Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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To study the recent trend of health-care associated infections (HAIs) across Thailand. ⋯ Recently, no significant change on nationwide prevalence and trend of HAIs in Thailand were demonstrated. Notably, Acinetobacter spp. emerged as the most common etiologic agents of HAIs.
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The Acute Dialysis Quality Initiative (ADQI) group developed RIFLE criteria and the Acute Kidney Injury Network published AKIN classification that modified form RIFLE criteria. ⋯ AKIN criteria improved sensitivity for detection of AKI and its discrimination for prediction of in-hospital mortality was better than that of RIFLE criteria. However, APACHE II had the best discriminative value for prediction of mortality in the critically ill patients.
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Comparative Study
Use of different approaches of acid-base derangement to predict mortality in critically ill patients.
There have been controversial data regarding the application of acid-base analysis based on Stewart methodology to predict clinical outcome in different populations. ⋯ Compared to the traditional approach, an alternative Stewart approach does not provide any greater advantage to predict mortality in the studied population. Because of complex calculation, the usefulness of such approach on the routine clinical practice may be limited.
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Cardiac trauma, if not recognized and properly treated, will lead to a fatal outcome. For the past 16 years, the authors' policy for diagnosing and treating cardiac trauma has not changed but the survival rate in our institute has improved when compared between the two cohorts. ⋯ High index of suspicion and prompt management for cardiac trauma should be considered in patients presenting with injuries to the chest, which has been the authors' policy for the past 16 years. The mortality rate had dropped from 26% to 4% but is not statistically significant.