Hair cortisol levels and mental health problems in children and adolescents exposed to victimization.

Youths who experience multiple forms of victimization are at a heightened risk for psychopathology across the lifespan. The hypothalamic-pituitary-adrenal (HPA) axis is a key target for the investigation of neurobiological changes induced by chronic stress and violence exposure. The measurement of hair cortisol concentration allows the investigation of long-term HPA activity and its association with victimization. The present study investigated the impact of exposure to polyvictimization in Latin-American children and adolescents on hair cortisol levels. We investigated association among cortisol, mental health problems and victimization. The study included 83 youths (mean age 10.84 years-old) from southern Brazil. We assessed self-reported victimization scores (Juvenile Victimization Questionnaire - JVQ-R2), mental health problems (Child Behavior Checklist - CBCL/6-18), and hair cortisol concentrations for the previous 30 days. The results showed an association between exposure to multiple forms of victimization and higher concentrations of hair cortisol; the results also showed that cortisol levels and mental health problems were associated with the severity of polyvictimization. These findings suggest that preadolescent victimization is associated with hyperactivation of HPA axis and with increased risk of mental health issues.

Diverticulite aguda / Acute diverticulitis

Objetivos: O objetivo deste estudo foi aprimorar o cuidado ao paciente com diverticulite aguda através de uma revisão da literatura relevante no tema, com foco em diagnóstico e manejo da condição. Métodos: Revisão de literatura, com consulta de artigos científicos no banco de dados PubMed e escolha de bibliografia por tempo de publicação inferior a 5 anos, estrutura em formato de guidelines e foco em diagnóstico e manejo. Resultados: A revisão apontou que a diverticulite possui maior prevalência a partir da 5ª década de vida e acomete mais comumente cólon sigmoide. A manifestação de dor em cólica na fossa ilíaca esquerda está presente em 70% dos pacientes, sendo que na agudização do quadro surgem sinais inflamatórios e irritação peritoneal. Outros sintomas frequentes são febre baixa e constipação. O diagnóstico normalmente é clínico, com exames complementares utilizados principalmente em quadros duvidosos e investigação de complicações da condição. O tratamento depende diretamente da presença de complicações, sendo este o fator determinante da escolha entre manejo conservador com analgesia e antibioticoterapia ou tratamento cirúrgico. Conclusões: Apesar do aprimoramento expressivo das diretrizes na última década, ainda é imperativa a busca de evidências mais robustas para o planejamento de tratamentos com o devido embasamento científico.

Aims: This study's objective was to improvethe healthcare of patients with acute diverticulitis, through a literature review of relevant scientific knowledge about this condition. Methods: A literature review was performed, with scientific articles searched in the PubMed Databases and bibliography chose according to publication date of 5 years or less, article structured in guideline format and with focus on diagnosis and available treatments. Results: The review indicated that diverticulitis has a higher prevalence at the fifth decade of life and affects more commonly the sigmoid colon. The manifestation of pain in left lower abdominal quadrant is present in 70% of the patients, with signs of peritoneal irritation. Other common symptoms are a low fever and constipation. The diagnosis is usually based on clinical signs, with complementary exams used mainly in doubtful cases and investigation of complications. Treatment depends directly on the presence of complications, which is the main factor for the choice between conservative treatment with analgesia and antibiotic therapy or surgery. Conclusions: Despite the improvement in guidelines during the last decade, it is important to continue the search for more evidence in order to plan clinical care with more robust scientific basis.