Persistent Vegetative State: From 2 Different Sources
Long-term unconsciousness caused by damage to areas of the brain that control higher mental functions. The eyes may open and close, and there may be random movements of the limbs, but there is no response to stimuli such as pain. Basic functions such as breathing and heartbeat are not affected. There is no treatment to reverse the situation, but, with good nursing care, survival for months or years is possible.
(PVS) the condition that may be diagnosed after a patient has been in the *vegetative state for more than 4 weeks and is normally regarded as permanent, with little or no hope of recovery, after 12 months. Following the high-profile case of Tony Bland, who was in PVS following injuries sustained in the Hillsborough Football Stadium disaster, the law currently allows medical treatment, such as *artificial nutrition and hydration, to be withdrawn from patients in a permanent vegetative state, but permission must first be granted by the courts.
See LIVING WILL.... advance statements about medical treatment
See NEUROSIS.... anxiety state
Diarrhoea that begins acutely but lasts more than 21 days. The usual enteropathogens are Shigella spp., Salmonella spp., Campylobacter jejuni, Yersinia enterocolitica, Capillaria philippinensis, Cryptosporidium. Giardia can also be a cause.... persistent chronic diarrhoea
Major government schemes to ensure adequate health services to substantial sectors of the community through direct provision of services.... state medicine (health care systems)
Acute or chronic, mild or severe.
Pathological anxiety is caused by a mood of fear, the resolution of which is usually psychological or spiritual. Apart from wise counselling it is sometimes necessary to give relaxants to reduce tension. Causes may be fatigue, low blood pressure, emotional exhaustion, autonomic imbalance, endocrine disturbance (hyperthyroidism, pre-menstrual tension), stress, conflict, schizophrenia, depression. Symptoms: dry mouth, increased sweating, fainting attacks, rapid heartbeat, shortness of breath. Prolonged consumption of strong tea, coffee and other caffeine drinks leads to a deficiency of Vitamin B1 which manifests as general anxiety, even agoraphobia.
Alternatives:– Passion Flower, German Chamomile, Lime Blossom, Skullcap, Oats, Cowslip, Damiana, Dogwood, Valerian, Wild Lettuce, Motherwort, Pulsatilla.
In cases of anxiety the heart is involved – whether physically or otherwise. A ‘heart sustainer’ may give the patient an unexpected ‘lift’ enabling him to cope.
Motherwort tea. Combine equal parts: Motherwort (heart), Balm (gentle nerve relaxant), Valerian (psycho-autonomic). 1-2 teaspoons in each cup boiling water; infuse 10-15 minutes; 1 cup 2-3 times daily.
Powders. Formula. Motherwort 2; Passion Flower 1; Valerian half. Dose: 500mg (two 00 capsules or one-third teaspoon) 2-3 times daily.
Tinctures. Combine, Oats 3; Hawthorn 1; Valerian 1. Dose: 1-2 teaspoons in water or honey thrice daily. Anxiety before menstruation. Evening Primrose Oil capsules. OR: Liquid Extract Pulsatilla BHP (1983) 3-5 drops, thrice daily.
Anxiety with obvious heart symptoms. Hawthorn 6; Valerian 1; Cactus 1; Holly 1; Hyssop 1. (Dr A. Vogel)
Bach Flower remedies: Rescue remedy.
Biostrath. Kava kava of special value.
Diet. Low salt, low fat, high fibre. Avoid alcohol, coffee, sugar and refined foods. Alfalfa tea for remineralisation.
Supplements. Vitamin B-complex, Magnesium, Zinc. 2-3 bananas daily for potassium.
Supportive: Relaxation technique: yoga, etc. ... anxiety states
See glue ear.... middle-ear effusion, persistent
(ASSR) an objective test of hearing that measures the electrical activity in the auditory nerve and *brainstem following sound stimulation using a modulated continuous tone.... auditory steady state response
(MSE) a full psychiatric examination of signs and symptoms, which takes place during a psychiatric interview and should apply only to signs and symptoms elicited at that time; it should not take into account historical information. The examination is usually divided into the following subheadings: appearance and behaviour, speech, mood, *affect, thought and perception, *insight, and orientation. Usually it also includes a *risk assessment.... mental state examination
(MCS) a disorder of consciousness distinct from *persistent vegetative state (PVS) and locked-in syndrome (see vegetative state). Unlike PVS, patients with MCS have partial preservation of conscious awareness although the level of awareness frequently fluctuates over time.... minimally conscious state
(MMSE) a brief 30-point questionnaire that is used to screen for cognitive impairment in the diagnosis of dementia. It is also used to estimate the severity of cognitive impairment and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document response to treatment. It tests functions including arithmetic, memory, and orientation.... mini-mental state examination
(in England and Wales under the Mental Capacity Act 2005) a legally recognized decision or statement by an adult with *capacity identifying any specific or general treatment the patient does not want in the event that he or she loses capacity. An advance directive or decision (formerly often called a living will) should be informed, made voluntarily, and must be valid and applicable to the medical situation that arises; at the extreme it can constitute an advance refusal of potentially life-saving treatment. It cannot, however, be used to demand future treatment and does not apply as long as the person retains capacity. An advance statement is a more general and less legally binding expression of the person’s values and views on the sort of treatment he or she may or may not wish to undergo. Directives and statements can raise ethical questions: for example, should life-saving treatment refused in advance nevertheless be given if it could restore the patient to a quality of life with which he or she was content before losing capacity.... advance directive, decision, or statement
(HHS) a state of extreme hyperglycaemia seen in type 2 diabetes accompanied by dehydration that can be severe, typically triggered by illness in a patient with type 2 diabetes or a patient with previously unknown type 2 diabetes. It was previously known as hyperosmolar non-ketotic hyperglycaemia (HONK). Emergency hospital treatment is required to control blood glucose levels and to treat the dehydration and the underlying precipitating cause. There is a significant mortality, especially in the elderly and patients with other disorders (e.g. vascular disease). While insulin is required as part of the initial emergency treatment, the patient often does not need insulin in the longer term, when well.... hyperosmolar hyperglycaemic state
a state of disordered mood that combines elements of *mania and *depression; it is a common feature of *bipolar affective disorder. Symptoms include overactivity, flight of ideas, depressed mood, and suicidal *ideation.... mixed affective state
(atypical facial pain, chronic idiopathic facial pain) a chronic pain in the face that has no known cause and does not fit the classic presentation of other cranial neuralgias. It may be stress-related, and in some cases appears to be associated with defective metabolism of *tyramine. Treatment may involve the use of antidepressants.... persistent idiopathic facial pain
n. the provision by a local authority of a statement of *special educational needs for children attending school who have mental or physical disabilities severe enough to require extra help at school.... statementing
a medical certificate that replaced forms Med 3 and Med 5 in April 2010 (see Appendix 8).... statement of fitness for work
adj. 1. relating to growth and nutrition rather than to reproduction. 2. functioning unconsciously; autonomic.... vegetative
the clinical condition of unawareness of the self or the environment. The patient breathes spontaneously and has a stable circulation and sleep/wake cycles. It results from extensive damage to the cerebral cortex and thalamus while the brainstem and hypothalamus remain intact. The commonest causes are traumatic brain injury (e.g. road-traffic accidents) and cardiopulmonary arrest. Conditions that mimic the vegetative state include the psychiatric state of *catatonia and the locked-in syndrome, resulting from damage to the brainstem, in which the patient is conscious but unable to speak or make any movements of the body except for blinking and upward eye movements. See also persistent vegetative state.... vegetative state
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