The diagnostic value of lymph node biopsy to detect Castleman’s disease

HIV is not indicated in the aetiology of Castleman’s disease. However, it impacts on the prevalence and natural history of this disease and signi cantly on the disease progression. Castleman’s disease is a uni- or multicentric disease of the lymph node with or without polyclonal proliferation of B-cells. It is a morphologically distinct form of lymph node hyperplasia and is characterised by signi cant architectural changes in all lymphatic compartments. Histopathologically, the disease is classi ed into two major subtypes: the hyaline-vascular type and the plasma-cell type. A mixed type is also identi ed, as there are frequent transitions between the types. e diagnosis of Castleman’s disease needs to be made histologically. Treatment modalities include surgery, which is curative for unicentric disease, and systemic therapy, which is needed for multicentric disease. is case highlights the diagnostic value of lymph node excision biopsy in HIV-infected patients.http://www.sajhivmed.org.zaam201

Interplay between ultrastructural findings and atherothrombotic complications in type 2 diabetes mellitus

Accelerated atherosclerosis is the main underlying factor contributing to the high risk of atherothrombotic events in patients with diabetes mellitus and atherothrombotic complications are the main cause of mortality. Like with many bodily systems, pathology is observed when the normal processes are exaggerated or uncontrolled. This applies to the processes of coagulation and thrombosis as well. In diabetes, in fact, the balance between prothrombotic and fibrinolytic factors is impaired and thus the scale is tipped towards a prothrombotic and hypofibrinolytic milieu, which in association with the vascular changes accompanying plaque formation and ruptures, increases the prevalence of ischaemic events such as angina and myocardial infarction. Apart from traditional, modifiable risk factors for cardiovascular disease like hypertension, smoking, elevated cholesterol; rheological properties, endogenous fibrinolysis and impaired platelet activity are rapidly gaining significance in the pathogenesis of atherosclerosis especially in diabetic subjects. Blood clot formation represents the last step in the athero-thrombotic process, and the structure of the fibrin network has a role in determining predisposition to cardiovascular disease. It is no surprise that just like platelets and fibrin networks, erythrocytes have been shown to play a role in coagulation as well. This is in striking contrast to their traditional physiological role of oxygen transport. In fact, emerging evidence suggests that erythrocytes enhance functional coagulation properties and platelet aggregation. Among the spectrum of haematological abnormalities in diabetes, erythrocyte aggregation and decreased deformability of erythrocytes predominate. More importantly, they are implicated in the pathogenesis of microvascular complications of diabetes. The morphology of platelets, fibrin networks and erythrocytes are thus essential role players in unravelling the pathogenesis of cardiovascular complications in diabetic subjects.National Research Foundation of South Africa (UNIQUE GRANT NO: 92709) and the MRC: E Pretorius (fund number A0X331).http://www.cardiab.comhb201

Pathophysiological changes in erythrocytes contributing to complications of inflammation and coagulation in COVID-19

Higher thrombotic burden in the acute phase of COVID-19 relies on a complex interplay between pro-inflammatory cytokine/chemokine release, increased endothelial dysfunction/ damage, and potential sepsis-induced coagulopathy development in severe cases, all promoting coagulation activation. Plasma levels of cytokines and chemokines are known to be increased in COVID-19 however, are much higher in severe infections. Increased levels of IL1β, IL-6, and IL-8 are known to play an important role in both acute and chronic inflammation, resulting in pathological clotting. However, little has been published on the effects of these interleukins on red blood cells (RBCs). Evidence shows that cytokines have a negative effect on the RBCs ultrastructure and introduce signs of eryptosis. Eryptosis can be described as a form of suicidal death of RBCs characterized by distinct findings of cell shrinkage, membrane blebbing, activation of proteases, and phosphatidylserine exposure at the outer membrane leaflet. Red blood cells from COVID-19 patients had increased levels of glycolytic intermediates, accompanied by oxidation and fragmentation of ankyrin, spectrin beta, and the N-terminal cytosolic domain of band 3 (AE1). Significantly altered lipid metabolism was also observed, in particular, short- and medium-chain saturated fatty acids, acyl-carnitines, and sphingolipids. Emerging research suggests that RBCs may contribute to a precision medicine approach to sepsis and have diagnostic value in monitoring complement dysregulation in COVID-19-sepsis and non-COVID sepsis as research indicates that complement activation products and viral antigens are present on RBCs in patients with COVID-19.https://www.frontiersin.org/journals/physiologydm2022AnatomyPhysiolog

Incidental finding of hypertension and diminished femoral pulses : short-segment stenosis of the aorta just distal to the origin of the left subclavian artery

Coarctation of the aorta is a congenital condition generally, and may vary from mild to severe. Symptomatology depends on early or late presentation. Young patients may present within the first few weeks of life with poor feeding, tachypnea and lethargy. They usually progress to overt congestive heart failure and shock. Older children may present with a murmur or hypertension. Diagnosis is often made after hypertension is detected as an incidental finding during evaluation of other problems, such as trauma or more common illnesses. Coarctation of the aorta can be cured surgically.www.safpj.co.zaam201

A crazy cause of dyspnoea : pulmonary alveolar proteinosis

In March, 2013, a 37-year-old woman presented to the emergency department with a 6 month history of worsening dyspnoea, fatigue, insomnia, and generalised body pains. She had no cough or haemoptysis, was a non-smoker, and had no background medical or surgical history or occupational risk factors for pulmonary disease. Before her admission she had been treated by different general practitioners with multiple courses of empirical antibiotics and bronchodilators without resolution of her symptoms.http://www.thelancet.com/hb201

The differential diagnosis of HIV related anaemia should include pure red cell aplasia

Hematologic abnormalities feature commonly in patients with human immunodeficiency virus (HIV) infection. This includes anaemia and it occurs in 70 – 80% of patients. The causes of HIV-related anaemia are multifactorial. The possible mechanisms causing the anaemia are those which are directly related to HIV and include infection, malignancy, drugs, anaemia of chronic disease, haemolysis, blood loss and hypersplenism, whilst there are multiple causes not related to HIV. Features found in HIV-related anaemia can be ascribed to a disturbance of the bone marrow cytokine homeostasis. HIV is cytotoxic to T-helper lymphocytes which in turn retards growth of bone marrow progenitors. The most common abnormal finding is dysplasia affecting one or more cell lines. A predominant finding is erythroid dysplasia which is seen in over 50% of HIV patients. Hematologic complications related to combined antiretroviral therapy (cART) add to the diagnostic challenge. Pure red cell aplasia (PRCA) is an uncommon hematologic disorder that causes anaemia. However in patients that present with normochromic normocytic anaemia, in particular those that are transfusion dependent, pure red cell anaemia should be considered. In patients with AIDS, the mechanisms postulated for PCRA is the autoimmune response as a consequence of immunedysregulated status in AIDS and the second being the myelosuppressive effect of antiretroviral therapy.http://www.elsevier.com/locate/hivarhb2014ay201

Frequency of the malignant hyperthermia gene in the South African pig industry

Porcine stress syndrome (PSS) is a genetic disorder caused by a recessive mutation in the halothane (HAL) gene and results in sudden death of pigs when placed under stress during transport and pre-slaughtering conditions. Animals that are affected by this mutation tend to develop pale, soft and exudative (PSE) meat, which results in an economic loss. In South Africa, the frequency of the number of carriers (Nn) and recessive (nn) pigs has increased by 21% to 30% from 2000 to 2003. This study aims to determine the prevalence of the malignant hyperthermia (MH) gene in breeding boars at nucleus or seed-stock level, and the prevalence at commercial abattoirs across the South African pig industry. Results indicate a low number of carriers (Nn = 17) and recessive (nn = 1) pigs at seed-stock level. For commercial abattoirs, 96.4% of the pigs tested did not carry the mutation. The low incidence of the MH mutation from breeding stock should eliminate a contributory factor to PSE meat in South Africa. Transport over long distances to abattoirs may ultimately have an effect on pork obtained even from non-carriers of the MH mutation.http://www.sasas.co.zahb201

Comparison of several parameters of sports vision tests between male and female recruits in the armed services

Eye-hand coordination is a visuomotor based technique that helps the eye and the hands to function as a single unit. The study investigates sports vision performance differences between male and female recruits in the armed services.This paper was initially delivered at the Annual Congress of the Biological Sciences Division of the South African Academy for Science and Art, ARC-Plant Protection Research Institute, Roodeplaat, Pretoria, South Africa on 01 October 2010.http://www.satnt.ac.zaam201

Prevalence of SLCO1B1 single nucleotide variations and their association with hypercholesterolaemia in hypercholesterolemic patients in Gauteng, South Africa

Statins, the standard treatment for hypercholesterolaemia, among the most widely prescribed, have been associated with side effects, including statin intolerance. The aim of this study was to determine the background prevalence of SLCO1B1 SNVs in a randomly selected sample and to investigate if there are associations between SLCO1B1 SNVs and hypercholesterolaemia patients on statin therapy. Using Polymerase Chain Reaction - Restriction Fragment Length Polymorphism, the presence of SLCO1B1 SNVs (rs4149056, rs2306283 and rs4363657) was identified, while ELISA was used to quantify serum CK levels. Statin intolerance risk was calculated using a quantitative questionnaire. The risk of developing statin intolerance was found to be low (in 36%), moderate (in 49%), or high (in 15%) in the statin-treated group. The prevalence of the rs4149056 variant was 16% in (controls) and 20% in (statin) group; rs2306283 variant was present in 31.5% (controls), 10.5% in (statin) group; while the prevalence of the rs4363657 variant was similar in each. No association between the presence of any one of the SNVs and the statin intolerance severity risk score or CK elevation was found. These findings will facilitate a more personalized approach to statin therapy, especially relevant within the diverse South African population.http://www.tandfonline.com/loi/ixen202022-06-30hj2022AnatomyPharmacologyPhysiolog

Prevalence of SLCO1B1 single nucleotide variations and their association with hypercholesterolaemia in hypercholesterolaemic patients in Gauteng, South Africa

https://drive.google.com/file/d/1z6hCeD7RCJ4akygaRSqduqfw89NX2jpq/view?usp=sharinghttps://drive.google.com/drive/folders/1lrYEGe5l8Du7-yfRH0BKWZwNfP2K2WKA?usp=sharinghttps://drive.google.com/drive/folders/1smb3JfLp3169sPrQJ8rl36g1gHym5uYp?usp=sharin