Subject(s)
Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms , Radiopharmaceuticals , Rhabdomyosarcoma , Humans , Positron Emission Tomography Computed Tomography/methods , Male , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Rhabdomyosarcoma/diagnostic imaging , ChildSubject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralSubject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralABSTRACT
The bulk photovoltaic effect is an experimentally verified phenomenon by which a direct charge current is induced within a non-centrosymmetric material by light illumination. Calculations of its intrinsic contribution, the shift current, are nowadays amenable from first-principles employing plane-wave bases. In this work, we present a general method for evaluating the shift conductivity in the framework of localized Gaussian basis sets that can be employed in both the length and velocity gauges, carrying the idiosyncrasies of the quantum-chemistry approach. The (possibly magnetic) symmetry of the system is exploited in order to fold the reciprocal space summations to the representation domain, allowing us to reduce computation time and unveiling the complete symmetry properties of the conductivity tensor under general light polarization.
ABSTRACT
It is generally accepted that spin-dependent electron transmission may appear in chiral systems, even without magnetic components, as long as significant spin-orbit coupling is present in some of its elements. However, how this chirality-induced spin selectivity (CISS) manifests in experiments, where the system is taken out of equilibrium, is still debated. Aided by group theoretical considerations and nonequilibrium DFT-based quantum transport calculations, here we show that when spatial symmetries that forbid a finite spin polarization in equilibrium are broken, a net spin accumulation appears at finite bias in an arbitrary two-terminal nanojunction. Furthermore, when a suitably magnetized detector is introduced into the system, the net spin accumulation, in turn, translates into a finite magneto-conductance. The symmetry prerequisites are mostly analogous to those for the spin polarization at any bias with the vectorial nature given by the direction of magnetization, hence establishing an interconnection between these quantities.
ABSTRACT
OBJECTIVE: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. MATERIALS AND METHODS: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged <16 years. Thus, 21 cases in adults (mean age, 57 years) were analyzed. RESULTS: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumours were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). CONCLUSIONS: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its aetiology and therapeutic management.
Subject(s)
Intussusception , Adult , Humans , Middle Aged , Intussusception/diagnostic imaging , Intussusception/etiology , Intussusception/therapy , Retrospective Studies , Tomography, X-Ray Computed , Abdominal Pain , HospitalsABSTRACT
Objetivo: Las invaginaciones intestinales en adultos son de difícil diagnóstico debido a la inespecificidad de los síntomas. Sin embargo, la mayoría tienen una causa estructural que requiere tratamiento quirúrgico. El objetivo de este estudio es revisar sus características epidemiológicas, hallazgos en imagen y manejo terapéutico. Materiales y métodos: Estudio retrospectivo de las invaginaciones intestinales que precisaron ingreso hospitalario diagnosticadas en nuestro hospital entre 2016 y 2020. De un total de 73 casos fueron excluidos errores de codificación (n=6) y pacientes menores de 16 años (n=46), resultando 21 invaginaciones en adultos. Resultados: La edad media fue de 57 años, y el dolor abdominal fue la manifestación clínica más frecuente en el 38% de los casos (n=8). El diagnóstico mediante tomografía computarizada (TC), con la presencia del signo de la diana, alcanzó una sensibilidad del 100%, siendo la región ileocecal la localización más frecuente en un 38% de los pacientes (n=8). Un 85,7% de los casos (n=18) tenían una causa estructural y el 81% (n=17) requirió cirugía. Los resultados anatomopatológicos fueron concordantes con la TC en un 94,1%, siendo la etiología más frecuente la neoplásica: 35,3% benignas (n=6) y 64,7% malignas (n=9). Conclusiones: La TC es la prueba de elección en el diagnóstico de las invaginaciones intestinales y resulta determinante a la hora de identificar la etiología y decidir el manejo terapéutico.(AU)
Objective: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. Materials and methods: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged<16 years. Thus, 21 cases in adults (mean age, 57 y) were analyzed. Results: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumors were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). Conclusions: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its etiology and therapeutic management.(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Intussusception/drug therapy , Intussusception/etiology , Therapeutics , Abdominal Pain , Intussusception/epidemiology , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Spin-orbit coupling gives rise to a range of spin-charge interconversion phenomena in nonmagnetic systems where certain spatial symmetries are reduced or absent. Chirality-induced spin-selectivity (CISS), a term that generically refers to a spin-dependent electron transfer in nonmagnetic chiral systems, is one such case, appearing in a variety of seemingly unrelated situations ranging from inorganic materials to molecular devices. In particular, the origin of CISS in molecular junctions is a matter of an intense current debate. Here, we derive a set of geometrical conditions for this effect to appear, hinting at the fundamental role of symmetries beyond otherwise relevant quantitative issues. Our approach, which draws on the use of point-group symmetries within the scattering formalism for transport, shows that electrode symmetries are as important as those of the molecule when it comes to the emergence of a spin-polarization and, by extension, to the possible appearance of CISS. It turns out that standalone metallic nanocontacts can exhibit spin-polarization when relative rotations which reduce the symmetry are introduced. As a corollary, molecular junctions with achiral molecules can also exhibit spin-polarization along the direction of transport, provided that the whole junction is chiral in a specific way. This formalism also allows the prediction of qualitative changes of the spin-polarization upon substitution of a chiral molecule in the junction with its enantiomeric partner. Quantum transport calculations based on density functional theory corroborate all of our predictions and provide further quantitative insight within the single-particle framework.
ABSTRACT
The suppression and excitation of Alfvén eigenmodes have been experimentally obtained, for the first time, by means of externally applied 3D perturbative fields with different spatial spectra in a tokamak plasma. The applied perturbation causes an internal fast-ion redistribution that modifies the phase-space gradients responsible for driving the modes, determining, ultimately their existence. Hybrid kinetic-magnetohydrodynamic simulations reveal an edge resonant transport layer activated by the 3D perturbative field as the responsible mechanism for the fast-ion redistribution. The results presented here may help to control fast-ion driven Alfvénic instabilities in future burning plasmas with a significant fusion born alpha particle population.
ABSTRACT
Canine distemper is caused by canine distemper virus (CDV), a multisystemic infectious disease with a high morbidity and mortality rate in dogs. Nanotechnology represents a development opportunity for new molecules with antiviral effects that may become effective treatments in veterinary medicine. This study evaluated the efficacy and safety of silver nanoparticles (AgNPs) in 207 CDV, naturally infected, mixed-breed dogs exhibiting clinical signs of the non-neurological and neurological phases of the disease. Group 1a included 52 dogs (experimental group) diagnosed with non-neurologic distemper treated with 3% oral and nasal AgNPs in addition to supportive therapy. Group 1b included 46 dogs (control group) diagnosed with non-neurological distemper treated with supportive therapy only. Group 2a included 58 dogs with clinical signs of neurological distemper treated with 3% oral and nasal AgNPs in addition to supportive therapy. Group 2b included 51 dogs (control group) diagnosed with clinical signs of neurological distemper treated with supportive therapy only. Efficacy was measured by the difference in survival rates: in Group 1a, the survival rate was 44/52 (84.6%), versus 7/46 in Group 1b (15.2%), while both showed clinical signs of non-neurological distemper. The survival rate of dogs with clinical signs of neurological distemper in Group 2a (38/58; 65.6%) was significantly higher than those in Control Group 2b (0/51; 0%). No adverse reactions were detected in experimental groups treated with AgNPs. AgNPs significantly improved survival in dogs with clinical signs of neurological and non-neurological distemper. The use of AgNPs in the treatment of neurological distemper led to a drastic increase in the proportion of dogs recovered without sequels compared to dogs treated without AgNPs. The evidence demonstrates that AgNP therapy can be considered as a targeted treatment in dogs severely affected by canine distemper virus.
Subject(s)
Distemper Virus, Canine , Distemper , Metal Nanoparticles , Animals , Dogs , Metal Nanoparticles/therapeutic use , Silver/therapeutic useABSTRACT
Objetivos: Recuperar la capacidad de deambulación con prótesis en los amputados de extremidad inferior es fundamental para mejorar su independencia funcional. El objetivo de este trabajo ha sido conocer qué factores intervienen en conseguir la protetización de pacientes amputados vasculares. Material y método: Estudio longitudinal observacional de los pacientes con amputación mayor de extremidad inferior de etiología vascular realizada desde el 1 de abril de 2017 hasta el 1 de abril de 2020. Se compararon las siguientes variables entre los pacientes que fueron protetizados y los que no: edad, sexo, índice de masa corporal, comorbilidades (escala de Charlson), independencia en las actividades de la vida diaria básicas (índice de Barthel) y capacidad de marcha (FAC) previas y al año de la amputación. La utilización de la prótesis al año se midió con el instrumento de Houghton. Resultados: Fueron amputados 80 pacientes con una edad media de 70,5 años, el 78,8% eran varones. El nivel de amputación fue supracondíleo en 42 pacientes y en 38 infracondíleo; se protetizaron 35. Las variables relacionadas con la posibilidad de protetización fueron la menor edad (p=0,020), presentar menos comorbilidad (p=0,00), la amputación infracondílea (p=0,024) y tener una mayor independencia funcional y de marcha previas a la amputación (p=0,00). Al año habían fallecido 22 pacientes, solo uno de los que fueron protetizados. Conclusión: Aunque no existen unas recomendaciones claras para determinar qué amputado ha de ser protetizado, en nuestros pacientes, tener menos comorbilidades, una buena situación funcional previa, menor edad y un nivel de amputación infracondíleo se relacionaron con un mayor éxito en conseguir dicho objetivo.(AU)
Objective: Restoring the ambulation ability with prostheses in lower limb amputeesis essential to improve their functional independence. The aim of this study was to determine the factors involved in achieving prosthesis fitting in vascular amputees. Material and method: Observational longitudinal study of patients with major lower limb amputation of vascular etiology performed from April 1st 2017 to April 1st 2020. The following variables were compared between the group of patients who were prosthetized and those who were not: age, gender, body-mass index, comorbidity (Charlson index), independence in the activities of daily living (Barthel index) and ambulation ability (FAC test) before and a year after the amputation. The prosthetic use after a year was measured with the Houghton scale. Results: A total of 80 patients were amputated with a mean age of 70.5 years old, 78.8% were male. The amputation level was supracondilealin 42 patients and infracondilealin 38 patients. The number of prosthetized patients was 35. The variables related to the possibility of prosthesis fitting were: younger age (P=0.020), less comorbidity (P=0.000), infracondileal amputation (P=0.024) and greater functional independence and ambulation ability prior to amputation (P=0.000). After a year 22 patients had died, only one of those who had been prosthetized. Conclusions: Although there are no clear recommendations to determine which amputees should be prosthetic fitting, in our patients the presence of fewer comorbidities and a good previous functional situation, younger age and infracondileal amputation, are related to greater success in achieving this objective.(AU)
Subject(s)
Humans , Male , Female , Amputees , Lower Extremity/surgery , Dependent Ambulation , Bone-Anchored Prosthesis , Physical and Rehabilitation MedicineABSTRACT
JUSTIFICACIÓN: los residentes de centros socio sanitarios son vulnerables a las caídas nocturnas al levantarse para ir al baño o deambular. En muchas ocasiones estas caídas se producen por la toma de benzodiacepinas prescritas para conciliar el sueño. Junto al responsable médico del centro se busca como eliminar o disminuir las benzodiacepinas.OBJETIVOS: los objetivos serán eliminar o disminuir las caídas nocturnas manteniendo la calidad del sueño del paciente.MATERIAL/MÉTODOS: el equipo médico decide eliminar las prescripciones de benzodiacepinas y sustituirlas mediante melatonina retard de 1,9mg. La farmacia busca una melatonina cuya forma farmacéutica se en comprimidos similares a las benzodiacepinas más comunes, LORAZEPAM y LORMETAZEPAM. Mediante el sistema SPD, el paciente no distingue si se le administra un comprimido nuevo o diferente puesto que no ve el envase del fármaco. Esto se realiza durante un periodo de siete días como prueba y se hace revisión a diario del equipo sanitario del centro.RESULTADOS/DISCUSION: el resultado fue que el 32 % de los residentes cambiaron el uso de benzodiacepinas por melatonina retard de 1,98mg. Las caídas nocturnas disminuyeron considerablemente y el paciente mantuvo su calidad de sueño o incluso mejoró evitando la resaca matinal. La búsqueda de comprimidos similares a las benzodiacepinas en forma, tamaño y color facilitó el cambio en la prescripción y el uso del SPD ayudó a que el paciente lo aceptara evitando el rechazo al cambio de tratamiento. (AU)
Subject(s)
Humans , Benzodiazepines , Melatonin , Therapeutics , Sleep , PatientsABSTRACT
PRESENTACION DEL CASO: paciente mujer con 79 años de edad que solicita elaboración de SPD porque se confunde al cambiar el color de los envases. Mediante la revisión de los tratamientos en la entrevista inicial realizada para elaborar un SPD con el paciente ambulatorio, encontramos tratamientos que demuestra una INERCIA TERAPEUTICA considerada como posible caso de falta de seguridad clínica.EVALUACIÓN: la paciente, en la primera entrevista, refiere tener problemas gástricos desde que toma Clopidogrel 75mg y AAS 100 mg. Fue intervenida para implantar un stent coronario hace cinco años. Después de su última revisión antes de la pandemia (enero de 2019), no le han cambiado nada en el tratamiento. Su médico de atención primaria le renueva la medicación por teléfono. Revisamos el tratamiento con informes médicos, comprobamos las prescripciones con lo retirado de farmacia y consideramos que puede existir un caso de INERCIA terapéutica.MÉTODO DE INTERVENCIÓN: realización de una segunda entrevista con los últimos informes médicos y toda la medicación que toma actualmente y retira de la farmacia. Aquí detectamos una posible inercia terapéutica por mantener la doble terapia antiagregante que puede estar originando un PRM. Realizamos informe al médico de atención primaria rogando revise su tratamiento por si la doble antiagregación pudiera tratarse de una inercia terapéutica puesto que los protocolos de consenso hablan de 6 a 12 meses únicamente.RESULTADOS: el médico de primaria considera necesario retirar la AAS para adecuarse a las guías terapéuticas de práctica clínica. La paciente experimenta una mejoría en sus molestias digestivas. (AU)
Subject(s)
Humans , Female , Aged , Pharmacy , Pharmaceutical Services , Patients , 34860 , TherapeuticsABSTRACT
OBJECTIVE: Restoring the ambulation ability with prostheses in lower limb amputeesis essential to improve their functional independence. The aim of this study was to determine the factors involved in achieving prosthesis fitting in vascular amputees. MATERIAL AND METHOD: Observational longitudinal study of patients with major lower limb amputation of vascular etiology performed from April 1st 2017 to April 1st 2020. The following variables were compared between the group of patients who were prosthetized and those who were not: age, gender, body-mass index, comorbidity (Charlson index), independence in the activities of daily living (Barthel index) and ambulation ability (FAC test) before and a year after the amputation. The prosthetic use after a year was measured with the Houghton scale. RESULTS: A total of 80 patients were amputated with a mean age of 70.5 years old, 78.8% were male. The amputation level was supracondilealin 42 patients and infracondilealin 38 patients. The number of prosthetized patients was 35. The variables related to the possibility of prosthesis fitting were: younger age (P=0.020), less comorbidity (P=0.000), infracondileal amputation (P=0.024) and greater functional independence and ambulation ability prior to amputation (P=0.000). After a year 22 patients had died, only one of those who had been prosthetized. CONCLUSIONS: Although there are no clear recommendations to determine which amputees should be prosthetic fitting, in our patients the presence of fewer comorbidities and a good previous functional situation, younger age and infracondileal amputation, are related to greater success in achieving this objective.
Subject(s)
Amputees , Artificial Limbs , Activities of Daily Living , Aged , Female , Humans , Longitudinal Studies , Lower Extremity/surgery , MaleABSTRACT
Many bacteria of the genus Bradyrhizobium are capable of inducing nodules in legumes. In this work, the importance of a type VI secretion system (T6SS) in a symbiotic strain of the genus Bradyrhizobium is described. T6SS of Bradyrhizobium sp. LmicA16 (A16) is necessary for efficient nodulation with Lupinus micranthus and Lupinus angustifolius. A mutant in the gene vgrG, coding for a component of the T6SS nanostructure, induced less nodules and smaller plants than the wild-type (wt) strain and was less competitive when co-inoculated with the wt strain. A16 T6SS genes are organized in a 26-kb DNA region in two divergent gene clusters of nine genes each. One of these genes codes for a protein (Tsb1) of unknown function but containing a methyltransferase domain. A tsb1 mutant showed an intermediate symbiotic phenotype regarding vgrG mutant and higher mucoidity than the wt strain in free-living conditions. T6SS promoter fusions to the lacZ reporter indicate expression in nodules but not in free-living cells grown in different media and conditions. The analysis of nodule structure revealed that the level of nodule colonization was significantly reduced in the mutants with respect to the wt strain.
Subject(s)
Bradyrhizobium , Lupinus , Type VI Secretion Systems , Bradyrhizobium/genetics , Lupinus/microbiology , Type VI Secretion Systems/genetics , Root Nodules, Plant/microbiology , Phylogeny , Symbiosis/geneticsABSTRACT
BACKGROUND: Secondary haemophagocytic lymphohistiocytosis (sHLH) is characterised by a hyper activation of immune system that leads to multiorgan failure. It is suggested that excessive immune response in patients with COVID-19 could mimic this syndrome. Some COVID-19 autopsy studies have revealed the presence of haemophagocytosis images in bone marrow, raising the possibility, along with HScore parameters, of sHLH. AIM: Our objective is to ascertain the existence of sHLH in some patients with severe COVID-19. METHODS: We report the autopsy histological findings of 16 patients with COVID-19, focusing on the presence of haemophagocytosis in bone marrow, obtained from rib squeeze and integrating these findings with HScore parameters. CD68 immunohistochemical stains were used to highlight histiocytes and haemophagocytic cells. Clinical evolution and laboratory parameters of patients were collected from electronic clinical records. RESULTS: Eleven patients (68.7%) displayed moderate histiocytic hyperplasia with haemophagocytosis (HHH) in bone marrow, three patients (18.7%) displayed severe HHH and the remainder were mild. All HScore parameters were collected in 10 patients (62.5%). Among the patients in which all parameters were evaluable, eight patients (80%) had an HScore >169. sHLH was not clinically suspected in any case. CONCLUSIONS: Our results support the recommendation of some authors to use the HScore in patients with severe COVID-19 in order to identify those who could benefit from immunosuppressive therapies. The presence of haemophagocytosis in bone marrow tissue, despite not being a specific finding, has proved to be a very useful tool in our study to identify these patients.
Subject(s)
COVID-19 , Lymphohistiocytosis, Hemophagocytic , Autopsy , Bone Marrow/pathology , COVID-19/complications , Humans , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/pathology , Multiple Organ Failure/pathologyABSTRACT
Antecedentes y objetivos En diciembre de 2019 surgió una nueva enfermedad por coronavirus en humanos causada por el virus SARS-CoV-2, la COVID-19, que se ha asociado con fenómenos trombóticos. La obstrucción venosa retiniana (OVR) es principalmente una consecuencia de los factores de riesgo vascular (FRV). El objetivo de este estudio ha sido analizar los casos de infección por SARS-CoV-2 en una cohorte de pacientes con OVR (cohorte Valdecilla). Pacientes y métodos Entre diciembre de 2008 y 2020 hemos atendido 429 pacientes con OVR. Diez han padecido COVID-19, de los que uno no presentaba FRV ni trombofilia. Los otros 9 fueron diagnosticados de OVR antes de la infección: todos tenían FRV; 6 ateromatosis carotídea y 4 presentaban un síndrome antifosfolípido. La infección no causó en ellos fenómenos trombóticos. Conclusiones La OVR es una manifestación infrecuente de la COVID-19. En nuestra cohorte de pacientes con OVR la COVID-19 no indujo eventos trombóticos (AU)
Background and objectives A new coronavirus disease in humans, COVID-19, caused by SARS-CoV-2, emerged in December 2019. It has been associated with the development of thrombotic phenomena. Retinal vein occlusion (RVO) is mainly a consequence of vascular risk factors (VRF). This study aimed to analyze cases of COVID-19 in a cohort of patients with RVO (Valdecilla cohort). Patients and methods Between December 2008 and December 2020, 429 patients with RVO were attended to in our clinic. Ten patients had COVID-19, one of which did not have VRF or thrombophilia. The remaining nine patients had RVO prior to the infection and VRF, six had carotid atherosclerosis, and four had antiphospholipid syndrome. The infection did not cause thrombotic phenomena in any of them. Conclusions RVO is a rare manifestation of COVID-19. In our cohort of patients with RVO, COVID-19 disease did not lead to thrombotic events (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Retinal Artery Occlusion/complications , /complications , Cohort Studies , Risk FactorsABSTRACT
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)