[Epidemiology of Internet Use by an Adolescent Population and its Relation with Sleep Habits]. / Epidemiologia do Uso de Internet numa População Adolescente e Sua Relação com Hábitos de Sono.

INTRODUCTION: In the last decades, the great technological development increased Internet popularity, emerging the concern about its overuse. The objectives of this study were to assess and characterize Internet use in adolescence, determine Internet addiction and clarify its association with sleep disorders and excessive daytime sleepiness. MATERIAL AND METHODS: It was performed an observational, cross sectional and community-based study. The target were students attending 7th and 8th grades, to whom was applied an online self-report questionnaire to assess sociodemographic features, Internet use, Internet dependence, sleep characteristics and excessive daytime sleepiness. RESULTS: A total of 727 adolescents were included with a mean age 13 ± 0.9 years. Three-quarters of teenagers use Internet daily and 41% do it for three or more hours/day, mainly at home. The phone and laptop were the main devices used. Online games and social networks use were the main activities performed. Internet dependence was observed in 19% of adolescents, and it was associated with male gender, social networks use, mainly Twitter and Instagram use, self-perceived sleep problems, initial and middle insomnia and excessive daytime sleepiness (p < 0.05). DISCUSSION: The results confirm the highlight that Internet has in adolescents routine, who prioritize in their use access to social networks and online games, using single devices, less subject to parental control. CONCLUSION: The Internet addiction rate observed and its association with sleep alterations and daytime sleepiness emphasizes the importance of this issue.

Introdução: A grande evolução tecnológica das últimas décadas tornou a Internet cada vez mais popular, sendo crescente a preocupação com a sua utilização excessiva. Foram objetivos do presente trabalho aferir e caracterizar o uso de Internet na adolescência, determinar a dependência de Internet e estabelecer a sua associação com alterações do sono e sonolência diurna excessiva. Material e Métodos: Foi realizado um estudo de base comunitária, observacional e transversal dirigido a adolescentes a frequentar o sétimo e oitavo ano de escolaridade. Recorreu-se a um questionário de autopreenchimento online, para aferir características sociodemográficas, uso e dependência de Internet, características do sono e sonolência diurna excessiva. Resultados: Foram incluídos 727 adolescentes com idade média de 13 ± 0,9 anos. Três quartos dos adolescentes usa a Internet diariamente e 41% fá-lo durante três ou mais horas/dia, maioritariamente em casa. O telemóvel e o computador portátil são os principais dispositivos utilizados. Os jogos online e o uso das redes sociais são das principais atividades realizadas. A dependência de Internet foi observada em 19% dos adolescentes, associando-se ao género masculino, à utilização de redes sociais, o Twitter e Instagram, à autopercepção de problemas de sono, insónia inicial e intermédia e sonolência diurna excessiva (p < 0,05). Discussão: Os resultados reiteram o destaque que a Internet tem na rotina dos adolescentes, que priorizam o seu uso no acesso a redes sociais e jogos online, fazendo-o com dispositivos de uso individual, menos passíveis de controlo parental. Conclusão: A dependência de Internet verificada e associação com alterações do sono e sonolência diurna excessiva enfatiza a relevância desta problemática.

Hereditary neuropathy with liability to pressure palsy: a recurrent and bilateral foot drop case report.

Hereditary neuropathy with liability to pressure palsy is characterized by acute, painless, recurrent mononeuropathies secondary to minor trauma or compression. A 16-year-old boy had the first episode of right foot drop after minor motorcycle accident. Electromyography revealed conduction block and slowing velocity conduction of the right deep peroneal nerve at the fibular head. After motor rehabilitation, he fully recovered. Six months later he had the second episode of foot drop in the opposite site after prolonged squatting position. Electromyography revealed sensorimotor polyneuropathy of left peroneal, sural, posterior tibial, and deep peroneal nerves and also of ulnar, radial, and median nerves of both upper limbs. Histological examination revealed sensory nerve demyelination and focal thickenings of myelin fibers. The diagnosis of hereditary neuropathy with liability to pressure palsy was confirmed by PMP22 deletion of chromosome 17p11.2. He started motor rehabilitation and avoidance of stressing factors with progressive recovery. After one-year followup, he was completely asymptomatic. Recurrent bilateral foot drop history, "sausage-like" swellings of myelin in histological examination, and the results of electromyography led the authors to consider the diagnosis despite negative family history. The authors highlight this rare disease in pediatric population and the importance of high index of clinical suspicion for its diagnosis.