OBJECTIVETo estimate the prevalence of prehypertension and elevated pulse pressure in adolescents and assess the association between those two conditions and sex, age, sexual development, obesity and physical activity. METHODSAnthropometrical data and blood pressure were measured in and a questionnaire was applied to 456 adolescents (aged 12 to 17 years) recruited from public and private schools, in the Fonseca district, in the city of Niterói, state of Rio de Janeiro, Brazil, from 2003 to 2004. RESULTSThirty nine (8.6%) presented prehypertension (PH) and 13.4%, elevated pulse pressure (PP). At bivariate analysis, PH was signifi cantly associated with sex, age and obesity, with more prevalent in boys aged between 15 and 17 years, and in the obese. Elevated PP was associated with gender only, as it was more prevalent in boys. Sexual maturation did not show an association with PH or elevated PP. Similar correlations were found at logistic regression. PH prevalence odds ratio was 7.7 for sex, 4.3 for age and 4.6 for obesity. Elevated PP prevalence odds ratio was 10.8 for sex. The correlation between PP and physical activity was positive and signifi cant. The elevation of PP was attributable to systolic blood pressure. CONCLUSIONPH and the elevated PP were shown to be present in adolescents from a population with a low prevalence of hypertension, mostly in boys. Further prospective studies are necessary to assess the persistence and the impact of those conditions.

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Background Medulloblastoma (MB),the most common malignant brain tumor of childhood has survival outcomes exceeding 80% for standard‐risk and 60% for high‐risk patients in high‐income countries (HICs). These results have not been replicated in low‐ and middle‐income countries (LMICs), where 80% of children with cancer live. Methods This is a retrospective review of 114 children aged 3–18 years diagnosed with MB from 1997 to 2016 at National Cancer Institute (INCA). Sociodemographic, clinical, and treatment data were extracted from the medical records and summarized descriptively. Overall survival (OS) and progression‐free survival (PFS) were calculated using the Kaplan–Meier method. Results The male‐to‐female ratio was 1.32 and the median age at diagnosis was 8.2 years. Headache (83%) and nausea/vomiting (78%) were the most common presenting symptoms. Five‐year OS was 59.1% and PFS was 58.4%. The OS for standard‐risk and high‐risk patients was 69% and 53%, respectively. The median time to diagnosis interval was 50.5 days and the median time from surgery to radiation therapy initiation was 50.4 days. Patients who lived >40 km from INCA fared better (OS = 68.2% vs. 51.1%, p = .032). Almost 20% of families lived below the Brazilian minimum wage. Forty‐five patients (35%) had metastatic disease at admission. Gross total resection was achieved in 57% of the patitents. Conclusions Although there are considerable barriers to deliver effective MB treatment in countries like Brazil, the OS seen in the present study demonstrates that good outcomes are not only feasible but can and should be increased with appropriate interventions.

BACKGROUND: Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. METHODS: Retrospective review of 114 children (3-18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively. Overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. RESULTS: The male/female ratio was 1.32 and the median age at diagnosis was 8.2 years. Headache (83%) and nausea/vomiting (78%) were the most common presenting symptoms. Overall survival (5y) was 59,1% and EFS (5y) was 58,4%. The OS for standard-risk patients was 69% and 53% for high-risk patients. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.25). Patients who lived >40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. CONCLUSIONS: The epidemiological characteristics of this series possibly explain the differences in survival that medulloblastoma patients have in Brazil. Issues related to limited health care resources, poverty, delayed diagnosis, treatment abandonment, and malnutrition are reflected in inferior survival outcomes when compared to high-income countries. Despite the difficulties encountered in an upper-middle income country, it was possible to deliver treatment with good results.