<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0121-0793</journal-id>
<journal-title><![CDATA[Iatreia]]></journal-title>
<abbrev-journal-title><![CDATA[Iatreia]]></abbrev-journal-title>
<issn>0121-0793</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Antioquia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0121-07932016000400478</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Bomba intratecal de baclofeno, ¿una intervención terapéutica útil y segura en pacientes con espasticidad? Presentación de casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Intrathecal baclofen pump, useful and safe therapeutic intervention in spasticity? Report of four cases]]></article-title>
<article-title xml:lang="pt"><![CDATA[Bomba intratecal de baclofeno, uma intervenção terapêutica útil e segura em doentes com espasticidade? Apresentação de casos]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cáceres-Jerez]]></surname>
<given-names><![CDATA[Luz Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villa-Acuña]]></surname>
<given-names><![CDATA[María Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vera-Campos]]></surname>
<given-names><![CDATA[Julián Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Industrial de Santander  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>29</volume>
<numero>4</numero>
<fpage>478</fpage>
<lpage>484</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0121-07932016000400478&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0121-07932016000400478&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0121-07932016000400478&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La espasticidad puede causar inmovilidad, postración, dolor crónico, úlceras, infecciones, trombosis y neumonías; los objetivos del tratamiento son controlar el dolor, mejorar la movilidad y la calidad de vida y reincorporar al paciente a sus actividades cotidianas por medio de medicamentos antiespásticos orales; sin embargo, los pacientes con espasticidad severa pueden requerir altas dosis orales de estos medicamentos y presentar efectos adversos, por lo que se ha planteado el uso del baclofeno por vía intratecal; en Colombia no se ha usado ampliamente esta intervención y no existen protocolos sobre las indicaciones para llevarla a cabo. El objetivo de esta serie de casos es presentar la experiencia de la Fundación Cardiovascular de Colombia en el tratamiento con bombas intratecales de baclofeno de cuatro pacientes con espasticidad severa, que no habían evolucionado favorablemente con antiespásticos orales, incluyendo altas dosis de baclofeno. Tres de ellos presentaron mejoría importante del dolor, la espasticidad y la calidad de vida, mientras que el otro cursó con síndrome de tolerancia a este medicamento. La bomba intratecal de baclofeno es una intervención útil y segura para pacientes con espasticidad severa que presentan mala respuesta al tratamiento oral o efectos adversos del mismo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY Spasticity may cause immobility, prostration, chronic pain, bedsores, infections, thrombosis and pneumonia; the purposes of its treatment are to control pain, improve mobility and quality of life, and reincorporate the patient to its daily activities by means of oral anti-spastic drugs; however, patients suffering from severe spasticity may require high oral doses of these medications, which may lead to adverse effects. In such cases, intrathecal baclofen has been proposed as a solution. This procedure has not been widely used in Colombia, so that protocols to perform it have not been established. We report the results obtained with the intrathecal administration of baclofen in four severely spastic patients, who had not previously responded to oral anti-spastic drugs, including high doses of baclofen. Pain, spasticity and quality of life significantly improved in three of them. The remaining one presented tolerance to the medication. Intrathecal baclofen pump is a useful and safe procedure for patients with severe spasticity and poor response to oral treatment.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO Bomba intratecal de baclofeno, uma intervenção terapêutica útil e segura em doentes com espasticidade? Apresentação de casos A espasticidade pode causar imobilidade, prostração, dor crônico, úlceras, infeções, trombose e pneumonias; os objetivos do tratamento são controlar a dor, melhorar a mobilidade e a qualidade de vida e reincorporar ao doente a suas atividades cotidianas por meio de medicamentos anti-espásticos orais; embora, os pacientes com espasticidade severa podem requerer altas doses orais destes medicamentos e apresentar efeitos adversos, pelo que se há planteado o uso do baclofeno por via intratecal; na Colômbia não se há usado amplamente esta intervenção e não existem protocolos sobre as indicações para levá-la a cabo. O objetivo desta série de casos é apresentar a experiência da Fundação Cardiovascular de Colômbia no tratamento com bombas intratecais de baclofeno de quatro doentes com espasticidade severa, que não haviam evolucionado favoravelmente com anti-espásticos orais, incluindo altas dose de baclofeno. Três deles apresentaram melhoria importante da dor, a espasticidade e a qualidade de vida, enquanto que o outro cursou com síndrome de tolerância a este medicamento. a bomba intratecal de baclofeno é uma intervenção útil e segura para doentes com espasticidade severa que apresentam má resposta ao tratamento oral ou efeitos adversos do mesmo.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Bomba Intratecal de Baclofeno]]></kwd>
<kwd lng="es"><![CDATA[Espasticidad]]></kwd>
<kwd lng="es"><![CDATA[Terapia]]></kwd>
<kwd lng="en"><![CDATA[Intrathecal Baclofen Pump]]></kwd>
<kwd lng="en"><![CDATA[Spasticity]]></kwd>
<kwd lng="en"><![CDATA[Therapy]]></kwd>
<kwd lng="pt"><![CDATA[Bomba Intratecal de Baclofeno]]></kwd>
<kwd lng="pt"><![CDATA[Espasticidade]]></kwd>
<kwd lng="pt"><![CDATA[Terapia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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