[PGE1-assisted treatment of microcirculation disturbance in complicated falciparum malaria]. / PGE1-unterstützte Behandlung einer Mikrozirkulationsstörung bei komplizierter Malaria tropica.

This article reports the course of a complicated malaria in a 41-year-old male patient. After spending several months in Mali, the patient decompensated shortly after onset of the first symptoms. Under the signs of a multi-organ failure and with an initial parasitic load of 25%, the patient developed a microcirculation disturbance in the acra. In addition to sepsis-induced disseminated microthrombosis, high-dose catecholamine treatment contributes to the genesis of this disease with a high clinical probability. To improve the peripheral blood circulation, intravenous treatment with the synthetic prostaglandin E1 (PGE1) alprostadil with 20 µg (1-0-1) was carried out over a period of 21 days. Relevant circulatory depression as a side effect did not occur. The microcirculatory disturbances were no longer evident and the necrosis healed. Furthermore, the clearance course of the plasmodia was delayed under artemisinin-based combination therapy. Prolonged hemolysis required multiple transfusions.

[Large multicystic space-occupying liver lesion in a 19-year-old woman]. / Große multizystische Leberraumforderung bei einer 19-jährigen Frau.

A 19-year-old woman presented with liver capsule pain and a liver lesion on sonography, which contained microvesicular cystic, necrotic and solid fibrotic formations typical for alveolar echinococcosis (AE). The diagnosis was confirmed by serology and histopathology. This parasitic infection which is endemic in Germany is feared because of its malignant growth. The increasing expansion of E. multilocularis in Europe will lead to a higher incidence of AE with an occurrence of cases outside classical endemic regions.

Household storage of medicines and self-medication practices in south-east Islamic Republic of Iran.

Self-medication and inappropriate storage of medicines at home are potential health risks. This crosssectional study in south-east Islamic Republic of Iran in 2010 aimed to determine where householders kept their medicines and to assess the frequency and determinants of self-medication. Householders from different parts of Birjand city (n = 500) were visited and completed a semi-structured questionnaire. Analgesics were the most common medicines stored at home, followed by adult cold remedies and antibiotics. The refrigerator was the most common place for storing medicines (50.6%). Most householders did not consult the package inserts. Many householders (53.6%) reported that they practised self-medication, and the frequency of reuse of physicianprescribed antibiotics was high. There was a significant association between self-medication and educational level but not with age, sex, martial status, occupation and type of insurance. Better public knowledge and information about storage and risks of reuse of prescription medications is needed.