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In recent years, important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This review will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females; 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In an evaluation of autonomy, 66% took showers, 78% performed their physiological needs, 77% intimate hygiene and 76% oral hygiene without help. 42% affirmed being able to do anything that is asked; 22% perform all tasks in the home; 10% felt they were incapable of doing anything and 4% used public transportation without help. 42% of the teenagers masturbated, 24% on a daily basis, 75% in private, and 25% in a public location. 42% had already kissed at a mean age of 12.9 years, mean age of the partner 16.1 years; 26.8% of these partners had DS. 82% found themselves attractive and 33% would not change anything in their appearance. We found that they presented normal development in the exercise of their sexuality, but with important difficulties in their autonomy and difficulties in school, needing careful interventions to make their social interaction the best possible. Their pubertal development was normal and they were satisfied with their body image with future perspectives of working, finding a partner, and living a normal life of getting married and having children.

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Over the last 3 decades since the first AIDS cases appeared, we have witnessed great progress in therapeutic methodologies that have transformed the evolution of the disease from debilitating and fatal, into chronic and controllable. HIV-infected children are arriving at adolescence and bringing specific challenges, not only to themselves, but also to their families and caregivers. This retrospective study sets forth epidemiological and treatment characteristics of 46 HIV-infected adolescents followed in a specialized university service relating said characteristics to therapy adherence assessed through a combination of three indirect methods. Therapy adherence did not reveal any association with either epidemiologic characteristics regarding age, sex, school level, household composition, age at diagnosis, mode of infection, knowledge of diagnosis, treatment time, or initial antiretroviral scheme. Patients with good therapy adherence presented lower viral load and used a smaller number of antiretroviral schemes.

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UNLABELLED: University students aged 17 to 24 years of age are prone to many risk factors. OBJECTIVES: Identify risk factors related to exploring sexuality and characteristics of consumption of psychoactive substances in students attending medical school. METHODS: 465 Medical students from Santa Casa of São Paulo Faculty of Medical Sciences (FCMSCSP) were prospectively and transversely evaluated during 2005. An anonymous, semi-structured, self-filling questionnaire was used. The average age of the students was 21.5 years, 43% females. 76.2% preferred alcohol, and 11.1% tobacco consumption; chloroethane (lança-perfume) consumption occurred in 22.6% and 15.3% consumption of other types of illicit drugs, with marijuana as the most used one (94%). 70.3%, of the parents drink alcohol and 30.5% smoke tobacco. As for the students' sexuality, 85.3% have already had sexual intercourses, starting at average age of 17. 88.8% used condom during the first sexual intercourse, however, 35.6% did not use it regularly; 5.4% had already had some type of DST. 79.8% of the females preferred having used contraceptive methods; however, 28.1% had a suspicion of pregnancy, which was confirmed in 7.9% of the cases. 9.9% of the students had ideas of abortion, 12.5% have effectively attempted it. 85% found medical school stressing and to relieve tension, 33.8% practiced sports; 6.9% preferred either licit or illicit drug consumption, and 5% used tranquilizers. The results showed risk behaviors: unsafe sex and the use of licit and illicit drugs indicated the need to establish guidance programs on reproductive health, improving self-esteem, and prevention during medical education.

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PURPOSE: To assess the impact of integral support on the health of children of adolescent mothers and their children. METHODS: A prospective study involving 50 adolescent mothers, who had frequent meetings with a multi-professional group throughout pregnancy. After birth, medical followup was provided to mother and child. RESULTS: Mean schooling proved higher than the national average. After follow-up, the rate of return to education was 24%. These adolescents had good social network support from both family and father of the child. They considered themselves good mothers and felt happier after maternity experience. Adolescents demonstrated a responsible sex life involving family planning and correct use of contraception, yielding extremely low levels of repeat pregnancy. Of the mothers, 48% were employed, working, earning a mean monthly salary of 150% minimum wage. The children of mothers followed by were breastfed longer and had greater vaccination cover than the average for São Paulo State. CONCLUSIONS: The results suggest that our program promotes education of adolescents and their children; demonstrates the importance of a social support network through the family of the young mother and father of the child; fosters positive maternal social model addressing self-esteem and responsibility; informs mothers on contraception and encourages a responsible sex life, baby care, vaccination, and maternal breastfeeding.

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PURPOSE: to assess knowledge of pediatric residents attending adolescents, including ethical issues on contraceptive advice. METHODS: A prospective study was conducted involving 75 residents in order to assess their knowledge, along with ethical issues involved, in clinical attendance of adolescents. The SPSS 13 software package was used for data analysis. RESULTS: 100% of interviewees stated that adolescents have the right to privacy during medical appointments. Yet, when asked from what age this privacy should be granted, 62% reported at any age. When questioned on whether an adolescent could be examined alone, without another person with them in the room, 50% of physicians answered yes and 50% no. 91.7% of interviewees felt that adolescents had the right to confidentiality and medical secrecy, but only 84.8% knew the contents of the Code of Medical Ethics regarding medical secrecy. A further 79.2% felt prepared to give advice on contraception to adolescents. CONCLUSIONS: The attitudes held by pediatric residents on privacy, confidentiality and medical secrecy are highly ambiguous. The doctors interviewed were ill-prepared to deal with the issues of contraception in adolescence on both practical and legal levels.

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The purpose of this study was to evaluate the impact of the integral attention to the health of pregnant adolescents and adolescent mothers, having follow-up from the Integral Support Program for the Pregnant Teen (ISPPT), with the intention to determine quality of life and prevent repeat pregnancy. A prospective study comprised 85 adolescents attended by the ISPPT between January 2002 and June 2006 who participated in meetings during pregnancy with a multidisciplinary team that provided orientation concerning family planning, self-esteem, pregnancy prevention, motivation to continue education and/or work, and evaluate the postpartum mother-child relationship. The following were analyzed: education level, marital status, contraceptive use, thoughts and attempts at abortion, repeat pregnancy. This study was approved by the Human Research Ethics Committee. The Epi-Info v6.0b software was used for data and result evaluation using the means and the chi-squared test. The mean age of the adolescents was 15.7 years, 3.52% had repeat pregnancy within a mean follow-up of 23 months after childbirth, the mean education level was 8.1 years, 30.5% dropped out of school, with 79.4% occurring before pregnancy, 64.6% used no contraceptives, 68.3% were single, and 81.3% had a positive role model. One year after birth, 67.5% studied, 50% worked, 55.1% lived with the partner, 77% correctly used contraceptives, every child lived with their mothers and their vaccinations were up to date. The results demonstrate that the global attention given to the health of adolescent mothers and pregnant adolescents is a protective factor for pregnancy relapse and quality of life.

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UNLABELLED: Pregnancy during adolescence represents a challenge to society as a whole. Its incidence is increasing and brings about social and medical consequences to both the teen mothers and their children. The purpose of this study was to evaluate pregnant teenager involvement in sexual activity and the social context. The group studied comprised 152 pregnant teenagers attending the Department of Pediatrics, Santa Casa de Sao Paulo (SCSP) General Hospital. All information was analyzed. The age at first intercourse was 14.2 years and the average period between first intercourse and pregnancy was 1.4 years. Most pregnancies (75%) were neither planned nor wanted, however, most teen mothers (64.3%) did not use any contraceptive method. Of the pregnant teenagers, 68.1% came from unstructured families where in 71% of the teen pregnancy cases, there was a role model (mother, sister, or cousin who already experienced teen pregnancy). The average number of school years attended by the analyzed pregnant teenagers was 8.1 years, however, there was a high dropout rate of 40.1%. The age at first intercourse was low and concurs with the high incidence of unstructured families. The average number of school years attended was high, which would theoretically reflect a greater knowledge with regard to human reproduction, pointing to the multicausality of teen pregnancy and the role played by the family. CONCLUSIONS: We confirmed that teen pregnancy presents multicausal etiology; sexual initiation of pregnant teenagers was quite early with high dropout rates, which indicated that prevention methodology should be based on early detection of risk factors for elaboration of appropriate prevention proposals.

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The main goal of this study was to investigate, through a biomolecular study, the correlation between papillomatosis of the vulvar vestibule and human papillomavirus (HPV) infection, as well as to establish the necessity of treatment. A total of 44 female adolescents between 12 and 18 years of age were selected through a prospective study with a confirmed diagnosis of papillomatosis of the vulvar vestibule. Vulvar biopsies were obtained for the histological and biomolecular detection of HPV DNA through polymerase chain reaction (PCR). Twenty (45%) adolescents were virgins (group A), the other 24 (55%) were sexually active. The virgin adolescents (group A) and 12 sexually active adolescents (group B) did not show cytological and/or colposcopic alteration, suggesting infection by HPV either on the cervix or vagina. These were compared with 12 other sexually active adolescents who showed cervicovaginal infection caused by HPV (group C). Fisher exact test was applied for statistical analysis of the results, considering alpha equal or less than 0.05. There was no statistically significant difference in relation to HPV DNA through PCR among virgin and sexually active adolescents in group B, however, both differed from those in group C (A + B C: p = 0.048*). The histological study did not reveal evident signs of infection caused by HPV on vestibular papillae, besides perinuclear halos. HPV DNA was detected on vestibular papillae in 27%. Our results confirmed a scarce correlation between vestibular papillae and HPV. Thus, we consider papillomatosis of the vulvar vestibule, in most cases, to be equivalent to physiological papillomatosis and, therefore, should not be treated.

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This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic rickets in infancy was the magnitude of the final stature. The use of growth hormone can be helpful in these patients. However, research reporting treatments with the use of the growth hormone for rickets are controversial. The majority of the authors agree that treatment using vitamin D and phosphate enables some statural growth in cases of early diagnosis, reflecting a better prognosis.

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Objetivo: Analisar comparativamente os dados clínicos e endoscópicos concernentes à doença péptica em grupo de crianças (CR) e adolescentes (AD). Material e Métodos: Foram estudadas 30 crianças e 76 adolescentes, no período de agosto de 1992 a novembro de 1994, portadores de doença péptica. O diagnóstico foi firmado mediante exame endoscópico e histológico em todos os casos. Pesquisou-se a colonizaçäo pelo H. pylori (biópsia gástrica corada pelo Giensa). Foram tomados e comparados dados clínicos quanto a dor abdominal (localizaçäo, intensidade, cronicidade e sintomas acompanhantes) em ambos os grupos. A análise estatística foi efetuada pelo teste exato de Fisher (valor de significância p<0,05). Resultados: os resultados foram similares quanto à predominância do sexo feminino (66 por cento grupo CR x 70 por cento grupo AD), cronicidade da dor entre 2 a 6 meses (40 por cento CR x 38 por cento AD), dor de intensidade forte (70 por cento CR x 83 por cento AD), presença de vômitos e náuseas (42 por cento CR x 55 por cento AD). Epigastralgia foi predominante nos AD (87 por cento x CR 63 por cento), sendo este estado significativo (p=0,012). A endoscopia foi normal em 30 por cento das CR e 14 por cento dos AD (p=0,052). A presença de gastrite leve e moderada foi significativamente mais encontrada no AD (72 por cento) que em crianças (37 por cento) (p<0,01). Nas CR houve nítida predominância de gastrite antral de aspesto nodular, enquanto nos AD prevaleceu gastrite de caráter difuso. A Bulboduodenite foi constatada nas CR (10 por cento) e nos AD (12 por cento),...

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La autora se propone describir e interpretar los fenómenos que precipitan y mantienen la crisis familiar desde el momento en que los hijos se hacen adolescentes hasta su independencia y salid de la casa paterna; describe y examina sumariamente las características evolutivas de algunas especies animales, como el hámster, los perros y gatos, el mono zag³i y el hombre; el promedio de vida el tipo de familia, la independencia y la madurez(AU)

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La autora se propone describir e interpretar los fenómenos que precipitan y mantienen la crisis familiar desde el momento en que los hijos se hacen adolescentes hasta su independencia y salid de la casa paterna; describe y examina sumariamente las características evolutivas de algunas especies animales, como el hámster, los perros y gatos, el mono zagüi y el hombre; el promedio de vida el tipo de familia, la independencia y la madurez

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