Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations.

Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscle weakness secondary to botulinum toxin diffusion and the possibility of antibody production. All these problems limit the number of patients treated.

Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation.

Context: A high number of hospitalized children do not receive adequate sedation due to inadequate evaluation and use of such agents. With the increase in knowledge of sedation and analgesia in recent years, concern has also risen, such that it is now not acceptable that incorrect evaluations of the state of children's pain and anxiety are made.

Objective: A comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation.

[Juvenile hereditary chorea. Study of a family with recessive pattern of transmission].

Report of a family in which the parents are consanguineous and healthy and 4 of their 8 children began with involuntary choreic movements at ages 10 to 14. In all cases the clinical manifestations remained stable throughout the 5-year period of observation. There have been no clinical deterioration and intellectual functions were found to be intact.

[Hallervorden-Spatz syndrome: report of a case].

It is reported the case of a male patient with 19 years old presenting progressive behavior disturbance and dystonic posture beginning on right, with approximately five years of evolution. Extrapyramidal and pyramidal syndrome was evidenced at examination. This finding suggests Hallervorden-Spatz disease which was confirmed by resonance imaging (MRI).