Selection of Safe Parameters for Jet Injection of Botulinum Toxin in Palmar Hyperhidrosis
Bibliographic record
Abstract
We commend Dr Doft and her coauthors1 on their excellent review article titled “Treatment of Hyperhidrosis With Botulinum Toxin,” but we wish to shed some light on the use of jet injection in the palmar skin because all jet injectors do not perform similarly, and even the same injector can perform differently in different body sites. For example, although the Dermojet (AKRA, Pau, France) is safe to use for plantar hyperhidrosis, its use for palmar hyperhidrosis can be hazardous. We would like to take this opportunity to elaborate on how to set safe parameters on the jet injector to prevent damage to underlying nerve and vessel structures. In the reference on jet injection cited by the authors,2 under the heading of palmar and plantar treatment, the device used was a low-pressure, CO2-driven, versatile jet injector: the MED-JET MBX (Medical International Technologies, Montreal, QC, Canada3; Figure 1) and not the standard Dermojet,4 which is a high-pressure jet injector device with a fixed volume of 0.1 mL per spurt. The Dermojet is activated by a spring, which generates a fixed driving pressure close to 1422 parts per square inch (psi). On the other hand, the MED-JET MBX is equipped with an adjustable pressure system (120–300 psi) and an adjustable volume per spurt that ranges from 0.02 to 0.3 mL. Figure 1 Versatile needle-free injector. MED-JET MBX (Medical International Technologies, Montreal, QC, Canada). As mentioned by the authors, pain associated with injections for …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".