Pickwick syndrome

Pickwick syndrome Pickwick syndrome represents a complex of symptoms that mainly affects people with extreme obesity. Syndrome name derives from the name of a character in Charles Dickens's novel "The Pickwick Papers, which show some signs of the disease. Home health problems of these patients is nocturnal apnea caused by excessive amount of fatty tissue surrounding the pectoral muscles, overburdening the heart, lungs and diaframa with limiting respiratory movements.
Etiology
Pickwick syndrome The exact cause is unknown. It is assumed that the genetic factor plays an important role in the determination of disease. The brain fails to properly control and respiratory function due to excessive weight and hit the chest wall, the patient can not breathe deeply. Because of this, the blood contains too much carbon dioxide and insufficient oxygen. Patients often suffer sleepless nights because of fatigue, poor sleep quality and chronic hypoxia (lack of oxygen in the blood). The main risk factor is the extreme obesity.
Clinical
Clinical manifestations of Pickwick syndrome occurs mostly due to lack of sleep and include: - Excessive sleepiness during the day; - Episodes of sleep during the day; - Increased risk of accidents and errors at work; - Depression; Additional symptoms that may occur translate low blood oxygen level (chronic hypoxia) dyspnea and fatigue after the slightest effort. Obesity Amid these symptoms occur: - Blue-violet coloring of the lips, fingers and skin (cyanosis); - Signs of right heart failure (lung chorus) memebrele swelling in legs, breathlessness, fatigue minimal effort; - Red facies; - Neck short and thick;
Diagnosis
For Pickwick syndrome diagnosis using various tests such as: - Echocardiography (to determine cardiomegaly or pulmonary hypertension); - Polysomnography (for objective assessment of daytime sleepiness); - Spirometry (for assessment of lung function); After the event, it also recommends: - Nuclear magnetic resonance; - Computertomografia; - Nazoscopie; Doctors differentiate nocturnal obstructive apnea syndrome Pickwick after high levels of carbon dioxide in the blood when the person is awake.
Treatment
Treatment of the Pickwick syndrome focuses on weight loss and physical activity. Sometimes he manages to potentate medroxyprogesterone results. Respiratory assistance options include: - Devices noninvasive mechanical ventilation (BiPAP: Bi-level Positive Airway Pressure.) Through a mask that adheres to the nose or mouth even when (especially during sleep); - Mechanical ventilation through a hole made in the trachea (tracheostomy); - Administer oxygen (oxygen); Support groups can offer help Pickwick syndrome patients and family members, helping them adapt in a timely manner to changes in lifestyle imposed by the treatment, but also to find information on new treatments.
Prognosis
Evolution Pickwick syndrome is reversible if diagnosed in time and treated properly. Untreated, can cause serious problems of health, the nature of cardiac and vascular risk of death. Pickwick syndrome correlates with complications
lack of sleep: - Increased risk of accidents; - Depression, restlessness, irritability; - Sexual Dysfunction; and overloading of the heart: - Hypertension; - Right heart failure (lung choir);
Prophylaxis
Pickwick syndrome can be prevented by maintaining normal body weight and physical exercise regularly. To prevent nocturnal apnea associated, there are several ways. If apnea occurs only in the supine position (patient sleeps on his back), it is sewing a tennis ball in pajamas to prevent the patient to adopt this position during sleep. In severe cases of nocturnal apnea can be a tonsillectomy (surgical removal of tonsils) or you can wear braces.