Background: In patients undergoing pneumonectomy, intraoperative pulmonary and cardiac complications are the major cause of morbidity and mortality. Protective lung ventilation strategies may decrease the overall lung injury. Right, ventricular dysfunction may occur during the surgery and after the pneumonectomy, in the early postoperative period, with reduced RV ejection fraction and increased RV end-diastolic volume index, caused by increased RV afterload. Case report: We describe the case of a 28-year-old non-smoker female who underwent to a right pneumonectomy. The patient presented intraoperative hemodynamic instability and signs of RV dysfunction, requiring vasoactive amines and nitric oxide. Discussion: This article is intended to provide an overview of the anesthetic management for pneumonectomy including the hemodynamic management and considerations of the causes and management of right ventricular dysfunction.

Laryngeal papillomatosis is a rare disease of viral etiology that can obstruct the airway. Symptomatic treatment is essentially surgical. Anesthetic management needs special attention due to a narrow airway that will be shared with the surgical team. We discuss the perioperative management of a child with recurrent papillomatosis and possible strategies to manage similar cases.

Background: Syncope is a common sign with an inpatient rate of up to 83%. Data on sex differences of patients with syncope in the emergency and hospitalization are scarce. Aim: The present study aimed to verify sex differences regarding clinical profile, risk scores, causes of syncope and treatment modalities. Study Design: This is a single center, prospective, observational study. Place and Duration of Study: Department of Internal Medicine, Faculty of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Brazil, between February 2015 and February 2017. Methodology: We included 375 consecutive patients, 203 men and mean age of 52 years, hospitalized because of syncope. They underwent clinical evaluation, the laboratory tests, and the calculation of Martin, OESIL and EGSYS scores. Results: 114 patients had chagasic cardiomyopathy. The causes of syncope due to arrhythmia were ventricular tachycardia in 127 patients (66.1% men), supraventricular in 117 (63.2% women) and bradyarrhythmias in 56 patients (66.1% men), p<0.0001. Odds ratio for ventricular tachycardia in chagasic patients was 8.78 (95% IC: 5.33-14.46). Heart disease was predominant among men (p=0.001), even among patients with Chagas' heart disease. Comparing male and female, median age was 57 versus 48 years (p=0.04) and ejection fraction was 53 versus 58% (p=0.03). Martin and OESIL scores were higher in males (p <0.0001). There was no difference in treatment. Applying the receiver operating characteristic curve for ventricular tachycardia, Martin score had the largest area under the curve (0.84), p <0.0001. Conclusions: Men hospitalized for syncope were older, had more systolic ventricular dysfunction, and had higher Martin and OESIL scores. The main causes of syncope were ventricular tachycardia and bradyarrhythmias among men and supraventricular tachycardias among women.