Extensive necrotising fasciitis in a 4-day-old neonate: a successful outcome from modern dressings, intensive care and early surgical intervention.

Necrotising fasciitis (NF) is a fulminant and life-threatening soft tissue infection, which leads to vascular thrombosis and cutaneous ischemia. We present our experience with extensive necrotising fasciitis in a 4-day-old neonate and stress the importance of early diagnosis, modern dressings including negative pressure therapy, prompt surgical debridement and intensive care to improve the survival and cosmetic outcome of children with NF.

Gastroschisis: determinants of neonatal outcome.

This retrospective study elicits information regarding the dependence of neonatal outcome in gastroschisis upon: (1) the mode of delivery, (2) place of birth, (3) time for birth to surgery, (4) method of closure, (5) time from operation to commencement of first enteral feeds. The neonatal intensive care database from five major tertiary centres was used to identify 181 neonates with gastroschisis from 1990 to 2000. There were 8 deaths.

Cardiac arrest outcomes at the Melbourne Cricket Ground and shrine of remembrance using a tiered response strategy-a forerunner to public access defibrillation.

The provision of medical, paramedical and first aid services at major public events is an important concern for pre-hospital emergency medical care providers. Patient outcomes of a cardiac arrest response strategy employed at the Melbourne Cricket Ground (MCG) and the Shrine of Remembrance by St John Ambulance Australia volunteers are reported. Twenty-eight consecutive events occurring between December 1989 and December 1997 have been analysed.

Does tea tree oil have a place in the topical treatment of burns?

Burnaid is a sorbalene-based cream containing 40 mg/g of tea tree oil and 1 mg/g of triclosan. This investigation was carried out to determine the effect of Burnaid, a commercial tea tree oil preparation, against Enterococcus faecalis (ATCC29212), Staphylococcus aureus (ATCC29213), Escherichia coli (ATCC25922), and Pseudomonas aeruginosa (ATCC27853), with the activity of the base product in the commercial preparation. The organisms were suspended in sterile saline (0.

Critical appraisal of surgical venous access in children.

Central venous catheters (CVC) have become an important adjunct to the overall management of paediatric patients, but their use is associated with frequent complications resulting in premature removal. This report evaluates the insertion techniques and complications of 295 consecutive surgically inserted CVC from 1987 to 1991 in a paediatric hospital. Fully implanted catheters had significantly less incidence of catheter-related problems necessitating removal (infection, dislodgment, leaking, blockage, or migration - 31%) compared to exteriorised catheters (58%).

Critical appraisal of surgical venous access in children.

Central venous catheters (CVC) have become an important adjunct to the overall management of paediatric patients, but their use is associated with frequent complications resulting in premature removal. This report evaluates the insertion techniques and complications of 295 consecutive surgically inserted CVC from 1987 to 1991 in a paediatric hospital. Fully implanted catheters had significantly less incidence of catheter-related problems necessitating removal (infection, dislodgment, leaking, blockage, or migration - 31%) compared to exteriorised catheters (58%).

Hereditary presacral teratoma.

A case of hereditary presacral teratoma involving father and daughter is described. The use of magnetic resonance imaging in the diagnosis of this condition is illustrated and a review of the literature of this unusual condition is presented.

Bicycle incidents in children--abdominal trauma and handlebars.

Objectives: To investigate the frequency and causes of bicycle related abdominal injuries in children and to examine the pattern of presentation.

Design: The study was a prospective study of bicycle related injury in children less than 15 years of age presenting to two paediatric hospitals (15 April-30 June 1992) and three general hospitals (1 August 1991-30 June 1992).

Results: In a series of 813 children, 41 sustained non-penetrating abdominal trauma due to a bicycle incident.

Metastasis of pineal germinoma via ventriculoperitoneal shunt.

The case of a 13 year old boy with pineal germinoma and subsequent metastasis 3 years later via ventriculoperitoneal shunt to the abdominal cavity is presented. The abdominal disease was managed with chemotherapy and subsequent surgical resection. He remains free of disease 2 years following the resection.

Cutaneous button battery injury: a new paediatric hazard.

Button or disc batteries have become increasingly popular as the energy source for electronic devices such as cameras, calculators, computers, watches, hearing aids and children's toys. Button battery burns to the gastrointestinal tract, ear and nose have been reported in children from many centres. Cutaneous injury from these sources has not been similarly reported.

Segmental dilatation of the small bowel: report of three cases and literature review.

Segmental dilatation of the small bowel is a rare congenital abnormality that occurs mainly in children and produces significant nonspecific symptoms. The authors reviewed 33 cases reported in the literature and present three new cases in which the lesion was demonstrated on radiographs obtained before laparotomy. These cases showed the spectrum of symptoms and characteristic radiologic features of this condition in both plain abdominal radiographs and barium studies.

Renal and urinary tract complications following the intravesical instillation of formalin.

The case is reported of a 10-yr-old girl who developed intractable hematuria from hemorrhagic cystitis following chemotherapy for a malignant lymphoma. Following the intravesical instillation of formalin, which controlled the hematuria, she developed oliguria attributable to ureteric stenosis and fibrotic contraction of the renal pelves. Bilateral nephrostomies were constructed, but recurrent pyelonephritis and further renal pelvic obstruction developed.

Spontaneous neonatal renal vein thrombosis.

A case of spontaneous neonatal renal vein thrombosis is presented. A 1 week old, 36 week gestation, male child presented with gross haematuria and a large right flank mass. Investigations including intravenous pyelogram, ultrasound and venacavogram indicated the diagnosis.