Factors associated with medicine use and self medication are different in adolescents

OBJECTIVE: To estimate the prevalence of medicine use among high school students (14-18 years old) living in an urban area in Southern Brazil and the proportion who self-medicate and to explore the association between medicine use and demographic, socioeconomic, and behavioral variables. METHODS: A school-based survey was conducted among high school students in the city of Maringa/PR, Brazil in 2007. The sample students were selected through two-stage random sampling. The sample included 991 students (54.5% females) from eight public and four private high schools. The data were collected using a structured questionnaire. Only medications used within the 15 days preceding data collection were considered. The independent variables studied were sex, age, socioeconomic status, living with parents, employment status, smoking habits, and alcohol use. RESULTS: The prevalence of medicine use among the adolescents was 55.8% (females = 64.3%, males = 45.7%, p<0.001) and 52.6% of this use represented self medication (females = 51.0%, males = 56.8, p = 0.21). The factors associated with medicine use were age, employment, and smoking, while the factors associated with self medication were male gender and employment. Chronic users did not tend to self-medicate. CONCLUSION: The data from this study demonstrate a high prevalence of medicine use and self medication; however, the variables associated with medicine use and self medication differed. Urgent strategies to promote the rational use of drugs in this population and their families are necessary

PREVALÊNCIA DE LESÕES MUSCULOESQUELÉTICAS EM JOGADORES AMADORES DE FUTEBOL DE CAMPO

Este estudo verificou a prevalência de lesões na prática esportiva do futebol amador. A amostra foi constituída por 30 praticantes amadores do sexo masculino, com idade entre 18 e 35 anos. Foi aplicado o questionário adaptado de Kroef em forma de entrevista para verificar a ocorrência de lesões. Todos os jogadores sofreram alguma lesão relacionada ao futebol. No ano de 2015 a incidência total de lesões foi de 72%. A frequência de lesões em praticantes amadores de futebol é alta, principalmente entorse (45,2%) e distensão muscular (36,7%). Observar a frequência e os fatores associados às lesões pode mostrar o melhor caminho para o manejo da saúde dos praticantes, buscando sempre a prevenção de problemas osteomusculares

Potential biases in the classification, analysis and interpretations in cross-sectional study: commentaries – surrounding the article "resting heart rate: its correlations and potential for screening metabolic dysfunctions in adolescents"

Abstract\ud \ud Background\ud Resting heart rate reflects sympathetic nerve activity. A significant association between resting heart rate (HR) and all causes of cardiovascular mortality has been reported by some epidemiologic studies. Despite suggestive evidence, resting heart rate (RHR) has not been formally explored as a prognostic factor and potential therapeutic outcome and, therefore, is not generally accepted in adolescents.\ud \ud \ud Discussion\ud The core of the debate is the methodological aspects used in "Resting heart rate: its correlations and potential for screening metabolic dysfunctions in adolescents"; the points are: cutoff used for cluster RHR, two different statistical models used to analyze the same set of variables, one for continuous data, and another for categorical data; interpretation of p-value < 0.05, sampling process involving two random stages, analysis of design effect and the parameters of screening tests.\ud \ud \ud Summary\ud Aspects that must be taken into account for evaluation of a screening test to measure the potential for discrimination for a common variable (population with outcome vs. no outcome population), the main indicators are: sensitivity, specificity, accuracy, positive predictive value and negative predictive value. The measures of argumentation equality (CI) or difference (p-valor) are important to validate these indicators but do not indicate quality of screening

Association between sleep time and pro- and anti-inflammatory biomarkers is mediated by abdominal obesity among adolescents

Objectives: Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. Methods: This multicenter cross-sectional study included 3591 adolescents (aged 12-17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. Results: The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = -0.08; 95% confidence interval, -0.38 to -0.02) and anti- (adiponectin, β = -0.31; 95% confidence interval, -2.13 to -0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). Conclusion: Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators

Sampling and processing blood samples within the South American Youth/Child cARdiovascular and Environmental (SAYCARE) Study

Obesity and overweight in children and adolescents is increasing rapidly worldwide; however, scarce data have been reported from South America countries. With the purpose of assessing hyperlipidemia, insulin resistance and chronic inflammation, the evaluation of blood biomarkers such as glucose, lipoproteins and chronic inflammation proteins is required. In the context of the SAYCARE study, in children and adolescents (3 to 18 years) from seven South American cities, our aim was to assess the impact of pre analytical conditions on different biomarkers evaluated in 474 fresh serum samples, in different country centers. We also evaluated the stability according to time and frozen storage within this study across the concordance of the results obtained from the 49 blood samples measured in three different centers. Significant correlations as well as concordance were observed in TG, Total-C, HDL-C and glucose between Buenos Aires and São Paulo. The samples evaluated in Teresina and São Paulo presented similar results, with exception of total cholesterol. We observed acceptable concordance between Buenos Aires vs São Paulo and Teresina vs São Paulo, suggesting that samples could be processed in each of these centers. This concordance is a consequence of the strict pre analytical conditions previously established in the SAYCARE study

Prevalência de inatividade física e fatores associados em adolescentes

OBJETIVO: Estimar a prevalência de inatividade física em adolescentes (14 a 18 anos) da cidade de Maringá/PR e explorar sua associação com variáveis demográficas, socioeconômicas, comportamental e indicadores de estado nutricional. MÉTODOS: Estudo transversal com uma amostra representativa de escolares do ensino médio da cidade incluindo 991 (54,5% moças) de 12 colégios públicos e privados selecionados por meio de amostragem em múltiplos estágios. O nível de atividade física habitual foi verificado por meio do IPAQ modificado para adolescentes, usando como referência a última semana. A inatividade física foi definida 4 h/dia), estado nutricional e obesidade abdominal. RESULTADOS: A prevalência de inatividade física em adolescentes foi de 56,9% (moças= 57,9%, rapazes= 55,7%, p=0,46). Os fatores de risco associados à inatividade física foram pertencer ao nível socioeconômico mais baixo, estudar em escolas públicas e ser obeso. CONCLUSÃO: Encontramos uma alta prevalência de inatividade física no estudo. Faz-se urgentemente necessário o desenvolvimento de estratégias, que visem o aumento da atividade física, o que pode ser obtido por meio de desenvolvimento de conteúdos escolares que promovam estilos de vida saudável.OBJECTIVE: To estimate the prevalence of physical inactivity among adolescents (14-18 years) in the city of Maringá/PR and to explore its association with demographic, socioeconomic and behavioral, indicators of nutritional status variables. METHODS: Cross-sectional study with a representative sample of 991 adolescents (54.5% girls) from both public and private high schools selected through multi stage random sampling. The level of habitual physical activity was verified through the IPAQ modified for adolescents, using the last week as a reference period. Physical inactivity was defined as 4 h/d), nutritional status and abdominal obesity. RESULTS: Prevalence of physical inactivity among adolescents was 56.9% (girls = 57.9%, boys = 55.7%, p =. 046). The risk factors associated with physical inactivity were belonging to the lower socioeconomic level, studying at public schools and being obese. CONCLUSION: We found a high prevalence of physical inactivity in the study. It is urgently necessary to develop strategies aimed at increasing physical activity, which can be achieved by development of an educational content that promotes healthy life styles

Vitamins and iron blood biomarkers are associated with blood pressure levels in European adolescents. The HELENA study

[Objectives]: Previous research showed that low concentration of biomarkers in the blood during adolescence (i.e., iron status; retinol; and vitamins B6, B12, C, and D) may be involved in the early stages of development of many chronic diseases, such as hypertension. The aim was to evaluate if iron biomarkers and vitamins in the blood are associated with blood pressure in European adolescents.[Methods]: Participants from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (N = 1089; 12.5–17.5 y; 580 girls) were selected by complex sampling. Multilevel linear regression models examined the associations between iron biomarkers and vitamins in the blood and blood pressure; the analyses were stratified by sex and adjusted for contextual and individual potential confounders.[Results]: A positive association was found in girls between RBC folate concentration and systolic blood pressure (SBP) (β = 3.19; 95% confidence interval [CI], 0.61–5.77), although no association between the vitamin serum biomarkers concentrations and diastolic blood pressure (DBP) was found. In boys, retinol was positively associated with DBP (β = 3.84; 95% CI, 0.51–7.17) and vitamin B6 was positively associated with SBP (β = 3.82; 95% CI, 1.46–6.18). In contrast, holotranscobalamin was inversely associated with SBP (β = −3.74; 95% CI, −7.28 to −0.21).[Conclusions]: Levels of RBC folate and vitamin B6 in blood may affect BP in adolescents. In this context, programs aimed at avoiding high BP levels should promote healthy eating behavior by focusing on the promotion of vegetable proteins and foods rich in vitamin B12 (i.e., white meat and eggs), which may help to achieve BP blood control in adolescents.The HELENA Study was financially support by the European Community SixthRTD Framework Programme (contract FOOD-CT-2005-007034). The writing group takes sole responsibility for the content of this article. This study was also supported by a grant from the Spanish Ministry of Health: Maternal, Child Health and Development Network (number RD08/0072), grant from the Spanish Ministry of Education (EX-2008-0641; AP-2008-03806) and the Swedish Heart-Lung Foundation (20090635). ACdeM received scholarship from S~ao PauloResearch FoundationdFAPESP (proc. 2011/11137-1 and 2011/20662-2). LAM received scholarship of visiting professor from the Brazilian government by Science without Borders Program by CNPq (National Counsel of Technological and Scientific Development) and CAPES (Coordination of Improvement of Higher Education Personnel) (proc. 007/2012). The GENUD Research Group cofinancedby the European Regional Development Fund (MICINN-FEDER)Peer reviewe