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At least 595 records · Page 33Linked to original sources
PubMed1977

The importance of spinal anaesthesia in surgical practice in tropical Africa.

Any medical officer or surgeon who intends to practice in tropical or young developing countries must be proficient in the use of local and spinal anaesthetics because of severe shortage of anesthetists and anesthetic machines. We have presented 95 cases operated on by us in three "peripheral" hospitals in the Western State of Nigeria. These cases included gastrectomy; cholecystectomy, vagectomy and pyloroplasty and splenectomy. We have also presented our method of administering spinal anaesthetics and of preventing major complication of cardiac arrest. We have reviewed briefly the physiology and complication of spinal anaesthesia.

Africa↗
PubMed1996

The use of microbiology in the study of hygiene behaviour.

Faecal indicator bacteria have been used to measure levels of hygiene in a variety of settings. This paper describes a study in northern Botswana which used the isolation of faecal indicator bacteria in combination with other quantitative and qualitative techniques to gain information regarding hygiene behaviour. The microbiological samples included, samples from stored drinking water and water sources; eating plates; infant feeding bottles; dishcloths and the fingertips of carers and children. Water was usually clean at source but contaminated after storage. Presumptive faecal coliforms contaminated 31% of the eating plates, 29% of the dishcloths and 40% of the infant feeding bottles. Many of the presumptive faecal coliform isolates were not identified as Escherichia coli, indicating the need for further research into methodologies appropriate for isolating E. coli in tropical climates.

Bacteriological Techniques↗
PubMed1997

[Melioidosis: a tropical time bomb that is spreading].

Melioidosis, an infectious disease that affects many mammals, was first identified in Burma by Whitmore in 1912. It is caused by Burkholderia pseudomallei, a gram negative bacillus of the Pseudomonas family, which is found in soil and water. Long present in Southeast Asia and numerous tropical areas, melioidosis has recently appeared in temperate zones including mainland France. The incidence in endemic areas is between 6% and 20% of the population and short period of exposure is sufficient to be contaminated. In man the contamination occurs mainly through skin wounds and the disease can be clinically inapparent. Diabetes, renal disease, and various forms of immunodepression are triggering factors for the onset of a variety of symptoms ranging from acute septicemia to abscesses involving almost any organ in the body. Ceftazidime alone or a combination of clavulanate and amoxicilline is the treatment of choice but the mortality rate in patients with acute forms is still 40% and relapse can occur if treatment is stopped too soon. Bacteriologic and serologic tests can fail and awareness of a history of geographic exposure is an important diagnostic criteria for this disease which has been expanded with the growth of international travel.

Anti-Bacterial Agents↗
PubMed1997

[French expatriates in the tropics. One hundred years of health history].

It is difficult to synthesize, for the 20th century, the evolution of mortality among travellers, since they make up a heterogenous and elusive category. Data for soldiers sent abroad are the most easily available and suggest two rates in the decline of mortality: one before and one after the Pasteurian revolution. There is no direct link between demographic curves and optimistic or pessimistic biological theories which have alternatively sought to interpret the phenomenon of being "transplanted" in the tropics. Today, the debate remains open as to the respective roles of genetic, behavioural, and ecological factors in the adaptation of the individual and the group. Although traumatology comes first among risks associated with voyaging, infectious disease still occupies an important place in how travel is perceived, perhaps because it symbolizes coming into contact with "strangers".

Colonialism↗
PubMed1998

[Imported fever. A diagnostic challenge].

Fevers without distinguishing symptoms in persons who have visited tropical or subtropical areas is an increasing health problem in most western countries. The condition may be caused by several different microbes, but among cases diagnosed in Norway five infections dominate: falciparum malaria, vivax malaria, typhoid fever, paratyphoid fever and dengue fever. Primary measures should be taken against immediate life-threatening diseases e.g. typhoid fever and falciparum malaria.

Africa↗
PubMed1997

[Travel and patients with allergies].

By changing their surroundings and lifestyle, travelers with allergic conditions exposed themselves to new risks. The main perennial allergens are house dust mites which thrive in tropical areas and can be especially sensitizing. The risk of seasonal reactions to grass-pollens varies from region to region. Reactions to some highly sensitizing respiratory allergens can occur in travelers who return to regions where they were previously exposed. Subjects with food allergies should beware of possible reactions to ingredients in exotic dishes. The bites of several insects can cause anaphylactic reactions. Some medications required for tropical travel (e.g. antimalarial drugs) can trigger severe hypersensitivity reactions. Avoidance of allergens is more difficult during travel. Travelers with allergic conditions should carry alert identification cards and medications for routine as well as emergency treatment including self-injectable adrenaline.

Humans↗
PubMed1997

[First aid kits: for whom and why?].

Anyone traveling far from home should take along a first aid kit. Contents should be chosen carefully with the awareness that infection is not the main problem facing travelers. The basic kit is the same regardless of the purpose or duration of the trip or of the health and knowledge of the traveler. Priority should be given to allergic risks, to the quality of the thermometer, to the packaging of indispensable medications to a medical certificate justifying transport of drugs and syringes for personal medical use, and to preventive devices for sexually transmitted diseases. Travel in tropical zones raises special requirements especially with regard to infectious risks such as traveler's diarrhea, malaria, fungal and bacterial contamination. Protection against insect-borne disease and sun exposure are also important considerations for travel in the tropics. Depending on planned activities, travelers should carry medication for prevention and treatment of motion sickness and emergency treatment of envenimation. Due to local inavailabilities, it may be necessary to pack contraceptives, personal hygiene products, and common medications.

Bites and Stings↗
PubMed1998

Diagnosis and treatment of leptospirosis in the primary care setting.

Leptospirosis is an infectious illness that usually develops 1 to 2 weeks after indirect or direct exposure to the urine of infected animals. Infection occurs through open cuts, absorption through intact mucous membranes, and drinking contaminated water. The typical presentation is a flulike syndrome of sudden onset that tends to resolve within 2 weeks. A mild immunologic phase usually presents as an aseptic meningitis. A more severe immunologic phase (Well's syndrome) can result in jaundice, renal failure, adult respiratory distress syndrome, disseminated intravascular coagulation, and death. Laboratory tests take too long to replace clinical diagnosis, which is imperative so that antibiotic therapy can begin before the fourth day of illness. Although leptospirosis is more common in tropical climates, detection in the continental United States is increasing. Early, accurate detection and treatment in the primary care setting are vital for limiting life-threatening complications.

Diagnosis, Differential↗
PubMed1998

[Return from the tropics: relevant diagnosis and rational therapy].

Gastrointestinal disorders, particularly diarrhoea, are the main reason to consult a physician after travelling to the tropics. Although mostly of infectious origin specific pathogens frequently cannot be demonstrated. As the majority of acute diarrhoeal episodes resolve without any specific therapy, bacterological and parasitological investigations should initially be ordered with reserve and economically. Fever after a stay in the tropics has to be always a matter of concern as it could be the expression of a potentially dangerous infection, e.g. falciparum malaria. The primary objective must be the exclusion of potentially life-threatening infections requiring a specific treatment. Numerous asymptomatic travellers returning from the tropics want their physicians to exclude an inapparent exotic infection. The value of such check-ups can be questioned, and there are just a few rational investigations in this particular context.

Diagnosis, Differential↗
PubMed1998

Primary care management of otitis externa.

Otitis externa (OE) is an acute, painful inflammatory condition of the external auditory canal that affects all age groups and accounts for about half of all patients presenting with ear pain. Common causes are gram-negative bacteria, Staphylococcus aureus, fungi, and dermatologic conditions such as eczema, seborrhea, and psoriasis. Risk increases with prolonged exposure to heat and moisture, especially in those who swim frequently or live in a tropical climate. Treatment involves cleaning the canal thoroughly and instilling ototopical broad-spectrum antibiotics. Although OE is relatively benign and easy to treat in the primary care setting, it can have life-threatening complications, especially in diabetic and immunocompromised patients. This article reviews the differential diagnosis, outlines treatment, and discusses preventive measures. A patient-education sheet is provided.

Diagnosis, Differential↗
PubMed2002

The importance of using broad spectrum SPF 30+ sunscreens in tropical and subtropical climates.

BACKGROUND/PURPOSE: To evaluate the Sun Protection Factors (SPF) of six sunscreens sold in Australia, using an ultraviolet (UV) spectrum which mimics sunlight as closely as possible, and by using volunteers with a range of skin types to reflect the Australian population. METHODS: Open prospective study. Seventy-five volunteers of skin types 1-3 were tested in a dermatology research laboratory in a major metropolitan teaching hospital in Sydney, Australia in the years 2000-2001. Sunscreen SPF's were measured using a solar simulator and procedures which complied with the Australian Standard. RESULTS: Sun Protection Factors, as measured by a solar simulator more approximating to natural sunlight than commercial simulators, and using individuals of skin type 1-3, were shown to be approximately between 50% and 80% of their labelled value. Sunscreen application method can also affect SPF measurement. CONCLUSION: For a number of reasons, Sun Protection Factors are often overestimated. In addition, many individuals use less than half the amount of sunscreen recommended. Those living in tropical or subtropical climates should be encouraged to use only broad spectrum SPF 30+ sunscreens to achieve adequate protection from the sun.

Australia↗
PubMed1999

[Candida and amoebiasis acquired in tropical and subtropical climatic zones].

The objective of the study was the analysis of occurrence and number of Candida in the alimentary tract of 209 patients with intestinal amoebiasis considering their state after the treatment. Amoebiasis was diagnosed on the grounds of Entamoeba histolytica present in the faeces, what has just recently been recognised equal to the presence of E. histolytica complex. In all patients serological investigations were performed using indirect haemagglutination (IHA) test. The cases with relapses or with the intestinal ailments after elimination of the parasite from the body at the simultaneous isolation of Candida in the faeces were focused on. In the compass of several years a wide number of qualitative and quantitative mycological tests were performed comprising 39 patients with relapses after symptomatic amoebiasis and 42 with ailments which had appeared after the treatment form asymptomatic amoebiasis. Observation of the dynamics of number of Candida cells revealed most often their increment in subsequent examinations. It occurred in 69% people examined after the treatment of asymptomatic amoebiasis and in 40,9% after the treatment of symptomatic amoebiasis. The differences obtained were statistically significant. The number of yeast remained at the same high level in 23,8% patients after asymptomatic amoebiasis and in 36% after symptomatic amoebiasis. Drop of Candida cells number was noted in 7,1% people after asymptomatic amoebiasis and in 11,4% after symptomatic amoebiasis. In the light of the results obtained it turns possible that suffering from amoebiasis could even in the long run affect Candida tendency to proliferate or the tendency to remain at the same high level. It may be presumed that the growing number of yeast was an important reason for the intestinal ailments after the elimination of E. histolytica. The results of mycoserological investigations also were taken into consideration.

Amebiasis↗
PubMed2004

Abrupt tropical vegetation response to rapid climate changes.

Identifying leads and lags between high- and low-latitude abrupt climate shifts is needed to understand where and how such events were triggered. Vascular plant biomarkers preserved in Cariaco basin sediments reveal rapid vegetation changes in northern South America during the last deglaciation, 15,000 to 10,000 years ago. Comparing the biomarker records to climate proxies from the same sediment core provides a precise measure of the relative timing of changes in different regions. Abrupt deglacial climate shifts in tropical and high-latitude North Atlantic regions were synchronous, whereas changes in tropical vegetation consistently lagged climate shifts by several decades.

Atmosphere↗