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Biomedical subjects

H McFarlane

Publications and source records attributed to H McFarlane.

9 recordsLinked to original sources

Iron therapy and refeeding in experimentally malnourished rats.

1. Rats suffering from protein-energy malnutrition were found to have low serum iron, low PCV, and low hemoglobin concentrations. 2. Oral iron supplement during the refeeding of these animals caused various types of infection, the severity of which was related to the dose given. 3. A close association between high serum iron, low serum transferrin, and high incidence of bacterial infection was found. 4. A high protein diet without any oral iron supplement was found to raise the PCV and hemoglobin concentration to the same levels as a high protein diet containing 65 mg iron/kg body wt/day, although this dose of iron was sufficient to produce infection in the malnourished rats during refeeding. Speculation Iron supplementation during the treatment of children with protein-energy malnutrition may predispose to bacterial infection, the severity of which depends on the dose of iron given.

Animals

Detection, significance and treatment of paraprotein in patients presenting with 'idiopathic' proteinuria without myeloma.

This paper describes the detection of a paraprotein in blood or urine in 12 of 260 patients with 'idiopathic' proteinuria, most of whom presented with the nephrotic syndrome. None had myeloma at presentation and only two have developed it. Initial clinical and biochemical findings did not suggest paraprotein-associated disease, total serum globulins and individual immunoglobulin levels usually being in the normal range. In seven of the 12 cases the paraprotein was detected only after repeated analysis of serum and urine specimens over months or years. Renal histopathology varied from case to case and is described in detail; amyloid deposition did not occur in patients who excreted kappa chain Bence Jones protein and was extensive in only three. One of these eventually developed myeloma. Patients were aged 27--69 years at onset and were observed without specific therapy for up to 56 months. Glomerular filtration rate tended to decline and proteinuria persisted. All patients have now been treated by a chemotherapeutic regimen consisting of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide, melphalan, and prednisolone, in repeated short courses. In some patients, particularly those who had kappa Bence Jones protein, there was striking improvement. Overall survival is good, eight patients being alive 17--90 months after the onset of symptoms. The importance of repeated search for paraprotein in apparently idiopathic renal disease in adults is emphasized.

Adult

A study of enocrine function in protein-energy malnutrition.

Serum concentration of cortisol, growth hormone, thyroxine, thyroid stimulating hormone, follicle stimulating hormone and luteinising hormone, together with triiodothyronine uptake have been measured in Nigerian children with kwashiorkor and marasmus and compared with controls. In both types of malnutrition the cortisol and growth hormone concentrations are raised, whereas those of thyroxine and thyroid stimulating hormone are lowered compared with the controls. Triiodothyronine uptake is lowered in malnutrition but there is no apparent effect on follicle stimulating hormone or luteinising hormone in this age group.

Child, Preschool

Specific protein assays in protein-calorie malnutrition.

Assessment of serum protein concentrations in protein-calorie malnutrition was carried out by two specific immunochemical methods, the Single Radial Immunodiffusion technique and the Automated Immunonephelometric procedure. The correlation coefficient (r) between the two methods was above 0.85 for all the serum proteins assayed. The automated nephelometric assay procedure has the advantages that it is rapid and that a large number of samples can be readily processed. The system in its present form could not be readily used to quantitate proteins such as prealbumin whose serum concentration was less than 50 mg/100 ml. The single radial immunodiffusiton technique gave more consitent results for IgA estimation than the automated technique. With the exception of C4 and the immunoglobulins, all the serum proteins assayed were lower in children with protein-calorie malnutrition than in control children. During refeeding in children with protein-calorie malnutrition the first serum protein to show a significant rise was C3. This was followed by transferin, then prealbumin and lastly albumin. C4 did not show any significant change. In experimental protein-calorie malnutrition in rats, the first serum protein to show a significant reduction was C3. This was followed by transferrin and then albumin. On refeeding the rats these serum proteins returned to normal values in the same order.

Animals

T and B cells in myelomatosis.

The majority of treated patients with myelomatosis had a significantly decreased number of T cells as measured by both lymphocyte stimulation to phytohaemagglutinin (PHA) and by their ability to form spontaneous rosettes with sheep red blood cells (SRBC). Seven untreated patients also had markedly depressed T cells. On the other hand, B-cell numbers' were significantly increased in the majority of the patients as judged by increased lymphocyte stimulation to pokeweed mitogen (PWM) and the markedly increased numbers of rosettes that were formed with antibody-coated complement activated SRBC, as well as by immunofluorescence cell markers to monospecific immunoglobulin antiserum.

B-Lymphocytes

Acute phase proteins in children with protein-calorie malnutrition.

The serum concentrations of the acute phase proteins, C-reactive protein, caeruloplasmin and haptoglobin were significantly higher in children with protein-calorie malnutrition than in age-matched controls, while the concentrations of alpha1 antitrypsin, alpha2 macroglobulin, transferrin and complement component C3 were significantly lower. During rehabilitation and treatment with antibiotics, C-reactive protein disappeared from the serum in most of the patients whilst the levels of caeruloplasmin and haptoglobin returned to normal values. On the other hand the serum concentration of alpha1 antitrypsin, alpha2 macroglobulin, transferrin and C3 showed significant increases. It is suggested that C-reactive protein and haptoglobin may provide useful indices of the presence or absence of infection in children with malnutrition.

Blood Proteins