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minimally consciousness state

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https://www.readbyqxmd.com/read/29140436/-%C3%A2-what-god-and-the-angels-know-of-us-character-autonomy-and-best-interests-in-minimally-conscious-state
#1
Giles Birchley
Determining the best interests of incapacitated patients has been observed to be an opaque area of the law, and this is no less so in decisions about the (non-)treatment of patients in the minimally conscious state. A systematic examination of the way best interests are used in judgments relating to this population suggests that narratives involving the character of the patient frequently form an important plank of judicial reasoning. Since insights into the concept of best interests may be gained by an engagement with the philosophy of well-being, I identify the court's character-based approach with perfectionist theories of well-being...
November 13, 2017: Medical Law Review
https://www.readbyqxmd.com/read/29123907/endoscopic-hematoma-evacuation-for-acute-subdural-hematoma-in-a-young-patient-a-case-report
#2
Atsushi Kuge, Daisuke Tsuchiya, Shigeki Watanabe, Mitsuya Sato, Toshihiko Kinjo
Case: The standard treatment for acute subdural hematoma (ASDH) is large craniotomy; decompressive craniectomy may also be carried out, if needed, to prevent secondary brain damage. Recently, an endoscopic procedure for elderly patients with ASDH was carried out and reported; its safety and effectiveness were emphasized because of minimal invasiveness. We report a young case and discuss its difficulties and tips.A 31-year-old man was found to be in a state of general convulsion. At the time of admission, we observed severe consciousness disturbance, anisocoria, and left hemiparesis...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29113962/woman-in-minimally-conscious-state-should-be-allowed-to-die-says-judge-after-hearing-evidence-from-family
#3
Clare Dyer
No abstract text is available yet for this article.
November 7, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29095850/lesions-in-deep-gray-nuclei-after-severe-traumatic-brain-injury-predict-neurologic-outcome
#4
Frédéric Clarençon, Éric Bardinet, Jacques Martinerie, Vincent Pelbarg, Nicolas Menjot de Champfleur, Rajiv Gupta, Eléonore Tollard, Gustavo Soto-Ares, Danielle Ibarrola, Emmanuelle Schmitt, Thomas Tourdias, Vincent Degos, Jérome Yelnik, Didier Dormont, Louis Puybasset, Damien Galanaud
PURPOSE: This study evaluates the correlation between injuries to deep gray matter nuclei, as quantitated by lesions in these nuclei on MR T2 Fast Spin Echo (T2 FSE) images, with 6-month neurological outcome after severe traumatic brain injury (TBI). MATERIALS AND METHODS: Ninety-five patients (80 males, mean age = 36.7y) with severe TBI were prospectively enrolled. All patients underwent a MR scan within the 45 days after the trauma that included a T2 FSE acquisition...
2017: PloS One
https://www.readbyqxmd.com/read/29070723/constructive-anthropomorphism-a-functional-evolutionary-approach-to-the-study-of-human-like-cognitive-mechanisms-in-animals
#5
Michal Arbilly, Arnon Lotem
Anthropomorphism, the attribution of human cognitive processes and emotional states to animals, is commonly viewed as non-scientific and potentially misleading. This is mainly because apparent similarity to humans can usually be explained by alternative, simpler mechanisms in animals, and because there is no explanatory power in analogies to human phenomena when these phenomena are not well understood. Yet, because it is also difficult to preclude real similarity and continuity in the evolution of humans' and animals' cognitive abilities, it may not be productive to completely ignore our understanding of human behaviour when thinking about animals...
October 25, 2017: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/29050383/early-detection-of-consciousness-in-patients-with-acute-severe-traumatic-brain-injury
#6
Brian L Edlow, Camille Chatelle, Camille A Spencer, Catherine J Chu, Yelena G Bodien, Kathryn L O'Connor, Ronald E Hirschberg, Leigh R Hochberg, Joseph T Giacino, Eric S Rosenthal, Ona Wu
See Schiff (doi:10.1093/awx209) for a scientific commentary on this article. Patients with acute severe traumatic brain injury may recover consciousness before self-expression. Without behavioural evidence of consciousness at the bedside, clinicians may render an inaccurate prognosis, increasing the likelihood of withholding life-sustaining therapies or denying rehabilitative services. Task-based functional magnetic resonance imaging and electroencephalography techniques have revealed covert consciousness in the chronic setting, but these techniques have not been tested in the intensive care unit...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29042005/analysis-of-italian-regulations-on-pathways-of-care-for-patients-in-a-vegetative-or-minimally-conscious-state
#7
D Sattin, L De Torres, G Dolce, Francesco Arcuri, Anna Estraneo, V Cardinale, R Piperno, E Zavatta, Rita Formisano, Mariagrazia D'Ippolito, C Vassallo, B Dessi, G Lamberti, E Antoniono, C Lanzillotti, J Navarro, P Bramanti, Silvia Marino, M Zampolini, F Scarponi, R Avesani, L Salvi, S Ferro, L Mazza, P Fogar, S Feller, F De Nigris, A Martinuzzi, M Buffoni, A Pessina, P Corsico, M Leonardi
Different rehabilitation models for persons diagnosed with disorders of consciousness have been proposed in Europe during the last decade. In Italy, the Ministry of Health has defined a national healthcare model, although, to date, there is a lack of information on how this has been implemented at regional level. The INCARICO project collected information on different regional regulations, analysing ethical aspects and mapping care facilities (numbers of beds and medical units) in eleven regional territories...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/29042001/recovery-from-vegetative-state-of-patients-with-a-severe-brain-injury-a-4-year-real-practice-prospective-cohort-study
#8
Alessio Baricich, A de Sire, E Antoniono, F Gozzerino, G Lamberti, C Cisari, M Invernizzi
Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU)...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/29020110/comprehensive-benchmarking-of-snv-callers-for-highly-admixed-tumor-data
#9
Regina Bohnert, Sonia Vivas, Gunther Jansen
Precision medicine attempts to individualize cancer therapy by matching tumor-specific genetic changes with effective targeted therapies. A crucial first step in this process is the reliable identification of cancer-relevant variants, which is considerably complicated by the impurity and heterogeneity of clinical tumor samples. We compared the impact of admixture of non-cancerous cells and low somatic allele frequencies on the sensitivity and precision of 19 state-of-the-art SNV callers. We studied both whole exome and targeted gene panel data and up to 13 distinct parameter configurations for each tool...
2017: PloS One
https://www.readbyqxmd.com/read/28980847/mirror-efficiency-in-the-assessment-of-visual-pursuit-in-patients-in-minimally-conscious-state
#10
Sarah Wannez, Audrey Vanhaudenhuyse, Steven Laureys, Serge Brédart
OBJECTIVE: Visual pursuit should be tested with a mirror in patients with disorders of consciousness. This stimulus was indeed more efficient than a person or an object, and the auto-referential aspect was supposed to be the key feature. The present study tested the hypothesis that the mirror was more efficient because of its self-aspect. METHODS: The mirror was compared (1) to the patient's picture and to the picture of a famous face, in 22 patients in minimally conscious state and (2) to the patient's picture and a fake mirror, which had dynamical and bright aspects of the mirror, without reflecting the face, in 26 other patients in minimally conscious state...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28946586/unexpected-recovery-from-a-vegetative-state-or-misdiagnosis-lesson-learned-from-a-case-report
#11
Antonino Naro, Rocco Salvatore Calabrò, Patrizia Pollicino, Carmen Lombardo, Placido Bramanti
BACKGROUND: Growing research is focusing on the identification of markers predicting recovery and demonstrating covert awareness in patients with chronic disorders of consciousness (DOC). Herein, we describe the case of a woman who emerged from unresponsive wakefulness syndrome (UWS) after four years, in whom an experimental protocol assessing brain connectivity predicted her awareness recovery, indicating a functional locked-in syndrome (FLIS) diagnosis. CASE DESCRIPTION: A 68-year-old woman was admitted to our institute in 2012 in a UWS secondary to a severe brain hemorrhage, with a Coma Recovery Scale-Revised score of five...
September 16, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28937345/practical-implications-of-the-minimally-conscious-state-diagnosis-in-adults
#12
Karola V Kreitmair, Katherine E Kruse
This article addresses questions surrounding the minimally conscious state (MCS) from the perspective of adult clinical ethics. It describes the background of the MCS diagnosis, analyzes phenomenological ambiguities inherent in the nature of MCS, and raises epistemological concerns surrounding its diagnosis. It argues that in many cases, the burdens of prolonging treatment for people who have sustained certain severe brain injuries (SBI) outweigh the benefits, even if they are in or have the prospect of entering into MCS...
October 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28918680/transcranial-direct-current-stimulation-in-disorders-of-consciousness-a-review
#13
Ye Zhang, Weiqun Song
It is a challenge to evaluate and treat the patients with disorders of consciousness (DOC) in the clinic. Due to the huge costs of prolonged intensive care, the management of these patients raises great financial strain on families and important ethical questions. To date, several studies have attempted to specifically detect pharmacologic or non-pharmacologic effectiveness, until now there were no evidence-based guidelines about the treatment of patients with DOC. Recently, because of ethical and procedural limitations on the use of invasive stimulation techniques, non-invasive brain stimulation, such as the transcranial direct current stimulation (tDCS), has been investigated for improving the level of consciousness in patients with DOC...
September 18, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28902713/long-lasting-repetitive-transcranial-magnetic-stimulation-modulates-electroencephalography-oscillation-in-patients-with-disorders-of-consciousness
#14
Xiaoyu Xia, Yang Liu, Yang Bai, Ziyuan Liu, Yi Yang, Yongkun Guo, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
Repetitive transcranial magnetic stimulation (rTMS) has been applied for the treatment of patients with disorders of consciousness (DOC). Timely and accurate assessments of its modulation effects are very useful. This study evaluated rTMS modulation effects on electroencephalography (EEG) oscillation in patients with chronic DOC. Eighteen patients with a diagnosis of DOC lasting more than 3 months were recruited. All patients received one session of 10-Hz rTMS at the left dorsolateral prefrontal cortex and then 12 of them received consecutive rTMS treatment everyday for 20 consecutive days...
September 11, 2017: Neuroreport
https://www.readbyqxmd.com/read/28901969/disorders-of-consciousness-after-severe-brain-injury-therapeutic-options
#15
Caroline Schnakers, Martin M Monti
PURPOSE OF REVIEW: Very few options exist for patients who survive severe traumatic brain injury but fail to fully recover and develop a disorder of consciousness (e.g. vegetative state, minimally conscious state). RECENT FINDINGS: Among pharmacological approaches, Amantadine has shown the ability to accelerate functional recovery. Although with very low frequency, Zolpidem has shown the ability to improve the level of consciousness transiently and, possibly, also in a sustained fashion...
December 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28898867/cerebral-fat-embolism-clinical-presentation-diagnostic-steps-and-long-term-follow-up
#16
Juliane Dunkel, Christian Roth, Frank Erbguth, Wenke Dietrich, Monika Hügens-Penzel, Andreas Ferbert
OBJECTIVE: Symptomatic cerebral fat embolism (CFE) is a rare complication that occurs after a traumatic injury or orthopaedic surgery and is diagnostically challenging. No data is currently available concerning long-term follow-up. METHODS: We identified from medical records 9 patients with CFE and revised the clinical signs and the diagnostic process. We then analysed long-term follow-up data, targeting clinical course after discharge, neurological impairment, and current quality of life, using the Barthel index and the modified Rankin Scale...
2017: European Neurology
https://www.readbyqxmd.com/read/28892566/brain-heart-interactions-reveal-consciousness-in-noncommunicating-patients
#17
Federico Raimondo, Benjamin Rohaut, Athena Demertzi, Melanie Valente, Denis A Engemann, Moti Salti, Diego Fernandez Slezak, Lionel Naccache, Jacobo D Sitt
OBJECTIVE: We here aimed at characterizing heart-brain interactions in patients with disorders of consciousness. We tested how this information impacts data-driven classification between unresponsive and minimally conscious patients. METHODS: A cohort of 127 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS; n = 70) and minimally conscious state (MCS; n = 57) were presented with the local-global auditory oddball paradigm, which distinguishes 2 levels of processing: short-term deviation of local auditory regularities and global long-term rule violations...
October 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28872596/survey-of-veterinarians-using-a-novel-physical-compression-squeeze-procedure-in-the-management-of-neonatal-maladjustment-syndrome-in-foals
#18
Monica Aleman, Kalie M Weich, John E Madigan
Horses are a precocious species that must accomplish several milestones that are critical to survival in the immediate post-birth period for their survival. One essential milestone is the successful transition from the intrauterine unconsciousness to an extrauterine state of consciousness or awareness. This transition involves a complex withdrawal of consciousness inhibitors and an increase in neuroactivating factors that support awareness. This process involves neuroactive hormones as well as inputs related to factors such as cold, visual, olfactory, and auditory stimuli...
September 5, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28870587/the-value-of-midbrain-morphology-in-predicting-prognosis-in-chronic-disorders-of-consciousness-a-preliminary-ultrasound-study
#19
Antonino Chillura, Antonino Naro, Katia Micchia, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Transcranial sonography (TCS) of the brainstem is currently used to support the clinical diagnosis of movement disorders. The aim of the study was to assess the usefulness of midbrain TCS in assessing outcome in patients with Chronic Disorders of Consciousness (DOC). Eleven patients with Minimally Conscious State (MCS) and Unresponsive Wakefulness Syndrome (UWS) were included in the study. We measured the area and echogenicity of the midbrain by encoding and digitally analyzing the corresponding images from the orbitomeatal plane, the morphology of brain parenchyma from the thalamic and cella media plane, and the intracranial circulation...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28828002/corrigendum-frontal-connectivity-in-eeg-gamma-30-45-hz-respond-to-spinal-cord-stimulation-in-minimally-conscious-state-patients
#20
Yang Bai, Xiaoyu Xia, Zhenhu Liang, Yong Wang, Yi Yang, Jianghong He, Xiaoli Li
[This corrects the article on p. 177 in vol. 11, PMID: 28701924.].
2017: Frontiers in Cellular Neuroscience
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