De lo no-velado a la capacidad de novelar. La virtualidad en la clínica con adolescentes durante la pandemia / From the unveiled to de capacity to novelize. Virtuality in clinic with adolecent during the pandemic / Du non voilé à la capacité de romancier. La clinique avec les adolescents pendant la pandémie / Do ñao-velar á capacidade de novelar. A clínica com adolescentes durante a pandemia

El presente artículo aborda las consecuencias psíquicas en los adolescentes, del aislamiento social obligatorio durante la pandemia de Covid19. Un acontecimiento social que dio lugar a procesos creativos y patológicos. La virtualidad como herramienta tecnológica ha transformado las formas del lazo social y de la subjetividad, pero también ha permitido sostener una continuidad en los dispositivos de salud y de educación. En el caso de los tratamientos se modificaron los encuadres dando lugar a nuevas formas de atención, con sus particularidades en el trabajo clínico con adolescentes AU

This article is about the psychological consequences in Atdolescents of mandatory social isolation during the Covid19 pandemic. A social event that gave rise to creative and pathological processes. Virtuality as a technological tool has transformed the forms of social bond and subjectivity, but it has also made it possible to sustain continuity in health and education devices. In the case of treatments, the frames were modified, giving rise to new forms of care, with their particularities in clinical work with adolescents AU

Cet article aborde les conséquences psychologiques chez les adolescents de l'isolement social obligatoire pendant la pandémie de Covid19. Un événement social qui a donné lieu à des processus créatifs et pathologiques. Levirtualité comme outil technologique a transformé les formes de lien social et de subjectivité, mais elle a aussi permis de pérenniser les dispositifs de santé et d'éducation. Dans le cas des traitements, les cadres ont été modifiés, donnant lieu à de nouvelles formes de soins, avec leurs particularités dans le travail clinique avec les adolescents AU

Este artigo aborda as consequências psicológicas em adolescentes do isolamento social obrigatório durante a pandemia de Covid19. Um acontecimento social que deu origem a processos criativos e patológicos. A virtualidade como ferramenta tecnológica transformou as formas de vínculo social e subjetividade, mastambém possibilitou sustentar a continuidade dos dispositivos de saúde e educação. No caso dos tratamentos, os quadros foram modificados, dando origem a novas formas de cuidado, com suas particularidades no trabalho clínico com adolescentes AU

Estadios de Tanner y orquidometría de Prader en varones adolescentes. Estudio descriptivo transversal / Tanner stages and Prader orchidometry in male adolescents. A descriptive, cross-sectional study

Introducción. La escala de Tanner y el orquidómetro de Prader son los instrumentos más utilizados para evaluar el desarrollo puberal en los niños. La evaluación de la pubertad en la clínica solo es útil si se dispone de datos de referencia recientes y confiables de la misma población para comparar. Objetivo: evaluar la correlación entre los estadios de Tanner y el volumen testicular (VT) en adolescentes argentinos. Población y métodos. Diseño descriptivo transversal, realizado con varones saludables de 9 a 20 años de edad. Se excluyeron varones con patología urogenital y enfermedades que afectan el crecimiento testicular. La correlación entre estadios de Tanner y VT fue evaluada con pruebas no paramétricas. Resultados. Se evaluaron 367 varones con una edad de 13,8 ± 2,5 años. El VT aumentó en correlación a los estadios de Tanner (Spearman 0,943; p <0,001) con volúmenes significativamente diferentes, salvo en los estadios iniciales genital 1-2 (p 0,343) y vello púbico 1-2 (p 0,447). El 16 % (intervalo de confianza del 95 % 9,6-24,4 %; n = 17/106) de los varones peripuberales fue clasificado erróneamente basado en los estadios de Tanner. Conclusiones. Durante la pubertad masculina, el VT aumentó en correlación con los estadios de Tanner, pero no presentó diferencias significativas entre los estadios 1 y 2 de Tanner. Es fundamental el uso del orquidómetro de Prader para detectar el inicio puberal en varones.

Introduction. The Tanner scale and the Prader orchidometer are the instruments most commonly used to assess pubertal development in children. The assessment of puberty in the clinic is only useful if recent and reliable references in the same population are available for comparison. Objective: to assess the correlation between Tanner stages and testicular volume (TV) in Argentine adolescents. Population and methods. Study with a descriptive, cross-sectional design conducted in healthy boys aged 9­20 years. Male children and adolescents with urogenital conditions and disorders affecting testicular growth were excluded. The correlation between Tanner stages and TV was assessed using non-parametric tests. Results. A total of 367 male adolescents with an average age of 13.8 ± 2.5 years were assessed. TV increased in correlation to Tanner stages (Spearman: 0.943, p < 0.001) with significantly different volumes, except in the early genital 1-2 stages (p 0.343) and pubic hair 1-2 stages (p 0.447). Among peripubertal boys, 16% (95% confidence interval: 9.6­24.4%, n = 17/106) were wrongly classified based on Tanner stages. Conclusions. During male puberty, TV increased in correlation to Tanner stages, but no significant differences were observed between Tanner stages 1 and 2. Using the Prader orchidometer is critical to establish the onset of puberty in boys

The relationship between anthropometric variables and swimming efficiency in early pubescent female front crawl swimmers / Relación entre las variables antropométricas y la eficiencia de natación en nadadoras de estilo crol en la pubertad temprana

SUMMARY: The aim of this study was twofold. The first aim was to examine the association of anthropometric measures on kinematic characteristic which represent stroke efficiency in young female front crawl swimmers. The second aim was to create a prediction model which could provide help to swimming coaches with the purpose of easier and better selection of female front crawl swimmers by measuring and following basic morphological characteristics. Eighty female competitive swimmers all members of the swimming Clubs in province of Vojvodina, Serbia (age 12.52 ± 08 years, years of training involvement 4.05 ± 1.2 and personal best times over 50 m front crawl 32.79 ± 0.86 s) performed 50 m front crawl race. The 50 m front crawl swimming efficiency expressed through stroke index significantly was related to body height (r = 0.44, p = 0.000), body mass (r = 0.402, p = 0.000), sitting height (r = 0.612, p = 0.000) arm spam (r = 0.576, p = 0.000), biacromial diameter (r = 0.470, p = 0.000), bicrestal diameter (r = 0.348, p = 0.001) and with chest circumference (r = 0.427, p = 0.000). Regression equation for stroke index prediction was defined by following variables: body mass, sitting height, arm span, chest circumference with 43.5% explained variance. Additionally by analyzing obtained model the higher the values of SH, ARSP, CHICR and the lower values of BM in a group of early pubescent female swimmers the higher 50 m front crawl efficiency values will be.

Este estudio tiene dos objetivos principales. El primer objetivo fue examinar la asociación de las medidas antropométricas con las características cinemáticas que representan la eficiencia de la brazada en nadadoras jóvenes estilo crol. El segundo objetivo era crear un modelo de predicción que pudiera ayudar a los entrenadores de natación con el propósito de seleccionar mejor y más fácilmente a las nadadoras crol midiendo y siguiendo las características morfológicas básicas. Ochenta nadadoras competitivas, todas miembros de los clubes de natación en la provincia de Vojvodina, Serbia (edad 12,52 ± 8 años, años de participación en el entrenamiento 4,05 ± 1,2 y mejores tiempos personales en 50 m estilo crol 32,79 ± 0,86 s) realizaron una carrera de 50 m estilo crol. La eficiencia de nado crol de 50 m expresada a través del índice de brazada se relacionó significativamente con la altura del cuerpo (r = 0,44, p = 0,000), la masa corporal (r = 0,402, p = 0,000), la altura sentado (r = 0,612, p = 0,000) y el brazo. spam (r = 0,576, p = 0,000), diámetro biacromial (r = 0,470, p = 0,000), diámetro bicrestal (r = 0,348, p = 0,001) y con perímetro torácico (r = 0,427, p = 0,000). La ecuación de regresión para la predicción del índice de brazada se definió mediante las siguientes variables: masa corporal, altura sentada, extensión de los miembros superiores, circunferencia del pecho con una varianza explicada del 43,5 %. Además, al analizar el modelo obtenido, cuanto más altos sean los valores de SH, ARSP, CHICR y los valores más bajos de BM en un grupo de nadadoras púberes tempranas, mayores serán los valores de eficiencia de crol de 50 m.

A classification of genes involved in normal and delayed male puberty / 亚洲男科学杂志(英文版)

Puberty is a pivotal biological process that completes sexual maturation to achieve full reproductive capability. It is a major transformational period of life, whose timing is strongly affected by genetic makeup of the individual, along with various internal and external factors. Although the exact mechanism for initiation of the cascade of molecular events that culminate in puberty is not yet known, the process of pubertal onset involves interaction of numerous complex signaling pathways of hypothalamo-pituitary-testicular (HPT) axis. We developed a classification of the mechanisms involved in male puberty that allowed placing many genes into physiological context. These include (i) hypothalamic development during embryogenesis, (ii) synaptogenesis where gonadotropin releasing hormone (GnRH) neurons form neuronal connections with suprahypothalamic neurons, (iii) maintenance of neuron homeostasis, (iv) regulation of synthesis and secretion of GnRH, (v) appropriate receptors/proteins on neurons governing GnRH production and release, (vi) signaling molecules activated by the receptors, (vii) the synthesis and release of GnRH, (viii) the production and release of gonadotropins, (ix) testicular development, (x) synthesis and release of steroid hormones from testes, and (xi)the action of steroid hormones in downstream effector tissues. Defects in components of this system during embryonic development, childhood/adolescence, or adulthood may disrupt/nullify puberty, leading to long-term male infertility and/or hypogonadism. This review provides a list of 598 genes involved in the development of HPT axis and classified according to this schema. Furthermore, this review identifies a subset of 75 genes for which genetic mutations are reported to delay or disrupt male puberty.

Clinical and genetic analysis of a case of Turner syndrome with rapidly progressive puberty and a literature review / 中华医学遗传学杂志

OBJECTIVE@#To investigate the clinical features and genetic etiology of a case of Turner syndrome (TS) with rapidly progressive puberty.@*METHODS@#A child who had presented at the Pediatric Endocrinology Clinic of the Shenzhen People's Hospital on January 19, 2022 was selected as the study subject. Clinical data of the child were collected. Peripheral blood sample of the child was subjected to chromosomal microarray analysis (CMA) and multiple ligation-dependent probe amplification (MLPA). Previous studies related to TS with rapidly progressive puberty were retrieved from the CNKI, Wanfang Data Knowledge Service Platform, Boku, CBMdisc and PubMed databases with Turner syndrome and rapidly progressive puberty as the keywords. The duration for literature retrieval was set from November 9, 2021 to May 31, 2022. The clinical characteristics and karyotypes of the children were summarized.@*RESULTS@#The child was a 13-year-and-2-month-old female. She was found to have breast development at 9, short stature at 10, and menarche at 11. At 13, she was found to have a 46,X,i(X)(q10) karyotype. At the time of admission, she had a height of 143.5 cm (< P3), with 6 ~ 8 nevi over her face and right clavicle. She also had bilateral simian creases but no saddle nasal bridge, neck webbing, cubitus valgus, shield chest or widened breast distance. She had menstruated for over 2 years, and her bone age has reached 15.6 years. CMA revealed that she had a 58.06 Mb deletion in the Xp22.33p11.1 region and a 94.49 Mb duplication in the Xp11.1q28 region. MLPA has confirmed monosomy Xp and trisomy Xq. A total of 13 reports were retrieved from the CNKI, Wanfang Data Knowledge Service Platform, Boku, CBMdisc and PubMed databases, which had included 14 similar cases. Analysis of the 15 children suggested that their main clinical manifestations have included short stature and growth retardation, and their chromosomal karyotypes were mainly mosaicisms.@*CONCLUSION@#The main clinical manifestations of TS with rapidly progressive puberty are short stature and growth retardation. Deletion in the Xp22.33p11.1 and duplication in the Xp11.1q28 probably underlay the TS with rapid progression in this child, which has provided a reference for clinical diagnosis and genetic counselling for her.

Resolução de conflitos familiares por adolescentes e defesa do domínio pessoal / Adolescents' family conflict resolution and defense of personal domain / Resolución de conflictos familiares por adolescentes y defensa del dominio personal

Compreender as estratégias de resolução de conflitos utilizadas por adolescentes na relação com seus pais é fundamental para entender como ocorre seu desenvolvimento saudável. Este artigo investigou a resolução de conflitos de adolescentes em situações de confronto entre o seu domínio pessoal e o controle parental. 36 adolescentes com idades entre 15 e 17 anos, divididos igualmente conforme o sexo, responderam a uma entrevista semiestruturada, que continha quatro situações de conflito hipotéticas. Os dados foram submetidos à análise de conteúdo semântica e a testes não paramétricos. Os resultados foram categorizados em sete estratégias: Assunção de culpa, Submissão, Mentira, Hostilidade, Diálogo/Explicação, Negociação e Outra. A forma predominante de resolução utilizada foi o Diálogo/Explicação, considerada como uma forma recorrente de defender o domínio pessoal. Foram encontradas diferenças em relação ao sexo dos participantes e à situação hipotética. Por fim, os resultados são discutidos em termos de grau de autonomia e tipo de defesa do domínio pessoal.(AU)

Understanding the conflict resolution strategies used by adolescents in their relationship with their parents is fundamental to understanding how their healthy development occurs. This article investigated the resolution of conflicts by adolescents in confrontation situations between their personal domain and parental control. A total of 36 adolescents, aged 15 to 17 years, divided equally according to sex, answered a semi-structured interview that contained four hypothetical conflict situations. Data were subjected to semantic content analysis and non-parametric tests. The results were categorized into seven strategies: Assumption of Guilt, Submission, Lie, Hostility, Dialogue/Explanation, Negotiation, and Other. The predominant form of resolution used was Dialogue/Explanation, considered a recurrent form of defense of the personal domain. Differences were found depending on the participants' gender and the hypothetical situation. Finally, the results are discussed regarding the degree of autonomy and type of defense of the personal domain.(AU)

Enterarse de las estrategias de resolución de conflictos que los adolescentes utilizan en la relación con sus padres es fundamental para comprender cómo ocurre el desarrollo saludable de los adolescentes. A partir de una entrevista semiestructurada, presentamos cuatro situaciones hipotéticas de conflicto que fueron analizadas y respondidas por 36 adolescentes de entre 15 y 17 años, divididos según el género. Los datos se sometieron a un análisis de contenido semántico y a pruebas no paramétricas. Los resultados se categorizaron en siete estrategias de resolución de conflictos: Asunción de culpa, Sumisión, Mentira, Hostilidad, Diálogo/Explicación, Negociación y Otros. La forma de resolución más utilizada fue Diálogo/Explicación, y esta categoría fue una forma de defensa del dominio personal. Asimismo, se encontraron diferencias en función del género de los participantes y conforme la situación hipotética. Los resultados se discuten en términos de grado de autonomía y tipo de defensa del dominio personal.(AU)

Corpos de adolescentes e a função do olhar / Cuerpos adolescentes y función de la mirada / Adolescent bodies and the function of the gaze / Corps d'adolescents et fonction du regard

Este artigo coloca em perspectiva a questão do olhar e o processo de subjetivação da adolescência. O que significa ver e ser visto durante este momento tão particular da existência que é a adolescência? Durante as metamorfoses da puberdade, a questão do olhar sobre um corpo que se transforma e escapa ao sujeito pode ser uma fonte de angústia e, às vezes, leva o adolescente a escondê-lo ou exibi-lo. Com base em monografias escritas no decorrer de sua prática profissional enquanto professora de Educação Física do Ensino Médio francês (lycée), a autora revisita os três tempos da pulsão escópica para entender as dificuldades que os adolescentes têm para tecer novamente um imaginário diante do real da puberdade

Este artículo pone en perspectiva la cuestión de la mirada y el proceso de subjetivación adolescente. ¿Qué significa ver y ser visto en este momento tan particular de la existencia que es la adolescencia? Durante las metamorfosis de la pubertad, la cuestión de cómo mirar un cuerpo que se transforma y se escapa del sujeto puede ser fuente de ansiedad y a veces lleva al adolescente a ocultarlo o bien a exhibirlo. Basándose en monografías escritas en el curso de su práctica profesional como profesora de educación física profesora en la enseñanza secundaria francesa (lycée),la autora revisa las tres etapas del impulso escópico para comprender las dificultades que tienen los adolescentes para volver a tejer un mundo imaginario destrozado por la realidad del inicio de la pubertad

This article puts into perspective the question of the gaze and the process of adolescent subjectivation. What does it mean to see and be seen during this very particular moment of existence that is adolescence? During the metamorphosis that occurs at puberty, the gaze directed on a transforming body that slips away from the subject can be a cause of anxiety and sometimes leads the adolescent to hide or exhibit their body. Based on monographs written in the course of her professional practice in French secondary education (lycée), the author revisits the three stages of the scopic drive to understand the difficulties adolescents have in reweaving an imaginary world shattered by the reality of the onset of puberty

Cet article met en perspective la question du regard et le processus de subjectivation adolescent. Que veut dire voir et être vu lors de ce moment si particulier de l'existencequ'est l'adolescence? Suite aux métamorphoses de la puberté, la question du regard sur un corps qui se transforme et échappe au sujet peut être source d'angoisse et amène parfois l'adolescent à le cacher ou à l'exhiber. À partir de monographies rédigées au cours de sa pratique professionnelle d'enseignante d'EPS au lycée, l'auteure revisite les trois temps de la pulsion scopique pour comprendre les difficultés qu'ont les adolescents à retisser un imaginaire percuté par le réel de l'irruption pubertaire

Educação sexual: dificuldades dos pais de jovens com síndrome de down / Sex education: difficulties for parents of young people with down syndrome / Educación sexual: dificultades para los padres de jóvenes con síndrome de down

Com este estudo buscou-se conhecer as dificuldades e barreiras de pais na educação sexual de jovens com Síndrome de Down, a partir de uma pesquisa descritiva e de natureza qualitativa, utilizando-se o conceito das representações sociais como referencial teórico-metodológico. O estudo foi conduzido em uma Organização Não Governamental (ONG), localizada em Recife (PE), após aprovação do Comitê de Ética e Pesquisa, sob parecer consubstanciado 3.558.587. A amostra do estudo envolveu 11 pais de jovens com Síndrome de Down com idades entre 15 e 24 anos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. A abordagem escolhida para a interpretação desses dados foi a análise de conteúdo proposta por Bardin. Pode-se elencar como principais dificuldades enfrentadas pelos pais ao conversarem com seus filhos sobre sexualidade: a infantilização do jovem com Síndrome de Down, julgando-o incapaz de experienciar tais fenômenos e compreender a orientação que pudesse ser repassada; o medo em ultrapassar etapas e, de repente, "estimular" o filho a viver sua sexualidade de maneira "precoce"; e o fato de os pais também terem recebido pouca ou nenhuma orientação sexual por parte de suas famílias. Diante das narrativas dos pais, é possível perceber que ainda são muitos os mitos, tabus e preconceitos que permeiam a sexualidade dos jovens com Síndrome de Down, demonstrando que os responsáveis estão despreparados para dar as devidas orientações.(AU)

This study sought to know the difficulties and barriers of parents in the sexual education of young people with Down Syndrome, from a descriptive, qualitative study, using the concept of social representations as a theoretical-methodological framework. The study was conducted in a Non-Governmental Organization (NGO), located in Recife (PE) after approval by the Ethics and Research Committee, under substantiated opinion 3,558,587. The study sample involved 11 parents of young people with Down Syndrome aged between 15 and 24 years. The data collection was carried out by using semi-structured interviews. The approach chosen for interpretation of these data was the content analysis proposed by Bardin. The main difficulties faced by parents in talking with their children about sexuality can be listed as: the infantilization of young persons with Down Syndrome, deeming them incapable of experiencing such phenomena and understanding the guidance that could be given; the fear of overshooting the stages and, suddenly, "stimulating" the child to live their sexuality in an "early" way; and the facts of the parents also having received little or no sexual guidance from their families. Given the parents' narratives, it is possible to realize that there are still many myths, taboos, and prejudices that permeate the sexuality of young people with Down Syndrome, demonstrating that parents were unprepared to provide the right guidance.(AU)

Este estudio buscó conocer las dificultades y barreras de los padres en la educación sexual de los jóvenes con síndrome de Down a partir de un estudio descriptivo, cualitativo, que utilizó el concepto de representaciones sociales como marco teórico-metodológico. La investigación se llevó a cabo en una Organización No Gubernamental (ONG), ubicada en la ciudad de Recife (Pernambuco, Brasil), después de la aprobación del Comité de Ética e Investigación, bajo la opinión fundamentada 3.558.587. La muestra del estudio incluyó a 11 padres de jóvenes con síndrome de Down con edades comprendidas entre 15 y 24 años. La recolección de datos se realizó mediante entrevista semiestructurada. El enfoque elegido para la interpretación de los datos fue el análisis de contenido propuesto por Bardin. Pueden enumerarse como las principales dificultades que enfrentan los padres para hablar sobre la sexualidad con sus hijos: la infantilización del joven con síndrome de Down, considerándolo incapaz de experimentar tales fenómenos y comprender la orientación que se le puede dar; el miedo de ir más allá de las etapas y, de repente, "estimular" al niño a vivir su sexualidad de una manera "temprana"; y el hecho de que los padres también habían recibido poca o ninguna orientación sexual de sus familias. Dadas las narraciones de los padres, es posible darse cuenta de que todavía hay muchos mitos, tabúes y prejuicios sobre la sexualidad de los jóvenes con síndrome de Down, lo que muestra que los padres no estaban preparados para brindarles este tipo de orientación.(AU)

Complicaciones endocrinológicas del síndrome de down en pediatría: revisión de la literatura / Endocrine complications of Down syndrome in pediatrics: a review of the literature

El síndrome de Down constituye la cromosopatía más frecuente a nivel mundial y afecta 6,03 a 7,86 de cada 10.000 nacidos vivos en Colombia. Los pacientes pediátricos de este grupo poblacional presentan una mayor incidencia de complicaciones endocrinológicas comparados con la población general. El objetivo de este artículo es revisar las complicaciones endocrinológicas prevalentes en el paciente pediátrico con síndrome de Down, relacionadas con el hipocrecimiento, desarrollo puberal, patología tiroidea, diabetes mellitus, dislipidemias y obesidad; así como describir su seguimiento y tratamiento. Se realizó una búsqueda en la literatura desde agosto de 2020 hasta diciembre de 2021, en las bases de datos PubMed y Google Scholar; incluyendo un total de 44 publicaciones para la presente revisión. Se concluye que el paciente pediátrico con síndrome de Down evidencia un patrón de hipocrecimiento junto a un mayor riesgo de obesidad y sobrepeso. Adicionalmente, presenta con mayor frecuencia patología tiroidea y diabetes mellitus.

Down syndrome is the most common chromosomal disorder worldwide, affecting 6,03 to 7,86 per 10.000 live births in Colombia. Pediatric patients with Down syndrome have a higher incidence of endocrine disorders compared to the general population. The aim of this paper was to review the endocrinological manifestations prevalent in pediatric patients with Down syndrome related to small stature, pubertal development, thyroid dysfunction, diabetes mellitus, dyslipidemia, and obesity. Additionally, their follow-up and adequate treatment are described. A literature search was carried out from August 2020 to December 2021 in the PubMed and Google Scholar databases. A total of 44 publications were included for this review. It is concluded that pediatric patients with Down syndrome are more likely to have short stature and have a higher risk of obesity and overweight. In addition, thyroid dysfunction and diabetes mellitus are frequent complications.

Infancias y adolescencias en el game digital. Subjetivación en juego / Childhood and adolescence in the digital game. Subjectivation at stake / Enfance et adolescence dans le jeu numérique (game). Subjectivation en jeu / Infância e adolescência no jogo digital. Subjetivação em jogo

Este trabajo parte de un interrogante actual y acuciante: qué condiciones de subjetivación encuentran las infancias y adolescencias contemporáneas en el ambiente tecnológico. Tomando el jugar como hilo conductor por su valencia estructurante y considerando su derrotero en los contextos virtuales, se van examinando las posibilidades y las encerronas que niños y adolescentes tienen en la actualidad. Se emplea la distinción winnicottiana entre jugar (play) y juego (game) como modelo para examinar tanto la cualidad del hacer de niños y adolescentes con la virtualidad, como así también la propuesta cultural conectiva. Por último, se describe la configuración de un gameepocal destituyente del jugar y del lazo social y se propone restituir una política sobre el jugar como apuesta subjetivante, dado que sin creatividad y sin poder pensar con otros, resulta extremadamente difícil habitar un mundo tan tambaleante, complejo y disruptivo AU

This work is based on a current and pressing question, what conditions of subjectivation do contemporary childhoods and adolescentsfind in the technological environment. Taking play as a guiding thread due to its structuring valence and considering its course in virtual contexts, the possibilities and obstacles that children and adolescents have today are examined. The Winnicottian distinction between playing (play) and game (game) is used as a model to examine both the quality of children and adolescents doing with virtuality, as well as the connective cultural proposal. Finally, the configuration of an epochal game destituting playing and the social bond is described and it is proposed to restore a policy on playing as a subjectivizing bet, given that without creativity and without being able to think with others, it is extremely difficult to inhabit such a shaky world. complex and disruptive AU

Ce travail est basé sur une question actuelle et pressante, quelles conditions de subjectivationles enfances et les adolescents contemporains trouvent-ils dans l'environnement technologique. En prenant le jeu comme fil conducteur en raison de sa valence structurante et en considérant son déroulement dans des contextes virtuels, les possibilités et les obstacles que les enfants et les adolescents ont aujourd'hui sont examinés. La distinction winnicottienne entre playet gameest utilisée comme modèle pour examiner à la fois la qualité des enfants et des adolescents faisant avec la virtualité, ainsi que la proposition culturelle connective. Enfin, la configuration d'un jeu d'époque dénué de jeu et de lien social est décrite et il est proposé de restituer une politique du jeu comme pari subjectivant, étant donné que sans créativité et sans pouvoir penseravec les autres, il est extrêmement difficile d'habiter un monde si instable, complexe et perturbateur AU

Este trabalho parte de uma questão atual e premente, quais as condições de subjetivação que as infâncias e os adolescentes contemporâneos encontram no ambiente tecnológico. Tomando o brincar como fio condutor por sua valência estruturante e considerando seu percurso em contextos virtuais, examinam-se as possibilidades e os obstáculos que as crianças e adolescentes têm hoje. A distinção winnicottiana entre brincar (jogar) e jogo (jogo) é utilizada como modelo para examinar tanto a qualidade do fazer de crianças eadolescentes com a virtualidade, quanto a proposta cultural conectiva. Por fim, descreve-se a configuração de um jogo epocal que destitui o brincar e o vínculo social e propõe-se restaurar uma política do brincar como aposta subjetivante, pois sem criatividade e sem poder pensar com os outros é extremamente difícil habitar um mundo tão instável, complexo e perturbador AU

Effect of Chronic Altitude Hypoxia on Redox Balance in Preadolescents and Adolescents / Efectos de la hipoxia altitudinal crónica sobre el balance Redox de preadolescentes y adolescentes / Efeito da exposição crônica à hipóxia de altitude no equilíbrio oxidante/antioxidante de crianças e adolescentes

Living at high altitude increases oxidative stress. Likewise, growth and maturation during adolescence can increase levels of reactive oxygen species (ros). Changes in redox profiles have been evaluated in adults living at high altitudes; however, there are no studies on these changes in peripubertal populations living at moderate altitudes, we determine how living at moderate altitude affects the oxidative and inflammatory status of healthy preadolescents and adolescents. Materials and Methods: A cross-sectional study was conducted in healthy male Colombian preadolescents and adoles-cents (9­18 years old, Tanner scale classification) who lived at low altitude (n = 26) or moderate altitude (n = 26). Plasma oxidative and inflammatory status was assessed via spectrophotometry. Oxidative markers included malondialdehyde, 4-hydroxy-trans-2-nonenal, and carbonyl groups. Antioxidant markers included total antioxidant status, glutathione, catalase, superoxide dismutase, uric acid, and thiols. Inflammatory markers included interleukins-1, -6, and -10 and tumor necrosis factor. Results:Only uric acid levels were higher in adolescents (5.34 and 5.66 mg/dl) compared to preadolescents (3.85 and 4.07 mg/dl) in both moderate and low altitude groups, respectively. Participants who lived at mod-erate altitude presented significantly higher levels of malondialdehyde (4.82 and 3.73 nM/mg protein) and lower level of glutathione and thiols (1.21 and 1.26 µmol/mg protein) than in those at low altitude. Their inflammatory profiles did not differ. Conclusion: Oxidant profiles increased in peripubertal popu-lations residing at moderate altitude; this could be owing to antioxidant consumption by ros and active metabolism during puberty.

vivir en altura es un factor que se asocia con el estrés oxidativo. El crecimiento y la maduración pueden ser un estresor adicional. Es insuficiente la evidencia sobre alteraciones del perfil redox en peripúberes residentes a altitudes moderadas. El propósito fue establecer el efecto de vivir en una altitud moderada sobre el perfil redox e inflamatorio en preadolescentes y adolescentes sanos. Materiales y métodos: estudio transversal en varones preadolescentes y adolescentes sanos (9-18 años) que viven en altitud baja (n = 26) o altitud moderada (n = 26). El estado oxidativo plasmático se evaluó mediante espectrofotometría a través de marcadores de oxidación (malondialdehído e hidroxinonenal y grupos carbonilo) y antioxidantes (estado antioxidante total, glutatión, catalasa, superóxido dismutasa, ácido úrico y tioles). El perfil inflamatorio se midió con interleucinas 1, 6, 10 y factor de necrosis tumoral α. Resultados: solo el ácido úrico fue diferente entre adolescentes (5.34 y 5.66 mg/dl para moderada y baja altitud, respectivamente) y preadolescentes (3.85 y 4.07 mg/dl para moderada y baja altitud, res-pectivamente). El grupo de preadolescentes y adolescentes de moderada altitud presentó niveles más altos de malondialdehído (4.82 y 3.73 nM/mg de proteína, respectivamente) y menor glutatión y tioles (1.21 y 1.26 µmol/mg de proteína), en comparación con sus contrapartes de baja altitud. Conclusión: las poblaciones peripúberes que residen en una altitud moderada presentan un perfil oxidante más alto, lo que puede estar relacionado con la depleción de antioxidantes, por una mayor producción de especies reactivas de oxígeno relacionada con la hipoxia y el metabolismo activo de la pubertad.

viver em grandes altitudes é um fator de estresse associado ao estresse oxidativo. Durante a adolescência, os processos de crescimento e maturação podem aumentar as espécies reativas de oxi-gênio. Alterações no perfil redox foram estudadas em adultos expostos a grandes altitudes, mas não em populações peripubertais vivendo em altitudes moderadas. Nosso objetivo é estabelecer o efeito de viver em uma altitude moderada sobre o estado oxidativo e inflamatório em pré-adolescentes e adolescentes saudáveis. Materiais and métodos: foi realizado um estudo transversal em pré-adolescentes e adolescen-tes colombianos saudáveis (9-18 anos, na escala de classificação de Tanner) que viviam em baixa altitude (n = 26) ou altitude moderada (n = 26). O estado oxidativo e inflamatório do plasma foi avaliado por espectrofotometria: 1) Marcadores de oxidação: grupos Malondialdeído + 4-hidroxi-trans-2-nonenal e carbonila; 2) antioxidantes: estado antioxidante total, glutationa, catalase, superóxido dismutase, ácido úrico e tióis; 3) Marcadores de inflamação: interleucinas 1, 6, 10 e fator de necrose tumoral α. Resultados:apenas o ácido úrico foi maior em adolescentes (5,34 e 5,66 mg/dl) em comparação com pré-adolescentes (3,85 e 4,07 mg/dl) dos grupos de altitude moderada e baixa, respectivamente. A altitude moderada apre-sentou níveis significativamente maiores de Malondialdeído (4,82 e 3,73 nM/mg de proteína), e menores níveis de Glutationa e tióis (1,21 e 1,26 µmol/mg de proteína), em comparação com a baixa altitude. Nenhuma diferença foi detectada no perfil inflamatório. Conclusão: as populações peripubertais que residem em altitude moderada apresentam maior perfil oxidante, o que pode estar relacionado ao con-sumo de antioxidantes devido à maior produção de ros relacionada à hipóxia e ao metabolismo ativo por volta da puberdade.

¿Aislamiento social preventivo, o aislamiento endogámico? Acerca de sus efectos en los trabajos psíquicos de una adolescente durante la pandemia / Preventive lockdown or endogamous lockdown? Its effects on the psychic work of anadolescent during the pandemic / Isolement social préventif ou isolement consanguin? Sur ses effets sur le travail psychique d'unadolescent pendant la pandémie / Isolamento social preventivo ou isolamento endogâmico? Reflexões sobre seus efeitos no atendimento psicoterápico com uma adolescente durante a pandemia

La pandemia por COVID-19 llevó a un nuevo orden mundial. El afuera se convirtió en un espacio vedado, la premisa principal fue la convivencia absoluta con una familia o la soledad del hogar, aparecieron el temor al contagio y la muerte que nos comunicaban a diario. El aislamiento como condición llevó a la virtualidad como posibilidad de conectarnos con otros, de explorar desde dentro y de sobrellevar de algún modo el encierro. La virtualidad como dispositivo de encuentro atravesó todas las áreas, incluida la salud, mediante la teleconsulta o videollamada se sostuvieron los tratamientos o bien se iniciaron otros. En el presente trabajo se analizarán las sesiones virtuales con una joven que llega a tratamiento psicoanalítico por pedido de su madre, con el fin de entrecruzar la sintomatología que permite la apertura de una demanda propia y los trabajos psíquicos adolescentes desde el interior de su cuarto AU

The COVID-19 pandemic led to a new world order. The outside became a barred territory and the main premise was full-time coexistence with all the household members or a life in the solitude of the household. The fear of contagion and death appeared as a result of daily reports. Isolation as a condition led to virtual communication as a way to connect with others, to explore from the inside and somehow endure lockdown. The virtual realm as a meeting point was used across all areas, including healthcare ⎯oldtreatments continued and new treatments started through teleconsultations or video calls. The present paper analyzes the virtual sessions of a young girl starting psychoanalytic treatment at the request of her mother in order to intertwine the symptoms enabling a personal demand and adolescent psychic work from inside her room AU

La pandémie de COVID-19 a conduit à un nouvel ordre mondial. L'extérieur se convertit en un espace clos, la prémisse principale devenait la coexistence absolue avec une famille ou la solitude du foyer, laissant apparaitre quotidiennement la peur de la contagion et de la mort. L'isolement en tant que condition a conduit à la virtualité en tant quepossibilité de se connecter aux autres, d'explorer de l'intérieur et de faire face d'une manière ou d'une autre à l'enfermement. La virtualité comme dispositif de rencontre traversait tous les domaines, y compris celui de la santé : grâce à la téléconsultation ou à l'appel vidéo, certains traitements pouvaient être maintenus tandis que d'autres modalités pouvaient apparaitre.Dans le présent travail, les séances virtuelles avec une jeune femme qui vient en cure psychanalytique à la demande de sa mère seront analysées, afin de croiser la symptomatologie que permet l'ouverture de son propre processus et le travail psychique adolescent depuis l'intérieur de sa chambre AU

A pandemia da COVID-19 levou a uma nova ordem mundial. A vida externa virou espaço proibido, a prioridade principal foi a convivência absoluta com a família ou a solidão da casa. Aparecerem o temor ao contágio e a morte que nos comunicavam diariamente. O isolamento como condição fez com que a virtualidade se tornasse possibilidade de conectarmos com os outros, de explorarmos a vida a partir de dentro e de suportarmos de algum modo o fato de estarmos isolados. O envolvimento virtual por meio de plataformas de comunicação digital abrangeu todas as áreas, incluindo a saúde: mediante as consultas online e as vídeos chamadas, alguns continuaram os tratamentos, outros iniciaram naquele novo formato. No presente trabalho são analisadas as sessões virtuais com uma adolescente que iniciou o tratamento psicanalítico a pedido de sua mãe, entrelaçando a sintomatologia que permite a abertura de uma demanda própria e os trabalhos psíquicos adolescentes desde o interior de seu quarto AU

Relationship between body mass index and sexual development in Chinese children / 中华儿科杂志

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.

Sexo, estadiamento puberal, hábitos alimentares e de vida e desfechos clínico-nutricionais na saúde adolescente / Sex, pubertal stage, eating and lifestyle habits and clinical-nutritional outcomes in adolescent health

Objetivo: Avaliar a associação entre sexo, variáveis sociodemográficas, maturacionais, alimentares e de estilo de vida e desfechos clínico-nutricionais. Métodos: Estudo transversal com 232 adolescentes entre 12 e 19 anos do projeto Camelia, realizado em Niterói, Rio de Janeiro, em 2006 e 2007, pela Universidade Federal Fluminense. Os participantes foram submetidos a questionário, consulta médica, mensuração da pressão arterial, coleta de sangue e urina, avaliação antropométrica, maturacional e nutricional. Modelos de regressão linear e logística foram utilizados para avaliar a associação entre o sexo, variáveis sociodemográficas, hábitos alimentares e estilo de vida com os desfechos: Índice de Massa Corporal (IMC), % de Gordura Corporal (%GC), lipoproteína de baixa densidade (LDL); glicemia, colesterol e pressão arterial, segundo o estadiamento puberal. Resultados: Hábitos saudáveis como o consumo semanal de feijão igual ou superior a cinco vezes impactaram positivamente no IMC, %GC, LDL, e no colesterol e glicose (até 2 vezes ao dia) (ambos no estadiamento puberal inicial); e o consumo de frutas (duas a três vezes por dia), e vegetais (três ou mais vezes por dia) no colesterol (no estadiamento puberal avançado). Hábitos deletérios como o consumo de açúcar ou refrigerantes ou sucos industrializados maior ou igual a 3 colheres de sobremesa ou 2 vezes ao dia ou 5 vezes na semana foram associados a piora do LDL, da glicemia (no estadiamento puberal inicial), do colesterol (em ambos estadiamentos) e da pressão arterial (no estadiamento puberal avançado), assim como despender 2 ou mais horas por dia em atividades sedentárias da glicemia (no estadiamento puberal inicial). A escolaridade materna fundamental associou se a glicemias superiores (no estadiamento puberal inicial) e a renda per capita intermediária à redução do LDL e do colesterol (no estadiamento puberal avançado). A omissão do almoço e do desjejum ocasionaram aumentos no IMC e %GC, e no LDL, respectivamente. E almoçar fora de casa (no estadiamento puberal inicial) e o consumo de frituras maior ou igual a 5 vezes por semana (no estadiamento puberal avançado) a níveis pressóricos mais altos. O sexo se associou à glicemia, colesterol e pressão arterial, somente no estadiamento puberal avançado, sendo desfavorável para o sexo masculino, nos desfechos glicemia (exceto filhos de mães com escolaridade igual ou superior ao 1º ano do ensino médio e, principalmente, nos mais sedentários e nos consumidores de suco industrializado em frequências iguais ou superiores a cinco vezes na semana) e pressão arterial; e para o sexo feminino no colesterol (exceto nas que consumiam frutas duas a três vezes por dia). Conclusão: O consumo de feijão despontou como hábito alimentar relevante para a saúde dos adolescentes, podendo este ser considerado uma "proxy" de alimentação saudável, ao passo que hábitos característicos de dietas e estilo de vida não saudáveis impactaram negativamente, mostraram-se sexualmente assimétricos e se intensificaram com o tempo, indicando que a prevenção deve ocorrer ainda nas idades iniciais da adolescência e deve considerar as diferenças inerentes ao sexo.

Investigating the association of individuals' sex, sociodemographic, maturational, dietary and lifestyle variables with clinical and nutritional outcomes. Methods: Cross-sectional study conducted with 232 adolescents in the age group 12-19 years, who participated in the Camelia project that was carried out by Fluminense Federal University, in Niterói County, Rio de Janeiro State, in 2006 and 2007. Participants were subjected to questionnaire application, medical consultation, blood pressure measurement, blood and urine sample collection, as well as to anthropometric, maturational and nutritional assessment. Linear and logistic regression models were used to assess the association of individuals' sex, sociodemographic variables, eating habits and lifestyle with the following outcomes: Body Mass Index (BMI), Body Fat % (BF%), low-density lipoprotein (LDL), blood glucose, cholesterol and blood pressure, based on pubertal stage. Results: Healthy habits, such as intake of beans equal to, or higher than, five times a week, had positive impact on BMI, BF%, LDL, as well as on cholesterol and glucose levels (up to 2 times a day) (both at initial pubertal stage); whereas fruits (two to three times a day) and vegetables' (three, or more, times a day) intake had positive impact on cholesterol levels (at advanced pubertal stage). Deleterious habits such as the intake of sugar, soft drinks or industrialized juices, at amounts higher than, or equal to, 3 dessert spoons or 2 times a day or 5 times a week were associated with worsened LDL, blood glucose (at initial pubertal stage), cholesterol (at both pubertal stages) and blood pressure (at advanced pubertal stage), as well as spending 2, or more, hours a day in sedentary activities was associated with worsened blood glucose (at initial pubertal stage). Primary maternal schooling was associated with higher blood glucose levels (at initial pubertal stage) and intermediate income per capita was associated with reduced LDL and cholesterol levels (at advanced pubertal stage). Skipping lunch and breakfast led to increased BMI and BF%, as well as to increased LDL, respectively. Having lunch out (at initial pubertal stage) and fried food intake higher than, or equal to, 5 times a week (at advanced pubertal stage) were associated with increased blood pressure. Sex was only associated with blood glucose, cholesterol and blood pressure at advanced pubertal stage; male participants recorded unfavorable blood glucose (except for children from mothers with schooling equal to, or higher than, the 1st year of high school; and mainly in the most sedentary individuals and in those who consumed industrialized juice at frequency equal to, or higher than, five times a week) and blood pressure outcomes; whereas female participants recorded unfavorable cholesterol outcome (except for those who consumed fruit two to three times a day). Conclusion: The intake of beans has emerged as relevant food habit for adolescents' health; thus, it can be considered a "proxy" of healthy eating, whereas habits typical of unhealthy diets and lifestyles had negative impact on participants' health. These habits were sexually asymmetrical and got worse overtime, which indicated the need of taking preventive measures in early adolescence to avoid the development of such habits by taking into account differences inherent to sex.

Disruptores endócrinos: interações com o meio ambiente e puberdade / Endocrine disruptors: interactions with the environment and puberty

Este estudo tem como objetivo apresentar substâncias conhecidas como disruptores endócrinos e suas possíveis interferências no desenvolvimento puberal das meninas. Trata-se de uma revisão da literatura feita a partir do levantamento e análise de 37 referências bibliográficas nas quais os autores chamam a atenção para as diversas formas de absorção de produtos ricos em componentes desequilibradores hormonais que, por ação conjunta e prolongada, interferem no sistema endócrino, promovendo antecipação no desenvolvimento dos caracteres sexuais secundários. Concluiu-se que a exposição a inúmeros agentes disruptores presentes no dia a dia das meninas, por ação prolongada e acumulativa, pode promover uma antecipação na maturação dos caracteres sexuais secundários.(AU)

This study aims to present substances known as endocrine disruptors and theirpossible interference in girls puberal development. This is a systematic review of the literaturebased on the survey and analysis of 37 bibliographical references in which the authors drawattention to the multiple ways of absorption of products rich in hormonal imbalancecomponents that by combined and prolonged action, interfere in the endocrine system, promoting anticipation in the development of secondary sexual characteristics. In conclusion, the exposure to numerous disrupting agents present in the daily lives of girls, by prolonged andcumulative action, can promote an anticipation in the maturation of secondary sexual characteristics.(AU)

Growth hormone deficiency and the transition from pediatric to adult care

Abstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.