/ Annals of Physical and Rehabilitation Medicine 54S (2011) e31–e37 e33etait excellente et la majorite des patients ont tolere les stimulations electriquessans probleme. Apres 6semaines d’utilisation, il existait une amelioration dela penibilite ( p =0,001), de la fatigue ( p <0,05), et des symptomes pharynges( p <0,001). Conclusion .– Cette etude montre que la dysphagie oropharyngee peut etre ame-lioreeparlastimulationelectriquesensitivesousmentonniereutiliseeadomicileet qu’elle ameliore les symptomes dysphagiques.doi:10.1016/j.rehab.2011.07.846CO03-006–FR Hypersialorrhee chez le patient cerebro-lese lourd traiteepar la toxine botulinique sous echoguidage J.-P. Crudo a , ∗ , N. Hadiji , M. Enjalbert ba CRF Bouffard-Vercelli, Cap Peyrefite, 66290 Cerbere, France b CRF Bouffard-Vercelli, CH Perpignan, Cerbere, France ∗ Auteur correspondant. Mots cles : Hypersialorrhee ; Toxine botulinique ; Echoguidage ; Glandessalivaires ; Amelioration morbidite Introduction .–Hypersialorrheeestunecomplicationfrequentedescerebro-leseslourds (EVC). Notre etude porte sur l’injection de toxine botulinique sous echo-guidage dans les glandes salivaires comme arsenal therapeutique pour endiguerla morbidite.

PURPOSES:To determine how many patients in a permanent vegetative state or a minimally conscious state are living in healthcare institutions in the Maine-et-Loire county of western France. To evaluate patient management, physical complications, problems encountered by nursing staff and the patient care teams' wishes.PATIENTS AND METHODS:We performed a cross-sectional, descriptive study in physical medicine and rehabilitation departments, nursing homes, geriatric units and local hospitals. All patients and their medical records were examined by the same investigator. A questionnaire for carers was used to evaluate nursing tasks and a second questionnaire for head nurses served to assess staff needs and the patient care teams' wishes.RESULTS:Thirteen patients were identified. Four were in a permanent vegetative state and nine were in a minimally conscious state. Ten patients were cared for in geriatric units, one in a physical medicine and rehabilitation department and two in local hospitals. All patients displayed limited joint angle ranges. All the patient care teams reported practical difficulties and ethical issues.DISCUSSION:Our survey highlighted the variety of care scenarios for patients in a permanent vegetative state or a minimally conscious state. It revealed practical difficulties and, above all, ethical questions. The present work could serve as a basis for implementation of a recently issued French government circular on defining specific wards for these patients.

Jusqu’à 40 % d’hommes et de femmes déclarent une altération de leur qualité de vie sexuelle au décours d’une fracture pelvienne [1]. Plusieurs facteurs en sont responsables, notamment une lésion neurologique, végétative et/ou somatique ou une lésion vasculaire. Les complications hémorragiques de ces traumatismes peuvent d’ailleurs être dramatiques à la phase initiale et l’embolisation artérielle hypogastrique peut constituer un geste salvateur en cas de constatation d’un hématome rétropéritonéal [2–4].