Primary amyloidosis of lower urinary tract

Primary amyloidosis of the lower urinary tract is a rare condition with an excellent prognosis in most cases. Three patients with this condition are described. In the cases of localized amyloidosis of the urethra and urinary bladder, the clinical presentation mimicked cancer of the respective sites. This was also true in the case of primary systemic amyloidosis involving the bladder. If significant associated systemic or local disease can be excluded, management is symptomatic and expectant.     

Cross contamination of cytological smears, with automated staining machines and bulk manual staining procedures. With a specific study of the problems of the Cytotek and the Shandon Elliott staining machines.

Further development of an individual staining machine is to be strongly encouraged but meanwhile, using bulk stainers, frequent changing of wash fluids and staining solutions, particularly leading up to and following the haematoxylin pot, is essential to reduce the risk of cross contamination. Certain smears, such as from semen or from serous fluids where malignancy is suspected or known, must be stained on separate racks. In some laboratories it is the rule not to stain semen or serous fluids in bulk staining machines at all and this may have to become the rule everywhere until we are provided with safe individual slide stainers.     

A comparison of the haemodynamic and hypokalaemic effects of inhaled pirbuterol and salbutamol

In this double blind study, the cardiovascular and hypokalaemic effects of equal doses of inhaled pirbuterol and salbutamol were compared in eight healthy volunteers. Increasing doses of 200, 400, 600 and 800 micrograms (total dose 2000 micrograms) were given from a metered dose inhaler at 15 min intervals, followed by measurement of heart rate, blood pressure, total electromechanical systole (QS2I) (as a measure of inotropic response) and plasma potassium (K+) concentration 15 min after each inhalation. After inhalation of the highest concentration, salbutamol resulted in a greater increase in heart rate (10.5 bpm vs 4.4 bpm, p less than 0.0007), and reduction in QS2I (-25.4 ms vs -9.6 ms, p less than 0.0001) than pirbuterol. There were no significant differences in changes in systolic blood pressure (1.9 mmHg vs 6 mmHg, p = 0.27), diastolic blood pressure (-5.8 mmHg vs -3.9 mmHg, p = 0.64) or plasma K+ (-0.21 mmol/L vs -0.15 mmol/L, p = 0.57). We conclude that the new beta-2 adrenergic agonist pirbuterol is at least as beta-2 selective as salbutamol when administered by repeated inhalation in healthy volunteers.     

Pediculus humanus capitis on children in Mahé, Seychelles

The incidence of Pediculus humanus capitis infestation in pre-school and schoolchildren in Mahé, Seychelles, was investigated. High infestation rates were discovered, particularly in urban schoolchildren at district schools. Infestation in preschoolchildren increased with age. Girls were more infested than boys. Control of infestation will not be possible using only the child health service and the school health service. A combined approach is necessary based on the family unit.