Botulinum toxin in gastric submucosa reduces stimulated HCl production in rats

BACKGROUND: Botulinum toxin blocks acetylcholine release from nerve endings and acts as a long term, reversible inhibitor of muscle contraction as well as of salivary, sweat gland, adrenal and prostatic secretions. The aim of the present study is to investigate whether gastric submucosal injection of botulinum toxin type A reduces stimulated gastric production of HCl. METHODS: Sixty-four rats were randomized in two groups and laparotomized. One group was treated with botulinum toxin-A 10 U by multiple submucosal gastric injections, while the second group was injected with saline. Two weeks later, acid secretion was stimulated by pyloric ligation and acid output was measured. Body weight, food and water intake were also recorded daily. RESULTS: HCl production after pyloric ligation was found to be significantly lower in botulinum toxin-treated rats (657 ± 90.25 micromol HCl vs. 1247 ± 152. P = 0.0017). Botulinum toxin-treated rats also showed significantly lower food intake and weight gain. CONCLUSIONS: Botulinum toxin type A reduces stimulated gastric acidity. This is likely due either to inhibition of the cholinergic stimulation of gastric parietal cells, or to an action on the myenteric nervous plexuses. Reduction of growth and food intake may reflect both impaired digestion and decreased gastric motility

Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients

Borreliosis as a cause of peripheral facial palsy: a multi-center study

Borreliosis is known to be a common cause of peripheral facial palsy in Stockholm and its vicinity. The aim of the present study was to investigate the frequency and characteristics of borreliosis among patients with peripheral facial palsy in different parts of Sweden. All serological tests were performed in one laboratory. Ten Swedish Ear Nose and Throat clinics participated in a prospective 1-year study of patients seeking medical attention for acute peripheral facial palsy. Twenty-eight (6%) out of totally 446 patients fulfilled the criteria for the diagnosis of borreliosis. The frequency varied between 1 and 16% and was highest along the southeast coast of Sweden whereas no case was reported from the northern part of the country. Borreliosis was more common among children with facial palsy than among adults. The infection occurred during all seasons although it appears to be less frequent during the spring months. Only a minority of the borrelial patients had a history of a preceding tick bite or erythema migrans. The fairly low overall frequency of this secondary stage of borreliosis in the study may be a result of better knowledge of the disease and earlier treatment of its early manifestations. In Sweden's endemic areas borreliosis is a common cause of peripheral facial palsy, and therefore all patients with facial palsy in these regions should be examined for borrelial infection

Lyme Neuroborreliosis - Diagnosis and Treatment

Lyme neuroborreliosis, the infection of the nervous system by the tick-borne bacterium Borrelia burgdorferi, is a common infection in the temperate parts of the Northern hemisphere. Manifestations of the disease include facial palsy, radicular pain, sensory disturbances, and occasionally CNS symptoms such as confusion and paraparesis. The diagnosis of Lyme neuroborreliosis is based on medical history, clinical examination and cerebrospinal fluid (CSF) analysis. Recommended antibiotic treatment is oral doxycycline or intravenous ceftriaxone. The overall aims of this thesis were to improve the diagnosis and treatment of Lyme neuroborreliosis. In paper I, 102 patients with peripheral facial palsy were studied. Onset of symptoms in July to October, additional neurological symptoms and CSF pleocytosis were factors that discriminate patients with peripheral facial palsy caused by Lyme neuroborreliosis from patients with Bell’s palsy. In paper II, it was shown that CSF levels of the chemokine CXCL13 are highly elevated in Lyme neuroborreliosis and that levels decline after treatment, but high and overlapping CXCL13 levels were also seen in patients with asymptomatic HIV-infection and the decrease in CXCL13 is correlated to the decrease in CSF cell count. The additional diagnostic value of CXCL13 analysis is therefore limited. In paper III, new reference ranges for CSF cell counts when analyzed with automatic cell counters were determined, based on CSF sampling of 80 healthy volunteers. The differentiation of mononuclear cells into lymphocytes and monocytes was shown to be of limited value in the discrimination between Lyme neuroborreliosis and viral CNS infections. In paper IV, it was shown that treatment with oral doxycycline resulted in a similar decrease in CSF mononuclear cell counts in patients with Lyme neuroborreliosis with CNS symptoms compared with patients with peripheral nervous systems symptoms, and that all patients with CNS symptoms improved on treatment with no need for retreatment. Oral doxycycline can therefore be considered an effective treatment for Lyme neuroborreliosis, irrespective of the severity of symptoms

Paralisia facial periférica em Petrópolis

O autor apresenta 83 casos de paralisia facial periférica «a frigore» ocorridos em Petrópolis, cidade montanhosa de clima tropical, sem estação seca, com média de temperatura 10ºC a 23ºC. Faz relação delas com viroses que ocorrem durante o ano. Cinquenta e seis pacientes são de sua clínica e têm «follow up», enquanto 25 outros são pacientes de outra clínica, para os quais são relatados apenas o início de instalação da paralisia, o sexo, o lado e a idade. Mostra que a maior incidência ocorreu nos meses de maio, agosto, setembro e outubro. Faz também considerações sobre a etiologia, incidência, prevalência, conduta, terapêutica e resultados na paralisia facial periférica