RESUMO
Issues concerning botulinum toxin still need resolution in the laboratory and clinic. Assay nomenclature is unsatisfactory and attempts to establish common units and/or equivalents are misguided and dangerous. Optimum toxin concentrations for most indications are unknown. Loss of response is too readily ascribed to antibody formation. New therapeutic indications for toxin raise the possibility of additional mechanisms of action.
Assuntos
Antidiscinéticos/farmacocinética , Toxinas Botulínicas/farmacocinética , Toxinas Botulínicas/uso terapêutico , Proteínas de Membrana/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Animais , Antidiscinéticos/imunologia , Antidiscinéticos/uso terapêutico , Toxinas Botulínicas/imunologia , Humanos , Dose Letal Mediana , Proteína 25 Associada a SinaptossomaRESUMO
Botulinum toxin type A (BTX-A) is increasingly being used for the treatment of childhood spasticity, particularly cerebral palsy. However, until very recently, all such use in this indication has been unapproved with no generally accepted treatment protocols, resulting in considerable uncertainty and variation in its use as a therapeutic agent. In view of the increasing awareness of, and interest in, this approach to the treatment of spasticity, and also the recent licensing in a number of countries of a BTX-A preparation for treating equinus deformity in children, it would seem timely to establish a framework of guidelines for the safe and efficacious use of BTX-A for treating spasticity in children. This paper represents an attempt, by a group of 15 experienced clinicians and scientists from a variety of disciplines, to arrive at a consensus and produce detailed recommendations as to appropriate patient selection and assessment, dosage, injection technique and outcome measurement. The importance of adjunctive physiotherapy, orthoses and casting is also stressed.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Animais , Toxinas Botulínicas Tipo A/administração & dosagem , Toxinas Botulínicas Tipo A/efeitos adversos , Paralisia Cerebral/fisiopatologia , Modelos Animais de Doenças , Humanos , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/administração & dosagem , Fármacos Neuromusculares/efeitos adversos , Seleção de Pacientes , Amplitude de Movimento Articular , Resultado do TratamentoRESUMO
A 5-day, non-residential exercise and living course for children with asthma is described as a feature of a programme of outpatient physiotherapy. Eleven children undertaking such a course were compared with 10 asthmatic children in a control group. The subject group showed, in the short term at least, an improvement in bronchial lability, peak flow rates, nocturnal and daytime wheeze, and activity compared with the controls. These findings were statistically significant. There was no difference between the groups in the number of days on which extra medication was taken. A short, sharp course is of benefit physically, socially and psychologically to children with asthma.
Assuntos
Atividades Cotidianas , Asma Induzida por Exercício/reabilitação , Asma/reabilitação , Terapia por Exercício , Asma Induzida por Exercício/fisiopatologia , Asma Induzida por Exercício/psicologia , Criança , Ensaios Clínicos como Assunto , Humanos , Pulmão/fisiopatologia , Qualidade de Vida , Poluição por Fumaça de TabacoAssuntos
Propilenoglicóis/uso terapêutico , Psoríase/tratamento farmacológico , Salicilatos/uso terapêutico , Dermatoses do Couro Cabeludo/tratamento farmacológico , Combinação de Medicamentos/metabolismo , Combinação de Medicamentos/uso terapêutico , Humanos , Propilenoglicóis/metabolismo , Salicilatos/metabolismo , Absorção Cutânea/efeitos dos fármacosRESUMO
Thirty one of 486 children followed from birth had recurrent croup in the first four years of life. Twenty one were boys, and 10 girls. Recurrent croup occurred significantly more often in families with a positive history of allergy but was not significantly associated with the initial feeding method.
Assuntos
Crupe/etiologia , Hipersensibilidade/complicações , Laringite/etiologia , Pré-Escolar , Feminino , Humanos , Hipersensibilidade/genética , Masculino , Recidiva , Fatores SexuaisRESUMO
The frequency of allergic manifestations in the first year of life was studied. The prevalence of allergic signs affecting the skin and respiratory tract in infants who had been started on breast feeding was compared with the prevalence of such signs in infants started on cows' milk formulae. The relationship of allergy to family history was investigated. Eczema and rhinitis were found to be present as often in the initially breast-fed group as in the initially cows' milk-fed group. Bottle-fed infants developed asthma and bronchitis more often than their breast-fed counterparts. Infants of allergic parents exhibited more allergy than those from non-allergic families, and this difference was particularly pronounced for asthma or bronchitis. Breast feeding gave some protection against the development of respiratory tract allergies in infants of non-allergic parents. Among the infants with a positive family history of allergy, fewer with eczema or chronic rhinitis were found in the initially breast-fed group group but this did not achieve statistical significance.
Assuntos
Hipersensibilidade Imediata/epidemiologia , Leite Humano/imunologia , Leite/imunologia , Adulto , Animais , Asma/epidemiologia , Eczema/epidemiologia , Inglaterra , Feminino , Humanos , Hipersensibilidade Imediata/genética , Hipersensibilidade Imediata/prevenção & controle , Lactente , Masculino , Estudos Prospectivos , Rinite/epidemiologiaRESUMO
A single-blind trial of oxolinic acid (750 mg. twice-daily for 14 days) and ampicillin (500 mg. 3-times daily for 14 days) in 60 cases with urinary tract symptoms showed superior results with oxolinic acid: 94% of pathogens were sensitive to oxolinic acid and 69% were sensitive to ampicillin. Sympotomatic relief and bacterial eradication occurred earlier in the oxolinic acid group.
