Conclusions-Linking national surveillance with a specialised laboratory service allowed estimation of HUS incidence and provided information on its aetiology. In contrast to North America, Japan, and the British Isles, STEC O157:H7 is rare in Australia; however, non-O157:H7 STEC cause severe disease including outbreaks. Disease severity in outbreak cases may relate to yet unidentified virulence factors of the O111:H− strain isolated. (Arch Dis Child 2001;85:125-131)

Two years ago we were impressed by an apparently high incidence of hypertension and diabetes mellitus among patients admitted for surgery for benign prostatic hypertrophy. Wishing to investigate this further we studied the records of 432 men who were operated upon at The London Hospital from 1958 to 1963. Histological confirmation of the diagnosis was present in every case included in this series. The age of the patient (Fig. l), his blood-pressure on admission, 100- 90-blood urea and blood group were recorded ; it was also noted whether the patient was a known diabetic or not. The majority of patients were admitted for elective surgery and their bloodpressure recorded for the present purposes was that taken at their routine admission examination.When the patient was admitted to a surgical ward after medical treatment, the blood-pressure reading nearest to operation was used. In patients in whom a two-stage transvesical operation was undertaken, the blood-pressure reading used was that prior to the operation for the second stage. The blood urea estimation used was that taken prior to operation, and in the case of the two-stage transvesical prostatectomy the blood urea recorded was that prior to the second stage.The blood-pressures of a control series of male patients admitted from 1958 to 1963 for elective surgery upon areas other than the genito-urinary tract were matched as closely as possible with the benign prostatic hypertrophy series. Men in this series with symptoms or signs of prostatic hypertrophy were excluded. A female series of similar size was also obtained.

A total of 300 patients undergoing elective colorectal surgery over a 3-year period were randomly assigned to receive intraoperative peritoneal lavage with either taurolidine or saline. Culture swabs were taken from the region of surgery before and after lavage and the development of postoperative infection monitored. Of the positive culture swabs before lavage, a significantly higher proportion were negative after lavage with taurolidine than after that with saline. However, there was no difference in the incidence of postoperative infection between groups, suggesting that taurolidine intraoperative peritoneal lavage confers no clinical benefit over that with saline.

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A randomized prospective trial of closed suction wound drainage compared with corrugated wound drainage after simple mastectomy for early breast cancer (lesion confined to the breast and without skin ulceration) is reported. Fifty-one patients were admitted to the study and there was no difference between the two groups with respect to local complications such as ifection, skin necrosis and collection under flaps and wound healing. Dressings require to be performed significantly less frequently with suction as opposed to corrugated drainage and suction drains were removed significantly sooner than corrugated drains. It is concluded that closed suction wound drainage should be used after simple mastectomy.

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There are variations in the management of acute stroke because of ethnicity and these variations could have substantial consequences on secondary rates of cerebrovascular and cardiovascular disease. Whether the reasons for this disparity are attributable to inequity or iniquity of care need to be further investigated perhaps along with the development of ethnicity specific protocols. Overall the management of stroke and its risk factors in either racial group remains lamentable.