scholarly journals Selective T3-T4 Sympathicotomy Versus Gray Ramicotomy On Outcome And Quality Of Life In Hyperhidrosis Patients. A Randomized Clinical Trial.

Author(s):  
Vicente Vanaclocha ◽  
Ricardo Guijarro-Jorge ◽  
Nieves Saiz-Sapena ◽  
Manuel Granell-Gil ◽  
Jose Ortiz-Criado ◽  
...  

Abstract Background: compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy.Objective: to reduce compensatory hyperhidrosis to increase patients' satisfaction. Patients and methods: a prospective randomized study on palmar hyperhidrosis, May 2016-September, 2019. Twenty-one patients T3-T4 sympathicotomy and 21 T3-T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and would recommend it.Results: No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50-63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75-27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was.Conclusions: T3-T4 gray ramicotomy had better results than T3-T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vicente Vanaclocha ◽  
Ricardo Guijarro-Jorge ◽  
Nieves Saiz-Sapena ◽  
Manuel Granell-Gil ◽  
José María Ortiz-Criado ◽  
...  

AbstractCompensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy. The study aimed to reduce compensatory hyperhidrosis to increase patients’ satisfaction. A prospective randomized study on palmar hyperhidrosis, May 2016–September 2019. Twenty-one patients T3–T4 sympathicotomy and 21 T3–T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and recommend it. No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50–63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75–27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was. T3–T4 gray ramicotomy had better results than T3–T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.


Author(s):  
José-Manuel Pastora-Bernal ◽  
María-José Estebanez-Pérez ◽  
Guadalupe Molina-Torres ◽  
Francisco-José García-López ◽  
Raquel Sobrino-Sánchez ◽  
...  

COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946.


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