The impact of the COVID-19 pandemic on the quality of sleep of medical residents in a tertiary care hospital.

Study Objectives: The COVID-19 pandemic has created unprecedented levels of stress and anxiety, which has a profound effect on sleep quality. However, limited data are available on the sleep quality of medical residents who work directly with patients infected with SARS-CoV-2. As sleep is a crucial brain state, our goal is to know the sleep quality of these medical residents.

Noninvasive mechanical ventilation assistance in amyotrophic lateral sclerosis: a systematic review.

Background: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS.

Objectives: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system.

Interaction between apolipoprotein E genotypes, excessive daytime sleepiness, and cognitive function in obstructive sleep apnea patients.

Background: Some studies show an association between the apolipoprotein E ε4 allele (ApoEε4) and obstructive sleep apnea syndrome (OSAS), and other studies, an association between ApoEε4 and excessive daytime sleepiness (EDS), but there are no data in the literature on the interaction between EDS, cognitive function, and ApoEε4 in patients with OSA.

Objective: To examine the cognitive function of adults with and without EDS and with and without ApoEε4.

Methods: A total of 21 male and female patients aged between 33 and 79 years, underwent a clinical interview, ApoE genotyping, neuropsychological evaluation, polysomnography, and the application of the Epworth Sleepiness Scale.

Brazilian Academy of Neurology practice guidelines for stroke rehabilitation: part I.

The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature.

Translation and adaptation of the sleep apnea quality of life index (SAQLI) to Brazilian Portuguese.

Background: Obstructive sleep apnea syndrome (OSAS) is characterized by episodes of upper airway obstruction during sleep, with a risk of cardiovascular and cerebrovascular diseases. There is no tool in Brazil to measure the impact of treatment on patients with OSAS.

Objective: To translate and culturally adapt the Sleep Apnea Quality of Life Index (SAQLI) into Brazilian Portuguese.

Neurologists' knowledge of and attitudes toward physical exercise for people with epilepsy in Latin America.

Introduction: Despite the favorable effects of exercise in people with epilepsy (PWE), the lower participation in physical/sports activities may be partly due to inadequate knowledge and attitudes of health professional about their benefits. In this regard, in 2016, the International League Against Epilepsy (ILAE) through its Task Force on Sports and Epilepsy published a consensus paper that provided general guidance concerning participation in exercise/sport activities for PWE. We investigated views and attitudes toward physical exercise practice among neurologists in Latin America.

A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room.

Background: Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s.

Objective: To compare high doses of inhaled ciclesonide with systemic hydrocortisone for managing acute asthma exacerbations in the emergency department.

Design And Setting: Double-blind, randomized clinical trial in the public healthcare system of the city of São Paulo.

Telemedicine use among neurologists before and during COVID-19 pandemic.

Background: After the public health emergency due to COVID-19 was declared in Brazil, the federal government temporarily regulated and authorized the use of telemedicine services for patient consultation, monitoring, and diagnosis. For more than a decade, neurologists have recognized the benefits of telemedicine in the acute management of stroke patients. However, as the use of telemedicine was restricted until the COVID-19 pandemic, the view of Brazilian neurologists about telemedicine is unknown.

Home sleep apnea testing: an accuracy study.

Aim: There are no studies comparing tests performed at home with those carried out in the laboratory, using the same device. The only studies that have been performed have compared the device used at home with the standard polygraph used in the laboratory. The purpose of this study was therefore to verify the accuracy of the home diagnosis of obstructive sleep apnea syndrome (OSAS) via unassisted type 2 portable polysomnography, compared with polysomnography using the same equipment in a sleep laboratory.

Impact of COVID-19 pandemic on the sleep quality of medical professionals in Brazil.

Introduction: Coronavirus pandemic began in China in 2019 (COVID-19), causing not only public health problems but also great psychological distress, especially for physicians involved in coping with the virus or those of the risk group in social isolation, and this represents a challenge for the psychological resilience in the world population. Studies showed that health professionals had psychological symptoms such as depression, anxiety, insomnia, stress, among others.

Objectives: To investigate the quality of sleep and the prevalence rate of sleeping disorders among physicians during COVID-19 pandemic, and identify the psychological and social factors associated with the condition.

Telemedicine in neurology: current evidence.

Background: Telemedicine was first introduced in Neurology as a tool to facilitate access to acute stroke treatment. More recently, evidence has emerged of the use of telemedicine in several other areas of Neurology. With the advent of the COVID-19 pandemic and the need for social isolation, Brazilian authorities have expanded the regulation of the use of telemedicine, thus allowing the treatment of many patients with neurological diseases to be conducted with less risk of SARS-CoV-2 contamination.

Factors associated with student performance on the medical residency test.

Objective: To determine whether the scores of the Progress test, the Skills and Attitude test, and the medical internship are correlated with the medical residency exam performance of students who started medical school at the Federal University of São Paulo in 2009.

Methods: The scores of 684 Progress tests from years 1-6 of medical school, 111 Skills and Attitude exams (5th year), 228 performance coefficients for the 5th and 6th years of internship, and 211 scores on the medical residency exam were analyzed longitudinally. Correlations between scores were assessed by Pearson's correlation.

Education is an important factor in end-of-life care: results from a survey of Brazilian physicians' attitudes and knowledge in end-of-life medicine.

Background: According to the Latin America Association for palliative care, Brazil offers only 0.48 palliative care services per 1 million inhabitants. In 2012, no accredited physicians were working in palliative care, while only 1.

Sensorimotor white matter projections and disease severity in primary Restless Legs Syndrome/Willis-Ekbom disease: a multimodal DTI analysis.

Background: Restless Legs Syndrome, a potentially disabling sleep disorder, also known as Willis-Ekbom disease (RLS/WED), may be caused by loss of inhibitory modulation of descending central motor pathways, structural changes in the somatosensory cortex, abnormal connectivity between motor and sensory areas, as well as by subtle abnormalities in white matter micro-organization.

Objective: To compare diffusion-tensor imaging (DTI) metrics in areas associated with sensory or motor function, as well as sensorimotor integration, between subjects with primary mild-to-severe RLS/WED and controls.

Methods: DTI metrics were assessed in 38 subjects with RLS/WED (14 mild to moderate, 24 severe to very severe) and 24 healthy age-matched controls with whole-brain Tract Based Spatial Statistics (TBSS), Region-of-interest (ROI) and probabilistic tractography based analyses.

Creating cartoons to represent habitual leg movements.

Unlabelled: Many people have a habit of moving their legs and believe that this behavior is due to the restless legs syndrome (RLS), a highly prevalent neurological condition that greatly impairs the quality of life of affected individuals. This behavioral pattern, characterized by the habit of moving one's legs and feet, may be an important confounding factor in the diagnosis of RLS.

Objective: To describe the main movements associated with this benign behavioral state to characterize a possible clinical condition that can contribute to the differential diagnosis of RLS.

Biofeedback Therapies for Chronic Insomnia: A Systematic Review.

The treatment of insomnia is still a challenge in clinical practice. This systematic review of randomized and quasi-randomized clinical trials aims to summarize the evidence for the use of biofeedback techniques in the treatment of chronic insomnia. Studies that compared biofeedback with other techniques of cognitive behavioral therapy, placebo, or absence of treatment were selected.

Exclusion of mimics does not influence Willis-Ekbom disease diagnosis among recent medical graduates.

Objective: In view of the diagnostic challenge posed by restless legs syndrome/Willis-Ekbom disease (RLS/WED) to health professionals and the challenge of its recognition by patients, the diagnostic criteria have been revised and updated to facilitate identification of this disease. However, in a previous study, we found that self-diagnosis of RLS/WED depends on the very name used to describe the condition. To ascertain whether the presence of the fifth diagnostic criterion of the International Restless Legs Syndrome Study Group (IRLSSG), is necessary for RLS/WED diagnosis when the term "Willis-Ekbom disease" is used.

Sleep apnea in Machado-Joseph disease: a clinical and polysomnographic evaluation.

Objective/background: Machado-Joseph disease (MJD) or spinocerebellar ataxia type 3 (SCA3) is the most common type of autosomal dominant spinocerebellar ataxia (SCA). Sleep disorders have been described as frequent non-motor symptoms in MJD, and with marked impairment on quality of life. However, few studies have evaluated the frequency and characteristics of sleep apnea in MJD.

WITHDRAWN: Treatments for adults with prominent lower front teeth.

Background: Prominent lower front teeth may be associated with a large or prognathic lower jaw (mandible) or a small or retrusive upper jaw (maxilla). Edward Angle, who may be considered the father of modern orthodontics, classified the malocclusion in this situation as Class III. The individual is described as having a negative or reverse overjet as the lower front teeth are more prominent than the upper front teeth.

The critical influence of nocturnal breathing complaints on the quality of sleep after stroke: the Pittsburgh Sleep Quality Index and STOP-BANG.

In stroke patients particularly, many factors, such as sleep-related respiratory disturbances, can impair sleep. Cheap and easy-to-use tools have been created to identify sleep quality and sleep disturbances in patients after stroke. This study described the scores of the sleep apnea screening questionnaire - STOP-BANG - in patients after a stroke, and correlated the findings with sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI).

Brazilian Academy of Neurology (2006 - 2016).

Brazil is a heterogeneous country with continental dimensions. The different characteristics of cultural, socioeconomic, and demographic status of the population drive different strategies for neurological care. This knowledge helps the understanding of the current scenario with the consequent possibility of preparing for future challenges.