IntroductionThe incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. The Southeast of Brazil has especially high incidences of melanoma, and early detection is low. Exposure to UV radiation represents a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation for adolescents for tanning. A medical student-delivered intervention that harnesses the broad availability of mobile phones as well as adolescents’ interest in their appearance may represent a novel method to improve skin cancer prevention.Methods and analysisWe developed a free mobile app (Sunface), which will be implemented in at least 30 secondary school classes, each with 21 students (at least 30 classes with 21 students for control) in February 2018 in Southeast Brazil via a novel method called mirroring. In a 45 min classroom seminar, the students’ altered three-dimensional selfies on tablets are ‘mirrored’ via a projector in front of their entire class, showing the effects of unprotected UV exposure on their future faces. External block randomisation via computer is performed on the class level with a 1:1 allocation. Sociodemographic data, as well as skin type, ancestry, UV protection behaviour and its predictors are measured via a paper–pencil questionnaire before as well as at 3 and 6 months postintervention. The primary end point is the group difference in the 30-day prevalence of daily sunscreen use at a 6-month follow-up. Secondary end points include (1) the difference in daily sunscreen use at a 3-month follow-up, (2) if a self-skin examination in accordance with the ABCDE rule was performed within the 6-month follow-up and (3) the number of tanning sessions.Ethics and disseminationEthical approval was obtained from the ethics committee of the University of Itauna. Results will be disseminated at conferences and in peer-reviewed journals.Trial registration numberNCT03178240; Pre-results.

Because exposure to UV radiation early in life is an important risk factor for melanoma development, reducing UV exposure in children and adolescents is of paramount importance. New interventions are urgently required.OBJECTIVE To determine the effect of the free face-aging mobile app Sunface on the skin cancer protection behavior of adolescents.DESIGN, SETTING, AND PARTICIPANTS This cluster-randomized clinical trial included a single intervention and a 6-month follow-up from February 1 to November 30, 2018. Randomization was performed on the class level in 52 school classes within 8 public secondary schools (grades 9-12) in Itauna, Southeast Brazil. Data were analyzed from May 1 to October 10, 2019.INTERVENTIONS In a classroom seminar delivered by medical students, adolescents' selfies were altered by the app to show UV effects on their future faces and were shown in front of their class, accompanied by information about UV protection. Information about relevant parameters was collected via anonymous questionnaires before and 3 and 6 months after the intervention. MAIN OUTCOMES AND MEASURESThe primary end point of the study was the difference in daily sunscreen use at 6 months of follow-up. Secondary end points included the difference in daily sunscreen use at 3 months of follow-up, at least 1 skin self-examination within 6 months, and at least 1 tanning session in the preceding 30 days. All analyses were predefined and based on intention to treat. Cluster effects were taken into account. RESULTS Participants included 1573 pupils (812 girls [51.6%] and 761 boys [48.4%]; mean [SD] age, 15.9 [1.3] years) from 52 school classes. Daily sunscreen use increased from 110 of 734 pupils (15.0%) to 139 of 607 ( 22.9%; P < .001) at the 6-month follow-up in the intervention group. The proportion of pupils performing at least 1 skin self-examination in the intervention group rose from 184 of 734 (25.1%) to 300 of 607 (49.4%; P < .001). Use of tanning decreased from 138 of 734 pupils (18.8%) to 92 of 607 (15.2%; P = .04). No significant changes were observed in the control group. The intervention was more effective for female students (number needed to treat for the primary end point: 8 for girls and 31 for boys). CONCLUSIONS AND RELEVANCEThese findings suggest that interventions based on face-aging apps may increase skin cancer protection behavior in Brazilian adolescents. Further studies are required to maximize the effect and to investigate the generalizability of the effects.

INTRODUÇÃO: A adolescência é um momento de importantes transformações biopsicossociais, sendo a fase da vida em que há maior exposição a fatores de risco para a saúde, como o tabaco. OBJETIVO: Estimar a prevalência e fatores associados ao tabagismo entre escolares do município de Itaúna-MG. MÉTODOS: A amostra compõe-se de 340 adolescentes, sendo incluídos estudantes matriculados no ensino médio, entre 14 e 20 anos. Foi aplicado um questionário adaptado do “VI Levantamento Nacional sobre o Consumo de Drogas Psicotrópicas entre Estudantes do Ensino Fundamental e Médio das Redes Pública e Privada de Ensino nas 27 Capitais Brasileiras”. A amostra simples foi selecionada através de sorteio simples. RESULTADOS: A prevalência de experimentação de tabaco do grupo avaliado foi de 28,24%. Aproximadamente 60% dos que se lembram, experimentaram tabaco entre os 14 e 16 anos. Fatores como a própria curiosidade e influência de amigos foram citados como os maiores motivadores para o primeiro contato com o cigarro. O fato de o estudante trabalhar ou já ter trabalhado apresentou significância estatística como fator de risco para a experimentação de tabagismo na amostra avaliada. CONCLUSÃO: A prevalência de experimentação de tabaco entre os adolescentes concorda com a tendência nacional. Nesse sentido, os dados do estudo apresentado podem ser utilizados como base para planejamento de estratégias de prevenção ao tabagismo.

Justificativa e Objetivos: A pericardite tuberculosa (PT) é uma importante, rara e grave complicação extrapulmonar da tuberculose que, na ausência de correto diagnóstico e tratamento, sua taxa de mortalidade pode chegar a 90%. O objetivo deste estudo é apresentar, sob a forma de relato de experiência, a ocorrência de um quadro de PT em uma cidade do interior do estado de Minas Gerais. Desenvolvimento: Paciente do sexo masculino, 31 anos, apresentando quadro clínico típico de tuberculose foi submetido a exames laboratoriais e de imagem inconclusivos. Submetido à pericardiectomia de toda área ântero-lateral do saco pericárdico para confirmação anatomopatológica da suspeita.Após achados compatíveis com PT, foi iniciado tratamento com drogas tuberculostáticas e, decorridos seis meses, evoluiu para cura em ótimo estado, sem demais medicações. Conclusão:A presença de derrame pericárdico associado à febre em pacientes procedentes de áreas endêmicas de tuberculose implica na investigação desta afecção.Portanto, um diagnóstico precoce através da realização de métodos específicos invasivos é de extrema importância, haja vista que a PT, caso não tratada, está associada à alta mortalidade.