Cochrane risk of bias tool was used inadequately in the majority of non-Cochrane systematic reviews.

OBJECTIVES: To analyze how many non-Cochrane systematic reviews (NCSRs) used Cochrane's risk of bias (RoB) tool, domains they used, and whether judgments and comments about RoB were in line with Cochrane Handbook. METHODS: This was a methodological (research-on-research) study. We retrieved NCSRs from PubMed, extracted information about methods used for RoB assessment, and if they used 2011 Cochrane RoB tool, we analyzed their RoB methods and compared them with Cochrane Handbook guidance. RESULTS: We included 508 NCSRs; 431 (85%) reported they analyzed RoB, and 269 (53%) used Cochrane RoB tool. Only 16 of those 269 (5.9%) reported both a judgment and a supporting comment in the Cochrane RoB table in the manuscript (N = 4) or in a supplementary file (N = 12). Fifteen reviews, with 158 included trials, used judgments low/high/unclear; 41% of analyzed available judgments were inadequate, either because judgment was not in line with comment or comment was missing. CONCLUSIONS: Most NCSRs use Cochrane RoB tool to assess RoB, but most of them reported it incompletely, with high prevalence of inadequate judgments. Authors, editors, and peer-reviewers should make an effort to improve completeness and adequacy of Cochrane RoB assessment in non-Cochrane reviews.

Risk behaviors in adolescence - a study in a Portuguese health unit.

INTRODUCTION: Adolescence is a time of social and self-affirmation, search of autonomy and pleasure. An early sexual debut and substance use are still public health problems. OBJECTIVES: To assess the prevalence of illicit drug use and sexual behavior of adolescents, ages 15- 17, followed in a Portuguese Family Health Unit. MATERIAL AND METHODS: This was a cross sectional descriptive study of a random convenience sample. Data were obtained from an anonymous and confidential questionnaire, given to patients at adolescent consultation, between the months of May and July 2016. Statistical significance p < 0.05. RESULTS: This study involved a sample of 134 adolescents, 54.5% girls. It was revealed that 73.1% of adolescents have tried alcohol, from which 18.7% experienced intoxication at least once. Regarding tobacco, 35.1% have tried it, 23.4% are regular users. Regarding cannabinoids, 7.5% of adolescents stated to have tried them once, or to consume them regularly. Adolescents start to experiment with tobacco earlier than with alcohol (9 years old vs. 11 years old), with a mean age of 15 years old. Regarding sexual behavior, 23.8% are sexually active, from which 9.4% do not use any form of contraception. Smoking behavior was a predictor of the consumption of illicit drugs, and it was found a significantly statistic association between sexual activity and substance use, p = 0.04. DISCUSSION: By descending order, the alcohol, tobacco and illicit drugs consumption are still worrisome and can affect the life of adolescents. Primarily health care and pediatric consultation should provide strategies for prevention and promotion of a healthy lifestyle for adolescents.

Teenage pregnancy - a study in São Tomé and Príncipe.

Introduction The increasing number of pregnant teenagers in São Tomé and Príncipe (STP) represents a serious public health issue. The aim of this study was to characterize the population of pregnant adolescents followed in a health facility dedicated to maternal health in STP. Methods A cross-sectional survey was conducted among pregnant teenagers that attended the Mother and Child Protection Center during the first quarter of 2017. The survey contained questions on sociodemographic characteristics, sexual and risk behaviors, family, partners and health support. Results The mean age of the 51 pregnant teenagers included was 16.37 ± 0.8 years. Eight girls reported that they had planned to fall pregnant. Teenagers whose pregnancy was unplanned usually present with a previous family history of adolescent pregnancy. About 59% of girls engaged in sexual activity before 16 years of age with a mean number of sexual partners of 1.84 ± 0.88. In this study, 51% of the girls do not use any contraceptive method, usually because their partner refuses to do so. The preferred contraceptive method are condoms. Information on contraception is given mainly at school. Pregnant girls' first medical consultation was at a mean gestational age of 6 weeks. Abortion was considered by 51% of girls after pregnancy was confirmed. Conclusion Teenage pregnancy imposes health problems for the mother and child and contributes to educational and socioeconomic disadvantages. The collaboration of healthcare providers, teachers and parents is needed to enhance sexual health education. This is the first study in STP on teenage pregnancy; although the sample is small, the authors believe that the results are representative of the general population.

Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease.

OBJECTIVES: Iron deficiency is the most common cause of anemia in children with inflammatory bowel disease, although the real prevalence is unknown. Intravenous iron is suggested as the first line treatment. This study aims to determine the prevalence of iron deficiency anemia in children with inflammatory bowel disease followed in a Pediatric Gastroenterology Unit of a tertiary center and to evaluate this unit's experience with intravenous iron. MATERIALS AND METHODS: A retrospective cohort study was designed involving children with inflammatory bowel disease followed in that unit between January 2001 and April 2016. Laboratory results were collected at the moment of diagnosis, after one-year follow-up and prior each IV iron administration performed during the study period. Anemia was defined according to World Health Organization criteria and the iron deficiency was defined using recent guidelines. RESULTS: Were studied 69 patients 71% had CD and 29% UC. 50.7% were female. Mean patient age at diagnosis was 13.3 years (range 1--17 years). Prevalence of ID and IDA at diagnosis was 76.8% and 43.5%, respectively. After one year follow-up, those values decreased to 68.1% (p = .182) and 21.7% (p = .002), respectively. Hemoglobin significantly increased (p < .001). Intravenous iron was administered to 92.8% of patients. No adverse reactions were reported. CONCLUSIONS: Intravenous iron is the first line in the treatment of Iron deficiency anemia in Inflammatory Bowel disease and it is safe and effective. Persistent anemia and iron deficiency are common.