972 resultados para botulinum toxin type C


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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BACKGROUND: Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. METHODS: Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. RESULTS: At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. CONCLUSION: Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Mucopolysaccharidoses are lysosomal storage disorders that are caused by a deficiency in the enzymes that degrade glycosaminoglycans. The accumulation of glycosaminoglycans affects multiple systems, resulting in coarse facial features, short stature, organomegaly, and variable neurological changes from normal intelligence to severe mental retardation and spasticity. Effects on the musculoskeletal system include dysostosis multiplex, joint stiffness, and muscle shortening. This article reports 2 patients with mucopolysaccharidosis type II (Hunter syndrome) who showed progressive equinus deformity of the feet. Both patients were treated with intramuscular botulinum toxin type A injections in the gastrocnemius and the soleus muscles, followed by serial casting. In both patients, passive range of motion, muscle tone, and gait performance were significantly improved. Botulinum toxin type A injections followed by serial casting are a therapeutic option for contractures in patients with mucopolysaccharidosis. However, the long-term effects and the effect of application in other muscles remain unknown.

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Background Focal spasticity is a significant motor disorder following stroke, and Botulinum Toxin Type-A (BoNT-A) is a useful treatment for this. The authors evaluated kinematic modifications induced by spasticity, and whether or not there is any improvement following injection of BoNT-A. Methods Eight patients with stroke with upper-limb spasticity, showing a flexor pattern, were evaluated using kinematics before and after focal treatment with BoNT-A. A group of sex- and age-matched normal volunteers acted as a control group. Results Repeated-measures ANOVA showed that patients with stroke performed more slowly than the control group. Following treatment with BoNT-A, there was a significant improvement in kinematics in patients with stroke, while in the control group, performance remained unchanged. Conclusions Focal treatment of spasticity with BoNT-A leads to an adaptive change in the upper limb of patients with spastic stroke.

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An outbreak of botulism was detected in goats in the semiarid region of Brazil. In a flock of 460 goats, 38 does were affected and 37 died. Kids and younger goats were not affected. The main clinical signs were flaccid tetraparesis leading to tetraplegia that was often accompanied by twisted neck, tongue paralysis, and muscle tremors. At the time of the visit, 4 out of 11 affected goats were recumbent. Ambulatory goats had uncoordinated and swaying gaits with hypometria and weakness, mainly of the hind limbs. Two recumbent and four ambulatory goats showed twisted neck. Two recumbent goats were euthanized and necropsied. Non-significant gross and histologic lesions were observed. Samples of the liver, gut and rumen content were collected from the two goats and examined for botulinum toxins using the mouse serum neutralization test. The three samples from one goat were positive for type C toxin. Marked osteophagia was observed when the goats had access to bones in the pasture, and the farmer mentioned that osteophagia was common among goats of the flock. A sample of the plant Hybantus ipecaconha, the most abundant forage available for the goats, contained 2800 mg/kg of Ca and 450 mg/kg of P. One soil sample contained 58.12 mg/kg of Ca and 2.02 mg/kg of P. It was concluded that in this outbreak, botulism was associated with osteophagia probably due to phosphorus deficiency. (C) 2012 Elsevier B.V. All rights reserved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Foram avaliadas a ocorrência e distribuição de esporos e toxinas de Clostridium botulinum tipos C e D em 300 cacimbas empregadas como bebedouro de bovinos em 130 propriedades rurais localizadas em 12 municípios do Vale do Araguaia, Estado de Goiás. A presença de esporos foi determinada indiretamente pelo cultivo em meio de cultura, seguido da inoculação e neutralização em camundongo das amostras de sedimento do interior das cacimbas, e do solo superficial e fezes de bovinos, coletadas ao seu redor. A presença de toxina foi avaliada diretamente pela inoculação em camundongo do sedimento filtrado das cacimbas, também seguida da neutralização em camundongo com antitoxinas C e D. A presença de esporos de C. botulinum foi significativamente maior (p<0,05) nas fezes de bovinos (31%), quando comparadas com os resultados das amostras de solo superficial (19%) e dos sedimentos (10%). Foram detectadas toxinas botulínicas dos tipos C, D, ou classificadas como pertencentes ao complexo CD, em seis amostras (2%) das 300 cacimbas. Das 130 propriedades trabalhadas, em 122(93,85%) foram encontrados esporos ou toxinas de Clostridium botulinum em pelo menos uma das variáveis pesquisadas, enquanto somente 8(6,15%) não apresentaram qualquer contaminação A idade e profundidade das cacimbas estiveram associadas com a freqüência de detecção de esporos e toxinas. Assim, quanto mais velhas e rasas, maior a freqüência do isolamento de esporos e toxinas. A contaminação das cacimbas do Vale do Araguaia goiano com esporos e toxinas do Clostridium botulinum tipos C e D demonstra o risco potencial permanente e crescente para a ocorrência da intoxicação botulínica de origem hídrica nos bovinos.

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Clostridium botulinum causative of toxic infections due to toxin ingestion previously formed, occur in several ingestion species, mainly birds. In a poultry farm, located at São Paulo State, more than 3,000 birds have been attacked by this toxic infections, when the birds showed motionless, loss of weight, accelerated, breathing, resulting in death of the birds. The blood harvest for attainment of the serum and later necropsy was carried out throwgh the following samples: liver, gizzard, crop, feed, water and litter. After that, the toxin was extracted by gelatin-phosphate buffer and inoculation in mice, isolation of the agent in Blood. Ágar and Reinforced Clostridium Ágar and neutralization of toxin determine its type. The inoculation in mice showed positive results in samples of liver, gizzad, crop and symptoms like was waist, and death of the birds by limp paralysis. The colonies that have been isolated, suspected of Clostridium botulinum showed expected results and further analysis revealed positive results to botulinical toxin type C. The farms have to pay attention in the routine jobs, choicer, and elimination of carcass because they are essential to keep this problem away.

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Beta toxin (CPB) is known to be an essential virulence factor in the development of lesions of Clostridium perfringens type C enteritis in different animal species. Its target cells and exact mechanism of toxicity have not yet been clearly defined. Here, we evaluate the suitability of a neonatal piglet jejunal loop model to investigate early lesions of C. perfringens type C enteritis. Immunohistochemically, CPB was detected at microvascular endothelial cells in intestinal villi during early and advanced stages of lesions induced by C. perfringens type C. This was first associated with capillary dilatation and subsequently with widespread hemorrhage in affected intestinal segments. CPB was, however, not demonstrated on intestinal epithelial cells. This indicates a tropism of CPB toward endothelial cells and suggests that CPB-induced endothelial damage plays an important role in the early stages of C. perfringens type C enteritis in pigs.

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Background. Clostridium difficile infection is one of the major causes of antibiotic associated diarrhea and colitis in the United States. Currently, there is a dearth of literature on the risk factors and outcomes differences between the patients with infection due to the hypervirulent strain vs. the non-hypervirulent strains. The objective of this study was to determine the relationship between C. difficile toxin type and clinical features, severity and outcome in patients with C. difficile diarrhea. ^ Methods. The case group included 37 patients who had infections due to hypervirulent strain (tcdC deletion) and the control group included 55 patients with other toxin types (toxin A, B, binary toxin). A univariate analysis was performed followed by a multivariable logistic regression analysis to assess the differences between cases and controls. ^ Results. In the multivariate analyses, we found out that being a male was a protective factor for developing the infection due to the hypervirulent strain [OR 0.33; 95% CI 0.12-0.90]. Also, the hypervirulent group has worse clinical and economic outcomes, although the differences were small and nonsignificant. ^ Conclusions. There may likely be no predictive risk factor for acquiring infection due to the hypervirulent strain and the acquisition may be more linked to the infection control practices of the individual hospitals or location of patients. Hence, better infection control practices may prove helpful in decreasing the overall disease burden and thus improve patient outcomes. ^