OBJECTIVE: This was a systematic review and meta-analysis of the prevalence of thromboembolic events in children and adolescents with antiphospholipid syndrome (APS).
METHODS: We searched PubMed, EMBASE and Web of Science to select relevant articles published between 1 January 2000 and 27 February 2022. We used the random-effects meta-analysis to estimate pooled point prevalence rates of thromboembolic events in studies with a minimum sample size of 30.
RESULTS: We included five studies reporting data of 336 children and adolescents with primary APS and secondary APS (SAPS). Pooled point prevalence rates of initial general thrombosis, arterial thrombosis, venous thrombosis and stroke in individuals with seropositive APS were 98.2% (95% confidence interval [CI] 87.5-100), 27.6% (95% CI 21.4-34.2), 51.1% (95% CI 38.2-63.9) and 13.4% 95% CI (6.3-22.7), respectively. Pooled point prevalence rates of initial arterial and venous thromboses in children and adolescents with SAPS were 45.7% (95% CI 21.1-71.6) and 29.2% (95% CI 14.8-46), respectively.
CONCLUSIONS: Arterio-venous thromboembolism is highly frequent in children and adolescents with SAPS. More studies using thrombotic and non-thrombotic APS classification criteria are warranted to better assess the frequency and predictors of thromboembolism in age- and ancestry-diverse pediatric populations affected by different types of APS.

OBJECTIVE: To assess the knowledge of adolescent girls and young women on pelvic-perineal disorders (PPD).
METHODS: We searched on PubMed, Cochrane Library, Kinédoc and Semantic Scholar databases using the MeSH keywords: \"knowledge\" \"awareness\" \"surveys\" \"young women\" \"pelvic floor\" \"adolescent\" \"teenager\" \"athletic injury\" \"urinary incontinence\". The articles had to have been published within the last 15 years, written in French or English, and deal with the state of knowledge of adolescents and young women concerning the perineal sphere using questionnaires.
RESULTS: A total of 8 studies were included in the review, 5 cross-sectional studies and 3 intervention studies. The knowledge of adolescent girls and young women interviewed about the anatomy of the pelvic floor, its function, and risk factors for PPD was low. The majority of the participants wanted more information about the pelvic floor. Two studies that conducted an educational intervention showed a significant improvement in knowledge.
CONCLUSIONS: Knowledge of pelvic-perineal disorders and pelvic floor function is poor in adolescent girls and young women. To better assess them, it would be necessary to validate a questionnaire containing all the items about knowledge.

BACKGROUND: Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal drug adverse reaction. There are still few studies of this entity in the child-adolescent population.
OBJECTIVE: Describe the clinical, laboratory and therapeutic characteristics of children and adolescent patients with NMS. Analyse the grouping of symptoms present in NMS in the same population.
METHODS: A MEDLINE/PubMed search of all reported cases of NMS from January 2000 to November 2018 was performed and demographic, clinical, laboratory and therapeutic variables were identified. A factorial analysis of the symptoms was performed.
RESULTS: 57 patients (42 males and 15 females) were included, (mean age 13.65 ± 3.89 years). The onset of NMS occurred at 11.25 ± 20.27 days with typical antipsychotics and at 13.69 ± 22.43 days with atypical antipsychotics. The most common symptoms were muscle stiffness (84.2%), autonomic instability (84.2%) and fever (78.9). The most common laboratory findings were CPK elevation and leucocytosis (42.1%). The most used treatment was benzodiazepines (28.1%). In the exploratory factorial analysis of the symptoms we found 3 factors: 1) \"Catatonic\" with mutism (0.912), negativism (0.825) and waxy flexibility (0.522); 2) \"Extrapyramidal\" with altered gait (0.860), involuntary abnormal movements (0.605), muscle stiffness (0.534) and sialorrhoea (0.430); and 3) \"Autonomic instability\" with fever (0.798), impaired consciousness (0.795) and autonomic instability (0.387).
CONCLUSIONS: NMS in children and adolescents could be of 3 types: catatonic, extrapyramidal and autonomic unstable.

BACKGROUND: Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal drug adverse reaction. There are still few studies of this entity in the child-adolescent population.
OBJECTIVE: Describe the clinical, laboratory and therapeutic characteristics of children and adolescent patients with NMS. Analyse the grouping of symptoms present in NMS in the same population.
METHODS: A MEDLINE/PubMed search of all reported cases of NMS from January 2000 to November 2018 was performed and demographic, clinical, laboratory and therapeutic variables were identified. A factorial analysis of the symptoms was performed.
RESULTS: 57 patients (42 males and 15 females) were included, (mean age 13.65±3.89 years). The onset of NMS occurred at 11.25±20.27 days with typical antipsychotics and at 13.69±22.43 days with atypical antipsychotics. The most common symptoms were muscle stiffness (84.2%), autonomic instability (84.2%) and fever (78.9). The most common laboratory findings were CPK elevation and leucocytosis (42.1%). The most used treatment was benzodiazepines (28.1%). In the exploratory factorial analysis of the symptoms we found 3factors: 1) \"Catatonic\" with mutism (0.912), negativism (0.825) and waxy flexibility (0.522); 2) \"Extrapyramidal\" with altered gait (0.860), involuntary abnormal movements (0.605), muscle stiffness (0.534) and sialorrhoea (0.430); and 3) \"Autonomic instability\" with fever (0.798), impaired consciousness (0.795) and autonomic instability (0.387).
CONCLUSIONS: NMS in children and adolescents could be of 3types: catatonic, extrapyramidal and autonomic unstable.

BACKGROUND: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions.
OBJECTIVE: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review.
METHODS: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter \"age: child\" was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included.
RESULTS: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses.
CONCLUSIONS: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development.

To gather current evidence on the use of fiber for constipation treatment in pediatric patients.
Systematic review with meta-analysis of studies identified through Pubmed, Embase, LILACS and Cochrane databases published up to 2016.
Randomized controlled trials; patients aged between 1 and 18 years and diagnosed with functional constipation receiving or not drug treatment for constipation; articles published in Portuguese, English, Spanish, French, and German in journals accessible to the researchers.
A total of 2963 articles were retrieved during the search and, after adequate evaluation, nine articles were considered relevant to the study objective. A total of 680 children were included, of whom 45% were boys. No statistical significance was observed for bowel movement frequency, stool consistency, therapeutic success, fecal incontinence, and abdominal pain with fiber intake in patients with childhood constipation. These results should be interpreted with care due to the high clinical heterogeneity between the studies and the methodological limitation of the articles selected for analysis.
There is a scarcity of qualified studies to evaluate fiber supplementation in the treatment of childhood constipation, generating a low degree of confidence in estimating the real effect of this intervention on this population. Today, according to the current literature, adequate fiber intake should only be recommended for functional constipation, and fiber supplementation should not be prescribed in the diet of constipated children and adolescents.

Children with juvenile idiopathic arthritis (JIA) often have impaired growth and short stature. There is evidence that the therapeutic use of growth hormone (GH) is useful and safe in these patients.
To analyze the effects of GH use in patients with JIA.
A systematic review of the literature over the last 18 years in Medline and Embase databases. The criteria were analyzed independently by the researchers. We used the following keywords: \"growth hormone\", \"arthritis, juvenile\", \"arthritis, rheumatoid\", \"child\" and \"adolescent\".
Among the 192 identified articles, 20 corresponded to the inclusion criteria. Seventeen longitudinal studies and 3 case reports were found. Most studies analyzed observed increased growth, muscle mass and bone mass using GH. Adverse effects observed were glucose intolerance, diabetes, bone deformities, osteonecrosis, reactivation of the disease and low final height.
The majority of studies reported positive effects after the therapeutic use of GH, but some variability in response to treatment was observed. The combination of growth hormone with other drugs seems to be a good option.

Juvenile fibromyalgia syndrome (JFMS) is a non-inflammatory chronic pain condition that occurs mainly in girls aged 9-15 years. JFMS is characterized by constant widespread pain in different parts of the body, poor sleep quality, daytime sleepiness and an altered mood. Concomitant psychological and organic factors result in a diminished capacity to cope with pain. The quality of life of individuals with chronic pain and their caregivers is severely restricted and the occurrence of symptoms of anxiety and depression is common in this population. The aim of the present study was to perform a systematic review of the literature on psychosocial factors related to JFMS. The findings reveal differences in opinion between patients and family members regarding the effect of the condition, as mothers tend to classify JFMS as more severe than the patients themselves. Individuals with JFMS seem to share the same personality traits and there seems to be a type of family environment that is favorable to the occurrence of this condition. Psychological and functional aspects should be treated with methods that can help patients and family members alter their coping strategies regarding day-to-day problems, attenuate the dysfunctional consequences of pain and fatigue and diminish the risk of catastrophizing that individuals submitted to constant pain develop in relation to their surrounding environment.

OBJECTIVE: Medication adherence is often suboptimal for adolescents with HIV, and establishing correct weight-based antiretroviral therapy dosing is difficult, contributing to virological failure. This review aimed to determine the proportion of adolescents achieving virological suppression after initiating ART.
METHODS: MEDLINE, EMBASE and Web of Science databases were searched. Studies published between January 2004 and September 2014 including ≥50 adolescents taking ART and reporting on the proportion of virological suppressed participants were included.
RESULTS: From a total of 5316 potentially relevant citations, 20 studies were included. Only eight studies reported the proportion of adolescents that were virologically suppressed at a specified time point. The proportion of adolescents with virological suppression at 12 months ranged from 27 to 89%.
CONCLUSIONS: Adolescent achievement of HIV virological suppression was highly variable. Improved reporting of virological outcomes from a wider range of settings is required to support efforts to improve HIV care and treatment for adolescents.

OBJECTIVE: To analyze the sleep characteristics in adolescents from different socioeconomic levels.
METHODS: Original studies found in the Medline/PubMed and SciELO databases without language and period restrictions that analyzed associations between sleep variables and socioeconomic indicators. The initial search resulted in 99 articles. After reading the titles and abstracts and following inclusion and exclusion criteria, 12 articles with outcomes that included associations between sleep variables (disorders, duration, quality) and socioeconomic status (ethnicity, family income, and social status) were analyzed.
RESULTS: The studies associating sleep with socioeconomic variables are recent, published mainly after the year 2000. Half of the selected studies were performed with young Americans, and only one with Brazilian adolescents. Regarding ethnic differences, the studies do not have uniform conclusions. The main associations found were between sleep variables and family income or parental educational level, showing a trend among poor, low social status adolescents to manifest low duration, poor quality of sleeping patterns.
CONCLUSIONS: The study found an association between socioeconomic indicators and quality of sleep in adolescents. Low socioeconomic status reflects a worse subjective perception of sleep quality, shorter duration, and greater daytime sleepiness. Considering the influence of sleep on physical and cognitive development and on the learning capacity of young individuals, the literature on the subject is scarce. There is a need for further research on sleep in different realities of the Brazilian population.