Implications of a new element in the early diagnostic pathway for prostate cancer for rural Australians.

Aims: To demonstrate the magnitude of the potential problem caused by the trend towards using positron emission tomography prostate-specific membrane antigen scans on men in rural Australia.

Context: Prostate-specific membrane antigen positron emission tomography scans have higher sensitivity to detect metastatic prostate cancer than other imaging modalities, especially at lower prostate specific antigen (PSAs). This has led to proposals that prostate-specific membrane antigen be the gold standard to investigate men with a suspicion of prostate cancer.

Editor's choice: Implications of isoniazid resistance in Mycobacterium bovis Bacillus Calmette-Guérin used for immunotherapy in bladder cancer.

We report a case of sepsis from Mycobacterium bovis Bacillus Calmette-Guérin (BCG) with low-level isoniazid resistance following intravesical treatment for bladder cancer. Isoniazid resistance in BCG has therapeutic implications when it causes infections after intravesical instillation. For these circumstances, we propose some modifications to existing treatment guidelines for BCG infection.

Type 2 and clear cell papillary renal cell carcinoma, and tubulocystic carcinoma: a unifying concept.

The clinical and pathological features of multiple different renal neoplasms arising in a setting of end-stage renal disease in a 72-year-old male are described. The kidney showed features of renal oncocytosis with multiple oncocytomas, hybrid tumours and chromophobe renal carcinoma. In addition, the kidney contained a type 2 papillary renal cell carcinoma, clear cell papillary and cystic renal cell carcinoma, and tubulocystic carcinoma.

Screaming, shrieking and muttering: the noise-makers amongst dementia patients.

We have described twelve dementia patients with noise making. We categorized noise making into (i) persistent screaming, (ii) perseverative vocalization, (iii) continuous chattering, muttering, singing or humming, and (iv) swearing, grunting and bizarre noise-making. The patients' ages ranged from 70 to 92 years with a mean of 78.