Effect of botulinum toxin in the treatment of drooling: a controlled clinical trial.

Abstract:

OBJECTIVE:To investigate the clinical effectiveness of botulinum neurotoxin type A (BoNT) to reduce drooling in children with cerebral palsy (CP). METHODS:A controlled clinical trial was performed in which the results of single-dose BoNT injections in the submandibular glands were compared with treatment with scopolamine. Forty-five children who had CP and experienced severe drooling were enrolled. Drooling severity was measured at baseline, during application of scopolamine, and at different intervals after BoNT injections up to 24 weeks, using the Drooling Quotient (DQ), the Teacher Drooling Scale (TDS), and Visual Analog Scales (VAS). RESULTS:Drooling was reduced during scopolamine application as well as after BoNT injections. Compared with baseline, the mean DQ showed a significant decrease throughout the study. Greatest reductions were achieved 2 to 8 weeks after BoNT injection. No significant differences were found between scopolamine measurements and those up to 24 months after BoNT injection. Using VAS, parents recorded the effect on drooling in which significant differences were found between baseline VAS score and all follow-up assessments. According to our definition of "success to therapy," demanding a 2-point decrease on the TDS, 61.5% of patients responded to BoNT injections. Analysis of the DQ demonstrated a response rate of 53% of the patients to scopolamine and 48.7% to BoNT until 24 weeks after BoNT injections, the actual duration of this study. As a reaction to scopolamine, 71.1% of the patients had moderate to severe side effects. Only nonsevere, incidental side effects were reported after BoNT injections. CONCLUSIONS:During scopolamine application as well as after intraglandular BoNT injections, a clinically relevant reduction in drooling was achieved in children with CP, demonstrating maximum effect 2 to 8 weeks after injections. This is the first controlled clinical trial that confirmed a significant effect of BoNT injections in the treatment of drooling. General anesthesia was needed for all children. BoNT injections show fewer and less serious side effects than transdermal scopolamine treatment.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Jongerius PH,van den Hoogen FJ,van Limbeek J,Gabreëls FJ,van Hulst K,Rotteveel JJ

doi

10.1542/peds.2003-1104-L

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

620-7

issue

3

eissn

0031-4005

issn

1098-4275

pii

114/3/620

journal_volume

114

pub_type

临床试验,杂志文章
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    doi:10.1542/peds.105.3.e38

    authors: Singhal A,Morley R,Abbott R,Fairweather-Tait S,Stephenson T,Lucas A

    更新日期:2000-03-01 00:00:00

  • Predictors of Medication Continuity in Children With ADHD.

    abstract:OBJECTIVES:To identify predictors of attention-deficit/hyperactivity disorder (ADHD) medication continuity, hypothesizing greater continuity among children with (1) greater child acceptance of treatment, (2) parent belief in longer time course for ADHD, (3) positive differential between parent-perceived need for and co...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-2580

    authors: Brinkman WB,Sucharew H,Majcher JH,Epstein JN

    更新日期:2018-06-01 00:00:00

  • Solitary renal myofibromatosis: an unusual cause of infantile hypertension.

    abstract:INTRODUCTION:Renovascular disease accounts for the vast majority of cases of infantile hypertension with complications resulting from umbilical arterial catheterization predominating in the neonatal period and fibrodysplastic lesions of the renal artery predominating outside the neonatal period. We report a previously ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.103.5.e66

    authors: Kasaragod AB,Lucia MS,Lum GM,Caldwell S,Stork L,Stenmark KR

    更新日期:1999-05-01 00:00:00

  • Legal, ethical, and financial dilemmas in electronic health record adoption and use.

    abstract::Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent o...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2010-2184

    authors: Sittig DF,Singh H

    更新日期:2011-04-01 00:00:00

  • Neuroprotection with prolonged head cooling started before postischemic seizures in fetal sheep.

    abstract:OBJECTIVE:Cerebral hypothermia has been shown to reduce damage from experimental hy-poxia-ischemia if started shortly after reperfusion. However, in the newborn infant it may not be feasible to determine prognosis so soon after exposure to asphyxia. The aim of this study was to determine whether head cooling, delayed u...

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    pub_type: 杂志文章

    doi:10.1542/peds.102.5.1098

    authors: Gunn AJ,Gunn TR,Gunning MI,Williams CE,Gluckman PD

    更新日期:1998-11-01 00:00:00

  • Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).

    abstract:OBJECTIVE:To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. METHODS:A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children b...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.112.3.593

    authors: Weller WE,Minkovitz CS,Anderson GF

    更新日期:2003-09-01 00:00:00

  • Subacute Neuropsychiatric Syndrome in Girls With SHANK3 Mutations Responds to Immunomodulation.

    abstract::Phenotypic and biological characterization of rare monogenic disorders represents 1 of the most important avenues toward understanding the mechanisms of human disease. Among patients with SH3 and multiple ankyrin repeat domains 3 (SHANK3) mutations, a subset will manifest neurologic regression, psychosis, and mood dis...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2019-1490

    authors: Bey AL,Gorman MP,Gallentine W,Kohlenberg TM,Frankovich J,Jiang YH,Van Haren K

    更新日期:2020-02-01 00:00:00

  • Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults.

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    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2015-2970

    authors: McCarthy NL,Gee J,Sukumaran L,Weintraub E,Duffy J,Kharbanda EO,Baxter R,Irving S,King J,Daley MF,Hechter R,McNeil MM

    更新日期:2016-03-01 00:00:00

  • Hypertension and Neuroimaging Changes After Bevacizumab for Retinopathy of Prematurity.

    abstract::Bevacizumab is a human monoclonal immunoglobulin G1 antibody to vascular endothelial growth factor indicated in several adult diseases. Emerging literature and expert opinion support the off-label use of intravitreal bevacizumab in the treatment of retinopathy of prematurity (ROP), a common disease process seen in pre...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2019-1814

    authors: Twitty G,Weiss M,Albayram MS,O'Mara K,Mowitz ME

    更新日期:2020-01-01 00:00:00

  • Surfactant replacement therapy with a single postventilatory dose of a reconstituted bovine surfactant in preterm neonates with respiratory distress syndrome: final analysis of a multicenter, double-blind, randomized trial and comparison with similar tria

    abstract::The effects of a single dose of surfactant TA were assessed in premature neonates (birth weight 750 to 1749 g) with respiratory distress syndrome (RDS) in a multicenter, double-blind, randomized clinical trial. Only neonates with surfactant deficiency and without ultrasonographic evidence of intracranial hemorrhage gr...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Fujiwara T,Konishi M,Chida S,Okuyama K,Ogawa Y,Takeuchi Y,Nishida H,Kito H,Fujimura M,Nakamura H

    更新日期:1990-11-01 00:00:00

  • Occipital encephalocele and early gestational hyperthermia.

    abstract::Hyperthermia as a human teratogen has been implicated as one cause for neurulation defects. To determine whether there is an association between early maternal hyperthermia (20 to 28 days' gestation) and isolated occipital encephalocele, record reviews were conducted for the period 1969 through 1979 in three major med...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Fisher NL,Smith DW

    更新日期:1981-10-01 00:00:00

  • Neuroimaging and neurodevelopmental outcome in extremely preterm infants.

    abstract:BACKGROUND:Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse f...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2014-0898

    authors: Hintz SR,Barnes PD,Bulas D,Slovis TL,Finer NN,Wrage LA,Das A,Tyson JE,Stevenson DK,Carlo WA,Walsh MC,Laptook AR,Yoder BA,Van Meurs KP,Faix RG,Rich W,Newman NS,Cheng H,Heyne RJ,Vohr BR,Acarregui MJ,Vaucher YE,P

    更新日期:2015-01-01 00:00:00

  • Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention.

    abstract:OBJECTIVE:The goal was to determine the impact of a community-wide educational intervention on parental misconceptions likely contributing to pediatric antibiotic overprescribing. METHODS:We conducted a cluster-randomized trial of a 3-year, community-wide, educational intervention directed at parents of children < 6 y...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2006-2600

    authors: Huang SS,Rifas-Shiman SL,Kleinman K,Kotch J,Schiff N,Stille CJ,Steingard R,Finkelstein JA

    更新日期:2007-04-01 00:00:00

  • Health supervision for children with Marfan syndrome. American Academy of Pediatrics Committee on Genetics.

    abstract::This set of guidelines is designed to assist the pediatrician in caring for children with Marfan syndrome confirmed by clinical criteria. Although pediatricians usually first see children with Marfan syndrome during infancy, occasionally they will be called on to advise the pregnant woman who has been informed of the ...

    journal_title:Pediatrics

    pub_type: 指南,杂志文章,实务指引

    doi:

    authors:

    更新日期:1996-11-01 00:00:00

  • A systematic review of faces scales for the self-report of pain intensity in children.

    abstract:CONTEXT:Numerous faces scales have been developed for the measurement of pain intensity in children. It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity, reliability, feasibility, and preference. OBJECTIVES:To summarize and systematically review faces pain ...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2010-1609

    authors: Tomlinson D,von Baeyer CL,Stinson JN,Sung L

    更新日期:2010-11-01 00:00:00

  • Returning a Genomic Result for an Adult-Onset Condition to the Parents of a Newborn: Insights From the BabySeq Project.

    abstract::The return of information from genomic sequencing in children, especially in early life, brings up complex issues around parental autonomy, the child's future autonomy, the best interest standard, and the best interests of the family. These issues are particularly important in considering the return of genomic results...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2018-1099H

    authors: Holm IA,McGuire A,Pereira S,Rehm H,Green RC,Beggs AH,BabySeq Project Team.

    更新日期:2019-01-01 00:00:00

  • Not everything in the maxillary sinus is sinusitis: a case of a dentigerous cyst.

    abstract::A 4-year-old girl presented to a medical clinic with a painless right facial swelling. The treating physician ordered a radiograph of the sinuses and received a report of "maxillary sinusitis." After appropriate antibiotic treatment, the facial swelling increased, and the mother took the child to her community pediatr...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-1940

    authors: Haber R

    更新日期:2008-01-01 00:00:00

  • Effect of iron therapy on behavior performance in nonanemic, iron-deficient infants.

    abstract::In an effort to determine whether iron deficiency, in the absence of anemia (hemoglobin greater than 11.0 g/dL), might produce alterations in behavioral development, four groups of nonanemic infants, 9 to 12 months of age, with varying degrees of iron deficiency were studied. Infants were classified as iron sufficient...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Oski FA,Honig AS,Helu B,Howanitz P

    更新日期:1983-06-01 00:00:00

  • Intima-media thickness and flow-mediated dilatation in the Helsinki study of very low birth weight adults.

    abstract:BACKGROUND:Adults born at a very low birth weight (VLBW) (< 1500 g), compared with those born at term, bear risk factors for cardiovascular disease, including higher blood pressure and insulin resistance. OBJECTIVE:We studied, in young adults born at a VLBW, early signs of an accelerated atherosclerotic process and th...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2010-2199

    authors: Hovi P,Turanlahti M,Strang-Karlsson S,Wehkalampi K,Järvenpää AL,Eriksson JG,Kajantie E,Andersson S

    更新日期:2011-02-01 00:00:00

  • Preventing abusive head trauma among infants and young children: a hospital-based, parent education program.

    abstract:OBJECTIVE:Abusive head injuries among infants (shaken infant or shaken impact syndrome) represent a devastating form of child abuse; an effective prevention program that reduces the incidence of abusive head injuries could save both lives and the costs of caring for victims. We wished to determine whether a comprehensi...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章

    doi:10.1542/peds.2004-1896

    authors: Dias MS,Smith K,DeGuehery K,Mazur P,Li V,Shaffer ML

    更新日期:2005-04-01 00:00:00

  • Cancer incidence among children and adolescents in the United States, 2001-2003.

    abstract:OBJECTIVE:Our goal was to describe current childhood cancer incidence in the United States and identify demographic and geographic variation among children and adolescents with cancer. METHODS:We examined data from 39 National Program of Cancer Registries and 5 Surveillance, Epidemiology, and End Results statewide reg...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-2964

    authors: Li J,Thompson TD,Miller JW,Pollack LA,Stewart SL

    更新日期:2008-06-01 00:00:00

  • Outcome measures of interventions in the study of children of substance-abusing parents.

    abstract::Children of substance-abusing parents, including children of alcoholics (COAs), are one of the highest risk groups of youth for substance-abuse problems. For both genetic and family environmental reasons, COAs and children of drug abusers are very vulnerable to becoming alcohol or other drug abusers.1,2 With drug use ...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Kumpfer KL

    更新日期:1999-05-01 00:00:00

  • Do pediatricians recognize mothers with depressive symptoms?

    abstract:OBJECTIVE:To determine whether pediatric health care providers recognize maternal depressive symptoms and to explore whether maternal, provider, and visit characteristics affect pediatric providers' ability to recognize inner-city mothers with depressive symptoms. DESIGN:A cross-sectional study was conducted at a hosp...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.6.1367

    authors: Heneghan AM,Silver EJ,Bauman LJ,Stein RE

    更新日期:2000-12-01 00:00:00

  • Lay Field-worker-Led School Health Program for Primary Schools in Low- and Middle-Income Countries.

    abstract:BACKGROUND AND OBJECTIVES:School health programs are frequently attempted in low- and/or middle-income countries; however, programmatic scope and reach is limited by human resource constraints. We sought to determine if trained community members could implement a school health program that improved outcomes in rural pr...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2018-0975

    authors: Matergia M,Ferrarone P,Khan Y,Matergia DW,Giri P,Thapa S,Simões EAF

    更新日期:2019-04-01 00:00:00

  • The effect of a community intervention trial on parental knowledge and awareness of antibiotic resistance and appropriate antibiotic use in children.

    abstract:BACKGROUND:Overuse of antibiotics for children's upper respiratory infections is widespread and contributes to the emergence of antibiotic-resistant bacteria. OBJECTIVE:To assess changes in knowledge and awareness regarding antibiotic resistance and appropriate antibiotic use after community-wide educational intervent...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.107.1.e6

    authors: Trepka MJ,Belongia EA,Chyou PH,Davis JP,Schwartz B

    更新日期:2001-01-01 00:00:00

  • Association of race and ethnicity with management of abdominal pain in the emergency department.

    abstract:OBJECTIVE:To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). METHODS:Secondary analysis of data from the 2006-2009 National Hospital Ambulatory Medical Care Survey regarding 2298 visits by patients ≤ 21 years old who presented to EDs wit...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2012-3127

    authors: Johnson TJ,Weaver MD,Borrero S,Davis EM,Myaskovsky L,Zuckerbraun NS,Kraemer KL

    更新日期:2013-10-01 00:00:00

  • Dating of bruises in children: an assessment of physician accuracy.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.112.4.804

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    更新日期:2003-10-01 00:00:00

  • Ten-year follow-up of children born at

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    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2005-0876

    authors: van Wassenaer AG,Westera J,Houtzager BA,Kok JH

    更新日期:2005-11-01 00:00:00

  • Congenital malaria: a rare cause of splenomegaly and anemia in an American infant.

    abstract::A 38-day-old infant had fever, jaundice, hepatosplenomegaly, and a hemolytic anemia. A peripheral blood smear demonstrated intraerythrocytic malarial parasites identified as Plasmodium vivax. Maternal and infant sera contained antibodies to this species. A directed history revealed the mother had suffered several febr...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Thompson D,Pegelow C,Underman A,Powars D

    更新日期:1977-08-01 00:00:00

  • Guidelines for developing admission and discharge policies for the pediatric intensive care unit. American Academy of Pediatrics. Committee on Hospital Care and Section of Critical Care. Society of Critical Care Medicine. Pediatric Section Admission Crite

    abstract::These guidelines were developed to provide a reference for preparing policies on admission to and discharge from pediatric intensive care units. They represent a consensus opinion of physicians, nurses, and allied health care professionals. By using this document as a framework for developing multidisciplinary admissi...

    journal_title:Pediatrics

    pub_type: 指南,杂志文章

    doi:

    authors:

    更新日期:1999-04-01 00:00:00