Mathematical model describing erythrocyte sedimentation rate. Implications for blood viscosity changes in traumatic shock and crush syndrome

BACKGROUND: The erythrocyte sedimentation rate (ESR) is a simple and inexpensive laboratory test, which is widespread in clinical practice, for assessing the inflammatory or acute response. This work addresses the theoretical and experimental investigation of sedimentation a single and multiple particles in homogeneous and heterogeneous (multiphase) medium, as it relates to their internal structure (aggregation of solid or deformed particles). METHODS: The equation system has been solved numerically. To choose finite analogs of derivatives we used the schemes of directional differences. RESULTS: (1) Our model takes into account the influence of the vessel wall on group aggregation of particles in tubes as well as the effects of rotation of particles, the constraint coefficient, and viscosity of a mixture as a function of the volume fraction. (2) This model can describe ESR as a function of the velocity of adhesion of erythrocytes; (3) Determination of the ESR is best conducted at certain time intervals, i.e. in a series of periods not exceeding 5 minutes each; (4) Differential diagnosis of various diseases by means of ESR should be performed using the aforementioned timed measurement of ESR; (5) An increase in blood viscosity during trauma results from an increase in rouleaux formation and the time-course method of ESR will be useful in patients with trauma, in particular, with traumatic shock and crush syndrome. CONCLUSION: The mathematical model created in this study used the most fundamental differential equations that have ever been derived to estimate ESR. It may further our understanding of its complex mechanism

Survival in primary a plastic anaemia; experience with 20 cases from a tertiary hospital in Nigeria

Background: Aplastic anaemia is a condition characterized by pancytopenia and unexplained bone marrow hypocellularity. Without treatment, it is invariably fatal. However with the currently available treatment options, patient survival is improving in the developed countries. Methods: The study is a retrospective study. We reviewed the cases of primary aplastic anaemia managed in our hospital over a period of fifteen years. Results: A total of twenty five cases were seen; out of which twenty had complete analyzable data. Management consisted of transfusion support with packed red cells, platelet concentrates and freshly collected unbanked blood; immunosuppressive therapy was with methyl prednisolone. None of the patients had the benefit of bone marrow/stem cell transplantation. Overall median survival was 6.5 weeks. Conclusions: There is a clear need to ensure the availability of proven therapeutic options for patients such as bone marrow/stem cell transplantation and drugs such as cyclosporine and antithymocyte globulin to improve on the present situation

Juvenile myelodysplastic syndrome in a Nigerian child-a case report and review of literature

No Abstract. Highland Medical Research Journal Vol. 3(2) 2005: 149-15

Leishmaniasis presenting as severe anaemia in an adult female Nigerian

Visceral leishmaniasis is a rare cause of anaemia. We report a case of visceral leishmaniasis presenting as severe anaemia and pyrexia of unknown origin in an adult female Nigerian. The objective was to highlight the importance of exhaustive investigations in the diagnosis of anaemia and pyrexia of unknown origin in our environment. Keywords: visceral leishmaniasis, chronic anaemia, pyrexia of unknown origin, NigeriaAfrican Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 253-25

Haematological and clinical profile in Nigerian sickle cell disease patients with and without chronic kidney disease

Background: Sickle cell disease (SCD) has adverse effects on the kidneys which impact on clinical outcome.Objectives: To study and compare some clinical and haematological profiles in SCD patients, with and without chronic kidney disease (CKD).Methods: Prospectively, 92 SCD patients were investigated and stratified into those with CKD (creatinine clearance ≤60ml/min) and those without (creatinine clearance≥60ml/min). Socio-demographic data, clinical and haematological parameters were documented and compared in the two groups as well as with gender stratification, using the student’s t-test.Results: The crises frequency and transfusion history (in males) together with the corrected reticulocyte count (in females) were significantly different in SCD patients with CKD, compared to those without (p values<0.05).Conclusion: Kidney disease significantly influences some clinical and haematological parameters in patients with SCD, which could impact on survival.Keywords: Corrected reticulocyte count, transfusion history, vaso-occlusive crise

Haemorheology in Gaucher disease

In Gaucher disease, a deficiency of glucocerebrosidase results in the accumulation of glucocerebroside within the lysosomes of the monocyte–macrophage system. Prior to the availability of enzyme replacement therapy (ERT), splenectomy was often indicated for hypersplenism. Haemorheological abnormalities could be expected in view of the anaemia and abnormal lipid metabolism in these patients and the role of the spleen in controlling erythrocyte quality. Objectives: To investigate the effect of Gaucher disease on blood and plasma viscosity, erythrocyte aggregation and erythrocyte deformability, and to determine whether observed rheological differences could be attributed to splenectomy. Methods: Haematological and haemorheological measurements were made on blood collected from 26 spleen-intact patients with Gaucher disease, 16 splenectomised patients with Gaucher disease, 6 otherwise healthy asplenic non-Gaucher disease subjects and 15 healthy controls. Results: No haemorheological differences could be demonstrated between spleen-intact patients with Gaucher disease and the control group. Compared to controls, both asplenic Gaucher disease and asplenic non-Gaucher disease study groups had a reduced MCHC (P = 0.003 and 0.005, respectively) and increased whole blood viscosity at 45% haematocrit (Hct), relative viscosity and red cell aggregation index – all measured at low shear (P < 0.05 for all). Additionally, asplenic patients with Gaucher disease alone showed an increased MCV (P = 0.006), an increased whole blood viscosity at 45% Hct measured at high shear (P = 0.019), and a reduced relative filtration rate (P = 0.0001), compared to controls. Conclusion: These observations demonstrate a direct and measurable haemorheological abnormality in Gaucher disease only revealed when there is no functioning spleen to control erythrocyte quality