Francesca Spinelli

Background/Objectives: Primary palmar hyperhidrosis (PPH) is a socially debilitating condition that often begins in adolescence. Although sympathicotomy is a low-risk procedure, there are conflicting opinions about the optimal time for surgery: some recommend it at onset in adolescence, while others are cautious because of the risk of recurrence associated with juvenile neuroplasticity. The primary objective was to assess the recurrence rate; secondary objectives included the management of hyperhidrosis, compensatory sweating onset, and satisfaction. Methods: This retrospective cohort study included sympathicotomy procedures for palmar hyperhidrosis performed between 2004 and 2024 in patients younger than 18 years with a preoperative Hyperhidrosis Disease Severity Scale (HDSS) class of 4. Quantitative data are presented as medians and interquartile ranges, while categorical data are presented as numbers and percentages. Results: 28 patients were included, of whom 4 underwent single-stage surgery and 24 two-stage surgery. The median age was 17.30 years, with no gender predominance. At a median follow-up of 75 months, the recurrence rate was 10.71%. Twenty-two patients experienced compensatory sweating, with the majority (60.7%) reporting mild symptoms and the remainder reporting moderate. The median patient satisfaction score was 9.34 (range 9–10). Conclusions: Even though PPH typically begins during adolescence, there is no consensus on the appropriateness of sympathicotomy for younger patients, primarily due to concerns about recurrence. Our data, characterized by long-term follow-up and large numbers of minors, are consistent with those observed in adults’ cohorts in terms of hyperhidrosis management, compensatory sweating rates, and, particularly, recurrence rates, supporting the surgical approach even at a young age.

The term ‘vaping’ refers to the use of electronic cigarettes or other devices to inhale a variety of heated and aerosolized substances. Vaping has been promoted as a less harmful and potentially oncogenic alternative to nicotine cigarettes, particularly to help heavy smokers quit. While vaping products do not produce the same carcinogenic substances—such as polycyclic aromatic hydrocarbons—generated by the combustion of tobacco, and while their fluids lack tobacco-related carcinogens like nitrosamines, it is now well established that they still generate harmful and potentially oncogenic byproducts. Several mechanisms have been proposed to explain the potential oncogenic effects of vaping fluids, including direct chemical action, epithelial–mesenchymal transition induction, redox stress, mitochondrial toxicity, and DNA damage. In addition to cancer risk, there have been reports of adverse effects on cardiovascular health, reproductive function, and non-oncologic lung injuries. These include exogenous lipoid pneumonia, diffuse alveolar hemorrhage with proven alveolar injury, and vaping-associated bronchiolitis obliterans. The aim of this review is to examine vaping devices, their potential role in lung carcinogenesis, vaping-associated lung injury, and other clinical implications, including impacts on cardiovascular, cerebrovascular, and respiratory diseases, and also pregnancy and fetus health.

Background: Major thoracic trauma represents a life-threatening condition, requiring a prompt multidisciplinary approach and appropriate pathways for effective recovery. While acute morbidity and mortality are well-known outcomes in thoracic-traumatized patients, long-term quality of life in patients surviving surgical treatment has not been widely investigated before. Methods: Between November 2016 and November 2023, thirty-two consecutive patients were operated on because of thoracic trauma. Age, sex, comorbidities, location and extent of thoracic trauma, Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), Organ Injury Scale (OIS), intra and extrathoracic organ involvement, mechanism of injury, type of surgical procedure, postoperative complications, ICU and total length of stay, immediate clinical outcomes and long-term quality of life—by using the EQ-5D-3L scale and Numeric Rate Pain Score (NPRS)—were collected for each patient Results: Results indicated no significant difference in EQOL.5D3L among patients with thoracic trauma based on AIS (p = 0.55), but a significant difference was observed in relation to ISS (p = 0.000011). Conclusions: ISS is correlated with the EQOL.5D3L questionnaire on long-term quality of life, representing the best prognostic factor—in terms of long-term quality of life—in patients surviving major thoracic trauma surgical treatment.