scholarly journals Efficacy of Intralesional Injection of Botulinum Toxin in Treatment of Keloids

2021 ◽  
pp. 124-130
Author(s):  
Toka Ahmed El Sayed ◽  
Yomna Mazid Neinaa ◽  
Dareen Abd El-Aziz Mohamed ◽  
Nashwa Naeem El Far
Keyword(s):  
Wound Healing ◽  
Botulinum Toxin ◽  
Rating Scale ◽  
Intradermal Injection ◽  
Intralesional Injection ◽  
Efficacy And Safety ◽  
Interventional Study ◽  
Botulinum Toxin Injections ◽  
Positive Significant Correlation

Background: Keloid is generally accepted to be the result of prolonged and aberrant wound healing. Botulinum toxin injections are considered an efficient therapy for keloids. The current study evaluated the efficacy and safety of intralesional injection of botulinum toxin in treatment of keloids. Methods: This prospective interventional study was carried out on 20 patients presented with keloids. Patients were treated by intradermal injection at the periphery of lesions by botulinum toxin as 100 IU diluted by 2 ml normal saline (5 IU/ cm3). Vancouver Scar Scale (VSS) and Verbal Rating Scale (VRS) were used for the assessment of the therapeutic efficacy. Results: There was a statistically significant improvement in all VSS and VRS parameters. Vast majority, 18 (90%) patients, were satisfied and 2 (10%) patient was not satisfied. There was non-significant correlation between the age of patients, duration of keloid nor size of keloid in relation to degree of improvement of VSS after treatment. There was positive significant correlation between VSS before treatment and degree of improvement of VSS after treatment. Conclusions: Intralesional injection of botulinum toxin was effective and safe therapeutic techniques in inhibiting keloids regarding the statistically significant improvement on comparing between before treatment and after the end of follow up period.

Number of botulinum toxin injections needed to stop requests for treatment for chronic lateral epicondylar tendinopathy. A 1-year follow-up study

2019 ◽  
Vol 62 (5) ◽  
pp. 336-341 ◽  
Author(s):  
Mélanie Cogné ◽  
Alexandre Creuzé ◽  
Hervé Petit ◽  
Claire Delleci ◽  
Patrick Dehail ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Follow Up Study ◽  
Botulinum Toxin Injections

scholarly journals Botulinum toxin injections as salvage therapy is beneficial for management of patellofemoral pain syndrome

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Yuval Kesary ◽  
Vivek Singh ◽  
Tal Frenkel-Rutenberg ◽  
Arie Greenberg ◽  
Shmuel Dekel ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Physical Therapy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Post Treatment ◽  
Functional Scores

Abstract Purpose Patellofemoral pain syndrome (PFPS) is a common pathology usually presenting with anterior or retropatellar pain. It is associated with a relative imbalance between the vastus medialis oblique (VMO) and the vastus lateralis (VL) muscles. This can lead to considerable morbidity and reduced quality of life (QOL). This study aims to assess the long-term functional outcome of PFPS treated with VL muscle botulinum toxin A (BoNT-A) injection. Materials and methods A retrospective review was performed on 26 consecutive patients (31 knees) with a mean age of 50.1 years (± 19.7 years) who were treated with BoNT-A injections to the VL muscle followed by physiotherapy between 2008 and 2015. Pre- and post-treatment pain levels (numerical rating scale, NRS), QOL (SF-6D), and functional scores (Kujala and Lysholm questionnaires) were measured. Demographics, physical therapy compliance, previous surgeries, perioperative complications, and patient satisfaction levels were collected. Results The mean follow-up time was 58.8 ± 36.4 months. There were significant improvements in all the examined domains. The average pain score (NRS) decreased from 7.6 to 3.2 (P < 0.01), and the Kujala, Lysholm, and SF-6D scores improved from 58.9 to 82.7 (P < 0.001), 56.2 to 83.2 (P < 0.001), and 0.6 to 0.8 (P < 0.001), respectively. Similar delta improvement was achieved irrespective of gender, age, compliance to post-treatment physical therapy, or coexisting osteoarthritis. Patients who presented with a worse pre-treatment clinical status achieved greater improvement. Prior to BoNT-A intervention, 16 patients (18 knees) were scheduled for surgery, of whom 12 (75%, 13 knees) did not require further surgical intervention at the last follow-up. Conclusions A single intervention of BoNT-A injections to the VL muscle combined with physiotherapy is beneficial for the treatment of patients with persistent PFPS. Level III evidence Retrospective cohort study.

Comparing Botulinum Toxin Injections with Extraocular Muscle Surgery in Toddlers with Esotropia: A Retrospective Analysis

2021 ◽  
Vol 238 (04) ◽  
pp. 478-481
Author(s):  
Tristan Michael Handschin ◽  
Francoise Roulez ◽  
Andreas Schötzau ◽  
Anja Palmowski-Wolfe
Keyword(s):  
Botulinum Toxin ◽  
Extraocular Muscle ◽  
Dose Effect ◽  
Advantages And Disadvantages ◽  
Angle Of Deviation ◽  
Group 2 ◽  
Encrypted Database ◽  
Botulinum Toxin Injections ◽  
Extraocular Muscle Surgery

Abstract Background In toddlers with esotropia, early alignment of the visual axes either with extraocular muscle surgery (EOMS) or botulinum toxin injections (BTIs) into both medial rectus muscles may result in improved depth perception. We compared the outcome of BTIs with EOMS in toddlers in order to gain further insight into the advantages and disadvantages of either method. Patients and Methods In this retrospective study, our encrypted database was searched for toddlers with esotropia aged 35 months or younger at the time of initial treatment with either BTIs or EOMS and who had a follow-up of at least 2 years. We analyzed the angle of deviation, dose effect (DE), and binocularity as well as the number of interventions. Results We identified 26 toddlers who received their first treatment for esotropia within the first 35 months of life: 16 with BTIs (9 males, 7 females) and 10 with EOMS (3 males, 7 females). Mean follow-up was considerably longer in the EOMS (87.7 months) than in the BTI group (35.7 months). Age at first intervention was 22.8 months in the BTI and 24.1 months in the EOMS group, and each toddler wore its full cycloplegic refraction. Mean angle at treatment was 41.25 prism diopters (PD) in the BTI compared to 52.9 PD in the EOMS group. The BTI group received an average of 1.68 BTIs, with a mean dosage of 14.5 IU Botox and a mean DE (mDE) of 1.8 PD/IU. In the EOMS group, the average number of surgeries was 1.4, with a mean dosage of 16.85 mm and a mDE of 3.14 PD/mm surgery. Some degree of binocularity could be observed in 9 (56%) of the BTI (5 × Bagolini positive, 2 × 550″, 2 × 220″) and in 4 (40%) of the EOMS group (2 × 3600″, 1 × 550″, 1 × 300″). By the end of the BTI group follow-up, four toddlers electively underwent EOMS rather than a 3rd BTI (followed by a 3rd BTI in 1), which resulted in the appearance of measurable binocularity in all four (1 × Bagolini positive, 1 × 220″, 1 × 200″, 1 × 60″). Conclusions Our results show that BTIs are a viable treatment alternative in early esotropia. Even if EOMS is ultimately required, some binocularity may develop as the visual axes are aligned for some time in the sensitive phase owing to the effects of Botox. Moreover, less surgical dosage is needed than would have otherwise been necessary to treat the original angle of deviation. BTIs are faster, less invasive, and present as an effective alternative when patient compliance is too low to reliably measure the angle of deviation, which is essential for the planning of EOMS.

scholarly journals Use of Botulinum Toxin for Androgenic Alopecia: A Systematic Review

2021 ◽  
pp. 1-8
Author(s):  
Robert S. English Jr. ◽  
Sophia Ruiz
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Hair Loss ◽  
Response Rates ◽  
Efficacy And Safety ◽  
Control Groups ◽  
Androgenic Alopecia ◽  
Serious Adverse Events ◽  
Prospective Cohorts ◽  
Botulinum Toxin Injections

In this systematic review, we summarize the efficacy and safety of intradermal and intramuscular botulinum toxin injections for androgenic alopecia (AGA). Using PubMed, we conducted a literature search up to February 2021 using the following keyword combinations: “botulinum toxin” or “botox” and “androgenetic alopecia,” “hair loss,” or “alopecia.” Five clinical studies met our inclusion criteria: 4 prospective cohorts and 1 randomized clinical trial (RCT). Study durations ranged from 24 to 60 weeks. No studies included control groups or compared botulinum toxin injections against approved treatments. A total of 165 participants were identified – all of whom were males with AGA. Of the 4 studies measuring response rates (i.e., subjects with &#x3e;0% hair changes), response rates ranged from 75 to 79.1%. Within studies measuring hair count changes from intramuscular injections, changes ranged from 18 to 20.9%. No serious adverse events were reported. Studies on botulinum toxin injections have produced favorable outcomes for AGA subjects. However, results should be interpreted with caution due to the absence of control groups, small numbers of participants, and relatively low Jadad quality scores. Large RCTs are recommended to confirm efficacy and safety, explore the effects of botulinum toxin on females with pattern hair loss, and establish best practices for intradermal and intramuscular injection methodologies.

scholarly journals Assessment of a Potential Synergistic Effect of Souvenaid® in Mild Alzheimer’s Disease Patients on Treatment with Acetylcholinesterase Inhibitors: An Observational, Non-Interventional Study

2021 ◽  
Vol 80 (4) ◽  
pp. 1377-1382
Author(s):  
Félix Viñuela ◽  
Angeles Barro
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Synergistic Effect ◽  
Acetylcholinesterase Inhibitors ◽  
Efficacy And Safety ◽  
Interventional Study ◽  
Clinical Dementia Rating ◽  
Ache Inhibitors ◽  
Real Clinical Practice

We evaluated the efficacy and safety of Souvenaid (a multinutrient supplement) in patients with mild Alzheimer’s disease (AD) in real clinical practice and assessed a potential synergistic effect of acetylcholinesterase (AChE) inhibitors. Clinical Dementia Rating (CDR) scale was evaluated after six months follow-up. Patients were divided into 4 groups according to the treatment they received: Souvenaid + AChE inhibitors (n = 23); only Souvenaid (n = 8); only AChE inhibitors (n = 7); no treatment (n = 16). The Souvenaid + AChE inhibitors and Souvenaid alone groups were associated with significantly lower increases in CDR per month than the AChE inhibitors or no treatment ones. The efficacy of Souvenaid + AChE inhibitors tended to be higher than Souvenaid alone.

Physiotherapy and Botulinum Toxin Injections Prior to Stabilization Surgery for Recurrent Atraumatic Anteroinferior Shoulder Dislocation with Abnormal Muscle Patterning

2012 ◽  
Vol 4 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Clare P. Donnellan ◽  
Martin A. Scott ◽  
Mary Antoun ◽  
W. Angus Wallace
Keyword(s):  
Botulinum Toxin ◽  
Shoulder Instability ◽  
Shoulder Dislocation ◽  
Marked Improvement ◽  
Latissimus Dorsi ◽  
Shoulder Stabilization ◽  
Patient Reported ◽  
Teres Major ◽  
Botulinum Toxin Injections

Shoulder instability is a complex phenomenon and repeated dislocation due to persistent abnormal muscle patterning can be challenging to manage. This case report describes the treatment of a 21-year old female who presented with repeated atraumatic anteroinferior shoulder dislocation due to abnormal muscle patterning. Management involved physiotherapy to re-educate muscle control combined with botulinum toxin injections into pectoralis major, latissimus dorsi and teres major prior to shoulder stabilization surgery. The patient reported marked improvement as reflected by improved scores on the Oxford Shoulder Instability Score and Western Ontario Shoulder Instability Score. Benefits were maintained at 3 year follow-up.

scholarly journals Unilateral pallidotomy in the treatment of cervical dystonia: a retrospective observational study

2021 ◽  
Vol 134 (1) ◽  
pp. 216-222 ◽  
Author(s):  
Shiro Horisawa ◽  
Atsushi Fukui ◽  
Kotaro Kohara ◽  
Takakazu Kawamata ◽  
Takaomi Taira
Keyword(s):  
Cervical Dystonia ◽  
Rating Scale ◽  
Age Of Onset ◽  
Spasmodic Torticollis ◽  
Poor Responders ◽  
Clinical Responses ◽  
The Mean ◽  
Unilateral Pallidotomy ◽  
Botulinum Toxin Injections

OBJECTIVEThe objective of this study was to assess the efficacy of unilateral pallidotomy in patients with asymmetrical cervical dystonia.METHODSThis study retrospectively included 25 consecutive patients with asymmetrical cervical dystonia refractory to botulinum toxin injections, who underwent unilateral pallidotomy between January 2015 and April 2017. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were evaluated preoperatively and 1 week, 3 months, and 6 months postoperatively. The clinical responses were defined as good responders, exhibiting > 50% improvement in the TWSTRS score at 6 months postsurgery, or poor responders, exhibiting < 50% improvement in TWSTRS scores at 6 months postsurgery.RESULTSTwelve and 9 patients showed right- and left-side rotation, respectively; 1 and 3 patients had right- and left-side laterocollis, respectively. The mean age of onset and duration of the disease were 40.2 ± 13.9 and 8.9 ± 10.9 years, respectively. Mean TWSTRS scores were 38.4 ± 12.6 (p < 0.001), 17.3 ± 12.4 (p < 0.001), 19.5 ± 13.4 (p < 0.001), and 20.0 ± 14.7 (p < 0.001), preoperatively and 1 week, 3 months, and 6 months postoperatively, respectively. Fourteen patients (56%) demonstrated > 50% improvement in their TWSTRS total score (mean improvement of TWSTRS total score = 70.5%) 6 months postsurgically. Furthermore, preoperative TWSTRS severity score was a prognostic factor (odds ratio 1.37, 95% confidence interval 1.06–1.78, p = 0.003).CONCLUSIONSThese results suggest that unilateral pallidotomy is an acceptable treatment option for asymmetrical cervical dystonia. Further investigations with a larger number of cases and longer follow-up period are required to confirm these data.

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