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Search Results: 1 - 10 of 213546 matches for " Sumadhya D Fernando "
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The 'hidden' burden of malaria: cognitive impairment following infection
Sumadhya D Fernando, Chaturaka Rodrigo, Senaka Rajapakse
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-366
Abstract: PUBMED and SCOPUS were searched for all articles with the key word 'Malaria' in the title field and 'cognitive impairment' in any field. Google Scholar was searched for the same keywords anywhere in the article. The search was restricted to articles published in English within the last 15 years (1995-2010). After filtering of abstracts from the initial search, 44 papers had research evidence on this topic.Cognitive abilities and school performance were shown to be impaired in sub-groups of patients (with either cerebral malaria or uncomplicated malaria) when compared with healthy controls. Studies comparing cognitive functions before and after treatment for acute malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups. The implications of these findings are discussed.Mortality and morbidity due to malaria is still substantial in many tropical countries. In 2006, 247 million cases of malaria were estimated, resulting in 881,000 deaths [1]. Of the 109 endemic countries, 30 countries in sub-Saharan Africa and five in Asia accounted for 98% of malaria deaths globally [2]. The financial cost to tackle malaria is staggering. The global estimate of direct losses due to malaria (i.e., the personal and public expenditures to prevent and treat the disease) is USD 12 billion annually. Approximately 35.4 million disability adjusted life years (DALYs) are lost in sub-Saharan Africa alone due to the mortality and morbidity of malaria [2]. The estimates of expenditure to tackle malaria globally in 2009 and 2010 are USD 5.335 billion and 6.180 billion, respectively, and include direct costs for diagnosis, treatment and prevention [2].There exists an important hidden burden of malaria, namely, that of cognitive impairment and effects on school performance resulting from malaria infectio
Genetic polymorphisms associated with anti-malarial antibody levels in a low and unstable malaria transmission area in southern Sri Lanka
Dewasurendra Rajika L,Suriyaphol Prapat,Fernando Sumadhya D,Carter Richard
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-281
Abstract: Background The incidence of malaria in Sri Lanka has significantly declined in recent years. Similar trends were seen in Kataragama, a known malaria endemic location within the southern province of the country, over the past five years. This is a descriptive study of anti-malarial antibody levels and selected host genetic mutations in residents of Kataragama, under low malaria transmission conditions. Methods Sera were collected from 1,011 individuals residing in Kataragama and anti-malarial antibodies and total IgE levels were measured by a standardized ELISA technique. Host DNA was extracted and used for genotyping of selected SNPs in known genes associated with malaria. The antibody levels were analysed in relation to the past history of malaria (during past 10 years), age, sex, the location of residence within Kataragama and selected host genetic markers. Results A significant increase in antibodies against Plasmodium falciparum antigens AMA1, MSP2, NANP and Plasmodium vivax antigen MSP1 in individuals with past history of malaria were observed when compared to those who did not. A marked increase of anti-MSP1(Pf) and anti-AMA1(Pv) was also evident in individuals between 45–59 years (when compared to other age groups). Allele frequencies for two SNPs in genes that code for IL-13 and TRIM-5 were found to be significantly different between those who have experienced one or more malaria attacks within past 10 years and those who did not. When antibody levels were classified into a low-high binary trait, significant associations were found with four SNPs for anti-AMA1(Pf); two SNPs for anti-MSP1(Pf); eight SNPs for anti-NANP(Pf); three SNPs for anti-AMA1(Pv); seven SNPs for anti-MSP1(Pv); and nine SNPs for total IgE. Eleven of these SNPs with significant associations with anti-malarial antibody levels were found to be non–synonymous. Conclusions Evidence is suggestive of an age–acquired immunity in this study population in spite of low malaria transmission levels. Several SNPs were in linkage disequilibrium and had a significant association with elevated antibody levels, suggesting that these host genetic mutations might have an individual or collective effect on inducing or/and maintaining high anti–malarial antibody levels.
Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis
Sumadhya Deepika Fernando,Chaturaka Rodrigo,Senaka Rajapakse
Journal of Tropical Medicine , 2011, DOI: 10.1155/2011/175941
Abstract: Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC) remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA) are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level. 1. Introduction There are nine filarial nematodes causing disease in humans. According to the location of the parasite and the pathogenesis, the disease can be classified as lymphatic, subcutaneous, and serous cavity filariasis. Two filarial worms, namely, Wuchereria bancrofti and Brugia malayi cause lymphatic filariasis. The World Health Organization (WHO) considers lymphatic filariasis to be a global health problem affecting approximately 120 million people in over 80 countries [1]. One-third of affected individuals are from South Asia and another one third is from Africa [1]. One sixth of the world population is at risk of infection [1]. The adult W. bancrofti worms live within the human lymphatic system. They have a long life span of 4–6 years. Females are viviparous and release thousands of microfilaria into the blood stream of the host after mating. These are taken up by vector mosquitoes during feeding, and the parasite undergoes several moults within the intermediate host to become the L3 larva which is the infective stage. During a feed, this larva enters the human blood stream and migrates to the lymphatics where it moults to become an adult worm [2]. There is a range of clinical manifestations in bancroftian filariasis with asymptomatic microfilaremics being at one end of the spectrum. Symptomatic patients may have acute (lymphangitis, lymphadenitis), chronic (elephantiasis, lymphoedema, hydrocoele, chyluria), or atypical (funiculitis, mastitis) manifestations [3]. Some may suffer from tropical pulmonary eosinophilia (TPE) due to the immunological hyperresponsiveness to the parasite [4].
Toxoplasma, Toxocara and Tuberculosis co-infection in a four year old child
Randeewari Guneratne, Devan Mendis, Tharaka Bandara, Sumadhya Fernando
BMC Pediatrics , 2011, DOI: 10.1186/1471-2431-11-44
Abstract: This case report describes a co-infection of Toxoplasma gondii, Toxocara spp and tuberculosis in a child with chronic lymphadenopathy and eosinophilia.The case report highlights two important points. First is the diagnostic challenges that are encountered by clinicians in tropical countries such as Sri Lanka, where lymphadenopathy and eosinophilia with a positive serology commonly point towards a parasitic infection. Secondly the importance of proper history taking and performing the Mantoux test as a first line investigation in a country where the incidence of tuberculosis is low, even in the absence of a positive contact history.Tuberculosis. toxocariasis and toxoplasmosis are among the common infectious causes of lymphadenitis in children [1]. Approximately 250,000 children worldwide develop tuberculosis, a larger proportion being reported from the South East Asian region [2,3]. Extra-pulmonary tuberculosis is more common in children, the most common form being lymphatic disease accounting for about two thirds of the cases of extra-pulmonary tuberculosis [4-6].Toxoplasma gondii and Toxocara spp. infections are cosmopolitan zoonotic diseases which may cause systemic and ocular diseases in humans [7-9]. Few publications exist regarding Toxoplasma and Toxocara co-infection [10,11].This case report describes a child with chronic lymphadenopathy and eosinophilia who was seropositive for both Toxoplasma gondii and Toxocara spp, together with a positive Mantoux test and lymph node histology suggesting tuberculosis.A 4 year-old, previously healthy boy was admitted to the surgical unit of the Colombo South Teaching Hospital, Sri Lanka with an abscess in the left big toe. No fever or local lymphadenopathy was present at initial presentation. The abscess was drained, treated with antibiotics and the child was discharged. Two weeks later the child was re-admitted with an infection at the site of original abscess and left sided inguinal lymphadenopathy. Full blood count (FBC)
Institutions and Intellectuals That Configure the Concept of the Environment and Development in Latin America and Its Global Impact  [PDF]
Fernando Estenssoro, Eduardo Déves
Journal of Environmental Protection (JEP) , 2013, DOI: 10.4236/jep.2013.49116

This paper is part of a research into the Latin American thinking on international affairs and a continuation of a line of work on Latin American contributions to the environmental discussion installed in the global political agenda in the early 70s. The premise was that Latin American contributions were initially made by professionals closely related to ECLAC, UNEP and the Bariloche Foundation. These professionals and agencies understood how poverty and backwardness were endured by the majority of the regional and world’s population was one of the main causes of environmental degradation; consequently, overcoming the environmental crisis meant that underdevelopment should be eradicated without delay. This view of the environmental problems was synthesized in the combined concept of environment and development, which was also understood in the region as “eco development”. Finally, the broad phenomenon they wanted to describe using the terms “environment and development” was summarized in the concept of sustainable development as defined in the 1987 World Commission on Environment and Development report “Our Common Future”.

The coming-of-age of the hygiene hypothesis
Fernando D Martinez
Respiratory Research , 2001, DOI: 10.1186/rr48
Abstract: There is now convincing evidence indicating that the prevalence of allergic diseases in general, and of asthma in particular, is on the rise in high income societies [1]. Many hypotheses have been proposed to explain these increases, but the most widely discussed and the most controversial is the so-called 'hygiene hypothesis' [2,3]. This hypothesis was first enunciated in quite straightforward terms: the Western lifestyle has succeeded in markedly decreasing the incidence of infections in early life, and these infections may have a protective effect on the subsequent development of allergies.Initially, the hypothesis was mainly based on epidemiologic evidence of an inverse relation between indirect markers of increased infectious burden and prevalence of allergic diseases and allergic sensitization (reviewed in [4]). Concomitant studies on the development of the immune system in early life seemed to provide a biological basis for the hypothesis' main postulate. It has been reported that mononuclear cells obtained from cord blood showed markedly decreased cytokine responses to nonspecific stimuli [5]. This included both responses that characterize the T-helper (Th) 1 type (ie IFN-γ) and the Th2 type (ie IL-4). When studied both in cord blood and during the first year of life [6,7], however, Th1-like responses were particularly decreased among children with a family history of allergies and among those who would subsequently become sensitized to aeroallergens. Since IFN-γ is known to downregulate Th2-type responses, and these responses are essential for IgE synthesis by B cells, it was suggested that the development of IFN-γ responses could be stimulated by exposure to infectious agents postnatally [3,8], and that this could be the mechanism by which these infections protected against the development of allergic diseases.Presented in this fashion, the 'hygiene hypothesis' was tested in relation to several infectious diseases. The results were contradictory: whereas m
A psicanálise como linguagem social: o caso argentino
Duarte, Luiz Fernando D.;
Mana , 2002, DOI: 10.1590/S0104-93132002000200007
Abstract: the recent book by mariano plotkin about the "psychoanalytical culture" in argentina brings forth ample discussions about the role of psychoanalysis in the dynamics of different national societies within the scope of modern western culture. the comparison between argentina and brazil is particularly rich, as also in the latter a significant diffusion of psychoanalysis took place during an homologous period. plotkin presents a very complex and minute analysis of the phenomena in focus. his analysis reveals the main constitutive tensions of argentine history during the xxth century, approaching the relationships with psychiatry, medicine, psychology, as well as with "peronism" and lef-wing militancy. i emphasize the importance of his demonstration that "psychoanalytical culture" has become a "social language" in argentine society, as well as the importance of his description of the diffusion of psychoanalysis by mass communication (which led to a wider social range of reception than in brazil). i also emphasize the analytical relevance of his demonstration of the association between this diffusion and a generalized "scientism" of argentine society, which is connected to the particular characteristics of that country's cultural "modernization".
Contracepción de emergencia con Levonorgestrel
Saraví,Fernando D.;
Medicina (Buenos Aires) , 2007,
Abstract: emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. its efficacy is moderate, preventing about 80% of pregnancies. efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. tolerance is similar to, or better than, those of other oral emergency contraceptives. adverse effects include nausea, vomiting, headache, breast tenderness and transient alteration of menstrual bleeding pattern. it is not known whether levonogestrel increases the risk of ectopic pregnancy when the treatment fails. its use as an ongoing contraceptive method is discouraged. when given before the preovulatory lh peak, levonorgestrel blocks or delays ovulation. it may also affect sperm migration in the female reproductive tract and have an effect on fertilization. although it has been often postulated, there is no evidence for an anti-implantatory effect. acquaintance with the method is quite variable among different societies, but it remains underutilized even where it is well known. advance provision of the drug has been proposed as a way to promote its use. in clinical trials, advance provision did not adversely modify sexual or regular contraceptive behavior, but it did not reduce pregnancy or abortion rate either. therefore, emergency contraception with levonorgestrel should be regarded as a backup method which is not a substitute for the continued use of more effective contraceptive methods.
Uma vis?o crítica do uso de padr?es de exposi??o na vigilancia da saúde no trabalho
Vasconcelos, Fernando D.;
Cadernos de Saúde Pública , 1995, DOI: 10.1590/S0102-311X1995000400007
Abstract: the reductionist application of the concepts of cause and standard in occupational medicine is studied by examining human exposure limits for chemical agents in industry. the author discusses several scientifc and technical shortcomings in such exposure standards, including those used in brazil, and analyzes their use as a way to classify as normal some risk factors in the workplace.
Morte encefálica, cuidados ao doador de órg?os e transplante de pulm?o
D'Império, Fernando;
Revista Brasileira de Terapia Intensiva , 2007, DOI: 10.1590/S0103-507X2007000100010
Abstract: background and objectives: organ transplantation is now an accepted option for end stage organ disease in well selected patients. this position is a result of great advances in the field of immunology, critical care medicine and pharmacology. however, organ transplantation is now suffering from its own success as the number of patients in waiting lists is dramatically increasing the same is not happening with organ availability results in increasing number of mortalities while waiting for transplantation. transplant community responses to this situation consist of reviewing the criteria for organ acceptability and developing new strategies to get organs as the called non-heart beating organ donors. contents: however the physiopathology of brain death and its consequences are now better understood helping in such patients' management. the purpose of this review is to help to identify the most important clinical and therapeutic aspects related to its physiopathology as depletion of vasoactives substances and its importance in the management of cardio and respiratory systems. we also discuss endocrine and hidroelectrolytes disturbances. organ specific data are also focused in order to offer a whole view of donor management. conclusions: it is important to observe that new technologies will be available in the near future to diminish the low rate between organ availability and organ waiting patients. in conclusion, with the raising numbers in transplant waiting lists and scarce resources of organs make us believe that we have to improve the management of multi organ donors and the preservation technology in order to reduce the mortality in such waiting lists.
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