What is in a name? Scientific name changes of potentially poisonous plants and fungi in South Africa.

Changes over the past five decades in the scientific names of some potentially poisonous plants and toxigenic fungi in South Africa are briefly reviewed. Some of the reasons why taxonomists change names are highlighted. In recent years, DNA sequencing data have contributed considerably towards establishing phylogenetic relationships among plants, often resulting in changes in generic circumscription and, consequently, the names of species. Philosophical differences between the phylogenetic and the evolutionary schools of plant classification are briefly explained as these may manifest as different classifications for the same group of plants. Although choice of classification remains the prerogative of the end-user of plant names, in this review, the classifications for plants currently adopted by the South African National Biodiversity Institute (SANBI) in its online database, Plants of Southern Africa (POSA), were followed. Noteworthy generic changes include Pachystigma to Vangueria, Homeria to Moraea, and Urginia to Drimia. Following much controversy, the species native to southern Africa that were formerly treated as Acacia are now classified in either Vachellia or Senegalia, with the genus name Acacia being retained for the mainly Australian members of the group, the latter commonly known as wattles. Former southern African members of Acacia implicated in poisoning include Vachellia erioloba(camel thorn), Vachellia sieberiana var. woodii (paperbark thorn), and Senegalia caffra (common hook thorn).

The initial impact of the COVID-19 pandemic on the diagnosis of new cancers at a large pathology laboratory in the public health sector, Western Cape Province, South Africa.

BACKGROUND: The COVID-19 pandemic has disrupted cancer diagnostic services. A decline in the number of new cancers being diagnosed over a relatively short term implies a delay in diagnosis and subsequent treatment. This delay is expected to have a negative effect on cancerrelated morbidity and mortality. The impact of the pandemic on the number of new cancer diagnoses in our setting is unknown. OBJECTIVES: To assess the impact of COVID-19 on the number of new cancers diagnosed at our institution in the first 3 months following the implementation of lockdown restrictions, by focusing on common non-cutaneous cancers. METHODS: A retrospective laboratory-based audit was performed at a large anatomical pathology laboratory in Western Cape Province, South Africa. The numbers of new diagnoses for six common cancers (breast, prostate, cervix, large bowel, oesophagus and stomach) from 1 April 2020 to 30 June 2020 were compared with the corresponding period in 2019. RESULTS: Histopathological diagnoses for the six cancers combined decreased by 192 (-36.2%), from 531 new cases in the 2019 study period to 339 in the corresponding period in 2020. Substantial declines were seen for prostate (-58.2%), oesophageal (-44.1%), breast (-32.9%), gastric (-32.6%) and colorectal cancer (-29.2%). The smallest decline was seen in cervical cancer (-7%). New breast cancers diagnosed by cytopathology declined by 61.1%. CONCLUSIONS: The first wave of the COVID-19 pandemic and the associated response resulted in a substantial decline in the number of new cancer diagnoses, implying a delay in diagnosis. Cancer-related morbidity and mortality is expected to rise as a result, with the greatest increase in mortality expected from breast and colorectal cancer.

The use of light-emitting diode fluorescence to diagnose mycobacterial lymphadenitis in fine-needle aspirates from children.

BACKGROUND: Fine-needle aspiration biopsy (FNAB) is a simple, safe and effective method for investigating suspected mycobacterial lymphadenitis in children. Fluorescence microscopy can provide rapid mycobacterial confirmation. Light-emitting diodes (LEDs) provide a cheap and robust excitation light source, making fluorescence microscopy feasible in resource-limited settings. OBJECTIVE: To compare the diagnostic performance of LED fluorescence microscopy on Papanicolaou (PAP) stained smears with the conventional mercury vapour lamp (MVL). METHODS: FNAB smears routinely collected from palpable lymph nodes in children with suspected mycobacterial disease were PAP-stained and evaluated by two independent microscopists using different excitatory light sources (MVL and LED). Mycobacterial culture results provided the reference standard. A manually rechargeable battery-powered LED power source was evaluated in a random subset. RESULTS: We evaluated 182 FNAB smears from 121 children (median age 31 months, interquartile range 10-67). Mycobacterial cultures were positive in 84 of 121 (69%) children. The mean sensitivity with LED (mains-powered), LED (rechargeable battery-powered) and MVL was respectively 48.2%, 50.0% and 51.8% (specificity 78.4%, 86.7% and 78.4%). Inter-observer variation was similar for LED and MVL (κ = 0.5). CONCLUSION: LED fluorescence microscopy provides a reliable alternative to conventional methods and has many favourable attributes that would facilitate improved, decentralised diagnostic services.

Efficacy of a genotype 2 Newcastle disease vaccine (Avinew) against challenge with highly virulent genotypes 5d and 3d.

Since 2002, following its introduction, the lineage 5d Newcastle disease virus (so-called Goose paramyxovirus - GPMV) strain has caused numerous disease outbreaks among commercial and backyard poultry in South Africa, raising questions about the ability of commercially available Newcastle disease vaccines to fully protect poultry against the strain. This study aimed to determine whether there are differences in the level of protection offered by Avinew Newcastle disease vaccine against GPMV virus as compared with a 3d Newcastle disease virus isolated in South Africa in 1993 (Rainbow challenge virus - RCV) strain. Six groups of 10-day-old, specific pathogen-free chickens were vaccinated with doses of 10(3.0), 10(4.5) and 10(6.0) EID50 of Avinew vaccine and challenged at 4 weeks of age intramuscularly at a dose of 10(5.3) EID50/0.2 ml/bird of GPMV and RCV. No statistically significant difference could be found in the protection offered by Avinew vaccine against GPMV as compared to RCV challenge. The protection offered against the ND challenge was found to be dose dependent. At the recommended field dose of 10(6.0) EID50 the vaccine gave 100% protection from mortality against both the challenge viruses, but not against infection and replication of the viruses, as gross lesions were evident even in apparently healthy birds that survived the challenge. The protective dose (PD90) of the Avinew vaccine against GPMV challenge was calculated at 10(4.38) and against that of RCV at 10(4.43).

Therapeutic uses of Aloe L. (Asphodelaceae) in southern Africa.

ETHNOPHARMACOLOGICAL RELEVANCE: The African-Arabian succulent genus Aloe L. (Aloaceae/Asphodelaceae) is represented by approximately 120 infrageneric taxa in southern Africa, including A. ferox Mill., a species long used in commercial natural products. AIMS OF THE STUDY: To assess the documented ethnobotanical knowledge and biocultural value of utility in the genus in southern Africa. MATERIALS AND METHODS: A survey of over 350 multidisciplinary publications was undertaken. RESULTS: Local uses for medicine and wellbeing were identified for over half the species of Aloe occurring in the Flora of Southern Africa region. The most frequently cited medicinal uses were the treatment of infections and internal parasites, digestive ailments and injuries. Numerous species were recorded for their social uses, notably as ingredients in tobacco snuff. CONCLUSION: The exceptional infrageneric diversity of Aloe, and extensive therapeutic uses in southern Africa, indicate its cultural importance in the subcontinent. These factors highlight the need for the conservation of the species as well as their potential as a source of natural products.

Effectiveness of Early Quadriceps Exercises after Anterior Cruciate Ligament Reconstruction

OBJECTIVE. To systematically review the published information regarding the effectiveness and safety of early postoperative quadriceps muscle exercise training on pain; joint laxity; function and range of motion in postoperative anterior cruciate ligament (ACL) reconstruction adult patients. DATA SOURCES. Five databases (CINAHL; PEDro; Pubmed; Science Direct and the Cochrane Library) were searched for studies published from January 1990 to May 2007. StTUDY SELECTION. Publications describing research into the effectiveness of early quadriceps exercises after ACL reconstruction were included. A total of three eligible articles met the inclusion criteria. DATA EXTRACTION. A review of the three eligible studies was undertaken to describe the key study components. The PEDro Scale was used to determine the methodological quality of the selected trials and the level of evidence of all the eligible studies was categorised according to the evidence hierarchy by Lloyd-Smith.24 Relevant data were extracted by the two reviewer groups to reduce bias. DATA SYNTHESIS. Due to study heterogeneity a meta-analysis could not be conducted. Effect sizes were calculated provided that sufficient data were provided. Outcome measures included range of motion (ROM); functional performance; pain and knee laxity. The methodological quality of the studies did not vary considerably across the studies and the average PEDro score was 66. Marginal significant differences were noted in knee ROM at 1 month ostoperatively; pain day 1 postoperatively; knee laxity and subjective evaluation of function at 6 months postoperatively. CONCLUSION. Early quadriceps exercises can be performed safely in the first 2 postoperative weeks; but clinically significant gains in ROM; function; pain and knee laxity were not evident. Further research should include standardised interventions; measurement time frames and outcome measurement tools to allow for a meta- analysis to be conducted

A large-scale automated method for hepatocyte isolation: effects on proliferation in culture.

Large-scale sterile methods for isolating hepatocytes are desirable for the development of bioartificial liver support systems. In this study the traditional centrifuge method was compared with the use of a Baylor Rapid Autologous Transfusion (BRAT) machine for isolating large quantities of porcine hepatocytes. After isolating hepatocytes, the methods were evaluated in terms of cell viability and yield per liver, proliferation over 7 days, and the effects on the cell cycle using the trypan blue exclusion test, conventional phase-contrast light microscopy, the lactate to pyruvate ratio, the leakage of lactate dehydrogenase (LD) and aspartate aminotransferase (AST), lidocaine clearance, albumin production, and flow cytometry. With the centrifuge method the mean cell viability was 92.5%, while with the BRAT method the viability was 95.9%. The minimal cell yields with the BRAT procedure were 7.3 x 10(9) for 250-ml centrifuge bowls and 2.8 x 10(9) for 165-ml bowls, which compares well with that found by other authors. Because the same initial procedures were employed in both methods the total hepatocyte yield per liver was comparable. Flow cytometry confirmed that the proliferation of hepatocytes was facilitated by oxygenation during the isolation procedure. The recovery of hepatocytes in culture following isolation was similar after either method. Daily microscopic investigation indicated that cytoplasmic vacuolization and granularities were present after either procedure and these disappeared following 3-4 days of culturing. Flow cytometry indicated that the hepatocyte cell cycle was similar after either method; at 7 days the profile indicated that the cells were still proliferating. Trends in the lactate to pyruvate ratio and the leakage of LD and AST indicated that the functional polarity of hepatocytes was regained after approximately 3 days. Lidocaine clearance at 4 days indicated that the cytochrome P450 system was active, while significant albumin production was apparent at day 5. The benefit of using BRAT technology in hepatocyte isolation lies in guaranteed sterility, convenience, speed, and the ability to oxygenate media and cell suspensions during the procedure.

Assessment of effectiveness of traditional herbal medicine in managing HIV/AIDS patients in South Africa.

BACKGROUND: Very few clinical studies have been conducted in South Africa to assess the value and efficacy of traditional herbal medicines that are commonly used by traditional healers for the treatment of HIV-positive patients. OBJECTIVE: To assess efficacy of a South African traditional herbal medicine in reducing viral load and increasing CD4+T cell counts of HIV/AIDS patients. DESIGN: A descriptive, prospective, follow-up study of 33 HIV-positive volunteers over a one year period. Viral load and CD4 counts were taken three times from each participant. SETTING: From November 2001 to October 2002, patients were treated at the Rustenburg Community Based Centre for traditional therapy. Clinical and paraclinical treatments and screening of patients were done at Pretoria Gynaecological Hospital. PARTICIPANTS: Seven men and 26 women aged between 22 and 43 years took part in a 12-month long follow-up study. HIV monitoring was done at the beginning and after 4 and 8 months in symptomatic and asymptomatic patients with CD4 counts below 200 cells/mm3 or viral load counts above 10,000 copies. INTERVENTION AND ASSESSMENT: ab mitio and after 4-months, viral load, CD4+T cell count, FBC, LFT, glycaemia, U/E, cholesterol, pap smear, clinical and subjective assessment, modern drugs plus hospitalisation for opportunistic infections and resuscitation where needed, powder or suspension of herbal medicine followed by meals. MAIN OUTCOME MEASURES: Improvement in overall health condition and immune system, increase in CD4+T cell count and decrease in viral load count. The two sample paired t-test was used to compare initial and final counts at the 5% level of significance and power of 80%. Ninety five per cent confidence intervals were obtained for differences between mean values. RESULTS: After four and/or eight months of therapy, significant health improvement was achieved: better physical appearance (80% of patients), increased appetite (65%), feeling of well-being (60%), disappearance of skin marks (70%) and urogenital lesions (100%), resumption of workplace duties (60%), weight gain (80%), significant reduction in viral loads (85.4%, p = 0.0015) and significant increase in CD4+ T cell counts (226%, p = 0.0000). CONCLUSION: Achievement of health improvement within eight months indicates that herbal medicine can be used as supplementary or alternative treatment for HIV/AIDS patients, and that it is an obvious immune system booster and probable "virus-cidal" factor. The apparent safety and efficacy of herbal medication warrants further research with a larger sample size of study.

Detection of antibodies to Newcastle disease virus in ostriches (Struthio camelus) by an indirect ELISA.

A two-graph receiver operating characteristic analysis, performed on the hemagglutination-inhibition (HI) and enzyme-linked immunosorbent assay (ELISA) test results of a Newcastle disease virus (NDV)-positive and NDV-negative control group of ostrich sera, proved that the ELISA was superior to the HI in both sensitivity and specificity. Comparison of results of the two assays performed on a panel of simulated positive sera ranging from very weak to very strong showed that the ELISA was at least 10 times more sensitive than the HI in detecting low levels of ostrich antibodies to NDV. The ELISA also has the advantage of using untreated serum in a single dilution as opposed to the HI test, which uses pretreated serum in titration.

Comparison of ELISA and HI for detection of antibodies against Wesselsbron disease virus.

A two-graph Receiver Operating Characteristic analysis was done to determine the optimal cut-off value of an indirect enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to Wesselsbron disease (WSL) virus. When ELISA and haemagglutination-inhibition (HI) results of WSL-positive and WSL-negative control sheep sera were compared, the sensitivity of ELISA was 97.9% and that of HI, 87.5%, while the specificity of ELISA and HI were 95.7% and 100%, respectively. The ELISA's superior sensitivity was confirmed by the results of the two assays performed on a simulated range of low-positive sera, which showed that the ELISA was able to detect WSL-antibody levels at least ten times lower than those the HI could. The ELISA was also less cross-reactive than the HI to guinea-pig antisera against nine flaviviruses relevant to southern Africa. The combination of the ELISA's ability to test untreated sera in single dilution and its superior sensitivity and lower cross-reactivity as compared to that of the traditional HI, makes it the assay of choice for automation and large-scale screening of animals for antibodies to WSL virus.

[Patient activity level plans for personnel scheduling in nursing in-patient units]. / N plan vir die bepaling van pasiëntakuutheidsvlakke vir verpleegkundige postebepaling.

This study of patient activity level plans (PALP) to determine nursing levels for in-patients units was carried out by means of an exploratory, descriptive instrumental study within the context of a nursing situation. With the literature study serving as background, a patient activity level plan (PALP) was designed, according to accepted criteria, to find data on which to base post determination of nursing staff. This study was done at a private research hospital in Johannesburg where all the patients and nursing staff (first- as well as second-in-charge) were involved. The PALP-instrument was designed by the researcher, and under supervision of the researcher it was implemented in seven nursing units in the hospital. (The instrument proved to be highly reliable p = 0.999). The difference between nursing post determination as recommended and determined by PALP, and nursing post determination as determined by means of a pragmatic subjective approach by the nursing service manager of the hospital, proved to be statistically insignificant. The PALP instrument showed, however, that more nursing staff were needed in four of the seven units. The quality of the nursing care was not investigated nor was a productivity study carried out. The total difference between the recommended and actual nursing hours needed for all the nursing units shows a statistically significant difference (p = 0.0001) on a 1% significance level. The instrument proved to be easily comprehended, easily implemented and relevant to its purpose. It also shows a high inter-rator reliability (a chronbach alpha value of 0.999). Thus a reliable PALP-instrument was developed and successfully implemented at a research hospital for the determination of nursing posts. The most significant recommendations include national standardization of the PALP-instrument in hospitals and refining and testing of the PALP-instrument in other clinical areas e.g. out-patients and critical care units. This instrument could also contribute towards a more cost-effective post determination in nursing.

Preparation and biokinetic evaluation of various halogenated iminodiacetic acid-type compounds labeled with technetium-99m for hepatobiliary scintigraphy in the baboon (Papio ursinus) model.

In an evaluation of various 99mTc-labeled halogenated (F, Cl, Br, I) iminodiacetic acid (IDA) derivatives for hepatobiliary scintigraphy, it was found that, in the baboon model, none of these compounds performed as well as did disida. F-IDA was least effective, with the lowest biliary excretion and highest renal participation, but multihalogen substitution as in penta-F-IDA increased the biliary specificity and reduced urinary excretion to the extent that penta-F-IDA scored second to disida and even above I-IDA, with its high molecular weight. Surprising also was the relatively good performance of Cl-IDA compared to Br-IDA and I-IDA.

99mTc ethoxy methylpropyl isonitrile: a radioactive tracer for myocardial perfusion imaging.

The initial experience with a new 99mTc labelled myocardial perfusion agent, ethoxy methylpropyl isonitrile (EMI), is described in the primate as model. Rapid biliary clearance of EMI ensures low radionuclide concentration in the liver and lungs after 60 min. Adequate visualization of the myocardium is therefore possible. Heart-to-lung and heart-to-liver ratios of 1.52 and 2.45 respectively were obtained. EMI is an efficient imaging agent to evaluate myocardial ischemia and infarction.

Using the "integral spleen" method of radiorenogram analysis and a baboon model to compare the diagnostic usefulness of technetium-99m-diethylenetriamine pentaacetic acid to that of various technetium-99m-mercaptoacetyltriglycene formulations and iodine-123-hippuran.

In light of the high price of commercially available mercaptoacetyltriglycene (MAG3) it was decided to attempt a local MAG3-formation and to test this against diethylenetriamine pentaacetic acid (DTPA), 123I-Hippuran, and commercial MAG3 for diagnostic radiorenographic capabilities also in conjunction with furosemide and captopril. A baboon model (n = 6) was used, and the parameters evaluated were obtained by the "integral spleen" method of radiorenogram analysis. Although the images and parameters pointed to 123I-Hippuran and commercial MAG3 as the ideal renal scanning agents and to DTPA as the least so, with the local product an acceptable alternative, the differences were not significant enough to warrant either the purchase of the commercial product or the extensive development of the local product. Inexpensive 99mTc-DTPA in conjunction with modern computer techniques will probably supply most of the answers.

The relationship between the microtitration serum agglutination and complement fixation tests in bovine brucellosis serology.

The relationship between antibody titres in the microtitration serum agglutination test and the complement fixation test in bovine brucellosis is described. For low and high MSAT values there is good agreement between the 2 tests. This is not the case for MSAT values between 54 and 338 IU/ml. For practical reasons, results falling into this category cannot all be repeated. Repetitions are so structured that less than 4% of the tests need to be repeated. If the level of repetitions should show an increase above 4%, it is assumed that technical or human error has occurred.

Experimental radionuclide ventriculography and the baboon (Papio ursinus) model: imaging projection of the heart and blood pool labelling.

The chacma baboon (Papio ursinus) presents a suitable animal model for the evaluation of interpretation problems of data from radionuclide ventriculography. However, the procedure has to be standardized: it is important to so view the heart as to ensure optimal ventricular separation and minimal ventricle-atrium overlap. Also necessary is efficient labelling of the blood pool for good cardiac images and prolonged experimentation. This report concerns an evaluation of different cardiac viewing projections and labelling procedures, and concludes with a preferred method.

Radionuclide studies in upper gastro-intestinal ulceration--are they reliable? A pilot study of 6 patients.

Endoscopy is at present the diagnostic technique of choice in the evaluation and detection of upper gastro-intestinal tract ulceration. Because of the physical discomfort suffered by patients during endoscopic examination, the search for better and less invasive methods of examination (especially in the unco-operative and seriously ill patient) continues. According to reports from the Orient, sucralfate (Ulsanic; Continental Ethicals) has prominent ulceravid properties. These properties are being used in conjunction with a tagging agent, in this case technetium-99m, as a diagnostic method for the detection and localization of upper gastro-intestinal ulceration. In this pilot study on 6 patients the positive findings of others regarding the specificity and promise of this method could not be confirmed.

Evaluation of (o)-[77Br]bromohippuran as renal tubular function agent.

(o)-[77Br]bromohippuran (BHIP) was developed as renal tubular function agent due to its favourable chemical and physical properties and compared to (o)-[131I]iodohippuran (IHIP). Renograms obtained from baboons were compared and absorbed radiation dose calculations performed. Although BHIP showed a delayed kidney uptake and washout pattern, good kidney clearance of the radionuclide was obtained after 30 min. Radiation dose values for BHIP were markedly lower than for IHIP indicating that larger activities of BHIP could be administered to increase counting statistics. BHIP imaging in normal volunteers did however not substantiate the favourable behaviour obtained in the primate.