Association between Acute Respiratory Distress Syndrome Due to COVID-19 and Long-Term Sleep and Circadian Sleep-Wake Disorders.

Current studies agree on the impact of sleep and circadian rest-activity rhythm alterations in acute respiratory distress syndrome (ARDS) survivors. However, research on the duration of this impact is scarce. In this study, we evaluate the impact of ARDS on the sleep and circadian rest-activity rhythm of COVID-19 survivors twelve months after hospital discharge. This is a prospective study including COVID-19 survivors with and without ARDS during hospitalization. Data was collected four and twelve months after hospital discharge. The interventions included one-week wrist actigraphy and a home sleep apnea test (HSAT), and evaluations were conducted according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and insomnia severity index (ISI). Fifty-two patients were evaluated (ARDS = 31 and non-ARDS = 21); they had a median age of 49.0 [39.0;57.2] years and 53.8% were male. After twelve months, 91.3% presented poor sleep quality, 58.7% presented insomnia, 50% presented daytime somnolence, and 37% presented comorbid insomnia and obstructive sleep apnea (COMISA). No significant improvement was observed in relation to sleep or the circadian rest-activity rhythm between four and twelve months. A tendency of poor sleep quality, insomnia, daytime somnolence, and COMISA was observed. Finally, there was no significant impact on the circadian rest-activity rhythm between four and twelve months or between the groups.

Resultados del tratamiento kinésico en un caso de doble parálisis facial / Physiotherapy treatment results in a case of double facial paralysis

Paciente de sexo masculino de 33 años que ingresa al Servicio Universitario de Kinesiología, con diagnóstico de parálisisfacial derecha, por lo cual se inició el tratamiento kinésico con corriente de tipo exponencial, (indicada paratratar músculos que tienen afectada la placa neuromuscular ya que son músculos patológicos), ejercicios de reeducación de la mímica y masoterapia.A los veinte días de evolución, se instala otra parálisis facial del lado izquierdo, cuando aún estaba realizando la rehabilitación de la hemicara derecha, por lo cual se efectuó el tratamiento de manera simultánea, pero con diferenciasen la utilización de la corriente exponencial, variando el ancho de pulso y la intensidad. El trofismo, las unciones, la simetría y la mímica comprometidas por la parálisis facial derecha, fueron recuperadas en 19 sesiones y la izquierda en 15 sesiones, lográndose la simetría total de la cara, sin secuelas perceptibles al final del tratamiento...

Male patient, 33 years old, who enters at the University Department of Kinesiology, diagnosed with right facial paralysis. He was initiating treatment with current exponential type, which is indicated to treat muscles that have affected the neuromuscular junction (muscle disease), exercise rehabilitation of mime and massage therapy. After twenty days of evolution, installs another left–sided facial paralysis, while still doing the right hemifacial rehabilitation, so treatment was performed simultaneously, but with differences in the use of the exponential current, varying the pulse width and intensity. The nutrition, functions, symmetry and mime committed by right facial palsy. were recovered in 19 sessions, and the left after fifteen sessions on achieving the overall symmetry of the face, withoutsqueale noticeable at the end of treatment...