Overview and management of post-intensive care syndrome

Any patient suffering from critical life-threatening illnesses in most cases require hospitalization, in the care unit (ICU) where they can receive essential life-sustaining treatments. This has created an impact including more than 50 million individuals world-wide. Although advancements, in technology and healthcare have increased survival rates many individuals who survive these illnesses experience long-term impairments known as post-intensive care syndrome (PICS). PICS encompasses cognitive and emotional challenges that significantly affect patients' quality of life and ability to return to their normal routines. Caregivers may also face similar emotional hurdles, a condition referred to as PICS-family (PICS-F). The prevalence of PICS varies but can affect up to 50% of ICU survivors. Cognitive difficulties can be noticed in, around 70% of instances impacting abilities like memory, focus, and decision-making. These difficulties can lead to emotions such, as sadness worry, and a condition known as traumatic stress disorder (PTSD). Multiple factors, such as delirium, sedation, and pre-existing health conditions play a role, in the emergence and severity of PICS. Diagnosing PICS involves comprehensive assessments covering physical, cognitive, and emotional dimensions. Screening should ideally commence during the ICU stay and continue post-discharge. Assessment tools such as the Montreal cognitive assessment (MoCA) and emotional functioning screenings aid in identifying PICS. This manifests physically through muscle weakness and fatigue, impacting mobility and daily activities. Effectively managing ICUs requires the implementation of models and strategies that optimize resource utilization. However, these strategies may entail challenges such as data integration and stakeholder involvement. Preventing PICS involves proactive measures like reducing sedation, promoting early mobility, and offering rehabilitation services. Addressing PICS necessitates a proactive approach, comprehensive patient care, and collaboration among multidisciplinary teams. The successful implementation of these strategies depends on thorough evaluation and active engagement with all stakeholders involved in ICU management.

The impact of pulpotomy on the long-term prognosis and survival of young permanent teeth

This review explores the impact of pulpotomies on the long-term prognosis and survival of primary and young permanent teeth. Pulpotomy is a vital pulp therapy procedure aiming to preserve pulp health and functions. The review covers various vital pulp therapy techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and full pulpotomy. Apexogenesis, a procedure promoting root end formation, is also discussed. Long-term success in endodontic therapy requires an effective coronal seal to prevent microleakage and bacterial ingress into root canals. The study's methodology involved a comprehensive literature search to gather information on pulpotomy's effects on tooth prognosis and survival. Factors influencing the success of vital pulp therapy, such as the size of the exposure, the state of the pulp, and the choice of capping material, are analyzed. Bacterial contamination is identified as a crucial factor affecting the therapy's prognosis. Strategies to improve pulp healing and treatment outcomes are explored, offering insights into clinical decision-making for pulpotomy procedures.

Synovial chondromatosis of the temporomandibular joint

When cartilage-like tissue is present in the synovial membrane of joints, it is known as synovial chondromatosis (SC). The main cause is believed to be the metaplasia of embryonal mesenchymal tissue in the synovial membrane. The metaplastic foci grow within the joint space and can detach from the synovial wall, forming free-floating bodies. While SC is more commonly associated with trauma in the temporomandibular joint (TMJ), the exact relationship between trauma and SC remains unclear. Improved diagnostic techniques, such as CT and MRI, have led to increased recognition of SC in the TMJ. Gender differences in the prevalence of TMJ SC have been observed, with women being more affected. Diagnosis involves imaging techniques like X-rays, CT scans, MRIs, and surgical removal of loose bodies is the preferred treatment. Arthroscopy is recommended for small, isolated loose bodies, while open surgery may be necessary for complete removal. Long-term follow-up is essential to monitor for recurrence. Histopathological findings reveal a mixture of cartilage and bone, with ossification and calcification present.