You searched for:"Elias Knobel"
We found (2) results for your search.Abstract
Rev Bras Ter Intensiva. 2008;20(2):197-204
DOI 10.1590/S0103-507X2008000200014
BACKGROUND AND OBJECTIVES: Acute coronary syndromes result from a disruption of a vulnerable coronary plaque complicated by intraluminal thrombus formation, embolisation, and variable degrees of coronary obstruction. Patients with total occlusion may present with acute ST Elevation Myocardial Infarction (STEMI). Partial vessel obstruction may result in Non-ST-Elevation Acute Myocardial Infarction (NSTEMI) or unstable angina (UA). Clinical symptoms and electrocardiographic changes are the main components of identification of ACS. The rapid and effective triage of such patients regarding presence or absence of ST-segment elevation is critical to dictate further therapeutic strategies. The objective of this chapter was to review current evidence and recommendations for the evaluation and early treatment of acute coronary syndromes. CONTENTS: We performed a clinical review using the electronic databases MedLine and LILACS from January 1990 to September 2007. CONCLUSIONS: Reperfusion of the infarct-related artery is the cornerstone of therapy for STEMI. Fibrinolysis and percutaneous coronary intervention are both well established as effective options. Management of UA/NSTEMI patients requires early risk stratification. High-risk patients should undergo an early invasive strategy that consists in performance of cardiac catheterization in the first 24 to 48 hours of presentation.
Abstract
Rev Bras Ter Intensiva. 2006;18(4):412-417
DOI 10.1590/S0103-507X2006000400016
BACKGROUND AND OBJECTIVES: In the intensive care unit, the nosocomial respiratory infection is responsible for high rates of morbidity, mortality and expressive increase in hospitals costs. Its establishment feels more commonly by the aspiration of the content present within the mouth and the pharynx. Thus we intended to review the literature on the participation of the oral condition in the establishment of the nosocomial respiratory infection. CONTENTS: Deficient oral hygiene is common in patients under intensive care, which provides the colonization of oral biofilm for pathogenic microorganisms, especially for respiratory pathogens. The studies clearly show that the amount of oral biofilm in patients under intensive care increases according to period hospitalization meanwhile there also is an increase in respiratory pathogens. That colonizes the oral biofilm. This biofilm is an important resource of pathogens in patients under intensive care. CONCLUSIONS: In spite of well-established hypotheses that narrow down the relationships between lung infections and the oral condition, the studies are not still completely defined. However, due to strong possibilities that these hypotheses are true, it is necessary to have and maintain the oral health, in addition to more integration of dentistry and of Medicine, seeking patients' global treatment, the prevention of diseases, and more humanization at the intensive care unit.