ABSTRACT
Today it is accepted that chronic infusion of baclofen produces significant relaxation and drastic reduction of spasms, amelioration of cramping pain and improvement of sphincter functions in spasticity of spinal cord origin. Based on these results our group had the opportunity of treating 11 cases with refractory spasticity and dystonic symptoms due to central damage caused by head injury in 8 cases and to cerebral palsy in 3 using cervical intrathecal infusion of baclofen. During the trial period with percutaneous intrathecal infusion of a daily bolus of 12.5-75 micrograms of baclofen through a reservoir, improvement of mentation and speech conditions, marked improvement of dystonic and abnormal movements of the upper limbs and trunk and a notable reduction of hypertonia were observed in all cases, which led to a better performance of motor activities in skilled acts and transfer. With these preliminary results in mind, in all cases the previous cervical subarachnoid catheter was attached to a programmable pump that infused a daily total dose varying from 100 to 190 micrograms of baclofen in a continuous or multistep complex mode. After a mean follow-up of 21 months previous results were long-lasting. Neither overdose side effects nor malfunction of the system were observed.
Subject(s)
Baclofen/therapeutic use , Muscle Spasticity/drug therapy , Adolescent , Adult , Case-Control Studies , Female , Humans , Infusion Pumps, Implantable , Male , Middle Aged , Neck , Spinal Cord/drug effects , Treatment OutcomeSubject(s)
Aminoglycosides/pharmacology , Bacteria/isolation & purification , Cephalosporins/pharmacology , Drug Resistance, Bacterial , Penicillin Resistance/physiology , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Humans , Intensive Care Units , Microbial Sensitivity Tests , PortugalABSTRACT
Energy requirements to produce ethyl alcohol from three different crops in Brazil (sugarcane, cassava, and sweet sorghum) were calculated. Figures are presented for the agricultural and industrial phases. The industrial phase is always more energy-intensive, consuming from 60 to 75 percent of the total energy. Sugarcane is the more efficient crop for ethyl alcohol production, followed by sweet sorghum and cassava from a net energy viewpoint. The utilization of sweet sorghum stems might increase the total energy gain from this crop to almost the same level as sugarcane. Cassava has a lower energy gain at the present state of agriculture in Brazil.
