[Epidemiology of Internet Use by an Adolescent Population and its Relation with Sleep Habits]. / Epidemiologia do Uso de Internet numa População Adolescente e Sua Relação com Hábitos de Sono.

INTRODUCTION: In the last decades, the great technological development increased Internet popularity, emerging the concern about its overuse. The objectives of this study were to assess and characterize Internet use in adolescence, determine Internet addiction and clarify its association with sleep disorders and excessive daytime sleepiness. MATERIAL AND METHODS: It was performed an observational, cross sectional and community-based study. The target were students attending 7th and 8th grades, to whom was applied an online self-report questionnaire to assess sociodemographic features, Internet use, Internet dependence, sleep characteristics and excessive daytime sleepiness. RESULTS: A total of 727 adolescents were included with a mean age 13 ± 0.9 years. Three-quarters of teenagers use Internet daily and 41% do it for three or more hours/day, mainly at home. The phone and laptop were the main devices used. Online games and social networks use were the main activities performed. Internet dependence was observed in 19% of adolescents, and it was associated with male gender, social networks use, mainly Twitter and Instagram use, self-perceived sleep problems, initial and middle insomnia and excessive daytime sleepiness (p < 0.05). DISCUSSION: The results confirm the highlight that Internet has in adolescents routine, who prioritize in their use access to social networks and online games, using single devices, less subject to parental control. CONCLUSION: The Internet addiction rate observed and its association with sleep alterations and daytime sleepiness emphasizes the importance of this issue.

Introdução: A grande evolução tecnológica das últimas décadas tornou a Internet cada vez mais popular, sendo crescente a preocupação com a sua utilização excessiva. Foram objetivos do presente trabalho aferir e caracterizar o uso de Internet na adolescência, determinar a dependência de Internet e estabelecer a sua associação com alterações do sono e sonolência diurna excessiva. Material e Métodos: Foi realizado um estudo de base comunitária, observacional e transversal dirigido a adolescentes a frequentar o sétimo e oitavo ano de escolaridade. Recorreu-se a um questionário de autopreenchimento online, para aferir características sociodemográficas, uso e dependência de Internet, características do sono e sonolência diurna excessiva. Resultados: Foram incluídos 727 adolescentes com idade média de 13 ± 0,9 anos. Três quartos dos adolescentes usa a Internet diariamente e 41% fá-lo durante três ou mais horas/dia, maioritariamente em casa. O telemóvel e o computador portátil são os principais dispositivos utilizados. Os jogos online e o uso das redes sociais são das principais atividades realizadas. A dependência de Internet foi observada em 19% dos adolescentes, associando-se ao género masculino, à utilização de redes sociais, o Twitter e Instagram, à autopercepção de problemas de sono, insónia inicial e intermédia e sonolência diurna excessiva (p < 0,05). Discussão: Os resultados reiteram o destaque que a Internet tem na rotina dos adolescentes, que priorizam o seu uso no acesso a redes sociais e jogos online, fazendo-o com dispositivos de uso individual, menos passíveis de controlo parental. Conclusão: A dependência de Internet verificada e associação com alterações do sono e sonolência diurna excessiva enfatiza a relevância desta problemática.

Acute Acalculous Cholecystitis by Epstein-Barr Virus Infection: A Rare Association.

Acute acalculous cholecystitis (AAC) is a rare complication of Epstein Barr virus (EBV) infection, with only a few cases reported among pediatric population. This clinical condition is frequently associated with a favorable outcome and, usually, a surgical intervention is not required. We report a 16-year-old girl who presented with AAC following primary EBV infection. The diagnosis of AAC was documented by clinical and ultrasonographic examination, whereas EBV infection was confirmed serologically. A conservative treatment was performed, with a careful monitoring and serial ultrasonographic examinations, which led to the clinical improvement of the patient. Pediatricians should be aware of the possible association between EBV and AAC, in order to offer the patients an appropriate management strategy.

[Breast cancer at Pico Island (1998-2008): an epidemiological perspective]. / Cancro da mama na ilha do pico (1998-2008): uma perspectiva epidemiológica.

INTRODUCTION: Neoplasic disease has been assuming an increasingly relevant role in the world's public health. Breast cancer is the most common cancer and the second cause of death by neoplasia in women. In the Portuguese population, breast cancer is the main cause of death by neoplasia in females. Among the Azorean women, the most frequently diagnosed malignant tumor is breast cancer, Pico Island being the third in terms of cancer incidence in the region. The risk factors are well known, well established and some of them can be prevented. Despite the great incidence of breast cancer, in the general population, particularly among the youngest, the knowledge about the disease is quite limited. The aims of this study are to characterize and identify the risk factors of women with breast cancer diagnose between 1998 and 2008 residing in Pico's island and, simultaneously to evaluate the knowledge of the students in Pico island about this disease. METHODS AND POPULATION: The method used for the gathering of the data in both cases was an anonymous and confidential questionnaire. In study 1 the questionnaire was conducted by an interviewer after the women's consent. Study 2 was performed in the three secondary schools of Pico island. RESULTS: The incidence rate of breast cancer in Pico island women is higher than the national incidence rate. There was an enormous variability in the incidence rates calculated for each year, with no clear tendency. The main responsible for the appearance of breast cancer in this population could be a conjugation of factors and not only a single isolated factor. The risk factors that stand out are: sedentariness (71.4%), family history (47.6%) and obesity (44.4%). The 295 students interviewed aged between 15 and 21 years. Of the total, 43 had relatives with breast cancer, however the majority (56.3%) assumes to be little informed about this disease. CONCLUSIONS: Through study 1 we conclude that there is a combination of hereditary and environmental risk factors, modifiable and non modifiable risk factors that may contribute to the onset of breast cancer. It is important to encourage changes in the life style of the women and rising of awareness towards risk factors. For the study of the student population, we conclude that the students have a very limited degree of knowledge of the disease; however, they assumed the will to more information, which leaves an open door for future formation and awareness actions.