Questionnaire of quality of life in patients with primary hyperhidrosis

BACKGROUND: Hyperhidrosis or excessive sudoresis is a chronic disease associated with important subjective distress. OBJECTIVE: To propose a specific questionnaire to evaluate the quality of life of patients with hyperhidrosis. METHODS: From October 1995 to March 2002, 378 patients (234 females), with a mean age of 26.8 years, were evaluated before and after video-assisted thoracic sympathectomy. RESULTS: Therapeutic success was obtained in 90 percent of the procedures. The recurrence rate was 10 percent for palmar and 11 percent for axillary hyperhidrosis; 27 percent of the patients who had recurrence were re-operated successfully. No serious complications were reported. Of the total number of patients, 91 percent answered to the quality of life questionnaire, and 86 percent of them reported improvement after the procedure. CONCLUSIONS: Thoracic sympathectomy is a therapeutic method capable of changing the quality of life of patients with hyperhidrosis. The questionnaire applied has shown these changes.

Ischemic rest pain of the lower extremities. Treatment with peripheral nerve crush

The authors report the results obtained from peripheral nerve crushing in the treatment of ischemic rest pain and/or trophic lesions of toes and feet. They studied retrospectively 102 patients who were submitted to peripheral nerve crushing at the "Hospital das Clínicas da Universidade de São Paulo" during a sixteen-year period, from March 1971 to April 1987. These patients had no other choice, either clinical or surgical. The results were evaluated under three aspects: elimination of pain, evolution of trophic lesions and postoperative complications. The follow-up period varied from 1 month to 6 years (mean of 18 months). The results showed immediate elimination of pain in 94 of the patients. The remaining 6 were reoperated on within 24 to 48 hours, due to technical failure in identifying some of the nerves during the first operation. Regarding the trophic lesions, in 71 of the patients the results were good and the remaining underwent amputation at leg or thigh. The worst results were obtained in patients with necrotic lesions (p < 0.05). Three patients presented surgical wound dehiscence. The authors conclude that peripheral nerve crushing constitutes a valid alternative for a select group of patients with uncontrollable ischemic rest pain in the feet.