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  1 / 1102 MEDLINE  
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[PMID]:29224753
[Au] Autor:Marinone S; Gaynor W; Johnston J; Mahadevan M
[Ad] Dirección:Department of Paediatric Otolaryngology - Head and Neck Surgery, Starship Children's Health, Park Road, Grafton, Auckland, 1023, New Zealand. Electronic address: smarinone@adhb.govt.nz.
[Ti] Título:Castillo Morales Appliance Therapy in the treatment of drooling children.
[So] Fuente:Int J Pediatr Otorhinolaryngol;103:129-132, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicación:Ireland
[La] Idioma:eng
[Ab] Resumen:OBJECTIVE: To evaluate the efficacy of Castillo Morales Appliance Therapy (CMAT) in reducing the severity and frequency of problematic drooling in children. METHODS: A de-identified extraction of all hospital morbidity records belonging to patients with drooling who underwent treatment with CMAT was performed between June 22, 2000 and April 12, 2016. Data were obtained from Starship Children's Hospital clinical records department. Demographic, diagnostic, and procedural data were included. Severity and frequency of drooling was quantified using the Thomas-Stonell and Greenberg classification method. RESULTS: There were fifty-three children less than 17 years of age who were treated with CMAT for the indication of problematic drooling between June 22, 2000 and April 12, 2016. 72% (n = 38) of patients had a reduction in the severity and frequency of drooling with CMAT. Mean follow up was 51 months. These patients did not require further treatment for drooling with botulinum toxin or surgery. Within this group, 63% (n = 24) of patients had significant improvement in drooling as per the Thomas-Stonell and Greenberg classification method (p = 0.024). CONCLUSIONS: Children who underwent CMAT for drooling were less likely to require further treatment with botulinum toxin or surgery. This result suggests that the use of CMAT in children with problematic drooling confers benefit.
[Mh] Términos MeSH primario: Aparatos Activadores
Sialorrea/terapia
[Mh] Términos MeSH secundario: Adolescente
Toxinas Botulínicas Tipo A/uso terapéutico
Niño
Preescolar
Femenino
Estudios de Seguimiento
Hospitales Pediátricos
Seres Humanos
Masculino
Estudios Retrospectivos
Glándulas Salivales/cirugía
Resultado del Tratamiento
[Pt] Tipo de publicación:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nombre de substancia:
EC 3.4.24.69 (Botulinum Toxins, Type A)
[Em] Mes de ingreso:1801
[Cu] Fecha actualización por clase:180104
[Lr] Fecha última revisión:180104
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:171212
[St] Status:MEDLINE


  2 / 1102 MEDLINE  
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[PMID]:28964285
[Au] Autor:Kay-Rivest E; Khendek L; Bernard G; Daniel SJ
[Ad] Dirección:Department of Pediatric Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
[Ti] Título:Pediatric leukodystrophies: The role of the otolaryngologist.
[So] Fuente:Int J Pediatr Otorhinolaryngol;101:141-144, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicación:Ireland
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Leukodystrophies consist of degenerative neurogenetic diseases often associated with comorbidities that extend beyond the neurological system. Despite their impacts on patients' quality of life and risks of complications, head and neck symptomology is poorly reported in the literature. The objective of this study was to identify and quantify the main head and neck complaints among a cohort of patients diagnosed with leukodystrophies and define the role of the otolaryngologist as part of a multidisciplinary team for treating these patients. METHODS: During the First Canadian National Conference on Leukodystrophies held at the Montreal's Children Hospital, a cohort of 12 patients diagnosed with leukodystrophies were recruited and evaluated by a multidisciplinary team. An otolaryngology-focused assessment was done through history and physical examination, and included a screening questionnaire for 23 common otolaryngology issues. If families reported a history of sialorrhea, a validated questionnaire (Drool Quality of Life Assessment Questionnaire (DroolQoL)) was subsequently distributed. Results from the questionnaires were then compiled and analyzed. RESULTS: Of the 12 recruited patients, 83% (10/12) were known to an otolaryngologist. Drooling affected 67% (8/12) of patients although only 37.5% (3/8) of patients had undergone medical or surgical therapies for this issue. Four patients experienced at least one aspiration pneumonia. 58% (7/12) of the patients had dysphagia, of whom 43% (3/12) were fed exclusively via gastrostomy tube and 28% (2/7) required thickening of feeds. Two patients, despite suspicion of dysphagia and aspiration, had never undergone evaluation. As for otologic issues, it was noted that 25% (3/12) of patients had a history of pressure equalizing tubes (PETs) and one patient had a history of hearing loss. CONCLUSION: Head and neck comorbidities affect children with leukodystrophies. Therefore, the otolaryngologist should be part of the multidisciplinary team, specifically for the management of dysphagia and sialorrhea.
[Mh] Términos MeSH primario: Trastornos de Deglución/etiología
Enfermedades Neurodegenerativas/complicaciones
Enfermedades Neurodegenerativas/terapia
Sialorrea/etiología
[Mh] Términos MeSH secundario: Adolescente
Canadá
Niño
Preescolar
Femenino
Gastrostomía
Hospitales Pediátricos
Seres Humanos
Lactante
Masculino
Otorrinolaringólogos
Calidad de Vida
Estudios Retrospectivos
Sialorrea/complicaciones
Encuestas y Cuestionarios
Adulto Joven
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1710
[Cu] Fecha actualización por clase:171023
[Lr] Fecha última revisión:171023
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:171002
[St] Status:MEDLINE


  3 / 1102 MEDLINE  
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[PMID]:28770414
[Au] Autor:Camacho-Alonso F; Cánovas-García C; Martínez-Ortiz C; De la Mano-Espinosa T; Ortuño-Celdrán T; Marcello-Godino JI; Ramos-Sánchez R; Sánchez-Siles M
[Ad] Dirección:Department of Oral Surgery, University of Murcia, Murcia, Spain. fcamacho@um.es.
[Ti] Título:Oral status, quality of life, and anxiety and depression in hemodialysis patients and the effect of the duration of treatment by dialysis on these variables.
[So] Fuente:Odontology;, 2017 Aug 02.
[Is] ISSN:1618-1255
[Cp] País de publicación:Japan
[La] Idioma:eng
[Ab] Resumen:This study aimed is to evaluate the oral health status, quality of life, anxiety and depression among hemodialysis patients and to analyze the effect of the duration of dialysis on these variables. 120 patients on hemodialysis and 120 control subjects underwent oral examination, periodontal evaluation, xerostomia study using a Visual Analogue Scale (VAS), sialometry evaluation; quality of life (QOL) using the OHIP-14 questionnaire and anxiety/depression. Bleeding index, CPTIN, clinical attachment level, and probing depth were significantly higher in the hemodialysis group than the control group (p < 0.001). VAS scores were higher in patients on hemodialysis with significant differences in 6 of the 8 domains (p ≤ 0.05). Unstimulated whole saliva was significantly lower in hemodialysis patients than control subjects (p < 0.001). OHIP-14 scores showed significantly poorer QOL in patients on hemodialysis than control subjects (p = 0.042). Hemodialysis patients presented greater depression and anxiety than control (p < 0.001). Periodontal health was worse among the patients who had been in treatment >10 years, xerostomia and sialorrea was worse in patients treated for 5-9.9, and >10 years, QOL was worse in patients who had spent <1 year; depression and anxiety was greater among those treated for 1-2.9 years. In conclusion, Oral health, QOL, anxiety and depression are worse in patients on hemodialysis, and oral health deteriorates as the time spent in dialysis lengthens, but patients in treatment for <3 years presented the poorest QOL and the greatest anxiety and depression.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1708
[Cu] Fecha actualización por clase:170803
[Lr] Fecha última revisión:170803
[St] Status:Publisher
[do] DOI:10.1007/s10266-017-0313-6


  4 / 1102 MEDLINE  
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[PMID]:28591387
[Au] Autor:Dias BLS; Fernandes AR; Maia HS
[Ad] Dirección:Rede SARAH de Hospitais de Reabilitação; Rio de Janeiro RJ, Brasil.
[Ti] Título:Treatment of drooling with sublingual atropine sulfate in children and adolescents with cerebral palsy.
[So] Fuente:Arq Neuropsiquiatr;75(5):282-287, 2017 May.
[Is] ISSN:1678-4227
[Cp] País de publicación:Brazil
[La] Idioma:eng
[Ab] Resumen:Objective: To report the effect of sublingual atropine sulfate to treat drooling in children with cerebral palsy by comparing the results of the Drooling Impact Scale in a non-controlled open clinical trial. Results: Twenty-five children were assessed. The difference in the mean scores of the pre- and post-treatment scales reached statistical significance. There was a low frequency of side effects compared to studies with other anticholinergics. Conclusion: The use of sublingual atropine sulfate seems to be safe and there is a reduction in the Drooling Impact Scale score, which suggests efficacy in the treatment of drooling in children and adolescents with cerebral palsy. Our results should be replicated in randomized, placebo-controlled studies with larger numbers of participants.
[Mh] Términos MeSH primario: Atropina/administración & dosificación
Parálisis Cerebral/complicaciones
Antagonistas Muscarínicos/administración & dosificación
Sialorrea/tratamiento farmacológico
[Mh] Términos MeSH secundario: Administración Sublingual
Adolescente
Atropina/efectos adversos
Niño
Preescolar
Relación Dosis-Respuesta a Droga
Femenino
Seres Humanos
Masculino
Antagonistas Muscarínicos/efectos adversos
Índice de Severidad de la Enfermedad
Sialorrea/etiología
Resultado del Tratamiento
[Pt] Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nombre de substancia:
0 (Muscarinic Antagonists); 7C0697DR9I (Atropine)
[Em] Mes de ingreso:1706
[Cu] Fecha actualización por clase:170630
[Lr] Fecha última revisión:170630
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170608
[St] Status:MEDLINE


  5 / 1102 MEDLINE  
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[PMID]:28304087
[Au] Autor:Ozturk K; Erdur O; Gul O; Olmez A
[Ad] Dirección:Department of Otolaryngology, Selcuk University, Konya, Turkey.
[Ti] Título:Feasibility of endoscopic submandibular ganglion neurectomy for drooling.
[So] Fuente:Laryngoscope;127(7):1604-1607, 2017 Jul.
[Is] ISSN:1531-4995
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:We performed endoscopic transoral neurectomy of the submandibular and sublingual glands to treat drooling. We bilaterally operated two adult cases with treatment-resistant drooling. In these patients, conventional treatment had failed. Repeated botilinum toxin type A (BOTOX®, Abdi Ibrahim Pharmaceutical Company, Istanbul, Turkey) injections had been effective but were becoming less so. The patients benefited from surgery in that their saliva scores decreased. No issue emerged over 6 months of follow-up. Endoscopic transoral neurectomy of the submandibular and sublingual glands reduces saliva production and allows management of drooling in treatment-resistant patients. Laryngoscope, 127:1604-1607, 2017.
[Mh] Términos MeSH primario: Desnervación
Endoscopía
Ganglios Parasimpáticos/cirugía
Sialorrea/cirugía
Glándula Submandibular/inervación
[Mh] Términos MeSH secundario: Adulto
Anciano
Infarto Cerebral/complicaciones
Parálisis Cerebral/complicaciones
Disección/métodos
Estudios de Factibilidad
Estudios de Seguimiento
Hemiplejía/complicaciones
Seres Humanos
Discapacidad Intelectual/complicaciones
Masculino
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
[Em] Mes de ingreso:1708
[Cu] Fecha actualización por clase:170818
[Lr] Fecha última revisión:170818
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170318
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26557


  6 / 1102 MEDLINE  
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[PMID]:28188210
[Au] Autor:McGeachan AJ; Mcdermott CJ
[Ad] Dirección:Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.
[Ti] Título:Management of oral secretions in neurological disease.
[So] Fuente:Pract Neurol;17(2):96-103, 2017 Apr.
[Is] ISSN:1474-7766
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:Sialorrhoea is a common and problematic symptom that arises from a range of neurological conditions associated with bulbar or facial muscle dysfunction. Drooling can significantly affect quality of life due to both physical complications such as oral chapping, and psychological complications such as embarrassment and social isolation. Thicker, tenacious oral and pharyngeal secretions may result from the drying management approach to sialorrhoea. The management of sialorrhoea in neurological diseases depends on the underlying pathology and severity of symptoms. Interventions include anticholinergic drugs, salivary gland-targeted radiotherapy, salivary gland botulinum toxin and surgical approaches. The management of thick secretions involves mainly conservative measures such as pineapple juice as a lytic agent, cough assist, saline nebulisers and suctioning or mucolytic drugs like carbocisteine. Despite a current lack of evidence and variable practice, management of sialorrhoea should form a part of the multidisciplinary approach needed for long-term neurological conditions.
[Mh] Términos MeSH primario: Manejo de la Enfermedad
Enfermedades del Sistema Nervioso/complicaciones
Sialorrea/etiología
Sialorrea/terapia
[Mh] Términos MeSH secundario: Toxinas Botulínicas Tipo A/uso terapéutico
Antagonistas Colinérgicos/uso terapéutico
Seres Humanos
Radioterapia Ayuvante/métodos
[Pt] Tipo de publicación:JOURNAL ARTICLE; REVIEW
[Nm] Nombre de substancia:
0 (Cholinergic Antagonists); EC 3.4.24.69 (Botulinum Toxins, Type A)
[Em] Mes de ingreso:1703
[Cu] Fecha actualización por clase:170327
[Lr] Fecha última revisión:170327
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170212
[St] Status:MEDLINE
[do] DOI:10.1136/practneurol-2016-001515


  7 / 1102 MEDLINE  
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[PMID]:28166999
[Au] Autor:Shelton F; Sproson E; Van der Veen J; Evans H; Burgess A; Ismail-Koch H
[Ad] Dirección:Department of Otolaryngology and Head and Neck Surgery, University Hospital Southampton, Tremona Rd, Southampton, SO16 6YD, England, UK. Electronic address: Fenella.shelton@doctors.org.uk.
[Ti] Título:Unresolved drooling in a previously healthy child caused by a brainstem malignancy.
[So] Fuente:Int J Pediatr Otorhinolaryngol;94:11-13, 2017 Mar.
[Is] ISSN:1872-8464
[Cp] País de publicación:Ireland
[La] Idioma:eng
[Ab] Resumen:Drooling occurs commonly in children below the age of two. In a small group of children this persists and an otorhinolaryngology consultation is sought. In children with no neurological abnormality or comorbidity, reassurance and behavioural management is often suggested. We present a case where drooling was the presenting feature of brain stem malignancy. Diagnosis was suggested following a sleep study demonstrating central apnoeas. Magnetic resonance imaging (MRI) showed an intra-axial brainstem tumour. This case highlights the importance of multidisciplinary team (MDT) management of children with persistent drooling of unknown cause.
[Mh] Términos MeSH primario: Neoplasias del Tronco Encefálico/complicaciones
Neoplasias del Tronco Encefálico/diagnóstico por imagen
Sialorrea/etiología
[Mh] Términos MeSH secundario: Preescolar
Seres Humanos
Imagen por Resonancia Magnética
Masculino
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
[Em] Mes de ingreso:1703
[Cu] Fecha actualización por clase:170817
[Lr] Fecha última revisión:170817
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170208
[St] Status:MEDLINE


  8 / 1102 MEDLINE  
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[PMID]:28129312
[Au] Autor:Man WH; Colen-de Koning JC; Schulte PF; Cahn W; van Haelst IM; Doodeman HJ; Egberts TC; Heerdink ER; Wilting I
[Ad] Dirección:From the *Department of Clinical Pharmacy, University Medical Center Utrecht; †Department of Clinical Pharmacy, Medical Centrum Alkmaar; ‡Mental Health Services North-Holland North, Heerhugowaard; §Department of Psychiatry, University Medical Center Utrecht; and ∥Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, The Netherlands.
[Ti] Título:The Effect of Glycopyrrolate on Nocturnal Sialorrhea in Patients Using Clozapine: A Randomized, Crossover, Double-Blind, Placebo-Controlled Trial.
[So] Fuente:J Clin Psychopharmacol;37(2):155-161, 2017 Apr.
[Is] ISSN:1533-712X
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Nocturnal sialorrhea is one of the most frequent adverse events in clozapine treatment. Symptomatic management of sialorrhea usually consists of off-label treatment with anticholinergic agents. The aim of the current study is to evaluate the efficacy and safety of glycopyrrolate in patients using clozapine that experience sialorrhea. METHODS: In a double-blind randomized crossover trial, patients with nocturnal sialorrhea (n = 32) were randomized to treatment with glycopyrrolate 1 mg or placebo. This double-blinded phase was followed by an optional open label extension phase with glycopyrrolate 2 mg. Exposure periods consisted of 6 consecutive days and were separated with 1 washout week. The primary outcome was clinical improvement of nocturnal sialorrhea assessed by the Patient Global Impression of Improvement (PGI-I). RESULTS: The proportion of patients with a clinical improvement according to PGI-I did not significantly differ between 1 mg and placebo (18.8% vs 6.3%, P = 0.289); however, in patients using glycopyrrolate 2 mg once daily versus placebo, it did (43.5% vs 6.3%, P = 0.039). Glycopyrrolate was not associated with severe adverse events or worsening of cognitive adverse events. CONCLUSIONS: Glycopyrrolate 1 mg was not superior to placebo, whereas 2 mg showed a significant clinical improvement of nocturnal sialorrhea compared with placebo. Glycopyrrolate seemed to be a tolerable anticholinergic agent in the treatment of clozapine-associated sialorrhea.
[Mh] Términos MeSH primario: Antipsicóticos/efectos adversos
Clozapina/administración & dosificación
Glucopirrolato/farmacología
Antagonistas Muscarínicos/farmacología
Evaluación de Resultado (Atención de Salud)
Sialorrea/tratamiento farmacológico
[Mh] Términos MeSH secundario: Adulto
Estudios Cruzados
Método Doble Ciego
Femenino
Glucopirrolato/administración & dosificación
Seres Humanos
Masculino
Trastornos Mentales/tratamiento farmacológico
Mediana Edad
Antagonistas Muscarínicos/administración & dosificación
Sialorrea/inducido químicamente
[Pt] Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nombre de substancia:
0 (Antipsychotic Agents); 0 (Muscarinic Antagonists); J60AR2IKIC (Clozapine); V92SO9WP2I (Glycopyrrolate)
[Em] Mes de ingreso:1706
[Cu] Fecha actualización por clase:170626
[Lr] Fecha última revisión:170626
[Sb] Subgrupo de revista:IM
[Da] Fecha de ingreso para procesamiento:170128
[St] Status:MEDLINE
[do] DOI:10.1097/JCP.0000000000000657


  9 / 1102 MEDLINE  
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[PMID]:28099276
[Au] Autor:Gonzalez-L MD; Martinez C; Bori Y Fortuny I; Suso-Vergara S
[Ad] Dirección:From the Vall d'Hebron University Hospital, Barcelona, Spain (MDG-L, CM, IBF); and University Clinic Hospital, Villarroel, Barcelona, Spain (SS-V).
[Ti] Título:Factors in the Efficacy, Safety, and Impact on Quality of Life for Treatment of Drooling with Botulinum Toxin Type A in Patients with Cerebral Palsy.
[So] Fuente:Am J Phys Med Rehabil;96(2):68-76, 2017 Feb.
[Is] ISSN:1537-7385
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:OBJECTIVE: To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN: Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study. All participants were classified as Gross Motor Function Classification System level III or higher and all had significant drooling as defined in prior studies. One group (group A) was treated with 100 U of BoNT-A, and another group (group B) served as control. In the treatment group, all patients first received combined parotid and submandibular injections, and then parotid injections only. The main outcome variables were a postinjection decrease in the drooling quotient (DQ) of 50% or more, total flow of 30% or more, and QoL as assessed by a set of 10 items related to drooling from the ICF. RESULTS: The proportion of patients who achieved at least 50% reduction in DQ was 45% in group A versus 0.0% in group B; 0.0% (P = 0.0012); and of those who achieved at least 30% reduction in total flow was 90% in group A versus 10% in group B (P < 0.0001). Within group A, 42.1% of the dyskinetic patients versus 58.0% of the spastic ones showed 50% or better response in DQ, which is not a statistically significant difference (P = 0.8045). With regard to ICF questions, group A showed statistically significant improvements in several related items. There did not seem to be a significant difference in overall response for providing parotid-only injections. Additional correlations and uncommon adverse effect experiences are also reviewed. CONCLUSION: Botulinum toxin A injection of the salivary glands is frequently effective and generally safe for the treatment of drooling in patients with either spastic or dyskinetic CP, both in objective measurement of saliva production and subjective symptoms related to the condition. There does not seem to be a significant advantage of injecting both submandibular and parotid glands over injecting parotid glands alone.
[Mh] Términos MeSH primario: Toxinas Botulínicas Tipo A/uso terapéutico
Parálisis Cerebral/complicaciones
Fármacos Neuromusculares/uso terapéutico
Calidad de Vida
Sialorrea/tratamiento farmacológico
[Mh] Términos MeSH secundario: Femenino
Seres Humanos
Inyecciones
Masculino
Glándula Parótida
Estudios Prospectivos
Sialorrea/etiología
Glándula Submandibular
Resultado del Tratamiento
Adulto Joven
[Pt] Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nombre de substancia:
0 (Neuromuscular Agents); EC 3.4.24.69 (Botulinum Toxins, Type A)
[Em] Mes de ingreso:1708
[Cu] Fecha actualización por clase:170804
[Lr] Fecha última revisión:170804
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:170119
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000525


  10 / 1102 MEDLINE  
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[PMID]:28081026
[Au] Autor:Lee ZI; Yu KJ; Lee DH; Hong SK; Woo SB; Kim JM; Park D
[Ad] Dirección:From the Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.
[Ti] Título:The Effect of Nebulized Glycopyrrolate on Posterior Drooling in Patients with Brain Injury: Two Cases of Different Brain Lesions.
[So] Fuente:Am J Phys Med Rehabil;96(8):e155-e158, 2017 Aug.
[Is] ISSN:1537-7385
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics. Although there has been one case report regarding the effectiveness of nebulized glycopyrrolate for drooling in a motor neuron patient, there have not been any reports on its effectiveness for posterior drooling. Herein, we report two cases (an 82-year-old male bilateral hemiplegic stroke patient and a 1-year-old female cerebral palsy infant with bilaterally spastic hemiplegia of posterior drooling treated with nebulized glycopyrrolate) and identify salivary aspiration and the effect of nebulized glycopyrrolate using radionuclide salivagram. Considering its advantages and effectiveness, nebulized glycopyrrolate should be considered as one of the reliable methods to manage posterior drooling in patients with impaired cognition or swallowing difficulties, such as severe brain injury.
[Mh] Términos MeSH primario: Parálisis Cerebral/complicaciones
Glucopirrolato/administración & dosificación
Antagonistas Muscarínicos/administración & dosificación
Sialorrea/tratamiento farmacológico
Accidente Cerebrovascular/complicaciones
[Mh] Términos MeSH secundario: Administración por Inhalación
Anciano de 80 o más Años
Femenino
Hemiplejía/complicaciones
Seres Humanos
Lactante
Masculino
Nebulizadores y Vaporizadores
Glándulas Salivales/efectos de los fármacos
Sialorrea/etiología
Resultado del Tratamiento
[Pt] Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nombre de substancia:
0 (Muscarinic Antagonists); V92SO9WP2I (Glycopyrrolate)
[Em] Mes de ingreso:1708
[Cu] Fecha actualización por clase:170830
[Lr] Fecha última revisión:170830
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000669



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