persistent vegetative state

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..To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R)...

Conflicting perspectives about the diagnosis and prognosis of the persistent vegetative state (PVS) as well as end-of-life (EOL) decision-making were disseminated in the Terri Schiavo case...

..At the present time the interactions of sleep and consciousness in brain-injured patients are a little studied subject but, the authors suggest, a potentially very interesting field of research...

..Mean ApEn values were lower in patients than in controls (t18 18 = 12.3, p < 0.001). ApEn is able to discriminate patients from controls thus supporting the hypothesis about a decreased neural networks complexity in VS...

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..To quantify the degree of unconsciousness with EEG nonlinear analysis and investigate the change of EEG nonlinear properties under different conditions...

Establishing prognosis in patients in a persistent vegetative state (VS) is still challenging...

..The prevalence of VS in adults in the US is between 40 and 168 PMP, and may be lower in the UK, but precise figures are not available. The incidence and prevalence of MCS have yet to be established...

..In addition to novel behavioural 'consciousness-scales', the role of para-clinical markers of consciousness, such as event related potentials and functional neuroimaging is reviewed...

..The purpose of this article is threefold: first, to examine the medical condition of a persistent vegetative state (PVS); second, to examine and analyze the Catholic Church's tradition on the ordinary-extraordinary ..

..We conclude by highlighting areas needing further research and collaboration...

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Sporadic cases of recovery from persistent vegetative state (PVS) after administration of intrathecal baclofen (ITB) have been reported without giving any possible explanation for its paradoxical effect...

..The aim of this study was to report that late recovery with moderate disability is possible, even after several months in vegetative state...

..To study the presence of electrophysiological indicators of remaining cortical functions in patients with persistent vegetative state (PVS) and minimally conscious state (MCS)...

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..The concept of withdrawal of nutrition and hydration is a sensitive issue and clinicians can expect to be considered as not acting in the patient's best interest whatever decision is taken...

..However, both ischaemic brain damage and the vascular complications of raised intracranial pressure contributed to the clinical signs and symptoms...

..A methodological analysis leads to the conclusion that any neurophysiological assessment of VS patients is biased toward under-, rather than over-estimation, of their remaining information processing abilities...

..We also try to find EEG cortical sources that differentiate between both conditions using LORETA source analysis...

..quot; Terri was diagnosed with persistent vegetative state, a term that is outdated, vague and imprecise and that likens a human being to a vegetable...

..Several pathophysiological mechanisms that might limit further recovery in MCS patients are considered. Implications for future research directions and possible therapeutic strategies are reviewed...

quot;Persistent vegetative state" (PVS) describes brain-damaged patients who survive their injuries in a sleeplike, insensible state, with periodic awakenings...

..To establish the prevalence of vegetative state in Dutch nursing homes, describe the patient characteristics, and highlight the possible influence of medical decisions at the end of life...

..In an extensive research project the effects of EINP were studied. This part of the project focused on the outcome in terms of level of consciousness (LOC) in relation to the specific characteristics of a retrospectively studied cohort...

..Patients may be diagnosed as being in a persistent vegetative state, having akinetic mutism, or being in a minimally conscious state...

..colleagues reveals that many lay people in Ohio classify legally living persons in irreversible coma or persistent vegetative state (PVS) as dead that additional respondents, although classifying such patients as living, would be ..

..The past and future scientific developments in this area provide an important background for continuing discussions of the ethical controversies surrounding end-of-life decision making and resource allocation...

..The Multi-Society Task Force Report on the persistent vegetative state and the Aspen Workgroup statement on the minimally conscious state represent two such initiatives...

..Although amyloid plaques and tau inclusions were identified in some, their contribution did not seem important in the ultimate clinical outcome...

..The term VS should be dropped and replaced with one that reflects what is truly known and verifiable about the condition and the individual patient...

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..Treatment decisions for patients in vegetative state or minimally conscious state should follow established ethical and legal principles and accepted practice guidelines of professional medical specialty societies...

..When asked to imagine playing tennis or moving around her home, the patient activated predicted cortical areas in a manner indistinguishable from that of healthy volunteers...

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..Therefore, better understanding of cerebral noxious processing in these patients is of clinical, therapeutic, and ethical relevance...

..To study cerebral response in a functional magnetic resonance imaging (fMRI) task of speech perception in a sample of patients in vegetative state (VS) and minimally conscious state (MCS) after traumatic brain injury...

..It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness...

..The clinical application of these functional neuroimaging techniques awaits validation from ongoing multi-centric cohort studies in these challenging patients with chronic disorders of consciousness...

..We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function...

..Here we tested the hypothesis that these rhythms are abnormal in persistent vegetative state (PVS) patients, who are awake but not aware of self and environment.

..Future studies are needed to give a full characterization of default network connectivity in the VS patients population...

..The purpose of this study was to identify by artificial intelligence procedures (classification and regression trees, data-mining) the significant neurological signs correlated to and predictive of outcome...

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..Here we review current possibilities and limitations of clinical and para-clinical assessment of chronic disorders of consciousness...

..We discuss the problems of evidence-based neurorehabilitation in disorders of consciousness, and recent functional neuroimaging data obtained in the vegetative state and minimally conscious state...

..To describe the theoretic framework, design, and potential clinical applications of functional neuroimaging protocols in patients with disorders of consciousness...

..Specifically, the activity could reflect unconscious reactions to the last word in the command, not conscious decisions to respond. A refined experimental design could clarify these issues...

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..To evaluate whether current clinical criteria and confirmatory tests for the diagnosis of 'brain death' satisfy the requirements for the irreversible cessation of all functions of the entire brain including the brainstem...

..These findings launch new ethical and practical implications for the management of VS patients...

..In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R)...

..To assess the phasic components of rapid eye movement (REM) sleep in patients in vegetative state and to evaluate the possible relationship of these activities to patient outcome...

..To establish consensus recommendations among health care specialties for defining and establishing diagnostic criteria for the minimally conscious state (MCS)...

..Finally it is pointed out that a holistic approach to the problem of "brain death" in humans should necessarily include the inspection of the content of consciousness...

..Neuroimaging techniques remain important tools for clinical research that will extend our understanding of the underlying mechanisms of these disorders...

Since the recent diagnostic criteria for persistent vegetative state (PVS) require the presence of a sleep-wake cycle, certain patients in similar conditions should be excluded from PVS...

..In the severely disabled patients with lesions similar to those of VS cases it is likely that a greater quantitative amount of damage occurred in the VS cases...

The persistent vegetative state (PVS) is a devastating medical condition characterized by preserved wakefulness contrasting with absent voluntary interaction with the environment...

Twenty cases of a persistent vegetative state (PVS) caused by various kinds of brain damage were neurologically and electrophysiologically evaluated at 3 months after persistence of the PVS, and were treated by deep brain stimulation (..

Despite converging agreement about the definition of persistent vegetative state, recent reports have raised concerns about the accuracy of diagnosis in some patients, and the extent to which, in a selection of cases, residual cognitive ..

..by John Paul II on the provision of artificial nutrition and hydration to patients who are in a persistent vegetative state, and it implications on previously held standards of judging medical treatments...

..BACKGROUND The current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility...

..A hopeless vegetative state can be prevented by using these transmural possibilities for cooperation, including an early input of knowledge and experience about the long-term course of a vegetative state...

..The implications, under the Texas statute, of varied interpretations of Pope John Paul II's recent allocution on artificial feeding and hydration in the persistent vegetative state will also be considered.

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..That deflects attention from the fundamental legal principle that whatever a patient or the relatives want, they are not legally entitled to demand treatment that doctors consider futile in the circumstances...

..Neurologic prognosis is determined by the underlying etiology and may be predicted by the combination of clinical signs and electrophysiological tests...

..To evaluate the changes of vegetative parameters and behavioural assessment in comatose patients after severe brain injury during the Multimodal-Early-Onset-Stimulation (MEOS) in early rehabilitation...

..Looking through a post-Schiavo lens, the Article examines state law addressing these issues and how these choices may be reexamined in the coming years...

..The best interests of the child can be affected by severe or profound intellectual disability. It is, though, not as clear-cut as some might expect...

..Contributions of a social worker and bioethicist are illustrated...

..Finally, we discuss the functional neuroanatomy of these conditions as assessed by positron emission tomography (PET) scanning...

..In conclusion, we discuss whether the fact that his grave neurological condition was caused by a suicide attempt was relevant to the decision to continue or withdraw life support...

..With this more of therapy we anticipate a resolution of GM2 storage and neuro-inflammation ultimately leading to amelioration of the clinical phenotype of the disease. ..

..Fourth, mice lacking both PPT1 and PPT2 will be created and characterized. The results from these studies will lead to unique new insights into lysosomal thioester metabolism, neurodegeneration, and aging. ..

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..The research described in the proposal is designed to test the veracity of these models, subsequently extend them, and provide general insight into the two-component mode of action. ..

..Without such studies, these patients will continue to remain categorically excluded from advances in medical diagnostics and therapeutics. ..

..Without such studies, these patients will continue to remain categorically excluded from advances in medical diagnostics and therapeutics. ..

..While these are long-range goals, and the studies proposed here do not represent direct investigations of these possibilities, completion of these experiments is necessary and logical step toward these goals. ..

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..The long-range goal of the studies proposed here is to provide a foundation for rational therapies for chronic cognitive disabilities following complex brain injuries. ..

..Importantly, a subject recruitment infrastructure within the Core will make it feasible for visiting or remote collaborators to identify appropriate subjects for study during brief research visits. ..

..The net result of the program will be a cadre of faculty for departments of PM&R who can compete successfully for extramural funds and be productive independent investigators, ultimately fulfilling a vision of physiatric research. ..

..The factor structure will also be compared to that obtained from a control sample. ..

..In addition, it will provide some insight into mechanisms underlying such recovery. Since stroke is the leading cause of motor disabilities this work has a clear clinical relevance. ..

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..untreated animals. We will also investigate the anatomical basis of white matter DTI abnormalities through electron microscopy to determine changes in axons and myelin in affected regions. 2. ..

..We request funding to support three (3) predoctoral and three (3) postdoctoral trainees in the next project period. ..

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..In addition, new predictions of the computational hypotheses have been derived and will form the basis of further empirical tests with human subjects. ..

..This will be of importance to diagnostic and therapeutic management of TBI, particularly in children in whom injury is underestimated, unrecognized and untreated. ..

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..Neurocognitive systems mediating resilience and successful adolescence will also be sought. ..