How does botulinum toxin work beyond cosmetic use. What medical conditions can it treat. Is botulinum toxin safe for therapeutic applications. What are the potential side effects of botulinum toxin injections. Who should avoid botulinum toxin treatments.

The Surprising Versatility of Botulinum Toxin in Medicine

Botulinum toxin, commonly associated with wrinkle reduction, has emerged as a versatile treatment option for various medical conditions. While its cosmetic applications under brand names like Botox, Xeomin, and Dysport are well-known, the therapeutic potential of this powerful neurotoxin extends far beyond aesthetics.

Originally developed for treating eye disorders, botulinum toxin injections have since found applications in numerous medical fields. This potent substance, produced by certain bacteria, works by blocking nerve signals that cause muscle contractions. By selectively targeting specific muscle groups, botulinum toxin can effectively treat conditions characterized by excessive muscle activity or involuntary movements.

How does botulinum toxin work in the body?

Botulinum toxin functions by interfering with the release of acetylcholine, a neurotransmitter responsible for muscle contraction. When injected into a specific area, it temporarily paralyzes the targeted muscles, leading to relaxation and reduced activity. This mechanism of action makes it particularly useful in treating conditions involving muscle spasms, excessive sweating, and certain types of pain.

Medical Conditions Treated with Botulinum Toxin

The therapeutic applications of botulinum toxin have expanded significantly over the years. Here are some of the key medical conditions that can benefit from this treatment:

• Chronic migraines
• Cervical dystonia (neck muscle spasms)
• Blepharospasm (eyelid spasms)
• Strabismus (crossed eyes)
• Hyperhidrosis (excessive sweating)
• Overactive bladder
• Muscle spasticity in conditions like cerebral palsy
• Temporomandibular joint (TMJ) disorders

Can botulinum toxin help with endometriosis-related pain?

Recent research has shown promising results in using botulinum toxin to manage pain associated with endometriosis. Dr. Pamela Stratton and Dr. Barbara Karp from the National Institutes of Health conducted a small proof-of-concept study that demonstrated improvements in pelvic pain for women with endometriosis following botulinum toxin injections. This innovative application could offer relief to patients who haven’t responded to conventional treatments like hormone therapy or surgery.

Safety Profile and Administration of Botulinum Toxin

Despite its reputation as a potent toxin, botulinum toxin has a remarkably good safety profile when used in medical settings. The key to its safe use lies in precise administration and dosage control.

How is botulinum toxin safely administered for medical purposes?

Botulinum toxin treatments involve the use of very small, carefully measured amounts of the toxin. These are injected directly into the target site, ensuring that the effects remain localized to the intended area. When administered by trained healthcare professionals, the risk of systemic effects is minimal.

It’s crucial to receive botulinum toxin treatments from licensed and experienced healthcare providers who are familiar with its use for your specific condition. This helps minimize the risk of complications and ensures optimal therapeutic outcomes.

Potential Side Effects and Precautions

While botulinum toxin is generally well-tolerated, it’s important to be aware of potential side effects and necessary precautions.

What are the common side effects of botulinum toxin injections?

Most side effects associated with botulinum toxin treatments are mild and temporary. These may include:

• Pain or bruising at the injection site
• Mild headaches
• Flu-like symptoms
• Temporary muscle weakness in the treated area

These effects typically resolve on their own within a few days to weeks after treatment.

Are there any serious risks associated with botulinum toxin use?

While rare, more serious complications can occur if the toxin spreads beyond the treatment site. This can lead to:

• Generalized muscle weakness
• Vision problems
• Difficulty speaking or swallowing
• Breathing difficulties

To minimize these risks, it’s crucial to follow your healthcare provider’s instructions carefully and report any unusual symptoms promptly.

Contraindications and Special Considerations

Certain individuals should avoid botulinum toxin treatments or use them with caution. Understanding these contraindications is essential for patient safety.

Who should not receive botulinum toxin injections?

Botulinum toxin treatments are generally not recommended for:

• Pregnant or breastfeeding women
• Individuals with neuromuscular disorders (e.g., myasthenia gravis)
• Those with known allergies to any components of the botulinum toxin formulation
• Patients taking certain medications that may interact with botulinum toxin

It’s crucial to discuss your complete medical history and current medications with your healthcare provider before considering botulinum toxin treatment.

The Future of Botulinum Toxin in Medicine

As research continues, the potential applications of botulinum toxin in medicine are likely to expand further. Scientists are exploring its use in treating a wide range of conditions, from depression to Parkinson’s disease.

What new applications for botulinum toxin are being researched?

Ongoing studies are investigating the use of botulinum toxin for:

• Chronic pain conditions
• Mood disorders
• Gastrointestinal disorders
• Wound healing
• Neuropathic pain

These potential applications highlight the versatility of botulinum toxin and its ability to address a diverse array of medical challenges.

Patient Experience and Treatment Expectations

Understanding what to expect from botulinum toxin treatment can help patients make informed decisions and set realistic expectations.

How long do the effects of botulinum toxin treatments typically last?

The duration of botulinum toxin effects can vary depending on the condition being treated and individual factors. Generally, results may last:

• 3-6 months for cosmetic applications
• 3-12 months for medical conditions, such as chronic migraines or hyperhidrosis
• Up to 12-18 months for some neurological conditions

Repeat treatments are often necessary to maintain the therapeutic effects. Your healthcare provider can give you a more precise estimate based on your specific situation.

What should patients consider before opting for botulinum toxin treatment?

Before deciding on botulinum toxin treatment, consider the following:

• The nature and severity of your condition
• Alternative treatment options available
• Potential risks and benefits
• Cost and insurance coverage
• The expertise of your healthcare provider
• Your overall health status and medical history

A thorough discussion with your healthcare provider can help you make an informed decision about whether botulinum toxin treatment is right for you.

Navigating the World of Botulinum Toxin Products

With several botulinum toxin products available on the market, it’s important to understand their differences and similarities.

How do different botulinum toxin brands compare?

While all botulinum toxin products work similarly, there are some differences in formulation, dosing, and approved indications. The main brands include:

• Botox (onabotulinumtoxinA)
• Dysport (abobotulinumtoxinA)
• Xeomin (incobotulinumtoxinA)
• Jeuveau (prabotulinumtoxinA)
• Myobloc (rimabotulinumtoxinB)

Your healthcare provider will determine the most appropriate product based on your specific needs and the condition being treated.

Are there significant differences in effectiveness between botulinum toxin brands?

While there may be slight differences in onset of action, duration of effect, and spread of the toxin, all FDA-approved botulinum toxin products are considered effective when used appropriately. The choice of product often depends on the provider’s experience, the specific indication, and individual patient factors.

It’s important to note that botulinum toxin units are not interchangeable between different brands, so dosing must be carefully adjusted when switching products.

The Importance of Professional Administration

The safe and effective use of botulinum toxin relies heavily on the skill and experience of the administering healthcare professional.

Why is it crucial to receive botulinum toxin treatments from a qualified provider?

Proper administration of botulinum toxin requires:

• Thorough knowledge of facial and body anatomy
• Understanding of appropriate dosing for different conditions
• Skill in injection techniques
• Ability to manage potential complications
• Experience in tailoring treatments to individual patient needs

Choosing a qualified and experienced provider ensures optimal results and minimizes the risk of adverse effects.

How can patients find a reputable botulinum toxin provider?

To find a qualified provider for botulinum toxin treatments:

• Seek referrals from your primary care physician or specialist
• Check the credentials and experience of potential providers
• Look for board-certified physicians in relevant specialties (e.g., dermatology, plastic surgery, neurology)
• Read patient reviews and testimonials
• Schedule consultations to discuss your needs and assess the provider’s approach

Remember that the cheapest option is not always the safest or most effective. Prioritize quality and expertise when choosing a botulinum toxin provider.

As research continues to uncover new applications for botulinum toxin, its role in medicine is likely to expand further. From treating chronic pain conditions to managing neurological disorders, this versatile neurotoxin has proven to be a valuable tool in the medical arsenal. While its cosmetic uses may have brought it into the spotlight, the therapeutic potential of botulinum toxin extends far beyond wrinkle reduction. As with any medical treatment, it’s essential to approach botulinum toxin therapy under the guidance of qualified healthcare professionals, weighing the potential benefits against the risks for each individual case. With proper use and ongoing research, botulinum toxin will continue to offer new possibilities for improving patient care and quality of life across a wide spectrum of medical conditions.

The Benefits of Botulinum Toxin

July 2023

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It’s Not Just for Wrinkles

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Botulinum toxin injections are well-known for their use smoothing out wrinkles. They’re available under brand names such as Botox, Xeomin, Dysport, Myobloc, and Jeuveau. While wrinkle removal is the most common use, it’s not the only one.

The first use for botulinum toxin injections came out decades ago. It was for treating certain eye problems. Since then, doctors have been finding that the injections can help treat all kinds of conditions.

Botulinum toxin is a poisonous substance that’s made by certain bacteria. It’s actually one of the most potent toxins found in nature. It causes botulism, a rare but potentially lethal form of food poisoning.

It may sound odd that something so dangerous could be helpful. But the very properties that make botulinum toxin dangerous also make it useful. It works by blocking the nerve signals that tell muscles to tighten, or contract. When this happens in the muscles that control breathing, it can cause you to suffocate. But some medical conditions involve muscles contracting too much or at the wrong time. Botulinum toxin injections can treat these conditions by forcing the muscles to relax.

Botulinum toxin can also relieve certain kinds of pain. It’s been shown to relieve a recurring type of headache called chronic migraines. It can block your body’s ability to make sweat and saliva, too. So, it can treat conditions in which your body makes too much of either of these. See the Wise Choices box for more about the conditions that botulinum toxin is used to treat.

Two NIH researchers, Dr. Pamela Stratton and Dr. Barbara Karp, have been studying botulinum toxin for treating pain associated with endometriosis. Endometriosis is when tissue normally found in the uterus grows outside it. This causes pain in the pelvic area. It’s usually treated with hormones or surgery to remove the abnormal tissue. But sometimes the pain remains even after these treatments. In a small, proof-of-concept study of women with endometriosis, Stratton and Karp found that botulinum toxin injections helped improve the pain.

Botulinum toxin treatments use very small amounts of the toxin, and only at the treatment site. When used properly, the injections only affect the muscle or organ being treated.

Side effects are usually mild. They can include pain where the toxin is injected, mild headaches, or flu-like symptoms. These usually clear up on their own. “It’s remarkably safe for a deadly toxin,” Karp says.

That being said, botulinum toxin isn’t risk-free. If it’s not given properly, the toxin might spread beyond the treatment site. Then it can affect other muscles in the body that you don’t want it to. This could cause muscle weakness or vision problems, or make it harder to talk, swallow, or even breathe. Because of this risk, always get botulinum toxin treatments from a licensed health care provider who has experience using it for your condition.

People who have certain health conditions shouldn’t get botulinum toxin injections. And it’s not recommended for people who are pregnant or breastfeeding. If you’re considering botulinum toxin treatment, talk with your health care professional. They can confirm if the treatment could help you and guide you to an experienced provider. They can also tell you if there are any reasons you shouldn’t get the treatment.

NIH Office of Communications and Public Liaison
Building 31, Room 5B52
Bethesda, MD 20892-2094
[email protected]
Tel: 301-451-8224

Editor: Harrison Wein, Ph.D.
Managing Editor: Tianna Hicklin, Ph.D.
Illustrator: Alan Defibaugh

Attention Editors: Reprint our articles and illustrations in your own publication. Our material is not copyrighted. Please acknowledge NIH News in Health as the source and send us a copy.

For more consumer health news and information, visit health. nih.gov.

For wellness toolkits, visit www.nih.gov/wellnesstoolkits.

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Through the air – (aerogenic, airborne way). About 50% of newly diagnosed patients emit the causative agent of tuberculosis into the environment when talking, coughing, sneezing. If a patient has an open form of tuberculosis, then a drop of his sputum may contain up to 2-3 million bacteria. Aerosol with tiny particles of sputum for a long time can be in the air and be a source of infection. If a person with TB is not treated, they can infect 10 to 15 people a year.
When consuming dairy products from tuberculosis-infected cattle (food route).
Intrauterine infection of the fetus with tuberculosis in pregnant women (extremely rare).

Factors contributing to the development of the disease:

• insufficient and improper nutrition
• 
  overwork, hypothermia, nervous stress
• 
  bad habits (smoking, alcohol, drug addiction)
• HIV infection
• 
  the presence of chronic diseases (diabetes mellitus, lung disease, peptic ulcer
• 
  stomach and duodenum).

The risk of developing the disease depends on individual sensitivity to Mycobacterium tuberculosis, as well as on the state of the body’s immune system. The most susceptible to tuberculosis are young children, whose defenses are not yet developed.

How the disease manifests itself, the main symptoms.

• Prolonged cough (more than three weeks) or coughing up sputum, possibly blood.
• 
  Pain in the chest.
• Loss of appetite, weight loss.
• 
  Increased sweating (especially at night).
• 
  General malaise and weakness.
• Periodic slight increase in body temperature (37.2° – 37.4°C).

How to prevent the disease, preventive measures.

• Anti-tuberculosis vaccination of children under 1 year old (3-5 days of a child’s life).
• Annual x-ray examination.
• Implementation of a set of measures that increase the body’s defenses: proper nutrition, a rational regime of work and rest, the rejection of bad habits, hardening, physical education.
• Compliance with the rules of personal hygiene.
• Carrying out measures to improve the living and working environment y (reduction of crowding and dustiness of premises, improvement of ventilation).
• Early detection of patients with tuberculosis and their treatment.

Take care of your health and the health of your loved ones!

You need to know!

MENINGOCOCCAL INFECTION IS A DANGEROUS DISEASE!

Meningococcal infection is one of the most severe childhood infections. Most often, children under 14 years of age get sick, of which children of the first two years of life, who have insufficient immunity, predominate.

Meningococcal infection is characterized by the ease of spread of the disease, mainly by airborne droplets (when coughing, sneezing, talking, with fairly close and prolonged communication).
The insidiousness of this infection is that the initial clinical manifestations of the disease resemble a cold or flu.

The danger of the disease is that it can develop in a matter of hours and even minutes, the so-called “lightning-fast” forms of the disease, and it is not always possible to save the patient.
Generalized forms of meningococcal infection are characterized by an acute and violent onset against the background of complete health. In this case, the disease begins suddenly. For example, a child goes to bed perfectly healthy, and at night he suddenly becomes restless, feels muscle weakness. If verbal contact is possible with the child, he will complain of a severe headache that is not relieved by conventional painkillers. Within an hour, the temperature usually rises to 39-40 °, after 5-6 hours vomiting occurs, which does not bring relief to the patient. But the most formidable symptom that you should definitely pay attention to is a rash that appears on the limbs, buttocks, lateral surfaces of the body, which does not disappear with pressure.

What you need to know to avoid getting meningococcal disease:

in the event of the first symptoms of meningococcal disease n you need to immediately call an ambulance and quickly take the patient to the hospital;
it is necessary to regularly ventilate the room, carry out wet cleaning with the use of disinfectants, use bactericidal lamps to disinfect the air;
observe personal and public hygiene when coughing and sneezing;
it is recommended to walk more with the child in the open air, to avoid traveling in public transport;
eat a nutritious and balanced diet;
play sports, hardening the body.

Parents should remember that young children should be protected as much as possible from communication with a large number of people!

You can’t go with them to markets, to shops where it’s crowded, there are a lot of people, to visit, etc. It has already been noted that often children fall ill 4-5 days after the parents celebrate the first birthday of the child, christening or other family holidays. Unfortunately, many parents are not fully aware of the danger of the disease, and therefore refuse qualified medical care.

Given the sudden onset and severity of meningococcal disease, it is necessary at the first signs of it to seek medical help as soon as possible, the results of successful treatment and a favorable outcome of the disease will depend on this!

CONSEQUENCES OF CHLAMYDIOSIS IN WOMEN.

Chlamydia is an infectious disease caused by the microorganism Chlamydia. It is one of the most common sexually transmitted diseases.
At the age of 15-19 years, chlamydial infection of the genitourinary system is diagnosed in 46% of people, at the age of 20-24 years – in 30%.
The incidence rate is quite high not only among the adult population and adolescents who have an active sex life, but also among young children.
The causative agent – chlamydia trachomatis – is not a simple bacterium, but an intracellular parasite, which means that it does not lead to the appearance of obvious clinical signs and is not always treatable. In 75% of women, an asymptomatic course was noted, and in adolescents in 30-40% – a latent course of infection.
The source is a person with an acute or chronic form of the disease. Ways of transmission – sexual (main), contact-household (rarely), vertical (from mother to fetus).
In infertile marriages, 50-55% of men are sterile, of which approximately 64% are caused by infection with chlamydia, which, by affecting spermatozoa, prevents fertilization.

In pregnant women, early chlamydial infection can lead to miscarriages and missed pregnancies. For later terms, the threat of termination of pregnancy, premature birth are characteristic. Infected women in 40-60% of cases transmit the infection to newborns.

More than half of women of reproductive age with chlamydia have a latent form, and as a result, inflammation of the fallopian tubes and their blockage, which leads to ectopic pregnancy, infertility, and unsuccessful attempts at in vitro fertilization.
Thus, timely and high-quality laboratory diagnosis of both overt and chronic forms is of paramount importance.

For all questions regarding laboratory diagnostics

urogenital chlamydia, you can contact the laboratory for the diagnosis of viral and especially dangerous infections

Gomel regional CGE and OZ

by phone 75-69-16.

WHAT IS UREAPLASMA TERRIBLE?

Unicellular microorganisms ureaplasma are the causative agents of such a disease as ureaplasmosis. Ureaplasmas can provoke inflammation of any parts of the genitourinary tract: in men – the bladder, urethra, prostate, testicles and their appendages, and in women – inflammation of the vagina, uterus and appendages, damage to the fallopian tubes, leading to infertility. In addition, ureaplasmas can be fixed on spermatozoa and disrupt their motor activity, and in some cases simply destroy them, which also leads to infertility.
In the body of a healthy person, ureaplasma can be in a small amount and not cause any pathology. In some diseases, an increase in the number of this bacterium can occur, which leads to the development of the disease. A particularly dangerous condition that provokes ureaplasma is the urethral canal syndrome. The condition is characterized by difficulty urinating, frequent and bloody discharge. In the chronic course of infection, clinical manifestations may not be observed.
Transmission of infection occurs mainly through sexual contact, but intrauterine infection from a sick mother during childbirth is also possible. Also, children often become infected from their parents in early childhood through everyday contact. Ureaplasma does not cause malformations in the fetus, but it can cause miscarriages, premature births, polyhydramnios and placental insufficiency – a condition in which the baby lacks oxygen and nutrients.
Ureaplasma carriers are about half of women. They are less common in men. In men, self-healing is possible. For laboratory diagnostics, various methods are used that allow not only to decide which infection provokes diseases of the urogenital area, but also to correctly treat the pathology, to detect pathogens even in the early stages. The most qualitative examination method is the polymerase chain reaction (PCR), which makes it possible to detect even one bacterium or virus.
If you are cured and your sexual partner is not, you can easily get re-infected. It is very important to tell your sexual partners about the disease, even if nothing bothers them, and to convince them to undergo examination and treatment.

If you have any questions about the laboratory diagnosis of ureaplasmosis, you can contact the laboratory

diagnostics of viral and especially dangerous infections

Gomel regional CGE and health center by phone 75-69-16, 75-03-00.

Insidious virus!

UNPLEASANT HERPES VIRUSES.

Probably, many people have experienced various manifestations of herpes. Appearing in the body once, it remains there forever (penetrates the nerve cells and remains there). If the immune system is weakened, then the viruses are activated, and then multiply, thereby causing an exacerbation. According to experts, more than 95% of the world’s population are carriers of HSV (herpes simplex virus).
In most cases, when herpes is mentioned in everyday life, they mean viruses of the first and second types (HSV). Currently, both types of virus are capable of infecting the mucous membranes of the mouth and genitals.
According to WHO, genital herpes ranks third among sexually transmitted diseases. Genital herpes is an extremely unpleasant disease that causes a sick patient a lot of inconvenience and serious problems, including social and psychological ones. The risk of contracting herpes increases with age. By the number of carriers of herpes, the most numerous age categories are 20-29years and 35-40 years.
And of course, the more sexual partners a person has, especially casual ones, the more he is at risk of contracting herpes.
The transmission of herpes simplex occurs through direct contact between two people (handshakes, kisses, hugs, contact sports, even a fight), during sexual contact. Children become infected by household means, using common utensils, food or clothing, by airborne droplets, when next to him a person with a recurrence of herpes on the lips sneezes or talks loudly, from the mother during childbirth or pregnancy.

The most well-known sign of the presence of HSV in the body is the well-known “cold on the lips” – a rash of blisters with a clear liquid on the lips. Genital herpes is manifested by small swelling in the groin, numbness and pulling pains in the hips and lower back, in some cases the temperature rises, and the patient suffers from general malaise, bubbles with liquid appear. In addition, herpes can affect: fingers, eyes and eyelids, the brain and its membranes.
The most numerous consequences of infection with herpes in children. They begin to become infected already at the age of six months, and their disease is even more pronounced than in adults. In this case, the consequences of infection in a child can be: herpetic encephalitis and meningitis, herpetic stomatitis and gingivitis, and liver damage.
In addition, with the development of herpes in infants, a violation of the heart is sometimes diagnosed, which in the future can persist and develop into chronic myocarditis.
Genital herpes is extremely dangerous for pregnant women: 30% of spontaneous abortions and 50% of late miscarriages are due to herpes. In the future, herpes in a newborn in more than half of the cases leads to the development of encephalitis. In addition, the herpes simplex virus is considered the second most dangerous virus for the development of deformity in a child after the rubella virus.

Diagnosis of HSV is currently carried out in two directions:

• PCR diagnostics to determine the presence of the virus (its DNA) in the body.
• ELISA diagnostics (detection of specific antibodies to the herpes virus in blood serum).

In general, most modern means of preventing and treating genital herpes can significantly reduce both the risk of infection with it and the strength of its manifestations. However, it is always better to avoid the disease than to treat it later. Therefore, mutual fidelity, moral purity and a healthy lifestyle are the most reliable ways of prevention!

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ONCOGENIC HPV (HUMAN PAPILLOMA VIRUS).

Human papillomaviruses (HPV) have been known to mankind for more than a millennium, causing damage to the skin and mucous membranes. Under the name “warts” they were described by the doctors of ancient Greece. However, human papillomavirus infection acquired particular relevance at the end of the 20th century, due to its unprecedented spread. Currently, HPV infection in the population is 20-60%.
The infection is transmitted mainly through sexual contact, as well as contact-household, from mother to child during pregnancy and childbirth during passage through the infected birth canal. The incubation period is from 1 to 6 months.
To date, more than 120 types of HPV are known, which are divided into two groups: high and low oncogenic risk. Infection caused by types of low oncogenic risk often occurs in the form of benign lesions of the skin and mucous membranes: warts, warts, papillomas of the larynx.
A terrible result of an infection caused by a virus of high oncogenic risk can often be cancer of the cervix, vulva, vagina, and perianal region.
Cervical cancer is the second most common malignant disease in women: more than 500,000 new cases are registered annually in the world. The period of time from the moment of infection with the virus to the development of the disease varies from 5 to 20 years. Therefore, a significant place in the prevention of cervical cancer should be occupied by research to determine the presence of HPV infection and precancerous changes in the early stages of the disease.

Laboratory for the diagnosis of viral and especially dangerous infections of the Gomel Regional Center for Health and Health

conducts a laboratory examination to identify high oncogenic risk HPV.