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The vegetative state
Monti, Martin M ; Laureys, Steven ; Owen, Adrian M
BMJ, 2010-08, Vol.341 (7767), p.292-296
[Periódico revisado por pares]
England: British Medical Journal Publishing Group
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Título:
The vegetative state
Autor:
Monti, Martin M
;
Laureys, Steven
;
Owen, Adrian M
Assuntos:
Age Factors
;
Alzheimer's disease
;
Brain injuries
;
Brain Injuries - complications
;
CLINICAL REVIEW
;
Coma
;
Coma - etiology
;
Comas
;
Consciousness
;
Diagnosis, Differential
;
Diagnostic Errors
;
Diagnostic Imaging
;
Disease management
;
Disorders
;
Euthanasia
;
Eye movements
;
Functional neuroimaging
;
Human health sciences
;
Humans
;
Medical diagnosis
;
Medical imaging
;
Misdiagnosis
;
Neurological disorders
;
Neurologie
;
Neurology
;
Neuropathology
;
Patients
;
Persistent Vegetative State - diagnosis
;
Persistent Vegetative State - etiology
;
Persistent Vegetative State/diagnosis/etiology
;
Persistent vegetative states
;
Physical trauma
;
Prognosis
;
Quadriplegia - etiology
;
Rehabilitation
;
Right to die
;
Sciences de la santé humaine
;
Signs
;
Sleep
;
Time Factors
;
Traumatic brain injury
;
Unconsciousness
É parte de:
BMJ, 2010-08, Vol.341 (7767), p.292-296
Notas:
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href:bmj-341-bmj-c3765.pdf
PMID:20679291
ArticleID:monm737171
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local:bmj;341/aug02_1/c3765
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-1
scopus-id:2-s2.0-77955374802
Descrição:
Summary points The vegetative state is a complex neurological condition in which patients appear to be awake but show no sign of awareness of themselves or their environment Current clinical methods of diagnosis are limited in scope, evidenced by a high rate (about 40%) of misdiagnosis (that is, patients who are aware are considered to be unconscious) The main causes of misdiagnosis are associated with a patient's disability (such as blindness), confusion in terminology, and lack of experience of this relatively rare condition Furthermore, standard behavioural assessments cannot distinguish an aware (that is, minimally conscious) but completely immobile patient from a non-aware patient (one with vegetative state) In such behaviourally non-responsive patients, functional neuroimaging methods (such as magnetic resonance imaging or electroencephalography) can detect residual cognition and awareness and can even establish two way communication, without requiring any behavioural output from patients Current guidelines should therefore be modified to include functional neuroimaging as an independent source of diagnostically relevant information The vegetative state may develop suddenly (as a consequence of traumatic or non-traumatic brain injury, such as hypoxia or anoxia; infection; or haemorrhage) or gradually (in the course of a neurodegenerative disorder, such as Alzheimer's disease). Misdiagnosis has many implications for a patient's care-such as day to day management, access to early interventions, and quality of life-and has ethical and legal ramifications pertaining to decisions on the discontinuation of life supporting therapies. 2 w2-w4 Overall, our understanding of the vegetative state is incomplete. The 2003 guidance from the UK's Royal...
Editor:
England: British Medical Journal Publishing Group
Idioma:
Inglês
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