Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Endovascular abdominal aortic aneurysm repair (EVAR) has increasingly been performed for the last two decades. One of the anatomical exclusion criterion of EVAR is the presence of thrombus within the infrarenal neck of an aneurysm. ⋯ The presence of aortic neck thrombus may not be a contraindication for EVAR in selected patients. However, it seems to negatively influence the outcomes in the aspect of renal and peripheral embolization, which could be prevented during EVAR procedure. There was no adverse graft-related complication, secondary intervention, or aneurysm-related mortality during mid-term follow-up period.
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To evaluate safety and efficacy of olanzapine for breakthrough emesis in addition to standard antiemetic regimen in cancer patients receiving highly emetogenic chemotherapy. ⋯ Olanzapine is considered to be safe and effective treatment of breakthrough vomiting in cancer patients undergoing highly emetogenic chemotherapy in the present study.
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To investigate the clinical characteristics, risk factors, outcomes, antibiotic treatment and complications of hospitalized patients infected with multi-drug resistant (MDR) gram-negative bacteria in Siriraj Hospital. ⋯ The strongest risk factor for acquiring MDR gram-negative infection was previous antibiotic use. Inadequate empirical antimicrobial treatment was common in patients infected with MDR pathogens, resulting in unfavorable outcome and mortality.
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Severe sepsis and septic shock are associated with high mortality. "Early goal-directed therapy" (EGDT) has been shown to improve survival. The authors report here the goal achievements in the protocol and their association with patients' outcomes. ⋯ The achievement of therapeutic targets at 6 hours after sepsis/septic shock resuscitation was associated with improved survival, especially when more goals were reached. Although the achievement of adequate tissue oxygenation was proved beneficial, only one-third of the patients were monitored.
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Observational Study
Non-invasive estimated continuous cardiac output (escCO) during severe sepsis and septic shock resuscitation.
Cardiac output (CO) is an important hemodynamic parameter during sepsis and septic shock resuscitation. Conventionally, this value is obtained at bedside by the thermodilution technique, which requires a pulmonary artery catheter (PAC). Estimated Continuous Cardiac Output (esCCO, Nihon Kohden, Japan) calculated from pulse-wave transit time (PWTT) was examined here as an alternative. ⋯ The estimated continuous cardiac output (esCCO) correlated well with the cardiac output obtained by thermodilution techniques, especially when patients were out of shock.