جستجوی مقالات مرتبط با کلیدواژه "hyperhidrosis" در نشریات گروه "پزشکی"

Many drugs, including antipsychotics, cause an adverse effect, such as excessive sweating (hyperhidrosis). Hyperhidrosis occurs by drugs that act on the thermoregulatory centers in the hypothalamus, spinal, and sympathetic ganglia or on the endocrine system. 

Case Report: 

This study reports two patients who developed hyperhidrosis while taking aripiprazole. A 38-year-old woman who had a diagnosis of obsessive-compulsive disorder and a 17-year-old boy who developed multiple motor tics continued to take aripiprazole even though they had hyperhidrosis. The dosage of aripiprazole was adjusted to reduce diaphoresis.

Besides the potential risks of dehydration, electrolyte depletion, and hypothermia, hyperhidrosis may be a distressing and embarrassing symptom that, if not addressed properly, can promote noncompliance with the medication. Therefore, it is imperative to create awareness of this unusual potential adverse effect of aripiprazole.

Although hyperhidrosis is regarded as a benign sympathetic disorder, it can have a significant psychosocial impact on affected individuals while markedly affecting their quality of life (QoL).

We aimed to evaluate the effects of endoscopic thoracic sympathectomy (ETS) on the treatment of primary hyperhidrosis and patients’ QoL).

This prospective interventional study included patients with primary hyperhidrosis referred to Shahid Mohammadi Hospital, Bandar Abbas, Iran, for ETS during 2012-2019. General characteristics including age, sex, and body mass index (BMI) were recorded for all patients. All participants underwent ETS by a single experienced surgeon. Patients were evaluated twice; once before the procedure and once one month after the procedure. The sites of hyperhidrosis, Hyperhidrosis Disease Severity Scale (HDSS), and QoL were the evaluated variables. Patients’ satisfaction, compensatory hyperhidrosis, and procedural complications such as pneumothorax were also assessed on follow-up.

From the 47 patients evaluated in this study with a mean ± SD age of 28.2±1.21 years, 27 (57.4%) were men. No patient experienced compensatory hyperhidrosis and procedural complications after the procedure. Also, 45 (95.7%) patients were 100% satisfied and 2 (4.3%) were 90% satisfied with the procedure. There was a significant reduction in the number of hyperhidrosis sites and HDSS score after one month compared with baseline (P=0.006 and P<0.001, respectively). Moreover, the QoL significantly improved after the procedure (P<0.001).

ETS appears to be very safe and effective for the treatment of primary hyperhidrosis in terms of the reduction of hyperhidrosis sites and HDSS score, as well as improving QoL and patient satisfaction.

 Hyperhidrosis is the maladjustment of excess sweating in specific parts of the body. Radiofrequency (RF) therapy has been successfully used to treat hyperhidrosis with a success rate of 85% - 95% in patients refractory to sympathectomy. The main hypothesis was the association between reduced palmar hyperhidrosis and radiofrequency RF therapy. The RF therapy is a less invasive technique, including the utilization of electromagnetic energy that is deposited near the nerve tissue. The mechanism of action of continuous RF could be explained by the destruction of afferent nerve fibers on their way from a nociceptive focus to the central nervous system. Pulsed RF was invented to explore this possibility, with the sole purpose of finding a less destructive and equally effective technique for the application of RF to afferent pathways. Herein, we further evaluated whether the procedure was safe without any complications in routine follow-up in palmar hyperhidrosis.

 Herein, we report the case of a male patient with an age of 22 years undergoing thermal RF sympathectomy therapy of thoracic T2 and T3 sympathetic ganglia for the palmar hyperhidrosis of his right hand observed for 3 months. The patient developed a contraction of the flexor involving the small muscles of the right hand with severe pain and congestion 17 days after the procedure without any other complications. The contraction was relieved by a sonar-guided median nerve block at the wrist with two injections of 2 mL lidocaine 2% and 2 mL dexamethasone.

 This study has been the first clinical case report complicated by the development of a contraction of the flexor muscles of the right hand with severe pain and congestion. The spasm was gradually relieved by sonar-guided median nerve injection at the level of the wrist and intended to assess the role of RF ablation with a success rate of 85% - 95% in palmar hyperhidrosis.

 Primary hyperhidrosis is a sympathetic disorder characterized by prolonged and uncontrollable sweating. It is associated with emotional stress or psychological causes that preferably affects the axillae, palms, feet, and face. Video-assisted thoracoscopic sympathetic surgery is currently a globally recognized treatment for primary palmar hyperhidrosis (PH). However, compensatory sweating (CS) is the most prominent long-term adverse effect of thoracoscopic sympathectomy.

 Here, we aim to perform selective sympathetic ramicotomy for primary palmar hyperhidrosis patients and evaluate the clinical outcomes of satisfaction, as well as the effect on the frequency, location, and severity of compensatory sweating.

 In this single-arm trial study, 24 sympathectomies were carried out on 12 patients with primary palmar hyperhidrosis who were candidates for bilateral thoracoscopic selective sympathectomy (ramicotomy) at Imam Khomeini Hospital. The patients’ demographic information was interviewed and followed up using telephone questionnaires in the health center one week after surgery. Then, the rates of compensatory sweating, satisfaction, and failure or recurrence were retrospectively analyzed.

 No significant differences were observed between age, gender, weight, BMI, and compensatory sweating rates. Notwithstanding, there was a statistically significant difference in the severity of compensatory sweating with patients’ height (P = 0.016). Compensatory sweating occurred in 66.7% of the patients; 50% of the patients were mild, 16.7% of the patients were moderate, and there was no intolerable compensatory sweating or recurrence. The most incidence of compensatory sweating was on the lower back. The rate of satisfaction was 94.5 ± 7.8%.

 Selective thoracoscopic sympathectomy (ramicotomy) is an effective surgical procedure with a very high level of precision and satisfaction. This technique hence should be considered the method of choice for the treatment of primary palmar hyperhidrosis.

Primary hyperhidrosis (PH) refers to excessive sweating, beyond normal physiological levels, in specific sites of the body for unknown reasons. It is usually bilateral and is most prominent in the palms, axillae, feet, and face. PH prevalence is estimated to be 0%-6.1% in different populations. It usually begins in childhood and is more frequent in women. In 57% of cases, there is a positive family history. It is an autosomal dominant disorder with variable penetration in chromosomes 5, 14, or both.
The aim of this study was to illustrate current treatments of PH while focusing on surgical therapies through a narrative review.
A complete search of online articles from 2007 to 2014 in PubMed, Scopus, and the Cochrane Library was performed. A free search and a search in the MeSH database for the study’s keywords were also done. More than 600 relevant articles were found, of which 51 were chosen for this study. This article is based on those articles.
Surgery is the best and more permanent therapy for PH. The most common consequences of surgery are compensatory sweating and gustatory sweating. There is controversy concerning whether lowering the level and limiting the number of ganglia on which surgery is performed reduces compensatory sweating.
It seems that ramicotomy (selective division of the sympathetic postganglionic fibers) reduces compensatory sweating, but this theory should be confirmed with more studies.

Approximately, 3% of the world’s population have hyperhidrosis, a situation in which excessive sweating occurs in response to the need to regulate body temperature. Endoscopic devices have been used for treatment of this disease through sympathicotomy. The aim of this study was to assess the effectiveness and adverse effects of endoscopic sympathicotomy in treatment of hyperhidrosis.Patients and We enrolled 41 patients in the study. Ganglion disconnection was performed at T2 - T3 level for patients with palmar hyperhidrosis and at T3 - T4 level for patients with axillary hyperhidrosis. Patients were evaluated for successful response to surgical treatment, occurrence of reflex hyperhidrosis following surgery, and location of reflex hyperhidrosis at one week and at six months of surgery. After surgical treatment, 75.6% of patients reported complete response to treatment while 82.9% reported reflex hyperhidrosis after surgery. The frequency for moderate and severe sweating was 8.8% and 26.5%, respectively. Sympathicotomy technique can be used in the treatment of primary hyperhidrosis in patients who did not respond to nonsurgical treatments; however, the incidence of reflex hyperhidrosis is of concern following surgical treatment.

Primary hyperhidrosis (PHH) is characterized by sweating more than physiologic need for thermoregulation in certain parts of body without a known cause, for a period of at least six months. Surgical methods such as sympathicotomy are efficient and permanent treatments for PHH.. This study was planned to evaluate and compare complications and patients’ satisfaction of thoracoscopic sympathicotomy in levels of R2-R4 versus R3-R5 for PHH treatment..Patients and From March 2010 to January 2013, a prospective single-blinded randomized study was performed on 94 patients with PHH in two groups, which were treated by thoracoscopic R2-R4 (group A) and R3-R5 (group B) sympathicotomies. The patients were evaluated at the first week and at least after six months postoperatively for outcomes, complications and satisfactions. Collected data were analyzed by SPSS version 18 using Student T test and Chi-square test.. In a total of 94 patients, 73 (77.7%) were men and 21 (22.3%) were women. Their mean age was 26.5 ± 6.5 years. Thoracoscopic R2-R4 sympathicotomy was done in 47 patients (group A) and thoracoscopic R3-R5 sympathicotomy was also done in 47 patients (group B). Early compensatory sweating (CS) were 78.7% and 66.0% in groups A and B (P = 0.167). The rates of late compensatory sweating were 74.4% (group A) and 70.7% (group B) (P = 0.241). Early and late postoperative satisfactions were 98.6% and 98.2% in group A and 97.9% and 97.3% in group B, respectively (P > 0.05). There were no statistical significant differences between two groups in early and late CS and postoperative satisfactions. The Rates of other early and late complications, such as pneumothorax, hemorrhage, hemothorax, and infection, were lower in group B. (P = 0.006 and P = 0.005). Thoracoscopic sympathicotomy shows proper results in treatment of PHH. Thoracoscopic R3-R5 sympathicotomy compared with R2-R4 sympathicotomy is a preferable method, because of similar results and fewer complications..

Primary hyperhidrosis (P.H.H.) is characterized by excessive sweating in certain parts of body. It’s estimated prevalence is 0%-6.1% in different populations. In Asian population its prevalence is around 3%. In 57% of cases, there is a positive family history.

To evaluate and compare the early and late satisfaction, outcomes and complications of thoracoscopic sympathectomy and sympathicotomy in the treatment of primary hyperhidrosis.

From April 2007 to January 2011, we prospectively treated 60 primary hyperhidrosis patients via thoracoscopic surgery. The first 30 patients underwent sympathectomy and the next 30 patients underwent sympathicotomy. We evaluated early and late satisfactions, outcomes and complications on the first visit (5-8days) following surgery and 12 months after surgery, for all patients.

The mean operative time was 66.3 minutes in sympathicotomy group and 110.8 minutes in sympathectomy group (P < 0.001). There were no significant differences between the two groups in overall early and late satisfaction, gustatory sweating, pompholyx and post-operative pain. There was comparatively less early and late compensatory sweating (C.S.), and other adverse influences of C.S. in the sympathicotomy group.

Because of shorter operative time, less C.S. and less adverse influence of C.S., sympathicotomy seems a better treatment for primary hyperhidrosis, compared with sympathectomy