Image_1_High Anal Canal Pressure and Rectal Washouts Contribute to the Decrease of Anal Basal Pressure After Botulinum Toxin Injections in Paediatric Patients With Chronic Constipation.JPEG

IntroductionChronic constipation can be treated by injecting botulinum toxin into the anal sphincter to decrease anal basal pressure. To assess the effect of botulinum toxin, we investigated the factors that contribute to changes in anal basal pressure after injection.MethodsThis was a retrospective study conducted in a tertiary hospital in the Netherlands. We included children with chronic constipation treated with botulinum toxin injections and measured anal basal pressure before and after each injection. Multivariable linear regression analyses were used.ResultsWe investigated 30 cases with idiopathic constipation. Their median age was 20.5 (7.75–53.25) months. Anal basal pressure decreased after injection in 20 cases. The mean decrease of anal basal pressure after injection was 18.17 ± 35.22 mmHg. The anal basal pressure change was linearly correlated with preinjection pressure (R2 = 0.593, P 70 mmHg. Preinjection anal basal pressure (β = −0.913, P ConclusionsBotulinum toxin significantly decreases anal basal pressure when preinjection pressure is higher than 70 mmHg. In patients with severely elevated anal basal pressure, we recommend rectal washouts to promote the decrease of anal basal pressure.</p

Table_1_High Anal Canal Pressure and Rectal Washouts Contribute to the Decrease of Anal Basal Pressure After Botulinum Toxin Injections in Paediatric Patients With Chronic Constipation.DOCX

IntroductionChronic constipation can be treated by injecting botulinum toxin into the anal sphincter to decrease anal basal pressure. To assess the effect of botulinum toxin, we investigated the factors that contribute to changes in anal basal pressure after injection.MethodsThis was a retrospective study conducted in a tertiary hospital in the Netherlands. We included children with chronic constipation treated with botulinum toxin injections and measured anal basal pressure before and after each injection. Multivariable linear regression analyses were used.ResultsWe investigated 30 cases with idiopathic constipation. Their median age was 20.5 (7.75–53.25) months. Anal basal pressure decreased after injection in 20 cases. The mean decrease of anal basal pressure after injection was 18.17 ± 35.22 mmHg. The anal basal pressure change was linearly correlated with preinjection pressure (R2 = 0.593, P 70 mmHg. Preinjection anal basal pressure (β = −0.913, P ConclusionsBotulinum toxin significantly decreases anal basal pressure when preinjection pressure is higher than 70 mmHg. In patients with severely elevated anal basal pressure, we recommend rectal washouts to promote the decrease of anal basal pressure.</p

Image_2_High Anal Canal Pressure and Rectal Washouts Contribute to the Decrease of Anal Basal Pressure After Botulinum Toxin Injections in Paediatric Patients With Chronic Constipation.JPEG

IntroductionChronic constipation can be treated by injecting botulinum toxin into the anal sphincter to decrease anal basal pressure. To assess the effect of botulinum toxin, we investigated the factors that contribute to changes in anal basal pressure after injection.MethodsThis was a retrospective study conducted in a tertiary hospital in the Netherlands. We included children with chronic constipation treated with botulinum toxin injections and measured anal basal pressure before and after each injection. Multivariable linear regression analyses were used.ResultsWe investigated 30 cases with idiopathic constipation. Their median age was 20.5 (7.75–53.25) months. Anal basal pressure decreased after injection in 20 cases. The mean decrease of anal basal pressure after injection was 18.17 ± 35.22 mmHg. The anal basal pressure change was linearly correlated with preinjection pressure (R2 = 0.593, P 70 mmHg. Preinjection anal basal pressure (β = −0.913, P ConclusionsBotulinum toxin significantly decreases anal basal pressure when preinjection pressure is higher than 70 mmHg. In patients with severely elevated anal basal pressure, we recommend rectal washouts to promote the decrease of anal basal pressure.</p

Funnel plots of high-TMB versus low-TMB in immunotherapy-treated NSCLC for PFS (A), OS (B) and ORR (C).

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Survival and response outcomes in meta-analysis of immunotherapy versus chemotherapy in NSCLC patients with high or low TMB.

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Baseline characteristics of studies in meta-analysis comparing immunotherapy with chemotherapy in NSCLC patients with high or low TMB.

Baseline characteristics of studies in meta-analysis comparing immunotherapy with chemotherapy in NSCLC patients with high or low TMB.</p

Meta-regression analysis of high-TMB versus low-TMB in immunotherapy-treated NSCLC for associations between sample size and PFS (A), OS (B) and ORR (C).

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Forest plots of PFS, OS and ORR in subgroup analyses according to various TMB thresholds.

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Sensitivity analysis of immunotherapy versus chemotherapy in NSCLC patients with high or low TMB.

(A) PFS in high-TMB patients; (B) PFS in low-TMB patients; (C) OS in high-TMB patients; (D) OS in low-TMB patients; (E) ORR in high-TMB patients; (F) ORR in low-TMB patients. (TIF)</p

Baseline characteristics of studies in meta-analysis comparing high TMB group with low TMB group in NSCLC patients receiving immunotherapy.

Baseline characteristics of studies in meta-analysis comparing high TMB group with low TMB group in NSCLC patients receiving immunotherapy.</p