جستجوی مقالات مرتبط با کلیدواژه « botulinum toxin A » در نشریات گروه « پزشکی »

Aesthetic applications of botulinum toxin type A (BoNT-A) may lead to some complications, including unwanted muscle paralysis. Moreover, BoNT-A effects may last several months, and there is no medical intervention so far to accelerate muscle function recovery.

Case Report:

A female patient with a movement disorder of the mimic muscles resulting from BoNT-A injections received daily sessions of photobiomodulation therapy (PBMT). A fast improvement in both facial asymmetry and muscle function was noted within a few weeks. After nine weeks, almost complete recovery was achieved.

According to the current case, PMBT seems to be an effective intervention to accelerate muscle function recovery following BoNT-A use.

We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH).

Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion.

The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up.

Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.

Synkinesis refers to an involuntary movement accompanying a voluntary one that is a consequence of facial paralysis. The cosmetic procedure is used for the management of synkinesis that results in facial symmetry. Botulinum A toxin (BTX-A) has been used for more than two decades for resolving asymmetry and synkinesis. However, the endpoints remain to be further explained. The purpose of this study was to analyze research trends in facial synkinesis and asymmetry after facial nerve palsy (FNP).

 The databases Medline, PubMed, ScienceDirect, CINHAL, Scopus, and ProQuest were searched for articles published between 1970 and 2017 using the keywords, ‘facial paralysis’, ‘Bell’s palsy’, ‘synkinesis’, and ‘Botulinum A toxin’.

In total, 13 eligible articles, cumulatively examining 332 patients, entered the analysis. They were divided into three groups as follows. Eight articles in group I were taken as case series with 181 patients. Two articles in group II compared BTX-A and neuromuscular rehabilitation with 61 patients. Both these groups concluded that BTX-A injection could help reduce synkinesis. In group III, only were three randomized clinical trials retrieved with 90 patients that reported disparate findings.

BTX-A injection cannot yet be proposed as a solution for synkinesis reduction to achieve symmetry and overcome this complication of facial nerve palsy because of the small number of randomized clinical trials available on the subject. Further studies are recommended to be able to make a firm conclusion.

Intradetrusor injection of botulinum toxin A (BTX‑A) might serve as a minimally invasive substitute in patients with refractory idiopathic overactive bladder (RIOAB). The aim of this study was to evaluate the clinical outcomes related to two different doses of abo‑BTX‑A (AboBTX‑A) in patients with RIOAB.

This prospective clinical trial was performed on 55 women with RIOAB. After determination of trabeculation grade, 300 (no or mild) or 500 (moderate or severe) unit of AboBTX‑A (Dysport) was intravesicaly injected. Before 1, 3, and 6 months after intervention, lower urinary tract symptoms during 24 h were recorded.

Of the study population, 62% had severe bladder trabeculation. The mean duration of overactive bladder (OAB) was 1.76 versus 5.85 years, for no or mild versus severe trabeculation, respectively. After injections of 300‑ and 500‑unit dosage, there were 19% and 26% early complications such as urinary retention. There was a statistically significant difference between the two groups in OAB score after 1 month (P < 0.001) and duration of OAB symptoms, over three follow‑up times (P < 0.001). The mean preinjection OAB scores between patients with and without recurrence were statistically significant (29.36 vs. 25.07; P < 0.03). Urinary tract infection as a late complication was distinguished in four patients.

In RIOAB, by adjusted dosage of AboBTX‑A related to the grade of bladder trabeculation, in addition to maintain efficacy, consequent complications might not be affected by dosage and the drug dosage could be increased to nearly 60% with less concern associated to complication.

The use of botulinum toxin-A is increasing for aesthetic treatments and new reassuring data have been reported in recent studies. The purpose of this study was to evaluate the complications of botulinum toxin-A (BoTo-A) (NEURONOX) injection to eliminate wrinkles in the upper one-third of the face.

The present study was conducted on 235 patients referring to the dermatology clinic of Rasoul Akram hospital in Iran (including 82 men and 153 women with a mean age of 50 years) for the treatment of forehead, frown, and lateral orbital rim wrinkles between 2011 and 2015. The injection level was 35 units of botulinum toxin-A (NEURONOX) for women and 45 for men in the glabella area, and 15 units for women and 20 units for men in the crow’s feet area.

The complications of botulinum toxin-A injection among 235 subjects were as follows: 1.3% ptosis (n = 3), 1.7% angioneurotic edema (n = 4), 2.1% vasovagal syncope (n = 5), 3.8% haematoma (n = 9), 1.7% diplopia (n = 4), and 2.1% musculoskeletal pain (n = 5). The satisfaction rate of patients with a complication measured one month after injection indicated that 63.3% (19/30) were satisfied with the injection and 36.7% (11/30) were dissatisfied. The satisfaction rate of patients without a complication showed that 91.7% (188/205) were pleased and 8.3% (17/205) were dissatisfied with the injection.

According to the findings of this study, the injection of BoTo-A (NEURONOX) to attenuate glabellar lines and the lateral orbital rim was safe and effective. The complications in this study were not serious and generally were transient and self-limiting