Ethnopharmacology and biological activities of the Aizoaceae.

ETHNOPHARMACOLOGICAL RELEVANCE: The Aizoaceae is one of the largest succulent plant families. Most members of the family are ornamental and form part of specialist succulent collections. The exceptional diversity of the Aizoaceae is not only limited to its growth forms, habitat, and chemistry, but is also reflected in its many traditional uses. Selected species are well known for their use in traditional medicines, with recent scientific studies validating their biological activity. AIM OF THE STUDY: Herein, this review aimed to articulate foundational and current global research endeavors related to the traditional uses and pharmacological activities of the Aizoaceae. MATERIALS AND METHODS: Research articles and search terms related to the ethnopharmacology and bioactivities of the Aizoaceae between 1940 and 2022 were evaluated using electronic databases such as Google Scholar, PubMed, ScienceDirect, Scopus, JSTOR, and Web of Science. RESULTS: Popular Aizoaceae genera including Mesembryanthemum, Trianthema, and Tetragonia are noted for their cultural value and are key components in herbal medicines for the treatment of a myriad of disorders. Isolated bioactive compounds isolated from selected species demonstrated varied antimicrobial, antioxidant, and neuroprotective functions in basic pharmacological studies. However, most studies lacked reliable correlation to in vivo activity and did not adequately validate the safety and efficacy of potential therapeutic compounds. CONCLUSIONS: While the cultural and therapeutic value of popular Aizoaceae species have been highlighted in the literature, there remains glaring inconsistencies among other related species. Data deficiency may be ameliorated by further studies focused on taxonomic markers, chemical characterization and underlying molecular mechanisms of activity of a wider pool of species to enhance our knowledge of this hyperdiverse family.

Foliar micromorphology, ultrastructure and histochemical analyses of Tagetes minuta L. leaves.

Many Tagetes species are known for producing essential oils and commercially useful bioactive compounds. This study investigated the micromorphological features of the internal and external foliar structures of Tagetes minuta that produce and store these compounds. Stereomicroscopy, light microscopy, scanning electron microscopy, transmission electron microscopy, and histochemical analyses were used to examine T. minuta leaves at three developmental stages. The development of the subdermal secretory cavities revealed that the cells undergo autolysis to form a schizolysigenous cavity in the mature leaves. The ultrastructure of the parenchymal sheath and secretory epithelium within the secretory cavity revealed that plastids change to contain lipid and osmiophilic molecules. The histochemical analyses showed that trichomes on the surface of T. minuta leaves appear to be linear and non-glandular but maintain the ability to store bioactive phytocompounds. These are new findings for T. minuta and provide a better understanding of the exudation process, which can help to optimise essential oil production for industrial applications.

Home therapy for inherited bleeding disorders in South Africa: Results of a modified Delphi consensus process.

BACKGROUND: Optimal care of patients with inherited bleeding disorders requires that bleeding episodes are treated early, or still better prevented, through extension of patient care beyond hospital-based treatment to home-based therapy. In South Africa (SA), adoption of home therapy is variable, in part owing to lack of consensus among healthcare providers on what constitutes home therapy, which patients should be candidates for it, how it should be monitored, and what the barriers to home therapy are. OBJECTIVES: To conduct a modified Delphi process in order to establish consensus on home therapy among haemophilia healthcare providers in SA. METHODS: Treaters experienced in haemophilia care were invited to participate in a consensus-seeking process conducted in three rounds. In round 1, provisional statements around home therapy were formulated as questions and collated in a structured list. In rounds 2 and 3, evolving versions of the questionnaire were administered to participants. Consensus was defined as ≥70% agreement among the participants. RESULTS: The panel composition included an equal number of physicians and non-physicians. The participation rate was 100% through all three consensus rounds. The group reached consensus for 92% of the statements. Consensus of 100% was reached on starting home therapy in paediatric patients, requiring all patients on home therapy to sign informed consent and indemnity, and providing round-the-clock support for patients on home therapy. CONCLUSIONS: The home therapy consensus statements in this report have the potential to translate to policy on home therapy and to guide the initiation, practice and evaluation of home therapy programmes in SA.

Home therapy for inherited bleeding disorders in south Africa: results of a modified delphi consensus process

Background. Optimal care of patients with inherited bleeding disorders requires that bleeding episodes are treated early, or still better prevented, through extension of patient care beyond hospital-based treatment to home-based therapy. In South Africa (SA), adoption of home therapy is variable, in part owing to lack of consensus among healthcare providers on what constitutes home therapy, which patients should be candidates for it, how it should be monitored, and what the barriers to home therapy are.Objectives. To conduct a modified Delphi process in order to establish consensus on home therapy among haemophilia healthcare providers in SA.Methods. Treaters experienced in haemophilia care were invited to participate in a consensus-seeking process conducted in three rounds. In round 1, provisional statements around home therapy were formulated as questions and collated in a structured list. In rounds 2 and 3, evolving versions of the questionnaire were administered to participants. Consensus was defined as ≥70% agreement among the participants.Results. The panel composition included an equal number of physicians and non-physicians. The participation rate was 100% through all three consensus rounds. The group reached consensus for 92% of the statements. Consensus of 100% was reached on starting home therapy in paediatric patients, requiring all patients on home therapy to sign informed consent and indemnity, and providing round-the-clock support for patients on home therapy.Conclusions. The home therapy consensus statements in this report have the potential to translate to policy on home therapy and to guide the initiation, practice and evaluation of home therapy programmes in SA

Testing in the HIV Counselling and Testing (HCT) campaign, HIV risk behaviours and ART enrolment in South Africa.

OBJECTIVES: To examine the association between testing in the 2010 HIV Testing and Counselling (HCT) campaign with HIV risk behaviours and enrolment on ART. STUDY DESIGN: Data for this study were collected as part of a nationally representative cross-sectional household survey conducted in 2012 in South Africa. METHODS: Consenting participants completed a structured questionnaire and provided a dry blood spot specimen which was tested for HIV antibodies and antiretroviral drugs. Multinomial logistic regression was used to examine the association between HIV testing history and explanatory variables of interest. RESULTS: There was no association between testing in the 2010 HCT campaign and condom use at last sex, number of sexual partnerships or HIV knowledge. Individuals who tested in the HCT campaign were more likely to disclose their status (COR 2.6, 95% CI: 1.71-3.8) and those who tested HIV positive in the campaign were more likely to be receiving ART (COR 1.8, 95% CI: 1.1-2.9). Testing in the HCT campaign was associated with having received both pretest and post-test counselling while testing before the campaign was associated with having received HIV results with no counselling (COR 2.1, 95% CI: 1.2-3.8). CONCLUSION: We highlight the success of the 2010 HCT campaign in improving HIV status disclosure and enrolment on ART as well as shortcomings on HIV risk behaviours and HIV knowledge. These may be related to issues of quality assurance in the counselling process. Our results further highlight possible HCT counselling inconsistencies across sectors requiring stronger public-private partnership in the delivery of HCT in South Africa.

Solitary extramedullary plasmacytoma of the colon, rectum and anus.

Solitary extramedullary plasmacytoma (SEP) is a neoplastic proliferation of a single clone of plasma cells that occur outside of the bone and bone marrow. It is rare, commonly occurring in the head and neck region, followed by the gastrointestinal tract. The aetiology, risk factors, natural history and consequent treatment are not well defined. We report an unusual case of SEP of the colon in an human immunodeficiency virus (HIV)-infected patient. The patient was managed with colonic resection and made an uneventful recovery. To our knowledge, this is the first reported case of extramedullary plasmacytoma of the colon and rectum in association with HIV infection.

Chronic rhinosinusitis assessment using the Adelaide Disease Severity Score.

AIM: This study aimed to validate the use of the Adelaide Disease Severity Score for the assessment of chronic rhinosinusitis. STUDY DESIGN: A prospective cohort study supplying level 2b evidence. METHODS: Forty-eight patients, scheduled for endoscopic sinus surgery for failed management of chronic rhinosinusitis, completed the Sino-Nasal Outcome Test 22 and the Adelaide Disease Severity Score tool (the latter assessing symptoms (i.e. nasal obstruction, rhinorrhoea, post-nasal drip, headache or facial pain, and olfaction) and quality of life). Lund-Mackay computed tomography scores and Lund-Kennedy endoscopic scores were also recorded. The Adelaide Disease Severity Score results were then compared with those of the other three tools to assess correlation. RESULTS: Mean scores (95 per cent confidence intervals) were 22.31 (21.47-24.15) for the Adelaide Disease Severity Score and 30.6 (27.15-34.05) for the Sino-Nasal Outcome Test 22; there was a statistically significant correlation (Spearman coefficient = 0.45; p = 0.0015). A statistically significant correlation was also noted with the Lund-Mackay score (p = 0.04) and with the Lund-Kennedy score (p = 0.03). CONCLUSION: The Adelaide Disease Severity Score is a simple, valid tool for clinical assessment of chronic rhinosinusitis, which correlates well with the Sino-Nasal Outcome Test 22, Lund-Mackay and Lund-Kennedy tools.

A retrospective case review of isolated sinonasal amyloidosis.

OBJECTIVE: We report an extremely rare case of isolated primary sinonasal amyloidosis. METHOD: A case report and comprehensive literature review are presented. Common symptoms, signs and treatment options are examined, and used to derive an algorithm with which the practising otolaryngologist can diagnose and manage this condition. RESULTS: Only 15 cases of true primary idiopathic amyloid restricted to the sinonasal tract have previously been reported. Isolated sinonasal amyloid presents with common rhinological symptoms which mimic chronic rhinosinusitis, i.e. nasal obstruction, nasal discharge, epistaxis, 'glue ear' and post-nasal drip. The lesion itself can appear as a simple inflammatory polyp. In children, the symptoms are easily attributed to enlarged adenoids. Although there is a concern that surgically induced trauma to the paranasal mucosa might incite reactive amyloid deposition, this seems not to be the case, and surgery provides symptomatic relief in the majority of patients. CONCLUSION: This article is the first to report the characteristic features of isolated primary sinonasal amyloidosis. The evidence suggests that meticulous surgery can produce substantial symptomatic improvement in these patients.

The foliar trichomes of Hypoestes aristata (Vahl) Sol. ex Roem. & Schult var aristata (Acanthaceae) a widespread medicinal plant species in tropical sub-Saharan Africa: with comments on its possible phylogenetic significance.

The micromorphology of foliar trichomes of Hypoestes aristata var. aristata was studied using stereo, light and scanning microscopy (SEM). This genus belongs to the advanced angiosperm family Acanthaceae, for which few micromorphological leaf studies exist. Results revealed both glandular and non-glandular trichomes, the latter being more abundant on leaf veins, particularly on the abaxial surface of very young leaves. With leaf maturity, the density of non-glandular trichomes decreased. Glandular trichomes were rare and of two types: long-stalked capitate and globose-like peltate trichomes. Capitate trichomes were observed only on the abaxial leaf surface, while peltate trichomes were distributed on both adaxial and abaxial leaf surfaces.

The foliar trichomes of Hypoestes aristata (Vahl) Sol. ex Roem. & Schult var aristata (Acanthaceae) a widespread medicinal plant species in tropical sub-Saharan Africa: with comments on its possible phylogenetic significance

The micromorphology of foliar trichomes of Hypoestes aristata var. aristata was studied using stereo, light and scanning microscopy (SEM). This genus belongs to the advanced angiosperm family Acanthaceae, for which few micromorphological leaf studies exist. Results revealed both glandular and non-glandular trichomes, the latter being more abundant on leaf veins, particularly on the abaxial surface of very young leaves. With leaf maturity, the density of non-glandular trichomes decreased. Glandular trichomes were rare and of two types: long-stalked capitate and globose-like peltate trichomes. Capitate trichomes were observed only on the abaxial leaf surface, while peltate trichomes were distributed on both adaxial and abaxial leaf surfaces.

Delayed ultrasound in patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy.

OBJECTIVES: To determine if patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy who have a low clinical likelihood of ectopic pregnancy are put at risk of adverse events by delaying ultrasonography 12-18 h after emergency department presentation. METHODS: A retrospective chart review of all surgically proven ectopic pregnancies at our Institution over a 2-year period. RESULTS: One hundred and seventeen cases of ectopic pregnancy were reviewed. Thirty-seven cases met predetermined criteria of 'clinical stability' at first presentation. These patients waited a median 14 h for diagnostic ultrasound with 62% waiting more than 12 h. No adverse events occurred while waiting for this diagnostic study. CONCLUSIONS: Preliminary results suggest that pregnant patients with abdominal pain and vaginal bleeding in the first trimester who meet specific low-risk clinical criteria could potentially have ultrasound delayed 12-18 h without risk of adverse event. Further prospective studies are warranted to confirm the safety of this strategy.

Cellular visualization of tissue prokallikrein in human neutrophils and myelocytes.

The vasoactive peptides bradykinin and kallidin (lysyl-bradykinin) have been implicated in diapedesis, a cellular process by which neutrophils migrate through endothelial cell gap junctions. The kinin peptides are released from their precursor moiety, kininogen, by the specific action of endoproteinases, the kallikreins. Kininogens have been demonstrated on the surface of neutrophils, and the presence of a competent processing enzyme such as tissue prokallikrein in neutrophils has been postulated, but firm evidence for this is still lacking. We have raised antibodies to a synthetic peptide that is a sequence copy of the activation segment of human TK and demonstrated that the anti-peptide antibodies specifically recognized the zymogen but not the active form of kallikrein. Using these anti-peptide antibodies, we showed by Western blotting, immunocytochemistry and electron microscopy that the tissue prokallikrein antigen was localized in neutrophils and their precursor cells, the myelocytes. We further demonstrated by in situ hybridization the presence of tissue kallikrein mRNA in the mature neutrophils and myelocytes. Our findings lend credence to the hypothesis that upon release and activation, neutrophil-borne TK acts on cell-associated kininogens to trigger the release of kinins, which may open endothelial gates for neutrophil diapedesis.

Immunocytochemical analysis of tissue kallikrein and the kinin moiety in rheumatoid synovial fluid neutrophils.

Polymorphonuclear leucocytes (PMNs) from the synovial fluid of patients with rheumatoid arthritis (RA) showed reduced tissue kallikrein and kinin immunoreactivity in comparison with blood PMNs from healthy individuals as judged visually using confocal microscopy. Similarly, synovial fluid PMNs exhibited reduced tissue kallikrein immunoreactivity as compared with blood PMNs from the same RA patients. Blood PMNs stimulated to degranulate in vitro also displayed less immunostaining for tissue kallikrein and kinin than non-stimulated PMNs. By contrast, no difference in kininogen immunostaining was detected between RA synovial fluid PMNs and blood PMNs from healthy people. It is considered that the results support the hypothesis that tissue kallikrein, released from the granules of RA synovial fluid PMNs, cleaves the kinin moiety from multifunctional kininogen protein on the surface of the PMNs.