Complications of video assisted thoracoscopic sympathectomy for primary hyperhidrosis

To document the possible complications of video-assisted thoracoscopic sympathectomy procedure and their frequency of occurrence. This retrospective study was conducted at King Hussein Medical Center, Amman, Jordan, between April 2001 and January 2006. Two hundred and seven patients underwent thoracoscopic sympathectomy for the treatment of facial, axillary, and/or palmar hyperhidrosis. Follow up was completed for one year. All possible early and late complications were documented and analyzed. Males constituted 59.4% of the studied patients. Mean age range was 25.2 +/- 4.6 13-34 years. One hundred and fifty-three patients 73.9% had palmar hyperhidrosis as the main indication for sympathectomy, 4 patients 1.9% had axillary hyperhidrosis, and facial sweating or blushing in 7 patients 3.4%. Palmar hyperhidrosis combined with axillary and/or facial sweating were found in 43 patients 20.8%. The most common recorded complication was compensatory hyperhidrosis, which occurred in 142 patients 68.6%. Compensatory sweating remains the most common, and most disabling complication of video-assisted thoracoscopic sympathectomy. Other alternative more selective methods, rather than cutting the main trunk should be studied thoroughly to assess their efficacy in reducing the complication of compensatory sweating

Foreign body aspiration: utilizing flexible fiberoptic bronchoscopy

To define the clinical spectrum of tracheobronchial foreign body aspiration in adults, evaluate the efficacy of bronchoscopy, and determine outcome and complications at King Hussein Medical Center. Retrospective analysis of 33 consecutive clinical series from a referral-based medical center [King Hussein Medical Center] was conducted. Case records of 33 adult patients [over 14 years of age] suspected to have foreign body aspiration over the past eight years were analyzed. All had bronchoscopic evaluation. Clinical-radiological features, types and location of foreign body were studied. About 98% of patients had their foreign bodies identified and removed using Flexible Fiberoptic Bronchoscopy while rigid bronchoscopy was needed in only three [9%] cases. Of 33 consecutive patients, 25 patients [76%] were females and the majority was below 30 years of age. A total of 30 patients [91%] presented within the first 24 hours after foreign body inhalation. A radio-opaque foreign body was evident in chest X-rays of 85% of the patients. Pins used to fix head scarves constituted 64% of the foreign bodies removed. The rest included a piece of bone, food particles and seeds. A total of 29 patients [88%] were discharged on the same day of the procedure. Ttracheobronchial foreign body aspiration in adults can occur in various settings. High clinical suspicion is necessary for diagnosis. Removal of foreign bodies can usually be accomplished with fiberoptic bronchoscopy. In our series the most commonly removed foreign bodies were metallic pins

Tracheobronchial straight metallic pin aspiration in young Jordanian females

To define the clinical spectrum of tracheobronchial straight metallic pin aspiration in adults, assess predisposing conditions, evaluate the efficacy of bronchoscopy, and determine the outcome and complications at the largest 2 hospitals in Jordan. Retrospective analysis of 60 consecutive clinical cases from 2 referrAl based medical centers [32 patients at King Hussein Medical Center [KHMC] and 28 patients at Al Basheer Hospital]. Medical records of adult patients [>13 years of age] who presented with history of straight metallic pin aspiration over 6-year period [July 2000 and July 2006] were analyzed. Clinico-radiological features and location of the pins were studied. The flexible fiberoptic bronchoscopy [FFB] was used for foreign body [FB] identification and removal in all KHMC patients; video assisted rigid bronchoscope under general anesthesia was used at Al Basheer Hospital. All patients were females<28 years of age. Fifty-six patients [93%] presented within the first 24 hours after aspiration. Medical history was suggestive of FB aspiration in all patients. Chest x-rays demonstrated the radio opaque pins in all patients. At bronchoscopy, the intermediate bronchus was the most common site of FB lodgment [62%]. Ninety-two percent of patients were discharged on the same day of the procedure. Tracheobronchial straight metallic pins are relatively frequent FB in Jordanian young females and can occur in a very specific clinical setting. Removal of these FBs can usually be accomplished successfully by FFB

effect of brompheniramine on cough sensitivity in healthy volunteers

In evaluate the anti-tussive effect of brompheniramine maleate a non-selective, sedative antihistamine using capsaicin challenge. Twelve subjects, five females and seven females, mean age 32 years with a range of [23-39] years, were studied on two occasions. On the two visits a baseline capsaicin dose-response was performed to determine C5 [the Lowest concentration causing 5 coughs]. After 30 minutes two C5 doses of capstucin were given and the total cough over one minute was counted. On the first visit Brompheniramine 8mg or a matched placebo was given orally, and 120, 240 minutes alter administration, two C5 doses of capsaicin were given and the total coughs over one minute period were counted. This was repeated exactly in the second visit except subjects received either a placebo or active treatment; either which they had not received on their first visit. Subjects were also asked to quantify their drowsiness using a 100mm visual analogue scale. Baseline mean cough number [confidence interval] was similar on the two study occasions 9.9 [8.2-11.7] before Brompheniramine and 9.2 [7.3-11.1] before placebo. Cough number did not differ on the two study days at 120 and 240 min after Brompheniramine treatment 77 [55-98] 74 [5.1-96] compared to 87 [64-110] 83 [68-9.8] after placebo. Mean visual analogue scale [confidence interval] after Brompheniramine was 31 [14-48] and 40 [21-60] compared to 7[2-12] and 7 [2-12] after Placebo at 120 and 240 nun respectively [p<0.005]. The sedative anti histamine Bromphcniraniine did not affect capsaicin induced cough though it produced significant drowsiness