Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Comparative Study
Body surface area and age as a guidance of the dose of intrathecal 0.5% heavy bupivacaine and fentanyl in transurethral procedures.
Observe the potency of various drugs doses as milliliters of 0.5% heavy bupivacaine with or without fentanyl for spinal block in transurethral cystoscopic procedures. These doses were calculated from patients and drugs 'characteristic risk factors that interfered with intrathecal drugs spread as weight, height, age, volume, and baricity. Various doses of fentanyl were also added to increase potency of block as necessary except the oldest group. ⋯ Age and body surface area guided spinal anesthesia is safe. The dose of bupivacaine is lower when combined with fentanyl. Furthermore, hemodynamic stability is better. The technique is suitable for transurethral procedure within 60 minutes but not in longer operation time. Additionally, it needs patients' cooperation due to less potent of motor and pressure sensation block.
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Comparative Study
Health insurance system and healthcare provision: nationwide hospital admission data 2010.
The three major health insurance systems are different in their medical service coverage, reimbursement process and choice of providers; leading to the question of how great are the variations in the healthcare offered and disease outcomes. ⋯ The differences in charges for some groups of diseases and significantly different clinical outcomes across schemes existed. The differences in disease outcomes were not adjusted for socioeconomic status and disease severity, requiring a cautious interpretation; nevertheless, an association with a higher mortality rate under the UC scheme for inpatient services need prompt further study
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Primary percutaneous coronary intervention (PCI) appears to be the preferred reperf usion methodfor patients with ST-segment elevation myocardial infarction (STEMI). This method was introduced in our hospital before the year 2000. In Thailand, data showing long experience results in patients with STEMI who underwent primary percutaneous coronary intervention remain limited. ⋯ During 11 years of primary PCI experience in King Chulalongkorn Memorial Hospital, the angiographic success rate was high with acceptable in-hospital mortality and major adverse cardiac event. This strategy of treatment should be the treatment of choice for patients with STEMI in experienced PCI capable center with 24 hours/7 days availability.