Intrathecal baclofen for the management of hereditary spastic paraparesis: a systematic review.

This systematic review aims to evaluate the use of intrathecal baclofen (ITB) for hereditary spastic paraparesis (HSP) treatment. An extensive search in two electronical databases was performed. We identified articles published between 1990 and 2022 (PubMed, Scopus), and applied the following inclusion criteria: diagnosis of HSP at the time of the intervention, either familial or sporadic; report on the effect of ITB in patients with HSP; test trial via either bolus injections or continuous infusion tests; and ITB pump implantation. A data extraction sheet based on the Cochrane Consumers and Communication Review Group's data extraction template was created and adapted to collect relevant data. A qualitative analysis was performed to present the results in narrative summary fashion. A total of 6 studies met our inclusion criteria. 51 patients with HSP had a pre-implantation ITB trial. The time since the diagnosis until the pump implantation ranged from 5 to 30 years. The initial bolus ranged from 20 to 50 µg and the mean doses used at steady state ranged from 65 to 705 µg. An improvement in spasticity was observed on the modified Ashworth Scale in patients treated with ITB. Although all studies reported a subjective gait improvement, not all found an objective improvement in gait. The most common side effect reported was catheter-related problems. The findings of this review support the use of ITB as an effective and a viable option for the treatment of spasticity in HSP refractory to conservative therapies.

Humanização dos cuidados ao recém-nascido no método canguru: relato de experiência / Humanization of care to newborns in the kangaroo method: experience report

Objetivo: relatar a vivência de uma assistência humanizada, por meio de práticas educativas no Método Canguru, em uma maternidade-escola. Método: estudo qualitativo, descritivo, tipo relato de experiência, realizado com 33 puérperas alojadas junto ao filho prematuro na unidade canguru. O estudo buscou obter dados descritivos provenientes do contato direto com a realidade estudada. Resultados: por meio das práticas educativas, as mães e os familiares dos recém-nascidos prematuros demonstraram-se receptivos em conhecer as vantagens da assistência humanizada realizada pela prática do Método Canguru. Conclusão: percebeu-se, pela vivência nas práticas educativas, a importância das orientações contínuas, de forma a empoderar as mães e familiares sobre os cuidados neonatais, com vistas à continuidade do método em todas as fases que o contemplam. Assim, deve-se valorizar tais ações educativas, nas práxis de Enfermagem, em prol da melhoria da qualidade de vida do recém-nascido e de sua família.