Botulinum toxin for bruxism treatment: a nationwide study among oral and maxillofacial surgeons in Germany.

INTRODUCTION: This study aimed to evaluate the use of botulinum toxin (BTX) for the treatment of bruxism in oral and maxillofacial surgery in Germany. MATERIAL AND METHODS: A dynamic online questionnaire comprising 7 to 25 questions was formulated to gather general and specific information regarding using BTX to treat bruxism. The questionnaire underwent internal and external assessments for validation. Subsequently, it was distributed to 906 oral and maxillofacial surgeons (OMFS) affiliated with the German Association for Oral and Maxillofacial Surgery (DGMKG). Weekly reminders were dispatched over four weeks to enhance response rates. Participation in the study was voluntary and anonymized. Descriptive methods were employed for data analysis. RESULTS: 107 OMFS participated in the study, yielding a response rate of 11.81%. On average, 17 patients with bruxism were per month, with 4 of these patients receiving BTX therapy. BTX administration was frequently accompanied by splints and physiotherapy (35.51% of participants). Botox® (Allergan) was the preferred BTX preparation, utilized by 40.79% and reconstituted with saline by 92.11% of participants. The masseter muscles were primarily targeted for BTX treatment (67.57% of participants), averaging 29 BTX (Allergan-) units per side. Injection points for each masseter muscle typically amounted to six per side, preferred by 30.67% of participants. Follow-up assessments post-BTX treatment were conducted regularly, predominantly after four weeks, by 36% of participants. In 8% of cases, additional BTX injections were necessary due to inadequate outcomes. Side effects were reported in 4% of cases, commonly manifesting as a non-disturbing reduction in bite force. Most participating OMFS (61.84%) using BTX for bruxism therapy regarded bruxism treatment with BTX as evidence-based. Notably, 97.37% of respondents expressed their willingness to recommend BTX-based bruxism treatment to their colleagues. Overall, the efficacy of BTX therapy for bruxism was rated as good (53.95%) and very good (40.79%). CONCLUSION: The use of BTX for the management of bruxism among OMFS in Germany has demonstrated efficacy. Substantial variances in certain facets of bruxism treatment employing BTX have been observed. CLINICAL RELEVANCE: Additional research endeavors are warranted to comprehensively investigate distinct elements of BTX therapy for bruxism, including the optimal dosage of BTX units and the precise localization of injection sites across various muscles.

Daily Vibrotactile Stimulation Exhibits Equal or Greater Spasticity Relief Than Botulinum Toxin in Stroke.

OBJECTIVE: To test the feasibility and efficacy of the VibroTactile Stimulation (VTS) Glove, a wearable device that provides VTS to the impaired limb to reduce spastic hypertonia. DESIGN: Prospective 2-arm intervention study-including 1 group of patients who use Botulinum toxin (BTX-A) for spasticity and 1 group of patients who do not use BTX-A. SETTING: Participants were recruited through rehabilitation and neurology clinics. PARTICIPANTS: Patients with chronic stroke (N=20; mean age=54 years, mean time since stroke=6.9 years). Patients who were previously receiving the standard of care (BTX-A injection) were eligible to participate and started the intervention 12 weeks after their last injection. INTERVENTION: Participants were instructed to use the VTS Glove for 3 hours daily, at home or during everyday activities, for 8 weeks. MAIN OUTCOME MEASURES: Spasticity was assessed with the Modified Ashworth Scale and the Modified Tardieu Scale at baseline and then at 2-week intervals for 12 weeks. Primary outcomes were the difference from baseline and at week 8 (end of VTS Glove use) and week 12 (4 weeks after stopping VTS Glove use). Patients who were receiving BTX-A were also assessed during the 12 weeks preceding the start of VTS Glove use to monitor the effect of BTX-A on spastic hypertonia. Range of motion and participant feedback were also studied. RESULTS: A clinically meaningful difference in spastic hypertonia was found during and after daily VTS Glove use. Modified Ashworth and Modified Tardieu scores were reduced by an average of 0.9 (P=.0014) and 0.7 (P=.0003), respectively, at week 8 of daily VTS Glove use, and by 1.1 (P=.00025) and 0.9 (P=.0001), respectively, 1 month after stopping VTS Glove use. For participants who used BTX-A, 6 out of 11 showed greater change in Modified Ashworth ratings during VTS Glove use (mean=-1.8 vs mean=-1.6 with BTX-A) and 8 out of 11 showed their lowest level of symptoms during VTS Glove use (vs BTX-A). CONCLUSIONS: Daily stimulation from the VTS Glove provides relief of spasticity and hypertonia. For more than half of the participants who had regularly used BTX-A, the VTS Glove provided equal or greater symptom relief.

Botox-A improve the thyroid-associated ophthalmopathy (TAO) orbital fibroblast activation through inhibiting the TGF-ß/Smad signaling.

The activation of orbital fibroblasts can result in fibrosis, finally contributing to thyroid-associated ophthalmopathy (TAO) progression. Although the effect of BTX-A on the treatment of TAO-related strabismus and upper eyelid retraction has long been recognized in clinical work, the underlying mechanism of BTX-A improving TAO-related strabismus and upper eyelid retraction has not been uncovered yet. In the present study, we successfully isolated and authenticated normal and TAO orbital fibroblasts. Compared with PBS, BTX-A and TACA exerted similar inhibitory effects on TAO orbital fibroblast proliferation and ECM production. TGF-ß stimulation induced the proliferation and ECM production by TAO orbital fibroblast, which was significantly inhibited by BTX-A or TACA treatment. Under TGF-ß stimulation, the inhibitory effects of BTX-A or TACA treatment on TAO orbital fibroblast proliferation and ECM production were reversed by TGF-ß/Smad signaling agonist SRI-011381. Collectively, BTX-A inhibited TGF-ß-induced TAO orbital fibroblast activation through inhibiting the TGF-ß/Smad signaling. Considering that TACA shows no satisfactory curative effects on symptoms closely related to the function of extraocular muscles, such as eye movement and diplopia, BTX-A might be a promising agent in TAO treatment.

Establishment of a cell line derived from the gills of Gymnocypris przewalskii, an endemic Schizothoracine fish from Qinghai Lake of Tibet Plateau.

Gymnocypris przewalskii (Naked carp), a native teleost, plays an important role in maintaining the ecological balance of Lake Qinghai (altitude, 3.2 km), the largest saline lake in China. In this study, a new gill cell line from G. przewalskii was developed using the explant technique and named as GPG. This cell line was maintained in Dulbecco's Modified Eagle Medium (DMEM) (high glucose), supplemented with 15% fetal bovine serum (FBS), and was successfully subcultured up to 32 passages. Meanwhile, this cell line was also authenticated by sequencing the mitochondrial cytochrome C oxidase subunit I (COI) and 16S rRNA genes and by chromosome analysis. With the Cytomegalovirus (CMV) promoter, the GPG cell line could express green fluorescent protein (GFP) at about 5% transfection efficiency. MTT test showed that Clostridium botulinum toxin (BTX) was toxic to the cell line. After cryopreservation with 10% dimethyl sulfoxide (DMSO), this cell line could be successfully revived at an efficiency over 70%. This study revealed that the GPG cell line could be used as materials for physio-chemical investigation of G. przewalskii and also provided a tool for gene function study and toxicological reaction in vitro.

Recent advances in one-stage conversion of lipid-based biomass-derived oils into fuel components - aromatics and isomerized alkanes.

Nowadays, production of biofuels is a rather hot topic due to depleting of conventional fossil fuel feedstocks and a number of other factors. Plant lipid-based feedstocks are very important for production of diesel-, kerosene-, and gasoline-like hydrocarbons. Usually, (hydro)deoxygenation processes are aimed at obtaining of linear hydrocarbons known to have poor fuel characteristics compared to the branched ones. Thus, further hydroisomerization is required to improve their properties as motor fuel components. This review article is focused on conversion of lipid-based feedstocks and model compounds into high-quality fuel components for a single step - direct cracking into aromatics and merged hydrodeoxygenation-hydroisomerization to obtain isoparaffins. The second process is quite novel and a number of the research articles presented in the literature is relatively low. As auxiliary subsections, hydroisomerization of straight hydrocarbons and techno-economic analysis of renewable diesel-like fuel production are briefly reviewed as well.

Low-Cost Benzene Toluene Xylene Measurement Gas System Based on the Mini Chromatographic Cartridge.

Benzene, toluene and xylene (BTX) are an important part of the volatile organic compounds (VOCs) to be detected and monitored in the air, due to their toxicity towards human health. One of the most reliable technique used in BTX detection is gas chromatography (GC), which presents a high sensitivity. On the other hand, it has important drawbacks, such as high costs, the need for qualified personnel and frequent maintenance. To overcome these drawbacks, this work reports the development of a low cost and portable BTX gas detection system based on a mini chromatographic cartridge, a photo ionization detector (PID), a simple control unit (based on Arduino architecture) and a mini pump. In order to separate the BTX components, we propose the use of a cartridge 80 mm in length, composed of several commercial chromatographic column sections. To test the system performances, we have injected different amounts (from about 0.3 to 5.3 µg) of benzene, toluene and xylene and two of the most frequent possible interferents (ethanol, acetone). Experimental results have shown different retention time values (i.e., 25 ± 0.5 s, 51 ± 1.2 s and 117 ± 4 s, respectively) for benzene, toluene and xylene.

Metal Oxide Nanoparticle-Decorated Few Layer Graphene Nanoflake Chemoresistors for the Detection of Aromatic Volatile Organic Compounds.

Benzene, toluene, and xylene, commonly known as BTX, are hazardous aromatic organic vapors with high toxicity towards living organisms. Many techniques are being developed to provide the community with portable, cost effective, and high performance BTX sensing devices in order to effectively monitor the quality of air. In this paper, we study the effect of decorating graphene with tin oxide (SnO2) or tungsten oxide (WO3) nanoparticles on its performance as a chemoresistive material for detecting BTX vapors. Transmission electron microscopy and environmental scanning electron microscopy are used as morphological characterization techniques. SnO2-decorated graphene displayed high sensitivity towards benzene, toluene, and xylene with the lowest tested concentrations of 2 ppm, 1.5 ppm, and 0.2 ppm, respectively. In addition, we found that, by employing these nanomaterials, the observed response could provide a unique double signal confirmation to identify the presence of benzene vapors for monitoring occupational exposure in the textiles, painting, and adhesives industries or in fuel stations.

Modifications to Botulinum toxin A delivery in the management of detrusor overactivity recalcitrant to initial injections: a review.

PURPOSE: One quarter of patients will not respond to initial intra-detrusor Botulinum toxin A (BTX) injections for detrusor overactivity. Alternative treatment options include long-term catheterization, sacral neuromodulation, urinary diversion or bladder augmentation. Some of these procedures are invasive. This review explores modifications to BTX delivery that can improve outcome. METHODS: A search of Medline, Embase and Cochrane Library to December 2017 was performed according to Preferred Reporting Items for Systematic Review and Metaanalysis (PRISMA) guidelines. Search criteria included, dose escalation, increasing injection site number, trigone injection, switching preparation and alternative methods of BTX delivery. RESULTS: Several modifications to BTX delivery may improve response. There is moderate evidence that increasing the dose from 100 U to 200 U results in statistically better symptom control. Trigone-including injections were associated with significantly improved patient-reported symptom scores, as well as superior results in urodynamic outcomes without risking urinary retention and vesico-ureteric reflux. Switching from onabotulinum (OTA) or abobotulinum (ATA) or vice versa may also improve response in over 50% of patients as shown in limited studies. Increasing the number of injection sites is not beneficial. Indeed, decreasing the number of injections to as low as three sites does not result in decreased clinical outcomes. Injection-free delivery is associated with lower efficacy compared to conventional intradetrusor injections. CONCLUSION: Before contemplating alternative treatments, practitioners can try to improve on BTX delivery. Firstly, the dose can be increased to 200 U; the trigone included in the injection sites and switching brands may also be helpful.

The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options.

Hyperhidrosis (HH) is a chronic disorder of excess sweat production that may have a significant adverse effect on quality of life. A variety of treatment modalities currently exist to manage HH. Initial treatment includes lifestyle and behavioral recommendations. Antiperspirants are regarded as the first-line therapy for primary focal HH and can provide significant benefit. Iontophoresis is the primary remedy for palmar and plantar HH. Botulinum toxin injections are administered at the dermal-subcutaneous junction and serve as a safe and effective treatment option for focal HH. Oral systemic agents are reserved for treatment-resistant cases or for generalized HH. Energy-delivering devices such as lasers, ultrasound technology, microwave thermolysis, and fractional microneedle radiofrequency may also be utilized to reduce focal sweating. Surgery may be considered when more conservative treatments have failed. Local surgical techniques, particularly for axillary HH, include excision, curettage, liposuction, or a combination of these techniques. Sympathectomy is the treatment of last resort when conservative treatments are unsuccessful or intolerable, and after accepting secondary compensatory HH as a potential complication. A review of treatment modalities for HH and a sequenced approach are presented.

Role of botulinum neurotoxin-A in cerebral revascularization graft vasospasm prevention: current state of knowledge.

Graft stenosis and occlusion remain formidable complications in cerebral revascularization procedures, which can lead to significant morbidity and mortality. Graft vasospasm can result in early postoperative graft stenosis and occlusion and is believed to be at least partially mediated through adrenergic pathways. Despite various published treatment protocols, there is no single effective spasmolytic agent. Multiple factors, including anatomical and physiological variability in revascularization conduits, patient age, and comorbidities, have been associated with graft vasospasm pathogenesis and response to spasmolytics. The ideal spasmolytic agent thus likely needs to target multiple pathways to exert a generalizable therapeutic effect. Botulinum toxin (BTX)-A is a powerful neurotoxin widely used in clinical practice for the treatment of a variety of spastic conditions. Although its commonly described paradigm of cholinergic neural transmission blockade has been widely accepted, evidence for other mechanisms of action including inhibition of adrenergic transmission have been described in animal studies. Recently, the first pilot study demonstrating clinical use of BTX-A for cerebral revascularization graft spasm prevention has been reported. In this review, the mechanistic basis and potential future clinical role of BTX-A in graft vasospasm prevention is discussed.

Botox treatment in patients with chronic functional anorectal pain: experiences of a tertiary referral proctology clinic.

BACKGROUND: Anorectal pain is a symptom which may have both structural and functional causes, and can, sometimes, develop into a chronic pain syndrome. Functional causes in particular are challenging to treat when conservative treatment measures fail. Botulinum toxin A (BTX-A) can be applied to relax the anal sphincter and/or levator ani muscle to break the vicious circle of pain and contraction. In our tertiary referral proctology clinic, we evaluated the outcome of patients treated with BTX-A for chronic functional anorectal pain. METHODS: Our electronic database was searched for patients who had BTX-A treatment for chronic functional anorectal pain from 2011 to 2016. All medical data concerning history, treatments, and clinical outcome were retrieved. The clinical outcome (resolution of pain) was scored as good, temporary, or poor. RESULTS: A total of 113 patients [47 (42%) males; age 51years, SD 13 years, range 18-88 years] with chronic functional anorectal pain were included. The outcome of BTX-A treatment was good in 53 (47%), temporary in 23 (20%), and poor in 37 (33%). To achieve this outcome, 29 (45%) patients needed a single treatment, 11 (44%) a second treatment, and 13 (54%) ≥ 3 treatments. CONCLUSIONS: Chronic functional anorectal pain can be treated successfully with BTX-A in 47% of patients who fail conservative management. Repeated injections may be needed to ensure complete cure in a subgroup of patients.

BTX-A Rejuvenation: Regional Botulinum Toxin-A Injection of the Platysma in Patients with Facial Sagging.

OBJECTIVE: To establish botulinum toxin-A (BTX-A) rejuvenation as an innovative technique to treat facial sagging with descent of the mid and lower face in Asian females. METHODS: Between March 2016 and March 2017, 512 female patients with facial sagging were treated with regional platysma BTX-A injection. Droplet injection into the dermis was performed. Among the patients, 192 were recruited into our retrospective study. Eligible patients were divided into a pre-senile group (28-39 years old) and a senile group (> 40 years old). We analyzed the patient/physician-graded improvement, the mean scores of the 5-point improvement scale, and any reported complications. RESULTS: The overall degree of both patient- and physician-graded mid-face aesthetic improvement was very high. Improvement ratings reached 97.92% for patients and 94.79% for physicians. Improvement ratings were significantly greater in the pre-senile group compared to the senile group (p < 0.001), suggesting that the pre-senile patients were more satisfied with their improvement. Moreover, the percent of patients who reported as "much improved" was significantly higher than the percent of physicians (p < 0.05), suggesting that patients felt more positively about their aesthetic results than the physicians. No severe side effects were reported. CONCLUSIONS: Our results demonstrated that regional BTX-A injection in the dermis for the purpose of aesthetical platysma rejuvenation is safe and effective in patients with facial sagging with descent of the mid and lower face. Specifically, regional platysma injections of BTX-A (BTX-A rejuvenation) can correct descent of the mid and lower face in Asian females, demonstrating clinical utility of this treatment strategy. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Synthesis of recyclable carbon/lignin biocomposite sorbent for in-situ uptake of BTX contaminants from wastewater.

In this work, both palm-date pits and pulping black liquor industrial wastes were recycled as low-cost starting materials for the production of three series of granule activated carbon (gAC)/Kraft lignin (KL) (gAC/KLx, x = 33, 50 and 67%) biocomposites using a one-pot solid-state method. The gAC/KLx biocomposites with defined characteristics were examined towards batch adsorption of BTX (Benzene, Toluene, and Xylene) in multi-solute salty wastewaters. Optimization of adsorption performances under different experimental conditions were carried out using high performance liquid chromatography (HPLC). Adsorption modeling versus contact time (0-12 h) and BTX concentrations (150-2250 mg/L) were examined using non-linear forms of nine kinetic and five isotherm equations to best understand gAC/KL0.5 suitability for BTX sorption/recovery processing. Accordingly, the gAC/KLx at KL blended ratio of 50% was found to be the topmost to achieve the highest BTX capacity even at broad ranges of water salinity (0-100 g/L) and pH (3-9) values. The adsorption mechanism found to best described by physico-sorption (E ≈ 0.12-1.38 kJ/mol) via the hydrophobic interaction and diffusion mechanisms. In respect to gAC/KL0.5 affinities, the sorption capacity followed the descending sequence of X ≥ T > B. Particularly, the maximum theoretical BTX capacity using the best fitted Langmuir-Freundlich model (L-FM) for gAC/KL0.5 was found to be slightly higher than obtained by gAC (363.9 and 360.1 mg/g, respectively), along with higher initial sorption (h) rate (≈742.47 mg/g.h) than of gAC (≈559.85 mg/g.h) and KL (≈22.22 mg/g.h). Batch BTX sorption/recovery processes and estimated cost suggested the effective utilization of gAC/KL0.5 as a promising in-expensive sorbent (0.31 ±â€¯0.05 US$/kg) for commercial decontamination of petroleum hazardous (BTX) pollutants from wastewaters up to five reuse cycles.

Assessment of changes in masseter muscle by three-dimensional close-range photogrammetry after Botulinum toxin type-A injection: A case report with review of literature.

Masseter muscle hypertrophy (MMH) is a benign, unilateral or bilateral, painless enlargement. Treatment protocols include surgical excision or a non-invasive option, using botulinum toxin type A (BTX-A). There is no study in the literature that measures this dimensional change in the masseter muscle (MM). The aim of this case report is to present changes in volume and surface area in MM with three-dimensional closer an gestereophotogrammetry (3DCS). For treatment 30 units of BTX-A was injected into the three points hypertrophic muscle and patient records were taken to compare with 3DCS with a non-metric Canon EOS 550 D camera before and after injection. The changes in the surface area and volume of this muscle were mapped and the objective data were obtained. This technique is useful for predicting the results of BTX-A application, and can be a useful tool for better physicianpatient communication.

Botulinum Toxin A Plays an Important Role in the Placement of Implants Deep Within the Pectoralis Major Muscle for Mammaplasty: A Systematic Review and Meta-analysis.

BACKGROUND: Breast prosthesis implants have been safely and efficiently used in the plastic surgery department. With the increasing demand for aesthetics, these silicon implants were not only used in breast augmentation surgery but also in breast reconstruction after mastectomy. Nevertheless, breast prosthesis implantation brings a lot of complications, such as: postoperative chronic pain, capsule contracture, prosthesis displacement and prosthesis rupture and infection in severe cases. From the year 1998, botulinum toxin A (BTX-A), a neurotoxin, has been reported to be effective for pain control, capsule contracture lessening, expander enlargement and so on. However, those articles included all kinds of study types: randomized, double-blinded controlled trial (RCT), nonrandomized trial, retrospective analysis and case series, besides the outcomes were varied. To clarify how BTX-A acts at the mammaplasty field, we made this systematic review and meta-analysis. PURPOSE: To review how BTX-A acts in the field of mammaplasty as well as discuss the relative mechanisms of BTX-A and the related research progress. METHODS: We searched Pubmed, Embase, Cochrane, Web of science, Clinical trials, Wanfang Database and VIP from inception until March 2018 for papers reporting the use of BTX-A in the breast surgery using implants deep within the pectoralis major muscle. System review, viewpoints and case reports were excluded. RESULTS: Ten articles met the criteria for inclusion including six prospective controlled (2 RCT; 4 other trails), three retrospective cohorts and one case series. These studies were all about patients using BTX-A during or after breast surgery with expanders or prostheses. A total of 682 patients were enrolled, 543 (79.61%) accepted BTX-A injection, 185 underwent mastectomies with immediate reconstruction, 13 with delayed reconstruction, 295 mastectomies with either immediate or delayed reconstruction and 189 with breast augmentation using silicone prostheses. The study time ranging from 4 months to 13 years, 15 patients (2.76%) received BTX-A injection more than two times, 9.2% received less than 75 U BTX-A, 34.3% 75-100 U, 0.18% 250 U, and in 56.4% the dosage was not stated. No complications associated with BTX-A were mentioned, almost all the studies reported efficacy for pain control. Other assessments included increased speed of expander enlargement and volume were mentioned in four papers, two articles analyzed the visual analogue scores, three suggested relief of capsular contracture, two reported lower narcotic use, three mentioned shorter hospital stays and one proved lowering the rate of unplanned expander. It seems all the studies demonstrate the valid usage of BTX-A, but the quality of this evidence still under the line. CONCLUSION: We could try to use BTX-A as a new method in the field of mammaplasty. There are so many advantages such as postoperative pain relief, reducing the hospital stay, and increasing operation success rate, but rigorous methodological evidence is still lacking. A lot of studies were retrospective, only two studies used the RCT method. Therefore, to obtain strong evidence to clarify the usage of BTX-A, more randomized double-blinded controlled trials will be required, meanwhile the mechanism study adds to the evidence. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effectiveness of BTX-A and neuromodulation in treating OAB with or without detrusor overactivity: a systematic review.

INTRODUCTION AND HYPOTHESIS: Patients with refractory overactive bladder (OAB) pose a therapeutic challenge. Guidelines such as those from the National Institute for Health and Care Excellence recommend invasive treatments such as botulinum toxin-A ((BTX-A), sacral neural stimulation (SNS) etc. only if there is detrusor overactivity (DO) on urodynamics. METHODS: Our aim was to systematically evaluate evidence based on the presence or absence of DO in relation to differences in effectiveness and complications related to invasive treatment in patients with refractory OAB. We carried out a systematic search of Cochrane, MEDLINE, Embase, CINAHL, LILACS, meta-Register of Controlled Trials (mRCT), CENTRAL, and Google Scholar databases from inception until April 2016. Abstracts presented at IUGA, ICS and EAU conferences (until April 2016) were included and journals that were hand searched. RESULTS: We found five studies (two prospective cohort studies and subgroup analyses of two randomized controlled trials (RCTs) and one cohort study for BTX-A, one multicenter prospective cohort study for percutaneous tibial nerve stimulation (PTNS) and three (one RCT and two cohort studies) for SNS. The outcomes in patients without (n = 77) or with (n = 135) DO were similar in the context of urodynamic findings, bladder diaries, quality of life (QoL) questionnaires, etc. when treated with BTX-A [odds ratio (OR) 1.52, 95% confidence interval (CI) 0.40-5.77] or SNS (50 patients without and 81 with DO; OR1.37, CI 0.76-2.48). Outcomes for PTNS (based on a single study) seem to be better in patients without DO. CONCLUSION: The limited evidence suggests that urodynamic diagnosis of DO does not alter patient reported outcomes for invasive treatments such as BTX-A and SNS. Noninferiority RCTs powered to evaluate the role of DO in predicting treatment response are required.

Oil exploration activities: assessment of hazardous impacts on 'Golden silk' cultivation.

Aliphatic-aromatic hydrocarbons and heavy metals (Cd, Cu, Co, Cr, Ni, Pb and Zn) were estimated in soil and leaf samples of Machilus bombycina (host plant of Antheraea assama silkworm) plantation along with atmospheric benzene, toluene and xylene (BTX) concentration near the oil exploration region of upper Assam, India, during the pre-monsoon and post-monsoon periods in six different sites. The results revealed higher aliphatic-aromatic hydrocarbons (ranging from 26.55 to 59.42 mg kg-1) and heavy metal contaminations in all the six soil sampling sites during the pre-monsoon period while the trend was the opposite for the plant leaves. Polyaromatic hydrocarbons (9.85 mg kg-1) were found in one soil sampling site near an abandoned oil well. The lead concentration in the soil showed values from 14.36 ± 1.5 to 96.5 ± 5.6 mg kg-1 and found to be higher than the WHO limit in most of the samples. The aliphatic-aromatic hydrocarbon m-xylene was also found in M. bombycina plant leaves which could be traced due to crude oil. Cd and Pb concentrations in leave samples were found to be higher than the maximum allowable limit of 0.3 and 5.3 mg kg-1, respectively. Principal component analysis of hydrocarbons in soil and leaves showed different clusters during the pre-monsoon and post-monsoon periods. The crude protein and total carbohydrate contents in the leaves were lower than those of uncontaminated samples which are an indication of a major disturbance to overall growth of plants. BTX concentration was found in the range of 119-198 µg m-3 which indicates that atmospheric contamination in the studied area is causing the death of A. assama larvae.

Joint instability leads to long-term alterations to knee synovium and osteoarthritis in a rabbit model.

OBJECTIVES: Joint instability is believed to promote early osteoarthritic changes in the knee. Inflammatory reactions are associated with cartilage degradation in osteoarthritis (OA) but their possible synergistic or additive effects remain largely unexplored. The goal of the present study was to investigate the in vivo effects of Botulinum Toxin A (BTX-A) induced joint instability on intraarticular alterations in an otherwise intact rabbit knee joint model. METHODS: Ten 1-year-old female New Zealand White rabbits (average 5.7 kg, range 4.8-6.6 kg) were randomly assigned to receive three monthly unilateral intramuscular injections of BTX-A (experimental group), or no treatment (control group). After 90 days, all knees were analyzed for specific mRNA levels using RT-qPCR. The synovium and cartilage tissue was assessed for histological alterations using the OARSI scoring system. RESULTS: Cartilage and synovial histology showed significant higher OARSI scores in the BTX-A group animals compared to the untreated controls and contralateral limbs. There were no differences between the untreated control and the contralateral experimental limbs. Gene expression showed significant elevations for collagen I, collagen III, nitric oxide, TGF-ß, IL-1 and IL-6 compared to the healthy controls. CONCLUSION: BTX-A induced joint instability in a muscle weakness model uniquely leads to alterations in gene expression and histological changes in the synovial membranes and cartilage in otherwise intact knee joints. These results lead to the conclusion that joint instability may promote an inflammatory intraarticular milieu, thereby contributing to the development of OA.

Kinetic study of biodegradation of BTX compounds in mono- and multicomponent systems in reactor with immobilized biomass.

In this study, kinetic parameters were determined for the biodegradation of BTX compounds in a fixed-bed reactor with immobilized biomass, fed with mono- and multicomponent systems. The parameter estimation was achieved through an algorithm using the finite volume method. Different kinetic models were evaluated. The Monod model proved to be suitable to predict the experimental data for the biodegradation individual BTX compound. In multicomponent systems, it was found that the presence of more than one compound tends to cause competitive inhibition. To identify the models that best fit the experimental data, a statistical analysis using the F test was applied. For the two- and three-component systems the presence of more than one compound tends to cause competitive inhibition. In this study, it was possible to predict kinetic parameters in mono- and multicomponent systems as well as different operation conditions for a fixed-bed reactor with immobilized biomass.