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Vegetative State (vegetative + state)
Selected AbstractsA Moment Dead, a Moment Alive: How a Situational Personhood Emerges in the Vegetative State in an Israeli Hospital UnitAMERICAN ANTHROPOLOGIST, Issue 1 2010Nurit Bird-David ABSTRACT, Here we address the personhood of patients in a permanent vegetative state (PVS), who fall outside categories of "alive" or "dead" and "subject" or "object." Drawing on fieldwork in an Israeli hospital, we examine multiple and shifting approaches to PVS patients, which are articulated in the course of caring for and living with them. We argue that, alongside the institutional definition of these patients as being in a PVS, which, as Kaufman showed, evokes irresolvable confusion as to their ontological nature, there appear and disappear other senses of their personhood. Allying with other studies of cognitively impaired patients (e.g., those with dementia and Alzheimer's), we explore this relational person-concept while demonstrating its situational nature. We analyze patients' admission to the hospital, showing how their essentialistic personhood is "emptied" and how and when their fluid, relational personhood appears and disappears, further showing how this personhood is reified by imagined life stories. [source] The correlation between cerebral glucose metabolism and benzodiazepine receptor density in the acute vegetative stateEUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2002J. Rudolf This paper compares the results of parallel positron emission tomography (PET) studies of regional cerebral glucose metabolism with the radiotracer 18F-fluorodeoxyglucose (FDG) and benzodiazepine receptor (BZR) density by PET using the BZR ligand 11C-flumazenil (FMZ), a tracer of neuronal integrity, in nine patients with acute vegetative state (AVS, duration <1 month). Overall glucose utilization was significantly reduced in AVS in comparison with age-matched controls (global metabolic rate for glucose 26 ,mol/100 g/min in AVS vs. 31 ,mol/100 g/min in controls). FMZ-PET demonstrated a considerable reduction of BZR binding sites in all cortical regions that grossly corresponded to the extent of reduction of cerebral glucose metabolism assessed with FDG-PET, whilst the cerebellum was spared from neuronal loss. In controls, cortical relative flumazenil binding was not lower than five times the average white matter activity, whilst in AVS, nearly all values were below this threshold. There was no relevant overlap of the data of relative flumazenil binding between both groups. The comparison of FDG- and FMZ-PET findings in AVS demonstrates that alterations of cerebral glucose consumption do not represent mere functional inactivation, but irreversible structural brain damage. [source] The effect of sward structure as influenced by ryegrass genotype on bite dimensions and short-term intake rate by dairy cowsGRASS & FORAGE SCIENCE, Issue 1 2003P. D. Barrett Abstract The effects of genotypic variation in ryegrasses on sward structure, bite dimensions and intake rate by dairy cows were investigated. Two experiments were conducted. In Experiment 1, swards were in a vegetative state whereas, in Experiment 2, they were partly reproductive and were taller with higher herbage mass but lower leaf proportion than in Experiment 1. Applicability of relationships between sward structure and bite characteristics, previously established from artificial or hand-constructed swards, to field conditions were tested. Additional short-term intake rates and/or sward structural characteristics were considered as indicators of potential intake for use in protocols for the evaluation of grass varieties. Four cultivars were studied: AberElan, Twins (diploid and tetraploid perennial ryegrasses respectively), Polly, a hybrid ryegrass (perennial × Italian ryegrass) and Multimo (Italian ryegrass), each established in 200-m2 plots in four replicated blocks. Herbage intake rate was determined by short-term liveweight change (taking account of insensible weight loss) using 16 dairy cows allocated to four balanced groups with each plot grazed by one group for a 1-h assessment period. One block was grazed per day, over a 4-d experimental period, with each group grazing each variety in a complete crossover design. Sward characteristics and bite rate were also measured in both experiments. Bite dimensions were subsequently estimated, with bite depth being determined as a function of extended tiller height (ETH) in both experiments. Within both experiments, bite mass and intake rate did not differ significantly between swards of different cultivars despite swards containing Multimo generally having a higher ETH and water-soluble carbohydrate concentration and lower green leaf mass, sward bulk density and neutral-detergent fibre concentration than the other swards. However, bite depth was significantly higher (P < 0·01) in swards containing Multimo swards than in the others and, in Experiment 1, bite depth, as a proportion of ETH, was higher in swards containing Multimo and lower in those containing Twins than in the other two cultivars, whereas there was no difference in Experiment 2. Taking both experiments together, the mean bite depth was 0·5 of ETH with sward bulk density accounting for almost half the variance in the relationship between bite depth and ETH. The bulk density of the bite (bite mass per unit bite volume), measured in Experiment 2, followed a similar pattern to sward bulk density, increasing in the order Multimo, Polly, AberElan and Twins. It is concluded that the relationships between sward characteristics and bite dimensions, derived from artificial swards, are applicable to field swards, although the range in natural ryegrass sward characteristics is usually not as wide as in experiments using artificial swards. Lack of precision in the measurement of short-term intake and in sward-based measurements is likely to preclude their use in the evaluation of grass varieties. [source] Prevalence and associated factors of pneumonia in patients with vegetative state in TaiwanJOURNAL OF CLINICAL NURSING, Issue 7 2008Li-Chan Lin PhD Aims., The aim of this study was to investigate the prevalence rate and influencing factors of pneumonia associated with long-term tube feeding in special care units for patients with persistent vegetative states (PVS) in Taiwan. Background., Pneumonia is a significant cause of morbidity, hospitalization and mortality in the nursing home population. Tube feeding has been found as a risk factor for the occurrence of pneumonia. Methods., Two hundred sixty subjects were chosen from three hospital-based special care units for patients with PVS and 10 nursing facilities for persons in PVS in Taiwan. All subjects, who were diagnosed with PVS, received either financial aid for institutional care or were means-tested from The Bureau of Social Welfare of cities and counties in Taiwan. Data were collected through chart review and observations. Results., The prevalence rate of pneumonia in nursing facilities for patients with PVS was 14·2%. The prevalence rate of tube-feeding in nursing facilities for PVS was 91·2%. The mean duration of tube-feeding was 73·21 SD 55·33 months. A total of 90·4% was fed with a nasogastric (NG) tube. Having a lower intake of food and fluids daily and having been institutionalized for a shorter period were three dominant factors associated with the occurrence of pneumonia. Conclusion., Research findings reveal that the incidence of pneumonia is higher in patients who do not receive adequate food and water. Continuing in-service training to improve caregivers' knowledge and skill in providing care to patients in PVS and monitoring their skills in feeding is needed to decrease the occurrence of pneumonia in this population. Relevance to clinical practice., Staff needs to be taught to monitor laboratory data and signs and symptoms of malnutrition and hydration deficit, and also be alert to early indicators of pneumonia in patients with PVS. [source] Antagonistic activity of Aeromonas media strain A199 against Saprolegnia sp., an opportunistic pathogen of the eel, Anguilla australis RichardsonJOURNAL OF FISH DISEASES, Issue 3 2003M J Lategan Abstract A bacteriocin-like inhibitory substance (BLIS) produced by Aeromonas media strain A199 inhibited the growth of Saprolegnia sp. in vitro, an opportunistic pathogen isolated from affected eels, Anguilla australis (Richardson). The presence of BLIS in solid media inhibited the growth of the vegetative state of the aquatic mould as well as the germination of cysts. Uninhibited growth was, however, observed in the presence of inactive BLIS, suggesting that the in vitro antagonism derived from the BLIS of A199. In four independent in vivo tank observations of fish affected with saprolegniosis, the daily addition of A199 to tank water contributed to the subsequent swift recovery of affected hosts from invasion by this opportunistic pathogen. [source] A Moment Dead, a Moment Alive: How a Situational Personhood Emerges in the Vegetative State in an Israeli Hospital UnitAMERICAN ANTHROPOLOGIST, Issue 1 2010Nurit Bird-David ABSTRACT, Here we address the personhood of patients in a permanent vegetative state (PVS), who fall outside categories of "alive" or "dead" and "subject" or "object." Drawing on fieldwork in an Israeli hospital, we examine multiple and shifting approaches to PVS patients, which are articulated in the course of caring for and living with them. We argue that, alongside the institutional definition of these patients as being in a PVS, which, as Kaufman showed, evokes irresolvable confusion as to their ontological nature, there appear and disappear other senses of their personhood. Allying with other studies of cognitively impaired patients (e.g., those with dementia and Alzheimer's), we explore this relational person-concept while demonstrating its situational nature. We analyze patients' admission to the hospital, showing how their essentialistic personhood is "emptied" and how and when their fluid, relational personhood appears and disappears, further showing how this personhood is reified by imagined life stories. [source] Sex chromosomes and sex determination pathway dynamics in plant and animal modelsBIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 4 2010BOHUSLAV JANOUSEK In this review, we discuss and compare data obtained from animal and plant models, focusing our attention on the mechanisms that affect sex linkage and changes in sex-determining pathways. Patterns in data across taxa suggest that sex bias and the dynamics that occurs within hybrid zones can play an important role in these processes that enable the spread of some otherwise handicapped genotypes. We discuss the data obtained from several main plant model species in the light of the patterns demonstrated in animal models. In several plant models, we discuss possible differences in the age of their sex-determining pathways and the age of their current sex chromosomes. We also address an open question: how can an X/A ratio based sex-determining system evolve from a sex-determining system based on two genes on the Y chromosome that control two separate sex-determining pathways (for the control of gynoecium suppression and anther promotion)? Taking inspiration from the well described mechanisms involved in sex determination dynamics in animals, we suggest a hypothetical stepwise scenario of change of the plant sex-determining system based on two separate sex-determining pathways (for the control of gynoecium suppression and anther promotion) into the other sex-determining systems. We suppose that an intermediate step occurs before shift to X/A based sex determination. At that phase, sex determination in plants is still based on an active Y chromosome, although there exists already a connected control of both sex-determining pathways. We suggest that this connection is enabled by the existence of the genes that control sexual dimorphism in the vegetative state of plant development, and that, in some circumstances, these genes can become sex-determining genes. © 2010 The Linnean Society of London, Biological Journal of the Linnean Society, 2010, 100, 737,752. [source] Persistent vegetative state with encephalitis in a pregnant woman with successful fetal outcomeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2005Pierre-François Ceccaldi No abstract is available for this article. [source] Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarctionACTA NEUROLOGICA SCANDINAVICA, Issue 5 2008T. S. Skoglund Objectives,,, To study the long-term outcome in patients with malignant middle cerebral artery (MCA) infarction treated with decompressive craniectomy. The outcome is described in terms of survival, impairment, disabilities and life satisfaction. Materials and methods,,, Patients were examined at a minimum of 1 year (mean 2.9, range 1,6) after the surgery and classified according to the Glasgow Outcome Scale (GOS), the National Institutes of Health Stroke scale (NIHSS), the Barthel Index (BI), the short-form health survey (SF-36) and the life satisfaction checklist (LiSat-11). Results,,, Eighteen patients were included. The long-term survival was 78%. The mean NIHSS score was 13.8 (range 6,20). No patient was left in a vegetative state. The mean BI was 63.9 (5-100). The SF-36 scores showed that the patients' view of their health was significantly lower in most items compared with that of a reference group. According to the LiSat checklist, 83% found their life satisfying/rather satisfying and 17% found their life rather dissatisfying/dissatisfying. Conclusion,,, We conclude that the patients remained in an impaired neurological condition, but had fairly good insight into their limitations. Although their life satisfaction was lower compared with that of the controls, the majority felt that life in general could still be satisfying. [source] Beyond Bland: a critique of the BMA guidance on withholding and withdrawing medical treatmentLEGAL STUDIES, Issue 1 2000John Keownz MA (Cantab) D Phil (Oxon) In Bland1 the House of Lords held it lawful to withdraw tube-feeding from a patient in a ,persistent vegetative state' (pvs), even with intent to kill him. The British Medical Association (BMA) recently published guidance on the withholding and withdrawal of ,medical treatment', so defined as to include food and water delivered by tube. The guidance endorses the withholding/withdrawal of tube-delivered food and water not only from patients in pvs but also from other non-terminally ill patients, such as those with severe dementia or serious stroke. The underlying justification appears (as in Bland) to be that such lives lack worth. This article offers three major criticisms of the guidance. First, its argument that tube-feeding is medical treatment rather than basic care is weak. Secondly, its reasons for not treating or tube-feeding undermine the BMA's longstanding opposition to active euthanasia and active assisted suicide. Thirdly, it relies heavily on legal precedent at the expense of ethical reasoning. [source] | |||||||||||||