Early releases for July 5, 2011 (about CUAJ early releases)
Variables influencing the likelihood of cardiac dysrhythmias during extracorporeal shock wave lithotripsy
Thomas A. A. Skinner, Richard W. Norman
Abstract
Laparoscopy, dorsal lumbotomy and flank incision live donor
nephrectomy: comparison of donor outcomes
Dinesh Samarasekera, David S.H. Kim, Rachel Wang, Gordon Yip, Steven S. Tang, Christopher Nguan
Abstract
Variables influencing the likelihood of cardiac dysrhythmias during
extracorporeal shock wave lithotripsy
Abstract
Introduction: Extracorporeal shock wave lithotripsy (ESWL) is a
safe and effective treatment of upper urinary tract calculi. While
serious side effects are rare, transient cardiac dysrhythmias (CD)
may be associated with ESWL. The exact etiology of these events,
which are often unpredictable, is poorly understood. Awareness
of CD during ESWL and identification of risk factors for developing
them could help clinicians predict and manage them safely
and effectively. The current study examines selected variables to
determine whether they may predispose individuals to developing
CD during ESWL.
Methods: We compared 16 patients who experienced CD during
ESWL to 56 control patients. Cases and controls were compared
with respect to several continuous and discrete variables, including
age, pre-treatment heart rate, number of shocks received during
treatment, energy setting of the lithotripter, gender, presence of a
ureteric stent, previous ESWL and side being treated.
Results: Cardiac dysrhythmias occurred more frequently in younger
patients and in those being treated for right-sided stones. The other
variables did not influence the likelihood of CD. All CD resolved
promptly following conversion to electrocardiogram (ECG)-gating.
Conclusion: Younger age and right-sided treatment predisposed
individuals to developing CD during ESWL. Careful ECG monitoring
should be performed during treatment.
Laparoscopy, dorsal lumbotomy and flank incision live donor nephrectomy: comparison of donor outcomes
Abstract
Background: Flank incision (FL), dorsal lumbotomy (DL) and laparoscopic
surgery have been effective approaches to donor nephrectomy.
While laparoscopic donor nephrectomy (LDN) has become
increasingly popular, there has yet to be a direct comparison of
the three modalities.
Methods: We performed a retrospective chart review of FL, DL and
LDN operations between 2002 and 2010 within a single institution.
Donor and recipient characteristics, as well as surgical outcomes,
were assessed.
Results: There were 496 donor nephrectomy operations available
for analyses. Patients in the LDN group had the lowest estimated
blood loss, compared to the DL and FL groups (p < 0.001), lowest
rate of complications (p < 0.01), and shortest hospital stay
(p < 0.0001). Donors who underwent DL used an average of
60.12 ± 5.0 mg of morphine, which was significantly less than
that used by patients in the LDN (93.2 mg, p < 0.0001) and FL
(111.82 mg, p < 0.001) groups. Mean serum creatinine of recipients
at day 1 post-op was the highest in the FL group (p < 0.0001
FL vs. LDN, p < 0.001 FL vs. DL), but there were no significant
differences between the three groups at 2 weeks, 6, 12, 18, and
24 months post-operation (p > 0.45).
Conclusion: Although a lower pain experience of LDN was not
indicated, the use of LDN should be favoured over DL and FL as it
is associated with fewer complications, and shorter length of stay.
Of note, DL appears to be associated with higher complications
and is likely not a preferred option for donor nephrectomy.
CUAJ has adopted an early release model, in which papers are published online in advance of their print publication. The print publication schedule remains the same: February, April, June, August, October, December; however, CUAJ is now posting new early release articles on its website (www.cuaj.ca) every other month (January, March, May, July, September, November). CUAJ early releases articles only apply to research articles.
These early release articles are peer-reviewed, accepted, edited and formatting just like print articles, except for the fact that they are released online before they are published in print and do not have a volume/issue/page number. Only the digital object identifier (DOI) is used as an identifier for the article (i.e., DOI:10.5489/cuaj.09116). The "DOI:10.5489" is the journal identifier and the "cuaj.09116" is the identifier associated with a particular article. Each CUAJ article carries a DOI, which serves as its unique electronic identification tag. As soon as an article is published in a print issue, it will be assigned a page number and transferred to that issue's table of contents on the website. The DOI remains attached to the paper to provide a persistent identifier.
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