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ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0-19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1-14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services.
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Abstract Objective: To examine the mental health status and related factors in children and adolescents, and to assess age groups and sexes differences in factors influencing mental health. Methods: This cross-sectional study was performed on Chinese children aged 6-18 years from November 2021 to January 2022. Mental health difficulties were accessed by the Strengths and Difficulties Questionnaire. Multivariate logistic regression was used to analyze factors associated with mental health status. Multiple linear regression was used to evaluate factors associated with the scores of the Strengths and Difficulties Questionnaire. Results: The prevalence of mental health difficulties was 12.98% (n =1348). Age (OR, 0.909, [95%CI, 0.830-0.996]), sex (OR, 1.424, [95%CI, 1.033-1.963]) and screen time on weekdays ("≥2" h/d vs "< 1" h/d: OR, 2.001, [95%CI, 1.300-3.080]) were related factors for mental health difficulties. For children (year ≤ 12), the strongest related factor for mental health difficulties was screen time on weekdays ("≥ 2" h/d vs "< 1" h/d: OR, 1.821 [95%CI, 1.203-2.755]). The risk of mental health difficulties in females with ≥ 2 h/d screen time on weekends was 3.420 times higher than those with < 1 h/d (OR, 3.420, [95%CI, 1.923-6.081]). Conclusion: The prevalence of mental health difficulties among children and adolescents was relatively high. The lower age, female sex and excessive screen time were associated with a higher risk of mental health difficulties. The factors influencing mental health varied by different age groups and sexes. Thus, specific measures for different age groups and sexes should be adopted to mitigate the impact.
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Resumo A socioeducação é proposta educacional e de (re)socialização do jovem em conflito com a lei, na qual se prevê, igualmente, o direito à atenção à saúde garantido pelo Sistema Único de Saúde (SUS). O presente trabalho visa investigar como se dá a relação entre os serviços de saúde e as unidades socioeducativas no estado do Paraná a partir da perspectiva de trabalhadores e gestores dos serviços. A pesquisa qualitativa e de cunho exploratório consistiu na realização de dezesseis entrevistas semiestruturadas em cinco municípios do estado, com posterior categorização das narrativas a partir de análise hermenêutica. Como resultado evidenciou-se considerável fragilidade na articulação entre os equipamentos da rede para promoção da assistência à saúde em geral e, mais notoriamente, à saúde mental dos jovens. Os quesitos de segurança exercem forte influência na regulação das ações, até mesmo de saúde, na socioeducação. A política atual de atenção integral à saúde na socioeducação, implantada no Brasil em 2014, representa, contudo, um importante contraponto na reordenação e na indução das ações nesse âmbito.
Abstract Socio-education is an educational and (re)socialization proposal for young people having troubles with the law, a law which also includes the right to health care guaranteed by the Unified Health System (SUS). This study aims to investigate the relationship between health services and socio-educational units in Paraná state, from the perspective of service workers and managers. The qualitative and exploratory research consisted of sixteen semi-structured interviews in five municipalities in the state, with subsequent categorization of the narratives based on hermeneutic analysis. As a result, there was considerable weakness in the coordination between the network's facilities to promote overall health care, specifically the mental health of young people. Security issues have a strong influence on the regulation of actions, even health actions, in socio-education. The current policy of comprehensive health care in socio-education, implemented in Brazil in 2014, is, however, an important counterpoint for the reordering and nudging policies in this area.
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Abstract Objectives: To analyze bone mineral content (BMC) and area bone mineral density (aBMD) accrual in adolescent male footballers who started their first football season. Methods: 17 athletes (14.8 ± 0.4 years) were monitored across 15 weeks of football training. Participants were evaluated for somatic maturation (HPHV), BMC, and aBMD at three time points: before (M1) and after (M2) a preparatory phase, and at the end of the competitive phase (M3). BMC and aBMD were measured using DXA scans. Participants were divided into groups according to maturation status (circa-PHV and post-PHV), and the amount of accumulated training load (median split). Results: A significant effect (12.1 g/week, standard error (SE) = 2.6 g/week) was observed for lower limbs BMC across the three time points. There were no significant effects of time for upper limbs BMC. There was a significant effect of time for total body aBMD (0.007, SE = 0.003 g/cm2/week) across the three time points. Adolescents at post-PHV had a significant 245.6 g (SE = 56.1 g) higher BMC compared to adolescents at circa-PHV. No significant effects were observed for the accumulated training load. Conclusion: Systematic football training, even during the growth spurt, has a positive impact on adolescent bone markers despite the accumulated training load and maturation.
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Abstract Objective: To assess the relationship between internet addiction, quality of life, and sleep problems among adolescents. Method: This research was conducted with a representative sample of 875 adolescents. This cross-sectional study used the Internet Addiction Test, Pediatric Quality of Life Inventory™ version 4.0, Pediatric Daytime Sleepiness Scale, and sleep duration. Sociodemographic factors were also analyzed. Structural equation modeling was used to investigate relationships between variables. Results: After adjusting the model for covariances between the latent variables of daytime sleepiness and correlations between the physical and emotional domains of quality of life, the authors obtained satisfactory fit indices (RMSEA = 0.031, CFI = 0.926, TLI = 0.909, SRMR = 0.058). Internet addiction was positively associated with daytime sleepiness (rho = 0.549, p < 0.001) and negatively associated with quality of life (rho = -0.173, p < 0.001). By contrast, sleep duration was negatively associated with daytime sleepiness (rho = -0.089, p = 0.007), positively associated with quality of life (rho = 0.105, p = 0.014), and dependent on school shift (rho = 0.453, p < 0.001). Conclusions: Adolescents with higher levels of internet addiction had lower perceptions of quality of life and higher daytime sleepiness. Moreover, sleep duration had a positive correlation with quality of life. Given its detrimental effects on quality of life and daytime sleepiness, parents should better supervise internet use in adolescents.
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O estudo analisa uma formação em Iniciação Científica sobre arboviroses, a partir da percepção de jovens estudantes, em Ceilândia Distrito Federal. Objetivo: compreender em que medida a Iniciação Científica mobiliza esses jovens a participarem de ações de vigilância e promoção da saúde no território, e entender sua motivação para participar do projeto. Metodologia: abrangeu-se a análise das redações escritas para a seleção ao Curso de Formação para Iniciação Científica na Educação Básica e as Arboviroses; a administração desse curso e; posteriormente, um grupo focal com estudantes para análise do processo educativo da Iniciação Científica que vivenciaram. Resultados: a análise de conteúdo evidenciou a percepção dos alunos sobre a Iniciação Científica, centrada em seis categorias analíticas: motivação dos alunos para Iniciação Científica; processo de formação do saber; formação de jovens cientistas; saúde e meio ambiente; participação e empoderamento juvenil e percepções acerca do Sistema Público de Saúde. Conclusão: o enfrentamento às arboviroses exige políticas e intervenções de amplo espectro, e a Iniciação Científica fortaleceu esses jovens estudantes enquanto sujeitos de direitos, ampliou sua percepção sobre ciência, saúde, relação com o ambiente, com o Sistema Único de Saúde e estimulou o interesse em ações preventivas no combate às arboviroses nesses territórios.
This study analyzes a Scientific Initiation (SI) program on arboviroses, from the perception of young high school students in Ceilândia Distrito Federal. Objective: It aims to understand to what extent the SI mobilizes these young people to participate in surveillance and health promotion actions in the territory and understand their motivation to participate in this project. Methodology: The methodology included the analysis of the essays written for the selection to the Training Course for Scientific Initiation in Basic Education and the Arboviroses, the administration of this course, and later a focus group with students to analyze the SI educational process they experienced. Results: The result of the Content Analysis showed that the students' perception about the SI could be grouped into six categories: students' motivation for the scientific initiation; the learning process; the training of young scientists; health and environment; youth participation and empowerment, and perceptions of the Public health system in Brazil (SUS). Conclusion: Confronting arboviroses requires broad-spectrum policies and interventions, and the SI strengthened these young students as subjects of rights, broadened their perception of science, health, relationship with the environment, with the Sistema Único de Saúde and stimulated interest in preventive actions to combat arboviroses in these territories. Keywords: Health education; Arbovirus infections; Adolescents; Public health.
Analiza una formación en Iniciación Científica (IC) sobre arbovirus, desde la percepción de jóvenes estudiantes de secundaria en Ceilândia, Distrito Federal. Objetivo: el objetivo es comprender en qué medida la IC moviliza a estos jóvenes a participar en acciones de vigilancia y promoción de la salud en el territorio, así como entender su motivación para participar en proyectos de IC. Metodología: la metodología incluyó el análisis de las redacciones escritas para la selección al Curso de Formación para Iniciación Científica en Educación Básica y Arbovirus, la administración de este curso y, posteriormente, un grupo focal con los estudiantes para analizar el proceso educativo de IC que vivieron. Resultados: los resultados del Análisis de Contenido mostraron la percepción de los estudiantes sobre la IC enfocada en seis categorías analíticas: motivación de los estudiantes por la iniciación científica; proceso de formación de conocimientos; formación de jóvenes científicos; salud y medio ambiente; participación y empoderamiento de los jóvenes y percepciones sobre el Sistema Público de Salud (SUS). Conclusiones: Enfrentar los arbovirus requiere políticas e intervenciones de amplio espectro, y la IC fortaleció a estos jóvenes estudiantes como sujetos de derechos, ampliando su percepción sobre ciencia, salud, relación con el entorno, con el Sistema Único de Salud y estimuló el interés en acciones preventivas en la lucha contra los arbovirus en estos territorios.
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Health LawABSTRACT
La diabetes mellitus tipo 2 de inicio temprano ha aumentado su prevalencia en los últimos años. Los principales factores de riesgo de padecerla en la adolescencia son: la obesidad, la predisposición genética y los antecedentes familiares. Se presenta el caso de una paciente de sexo femenino, de 15 años, que acudió a los servicios de salud con diagnóstico previo de prediabetes y sobrepeso. Al examen físico se observó sobrepeso y distribución de grasa central. Los exámenes de laboratorio indicaron hiperglucemia y hormonas tiroideas dentro de rangos de normalidad. Se diagnosticó diabetes mellitus tipo 2 y se propuso tratamiento con dieta, ejercicios físicos y metformina. Se reevaluó a los 3 meses y se constató que la paciente no cumplía el tratamiento a cabalidad. Este reporte de caso tiene como objetivo describir las características clínicas y de laboratorio de una paciente adolescente con diagnóstico de diabetes mellitus tipo 2 porque el diagnóstico precoz y el tratamiento intensivo es fundamental en el manejo de esta patología en este grupo etáreo.
Early-onset type 2 diabetes mellitus has increased in prevalence in recent years. The main risk factors for suffering from it in adolescents are: obesity, genetic predisposition and family history. The case of a 15-year-old female patient who attended health services with a previous diagnosis of prediabetes and overweight is presented. The physical examination revealed overweight and central fat distribution. Laboratory tests indicated hyperglycemia and thyroid hormones within normal ranges. Type 2 diabetes mellitus was diagnosed and treatment with diet, physical exercise and metformin was proposed. She was reassessed after 3 months and it was found that the patient was not fully complying with the treatment. This case report aims to describe the clinical and laboratory characteristics of an adolescent patient diagnosed with type 2 diabetes mellitus because early diagnosis and intensive treatment is essential in the management of this pathology in this age group.
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Fundamento: la hipertensión arterial es una enfermedad de origen multifactorial relacionada con factores genéticos y ambientales, que ha experimentado un incremento notable en su prevalencia durante los últimos años. Es causa silente de morbilidad y daño de órganos diana en adolescentes. La detección precoz de este padecimiento es importante como marcador de riesgo de hipertensión en la adultez. Objetivo: determinar la prevalencia y caracterizar la hipertensión arterial en adolescentes de 15-19 años de edad. Métodos: se realizó un estudio de corte transversal en el periodo de septiembre a diciembre de 2022. El universo lo constituyeron los 1561 adolescente de 15-19 años de edad, la muestra 1444 (92,50 %). El muestreo fue probabilístico sistemático. Las variables analizadas fueron: edad, sexo, color de la piel, prehipertensión e hipertensión arterial (sistólica, diastólica y sistodiastólica) y severidad de la hipertensión. Se analizaron los estadígrafos: frecuencia, porcentaje y prevalencia. Resultados: el 8,21 % fueron diagnosticados con prehipertensión arterial y el 39 (7,44 %, prevalencia aparente) con hipertensión. El 7,69 % de los hipertensos tenían elevada la tensión arterial diastólica, el 35,90 % la sistólica y el 56,41 % ambas. El 89,74 % de los hipertensos se encontraban en el estadio 1 y el 10,26 % en estadio 2. Conclusiones: la prevalencia de la hipertensión arterial en los adolescentes incluidos en la investigación fue superior a la reportada en Cuba. El mayor porcentaje de pacientes con prehipertensión e hipertensión arterial se evidenció en mayores de 19 años de edad, varones y de color de piel negra.
Foundation: high blood pressure is a disease of multifactorial origin related to genetic and environmental factors, which has experienced a notable increase in its prevalence in recent years. It is a silent cause of morbidity and target organ damage in adolescents. Early detection of this condition is important as a risk marker for hypertension in adulthood. Objective: determine the prevalence and characterize arterial hypertension in adolescents 15-19 years of age. Methods: a cross-sectional study was carried out in the period from September to December 2022. The universe consisted of 1,561 adolescents aged 15-19 years, the sample being 1,444 (92.50 %). The sampling was systematic probabilistic. The variables analyzed were: age, sex, skin color, prehypertension and arterial hypertension (systolic, diastolic and systodiastolic) and severity of hypertension. The statisticians were analyzed: frequency, percentage and prevalence. Results: 8.21 % were diagnosed with prehypertension and 39 (7.44 %, apparent prevalence) with hypertension. 7.69 % of hypertensive patients had elevated diastolic blood pressure, 35.90 % had elevated systolic blood pressure, and 56.41 % both. 89.74 % of hypertensive patients were in stage 1 and 10.26 % in stage 2. Conclusions: the prevalence of arterial hypertension in the adolescents included in the research was higher than that reported in Cuba. The highest percentage of patients with prehypertension and high blood pressure was seen in people over 19 years of age, men, and black skin color.
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Desde 2007, el Servicio de Epidemiología e Infectología, ha implementado un programa de transición que busca optimizar la atención de los adolescentes con infección por el HIV durante el paso de la atención pediátrica a la de adultos. Objetivo: Describir las características clínicas, epidemiológicas, virológicas y psicosociales de los adolescentes con infección HIV atendidos en el Programa y analizar el proceso de transición. Materiales y Métodos: Estudio de cohorte retrospectivo. Se incluyeron a los adolescentes, atendidos en el Programa de Transición entre enero de 2019 y diciembre de 2023, en el Hospital Garrahan, con al menos un resultado de CV y CD4+ en ese período. Se obtuvo la información de la historia clínica electrónica y se analizaron variables clínicas, epidemiológicas, virológicas, terapéuticas y psicosociales. Resultados: Se incluyeron 124 pacientes. La vía de transmisión fue vertical en el 92,74% y el estadio clínico e inmunológico era avanzado. En el momento de la transición 77,4% se encontraban con supresión virológica y con recuperación inmunológica. El 55,6% ya realizó la transición a un centro de adultos, 31,4% continúan en el programa, 11,3% se perdieron en el seguimiento y 1,7% fallecieron. Se recopilaron los datos de 31 pacientes transferidos. La mediana de seguimiento fue de 2 años; 25 pacientes (80,6%) continúan en seguimiento. Conclusiones: A pesar de la pandemia de COVID-19, el programa logró la retención de los adolescentes con infección por HIV y una transferencia sostenida en el tiempo. Además de un programa de transición estructurado para garantizar una atención continua y de calidad, es necesario continuar evaluando la evolución postransición (AU)
Since 2007, the Epidemiology and Infectious Diseases Department has implemented a transition program to optimize the care of adolescents with HIV infection during their transition from pediatric to adult care. Objective: To describe the clinical, epidemiological, virological, and psychosocial characteristics of adolescents with HIV infection treated in the program and to analyze the transition process. Materials and Methods: A retrospective cohort study was conducted. Adolescents followed in the Transition Program at Garrahan Hospital between January 2019 and December 2023, with at least one viral load and CD4+ result during that period, were included. Information was obtained from electronic medical records, and clinical, epidemiological, virological, therapeutic, and psychosocial variables were analyzed. Results: A total of 124 patients were included. The route of transmission was vertical in 92.74%, and the clinical and immunologic stage was advanced. At the time of transition, 77.4% were virologically suppressed and had achieved immunologic recovery. Of the patients, 55.6% had already transitioned to an adult center, 31.4% were still in the program, 11.3% were lost to follow-up, and 1.7% died. Data were collected from 31 transferred patients, with a median follow-up of 2 years; 25 patients (80.6%) remain in follow-up. Conclusions: Despite the COVID-19 pandemic, the program successfully retained HIVinfected adolescents and ensured sustained transition over time. In addition to a structured transition program to ensure continuous and quality care, it is necessary to continue evaluating post-transition outcomes (AU)
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Humans , Adolescent , Patient Care Team , HIV Infections/drug therapy , Continuity of Patient Care , Anti-Retroviral Agents/therapeutic use , Transition to Adult Care/organization & administration , Retrospective Studies , Cohort StudiesABSTRACT
El desarrollo de nuevos abordajes terapéuticos ha generado un aumento en la esperanza de vida de los pacientes con enfermedades neuromusculares (ENM). Se trata de un grupo de enfermedades heterogéneas desde la clínica y los posibles tratamientos. La transición en los pacientes con ENM, implica un gran desafío por presentar niveles intelectuales dentro de rangos promedio, compromisos motor, respiratorio y cardiológico progresivos que resulta en aumento de la dependencia física conforme aumenta la necesidad de autonomía emocional del adolescente. La descripción de transiciones exitosas en ENM incluye intervenciones psicosociales individuales o grupales con un enfoque multidimensional e interdisciplinario, que contemple la participación de la familia para reducir la ansiedad y la preocupación sobre sus hijos. En el Hospital Garrahan los pacientes con ENM son atendidos dentro del Programa de Atención, Docencia e Investigación de Pacientes con Enfermedad Neuromuscular desde 2008. En este trabajo nos proponemos describir la experiencia en transición pre y post pandemia, de los adolescentes con ENM en seguimiento en el Hospital de Pediatría Garrahan (AU)
The development of new care and therapeutic approaches has generated an increase in the life expectancy of patients with neuromuscular diseases (NMD), a group of heterogeneous diseases from a clinical point of view. The transition in patients with MND involves a great challenge due to progressive motor, respiratory and cardiological compromises that result in an increase in physical dependence as the adolescent needs emotional autonomy. The description of successful transitions in patients with MND includes individual and psychosocial interventions with a multidimensional and interdisciplinary approach with family participation. Since 2008, we developed a Care, Teaching and Research Program for Patients with NMD Disease at the Garrahan Hospital. The objective of this work is to describe the pre- and post-pandemic transition experience of adolescents with NMD follow-up in our hospital (AU)
Subject(s)
Humans , Adolescent , Patient Care Planning , Transition to Adult Care/organization & administration , Neuromuscular Diseases/therapy , Patient Care Team , Family , Chronic Disease , Hospitals, PediatricABSTRACT
Introducción: los niños y adolescentes con enfermedad renal crónica suelen enfrentar desafíos únicos que afectan significativamente su bienestar mental. Objetivo: este estudio tuvo como objetivo evaluar el estado de salud mental de niños y adolescentes con enfermedad renal crónica que reciben atención en el Departamento de Nefrología Pediátrica de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción. Metodología: este fue un estudio observacional descriptivo, prospectivo y transversal. Clasificamos a los participantes según factores sociodemográficos (edad, sexo, lugar de residencia, estado civil y educación de los padres, y ocupación parental) y variables clínicas (edad al diagnóstico de enfermedad renal crónica, patología subyacente, tipo de tratamiento). Las evaluaciones de salud mental utilizaron el Cuestionario Breve para el Cribado y Diagnóstico, adaptado de la Escala Infantil de Rutter. Los diagnósticos se clasificaron como no casos, casos probables sin complicaciones o casos definitivos complicados según la severidad de los síntomas. Resultados: nuestro estudio analizó a 28 jóvenes, predominantemente masculinos (57.1 %), con edades entre 2 y 17 años y una edad media de 12.3 años. Aproximadamente el 42.9 % provenía del campo, y la mitad tenía padres divorciados o separados. Clínicamente, el 42.9 % tenía enfermedad renal crónica en etapas I a III, el 17.9 % estaba en etapa IV, y el 39.3 % había recibido trasplantes de riñón. Las evaluaciones de salud mental mediante Cuestionario Breve para el Cribado y Diagnóstico revelaron que el 39.3 % no mostraba trastornos mentales probables, el 32.1 % eran casos probables sin complicaciones y el 28.6 % eran casos probables con complicaciones. La ansiedad con inhibición y los trastornos de conducta fueron los trastornos predominantes, afectando cada uno al 39.3% de los participantes. Conclusión: nuestra investigación subraya la significativa carga de trastornos de salud mental en un grupo de niños y adolescentes paraguayos con enfermedad renal crónica y la urgente necesidad de servicios de salud mental completos e integrados que estén específicamente diseñados para satisfacer las necesidades de esta población vulnerable.
Introduction: children and adolescents with chronic kidney disease often face unique challenges that significantly affect their mental well-being. Objective: this study aimed to assess the mental health status of children and adolescents with chronic kidney disease receiving care at the Departamento de Nefrología Pediátrica of the Facultad de Ciencias Médicas of the Universidad Nacional de Asunción. Methodology: this was a descriptive, prospective, cross-sectional observational study. We categorized participants based on sociodemographic factors (age, sex, residence, parents' marital status and education, and parental occupation) and clinical variables (age at chronic kidney disease diagnosis, underlying pathology, treatment type). Mental health assessments utilized the Brief Questionnaire for Screening and Diagnosis, adapted from Rutter's Child Scale. Diagnoses were classified as non-cases, probable uncomplicated cases, or definite complicated cases based on symptom severity. Results: our study analyzed 28 young individuals, predominantly male (57.1 %), aged between 2 and 17 years with a mean age of 12.3 years. Approximately 42.9 % hailed from the countryside, and half had parents who were divorced or separated. Clinically, 42.9 % had chronic kidney disease stages I to III, 17.9 % were at stage IV, and 39.3 % had received kidney transplants. Mental health assessments via Brief Questionnaire for Screening and Diagnosis revealed that 39.3 % did not show probable mental disorders, 32.1 % were probable cases without complications, and 28.6 % were probable cases with complications. Anxiety with inhibition and conduct disorders were the predominant disorders, each impacting 39.3 % of participants. Conclusion: our research underlines the significant burden of mental health disorders in a group of Paraguayan children and adolescents with chronic kidney disease and the pressing need for comprehensive, integrated mental health services that are specifically designed to meet the requirements of this vulnerable population.
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Abstract Objectives To review and discuss the role of an elimination diet in food-allergic children, emphasizing nutritional aspects for a better practical approach. Sources Non-systematic review of the literature. Findings Under an elimination diet, food-allergic patients may suffer from growth impairment or obesity and compromised quality of life. Disease phenotype, age, type, number of foods excluded, comorbidities, eating difficulties, economic status, and food availability must be considered for an appropriate diet prescription. Diet quality encompasses diversity and degree of food processing, which may alter immune regulation. Conclusions A friendly food elimination diet prescription depends on a multidisciplinary approach beyond macro and micronutrients.
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Abstract Objectives To provide a narrative review of the main eating disorders (ED), specifically focusing on children and adolescents. This review also aims to help the pediatrician identify, diagnose, and refer children and adolescents affected by this medical condition and inform them about the multidisciplinary treatment applied to these disorders. Data source The research was conducted in the Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (Medline) databases via PubMed and Embase. Consolidated Guidelines and Guidebooks in the area were also included in the review to support the discussion of ED treatment in childhood and adolescence. Data synthesis ED are psychiatric condition that usually begins in adolescence or young adulthood but can occur at any time of life, including in childhood, which has been increasingly frequent. Pediatricians are the first professionals to deal with the problem and, therefore, must be well trained in identifying and managing these disorders, which can be severe, and determine physical complications and quality of life of patients and their families. Conclusion ED has shown an increase in prevalence, as well as a reduction in the age of diagnosed patients, requiring adequate detection and referral by pediatricians. The treatment requires a specialized multidisciplinary team and is generally long-lasting for adequate recovery of affected individuals.
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Abstract Objectives To present observational studies investigating associations between the consumption of ultra-processed foods and health outcomes in childhood and adolescence. Data source Observational, cross-sectional, or longitudinal studies were considered, and identified in the Scopus, Web of Science, Pubmed and Scielo databases, without date restrictions. Data synthesis The most frequent combinations of risk factors in children and adolescents involved an unhealthy diet, with regular consumption of ultra-processed foods to the detriment of a diet based on fresh or minimally-processed foods and insufficient levels of physical activity; records on alcohol and tobacco use were identified. Combined, these practices contribute to the findings that indicate an increase in the prevalence of obesity in children and adolescents and a sedentary lifestyle, with a decrease in physical activity, in addition to representing a risk for the development of chronic non-communicable diseases, such as cardiovascular diseases and periodontal disease in childhood and adolescence. Conclusions The present study maps the current literature on the topic and indicates the direction of the approach for health promotion and prevention of NCDs in children and adolescents. Among the different risk factors that negatively affect the full development of this population, frequently eating breakfast and practicing physical activity is most strongly associated with a lower consumption of ultra-processed foods and should be part of an integrated approach to promoting eating practices that favor the reduction of diseases also in adult life.
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Introducción: Sulfato de magnesio (MgSO4) y aminofilina son broncodilatadores intravenosos utilizados en el tratamiento de niños con broncoobstrucción (BO). La evidencia disponible para recomendar su uso es escasa. Objetivo: Caracterizar el perfil de uso y la respuesta terapéutica al MgSO4 y aminofilina en el tratamiento de la BO en niños hospitalizados en un centro de referencia de Uruguay. Materiales y métodos: Estudio descriptivo de corte transversal mediante revisión de historias y entrevistas. Se incluyeron a todos los menores de 15 años que utilizaron estos fármacos. Se evaluó la respuesta terapéutica a la administración de ambos fármacos en forma exclusiva y concomitante y la presencia de efectos adversos. Resultados: Se incluyeron 102 niños, mediana de edad 4 años, ≤5 años 62%. Los principales diagnósticos fueron: crisis asmática 56% y neumonía viral 31%. Recibieron ambos fármacos 48%, únicamente aminofilina 28% y exclusiva de MgSO4 24%. Se observó buena respuesta terapéutica a la administración: exclusiva de MgSO4 67%, consecutiva de MgSO4 y aminofilina 45% y exclusiva de aminofilina en 34%. En 38,2% se registró al menos un efecto adverso, 64% eran menores de 5 años, riesgo aumentado en 1,5 veces. Conclusiones: Se registraron variadas indicaciones, la mayoría en niños asmáticos y en un porcentaje menor indicaciones fuera de prospecto. Menos de la mitad presentaron buena respuesta luego de la administración de MgSO4 y/o aminofilina. En un porcentaje no despreciable se registraron efectos adversos, predominaron en menores de 5 años. Son necesarios nuevos estudios para continuar caracterizando el perfil de uso y seguridad de estos fármacos.
Introduction: Magnesium sulfate (MgSO4) and aminophylline are intravenous bronchodilators used in the treatment of children with bronchoobstruction (BO). The evidence available to recommend their use is scarce. Objective: To characterize the use profile and therapeutic response to MgSO4 and aminophylline in the treatment of BO in children hospitalized in a reference center in Uruguay. Materials and methods: This was a descriptive cross-sectional study through review of clinical histories and interviews. All children under 15 years of age who used these drugs were included. The therapeutic response to the administration of both drugs exclusively and concomitantly and the presence of adverse effects were evaluated. Results: 102 children were included, median age was 4 years, 62% were ≤5 years. The main diagnoses were: asthmatic crisis, 56% and viral pneumonia, 31%. 48% received both drugs, 28% only aminophylline and 24% exclusively MgSO4. Good therapeutic response was observed to the administration: MgSO4 exclusively, 67%, MgSO4 followed by aminophylline, 45% and aminophylline exclusively in 34%. At least one adverse effect was recorded in 38.2%, of these, 64% were under 5 years of age, risk increased by 1.5 times. Conclusions: Various indications were recorded, the majority in asthmatic children and a smaller percentage off-label indications. Less than half had a good response after the administration of MgSO4 and/or aminophylline. Adverse effects were recorded in a non-negligible percentage, predominating in children under 5 years of age. New studies are necessary to continue characterizing the use and safety profile of these drugs.
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Introducción: Las barreras de acceso a los servicios de salud primario conforman estructuras sociales que agravan la situación de salud de los adolescentes, impactando negativamente en el ejercicio pleno de la salud sexual reproductiva, situando a los adolescentes en una población de riesgo social. Objetivo: Determinar las barreras en el acceso a los servicios primarios de Salud Sexual y Reproductiva de atención diferenciada a los adolescentes del Centro de Salud I - 4 Pampa Grande Tumbes 2018. Metodología: Estudio analítico de caso control, se entrevistaron a 288 adolescentes del tercero, cuarto y quinto de secundaria de la institución educativa pública Túpac Amaru del centro poblado Pampa Grande de Tumbes en el año 2019, entre experimento y control con una razón de 1 a 1. Se aplicaron cuestionarios anónimos para evaluar las barreras de accesibilidad a los servicios primarios de salud. Se recogieron variables: características sociodemográficas y culturales que son consideradas, como barreras de acceso a los servicios de salud. Se realizó un análisis descriptivo e inferencial con el programa SPSS® v.23. Resultados: La edad, sexo e ingreso económico están directa y significativamente relacionadas con la accesibilidad a los servicios de salud sexual y reproductiva (p<0.01 IC 95 %); La disposición de recursos económicos para asumir los costos de traslado al centro de salud (OR = 4,23); la utilización del transporte público (OR = 1,58), el conocimiento de los servicios de salud sexual y reproductiva (OR = 1,15) incrementan la probabilidad de acceder a los servicios de salud sexual y reproductiva de los adolescentes. Discusión: Las barreras socioeconómicas a los servicios de salud sexual y reproductiva de los adolescentes son modificables y dependen de la gestión en salud pública.
Introduction: The barriers to access to primary health services make up social structures that aggravate the health situation of adolescents, negatively impacting the full exercise of reproductive sexual health, placing adolescents in a population at social risk. Objective: To determine the barriers in the access to the primary services of Sexual and Reproductive Health of differentiated attention to the adolescents of the Health Center I - 4 Pampa Grande Tumbes 2018. Methods: Analytical case control study, 288 adolescents from the third, fourth and fifth grade of secondary school of the public educational institution Túpac Amaru in the Pampa Grande de Tumbes town center were interviewed in 2019, between experiment and control with a ratio of 1 to 1. Anonymous questionnaires were applied to assess accessibility barriers to primary health services. Variables were collected: sociodemographic and cultural characteristics that are considered as barriers to access to health services. A descriptive and inferential analysis was carried out with the SPSS® v.23 program. Results: Age, sex and economic income are directly and significantly related to accessibility to sexual and reproductive health services (p<0.01 95% CI); The availability of economic resources to assume the costs of transportation to the health center (OR = 4.23); the use of public transport (OR = 1.58), knowledge of sexual and reproductive health services (OR = 1.15) increase the probability of accessing sexual and reproductive health services for adolescents. Discussion: Socioeconomic barriers to sexual and reproductive health services for adolescents are modifiable and depend on public health management.
ABSTRACT
Em 11 de março de 2020, a Organização Mundial de Saúde declarou que a epidemia da covid-19 evoluiu para uma pandemia. As medidas de isolamento tomadas diante do cenário pandêmico provocaram impactos diretos na vida e na saúde física e mental da população. O objetivo deste estudo foi investigar a perspectiva do adolescente em relação à prática de atividade física e à saúde mental durante a pandemia da covid-19. Trata-se de um estudo descritivo de abordagem qualitativa, seguindo um roteiro semiestruturado, com 11 adolescentes de 11 a 19 anos de idade em acompanhamento com a equipe Residência Multiprofissional em Saúde do Adolescente. Para a análise dos dados, foi utilizada a análise de conteúdo de Bardin. A partir da análise das falas dos participantes, foram construídas três categorias analíticas. Os achados do estudo identificaram que os adolescentes que praticavam atividade física antes da pandemia pararam as práticas em algum momento após o início das medidas para contenção da disseminação do vírus. Em relação à saúde mental, foi possível identificar nos relatos os sentimentos de tristeza, medo e insegurança que a pandemia gerou nesses indivíduos. O impacto da pandemia na prática de atividade física e na saúde mental dos adolescentes, segundo a sua perspectiva e os resultados deste estudo, foi negativo.
On March 11, 2020, the World Health Organization recognized that the COVID-19 outbreak had evolved into a pandemic. Isolation measures taken during the pandemic have directly impacted the lives and physical and mental health of both adolescents and the general population. Hence, this study investigates the adolescent perspective regarding physical activity and mental health during the COVID-19 pandemic. A descriptive qualitative study was conducted following a semi-structured interview guide with eleven adolescents aged 11 to 19 years attended by the REMSA team. Data underwent Bardin's content analysis, resulting in three analytical categories. Results showed that adolescents who exercised before the pandemic stopped the practice at some point after the measures to contain the virus spread were implemented. Regarding mental health, the participants mentioned feelings of sadness, fear and insecurity brought by the pandemic. In their perspective, the COVID-19 pandemic negatively impacted physical activity and mental health. These findings impact public health decision-making where strategies to overcome this negative impact on adolescent health must be created for a better quality of life among this population.
El 11 de marzo de 2020, la Organización Mundial de la Salud (OMS) declaró que el brote del covid-19 se ha convertido en una pandemia. Las medidas de aislamiento han tenido un impacto directo en la vida y la salud física y mental de la población en general. El objetivo de este estudio fue conocer la perspectiva del adolescente sobre la práctica de actividad física y salud mental durante la pandemia del covid-19. Se trata de un estudio descriptivo, de enfoque cualitativo, que aplicó una guía semiestructurada a adolescentes de entre 11 y 19 años en seguimiento con el equipo Residencia Multiprofesional en Salud del Adolescente. Para el análisis de datos se utilizó el análisis de contenido de Bardin. A partir del análisis de contenido de los discursos de los participantes, se construyeron tres categorías analíticas. Los hallazgos de este estudio identificaron que los adolescentes que practicaban actividad física antes de la pandemia detuvieron las prácticas en algún momento posterior al inicio de las medidas de contención del virus. En cuanto a la salud mental, los participantes reportaron sentimientos de tristeza, miedo e inseguridad provocados por la pandemia. El impacto de la pandemia del covid-19 en la práctica de actividad física y la salud mental de los adolescentes según su perspectiva y los resultados de este estudio fue negativo.
Subject(s)
AdolescentABSTRACT
O objetivo do estudo foi verificar a associação entre diferentes volumes de atividade física moderada e/ou vigorosa durante o lazer e a aptidão cardiorrespiratória (ACR) adequada em adolescentes de ambos os sexos. A atividade física moderada (AFM), vigorosa (AFV ) ou moderada-vigorosa (AFMV) de lazer foi avaliada por meio de questionário e a ACR foi medida com o teste de vai-e-vem de 20m. Foram utilizados modelos de Regressão Poisson para análises. As AFM, AFV ou AFMV no lazer foram categorizadas de acordo com três limiares de atividade física no lazer (150, 300 e 420 min/sem). Foram consideras para as análises de associação as AFM, AFV e AFMV, de acordo com o compêndio de atividade físicas para adolescentes. A prática de AFMV no lazer por pelo menos 420 min/sem obteve a maior probabilidade de ACR adequada (RP = 2,03; IC95%: 1,18 3,51). Na mesma direção, a prática de AFV por pelo menos 150 min/sem também foi estatisticamente significativa (RP = 1,72; IC95%: 1,07 2,80). Os resultados indicaram uma associação positiva entre prática de atividade física no lazer e ACR, independentemente da intensidade e limiar de tempo, enfatizando que a participação em ambas as intensidades de atividade física no lazer estão associadas aos níveis adequados de aptidão cardiorrespiratória.
The aim of this study was to verify the association between different volumes of moderate and/or vigor-ous physical activity during leisure time and adequate cardiorespiratory fitness in adolescents of both sexes. Leisure-time moderate and/or vigorous physical activity (MPA, VPA, and MVPA) was assessed by means of a questionnaire and cardiorespiratory fitness was measured with the 20m back-and-forth test. Poisson regression models were used for analyses where moderate and/or vigorous physical activity in leisure time, it was categorized according to three thresholds of leisure-time physical activity (150, 300 and 420 min/week). The following factors were considered for the association analyses: MPA, VFA, and MVPA, according to the compendium of physical activity for adolescents. Leisure time MVPA for at least 420 min/week had the highest probability of adequate cardiorespiratory fitness (PR = 2.03; 95%CI: 1.18 3.51). In the same direction, the practice of VFA for at least 150 min/week was also statistically significant (PR = 1.72; 95%CI: 1.07 2.80). The results indicated a positive association between leisure time physical activity and cardiorespiratory fitness, regardless of intensity and time threshold, emphasizing that participation in both modalities of leisure time physical activity can provide substantial benefits for cardiorespiratory fitness.
Subject(s)
Humans , Male , Female , Adolescent , Oxygen Consumption , Motor Activity , Cross-Sectional Studies , AdolescentABSTRACT
The objective of this study was to analyze the association of the level of physical activity (PA) and body composition in relation to the amount and distance of built environments favorable to the practice of PA in relation to the homes of adolescents in the city of Lagoa do Carro/Pernambuco, Brazil. A total of 289 adolescents (153 boys; 10 to 18 years) participated in the study, duly enrolled in schools municipality. The self-administered Physical Activity Questionnaire for Children (PAQ-C) and Physical Activity Questionnaire for Adolescent (PAQ-A) was used to assess the PA level. The Geographic Information System was used to assess the built environments. Buffers of 100 to 500 meters were created from the center of the built environment. The Artificial Neural Network in the Feedforward method was used to assess the association and importance of built environment and body composition variables with PA level. The different distances from the built environment to the place of residence do not present statistical differences. It is noteworthy that the number of buffers up to 500 meters away was the variable that showed the greatest importance for the PA level, along with adolescents who live in places with greater exposure in terms of built environments, being considered more active. It was possible to conclude that the main determinants of the PA level of adolescents were the amount of buffers at 500 meters, sex and the distance to the built environment. However, the variables, housing area, body mass and amounts of buffers at 100 meters were the ones with the lowest power of influence.
O objetivo deste estudo foi analisar a associação do nível de atividade física (AF) e composição corporal em relação à quantidade e distância de ambientes construídos favoráveis à prática da AF em relação ao domicílio de adolescentes da cidade de Lagoa do Carro/Pernambuco, Brasil. Participaram do estudo 289 adolescentes (153 meninos; 10 a 18 anos), devidamente matriculados nas escolas do município. O Physical Activity Questionnaire for Children (PAQ-C) e Physical Activity Questionnaire for Adolescent (PAQ-A) autoaplicável foram utilizados para avaliar o nível de AF. O Sistema de Informação Geográfico foi utilizado para avaliação dos ambientes construídos. Foram criados Buffers de 100 a 500 metros de raio a partir do centro do ambiente construído. A Rede Neural Artificial no método de Feedforward foi utilizada para analisar a associação e a importância das variáveis do ambiente construído e composição corporal com o nível de AF. Não foram observadas diferenças estatisticamente significativas entre o nível de AF e as distâncias do ambiente construído. Ressalta--se que a quantidade de buffers até 500 metros de distância, foi a variável que apresentou maior importância para o nível de AF, juntamente com os adolescentes que residem em locais com maior exposição em quantidade de ambientes construídos, sendo considerados mais ativos. Os principais determinantes do nível da AF dos adolescentes foram à quantidade de buffers a 500 metros, o sexo e a distância para o ambiente construído. Em contrapartida, as variáveis, zona de moradia, massa corporal e quantidades de buffers a 100 metros foram as que apresentaram um menor poder de influência.
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Introducción. El tabaquismo es responsable de una gran cantidad de muertes en el mundo, la gran prevalencia del tabaquismo entre adolescentes, así como la baja edad de inicio del consumo, genera preocupación y la necesidad de implementar intervenciones específicas a esta población. Objetivo. Evaluar los efectos de una charla antitabaco en adolescentes de colegios públicos y privados en la Región Metropolitana de Santiago. Métodos. Estudio cuantitativo cuasi-experimental, se realizó una charla antitabaco en dos colegios (público y privado), se evaluó la motivación para dejar de fumar con el Test de Richmond en una muestra de 13 estudiantes pre y post charla. Resultados. hubo una mejora en los puntajes de Richmond post charla en ambos colegios, siendo mayor en el colegio público, sin embargo, la diferencia no fue estadísticamente significativa (p=0,09). Discusión. La evidencia respalda la efectividad de las charlas antitabaco. Existe una relación entre nivel socioeconómico y tabaquismo, sin embargo, no hay otros estudios que comparen la efectividad en los distintos estratos sociales. Se reconocen limitaciones del estudio como el tamaño de la muestra y el muestreo no aleatorio, se recomiendan nuevos estudios que incluyan otras variables. Conclusiones. A pesar de limitaciones del estudio, se respalda la implementación de charlas antitabaco en entornos educativos, enfatizando la necesidad de adaptar estrategias a contextos socioeconómicos específicos para mejorar la salud pública.
Background. Introduction: Smoking is responsible for a significant number of deaths worldwide, and the high prevalence of smoking among adolescents, as well as early age of onset, raises concerns, and the need of targeted interventions for this group. The aim of this study was to assess the effects of an anti-smoking talk on students from public and private schools in the Metropolitan Region of Santiago. Methods. A quasi-experimental quantitative study involving an anti-smoking talk in two schools (public and private) assessed the motivation to quit smoking using the Richmond Test in a sample of 13 students pre and post the talk. Results. There was an improvement in Richmond scores post-talk in both schools, with a greater increase observed in the public school. However, the difference was not statistically significant (p=0.09). Discussion. The evidence supports the effectiveness of anti-smoking talks. A relationship between socioeconomic status and smoking exists, yet there are no studies comparing effectiveness across different socioeconomic strata. Study limitations, such as sample size and non-random sampling, are acknowledged, and further research incorporating additional variables is recommended. Conclusions. Despite study limitations, advocating for the implementation of anti-smoking talks in educational settings is supported, emphasizing the need to adapt strategies to specific socioeconomic contexts to enhance public health.