Platypnea-orthodeoxia syndrome: an intriguing perioperative hypoxemia case report

Abstract Platypnea-orthodeoxia syndrome (POS) is a rare condition of positional hypoxemia and dyspnea. The following is a case of hypoxemia for no obvious reason in the perioperative scenario. A 70-year-old male patient was submitted to a radical prostatectomy. On several occasions after anesthetic induction, peripheral oxygen saturation decreased without any understandable cause. In the postanesthesia care unit, severe hypoxemia occurred in the upright position, oddly correcting with recumbency. An echocardiography showed a right-to-left intracardiac shunt through a patent foramen ovale with no pulmonary hypertension, establishing POS. Achieving this diagnosis required a broad workup with a high degree of suspicion.

Platypnea-orthodeoxia syndrome: an intriguing perioperative hypoxemia case report.

Platypnea-orthodeoxia syndrome (POS) is a rare condition of positional hypoxemia and dyspnea. The following is a case of hypoxemia for no obvious reason in the perioperative scenario. A 70-year-old male patient was submitted to a radical prostatectomy. On several occasions after anesthetic induction, peripheral oxygen saturation decreased without any understandable cause. In the postanesthesia care unit, severe hypoxemia occurred in the upright position, oddly correcting with recumbency. An echocardiography showed a right-to-left intracardiac shunt through a patent foramen ovale with no pulmonary hypertension, establishing POS. Achieving this diagnosis required a broad workup with a high degree of suspicion.

Blood pressure in young adults.

INTRODUCTION: Hypertension (HT) is a major cardiovascular risk factor. Elevated blood pressure (BP) in childhood predisposes to HT in adulthood. Epidemiological studies in young age-groups are scarce. The aim of this study was to determine the prevalence of HT in a population of university students aged between 18 and 25 years; to analyze the profile of HT in the presence of other risk factors; and to alert patients and physicians to the need to assess and control cardiovascular risk factors in young adults. METHODS: We performed an observational, descriptive and cross-sectional study of a convenience sample of 402 university students, born between June 1, 1980 and May 24, 1988. Through a self-administered questionnaire and biometric measurements we recorded the following variables: BP, age, gender, smoking, regular medication, family history of HT, stress and body mass index. BP was determined by the mean of two measurements and classified according to the European Society of Cardiology guidelines. RESULTS: In the study population 229 (57%) individuals were female and 173 (42%) male, mean age 21 +/- 2 years. The prevalence of HT was 24.9% (20.4% with isolated systolic HT) and 27.4% had high normal BP. Among males 43.9% had HT, while among females only 10.5% were hypertensive. There was a high prevalence of HT in overweight (50.8%) and obese (50.0%) subjects. Among those exposed to stress, 27.2% had isolated systolic HT. A trend for HT was also found in young women taking oral contraceptives and in students with hypertensive first-degree relatives. CONCLUSIONS: The prevalence of HT and high normal BP in the study population of young adults was high. There was a statistically significant correlation between HT and male gender, HT and overweight and between isolated systolic HT and stress, confirming the existence of clusters of cardiovascular risk factors. Patients and their primary care physicians were alerted to the importance of assessing and controlling overall cardiovascular risk in young subjects.

Smoking habits of sixth year medical students and anti-smoking measures in Portugal.

OBJECTIVES: To study the smoking habits of 6th year Portuguese medical students and assess their knowledge and acceptance of anti-smoking measures and how they felt these would impact on public health. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study, in which a self-administered, anonymous questionnaire was made available online to the target population (6th year Portuguese medical students). The relationships between some of the variables were analysed using contingency tables and the chi2 test, with p<0.05 taken as statistically significant. RESULTS: We obtained 255 answers to our questionnaire. We found an 18.04% prevalence of smokers. The majority of smokers smoked 1 - 10 cigarettes per day, with men smoking more, and most of them had begun their habit between 13 and 18 years of age, with women beginning later. 36.96% of smokers had already made an attempt to quit smoking. The great majority of the respondents agreed with the anti-smoking measures listed in the questionnaire. Furthermore, they expected these measures to have a positive impact on smoking and on smoking-related morbidity and mortality. Only 34.90% of the students judged smoking cessation to be sufficiently taught in their curricula. CONCLUSIONS: The results are in accordance with the population in general in terms of the prevalence of smokers, the age of beginning smoking and a high prevalence of women smokers. There appears to be across-the-board agreement with anti-smoking measures, along with hope for a reduced general and individual consumption and morbi-mortality.

Smoking habits of sixth year medical students and anti-smoking measures in Portugal.

OBJECTIVES: To study the smoking habits of 6th year Portuguese medical students and assess their knowledge and acceptance of anti-smoking measures and how they felt these would impact on public health. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study, in which a self-administered, anonymous questionnaire was made available online to the target population (6th year Portuguese medical students). The relationships between some of the variables were analysed using contingency tables and the chi2 test, with p<0.05 taken as statistically significant. RESULTS: We obtained 255 answers to our questionnaire. We found an 18.04% prevalence of smokers. The majority of smokers smoked 1 - 10 cigarettes per day, with men smoking more, and most of them had begun their habit between 13 and 18 years of age, with women beginning later. 36.96% of smokers had already made an attempt to quit smoking.