Objectives. To determine the outcome of surgical intervention in patients with HIV associated vascular disease. Design. Prospective clinical survey. Materials and methods. Routine voluntary testing for HIV/AIDS was performed in patients who presented to our unit with peripheral vascular disease. One hundred and nine patients (5.7%) were prospectively identified over a 5year period (2001-2006). Results. 24 patients presented with aneurysmal disease whilst occlusive disease was present in 66 patients. There was not much difference between patients with aneurysmal disease and patients with occlusive disease as to age, CD4 count and other risk factors for vascular disease. The peri-operative mortality for aneurysmal disease was 10.6% versus 3.6% for occlusive disease (p = 0.264). Long-term mortality was significantly worse (p = 0.049) for patients with aneurysmal disease. The results of revascularization in occlusive disease were poor with a limb salvage rate of 31.6%. There was no significant difference in CD4 T-cell counts between primary amputation and revascularization groups (p = 0.058). Conclusion. Patients with aneurysmal disease have a high peri-operative and long-term mortality and it appears that surgical intervention should be reserved for life-threatening aneurysms only. Patients with occlusive disease have a better survival rate but limb salvage is poor. Primary amputation may be preferable to bypass surgery in patients with critical limb ischaemia.

Patients with aneurysmal disease have a high peri-operative and long-term mortality and it appears that surgical intervention should be reserved for life-threatening aneurysms only. Patients with occlusive disease have a better survival rate but limb salvage is poor. Primary amputation may be preferable to bypass surgery in patients with critical limb ischaemia.

Green wall systems have greatly advanced over the past few decades and hold important potential for the future in light of predicted urban population growth, densification, and climate change. This article provides a brief background to living walls, followed by a summary of the advantages and disadvantages of the four types of systems that are currently available in South Africa. It makes use of a case study review of three recently implemented edible living walls in Gauteng to reflect on the challenges currently experienced and the future potential benefits, with specific focus on system resilience, economic feasibility, and edible plant possibilities. Interviews were conducted with clients and client representatives, contractors and/or designers on each project. The findings suggest that living walls have indirect commercial value through customer experience and satisfaction, as well as educational value. Should the scale, economic feasibility and resilience of living wall systems be enhanced, they can improve urban food production. The article concludes that this could be achieved in the Global South by using simplistic technologies with lower cost living wall infrastructure systems. When deployed on a large scale, with climate-tolerant indigenous and edible plants in exterior systems, productivity will be improved.

In terms of the 2030 Agenda for Sustainable Development and the United Nations (UN) Sustainable Development Goals (SDGs), sustainable cities and communities (SDG 11), combined with good health and wellbeing (SDG 3), are vital. The world is not making adequate progress in meeting the UN’s targets to address food security (SDG 2). In South Africa, the growing population, rapid urbanization, poverty, and unemployment exacerbate the issue of food security; even more so considering climate change (SDG 13). The built environment needs to respond to these demands and incorporate green initiatives that can provide ecosystem services. Novel approaches are required to optimize land use and promote sustainable built environments through food production. This paper consolidates literature on local vertical urban food production with vegetable crops to enhance ecosystem services and lower the carbon footprint of buildings in the Global South. The literature review points to the potential of small-scale edible living walls that utilize local materials and traditional African vegetable (TAV) species to enhance system sustainability and resilience. TAV species offer advantages as opposed to exotic food crops as they are tolerant to extreme heat and drought, have a high nutritional value, and have low irrigation and agrochemical maintenance requirements.