The results of the present study demonstrate that the PSQI-BR is a valid and reliable instrument for the assessment of sleep quality and equivalent to its original version when applied to individuals who speak the Brazilian Portuguese language. Despite relevant influences of language and cultural background, no major cultural adaptations were necessary during the validation process. The PSQI-BR can be a tool either for clinical management or research.

Objective: The aim of this study was to develop a Portuguese-language version of the Epworth sleepiness scale (ESS) for use in Brazil. Methods: The steps involved in creating the ESS in Brazilian Portuguese (ESS-BR) were as follows: translation; back-translation; comparison (by a committee) between the translation and the back-translation; and testing in bilingual individuals. The ESS-BR was applied to a group of patients who were submitted to overnight polysomnography in order to identify obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia and primary snoring. A control group was composed of subjects with a history of normal sleep habits, without reported snoring. Results: A total of 114 patients and 21 controls were included. The 8-item scores of the ESS-BR had an overall reliability coefficient of 0.83. The study group was composed of 59 patients with OSAHS, 34 patients with primary snoring and 21 patients with insomnia. One-way ANOVA demonstrated significant differences in ESS-BR scores among the four diagnostic groups (p < 0.001). Post-hoc tests between groups showed that the ESS-BR scores of the patients with insomnia did not differ from those of the controls (p > 0.05). The ESS-BR scores were significantly higher for OSAHS patients and for primary snorers than for controls (p < 0.05). In addition, the scores for OSAHS patients were significantly higher than were those for primary snorers (p < 0.05). Conclusions: The results of the present study demonstrate that the ESS-BR is a valid and reliable instrument for the assessment of daytime sleepiness, equivalent to its original version when applied to individuals who speak Brazilian Portuguese.Keywords: Validation studies; Sleep disorders; Cross-cultural comparison; Disorders of excessive somnolence. ResumoObjetivo: Desenvolver uma versão da escala de sonolência de Epworth (ESE) para o português para uso no Brasil. Métodos: A versão no português do Brasil (ESE-BR) foi desenvolvida de acordo com as seguintes etapas: tradução; retrotradução; comparação entre a tradução e a retrotradução (por um comitê); e aplicação em indivíduos bilín-gues. A ESE-BR foi aplicada a um grupo de pacientes submetidos à polissonografia de noite inteira para identificar síndrome da apneia-hipopneia obstrutiva do sono (SAHOS), insônia e ronco primário. Um grupo controle foi composto de indivíduos com história de hábitos normais de sono, sem ronco aparente. Resultados: Um total de 114 pacientes e 21 controles foram incluídos. Os 8 itens do ESE-BR tiveram um coeficiente de confiabilidade total de 0,83. O grupo em estudo foi composto por 59 pacientes com SAHOS, 34 pacientes com ronco primário e 21 pacientes com insônia. One-way ANOVA demonstrou diferenças significativas nos escores do ESE-BR entre os quatro grupos diagnósticos (p < 0,001). Testes post hoc entre grupos pareados mostraram que os escores do ESE-BR para insones não diferiram daqueles dos controles (p > 0,05). Os escores dos pacientes com SAHOS e nos roncadores primários foram significativamente maiores que os...

Hereditary hemorrhagic telangiectasia is an autosomal dominant disease in which arteriovenous communications are typically seen in the skin, mucosal surfaces, lungs, brain and gastrointestinal tract. This disease typically presents as epistaxis, gastrointestinal bleeding and arteriovenous malformations (in the brain and lungs). Although the epistaxis and gastrointestinal bleeding can result in anemia, patients diagnosed with hereditary hemorrhagic telangiectasia rarely present severe anemia. Herein, we report the case of a 49-year-old man with severe anemia and undiagnosed hereditary hemorrhagic telangiectasia. Keywords:Hereditary hemorrhagic telangiectasia; Iron deficiency anemia; Case reports [publication type]. ResumoTelangiectasia hemorrágica hereditária é uma doença autossômica dominante na qual comunicações arteriovenosas afetam comumente pele, superfícies mucosas, pulmões, cérebro e trato gastrointestinal. As manifestações comuns desta doença são epistaxe, sangramento gastrointestinal, e malformações arteriovenosas cerebrais e pulmonares. Apesar de a epistaxe e o sangramento gastrointestinal poderem causar anemia, telangiectasia hemorrágica hereditária raramente é diagnosticada com anemia grave. Neste artigo é relatado o caso de um homem de 49 anos de idade com telangiectasia hemorrágica hereditária não diagnosticada e anemia grave.

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Tumor de células granulares (TCG) é um termo descritivo para um tumor com histologia distintiva, perfil imunohistoquímico característico e achados ultra-estruturais peculiares. Tem distribuição topográfica ampla e sua localização nas vias aéreas é considerada incomum. Os autores relatam o caso de uma mulher de 40 anos com tosse produtiva e febre há dois meses e exame físico normal. A tomografia computadorizada evidenciou espessamento de parede do brônquio intermediário e a broncoscopia mostrou, nesse nível, hiperemia e elevação da mucosa endobrônquica. Os exames histopatológicos e imunohistoquímico dos tecidos deste local diagnosticaram TCG. O objetivo do presente relato é chamar a atenção para a possibilidade de diagnóstico desse tumor em pequenas biópsias endoscópicas.

Background: The SARS-CoV-2 pandemic first reached Brazil in late February 2020. Since then, it is one of the most affected countries globally. The rise of mental health problems in the population directly or indirectly affected is now a major concern. In the present study, we show the results of the first wave of the COVIDPsiq cohort study, which started early on (April 2020). The aim of this study was to investigate and compare independent predictors of symptoms of stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in Brazilians one month after social distancing measures were implemented. Methods: Depression, Anxiety, and Stress Scale (DASS-21) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) were the two self-report instruments used to assess the symptoms. Variables related to demographics, social distancing, exposure to the news of coronavirus pandemic, substance use, and traumatic situations were also analyzed. Data was gathered through a web-based survey. Multivariate analyses were performed through hierarchical multiple linear regression models (HMLR). Result: A sample of 3,587 participants completed the questionnaire, among which approximately two-thirds considered that their mental health worsened after the beginning of the social restriction measures. Stress, anxiety, depression, and PTSD levels were highly correlated with this self-perception. The five most important predictors of psychological distress were the distress related to pandemic news, younger age, current psychiatric diagnosis, trouble sleeping, and emotional abuse or violence. Limitations: This is an internet survey-based study in which convenience sample bias may limit its external validity. It does not represent the northern regions of the country and most participants are white wealthier females. It was not possible to evaluate if symptoms are clinically relevant to infer an increased incidence of mental illness. Conclusions: These results confirm the hypothesis that a pandemic would have important impacts on the mental health of the population and indicate the level of distress related to the media as an important predictor of mental symptoms.

An unusual case of chronic pulmonary paracoccidiodomycosis and disseminated cryptococcosis in a non-HIV infected patient is reported in a 72-year-old previously healthy man. A chest radiograph disclosed a bilateral diffused interstitial infiltrate involving middle and lower lung fields. Specimen samples taken from the tracheal tube revealed yeast-like organisms suggestive of Cryptococcus neoformans and Paracoccidiodes brasiliensis. Blood and cerebrospinal fluid culture was positive for C. neoformans and the immunodiffusion test against paracoccidiodin revealed a precipitation band. The patient died 24 days after the admission.

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