J Formos Med Assoc
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Comparative Study
Comparison of predictive accuracy among six prognosis prediction systems for patient mortality in intensive care units.
This study compared the goodness-of-fit of six prognostic prediction systems. ⋯ In this study, MPM II or APACHE II had the best predictive model of the tested systems for critically ill patients.
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Failure of embryologic development of a lobe of the thyroid gland is a rare anomaly. We report a 47-year-old female with right thyroid hemiagenesis, papillary thyroid cancer, and an ectopic prelaryngeal thyroid rest. ⋯ During the operation, an isthmus and an enlarged left lobe with a cancer mass 2 cm in diameter were found, and a solitary piece of thyroid tissue about 0.7 cm in length was present just below the hyoid bone. We conclude that recognition of this rare anomaly by means of both scintigraphy and ultrasonography is valuable for a complete thyroidectomy, and for avoiding unnecessary contralateral dissection and damage.
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Few reports exist concerning the peak serum concentration of creatine kinase (CK) and the severity of crush syndrome, and the efficacy of fasciotomy in crush syndrome patients remains controversial. This study aimed to analyze and assess the clinical features, treatment, and outcome of patients with crush syndrome sustained in the Chi-Chi earthquake in September 21, 1999. ⋯ CK concentration is a good indicator of the occurrence of acute renal failure and the need for dialysis. The high infection rate and amputation rate after fasciotomy may be due to inadequate debridement. Fasciotomy in crush syndrome patients with high serum CK concentrations should be deliberated.
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Many reports have confirmed that endoscopic ultrasonography (EUS) can differentiate gastric submucosal tumor from extragastric compression, but only a few specifically concentrated on EUS in identifying the causes of external compression. ⋯ When an extragastric compression mimicking submucosal tumor is detected by upper gastrointestinal endoscopy, EUS is indicated to identify the cause of extragastric compression.
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Advances in critical care medicine have increased the chances of survival for patients with severe illness or trauma. However, such patients consume a large proportion of medical resources. This study sought risk factors for mortality that have potential to be modified among patients treated in medical or surgical intensive care units (ICUs). ⋯ In addition to SIRS and the APACHE II and TISS scores, this study found that nosocomial Candida infection and parenteral nutrition were independently associated with mortality after control for admission conditions, severity of illness scores, and interventions.