Tratamento não medicamentoso da hipertensão arterial

Hypertension is a multifactorial disease that is influenced by the environment. In those patients with a genetic predisposition, hypertension may develop if there is an excess of carbohydrate, salt and alcohol consumption associated to sedentary life style and stress. It is very important that always, in the treatment of hypertension, we encourage patients to life style modifications in order to better control their blood pressure.A hipertensão arterial é uma doença multifatorial que sofre grande influência do meio ambiente no seu desenvolvimento. Pacientes com predisposição genética à hipertensão arterial poderão desenvolver a doença na idade adulta, se mantiverem um estilo de vida que inclua ingestão excessiva de carboidratos, sal e álcool, além de vida sedentária e competitiva. É importante que, na abordagem terapêutica do paciente hipertenso, tenhamos sempre em mente a necessidade de estimular a mudança de estilo de vida, através de modificações dietético-comportamentais, que contribuirão, em muito, para o melhor controle da pressão arterial

The brain decade in debate: I. Neurobiology of learning and memory

This article is a transcription of an electronic symposium in which some active researchers were invited by the Brazilian Society for Neuroscience and Behavior (SBNeC) to discuss the last decade's advances in neurobiology of learning and memory. The way different parts of the brain are recruited during the storage of different kinds of memory (e.g., short-term vs long-term memory, declarative vs procedural memory) and even the property of these divisions were discussed. It was pointed out that the brain does not really store memories, but stores traces of information that are later used to create memories, not always expressing a completely veridical picture of the past experienced reality. To perform this process different parts of the brain act as important nodes of the neural network that encode, store and retrieve the information that will be used to create memories. Some of the brain regions are recognizably active during the activation of short-term working memory (e.g., prefrontal cortex), or the storage of information retrieved as long-term explicit memories (e.g., hippocampus and related cortical areas) or the modulation of the storage of memories related to emotional events (e.g., amygdala). This does not mean that there is a separate neural structure completely supporting the storage of each kind of memory but means that these memories critically depend on the functioning of these neural structures. The current view is that there is no sense in talking about hippocampus-based or amygdala-based memory since this implies that there is a one-to-one correspondence. The present question to be solved is how systems interact in memory. The pertinence of attributing a critical role to cellular processes like synaptic tagging and protein kinase A activation to explain the memory storage processes at the cellular level was also discussed.University of Bristol Department of PsychologyUniversidade Federal de São Paulo (UNIFESP) Departamento de PsicobiologiaUniversity of California Center for Neurobiology of Learning and Memory Department of Neurobiology and BehaviorUniversity of California Neuropsychiatric InstituteUniversidade Federal do Rio Grande do Sul Instituto de Biociências Departamento de BioquímicaUniversity of Edinburgh Department of NeuroscienceUniversity of Arizona Department of PsychologyNorthwestern UniversityUniversidade de São Paulo Instituto de Biociências Departamento de FisiologiaUniversidade Federal do Paraná Departamento de Farmacologia Laboratório de Fisiologia e Farmacologia do Sistema Nervoso CentralUNIFESP, Depto. de PsicobiologiaSciEL

Hipertensão arterial sistêmica secundária

The prevalence of secondary systemic arterial hypertension (S-SAH) is 3% to 5%. Before investigating the secondary causes of SAH, the following should be excluded: ._ Inadequate measurement of arterial pressure (AP). ._ White-coat hypertension; ._ Inadequate treatment; ._ Treatment non-adherence; ._ Progression of lesions in hypertension target organs; ._ Presence of co-morbidities; ._ Interaction with prescription drugs. Table 1 lists the situations when the presence of S-SAH should be investigated. Next, the main causes of S-SAH will be discussed. [Author supplied abstract

A web-based Alcohol Clinical Training (ACT) curriculum: Is in-person faculty development necessary to affect teaching?

<p>Abstract</p> <p>Background</p> <p>Physicians receive little education about unhealthy alcohol use and as a result patients often do not receive efficacious interventions. The objective of this study is to evaluate whether a free web-based alcohol curriculum would be used by physician educators and whether in-person faculty development would increase its use, confidence in teaching and teaching itself.</p> <p>Methods</p> <p>Subjects were physician educators who applied to attend a workshop on the use of a web-based curriculum about alcohol screening and brief intervention and cross-cultural efficacy. All physicians were provided the curriculum web address. Intervention subjects attended a 3-hour workshop including demonstration of the website, modeling of teaching, and development of a plan for using the curriculum. All subjects completed a survey prior to and 3 months after the workshop.</p> <p>Results</p> <p>Of 20 intervention and 13 control subjects, 19 (95%) and 10 (77%), respectively, completed follow-up. Compared to controls, intervention subjects had greater increases in confidence in teaching alcohol screening, and in the frequency of two teaching practices – teaching about screening and eliciting patient health beliefs. Teaching confidence and teaching practices improved significantly in 9 of 10 comparisons for intervention, and in 0 comparisons for control subjects. At follow-up 79% of intervention but only 50% of control subjects reported using any part of the curriculum (p = 0.20).</p> <p>Conclusion</p> <p>In-person training for physician educators on the use of a web-based alcohol curriculum can increase teaching confidence and practices. Although the web is frequently used for disemination, in-person training may be preferable to effect widespread teaching of clinical skills like alcohol screening and brief intervention.</p

Kinematic Sunyaev-Zel'dovich effect with ACT, DES, and BOSS: A novel hybrid estimator

The kinematic and thermal Sunyaev-Zel'dovich (kSZ and tSZ) effects probe the abundance and thermodynamics of ionized gas in galaxies and clusters. We present a new hybrid estimator to measure the kSZ effect by combining cosmic microwave background temperature anisotropy maps with photometric and spectroscopic optical survey data. The method interpolates a velocity reconstruction from a spectroscopic catalog at the positions of objects in a photometric catalog, which makes it possible to leverage the high number density of the photometric catalog and the precision of the spectroscopic survey. Combining this hybrid kSZ estimator with a measurement of the tSZ effect simultaneously constrains the density and temperature of free electrons in the photometrically selected galaxies. Using the 1000 deg2 of overlap between the Atacama Cosmology Telescope (ACT) Data Release 5, the first three years of data from the Dark Energy Survey (DES), and the Baryon Oscillation Spectroscopic Survey (BOSS) Data Release 12, we detect the kSZ signal at 4.8σ and reject the null (no-kSZ) hypothesis at 5.1σ. This corresponds to 2.0σ per 100,000 photometric objects with a velocity field based on a spectroscopic survey with 1/5th the density of the photometric catalog. For comparison, a recent ACT analysis using exclusively spectroscopic data from BOSS measured the kSZ signal at 2.1σ per 100,000 objects. Our derived constraints on the thermodynamic properties of the galaxy halos are consistent with previous measurements. With future surveys, such as the Dark Energy Spectroscopic Instrument and the Rubin Observatory Legacy Survey of Space and Time, we expect that this hybrid estimator could result in measurements with significantly better signal-to-noise than those that rely on spectroscopic data alone

First Brazilian Position on Resistant Hypertension

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The Atacama Cosmology Telescope: A Catalog of >4000 Sunyaev–Zel’dovich Galaxy Clusters

We present a catalog of 4195 optically confirmed Sunyaev–Zel'dovich (SZ) selected galaxy clusters detected with signal-to-noise ratio >4 in 13,211 deg2 of sky surveyed by the Atacama Cosmology Telescope (ACT). Cluster candidates were selected by applying a multifrequency matched filter to 98 and 150 GHz maps constructed from ACT observations obtained from 2008 to 2018 and confirmed using deep, wide-area optical surveys. The clusters span the redshift range 0.04 1 clusters, and a total of 868 systems are new discoveries. Assuming an SZ signal versus mass-scaling relation calibrated from X-ray observations, the sample has a 90% completeness mass limit of M500c > 3.8 × 1014 M⊙, evaluated at z = 0.5, for clusters detected at signal-to-noise ratio >5 in maps filtered at an angular scale of 2farcm4. The survey has a large overlap with deep optical weak-lensing surveys that are being used to calibrate the SZ signal mass-scaling relation, such as the Dark Energy Survey (4566 deg2), the Hyper Suprime-Cam Subaru Strategic Program (469 deg2), and the Kilo Degree Survey (825 deg2). We highlight some noteworthy objects in the sample, including potentially projected systems, clusters with strong lensing features, clusters with active central galaxies or star formation, and systems of multiple clusters that may be physically associated. The cluster catalog will be a useful resource for future cosmological analyses and studying the evolution of the intracluster medium and galaxies in massive clusters over the past 10 Gyr

SPIRITS: Uncovering Unusual Infrared Transients with Spitzer

We present an ongoing, five-year systematic search for extragalactic infrared transients, dubbed SPIRITS—SPitzer InfraRed Intensive Transients Survey. In the first year, using Spitzer/IRAC, we searched 190 nearby galaxies with cadence baselines of one month and six months. We discovered over 1958 variables and 43 transients. Here, we describe the survey design and highlight 14 unusual infrared transients with no optical counterparts to deep limits, which we refer to as SPRITEs (eSPecially Red Intermediate-luminosity Transient Events). SPRITEs are in the infrared luminosity gap between novae and supernovae, with [4.5] absolute magnitudes between −11 and −14 (Vega-mag) and [3.6]–[4.5] colors between 0.3 mag and 1.6 mag. The photometric evolution of SPRITEs is diverse, ranging from 7 mag yr−1. SPRITEs occur in star-forming galaxies. We present an in-depth study of one of them, SPIRITS 14ajc in Messier 83, which shows shock-excited molecular hydrogen emission. This shock may have been triggered by the dynamic decay of a non-hierarchical system of massive stars that led to either the formation of a binary or a protostellar merger

Neurobiology of rodent self-grooming and its value for translational neuroscience

Self-grooming is a complex innate behaviour with an evolutionarily conserved sequencing pattern and is one of the most frequently performed behavioural activities in rodents. In this Review, we discuss the neurobiology of rodent self-grooming, and we highlight studies of rodent models of neuropsychiatric disorders-including models of autism spectrum disorder and obsessive compulsive disorder-that have assessed self-grooming phenotypes. We suggest that rodent self-grooming may be a useful measure of repetitive behaviour in such models, and therefore of value to translational psychiatry. Assessment of rodent self-grooming may also be useful for understanding the neural circuits that are involved in complex sequential patterns of action.National Institutes of Health (U.S.) (Grant NS025529)National Institutes of Health (U.S.) (Grant HD028341)National Institutes of Health (U.S.) (Grant MH060379