Clinical benefit of botulinum toxin for treatment of persistent TMD-related myofascial pain: A randomized, placebo-controlled, cross-over trial.

BACKGROUND: Injections of botulinum toxin type A (BoNT-A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)-related myofascial pain (MFP). BoNT-A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo-controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT-A. METHODS: Sixty-six subjects were randomized into two groups, one which received BoNT-A first and a second which received a saline solution (SS) first. Follow-ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain-related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. RESULTS: The within-group analysis showed a significant improvement in pain intensity and pain-related disability after BoNT-A (p < 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between-group analysis of pain-related variables revealed no differences between groups at any time. Nonetheless, BoNT-A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16-week follow-ups favoring BoNT-A. CONCLUSIONS: Injections of 50 U of BoNT-A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious.

New Experimental Models of Retinal Degeneration for Screening Molecular Photochromic Ion Channel Blockers.

Application of molecular photochromic ion channel blockers to recover the visual function of a degenerated retina is one of the promising trends in photopharmacology. To this day, several photochromic azobenzene-based compounds have been proposed and their functionality has been demonstrated on cell lines and knockout mouse models. Further advance necessitates testing of the physiological activity of a great number of new compounds. The goal of this study is to propose animal models of photoreceptor degeneration that are easier to obtain than knockout mouse models but include the main features required for testing the physiological activity of molecular photoswitches. Two amphibian-based models were proposed. The first model was obtained by mechanical deletion of the photoreceptor outer segments. The second model was obtained by intraocular injection of tunicamycin to induce the degeneration of rods and cones. To test our models, we used 2-[(4-{(E)-[4-(acryloylaminophenyl]diazenyl}phenyl)amino]-N,N,N-triethyl-2-oxoethanammonium chloride (AAQ), one of the compounds that have been studied in other physiological models. The electroretinograms recorded from our models before and after AAQ treatment are in agreement with the results obtained on knockout mouse models and reported in other studies. Hence, the proposed models can be used for primary screening of molecular photochromic ion channel blockers.

[Clinical assessment of various treatments for tracheal stenosis].

The paper deals with the management of cicatricial stenoses of the trachea, which is a topical problem of modern thoracic surgery. Surgical techniques and endoscopic operations aimed at expanding and maintaining the lumen of the airways have been employed. Original types of surgical operations and new endoscopic tools are proposed.

[Circadian rhythms of urinary parameters in children with glomerulonephritis]. / Tsirkadiannye ritmy parametrov mochi pri glomerulonefrite u detei.

Circadian rhythms of urinary parameters were studied in healthy children and those with glomerulonephritis. In healthy children, urinary excretion of many substances rhythmically varied during a day. Variations were related to the volume and specific gravity of urine, to the levels of creatinine, MDA, and SOD activities. Children with glomerulonephritis showed changes in values of circadian rhythm of urine parameters. These disorders included changes in circadian variations and mean daily values, inversion of group and individual excretion patterns, which indicates that there is an external and internal disagreement of biological rhythms in children with glomerulonephritis.

[Criteria of chronic state and treatment effectiveness of acute glomerulonephritis without nephrotic syndrome in children]. / Kriterii khronizatsii i éffektivnosti lechenia ostrogo glomerulonefrita bez nefroticheskogo sindroma u detei.

A study was made of criteria for acute glomerulonephritis chronicity, efficacy of etiotrophic therapy, and of the survival rates in a group of 200 ill children. It has been established that proteinuria ranging within 0.1-0.99 g/l, no arterial hypertension at the disease debut, concomitant urodynamic disorders are of unfavourable prognostic significance for the clinical recovery. A relationship has been discovered between glomerulonephritis chronicity and the patients' sex and age, and preceding diseases. A conclusion is made about the highest efficacy of antibacterial therapy commenced at the first week of the disease, continued for one month. The patients' survival rate for 20 years amounted to 100%.

[Clinical significance of circulating immune complexes in children with glomerulonephritis]. / Klinicheskoe znachenie tsirkuliruiushchikh immunnykh kompleksov pri glomerulonefrite u detei.

The paper is concerned with the determination of the physicochemical properties of the circulating immune complexes in children with different varieties of glomerulonephritis at different disease stages. The assessment was made of the diagnostic and prognostic significance of these complexes. It has been shown that the intensity and the frequency of the concomitant signs of glomerulonephritis turn out maximal in patients, provided the circulation contains the pathogenic complexes whose long demonstration in the active disease phase is of unfavourable prognostic significance.

[Surgical tactics in pleural empyema with regard to the use of a carbon dioxide laser and argon plasma]. / Khirurgicheskaia taktika pri émpieme plevry s uchetom ispol'zovaniia uglekislotnogo lazera i argonovoi plazmy.

The authors analyze the experience gained in treating 30 patients with acute and 23 with chronic pleural empyema. The management policy identified the following points. Laser thoracoscopic necrectomy and empyemic cavity sanitation are indicated in acute destructive pulmonitis. A combination of temporary bronchial occlusion and laser treatment of the empyemic cavity and bronchopleural fistula should be performed after debridement of a destructive pulmonitis area from necrotic tissues. Radical treatment of chronic pleural empyema should be better conducted in the early periods by employing a plasma scalpel at all the stages of surgical intervention for hemostasis, aerostasis and sterilization of the operation field.

Structural composition of blood erythrocytes in children with nephropathies.

Study of the structural characteristics of peripheral blood erythrocytes in the pathogenesis of nephropathies in children by means of automated recording of integral osmotic erythrograms and analysis of differential curves of hypoosmotic hemolysis showed decreased osmotic resistance of erythrocytes, which was most pronounced during renal dysfunction. A molecular model of possible modification of the erythrocyte membrane in the pathogenesis of nephropathies is proposed.

[The thoracoscopic use of the CO2 laser in the combined treatment of pleural empyema]. / Torakoskopicheskoe primenenie CO2-lazera v kompleksnom lechenii émpiemy plevry.

A new method for treating acute pneumothorax with a bronchopleural fistula was experimentally developed and clinically tested. It is based on thoracoscopic use of CO2 laser radiation. The laser beam energy is employed for evaporation of necrotic tissues in the area of pulmonary destruction, "welding" of the bronchopulmonary fistulae, and general irradiation of the empyema cavity with a defocused beam. Nineteen patients with various disease duration were treated. In 16 patients the bronchial fistulae and the empyema cavity were eliminated and the lung re-expanded. The purulent inflammation in the pleural cavity was acute in these cases.

[Comparison of the frequency of detection of autoantibodies to epidermal antigens with the level of antibodies to polysaccharide of group A Streptococcus and the number of T-suppressors in glomerulonephritis]. / Sopostavlenie chastoty obnaruzheniia autoantitel k antigenam épidermisa s urovnem antitel k polisakharidu streptokokka gruppy A i chislom T-supressorov pri glomerulonefrite.

By the acute glomerulonephritis (GN) of streptococcal etiology, autoantibodies (AA) reacting with the basal layer of skin epithelium (BLSE) are discovered. The presence of this AA's correlate with the high level of antibodies to the streptococcal group A polysaccharide (A-PS). In the control sera such AA's and the high level antibodies to A-PS are discovered very rarely. By the GN of non-streptococcal etiology, AA's to the BLSE apparently of other specificity are obtained in some cases, in spite of the absence of antibodies to A-PS. AA's reacting with the differentiated layers of skin epithelium are discovered in the high percent of cases by GN. The presence of these AA's do not correlate with the levels of antibodies to A-PS. The reduction of the number of T-lymphocyte suppressors is established in the blood by the presence of AA's to the BLSE by GN. This question is a subject of later investigations by the different autoimmune processes. Such data can apparently corroborate the previously expressed hypothesis, that AA's to BLSE, which as a rule react with endocrine thymus epithelium, are the cause of the beginning of immunoregulatory disorders, characteristic of autoimmune processes.

The effect of sodium nucleinate on allergic and immunological reactions.

Experiments on immunized rabbits and guinea pigs indicated that sodium nucleinate (SN) was capable of weakening or entirely eliminating anaphylactic and skin reactions of delayed type hypersensitivity to repeated administration of staphyloanatoxin, APDT vaccine. The findings on patients with the infectious form of bronchial asthma and chronic rheumatism showed that sodium nucleinate attenuated reactions to the subcutaneous administration of staphylococcal and streptococcal allergens. The treatment of patients suffering from infectious-allergic bronchial asthma and rheumatism with SN resulted in the recovery of deficient T cells, T-suppressors, normalization of immunoglobulin concentrations. In children with acute glomerulonephritis sodium nucleinate normalized decreased T-suppressor cells and increased IgG and circulating immune complexes (CIC), resulting in a pronounced remission of disease. The mechanism of desensitization and elimination of CIC by SN has not been explored, however, the parameters of SN-induced immunomodulation are known rather completely. It is suggested that SN brings about accumulation in the cell of cyclic AMP which diminished membrane permeability, activates monoaminooxidase resulting in the degradation of histamine and other biogenic amines, enhances the synthesis of endogenous corticosteroids with their desensitizing properties. All these effects contribute to the elimination of delayed type hypersensitivity. The role of SN in the inhibition of delayed type hypersensitivity remains obscure.

Distribution of CCR5-delta 32 gene deletion across the Russian part of Eurasia.

32-bp inactivating deletion in the beta-chemokine receptor 5 (CCR5) gene, common in Nothern European populations, is associated with reduced HIV-1 transmission risk and delayed disease progression. We have studied the deletion distribution in many populations in Eurasia by polymerase chain reaction analysis of 531 DNA samples representing West and East Siberian, Central Asian, and Far Eastern parts of Russia. An unusually high frequency (11.1%) of the deleted variant in natives of West Siberia, of Finno-Ugrian descent, was observed. Furthermore, the deletion was infrequent in indigenous populations of Central Asia, East Siberia, the Russian Far East, and Canada. We conclude that the delta(ccr5) distribution is limited primarily to Europeans and related western Siberian Finno-Ugrian populations, with a sharp negative gradient toward the east along the territory of Russian Asia.