A survey of wasp sting injuries in urban Auckland from December to April in 1991/2 and 1992/3

AIM

To determine the numbers and the seasonal variations in patients seeking medical consultation for wasp sting injuries in urban Auckland.

METHOD

A monthly record of the number of people seeking treatment for wasp stings was kept by 50 general practitioners from 18 medical centres and accident and emergency departments from three hospitals in urban Auckland.

RESULTS

From December to April, 47 people in 1991/2 and 49 in 1992/3 received treatment for wasp sting injuries from the family practitioners surveyed. In addition, 27 people and 35 people received treatment at the three accident and emergency clinics over the same time period in 1991/2 and 1992/3 respectively. Paper wasps were found to be responsible for the majority of the sting injuries reported.

CONCLUSION

Our data indicates that wasp stings have a significant impact on the health of the Auckland population and indicates the urgent need for more detailed studies in other parts of New Zealand.

The regulation of IgG4. 1. An immunoassay to detect bee venom specific IgG4 subclass levels

Serum IgG consists of 4 subclasses designated IgG1-4. IgG subclasses have differing structures and different functions. The levels of antigen specific immunoglobulin in each of the subclasses is difficult to quantitate accurately but may be of significant diagnostic and therapeutic value. IgG4 constitutes approximately 4% of total IgG level in the serum. We describe an immunoassay which is highly sensitive and specific for IgG4 directed against bee venom. The assay can be performed in a routine diagnostic laboratory enhancing its value as a clinical tool. It is potentially useful in identifying patients who fail to respond to standard immunotherapy with bee venom. This immunoassay format can also be adapted to other antigens.

Metastatic malignancy associated with reflex sympathetic dystrophy

A patient who presented with reflex sympathetic dystrophy of the foot is described. Biopsy confirmed metastases of the small bones which at postmortem proved to be from carcinoma of the lung.

The alveolar carbon monoxide uptake fraction: a simple, alternative measure of carbon monoxide transfer

The measurement and interpretation of "diffusing capacity" by either single-breath or steady-state methods are complicated by both technical and conceptual difficulties. The CO uptake fraction is less complex but, as originally described, it is unacceptably sensitive to dead-space ventilation. A modification (the "alveolar CO uptake fraction", UA) largely removes this factor. We have measured UA in thirteen healthy subjects and 100 patients with a variety of pulmonary disorders. It is reproducible and appears sensitive to clinical abnormality. Its technical and interpretative simplicity suggest its use as an alternative to other measures of CO transfer.

The alveolar carbon monoxide uptake fraction: a simple, alternative measure of carbon monoxide transfer

The measurement and interpretation of "diffusing capacity" by either single-breath or steady-state methods are complicated by both technical and conceptual difficulties. The CO uptake fraction is less complex but, as originally described, it is unacceptably sensitive to dead-space ventilation. A modification (the "alveolar CO uptake fraction", UA) largely removes this factor. We have measured UA in thirteen healthy subjects and 100 patients with a variety of pulmonary disorders. It is reproducible and appears sensitive to clinical abnormality. Its technical and interpretative simplicity suggest its use as an alternative to other measures of CO transfer.