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Biomedical subjects

K De Ceulaer

Publications and source records attributed to K De Ceulaer.

At least 19 recordsLinked to original sources

Lipid profile in eggs of Araucana hens compared with Lohmann Selected Leghorn and ISA Brown hens given diets with different fat sources.

1. In a cross-over trial, the egg cholesterol and fatty acid composition of Araucana hens was compared with those of two commercial breeds (Lohmann Selected Leghorn and ISA Brown) under two feeding regimes, either high (Hn-3) or low (Ln-3) in long-chain n-3 fatty acids. 2. The Hn-3 diet was formed by isocaloric substitution of animal fat in the control diet (Ln-3) by a dry product containing stabilised fish oil with standardised concentrations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). 3. Both breed and diet had influences on egg composition, without interactions. 4. The Araucana breed showed lower feed intake and lower egg weights than the other two breeds. The yolk weight was similar, leading to a much higher yolk:albumen ratio in the Araucana eggs. 5. In comparison to commercial breeds, Araucanas produced eggs with higher cholesterol content per g of yolk, which was even more pronounced when expressed per g of egg, due to the high yolk content of the eggs. The cholesterol content of an egg remained unchanged by the diet, irrespective of the dietary fat source. 6. Changing to the Hn-3 diet led to greater concentrations of polyunsaturated fatty acids (PUFA) and lower concentrations of monounsaturated fatty acids (MUFA) contents in the yolk, without a change in the ratio of saturated (SFA) to unsaturated fatty acids (UFA). 7. Within the PUFA, the n-3 fatty acids increased at the expense of the n-6 fatty acids, indicating a competition between n-3 and n-6 fatty acids for incorporation in the yolk.

Animal Feed↗

Osteoarticular disorders of haematological origin.

Clinical abnormalities of the musculoskeletal system may be the first manifestation of sickle haemoglobinopathies, leukaemias, lymphomas and haemophilia. In addition to this, known patients with these diseases exhibit a variety of osteoarticular features. The painful crisis is the most common manifestation of sickle cell disorders, but avascular necrosis, osteomyelitis and various forms of arthritides are also common. In haematological malignancies, bone pain and arthritis may occur at any stage of the disease. The diagnosis must be confirmed by the presence of malignant cells on histological examination of various samples. Haemarthrosis is the main symptom of haemophilia. It needs early treatment to avoid damage to the joints. The availability of new safe coagulation factors has improved the prognosis of haemophilia.

Adolescent↗

Abnormal plasma and serum viscosity in systemic lupus erythematosus (SLE): a Jamaican study.

Vascular complications occur frequently in SLE, and their development may be related to haemorheological derangements. However, the range of rheological abnormality in Jamaican SLE patients have not been studied. The present investigation was aimed at determining the changes in the three major blood proteins, namely fibrinogen, albumin and globulin, and their effect on plasma and serum viscosity in SLE patients during the course of treatment. The concentrations of fibrinogen and globulin were significantly increased (p<0.001), while albumin was decreased (p<0.05) in the SLE patients as compared with the control group. This increase in the fibrinogen and globulin contributed significantly to the rise of both serum and plasma viscosity. SLE patients with more severe disease had higher serum viscosity values, suggesting that serum viscosity values may provide an important marker for disease severity.

Adult↗

Antiphospholipid antibodies in homozygous sickle cell disease.

Serum samples from 108 unselected Jamaican patients with homozygous sickle cell disease and 116 control subjects with normal haemoglobin were screened for the presence of antiphospholipid antibodies. Slightly increased levels of IgG antiphospholipid antibodies were found in nine patients with sickle cell disease and in none of the control subjects. Serial control samples confirmed the increased levels of antiphospholipid antibodies. A comparison of the haematological and clinical features of patients with positive and negative antiphospholipid sickle cell disease did not highlight any differences between the groups.

Adolescent↗

The haematology of homozygous sickle cell disease after the age of 40 years.

Haematological indices have been studied in 181 patients with homozygous sickle cell (SS) disease aged 40-73 years. Cross-sectional analyses in 5-year age bands indicated age-related decreases in HbF (males only), total haemoglobin and platelet counts. Longitudinal studies within individuals confirmed the downward age-related trend in haemoglobin and platelets and also revealed a falling reticulocyte count, most significant when expressed as absolute values. Total nucleated cells also fell although the decline was significant only in females. These observations are consistent with a progressive bone marrow failure which is not explained by the commonly occurring renal impairment in older SS patients since the changes persisted in analyses confined to patients with normal creatinine levels. The mechanism of this bone marrow failure is currently unknown.

Adult↗

Peak expiratory flow rate and the acute chest syndrome in homozygous sickle cell disease.

The peak expiratory flow rate (PEFR) was studied in 20 matched pairs of children with homozygous sickle cell disease with either no episodes or six or more episodes of acute chest syndrome. The pairs were carefully matched for height and a highly significant reduction in PEFR was observed in children with multiple episodes of acute chest syndrome. Lateral and anteroposterior chest diameters and chest circumference correlated with PEFR but did not differ between index and control cases. The most likely cause of the reduced PEFR in children with multiple episodes of acute chest syndrome is an accumulating pulmonary fibrosis that decreases lung compliance.

Acute Disease↗

Mortality of Jamaican patients with systemic lupus erythematosus.

A retrospective study of all patients with systemic lupus erythematosus (SLE) who died at the University Hospital of the West Indies over a 14-year period is presented. The major cause of death was infection followed by renal failure. Gram-negative organisms were the major microbiological agents causing infections. Side-effects of therapy were common, in particular bone marrow depression and haemorrhage related to anticoagulants. It appears that controlling severe lupus activity without increasing the risk of lifethreatening complications remains an important goal in the treatment of SLE.

Acute Kidney Injury↗

Arthritis in childhood. A report on 65 consecutive cases observed at the University Hospital of the West Indies.

In a two-year period (October 1985 - September 1987), 65 children presented to the Child Health department and/or rheumatology clinic at the University Hospital with arthritis. Eighteen children (28%) had Juvenile Chronic Arthritis, ten (15%) rheumatic fever, eight (12%) systemic lupus erythematosus and thirteen (20%) had self-limiting arthritis. Systemic onset of Juvenile Chronic Arthritis occurred only in one child; nine children had polyarticular and eight pauci-articular onset of disease. The self-limiting arthritis was difficult to differentiate from Juvenile Chronic Arthritis; therefore serological testing for bacterial and viral infections should be performed before anti-rheumatic therapy is undertaken. Arthritis in childhood is not uncommon in Jamaica. However, the outcome appears to be generally favorable except in a few cases of Juvenile Chronic Arthritis.

Adolescent↗

Lack of relation between human T-lymphotropic virus type I infection and systemic lupus erythematosus in Jamaica, West Indies.

To determine whether systemic lupus erythematosus (SLE) is associated with human T-lymphotropic virus, type I (HTLV-I) infection in Jamaica, an endemic area for the virus, we studied 63 patients with SLE at the University Hospital of the West Indies in Kingston. Antibodies to HTLV-I were measured by an enzyme-linked immunosorbent assay (ELISA) technique using purified disrupted whole virus as antigen, with confirmation by p24 protein RIA or competitive binding. Four of 63 SLE patients were HTLV-I seropositive (6.3%). There was no evidence for excess HTLV-I infection in SLE patients when their age- and sex-standardized HTLV-I seroprevalence rate was compared to that of a large group of healthy food service employees. None of 13 patients with rheumatoid arthritis were seropositive for HTLV-I. We conclude that HTLV-I infection does not appear to be linked with SLE in Jamaica.

Adolescent↗

Complement and immunoglobulin levels in early childhood in homozygous sickle cell disease.

Complement levels, tests of complement function, and immunoglobulin levels were studied in 63 children with homozygous sickle cell (SS) disease and in 88 children with a normal haemoglobin (AA) genotype from birth to 2 yr of age. Levels of complement component C3 were consistently lower in SS children, the difference being highly significant (p less than 0.001) by the age of 2 yr and levels of C3d were significantly higher from the age of 6 months. These observations are compatible with increased turnover of C3 in SS disease from early in life. No consistent genotype differences were observed in the levels of C4, factor B, or functional assays. IgA levels in SS disease were significantly higher at age 2 yr but there were no consistent patterns with IgM or IgG. There was no difference in the prevalence of infections between groups with low C3 or low values of alternative pathway activity but the groups were small and only capable of detecting major differences. However, the findings cast some doubt on the role of individual complement deficiencies in the susceptibility to infection in SS children at this age.

Anemia, Sickle Cell↗

Recurrent infections in sickle cell disease: haematological and immune studies.

Some haematological and immunological indices were compared in 19 children with sickle cell disease and a history of recurrent infections and in 16 children with sickle cell disease without any known infections. The recurrent infection group had significantly greater pitted red cell counts and greater absolute monocyte counts. No differences were apparent in routine haematological indices, foetal haemoglobin, immunoglobulin, or complement levels between the groups. The interpretation of these results is discussed.

Anemia, Sickle Cell↗

Pneumonia in young children with homozygous sickle cell disease: risk and clinical features.

The incidence and clinical features of pneumonia have been examined in children with homozygous sickle cell (SS) disease and in age/sex matched control children with a normal haemoglobin (AA) genotype followed in a cohort study of sickle cell disease from birth. Survival curve analysis indicated a similar incidence of pneumonia in the two genotypes up to the ages of 8 months after which pneumonia became significantly more prevalent in SS disease, the relative risk exceeding a factor of four by 4 years of age. Children with SS disease were also more prone to multiple episodes. Comparison of clinical features in the two genotypes yielded no difference in sex or seasonal involvement, or in the results of bacteriological and radiological investigations. Children with SS disease and pneumonia had an increased frequency and increased duration of hospital admission, and mortality was confined to this group. It is concluded that children with SS disease have an increased prevalence of single and multiple attacks of pneumonia and that these events run a more serious clinical course than in control children.

Anemia, Sickle Cell↗

Glomerular function and hyperuricaemia in sickle cell disease.

Renal insufficiency is common in adults with homozygous sickle cell disease, and the contribution of glomerular failure to the hyperuricaemia which is often a feature of the disease has therefore been investigated. In a study of 64 patients between the ages of 15 and 66, serum urate concentration was dependent on renal urate clearance and also on creatinine clearance. The relation between serum urate and creatinine clearance was abnormal in patients with sickle cell disease and it is suggested that this might be caused by high single nephron glomerular filtration rates. Both the amount of urate excreted per millilitre of glomerular filtrate and the fractional excretion of urate increased with falling creatinine clearance, suggesting that the ability to increase tubular urate secretion was preserved. Patients with extensive tubular disease as shown by tubular proteinuria had serum urate concentrations which were not significantly different from those of age and sex matched non-proteinuric patients. Evidence that renal tubular disease interferes with urate secretion and causes hyperuricaemia in patients with sickle cell disease needs to be reinterpreted in the light of these findings.

Adolescent↗

Mononuclear cells in sickle cell disease: subpopulations and in vitro response to mitogens.

The subpopulations of mononuclear cells and the lymphocyte proliferative capacity following mitogen stimulation were studied in 22 patients with homozygous sickle cell (SS) disease and 25 controls with a normal haemoglobin (AA) genotype. The total number of lymphocytes in peripheral blood samples was higher in SS patients compared to controls. Expressed as a percentage of total lymphocytes, the number of B lymphocytes (detected by membrane immunoglobulin fluorescence) was normal and of T lymphocytes (identified by sheep erythrocyte rosetting) was slightly reduced in SS disease. Expressed in absolute numbers, both B and T lymphocytes were increased. Lymphocyte proliferation measured by tritium labelled thymidine incorporation following stimulation with phytohemagglutinin A, and concanavalin A was normal. Following pokeweed mitogen stimulation, thymidine incorporation was significantly increased in SS disease although normal when expressed as a stimulation index. These results do not suggest a major defect in cell mediated immunity in sickle cell disease. The number of circulating monocytes was increased in SS disease and correlated inversely with the number of reticulocytes (r = -0.58, p less than 0.005).

Adolescent↗

Serum immunoglobulin levels in children with homozygous sickle cell disease.

Serum immunoglobulin levels (IgA, IgG, and IgM) have been assayed in a representative sample of children (aged 1-7 years) with homozygous sickle cell disease and in the age/sex-matched control children with a normal haemoglobin genotype, followed from birth in a prospective cohort study. In SS disease, significant elevation of IgA occurred from the age of two years and of IgG from the age of six years. IgM levels were not significantly different in the two genotypes. The mechanisms contributing to these changes in immunoglobulins are currently unclear as is their clinical significance.

Aging↗

Medroxyprogesterone acetate and homozygous sickle-cell disease.

The haematological and clinical effects of medroxyprogesterone acetate in homozygous sickle-cell (SS) disease were assessed in a 2-year controlled crossover trial completed by 23 patients. Haematological indices remained steady during the placebo phase, but during the medroxyprogesterone-acetate phase fetal haemoglobin, total haemoglobin, red-cell mass, and red-cell survival rose significantly, and reticulocytes, irreversibly-sickled-cell counts, and total bilirubin fell significantly. Painful crises were significantly less frequent during the medroxyprogesterone-acetate than the placebo phase. These results are compatible with an inhibition of in-vivo sickling in patients with SS disease during medroxyprogesterone-acetate treatment. The mechanisms of such an effect require further study.

Adult↗

Serum urate concentrations in homozygous sickle cell disease.

Serum and urinary urate concentrations were studied in 44 patients with homozygous sickle cell (SS) disease, and in 27 controls with normal haemoglobin. Hyperuricaemia (>0.39 mmol/l (6.5 mg/100 ml)) occurred in 41% of SS patients and inversely correlated with renal urate clearance but not with indices of bone marrow turnover. Higher serum urate concentrations occurred in patients with proteinuria, probably due to associated tubular damage. Higher serum urate concentrations and lower urate clearance occurred in males compared to females.

Adolescent↗