Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Comparative Study
Improving the Surgical Outcomes after Liver Resection with ERAS Program.
Enhanced recovery after surgery (ERAS) has been accepted as the program to improve the surgical outcomes. This program has been increasingly utilized in liver resection. ⋯ ERAS program improves the surgical outcomes in patients who underwent liver resection.
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Explore the characteristics of insomnia in persons with heart failure and identify the predictive factors of insomnia in patients with heart failure. ⋯ Insomnia is a significant problem in heart failures patients. Therefore, healthcare providers need to pay attention to this sensitive outcome. Several factors should be considered for further management.
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Reintubation, following an unsuccessful extubation from mechanical ventilation is traumatic to the infant and the family. However, 20 to 40% of infants fail extubation and reintubation. ⋯ The SBT and minute ventilation ratio in low birth weight infants were not optimal predictors of readiness for extubation. However, a further prospective study in this field with a larger number of subjects and a proper indication for extubation should be considered.
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Necrotizing fasciitis (NF) is a rapidly progressive inflammatory infection of the fascia. Early diagnosis of NF is essential, as delayed diagnosis leads to higher rates of amputation and mortality. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is used to obtain early diagnosis in order to reduce morbidity and mortality rates. ⋯ The LRINEC score is a diagnostic tool which can assist in differentiating NF from cellulitis. Many adjuncts have been described which can help to achieve early recognition of the disease, and the LRINEC score is a reliable tool for use by surgeons in identifying diseases that can develop into NF.
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Observational Study
Complications and Outcomes in Breast Reconstruction using A Transverse Rectus Abdominis Myocutaneous Flap-Single Surgeon Experience.
Breast cancer is the most common cancer in Thai women. Current treatments of breast cancer aim not only at complete cure but also at maintaining the patients’ quality of life. Mastectomy is still a standard procedure for removal of cancer, but nowadays the patient has many modalities to choose from in order to achieve cosmetic satisfaction. Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is one of the options; however, it is a complicated procedure because of its resultant longer operative time, decrease in abdominal wall strength, and unpredict ability of blood supply in some areas. ⋯ TRAM flap reconstruction after mastectomy is an appropriate way to improve the patient’s postoperative physical appearance. The results of this study indicated that TRAM flap reconstruction after mastectomy is safe, with an acceptably low number of complications and can be performed by a single surgeon in conjunction with a mastectomy procedure; furthermore, the majority of patients were satisfied with their reconstructed breast.