Adolescent pregnancy: An important issue for paediatricians and primary care providers-A position paper from the European academy of paediatrics.

Adolescent pregnancy and childbearing, remain a widespread health-related problem with potential short and long-term consequences. Comprehensive social, economic, environmental, structural, and cultural factors heavily impact on adolescents' sexual and reproductive health and early pregnancy. Health professionals can play a pivotal role in the prevention of unplanned pregnancy. Improved access to family planning, sexuality education in schools, community-based interventions, and policies contribute greatly to reduce the risk of adolescent pregnancy and the adoption of respectful and responsible sexual behaviour. Additionally, health care professionals can support pregnant adolescents in making decisions under these circumstances and provide adequate health care. This review highlights actions that can guide healthcare professionals in empowering young adolescents to become more aware and capable of making informed decisions about their sexual life, health, and future.

A Case Series Study on Growth Hormone Therapy in Children with Prader-Willi Syndrome in Portugal.

INTRODUCTION: Prader-Willi syndrome is a multisystemic genetic disorder associated with shorter adult height. Nowadays, all paediatric Prader-Willi syndrome patients are considered for growth hormone treatment. We present the experience of this treatment at a Portuguese paediatric endocrinology unit and intend to emphasise the importance of creating a follow-up national network of these patients. MATERIAL AND METHODS: Longitudinal, retrospective, analytical study of Prader-Willis syndrome patients using data between 1989 and 2021. Growth hormone therapy was offered to eligible patients. The analysis included all Prader-Willis syndrome patients, with a comparison between treated and untreated patients; a longitudinal analysis of patients receiving growth hormone therapy (baseline, 12 and 36 months of follow-up) was also carried out. The statistical analysis was carried out using STATA® v13.0. RESULTS: Out of 38 patients with Prader-William syndrome, 61% were male. The median age at diagnosis was four months and 61% received growth hormone therapy. The patients who reached adulthood, or 18 years old, had a median near-adult height, Z-score of -2.71, and their median body mass index indicated class 2 obesity, regardless of growth hormone therapy. Patients had a lower body mass index in the growth hormone group (35 vs 51 kg/m2, p < 0.042) near-adult height. CONCLUSION: This case series represents the first national study that included patients on growth hormone therapy after the National Health Service started supporting the treatment for Prader-Willi syndrome patients and supports its use, reinforcing the positive effects on growth and body mass index. Longer follow-up studies are needed to analyse the effect of growth hormone on patient metabolic profiling, body composition and cognitive level.

Introdução: A síndrome de Prader-Willi é uma doença genética multissistémica associada a baixa estatura. Atualmente, todos os doentes pediátricos com síndrome de Prader-Willi são candidatos a terapia com hormona do crescimento. Apresentamos a experiência desta terapêutica numa unidade de Endocrinologia Pediátrica portuguesa e realçamos a importância de criar uma base de dados nacional de seguimento destes doentes. Material e Métodos: Estudo longitudinal, retrospetivo e analítico de doentes com síndrome de Prader-Willi utilizando dados entre 1989 e 2021. A terapia com hormona de crescimento foi administrada aos doentes elegíveis. Foi realizada análise de todos os doentes com síndrome de Prader-Willi, com comparação doentes tratados/não tratados; foi também realizada uma análise longitudinal dos doentes sob hormona de crescimento (início/12/36 meses de seguimento). O tratamento estatístico foi realizado com recurso ao STATA® v13.0. Resultados: De um total de 38 doentes com síndrome de Prader-Willi, 61% eram do sexo masculino. Idade média de diagnóstico quatro meses e 61% sob hormona de crescimento. Os doentes que atingiram a idade adulta apresentaram um Z-score de mediana de estatura alvo de -2,71, e índice de massa corporal obesidade nível 2, independentemente da terapêutica com hormona de crescimento. Os doentes apresentaram um índice de massa corporal menor no grupo tratado com hormona de crescimento (35 vs 51 kg/m2, p < 0,042). Conclusão: Este estudo de série de casos de doentes com síndrome de Prader-Willi tratados com hormona de crescimento é pioneiro a nível nacional desde a comparticipação deste tratamento pelo Sistema Nacional de Saúde português e apoia esta terapêutica, reforçando os seus efeitos positivos no crescimento e índice de massa corporal. Serão necessários estudos com seguimento mais prolongado para analisar o seu efeito no perfil metabólico, composição corporal e cognição.

Correction to the article "Profiles on Adolescent Internet Addiction: A Taxonomy with Latent Profiling Analysis", Published on Acta Med Port 2022 Sep;35(9):644-651.

On page 646, Section 'RESULTS',On paragraph 'Model estimation and selection',Line 3, where it reads (in red):Firstly, we examined fit statistics (Table 5), namely the Akaike Information criterion (AIC) (...)It should read (in blue):Firstly, we examined fit statistics (Table 3), namely the Akaike Information criterion (AIC) (...)Line 9, where it reads (in red):(...) (LRT = 57.33, p < 0.0001, see Table 5) (...)It should read (in blue):(...) (LRT = 57.33, p < 0.0001, see Table 3) (...)On paragraph 'Classification accuracy of the model',Line 1, where it reads (in red):The probabilities of correct classification of observations are shown in the main diagonal of Table 6, (...)It should read (in blue):The probabilities of correct classification of observations are shown in the main diagonal of Table 4, (...)Line 7, where it reads (in red):The classification accuracy of the testing subsample was 96%, as shown in Table 7.It should read (in blue):The classification accuracy of the testing subsample was 96%, as shown in Table 5.On page 647,Chapter Description of profiles, 2nd paragraph, line 4, where it reads (in red):This group scores negatively (less than 2.5, below the green, dotted bottom line) in all dimensions (Table 3), (...)It should read (in blue):This group scores negatively (less than 2.5, below the green, dotted bottom line) in all dimensions (Table 6), (...)On page 648,Line 6, where it reads (in red):(...) equal parental control rates or absence thereof (Table 4).It should read (in blue):(...)equal parental control rates or absence thereof (Table 7).2nd paragraph, line 9, where it reads (in red):(...) compared with other profiles, are noteworthy (Table 4).It should read (in blue):(...) compared with other profiles, are noteworthy (Table 7).3rd paragraph, line 7, where it reads (in red):Here we also highlight users with the least difficulty in making friends (Table 4).It should read (in blue):Here we also highlight users with the least difficulty in making friends (Table 7).4th paragraph, line 10, where it reads (in red):(...) and lower parental control rate stood out compared with the other profiles (Table 4).It should read (in blue):(...) and lower parental control rate stood out compared with the other profiles (Table 7).Article published with errors: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17047.

Profiles on Adolescent Internet Addiction: A Taxonomy with Latent Profiling Analysis.

INTRODUCTION: Addictive use of the Internet among adolescents has been linked to a negative psychosocial development, but more detailed information about Internet addiction (IA) profiles is warranted. The aim of this study was to identify IA profiles in adolescents based on psychometric properties from the Internet Addiction test (IAT), and to assess the associations between the profiles and personal/social behaviors. MATERIAL AND METHODS: A cross-sectional study was performed at public schools from a Portuguese region, using a survey that included the IAT. We performed a latent profiling analysis to identify the profiles of adolescent based on the six IAT dimensions. RESULTS: From the 1915 responses, students' mean age was 15 ± 1.82 years, 53% were female. IA was found in 16.5%. Four models were estimated with latent profiling analysis. Analysis of the models by fit statistics, integrated completed likelihood and Lo-Mendell-Rubin likelihood ratio test, indicated a better solution with four profiles: Profile 1 - Worrisome lack of control users, Profile 2 - Balanced users, Profile 3 - Worrisome anticipation users, Profile 4 - Problematic users. CONCLUSION: This study provides a characterization of different patterns in adolescents' traits and behaviors associated with Internet addiction. Preventive approaches may be useful to reduce IA.

Introdução: A dependência da Internet em adolescentes tem sido associada a problemas no seu desenvolvimento psicossocial. Porém, a literatura carece de dados sobre diferentes perfis do uso de Internet. Este estudo pretendeu identificar perfis de dependência de Internet (DI), baseado nas características psicométricas do Internet Addiction test (IAT), verificando associações entre os perfis e comportamentos sociais. Material e Métodos: Estudo transversal realizado em escolas públicas de uma região Portuguesa mediante questionário que incluiu o IAT. Realizou-se uma análise de perfis latentes (APL) para identificar perfis de adolescentes, com base nos seis domínios do IAT. Resultados: Dos 1915 participantes, a idade média foi 15 ± 1,82 anos; 53% eram do sexo feminino. Identificou-se DI em 16,5%. A análise de modelos por qualidade de ajuste e rácio de verossimilhança de Lo-Mendell-Rubin revelou um modelo adequado com 4 perfis: 1 ­ Utilizadores com dificuldade de controlo; 2 ­ Utilizadores equilibrados; 3 ­ Utilizadores com problemas de antecipação; 4 ­ Utilizadores problemáticos. Conclusão: Este estudo permitiu a caracterização de diferentes padrões e comportamentos de adolescentes na DI, pelo que se alerta para uma abordagem preventiva na redução da DI.

Azacitidine-induced massive pericardial effusion in a child with myelodysplastic syndrome.

INTRODUCTION: Pericardial effusions are rare yet potentially fatal conditions in children. Azacitidine is a DNA-hypomethylating agent used in the treatment of myelodysplastic syndrome. Although seldomly described in adults, no cases of azacitidine-induced pericardial effusion have been reported in children. CASE REPORT: A 7-year-old boy with myelodysplastic syndrome presented with a large pericardial effusion with risk for cardiac tamponade after his first azacitidine cycle. MANAGEMENT & OUTCOME: The patient was admitted to a pediatric ICU, antibiotic and steroid therapy were initiated. Pericardiocentesis was done due to hemodynamic instability. Serum and pericardial fluid complementary evaluation excluded infectious and malignant causes. The pericardial effusion did not reappear and additional pleural and ascitic slight effusions responded well to diuretics. Follow-up azacitidine cycles were administered by tapering daily dosages and using adjunctive steroid therapy, with no additional adverse events. DISCUSSION: We report the first pediatric case of large pericardial effusion secondary to azacitidine therapy in a child with MDS. This adverse reaction has not been described in pediatric patients, in which this therapeutic option has been increasingly used. We seek to raise awareness on the potential life-threatening cardiotoxicity of azacitidine in pediatric patients.

SARS-CoV-2 Vaccination in Children and Adolescents-A Joint Statement of the European Academy of Paediatrics and the European Confederation for Primary Care Paediatricians.

Stopping the COVID-19 pandemic and its socio-economic consequences is only possible with a multifaceted strategy, including mass vaccination. Studies have been conducted mainly in adults, and data on the pediatric population is relatively limited. However, it appears that vaccination in children and adolescents is highly effective and safe. Despite the apparent benefits of vaccinating this age group, there are some medical and ethical concerns. Based on the above considerations, the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Pediatricians (ECPCP) assessed the current situation and presented recommendations for international and national authorities, pediatricians, and pediatric societies regarding vaccination against SARS-CoV-2 in children and adolescents.

Diaphragmatic eventration as a first sign of Scimitar syndrome.

Diaphragmatic eventration is an anomaly of the diaphragm. In Scimitar syndrome, a curved-shaped anomalous pulmonary venous drainage is seen. Association between these conditions is rare. We present a newborn with diaphragmatic eventration, whose diagnosis of Scimitar syndrome was made after surgical repair. Scimitar syndrome is a congenital disorder often associated with other heart and lungs anomalies. Diagnosis can be fortuitous but with important prognostic features.

Linear scleroderma en coup de sabre - a different clinical presentation.

Localized scleroderma (LoS) is a rare condition featuring skin and underlying tissue sclerosis not usually compromising other systems. A subtype of LoS including lesions in the head is further classified as linear scleroderma en coup de sabre (LSeCS). Neurological involvement in LSeCS can reach up to 4% and may include seizures. Cutaneous lesions usually emerge before neurologic symptoms and these oftentimes manifest with intracranial abnormalities. We describe a case of an 11-year-old boy with an onset of self-limited unexplained seizures at 20-months of life. During the first year of follow-up, a midline frontoparietal lesion with alopecia and hypopigmentation was noted and a referral to dermatology and pediatric rheumatology consultation was made. A diagnosis of LEsCS was made. A 10-year follow-up of this patient is presented with favorable outcome. LSeCS is a rare form of LoS most frequently diagnosed in children and adolescents. A meticulous examination of these patients should be performed with particular attention to the face and scalp. The mainstay therapeutical approach is based on methotrexate and corticosteroids. Neurologic abnormalities associated with skin lesions on the head should should raise clinical suspicion of LSeCS.