Antonio Montoto Marqués - Academia.edu (original) (raw)
Papers by Antonio Montoto Marqués
International Journal of Molecular Sciences
Recovery from a traumatic spinal cord injury (TSCI) is challenging due to the limited regenerativ... more Recovery from a traumatic spinal cord injury (TSCI) is challenging due to the limited regenerative capacity of the central nervous system to restore cells, myelin, and neural connections. Cell therapy, particularly with mesenchymal stem cells (MSCs), holds significant promise for TSCI treatment. This systematic review aims to analyze the efficacy, safety, and therapeutic potential of MSC-based cell therapies in TSCI. A comprehensive search of PUBMED and COCHRANE databases until February 2023 was conducted, combining terms such as “spinal cord injury,” “stem cells,” “stem cell therapy,” “mesenchymal stem cells,” and “traumatic spinal cord injury”. Among the 53 studies initially identified, 22 (21 clinical trials and 1 case series) were included. Findings from these studies consistently demonstrate improvements in AIS (ASIA Impairment Scale) grades, sensory scores, and, to a lesser extent, motor scores. Meta-analyses further support these positive outcomes. MSC-based therapies have sh...
The Journal of Spinal Cord Medicine
Current Gastroenterology Reports, 2018
Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals o... more Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals of this study are to understand bowel dysfunction in SCI and its effects on quality of life (QOL). Cross-sectional study based on interview and assessment of 41 clients. A majority of them were dissatisfied. Bowel opening time was long in about 65% while 76.6% were incontinent. Socially, approximately half refrained from outings even though 90.3% of them carried out bowel evacuation before going out. Attention to bowel education is necessary to improve social continence.
Medicina Intensiva (English Edition)
Spinal Cord, Feb 14, 2017
Study design: Observational study with prospective and retrospective monitoring. Objective: To de... more Study design: Observational study with prospective and retrospective monitoring. Objective: To describe the epidemiological and demographic characteristics of traumatic spinal cord injury (TSCI), and to analyze its epidemiological changes.
Copyright © 2013 Rita Galeiras Vázquez et al. This is an open access article distributed under t... more Copyright © 2013 Rita Galeiras Vázquez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratorymuscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VCmay require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency.Mechanical ventilation can adversely affect the structur...
Archivos españoles de urología, 2020
espanolOBJETIVO: El objetivo principal de la evaluacionde este producto consistio en la obtencion... more espanolOBJETIVO: El objetivo principal de la evaluacionde este producto consistio en la obtencion de evaluaciones de los pacientes tras el uso del cateter intermitente (CI) Onli™, de 17 cm y 40 cm, y de las opiniones de los profesionales sanitarios sobre su uso para el cateterismo en funcion de sus caracteristicas de diseno. La imposibilidad de acceder al cateter correcto suele ser el motivo por el cual los pacientes suspenden el autocateterismo intermitente (1). Los factores de diseno juegan un rol importante en la probabilidad de usar un CI y seguir el tratamiento. El objetivo secundario de la evaluacion de este producto consistio en evaluar si la facilidad de aprendizaje y de uso de este cateter intermitente Onli facilitaria la adherencia del paciente a un plan de tratamiento con sondaje vesical intermitente. METODOS: Se realizo un estudio multicentrico abierto en 10 Unidades de Lesion Medular (ULMs) de distintos lugares de Espana. Los medicos y la enfermeria de Rehabilitacion re...
Archivos espanoles de urologia, 2020
OBJECTIVE The primary objective of this product evaluation involved obtaining assessments from pa... more OBJECTIVE The primary objective of this product evaluation involved obtaining assessments from patients following the use of the Onli™ intermittent catheter(IC) 17cm and 40cm; and opinions from clinicians on its use for catheterization based on its design features.The inability to access the right catheter is often why patients discontinue intermittent self-catheterization(1). Design factors play an important role in the like lihood of using and remaining compliant to an IC device.The secondary objective of this product evaluation was to assess if the ease-of-learning and ease-of-use of Onli intermittent catheter, would support patient adherence to a catheterization treatment plan. METHODS: A multi-center, unblinded evaluation was executed in 10 different SCI Units across Spain. Rehabilitation physicians and nurses recruited patients with neurogenic bladder disorder and used IC's. The patient sused 30 catheters in according to their standard of care.A total of 100 subjects were ...
Archivos espanoles de urologia, 2019
OBJECTIVES The purpose of this document is to establish practical recommendations on neurogenic b... more OBJECTIVES The purpose of this document is to establish practical recommendations on neurogenic bladder (NB) management based on scientific evidence and medical and nursing perspective in Spinal Cord Injury (SCI) Units as a first multidisciplinary consensual approach in Spain. METHODS: This paper reports results from the first modified Delphi consensus building exercise on this procedure. A committee of recognised opinion-leaders in rehabilitation and urology with special interest in NB was constituted. A working group formed by rehabilitation doctors, urologists and nursing staff of SCI and Neurorehabilitation Units of a number of Spanish hospitals and specialised centres associated with the panel of NB experts have prepared this document. RESULTS: This review provided an overview of the main aspects described by the different clinical guidelines already available and highlighted the need to focus on recommendations in special priority situations in which there was no consensus. In...
Rehabilitación, 2016
Resumen Introduccion Los programas de rehabilitacion domiciliaria y ambulatoria son fundamentales... more Resumen Introduccion Los programas de rehabilitacion domiciliaria y ambulatoria son fundamentales en la recuperacion funcional en personas con dano cerebral adquirido. El objetivo de esta revision es comprobar la efectividad de programas de terapia ocupacional domiciliaria y atencion primaria, sobre el nivel de independencia de las actividades de la vida diaria, en personas adultas con dano cerebral adquirido. Metodologia Se realizo una busqueda bibliografica, en bases de datos especializadas en revisiones sistematicas (CRD Database) y de estudios originales (Pubmed, Scopus, Web of Science y OTseeker). Se analizaron las siguientes variables: funcionalidad en las actividades de la vida diaria, n.° de dias de estancia hospitalaria, intensidad de las sesiones de rehabilitacion realizadas, tiempo de espera desde el alta hospitalaria al inicio del proceso de rehabilitacion y n.° de reingresos. Resultados Se seleccionaron una revision sistematica y cuatro estudios originales. Tres de los cuatro estudios fueron ensayos clinicos aleatorizados, el estudio restante fue un ensayo clinico no controlado. Conclusiones La evidencia es limitada para afirmar con rotundidad la efectividad de los programas de terapia ocupacional en rehabilitacion domiciliaria y ambulatoria, en personas con dano cerebral adquirido. Se produjeron algunas diferencias significativas sobre los niveles de independencia en actividades de la vida diaria, fruto de intervenciones muy heterogeneas entre si.
Spinal cord, 2021
STUDY DESIGN This is a retrospective, observational study. OBJECTIVES To evaluate organ dysfuncti... more STUDY DESIGN This is a retrospective, observational study. OBJECTIVES To evaluate organ dysfunction in patients with an acute traumatic spinal cord injury (ATSCI) above T6 using the Sequential Organ Failure Assessment (SOFA) score to determine its association with mortality. SETTING The study was performed at the intensive care unit (ICU) of a tertiary hospital in the northwest of Spain. METHODS The study included 241 patients with an ATSCI above T6 who had been admitted to the ICU between 1998 and 2017. A descriptive analysis of all variables collected was performed to compare the survivors with the non-survivors. In addition, a logistic regression model was used in the multivariate analysis to identify variables that were independently associated with mortality. RESULTS The results revealed significant differences between the survivors and non-survivors in terms of their age, Charlson Comorbidity Index, Glasgow Coma Scale score on admission, APACHE II score, SOFA score on day 0 an...
espanolIntroduccion La incidencia mundial de la lesion medular traumatica (LMT) es muy variable. ... more espanolIntroduccion La incidencia mundial de la lesion medular traumatica (LMT) es muy variable. Recientes estudios senalan que estamos asistiendo a un cambio epidemiologico de la LMT. Este cambio puede originar una serie de consecuencias en el modelo de atencion. Conocer las caracteristicas epidemiologicas y demograficas de la LMT es vital para planificar las prioridades, asignar los recursos sanitarios adecuados y tambien, para identificar las directrices de la prevencion. Objetivo Determinar las caracteristicas epidemiologicas de los pacientes con LMT en Galicia durante el periodo 1995-2014 y analizar la afectacion neurologica y los factores determinantes de la evolucion clinica y funcional en dicho periodo. Material y metodo Se realizo un estudio observacional con seguimiento retrospectivo y prospectivo de los pacientes con lesion medular de etiologia traumatica que ingresaron en la Unidad de Lesionados Medulares (ULM) del Complejo Hospitalario Universitario de A Coruna en el pe...
Neurocirugía (English Edition)
Spinal Cord
Study design This was a psychometric study. Objectives To determine the validity of the Spanish v... more Study design This was a psychometric study. Objectives To determine the validity of the Spanish version of the World Health Organization Quality of Life instrument (WHOQOL-BREF) for its use in persons with traumatic spinal cord injury and, as secondary objectives, to correlate the results with variables such as functional status, psychological well-being, and social support.
Spinal Cord
Study design Descriptive retrospective study. Objectives To analyze risk factors associated with ... more Study design Descriptive retrospective study. Objectives To analyze risk factors associated with mechanical ventilation (MV) in cases of acute traumatic Cervical Spinal Cord Injury (tCSCI). Setting Unidad de Lesionados Medulares, Complejo Hospitalario Universitario A Coruña, in Galicia (Spain). Methods The study included patients with tCSCI who were hospitalized between January 2010 and December 2014. The following variables were analyzed: age, gender, etiology, neurological level, ASIA (American Spinal Injury Association) grade, associated injuries, injury severity score (ISS), ASIA motor score (AMS) at admission and mortality. Results A total of 146 patients met the study's inclusion criteria. The majority were men (74.7%) with mean age of 62.6 (s.d. ± 18.8) years. Sixty patients (41.1%) required MV. Mean age of ventilated vs. non-ventilated patients was 57.3 vs. 65.7. Men were more likely to require MV than women, ASIA grades A and B were also more likely to need MV than grades C and D, as well as patients with associated injuries. The AMS of patients receiving MV was lower than that of those who did not require MV (20.1 vs. 54.3). Moreover, the ISS was higher in patients receiving MV (31.2 vs. 13.4). An AMS ≤ 37 and an ISS ≥ 13 increased the risk of requiring MV by a factor of 11.98 and 7.28, respectively. Conclusions Isolated factors associated with a greater risk of MV in tCSCI were: age, gender, ASIA grade, ISS and AMS. However, the only factor with a significant discriminatory ability to determine the need for MV was the AMS at admission.
Galicia Clínica, 2016
La lesión medular es un factor de riesgo importante para la enfermedad tromboembólica venosa, ent... more La lesión medular es un factor de riesgo importante para la enfermedad tromboembólica venosa, entidad que engloba la trombosis venosa profunda y el tromboembolismo pulmonar, siendo este una causa potencialmente reversible de parada cardíaca. Presentamos el caso de un varón joven con lesión medular completa (grado ASIA A) con nivel C6 que sufre una parada cardíaca por tromboembolismo pulmonar masivo secundario a trombosis venosa profunda en extremidad inferior izquierda en la 6ª semana de ingreso. Exponemos la incidencia de ambas entidades en la lesión medular aguda así como su fisiopatología, profilaxis y tratamiento; destacamos la importancia de la identificación de la parada cardíaca e inicio precoz de las maniobras de reanimación cardiopulmonar por el personal sanitario y analizamos las consecuencias de la lesión cerebral hipóxico-isquémica derivada de una parada cardíaca recuperada.
The Journal of Spinal Cord Medicine, 2017
International Journal of Molecular Sciences
Recovery from a traumatic spinal cord injury (TSCI) is challenging due to the limited regenerativ... more Recovery from a traumatic spinal cord injury (TSCI) is challenging due to the limited regenerative capacity of the central nervous system to restore cells, myelin, and neural connections. Cell therapy, particularly with mesenchymal stem cells (MSCs), holds significant promise for TSCI treatment. This systematic review aims to analyze the efficacy, safety, and therapeutic potential of MSC-based cell therapies in TSCI. A comprehensive search of PUBMED and COCHRANE databases until February 2023 was conducted, combining terms such as “spinal cord injury,” “stem cells,” “stem cell therapy,” “mesenchymal stem cells,” and “traumatic spinal cord injury”. Among the 53 studies initially identified, 22 (21 clinical trials and 1 case series) were included. Findings from these studies consistently demonstrate improvements in AIS (ASIA Impairment Scale) grades, sensory scores, and, to a lesser extent, motor scores. Meta-analyses further support these positive outcomes. MSC-based therapies have sh...
The Journal of Spinal Cord Medicine
Current Gastroenterology Reports, 2018
Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals o... more Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals of this study are to understand bowel dysfunction in SCI and its effects on quality of life (QOL). Cross-sectional study based on interview and assessment of 41 clients. A majority of them were dissatisfied. Bowel opening time was long in about 65% while 76.6% were incontinent. Socially, approximately half refrained from outings even though 90.3% of them carried out bowel evacuation before going out. Attention to bowel education is necessary to improve social continence.
Medicina Intensiva (English Edition)
Spinal Cord, Feb 14, 2017
Study design: Observational study with prospective and retrospective monitoring. Objective: To de... more Study design: Observational study with prospective and retrospective monitoring. Objective: To describe the epidemiological and demographic characteristics of traumatic spinal cord injury (TSCI), and to analyze its epidemiological changes.
Copyright © 2013 Rita Galeiras Vázquez et al. This is an open access article distributed under t... more Copyright © 2013 Rita Galeiras Vázquez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratorymuscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VCmay require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency.Mechanical ventilation can adversely affect the structur...
Archivos españoles de urología, 2020
espanolOBJETIVO: El objetivo principal de la evaluacionde este producto consistio en la obtencion... more espanolOBJETIVO: El objetivo principal de la evaluacionde este producto consistio en la obtencion de evaluaciones de los pacientes tras el uso del cateter intermitente (CI) Onli™, de 17 cm y 40 cm, y de las opiniones de los profesionales sanitarios sobre su uso para el cateterismo en funcion de sus caracteristicas de diseno. La imposibilidad de acceder al cateter correcto suele ser el motivo por el cual los pacientes suspenden el autocateterismo intermitente (1). Los factores de diseno juegan un rol importante en la probabilidad de usar un CI y seguir el tratamiento. El objetivo secundario de la evaluacion de este producto consistio en evaluar si la facilidad de aprendizaje y de uso de este cateter intermitente Onli facilitaria la adherencia del paciente a un plan de tratamiento con sondaje vesical intermitente. METODOS: Se realizo un estudio multicentrico abierto en 10 Unidades de Lesion Medular (ULMs) de distintos lugares de Espana. Los medicos y la enfermeria de Rehabilitacion re...
Archivos espanoles de urologia, 2020
OBJECTIVE The primary objective of this product evaluation involved obtaining assessments from pa... more OBJECTIVE The primary objective of this product evaluation involved obtaining assessments from patients following the use of the Onli™ intermittent catheter(IC) 17cm and 40cm; and opinions from clinicians on its use for catheterization based on its design features.The inability to access the right catheter is often why patients discontinue intermittent self-catheterization(1). Design factors play an important role in the like lihood of using and remaining compliant to an IC device.The secondary objective of this product evaluation was to assess if the ease-of-learning and ease-of-use of Onli intermittent catheter, would support patient adherence to a catheterization treatment plan. METHODS: A multi-center, unblinded evaluation was executed in 10 different SCI Units across Spain. Rehabilitation physicians and nurses recruited patients with neurogenic bladder disorder and used IC's. The patient sused 30 catheters in according to their standard of care.A total of 100 subjects were ...
Archivos espanoles de urologia, 2019
OBJECTIVES The purpose of this document is to establish practical recommendations on neurogenic b... more OBJECTIVES The purpose of this document is to establish practical recommendations on neurogenic bladder (NB) management based on scientific evidence and medical and nursing perspective in Spinal Cord Injury (SCI) Units as a first multidisciplinary consensual approach in Spain. METHODS: This paper reports results from the first modified Delphi consensus building exercise on this procedure. A committee of recognised opinion-leaders in rehabilitation and urology with special interest in NB was constituted. A working group formed by rehabilitation doctors, urologists and nursing staff of SCI and Neurorehabilitation Units of a number of Spanish hospitals and specialised centres associated with the panel of NB experts have prepared this document. RESULTS: This review provided an overview of the main aspects described by the different clinical guidelines already available and highlighted the need to focus on recommendations in special priority situations in which there was no consensus. In...
Rehabilitación, 2016
Resumen Introduccion Los programas de rehabilitacion domiciliaria y ambulatoria son fundamentales... more Resumen Introduccion Los programas de rehabilitacion domiciliaria y ambulatoria son fundamentales en la recuperacion funcional en personas con dano cerebral adquirido. El objetivo de esta revision es comprobar la efectividad de programas de terapia ocupacional domiciliaria y atencion primaria, sobre el nivel de independencia de las actividades de la vida diaria, en personas adultas con dano cerebral adquirido. Metodologia Se realizo una busqueda bibliografica, en bases de datos especializadas en revisiones sistematicas (CRD Database) y de estudios originales (Pubmed, Scopus, Web of Science y OTseeker). Se analizaron las siguientes variables: funcionalidad en las actividades de la vida diaria, n.° de dias de estancia hospitalaria, intensidad de las sesiones de rehabilitacion realizadas, tiempo de espera desde el alta hospitalaria al inicio del proceso de rehabilitacion y n.° de reingresos. Resultados Se seleccionaron una revision sistematica y cuatro estudios originales. Tres de los cuatro estudios fueron ensayos clinicos aleatorizados, el estudio restante fue un ensayo clinico no controlado. Conclusiones La evidencia es limitada para afirmar con rotundidad la efectividad de los programas de terapia ocupacional en rehabilitacion domiciliaria y ambulatoria, en personas con dano cerebral adquirido. Se produjeron algunas diferencias significativas sobre los niveles de independencia en actividades de la vida diaria, fruto de intervenciones muy heterogeneas entre si.
Spinal cord, 2021
STUDY DESIGN This is a retrospective, observational study. OBJECTIVES To evaluate organ dysfuncti... more STUDY DESIGN This is a retrospective, observational study. OBJECTIVES To evaluate organ dysfunction in patients with an acute traumatic spinal cord injury (ATSCI) above T6 using the Sequential Organ Failure Assessment (SOFA) score to determine its association with mortality. SETTING The study was performed at the intensive care unit (ICU) of a tertiary hospital in the northwest of Spain. METHODS The study included 241 patients with an ATSCI above T6 who had been admitted to the ICU between 1998 and 2017. A descriptive analysis of all variables collected was performed to compare the survivors with the non-survivors. In addition, a logistic regression model was used in the multivariate analysis to identify variables that were independently associated with mortality. RESULTS The results revealed significant differences between the survivors and non-survivors in terms of their age, Charlson Comorbidity Index, Glasgow Coma Scale score on admission, APACHE II score, SOFA score on day 0 an...
espanolIntroduccion La incidencia mundial de la lesion medular traumatica (LMT) es muy variable. ... more espanolIntroduccion La incidencia mundial de la lesion medular traumatica (LMT) es muy variable. Recientes estudios senalan que estamos asistiendo a un cambio epidemiologico de la LMT. Este cambio puede originar una serie de consecuencias en el modelo de atencion. Conocer las caracteristicas epidemiologicas y demograficas de la LMT es vital para planificar las prioridades, asignar los recursos sanitarios adecuados y tambien, para identificar las directrices de la prevencion. Objetivo Determinar las caracteristicas epidemiologicas de los pacientes con LMT en Galicia durante el periodo 1995-2014 y analizar la afectacion neurologica y los factores determinantes de la evolucion clinica y funcional en dicho periodo. Material y metodo Se realizo un estudio observacional con seguimiento retrospectivo y prospectivo de los pacientes con lesion medular de etiologia traumatica que ingresaron en la Unidad de Lesionados Medulares (ULM) del Complejo Hospitalario Universitario de A Coruna en el pe...
Neurocirugía (English Edition)
Spinal Cord
Study design This was a psychometric study. Objectives To determine the validity of the Spanish v... more Study design This was a psychometric study. Objectives To determine the validity of the Spanish version of the World Health Organization Quality of Life instrument (WHOQOL-BREF) for its use in persons with traumatic spinal cord injury and, as secondary objectives, to correlate the results with variables such as functional status, psychological well-being, and social support.
Spinal Cord
Study design Descriptive retrospective study. Objectives To analyze risk factors associated with ... more Study design Descriptive retrospective study. Objectives To analyze risk factors associated with mechanical ventilation (MV) in cases of acute traumatic Cervical Spinal Cord Injury (tCSCI). Setting Unidad de Lesionados Medulares, Complejo Hospitalario Universitario A Coruña, in Galicia (Spain). Methods The study included patients with tCSCI who were hospitalized between January 2010 and December 2014. The following variables were analyzed: age, gender, etiology, neurological level, ASIA (American Spinal Injury Association) grade, associated injuries, injury severity score (ISS), ASIA motor score (AMS) at admission and mortality. Results A total of 146 patients met the study's inclusion criteria. The majority were men (74.7%) with mean age of 62.6 (s.d. ± 18.8) years. Sixty patients (41.1%) required MV. Mean age of ventilated vs. non-ventilated patients was 57.3 vs. 65.7. Men were more likely to require MV than women, ASIA grades A and B were also more likely to need MV than grades C and D, as well as patients with associated injuries. The AMS of patients receiving MV was lower than that of those who did not require MV (20.1 vs. 54.3). Moreover, the ISS was higher in patients receiving MV (31.2 vs. 13.4). An AMS ≤ 37 and an ISS ≥ 13 increased the risk of requiring MV by a factor of 11.98 and 7.28, respectively. Conclusions Isolated factors associated with a greater risk of MV in tCSCI were: age, gender, ASIA grade, ISS and AMS. However, the only factor with a significant discriminatory ability to determine the need for MV was the AMS at admission.
Galicia Clínica, 2016
La lesión medular es un factor de riesgo importante para la enfermedad tromboembólica venosa, ent... more La lesión medular es un factor de riesgo importante para la enfermedad tromboembólica venosa, entidad que engloba la trombosis venosa profunda y el tromboembolismo pulmonar, siendo este una causa potencialmente reversible de parada cardíaca. Presentamos el caso de un varón joven con lesión medular completa (grado ASIA A) con nivel C6 que sufre una parada cardíaca por tromboembolismo pulmonar masivo secundario a trombosis venosa profunda en extremidad inferior izquierda en la 6ª semana de ingreso. Exponemos la incidencia de ambas entidades en la lesión medular aguda así como su fisiopatología, profilaxis y tratamiento; destacamos la importancia de la identificación de la parada cardíaca e inicio precoz de las maniobras de reanimación cardiopulmonar por el personal sanitario y analizamos las consecuencias de la lesión cerebral hipóxico-isquémica derivada de una parada cardíaca recuperada.
The Journal of Spinal Cord Medicine, 2017