ETHICAL AND LEGAL ASPECTS OF THE USE OF FAKE DRUGS FOR OROFACIAL AESTHETICS – A CASE REPORT

Introduction: Over the last decade, Botulinum Toxin (BT) gained space in the armamentarium of drugs used for orofacial aesthetics. The contemporary scenario of Dentistry led to new horizons within aesthetic treatments founded on the application of BT. Objective: This study aimed to report a case of fake type-A BT sold to a dentist on training for orofacial aesthetics. Material and methods: During a 16-hour training course, a dentist bought form a reference seller a “so-called” quality drug allegedly consisting of type-A BT. After suspecting of fake drug based on uncommon label and flask, the dentist sent images of the product to the laboratory responsible for registering the drug at the National Health Surveillance Agency (ANVISA). Results: The laboratory confirmed the fake drug. ANVISA blocked the commercialization, use and distribution of the product as well as made efforts to remove the available products from the market. Parallel police investigations were carried out and forensic expertise for drug profiling was accomplished – confirming the fake drug. Conclusion: This study drives attention to the possibility of existing fake drug commercialization to dentists dedicated to orofacial aesthetics, and the potential impact of this drugs if used in patients. Consequences might extend to penalties in the consumer relation interface, as well as in the criminal field as offense against public health.

Download Full-text

Constraint-Induced Movement Therapy After Injection of Botulinum Toxin Type A for a Patient With Chronic Stroke: One-Year Follow-up Case Report

Physical Therapy ◽

10.2522/ptj.20140329 ◽

2015 ◽

Vol 95 (7) ◽

pp. 1039-1045 ◽

Cited By ~ 4

Author(s):

Satoru Amano ◽

Takashi Takebayashi ◽

Keisuke Hanada ◽

Atsushi Umeji ◽

Kohei Marumoto ◽

...

Keyword(s):

Case Report ◽

Botulinum Toxin ◽

Muscle Tone ◽

Botulinum Toxin Type A ◽

Type A ◽

Movement Therapy ◽

Chronic Stroke ◽

Constraint Induced Movement Therapy ◽

Arm Function

Background and Purpose Spasticity, an aspect of upper motor neuron syndrome, is a widespread problem in patients with stroke. To date, no study has reported the long-term (up to 1 year) outcomes of botulinum toxin (BTX) injection in combination with constraint-induced movement therapy in patients with chronic stroke. In this case report, the long-term (1 year) effects of the combination of BTX type A injection and constraint-induced movement therapy on spasticity and arm function in a patient with chronic stroke and arm paresis are described. Case Description The patient was a 66-year-old man who had had an infarction in the right posterior limb of the internal capsule 4 years before the intervention. At screening, the patient was not able to voluntarily extend his interphalangeal or metacarpophalangeal joints beyond the 10 degrees required for constraint-induced movement therapy. From 12 days after BTX type A injection, the patient received 5 hours of constraint-induced movement therapy for 10 weekdays. Outcomes All outcome measures (Modified Ashworth Scale, Fugl-Meyer Assessment, Action Research Arm Test, and amount of use scale of the Motor Activity Log) improved substantially over the 1-year period (before intervention to 1 year after intervention). Repeat BTX type A injections were not necessary because muscle tone and arm function did not worsen during the observation period. Discussion The improved arm function may have reflected improvements in volitional movements and coordination or speed of movements in the paretic arm as a result of a reduction in spasticity, a reduction of learned nonuse behaviors, or use-dependent plasticity after the combination of BTX type A injection and constraint-induced movement therapy. In addition, the possibility of an influence of the passage of time or the Hawthorne effect cannot be ruled out. If this approach proves useful in future controlled studies, it may reduce the rising medical costs of the treatment of stroke.

Download Full-text