Effectiveness training type on body composition and metabolic parameters in adolescents with obesity: review

No systematic reviews had analyzedthe most effective training for adolescents with obesity, thus, the aim of our review was to understand whether aerobic, resistance, or combinate, is appropriate for improving body composition, and factors associated with obesity in adolescents. We followed PRISMA methods, in the Pubmed, SCOPUS, and Web of Science databases, using the terms Obesity, teenager, fat mass, body mass index, body mass, intervention, aerobic, resistance, training and physical activity. Subsequently, titles and abstracts were read to filter the articles. Of the 3585 results found, 10 articles were selected with protocols of 3 to 4 weekly training sessions of 15 to 60 minutes, with interventions of 4 to 12 weeks. All types of training were beneficial for anthropometric and biochemical improvement, only resistance training (RT) has a significant difference for muscle mass compared to aerobic training (AT). Even though of the small number of studies with this type of comparison, it is still unclear which type of training is better or whether the two done concurrently would be a better alternative. According to our findings adolescents who want to maximize the effect of exercise on anthropometric variables should ideally perform aerobic and endurance exercises, but significant benefit can be achieved through any type of exercise, and if it were to have a significant differentiation within muscle mass the resistance exercise may be ideal to achieve this goal(AU)

En este artículo de revisión, fue analizado cual es el método de entrenamiento que es más efectivo para adolescentes con obesidad, de allí, a que nuestro objetivo en esta revisión es definir cual de los protocolos de entrenamiento (aeróbico, de resistencia o combinado) es mas apropiado para mejorar la composición corporal y otros factores asociados con la obesidad en adolescentes. Siguiendo los métodos de PRISMA se realizó la búsqueda en las bases de datos de, Pubmed, SCOPUS, y Web os Science, utilizando términos de obesidad, adolescentes, masa grasa, índice de masa corporal, masa corporal, intervención, ejercicio aeróbico, ejercicio de resistencia, ejercicio combinado y actividad física, subsecuentemente se leyeron títulos y resúmenes para filtrar los artículos. De los 3585 artículos encontrados, 10 artículos fueron seleccionados con protocolos de 3 a 4 días a la semana, donde cada sesión era de 15 a 60 minutos, con intervenciones entre 4 y 12 semanas. Todos los tipos de entrenamiento fueron beneficiosos para mejorar composición corporal y parámetros bioquímicos, el ejercicio de resistencia demuestra tener diferencia con relación a los otros dos protocolos de entrenamiento donde post-intervención consiguen mejorar la masa muscular. Debido al número pequeño de estudios aun la información es poco clara sobre cual protocolo es más efectivo y así poder elegir una alternativa mas adecuada. De acuerdo con los hallazgos realizar ejercicios aeróbicos y/o combinados mejoran la composición corporal a nivel de masa grasa, y el ejercicio de resistencia demuestra mejorar musculatura en adolescentes con obesidad(AU)

Tricotilomania: dificuldades diagnósticas e relato de dois casos / Trichotillomania: difficulties in diagnosis and report of two clinical cases

OBJETIVO: Relatar dois casos de tricotilomania, um transtorno psiquiátrico ainda subdiagnosticado e que pode estar associado a problemas sociais e clínicos relevantes. Pretende-se destacar as características clínicas, discutindo as implicações do diagnóstico precoce para a evolução dos pacientes. DESCRIÇÃO DO CASO: Uma adolescente com diagnóstico de tricotilomania "pura" e outra menina cujo quadro estava associado ao transtorno obsessivo-compulsivo. Embora com o tratamento, a evolução de ambas tenha sido favorável, houve demora significativa para estabelecer o diagnóstico e encaminhá-las a um serviço de saúde mental, com prejuízos escolares e sociais. COMENTÁRIOS: A tricotilomania difere dos quadros benignos e transitórios de arrancar cabelos observados nos primeiros anos de vida e ainda é subdiagnosticada. A vergonha dos sintomas observada nos portadores e o desconhecimento por parte dos profissionais de saúde contribuem para essa situação. O quadro pode ser grave, particularmente se acompanhado de tricofagia. Profissionais da saúde precisam identificar o transtorno precocemente e encaminhar as crianças para tratamento especializado antes das possíveis complicações clínicas e repercussões psicossociais.

OBJECTIVE: To report two cases of trichotillomania, an underdiagnosed psychiatric disorder that may be associated with important social and clinical problems. The clinical features will be highlighted considering the implications of early diagnosis on patients' outcome. CASE DESCRIPTION: An adolescent with isolated trichotillomania and another girl whose symptoms were associated with obsessive-compulsive disorder are described. Although both patients presented a favorable outcome with treatment, there was a significant delay in establishing the diagnosis and in referring them to a mental health service, leading to negative impact in educational and social domains. COMMENTS: Trichotillomania differs from the benign and transitory hair pulling habits observed in the first years of life, and it is still underdiagnosed. The embarrassment related the patients' symptoms and the lack of knowledge of health professionals contribute to this situation. The condition may be severe, particularly if associated with trichophagia. Health care professionals need to identify the disorder early and refer these children to specialized treatment before clinical complications and psychosocial problems occur.