Sleep and Awakening Quality during COVID-19 Confinement: Complexity and Relevance for Health and Behavior.

OBJECTIVE: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. METHODS/RESULTS: Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. CONCLUSIONS: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences.

[Lung abscess in infancy--a rare disease. Clinical cases]. / Abcesso pulmonar na infância--uma doença rara. Casos clínicos.

Lung abscess is a rare entity in childhood, but leads to high morbidity and long length of hospitalisation. It appears commonly in children with risk factors or other disease, have a good response to antibiotic therapy and it is rarely necessary the use of invasive techniques. Authors present two cases of lung abscess in children, one of them with risk factors to aspiration, that improved with antibiotic therapy and make a revision about this entity in infancy.

[Difficulties on diagnosis of ventilator associated pneumonia]. / Dificuldades no diagnóstico da pneumonia associada ao ventilador.

Ventilator associated pneumonia is associated with high morbidity and mortality. It is important a correct diagnosis in way to guide the antibiotic therapy in the most appropriate way. However, its diagnosis is difficult, because clinical and radiologic features are not specific and approaches to standard diagnosis, that allow its confirmation, are very invasive or not very frequent. Protected techniques and quantitative cultures have been trying to outline the problem of the contamination of the samples obtained by routine methods and to allow the distinction between colonization and infection. The author makes a revision on the different methods of diagnosis of this clinical entity.

Manifestaçöes clínicas e radiográficas pulmonares na leptospirose benigna, durante surto epidêmico no Rio de Janeiro: algumas nótulas sobre a epidemia / Clinical and radiological pulmonary manifestations in mild leptospirosis during an epidemical outbreak in Rio de Janeiro: brief notes about the epidemic

Foram comunicados a Secretaria Estadual de Saúde 1.177 casos de leptospirose, durante o surto epidêmico que, de fevereiro a março de 1988, afligiu o Rio de Janeiro e o Grande Rio, por ocasiäo das chuvas torrenciais ocorridas nesse período. Algumas observaçöes parciais sobre as características gerais desta epidemia säo apresentadas no decorrer deste trabalho que analisa os aspectos clínico-radiológicos das alteraçöes respiratórias de 86 pacientes internados no Instituto Estadual de Infectologia Säo Sebastiäo (RJ). Excetuando-se um (forma grave que foi a óbito), todos tiveram o espectro leve ou moderado da doença. O exame radiográfico de tórax foi normal em 64 enfermos e 61 eram assintomáticos sob o ponto de vista clínico-respiratório. Em 25 casos, foram verificadas as seguintes alteraçöes clínicas: tosse produtiva (em 18), tosse seca (em sete), escarros hemáticos (em sete) e dor torácica (em cinco). Com relaçäo aos achados de ausculta pulmonar, predominou a presença de estertores creptantes e subcreptantes - em 10 doentes - e de murmúrio vesicular diminuído - em sete. Foram descritas alteraçöes na radiografia de tórax de 22 enfermos, assim classificadas: infiltrado retículo-nodular - nove casos; infiltrado intersticial - quatro casos; infiltrado alveolar - três casos; lesäo infiltrativa localizada - dois casos; infiltrado reticular - um caso; infiltrado nodular - um caso; infiltrado misto - um caso; e pulmäo de síndrome de angústia respiratória aguda - um caso...