65 Atropine for the treatment of paediatric sialorrhea: A retrospective case series
Bibliographic record
Abstract
Abstract Background Sialorrhea is a common problem among children with neurodevelopmental disorders, and can lead to significant complications, including aspiration pneumonia, skin breakdown, secondary infection, damaged dentition, and social challenges. Multiple medical options exist for the management of sialorrhea, but there is a paucity of data on efficacy and adverse effects in the paediatric population. Objectives This single centre, retrospective chart review examined the efficacy of sublingual atropine drops in a paediatric population followed in a multidisciplinary sialorrhea clinic. Design/Methods Patient demographics, comorbidities, clinical presentation, previous interventions, quality of life and medication side effects were collected. The Drooling Frequency and Severity Scale (DFSS) scores, collected during patient appointments, were reviewed to compare sialorrhea management pre- and post-treatment. A descriptive analysis was conducted to evaluate the efficacy of atropine. Wilcoxon signed rank tests were conducted to compare pre- versus post-treatment DFSS scores. Results Between January 2015 and September 2023, 32 patients were treated with sublingual atropine; of these, 21 met inclusion criteria. The mean age of patients at initial presentation was 9.4 years. The majority of patients had neurodevelopmental disability and required assistive devices for ambulation. Twenty four percent of patients had previous trials of medication for sialorrhea, and 23.8% had previously trialled botox. The median DFSS score prior to atropine administration was 4 for both frequency and severity and decreased to 3 for both frequency and severity post-atropine treatment (p = 0.005, p = 0.003, respectively). This represents a statistically and clinically significant reduction in both drooling frequency and severity with sublingual atropine treatment. Seventy-one percent of patients reported no side effects of atropine. For those that experienced side effects, the most commonly reported were unpleasant taste (9.6%), constipation (9.5%), facial flushing (4.8%), and behaviour concerns (4.8%). Conclusion These results support the safety and efficacy for atropine in paediatric patients with sialorrhea.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".