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Biomedical subjects

S Nava

Publications and source records attributed to S Nava.

149 records · Page 9Linked to original sources
PubMedDate not supplied

Muscle retraining in ICU patients.

The general aim of an ICU respiratory rehabilitation programme is to improve the patient's measured quality of life. It can be done by applying advanced therapeutic modalities in order to improve the remaining functions and to decrease the patient's dependency as well as the risks associated with an ICU admission. A number of physiological changes involve all the body systems as a consequence of a bed-rest period and play an important role in the weaning failure of ventilated patients. Inactivity muscle mass declines from the first week of ICU admission, as well as the muscle's ability to perform aerobic exercise. The respiratory muscles strength and endurance decreases, also the ventilatory pump and the cardiovascular response to exercise may be alterated. Disorientation, and disfunction of the Central Nervous System may occur. The aim of this review is to analyse the usefulness of skeletal and respiratory muscle training in improving strength, endurance and decreasing dyspnea at rest and during exercise and the role of rehabilitation in obtaining maximal functional capacity of ICU patients.

Breathing Exercises↗
PubMedDate not supplied

Ethics, attitude and practice in end-of-life care decision: an European perspective.

Only in the last decade in Europe has there been increased attention dedicated to the end-of-life care in the hospital, especially in the Intensive Care Unit (ICU). The definitions of the potential decision are extremely important. Withholding is a planned decision not to institute therapies that were otherwise warranted, Withdrawal is the discontinuation of treatments that had been started, Terminal sedation consists of pain and symptom treatment with the possible side effect of shortening life, while Euthanasia means that a doctor is intentionally killing a person who is suffering unbearably and hopelessly at the latter's explicit informed request. The overall incidence of these practices in Europe is only partially known, but there are important differences between Countries or regions, reflecting the absence of a common strategy even within the European Community. Only <15% of ICU patients retain decision making capacity, allowing the impossibility of discussing the decision with them. It is rare that the patient's family is involved in the decision and when such case does arise, the relatives rate the communication with hospital staff poor. The "shared decision" taken together by physicians, nurses, and the patient's family may be the best approach for end-of-life decision, therefore common European guidelines are needed.

Decision Making↗
PubMedDate not supplied

Temporary and permanent restorations for fractured permanent teeth with immature apices: a clinical study.

Clinical and radiological studies of the fractured teeth of patients between seven and eleven years old were conducted to assess the use of permanent and immediate (emergency) techniques for reconstructing anterior permanent teeth with immature apices. The general hypothesis states that, given the physical and biocompatible properties of the materials used in the immediate (emergency) technique, there are no significant differences between the two techniques as far as pulp vitality and apical growth are concerned. A sample of fifty-six patients was selected. They had Class I, II or III fractures, for which permanent and immediate (emergency) techniques were used in equal numbers. Thermal, mechanical, and electrical tests were used to evaluate pulp vitality compared with the homologous tooth. Apical convergence was the radiological criterion used for determining the end of the radicular process. After one year, both techniques allow preservation of pulp vitality. Results show that, unlike the conventional technique (permanent), radicular formation was completed first in teeth reconstructed using the immediate (emergency) technique. Statistical analysis shows no definitive relationship between the technique used and completion of apical growth time (P > 0.05). In conclusion, comparison between the mediate (permanent) and immediate (emergency) techniques shows that the immediate (emergency) technique is an adequate alternative for reconstructing fractured teeth, because of the greater esthetic and functional advantages at the patient's disposal.

Biocompatible Materials↗