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Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Background and objectives: The efficacy of deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) in patients with drug-resistant epilepsy (DRE) was demonstrated in the double-blind Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy randomized controlled trial. The Medtronic Registry for Epilepsy (MORE) aims to understand the safety and longer-term effectiveness of ANT DBS therapy in routine clinical practice. Methods: MORE is an observational registry collecting prospective and retrospective clinical data. Participants were at least 18 years old, with focal DRE recruited across 25 centers from 13 countries. They were followed for at least 2 years in terms of seizure frequency (SF), responder rate (RR), health-related quality of life (Quality of Life in Epilepsy Inventory 31), depression, and safety outcomes. Results: Of the 191 patients recruited, 170 (mean [SD] age of 35.6 [10.7] years, 43% female) were implanted with DBS therapy and met all eligibility criteria. At baseline, 38% of patients reported cognitive impairment. The median monthly SF decreased by 33.1% from 15.8 at baseline to 8.8 at 2 years (p < 0.0001) with 32.3% RR. In the subgroup of 47 patients who completed 5 years of follow-up, the median monthly SF decreased by 55.1% from 16 at baseline to 7.9 at 5 years (p < 0.0001) with 53.2% RR. High-volume centers (>10 implantations) had 42.8% reduction in median monthly SF by 2 years in comparison with 25.8% in low-volume center. In patients with cognitive impairment, the reduction in median monthly SF was 26.0% by 2 years compared with 36.1% in patients without cognitive impairment. The most frequently reported adverse events were changes (e.g., increased frequency/severity) in seizure (16%), memory impairment (patient-reported complaint, 15%), depressive mood (patient-reported complaint, 13%), and epilepsy (12%). One definite sudden unexpected death in epilepsy case was reported. Discussion: The MORE registry supports the effectiveness and safety of ANT DBS therapy in a real-world setting in the 2 years following implantation. Classification of evidence: This study provides Class IV evidence that ANT DBS reduces the frequency of seizures in patients with drug-resistant focal epilepsy., The MORE registry was sponsored and funded by Medtronic, plc.

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Acknowledgments: Gina Tomé is a postdoctorate funded by the Fundação Ciência e Tecnologia (FCT) SFRH/BPD/108637/2015. Objective: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. Methods/Results:Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. Conclusions: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences. publishersversion published

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Introduction: Unfractionated heparin (UFH) has been used for decades to prevent thrombotic events during vascular surgery. Although it is known that UFH has a complex and nonlinear pharmacokinetics, with great individual variability, anticoagulation monitorization in vascular surgery is not routine and a standard empirical dose is often used. Activated clotting time (ACT) has been shown to be a simple, reliable and inexpensive way to monitor UFH anticoagulant effect, being routinely used during cardiac surgery. However, heparinisation remains a dilemma in vascular surgery and few studies emphasized the role of anticoagulation monitoring in this setting. Objectives: To investigate whether a fixed heparin dose of 5000 IU in arterial vascular surgery results in adequate and homogeneous heparinisation in all patients. Secondary endpoints: to identify preoperative factors for heparin response, intraoperative events and outcomes. Methods: This observational prospective pilot study included 30 consecutive patients undergoing arterial vascular surgery. ACT monitoring was performed before clamping and at 3, 30 and 60 minutes after 5000 IU UFH bolus. Preoperative and intraoperative data were also accessed. A target ACT of ��� 200 s was set, taking in account of the lowest ACT value admitted by vascular surgery recommendations. Results: The average ACT value increased to 210.20 �� 28.82 s (1.61 �� 0.25 times vs baseline) 3 minutes after bolus, then declined to 191.60 �� 21.86 s and 173.4 �� 21.37 s after 30 and 60 minutes, respectively. Three minutes after UFH bolus, 53% patients had ACT ��� 200 s, decreasing to one third and 7% at 30 and 60 minutes, respectively. Even when weight-based, a correlation between heparin dose per kilogram and ACT change was not found (r = 0.187; p = 0.322). There was also no correlation between ACT values and preoperative hemoglobin, platelet count, creatinine clearance or INR. There was a positive correlation between preoperative aPTT and intraoperative ACT measurements (r = 0.432; p = 0.017). There was no difference between ACT values and previous antithrombotic/anticoagulant therapy and between intraoperative ACT and intraoperative blood loss. Conclusions: This study confirms that administrating a fixed or even a weight-based heparinisation is insufficient to provide consistent anticoagulation levels in all patients. Perioperative anticoagulation should be monitored and ACT-based. Larger clinical RCT's are warranted., Angiologia e Cirurgia Vascular, Vol 14 No 4 (2018): December

Submitted by Paula Guerreiro (passarinho@reitoria.ulisboa.pt) on 2019-04-24T09:31:28Z No. of bitstreams: 1 ULSD7328948_td_Carla_Bentes.pdf: 36684370 bytes, checksum: fe0111442d8fff5a08d66e12df78c4a6 (MD5) Made available in DSpace on 2019-05-06T09:09:06Z (GMT). No. of bitstreams: 1 ULSD7328948_td_Carla_Bentes.pdf: 36684370 bytes, checksum: fe0111442d8fff5a08d66e12df78c4a6 (MD5) Previous issue date: 2018

Purpose: To evaluate morning dream recall frequency and content in patients with temporal lobe epilepsy (TLE). Methods: Fifty-two patients with pharmacoresistant TLE submitted to a written dream diary during five consecutive days and continuous video–electroencephalographic (video-EEG) monitoring. A matched control group of 41 healthy subjects completed the same diary at home. The number of recalled dreams (including long dreams) and nonrecalled dream mentation were collected, and the Dream Recall Rate (DRR) was calculated. Hall and Van de Castle dream content analysis was performed. Key Findings: Greater than 70% of patients with TLE (37 of 52) recall their dreams, but DRR rate in these patients is lower than in controls (p £ 0.001). Dream recall does not appear to be influenced by the presence of neuropsychological deficits nor seizure frequency. In dreams descriptions, TLE patients (vs. controls) have a higher percentage of familiarity in settings and fewer dreams with at least one success. Significance: Onirical activity of patients with TLE is different from that of healthy subjects. Our results support the role of mesial and neocortical temporal structures in dream experience. The selective activation of dysfunctional mesial structures may be responsible for some of the observed variability. However, dream content changes can also mirror social and psychological comorbidities of patients with epilepsy.

Tese de mestrado, Neurociências, Universidade de Lisboa, Faculdade de Medicina, 2020 Submitted by Fernando João Machado (fjmachado@fm.ul.pt) on 2021-02-05T14:02:45Z No. of bitstreams: 1 12466_Tese.pdf: 2040471 bytes, checksum: 6190b30bf4d5b83b79b8236ef8399a7b (MD5) Made available in DSpace on 2021-02-05T14:02:59Z (GMT). No. of bitstreams: 1 12466_Tese.pdf: 2040471 bytes, checksum: 6190b30bf4d5b83b79b8236ef8399a7b (MD5) Previous issue date: 2020-07-20

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020 Submitted by Sofia Amador (sofiamador@fm.ul.pt) on 2021-06-02T10:10:05Z No. of bitstreams: 1 PatriciaBNascimento.pdf: 2208346 bytes, checksum: 033622acea486b78ca12cd1533075c65 (MD5) Made available in DSpace on 2021-06-04T10:37:07Z (GMT). No. of bitstreams: 1 PatriciaBNascimento.pdf: 2208346 bytes, checksum: 033622acea486b78ca12cd1533075c65 (MD5) Previous issue date: 2020-07-17

Tese de mestrado, Neurociências, Universidade de Lisboa, Faculdade de Medicina, 2018 Submitted by Fernando João Machado (fjmachado@fm.ul.pt) on 2018-05-22T14:25:53Z No. of bitstreams: 1 11503_Tese.pdf: 1801606 bytes, checksum: aa2388885b408eed678ecff5238c0bc4 (MD5) Made available in DSpace on 2018-05-22T14:26:04Z (GMT). No. of bitstreams: 1 11503_Tese.pdf: 1801606 bytes, checksum: aa2388885b408eed678ecff5238c0bc4 (MD5) Previous issue date: 2017

Tese de mestrado, Ciências do Sono, Faculdade de Medicina, Universidade de Lisboa, 2016 Submitted by Lucília Mateus (luciliamateus@fm.ul.pt) on 2016-05-16T08:41:16Z No. of bitstreams: 1 11044_Tese.pdf: 1748801 bytes, checksum: 7e3fe8617a04fab11dd35bb786abf447 (MD5) Made available in DSpace on 2016-05-16T16:03:48Z (GMT). No. of bitstreams: 1 11044_Tese.pdf: 1748801 bytes, checksum: 7e3fe8617a04fab11dd35bb786abf447 (MD5) Previous issue date: 2016

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014 Submitted by Biblioteca da Faculdade de Medicina da Universidade de Lisboa (repositorio@medicina.ulisboa.pt) on 2016-06-07T14:33:53Z No. of bitstreams: 1 FlavioMLPereira.pdf: 588149 bytes, checksum: 69ef3af0b09a6dec03ce175ac8552f02 (MD5) Made available in DSpace on 2016-06-07T17:30:53Z (GMT). No. of bitstreams: 1 FlavioMLPereira.pdf: 588149 bytes, checksum: 69ef3af0b09a6dec03ce175ac8552f02 (MD5) Previous issue date: 2014

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014 Submitted by Biblioteca da Faculdade de Medicina da Universidade de Lisboa (repositorio@medicina.ulisboa.pt) on 2016-07-21T12:40:17Z No. of bitstreams: 1 SaraFPinelo.pdf: 648438 bytes, checksum: 5abbe1b63c93b55efb50f6550be1ba24 (MD5) Made available in DSpace on 2016-08-10T09:41:36Z (GMT). No. of bitstreams: 1 SaraFPinelo.pdf: 648438 bytes, checksum: 5abbe1b63c93b55efb50f6550be1ba24 (MD5) Previous issue date: 2014

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020 Submitted by Sofia Amador (sofiamador@fm.ul.pt) on 2021-10-29T07:37:14Z No. of bitstreams: 1 TiagoSFernandes.pdf: 1104563 bytes, checksum: 564407352350aef8681297945d4e5629 (MD5) Made available in DSpace on 2021-10-29T10:12:01Z (GMT). No. of bitstreams: 1 TiagoSFernandes.pdf: 1104563 bytes, checksum: 564407352350aef8681297945d4e5629 (MD5) Previous issue date: 2020-07-17