Maria Sylvia de Souza Vitalle

O conhecimento das adolescentes sobre questões relacionadas ao sexo

OBJECTIVE: To evaluate knowledge about sexuality, contraceptive methods and sexually transmitted diseases (STD) by female adolescents from both rural and urban zone attending public school. METHODS: A cross sectional study was made with 506 teenagers, 10 to 16 years old, attending Dr. Roberto Feijo Public School in Guararema, Sao Paulo. A semi-structured questionnaire with general questions about sexuality, contraceptive methods and STD was administered. The Chi-square test was used to verify the association between variables. RESULTS: Mean age of the girls from the rural zone was13 years and 11 months and from the urban zone age was 13 years and 7 months, with no statistical difference. Of all the girls, 31% came from the rural and 69% from the urban zone. Adolescents from the rural zone looked for more information about sexuality (81.2%) when compared to those from the urban zone (72.2 %) (p<0.0568). Parents were the main source of information for both zones. The condom was the most familiar method in the rural (44%) and the urban (45%) zones (p=0.0022). AIDS was the best known STD by girls from the rural (43%) and urban (39%) zones (p=0.7843). CONCLUSION: Most of the surveyed female adolescents sought information about sexuality, however their knowledge about STD and contraceptive methods was inadequate.

Body composition and nutritional profile of male adolescent tennis players

Abstract In this cross-sectional study, we evaluated the body composition and dietary intake of 44 adolescent tennis players. After being divided into two groups (age 10–13 years and age 14–18), the players had their weight, height, and sexual maturation assessed. Dual-energy X-ray absorptiometry was used to assess body composition. Food intake was obtained from a non-consecutive 4-day food record. The data were analysed using the Virtual Nutri v.1.0 software and compared with the present recommendations for adolescent athletes or dietary reference intakes. Body mass index and body fat for tennis practice were adequate for 89% and 71% of the tennis players respectively, regardless of age group. A calorie deficit greater than 10% of energy expenditure was observed in 32% of the sample. Fifty percent of the athletes consumed carbohydrates in accordance with recommended values. Protein and lipid intakes were above recommended values, while fibre, calcium, potassium, magnesium, and folic acid intakes were below recommendation for 98%, 80%, 100%, 100%, and 98% of the tennis players respectively. The observed nutritional deficiencies represent an additional barrier for adolescents engaged in competitive sports to achieve an optimum nutrition to maintain growth, health, and performance.

Analysis of the stimulated whole saliva in overweight and obese school children

OBJECTIVE To determine if some stimulated whole saliva parameters are influenced by an increase of Body Mass Index. METHODS Controlled cross-sectional study involving 90 school children of both genders between 7 and 10 years of age, from Bragança Paulista - SP. Three groups were formed: overweight, obese and control. Body Mass Index and diet intake by the Food Register method were evaluated. The salivary pH, flow rate, buffer capacity, protein, phosphate, calcium, fluoride, total and free sialic acid, and peroxidase activity were determined. RESULTS The overweight and obese groups showed greater energy and lipid intake (P< 0.001) than the control group. There was no difference in the saliva flow rate between groups, however only the control group showed a mean value considered normal. In the overweight and obese groups a decrease in both the concentration of phosphate (P< 0.001) and peroxidase activity (P<0.001) was observed. In the obese group an increase in the concentrations of free sialic acid (P= 0.004) and protein (P= 0.003) occurred. CONCLUSION Overweight and obese children show alterations in the concentrations of phosphate, free sialic acid and proteins, and in the peroxidase activity that are favorable conditions for dental caries.

Índice de massa corporal, desenvolvimento puberal e sua relação com a menarca

OBJECTIVE: age of menarche, nutritional status and the pubertal development were studied in a sample of low economic level adolescents. METHODS: retrospective study, collecting data from the register charts of 229 adolescents between 10 and 18.8 years of age, attended at primary level of public institution. Were collected: chronological age, age of menarche, body weight and height (from which the body mass index was calculated), and Tanners pubertal stage for breast development. Register charts of adolescents with pathological conditions compromising the occurrence of menarche were not taken into consideration. Two groups were formed, with and without the occurrence of menarche. RESULTS: the mean chronological age (p<0.001) and the body mass index (p<0.001) were greater in the group with menarche. The occurrence of menarche was at 12.1±1.1 years. There was significant difference between groups in relation to breast development, being the n of the group with menarche greater in M4 + M5 stages (p<0.001), and the group without menarche greater in M1 (p<0.001) and M2 (p<0.001) stages. An overweight (p<0.001) and obesity (p<0.001) relationship with the group with menarche was observed, and a relationship of undernutrition (p<0.001) and eutrophy (p<0.001) with the groups without menarche. CONCLUSIONS: an attentive follow-up of weight and height of adolescents before menarche, before the menarche period, in relatively precocious pubertal stages, is necessary to allow attitudes to prevent and control disorders such as obesity.OBJECTIVE Age of menarche, nutritional status and the pubertal development were studied in a sample of low economic level adolescents. METHODS Retrospective study, collecting data from the register charts of 229 adolescents between 10 and 18.8 years of age, attended at primary level of public institution. Were collected: chronological age, age of menarche, body weight and height (from which the body mass index was calculated), and Tanners pubertal stage for breast development. Register charts of adolescents with pathological conditions compromising the occurrence of menarche were not taken into consideration. Two groups were formed, with and without the occurrence of menarche. RESULTS The mean chronological age (p<0.001) and the body mass index (p<0.001) were greater in the group with menarche. The occurrence of menarche was at 12.1 +/- 1.1 years. There was significant difference between groups in relation to breast development, being the n of the group with menarche greater in M4 + M5 stages (p<0.001), and the group without menarche greater in M1 (p<0.001) and M2 (p<0.001) stages. An overweight (p<0.001) and obesity (p<0.001) relationship with the group with menarche was observed, and a relationship of undernutrition (p<0.001) and eutrophy (p<0.001) with the groups without menarche. CONCLUSIONS An attentive follow-up of weight and height of adolescents before menarche, before the menarche period, in relatively precocious pubertal stages, is necessary to allow attitudes to prevent and control disorders such as obesity.

[Iron, copper and zinc in adolescents during pubertal growth spurt].

OBJECTIVE To examine iron, copper and zinc nutritional status and their correlation with Body Mass Index (BMI), serum and dietetic levels in adolescents during the pubertal growth spurt. METHODS A descriptive cross-sectional study involving a sample of 47 adolescents out of 360 patients (19 boys, whose ages ranged from 12.3 to 16 years and 28 girls, whose ages ranged from 11.1 to 13.6 years), who were seen at a clinic for adolescents from March to December 1999. The variables analyzed were: Diet (24 hours Dietary Recall, Food Frequency Intake Questionnaire and Food Register Methods) to determine iron, copper and zinc intake; anthropometry (weight and height) to check BMI; biochemistry (measure of serum iron level through a Diagnóstica kit in vitro; ferritin through Immulite kit, and atomic absorption spectrophotometry for biochemical evaluation of serum iron, ferritin, copper and zinc. Spearman coefficient correlation was used for statistical analysis. RESULTS Forty seven adolescents during pubertal growth spurt showed adequate ingestion: iron (95% and 36%), copper (53% and 57%) and zinc (21% and 21%) in males and females, respectively. Most of them were eutrophic according to the BMI percentiles. Biochemically, boys presented normal values for serum iron and zinc in the whole sample, 95% for copper and 84% for ferritin. Girls also presented normal values for iron and zinc values in the whole sample, 96.4% for copper and 96% for ferritin. There were no statistically significant correlation between BMI and serum Fe, ferritin, Cu and Zn concentrations and between serum concentration and dietetic ingestion of the studied minerals, neither between serum iron and ferritin. CONCLUSIONS It is not clear if serum levels of Zn and Cu are floating during the growth process or if each adolescent has a stable level of these minerals during the pubertal growth spurt. Normal Fe, Cu and Zn serum levels in most adolescents evaluated may reflect the organism ability to accomplish homeostatic adjustments.

Anemia ferropriva e estado nutricional de crianças de creches de Guaxupé

OBJECTIVE: To evaluate the nutritional status and the prevalence of iron deficiency anemia in children attending public day care centers in the city of Guaxupe (MG), Brazil. METHODS: Children of both genders, from 6 to 72 months, registered in public day-care centers in the city of Guaxupe, were studied. Nutritional evaluation was conducted using the Z-score for height-to-age and weight-to-height relationships. Hemoglobin dosage, serum iron, total iron binding capacity and the transferrin saturation index were used for diagnosis of anemia. RESULTS: Z score < - 2 was observed in 3.3% of the children for the height-to-age relationship and of 0.4% for the weight-to-height relationship. Prevalence of total iron deficiency anemia was of 16.1%. In the age span from 6 to 36 months it was of 44.6%. The entire sample showed 45% with low serum iron, 37.9% with high total iron binding capacity and 43.1% with a low transferrin saturation index. CONCLUSION: Malnutrition was not considered to be a problem due to its low prevalence; however, an important prevalence of iron deficiency was observed. Iron deficiency anemia is more prevalent in children between 6 and 36 months confirming that this age span is more vulnerable. No association between iron deficiency anemia and the Z score of the studied anthropometry relationships was found.

Social anxiety score is high in adolescents with chronic migraine

Background:  Social anxiety disorder, also known as social phobia, is a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. It usually begins in mid‐adolescence and has a chronic course and interferes in academic, social, family and personal functioning. Recent studies have shown that social anxiety disorder is more prevalent in adults with migraine. Little evidence on this subject is available for the adolescent population.

Deficiência de ferro na criança

Iron deficiency anemia afflicts an estimated two billion people and iron deficiency approximately 4 billion people in developed countries and is even more common in developing countries. In Brazil, depending on the region and age, studies point to high prevalences of iron-deficiency anemia in children. The high growth speed, which requires a greater amount of iron, connected with an inadequate iron diet and early weaning contribute to the high prevalence, mainly within the first 2 years of life. Other risk factors, such as prematurity, low birth weight, early umbilical cord clamping and weaning from exclusive breastfeeding may contribute. The impact of iron deficiency on growth is controversial as several other variables contribute to improve or worsen the nutritional status. Alterations in the psychomotor and neural-cognitive development of infants with iron deficiency have been reported in various studies with the catch-up growth rate after treatment being controversial. Additionally, some studies have demonstrated a decrease in the intellectual development and cognitive acquisition in school age children and adolescents that is reverted after iron therapy. The best preventive measure is nutritional education, however due to the high prevalence of iron deficiency anemia, other measures should also be used as iron supplementation and food fortification with iron.

Direitos sexuais e reprodutivos na adolescência

OBJECTIVE: To present legal milestones to ensure the Brazilian adolescent autonomy indealing with their sexual and reproductive health. METHODS: Literature review of national legislation published on the official sites of governmental organs (Ministry of Health and Ministry of Education) and Class Associations (Federal Council of Medicine [Conselho Federal de Medicina - CFM] and the Federal Council of Nursing - COFEN). RESULTS: We found 8 legislations, of which 3 were from Class Associations (COFEN and CFM), one Interministerial Ordinance (Ministries of Health and Education), one Technical Note of the National STD/AIDS Program, and 3 Federal Laws. Many of the legal guarantees directly affect the adolescent population (guarantee of schooling during pregnancy and puerperal period or maternity leave, condom distribution, no discrimination in the school environment on the basis of serology). They are important tools for the preservation of sexual and reproductive rights, privacy of medical care, search for reliable health information, and access to inputs such as condoms and contraceptive methods. CONCLUSION: The analysis of the legislation listed in the present study demonstrated that these legal milestones are essential to ensure the safe and healthy experience of sexuality, and all health and education professionals involved in adolescent counseling should know them comprehensively.

Sleep terrors antecedent is common in adolescents with migraine

UNLABELLED Migraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs), 57 had chronic migraines (CMs) and 51 were control subjects (CG). Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.