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J. pediatr. (Rio J.) ; 97(6): 595-602, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350976


Abstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.

Humans , Child , Adolescent , Adult , Human Growth Hormone , Transition to Adult Care , Quality of Life , Insulin-Like Growth Factor I , Growth Hormone , Puberty
Arch. argent. pediatr ; 119(4): 251-258, agosto 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1280909


Introducción. El orquidómetro de Prader es el método estándar para medir el volumen testicular (VT) en niños y adolescentes. Objetivo. Evaluar la concordancia en la estimación del VT y del inicio puberal con las técnicas de orquidometría de Prader, Chipkevitch y Sotos. Métodos. Diseño descriptivo transversal realizado en varones de entre 9 y 20 años. Se midió el VT (ml) en cada adolescente con las técnicas de Prader (método de referencia), Chipkevitch (modelo gráfico) y Sotos (medición de ancho testicular con regla plástica y fórmula equivalente a ecuación elipsoide). Se excluyeron varones con patología urogenital y enfermedades que afectan el crecimiento testicular. Para la concordancia entre métodos, se utilizó kappa para el inicio puberal, y coeficiente de correlación intraclase (CCI) y gráficos de Bland-Altman (GBA) para el VT. Resultados. Se incluyeron 377 varones sanos. Para la concordancia en VT (ml), la comparación Prader-Chipkevitch obtuvo CCI: 0,994 y p < 0,001; y de CCI; 0,312 y p < 0,001 para la de Prader-Sotos. En los GBA se halló una media de las diferencias cercana a 0 ml en la comparación Prader-Chipkevitch y cercana a 8 ml en la de Prader-Sotos. El acuerdo en el inicio puberal obtuvo un valor de kappa 0,93 en la comparación Prader-Chipkevitch y de 0,75 en la de Prader-Sotos. Conclusión. Los orquidómetros de Prader y Chipkevitch tienen una excelente concordancia en la estimación del VT y el inicio puberal; por lo tanto, podrían intercambiarse en la atención diaria de varones adolescentes. El método de Sotos mostró una concordancia buena en la estimación del inicio puberal, pero baja en la medición del VT

Introduction. The Prader orchidometer is the standard method used to measure testicular volume (TV) in children and adolescents. Objective. To assess the concordance in the estimation of TV and puberty onset with the Prader, Chipkevitch, and Sotos orchidometric techniques. Methods. Cross-sectional descriptive study conducted among male children and adolescents aged 9-20 years. For each adolescent, TV was measured with the methods by Prader (gold standard), Chipkevitch (graphic model), and Sotos (measurement of testicular width with a plastic ruler and use of a formula equivalent to the ellipsoid equation). Male children and adolescents with urogenital conditions and disorders affecting testicular growth were excluded. Kappa statistics was used to determine concordance among methods for puberty onset, and intraclass correlation coefficient (ICC) and Bland-Altman (B&A) plots for TV. Results. In total, 377 healthy males were included. Regarding the concordance for TV (mL), the Prader-Chipkevitch comparison obtained an ICC of 0.994 and a p < 0.001; while the Prader-Soto comparison obtained an ICC of 0.312 and a p < 0.001. With the B&A plots, mean differences were close to 0 mL in the Prader-Chipkevitch comparison and close to 8 mL in the Prader-Sotos comparison. Concordance for puberty onset obtained a kappa value of 0.93 and 0.75 in the Prader-Chipkevitch and Prader-Sotos comparisons, respectively. Conclusion. The Prader and Chipkevitch orchidometers show an excellent concordance in estimating TV and puberty onset; therefore, both methods could be used interchangeably in the daily care of male adolescents. The Sotos method showed a high concordance in estimating pubertal onset, but low in measuring TV.

Humans , Male , Child , Adolescent , Testis/anatomy & histology , Sexual Development , Pediatrics/instrumentation , Testis/growth & development , Anthropometry/instrumentation , Cross-Sectional Studies , Puberty
Rev. bras. ginecol. obstet ; 43(5): 362-367, May 2021. tab
Article in English | LILACS | ID: biblio-1288561


Abstract Objective The aim of the present study is to explain the barriers to puberty talk between mothers and daughters. Methods In the present study, the conventional content analysis method was used. The present study was conducted from September 2018 to August 2019 in Iran. The study population consisted of mothers and adolescent girls. The data was collected using purposeful sampling method. The sample consisted of 4 mothers and 6 girls that were interviewed using semistructured interviews. Data collection continued until data saturation was achieved. Data analysis was conducted as described by Graneheimet al. using NVivo 11 software. Results In the present study, after exploring the views of the participants about barriers to puberty talk between mothers and daughters, one dominant theme emerged. Puberty talk is seen as an "inappropriate talk with a girl." There were several subthemes, including "lack of mother's awareness regarding the school role, the busy schedule of the mother, and the adoption of alternatives to mother's talk with girls". Conclusions Different sociocultural factors affect puberty talk between mothers and adolescent girls. It is important thatmothers and policymakers take these barriers intoaccount.

Humans , Female , Adolescent , Adult , Nuclear Family/psychology , Health Knowledge, Attitudes, Practice , Puberty/physiology , Mothers/psychology , Interviews as Topic , Puberty/psychology , Qualitative Research , Mother-Child Relations
Arq. ciências saúde UNIPAR ; 25(1): 25-30, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151401


O objetivo do estudo foi analisar a composição corporal com utilização do DXA e correlacioná-la com a idade cronológica em adolescentes pós-púberes, de ambos os sexos. Participaram da pesquisa 46 adolescentes em fase pós-puberal, sendo 27 meninas (17,23±0,98) e 19 meninos (17,65±0,74) de ensino médio de uma escola estadual da Zona Sul da cidade do Rio de Janeiro. Foram realizadas uma anamnese, avaliação antropométrica e o DXA para avaliações. O teste U de Mann Whitney e o coeficiente de correlação de Spearman foram utilizados, adotando P<0,05 para significância. Verificou-se que as meninas apresentam composição corporal diferentedos meninos (P<0,05) e que com o aumento da idade elas tendem a diminuir o percentual de gordura, embora tenha sido observado um quantitativo alto de meninas com percentual de gordura elevado. Os meninos apresentaram uma tendência de aumento do percentual de gordura e da massa magra com o aumento da idade. As medidas de conteúdo e densidade mineral ósseo dentro da normalidade, com tendência de aumento com o avanço da idade cronológica. Conclui-se que os grupos masculino e feminino apresentaram comportamentos diferenciados quanto à composição corporal e os valores apresentados trazem mais um complemento à literatura a respeito de referências para a composição corporal, obtida com o DXA, em adolescentes pós-púberes.

The purpose of this study was to analyze body composition using DXA and correlate it with chronological age in post-pubertal adolescents of both genders. A total of 46 adolescents participated in the study, of which 27 were girls (17.23±0.98) and 19 boys (17.65±0.74) from a state school in the South District in the city of Rio de Janeiro. An anamnesis, anthropometric evaluation and DXA were performed for evaluations. The Mann-Whitney U test and the Spearman correlation coefficient were used, adopting P <0.05 for significance. Girls were found to have a different body composition than boys (P <0.05) and that, with increasing age, they tended to present a decrease in fat percentage, although in general a high number of girls presented a high fat level. The boys presented a tendency to increase the percentage of fat and lean mass with the increase of the age. Measurements of bone mineral content and density were considered as being within normality, with a tendency to increase with the advancing of the chronological age. Girls and boys present a different behavior regarding body composition and the values presented in this study bring an addition to the literature regarding body composition references through DXA in post-pubertal adolescents.

Humans , Male , Female , Adolescent , Body Composition/physiology , Body Weights and Measures , Puberty/physiology , Weight by Height/physiology , Bone Density/physiology , Nutritional Status , Adolescent/physiology , Fats/metabolism , Obesity/metabolism
Article in English | WPRIM | ID: wpr-922405


OBJECTIVES@#To systematically evaluate the effect of gonadotropin-releasing hormone analogue (GnRHa) treatment on the final adult height of children over 6 years of age with central precocious puberty (CPP) or early and fast puberty (EFP).@*METHODS@#PubMed, MEDLINE, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for related articles on GnRHa treatment for children with CPP or EFP. Stata 12.0 software was used to perform a Meta analysis of related data.@*RESULTS@#A total of 10 studies were included, and the total sample size was 720 children, with 475 children in the GnRHa treatment group and 245 children in the control group. The Meta analysis showed that compared with the control group, the GnRHa treatment group had significantly better final adult height (@*CONCLUSIONS@#GnRHa treatment is safe and effective in improving the final adult height of children over 6 years of age with CPP or EFP.

Adult , Body Height , Child , Gonadotropin-Releasing Hormone , Humans , Puberty , Puberty, Precocious/drug therapy
Buenos Aires; s.n; 2021. 50 p.
Non-conventional in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1354749


Escrito del Equipo de Psicopedagogía del Centro de Salud Nº 10, perteneciente al Área Programática del Hospital Dr. José María Penna, de la Ciudad de Buenos Aires. Debido a la pandemia la atención clínica presencial debió ser suspendida, y se continuó con la asistencia a los pacientes de manera virtual. Con algunxs se realizaron seguimientos telefónicos con lxs referentes familiares y en algunos casos con lxs niñxs así como también se mantuvieron comunicaciones con las escuelas, derivaciones e interconsultas; con otrxs se logró cierta continuidad en el tratamiento por lo general a través de videollamadas de whastapp. Este es el caso del grupo de tratamiento de púberes del que se propone compartir y reflexionar. En la sede de este equipo, el abordaje clínico grupal data ya de varios años pero particularmente el grupo de púberes surgió en el año 2018. Por tanto, en un primer momento, se propone historizar y contextualizar al grupo de tratamiento psicopedagógico así como también compartir la concepción de la clínica grupal. Además, se comparten la conceptualización de la pubertad que sostiene el equipo y los procesos psíquicos esperables que se dan en este tiempo articulado con el contexto actual. (AU)

Humans , Male , Female , Child , Adolescent , Health Centers , Puberty/psychology , Adolescent Health Services/organization & administration , Adolescent Health Services/supply & distribution , Adolescent Health Services/trends , Pandemics , Academic Performance , Online Social Networking , COVID-19 , Learning
Arch. endocrinol. metab. (Online) ; 65(5): 632-639, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345198


ABSTRACT Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Subjects and methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusions: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.

Humans , Female , Cystic Fibrosis/diagnostic imaging , Menarche , Case-Control Studies , Cross-Sectional Studies , Ultrasonography , Puberty
Rev. habanera cienc. méd ; 19(5): e3079, sept.-oct. 2020. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1144687


RESUMEN Introducción: los agrandamientos gingivales suelen tratarse a través de terapias quirúrgicas de gingivectomías; su tratamiento no quirúrgico mecánico también es una opción sobre todo en los casos de gingivitis asociada a la pubertad como consecuencia de los cambios hormonales. Objetivo: describir el tratamiento no quirúrgico de una paciente de 12 años con agrandamiento gingival asociado a la pubertad y lesiones gingivales inducidas por biofilm dental. Presentación del caso: el caso presentó un agrandamiento gingival leve localizado que remitió al cabo de un mes a la primera fase de tratamiento, después de tres sesiones de fisioterapias con la remoción de biofilm calcificado se obtuvo una reducción del porcentaje del índice de higiene oral sin requerir intervención quirúrgica. A los cuatro años de seguimiento se observó reducción completa del agrandamiento gingival y bolsas periodontales. Conclusiones: la terapia periodontal mecánica es una alternativa eficaz en la reducción de la inflamación gingival inducida por hormonas durante la pubertad sin la necesidad de requerir intervenciones quirúrgicas para el tratamiento del agrandamiento gingival. Otras alternativas como las gingivectomías son aplicables; sin embargo requieren procedimientos más complejos, costosos y aumento de la morbilidad del paciente; en ese sentido el tratamiento mecánico no quirúrgico se muestra como una opción viable(AU)

ABSTRACT Introduction: Gingival enlargement is usually treated with gingivectomy as an alternative to surgery; however, non-surgical mechanical treatment is another option especially in cases of gingivitis associated with puberty as a result of hormonal changes. Objective: To describe the non-surgical treatment of a 12-year-old patient with gingival enlargement associated with puberty and gingival lesions induced by dental biofilm. Case presentation: The patient presented a localized mild gingival enlargement that relapsed to the first phase of treatment after one month. Three months after physiotherapy sessions with removal of calcified biofilm, a reduction in the percentage of oral hygiene index to "good" was obtained; therefore, surgical treatment was not required. Four years later, there was a complete reduction in gingival enlargement and periodontal pockets. Conclusions: Mechanical periodontal therapy is an effective alternative to reduce gingival inflammation induced by hormones during puberty not requiring surgical intervention to treat gingival enlargement. Other alternatives such as gingivectomies are performed; however, they require more complex, expensive procedures and they can also increase patient morbidity. In that sense, the uniqueness of the non-surgical mechanical treatment is chosen as a feasible option(AU)

Humans , Female , Child , Surgical Procedures, Operative , Oral Hygiene Index , Puberty , Dental Plaque/therapy , Periodontal Debridement/methods , Gingival Hypertrophy/therapy
Psicol. ciênc. prof ; 40: e215913, jan.-maio 2020.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1143543


Resumo A adolescência corresponde a um fenômeno cultural e moderno, que implicou uma mudança na sensibilidade relativa à puberdade e à infância. A ela associou-se o surgimento de uma moratória social como imposição da espera de aproximadamente dez anos para os púberes atingirem a condição de adultos. Quanto ao aspecto psíquico, a adolescência se caracteriza pelo retorno de questões de caráter edípico, o que a torna um período de conflitos e afetos a serem elaborados. Freud destaca a importância da identificação na formação do Eu e da personalidade. As obras literárias podem constituir-se em meio de comunicação com aspectos inconscientes, auxiliando na representação de seus conteúdos. Este trabalho tem como objetivo analisar os processos de identificação com personagens literários na adolescência. Foram realizadas entrevistas com estudantes do Ensino Médio: a primeira entrevista, semiestruturada, contou com a participação de 26 adolescentes; para a segunda entrevista, não estruturada, foram selecionados quatro estudantes dentre esses 26. Com a análise das entrevistas foram encontrados três principais tipos de aspectos de identificação com personagens literários: identificação com quem já se é; identificação com quem se gostaria de ser; e identificação com quem se gostaria de ter como par. Foi possível perceber também aspectos identificatórios de reparação narcísica, pela eleição de personagens que vencem os obstáculos que lhes são impostos. Tais narrativas parecem auxiliar a equacionar a moratória social imposta aos adolescentes. Também se percebeu que a literatura pode servir como um recurso transicional, de forma a oferecer acesso a possibilidades de vida social, amorosa e profissional.

Abstract Adolescence corresponds to a cultural and modern phenomenon that implies a change in the perception of the distinctness between puberty and childhood. This was associated with the emergence of a social moratorium as an imposition of an approximately ten-year wait until the youngsters could be considered as adults. The psychic aspect of adolescence is marked by the return of Oedipal matters, which reinforces adolescence as a period of revived conflicts and affects that must be elaborated. Freud highlights the importance of identification when considering its participation crucial to the constitution of Ego and personality. Literary works can work as a means of communication for unconscious aspects, as they can help in the representation of its matters. The objective of this study was to analyze the processes of identification with literary characters in adolescence. Interviews were carried out with students attending high school: the first interview was semi-structured and counted with the participation of 26 adolescents; for the second, non-structured interview, 4 students were selected among these 26. Analyzing the interviews, we found three main types of identificatory aspects with literary characters, which are: identification with who you already are; identification with who you would like to be; and identification with who you would like to have as a partner. When examining the narratives of the most mentioned literary characters we noticed what seems to be identificatory aspects of narcisical reparation considering the preference for characters who invariably overcome the obstacles that are set. Those narratives also seem to equate the social moratorium that is imposed to the adolescents. We also realized that literature may work as a transitional resource, offering access to possibilities of social, love and professional lives.

Resumen La adolescencia corresponde a un fenómeno cultural y moderno, que implica un cambio en la sensibilidad relativa a la pubertad y la infancia. A ella se asoció el surgimiento de una moratoria social como imposición de una espera de aproximadamente diez años para que los púberes pudieran alcanzar la condición de adultos. En lo que se refiere al aspecto psíquico, la adolescencia se caracteriza por el retorno de cuestiones de carácter edípico, lo que la convierte en un período de conflictos y afectos a ser elaborados. Freud destaca la importancia de la identificación en la formación del Yo y de la personalidad. Las obras literarias pueden constituirse como un medio de comunicación con aspectos inconscientes al auxiliar en la representación de sus contenidos. Este trabajo tuvo como objetivo analizar los procesos de identificación con personajes literarios en la adolescencia. Se realizaron entrevistas con estudiantes de la enseñanza media: la primera entrevista, semiestructurada, contó con la participación de 26 adolescentes; para la segunda entrevista, no estructurada, se seleccionaron a 4 estudiantes entre los 26. Del análisis de las entrevistas encontramos tres principales tipos de aspectos identificatorios con personajes literarios: identificación con quien ya es; identificación con quien quisiera ser; e identificación con quien quisiera tener como pareja. Pudimos percibir también aspectos identificatorios de reparación narcísica, por la elección de personajes que vencen los obstáculos que les son impuestos. Estas narrativas también parecen auxiliar a ecuacionar la moratoria social impuesta a los adolescentes. También percibimos que la literatura puede servir como un recurso transicional por ofrecer acceso a posibilidades de vida social, amorosa y profesional.

Humans , Male , Female , Adolescent , Students , Adolescent , Adolescent Development , Literature , Personality , Research , Teaching , Puberty , Life , Education, Primary and Secondary , Research Report , Love
J. pediatr. (Rio J.) ; 96(2): 240-246, Mar.-Apr. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1135012


Abstract Objective: To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. Method: The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n = 727; 72.5%) and had not undergone menarche (G2; n = 199; 21.5%), from public and private schools, using the stratified random proportional sampling technique. Weight, fat weight, muscle weight, and body mass index were measured using bioimpedance analysis. Body height was measured using a stadiometer. Age at menarche was obtained using the conventional method. For the evaluation of sexual maturation, self-assessment was performed according to criteria described by Tanner. Results: The highest cumulative distribution of menarche was found at age 11, and presented significant differences between G1 and G2 at ages 11 and 12 years in all variables of body composition, except body mass index Z-score. Fat and muscle mass were associated with age at menarche. Conclusion: The present results support the notion of menarche anticipation in girls from Brazilian Amazon and its association with body composition. Further studies are needed to investigate the influence of other possible factors that may interfere with the time of growth spurt, thus determining the timing of puberty in these girls in comparison to other regions of Brazil.

Resumo Objetivo Analisar a associação entre idade da menarca e variáveis da composição corporal em meninas na região norte do Brasil, a Amazônia brasileira. Método A amostra foi composta por 926 meninas em idade escolar, entre 8 e 18 anos, divididas em dois grupos, com presença de menarca (G1), n = 727 (72,5%) e ausência (G2) n = 199 (21,5%), provenientes de escolas públicas e privadas, com a técnica de amostragem aleatória estratificada proporcional. Peso, massa de gordura, massa muscular e índice de massa corporal foram medidos através da análise de bioimpedância. A altura foi medida com um estadiômetro. A idade da menarca foi obtida pelo método status quo. Para a avaliação da maturação sexual, a autoavaliação foi realizada de acordo com os critérios descritos por Tanner. Resultados A maior distribuição cumulativa da menarca foi encontrada aos 11 anos e apresentou diferenças significativas entre a presença e ausência de menarca aos 11 e 12 anos em todas as variáveis de composição corporal, exceto o escore-z do índice de massa corporal. Massa de gordura e massa muscular foram associadas com a idade da menarca. Conclusão Os resultados apresentados corroboram a antecipação da menarca em meninas da Amazônia brasileira e sua associação com a composição corporal. Mais estudos são necessários para investigar a influência de outros possíveis fatores que podem interferir na época do estirão de crescimento e determinar, assim, a ocorrência da puberdade em meninas amazônicas em comparação com as de outras regiões do Brasil.

Humans , Female , Child , Adolescent , Body Composition , Menarche , Body Height , Body Weight , Brazil , Body Mass Index , Age Factors , Puberty
Rev. cuba. endocrinol ; 31(1): e187, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126455


RESUMEN Introducción: En la hiperplasia adrenal congénita el aumento de los niveles de andrógenos suprarrenales en las pacientes no tratadas o mal controladas, puede alterar el inicio y/o la progresión puberal (progresión puberal/progresiones puberales?). Objetivos: Describir las características puberales de pacientes con hiperplasia adrenal congénita asignadas como femeninas e identificar si existe asociación entre elementos relacionados con la enfermedad y el inicio y progresión puberales. Métodos: Se incluyeron todas las pacientes con diagnóstico de hiperplasia adrenal congénita asignadas como femeninas, que fueron atendidas en el INEN de enero 2000 a mayo 2019. Resultados: Fueron estudiadas 47 pacientes, con una media de edad de 14,76 ± 7,04 años. Se comprobó un predominio de las formas clínicas clásicas en 25 pacientes (53,19 por ciento), de ellas 11 (23,40 por ciento) fueron formas virilizantes simples, 14 (29,78 por ciento) perdedoras de sal y 22 (46,80 por ciento) formas no clásicas. El inicio del vello pubiano fue a una edad promedio de 7,78 ± 3,2 años. El comienzo de la telarquia resultó en una media de 10,09 ± 2,4 años y la menarquia a los 12,2 ± 2,3 años como promedio. De las 29 pacientes que ya habían menstruado 16 (55,2 por ciento) presentaban irregularidades menstruales. El tiempo entre el inicio puberal y la menarquia fue de 3,4 años en las formas no clásicas, 5,6 años en las perdedoras de sal y 7,0 años en las virilizantes simples. La edad al diagnóstico, la edad de inicio del tratamiento y la dosis de esteroides empleada se relacionaron con algunos aspectos puberales. Conclusiones: El diagnóstico oportuno y el ajuste cuidadoso del esquema esteroideo, constituyen pilares importantes en el inicio y progresión puberales, y en la consecución de ciclos ovulatorios regulares que aseguren desde la adolescencia, un inicio y desarrollo puberales normales y en edades reproductivas, la optimización de la fertilidad(AU)

ABSTRACT Introduction: In the congenital adrenal hyperplasia, the increased levels of adrenal androgens in patients untreated or poorly controlled can alter the start and/or pubertal progression (pubertal progression/pubertal progressions). Objectives: To describe the pubertal characteristics of patients with congenital adrenal hyperplasia assigned as females and to identify whether there is an association between elements related to the disease and the pubertal onset and progression. Methods: There were included all patients diagnosed with congenital adrenal hyperplasia assigned as females that were attended at the National Institute of Endocrinology from January 2000 to May 2019. Results: 47 patients were studied, with an average age of 14.76 ± 7.04 years. It was found a predominance of classic clinical forms in 25 patients (53.19 percent, of which 11 (23.40 percent) had simple virilization forms, 14 (29.78 percent) were salt-losers and 22 (46.80 percent) had non-classical forms. The onset of the pubic hair was at an average age of 7.78 ± 3.2 years. The beginning of the thelarche resulted in an average of 10.09 ± 2.4 years and menarche at the 12.2 ± 2.3 years on average. Of the 29 patients who had menstruated, 16 (55.2 percent) presented menstrual irregularities. The time between the puberty onset and menarche was 3.4 years in the non-classical forms, 5.6 years in the salt-losers, and 7.0 years in the simple virilizations. The age at initial diagnosis treatment and the dose of steroids used were related to some pubertal aspects. Conclusions: Early diagnosis and careful adjustment of the steroid scheme are important pillars in the pubertal onset and progression, the achievement of regular ovulatory cycles, and with it, in the optimization of fertility(AU)

Humans , Female , Child , Adolescent , Menarche/physiology , Puberty , Adrenal Hyperplasia, Congenital/diagnosis , Menstruation Disturbances/therapy , Epidemiology, Descriptive , Cross-Sectional Studies
Rev. enferm. UFPI ; 9: e8259, mar.-dez. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1371540


Objetivo: Relatar a experiência de discentes de enfermagem em oficinas com foco na saúde sexual e reprodutiva de adolescentes. Metodologia: Trata-se de um estudo descritivo, do tipo relato de experiência, realizado em ambiente escolar com a participação de adolescentes entre 15 e 17 anos. As atividades desenvolvidas consistiram em oficinas sobre Mudanças Biopsicossociais, Sexualidade, Violência Sexual, Gravidez na Adolescência e Infecções Sexualmente Transmissíveis. Para o desenvolvimento das oficinas, foram considerados os preceitos éticos da Resolução n° 466/2012 não havendo variáveis que possibilitem a identificação dos participantes da oficina. Resultados: Verificou-se a participação assídua do público alvo com diversos questionamentos e a aplicabilidade positiva das oficinas na prevenção e promoção da saúde. Destacou-se o papel do enfermeiro como principal mediador em promover educação em saúde nas escolas e nas comunidades. Conclusão: A implementação de atividades de educação sexual e reprodutiva na adolescência mostrou-se relevante para a redução de vulnerabilidades, esclarecimentos de dúvidas e conscientização dessa população.

Objective: To report the experience of nursing students in workshops focusing on the sexual and reproductive health of adolescents. Methodology: This is a descriptive, experience-type study conducted in a school environment with the participation of adolescents between 15 and 17 years of age. The activities developed consisted of workshops about Biopsychosocial Changes, Sexuality, Sexual Violence, Teen Pregnancy and Sexually Transmitted Infections. For the development of the workshops, the ethical precepts of Resolution No. 466/2012 were considered and there were no variables that allowed the identification of workshop participants. Results: It was verified the assiduous participation of the target public with several questions and the positive applicability of the workshops in the prevention and promotion of health. The role of the nurse as the main mediator in promoting health education in schools and in communities was highlighted. Conclusion: The implementation of sexual and reproductive education activities in adolescence was relevant for the reduction of vulnerabilities, clarification of doubts and awareness of this population.

Health Education , Nursing , Puberty , Sexual and Reproductive Health , Health Promotion
Demetra (Rio J.) ; 15(1): 42737, jan.- mar.2020.
Article in English, Portuguese | LILACS | ID: biblio-1096289


Objetivo: Avaliar a associação do estado nutricional e maturação sexual com a insatisfação corporal em adolescentes. Métodos: Trata-se de estudo transversal, realizado com adolescentes de 10 a 14 anos de escolas públicas. Avaliaram-se peso, altura, IMC para idade, perímetro da cintura, percentual de gordura corporal, maturação sexual (escala de Tanner) e insatisfação corporal, por meio da pontuação na Escala de Evaluación de Insatisfación Corporal para Adolescentes (EEICA). Para as análises estatísticas, utilizou-se o programa SPSS versão 17.0 e realizaram-se os testes de Kolmogorov-Smirnov, Qui-quadrado de Pearson, t de Student ou Anova, considerando-se nível de significância de 5%. Resultados: A amostra foi composta por 345 adolescentes, sendo 53,6% do sexo feminino. A maioria (63,6 % meninas e 66,7% dos meninos) são eutróficos. A pontuação média da EEICA no sexo feminino (11,46 ± 5,90) foi superior ao masculino (9,29 ± 4,71) (p<0,001). Em ambos os sexos, o IMC para idade, percentual de gordura corporal e razão cintura/estatura associaram-se a uma maior pontuação na EEICA (p<0,001). No sexo feminino, as pós-puberes foram mais insatisfeitas que as púberes. Conclusão: Observou-se maior pontuação no sexo feminino, assim como associação entre insatisfação corporal e o estado nutricional em ambos os sexos e com a maturação sexual no sexo feminino. Tais achados reforçam a importância da abordagem do tema e suas possíveis consequências, estimulando a reflexão sobre os padrões de beleza. (AU)

Objective: To evaluate the association of nutritional status and sexual maturation with body dissatisfaction in adolescents. Methods: This is a crosssectional study carried out with adolescentes aged 10 to 14 from public schools. Weight, height, BMI for age, waist circumference, percentage of body fat,sexual maturation (Tanner's scale) and body dissatisfaction were assessed using the Scale for Assessment of Body Dissatisfaction for Adolescents (EEICA). For the statistical analysis, the SPSS version 17.0 program was used and the Kolmogorov-Smirnov, Pearson's Chi-square, Student's T or Anova tests were used, considering a significance level of 5%. Results: The sample consisted of 345 adolescents, 53.6% female. The majority (63.6% girls and 66.7% boys) are eutrophic. The mean EEICA sco ,302r for females (11.46 ± 5.90) was higher than for males (9.29 ± 4.71) (p <0.001). In both sexes, the BMI for age, percentage of body fat and waist-toheight ratio were associated with a higher score in the EEICA (p <0.001). In the female, the post-puberals were more dissatisfied than the pubescent ones. Conclusion: It was observed a higher score in the female, as well as an association between body dissatisfaction and nutritional status in both sexes and sexual maturation in females. Such findings reinforce the importance of approaching the theme and its possible consequences, stimulating reflection on beauty standards. (AU)

Humans , Male , Female , Child , Adolescent , Body Image , Nutritional Status , Body Dissatisfaction , Adolescent , Puberty , Adolescent Development
Int. j. med. surg. sci. (Print) ; 7(1): 4-13, mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1179296


Background: Human growth and development is a complex process of bio-psycho-social changes in children and adolescents. The evaluation of these two processes is of high importance in clinical and anthropological contexts. The present study aimed to find out and to evaluate the velocity of the biological growth and development during different ages of Kosovo children and adolescents of both genders.Materials and methods: Body Height, Body Weight, and Ideal Body Weight were measured in 68762 children and adolescents from Kosovo (66264 boys, 2498 girls). Age groups were classified into 13 categories, ages 6.0-18.9 years old. There have been analyzed the systematic differences between males and females in the annual changing of Body Height, Body Weight, and Ideal Body Weight.Results: Based on the results of the present study growth and development in boys can be divided into three stages that are distinct from one another, compared with the girls' growth and development that can be divided into four stages. Boys have reached the Peak Height Velocity (PHV=7.8cm), respectively the Peak Weight Velocity (PWV=6.6kg) at the age-group of 14 years old, while girls have reached the Peak Height Velocity (PHV=8.4cm) and the Peak Weight Velocity (PWV=12.6kg) at the age-group of 11 years old.Conclusion: The puberty stage occurs approximately three years earlier in girls (11yrs) compared with the boys (14yrs). Although the boys experience a later achievement of PHV, their growth, and development, with reduced intensity, it continues even after the age of 18th. The girls' body growth and development commence earlier in age, and it reaches the maximal values earlier. This fact suggests that males will grow more during the late stage of the adolescence compared with females; therefore, in general males' morphometric features tend to be larger.

Antecedentes: el crecimiento y desarrollo humano es un proceso complejo de cambios biopsicosociales en niños y adolescentes. La evaluación de estos dos procesos es de gran importancia en contextos clínicos y antropológicos. El presente estudio tuvo como objetivo descubrir y evaluar la velocidad del crecimiento y desarrollo biológicos durante diferentes edades de niños y adolescentes de ambos sexos de Kosovo.Materiales y métodos: se midió la altura y el peso corporal y se estimó el peso corporal ideal en 68762 niños y adolescentes de Kosovo (66264 niños, 2498 niñas). Los grupos de edad se clasificaron en 13 categorías, con edades entre 6.0-18.9 años. Se analizaron las diferencias entre hombres y mujeres en el cambio anual de altura y peso corporal y peso corporal ideal.Resultados: Según los resultados del presente estudio, el crecimiento y el desarrollo en los niños se pueden dividir en tres etapas que son distintas entre sí, en comparación con el crecimiento y el desarrollo de las niñas que se pueden dividir en cuatro etapas. Los niños han alcanzado la Velocidad de Altura Máxima (PHV = 7.8cm), respectivamente, la Velocidad de Peso Máximo (PWV = 6.6kg) en el grupo de edad de 14 años, mientras que las niñas han alcanzado la Velocidad de Altura Máxima (PHV = 8.4cm) y la velocidad máxima de peso (PWV = 12.6 kg) en el grupo de edad de 11 años.Conclusión: la etapa de la pubertad ocurrió aproximadamente tres años antes en las niñas (11 años) en comparación con los niños (14 años). Aunque los niños experimentan un incremento posterior de PHV, su crecimiento y desarrollo, con intensidad reducida, continúa incluso después de los 18 años. El crecimiento y el desarrollo corporal de las niñas comienzan más temprano en la edad y alcanzan los valores máximos antes. Este hecho sugiere que los hombres crecerán más durante la etapa tardía de la adolescencia en comparación con las mujeres; por lo tanto, en general, las características morfométricas de los hombres tienden a ser más grandes.

Humans , Male , Female , Child , Adolescent , Child Development , Anthropometry , Puberty , Growth , Body Weight , Body Weights and Measures , Kosovo/epidemiology
Article in Korean | WPRIM | ID: wpr-811245


Narcolepsy is a chronic neurological sleep disorder caused by hypocretin neuron loss, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and intrusions of aspects of rapid eye movement sleep in wakefulness, such as cataplexy, sleep paralysis, and hypnopompic/hypnagogic hallucinations. Narcolepsy disrupts the maintenance and orderly occurrence of the wake and sleep stages. Cataplexy is a highly specific symptom of narcolepsy, but many other symptoms can be observed in a variety of sleep disorders. The diagnosis of narcolepsy type 1 requires a history of excessive daytime sleepiness and one of the following : 1) a low cerebrospinal fluid hypocretin-1 level or 2) cataplexy and a positive multiple sleep latency test result. The diagnosis of narcolepsy type 2 requires a history of excessive daytime sleepiness and a positive mean sleep-latency test result. The mean sleep-latency test must be preceded by nighttime polysomnography to exclude other sleep disorders and to document adequate sleep. The mean sleep-latency test result can be falsely positive in other sleep disorders, such as shift work, sleep apnea, or sleep deprivation, and it is influenced by age, sex, and puberty. Modafinil and armodafinil can reduce the excessive daytime sleepiness without many of the side effects associated with older stimulants. Although there is no cure for narcolepsy, the treatments are often effective and include both behavioral and pharmacologic approaches.

Adolescent , Cataplexy , Cerebrospinal Fluid , Diagnosis , Disorders of Excessive Somnolence , Hallucinations , Humans , Narcolepsy , Neurons , Orexins , Polysomnography , Puberty , Sleep Apnea Syndromes , Sleep Deprivation , Sleep Paralysis , Sleep Stages , Sleep Wake Disorders , Sleep, REM , Wakefulness
Article in English | WPRIM | ID: wpr-826310


BACKGROUND AND OBJECTIVE@#Early pubertal timing is associated with sleep among Western adolescents, but little is known about this association in Chinese adolescents, especially with regard to the association between bedtimes and early pubertal timing. This paper aimed to identify the association between sleep duration, bedtimes, and early pubertal timing in Chinese adolescents.@*METHODS@#An anonymous cross-sectional survey was conducted among primary and junior middle students (grades 3 to 9) from QiJiang District, ChongQing, China. Participants were recruited by applying stratified cluster sampling. Pubertal timing, sleep duration, and bedtimes were assessed using the Pubertal Development Scale and a self-designed sleep questionnaire. We utilized multivariable logistic linear regression (MLLR) to test the association between sleep duration, bedtimes, and pubertal timing.@*RESULTS@#A total of 5461 adolescents were evaluated, with mean age and BMI values of 11.41 ± 2.05 and 18.03 ± 3.03, respectively, of whom 1257 (23.02%) were in early pubertal timing. In MLLR controlling for age, BMI, family economic status, and other covariates, sufficient sleep (b = - 0.214, P = 0.032, OR = 0.808, 95% CI 0.664-0.982) was negatively related to early pubertal timing, and later bedtime (b = 0.195, P < 0.001, OR = 1.215, 95% CI 1.104-1.338) was positively associated with early pubertal timing.@*CONCLUSION@#Students with early pubertal timing had less sleep duration and later bedtimes, which may be the result of increased stress caused by physical and psychological changes. Therefore, more attention should be paid to pubertal health education for adolescents during puberty. Further longitudinal studies are needed to confirm the causality between sleep and early pubertal timing in Chinese adolescents.

Adolescent , China , Circadian Rhythm , Cross-Sectional Studies , Female , Humans , Male , Puberty , Sexual Maturation , Sleep
Fisioter. Mov. (Online) ; 33: e003328, 2020. tab
Article in English | LILACS | ID: biblio-1133905


Abstract Introduction: Hyperlordosis can cause several degenerative spinal pathologies in children and adolescents. Objective: Determine whether body mass index, age and sexual maturation predict the occurrence of hyperlordosis in children and adolescents. Method: The study analyzed 380 students aged between 10 and 18 years. Body mass index was evaluated using the reference values suggested by the Fitnessgram test battery, and sexual maturation through Tanner's scale of self-assessed pubic hair growth. Postural assessment was conducted using the DIPA photogrammetry method, version 3.1. (Digital Image Based Postural Assessment) The SPSS 24.0 program was used to analyze the data, and the following statistical tests were applied: chi-squared, Mann-Whitney, Fisher's exact and binary logistic regression. Results: There was statistical significance between hyperlordosis, girls' age and puberty in boys (p <0.05). The adjusted binary logistic regression for the girls (OR = 0.656) indicated that this disorder declined by 34% with advancing age and for stage P2 of puberty in boys (OR = 4.292), and the likelihood of boys' presenting with hyperlordosis at this stage is approximately 4-fold higher. There was no statistical significance between body mass index and hyperlordosis (p> 0.05). Conclusion: The girls' age and boys' stage of puberty were associated with the occurrence of hyperlordosis.

Resumo Introdução: A Hiperlordose lombar pode ocasionar diversas patologias degenerativas na coluna vertebral de crianças e adolescentes. Objetivo: Identificar se o Índice de Massa Corporal, a Idade e a Maturação Sexual são previsores da ocorrência da hiperlordose lombar em crianças e adolescentes. Método: O estudo analisou 380 estudantes entre 10 e 18 anos. O Índice de Massa Corporal foi avaliado por meio dos valores de referência sugeridos pela bateria de testes Fitnessgram e a maturação sexual por meio da auto-avaliação da pilosidade pubiana de Tanner. A avaliação postural foi realizada pelo método de fotogrametria DIPA versão 3.1. (Avaliação Postural Baseada em Imagem Digital). Para análise dos dados foi utilizado o programa SPSS 24.0, tendo sido aplicados os testes estatísticos: Qui-Quadrado, Mann Whitney, Exato de Fisher e Regressão Logística Binária. Resultados: Observou-se que houve significância estatística entre a Hiperlordose lombar e a idade das meninas e a puberdade dos meninos (p<0,05). A regressão logística binária ajustada para o grupo das meninas (OR=0,656) apresentou a posssibilidade de que com o avanço da idade esta patologia diminui sua ocorrência em 34% e no grupo dos meninos (OR=4,292), a puberdade foi significativa na fase P2, verificando-se que a chance dos meninos apresentarem a hiperlordose lombar nesta fase é aproximadamente 04 vezes maior. Não houve significância estatística entre o Índice de Massa Corporal, a Idade e a Maturação Sexual e a hiperlordose lombar (p>0,05). Conclusão: A idade das meninas e a puberdade dos meninos foi associada à ocorrência da hiperlordose lombar.

Humans , Male , Female , Child , Adolescent , Students , Body Mass Index , Puberty , Lordosis , Posture , Sexual Maturation , Spine
Actual. osteol ; 16(3): 176-186, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1253780


Una persona transgénero es aquella en la cual el género autopercibido difiere del asignado al nacer, mientras que el término cisgénero es utilizado en aquellos individuos no trans. El tratamiento hormonal cruzado (THC) constituye una opción para lograr caracteres sexuales secundarios deseados. Es conocido que los esteroides sexuales desempeñan un rol fundamental en la adquisición de la densidad mineral ósea (DMO) durante la pubertad. Por lo tanto, el impacto del THC sobre la masa ósea se ha convertido en materia de estudio. En estadios puberales tempranos, los análogos de la hormona liberadora de gonadotrofinas (GnRH) son utilizados con un efecto reversible. Si bien la DMO parece mantenerse estable, cuando se compara con una población de referencia del mismo sexo biológico y edad, el Z-score se encuentra por debajo de lo esperado. En adultos, durante el THC no se informaron disminuciones en la DMO. Está reportado que las mujeres trans antes del inicio del TH presentan características densitométricas diferentes de los hombres cisgénero. Hasta el momento, la carga de datos para los calculadores del riesgo de fractura y el software del equipo DXA se basan en el sexo biológico y no en identidad de género. Recientemente, la International Society for Clinical Densitometry (ISCD) emitió sus recomendaciones para la evaluación de la masa ósea en personas transgénero y en aquellos individuos no conformes con el género. Si bien la ISCD sugiere realizar la evaluación únicamente en aquellos pacientes con factores de riesgo, es de importancia realizar DXA basal, sobre todo en mujeres transgénero, para determinar el riesgo inicial de dicha población. En este artículo se revisa la evidencia disponible sobre el impacto del THC en la salud ósea de personas transgénero. (AU)

Cross sex hormone therapy (CSHT) in transgender women (TW) it is an option to achieve desired secondary sexual characteristics. It is known that sex steroids play a fundamental role in the acquisition of bone mineral density during puberty, in addition to determining a different characteristic bone pattern between both biological sexes. So the impact of affirming HT on bone is it has become in subject of study. In early pubertal stages, GnRH analogs are used with a reversible effect. Although bone mineral density (BMD) seems to remain stable, when compared with a reference population of the same biological sex and age, the Z-score is lower than expected. In adults, during CSHT no decreases in BMD were reported. However, it was reported that TW prior to starting CSHT present different densitometric characteristics than cisgender men. So far, the data load for the fracture risk calculators and DXA software is based on biological sex and not gender identity. Recently the ISCD issued its recommendations for the evaluation of bone mass in transgender subjects and in those non-conforming to gender. Although the ISCD suggests performing the evaluation only in those patients with risk factors, our group recognizes that baseline DXA, especially in TW, constitutes a useful tool to determine the initial risk of this population. Our proposal arises from our own experience and from that compiled in the international literature, where it is observed that even without starting CSHT, transgender women have lower BMD. DXA. This article reviews the available evidence regarding the effect of CSHT on health bone in transgender people. (AU)

Humans , Male , Female , Bone Density/drug effects , Cisgender Persons , Gonadal Steroid Hormones/therapeutic use , Testosterone/therapeutic use , Sex Factors , Risk Factors , Gonadotropin-Releasing Hormone/analogs & derivatives , Puberty , Sex Characteristics , Densitometry , Estrogens/therapeutic use , Sex Reassignment Procedures , Transgender Persons , Androgen Antagonists/therapeutic use
J. pediatr. (Rio J.) ; 95(6): 696-704, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056663


ABSTRACT Objective: To assess the carotid intima-media thickness and factors associated with cardiovascular disease in children and adolescents with chronic kidney disease. Material and methods: Observational, cross-sectional study carried out at the Universidade Federal de São Paulo (chronic kidney disease outpatient clinics) with 55 patients (60% males) with a median age of 11.9 years (I25-I75: 9.2-14.8 years). Of the 55 patients, 43 were on conservative treatment and 12 were on dialysis. Serum laboratory parameters (creatinine, uric acid, C-reactive protein, total cholesterol and fractions, and triglycerides), nutritional status (z-score of body mass index, z-score of height/age), body fat (fat percentage and waist circumference), and blood pressure levels were evaluated. The carotid intima-media thickness measure was evaluated by a single ultrasonographer and compared with percentiles established according to gender and height. Data collection was performed between May 2015 and March 2016. Results: Of the children and adolescents with chronic kidney disease, 74.5% (95% CI: 61.0; 85.3) showed an increase (>P95) in carotid intima-media thickness. In patients with stages I and II hypertension, 90.9% had increased carotid intima-media thickness. Nutritional status, body fat and laboratory tests were not associated with increased carotid intima-media thickness. After multivariate adjustment, only puberty (PR = 1.30, p = 0.037) and stages I and II arterial hypertension (PR = 1.42, p = 0.011) were independently associated with carotid intima-media thickness alterations. Conclusion: The prevalence of increased carotid thickness was high in children and adolescents with chronic kidney disease. Puberty and arterial hypertension were independently associated with increased carotid intima-media thickness.

RESUMO Objetivo: Avaliar a espessura médio-intimal da carótida e os fatores associados à doença cardiovascular em crianças e adolescentes com doença renal crônica. Material e métodos: Estudo observacional transversal feito na Universidade Federal de São Paulo (ambulatórios de doença renal crônica) com 55 pacientes (60% do sexo masculino) com mediana de 11,9 anos (I25-I75: 9,2-14,8). Dos 55 pacientes, 43 estavam em tratamento conservador e 12 em terapia dialítica. Foram avaliados os parâmetros laboratoriais séricos (creatinina, ácido úrico, proteína C-reativa, colesterol total e frações e triglicérides), estado nutricional (escore z de índice de massa corpórea, escore z de estatura/idade), gordura corporal (percentual de gordura e circunferência abdominal) e pressão arterial. A medida da espessura médio-intimal da carótida foi avaliada por um único ultrassonografista e comparada com percentis estabelecidos de acordo com o sexo e a estatura. A coleta de dados foi feita entre maio de 2015 e março de 2016. Resultados: Das crianças e adolescentes com doença renal crônica, 74,5% (IC 95%: 61,0; 85,3) apresentaram aumento (> P95) da espessura médio-intimal da carótida. Nos pacientes com hipertensão arterial estágios I e II, 90,9% apresentaram aumento da espessura médio-intimal da carótida. O estado nutricional, a gordura corporal e os exames laboratoriais não apresentaram associação com o aumento da espessura médio-intimal da carótida. Após ajuste multivariado, apenas a puberdade (RP = 1,30; p = 0,037) e a hipertensão arterial estágios I e II (RP = 1,42; p = 0,011) mostraram-se independentemente associados à alteração da espessura médio-intimal da carótida. Conclusão: A prevalência do aumento da espessura da carótida foi elevada em crianças e adolescentes com doença renal crônica. A puberdade e a hipertensão arterial mostraram-se independentemente associadas ao aumento da espessura médio-intimal da carótida.

Humans , Male , Female , Child , Adolescent , Cardiovascular Diseases/complications , Carotid Arteries/physiopathology , Renal Insufficiency, Chronic/complications , Carotid Intima-Media Thickness , Sexual Maturation , Blood Pressure , Cross-Sectional Studies , Risk Factors , Puberty , Hypertension/complications , Hypertension/physiopathology
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 428-434, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041351


ABSTRACT Objective: To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents. Methods: A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Results: Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p<0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p<0.025 and p<0.003). It was higher in males compared to females. Conclusions: An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.

RESUMO Objetivo: Contribuir para a avaliação dos parâmetros normais da espessura médio-intimal carotídea (EMIC) em adolescentes saudáveis. Métodos: Estudo transversal realizado por meio de avaliações clínicas, laboratoriais e ultrassonográficas em 61 adolescentes saudáveis. O critério de inclusão foi ter boa saúde. Os critérios de exclusão foram: presença ou histórico de doença crônica; obesidade ou sobrepeso segundo os parâmetros estabelecidos pela Organização Mundial da Saúde (OMS); uso contínuo de medicação; e quadro febril ou que necessitasse de uso de medicação nas 48 horas anteriores à avaliação. Os estágios puberais foram avaliados pela escala de Tanner. As ultrassonografias em modo B de alta resolução foram realizadas seguindo as recomendações do Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force (Declaração de Consenso da Força Tarefa da Sociedade Americana de Ecocardiografia sobre Espessura Médio-Intimal Carotídea). Resultados: Os adolescentes tinham 14±2,6 anos, 62,3% eram do sexo feminino, 19 (31%) estavam em estágios iniciais da puberdade (2 e 3) e 38 (62%) em estágios avançados (4 e 5) de acordo com a escala de Tanner. Todos apresentavam parâmetros clínicos e laboratoriais normais. Os valores da EMIC variaram de 0,46±0,04 a 0,55±0,04 mm do lado direito e 0,48±0,02 a 0,53±0,04 mm do lado esquerdo, conforme a maturação puberal. Houve aumento significativo nos valores da EMIC em ambos os lados de acordo com o estágio puberal (p<0,001 e p=0,016) e os diâmetros internos máximos da artéria carótida comum (p<0,025 e p<0,003). A EMIC foi maior em participantes do sexo masculino em relação ao feminino. Conclusões: O aumento da EMIC em adolescentes saudáveis, conforme a idade e o grau de maturação puberal, deve ser levado em consideração nas avaliações diagnósticas.

Humans , Male , Female , Child , Adolescent , Young Adult , Puberty/psychology , Carotid Intima-Media Thickness , Cross-Sectional Studies , Adolescent Health , Healthy Volunteers