Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Acute upper gastrointestinal bleeding (UGIB) is common and carries significant morbidity worldwide. Effective risk assessment for UGIB is required in order to deliver the optimal therapeutic plans. ⋯ The overall outcomes of UGIB were good, with better outcomes in NVUGIB than in VUGIB. AIMS65 score and serum sodium may be useful in predicting rebleeding and complications in UGIB.
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Comparative Study
A Comparison of Accuracy of Planar and Evolution SPECT/CT Bone Imaging in Differentiating Benign from Metastatic Bone Lesions.
To compare sensitivity, specificity, accuracy and diagnostic confidence in the differentiation between benign and metastatic bone lesions on whole body planar bone scintigraphy and Evolution SPECT/CT. ⋯ Differentiation of benign and metastatic lesions by Evolution SPECT/CT images has superior diagnostic performance and diagnostic confidence over the planar scintigraphy. Thus, Evolution SPECT/CT images should be considered in characterization of indeterminate lesions on planar scintigraphy, especially in the axial skeleton.
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To assess changes in physical fitness level and anthropometric characteristics of medical cadets in Phramongkutklao College of Medicine (PCM). ⋯ Male medical cadets tended to gain more weight over the four years spent at PCM. Health-related physical fitness of medical cadet improved in preclinical year and cardiorespiratory fitness declined in clinical year. To establish motivation to have regular physical activity in medical student, physical fitness test and anthropometric measurement should be integrated into the medical student’s curriculum.
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To evaluate the concordance of language lateralization between functional magnetic resonance imaging (fMRI) using Thai version of language paradigm and Wada test or awake surgery with direct cortical brain stimulation (DCS). ⋯ There was good concordance between fMRI and gold standard. Regional calculation from frontal lobes and whole brain excluded cerebellum and occipital lobes gave the best results. The results supported feasibility to use the fMRI with Thai language paradigm as an alternative way to determine the language dominant hemisphere in Thai patients. In case of language dominant hemisphere is unclear, further invasive investigation of language mapping such as Wada test or DCS is crucial.
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The popliteal vessels and nerve are the structures most at risk during surgery of the posterior knee compartment. Common procedures that could interfere with or otherwise affect these structures include synovectomy, meniscal repair, proximal tibial osteotomy, knee replacement and fixation around the knee joint. Magnetic resonance imaging (MRI) can be used to locate the neurovascular structures from the posterior bony landmark. MRI imaging is routinely studied in the extended knee, but surgery of the posterior knee compartment is most often performed with the knee in a flexed position. ⋯ During 90-degree knee flexion, the neurovascular structures move posterolaterally, as compared to fully extended knee position at joint line level and 1 cm above and below joint line level. To prevent neurovascular injury during surgery, surgeons should avoid or be cautious during blind penetration of the midline joint capsule and 90 degree flexed knee position increases the distance of the neurovascular bundle away from the posterior bony aspect.