40 research outputs found
Clues to hepatic histoplasmosis in an immunocompromised patient
Disseminated histoplasmosis can be the initial clue to the presence of AIDS. In HIV infected patients, histoplasmosis can present with unusual manifestations, without a positive exposure history or outside the typical endemic area. Untreated histoplasmosis can be potentially life-threatening and clues to diagnose it effectively and efficiently are essential
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
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
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
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