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Background In May 2021, the B.1.617 variant of SARS-CoV-2 emerged in Ireland, and both Delta and Kappa sub-lineages were initially deemed variants of concern (VOCs) on a precautionary basis. We describe a large outbreak of SARS-CoV-2 B.1.617.1 (Kappa mutation) linked to a private gathering among third level students in Cork, Ireland. Methods Surveillance data were available from the Health Service Executive COVID Care Tracker. The epidemiological sequence of infection for each new case in this outbreak was tracked and whole genome sequencing was requested on all linked cases. Enhanced public health control measures were implemented by the Department of Public Health HSE-South to contain onward spread of VOCs, including retrospective contact tracing, lengthy isolation and quarantine periods for cases and close contacts. Extensive surveillance efforts were used to describe and control onward transmission. Results There were 146 confirmed SARS-CoV-2 cases linked to the outbreak. All sequenced cases (53/146; 36%) confirmed Kappa mutation. The median age was 21 years (range 17–65). The majority (88%) had symptoms of SARS-CoV-2 infection. There were 407 close contacts; the median was 3 per case (range 0–14). There were no known hospitalisations, ICU admissions or deaths. Vaccination data was unavailable, but the outbreak pre-dated routine availability of COVID-19 vaccines among younger adults in Ireland. Conclusion Enhanced public health control measures for new and emerging variants of SARS-CoV-2 may be burdensome for cases and close contacts. The overall public health benefit of enhanced controls may only become apparent when evidence on disease transmissibility and severity becomes more complete.

We report the incidence of the chronic lymphoproliferative disorders evolving with leukaemia in Hong Kong. Our findings demonstrate that B cell malignancies are significantly more frequent than mature T cell neoplasms, a picture similar to that seen in Western countries but different from other Eastern countries, eg Japan, where T cell malignancies are more frequent. In contrast to the West, where chronic lymphocytic leukaemia (CLL) is the most common disorder, in Hong Kong there is a clear predominance of B cell lymphomas in leukaemic phase accounting for two-thirds of the cases and particularly those displaying lymphoplasmacytic features or with villous lymphocytes. CLL in Hong Kong has similar clinical and laboratory features to the disease in patients from the West. Distinct disease categories, rare in the West such as the variant form of hairy cell leukaemia and T cell prolymphocytic leukaemia, are also documented. It is unclear whether the differences in prevalence of disease subtypes between Hong Kong and the West relate to different genetic background or environmental factors determinant of the development or progression of the leukaemia. Further studies investigating the genetic/molecular lesions may help to clarify whether the aetiopathogenesis of the lymphoid disorders in Hong Kong is similar to that of Western countries.

Different types of foreign bodies have been reportedly introduced into the urethra, including electric wires, thermometers, hairpins, toothpicks, eyeglass rims, straws, pencils, paperclips, and fishhooks.1 2 Autoerotism is one of the most common reasons given for polyembolokoilamania, although others include curiosity, psychiatric illness, iatrogenic causes, and an attempt to relieve urinary symptoms.3 The prevalence of the condition is unknown and probably underreported owing to embarrassment of patients so a high index of suspicion and targeted history taking play an important role in correctly diagnosing the condition. Late presentation may lead to complications such as recurrent urinary tract infection and urolithiasis or, less commonly, erosion of foreign body to adjacent organs.5 Presenting time is highly variable, ranging from hours to months.1 Delay in seeking medical consultation may stem from ignorance, psychiatric illness, or embarrassment.1 X-ray is often performed but is helpful in identifying only radio-opaque objects. [...]insertion of a foreign body into the lower urinary tract for erotism is not uncommon, especially in men.

To evaluate the use of an electronic barcode system for patient identification during blood transfusion. Retrospective study. Regional hospital, Hong Kong. For all patients requiring blood transfusion between May 1999 and April 2002, with the exception of patients in the psychiatric wards and the accident and emergency department, a portable, hand-held scan-and-print electronic device was used to verify and document patients' identity at two critical points of transfusion: blood sampling for the compatibility test and blood administration. Scope of use of the electronic device, cost, effectiveness, staff compliance, problems and solution for improvement. In the first 3 years of hospital-wide use of the new device, no incidents of blood transfusion to wrong patients, or wrong labelling of blood samples, occurred with 41,00 blood sampling procedures and administration of 27 000 units of blood. Blood sampling took 6 minutes to complete with the use of the electronic device-similar to that taken by the conventional second-checker system. Among hospital staff, the compliance rate of using the new device approached 90%. Battery problems occurred in 12% of episodes of use of the device. The electronic barcode system was effective in reducing human error related to bedside transfusion procedures. The future goal is to tailor-make a more efficient device with additional functions.

Leukocyte contamination during blood transfusion can cause many adverse effects, such as the transmission of cell-associated infectious agents, febrile non-haemolytic reactions, graft-versus-host disease, and immunosuppression. While using leukodepleted blood components can minimise some of these adverse effects, the leukodepletion of all cellular blood components is costly. A more cost-effective alternative would be to supply leukodepleted blood components to at-risk patients only.

To the Editor: There have been a few case reports of malignant melanoma occurring in both husband and wife. 1 2 3 4 5 Two of these cases had an unknown primary site. This report is of a similar instance of malignant melanoma occurring in both husband and wife — one of whom had an unknown primary site. The wife presented at Tulane Medical Center at 55 years of age in September 1983, with a 3-by-5-cm mass in the left axilla. A biopsy was performed; Dr. Richard Reed of Tulane University School of Medicine reviewed the histology and diagnosed a spindle-cell malignant neoplasm compatible with . . . No extract is available for articles shorter than 400 words.

A prospective study of Chinese patients with megaloblastic anaemia was conducted at the Pamela Youde Nethersole Eastern Hospital from 1 May 1994 to 31 August 1997. Megaloblastic anaemia was diagnosed in 57 patients, 52 of whom were eligible for further evaluation. The median age of these 52 patients was 73.5 years and the male to female ratio was 1.08:1. The serum cobalamin level (median, 56 ng/L) was low in 46 (86.5%) patients. In five (9.6%) patients, both serum cobalamin and red blood cell folate concentrations were low. Isolated low red blood cell folate level was demonstrated in one (1.9%) patient. Serum antibodies against intrinsic factor and gastric parietal cells were detected in 32 (61.5%) and 26 (50.0%) patients, respectively; 19 (36.5%) patients had both types of antibody. The aetiology of megaloblastic anaemia included pernicious anaemia in 39 (75%) patients, postgastrectomy vitamin B12 deficiency in five (9.6%) patients, and nutritional deficiency in two (3.8%) patients; the cause was undetermined in six (11.5%) patients.

JOAN and I were expecting Mr. Shia Poeng Chuang. Shia was my friend. We went to college together in China. Together we joined the Chinese Army during World War II, and were sent to the U. S. as liaison officers. Then came the defeat of the government by the Communists.