Aims: To assess the outcomes of switching to a different brand of botulinum toxin A (BTA, from Botox® to Dysport®) in case of failure of intradetrusor injections (IDI) of Botox® in the treatment of neurogenic detrusor overactivity (NDO). Methods: The charts of all patients who underwent a switch to IDI of Dysport® after failure of an IDI of Botox® at six departments of neurourology were retrospectively reviewed. The main outcomes of interest were the bladder diary data and four urodynamic parameters: maximum cystometric capacity (MCC), maximum detrusor pressure (PDET max), and volume at first uninhibited detrusor contraction (UDC). Results: Fifty-seven patients were included. After the first injection of Dysport®, no adverse events were reported. A significant decrease in number of urinary incontinence episodes per day was observed in 52.63% of patients (P < 0.001) and all patients experienced a reduction in PDET Max (−8.1 cmH20 on average; P = 0.003). MCC significantly increased by a mean of 41.2 (P = 0.02). The proportion of patients with no UDC increased significantly at week 6 after ATA injections (from 15.79% to 43.9%; P = 0.0002). Hence, 32 patients draw clinical and/or urodynamic benefits from the botulinum toxin switch from (56.14%). After a median follow up of 21 months, 87% of responders to BTA switch were still treated successfully with BTA.

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The aetiology of acute respiratory infections between September 1962 and August 1963 was studied in two general practices in Cambridge. These practices were reasonably representative of the permanent community of Cambridge.There were 592 spells of acute respiratory infection in the combined practices, representing an incidence of 11·4 spells per 100 persons. Children aged 0–4 had the highest rates (51·6 spells per 100 persons).It was possible to establish a diagnosis in 62·5% of cases investigated. Influenza and parainfluenza infections featured prominently, being responsible between them for 46·6% of all respiratory infections investigated. From September 1962 to January 1963, parainfluenza viruses were prevalent, causing acute laryngo-tracheo-bronchitis in children (croup), and an influenza-like illness in adults. From February to April 1963, influenza A (Asian) was epidemic, a clinical diagnosis of influenza being frequently confirmed by laboratory studies at this time. There were nine cases of Eaton agent infection, seven of which had PAP, the other two being family contacts who later developed influenza-like illnesses.Adenovirus (four cases), and RS virus (three cases) were not prevalent to any large extent in Cambridge during the survey.