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https://www.readbyqxmd.com/read/29786953/iatrogenic-botulism-outbreak-in-egypt-due-to-a-counterfeit-botulinum-toxin-a-preparation-a-descriptive-series-of-patient-features-and-outcome
#1
Eman Abdel Monaem Abdel Rashid, Nashwa Mohamed El-Mahdy, Huda Shehata Kharoub, Ahmed Salah Gouda, Naglaa Ahmed ElNabarawy, Bruno Mégarbane
Iatrogenic botulism resulting from the substantial increase in use of botulinum neurotoxin type-A (BoNT-A) treatment is rarely reported. We aimed to describe a large iatrogenic botulism outbreak in Egypt in June-July 2017. Nine patients developed botulism after receiving intramuscular injections of BoNT-A (dose: 200-300 IU) to treat cerebral palsy (N=7), spastic dystonia (N=1), and hyperhidrosis (N=1). Detailed findings were available in 5/9 cases. Patients were admitted to the hospital 5-10 days after the BoNT-A injection...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29783676/the-expanding-therapeutic-utility-of-botulinum-neurotoxins
#2
REVIEW
Elena Fonfria, Jacquie Maignel, Stephane Lezmi, Vincent Martin, Andrew Splevins, Saif Shubber, Mikhail Kalinichev, Keith Foster, Philippe Picaut, Johannes Krupp
Botulinum neurotoxin (BoNT) is a major therapeutic agent that is licensed in neurological indications, such as dystonia and spasticity. The BoNT family, which is produced in nature by clostridial bacteria, comprises several pharmacologically distinct proteins with distinct properties. In this review, we present an overview of the current therapeutic landscape and explore the diversity of BoNT proteins as future therapeutics. In recent years, novel indications have emerged in the fields of pain, migraine, overactive bladder, osteoarthritis, and wound healing...
May 18, 2018: Toxins
https://www.readbyqxmd.com/read/29773602/clofarabine-high-dose-cytarabine-and-liposomal-daunorubicin-in-pediatric-relapsed-refractory-acute-myeloid-leukemia-a-phase-ib-study
#3
Natasha K A van Eijkelenburg, Mareike Rasche, Essam Ghazaly, Michael N Dworzak, Thomas Klingebiel, Claudia Rossig, Guy Leverger, Jan Stary, Eveline S J M de Bont, Dana A Chitu, Yves Bertrand, Benoit Brethon, Brigitte Strahm, Inge M van der Sluis, Gertjan J L Kaspers, Dirk Reinhardt, C Michel Zwaan
Survival in children with relapsed/refractory acute myeloid leukemia is unsatisfactory. Treatment consists of one course fludarabine, cytarabine and liposomal daunorubicin, followed by fludarabine and cytarabine and stem-cell transplantation. Study ITCC 020/I-BFM 2009-02 aimed to identify the recommended phase 2 dose of clofarabine replacing fludarabine in the abovementioned combination regimen (3+3 design). Escalating dose-levels of clofarabine (20-40mg/m2/day x5days) and liposomal daunorubicin (40-0mg/m2/day) were administered with cytarabine (2g/m2/day x5days)...
May 17, 2018: Haematologica
https://www.readbyqxmd.com/read/29772837/conventional-pathology-versus-gene-signatures-for-assessing-luminal-a-and-b-type-breast-cancers-results-of-a-prospective-cohort-study
#4
Julia E C van Steenhoven, Anne Kuijer, Paul J van Diest, Joost M van Gorp, Marieke Straver, Sjoerd G Elias, Jelle Wesseling, Emiel Rutgers, Johanna N H Timmer-Bonte, Peter Nieboer, Tineke J Smilde, Alex Imholz, Charlotte F J M Blanken, Sabine Siesling, Thijs van Dalen
In this study, in estrogen receptor positive (ER+) early stage breast cancer patients who were considered candidates for 70-gene signature (70-GS, "MammaPrint") use, we compared molecular subtyping (MS) based on the previously validated 80-gene signature (80-GS, "BluePrint") versus surrogate pathological subtyping (PS). Between 1 January 2013 and 31 December 2015, 595 clinical intermediate risk ER+ early stage breast cancer patients were enrolled. Hormone receptor (HR) and HER2 receptor status were determined by conventional pathology using immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH)...
May 17, 2018: Genes
https://www.readbyqxmd.com/read/29772695/botulinum-toxin-type-a-injection-for-cervical-dystonia-in-adults-with-dyskinetic-cerebral-palsy
#5
You Gyoung Yi, Keewon Kim, Youbin Yi, Young-Ah Choi, Ja-Ho Leigh, Moon Suk Bang
We aimed to evaluate the efficacy and safety of injecting botulinum toxin A (BoNT-A) into the neck muscles to treat cervical dystonia (CD) in patients with dyskinetic cerebral palsy (CP). This was a randomized, double-blinded, placebo-controlled trial with cross-over design. We prospectively enrolled adults with dyskinetic CP who were over 20 years old and had been clinically diagnosed with CD for more than one year. The primary outcome measure was the change in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at four weeks from the baseline TWSTRS...
May 16, 2018: Toxins
https://www.readbyqxmd.com/read/29771161/casting-protocols-following-bont-a-injections-to-treat-spastic-hypertonia-of-the-triceps-surae-in-children-with-cerebral-palsy-and-equinus-gait-a-randomized-controlled-trial
#6
Barbara Kelly, Marilyn MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
AIM: To study the effects of single versus serial casting post-Botulinum toxin A (BoNT-A) injections on hypoextensibility of triceps surae in children, 2-7 years old, with cerebral palsy and equinus gait. METHODS: A randomized, stratified, parallel, two-group trial was conducted at a pediatric health center with assessments at baseline, precast, postcast and, 1-, 2-, and 6-month follow-ups. One week following BoNT-A injections into triceps surae muscle, a single below-knee cast (n = 10) or 3 serial casts (n = 10) were applied for 3 weeks...
May 17, 2018: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/29768338/botulinum-toxin-injection-to-improve-functional-independence-and-to-alleviate-parenting-stress-in-a-child-with-advanced-pantothenate-kinase-associated-neurodegeneration-a-case-report-and-literature-review
#7
Cho-I Lin, Kuan-Lin Chen, Ta-Shen Kuan, Sheng-Han Lin, Wei-Pin Lin, Yu-Ching Lin
RATIONALE: Pantothenate kinase-associated neurodegeneration (PKAN) is a rare autosomal recessive disease. Progressive motor symptoms such as dystonia and spasticity begin in childhood and relentlessly become incapacitating later in life. Treatments including anticholinergics and iron chelation are usually ineffective. Botulinum toxin type A (BoNT-A) is effective for adult patients with dystonia or spasticity. PATIENT CONCERNS: We reported a 10-year-old female patient with advanced PKAN, manifesting as generalized dystonia and spasticity...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767449/outcomes-of-intradetrusor-onabotulinum-toxin-a-injection-in-patients-with-parkinson-s-disease
#8
Gregory Vurture, Benoit Peyronnet, Andrew Feigin, Milton C Biagioni, Rebecca Gilbert, Nirit Rosenblum, Steven Frucht, Alessandro Di Rocco, Victor W Nitti, Benjamin M Brucker
OBJECTIVE: To assess the safety and efficacy of intradetrusor onabotulinum toxin A injections for the treatment of overactive bladder (OAB) in patients with Parkinson's disease (PD). METHODS: All PD patients who underwent intradetrusor injections of onabotulinum toxin A (BoNT-A) for storage symptoms between 2010 and 2017 were included in a retrospective study. A 100 U dose of BoNT-A (Botox®, Allergan Irvine, CA) was used for the first injection in all patients...
May 16, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29763764/machine-learning-based-brain-tumour-segmentation-on-limited-data-using-local-texture-and-abnormality
#9
Stijn Bonte, Ingeborg Goethals, Roel Van Holen
Brain tumour segmentation in medical images is a very challenging task due to the large variety in tumour shape, position, appearance, scanning modalities and scanning parameters. Most existing segmentation algorithms use information from four different MRI-sequences, but since this is often not available, there is need for a method able to delineate the different tumour tissues based on a minimal amount of data. We present a novel approach using a Random Forests model combining voxelwise texture and abnormality features on a contrast-enhanced T1 and FLAIR MRI...
May 7, 2018: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29762276/short-term-effect-of-low-dose-electromyography-guided-botulinum-toxin-a-injection-in-the-treatment-of-chronic-lateral-epicondylar-tendinopathy-a-randomized-double-blinded-study
#10
Alexandre Creuzé, Hervé Petit, Mathieu de Sèze
BACKGROUND: Botulinum toxin A (BoNT-A) is a novel treatment for chronic lateral epicondylar tendinopathy. Preliminary studies have demonstrated promising results; however, confirmation of the effectiveness of BoNT-A treatment and further assessment of its side effects are required. This study investigated the analgesic effects of BoNT-A in the treatment of chronic lateral epicondylar tendinopathy. METHODS: This was a phase-III, single-center, randomized, double-blinded, placebo-controlled study including 60 patients with chronic lateral epicondylar tendinopathy that had been resistant to treatment for >6 months...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29751611/purification-and-characterization-of-recombinant-botulinum-neurotoxin-serotype-fa-also-known-as-serotype-h
#11
Gavin Hackett, Kevin Moore, David Burgin, Fraser Hornby, Bryony Gray, Mark Elliott, Imran Mir, Matthew Beard
We have purified and characterized recombinant botulinum neurotoxin serotype FA (BoNT/FA). This protein has also been named as a new serotype (serotype H), but the classification has been controversial. A lack of well-characterized, highly pure material has been a roadblock to study. Here we report purification and characterization of enzymatically active, and of inactive nontoxic, recombinant forms of BoNT/FA as tractable alternatives to purifying this neurotoxin from native Clostridium botulinum . BoNT/FA cleaves the same intracellular target proteins as BoNT/F1 and other F serotype BoNTs; the intracellular targets are vesicle associated membrane proteins (VAMP) 1, 2 and 3...
May 11, 2018: Toxins
https://www.readbyqxmd.com/read/29748471/novel-botulinum-neurotoxins-exploring-underneath-the-iceberg-tip
#12
REVIEW
Domenico Azarnia Tehran, Marco Pirazzini
Botulinum neurotoxins (BoNTs), the etiological agents of botulism, are the deadliest toxins known to humans. Yet, thanks to their biological and toxicological features, BoNTs have become sophisticated tools to study neuronal physiology and valuable therapeutics for an increasing number of human disorders. BoNTs are produced by multiple bacteria of the genus Clostridium and, on the basis of their different immunological properties, were classified as seven distinct types of toxin. BoNT classification remained stagnant for the last 50 years until, via bioinformatics and high-throughput sequencing techniques, dozens of BoNT variants, novel serotypes as well as BoNT-like toxins within non-clostridial species have been discovered...
May 10, 2018: Toxins
https://www.readbyqxmd.com/read/29746518/an-ambient-temperature-stable-antitoxin-of-nine-co-formulated-antibodies-for-botulism-caused-by-serotypes-a-b-and-e
#13
Mingxiang Li, Dennis Lee, Chidi R Obi, Joel K Freeberg, Shauna Farr-Jones, Milan T Tomic
Safe and effective antitoxins to treat and prevent botulism are needed for biodefense. We have developed recombinant antibody-based therapeutics for botulinum neurotoxin (BoNT) serotypes A, B, and E. The mechanism of action of this antitoxin requires that three mAbs bind one toxin molecule to achieve clearance. Here we present a co-formulation of an antitoxin to the three most important serotypes. Combining these antibodies obviates the need to identify the serotype causing intoxication prior to drug administration, which would facilitate administration...
2018: PloS One
https://www.readbyqxmd.com/read/29740633/effect-of-early-use-of-abobotulinumtoxina-after-stroke-on-spasticity-progression-protocol-for-a-randomised-controlled-pilot-study-in-adult-subjects-with-moderate-to-severe-upper-limb-spasticity-ontime-pilot
#14
Keng He Kong, Jovita Balcaitiene, Hugues Berard, Pascal Maisonobe, Khean Jin Goh, Witsanu Kumthornthip, Raymond L Rosales
Introduction: Approximately 15 million people suffer a stroke annually, up to 40% of which may develop spasticity, which can result in impaired limb function, pain and associated involuntary movements affecting motor control.Robust clinical data on spasticity progression, associated symptoms development and functional impairment is scarce. Additionally, maximal duration of muscle tone reduction following botulinum toxin type A (BoNT-A) injections remains undetermined. The ONTIME pilot study aims to explore these issues and evaluate whether abobotulinumtoxinA 500 U (Dysport® ; Ipsen) administered intramuscularly within 12 weeks following stroke delays the appearance or progression of symptomatic (disabling) upper limb spasticity (ULS)...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29735936/experimental-intrastriatal-applications-of-botulinum-neurotoxin-a-a-review
#15
REVIEW
Alexander Hawlitschka, Andreas Wree
Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders. Its main pathophysiological characteristic is the loss of dopaminergic neurons in the substantia nigra pars compacta followed by a lack of striatal dopaminergic input and a consequent disinhibition of tonically active cholinergic interneurons. The resulting striatal hypercholinism causes major motor symptoms in PD. Anticholinergic pharmacotherapies have antiparkinsonian effects on motor symptoms, but, due to systemic actions, also numerous severe side effects occur on a regular basis...
May 7, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29718991/a-lipid-binding-loop-of-botulinum-neurotoxin-serotypes-b-dc-and-g-is-an-essential-feature-to-confer-their-exquisite-potency
#16
Daniel Stern, Jasmin Weisemann, Alexander Le Blanc, Laura von Berg, Stefan Mahrhold, Janett Piesker, Michael Laue, Peter B Luppa, Martin Bernhard Dorner, Brigitte Gertrud Dorner, Andreas Rummel
The exceptional toxicity of botulinum neurotoxins (BoNTs) is mediated by high avidity binding to complex polysialogangliosides and intraluminal segments of synaptic vesicle proteins embedded in the presynaptic membrane. One peculiarity is an exposed hydrophobic loop in the toxin's cell binding domain HC, which is located between the ganglioside and protein receptor-binding sites, and that is particularly pronounced in the serotypes BoNT/B, DC, and G sharing synaptotagmin as protein receptor. Here, we provide evidence that this HC loop is a critical component of their tripartite receptor recognition complex...
May 2, 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29718712/therapy-influences-goal-attainment-following-botulinum-neurotoxin-injection-for-focal-spasticity-in-adults-with-neurological-conditions
#17
Elizabeth Jane Moore, John Olver, Adam Leigh Bryant, Dean Philip McKenzie, Gavin Williams
OBJECTIVE: To determine whether therapy influenced goal attainment following botulinum toxin (BoNT-A) injection for focal spasticity in adults with neurological conditions. METHODS: A prospective observational cohort study conducted in a large metropolitan spasticity clinic on adults with focal spasticity of any origin. Participants were provided with a therapy programme, designed to maximise therapeutic outcome. The primary outcome measure was Goal Attainment Scaling...
May 2, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29709494/pyloric-sphincter-characteristics-using-endoflip-%C3%A2-in-gastroparesis
#18
M Saadi, D Yu, Z Malik, H P Parkman, R Schey
INTRODUCTION AND AIMS: Pyloric sphincter abnormalities may be detected in gastroparesis. Botulinum toxin A (BoNT/A) injection into the pylorus has been used to treat gastroparesis with varying results. The aim of the present article was to assess whether pyloric sphincter characteristics using the endoscopic functional lumen imaging probe (EndoFLIP® ) with impedance planimetry in patients with gastroparesis correlated with symptoms, gastric emptying, and therapeutic response to pyloric sphincter BoNT/A injection...
April 27, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29707238/open-surgery-for-haemorrhoids-in-persons-with-spinal-cord-injury
#19
J G Previnaire, N De Bont, H Bordi, N Senal, P E Mortier
Study design: Pilot retrospective study on the outcome of open surgery for grade III and IV haemorrhoids in patients with SCI. Objective: Haemorrhoids and anal fissures are common in patients with spinal cord injury (SCI). Grade I to III haemorrhoids are usually managed medically or by surgical ligation. Grade III and IV haemorrhoids are treated with surgical haemorrhoidectomy in the general population, but not in patients with SCI, most probably due to fear of complications...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29694645/effects-of-ultrasound-guided-botulinum-toxin-type-a-injections-with-a-specific-approach-in-spastic-cerebral-palsy
#20
Raikan Büyükavcı, Mehmet Akif Büyükavcı
The aim of this study was to detect effects of ultrasound-guided botulinum toxin type-A (US-guided BoNT-A) injections prepared according to lower extremity innervation zones on spasticity and motor function in 3-16 years children with diplegic and hemiplegic spastic cerebral palsy. This study included 25 patients between 3 and 16 years of age who admitted to our clinic in 2017, were being followed in our clinic with a diagnosis of cerebral palsy, had BoNT-A injections due to lower extremity spasticity. The US-guided BoNT-A injections were administered into the spastic muscles using a specific approach according to innervation zones of muscle...
April 24, 2018: Acta Neurologica Belgica
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