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https://www.readbyqxmd.com/read/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#1
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27889103/cardiac-autonomic-changes-after-thoracic-sympathectomy-a-prospective-randomized%C3%A2-study
#2
Alfonso Fiorelli, Giovanni Messina, Paolo Chiodini, Saveria Costanzo, Andrea Viggiano, Marcellino Monda, Giovanni Vicidomini, Mario Santini
BACKGROUND: We evaluated whether cardiac autonomic changes could be associated with different extent of sympathetic nerve resection in the management of essential palmar hyperhidrosis. METHODS: Sixty patients with essential palmar hyperhidrosis were randomly allocated to undergo excision of T3 ganglia (sympathicectomy group; n = 30) or to interruption of sympathetic chain at the T2 to T3 level with ganglion sparing (sympathicotomy group; n = 30). Time and frequency domains were measured with a 24-Holter monitor during daytime, nighttime, and 24-hour periods at different interval points (7 days before operation; 24 hours; and 1, 3, and 6 months later), and the differences were statistically compared...
November 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884744/technical-description-of-oblique-lateral-interbody-fusion-at-l1-l5-olif25-and-at-l5-s1-olif51-and-evaluation-of-complication-and-fusion-rates
#3
Kamal R M Woods, James B Billys, Richard A Hynes
BACKGROUND: The OLIF procedure is aimed at mitigating some of the challenges seen with traditional ALIF and transpsoas LLIF and allows for interbody fusion at L1-S1. PURPOSE: To describe the OLIF technique and assess the complication and fusion rates. STUDY DESIGN: A retrospective cohort study. PATIENT SAMPLE: 137 patients who underwent the oblique lateral interbody fusion (OLIF) procedure. OUTCOME MEASURES: Adverse events within 6 months of surgery: Infection, symptomatic pseudarthrosis, hardware failure, vascular injury, perioperative blood transfusion, ureteral injury, bowel injury, renal injury, prolonged postoperative ileus (greater than 3 days), incisional hernia, pseudohernia, reoperation, neurological deficits (weakness, numbness, paresthesia), hip flexion pain, retrograde ejaculation, sympathectomy affecting lower extremities, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, and cerebrovascular accident...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27871512/case-report-management-of-differential-diagnosis-and-treatment-of-severe-anaphylaxis-in-the-setting-of-spinal-anesthesia
#4
Brian M Osman, Joni M Maga, Sebastian M Baquero
The purpose of this case report is to educate fellow anesthesiologists of a complicated differential diagnosis for sudden cardiovascular collapse after spinal anesthesia. We report a case where anaphylaxis occurred while under spinal anesthesia and resulted in difficult resuscitation. A 58-year-old woman undergoing bilateral knee replacements under spinal anesthesia experienced sudden seizure and cardiovascular collapse from acute anaphylactic shock while administering a cephalosporin. Local anesthetic toxicity, high spinal, and anaphylaxis were considered due to overlapping of symptoms...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27843688/extreme-lateral-lumbar-interbody-fusion-do-the-cons-outweigh-the-pros
#5
Nancy E Epstein
BACKGROUND: Major factors prompted the development of minimally invasive (MIS) extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USE) for the thoracic/lumbar spine. These include providing interbody stabilization and indirect neural decompression while avoiding major visceral/vessel injury as seen with anterior lumbar interbody fusion (ALIF), and to avert trauma to paraspinal muscles/facet joints found with transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterior-lateral fusion techniques (PLF)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843680/non-neurological-major-complications-of-extreme-lateral-and-related-lumbar-interbody-fusion-techniques
#6
Nancy E Epstein
BACKGROUND: Complications exclusive of new neurological deficits/injuries that follow extreme lateral interbody fusion (XLIF) and related lateral lumbar interbody techniques should be better recognized to determine the safety of these procedures. Unfortunately, a review of the XLIF literature did not accurately reflect the frequency of these "other complications" as few US surgeons publish such adverse events that may lead to medicolegal suits. METHODS: Major complications occurring with XLIF included sympathectomy, major vascular injuries, bowel perforations, sterile seromas, and instrumentation failures...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27797908/hematopoietic-stem-cell-mobilization-is-necessary-but-not-sufficient-for-tolerance-in-islet-transplantation
#7
Blair T Stocks, Analise B Thomas, Sydney K Elizer, Yuantee Zhu, Andrew F Marshall, Christopher S Wilson, Daniel J Moore
Overcoming the immune response to establish durable immune tolerance in Type 1 Diabetes remains a substantial challenge. The ongoing effector immune response involves numerous immune cell types but is ultimately orchestrated and sustained by the hematopoietic stem cell (HSC) niche. We therefore hypothesized that tolerance induction also requires these pluripotent precursors. Herein, we determined that the tolerance inducing agent anti-CD45RB induces HSC mobilization in non-autoimmune B6 mice but not in diabetes-prone NOD mice...
October 26, 2016: Diabetes
https://www.readbyqxmd.com/read/27754027/yia-03-03-effect-of-gabapentin-ligand-of-alpha-2-delta-subunit-of-voltage-dependent-calcium-channels-on-blood-pressure-and-baroreflex-sensitivity-in-spontaneously-hypertensive-rats-the-influence-of-guanethidine-induced-sympathectomy
#8
Michal Behuliak, Michal Bencze, Anna Vavrinova, Ivana Vaneckova, Josef Zicha
OBJECTIVE: Voltage-dependent calcium channels (VDCCs) play an important role in two major abnormalities observed in spontaneously hypertensive rats (SHR) - hyperactivity of sympathetic nervous system (SNS) and enhanced Ca influx to vascular smooth muscle cells (VSMC). α2δ subunit of VDCC, which promotes surface trafficking and modulates the biophysical properties of VDCC, was identified as a critical component of increased L-type VDCC calcium currents in arterial myocytes of SHR. On the other hand, N-type VDCCs control a neurotransmitter release in the peripheral sympathetic nervous system and play an important role in sympathetic hyperactivity in SHR...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27749585/a-case-report-of-the-beneficial-effects-of-botulinum-toxin-type-a-on-raynaud-phenomenon-in-a-patient-with-lung-cancer
#9
Lu Wang, Qi-Song Lei, Yu-Ying Liu, Guan-Jie Song, Chun-Ling Song
OBJECTIVE: Raynaud phenomenon is a vasospastic disorder affecting the hands and feet, and the efficacies of traditional treatments, such as pharmacological therapies and sympathectomy, are not uniform. Patients with paraneoplastic Raynaud phenomenon do not benefit from the traditional treatments. The use of botulinum toxin type A (BTX-A) for Raynaud phenomenon has been reported for several years; however, there are few reports regarding botulinum toxin type A in the treatment of paraneoplastic Raynaud phenomenon...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27721001/altered-contractile-responses-of-arteries-from-spontaneously-hypertensive-rat-the-role-of-endogenous-mediators-and-membrane-depolarization
#10
Michal Bencze, Michal Behuliak, Anna Vavřínová, Josef Zicha
AIMS: The goal of our study was to reveal the important mechanism(s) responsible for the enhanced contractility of isolated arteries from animals suffering genetic hypertension. MAIN METHODS: Contractile force of endothelium-denuded arteries, modulated by various interventions, was measured by wire myography. KEY FINDINGS: Spontaneously hypertensive rat (SHR) and Wistar-Kyoto rat (WKY) arteries were stimulated by norepinephrine, increased extracellular K(+) or tyramine...
October 6, 2016: Life Sciences
https://www.readbyqxmd.com/read/27692206/management-of-plantar-hyperhidrosis-with-endoscopic-lumbar-sympathectomy
#11
Roman Rieger
Primary plantar hyperhidrosis is defined as excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle and reduction of health-related quality of life. Conservative therapy measures usually fail to provide sufficient relieve of symptoms and do not allow long-lasting elimination of hyperhidrosis. Endoscopic lumbar sympathectomy appears to be a safe and effective procedure for eliminating excessive sweating of the feet and improves quality of life of patients with severe plantar hyperhidrosis...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692204/less-common-side-effects-of-sympathetic-surgery
#12
Lyall A Gorenstein, Mark J Krasna
Because of video-assisted thoracic technology and increased patient awareness of treatment options for palmar hyperhidrosis, endoscopic thoracic sympathectomy (ETS) has become a well-accepted treatment for this disorder. Video assistance affords excellent visualization of thoracic anatomy, which allows the procedure to be done quickly with few complications. However, despite the ease of performing ETS, complications can occur unless thoracic anatomy and physiology are well-understood. Awareness of possible intraoperative and postoperative complications is essential if this procedure is gong to be performed safely...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692203/management-of-compensatory-sweating-after-sympathetic-surgery
#13
Nelson Wolosker, José Ribas Milanez de Campos, Juliana Maria Fukuda
Compensatory hyperhidrosis (HH) is the most common and feared side effect of thoracic sympathectomy, because patients with severe forms have their quality of life greatly impaired. The most well-known factors associated with compensatory HH are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Technical developments as well as the proper selection of patients for surgery have been crucial in reducing the occurrence of severe forms of compensatory HH. Therapeutic options include topical agents, botulinum toxin, systemic anticholinergics, clip removal, and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692202/quality-of-life-changes-following-surgery-for-hyperhidrosis
#14
José Ribas Milanez de Campos, Hugo Veiga Sampaio da Fonseca, Nelson Wolosker
The best way to evaluate the impact of primary hyperhidrosis on quality of life (QL) is through specific questionnaires, avoiding generic models that do not appropriately evaluate individuals. QL improves significantly in the short term after sympathectomy. In the longer term, a sustained and stable improvement is seen, although there is a small decline in the numbers; after 5 and even at 10 years of follow-up it shows virtually the same numerical distribution. Compensatory hyperhidrosis is a major side effect and the main aggravating factor in postoperative QL, requiring attention to its management and prevention...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692201/reconstruction-of-the-sympathetic-chain
#15
Cliff P Connery
There is a small subset of patients who have undergone endoscopic thoracic sympathectomy for hyperhidrosis or facial blushing who are dissatisfied and would wish reversal. Compensatory sweating is the most common side effect that causes a person to regret surgery. Treatment options are limited and usually not effective in patients with severe side effects from sympathectomy. Nerve graft interposition has been proven to be effective in experimental models and small clinical series. Da Vinci robotic nerve graft reconstruction with interposition graft and direct suturing of nerve and high magnification dissection most closely mirrors standard nerve reconstruction principles when done as a minimally invasive procedure...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692200/reversibility-of-sympathectomy-for-primary-hyperhidrosis
#16
Conor F Hynes, M Blair Marshall
Endoscopic thoracic sympathectomy (ETS) is an effective treatment of primary hyperhidrosis of the face, upper extremities, and axillae. The major limitation is the side effect of compensatory sweating severe enough that patients request reversal in up to 10% of cases. When ETS is performed by cutting the sympathetic chain, reversal requires nerve grafting. However, for ETS done with clips, reversal is a simple thoracoscopic outpatient procedure of removing the clips. Subsequent reversal of the sympathectomy, ie, nerve regeneration, is successful in many cases...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692198/selecting-the-right-patient-for-surgical-treatment-of-hyperhidrosis
#17
Alan Edmond Parsons Cameron
This article presents a personal view of the indications for surgical treatment of patients with hyperhidrosis based on long clinical experience. Endoscopic thoracic sympathectomy is the preferred opinion for palmar sweating. It is also useful when there is additional axillary sweating but is not the first choice for isolated armpit symptoms. Surgical treatment of craniofacial sweating is much more likely to be followed by undesirable side-effects.
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27692195/the-history-of-sympathetic-surgery
#18
Moshe Hashmonai
At present, primary hyperhidrosis is the main indication for sympathectomy. For upper thoracic sympathetic ablation, excision of the second thoracic ganglion alone or with the first and/or third ganglia was the standard during the open surgery era. With the advent of thoracoscopy, modifications related to the level, extent, and type of ablation were proposed to attenuate compensatory hyperhidrosis. The ideal operation for sympathetic denervation of the face and upper limbs remain to be defined. Controlled double-blind studies with quantitave measurements of sweat production are required...
November 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27642945/yia-03-03-effect-of-gabapentin-ligand-of-alpha-2-delta-subunit-of-voltage-dependent-calcium-channels-on-blood-pressure-and-baroreflex-sensitivity-in-spontaneously-hypertensive-rats-the-influence-of-guanethidine-induced-sympathectomy
#19
Michal Behuliak, Michal Bencze, Anna Vavrinova, Ivana Vaneckova, Josef Zicha
OBJECTIVE: Voltage-dependent calcium channels (VDCCs) play an important role in two major abnormalities observed in spontaneously hypertensive rats (SHR) - hyperactivity of sympathetic nervous system (SNS) and enhanced Ca influx to vascular smooth muscle cells (VSMC). α2δ subunit of VDCC, which promotes surface trafficking and modulates the biophysical properties of VDCC, was identified as a critical component of increased L-type VDCC calcium currents in arterial myocytes of SHR. On the other hand, N-type VDCCs control a neurotransmitter release in the peripheral sympathetic nervous system and play an important role in sympathetic hyperactivity in SHR...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27636740/neuraxial-anesthesia-reduces-lymphatic-flow-proof-of-concept-in-first-in-human-study
#20
Jonathan G Hiller, Hilmy M Ismail, Michael S Hofman, Kailash Narayan, Shakher Ramdave, Bernhard J Riedel
Dilation of lymphatic vessels may contribute to iatrogenic dissemination of cancer cells during surgery. We sought to determine whether neuraxial anesthesia reduces regional lymphatic flow. Using nuclear lymphoscintigraphy, 5 participants receiving spinal anesthesia for brachytherapy had lower extremity lymph flow at rest compared with flow under conditions of spinal anesthesia. Six limbs were analyzed. Four limbs were excluded because of failure to demonstrate lymph flow (1 patient, 2 limbs), colloid injection error (1 limb), and undiagnosed deep vein thrombosis (1 limb)...
September 15, 2016: Anesthesia and Analgesia
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