Small bowel morphology in British Indian and Afro Caribbean subjects: evidence of tropical enteropathy

Distal duodenal biopsy specimens taken from 30 white, 35 Indian, and 20 Afro-Caribbean residents of West Birmingham during routine endoscopy for dyspepsia, were assessed by disecting microscopy and morphometry. Finger-shaped villi were significantly less frequent in the Indian and Afro-Caribbean subjects than in the white subjects when assessed by disecting microscopy (p<0.005), and both immigrant groups had decreased mucosal thickness (p<0.01), villous height (p<0.001), villous:crypt ratios (p<0.01) and enterocyte height (p<0.05) compared with the white group. In the Indian subjects villous height and villous:crypt ratios correlated significantly with the time since the last visit to the Indian subcontinent (p<0.005). Serum alkaline phosphatase values were significantly higher in the Indian subjects compared with the white (p<0.02), and serum globulins were increased in both the Afro-Caribbean and Indian subjects (p<0.01). There were no correlations between morphometric indices and body habitus or biochemical or haematological indices and the long term effect of the morphological changes is not clear. (AU)

A controlled study of morbidity of Schistosomiasis mansoni in St. Lucian children, based on quantitative egg excretion

A study of the morbidity of schistosomiasis mansoni was made in 138 schoolchildren (age range, 7-16 years) in St. Lucia. The study was based on quantitative egg excretion data collected over a 4-year period before the study and included a comparable uninfected control group. All examinations were carried out "blind". Infected subjects were divided into three levels of intensity of infection: heavy, 400 or more eggs/ml of feces; moderate, 100 to 300 eggs/ml; and light, 10 to 75 eggs/ml. The children were hospitalized for medical histories and physical and laboratory examinations. Gastrointestinal symptoms were present at relatively high levels in all groups, and were more frequent in the Schistosoma mansoni-infected subjects than in the controls. Anthropometric measurements showed no differences between the groups. Hepatomegaly and splenomegaly were significantly more frequent in the heavy-moderate infection group, and extension of the liver below the coastal margin was found to increase with intensity of infection; serum albumin level was inversely related. It was clear that in this St. Lucian study, infection with S. mansoni did not result in disease in most of the school-age subjects investigated; assessment of possible long-term(>4 years) effects was not made. This study provides a method for assessing morbidity of schistosomiasis based on quantitative egg excretion and demonstrates the relation of objective morbidity to intensity of infection.(AU)

Immunological studies in Schistosoma mansoni infection in St. Lucia

An investigation was made of the immunological status of matched groups of patients with Schictosoma mansoni infection in St. Lucia, one group with hepatosplenic disease and the other with only intestinal disease. No impairment of humoral or cellular immunity was detected in either group. IgG and IgM levels were above normal range and were higher in the patients with intestinal disease, but only the difference between groups in IgG level was statistically significant. In their reaction to specific schistisome antigens and ability to develop delayed hypersensitivity, the groups were about equal. (AU)

Epidemic scabies and acute glomerulonephritis in Trinidad

In September, 1970, an increasing number of the patients admitted with acute glomerulonephritis to San Fernado General Hospital in Trinidad were noted to have skin lesions characteristic of scabies. á-haemolytic streptococci were isolated from these lesions and also from similar scabetic lesions in members of the patients' families, in " normal" schoolchildren, and in the general population of a small village. Concomitantly, many dogs in nephritic households, as well as others running wild, were observed to have lesions compatible with scabies from which á-haemolytic streptococci also were isolated. Sarcoptes scabiei were indentified in lesions of both patients and dogs and were morphologically indentical. After the onset of this infestation with scabies, the admission-rate of patients with acute proportions which have proved, since this study, to be the beginning of the largest epidemic of acute glomerulonephritis yet recorded in Trinidad.(AU)

Albumin metabolism: effect of the nutritional state and the dietary protein intake

Nine malnourished and nine children who had recovered from malnutrition were given a single injection of albumin-131I and were studied during consecutive periods in which the dietary protein was changed. Malnourished children had significantly lower catabolic rates of albumin than had recovered children on the same protein intake. Both nutritional groups, however, showed a progressive fall in catabolic rate after 3-5 days on a low protein diet (0.7-1.0g/kg per day), and the maximum effect was seen in the 2nd wk of low protein feeding. The catabolic rate could return to normal within 3wk in a malnourished child fed 4g of protein/kg per day. The albumin synthetic rate was measured by a computer technique suitable for nonsteady-state conditions. The synthyetic rate in the malnourished groups (101mg/kg per day) fed on a low protein diet was significantly lower than the rate in the recovered groups (148mg/kg per day). The synthetic rate responded rapidly to a change in diet; when the rate fell, the intavascular albumin mass was maintained by two compensating mechanisms: (1) a net transfer of extravascular albumin into the intravascular pool; and (2) by a delayed fall in the catabolic rate. The net transfer of albumin into the intravascular compartment diminished as the catabolic rate fell. Adaptation to a low protein diet was associated with: (a) low synthetic and catabolic rates of albumin; (b) a reduced extravascular albumin mass; and (c) a capacity for a rapid return to normal in the synthetic rate when the dietary protein was increased (AU)

Studies on protein metabolism in rats fed a tropical diet

This thesis is an account of investigations in which a special diet was fed to rats and the resulting effects on protein metabolism studied. The special diet closely resembled a type of diet consumed by poorer Jamaicans; similar diets are implicated in the protein malnutrition common in tropical areas. Rats fed this special diet were compared with others consuming adequate amounts of all the known essential nutrients. It was shown that the special diet was deficient in protein of good nutritional quality, and also in certain vitamins and minerals. The protein deficiency was chiefly responsible for the growth failure observed. The diet induced an increased susceptibility to Hypoglycin A, a toxic principle derived from the fruit of Blighia sapida. It appeared likely that this was a result of depressed gluconeogenesis. Liver and kidney, but not heart, were found to be depleted of protein. In liver, protein of varying sulphur content appeared equally affected. Serum albumin and globulin were both reduced, with no change in ratio. Respiration rates of tissue slices remained normal. The protein depletion in liver was accompanied by a parallel decrease in succinic dehydrogenase enzyme. Methionine containing radioactive sulphur was used to observe the rates of protein synthesis in tissue of animals fed the special diet. Experiments "in vitro" with liver slices gave inconclusive results, but experiments "in vivo" showed that synthesis of liver, serum and kidney protein was depressed, while that of heart protein was normal. Radioactive measurements on urine and on the non-protein fraction of serum supported the conclusion that protein synthesis was depressed in rats fed the special diet. It appeared that the major effect of the special diet was to decrease the rate of protein synthesis in the animals, the result being most apparent in tissues normally containing appreciable stores of labile protein (AU)

Serum proteins in lymphogranuloma venereum

Acute cases of L.G.V. showed a moderately raised serum globulin - mean 3.95gm. per 100 ml. (normal mean 3.37 gm. per 100 ml.). Chronic cases showed greatly raised serum globulin - mean 5.61 gm. per 100 ml. - with a depression of albumin - mean 2.95 gm. per 100 ml. (normal 3.86 gm. per 100 ml.) - and elevation of total protein - mean 8.05 gm. per 100 ml. (normal 7.24 gm. per 100 ml.) The relationship of antibody titre to serum globulin, and the effect of serum globulin on plasma volume are being investigated (AU)