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Q: Could you please tell me what the Pickwickian Syndrome is?

A: The Pickwickian syndrome may be defined as hypoventilation due to obesity. Hypoventilation is the condition characterized by elevated arterial carbon dioxide pressure in the arterial blood, with decreased oxygen tension. Since this is a chronic condition, the blood of these individuals also contains an increase in the number of red blood cells per unit volume of blood, in an attempt of the organism to compensate for the decreased oxygen tension in the arterial blood. Therapy of this condition is directed at weight loss, which improves the ventilatory response of the organism. Also, certain substances which also improve this response, such as medroxyprogesterone, may be useful in improving the condition. The Pickwickian syndrome appears to occur in some obese individuals because of a combination of a decreased ventilatory drive in these individuals, in conjuction with with the mechanical load caused by obesity.

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