Platypnoea-Orthodeoxia Syndrome: An Intriguing Diagnosis.

Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterized by dyspnoea and hypoxaemia induced by upright posture and relieved by recumbence. It is often associated with right-to-left shunting through a patent foramen ovale (PFO) or an atrial septal defect. We report the case of a 79-year-old woman with hypoxaemia initially attributed to a pulmonary infection but persisting after successful treatment. Being in the upright position triggered the hypoxaemia. A thoracic CT angiogram and ventilation/perfusion lung scan excluded a pulmonary embolism, but a transoesophageal echocardiogram with a bubble test showed a PFO with a right-to-left shunt, without pulmonary hypertension. The patient underwent percutaneous closure of the PFO which led to prompt symptom relief and full functional recovery. LEARNING POINTS: Platypnoea-orthodeoxia syndrome is an uncommon condition that should be suspected in the presence of unexplained positional hypoxaemia.A high level of suspicion is required and the diagnosis can be safely established by tilt-table transoesophageal echocardiography.Percutaneous closure of a patent foramen ovale is safe and effective even in elderly patients.

Percepção do homem paraplégico sobre sexualidade nas dimensões sociopsicoafetivas / The paraplegic mans perception about sexuality on the social, psycho and affectional dimensions / Percecpción del hombre paraplegico encima de la sexualidad en sus dimensiones sociopsicoafectivas

Trata-se de uma pesquisa qualitativa descritivo-exploratória que objetivou estudar a percepção do homem paraplégico sobre sua sexualidade, verificando as alterações psicoafetivas e identificando como o indivíduo paraplégico percebe sua inserção social. Constatou-se que o homem paraplégico relata alterações na manifestação da sua sexualidade, com repercussões na auto-estima e na auto-imagem, além de várias mudanças nas relações psicoafetivas e de preconceitos sociais, com dificuldade de inserção no mercado de trabalho.

The present study is a descriptive and exploratory qualitative research that purposed to study the paraplegic man' perceptions about sexuality, verifying the psycho and affectives alterations and identifying how the paraplegic person discerns your social insertion. It was detected that the paraplegic man reports alterations in the sexuality' manifestation, with resounds on self esteem and self image, beyond many changes on the psycho and affectives relationships and social preconceptions, with difficulty of insertion on the business market.

El presente estudio es una investigación cualitativa, descriptiva y exploratoria que objetivó estudiar la percepción del hombre paraplegico encima de la sexualidad, verificando las mudanzas psicoafectivas y identificando como el hombre paraplegico percibi su inserción social. Se constató que el hombre paraplegico refere mudanzas en la manifestación de su sexualidad, con repercuciones en su autoestima y en su autoimagen, como también muchas mudanzas en las relaciones psicoafectivas y prejuicios sociales, con dificultad de inserción en el mercado de trabajo.