Mackerel and Seaweed Burger as a Functional Product for Brain and Cognitive Aging Prevention.

Most world countries are experiencing a remarkable aging process. Meanwhile, 50 million people are affected by Alzheimer's disease (AD) and related dementia and there is an increasing trend in the incidence of these major health problems. In order to address these, the increasing evidence suggesting the protective effect of dietary interventions against cognitive decline during aging may suggest a response to this challenge. There are nutrients with a neuroprotective effect. However, Western diets are poor in healthy n-3 polyunsaturated fatty acids (n-3 PUFAs), such as docosahexaenoic acid (DHA), iodine (I), and other nutrients that may protect against cognitive aging. Given DHA richness in chub mackerel (Scomber colias), high vitamin B9 levels in quinoa (Chenopodium quinoa), and I abundance in the seaweed Saccorhiza polyschides, a functional hamburger rich in these nutrients by using these ingredients was developed and its formulation was optimized in preliminary testing. The effects of culinary treatment (steaming, roasting, and grilling vs. raw) and digestion on bioaccessibility were evaluated. The hamburgers had high levels of n-3 PUFAs in the range of 42.0-46.4% and low levels of n-6 PUFAs (6.6-6.9%), resulting in high n-3/n-6 ratios (>6). Bioaccessibility studies showed that the hamburgers could provide the daily requirements of eicosapentaenoic acid (EPA) + DHA with 19.6 g raw, 18.6 g steamed, 18.9 g roasted, or 15.1 g grilled hamburgers. Polyphenol enrichment by the seaweed and antioxidant activity were limited. The hamburgers contained high levels of Se and I at 48-61 µg/100 g ww and 221-255 µg/100 g ww, respectively. Selenium (Se) and I bioaccessibility levels were 70-85% and 57-70%, respectively, which can be considered high levels. Nonetheless, for reaching dietary requirements, considering the influence of culinary treatment and bioaccessibility, 152.2-184.2 g would be necessary to ensure daily Se requirements and 92.0-118.1 g for I needs.

New Forms of Neuroactive Phospholipids for DHA Enrichment in Brain.

Low levels of docosahexaenoic acid (DHA) in the brain have been related to neurological disorders, like Alzheimer's disease (AD). After ingestion, dietary DHA must cross the blood-brain barrier, where it is absorbed as lysophosphatidylcholine (LPC), due to its role as a preferential DHA carrier in the brain. This work aimed at the production of LPC-DHA extracts to be used in supplementation/food fortification intended neural enrichment in DHA. As it is rich in DHA, especially its phospholipids (PL), Atlantic mackerel (Scomber scombrus, caught in Spring/2022) was used as a raw material. The polar lipids fraction was separated and hydrolysed with Rhizomucor miehei lipase, to enzymatically convert phosphatidylcholine (PC) into LPC. The fish (muscle and by-products) lipids fraction was used for total lipids (TL) content, lipid classes (LC) and fatty acid (FA) profile evaluation, whilst polar lipids extracts were studied for LC production and FA analysis. Muscle TL ranged between 1.45 and 4.64 g/100 g (WW), while by-products accounted for 7.56-8.96 g/100 g, with the highest contents being found in March. However, PL were more abundant in muscle (22.46-32.20% of TL). For polar lipids extracts, PL represented 50.79% of TL, among which PC corresponded to 57.76% and phosphatidylethanolamine to 42.24%. After hydrolysis, nearly half of this PC was converted into LPC. When compared to the initial PC, DHA relative content (33.6% of total FA) was significantly higher after hydrolysis: 55.6% in PC and 73.6% in LPC. Such extract, obtained from this undervalued species, may represent a promising strategy to increase DHA uptake into brain cells while allowing this species to upgrade.

Influence of cooking methods and storage time on colour, texture, and fatty acid profile of a novel fish burger for the prevention of cognitive decline.

Western diets are poor in healthy n-3 polyunsaturated fatty acids (n-3 PUFA), namely eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), iodine (I), and other nutrients that may protect against cognitive ageing. Given DHA richness in chub mackerel (Scomber colias), high vitamin B9 levels in quinoa (Chenopodium quinoa), and I abundance in the seaweed Saccorhiza polyschides, a functional hamburger rich in these nutrients by using these ingredients was developed. This research focused on the factors affecting its quality by examining the impact of cooking (steaming at 100 °C, roasting at 180 °C, grilling at 180 °C) and storage time (after 4 and 6 months at -20 °C) upon the product's properties. Cooking treatments were found to influence the burger's colour and texture, whereas storage duration impacted FA levels and the polyene index. Cooked burgers presented lighter (L*, 45.1-55.0 vs 36.9 ± 2.4) and more yellow colouration (b*, 15.8-17.8 vs 13.6 ± 1.0) than raw burgers. Cooked burgers also exhibited higher textural values across various parameters than their raw versions. Grilled burgers (excluding initial time) were firmer (50.0 ± 5.1 N) than those cooked otherwise (37.0-39.9 N). Regarding FA levels, a decrease in DHA was recorded after four months (21.8-23.0% vs 26.4-30.6%). The polyene index followed a similar trajectory, declining from 2.6 to 3.6 initially to 1.8-1.9 in the fourth month. Hence, the studied mackerel burger could be a promising source of EPA, DHA, and other n-3 PUFAs in human diets, optimally with a frozen storage duration of fewer than four months to preserve nutritional integrity.

Fluid overload: clinical outcomes in pediatric intensive care unit

Abstract Objective The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. Methods A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. Results 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p = 0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p = 0.049) and between renal replacement therapy and death (p = 0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p = 0.064). There was no statistically significant association between death and the variables sex or age. Conclusions The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children.

High and low-fidelity simulation for respiratory diseases pediatric training: a prospective and randomized study.

OBJECTIVE: To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. METHODS: 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. RESULTS: In the theory test there was an increase in scores in both methodologies (p < 0.001); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). CONCLUSION: The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.

Fluid overload: clinical outcomes in pediatric intensive care unit.

OBJECTIVE: The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. METHODS: A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. RESULTS: 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p = 0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p = 0.049) and between renal replacement therapy and death (p = 0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p = 0.064). There was no statistically significant association between death and the variables sex or age. CONCLUSIONS: The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children.

High and low-fidelity simulation for respiratory diseases pediatric training: a prospective and randomized study

Abstract Objective: To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. Methods: 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. Results: In the theory test there was an increase in scores in both methodologies (p < 0.001 ); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). Conclusion: The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.

Elemental composition and bioaccessibility of farmed oysters (Crassostrea gigas) fed different ratios of dietary seaweed and microalgae during broodstock conditioning.

The Pacific oyster (Crassostrea gigas) culture has been expanding, thereby leading to a greater importance of hatcheries. Broodstock conditioning is very important in the hatchery process, in which diet composition may have a strong influence on the offspring production and quality. Therefore, the current study evaluated elemental composition and bioaccessibility of oysters fed different ratios of dietary seaweed (SW) and microalgae. The dietary conditioning consisted of direct replacement of microalgae by SW at four substitution levels (0%, 25%, 50%, and 100% diet). It was observed that oysters fed 100% SW had the highest levels of Be, Cu, Zn, Sr, and Cd. The most important trend was a concentration decline of most elements with progressively lower levels of SW substitution for microalgae in the feeds. No Cd or Pb hazard (contents below 1.0 mg/kg for Cd and 1.5 mg/kg for Pb) was found in oyster meat. Regarding elemental bioaccessibility, values were similar, near 100% in the cases of Cu, Br, and I. Only for Mn and Pb, bioaccessibility percentages deviated more from 100%. Indeed, the value for Pb was 50% ± 7% (initial group), and for Mn, all values were equal or lower than 29% ± 2% (final group of oysters fed microalgae). It was observed that Mn, Cd, and Pb bioaccessibility increased with a growing share of microalgal biomass in the feed. Therefore, this study showed that SW incorporation into the feed influences elemental composition and bioaccessibility of the oysters.

Fatty Acid Profile of Pacific Oyster, Crassostrea gigas, Fed Different Ratios of Dietary Seaweed and Microalgae during Broodstock Conditioning.

The fatty acid (FA) profile of oysters generally reflects the dietary FA composition. Moreover, incorporation of FA into tissues is modulated by various metabolic factors, and final composition will depend upon the dietary sources, cumulative intake, and oysters' development stage. Thus, the aim of this study was to assess the impact of dietary incorporation of seaweed (SW) Ulva rigida, in replacement of traditional microalgae diet, on the FA composition of Pacific oysters Crassostrea gigas, during broodstock conditioning. The dietary conditioning consisted of direct replacement of microalgae (33% Tisochrysis lutea, 50.25% Skeletonema costatum, and 16.75% Chaetoceros calcitrans) by SW at four different substitution levels (0%, 25%, 50%, and 100% diet). The dietary docosahexaenoic acid (DHA) (22:6n-3) and eicosapentaenoic acid (EPA) (20:5n-3) contents showed a positive correlation with the dietary microalgae level. During the trial, oysters fed with higher percentages of microalgae revealed a depletion of DHA and accumulation of EPA. The 100% SW caused a significant reduction in oxygen consumption and, consequently, in the standard metabolic rate. Based on these results, a partial substitution of up to 25% of dietary microalgae seems to be a suitable alternative, because it elicited similar results to the commercial 100% microalgae diet.

Comparison of fish and oil supplements for a better understanding of the role of fat level and other food constituents in determining bioaccessibility.

In order to investigate the effects of fat level and protein and other components on lipid bioaccessibility, the bioaccessibility of total lipids and particular fatty acids (FAs) of fish samples with different fat levels (5.4% w/w, 10.2% w/w, and 16.6% w/w) and cod liver oil supplement in different quantities (82, 154, 313, 604, and 1,027 mg) was determined by an in vitro digestion model. Digestion of the fish and oil (up to 154 mg) samples as measured by TAG disappearance was complete. Lipolysis was impaired by high amounts of oil (313 mg and higher). Bioaccessible FA profiles had similarities with the initial (before digestion) FA profiles. However, total MUFA and oleic acid contents were higher in the bioaccessible fraction. The bioaccessibility of EPA and DHA was generally lower than that of oleic acid and total MUFA. Fat level did not affect FAs' bioaccessibility. On the other hand, protein and other components may have interfered in lipid bioaccessibility and it was found that the reduction of bioaccessibility was stronger when the ratio of the lipid fraction to the nonlipid fraction (mainly protein) was smaller.

O lugar do perito e o lugar do analista na abordagem do louco infrator

Busca-se identificar e discutir o lugar da perícia e o do analista no acompanhamento de loucos infratores, a partir das contribuições da psicanálise de orientação lacaniana. Enquanto a perícia se orienta pelo saber disciplinar que visa o controle baseado em modelo standard de tratamento, resultando na segregação das singularidades, a psicanálise propõe que se ocupe um lugar esvaziado de saber e que o analista se guie pelas invenções do sujeito capazes de conectá-lo ao laço social, sem perder de vista os modos de satisfação singulares ligados às amarrações de cada um

The expertise's and analyst's place in the approach of insane offender. The article discusses the place of expert and the place of analyst in attending insane offenders, from the contributions of Lacanian psychoanalysis. While the expertise is guided by the disciplinary knowledge that seeks to control based in a standard model of treatment that segregates the singularities, psychoanalysis proposes that analyst occupies a place emptied of knowledge and is guided by the inventions of subject able to connect him to social bond, without losing sight the singular modes of satisfaction of the each one knot

O lugar do perito e o lugar do analista na abordagem do louco infrator / The place and the place of the expert analyst in addressing offender madman

Busca-se identificar e discutir o lugar da perícia e o do analista no acompanhamento de loucos infratores, a partir das contribuições da psicanálise de orientação lacaniana. Enquanto a perícia se orienta pelo saber disciplinar que visa o controle baseado em modelo standard de tratamento, resultando na segregação das singularidades, a psicanálise propõe que se ocupe um lugar esvaziado de saber e que o analista se guie pelas invenções do sujeito capazes de conectá-lo ao laço social, sem perder de vista os modos de satisfação singulares ligados às amarrações de cada um.

The expertise's and analyst's place in the approach of insane offender. The article discusses the place of expert and the place of analyst in attending insane offenders, from the contributions of Lacanian psychoanalysis. While the expertise is guided by the disciplinary knowledge that seeks to control based in a standard model of treatment that segregates the singularities, psychoanalysis proposes that analyst occupies a place emptied of knowledge and is guided by the inventions of subject able to connect him to social bond, without losing sight the singular modes of satisfaction of the each one knot.

Sobre a avaliação pericial do psicótico infrator: contribuições da psicanálise de orientação lacaniana / What Lacan orientated psychoanalysis has contributed to the evaluation of the psychotic offender / Contributions de la psychanalyse d’orientation lacanienne à l’évaluation du délinquant psychotique

Este artigo recupera a constituição da ordem social a partir da ideia de perigo atribuída ao psicótico infrator desde o início do século XIX. Esta ideia deu lugar às avaliações periciais e constituiu mecanismos de segregação. Retoma, a seguir, a tese de Lacan sobre a responsabilidade para leva-la às últimas consequências como um elemento fundamental que pode definir a humanidade do ser falante e que permite oferecer um contraponto aos dispositivos do biopoder. Para a autora, são estas contribuições lacanianas que permitem oferecer um modo de tratamento ao problema da segregação(AU)

This article recovers the constitution of the social order from the idea of danger attributed to psychotic offender since the early nineteenth century. This idea gave rise to the expert evaluations and formed mechanisms of segregation. It then resumes, Lacan's thesis about the responsibility to take it to its logical conclusion as a key element that can define humanity of the talking entity and that allows us to offer a counterpoint to the provisions of biopower. For the author, these are contributions that allow Lacanian offer a way of treating the problem of segregation(AU)

Cet article reprend la constitution de l'ordre social de l'idée de danger attribuée aux délinquants psychotiques depuis le début du XIXe siècle. Cette idée a donné lieu à des évaluations d'experts et a forme des mécanismes de ségrégation. Ensuite, Il retourne à l’examen de la thèse de Lacan à propos de la responsabilité de prendre à sa conclusion logique comme un élément clé qui permet de définir l'humanité par l’être parlant et qui nous permet d'offrir un contrepoint aux dispositions du biopouvoir. Pour l'auteur, il s'agit de contributions qui permettent à Lacan d’offrir un moyen de traiter le problème de la ségrégation(AU)

Sobre a avaliação pericial do psicótico infrator: contribuições da psicanálise de orientação lacaniana / What Lacan orientated psychoanalysis has contributed to the evaluation of the psychotic offender / Contributions de la psychanalyse d’orientation lacanienne à l’évaluation du délinquant psychotique

Este artigo recupera a constituição da ordem social a partir da ideia de perigo atribuída ao psicótico infrator desde o início do século XIX. Esta ideia deu lugar às avaliações periciais e constituiu mecanismos de segregação. Retoma, a seguir, a tese de Lacan sobre a responsabilidade para leva-la às últimas consequências como um elemento fundamental que pode definir a humanidade do ser falante e que permite oferecer um contraponto aos dispositivos do biopoder. Para a autora, são estas contribuições lacanianas que permitem oferecer um modo de tratamento ao problema da segregação.

This article recovers the constitution of the social order from the idea of danger attributed to psychotic offender since the early nineteenth century. This idea gave rise to the expert evaluations and formed mechanisms of segregation. It then resumes, Lacan's thesis about the responsibility to take it to its logical conclusion as a key element that can define humanity of the talking entity and that allows us to offer a counterpoint to the provisions of biopower. For the author, these are contributions that allow Lacanian offer a way of treating the problem of segregation.

Cet article reprend la constitution de l'ordre social de l'idée de danger attribuée aux délinquants psychotiques depuis le début du XIXe siècle. Cette idée a donné lieu à des évaluations d'experts et a forme des mécanismes de ségrégation. Ensuite, Il retourne à l’examen de la thèse de Lacan à propos de la responsabilité de prendre à sa conclusion logique comme un élément clé qui permet de définir l'humanité par l’être parlant et qui nous permet d'offrir un contrepoint aux dispositions du biopouvoir. Pour l'auteur, il s'agit de contributions qui permettent à Lacan d’offrir un moyen de traiter le problème de la ségrégation.

Sobre a hipótese freudiana de histeroepilepsia de Dostoiévski / On Freud's hypothesis about Dostoyevsky's hystero-epilepsy / Sur l'hypothèse freudienne de l'hystéro-épilepsie de DostoÏevski / Acerca de la hipótesis freudiana de histeroepilepsia de Dostoievski

Busca-se elucidar a leitura proposta por Freud sobre a histeroepilepsia de Dostoiévski, recorrendo-se aos textos, biografia e correspondência do escritor russo. A hipótese de ausência de epilepsia encontra limites, mas verifica-se que a relação de Dostoiévski aos representantes paternos tem papel decisivo em sua neurose, como construção sintomática para lidar com o desamparo.(AU)

This paper discusses Freud's reading of Dostoyevsky's hystero-epilepsy, based on this latter's literary production, biography and correspondence. The hypothesis that there was no epilepsy has its limits, but we found that the relationship between Dostoyevsky and father figures did play a crucial role in his neurosis, which served as a symptomatic construction to deal with his helplessness.(AU)

Dans cet article, nous cherchons à élucider la lecture proposée par Freud sur l'hystéro-épilepsie de DostoÏevski en nous référant aux écrits, à la biographie et à la correspondance de l'écrivain russe. L'hypothèse de l'absence de l'épilepsie a ses limites, mais nous vérifions que le rapport entre DostoÏevski et les représentants paternels joue un rôle décisif dans sa névrose en tant que construction symptomatique pour faire face à l'impuissance.(AU)

El artículo se propone a dilucidar la lectura propuesta por Freud a respecto de la histeroepilepsia de Dostoiesky recurriendo a textos, biografia y correspondência del escritor ruso. La hipótesis de ausencia de epilepsia es limitada, aunque se encuentra que la relación de Dostoiesky com los representantes paternos tienen um papel decisivo em su neurosis, como uma construcción sintomática para hacer frente al desamparo.(AU)

Sobre a hipótese freudiana de histeroepilepsia de Dostoiévski / On Freud's hypothesis about Dostoyevsky's hystero-epilepsy / Sur l'hypothèse freudienne de l'hystéro-épilepsie de DostoÏevski / Acerca de la hipótesis freudiana de histeroepilepsia de Dostoievski

Busca-se elucidar a leitura proposta por Freud sobre a histeroepilepsia de Dostoiévski, recorrendo-se aos textos, biografia e correspondência do escritor russo. A hipótese de ausência de epilepsia encontra limites, mas verifica-se que a relação de Dostoiévski aos representantes paternos tem papel decisivo em sua neurose, como construção sintomática para lidar com o desamparo.

This paper discusses Freud's reading of Dostoyevsky's hystero-epilepsy, based on this latter's literary production, biography and correspondence. The hypothesis that there was no epilepsy has its limits, but we found that the relationship between Dostoyevsky and father figures did play a crucial role in his neurosis, which served as a symptomatic construction to deal with his helplessness.

Dans cet article, nous cherchons à élucider la lecture proposée par Freud sur l'hystéro-épilepsie de DostoÏevski en nous référant aux écrits, à la biographie et à la correspondance de l'écrivain russe. L'hypothèse de l'absence de l'épilepsie a ses limites, mais nous vérifions que le rapport entre DostoÏevski et les représentants paternels joue un rôle décisif dans sa névrose en tant que construction symptomatique pour faire face à l'impuissance.

El artículo se propone a dilucidar la lectura propuesta por Freud a respecto de la histeroepilepsia de Dostoiesky recurriendo a textos, biografia y correspondência del escritor ruso. La hipótesis de ausencia de epilepsia es limitada, aunque se encuentra que la relación de Dostoiesky com los representantes paternos tienen um papel decisivo em su neurosis, como uma construcción sintomática para hacer frente al desamparo.

Primary versus secondary hypertension in children followed up at an outpatient tertiary unit.

Childhood hypertension has classically been recognized as a secondary disease. However, primary hypertension also occurs in children. The aim of this study was to compare clinical features of pediatric patients with elevated blood pressure, which were referred to an outpatient tertiary unit, and to detect variables associated with the identification of primary hypertension. The records of 220 patients with hypertension followed between 1996 and 2006 were analyzed. The variable of interest was primary hypertension. Logistic regression analysis was applied to identify clinical variables that were independently associated with primary hypertension. Of 220 patients, 33 (15%) had primary hypertension, and 187 (85%) exhibited secondary hypertension. No statistically significant differences were detected in gender, race, age at diagnosis, and systolic/diastolic blood pressure levels between both groups. After adjustment, four variables at baseline remained independently associated with primary hypertension: absence of signs/symptoms (OR 18.87, 95% CI 6.32-56.29), normal serum creatinine (OR 0.02, 95% CI 0.00-0.27), family history of hypertension (OR 3.03, 95% CI 1.04-8.79), and elevated body weight (OR 1.06, 95% CI 1.02-1.10). The absence of signs/symptoms, normal serum creatinine, family history of hypertension, and overweight/obesity at admission are clues to diagnose primary hypertension in childhood.

Hipertensão arterial em crianças e adolescentes / Arterial hipertension in children and adolescents

A hipertensão arterial em pediatria é definida por níveis pressóricos iguais ou superiores ao percentil 95 para idade, sexo e estatura após três medidas sucessivas de pressão arterial (PA), tomadas pelo mesmo examinador em visitas diferentes, utilizando-se equipamento e técnica adequados. Embora a pressão arterial predomine na idade adulta, sua prevalência em criança e adolescentes não é desprezível, variando de 1,20 a 13% nos diversos estudos nacionais e internacionais. Neste artigo de revisão são abordados aspectos gerais de hipertensão arterial em crianças e adolescentes (definição, classificação, etiologia), sua abordagem diagnóstica e terapêutica e suas complicações.

A escrita freudiana do pai-sintoma / Freud's father-symptom writing

O recurso de Freud ao texto de Dostoiévski reenvia-nos à teoria freudiana do pai e seus impasses. Édipo, Totem e tabu e Moisés e o monoteísmo seriam os três principais momentos da escrita freudiana do pai. Ao longo desses textos, apesar de recair em alguns impasses, Freud fornece elementos para tomarmos o pai como um semblante e uma formação sintomática. No último momento dessa teorização, em Moisés, o pai irá aparecer explicitamente como escrita e como sintoma (AU)

A escrita freudiana do pai-sintoma / Freud's father-symptom writing

O recurso de Freud ao texto de Dostoiévski reenvia-nos à teoria freudiana do pai e seus impasses. Édipo, Totem e tabu e Moisés e o monoteísmo seriam os três principais momentos da escrita freudiana do pai. Ao longo desses textos, apesar de recair em alguns impasses, Freud fornece elementos para tomarmos o pai como um semblante e uma formação sintomática. No último momento dessa teorização, em Moisés, o pai irá aparecer explicitamente como escrita e como sintoma