Enjolras Vampré and the character of Les Misérables / Enjolras Vampré e o personagem de Les Misérables

ABSTRACT Enjolras Vampré (1885-1938) was one of the pioneering neurologists in Brazil whose name is a tribute to one of the characters of the book Les Misérables (1862), written by Victor Hugo (1802-1885). In this article, the authors point out evidence that the coincident names were not just a matter of homage, and even more so, the life of Dr. Enjolras had many similarities with the interesting character.

RESUMO Enjolras Vampré (1885-1938) foi um dos neurologistas pioneiros no Brasil cujo nome é uma homenagem a um dos personagens do livro Les Misérables (1862), escrito por Victor Hugo (1802-1885). Neste artigo, os autores apontam evidências de que os nomes coincidentes não são apenas uma questão de homenagem, mas ainda mais, a vida de Dr. Enjolras teve muitas outras semelhanças com o interessante personagem.

Reducing body myopathy - A new pathogenic FHL1 variant and literature review.

Reducing body myopathy (RBM) is a rare disease marked by progressive muscle weakness caused by a mutation in FHL1 gene. We describe a new pathogenic variant and contrasted it with 44 other cases identified in the literature. A male child presented at age 3 suffering frequent falls and progressive muscular weakness. At age 8, he was wheelchair-bound and required ventilatory support. His mother and sister died due to the same problem. Creatine kinase was 428 IU/L (<190). Muscle biopsy showed typical reducing bodies, and genetic analysis identified a novel pathogenic hemizygous variant, c.370_375del. We identified 44 previous reported cases separated in two groups: 28 cases with mean age onset 7.6 ±â€¯5 years and 16 with 26.7 ±â€¯4.2 years. The time for the diagnosis was shorter to younger group. The initial symptoms, rigid spine, contractures, scoliosis and axial and neck weaknesses, dysphagia, cardiac involvement, were predominant in younger group. The variant c.369C > G predominated in younger group and c.448T > C in older one. Pathogenic variants positions seemed related to severe phenotype. Most wheelchair patients belonged to younger group. The data from this compilation and our case provided a general characterization spectrum and prognosis between two groups of age onset with RBM.

Paraneoplastic Limbic Encephalitis Secondary to SCLC on 18F-FDG PET/CT.

ABSTRACT: A 67-year-old man with rapidly neurologic deterioration and 15 kg weight loss in 2 months was extensively evaluated by several medical specialties and conventional image examinations, with no diagnostic definition. 18F-FDG PET/CT was performed, showing glycolytic hypermetabolism in the hippocampus, cerebral hypometabolism with posterior temporoparietal pattern, multiple cervical and supraclavicular lymph nodes, and mediastinal hypermetabolic and enlarged lymph nodes, suggesting paraneoplastic limbic encephalitis, Alzheimer dementia, and lymphoma. Lymph node biopsy resulted in small cell lung carcinoma. The patient presented rapid clinical deterioration and died.

Impact of COVID-19 on eating habits, physical activity and sleep in Brazilian healthcare professionals.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, Brazilian healthcare professionals could have been experiencing impacts on their routine, behavior and mental health. OBJECTIVE: To investigate changes in the daily life and sleeping habits of healthcare professionals in Brazil. METHODS: We conducted an observational and cross-sectional study from May to July 2020. A Google Forms questionnaire was made available to Brazilian healthcare professionals on the WhatsApp mobile application and through the website of the Brazilian Hospital Services Company. RESULTS: The sample (n=710) was mostly composed of women (80.8%), aged between 30 and 40 years old (46.6%), predominantly physicians (41.8%) and residing mostly in the state of Paraíba (66.9%), Brazil. Approximately two-thirds of the total sample had some sleep-related complaints, 25.8% due to difficulty initiating sleep, 29.6% due to difficulty staying asleep and 32.5% due to early morning waking. From the population studied, 28.7% (n=204) reported the use of insomnia medication, and 60.3% (n=123) of these were self-medicating. Some participants reported a change in diet (n=557; 78.5%), especially related to the increase in carbohydrate intake (n=174; 24.5%), and 27% (n=192) of the individuals reported an increase of the consumption of alcoholic beverages. Of the total, 561 (81.8%) reported a change in the practice of physical activity. CONCLUSION: In this study, Brazilian healthcare professionals showed aspects of quality of life that were more affected during the COVID-19 pandemic than the prevalence seen in surveys of international studies for the general population.

Impact of COVID-19 on eating habits, physical activity and sleep in Brazilian healthcare professionals / Impacto da COVID-19 nos hábitos alimentares, atividade física e sono em profissionais de saúde brasileiros

ABSTRACT Background: During the coronavirus disease 2019 (COVID-19) pandemic, Brazilian healthcare professionals could have been experiencing impacts on their routine, behavior and mental health. Objective: To investigate changes in the daily life and sleeping habits of healthcare professionals in Brazil. Methods: We conducted an observational and cross-sectional study from May to July 2020. A Google Forms questionnaire was made available to Brazilian healthcare professionals on the WhatsApp mobile application and through the website of the Brazilian Hospital Services Company. Results: The sample (n=710) was mostly composed of women (80.8%), aged between 30 and 40 years old (46.6%), predominantly physicians (41.8%) and residing mostly in the state of Paraíba (66.9%), Brazil. Approximately two-thirds of the total sample had some sleep-related complaints, 25.8% due to difficulty initiating sleep, 29.6% due to difficulty staying asleep and 32.5% due to early morning waking. From the population studied, 28.7% (n=204) reported the use of insomnia medication, and 60.3% (n=123) of these were self-medicating. Some participants reported a change in diet (n=557; 78.5%), especially related to the increase in carbohydrate intake (n=174; 24.5%), and 27% (n=192) of the individuals reported an increase of the consumption of alcoholic beverages. Of the total, 561 (81.8%) reported a change in the practice of physical activity. Conclusion: In this study, Brazilian healthcare professionals showed aspects of quality of life that were more affected during the COVID-19 pandemic than the prevalence seen in surveys of international studies for the general population.

RESUMO Antecedentes: Durante a pandemia de COVID-19, os profissionais de saúde brasileiros podem estar sofrendo impactos em sua rotina, comportamento e saúde mental. Objetivo: Investigar mudanças na vida diária e nos hábitos de sono de profissionais de saúde no Brasil. Métodos: Estudo observacional e transversal, que ocorreu de maio a julho de 2020. Um questionário da Google (Google forms) foi disponibilizado aos profissionais de saúde brasileiros no aplicativo móvel WhatsApp e no site da Empresa Brasileira de Serviços Hospitalares. Resultados: A amostra (n=710) foi composta em sua maioria por mulheres (80,8%), com idade entre 30 e 40 anos (46,6%), predominantemente composta de médicos (41,8%) e residentes, em sua maioria no estado da Paraíba (66,9%). Aproximadamente dois terços do total da amostra tinham algumas queixas relacionadas ao sono: 25,8% sobre a dificuldade de iniciar o sono, 29,6% sobre a dificuldade de mantê-lo e 32,5% sobre despertar precoce pela manhã. Da amostra, 28,7% (n=204) referiram fazer uso de medicamentos para insônia e 60,3% (n=123) desses realizaram automedicação. Alguns participantes relataram mudança na dieta alimentar (n=557; 78,5%), principalmente relacionada ao aumento da ingestão de carboidratos (n=174; 24,5%). Observou-se também que 27% (n=192) dos indivíduos relataram aumento no consumo de bebidas alcoólicas. Do total, 561 (81,8%) relataram mudança na prática de atividade física. Conclusão: Nesta pesquisa, os profissionais de saúde brasileiros apresentaram aspectos da qualidade de vida que foram mais afetados durante a pandemia de COVID-19 do que as prevalências obtidas em pesquisas de estudos internacionais para a população em geral.

Bereitschaftspotential preceding eyelid blinks in Parkinson's disease / Potencial de Bereitschafts precedendo o piscamento ocular na doença de Parkinson

ABSTRACT The Bereitschaftspotential (BP) is a negative wave observed in EEG retrograde averaging, preceding a motor act. The objective was to study the BP preceding voluntary eyelid blinks in Parkinson's disease (PD) patients during off and on phases of levodopa. Methods Ten PD patients in stages 1 and 2 of the Hoehn & Yahr classification were compared to 18 healthy controls. Artifact-free EEG segments of two seconds preceding the onset of the blink potential were averaged and analyzed, and the statistical significance of the measured amplitudes were evaluated by analysis of variance models. Results The presence of a BP in the PD patients was demonstrated. The mean amplitudes at 0 ms were respectively 0.6 µV and 3.3 µV for the BP patients and the normal controls, respectively. Conclusions The BP amplitudes were significantly smaller in PD patients than normal participants. The amplitudes of the BP were not modified by levodopa.

RESUMO O Potencial de Bereitschafts (PB) é uma onda negativa observada retrogradamente no EEG precedendo um ato motor. Objetivo Estudar o PB precedendo o piscamento palpebral voluntário em pacientes com doença de Parkinson (DP) durante as fases off e on da levodopa. Foram comparados dez pacientes com DP nos estágios 1 e 2 de Hoehn & Yahr com 18 controles saudáveis. Os segmentos de EEG livres de artefatos 2 segundos antes do início do potencial foram calculados e analisados e a significância estatística das amplitudes foi medida por modelos de análise de variância. Resultados A presença de PB nos pacientes com DP foi demonstrada. As amplitudes médias a 0 ms foram respectivamente 0,6 μV e 3,3 μV para os pacientes com DP e controles respectivamente. Conclusões As amplitudes do PB foram significativamente menores nos pacientes com DP do que controles. As amplitudes do PB não foram modificadas pela levodopa.

Sintomas Depressivos em Pacientes do Ambulatório de Neurologia do Hospital Universitário Lauro Wanderley / Depressive Symptoms among patients admitted to the Outpatient Neurology Service at Lauro Wanderley University Hospital

Objetivo: Avaliar prevalência e intensidade de sintomas depressivos em pacientes admitidos no ambulatório de neurologia do HULW-UFPB por diversas outras queixas, analisando o perfil sociodemográfico e epidemiológico dessa população. Material e Métodos: Inquérito realizado de março de 2013 a agosto de 2015, com aplicação do Inventário de Depressão de Beck-II em 235 pacientes entre 17 e 59 anos de idade. A pesquisa realizada foi do tipo transversal, qualitativa e quantitativa. A análise dos dados foi realizada por meio de estatística inferencial univariada e bivariada. Resultados: O sexo feminino foi o mais frequente, 70% dos entrevistados; com média de 40,1 anos; casadas e com segundo grau completo. 48% exercem alguma atividade laboral, com jornada de dois turnos de trabalho (22,1%). Foram observados sinais de depressão mínima ou ausente em 51,9%; sintomas leves, em 23,4%; moderados em 15,7% e severos em 8,9% dos pacientes avaliados. Conclusão: Os sintomas depressivos foram cerca de 5 a 9 vezes mais prevalentes que os referidos na literatura, com uma porcentagem de sinais depressivos severos alarmantes. Esses achados configuram um importante problema de saúde pública, alertando quanto à investigação de queixas depressivas subestimadas por essa população.(AU)

Objective: To evaluate the prevalence and severity of depressive symptoms among patients admitted to the HULWUFPB outpatient neurology service due to varied complaints. The sociodemographic and epidemiological profile of this population was further evaluated. Material and Methods: This was a cross-sectional, qualitative and quantitative study carried out from March 2013 to August 2015, with the application of the Beck-II Depression Inventory in 235 patients randomly selected between 17 and 59 years of age. The data were analyzed using univariate and bivariate inferential statistics. Results: There was a prevalence of women (70% of respondents), with an average of 40.1 years, married, and with a high school education; 48% had some work activity, with a work journey of two shifts (22.1%). Signs of minimal or absent depression were observed in 51.9% of the cases; while mild, moderate and severe symptoms were found in 23.4%, 15.7%, and 8.9% of the patients evaluated. Conclusion: Depressive symptoms reported in this study were found to be about 5 to 9 times more prevalent than those reported in the literature, with an alarming percentage of severe depressive symptoms. These findings indicate the presence of an important public health problem and should further guide the investigation of the underestimated depressive complaints in this population.(AU)

Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic / Disfunção temporomandibular é mais prevalente entre pacientes com cefaleias primárias em um ambulatório de nível terciário

Objective The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with primary headaches attended in a tertiary neurology ambulatory.Method Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil.Results The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1). TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001).Conclusion TMD has a high prevalence in patients with primary headaches (54.8%). Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.

Objetivo Estimar a prevalência de sinais e sintomas de disfunção temporomandibular (DTM) e fatores associados em pacientes com cefaleias primárias atendidos em um ambulatório de neurologia.Método Autorizado pelo Comitê de Ética, o presente estudo transversal foi conduzido com uma amostra aleatória de pacientes investigados para dor orofacial e cefaleias primárias em um hospital terciário no nordeste do Brasil.Resultados A amostra consistiu em 42 pacientes com cefaleias primárias, sendo 59,5% homens. A prevalência de > 6 sinais e sintomas de DTM foi 54,8%. Naqueles pacientes com migrânea, DTM estava presente em 71,4% e em 38,1% daqueles com cefaleia do tipo tensional (p = 0,030; OR = 4,1). DTM foi relacionada à condição clínica de cefaleia por abuso de medicamentos (p = 0,001).Conclusão A DTM é uma condição com alta prevalência em pacientes com cefaleias primárias (54,8%). Atenção especial deve ser dada a pacientes com migrânea e cefaleia por abuso de medicamentos.