A Case of Plasmodium Falciparum Malaria Presentation

New York City is a multicultural city where people of different ethnicities and backgrounds from all over the world live together. Of the different ethnicities, it is home to a large population of Western African immigrants. This case report is that of an elderly female of Western African descent presenting to Lincoln Hospitals Emergency Department with fevers and fatigue.The patients travel history to Togo, along with her symptoms, resulted in a differential diagnosis which included Ebola as well as Malaria. New York City''s Department of Health and Mental Hygiene was contacted for further clarification of presence of Ebola in Togo. The present case report is meant to educate about the presentation, hospital course, and differential diagnoses of a patient traveling from Western Africa with fever and chills.     

快速薄层色谱法用于诊断恶性疟的研究

为建立一种快速、简易而实用的恶性疟诊断方法,应用快速薄层色谱法检测恶性疟病人血样中的恶性疟原虫乳酸脱氢酶（Ｌａｃｔａｔｅ ｄｅｈｙｄｒｏｇｅｎａｓｅ ｏｆ Ｐｌａｓｍｏｄｉｕｍ ｆａｌｃｉｐａｒｕｍ,ＬＤＨ－Ｐ）,诊断恶性疟感染。结果显示,该方法的敏感性和特异性分别为９０％和９３．７％。应用快速薄层色谱法检测ＬＤＨ－Ｐ诊断恶性疟,方法快速、简便、敏感性高、特异性强,具有很好的临床和现场应用前景。     

Evaluation of the NOW Malaria Immunochromatographic Test for Quantitative Diagnosis of Falciparum and Vivax Malaria Parasite Density

The NOW® Malaria Test, an immunochromatographic test (ICT), was evaluated to determine its ability to quantitatively detect malaria parasites using 100 blood samples from Thailand, including 50 Plasmodium falciparum (Pf) infections and 50 P. vivax (Pv) infections. Intensities of the thickness of the visible bands of the positive ICT were compared with the parasite densities. In cases of Pf infection, the intensities of both HRP-2 bands (T1 bands: Pf specific bands) and aldolase bands (T2 bands: pan-Plasmodium bands) correlated with the parasite densities. The intensities of T2 bands in Pf positive samples showed better correlation with the parasite densities than the T1 bands. In the cases of Pv infection, the intensities of T2 bands were also well correlated with parasite density. These results suggest that the ICT is useful not only for rapid detection of malaria parasites but also for estimating parasite density.     

Falciparum Malaria Infection in a Case of Sickle Cell Trait; Unbalancing the Balanced Polymorphism

Suffers of Sickle cell trait are protected against plasmodium falciparum malaria because of the law of balanced polymorphism. We present a case of sickle cell trait infected with severe falciparum malaria unbalancing of balanced polymorphism.     

The Cell-Washing Centrifuge — a New Aid in Blood Group Serology

A cell-washing centrifuge for the antiglobulin test is tested in practical work. The washing effect is compared with that of manual washing. The different sources of error and deficient performance are described. The amount of red cells which can be washed is investigated. Controls for detecting failure in the washing procedure are suggested.     

Diabetes Mellitus — A Membrane Receptor Defect

Summary: It is proposed that diabetes mellitus, characterised by hyperglycaemia and either relative or absolute insulin deficiency, represents a spectrum of clinical disorders produced by one or more abnormalities at hormone or glucose receptor sites in the membrane of the pancreatic islet beta cell.
Separate receptors with finite binding affinity have been described for glucose, glucagon, gastrointestinal hormones and adrenaline. In diabetes mellitus glucose-receptor binding is always abnormal. In some diabetics, one or more of the hormone-receptor binding sites may be abnormal in addition. Sulphonylureas such as tolbutamide, act by either altering the properties of the hormone-receptor binding site or modifying the tertiary structure of the insulinogenic substance to provide tighter or more effective binding—they lubricate the lock.
Diabetes mellitus may represent a spectrum of disorders presenting with the same clinical features. The concept of selective receptor involvement may clarify the confusion surrounding the mode of inheritance of the disorder and pro-vide a rational basis for early diagnosis and effective management.     

美罗培南在90例老年血液病合并感染中的应用分析

目的评价美罗培南在治疗老年性血液病患者合并中重度感染时的临床疗效及安全性。方法回顾性分析90例老年血液病患者合并感染时应用美罗培南进行治疗,剂量为1givgttQ812h静脉滴注,疗程21d。根据国家食品药品监督管理局新药临床研究指导原则标准判定疗效。结果美罗培南治疗老年血液病合并感染的有效率为74.4%(67/90);在合并败血症7例中,6例有效。中性粒细胞绝对值0.5×109/L以下者,有效率为72.1%(49/68)。不良反应发生率为6.7%(6/90)。结论美罗培南治疗老年血液系统疾病合并感染疗效显著而且安全性高。     

Hemodilution — New Clothes for an Anemic Emperor

This review deals with the rationale for the use of hemodilution in patients not subjected to open heart surgery. The claim for an optimum of circulatory oxygen transport at 30% hematocrit has been disproved; hemodilution thus simply means acute normovolemic anemia. Accordingly, it generates a cardiovascular strain and particularly jeopardizes cerebral and myocardial oxygen supply. Potentially serious clinical side effects have been reported. Hemodilution should therefore not be carried beyong the lower normal range for the hemoglobin or hematocrit level, i.e. 12--12.5 g% or 35--36%.     

A Multi-stage asthma Screening Procedure for Elementary School Children †

This paper describes an asthma screening procedure developed to identify children with asthma for an intervention study. Students were classified into three categories based on questionnaire responses (previous asthma, suspected asthma, and no evidence of asthma). Those classified as suspected asthma by questionnaire underwent further testing, including spirometry and exercise challenge. Using the questionnaire alone, the measured asthma prevalence was 32%; the addition of spirometry and step testing reduced this estimate to 9.89%. The diagnosis of asthma was confirmed in 96% of children who saw the study physician. This screening procedure can identify school children with suspected undiagnosed asthma.     

A Screening Procedure for Oropharyngeal Dysphagia

The present study was designed to examine the sensitivity and specificity of a 28-item screening test in identifying patients who aspirate, have an oral stage disorder, a pharyngeal delay, or a pharyngeal stage disorder. The screening test includes 28 items divided into 5 categories: (1) 4 medical history variables; (2) 6 behavioral variables; (3) 2 gross motor variables; (4) 9 observations from oromotor testing; and (5) 7 observations during trial swallows. Results identified variables that were able to classify patients correctly as having or not having aspiration 71% of the time, an oral stage disorder 69% of the time, a pharyngeal delay 72% of the time, and a pharyngeal stage swallowing problem 70% of the time. Sensitivity and specificity for each of these judgments and all 28 items on the test are also provided. Results are discussed relative to statistical, clinical, and third-party perspectives on the goals of screening, data from other screening tests, and the role of screening versus diagnostic testing in care of dysphagic patients.