Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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Comparative Study
Robot-assisted versus standard laparoscopic partial nephrectomy: comparison of perioperative outcomes from a single institution.
To evaluate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy and standard laparoscopic partial nephrectomy in a teaching hospital. ⋯ Robot-assisted laparoscopic partial nephrectomy is a technically feasible alternative to standard laparoscopic partial nephrectomy, and provides comparable results. Robot-assisted laparoscopic partial nephrectomy appears to offer the advantage of decreased warm ischaemic time. Longer follow-up is required to assess renal function and oncological outcomes. Further experience and randomised trials are necessary to compare robot-assisted with standard laparoscopic partial nephrectomy.
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Multicenter Study
Hong Kong's experience on the use of extracorporeal membrane oxygenation for the treatment of influenza A (H1N1).
To report Hong Kong's experience on the use of extracorporeal membrane oxygenation for the treatment of acute respiratory distress syndrome caused by influenza A (H1N1). ⋯ In response to the pandemic of influenza A (H1N1), some intensive care units in Hong Kong were able to offer extracorporeal membrane oxygenation to selected cases. In this small series, patient outcomes were similar to those reported in other observational studies, indicating that intensive care units in Hong Kong are capable of successfully introducing this technology. However, the cost-effectiveness and optimal delivery of this strategy remain uncertain.
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Local anaesthetic administration is a common clinical practice not only in the operating theatres, but also in other clinical settings. Relevant monitoring and resuscitation facilities in certain clinical settings outside the operation rooms may not be optimal. ⋯ This article reviews the pharmacology of local anaesthetics, clinical features of systemic toxicity resulting from their local use, and necessary preventive measures and management. The role of lipid emulsion therapy is also discussed.
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Case Reports
Cast nephropathy with acute renal failure treated with high cut-off haemodialysis in a patient with multiple myeloma.
We report a case of a Chinese woman who presented with multiple myeloma and acute renal failure due to cast nephropathy, with an extremely high serum lambda free light chain concentration. She was successfully treated with chemotherapy and high cut-off extended haemodialysis. High cut-off haemodialysis is a new treatment modality which can achieve rapid free light chain clearance. This may contribute to a better renal outcome and overall prognosis for patients with multiple myeloma.
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Sudden deaths of children and adolescents during competitive sports are usually due to congenital heart diseases. Ventricular fibrillation, however, may also occur in individuals with no underlying cardiac disease who have sustained a low-impact chest wall blow. This phenomenon is described as commotio cordis, and the overall survival rate is poor. ⋯ Ventricular fibrillation was detected and responded to defibrillation. Subsequent investigations including imaging and electrophysiological studies did not reveal any cardiac or brain abnormality, and the patient recovered well neurologically. Accessible cardiopulmonary resuscitation-trained personnel and automated external defibrillators should be present at all organised sporting events.