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magic essay writer Survivability and prognosis in coma are ar more di cult to predict than most typical medical diagnoses. Coma itsel can be caused by multiple etiologies, each o which carries independent risk actors contributing to overall morbidity and mortality. In studies o prognosis, several authors have identi ed objective markers critical table 36 8. System-based management o the neurocritical care patient neurologic metabolic icp management seizure management thermoregulation rehabilitation electrolyte management monitoring of urine output monitoring of renal function fluid management acid–base management respiratory ventilator management noninvasive ventilation management pulmonary prophylaxis cardiovascular blood pressure management cardiac supportive management fluid management infection control antibiotic/antiviral/antifungal therapy thermoregulation precautionary infectious management appropriate surveillance hematologic monitoring of blood counts coagulopathy management deep venous thrombosis prophylaxis gastrointestinal bowel management gi prophylaxis endocrine glucose management adrenal-axis management skin pressure ulcer prophylaxis eye care alimentary nutrition management oral care 598 c h apt er 36 to outcome, but no consensus on quanti cation o these markers exists. O all etiologies, metabolic coma carries the greatest what critical actors in the comatose xt state guide decisions on prognosis?. 24 most patients who survive nontraumatic coma outcome studies in coma all under the two broad t e 3 major clinical actors predicting outcome are categories o traumatic and nontraumatic coma. T e majority o in ormation obtained rom the nontraumatic coma population is in anoxic ischemic encephalopathy. In etiologies other than anoxia, prognostic data are extrapolated rom those studies and weighed accordingly. Most prognostic data rely on the use o outcome scales that group patients according to neurologic unctionality at predetermined times (90 days versus 6 months). Familiar scales include the modi ed rankin scale (mrs) and the gos. T e most reliable indicators o prognosis in coma are etiology, depth o coma, and length o coma. In addition, patient age, neurologic examination ndings, increased icp, and hypoxia are important in outcome assessment. With speci c disease states, what xt important actors aid in predicting prognosis?. Raumatic coma25 overall prognosis in traumatic coma is better than nontraumatic coma. Prognosis decreases in a stepwise ashion with lower gcs scores. Age and prognosis are inversely related (70% positive predictive value). Absent pupillary responses are associated with poor outcomes (70% positive predictive value). Hypotension and hypoxia in the setting o traumatic coma are associated with poor outcomes (79% positive predictive value). Cranial c evidence o compression, ventricular e acement, and sah are associated with poor outcomes (70% positive predictive value). Raumatic coma o 6 hours or more carries a 40% chance or good neurologic recovery. There ore, length o coma is not a good predictor o outcome. Eeg is not a reliable predictor o outcomes in traumatic coma. Nontraumatic coma26,27 medical coma lasting 6 hours or more carries a poor prognosis, with a mortality o 76% in the rst 30 days. Chance o recovery (30%). Achieve permanent baseline states at 1 month ollowing presentation. Duration o coma, neuro-ophthalmologic signs, and motor unction.

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http://cs.gmu.edu/~xzhou10/semester/how-to-write-thesis-chapter-4.html how to write thesis chapter 4 2006;15:117–124. 13. Mclaughlin jr, risch ha, lubinski j, et al. Reproductive risk factors for ovarian cancer in carriers of brca1 or brca2 mutations. A case control study. Lancet oncol. 2007;8:26–34. 14. Harris re, beebe-donk j, doss h, et al. Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs in cancer prevention. A critical review of non-selective cox-2 blockade. Oncol rep. 2005;13:559–583. 15. Bertone er, hankinson se, newcomb pa, et al. A populationbased case-control study of carotenoid and vitamin a intake and ovarian cancer. Cancer causes control. 2001;12:83–90. 16. Meeuwissen pam, seynaeve c, brekelmans ctm, et al. Outcome of surveillance and prophylactic salpingo-oophorectomy in asymptomatic women at high risk for ovarian cancer. Gynecol oncol. 2005;97(2):476–482. 17. Dann jl, zorn kk. Strategies for ovarian cancer prevention. Obstet gynecol clin north am. 2007;34:667–686. 18. Finch a, beiner m, lubinski j, et al.

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