Ann Acad Med Singap
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Because the use of procalcitonin (PCT) as a marker of bacterial infection has been advocated, this study was carried out to determine the usefulness of plasma PCT in the early diagnosis and differentiation of patients with non-infectious systemic inflammatory response syndrome (SIRS) from those with sepsis, and the relationship between plasma PCT level and severity of organ failure. ⋯ CRP is increased by inflammatory disease as well as infection and is therefore not a good indicator of infection in patients with severe SIRS. On the other hand, PCT is a good indicator of severity of sepsis and organ failure in patients with severe SIRS since PCT levels correlated with sepsis and SOFA scores. PCT level is useful for diagnosis of sepsis and as an indicator of severity of organ failure in patients with SIRS.
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This is a retrospective study to assess the accuracy of the Alvarado score in predicting appendicitis for patients with right iliac fossa pain. ⋯ Alvarado score is a useful tool in the diagnosis of appendicitis, especially at both ends of the scale.
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Ann Acad Med Singap · May 2001
Obstetric admissions to the intensive therapy unit of a tertiary care institution.
Between 0.1% and 0.9% of women develop pregnancy complications which require admission to an intensive therapy unit. The aim of this study was to review all obstetric admissions to the intensive therapy unit at the KK Women's and Children's Hospital from 1998 to 1999 with respect to indications for admission, interventions employed and clinical outcome. ⋯ The admission rate to the intensive therapy unit in our institution was 0.73% of all deliveries during the 2-year study period. Hypertensive disease and haemorrhage were the predominant admitting diagnoses.
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The optimal haematocrit for the critically ill patient is undetermined. ⋯ Oxygen consumption requires oxygen delivery. Haematocrit delivers oxygen. However, if oxygen delivery is not limited by haematocrit or is achieved by other means, then the concept of the optimal haematocrit is irrelevant. There are currently no guidelines for the management of anaemia in the critically ill.
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Ann Acad Med Singap · May 2001
An audit of patients with rheumatic disease requiring medical intensive care.
Medical intensive care for patients with rheumatic disease is usually complicated by significant morbidity and mortality. The aims of this study were to examine the reasons for admission, the outcomes of these patients and the possible prognostic factors in an Asian cohort. ⋯ Many of our critically-ill patients with rheumatic disease were young females with good functional status. Despite the high mortality, they should be aggressively treated because infection and acute respiratory failure are potentially reversible.