[Objective measurement tools that predict success in the fitting of major unilateral lower limb amputations patients]. / Instrumentos predictores del éxito en la protetización de pacientes con amputaciones unilaterales mayores de miembro inferior.

The profile of the patient who most frequently suffers lower limb amputations is usually an elderly patient with high comorbidity. Physiatrists need objective tools in the assessment of these patients that predict the results of prosthetic programs to increase patient safety and efficiency of prosthetic rehabilitation programs. Given the need to update scientific knowledge in this field, we have carried out a review of the literature with the aim of defining a proposal for tools that facilitate decision-making in the indication of prosthetic rehabilitation in these patients. A bibliographic search strategy has been carried out using the scientific databases PubMed, Web of Science, Scopus and Cochrane Library. The quality of the selected articles has been assessed according to the tools proposed by CASPe.

Protocolo de sedación con sevoflurano para la infiltración de toxina botulínica tipo A en parálisis cerebral infantil / Sevoflurane sedation protocol in children with cerebral palsy undergoing botulinum toxin-A injections

Objetivo Describir nuestra experiencia con un protocolo basado en el uso de sevoflurano para la sedación y analgesia durante la infiltración de toxina botulínica tipo A (BoNT-A), en niños con parálisis cerebral (PC), especialmente en términos de seguridad y eficacia. Material y métodos Estudio observacional retrospectivo de pacientes con PC a los que se realizó infiltración con BoNT-A bajo sedación con sevoflurano desde noviembre de 2012 hasta diciembre de 2019. Se revisaron las características demográficas, las características clínicas y funcionales, la efectividad de la sedación, los eventos adversos (EA) y la satisfacción del profesional. Resultados Se realizaron 387 sedaciones en 74 pacientes diagnosticados de PC. La sedación efectiva se logró en el 100% de los procedimientos, facilitando la colaboración durante la infiltración y la satisfacción del profesional. Se notificaron EA en el 6,02% de los procedimientos, siendo los más frecuentes las náuseas y los vómitos (3,88%) y la hipoxemia transitoria (2,07%). No se informaron EA graves. No se encontró asociación entre la incidencia de EA y las variables clínicas, funcionales o el riesgo antes de la anestesia. Conclusiones La sedación con sevoflurano muestra resultados prometedores en términos de seguridad y efectividad para el manejo de la agitación y el dolor durante la infiltración de BoNT-A en nuestra práctica clínica diaria. Además, puede facilitar la infiltración, permitir la exploración bajo sedación e infiltración multinivel con buena tolerancia (AU)

Objective This study aimed to describe our experience with a protocol based on sevoflurane sedation to control pain and agitation during botulinum toxin-A (BoNT-A) infiltration in children with cerebral palsy (CP), especially in terms of safety and efficacy. Material and methods We conducted a retrospective observational study of patients diagnosed with CP who underwent BoNT-A infiltration with sevoflurane sedation from November 2012 to December 2019. Demographic, clinical and functional characteristics, the effectiveness of sedation, adverse events (AE) and professional satisfaction were reviewed. Results A total of 387 sedations were successfully performed in 74 patients. Effective sedation was achieved in 100% of procedures, facilitating collaboration during infiltration and improving professional satisfaction. AE were reported in 6.02% of the procedures, the most frequent being nausea and vomiting (3.88%) and transient hypoxemia (2.07%). There were no severe AE. No association was found between the incidence of AE and the clinical and functional variables or risk before anaesthesia. Conclusion Sevoflurane sedation shows promising results in terms of safety and effectiveness for the management of agitation and pain during BoNT-A infiltration in our daily clinical practice. In addition, it can facilitate infiltration, allowing examination under sedation and multilevel infiltration with good tolerance (AU)

[Sevoflurane sedation protocol in children with cerebral palsy undergoing botulinum toxin-A injections]. / Protocolo de sedación con sevoflurano para la infiltración de toxina botulínica tipo A en parálisis cerebral infantil.

OBJECTIVE: This study aimed to describe our experience with a protocol based on sevoflurane sedation to control pain and agitation during botulinum toxin-A (BoNT-A) infiltration in children with cerebral palsy (CP), especially in terms of safety and efficacy. MATERIAL AND METHODS: We conducted a retrospective observational study of patients diagnosed with CP who underwent BoNT-A infiltration with sevoflurane sedation from November 2012 to December 2019. Demographic, clinical and functional characteristics, the effectiveness of sedation, adverse events (AE) and professional satisfaction were reviewed. RESULTS: A total of 387 sedations were successfully performed in 74 patients. Effective sedation was achieved in 100% of procedures, facilitating collaboration during infiltration and improving professional satisfaction. AE were reported in 6.02% of the procedures, the most frequent being nausea and vomiting (3.88%) and transient hypoxemia (2.07%). There were no severe AE. No association was found between the incidence of AE and the clinical and functional variables or risk before anaesthesia. CONCLUSION: Sevoflurane sedation shows promising results in terms of safety and effectiveness for the management of agitation and pain during BoNT-A infiltration in our daily clinical practice. In addition, it can facilitate infiltration, allowing examination under sedation and multilevel infiltration with good tolerance.

[Complications arising from traumatic brain injuries in a hospital rehabilitation unit: a series of 126 cases]. / Complicaciones de los traumatismos craneoencefálicos en una unidad hospitalaria de rehabilitación: serie de 126 casos.

INTRODUCTION: The consequences of traumatic brain injuries (TBI) are devastating, whether it is in the personal, family, health care or social spheres. Sufferers will have to follow a rehabilitation programme in which we are going to be faced with a large number of medical, neurological and orthopaedic problems that will exert an influence on that programme. AIMS: The aim of this study is to determine the epidemiological data and the gravity of the cases of TBI admitted to our Rehabilitation Unit, to identify medical and orthopaedic problems that occurred during the time patients were in hospital, and also to determine factors and variables that could have an effect on the onset of such complications. PATIENTS AND METHODS: A retrospective descriptive study was conducted in which we surveyed and collected data from 126 case histories chosen at random from the 210 patients admitted to our Rehabilitation Unit between 1999 and 2001. RESULTS: Mean age, 29 years (interval 4 67), ratio of males to females, 4:1. The TBI were due to motorcycle accidents (40%), car accidents (30%) and falls (11.5%). Neurological problems appeared in 63%, the most frequent of which was psychomotor agitation. 14% displayed post traumatic hydrocephalus, and 8% presented post traumatic seizures. Gastro intestinal problems were seen in 41%, the most frequent being constipation. Respiratory problems were found in 36%, and 15.6% of the patients suffered from pneumonia. 8% displayed para articular ossifications. The number of days spent in the ICU and the days in coma were the more highly statistically significant variables associated with the onset of these complications. CONCLUSIONS: The problems presented by TBI patients during their stay in a Hospital Rehabilitation Unit are diverse and complex; the number of days spent in the ICU and the days they are in coma are the variables that can be of most use in predicting the onset of such complications.