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Biomedical subjects

G D Shanks

Publications and source records attributed to G D Shanks.

At least 55 records · Page 3Linked to original sources
PubMed1990

A comparative study of gastrointestinal infections in United States soldiers receiving doxycycline or mefloquine for malaria prophylaxis.

A double blind study of daily doxycycline (100 mg) vs. weekly mefloquine (250 mg) was performed on United States soldiers training in Thailand to assess the effect of doxycycline malaria prophylaxis on the incidence of gastrointestinal infections. During a 5 week period, 49% (58/119) of soldiers receiving doxycycline and 48% (64/134) of soldiers receiving mefloquine reported an episode of diarrhea. Infection with bacterial enteric pathogens was identified in 39% (47/119) of soldiers taking doxycycline and 46% (62/134) of soldiers taking mefloquine. Forty-four percent (59/134) of soldiers receiving mefloquine and 36% (43/119) of soldiers receiving doxycycline were infected with enterotoxigenic Escherichia coli (ETEC), while 9% (12/134) of soldiers receiving mefloquine and 4% of soldiers receiving doxycycline were infected with Campylobacter. Side effects from either medication were minimal. After 5 weeks in Thailand, the percent of non-ETEC strains resistant to greater than or equal to 2 antibiotics increased from 65% (77/119) to 86% (95/111) in soldiers on mefloquine and from 79% (84/106) to 93% (88/95) in soldiers on doxycycline. Doxycycline prophylaxis did not prevent or increase diarrheal disease in soldiers deployed to Thailand where ETEC and other bacterial pathogens are often resistant to tetracyclines.

Adolescent↗
PubMed1990

Malaria in displaced persons along the Thai-Burmese border.

Malaria epidemiology in displaced Karen ethnic children along the Thai-Burmese (Myanmar) border was observed for 3 years. An active screening process in connection with malaria chemoprophylaxis trials showed a decrease in malaria prevalence over time in children not receiving chemoprophylaxis. The number of malaria cases detected at a primary health care clinic in the same area remained stable.

Adolescent↗
PubMed1989

Malaria prophylaxis during military operations in Thailand.

Thai soldiers deployed along the Thai-Kampuchean border experience high attack rates of drug-resistant falciparum malaria. Adequate drug prophylaxis has proven difficult with the failure of chloroquine, pyrimethamine/sulfadoxine, and pyrimethamine/dapsone. Under some circumstances, mefloquine, doxycycline, and proguanil/sulfamethoxazole can successfully prevent falciparum malaria in Thailand. Decisions regarding chemoprophylaxis drugs in Thailand depend on a complex interaction of effectiveness, compliance, side effects, and long-term usefulness.

Animals↗
PubMed1987

Safety and efficacy of high-dose sodium stibogluconate therapy of American cutaneous leishmaniasis.

40 patients with American cutaneous leishmaniasis caused primarily by Leishmania braziliensis panamensis were treated with sodium stibogluconate in a double-blind, randomised controlled trial. Nine weeks after starting treatment, all 19 patients treated with 20 mg Sb/kg per day for twenty days were cured but 5 of 21 patients treated with 10 mg Sb/kg per day for twenty days had persistent active disease (p less than 0.05). Both treatment regimens were well tolerated and they were associated with a similar incidence of reversible toxic effects. Existing recommendations for therapy of American cutaneous leishmaniasis with sodium stibogluconate are inadequate for some patients, and higher doses are both safe and efficacious.

Adolescent↗
PubMedDate not supplied

Proguanil-sulphonamide for malaria prophylaxis.

There are few safe, effective chemoprophylactic regimens for preventing Plasmodium falciparum infection in south-east Asia. In two randomized placebo-controlled trials, combinations of proguanil and sulphonamide were tested for chemoprophylactic activity in schoolchildren, aged 6-15 years, living near the Thai-Burmese border. Proguanil at an equivalent adult dose of 200 mg/d was combined with sulphafurazole (= sulfisoxazole) at 25 mg/kg/d or sulphamethoxazole at 25 and 10 mg/kg/d. Combinations of daily proguanil/sulphafurazole and proguanil/sulphamethoxazole were equally effective (greater than 75%) against both falciparum and vivax malaria when the sulphonamide component was used at 25 mg/kg/d. Proguanil and sulphamethoxazole at 10 mg/kg/d was ineffective. Approximately 1% of the children had sulphonamide-related skin rashes which resolved when treatment stopped. Proguanil/sulphonamide is a possible alternative chemoprophylactic regimen in areas with multiple drug-resistant P. falciparum.

Adolescent↗
PubMedDate not supplied

Prognostic significance of rises in parasitaemia during treatment of falciparum malaria.

Transient rises in parasitaemia occur commonly during the treatment of falciparum malaria but their prognostic significance has not been well defined. Twelve-hourly parasite counts from 133 malaria patients who were ultimately cured were therefore compared with counts from 97 therapeutic failures to determine if increase in parasitaemia was a useful early indicator of poor treatment response. Parasitaemia in both groups frequently rose during the initial 12 h of therapy (41% of all patients), but rising counts thereafter were rarer in treatment successes (P < 0.01). The relative risk of treatment failure was 3.8 if the count was higher at 24 h than 12 h, rose to 7.8 for increases at 48-60 h, and was 13.7 and 19.4 for counts above admission levels at 48 h and 60 h. These data suggest a way to identify patients at high risk of treatment failure.

Antimalarials↗