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Bankstown, Australia

Emder P.J.,Bankstown Hospital | Jack M.M.,Paediatric Diabetes and Endocrine Service
Journal of Paediatrics and Child Health | Year: 2011

Mild iodine deficiency is a recognised problem in Australia and New Zealand. However, iodine excess can cause hypothyroidism in some infants. We highlight two cases which illustrate the risks of excess dietary iodine intake during pregnancy and breastfeeding. They also describe a cultural practice of consuming seaweed soup to promote breast milk supply. Although most attention recently has been on the inadequacy of iodine in Australian diets, the reverse situation should not be overlooked. Neither feast nor famine is desirable. © 2011 The Authors.

Jefferson N.,Liverpool Hospital | Riffat F.,Liverpool Hospital | McGuinness J.,Liverpool Hospital | Johnstone C.,Bankstown Hospital
Laryngoscope | Year: 2011

Objectives/Hypothesis: To review the use of the laryngeal mask airway (LMA) in otorhinolaryngology, as well as the advantages and disadvantages across the range of procedures typically performed. Study Design: Contemporary review. Methods: Published articles identified through PubMed, Medline, and conference proceedings were reviewed. Results: With only minimal stimulation of the oropharyngeal airway at the time of insertion and removal, the LMA provides safe, hands-free airway maintenance and is ideally suited to many of the procedures performed in otorhinolaryngology. Conclusions: The relationship between surgeon and anesthetist is particularly strong in otorhinolaryngology. The impact of airway management on the surgical field and perioperative conditions requires the surgeon to be aware of contemporary tools and techniques available. The LMA has been shown to be safe and efficacious by both the literature and clinical practice. Its use in selected patients should be encouraged. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Mac K.,South Western Sydney Local Health District | Chavada R.,South West Sydney Pathology Services | Paull S.,Bankstown Hospital | Howlin K.,South Western Sydney Local Health District | Wong J.,South Western Sydney Local Health District
BMC Nephrology | Year: 2015

Background: Nephrotoxicity due to drugs especially beta lactams and cephalosporins has been well recognised. Cefepime is a fourth-generation cephalosporin that is widely prescribed with few severe adverse reactions reported. Although cefepime induced neurotoxicity has frequently been reported, there is yet no reported case of acute interstitial nephritis caused by this drug. We report a biopsy proven case of acute kidney injury due to acute interstitial nephritis associated with use of cefepime for treatment of mastoiditis and temporal bone osteomyelitis. Case presentation: A 62-year-old Caucasian female presented with symptoms of right sided mastoiditis. A brain Magnetic Resonance Imaging scan revealed presence of right sided mastoiditis with concurrent temporal bone osteomyelitis. Microbiological specimen isolated an Escherichia coli. Therapy was commenced with intravenous cefepime. After 4 weeks of therapy with intravenous cefepime she developed acute kidney injury. No other medications were taken by the patient. Urine analysis revealed non-nephrotic range proteinuria. There was no red cell casts or white cell casts. Renal biopsy confirmed acute interstitial nephritis as cause of acute kidney injury. Cefepime therapy was ceased and treatment with ciprofloxacin was given to complete the treatment course. Renal function improved only partially with conservative management without any corticosteroid use. To our knowledge this is the first report of cefepime induced interstitial nephritis. Conclusions: Although cefepime has been considered to be a safe antibiotic from nephrotoxicity point, like other cephalosporins this adverse effect can occur rarely. Physicians need to be mindful of nephrotoxicity associated with its use and careful monitoring of renal parameters should be performed in patients on prolonged therapy with cefepime. © 2015 Mac et al.; licensee BioMed Central.

McKay G.D.,Bankstown Hospital | Morgan M.J.,Bankstown Hospital | Wong S.-K.C.,Bankstown Hospital | Gatenby A.H.,Campbelltown Hospital | And 5 more authors.
Diseases of the Colon and Rectum | Year: 2012

BACKGROUND: Evidence demonstrates short-term benefits of laparoscopic surgery for colon cancer. The situation for rectal cancer is less clear. OBJECTIVES: This review assessed the use and short-term outcomes of elective open and laparoscopic colon and rectal cancer resections within an area health service. DESIGN: This was a multicenter, retrospective review of a prospective database. SETTINGS: All elective colon and rectal cancer resections in the western zone of Sydney South West Area Health Service from 2001 until 2008 were included. PATIENTS: Included were 1721 patients who underwent either a laparoscopic colon (n = 434) or rectal (n = 157) resection or an open colon (n = 742) or rectal (n = 388) resection. MAIN OUTCOME MEASURES: Outcomemeasures included operating time, blood loss, adequacy of resection, conversion rate, intensive care unit admission, length of stay, and 26 acute postoperative complications. RESULTS: Patients were matched for age, sex, ASA, BMI, and tumor stage. Laparoscopic surgery increased in frequency. Fewer patients experienced a complication in both the laparoscopic colon (28.8 vs 54.4%; p < 0.0001) and rectal (41.4 vs 60.3%; p < 0.0001) group irrespective of age. Laparoscopic operating time for colon and rectal cancer was 24.1 minutes (p < 0.0001) and 25.8 minutes (p < 0.0001) longer, with a low conversion-to-open rate (6.5% and 8.3%; p = 0.44). Laparoscopic surgery resulted in fewer transfusions (0.4 vs 0.7units; p = 0.0028) and length of stay (7 vs 10 days; p = 0.0011) for colon cancers, and reduced intraoperative hemoglobin drop (20.5 vs 24.8; p = 0.029) and intensive care unit admissions (26.8 vs 36.3%; p = 0.032) for rectal cancers. LIMITATIONS: This was a nonrandomized study with rectal cancers more often resected with the open technique (71.2 vs 28.8%; p < 0.001). CONCLUSIONS: Within an area health service, elective laparoscopic resection for colon and rectal cancer had improved short-term outcomes in comparison with open surgery. ©The ASCRS 2012.

McKay G.D.,Bankstown Hospital | Wong K.,Liverpool Hospital | Kozman D.R.,Bankstown Hospital
Radiation Oncology | Year: 2011

Radiation enteritis is a significant complication of external beam radiotherapy (EBRT) to the pelvis, particularly in patients having high dose radiotherapy (>80 Gy) and in those with a low pelvic peritoneal reflection allowing loops of small bowel to enter the radiation field. Laparoscopic insertion and subsequent removal of a pelvic tissue expander before and after external beam radiotherapy is a relatively convenient, safe and effective method for displacing loops of bowel out of the pelvis. We report on a patient with prostate cancer who ordinarily would not have been a candidate for EBRT due to loops of bowel low in the pelvis. With laparoscopic insertion and subsequent removal of a tissue expander, he was able to have radiotherapy to the prostate without developing radiation enteritis. © 2011 McKay et al; licensee BioMed Central Ltd.

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