Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Observational Study
One-year clinical outcomes of ST segment elevation myocardial infarction patients treated with emergent percutaneous coronary intervention: the impact of thrombus burden.
To investigate the impact of thrombus burden on 1-year clinical outcomes in patients who underwent emergent percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). ⋯ In the current study, large thrombus burden is not an independent predictor of 1-year cumulative MACE in STEMI patients who were treated with emergent PCI.
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Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. ⋯ Prolonged hospitalization had adverse outcomes for the patients and the hospital, such as high complications, poor outcomes, high costs of treatment and low reimbursement ratio that created an enormous economic burden for the hospital. Therefore possible preventable causes of prolonged admission must be identified, prevented and managed by improving quality of multidisciplinary health care system and ancillary services.
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To examine the efficacy of using capillary beta-hydroxy butyrate (beta-OHB) levels in comparison with serum ketone levels in distinguishing diabetic ketoacidosis (DKA) from non-DKA states in patients who had severe hyperglycemia and to determine a cut-off level of capillary beta-OHB that is best for the diagnosis of DKA. ⋯ Using a cut-off capillary beta-OHB level of > 3.1 mmol/L is highly effective in the diagnosis of DKA in patients who presented with hyperglycemia. Quantitative measurement of capillary beta-OHB levels using a ketometer offers an immediate result that is useful for a reliable triage of screening for DKA in patients presented with severe hyperglycemia.
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Breastfeeding is recommended as the exclusive feeding for the first six months of the newborns life. Difficulty in latching and breastfeeding resulting from tongue-tie are believed to be a problem. ⋯ The latch scores in tongue-tied newborns were significantly lower than those in normal newborns.
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Observational Study
The temporal changes of tissue oxygen saturation (StO2) and central venous oxygen saturation (ScvO2) during sepsis/septic shock resuscitation.
Restoration of adequate tissue oxygenation is the goal of shock resuscitation. Commonly, central venous oxygen saturation and lactate clearance are used to monitor this therapeutic endpoint in sepsis. Tissue oxygen saturation (StO2) obtained by near-infrared spectroscopy (NIRS) has been introduced as an alternative. ⋯ The temporal changes of StO2 and ScvO2 during sepsis/septic shock resuscitation were demonstrated. Their correlation and agreement were not satisfactory. No specific StO2 value for the reversal of tissue hypoxia was observed. More studies are needed to explore the benefit of StO2 as a bedside tool for tissue perfusion monitoring.