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Chapter 32 - Use of Botulinum Toxin in Musculoskeletal Pain and Arthritis
- Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
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- Book:
- Manual of Botulinum Toxin Therapy
- Published online:
- 02 November 2023
- Print publication:
- 23 November 2023, pp 260-268
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Summary
Osteoarthritis (OA) is the most common type of non-inflammatory arthritis that affects the aging population but can present at a younger age in those with trauma or obesity. Inflammatory arthritis (e.g., rheumatoid arthritis [RA] and gout) is characterized by swelling of the joint lining that leads to joint destruction and bony erosions when not optimally treated. The treatment of refractory joint pain remains a big challenge with few available therapeutic options, which include oral analgesics and anti-inflammatories, topical treatments, intra-articular therapies and physical therapy.
Several contraindications and common adverse events limit the long-term use of each medication.
This chapter reviews studies on the use of BoNT-A (onabotulinumtoxinA, ONA) for osteoarticular pain. Supported by pre-clinical laboratory evidence of anti-nociception, intra-articular BoNT seems to be efficacious for knee, shoulder, ankle and tennis elbow joint pain, based on RCT and systematic review data. Injection techniques for these joints are discussed, along with dosing recommendations and clear anatomical illustrations showing injection approach and placement.
Chapter 12 - ECT in Neuropsychiatric Disorders
- Edited by I. Nicol Ferrier, University of Newcastle upon Tyne, Jonathan Waite, University of Nottingham
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- Book:
- The ECT Handbook
- Published online:
- 27 June 2019
- Print publication:
- 04 July 2019, pp 96-108
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Summary
Electroconvulsive therapy (ECT) has long been used in the treatment of patients with neuropsychiatric disorders and continues to be a valuable option for a variety of conditions. The range of conditions for which ECT has been used is broad, but in many instances there is a common indication such as the treatment of psychosis, depression or catatonia occurring in conjunction with the primary neuropsychiatric presentation. Substantial, systematically acquired data supports the use of ECT in the functional psychoses (as set out in Chapters 3–11) but the complexity of additional underlying pathology prevents simple inferences being made about the efficacy of ECT in neuropsychiatric conditions. Regrettably, the evidence for ECT as a treatment for neuropsychiatric disorders is generally low grade, mostly comprising case reports, case series and retrospective and observational studies rather than double-blind randomised controlled trials.
Contributors
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- By Lenard A. Adler, Pinky Agarwal, Rehan Ahmed, Jagga Rao Alluri, Fawaz Al-Mufti, Samuel Alperin, Michael Amoashiy, Michael Andary, David J. Anschel, Padmaja Aradhya, Vandana Aspen, Esther Baldinger, Jee Bang, George D. Baquis, John J. Barry, Jason J. S. Barton, Julius Bazan, Amanda R. Bedford, Marlene Behrmann, Lourdes Bello-Espinosa, Ajay Berdia, Alan R. Berger, Mark Beyer, Don C. Bienfang, Kevin M. Biglan, Thomas M. Boes, Paul W. Brazis, Jonathan L. Brisman, Jeffrey A. Brown, Scott E. Brown, Ryan R. Byrne, Rina Caprarella, Casey A. Chamberlain, Wan-Tsu W. Chang, Grace M. Charles, Jasvinder Chawla, David Clark, Todd J. Cohen, Joe Colombo, Howard Crystal, Vladimir Dadashev, Sarita B. Dave, Jean Robert Desrouleaux, Richard L. Doty, Robert Duarte, Jeffrey S. Durmer, Christyn M. Edmundson, Eric R. Eggenberger, Steven Ender, Noam Epstein, Alberto J. Espay, Alan B. Ettinger, Niloofar (Nelly) Faghani, Amtul Farheen, Edward Firouztale, Rod Foroozan, Anne L. Foundas, David Elliot Friedman, Deborah I. Friedman, Steven J. Frucht, Oded Gerber, Tal Gilboa, Martin Gizzi, Teneille G. Gofton, Louis J. Goodrich, Malcolm H. Gottesman, Varda Gross-Tsur, Deepak Grover, David A. Gudis, John J. Halperin, Maxim D. Hammer, Andrew R. Harrison, L. Anne Hayman, Galen V. Henderson, Steven Herskovitz, Caitlin Hoffman, Laryssa A. Huryn, Andres M. Kanner, Gary P. Kaplan, Bashar Katirji, Kenneth R. Kaufman, Annie Killoran, Nina Kirz, Gad E. Klein, Danielle G. Koby, Christopher P. Kogut, W. Curt LaFrance, Patrick J.M. Lavin, Susan W. Law, James L. Levenson, Richard B. Lipton, Glenn Lopate, Daniel J. Luciano, Reema Maindiratta, Robert M. Mallery, Georgios Manousakis, Alan Mazurek, Luis J. Mejico, Dragana Micic, Ali Mokhtarzadeh, Walter J. Molofsky, Heather E. Moss, Mark L. Moster, Manpreet Multani, Siddhartha Nadkarni, George C. Newman, Rolla Nuoman, Paul A. Nyquist, Gaia Donata Oggioni, Odi Oguh, Denis Ostrovskiy, Kristina Y. Pao, Juwen Park, Anastas F. Pass, Victoria S. Pelak, Jeffrey Peterson, John Pile-Spellman, Misha L. Pless, Gregory M. Pontone, Aparna M. Prabhu, Michael T. Pulley, Philip Ragone, Prajwal Rajappa, Venkat Ramani, Sindhu Ramchandren, Ritesh A. Ramdhani, Ramses Ribot, Heidi D. Riney, Diana Rojas-Soto, Michael Ronthal, Daniel M. Rosenbaum, David B. Rosenfield, Durga Roy, Michael J. Ruckenstein, Max C. Rudansky, Eva Sahay, Friedhelm Sandbrink, Jade S. Schiffman, Angela Scicutella, Maroun T. Semaan, Robert C. Sergott, Aashit K. Shah, David M. Shaw, Amit M. Shelat, Claire A. Sheldon, Anant M. Shenoy, Yelizaveta Sher, Jessica A. Shields, Tanya Simuni, Rajpaul Singh, Eric E. Smouha, David Solomon, Mehri Songhorian, Steven A. Sparr, Egilius L. H. Spierings, Eve G. Spratt, Beth Stein, S.H. Subramony, Rosa Ana Tang, Cara Tannenbaum, Hakan Tekeli, Amanda J. Thompson, Michael J. Thorpy, Matthew J. Thurtell, Pedro J. Torrico, Ira M. Turner, Scott Uretsky, Ruth H. Walker, Deborah M. Weisbrot, Michael A. Williams, Jacques Winter, Randall J. Wright, Jay Elliot Yasen, Shicong Ye, G. Bryan Young, Huiying Yu, Ryan J. Zehnder
- Edited by Alan B. Ettinger, Albert Einstein College of Medicine, New York, Deborah M. Weisbrot, State University of New York, Stony Brook
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- Book:
- Neurologic Differential Diagnosis
- Published online:
- 05 June 2014
- Print publication:
- 17 April 2014, pp xi-xx
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Chapter 27 - The use of botulinum neurotoxin in musculoskeletal pain and arthritis
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- By Jasvinder A. Singh, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA, and Mayo Clinic College of Medicine, Rochester, MN, USA
- Edited by Daniel Truong, Dirk Dressler, Mark Hallett, Christopher Zachary
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- Book:
- Manual of Botulinum Toxin Therapy
- Published online:
- 05 February 2014
- Print publication:
- 23 January 2014, pp 233-242
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Summary
Prevalence and impact of arthritis
Arthritis affects nearly 50 million adults in the USA and is projected to increase in prevalence to 67 million adults, or 25% of those aged 18 years and older, by the year 2030 (Centers for Disease Control and Prevention, 2010a).
Arthritis is associated with significant healthcare and cost burden on society. In the USA alone, arthritis results in about 1 million annual hospitalizations (Helmick et al., 2008) and 44 million annual outpatient visits (American Academy of Orthopedic Surgeons, 2008). In 2003, the total cost of arthritis was $128 billion in the USA, including $81 billion in direct medical costs and $47 billion in indirect costs (lost earnings) (Centers for Disease Control and Prevention, 2007). Osteoarthritis alone is responsible for between $3.4 and $13.2 billion job-related costs each year (Buckwalter et al., 2004; Centers for Disease Control and Prevention, 2010b). Consequently, arthritis constitutes a public health problem associated with significant socioeconomic burden.
Osteoarthritis is the most common type of non-inflammatory arthritis that affects the aging population, but it can also present at a younger age in those with trauma or obesity. It primarily affects hands, knees and hips but can be generalized and affect other joint areas. It is characterized by cartilage lesions leading to symmetric narrowing of joint space, overproduction of bone leading to osteophytes and bony deformities. Inflammatory arthritis is characterized by swelling of the joint lining, which leads to joint destruction and bony erosions when not optimally treated. Two common types of inflammatory arthritis are rheumatoid arthritis and gout, which have predilection for different joints and have a different pathophysiology. Both are also associated with significant joint swelling, warmth and tenderness.
The Establishment of the GENEQOL Consortium to Investigate the Genetic Disposition of Patient-Reported Quality-of-Life Outcomes
- Mirjam A. G. Sprangers, Jeff A. Sloan, Ruut Veenhoven, Charles S. Cleeland, Michele Y. Halyard, Amy P. Abertnethy, Frank Baas, Andrea M. Barsevick, Meike Bartels, Dorret I. Boomsma, Cynthia Chauhan, Amylou C. Dueck, Marlene H. Frost, Per Hall, Pål Klepstad, Nicholas G. Martin, Christine Miaskowski, Miriam Mosing, Benjamin Movsas, Cornelis J. F. Van Noorden, Donald L. Patrick, Nancy L. Pedersen, Mary E. Ropka, Quiling Shi, Gen Shinozaki, Jasvinder A. Singh, Ping Yang, Ailko H. Zwinderman
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- Journal:
- Twin Research and Human Genetics / Volume 12 / Issue 3 / 01 June 2009
- Published online by Cambridge University Press:
- 21 February 2012, pp. 301-311
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To our knowledge, no comprehensive, interdisciplinary initiatives have been taken to examine the role of genetic variants on patient-reported quality-of-life outcomes. The overall objective of this paper is to describe the establishment of an international and interdisciplinary consortium, the GENEQOL Consortium, which intends to investigate the genetic disposition of patient-reported quality-of-life outcomes. We have identified five primary patient-reported quality-of-life outcomes as initial targets: negative psychological affect, positive psychological affect, self-rated physical health, pain, and fatigue. The first tangible objective of the GENEQOL Consortium is to develop a list of potential biological pathways, genes and genetic variants involved in these quality-of-life outcomes, by reviewing current genetic knowledge. The second objective is to design a research agenda to investigate and validate those genes and genetic variants of patient-reported quality-of-life outcomes, by creating large datasets. During its first meeting, the Consortium has discussed draft summary documents addressing these questions for each patient-reported quality-of-life outcome. A summary of the primary pathways and robust findings of the genetic variants involved is presented here. The research agenda outlines possible research objectives and approaches to examine these and new quality-of-life domains. Intriguing questions arising from this endeavor are discussed. Insight into the genetic versus environmental components of patient-reported quality-of-life outcomes will ultimately allow us to explore new pathways for improving patient care. If we can identify patients who are susceptible to poor quality of life, we will be able to better target specific clinical interventions to enhance their quality of life and treatment outcomes.