Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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To assess the cost effectiveness of an initial ICU admissionforpatients with severe sepsis or those in septic shock following the initial resuscitation in the emergency department. ⋯ Immediate ICU admission for patients with severe sepsis or in septic shock following the initial resuscitation in the emergency department has shown a satisfactory cost-effectiveness profile in low-to-middle income countries.
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To evaluate the performance of arterial pressure-based cardiac output (APCO) and pulse wave transit time-based cardiac output (esCCO) monitors in Thai patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ Despite the overestimation of CO measurements, APCO and esCCO calibrated with patient information has shown an acceptable trend as compared to TDCO in Thai patients undergoing CABG with cardiopulmonary bypass. Compared to esCCO, APCO demonstrated no significant differences ofprecision however; a lower mean bias was exhibited.
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In addition to cardiopulmonary monitoring, non-cardiopulmonary monitoring (non-CPM) is considered to be an important parameter in intensive care units (ICUs). However no data on this subject has been reported for Thai ICUs. The objective of the present study is to describe the non-CPM situation in Thai ICUs. ⋯ Some of the more advanced non-CPM devices are not found in Thai ICUs. Basic non-CPM devices are available in all ICUs. Some new devices for measurements and for biomarkers are used with greater prevalence in ACAD ICUs. Some measurements including IAP core temperature, lactate and ScvO2/SvO) are monitored less frequently in Thai ICUs (Thai Clinical Trial Registry: TCTR-201200005).
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Comparative Study
Comparison of 18F-FDG Pet/CT and CT: diagnosis performance in lymphoma patient after treatment.
Retrospectively comparing 18F-FDG PET/CT and CT findings at the same anatomic locations in patients with lymphoma by using a combined PET/CT scanner and to analyze the lesions on both metabolic and anatomic bases to evaluate their sensitivity specificity positive predictive value (PPV), negative predictive value (NPV), and accuracy. We analyzed all studies, all patients, common cell type in this study such as diffuse large B cell lymphoma (DLBCL) and Hodgkin's lymphoma and indication of the study such as restaging for recurrence post-therapy and evaluate residual disease within two months after chemotherapy. ⋯ The PET/CT is better than CT for post-treatment lymphoma patient particularly for cell type of DLBCL and indication for evaluation of active lymphoma within two months after chemotherapy.
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Recent treatments in hematological malignancies have substantially improved. Unfortunately, once a patient with a hematological malignancy has complications, the prognosis is poor and the in hospital and ICU mortality rates are high. Debates concerning the reluctance to admit patients into ICUs with poor prognoses often emerge. The aim of the present study is to identify the patients who are more likely to benefit from ICU admissions. ⋯ Patients with lymphoma and acute myeloid leukemia admitted into the ICU referral center in the south of Thailand who had mechanical ventilation, use of vasopressors and APACHE II scores greater than 27 were associated with a higher ICU mortality rate. The authors suggest that early identification of the subgroup of patients whose probability of survival is so low that advanced ICU support should not be continued would be a more reasonable goal. This will allow more efficient care to potential survivors not in this group.