Acute Motor Axonal Neuropathy presenting as Person-in-a-Barrel syndrome

Background and aims: Person-in-a-barrel syndrome (PIBS) is clinically characterized by brachial diparesis, with preserved cranial and crural muscle strength. It is a rare neurological syndrome most commonly caused by bilateral and symmetric injury of the motor neurons that control the upper limb movements, including bilateral injury to the brain hemispheres, brainstem, cervical spinal cord, brachial plexus, or peripheral nerves. Methods: N/A Results: A 70-year-old male patient with a history of hypertension, dyslipidaemia and hyperuricemia was admitted with an acute and rapidly progressive (10 days of evolution) bilateral upper limb weakness. The patient denied respiratory or gastrointestinal symptoms, fever or recent cervical trauma/pain. Two weeks earlier he was given the first dose of the Pfizer-BioNTech™ vaccine for COVID- 19. The neurological examination revealed severe brachial diparesis and generalized hyporeflexia. Ancillary testing revealed positive serum anti-GM1 and GD1b antibodies. The PCR for SARS-CoV-2 was negative (with positive serum T-Spike antibodies). CSF analysis and Brain/Spinal MRI were normal. The electromyography and nerve conduction studies disclosed diffuse motor conduction blocks in the upper extremities, ultimately fulfilling criteria for Acute Motor Axonal Neuropathy (AMAN) with reversible conduction failure. Intravenous human immunoglobulin (0.4g/kg/day, 5 days) and rehabilitation were started, with subsequent motor improvement. Conclusion: To our knowledge this is the first case of AMAN presenting as PIBS. We intend to highlight that AMAN should be added to the list of causes of this syndrome. The role of the COVID-19 vaccine in this case remains uncertain, and it is not possible, at this moment, to infer causality.

Adaptation and development of IR services in response to the COVID-19 pandemic: preliminary results of a focused survey

Purpose: The cyclic nature of active and recovery phases of the COVID-19 pandemic, has demanded fast adaptations and preparation for health care workers world-wide. We aimed to assess how interventional radiologists are handling the pandemic during active and recovery phases with regard to work and team structures, as well as mental health and how the pandemic could have increased the awareness of minimally-invasive therapies as alternatives to postponements of non-urgent procedures. Material and methods: 7125 CIRSE members were invited to participate. For this interim report, responses were collected between 23 November 2021 and 17 December 2021. Results: 114 responses were obtained for this preliminary report, of which 102 were complete. 94% (n=99) of respondents were interventional radiology specialists. Most respondents reported having established a routine to handle different waves of the pandemic (89.5%;n=102). Compared to active phases, fewer respondents indicated at least one pandemic-associated measure in their department during recovery phases (46%-71% vs 13%). 56% reported an increase in ambulatory care patients either during active and/or recovery phases. 54% reported more referrals during active and/or recovery phases. 25% reported increased hours at the hospital during recovery phases, 52% indicated increased sick leave, care leave, quarantine, and burn-out of team members and only 39% reported to get enough time to rest during recovery phases. Conclusion: While the COVID-19 pandemic is continuing to burden IR departments and the mental health of IRs, more than half of respondents reported an increase in referrals for minimally-invasive therapies and ambulatory care.

The influence of strategy on performance: the case of REMAX real estate network - Portugal

Globalisation has changed the way business is viewed and oriented. Its impact is broad and wide-ranging, requiring an analysis and reflection of the existing business approaches and their respective practices. Covid-19 pandemic accelerated this situation and made it necessary for organisations to create new methods and tools to adapt to the actual context we are living in. This paper has as main goal to analyse the influence of strategy on the performance of REMAX real estate companies in Portugal. To achieve this objective, this research was developed according to a quantitative methodology, whose data was collected through a questionnaire survey, addressed to the directors boards of the real estate mediation companies of REMAX network, in Portugal, of which 70 valid answers were obtained. The obtained results show that the strategy has a strong influence on the performance. In addition, the results reveal that only the adopted prospective strategy by the companies has a direct impact on performance. The performance skills of the organisations, such as financial performance, customers and internal processes are the antecedents that most influence the strategy. © 2021 Inderscience Enterprises Ltd.

Teacher representations about remote teaching in the transition from face-to-face classes to online remotes

This work is justified by presenting the teacher's office in a context of social distancing, given the health pandemic resulting from COVID-19 that initiated crises in several social institutions. Motivated by questioning - What crises seem to overlap with the reports of teachers in pandemic situations? - we propose to investigate representations of teachers about remote teaching in the transition scenario from face-to-face to remote online classes. Specifically, we recognize as objectives: i) to identify representation(s) of teachers about remote teaching in a context of social distancing;ii) verify reception of teachers about the implementation of remote education in the transition scenario from face-to-face to online teaching. Theoretically, we start from considerations about education mediated by digital technologies, remote teaching, digital literacy, social and professional representations. Methodologically, this study is part of the qualitative paradigm with a netnographic approach. The data were generated through an online form and online focus group sessions. For sampling, we elect the corpus developed in the first session with a teacher Portuguese and a Biology teacher. By identifying that the participants understand remote education as an emergency measure, we found that the transition of the classes did not occur peacefully, because they were surprised by the implementation and did not feel represented by government interventions. The data seem to indicate a crisis established in the condition of the class's performance, since there is an overlap of opaque barriers between professional and family actions. The previously familiar environment is "invaded" by the professional space, constituting a space of deterritorialization/reterritorialization that implies in educational practices.

The Impact of COVID-19 on Interventional Radiology Practice Worldwide: Results from a Global Survey.

BACKGROUND: The COVID-19 pandemic had an unprecedented impact on clinical practice and healthcare professionals. We aimed to assess how interventional radiology services (IR services) were impacted by the pandemic and describe adaptations to services and working patterns across the first two waves. METHODS: An anonymous six-part survey created using an online service was distributed as a single-use web link to 7125 members of the Cardiovascular and Interventional Radiological Society of Europe via email. Out of 450 respondents, 327 who completed the survey at least partially including 278 who completed the full survey were included into the analysis. RESULTS: Interventional radiologists (IRs) reported that the overall workload decreased a lot (18%) or mildly (36%) or remained stable (29%), and research activities were often delayed (30% in most/all projects, 33% in some projects). Extreme concerns about the health of families, patients and general public were reported by 43%, 34% and 40%, respectively, and 29% reported having experienced significant stress (25% quite a bit; 23% somewhat). Compared to the first wave, significant differences were seen regarding changes to working patterns, effect on emergency work, outpatient and day-case services in the second wave. A total of 59% of respondents felt that their organisation was better prepared for a third wave. A total of 19% and 39% reported that the changes implemented would be continued or potentially continued on a long-term basis. CONCLUSION: While the COVID-19 pandemic has negatively affected IR services in terms of workload, research activity and emotional burden, IRs seem to have improved the own perception of adaptation and preparation for further waves of the pandemic.

RESISTÊNCIA AOS CARBAPENÊMICOS EM CENTRO DE MEDICINA TROPICAL DE RONDÔNIA, NA AMAZÔNIA OCIDENTAL

Introdução/Objetivo: A resistência antimicrobiana é considerada hoje uma ameaça global pela OMS e um desafio constante na prática médica intra-hospitalar. Bactérias resistentes aos carbapenêmicos, principalmente via produção de carbapenemases, frequentemente são relacionadas a infecções graves e com limitado arsenal terapêutico. Dessa forma, objetivou-se neste estudo a caracterização de microorganismos isolados conforme o perfil de resistência aos carbapenêmicos no Centro de Medicina Tropical de Rondônia (CEMETRON). Métodos: Estudo retrospectivo no CEMETRON no primeiro semestre de 2021. Avaliação dos resultados de culturas provenientes do banco de dados não nominal do Serviço de Controle de Infecção Hospitalar. Para as análises estatísticas utilizamos o SPSS® versão 25.0. Resultados: No primeiro semestre de 2021 o CEMETRON teve 303 culturas positivas, destas, 153 bactérias Gram negativas, sendo incluídas 61 (39,9%) resistentes a pelo menos um carbapenêmico. A topografia mais prevalente foi o aspirado traqueal (52,5%), seguido por sangue (18,0%) e urina (14,8%). Em ordem de prevalência tivemos 38 (62,3%) Klebsiella pneumonie, 12 (19,7%) Acinetobacter baumannii, cinco (8,2%) Pseudomonas aeroginosa, quatro (6,6%) Escherichia coli, uma (1,6%) Burkholderia cepacia e uma (1,6%) Serratia marcescens. Das 61 culturas incluídas, 19 (31,1%) foram avaliadas quanto a presença de gene de resistências enzimática, sendo 11 Klebsiella pneumonie, seis Acinetobacter baumanni, uma Pseudomonas aeroginosa e uma Serratia marcescens. Foram detectados genes enzimáticos de resistência em seis das 19 (31,6%) bactérias testadas, sendo quatro KPC detectáveis em Klebsiella pneumonie, dois OXA-51 e um OXA-58 detectáveis em Acinetobacter baumanni. Conclusão: Nosso estudo demonstra uma grande incidência de bactérias resistentes aos carbapenêmicos, quase 40% das culturas com bactérias Gram negativas no período. Importante ressaltar que a maioria dessas culturas eram de aspirado traqueal, o que pode estar relacionado com o atual cenário da pandemia de COVID-19, onde as infecções pulmonares secundárias são as mais prevalentes em UTIs. É de fazer notar a detecção de produtores de carbapenemases de classe A e D cujas terapias envolvem o uso de novos inibidores de beta-lactamases (p. ex. ceftazidima-avibactam) que não estão disponíveis na maioria dos hospitais da rede pública, nos restando terapias com menor índice de sucesso (p. ex. polimixina) comparados a medicação de primeira escolha.

Approach for the Development of a System for COVID-19 Preliminary Test

Nowadays, Coronavirus is the biggest challenge of medicine. This problem is divided into two sectors: health and economy. In relation to health, there has been an alarming exponential rise in deaths, those who do not belong to the risk group are precisely those who contaminate and lead to disease. The economy also bleeds globally, and companies are failing. Thus, thousands of people are out of work. This paper is focused on predicting whether an individual is possible with symptoms of COVID-19 and proposing the use of technology. In a context of ambient assisted living, it can save thousands of lives and builds the world economy. Therefore, a preliminary mobile diagnosis may provide a reduction in government costs and a potential alternative to the existing tests. In view of all that has been mentioned, sensors are the best solution to detect the symptoms of the disease. This project will try to identify different symptoms, such as high body temperature, breathing difficulties, and cough. The sensors that may be used to identify these symptoms are a thermometer, an electroencephalogram (EEG) sensor, an electromyography (EMG) sensor and an electrodermal activity (EDA) sensor. © 2021, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

Detection of a SARS-CoV-2 sequence with genosensors using data analysis based on information visualization and machine learning techniques

We report on genosensors to detect an ssDNA sequence from the SARS-CoV-2 genome, which mimics the GU280 gp10 gene (coding the viral nucleocapsid phosphoprotein), using four distinct principles of detection and treating the data with information visualization and machine learning techniques. Genosensors were fabricated on either gold (Au) interdigitated electrodes for electrical and electrochemical measurements or on Au nanoparticles on a glass slide for optical measurements. They contained a matrix of 11-mercaptoundecanoic acid (11-MUA) self-assembled monolayer (SAM) onto which a layer of capture probe (cpDNA) sequence was immobilized. Detection was performed using electrical and electrochemical impedance spectroscopies and localized surface plasmon resonance (LSPR). The highest sensitivity was reached with impedance spectroscopy, including using a low-cost (US$ 100) homemade impedance analyzer. Complementary ssDNA sequences were detected with a detection limit of 0.5 aM (0.3 copy per mu L). This performance may be attributed to the high sensitivity of the electrical impedance technique combined with an appropriate arrangement of the sequences on the electrodes and hybridization between the complementary sequences, as inferred from polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS). The selectivity of the genosensor was confirmed by plotting the impedance spectroscopy data with a multidimensional projection technique (interactive document mapping, IDMAP), where a clear separation was observed among the samples of the complementary DNA sequence at various concentrations and from buffer samples containing a non-complementary sequence and other DNA biomarkers. The diagnosis of SARS-CoV-2 mimicking sequences was also achieved with machine learning techniques applied to scanning electron microscope images taken from genosensors exposed to distinct concentrations of the complementary ssDNA sequences. In summary, the genosensors proposed here are promising for detecting SARS-CoV-2 genetic material (RNA) in biological fluids in point-of-care settings.

Large vessel ischaemic stroke related to COVID19

A Doença causada pelo Novo Coronavírus (COVID19) apareceu em Dezembro de 2019 na China e rapidamente se espalhou por todo o mundo, causando centenas de milhares de mortes, principalmente devido síndrome de desconforto respiratório. Entretanto, em poucos meses, a comunidade médica percebeu outras complicações severas nos pacientes com COVID19, e agora já é claro que existe uma associação entre acidente vascular cerebral isquêmico e COVID19. Objetivo: reportar uma complicação neurológica em um paciente com COVID19. Apresentação de caso: nós reportamos o caso de um homem, com menos de 60 anos, sem doenças crônicas prévias, que apresentou acidente vascular cerebral isquêmico de um grande vaso durante o curso de uma grave quadro de COVID19. A epidemiologia, características clínicas, laboratoriais e radiológicas do caso são comparadas com os dados da literatura. Conclusão: esse caso ajuda a encorpar o conhecimento atual dessa nova infecção e suas complicações neurológicas, destacando a importância de se conhecer essas complicações para melhor manejar os pacientes acometidos. © 2020 Editora Cientifica Nacional Ltda. All rights reserved.

Food habits and body image perception changes during Covid-19 pandemic in Portugal

Rationale: Our aim was to understand dietary behaviour changes and body image perception during the COVID-19 pandemic. Methods: This was a cross-sectional study, enrolling a sample of 828 participants living in Portugal. Data was collected through an online survey, during the period of social lockdown from April to May 2020. Height and weight were reported by participants, and Body Mass Index (BMI) were calculated. A dietary changes questionnaire ad a body image perception test were applied. A descriptive analysis and Spearman correlation test were performed. Results: The analysed sample consisted of 828 participants with ages ranging from 14 -76 years old, the majority being female (n=706). Median BMI was 24,7kg/m2 (range: 15,8kg/m2- 52,7kg/m2). A correlation between the BMI and the body image perception was clear in every participant (p=0,000;ρ= 0,777). This correlation could also be found in some dietary behaviours such as the choice for a complete, varied and balanced diet (p=0,000;ρ= 0,179), the increased repetition of servings each meal (p=0,003;ρ= -0,103), and also the decrease of physical activity (p=0,000;ρ= -0,203), during social confinement. It was also possible to identify that 65,9% of the population did not consume the recommended daily allowances as to fruits, 64,4% did not consume legumes at least once a day and 54,7% did not consume soup at least once a day. On the other hand, around 52% of the population started consuming more sweets and cakes. Conclusion: We conclude that in the present scenario, marked by social lockdown, the routines, the perception of one-self and also the dietary behaviours and habits have suffered negative changes in our sample. This highlights the importance of nutrition education during pandemic situations. References: Naja F, Hamadeh R. Nutrition amid the COVID-19 pandemic: a multi-level framework for action,. Eur J Clin Nutr. 2020;Disclosure of Interest: None declared

Nutritional status of children in school age: A look of concern in an era of COVID-19 pandemic

Rationale: To analyze the evolution of the nutritional status of Elementary School children, over four years, and to infer the impact of nutritional imbalances to child infection susceptibility. Methods: A convenience sample of two elementary schools were studied during 4 school years, starting in 2016/2017. Weight and height were collected. Body mass index (BMI) z-score was calculated using the WHO AnthroPlus software. Nutritional status was evaluated according to WHO guidelines. Results: 1155 students (6 - 14 years-old, 48.5% female) were included. The mean z-scores of each year were: 0.43 ±1.17 in 2016/2017, 0.70 ±1.31 in 2017/2018, 0.38 ±1.30 in 2018/2019, and 0.34 ±1.86 in 2019/2020. The 2019/2020 school year recorded the highest percentage of underweight (10%), the highest percentage of normal weight was recorded in 2016/2017 (67.2%), 2017/2018 registered the highest percentage of overweight (24.6%) and the highest percentage of obesity was registered in 2019/2020 (18.2%). In these 4 years there has been an increase in the percentage of underweight (2.2% to 10%) and obesity (8.1% to 18.2%) and a decrease in the percentage of normal weight (67.2% to 54.6%) and overweight (22.5% to 17.1%). Conclusion: The increase in the prevalence of underweight and obesity between 2016 and 2020 is worrying, mainly during a pandemic that has obesity and malnutrition as risk factors. Also, the decrease in the prevalence of overweight may be related to conversion of these cases into obesity cases, since normal weight cases also decreased. We are implementing a nutrition education program in these schools to try reverting this serious public health problem, although facing some resistance. Therefore, nutritionists are needed in Portuguese schools, to promote health and nutrition literacy among students, especially during pandemic times. References: de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7. Disclosure of Interest: None declared.