A practical booklet for ultrasound-guided botulinum toxin injections

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon Pub Date : 2025-02-06 DOI:10.1016/j.toxicon.2025.108287

Stefano Carda , Rajiv Reebye

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引用次数: 0

Abstract

In the last 15 years, the use of ultrasound to guide botulinum neurotoxin type A injections has been advocated by many authors, with growing evidence showing the benefits of using ultrasound guidance to improve the efficacy of injections.

Patients with spasticity may show severely altered postures, atrophy and fibrotic modifications of target muscles, leading to significant challenges in recognising and differentiating between the muscles to be injected or not. At present time, there are no available books with images that clarify how to identify and inject muscles in patients showing these problems.

Another problem we considered is the accessibility, from an economic standpoint, of medical books for clinicians in low-income countries.

We have created a practical booklet to help clinicians acquire the confidence and expertise needed to administer US-guided injections in patients with severe spasticity, combining the experience of more than 10 years in training clinicians in ultrasound-guided injections. We utilised our experience to create a method that offers a consistent way to recognise muscles, even in challenging conditions.

The aim of our booklet is to offer a reliable technique for identify and target muscles in patients with altered muscular structure and pathological postures due to spasticity, relying on easily identifiable anatomical structures such as bones, vessels or nerves, or “iconic” patterns that can easily be learned and remembered.

We have provided images and anatomical schemes, as well as ergonomic clinical pearls, to help clinicians providing reliable ultrasound-guided injections.

To reduce barriers to education, this booklet is be distributed for free without any royalties.

查看原文本刊更多论文

超声引导下肉毒杆菌毒素注射实用手册。

在过去的15年中，许多作者都提倡使用超声指导A型肉毒杆菌神经毒素注射，越来越多的证据表明使用超声指导可以提高注射效果。痉挛患者可能表现出严重的姿势改变，目标肌肉萎缩和纤维化改变，导致识别和区分需要注射或不需要注射的肌肉的重大挑战。目前，还没有可用的带有图像的书籍来阐明如何识别和注射出现这些问题的患者的肌肉。我们考虑的另一个问题是，从经济角度来看，低收入国家的临床医生能否获得医学书籍。我们制作了一本实用的小册子，以帮助临床医生获得对严重痉挛患者进行超声引导注射所需的信心和专业知识，并结合10多年来培训临床医生进行超声引导注射的经验。我们利用我们的经验创造了一种方法，即使在具有挑战性的条件下，也能提供一致的方法来识别肌肉。我们的小册子的目的是提供一种可靠的技术，以识别和目标肌肉的患者改变肌肉结构和病理姿势，由于痉挛，依靠容易识别的解剖结构，如骨骼，血管或神经，或“标志性”模式，很容易学习和记忆。我们提供了图像和解剖方案，以及符合人体工程学的临床珍珠，以帮助临床医生提供可靠的超声引导注射。为了减少受教育的障碍，这本小册子免费分发，不收取任何版税。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Toxicon 医学-毒理学

CiteScore

4.80

自引率

10.70%

发文量

358

审稿时长

68 days

期刊介绍： Toxicon has an open access mirror Toxicon: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. An introductory offer Toxicon: X - full waiver of the Open Access fee. Toxicon''s "aims and scope" are to publish: -articles containing the results of original research on problems related to toxins derived from animals, plants and microorganisms -papers on novel findings related to the chemical, pharmacological, toxicological, and immunological properties of natural toxins -molecular biological studies of toxins and other genes from poisonous and venomous organisms that advance understanding of the role or function of toxins -clinical observations on poisoning and envenoming where a new therapeutic principle has been proposed or a decidedly superior clinical result has been obtained. -material on the use of toxins as tools in studying biological processes and material on subjects related to venom and antivenom problems. -articles on the translational application of toxins, for example as drugs and insecticides -epidemiological studies on envenoming or poisoning, so long as they highlight a previously unrecognised medical problem or provide insight into the prevention or medical treatment of envenoming or poisoning. Retrospective surveys of hospital records, especially those lacking species identification, will not be considered for publication. Properly designed prospective community-based surveys are strongly encouraged. -articles describing well-known activities of venoms, such as antibacterial, anticancer, and analgesic activities of arachnid venoms, without any attempt to define the mechanism of action or purify the active component, will not be considered for publication in Toxicon. -review articles on problems related to toxinology. To encourage the exchange of ideas, sections of the journal may be devoted to Short Communications, Letters to the Editor and activities of the affiliated societies.