User:C. Do, Future UCSF Pharm.D./sandbox

Fibrocartilaginous mesenchymoma of bone

Suggested edits:


 * I would change the second sentence to reflect more up-to-date statistics on the disease. I found an article suggesting that more than 20 cases of fibrocartilaginous mesenchymoma have been recorded.
 * I would add more details about the disease state and its etiology to the first paragraph.
 * I would reformat the Notes & References sections to combine them.
 * Add "citation needed" in Treatment.
 * If possible, maybe add photos to illustrate the disease and contribute to the sentence regarding differential diagnosis.
 * Add some history regarding its discovery, since it is a relatively recent one.

How my changes might affect others editing the article:

Additional changes to the article might require future editors to make sure the sources I have added are reliable. It will require other editors to ensure that information is up to date and check on any new formatting.

Maternal and fetal outcomes/complications
In general, women with PAM have a higher likelihood of premature birth and low birthweight of their infant. In examination of possible malarial immunity, some studies have shown that the presence of P. falciparum antibodies (specifically CSA adhesion inhibitory antibodies or IgG antibodies) may decrease the likelihood of low birthweight in the infants of women who have had pregnancy-associated malaria, but these findings do not specifically correlate to malarial immunity during pregnancy. However, the relationship between many P. falciparum antibodies during pregnancy and maternal and birth outcomes remains variable.

Lower birthweight of infants born from mothers with PAM can be attributed to placental infection, as well as other complications such as anemia and malnutrition, since the malarial parasite can be passed vertically from mother to the infant via infected red blood cells. Children who are born with a below-average birthweight are at risk for other health problems, including increased risk of mortality.

Anemia is a great concern as an adverse effect of pregnancy-associated malaria, since it can be life-threatening to the mother. Its cause is often compounded with other factors, such as nutrition and genetics. Some studies have suggested that iron supplementation can help with maternal anemia, but more research on malaria-endemic regions is required to make a better recommendation for mothers with PAM.

One systematic review showed that children of women with PAM are also more likely to contract clinical malaria and P. falciparum parasitaemia, although the reasoning for this is uncertain.

Maternal death is one of the biggest complications of malaria in some areas during epidemics. Furthermore, its cause is compounded with other malarial complications, such as anemia.

Epidemiology
Due to the nature of disease transmission (i.e. via mosquitoes) and life cycle of the parasite, malaria is prevalent in warm, humid climates, such as tropical and subtropical regions. Consistent with previous years, the incidence of malaria in general is greatest in African regions, specifically sub-Saharan Africa, as defined by the World Health Organization (WHO), although there was a decline from 2010 to 2018. Particularly, in Central and West Africa, the amount of pregnancies with malarial infection reached around 35% of all pregnancies in those regions in 2018. The regions that follow Africa in terms of malaria cases are Southeast Asia and the Mediterranean, although it is important to note that Africa has the largest amount of cases by far; these regions comprise over 90% of the global incidences of malaria.

In the realm of pregnancy, individual immunity and level of transmission within the area play an important role in the malarial complications that manifest. For example, areas with high level of transmission are also associated with higher incidence of immunity. Therefore, infection from P. falciparum is usually associated with no symptoms in pregnant women. However, it is not to conclude that the presence of P. falciparum is completely benign, as it has been associated with maternal anemia. Specifically, in these settings, women in their first pregnancy are at greatest risk of complications that arise from P. falciparum. Similarly to P. falciparum, Plasmodium vivax (P. vivax), another malarial pathogen found primarily in Asia and South America, has also been associated with maternal anemia and low birthweight. On the contrary, women who live in areas with lower transmission are at a very high risk of adverse malarial outcomes despite their amount of pregnancies.

Research Directions
Although the vaccine was injected in healthy participants who did not have malaria, the study provided insight into the vaccine's safety before administration into the target population – women with PAM.