Number of Preoperative Hyperhidrosis Sites Does Not Affect the Sympathectomy Postoperative Results and Compensatory Hyperhidrosis Occurrence

2018 ◽  
Vol 67 (05) ◽  
pp. 407-414 ◽  
Author(s):  
Nelson Wolosker ◽  
Dafne Braga Diamante Leiderman ◽  
Jose Ribas Millanez de Campos ◽  
Paulo Kauffman ◽  
Miguel Lia Tedde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Improvement ◽  
Clinical Treatment ◽  
Postoperative Results ◽  
Compensatory Hyperhidrosis ◽  
General Satisfaction ◽  
Primary Endpoints ◽  
Primary Hyperhidrosis ◽  
Surgery Outcomes

Background Patients with primary hyperhidrosis present with sweating in two or more sites in nearly 85% of cases. In this study, we examined whether the number of hyperhidrosis sites is related to the surgery outcomes. Methods One hundred ninety-three hyperhidrosis patients who underwent bilateral videothoracoscopic sympathectomy after failure or dissatisfaction with clinical treatment were distributed into three groups based on the number of hyperhidrosis sites (one site, two sites, and three or more sites of hyperhidrosis). The primary endpoints in the study were as follows: quality of life prior to surgery, improvement of quality of life after surgery, clinical improvement of sweating, presence or absence of compensatory hyperhidrosis, and general satisfaction after 1 month of surgery. Results Patients with two or more hyperhidrosis sites had worse quality of life before surgery than patients with a single hyperhidrosis site. There was an improvement in the quality of life in more than 95% of the patients, clinical improvement in more than 95% of patients, severe compensatory hyperhidrosis in less than 10%, and low general satisfaction after 1 month of surgery in only 2.60% of the patients, with no differences among the three groups. Conclusions Patients with more than one preoperative hyperhidrosis site present worse quality of life prior to surgery than those with a single hyperhidrosis site, but the number of hyperhidrosis sites before surgery does not affect surgery outcomes.

scholarly journals Is age group a predictive factor for satisfaction among patients undergoing sympathectomy to treat hyperhidrosis?

2011 ◽  
Vol 10 (4) ◽  
pp. 284-288 ◽  
Author(s):  
José Ribas Milanez de Campos ◽  
Nelson Wolosker ◽  
Marco Antonio Soares Munia ◽  
Guilherme Yazbek ◽  
Paulo Kauffman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Body Mass ◽  
Age Groups ◽  
Age Group ◽  
Compensatory Hyperhidrosis ◽  
Thoracic Sympathectomy ◽  
Video Assisted ◽  
Primary Hyperhidrosis

OBJECTIVE: Video-assisted thoracic sympathectomy is currently the procedure of choice for the definitive treatment of primary hyperhidrosis, because it is an effective, safe, and minimally invasive method. In the search for better quality of life indexes, all researchers look for predictive factors indicating better surgical outcomes. Failure in the primary treatment, postoperative compensatory hyperhidrosis, body mass index over 25, level of resection of the sympathetic chain, and extent of resection are some of the factors that may negatively influence the results. The objective of this study was to compare, according to the age group, the quality of life after bilateral thoracic sympathectomy for treatment of primary hyperhidrosis in a cohort of 1,644 patients. METHODS: From February 2000 to October 2008, data were collected from 1,644 patients with palmar (71%) or axillary (29%) hyperhidrosis who underwent video-assisted thoracic sympathectomy. The patients were divided into three groups according to their ages. The first group consisted of patients up to 17 years-old, the second from 18 to 30 years-old, and the third of over 30 years-old. All patients had a body mass index of less than 25. RESULTS: In the evaluation 30 days after surgery, improvement of the quality of life in the three groups was observed. There was no significant difference between the age groups. In the present study, 91.9% of the patients presented compensatory hyperhidrosis, with no difference between the age groups. CONCLUSIONS: Patients with primary hyperhidrosis experience quality of life improvement after thoracic sympathectomy regardless of their age.

Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

2020 ◽  
Author(s):  
Hüseyín Ulaş Çınar ◽  
Burçin Çelik
Keyword(s):  
Patient Satisfaction ◽  
Clinical Improvement ◽  
Severity Score ◽  
Postoperative Results ◽  
Satisfaction Rate ◽  
Significant Difference ◽  
Group A ◽  
Primary Hyperhidrosis ◽  
Group B

Abstract Background Improvement in quality of life (QOL) and patient satisfaction after endoscopic thoracic sympathotomy (ETS) in patients with primary hyperhidrosis may be affected by various factors. We examined whether the preoperative sweating severity of primary hyperhidrosis sites affects postoperative results. Methods The records of 112 patients who underwent bilateral ETS were reviewed retrospectively. The patients were divided into three groups according to the sweating severity score obtained from all primary hyperhidrosis sites (primary hyperhidrosis severity score [PHSS]) and analyzed comparatively. Group A (PHSS = 1–4) included 22 patients, Group B (PHSS = 5–8) 36 patients, and Group C (PHSS ≥ 9) 54 patients. Outcome measures included QOL prior to surgery, improvement in QOL after surgery, degree of clinical improvement, presence, severity, localization, and site number of reflex sweating (RS) and general patient satisfaction after 6 months of surgery. Results The preoperative QOL of patients with higher PHSS (groups B, C) was worse than other patients (group A). More than 91% of all patients had any level improvement in QOL, and over 96% had slight or great clinical improvement. RS developed in 80% of the patients, mostly in the back, very severe in 8%, and in median two different body areas. The overall patient satisfaction rate was more than 95%. There was no significant difference between the three groups in terms of all postoperative results. Conclusion Preoperative sweating severity of primary hyperhidrosis sites does not affect post-sympathotomy results. Surgeons should not be worried when deciding upon surgery, even in patients with high sweating severity.

scholarly journals Evaluation of quality of life before and after videothoracoscopic simpathectomy for primary hyperhidrosis

2014 ◽  
Vol 41 (5) ◽  
pp. 325-330 ◽  
Author(s):  
João Batista Baroncello ◽  
Layla Regina Zambenedetti Baroncello ◽  
Emílio Gabriel Ferro Schneider ◽  
Guilherme Garcia Martins
Keyword(s):  
Quality Of Life ◽  
Average Quality ◽  
Axillary Hyperhidrosis ◽  
Cross Sectional ◽  
Compensatory Hyperhidrosis ◽  
Thoracoscopic Sympathectomy ◽  
Before And After ◽  
Primary Hyperhidrosis ◽  
Assess Quality

Objective: To assess quality of life before and after thoracoscopic sympathectomy for treatment of primary hyperhidrosis.Methods: we conducted an observational, analytical, cross-sectional and quantitative study. We evaluated patients undergoing thoracoscopic sympathectomy for primary axillary hyperhidrosis, primary palmar hyperhidrosis, and axillary hyperhidrosis associated with palmar one. We applied a questionnaire on quality of life related to hyperhidrosis before and after the operation.Results: The questionnaire was administered to 51 patients with a mean age of 32.4 years, 45 women and six men. The average quality of life related to hyperhidrosis in a score of 0-100 before sympathectomy was 34.6 and after the operation it was 77.1. Compensatory hyperhidrosis occurred in 84.3% of patients.Conclusion: thoracoscopic sympathectomy improves the quality of life of patients with primary hyperhidrosis, with results supported over time. Compensatory hyperhidrosis occurred in most patients, but did not significantly influence the improved quality of life.

scholarly journals Tu1228 – Achalasia Quality of Life Score and Eckardt Score: A Comparison for the Assessment of Clinical Improvement Post Treatment for Achalasia

2019 ◽  
Vol 156 (6) ◽  
pp. S-994
Author(s):  
Samuel O. Slone ◽  
Joel E. Richter ◽  
Vic Velanovich ◽  
John W. Jacobs ◽  
Ambuj Kumar
Keyword(s):  
Quality Of Life ◽  
Clinical Improvement ◽  
Post Treatment ◽  
Life Score ◽  
Eckardt Score

scholarly journals Hyperhidrosis: prevalence and impact on quality of life

2018 ◽  
Vol 44 (4) ◽  
pp. 292-298 ◽  
Author(s):  
Erica Nishida Hasimoto ◽  
Daniele Cristina Cataneo ◽  
Tarcísio Albertin dos Reis ◽  
Antonio José Maria Cataneo
Keyword(s):  
Quality Of Life ◽  
Poor Quality ◽  
Cluster Sampling ◽  
Excessive Sweating ◽  
Medical Evaluation ◽  
Primary Hyperhidrosis ◽  
Systematic Cluster ◽  
The City ◽  
Impaired Quality

ABSTRACT Objective: To determine the prevalence of primary hyperhidrosis in the city of Botucatu, Brazil, and to evaluate how this disorder affects the quality of life in those suffering from it. Methods: A population survey was conducted in order to identify cases of hyperhidrosis among residents in the urban area of the city, selected by systematic cluster sampling. In accordance with the census maps of the city, the sample size should be at least 4,033 participants. Ten interviewers applied a questionnaire that evaluated the presence of excessive sweating and invited the subjects who reported hyperhidrosis to be evaluated by a physician in order to confirm the diagnosis. Results: A total of 4,133 residents, in 1,351 households, were surveyed. Excessive sweating was reported by 85 residents (prevalence = 2.07%), of whom 51 (60%) were female. Of those 85 respondents, 51 (60%) agreed to undergo medical evaluation to confirm the diagnosis and only 23 (45%) were diagnosed with primary hyperhidrosis (prevalence = 0.93%). Of the 23 subjects diagnosed with primary hyperhidrosis, 11 (48%) reported poor or very poor quality of life. Conclusions: Although the prevalence of self-reported excessive sweating was greater than 2%, the actual prevalence of primary hyperhidrosis in our sample was 0.93% and nearly 50% of the respondents with primary hyperhidrosis reported impaired quality of life.

scholarly journals The use of oxybutynin for treating facial hyperhidrosis

2011 ◽  
Vol 86 (3) ◽  
pp. 451-456 ◽  
Author(s):  
Nelson Wolosker ◽  
José Ribas Milanez de Campos ◽  
Paulo Kauffman ◽  
Marco Antonio Munia ◽  
Samantha Neves ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Good Alternative ◽  
Emotional Disturbances ◽  
Thoracic Ganglion ◽  
Compensatory Hyperhidrosis ◽  
Thoracic Sympathectomy ◽  
Serious Emotional Disturbances ◽  
Important Complication ◽  
Before And After

BACKGROUND: Facial hyperhidrosis is a disease that may lead patients to serious emotional disturbances. Video-assisted thoracic sympathectomy provides excellent resolution of facial hyperhidrosis, but is associated with certain complications. The most frequent and important complication is compensatory hyperhidrosis. Especially in patients who have undergone resection of the second thoracic ganglion, the risk of severe compensatory hyperhidrosis is higher, which may cause dissatisfaction with the procedure. OBJECTIVE: The aim of this study was to evaluate the efficacy of the use of low doses of oxybutynin in treating facial hyperhidrosis as well as the level of patient satisfaction with its use. METHODS: 25 patients with facial hyperhidrosis were treated with oxybutynin. The patients underwent 2 evaluations: before and after treatment. These evaluations were used to assess the patients' clinical improvement and quality of life. RESULTS: We observed that more than 75% of the patients evolved with an improvement in facial hyperhidrosis, and 52% of them presented a great improvement. CONCLUSION: Treatment of facial hyperhidrosis with oxybutynin is a good alternative to sympathectomy, since it presents good results and improves quality of life, in addition to not exposing patients to the risk of experiencing the side effects of sympathectomy

scholarly journals Diagnosis and management of gastroesophageal reflux disease

2014 ◽  
Vol 27 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Maria Aparecida Coelho de Arruda Henry
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Drug Use ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Disease Diagnosis ◽  
Clinical Treatment ◽  
Atypical Symptoms

INTRODUCTION: Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

scholarly journals PP028 Hyperhidrosis Quality Of Life Measures: Review And Patient Perspective

2017 ◽  
Vol 33 (S1) ◽  
pp. 82-83
Author(s):  
Julie Jones-Diette ◽  
Ros Wade ◽  
Kath Wright ◽  
Alexis Llewellyn ◽  
Stephen Rice ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Quality ◽  
Health Utility ◽  
Life Questionnaire ◽  
Related Quality ◽  
Health Related ◽  
Quality Of Life Index ◽  
Primary Hyperhidrosis ◽  
Disease Specific

INTRODUCTION:Primary hyperhidrosis has no discernible cause and is characterised by uncontrollable excessive and unpredictable sweating, which occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life, and can lead to social embarrassment, loneliness, anxiety and depression.The aim of this literature review was to identify the tools used to measure quality of life in studies of hyperhidrosis. Patient advisors provided insight and their perspective.METHODS:Studies were identified through searches undertaken in January 2016. The search strategies combined topic terms for hyperhidrosis with a recognised search filter for “quality of life”. All studies that reported measuring quality of life or described a quality of life measure/tool in the context of primary hyperhidrosis were included. The information on the tools and their use in hyperhidrosis was summarized in a narrative synthesis. Patient advisors contributed to the interpretation of the findings.RESULTS:The review included 184 studies and many studies used multiple tools. Twenty-two individual tools were identified. The review identified disease specific, dermatology specific, and general health/utility tools. The most commonly identified tools were the Dermatology Life Quality Index (DLQI), the Hyperhidrosis Disease Severity Scale (HDSS), and the Hyperhidrosis Quality of Life Questionnaire (HQLQ). The Hyperhidrosis Quality of Life index (HidroQoL©) is recently designed and validated, and therefore was used only in its validation study.When asked about these four quality of life tools patient advisors agreed that the HidroQoL© tool covered disease-specific quality of life dimensions relevant to them most comprehensively and was easy to complete. The DLQI was considered to be too general and too focussed on the skin. The HDSS was considered to be too basic and not sufficiently discriminating.CONCLUSIONS:Future studies of the effectiveness of interventions for hyperhidrosis on health-related quality of life may benefit from including the HidroQoL© tool.

scholarly journals Robotic sacrocolpopexy for the management of pelvic organ prolapse: quality of life outcomes

2019 ◽  
Vol 11 ◽  
pp. 175628721986859
Author(s):  
Annah Vollstedt ◽  
William Meeks ◽  
Veronica Triaca
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Clinical Improvement ◽  
Pelvic Organ ◽  
Robotic Sacrocolpopexy ◽  
Robotic Assisted ◽  
Rectocele Repair ◽  
Bowel Symptoms

Background: Our aim was to investigate longer-term surgical and quality of life (QOL) outcomes in a cohort of women undergoing robotic-assisted laparoscopic sacrocolpopexy (RALS) for pelvic organ prolapse (POP). Methods: We performed a retrospective cohort study at a single institution of female patients undergoing RALS with and without concomitant robotic-assisted laparoscopic hysterectomy, urethral sling, and rectocele repair. Scores from the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) surveys were used to evaluate QOL outcomes. Clinical improvement was defined by a decrease in a patient’s PFDI and PFIQ postoperative score by ⩾70%. Results: Clinical improvement was seen in 62.6% by the PFIQ and in 64% by the PFDI survey. Younger patient age (OR 0.92, p = 0.011) and worse preoperative American Urological Association (AUA) Quality of Life score (OR 1.42, p = 0.046) were associated with clinical improvement. Within the PFIQ, 35.6% of patients saw clinical improvement with their bowel symptoms, compared with bladder (54.1%, p < 0.001) and prolapse (45.6%, p = 0.053) symptoms. Within the PFDI, 45.5% of patients reached clinical improvement with their bowel symptoms, compared with bladder (56.7%, p = 0.035) and prolapse (62.6%, p < 0.001) symptoms. Of the patients who had a rectocele repair, 46.3% reached clinical improvement in their CRADI-8 score, and 51% saw clinical improvement in the bowel portion of the PDFI. Conclusions: Significantly fewer patients reached clinical improvement within the portions of the surveys that focus on bowel symptoms, compared with symptoms related to urination and POP. Of those that had a concomitant rectocele repair, approximately half reached clinical improvement with their bowel symptoms.

scholarly journals T231. QUALITY OF LIFE IN ANTIPSYCHOTIC-NAïVE YOUTH: EXPLORING THE INTERPLAY WITH METABOLIC SIDE-EFFECTS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S321-S321
Author(s):  
Araba Chintoh ◽  
Mahavir Agarwal ◽  
Nicole Mackenzie ◽  
Gary Remington ◽  
Margaret Hahn
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Waist Circumference ◽  
Clinical Improvement ◽  
Clinical Presentation ◽  
Well Being ◽  
Small Sample ◽  
Metabolic Side Effects ◽  
Metabolic Indices

Abstract Background This observational, exploratory pilot study aims to understand changes in clinical presentation and quality of life (QoL) in antipsychotic-naïve youth. Outcomes for these first-episode psychosis patients will be explored in the context metabolic changes during their first three months of treatment. Methods Participants (n = 10) aged 14–29 years were followed throughout their first three months of treatment with an antipsychotic medication (of physician’s/patient’s choice). Participants were evaluated on metabolic indices including weight, waist circumference, and BMI, as well as QoL [Pediatric Quality of Life Index (PedsQL) and PedsQL General Well-Being Scale] and clinical presentation [Clinical Global Impression (CGI) scale]. Descriptive statistics and nonparametric tests were conducted to compare significant changes across these variables. Results Significant changes in metabolic indices were observed over the first three months of treatment, as measured in weight gain (p = 0.02), increased waist circumference (p = 0.02) and increased BMI (p = 0.01). Physicians rated clinical improvement in participants, CGI score (p = 0.03). However, patient-rated QoL remained unchanged within all subcategories, including psychosocial (p = 0.52) and general well-being (p = 0.35). Discussion It appears that antipsychotic-related metabolic side effects may not impede upon early clinical improvement or impact QoL. In addition, there does not appear to be a relationship between clinical presentation and QoL as our small sample show QoL remains neutral or positive. Taken together, these findings suggest that clinical presentation and metabolic side effects may not be influential in early psychosis. From a clinical perspective, these early pilot data add to the literature highlighting the significant, early, antipsychotic-induced metabolic side effects in youth, and also encouraging clinicians to attend to the interplay between treatment and related QoL. This study is limited by its small sample size and naturalistic treatment allocation. These participants will be followed longitudinally to monitor development of adverse metabolic outcomes as well as changes in QoL in later stages of treatment/illness. The field must to understand how treatment and management of metabolic side effects can be augmented to promote clinical improvement and QoL, given the prevalence of adolescent patients who eventually wish to discontinue antipsychotic drugs because of metabolic side effects.

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