An analysis of the natural course of compensatory sweating following thoracoscopic sympathectomy

AbstractBackgroundTo evaluate the long-term results of thoracoscopic sympathectomy in the treatment of hyperhydrosis.MethodsTheatre log books were used to identify all patients who underwent thoracoscopic sympathectomy between 2000 and 2006. Details of pre-operative symptoms, surgical procedure and post-operative complications were collected from the patient notes. Each patient was sent a questionnaire regarding success of the procedure, compensatory sweating and overall satisfaction.Results46 hyperhydrosis patients (34 females) age range 14–57 years. 20 patients suffered with hyperhydrosis in a combination of areas, 14 in the axillae alone, 9 palms alone and with 2 facial symptoms. There were 2 early post-operative complications, 1 haemothorax which required a chest drain and a chest infection. 3 patients required redo procedures. Of follow-up of 42 months (range 6–84), 32 (69·5%) patients reported complete dryness or a significant improvement in symptoms and 15 a substantial improvement in quality of life. However 43 patients (93%) suffered with compensatory sweating, of these 27 had to change clothes more than once daily. Compensatory sweating was graded as severe in 18 and incapacitating in 2. Of note only 5 patients noticed an improvement in the compensatory sweating over time. Only 26 (56%) would recommend thoracoscopic sympathectomy to others with hyperhydrosis.ConclusionThoracoscopic sympathectomy is effective in the treatment of hyperhydrosis. However compensatory sweating seems unavoidable and infrequently improves with time. Patients need to be carefully counselled before committing to surgery

Impact of centralisation on vascular surgical services

Studies showing a volume-outcome relationship in vascular surgery have led to a drive towards centralisation of vascular surgical services. This has led to these services being transferred from the district general hospital (DGH) to a central ‘network’ hospital. An unintended consequence of this is that the tariff funding stays with the operating hospital. Patients who are transferred back to the DGH for rehabilitation following treatment at the network hospital do not receive funding to cover their inpatient stay. We present data showing that since centralisation there has been a drop in overall income in a DGH along with sicker patients being repatriated. These patients also stay longer. This has implications for funding of rehabilitation tariffs and for the viability of district general vascular services. </jats:p

Synthesis and characterization of nanocrystalline strontium titanate through a modified combustion method and its sintering and dielectric properties

10.1016/j.jallcom.2009.07.045Journal of Alloys and Compounds4861-2711-715JALC

Characterization, sintering and dielectric properties of nanocrystalline barium titanate synthesized through a modified combustion process

10.1016/j.matchar.2008.09.012Materials Characterization604322-326MACH