Factors in the Efficacy, Safety, and Impact on Quality of Life for Treatment of Drooling with Botulinum Toxin Type A in Patients with Cerebral Palsy.

OBJECTIVE: To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN: Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study. All participants were classified as Gross Motor Function Classification System level III or higher and all had significant drooling as defined in prior studies. One group (group A) was treated with 100 U of BoNT-A, and another group (group B) served as control. In the treatment group, all patients first received combined parotid and submandibular injections, and then parotid injections only. The main outcome variables were a postinjection decrease in the drooling quotient (DQ) of 50% or more, total flow of 30% or more, and QoL as assessed by a set of 10 items related to drooling from the ICF. RESULTS: The proportion of patients who achieved at least 50% reduction in DQ was 45% in group A versus 0.0% in group B; 0.0% (P = 0.0012); and of those who achieved at least 30% reduction in total flow was 90% in group A versus 10% in group B (P < 0.0001). Within group A, 42.1% of the dyskinetic patients versus 58.0% of the spastic ones showed 50% or better response in DQ, which is not a statistically significant difference (P = 0.8045). With regard to ICF questions, group A showed statistically significant improvements in several related items. There did not seem to be a significant difference in overall response for providing parotid-only injections. Additional correlations and uncommon adverse effect experiences are also reviewed. CONCLUSION: Botulinum toxin A injection of the salivary glands is frequently effective and generally safe for the treatment of drooling in patients with either spastic or dyskinetic CP, both in objective measurement of saliva production and subjective symptoms related to the condition. There does not seem to be a significant advantage of injecting both submandibular and parotid glands over injecting parotid glands alone.

Impact of NEGR1 genetic variability on psychological traits of patients with eating disorders.

Genetics variants in the NEGR1 gene, strongly expressed in the brain, have been reported to affect the neuronal control of food intake therefore inducing obesity. With the same rationale, we hypothesized that this genetic variability may be associated with psychological traits commonly displayed by eating disorder (ED) patients and/or with the risk for the disorder. We analyzed 21 tag-single-nucleotide polymorphisms (SNPs) in the coding sequence and adjacent regions of the NEGR1 gene. A total of 169 ED patients (106 with anorexia nervosa (AN) and 63 with bulimia nervosa (BN)) and 312 healthy subjects were genotyped. Personality traits and general psychopathological symptoms were assessed by the Eating Disorders Inventory Test-2 (EDI-2) and Symptom Checklist 90 Revised inventories. None of the SNPs or haplotypes analyzed were associated with a greater risk of ED or correlated with anthropometric parameters. However, in patients with BN, four SNPs (rs12740031, rs10789322, rs6659202 and rs591540) correlated with the scores in Drive for Thinness (DT), Ineffectiveness (I) and Interoceptive Awareness (IA) (Bonferroni-P<0.05 in all instances). The first two SNPs along with rs954299 and rs2422021 formed a haplotype block, which showed a consistent association with the EDI-2 score in BN patients (Bonferroni-P=0.01). A subsequent three-SNP sliding-window approach identified a central area, encompassing both the haplotype block and the individually relevant SNPs that strongly correlated with the scores of BN patients in DT, I, IA and Bulimia. No associations were identified in the AN group. These preliminary results indicate that NEGR1 could be an important locus influencing certain personality dimensions in BN patients.

Clasificación de los rotavirus aislados de granjas porcícolas localizadas en el estado de Yucatán / Classification of rotaviruses isolated from pig farms in the state of Yucatan, Mexico

La diarrea infecciosa aguda (DIA) por rotavirus (RV) es un problema de salud que afecta a la industria porcina, causando porcentajes variables de morbilidad y mortalidad que repercuten en el crecimiento, en la ganancia de peso y en la conversión alimenticia de los lechones. En el estado de Yucatán un informe preliminar indica la presencia de un 8.8 por ciento de RV en el ganado porcino. El presente trabajo da a conocer la frecuencia y la clasificación de RV del ganado porcino en granjas ejidales y particulares. El diagnóstico se realizó por la técnica de electroforesis en geles de poliacrilamida y la determinación del subgrupo y serotipo por medio de la técnica de ELISA con anticuerpos monoclonales específicos. El 26 por ciento del total de las muestras examinadas fueron positivas; 84 por ciento en las granjas ejidales y 16 por ciento en granjas particulares. Se le determinó el subgrupo de RV a 24 muestras: el subgrupo I se observó en 95.84 por ciento y 4.16 fue para el subgrupo II. Se puede asignar serotipo a 8 muestras (4 fueron del serotipo 1 y 4 del 3). El patrón electroforético encontrado fue el largo y se observó el Grupo A en 69 muestras, el B en 3, el C en 1, infección mixta en 1. La frecuencia y la variedad de genogrupos demuestra la distribución de diversas cepas y grupos de RV que se encuentran circulando en el ganado porcino