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ABSTRACT Objective: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association. Methods: A cross-sectional study was conducted in 2015 involving 799 adolescents (10-16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as "does not practice," "practices ≤300 min/week," and "practices >300 min/week" by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID. Results: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08-1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35-0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID. Conclusions: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status.

RESUMO Objetivo: Analisar a associação entre a participação em exercícios físicos relacionados ao fitness (EFRF) e a insatisfação com a imagem corporal (IIC) em adolescentes e avaliar a interação entre os exercícios físicos e o estado nutricional nesta associação. Métodos: Estudo transversal realizado em 2015 com 799 adolescentes (10 a 16 anos) de 14 escolas públicas de Curitiba (PR), Brasil. A IIC foi avaliada por meio do Body Shape Questionnaire e da Escala de Silhuetas. A participação em EFRF foi avaliada pelo Questionário de Atividade Física para Adolescentes e classificada em "não pratica", "pratica ≤300 minutos/semana" e "pratica >300 minutos/semana". As regressões de Poisson e logística multinomial, ajustadas por sexo, maturação sexual e estado nutricional, analisaram a associação entre EFRF e IIC. Resultados: A prevalência de IIC foi de 28,3%; 52,4% dos adolescentes queriam reduzir a silhueta e 48,7% não praticavam a EFRF. Adolescentes que praticavam EFRF >300 minutos/semana tiveram prevalência 28% maior para algum nível de IIC (razão de prevalência — RP 1,28; intervalo de confiança de 95% — IC95% 1,08-1,52) e chance 46% menor de querer reduzir silhuetas (OR 0,54; 95IC% 0,35-0,82), comparados aos não praticantes. Não houve interação entre os EFRF e o estado nutricional na associação com IIC. Conclusões: Os adolescentes que praticam EFRF >300 minutos/semana estão mais propensos a apresentar algum nível de IIC e têm menores chances de reportar o desejo de aumentar silhuetas, independentemente do estado nutricional.

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ABSTRACT Objective: To describe how smartphone applications can contribute to the management of epilepsy in children and adolescents. Data source: This is an integrative review conducted on the Medline, PubMed, and SciELO databases, based on the descriptors "epilepsy" and "smartphone." Original studies published between 2017-2023 in Portuguese or English that addressed the research question were included. Theses and dissertations, duplicate studies, literature reviews, and studies that did not answer the research question were excluded. Data synthesis: A total of 178 studies were located, of which six were selected for this review. The sample included 731 participants (631 children and adolescents with epilepsy and 100 caregivers). The applications allow for the collection of seizure frequency; timing and type of crisis; reminders for medication administration; and information about sleep quality. They can store these data for healthcare professionals, caregivers, and users to monitor the progress of the condition. Conclusions: The use of applications in managing seizures in children and adolescents with epilepsy shows promising results by promoting continuous and personalized monitoring. Further studies are needed to optimize beneficial outcomes and overcome challenges.

RESUMO Objetivo: Descrever como aplicativos de smartphone podem contribuir para o gerenciamento de quadros de epilepsia em crianças e adolescentes. Fontes de dados: Trata-se de uma revisão integrativa realizada nas bases de dados Medline; PubMed e SciELO, com base nos descritores "epilepsy" e "smartphone". Foram incluídos estudos originais publicados entre 2017-2023 em português ou inglês que respondessem à pergunta de investigação. Teses e dissertações, estudos duplicados, revisões de literatura e estudos que não responderam à questão de pesquisa foram excluídos. Síntese dos dados: Foram localizados 178 estudos, dos quais seis foram selecionados para compor esta revisão. A amostra incluiu 731 participantes (631 infantojuvenis com epilepsia e 100 cuidadores). Os aplicativos permitem a coleta da frequência de convulsões; momento e o tipo de crise; lembretes para a administração de medicamentos; e informações sobre a qualidade do sono, sendo capazes de armazenar esses dados para profissionais da saúde, cuidadores e usuários acompanharem a evolução do quadro. Conclusões: O uso de aplicativos no manejo das convulsões de crianças e adolescentes com epilepsia apresenta resultados promissores ao promoverem um monitoramento contínuo e personalizado. Novos estudos são necessários para otimizar os resultados benéficos e superar desafios.

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Abstract Introduction: Knowing the forms of termination of psychotherapy and the associated factors allows us to understand this moment of treatment and to think about strategies to improve the process. Objective: The present study seeks to identify the types of termination of psychotherapy in children and adolescents and the factors that influence them in two psychological care centers. Methodology: A quantitative, exploratory, cross-sectional design was used, with a descriptive and association scope; 100 patients (48 children and 52 adolescents) were surveyed. Results: Four types of termination were found: due to institutional or therapist factors, attributed to factors external to the treatment, due to user dissatisfaction, and achievement of objectives. Some associations between them and the clinical and sociodemographic characteristics of the treatment were identified. Discussion: Institutional aspects and external conditions to the patient must be considered in constructing intervention strategies for this population. In addition, educating parents on psychological intervention and its institutional scope is required to modulate the expectations associated with the process.

Resumen Introducción: Conocer los tipos de terminación de las psicoterapias y los factores asociados, permite comprender esta dimensión del tratamiento y pensar estrategias para el mejoramiento del proceso. Objetivo: El presente estudio busca identificar los tipos de terminación de la psicoterapia en niños y adolescentes y los factores que influyen en ellos en dos centros de atención psicológica. Metodología: Se utilizó un diseño cuantitativo, exploratorio, transversal, con un alcance descriptivo y de asociación, fueron encuestados 100 pacientes (48 niños y 52 adolescentes). Resultados: Se encontraron cuatro tipos de terminación: por factores institucionales o del terapeuta, atribuida a factores externos del tratamiento, por insatisfacción de los usuarios y por cumplimiento de objetivos. Se identifican algunas asociaciones entre estos y las características clínicas y sociodemográficas del tratamiento. Discusión: Los aspectos institucionales y las condiciones externas al paciente deben ser considerados en la construcción de las estrategias de intervención con esta población. Además, se requiere un proceso de educación a padres sobre la intervención psicológica y su alcance institucional para modular las expectativas asociadas al proceso.

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Abstract Introduction: Adverse or favourable rearing conditions early in life affect emotional response during adolescence. To study the effect of early rearing on emotional response, animal models such as maternal separation (MS) and social enrichment (SE) by community nesting have been useful. However, the comparison of the effect of MS and SE on anxiety-related behaviours in adolescent rats is unknown. Objective: This study aimed to assess the effects of MS and SE on the emotional response of adolescent rats exposed to the elevated plus-maze test (EPM). Method: Pregnant Wistar rats were randomly distributed into three groups according to the rearing condition. In the MS group, pups were separated daily from their dams for 180 minutes, from postnatal day (P) 2 to 14. In the SE group, two females that gave birth synchronously were housed in a cage with a litter of eight pups. Females from control standard housing (SH) were individually housed and kept with their offspring until weaning (P23). On P32, anxiety-related measures were evaluated using an EPM. Results: MS and SE increase anxiety-related behaviours and locomotion in rats exposed to the EPM. SE had sex-dependent effects on anxiety-related measures, increasing vertical activity in females and horizontal activity in males. MS but not SE increased body weight gain in female rats. Conclusion: Adverse or favourable rearing conditions early in life may result in an increased anxiety phenotype in the EPM during adolescence. It is likely that the favourable effect of SE depends on the number of dams per communal nest.

Resumen Introducción: Las condiciones de crianza adversas o favorables en etapas tempranas de la vida afectan la respuesta emocional durante la adolescencia. Para estudiar el efecto de la crianza temprana sobre la respuesta emocional, han sido útiles modelos animales como la separación materna (SM) y el enriquecimiento social (ES) mediante anidamiento comunitario. Sin embargo, se desconoce la comparación del efecto de la SM y el ES sobre las conductas relacionadas con la ansiedad en ratas adolescentes. Objetivo: Este estudio pretende evaluar los efectos de la SM y el ES sobre la respuesta emocional de ratas adolescentes expuestas al test del laberinto en cruz elevado (EPM). Método: Las ratas Wistar preñadas se distribuyeron aleatoriamente en tres grupos según la condición de crianza. En el grupo SM, las crías fueron separadas diariamente de sus madres durante 180 minutos, desde el día postnatal (P) 2 hasta el 14. En el grupo ES, dos hembras que parieron de forma sincronizada se alojaron en una caja con una camada de ocho crías. Las hembras del alojamiento estándar de control (SH) se alojaron individualmente y se mantuvieron con sus crías hasta el destete (P23). En P32, se evaluaron las medidas relacionadas con la ansiedad mediante un EPM. Resultados: La SM y el ES aumentan las conductas relacionadas con la ansiedad y la locomoción en las ratas expuestas al EPM. El ES tuvo efectos dependientes del sexo en las medidas relacionadas con ansiedad, aumentando la actividad vertical en las hembras y la actividad horizontal en los machos. La SM, pero no el ES, incrementó la ganancia de peso corporal en las ratas hembra. Conclusiones: Condiciones de crianza adversas o favorables en etapas tempranas de la vida pueden dar lugar a un fenotipo de ansiedad aumentado en el EPM durante la adolescencia. Es probable que el efecto favorable del ES dependa del número de hembras por nido comunitario.

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Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.

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Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

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Introducción. El trastorno del espectro autista (TEA) se caracteriza por dificultades de comunicación social y comportamientos repetitivos y estereotipados. Además de la categoría diagnóstica, las actividades que los niños, niñas y adolescentes (NNyA) pueden realizar y la participación social son los aspectos principales por considerar desde el marco de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud (CIF), propuesta por la Organización Mundial de la Salud, para describir los estados de salud. En una investigación previa, elaboramos la primera versión de una herramienta pediátrica basada en la CIF llamada TEA-CIFunciona para evaluación funcional de NNyA con diagnóstico de TEA, que permitió captar características funcionales adaptadas a nuestro contexto cultural. Se propuso como objetivo posterior aplicar TEA-CIFunciona en formato multicéntrico para evaluar NNyA de diferentes regiones, revisar y actualizar la herramienta, e identificar barreras y facilitadores. Población y métodos. Se administró TEA-CIFunciona versión 1.0 a NNyA con diagnóstico confirmado de TEA (según criterios del DSM-5), menores de 16 años, en seguimiento en cinco centros de atención pediátrica del país. Resultados. Se obtuvo la versión 2.0 de TEA-CIFunciona con 34 categorías (10 funciones corporales, 15 actividades y participación, y 9 factores ambientales). Se elaboró el perfil funcional de la muestra completa (n = 308). Conclusiones. La versión actualizada de TEA-CIFunciona contribuye a estandarizar y a sistematizar la obtención de información necesaria para adecuar el seguimiento de los NNyA con TEA a nivel nacional. Además, permite identificar barreras por superar y facilitadores para generalizar

Introduction. Autism spectrum disorder (ASD) is characterized by difficulties in social communication and repetitive and stereotyped behaviors. In addition to the diagnostic category, the activities performed by children and adolescents and their social involvement are the main aspects to be considered according to the International Classification of Functioning, Disability, and Health (ICF) proposed by the World Health Organization to describe health status. In a previous study, we developed the first version of a pediatric tool based on the ICF called ICF-ASD for the functional assessment of children and adolescents with ASD to capture functional characteristics adapted to our cultural setting. Our subsequent objective was to apply the ICF-ASD in a multicenter format to assess children and adolescents from different regions, review, and update it, and identify barriers and facilitators. Population and methods. The ICF-ASD version 1.0 was administered to children and adolescents younger than 16 years with a confirmed diagnosis of ASD (as per DSM-5 criteria), who were receiving follow-up at 5 children's health centers across Argentina. Results. Version 2.0 of the ICF-ASD was obtained, which included 34 categories (10 under body function, 15 under activities and participation, and 9 under environmental factors). A functional profile was developed for the whole sample (n = 308). Conclusions. The updated version of the ICF-ASD helps to standardize and systematize the collection of necessary data for an adequate follow-up of children and adolescents with ASD at a national level. It also allows to identify barriers to overcome and facilitators to be generalized

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To analyze the distribution and factors associated with lack of knowledge about the human papillomavirus (HPV) vaccine among Brazilian adolescents.Cross-sectional study using the 2019 National School Health Survey among 17,805 Brazilian students of public and private schools, aged 13-17 years. The outcome variable was "lack of knowledge about the HPV vaccine" and the explanatory variables were sociodemographic, behaviors, knowledge, and health conditions. Logistic regression model was used to calculate Odds Ratio (OR) and 95% confidence intervals (95%CI). Spatial analysis techniques were used to determine the formation of clusters in the federated units with similar proportions of adolescents who were unaware of the vaccine. The lack of knowledge about the HPV vaccine was reported by 45.54% of Brazilian students. There was a higher chance of lack of knowledge having had sexual intercourse (OR 1.43; 95% CI 1.20-1.70); attending public school (OR 1.72; 95%CI 1.47-2.02) and located in the Northeast Region (OR 1.35; 95%CI 1.08-1.69). The lower chance of lack of knowledge were female gender (OR 0.41; 95% CI 0.35-0.48), higher maternal education (OR 0.62; 95% CI 0.50-0.77) self-rated health as Poor/very poor (OR 0.64; 95% CI 0.49-0.86) and receiving contraceptive counseling (OR 0.77; 95% CI 0.65-0.91). The proportion of lack of knowledge about the HPV vaccine was higher with the formation of High-High spatial clusters in the states of Maranhão, Piauí, and Pernambuco. Sociodemographic, health, and behavioral conditions and knowledge of students, as well as school characteristics, were associated with lack of knowledge about the HPV vaccine. A higher frequency of lack of knowledge about the HPV vaccine among adolescents was found in the states of the Northeastern Region.

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Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

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[This corrects the article DOI: 10.3389/fpsyg.2023.1194294.].

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Ectomesenchymal chondromyxoid tumor (ECT) is a rare soft tissue tumor with peculiar histogenesis, exhibiting a predilection for the dorsum of the tongue. Molecular evidence suggests that it may originate from the migration of ectomesenchymal pluripotent cells from the neural crest to the tongue, where these cells may eventually proliferate and undergo myxoid and chondroid differentiation. This article illustrates a case of a 16-year-old female patient who presented with a nodule on the dorsum of her tongue, which had been present for four years. Surgical excision was performed, and histopathological analysis revealed a myxoid neoplasia composed of polygonal and spindle cells within a loose stroma containing chondroid areas. Tumor cells were positive for GFAP and S-100 proteins on immunohistochemical study, confirming the diagnosis of ECT. After a 5-year follow-up, the patient has shown no evidence of recurrence. Although rare, ECT can be diagnosed straightforwardly due to its distinctive clinical, histopathological, and immunohistochemical features. Clinicians and pathologists should become familiar with this tumor in order to avoid misdiagnosis.

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Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints.

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The inappropriate use of electronic devices can affect the psychological and physical health of children and adolescents. Therefore, it is essential to accompany them and promote media literacy to ensure a healthy and responsible use of technology. On occasions that depend on a multifactorial complex, the inappropriate use of networks can trigger problematic consumption and seriously affect the lives of young people. In 2022, the World Health Organization recognized, through ICD-11, the addiction to video games and used the term "problematic use" for the Internet and social networks. This article attempts to update professionals on new trends in the consumption of social networks, video games, and online gambling platforms and their consequences on the psychophysical well-being of children and adolescents.

El uso inapropiado de dispositivos electrónicos puede afectar la salud psicofísica de niños y adolescentes. Por ello, es fundamental acompañarlos y fomentar la alfabetización mediática para garantizar un uso saludable y responsable de la tecnología. En ocasiones que dependen de un complejo multifactorial, el uso inadecuado de las redes puede desencadenar consumos problemáticos y afectar gravemente la vida de los jóvenes. En 2022, la Organización Mundial de la Salud reconoció, a través del CIE 11, la adicción a los videojuegos y utilizó el término "uso problemático" para internet y redes sociales. Este artículo intenta actualizar a los profesionales sobre las nuevas tendencias en el consumo de las redes sociales, los videojuegos, las plataformas de apuestas en línea y sus consecuencias en el bienestar psicofísico de los niños y adolescentes.

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Background: Isoniazid-resistant, rifampin-susceptible tuberculosis (Hr-TB) is associated with poor treatment outcomes and higher rates of acquisition of further drug resistance during treatment. Due to a lack of widespread diagnostics, Hr-TB is frequently undetected and its epidemiology is incompletely understood. Methods: We studied the molecular epidemiology of Hr-TB among all patients diagnosed with culture-positive pulmonary tuberculosis between January 1 and June 30, 2017, at an urban referral tuberculosis clinic in Port-au-Prince, Haiti. Demographic and clinical data were extracted from the electronic medical record. Archived diagnostic Mycobacterium tuberculosis isolates were tested for genotypic and phenotypic isoniazid resistance using the Genotype MTBDRplus assay (Hain, Nehren, Germany) and culture-based testing, respectively. All isoniazid-resistant isolates and a randomly selected subset of isoniazid-susceptible isolates underwent whole-genome sequencing to confirm the presence of mutations associated with isoniazid resistance, to validate use of Genotype MTBDRplus in this population, and to identify potential transmission links between isoniazid-resistant isolates. Results and Conclusions: Among 845 patients with culture-positive pulmonary tuberculosis in Haiti, 65 (7.7%) had Hr-TB based on the Genotype MTBDRplus molecular assay. Age < 20 years was significantly associated with Hr-TB (odds ratio, 2.39; 95% confidence interval, 1.14, 4.70; P = .015). Thirteen (20%) isoniazid-resistant isolates were found in 5 putative transmission clusters based on a single nucleotide polymorphism distance of ≤ 5. No patients in these transmission clusters were members of the same household. Adolescents are at higher risk for Hr-TB. Strains of isoniazid-resistant M tuberculosis are actively circulating in Haiti and transmission is likely occurring in community settings.

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Introducción. La pandemia por COVID-19 ha tenido un impacto profundo en la salud de la población joven de todo el mundo y especialmente en personas con trastornos de la conducta alimentaria (TCA) por situaciones de estrés, ansiedad y cambios en el acceso a la atención médica. Objetivo. Explorar las percepciones de adolescentes sobre los cambios en sus vínculos sociales y modalidades de atención en pacientes con TCA. Población y métodos. Se realizó un estudio cualitativo a través de entrevistas en profundidad a adolescentes con TCA en un hospital universitario durante la pandemia por COVID-19. Resultados. Se entrevistó a 15 adolescentes; el 93 % fueron mujeres y la mediana de edad fue 18 años. El 86,6 % tuvo anorexia nerviosa. Los aspectos negativos percibidos más importantes fueron los malestares en la convivencia familiar (80 %) y la disconformidad con los contenidos de las redes sociales sobre la imagen corporal y dietas (73 %). Los aspectos percibidos positivos fueron la ayuda de los pares (66 %) y mejoras en relación con la alimentación (66 %). El principal cambio identificado en comparación con el tratamiento recibido previo a la pandemia por COVID-19 fue el seguimiento virtual por salud mental (73 %). Conclusión. La población adolescente con TCA durante el ASPO manifestó malestar en la convivencia familiar y disconformidad en los contenidos en redes sociales sobre imagen corporal y dietas. Aunque resaltaron como aspectos positivos la ayuda de los pares y mejoras en su alimentación

Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects.

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Resumo Este estudo analisa as histórias de vida de oito jovens vivendo com HIV por transmissão vertical, visando compreender suas percepções marcadas pelo segredo e silêncio sobre suas vivências com o vírus. Realizado em ambulatório especializado no Rio de Janeiro, o estudo adotou como ferramenta de cuidado a dança circular, considerada uma Prática Integrativa e Complementar em Saúde. Utilizando abordagem qualitativa e a História de Vida como método de coleta, o foco foi compreender as experiências dos jovens, não apenas relacionadas à doença, mas também a aspectos cruciais de suas vidas. Participaram do estudo três meninas e cinco meninos, todos cientes de seu diagnóstico. Os principais temas emergentes incluíram dinâmica familiar, conexão com o ambiente escolar, desafios na adesão ao tratamento, idade no momento da revelação do diagnóstico e tempo decorrido desde então. A análise das narrativas desses jovens, permitiu explorar aspectos individuais e sociais da experiência, revelando similaridades e diferenças entre eles. As oficinas de dança circular ofereceram um espaço lúdico para a expressão de emoções e sentimentos por meio dos movimentos corporais, ampliando as perspectivas dos jovens em relação ao futuro.

Abstract This study analyzes the life stories of eight young people living with vertically transmitted HIV in order to understand their perceptions marked by secrecy and silence regarding their experiences with the virus. Conducted at a specialized outpatient clinic in Rio de Janeiro, the study adopted circle dance, a Complementary and Integrative Health Practice, as a care tool. Using a qualitative approach and Life History as a data collection method, the focus was to understand the youth's experiences related to the disease and the crucial aspects of their lives. Three girls and five boys participated in the study, all aware of their diagnosis. The principal emerging themes included family dynamics, school environment connection, challenges in treatment adherence, age at the time of diagnosis disclosure, and time elapsed since then. Analyzing these young people's narratives allowed us to explore individual and social aspects of their experiences, revealing their similarities and differences. The circle dance workshops provided a playful space for expressing emotions and feelings through body movements, expanding young people's perspectives on the future.

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La actinomicosis pélvica es una infección poco común del tracto genital inferior y la pelvis. La especie causal más frecuente es la bacteria Actinomyces israelii, y se debe sospechar en toda paciente que presente dolor crónico pélvico y hemorragia uterina. Aunque se manifiesta excepcionalmente en mujeres sin antecedentes de portar dispositivos intrauterinos, es importante considerarla como diagnóstico. Se presenta el caso clínico de una paciente de 12 años con hemorragia uterina anormal resistente al tratamiento, que requirió intervención quirúrgica, incluyendo biopsia endometrial. El diagnóstico resultante fue actinomicosis endometrial. Este caso aporta la actualización del conocimiento sobre esta rara enfermedad y su presentación poco frecuente en adolescentes(AU)

Pelvic actinomycosis is a rare infection of the lower genital tract and pelvis. The most common causative species is the bacterium Actinomyces israelii, and it should be suspected in any patient who presents with chronic pelvic pain and uterine bleeding. Although it occurs exceptionally in women without a history of carrying intrauterine devices, it is important to consider it as a diagnosis. It is presented the clinical case of a 12-year-old patient with abnormal uterine bleeding resistant to treatment, which required surgical intervention, including endometrial biopsy. The resulting diagnosis was endometrial actinomycosis. This case contributes to updating knowledge about this rare disease and its uncommon presentation in adolescents(AU)

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SUMMARY: Underage drinking has become a major public concern having a negative impact on the growth and development of the skeleton. Peak bone mass is attained during adolescence hence the aim of the study was to investigate the effect of acute binge alcohol consumption on trabecular morphometry and tensile strength of the adolescent mandible in the Sprague Dawley (SD) rat. The study comprised of 24 SD rats, aged 7 weeks, placed into either the alcohol-exposed [n=12 (6 males and 6 female)] or pair-fed control group [n=12 (6 male and 6 female)]. The treatment of the groups was as follows; the alcohol exposed group and the pair-fed control were administered a single daily dose of 3 g/kg of 20 % alcohol 3 days a week (alternate days) for 7 days and a caloric equivalent dose of maltose dextrin via oral gavage, respectively. The animals were terminated on day 7 via pentobarbital injection. The mandibles were harvested and scanned using a Nikon XTH 255L 3D-microCT scanner (Nikon Metrology, Leuven, Belgium), and biomechanical tests were done using a Shimadzu universal tensile strength testing machine (China). Following scanning and reconstruction, the trabecular morphometry was assessed using Volume Graphics Studio® software. A 3-point bending test was used to evaluate the tensile strength of the bone. Findings from our study showed changes in some trabecular parameters in the female alcohol-exposed group, while the male groups remained unaffected. No changes in tensile strength were seen when comparing male pair-fed control and alcohol-exposed groups and when comparing female pair-fed control and alcohol-exposed groups. Trabecular and tensile strength differences were observed between the sexes when comparing male pair-fed control and alcohol-exposed groups to female pair-fed control and alcohol-exposed groups. These findings do suggest that acute binge alcohol consumption has detrimental effects on the bone micro-architecture in female alcohol-exposed rats and that differences are seen between the sexes.

El consumo de alcohol entre menores de edad se ha convertido en una importante preocupación pública que tiene un impacto negativo en el crecimiento y desarrollo del esqueleto. La masa ósea máxima se alcanza durante la adolescencia, por lo que el objetivo del estudio fue investigar el efecto del consumo excesivo de alcohol en forma aguda sobre la morfometría trabecular y la resistencia a la tracción de la mandíbula en ratas adolescente Sprague Dawley (SD). El estudio estuvo compuesto por 24 ratas, de 7 semanas de edad, colocadas en el grupo control expuesto al alcohol [n=12 (6 machos y 6 hembras)] y alimentado en parejas [n=12 (6 machos y 6 hembras)]. El tratamiento de los grupos fue el siguiente; al grupo expuesto al alcohol y al control alimentado en parejas se les administró una dosis única diaria de 3 g/kg de alcohol al 20 % 3 días a la semana (días alternos) durante 7 días y una dosis equivalente calórica de maltosa dextrina mediante sonda oral, respectivamente. Los animales fueron sacrificados el día 7 mediante inyección de pentobarbital. Las mandíbulas se recolectaron y se escanearon utilizando un escáner 3D-microCT Nikon XTH 255L (Nikon Metrology, Lovaina, Bélgica), y las pruebas biomecánicas se realizaron utilizando una máquina de prueba de resistencia a la tracción universal Shimadzu (China). Después del escaneo y la reconstrucción, la morfometría trabecular se evaluó utilizando el software Volume Graphics Studio®. Se utilizó una prueba de flexión de 3 puntos para evaluar la resistencia a la tracción del hueso. Los hallazgos de nuestro estudio mostraron cambios en algunos parámetros trabeculares en el grupo de hembras expuestas al alcohol, mientras que los grupos de machos no se vieron afectados. No se observaron cambios en la resistencia a la tracción al comparar los grupos control de machos alimentados en parejas y los grupos expuestos al alcohol y al comparar los grupos control de las hembras alimentadas en parejas y los grupos expuestos al alcohol. Se observaron diferencias trabeculares y de resistencia a la tracción entre los sexos al comparar los grupos control de los machos alimentados en parejas y expuestos al alcohol con los grupos de control de hembras alimentadas en parejas y expuestas al alcohol. Estos hallazgos sugieren que el consumo excesivo de alcohol tiene efectos perjudiciales sobre la microarquitectura ósea en ratas hembras expuestas al alcohol y que se observan diferencias entre los sexos.

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Abstract Objective: To estimate the prevalence of vitamin D deficiency and severe deficiency in children and adolescents, in a large Brazilian sample. Methodology: Results of 413,988 25(OH)D measurements in children and adolescents aged 0 to 18 years collected between 01/2014 and 10/2018 were obtained from the database of a Clinical Laboratory. In this population, 25 hydroxyvitamin D concentrations below 20 ng/mL are considered deficient, and below 12 ng/mL as severe deficiency. All measurements were performed by immunoassay and the results were distributed by gender, age group, seasonality, and latitude. Results: The mean of 25(OH)D levels was 29.2 ng/mL with a standard deviation of 9.2 ng/mL. Of the total samples, 0.8% had a concentration < 12 ng/mL, and 12.5% of the samples had a concentration < 20 ng/mL, with a higher prevalence in females. Children under 2 years of age had the lowest prevalence. The effects of latitude and seasonality were quite evident. In samples of female adolescents from the southern region in winter, 36% of vitamin D deficiency and 5% of severe deficiency were found. Conclusion: In this large number of measurements of 25(OH)D in children and adolescents, 12.5% had a deficiency and 0.8% had severe deficiency. A greater deficiency was observed among adolescents, especially females, which raises questions about the need for supplementation during this period of life.

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Abstract Objective: Suicide attempt (SA) is the strongest predictive variable for completed suicide. The Department of Cauca in Colombia has an SA rate higher than the national average, but the factors are unknown. The objective was to identify the profiles of SA in children and adolescents of Cauca. Methods: Cross-sectional study, which included all SA (Event-356) records from the SIVIGILA platform in children under 18 years of age between 2016 and 2019. The authors described the variables and multiple correspondence analysis (MCA) with the Burt method, according to the completeness of the data to establish the possible SA profiles using STATA 15.1, and R. The Ethics Committee at Universidad del Cauca approved it. Results: The study found 977 SA during this period, 72.4% female, 97.1% adolescent, 74.4% mestizo, 19.3% indigenous, 45.3% resided in municipalities exposed to the armed conflict, 32.3% expressed ideation and previous attempts, and 15.5% prior attempts. The MCA included 810 SA and identified three profiles: "Classic", which had mestizo adolescents with a history of prior SA, mental illness, or psychoactive substance use problems; "Related to the armed conflict", which included female adolescents with a first SA and residents in municipalities exposed to the armed conflict; "Ethnic" represented by male indigenous, with housing in a rural area. Conclusion: The SA profiles found in Cauca were "Classic", "Related to the armed conflict", and "Ethnic"; these can be considered to implement prevention strategies from a cross-cultural, mental health, and gender perspective, with the presence of the state in the territories.