Sleep disorder syndromes of post-acute sequelae of SARS-CoV-2 (PASC) / Long Covid.

INTRODUCTION: COVID-19 infection has resulted in a high prevalence of a post-infectious syndrome, known as post-acute sequelae of SARS-CoV-2 (PASC) or "Long COVID". PASC is a heterogeneous disease with a high prevalence of sleep disturbances, varying from an insomnia disorder to excessive daytime sleepiness. METHODS: Patients seen in the Covid Survivorship Program at the Beth Israel Deaconess Medical Center Boston, USA, were screened for sleep disorders as part of a comprehensive multi-system evaluation. Those who screened positive were referred for a comprehensive sleep evaluation in a dedicated COVID-19-Sleep clinic, followed by diagnostic sleep testing and treatment. This report summarizes patients who completed an American Academy of Sleep Medicine (AASM) accredited facility-based diagnostic evaluation. International Classification of Sleep Disorders 3rd Edition-Revised criteria were met for all diagnoses. RESULTS: In 42 patients with PASC, five categories of sleep disorder syndromes were observed following a sleep clinic evaluation, including obstructive sleep apnea, chronic insomnia disorder, primary hypersomnia, REM behavior disorder (RBD), and new onset circadian phase delay. Seven patients met criteria for idiopathic hypersomnia, and two had narcolepsy type 2. RBD patients were infected in three different waves; circadian disturbance patients were all infected in the winter wave of 2020/21, and the primary hypersomnolence group occurred during all waves, predominantly the initial wave of 2020. A peculiar form of insomnia was a persistent loss of sleep regularity. CONCLUSIONS: Specific sleep symptoms/syndromes are reported in this select group of patients with PASC/Long Covid. As new onset sleep complaints are prevalent in PASC, we recommend a complete clinical and investigative sleep evaluation for persistent severe sleep symptoms following COVID-19 infection.

Implementing Palliative Care Training in the Caribbean: Development and Assessment of a Basic Palliative Care Training Course in Jamaica.

CONTEXT: The majority of people in need of palliative care (PC) in low- and middle-income countries lack access to it and suffer unnecessarily as a consequence. This unmet need is due, in part, to the lack of trained PC providers. OBJECTIVES: This study aims to assess the effects of regional training in PC for doctors, nurses, and pharmacists in the Caribbean through assessment of participant satisfaction, anticipated course impact on participants' clinical practice, barriers to changing practice, and perceived course impact on achievement of key PC milestones. METHODS: We created and taught a course in basic PC for clinicians from the Caribbean region and collected and analyzed postcourse quantitative and qualitative data on satisfaction and expected impact. RESULTS: Eighty-three clinicians from five Caribbean countries participated in this workshop. Thirty participants completed the post-course survey. One hundred percent of these participants ranked the quality of the course as "very high quality" or "high quality." The majority of participants anticipated changing their practice as a result of this course. Several barriers were reported, including lack of formal PC training in participants' home countries. Results of participants' retrospective pre- and postcourse self-assessment for achievement of key PC milestones showed a statistically significant mean increase of at least one point on the seven-point Likert scale for each milestone. CONCLUSION: Overall satisfaction with the course was high, and self-assessed competency in PC improved. These data suggest that an intensive training over several days is an effective format for increasing providers' perceived efficacy in delivering PC.

A new species of emThamnodynastes/em Wagler, 1830 from western Amazonia, with notes on morphology for members of the emThamnodynastes/em empallidus/em group (Serpentes, Dipsadidae, Tachymenini).

The genus Thamnodynastes is the most diverse within the tribe Tachymenini, with an extensive and complex taxonomic history. The brief descriptions and lack of robust diagnostic characters are the main sources for identification errors and for the difficulty to assess the diversity estimates of the genus. The Thamnodynastes pallidus group was briefly designated to encompass the most arboreal species of the genus, with thinner bodies and longer tails: T. pallidus, T. longicaudus, T. sertanejo, and a fourth undescribed species. After its designation, no other paper addressed this group and its morphological variation, especially for the hemipenis, is still undetermined. After the analysis of all species of Thamnodynastes we were able to corroborate the distinctiveness of the T. pallidus group and to accurately diagnose its fourth species from the western portion of the Amazonia lowlands. The new species is distinguishable from all congeners, except T. sertanejo, by the absence of ventral longitudinal stripes, 17/17/11 dorsal scale rows, and dorsal dark brown blotches on the anterior third of the body. The new species is distinguished from T. sertanejo by the higher number of subcaudals, lower number of ventrals, and smaller body and head sizes. We also provide additional diagnostic features for the Thamnodynastes pallidus group, including new data on hemipenial variation. Finally, we briefly discuss the defensive behavior and morphological characters associated with arboreality in members of the T. pallidus species group.

A new species of Thamnodynastes Wagler, 1830 from western Amazonia, with notes on morphology for members of the Thamnodynastes pallidus group (Serpentes, Dipsadidae, Tachymenini)

The genus Thamnodynastes is the most diverse within the tribe Tachymenini, with an extensive and complex taxonomic history. The brief descriptions and lack of robust diagnostic characters are the main sources for identification errors and for the difficulty to assess the diversity estimates of the genus. The Thamnodynastes pallidus group was briefly designated to encompass the most arboreal species of the genus, with thinner bodies and longer tails: T. pallidus, T. longicaudus, T. sertanejo, and a fourth undescribed species. After its designation, no other paper addressed this group and its morphological variation, especially for the hemipenis, is still undetermined. After the analysis of all species of Thamnodynastes we were able to corroborate the distinctiveness of the T. pallidus group and to accurately diagnose its fourth species from the western portion of the Amazonia lowlands. The new species is distinguishable from all congeners, except T. sertanejo, by the absence of ventral longitudinal stripes, 17/17/11 dorsal scale rows, and dorsal dark brown blotches on the anterior third of the body. The new species is distinguished from T. sertanejo by the higher number of subcaudals, lower number of ventrals, and smaller body and head sizes. We also provide additional diagnostic features for the Thamnodynastes pallidus group, including new data on hemipenial variation. Finally, we briefly discuss the defensive behavior and morphological characters associated with arboreality in members of the T. pallidus species group.

Knowledge about epilepsy in university health students: A multicenter study.

Even with economic development and improvements in health care around the world, it is estimated that nowadays, 50 million people have epilepsy. It is one of the most prevalent neurological diseases, yet it is still surrounded by prejudice, stigma, lack of awareness, and wrong attitudes of the population towards the disease. The aim of this study was to evaluate and compare the knowledge about epilepsy in health students from different countries: Brazil, Argentina, Portugal, United States, and South Africa. Students were asked to complete a survey regarding knowledge about epilepsy (the Epilepsy Knowledge Questionnaire). One hundred and two students participated, 62.2% of them were female. Portuguese students had significantly higher values than the American ones (p=0.025). Regarding the medical aspects, on average, students hit 63.8% of the questions, and the students from Portugal had significantly higher average than the ones from the United States (p=0.0007). Statements with lower percent of correct answers were about pathophysiology, medication, and treatment of the disease. There were no differences between the scores obtained by the students of each country in the social aspects of the disease. Statements with higher percent of mistakes were about sports practice, labor, proceedings in case of convulsion, and ability to drive vehicles. General knowledge of senior health students about epilepsy was considered low, however, regarding the medical aspects of the disease, students from Brazil and Portugal exhibited a slightly superior knowledge. Changing the way of seeing and treating people with epilepsy brings, as a consequence, increased opportunities for these people in different sectors of society.

Sorção de cobre e manganês por bactérias rizosféricas do trigo

The metals bioaccumulation in microganisms is mainly a result of superficial phenomena, occurring adsoption, in a stoychometric way, with the anionic radicals of cellular walls followed or not by precipitation of metals. To study the sorption of metals by live bacteria, the Cu2+ and Mn2+ taken up by a Bacillus sp. and a Pseudomonas sp., were quantified isolated from weath rizosphere, from a cloride solution of metals resting in the supernatant, after centrifugation. A completely randomized experimental design was used, with 3 repetitions. The effect of Cu2+ and Mn2+ contents, pH and time of bacterial growth were tested. Bacillus sorbed more Cu2+ and Mn2+ than Pseudomonas in all concentrations of those metals. Cu2+ sorption by both bacteria showed more increase than Mn2+ with rising those metals content in the solution. Alteration of pH from 5,0 to 3,0 reduced the metal sorption. With 90 hour cultivation time, Pseudomonas showed more Cu2+ and Mn2+ sorption than with 16 hour cultivation time. The results agree with the colloids cations exchange phenomena.

A bioacumulação de metais por microrganismos se deve principalmente a fenômenos de superfície, ocorrendo adsorção, de forma estequiométrica, com os radicais aniônicos dos envoltórios celulares, seguido ou não de precipitação dos metais. Para estudar condicionantes da sorção de metais por bactérias vivas, quantificou-se o Cu2+ e Mn2+ retirados por um Bacillus sp. e uma Pseudomonas sp., isolados da rizosfera de trigo, de uma solução de cloreto dos metais, determinando-se a quantidade de metal restante no sobrenadante, após centrifugação. Usou-se delineamento experimental inteiramente casualizado, com três repetições. Ensaiaram-se efeito dos teores de Cu2+ e Mn2+, do pH e do tempo de crescimento bacteriano. O Bacillus sorveu mais Cu2+ e Mn2+ do que Pseudomonas. em todas as concentrações desses metais. A sorção de Cu2+ por ambas as bactérias apresentou maiores incrementos do que Mn2+ com aumento dos teores desses metais na solução. A alteração do pH 5,0 para 3,0 diminuiu a sorção dos dois metais. Com o tempo de cultivo de 90 horas a Pseudomonas apresentou maior sorção de cobre e de manganês do que no tempo de 16 horas. Os resultados obtidos assemelham-se aos fenômenos de troca de cátions em colóides.

Sorção de cobre e manganês por bactérias rizosféricas do trigo

The metals bioaccumulation in microganisms is mainly a result of superficial phenomena, occurring adsoption, in a stoychometric way, with the anionic radicals of cellular walls followed or not by precipitation of metals. To study the sorption of metals by live bacteria, the Cu2+ and Mn2+ taken up by a Bacillus sp. and a Pseudomonas sp., were quantified isolated from weath rizosphere, from a cloride solution of metals resting in the supernatant, after centrifugation. A completely randomized experimental design was used, with 3 repetitions. The effect of Cu2+ and Mn2+ contents, pH and time of bacterial growth were tested. Bacillus sorbed more Cu2+ and Mn2+ than Pseudomonas in all concentrations of those metals. Cu2+ sorption by both bacteria showed more increase than Mn2+ with rising those metals content in the solution. Alteration of pH from 5,0 to 3,0 reduced the metal sorption. With 90 hour cultivation time, Pseudomonas showed more Cu2+ and Mn2+ sorption than with 16 hour cultivation time. The results agree with the colloids cations exchange phenomena.

A bioacumulação de metais por microrganismos se deve principalmente a fenômenos de superfície, ocorrendo adsorção, de forma estequiométrica, com os radicais aniônicos dos envoltórios celulares, seguido ou não de precipitação dos metais. Para estudar condicionantes da sorção de metais por bactérias vivas, quantificou-se o Cu2+ e Mn2+ retirados por um Bacillus sp. e uma Pseudomonas sp., isolados da rizosfera de trigo, de uma solução de cloreto dos metais, determinando-se a quantidade de metal restante no sobrenadante, após centrifugação. Usou-se delineamento experimental inteiramente casualizado, com três repetições. Ensaiaram-se efeito dos teores de Cu2+ e Mn2+, do pH e do tempo de crescimento bacteriano. O Bacillus sorveu mais Cu2+ e Mn2+ do que Pseudomonas. em todas as concentrações desses metais. A sorção de Cu2+ por ambas as bactérias apresentou maiores incrementos do que Mn2+ com aumento dos teores desses metais na solução. A alteração do pH 5,0 para 3,0 diminuiu a sorção dos dois metais. Com o tempo de cultivo de 90 horas a Pseudomonas apresentou maior sorção de cobre e de manganês do que no tempo de 16 horas. Os resultados obtidos assemelham-se aos fenômenos de troca de cátions em colóides.

Xanthan Production by Xanthomonas campestris in a whey-based medium

Isodados de Xanthomonas campestris foram adaptados à utilizaçäo de lactose para produçäo de xantana. Um meio mínimo de soro de leite (sem desproteinizaçäo e hidrólise) foi desenvolvido contendo 0,5 por cento K2HPO4; 0,01 por cento MgSO4 e 4 por cento leite gerando 14Kg/10 de goma. A viscosidade de soluçöes das gomas obtidas pelos isolados também foi avaliada

Pott's puffy tumour and subdural empyema following frontal sinusitis

A previously healthy 17-year-old lad presented with purulent sinusitis and subsequently developed subdural empyema in association with Pott's puffy tumour. Complete resolution occurred with an intensive antibiotic regime and drainage of the subgaleal space (AU)