of sensitivity to B. tropicalis and its relationship to Dermatophagoides pteronyssinus sensitivity have not been widely examined in families with asthma. The main objective of this study was to determine prevalence and correlates of sensitivity to these mites in families with asthma and characteristics of persons sensitized to both. METHODS: Antibodies to major antigens (Blo t 5 and Der p 1) of these mites were measured by immunochemiluminescent assay in 481 members of 29 families from Barbados ascertained through two asthmatic siblings. RESULTS: Blo t 5 sensitivity was present in 261 subjects (46%) and was associated with younger age, higher total serum IgE level, and more than a three-fold increased prevalence of asthma (42 vs. 13%). Der p 1 sensitivity was less common (27%) and showed similar associations with age, IgE, and asthma. Of the 261 subjects sensitized to Blo t 5, 116 were also sensitized to Der p 1; they were younger, had higher total and Blo t 5 specific IgE levels, and had more than twice the asthma prevalence as those sensitized to Blo t 5 alone (59 vs. 29%). Der p 1 sensitivity without Blo t 5 sensitivity was uncommon; 90% of those sensitized to Der p 1 were also sensitized to Blo t 5. Geometric mean total IgE levels were lowest in the 207 participants without any mite sensitization (102 U/ml), intermediate in 158 sensitized to either Blo t 5 OR Der p 1 (609 U/ml), and highest in 116 sensitized to both (1,869 U/ml). CONCLUSIONS: Blo t 5 is the predominant sensitizing mite allergen in these Barbadian families with correlates similar to Der p 1. Concomitant sensitization to Der p 1 appears to identify a more reactive subgroup of individuals at a higher risk of asthma.

Adult↗
PubMed2000

Antimicrobial resistance in the tropics.

Bacterial resistance to antimicrobial agents is an increasing problem in many areas of the tropics. In most countries there is little information available to determine the patterns of resistance in different pathogens, nor are local data available to influence prescribing. This paper will review the development of antimicrobial resistance in the tropics, consider the current priority problems, and suggest strategies that may be taken to improve the surveillance of resistance.

Bacterial Infections↗
PubMed2006

Clinico-laboratory profile and outcome of Japanese encephalitis in Nepali children.

BACKGROUND: Japanese encephalitis (JE) is associated with high mortality and neurological sequelae. The unpredictable course and lack of specific treatment pose major challenges in management. The tropical climate and paddy ecosystem in Nepal provide a suitable setting. AIMS: To determine the aetiology of febrile encephalopathy and describe the clinico-laboratory profile and outcome of JE in Nepali children. METHODS: A hospital-based prospective and observational study was conducted over a 1-year period (2000-2001). Children aged from >1 month to 14 years with fever >38 degrees C for <2 weeks and altered sensorium were recruited. JE was confirmed by anti-JE IgM in cerebrospinal fluid and/or serum. RESULTS: Of 117 consecutively enrolled patients, 58 had JE. Ten patients had concomitant infections, four with malaria and six with bacterial meningitis, and were excluded from analysis. Clinical findings were as follows: boys, 69%; age 4-14 years, 71%; presentation during summer and autumn, 83%; fever >3 days, 69%; altered sensorium <2 days, 50%; Glasgow coma score 8-12, 63%; seizures, 58%. Four (8.3%) died. At discharge, neurological sequelae were detected in 24 (50%) and hemiparesis was the most common form. Longer duration of vomiting, altered sensorium and focal neurological deficit on admission were independently associated with sequelae at discharge. Sequelae persisted in nine (18.8%) at 6 weeks follow-up. Long duration of altered sensorium (beta co-efficient 0.35, odds ratio 1.4, p=0.042) and presence of focal neurological deficit on admission (beta co-efficient 1.6, odds ratio 5.2, p=0.049) were independent predictors of sequelae at 6 weeks. CONCLUSION: JE was the commonest cause of febrile encephalopathy. Neurological sequelae were common but resolved in two-thirds of cases.

Adolescent↗
PubMed2005

Variability of observed low-altitude astronomical refraction (LAAR) from different geographic locations: progress toward a global map of LAAR variability.

The variability of the astronomical refraction of the setting Sun as measured from Holetown, Barbados, West Indies, is compared to sunset refraction measured from Edmonton, Alberta, during the same time of year. At about 13 degrees N latitude, Holetown experiences a marine tropical climate, while Edmonton (53 degrees N) has a subarctic continental climate. The 17 sunsets recorded from Holetown between 27 December 2003, and 21 February 2004, and between 25 and 30 December 2004, show a mean astronomical refraction of 0 degrees .475 and standard deviation of 0 degrees .012. The 26 sunsets recorded from Edmonton between 31 December 1992, and 17 February 1993, show a mean astronomical refraction of 0 degrees .699 and standard deviation of 0 degrees .118. The Barbados mean is significantly less than the Edmonton mean, while the variability of the Barbados data is an order of magnitude less than the Edmonton data. The variability of refraction appears to be strongly correlated with the variability in the surface vertical temperature gradient recorded on the same day as the sunset observations. This suggests that mapping of the geographic distribution of low-altitude astronomical refraction variability could be based on climatology of the surface vertical temperature gradient.

Journal Article↗