Sleep in multiple sclerosis and neuromyelitis optica spectrum disorder-the SEMN study.

PURPOSE: This study aimed to (1) evaluate in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) the presence of sleep disorders such as hypersomnia, fatigue, risk of apnea, and the presence of restless legs syndrome/Willis-Ekbom disease (RLS/WED); (2) evaluate quality of sleep in patients with MS and NMOSD; and (3) correlate them with clinical and imaging data. METHODS: The study was cross-sectional and was carried out in the sector of demyelinating diseases of the neurology service of HUGV-UFAM, Manaus, Brazil, from January 2017 to December 2020. RESULTS: Our sample consisted of 60 patients, 41 with MS and 19 with NMOSD. We found that patients with MS and NMOSD have poor sleep quality (65%) and hypersomnia (53% in MS; 47% in NMOSD), but low risk of apnea by STOP-BANG. The frequency of RLS/WE found was 14% in MS, and 5% in NMOSD. No correlation existed between sleep quality, number of relapses, and sleep quality for the Expanded Disability Status Scale (EDSS), i.e., fatigue/illness duration. CONCLUSION: Patients with MS and NMOSD have poor sleep quality, excessive sleepiness, and are at low risk for OSA, yet the frequency of RLS/WED is like that of the general population. There does not seem to be a significant difference between these sleep disorders in these demyelinating diseases of the CNS.

Genotypes of clinical varicella-zoster virus isolates from Manaus, Brazil.

INTRODUCTION: Vaccination against varicella-zoster virus (VZV) has been effective and safe in countries that routinely administer the vaccine. Brazil began universal VZV vaccination in 2013. This study aimed to identify VZV genotypes present in Manaus, Brazil prior to widespread immunization. METHODS: Vesicular lesions or cerebral-spinal-fluid samples were collected from patients diagnosed with VZV, herpes zoster, or meningitis/encephalitis. DNA was extracted, amplified, and sequenced. RESULTS: Half the isolates were clade-5 viruses and the remaining were divided between the European clades 1 and 3. CONCLUSIONS: This study provides insights into the circulating VZV genotypes in Manaus prior to widespread vaccination.

Genotypes of clinical varicella-zoster virus isolates from Manaus, Brazil

Abstract INTRODUCTION: Vaccination against varicella-zoster virus (VZV) has been effective and safe in countries that routinely administer the vaccine. Brazil began universal VZV vaccination in 2013. This study aimed to identify VZV genotypes present in Manaus, Brazil prior to widespread immunization. METHODS: Vesicular lesions or cerebral-spinal-fluid samples were collected from patients diagnosed with VZV, herpes zoster, or meningitis/encephalitis. DNA was extracted, amplified, and sequenced. RESULTS: Half the isolates were clade-5 viruses and the remaining were divided between the European clades 1 and 3. CONCLUSIONS: This study provides insights into the circulating VZV genotypes in Manaus prior to widespread vaccination.

Hematoma espontâneo do músculo reto abdominal. Relato de caso / Spontaneous rectus sheath hematoma. Case report

O hematoma espontâneo do músculo reto abdominal é uma condição incomum, causado pela concentração de sangue emsua própria bainha muscular, sem associação com traumas, mas pelo rompimento dos vasos epigástricos ou por lesão da própria musculatura. O presente trabalho relata o caso de uma idosa de 75 anos que apresentou, após crises de tosse, intensa dor abdominal e equimose periumbilical e em flancos, simulando abdome agudo, caracterizado como hematoma espontâneo do músculo reto abdominal após exames de imagem. A paciente foi submetida a tratamento conservador, mas, no 20° dia após o quadro agudo, evoluiu com abscesso local, sendo tratada com drenagens e antibióticos. Ressalta-se a importância do reconhecimento do quadro na prática clínica, pois sua semelhança com outras condições abdominais agudas pode levar a intervenções cirúrgicas desnecessárias...

Spontaneous rectus sheath hematoma is a rare situation, caused by the accumulation of blood inside the rectus abdominal muscle sheath, not associated with trauma, because of rupture of epigastric vessels or muscle lesion. This paper reports the case ofa 75-year old woman, who presented severe abdominal pain and ecchymosis, identified as spontaneous rectus sheath hematoma after imaging. She was treated conservatively, but an abscess was drained and used antibiotics on the 20th day after the beginning of pain, finally resolving the case. This report reinforces the need for recognizing this situation in clinical practice, because it is similar to other acute abdominal conditions, and it could lead to an unnecessary surgery...