RESUMO
Obesity is currently considered a global epidemic, and its implications in mortality and morbidity in a paediatric patient and in adulthood are increasingly important. The objective of this article is to review in detail the definition of obesity according to age group, and, in turn, the epidemiology of this entity worldwide and in South America. Available evidence about pathophysiology and, additionally, associated comorbidities are reported in some of the most important and clinically relevant body systems. The recommendations on pharmacological and nonpharmacological management through changes in lifestyle and relevant aspects of bariatric surgery in the paediatric population are also described.
Assuntos
Estilo de Vida , Obesidade Infantil/etiologia , Obesidade Infantil/terapia , Criança , Comorbidade , HumanosRESUMO
El embarazo en adolescentes tiene consecuencias biológicas y sociales. En Colombia la tasa de fecundidad entre 15 y 19 años es del 20.5%. El 44.5% de las menores de 19 años han abortado. Analizar las vivencias del embarazo de las adolescentes permitió retroalimentar el programa de protección. Estudio cualitativo con 17 jóvenes, información recopilada previo consentimiento informado, de historias clínicas, grupos focales, entrevistas en profundidad. Procesamiento con Atlas Ti, análisis de contenido. Resultados: Embarazo no planeado, 11 casos en el noviazgo, 1 por promiscuidad y 5 (29.4%) por abuso sexual o incesto. Se oculta por vergüenza, temor al rechazo social. Hubo abandono de pareja en 9 casos, crisis y aislamiento familiar y social, deserción escolar. Cambios psicosociales: negación y rechazo (aborto, abandono, adopción, conductas de riesgo); aceptación y establecimiento del vínculo madre-hijo. La institución de protección atiende 12 meses sin seguimiento al egreso. Conclusión: el programa de protección del estado dirigido a adolescentes embarazadas necesita: establecer mecanismos que garanticen la continuidad de las jóvenes en el sistema educativo; incluir el seguimiento ambulatorio al binomio madre-hijo al egreso; implementar estrategias participativas que promuevan el ejercicio de una sexualidad responsable en el marco de los derechos sexuales y reproductivos. La institución debe continuar con la sistematización y monitoreo de información y difundir de manera periódica los hallazgos con otras instituciones de protección, de salud y educación ubicadas en el área de influencia, como insumo para retroalimentar el programa e incentivar la búsqueda de estrategias de prevención del embarazo o su reincidencia (AU)
Pregnancy during the adolescence has biological and social consequences. In Colombia women between 15 and 19 years old show fecundity rate of 20.5%. 44.5% of women fewer than 19 years aborted. The analysis of pregnancy experience of adolescents helped to feed back the protection program. Qualitative Study, 17 adolescents were included; information was recollected after informed consent, by clinic histories, focal groups, and deep interviews. Data were processed using Atlas Ti, content analysis. Results: Pregnancy was not planned; 11 cases by the relationship, 1 by promiscuity, 5 by sexual abuse or incest. It was hidden for embarrass or frightened to social rejection. The partner abandoned in 9 cases; produced family crisis, social isolation, and school dropout. Psychosocial changes: denial and rejection (abortion, abandonment, adoption, risk behaviour); acceptance and establishment of mother-child bond. The institution of protection provides services during 12 months without follow-up at discharge. The state program aimed to protect pregnant teens need to: establish mechanisms to ensure the continuity of the girls in the educational system, including outpatient follow-up to mother-infant at discharge; implement participation strategies to promote the exercise of responsible sexuality in the context of sexual and reproductive rights. The institution must continue to systematize and disseminate the information and monitor periodically the findings with other institutions of protection, health and education, located in the catchment area as an input to provide feedback for the program and encourage the search for prevention strategies pregnancy or its recurrence (AU)
