OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents.METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population.RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%.CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

This cross-sectional study aimed to assess gender differences in adolescents in relation to onset of sexual activity. A total of 406 15-19-year-old adolescents from a family health unit in the city of São Paulo, Brazil, were interviewed from May to December 2002. Nearly half had already had their first sexual intercourse, at a mean age of 15, independently of gender. Sexual debut was usually unplanned (72.7%) and inside the home (86.1%). An equal proportion (61.0%) of males and females used some contraceptive method in their first sexual intercourse; however, more males had used a contraceptive method in their most recent intercourse. Having initiated their sexual activity in stable, affective relationships, females proved to be more vulnerable to STD/AIDS, since they switched from condoms to the pill in their subsequent sexual activity. Male adolescents continued to use mostly condoms, probably because they were involved mainly in non-stable relationships.

OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.

Introdução O comportamento contraceptivo na juventude apresenta uma dinâmica própria, em que o perfil de uso de métodos anticoncepcionais modificase conforme o tipo de relacionamento afetivoamoroso estabelecido entre os parceiros, ou seja, se é eventual, recente ou estável 1,2,3 . No que concerne especificamente a jovens altamente escolarizados, entre os quais, supostamente, informação e acesso aos métodos contraceptivos não seriam problema, Pirotta & Schor 1 observaram que a prática contraceptiva de universitários no Município de São Paulo era marcada tanto pela alta freqüência de uso de métodos contraceptivos, embora nem sempre de forma consistente, quanto pela tendência de substituição do preservativo masculino pela pílula oral. Neste caso, verificou-se paralelamente, ao longo dos relacionamentos, o uso esporádico de métodos considerados de baixa eficácia, como tabelinha e coito interrompido.Este estudo toma como hipótese que é justamente nesses momentos de inconsistências nas práticas contraceptivas, como na substituição de métodos contraceptivos dentro de um mesmo relacionamento ou no início de outro, que a anticoncepção de emergência -foco deste trabalho -é adotada como uma opção para a prevenção de uma gravidez não planejada, e não somente em situações de emergência, como recomendado pelo Ministério da Saúde 4 , espe-ARTIGO ARTICLE

ObjectivesTo assess knowledge, pregnancy attitudes and contraceptive practices in relation to the Zika virus outbreak in Brazil. MethodsWe interviewed 526 women 18 to 49 years old in primary health services in a Northeastern capital of Brazil, in 2016. They provided information about their knowledge of Zika transmission and health consequences, their receipt of counseling related to sexual and perinatal transmission of Zika, their pregnancy intentions and reassessment of contraceptive options in the context of the Zika virus outbreak.

Estudo quantitativo exploratório para identificar e verificar a freqüência dos problemas éticos vividos por enfermeiros e médicos no PSF. Coleta de dados com questionário auto-aplicado, contendo situações geradoras de problemas éticos e escala de quatro pontos para a freqüência. Desrespeito do profissional para com o usuário; problemas relacionados às informações para usuários e famílias e à preservação da privacidade e confidencialidade apareceram na maioria dos questionários, embora com freqüências diferentes. Os resultados indicam que a bioética na atenção básica lida com situações do cotidiano e não com dilemas de maior apelo dramático. A sutileza desse panorama pode levar a não percepção dos problemas, reforçando a necessidade de capacitação dos profissionais em comunicação e acolhimento, para instituir uma atitude ética baseada na cidadania, solidariedade e humanismo.

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O início sexual cada vez mais cedo propicia alta vulnerabilidade da adolescente a problemas da esfera sexual/reprodutiva, incluindo o câncer de colo uterino e a infecção pelo HPV. O presente estudo teve como objetivo identificar o conhecimento, atitude e prática na prevenção do câncer de colo uterino e infecção pelo HPV na população adolescente e avaliar as situações que as tornam vulneráveis. Trata-se de estudo transversal realizado em uma escola pública de São Paulo com 134 adolescentes entre 14 e 19 anos. Verificou-se idade de iniciação sexual aos 14,8 anos em média. Grande parte das adolescentes não apresentou conhecimento adequado sobre a prevenção desta neoplasia. A adesão ao Papanicolaou também se mostrou baixa. As estatísticas justificam a inserção da adolescente nos programas de detecção deste câncer. É preciso haver investimentos na educação sexual nas instituições de ensino e associar campanhas de Papanicolaou com atividades educativas, com enfoque adequado e linguagem apropriada.