Inquérito sobre a qualidade de vida relacionada à saúde em crianças e adolescentes portadores de artrites idiopáticas juvenis

Objective: to study the impact of chronic arthritis on health related quality of life by means of two self-reported tools: the parents' version of the Childhood Health Assessment Questionnaire (CHAQ) and the Childhood Health Questionnaire PF50® (CHQ). Methods: both tools were filled in after proper instructions by 36 parents, during 1-2 clinic visits. The Disability Index (CHAQ) and the Physical and Psychosocial scores (CHQ) were compared to the core set of outcome measures, namely 1) physician's global assessment, 2) parents' global assessment, both scored by 10 cm visual analogue scale, 3) number of joints with active arthritis, 4) number of joints with limited range of motion, 5) erythrocyte sedimentation rate. Results: there was significant difference for all measures of disease activity, being higher in the polyarticular as compared to oligoarticular except for erythrocyte sedimentation rate, parents' global assessment, and psychosocial score. This leads to different parents' perceptions of disease activity and outcome. The responsiveness of the outcome measures during two follow-up visits of patients receiving active treatment indicated better responsiveness of physicians' global assessment among the subjective measures, and intermediate responsiveness of the self-reported measures in comparison to the number of active and limited joints, and erythrocyte sedimentation rate. Conclusions: the responsiveness of two health related quality of life tools indicates their relative sensitivity for assessing clinical improvement during active treatment in Juvenile Idiopathic Arthritis patients. Copyright © 2003 by Sociedade Brasileira de Pediatria.

Oral manifestations during chemotherapy for acute lymphoblastic leukemia: A case report

A 14-year-old, male patient was referred for the treatment of mucositis, idiopathic facial asymmetry, and candidiasis. The patient had been undergoing chemotherapy for 5 years for acute lymphoblastic leukemia. He presented with a swollen face, fever, and generalized symptomatology in the mouth with burning. On physical examination, general signs of poor health, paleness, malnutrition, and jaundice were observed. The extraoral clinical examination showed edema on the right side of the face and cutaneous erythema. On intraoral clinical examination, generalized ulcers with extensive necrosis on the hard palate mucosa were observed, extending to the posterior region. Both free and attached gingivae were ulcerated and edematous with exudation and spontaneous bleeding, mainly in the superior and inferior anterior teeth region. The tongue had no papillae and was coated, due to poor oral hygiene. The patient also presented with carious white lesions and enamel hypoplasia, mouth opening limitation, and foul odor. After exfoliative cytology of the affected areas, the diagnosis was mixed infection by Candida albicans and bacteria. Recommended treatment was antibiotics and antifungal administration, periodontal prophylaxis, topical application of fluor 1.23%, and orientation on and control of proper oral hygiene and diet during the remission phase of the disease.

Comparison between protocols for the determination of anaerobic threshold in adolescent swimmers

Aim. The purpose of this study was to compare the anaerobic threshold speed (AT) obtained from fixed lactate blood concentrations (AT 4 mM and AT 3.5 mM), lactate minimum speed (LM) and critical speed (CS), determined from different distances in fifteen Brazilian national level swimmers (10 boys = 14.8 ± 0.6 years old and 5 girls = 14.6 ±0.8 year-old). Methods. The tests to determine the AT 4 mM, AT 3.5 mM, LM and CS were performed in a 25 m swimming pool and consisted of 7 or 8 evaluations separated by 24-48 h intervals. Data were submitted to analysis of variance (ANOVA) for repeated measures, followed by the post hoc Scheffé test and Pearson correlation coefficients. Significance was set at P<0.01. Results. There were no significant differences among the values for AT 4 mM and CS1 (1.34 ± 0.05 vs. 1.33 ± 0.05 m.s -1, respectively). However, AT 4 mM and CS1 were significantly higher than AT 3.5 mM (1.28 ± 0.04 m.s -1), LM (1.27 ± 0.05 m.s -1), CS2 (1.26 ± 0.06 m.s -1), CS3 (1.27 ± 0.06 m.s -1) and CS4 (1.25 ± 0.07 m.s -1). There were no significant differences among the values for AT 3.5 mM, LM, CS2, CS3 and CS4. Conclusion. The results obtained in this study suggest that the anaerobic threshold determined by a fixed lactate concentration of 3.5 mM, as well as the LM and the CS methods determined by different distances, seem to be the most appropriate indexes for the evaluation of aerobic capacity in adolescent swimmers.

Association of enamel microabrasion and dentinal bleaching in recovering an adolescent patient's smile: a case report

This article presents the enamel microabrasion protocol for removing intrinsic white stains of hard texture on the enamel surface, using a 37% phosphoric acid/pumice mixture associated with a carbamide peroxide-based bleaching agent in custom-made mouth trays. We observed that these clinical procedures were safe and effective, and solved our patient's esthetic problem. © 2010 Nova Science Publishers, Inc.

SED-brachydactyly and distinctive speech: Report of a new familial case

Background: Spondyloepiphyseal dysplasia-brachydactyly and distinctive speech (SED-BDS) is a syndrome characterized by short stature, disproportionately short limbs, peculiar face, thick and abundant hair, high-pitched and coarse voice, small epiphyses, brachymetacarpalia, brachymetatarsalia and brachy-phalangia of fingers and toes, small pelvis and delayed carpal bone age, among other features. Case Report: We report a Brazilian patient with father, brother and sister presenting with the same typical features of the syndrome. Clinically, he showed disproportionately short stature, rhizo-meso-acromelic shortness of the extremities, short hands and feet, a peculiar distinctive high-pitched voice, peculiar facies, and other features already reported as characteristic of this syndrome. Radiographic fndings included shape anomalies of the vertebral bodies such as cuboid-shaped vertebral bodies, mild scoliosis, short and broad tubular bones, brachymetacarpalia, brachymetatarsalia, and brachy-dactyly, lumbar hyperlordosis, generalized osteopenia, and hypoplastic iliac wings. Conclusions: Few cases have been described, as this is a rare skeletal dysplasia. This paper describes a new familial case of SED-BDS. © The American Journal of Case Reports.

Adolescent reproduction: the case of Chile and its policy implications

Includes bibliography

Sports injuries among adolescent basketball players according to position on the court

Background: The participation of children and adolescents in sports, including basketball, is becoming increasingly common, and this increased involvement raises concerns about the potential risk of sports injuries. Objective. To analyze the occurrence of sports injuries among young basketball players according to their position on the court and to associate these injuries with risk factors. Method. A retrospective, epidemiological study. A sample consisting of 204 basketball players with a mean age of 14.33 ± 1.19 years participated in the study. The players were interviewed using a reported condition questionnaire containing anthropometric and training data as well as information on injuries during the previous 12 months. Results: The frequency of injury was highest among the shooting guards (47.8%), followed by the centers (34.8%) and point guards (17.4%). Among the 204 participants, 40 players reported a total of 46 injuries, representing 0.22 injuries per participant and 1.15 injuries per injured participant. For the shooting guards and centers, statistically significant differences between injured and non-injured players were found related to age, weight, height, length of time in training and number of weekly practice hours (p < 0.05). For point guards, a statistically significant difference between injured and non-injured players was found based on weight alone (p < 0.05). Conclusion: The occurrence of injuries among basketball players was low. Injuries were associated with both intrinsic and extrinsic factors among shooting guards and centers, whereas injuries were only associated with weight among point guards. © 2013 Vanderlei et al; licensee BioMed Central Ltd.

Dinámica de la población y desarrollo en el Caribe: con especial énfasis en la fertilidad de adolescentes, migración internacional, política de población y planes de desarrollo = Population dynamics and development in the Caribbean: with special emphasis on adolescent fertility, international migration and population policy and development planning

Incluye Bibliografía

Validation of Relapse Risk Biomarkers for Routine Use in Patients With Juvenile Idiopathic Arthritis

Objective. The myeloid-related proteins 8 and 14 (MRP-8/MRP-14) and neutrophil-derived S100A12 are biomarkers of inflammation. They can be used to determine the relapse risk in patients with juvenile idiopathic arthritis (JIA) after stopping antiinflammatory treatment. In this study, we tested the performance of different enzyme-linked immunosorbent assays (ELISAs) in order to validate systems available for routine use.Methods. MRP-8/MRP-14 and S100A12 serum concentrations of 188 JIA patients in remission were analyzed. Commercially available test systems were compared to experimental ELISAs established in house. The ability of the assays to identify JIA patients at risk for relapse was analyzed.Results. For MRP-8/MRP-14, the PhiCal Calprotectin and Buhlmann MRP8/14 Calprotectin ELISAs revealed hazard ratios of 2.3 and 2.1, respectively. For S100A12, the CircuLex S100A12/EN-RAGE ELISA revealed a hazard ratio of 3.1. The commercial assays allowed a JIA relapse prediction that was at least comparable to the experimental ELISAs.Conclusion. For the prediction of JIA relapse after stopping medication, the biomarkers MRP-8/MRP-14 and S100A12 can be determined by using assays that are available for routine use. The tested commercial MRP-8/MRP-14 and S100A12 ELISAs showed a performance comparable to well-established experimental ELISA protocols when assay-specific cutoffs for the indication of relapse prediction are thoroughly applied.

Characteristics of sexual violence against adolescent girls and adult women

Background: Sexual violence is considered a serious violation of human rights which affects mainly young women and adolescents. There is little information about the conditions under which sexual offences occur. We evaluated characteristics of sexual violence against adolescent girls and adult women.Method: This is a quantitative, retrospective, descriptive study of sexual violence against adolescent girls and adult women. Analyses were carried out on data collected from 1118 women, 546 adolescents (10-19 years) and 572 adults (>= 20 years), with a complaint of rape treated at Hospital Perola Byington, Sao Paulo, between 1994 and 1999. The age limit of the adolescent sample met the World Health Organization's (WHO) criteria. We analyzed the type of sexual contact, degree of intimidation, perpetrator and activity of the victim during the approach.Results: Crimes without penetration were five times more frequent in adolescents and use of threats of death or intimidation was common in both groups. Mental illness was more prevalent in adult victims and the majority of adolescent victims were aged < 14 years. Uncle and stepfather perpetrators were more frequent among adolescents and partners or former intimate partners in adult women. In most cases the approach occurred in public places, although sex crimes at the perpetrator's residence were more frequent amongst adolescents.Conclusions: Although children and adolescents require the same intervention measures and legal protection, a considerable proportion of adolescent sex offenders can face conditions similar to those of adult women.

Probability of remission of juvenile idiopathic arthritis following treatment with steroid joint injection

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Optical coherence tomography evaluation of idiopathic macular hole treatment by gas-assisted posterior vitreous detachment

PURPOSE: To report a case of idiopathic macular hole, with vitreoretinal traction confirmed by optical coherence tomography that was successfully treated by a single intravitreous perfluoropropane (C3F8) gas bubble injection.METHODS: Case report. A 65-year-old patient with idiopathic macular hole (stage 2, one eye) received an intravitreous gas injection and was prospectively followed with optical coherence tomography.RESULTS: A complete posterior vitreous detachment was achieved within 6 weeks after gas injection. Visual acuity improved from 20/80 to 20/25 by 10 months of followup. Optical coherence tomography disclosed vitreoretinal traction release and macular hole closure. No complications were related to the procedure.CONCLUSION: This simple procedure can assist a complete posterior vitreous detachment with relief of the hyaloid-foveolar traction, facilitating macular hole closure. (C) 2001 by Elsevier Science Inc. All rights reserved.

Cardiovascular Complications following Chronic Treatment with Cocaine and Testosterone in Adolescent Rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)