Associação do autorrelato de problemas no sono com morbidades e multimorbidades segundo sexo: Pesquisa Nacional de Saúde 2019 / Asociación de los problemas de sueño autoinformados con morbilidades y multimorbilidades según el sexo: Encuesta Nacional 2019 / Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019

Objetivo: Avaliar a associação do autorrelato de problemas no sono com a presença de doenças crônicas não transmissíveis (DCNTs) e multimorbidades, e se essas associações diferem por sexo. Métodos: Estudo transversal realizado com dados da Pesquisa Nacional de Saúde 2019. Razões de prevalências entre morbidades, número de DCNTs e autorrelato de problemas no sono foram estimadas por regressão de Poisson com variância robusta, por sexo. Resultados: Foram analisados 85.531 brasileiros com idade ≥18 anos. Os problemas no sono autorrelados associaram-se a todas as morbidades e multimorbidades. A prevalência dos problemas no sono foi maior nos que declararam uma ou duas (RP = 2,37; IC95% 2,22;2,54) e três ou mais DCNTs (RP = 4,73; IC95% 4,37;5,11). As razões de prevalências da associação com diabetes, doenças pulmonares, mentais, renais e multimorbidades foram mais elevadas entre o sexo masculino. Conclusão: As DCNTs impactaram significativamente a qualidade do sono em ambos os sexos, com associação mais forte para o sexo masculino.

Objetivo: Evaluar la asociación de problemas de sueño con la presencia de enfermedades crónicas no transmisibles (ECNTs) y multimorbilidades, y si estas asociaciones difieren por sexo. Métodos: Estudio transversal con datos de la encuesta epidemiológica Pesquisa Nacional de Saúde 2019. Se estimaron las razones de prevalencia entre morbilidades, número de ECNTs y problemas de sueño por regresión de Poisson con variación robusta, por sexo. Resultados: Se analizaron 85.531 brasileños ≥ 18 años. El autoinforme de problemas de sueño se asoció con todas las morbilidades estudiadas y con multimorbilidades. La prevalencia de problemas de sueño fue mayor en aquellos que informaron uno o dos (PR = 2,37; IC95% 2,22;2,54) y tres o más ECNTs (RP = 4,73; IC95%4,37;5,11). Las razones de prevalencia de la asociación de diabetes con enfermedades pulmonares, mentales, renales y multimorbilidades han sido más fuertes en el sexo masculino. Conclusión: Las ECNTs tienen un impacto significativo en la calidad del sueño con fuerte asociación en ambos sexos, masculino y feminino.

Objective: To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. Methods: This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. Results: This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. Conclusion: NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Sleep-related problems and eating habits during COVID-19 lockdown in a southern Brazilian youth sample.

The pandemic has affected children's behaviors and this fact has an effect on their healthy habits, such as sleep and diet. The aim of the current study was to determinate the prevalence of sleep-related problems and its relationship with eating habits in children from the south of Brazil during the pandemic. Parents/legal guardians of 3-17 years old participants responded to a online survey distributed using the snowball sampling strategy in Brazil. The survey was conducted in April, 2020. Participants were asked for their sleep duration and sleep-related problems, as well as for their eating habits. Logistic regressions were performed to analyze the relationship between sleep-related problems and eating habits. 495 participants were included in the analysis. 48.8% of participants reported sleep-related problems with 12.3% not meeting the sleep guidelines. Moreover, participants reported eating fruits or vegetables and sweets over four and three per week, respectively. Different associations were found between varibles of sleep and eating habits. Those participants with healthy eating habits showed a lower prevalence of sleep-related problems.

Evaluation of Sleep Quality and Daytime Sleepiness in Dentistry Students

Abstract Objective: To evaluate sleep quality and excessive daytime sleepiness in undergraduate dentistry students. Material and Methods: This research is characterized as an observational study of transversal type, having analysed undergraduate students in dentistry from a public university in the State of Pernambuco, Brazil. The sample consisted of 325 students enrolled between the 1st and 10th academic semester. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while excessive daytime sleepiness was analysed through the Epworth Sleepiness Scale (ESS). The t-Student and Mann-Whitney tests were used for the numerical values, with the F-test (ANOVA) or the Kruskal-Wallis test being used to compare more than two categories. Results: It was observed that 71.1% of students presented a poor sleep quality, with more than half of the students exhibiting excessive daytime sleepiness (58.1%). A relationship between sleep quality and the academic semester was verified. However, gender and age were not associated with sleep quality or with excessive daytime sleepiness. Conclusion: A high prevalence of poor sleep quality and excessive daytime sleepiness was observed among undergraduate students in dentistry. The data suggest that the undergraduate degree in Dentistry can influence the students' quality of sleep, regardless of age or gender.

Alteraciones del sueño y bruxismo / Sleep alterations and bruxism

El sueño es un requerimiento biológico para la vida, sus alteraciones o su ausencia pueden disminuir la calidad de vida, el estado anímico y funcional, afectando seriamente la salud. Un sueño placentero y reparador implica cursar por facetas de profundidad diversa y actividad neuronal compleja. En este artículo se intentan explicar las generalidades del proceso del sueño y algunos de sus trastornos que lo relacionan con aumento de la actividad de los músculos masticatorios (bruxismo). Son presentados aspectos clínicos y neuronales que inducen a un incremento de microdespertares como alteración del sueño, estimulando bruxismo nocturno y bruxismo asociado a apnea nocturna. Son discutidas las posibles relaciones bidireccionales entre bruxismo diurno y nocturno secundarias a modifi caciones en la cantidad y calidad del proceso del sueño. De la misma manera, son sugeridas algunas consideraciones semiológicas y nosológicas para el mejor manejo y control del bruxismo asociado a las alteraciones del sueño, bajo el diagnóstico, atención y supervisión de equipos de atención multi- e interdisciplinarios (AU)

Sleep is a biological requirement for life, its alterations or privation thereof may reduce a person's quality of life, his or her state of mind and physical functions, which signifi cantly aff ects their health. Pleasant and repairing sleep implies going through variable deepness sleep stages, and a complex neuronal activity. This article intends to explain the generalities of the sleep process and certain disorders, particularly those in connection with the activity of the mastication muscles (bruxism). Clinical and neuronal aspects are presented inducing an increase in micro-awakenings such as sleep alterations stimulating nocturnal and bruxism associated with sleep apnea. Bidirectional connections between diurnal and nocturnal bruxism are argued as secondary to changes in the amount and quality of the sleep process. In the same manner, certain considerations associated to semiology and nosology of the diverse bruxism manifestations are considered for the better handling and control of the bruxism associated with sleep alterations under the diagnosis attention and supervision of multi- and interdisciplinary teams (AU)

Mild Traumatic Brain Injury and Post-concussion Syndrome: Treatment and Related Sequela for Persistent Symptomatic Disease.

Sport-related concussion typically resolves within a few weeks of the injury; however, persistent symptoms have been reported to occur in 10% to 15% of concussions. These ongoing symptoms can cause significant disability and be frustrating for the patient and family. In addition, factors other than brain injury can cause complications for these patients, such as adjustment disorder or exacerbation of preexisting conditions such as depression or migraine. Individuals with prolonged symptoms of concussion may be classified as having post-concussion syndrome. A careful and thoughtful evaluation is important, as the clinician must determine whether these prolonged symptoms reflect brain injury pathophysiology versus another process. Although there have been numerous studies on the acute management of concussion, much less is available on the treatment of persistent disease. This review will provide an evaluation approach for the patient with prolonged concussion symptoms and review recent literature on treatment strategies.

Vida cotidiana del adulto mayor y la necesidad de sueño-descanso / Daily life of the elderly and the need for sleep-rest

La necesidad de sueño-descanso en el adulto mayor se encuentra seriamente comprometida debido a la presencia de trastornos del sueño, específicamente insomnio y somnolencia excesiva diurna, que en la actualidad representan un problema de salud pública. La etiología de dichos trastornos es multifactorial, ya que además del factor biológico existen otros componentes en su vida cotidiana que los agravan, tales como factores psicológicos, ambientales y económicos. En este sentido, la vida cotidiana del adulto mayor se visualiza como objeto de estudio de esta investigación en relación a la necesidad de sueño-descanso. OBJETIVO: Describir, analizar e interpretar las vivencias de la vida cotidiana del adulto mayor en relación con la necesidad de sueño-descanso. MÉTODO: Se realizó un estudio usando la técnica de investigación cualitativa, fenomenológica, exploratoria y descriptiva. Se eligieron a cinco adultos mayores que presentaran insomnio o somnolencia excesiva diurna y se les aplicó la entrevista en profundidad. El análisis de los datos fue de contenido tipo temático. RESULTADOS: Se encontraron dos categorías y tres subcategorías. 1. Prácticas del adulto mayor: a) Prácticas repetitivas, las cuales realiza de forma involuntaria el adulto mayor en su vida cotidiana, tales como establecer un horario autoimpuesto para dormir y despertar, el cual reduce la cantidad de horas recomendadas de sueño y por consecuencia la eficacia del mismo. b) Tareas agobiantes: Son actividades que realiza el adulto mayor como parte de su cotidianeidad y que responden a necesidades de terceras personas y que le generan una sensación de estrés durante el día, el cual, modifica el ciclo de sueño, presentando insomnio y cansancio emocional y mental, así como una disminución del tiempo que dedican a sí mismos. c) Actividades recreativas, que son regeneradoras de energía, ayudan a liberar el estrés y fomentan un descanso integral en el adulto mayor, sin embargo no hay una consciencia de la importancia que tiene el tiempo de ocio en la vejez, y los adultos mayores no le dan prioridad en su vida cotidiana. 2 Ansiedad nocturna, se refiere a un estado de agitación e inquietud que dificulta la conciliación y mantenimiento del sueño, propiciando la aparición de pensamientos y sentimientos negativos por problemas familiares y económicos principalmente, los cuales provocan síntomas de insomnio, afecto deprimido y somatización de enfermedades. CONCLUSIÓN: Los resultados obtenidos sugieren que el adulto mayor cae en un círculo vicioso que afecta la necesidad de sueño-descanso, pues no distribuye de manera adecuada el tiempo en su vida cotidiana, ya que realiza actividades que son generadoras de estrés que provocan un cambio en el ciclo de sueño-vigilia con la presencia de insomnio, el cual conlleva a un agotamiento y un deterioro en la realización de actividades cotidianas.

The elderly necessity of sleeping is compromised due to sleep disorders, specifically insomnia and excessive daytime sleepiness (EDS), which are currently an issue in public health. The etiology of said disorders is multifactorial because, besides the biological factor, there are other components in the everyday- life that aggravate them; such as psychological factors, environmental factors and economic factors. Considering this, the elderly everyday-life will be this research object of study in relation to the necessity of sleeping. OBJECTIVE: Describe, analyze and interpret the elderly everday-life experiences in relation to the necessity of sleeping. METHOD: The study was made using a qualitative, phenomenological, exploratory and descriptive research method. Five elderlies suffering from insomnia or EDS were chosen and interviewed. The data was analyzed using thematic analysis. RESULTS: There are two categories and three subcategories. 1. Elderly customs: a) Repetitive customs, which are done unintentionally by the elderly in their everyday-life, such as having a self-imposed schedule to sleep and wake, which, reduces the recommended amount of sleep and therefore the efficacy of it. b) Overwhelming activities, which are activities that the elderly do in their everyday-life in order to fulfil other's needs, which cause them a feeling of stress during the day that affects the sleep cycle, causing insomnia, emotional exhaustion and mental fatigue, as well as a decrease in the amount of time they spend on themselves. c) Recreational activities, which give energy, help to relieve stress and promote complete rest in the elderly. However, there is not awareness of how important this leisure time is at old age, so the elderly do not give it priority in their everyday-life. 2. Sleep anxiety, which refers to a state of turmoil and restlessness that causes problems to fall asleep and stay asleep, leading to negative thoughts and feelings, caused mainly by family and economic problems, which results in insomnia, depression and somatization. CONCLUSION: The results suggest that the elderly falls into a vicious circle that affects the necessity of sleeping. As a result of they not being able to organize their everyday-life time properly; due to the fact that they do activities that cause stress and a change in the sleep-wake cycle in conjunction with the presence of insomnia, which leads to exhaustion and deterioration in the performance of daily activities.

Need for recovery from work and sleep-related complaints among nursing professionals.

The concept of need for recovery from work (NFR) was deduced from the effort recuperation model. In this model work produces costs in terms of effort during the working day. When there is enough time and possibilities to recuperate, a worker will arrive at the next working day with no residual symptoms of previous effort. NFR evaluates work characteristics such as psychosocial demands, professional work hours or schedules. However, sleep may be an important part of the recovery process. The aim of the study was to test the association between sleep-related complaints and NFR. A cross-sectional study was carried out at three hospitals. All females nursing professionals engaged in assistance to patients were invited to participate (N = 1,307). Participants answered a questionnaire that included four sleep-related complaints (insomnia, unsatisfactory sleep, sleepiness during work hours and insufficient sleep), work characteristics and NRF scale. Binomial logistic regression analysis showed that all sleep-related complaints are associated with a high need for recovery from work. Those who reported insufficient sleep showed a greater chance of high need for recovery; OR=2.730 (CI 95% 2.074 - 3.593). These results corroborate the hypothesis that sleep is an important aspect of the recovery process and, therefore, should be thoroughly investigated.

Effect of morning school schedule on sleep and anthropometric variables in adolescents: a follow-up study.

The aim of this study was to assess whether the shift from afternoon to morning classes reduces the duration of sleep and whether this reduction has any relation to body fat measurements. This is a follow-up study in which students (n = 379), 12.4 (SD(+/-)0.7) yrs old, were evaluated before and after the school schedule shift, with a 1-yr interval between the first and second data collections. Adolescents were divided into two groups: an afternoon-morning group (students who shifted from afternoon to morning classes) and an afternoon-afternoon group (students who remained in afternoon classes). The morning schedule of classes lasted from 07:30 and 12:00?h, and the afternoon schedule of classes lasted from 13:00 and 17:30?h. Self-reported bedtime, wake-up time, and time-in-bed were obtained. Body mass index, waist circumference, and body fat percentage were obtained by direct measures. The results showed a reduction of time-in-bed during weekdays for those students who changed to the morning session (p < .001). Analysis of covariance (ANCOVA) for repeated measures of anthropometric differences between afternoon-afternoon and afternoon-morning groups showed no effect of the school schedule change on weight gain. In conclusion, the time-in-bed reduction in the period analyzed cannot be considered to be a mediating factor to modifications in overweight anthropometric indicators.

Valoración de la higiene del sueño mediante una escala modificada en adultos mayores / An assessment of sleep quality in the elderly by using a modified scale

Objetivo: Modificar el índice desarrollado por Mastin y col, para aplicarlo en Adultos Mayores. Material y método: Se realizó la traducción, validación mediante jueces y la evaluación de la consistencia interna mediante el estadístico alfa de Cronbach del “Índice de Higiene del Sueño modificado para adultos mayores” (IHS-AM), construido a partir del índice desarrollado por Mastin y col. Resultados: Se realizó la traducción del instrumento y la modificación para su aplicación en adultos mayores mediante seis expertos encontrándose una validación del instrumento mediante jueces por coincidencia del 80. Se realizó una prueba preliminar para ajuste de la escala a 50 personas mayores de 60 años, previa autorización mediante consentimiento informado, excluyéndose a aquellos iletrados, con deterioro cognitivo moderado o severo y con déficit severo visual o auditivo. El instrumento IHS-AM elaborado obtuvo una confiabilidad determinada por un alfa de Cronbach de 0,7. Conclusión: El índice de higiene del sueño modificado para adultos mayores (IHS-AM) es un instrumento útil para ser aplicado en adultos mayores.

Objective: To modify the currently used Sleep Hygiene Index by Mastin et al, in order to use it in the elderly. Material and method: An elderly-adapted version of the Sleep Hygiene Index originally proponed by Mastin et al. was translated, peer-validated and had its internal consistency assessed using Cronbach’s Alpha method. Results. The aforementioned instrument was translated and modifications for its use in the elderly were performed by six experts, and the instrument was validated for use in the elderly according to an 80 coincidence. A preliminary test for adjusting the scale was performed in 50 subjects who were more than sixty-years old, after signing an informed consent and excluding the illiterate persons, those with moderate or severe cognitive deterioration, and those with sever visual or auditory deficit. The modified instrument obtained a 0.7 value for reliability according to Cronbach’s alpha test. Conclusion: The modified Sleep Hygiene Index is a useful instrument to be applied in the elderly.

Prevalencia de los trastornos del sueño en niños escolares de Sabaneta, Colombia, 2005 / Prevalence of sleep disorders in school children from Sabaneta, Colombia 2005

El sueño es una de las funciones básicas en la vida del niño y condición esencial para el estado de alerta diurno, por tanto su alteración influye negativamente sobre su desarrollo yel bienestar de la familia. Los trastornos del sueño son muy comunes durante la niñez, la Academia Americana de Pediatría en 2001 informó una tasa global de 20% a 30%. Sin embargo,en Colombia han sido escasamente estudiados. Objetivo: establecer la prevalencia de trastornos del sueño en niños escolares del municipio de Sabaneta, los antecedentes familiaresy las características sociodemográficas asociadas. Métodos: se realizó un estudio de observación descriptivo, aleatorizado y de corte transversal donde se analizaron los resultadosobtenidos de 296 cuestionarios diligenciados por los padres de niños pertenecientes a colegios de las áreas urbana y rural del municipio. Dicho cuestionario contenía criteriosclínicos para la clasificación de los trastornos del sueño según el DSM-IV. Resultados: la prevalencia de los diferentes trastornos del sueño fue como sigue: ronquido 39,2%;somniloquia 35,1%; bruxismo 33,1%; apnea obstructiva del sueño 16,9; colecho 16,9%; insomnio 14,9%; pesadillas 12,8%; enuresis 9,5%; sonambulismo 7,4%; despertares nocturnos 7,4%; terrores nocturnos 6,1%; resistencia/miedo a dormir 4,1%. Los despertares nocturnos fueronsignificativamente más frecuentes en niños de estratos socioeconómicos altos (IC: 0,19-0,97); la enuresis lo fue en varones (IC: 0,14-0,96) y las pesadillas lo fueron en niños mayores de 9años (IC: 0,24-0,91). Conclusión: la prevalencia de trastornos del sueño en la población escolar del municipio de Sabaneta es alta y similar a la reportada en otros países. Estos resultados deben incentivar a los padres de familia y pediatras a estar alerta para poderhacer un diagnóstico precoz, que evite complicaciones a largo plazo de un trastorno de sueño no tratado.

Sleep is one of the basic needs in a child’s life and it is essential for day time alert state. Any sleep disturbancehas a negative impact on the child’s development, his/her own well-being and that of the family. Sleep disorders are common in childhood. The AmericanAcademy of Pediatrics showed in 2001 a prevalence of 20-30%. In Colombia these disorders have not been well investigated. Objective: to find out the prevalence of sleep disorders in schoolchildren of Sabaneta, Colombia,as well as their medical histories and sociodemographic characteristics. Methods: an observational, descriptive, randomized, cross sectional studywas carried out, based on the results of 296 questionnaires answered by parents. DSM-IV criteria for the classification of sleep disorders were included in the questionnaire. Results: prevalence of the various disorders was as follows: snoring 39.2%; sleeptalking disorder 35.1%; bruxism 33.1%; obstructive sleep apnea 16.9%; cosleeping 16.9%; insomnia 14.9%;nightmares 12.8%; enuresis 9.5%; sleep walking disorder 7.4%; night awakenings 7.4%; night terrors6.1%; fear to fall asleep 4.1%. Enuresis was significantly more frequent in males (CI: 0.14-0.96), night awakenings in children from higher socioeconomicstrata (CI: 0.19-0.97), and nightmares in those older than 9 years (CI: 0.24-0.91). Conclusion: sleep disorders are frequent in the studied group; theirprevalence is similar to that reported from other countries. These results should motivate parents andpediatricians in order to make early diagnosis and, therefore, to avoid long-term complications.

Impacto dos transtornos do sono sobre o funcionamento diário e a qualidade de vida / Sleep disorders impact on daily functioning and life quality

Os distúrbios do sono provocam conseqüências adversas na vida das pessoas por diminuir seu funcionamento diário, aumentar a propensão a distúrbios psiquiátricos, déficits cognitivos, surgimento e agravamento de problemas de saúde, riscos de acidentes de tráfego, absenteísmo no trabalho, e por comprometer a qualidade de vida. Este estudo foi realizado com o objetivo de revisar a literatura especializada sobre as características dos distúrbios de sono mais freqüentes na população geral e suas implicações sobre os comportamentos, a rotina diária e a qualidade de vida das pessoas portadoras dessa condição. Os estudos revisados mostram que os distúrbios do sono desencadeiam conseqüências adversas à saúde e ao bem-estar dos indivíduos, afetando o trabalho, a cognição, os relacionamentos e o funcionamento diário, com diferentes desdobramentos a curto, médio e longo prazo.(AU)

Sleep disorders are responsable for many adverse outcomes on people's lives by reducing their daily functioning, increasing psychiatric disorders susceptibility, cognitive deficits, onset and aggravation of health problems, traffic accident risks, work absenteeism, and by diminishing the quality of life. This study was aimed to review the specialized literature about the characteristics of the sleep disturbances that present greater incidence in the general population, and its implications on affected people's behaviors, daily routine and quality of life. Sleep disorders were found to trigger adverse outcomes to people's health and well being by disturbing their work, cognition, relationship and daily functioning, with multiple unfolding in short, medium and long time.(AU)

Impacto dos transtornos do sono sobre o funcionamento diário e a qualidade de vida / Sleep disorders impact on daily functioning and life quality

Os distúrbios do sono provocam conseqüências adversas na vida das pessoas por diminuir seu funcionamento diário, aumentar a propensão a distúrbios psiquiátricos, déficits cognitivos, surgimento e agravamento de problemas de saúde, riscos de acidentes de tráfego, absenteísmo no trabalho, e por comprometer a qualidade de vida. Este estudo foi realizado com o objetivo de revisar a literatura especializada sobre as características dos distúrbios de sono mais freqüentes na população geral e suas implicações sobre os comportamentos, a rotina diária e a qualidade de vida das pessoas portadoras dessa condição. Os estudos revisados mostram que os distúrbios do sono desencadeiam conseqüências adversas à saúde e ao bem-estar dos indivíduos, afetando o trabalho, a cognição, os relacionamentos e o funcionamento diário, com diferentes desdobramentos a curto, médio e longo prazo.

Sleep disorders are responsable for many adverse outcomes on people's lives by reducing their daily functioning, increasing psychiatric disorders susceptibility, cognitive deficits, onset and aggravation of health problems, traffic accident risks, work absenteeism, and by diminishing the quality of life. This study was aimed to review the specialized literature about the characteristics of the sleep disturbances that present greater incidence in the general population, and its implications on affected people's behaviors, daily routine and quality of life. Sleep disorders were found to trigger adverse outcomes to people's health and well being by disturbing their work, cognition, relationship and daily functioning, with multiple unfolding in short, medium and long time.

[Maternal breast-feeding: changes occurred in the father's conjugal life]. / Aleitamento materno: mudanças ocorridas na vida conjugal do pai.

It is a qualitative study with the objective of identifying the man's perception regarding the changes that took place in his marital relationship during the child's breast-feeding. The data were collected through interview with 13 fathers. The results indicate that men develop attitudes and feelings relative to the son and the wife; they recognize that the alterations in their marital relationship are more evident during the first three months of the child's life and they try to understand or to demonstrate indifference towards the changes. Although breastfeeding results in modifications in the spouses' relationship, the fathers do not consider them as something negative in their lives.

A study in a community in Brazil in which cutaneous larva migrans is endemic.

BACKGROUND: Cutaneous larva migrans (CLM) is a common but neglected parasitic skin disease in impoverished communities of the developing world. METHODS: To describe the clinical features and the morbidity associated with CLM, active-case finding was performed during rainy and dry seasons in a rural community in the state of Alagoas, Northeast Brazil. RESULTS: A total of 62 individuals received a diagnosis for CLM, and among them there were a total of 75 larval tracks. The number of tracks per person ranged from 1 to 3. Children <9 years old were affected significantly more often than other age groups (P<.001). Children had their lesions mainly on the buttocks, genitals, and hands, whereas in older patients, the majority of lesions were located on the feet. Twenty-four percent of the 75 lesions were superinfected. Bacterial superinfection was more common among children. All but 1 patient complained about itching, and 84% of the 62 patients complained about sleep disturbances. Itching was classified as being severe by 61% of patients. Approximately 40% of the 62 patients had attempted to treat their creeping eruption previously. Larvae moved forward 2.7 mm per day. There was a significant correlation between the length of the track and the duration of infestation ( rho =.53; P<.0001). CONCLUSIONS: CLM is a common parasitic skin disease in this rural community, with different topographic patterns of lesions in children and adults. CLM is associated with considerable morbidity. The length of the track can be used to estimate the duration of infestation.

Enfermedades del sueño y su impacto laboral / Sleep disorders and its impacts on work

El desarrollo progresivo de la medicina del sueño, y su papel en la calidad de vida y en el riesgo de padecer enfermedades cardio- y cerebrovasculares, ha incentivado la investigación en otras importantes áreas, como la medicina del trabajo. La asociación de accidentes automovilísticos con la hipersomnia diurna es bien conocida; a pesar de eso, hay un gran desconocimiento tanto en los médicos como la población en general sobre estos temas. por esta razón se efectúa un análisis del impacto de los problemas del sueño en la actividad laboral.

Introducción a la medicina del sueño / Introduction to sleep medicine

Psiquiatras, neurofisiólogos y una gran diversidad de especialistas han tenido interés por el estudio del sueño. El interés probablemente se deba al poco conocimiento de la fisiología del sueño. En la mayoría de los mamíferos el sueño tiene dos tipos de estadios: el sueño de ondas lentas (SWS) y el sueño de movimientos oculares rápidos (REM). El SWS o sueño no REM tiene cuatro etapas I, II, III/IV. El sueño no es un fenómeno continuo, sino tiene un ritmo diario circadiano y nocturno ultradiano. Existen muchos problemas del sueño como el insomnio, la hipersomnia y las parasomnias, éstas producen problemas neuropsicológicos además de dificultades sociales y de personalidad.

Controversias sobre sueño y trabajo / Controversies on sleep and work

Aún cuando existe abundante literatura sobre los efectos del trabajo nocturno en la fisiología humana y su repercusión en el mundo laboral, hay muchos aspectos que no están suficientemente entendidos. Este artículo presenta algunos de los ámbitos más controvertidos y entrega algunas recomendaciones sobre cómo enfrentar de mejor manera este tipo de trabajo y cómo sospechar la presencia de trastornos del sueño.