BOTOX injection and Rehabilitation after BOTOX
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BOTOX injections work by paralyzing muscles and reducing spasticity. It binds to nerve endings and is internalized, with the light chain inhibiting the release of acetylcholine and preventing muscle contraction. Rehabilitation after BOTOX includes electrical stimulation, task-specific training, stretching, and strengthening to improve function while muscles are weakened. Serial casting may also be used short-term to reduce contractures as therapy maximizes the benefits of BOTOX injections.
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This document provides a historical overview and detailed information on botulinum toxin (BTX), including:
- Its discovery in the early 19th century by Justinus Kerner who identified botulism from sausage poisoning.
- Isolation of the Clostridium botulinum bacterium in 1895 and use of botulinum toxin to treat human disease beginning in 1980.
- FDA approval of Botox Cosmetic in 2002 for frown lines and additional approvals through 2004.
- Mechanism of action whereby BTX blocks acetylcholine release at neuromuscular junctions.
- Commercial preparations of botulinum toxin serotype A and approved therapeutic uses in medical conditions and for cosmetic purposes.
Botox
This document discusses the use of botulinum toxin (Botox) in urology. It provides:
1. A brief history of Botox discovery and its first urologic application in 1988 for detrusor sphincter dyssynergia.
2. An overview of Botox mechanism of action by inhibiting neurotransmitter release at the neuromuscular junction.
3. A description of various clinical applications of Botox in urology, including neurogenic detrusor overactivity, overactive bladder, bladder pain syndrome, and benign prostatic hyperplasia.
4. Details on Botox injection techniques, effectiveness, side effects,
Costridial toxins botulinum toxin
Clostridium botulinum produces a potent neurotoxin that causes the disease botulism. There are three key points:
1) C. botulinum toxin works by blocking the release of acetylcholine at neuromuscular junctions, preventing muscle contraction. It does this by cleaving SNARE proteins involved in synaptic vesicle fusion.
2) There are four main types of botulism - foodborne, wound, infant, and inhalation. Symptoms include blurred vision, dry mouth, muscle weakness and paralysis. If untreated, paralysis can affect respiratory muscles and cause death.
3) Treatment involves antitoxin to halt progression of symptoms, especially in food/w
Posttraumatic stiff elbow
The document discusses posttraumatic stiff elbow. It covers the pathology, classification, treatment options and postoperative care of stiff elbow. The key causes of stiff elbow are capsular contracture, osteophyte formation and myositis ossificans. Treatment options include nonsurgical methods like splinting or manipulation under anesthesia, as well as open or arthroscopic surgery to release soft tissue contractures. Early motion after injury or surgery is important to prevent stiffness.
Botox.pptx Dr eman.pptx
Botulinum toxin works by blocking the release of acetylcholine at the neuromuscular junction, causing temporary paralysis of muscles. It is used cosmetically to relax muscles that cause wrinkles and lines on the face. The main applications are for glabellar frown lines between the eyebrows, crow's feet around the eyes, and forehead lines. Adverse effects can include bruising, eyelid drooping, and asymmetry. Careful injection technique and avoiding certain areas can help prevent complications.
Botulinum Toxin Teaching Slides, Dr M D Mohire, Kolhapur, Maharashtra, INDIA.
Botulinum toxin (Botox) is a neurotoxin produced by the bacterium Clostridium botulinum that is used medically to treat various medical conditions. It was first used to treat eye muscle disorders and facial wrinkles. It is now commonly used to treat movement disorders like blepharospasm, hemifacial spasm, and cervical dystonia. Botox works by blocking nerve impulses from reaching the muscles, weakening them temporarily. When injected in precise doses into specific muscles, it can provide relief from involuntary muscle contractions and spasms. Common side effects are minor and temporary, including eyelid drooping and weakness of nearby muscles.
Botulinum toxin in urology2
Botulinum toxin has been used in urology since the late 1980s. It works by blocking acetylcholine release at the neuromuscular junction, relaxing overactive bladder muscles. The document discusses botulinum toxin's mechanism of action, indications for overactive bladder, neurogenic conditions, pelvic pain, prostate issues, and pediatric incontinence. Potential side effects are typically minor and temporary, with the effects lasting 6-16 months before repeat treatment is needed.
BOTOX-Migraine_DetailAid_withDisclaimer
- Botox is approved for the prevention of headaches in adults with chronic migraine, defined as 15 or more headache days per month (vs 14 or fewer for episodic migraine).
- In clinical trials, patients receiving Botox injections in specific head and neck muscles had 12 fewer headache days per month on average compared to 10 fewer with placebo.
- The recommended treatment protocol involves administering 155 units of Botox divided across 31 injection sites in 7 head and neck muscle areas based on an established dosing regimen.
Botox
Botulinum toxin in ophthalmology
Botulinum toxin type A (Botox) is produced by Clostridium botulinum and effectively treats strabismus and other eye muscle disorders by temporarily paralyzing muscles. It works by inhibiting the release of acetylcholine at the neuromuscular junction, preventing nerve impulses from being transmitted to muscles. Common uses in ophthalmology include treating blepharospasm, hemifacial spasm, dry eye, and strabismus, with the effects lasting 2-4 months before the muscle function returns.
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The Electrocardiogram - Physiologic Principles
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Learning objectives:
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2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Recomendamos muito.
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Esta publicação só está disponível em inglês até o momento.
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www.agostodourado.com
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BOTOX injection and Rehabilitation after BOTOX
- 1. BOTOX injection and Rehabilitation after BOTOX Dr. Krati Omar MPT (Pediatric disorders) MMIPR, MMDU
- 2. Background • BOTOX or Botulinum toxin A (BoNT-A) injections are increasingly used to treat muscle spasticity and are often complemented by adjunctive rehabilitation therapies • Rehabilitation Therapies After Botulinum Toxin-A Injection to Manage Limb Spasticity: A Systematic Review; Bianca Z. Kinnear et. All; 94;11;1 nov.2014; Pages 1569–1581
- 3. Introduction • BOTOX injection is a metabolic product of the Gram-positive, spore forming bacterium Clostridium botulinum • It is a ubiquitous bacterium, especially present in soil Essentials of physical medicine and rehabilitation; musculoskeletal disorders, pain, and rehabilitation; third edition; Walter R. Frontera et. All; ch. 136; page;723
- 4. Introduction • The latency period to the onset of symptoms ranges from 4 to 6 hours, but may be up to 14 days in extreme cases Essentials of physical medicine and rehabilitation; musculoskeletal disorders, pain, and rehabilitation; third edition; Walter R. Frontera et. All; ch. 136; page;723
- 6. Mechanism of action • Botulinum toxin acts directly on the neuromuscular endplate and other cholinergic synapses, where it inhibits release of the neurotransmitter acetylcholine, leading to muscular paralysis of the affected fiber and loss of target organ function Illustrated Guide to Aesthetic Botulinum Toxin Injections Basics; Localization; Uses
- 7. Mechanism • The mechanism of action of BOTOX have three steps: ➢Binding ➢Internalization ➢Intracellular effect on SNARE proteins
- 8. Binding • When the toxin is injected or absorbed from the gastrointestinal tract, its heavy H-chain initially binds to specific receptors on the plasma membrane of the cholinergic nerve endings • This binding to the presynaptic membrane shows a high degree of affinity and specificity
- 10. Internalization • The neurotoxin is taken up into the nerve cell through receptor-mediated endocytosis • The heavy H-chain of the toxin allows the large molecule to penetrate the cell membrane and the endosome that is thus formed • The H-chain separates from the L-chain as the disulfide bond is broken. This allows the L-chain to enter the cytoplasm of the neuron.
- 11. Intracellular effect on SNARE proteins • The botulinum toxin light chain acts as a zinc- dependent endopeptidase with proteolytic activity • In the cytosol, depending on serotype, it splits a specific protein of the SNARE complex (soluble N- ethylmaleimide- sensitive factor attachment receptor), which is responsible for one step of the exocytosis of the acetylcholine vesicles.
- 13. The syringe is held between the index and middle fingers, the thumb is placed loosely on the plunger and the injection hand is supported with the little finger. The needle should be inserted gently and in a diagonal direction to the skin surface.
- 14. Rhythmical slapping on the patient’s forehead before the injection is done will significantly reduce the pain during injection.
- 15. Indications • Neurological conditions ➢Stroke ➢Brain injury ➢Multiple sclerosis ➢Cerebral palsy
- 16. Goals of BOTOX • Reduced the dynamically produced lines that run across the forehead • Weakening inappropriate muscle contraction to prevent contracture and tissue shortening
- 17. Rehabilitation after BOTOX • Electrical stimulation • Task-specific movement training • Stretching • Strengthening • Serial casting for contracture reduction- 2 weeks Intensive therapy after botulinum toxin in adults with spasticity after stroke versus botulinum toxin alone or therapy alone: a pilot, feasibility randomized trial Natasha A. et all;2018;4;82
- 18. Rehabilitation • Splinting: used to provide long stretch to a muscle • Orthotics: used to assist walking by corrected foot position Intensive therapy after botulinum toxin in adults with spasticity after stroke versus botulinum toxin alone or therapy alone: a pilot, feasibility randomized trial Natasha A. et all;2018;4;82
- 19. Thank you