teenagers | MY SPECIAL DOCTOR

Teenagers with tattoos and piercings: first recommendations from US pediatricians

25 February 20246 January 2024 by psalari

Birds of prey, fierce animals, butterflies, names, quotes from stanzas of songs or poems ’embroidered’ on the skin. All kinds of them are seen in every part of the body. The passion for tattoos and piercings has grown in recent years, and these practices have been joined by scarification, or skin deformation for decorative purposes. These are modes of expression that are also chosen by the very young today. However, not without some risks that it is good to know and make known.

U.S. pediatricians’ recommendations

U.S. pediatricians have presented the first recommendations on tattoos and piercings for adolescents and young adults. In many American states, as indeed in Italy, you have to be at least 18 years old to get a tattoo, but the rules vary widely. The first piece of advice to teens is first to do their research and think hard about why they want a tattoo and where they want it. Second, they need to be aware of the possible repercussions: for example, in a 2014 study of 2,700 people, 76 percent of respondents expressed the belief that a piercing or tattoo reduced their chances of finding a job. Then there is the rate of possible skin complications, which is not known but is considered rare: the most serious danger, in any case, is related to infections.

Due precautions

Before undergoing a tattoo or piercing, U.S. pediatricians recommend, be sure that the salon you choose is sterile, clean and has a good reputation. Managers should explain to clients, and in some cases their parents, how to care for the treated area after piercing or tattooing. In addition, the place should meet the same hygienic requirements as a medical office. Scarification, a kind of extreme tattooing that may involve cutting (etching), branding (branding), and ice kissing (ice branding) to “relief draw” images on the skin in the United States is prohibited.

Anyone thinking of getting a tattoo should be sure that they have had their vaccination booster shots and are not taking any immune-compromising drugs. Finally, very young tattoo wannabes “may not realize how expensive it is to get rid of a tattoo or the fact that tongue piercing can damage teeth,” the U.S. paper says. Ultimately, tattoos and piercings are equated with minor outpatient surgeries, but instead of helping to solve problems they can themselves become the cause of them.

The first task in resuming school: following proper nutrition

25 February 20246 January 2024 by psalari

Experts from the Grana Padano Nutrition Observatory (Ogp) to coincide with the resumption of school studies have investigated the eating habits of 500 school-age females and males, estimating the number of daily meals and total intake of daily macronutrients (protein, carbohydrates, and lipids) to make dietary suggestions that can improve the state nutrition of children. The study shows that as age increases, the number of meals decreases, and in particular the number of meals goes from the 5% Of children who do not eat breakfast in the under-6 age group at the 20% of 14- to 17-year-olds, despite the fact that the first meal of the day is crucial for them to cope with the morning’s study hours. The decrease in the number of daily meals increases with increasing age, ranging from 4.2% of children under 6 years old having only 3 daily meals to 22.1% over 14 years old. As people get older, they tend to lose the snack eo habit, which is 100% present in younger children.

Expert advice

To improve the nutrition of toddlers, experts from the Observatory have compiled 5 tips that should be strictly followed to feed children in the right way. Here they are:

Breakfast: is an important meal and should never be skipped, we recommend a carbohydrate portion (complex sugars needed by the brain) such as bread or rusk or cereal, preferably whole grain, with milk or yogurt. A small amount of jam or honey can also be used for spreading or to sweeten drinks.
Snacks/meal: prefer fresh seasonal fruit, or a low-fat yogurt including fruit, in some cases salty snacks, bread and cheese can also be recommended, especially if the kid has to sustain physical activity.
Fruits and vegetables: consume 3 servings of fruits and 2 servings of vegetables daily to ensure vitamins, minerals and the right amount of fiber.
Sweets: in moderation, ice cream or pastries once a week, limit added sugar and sugary drinks, prefer smoot hies or juices, drink only water at the table.
Fish: at least two to three times a week, ideally cooked simply, steamed or baked.
Nuts: walnuts, almonds hazelnuts, contain Omega 3 fats, 10-20 grams daily as a snack.

Acne: what it is and how to fight it

25 February 20246 January 2024 by psalari

The term acne comes from the Greek word acmé or acné, meaning foam or summit. It is one of the most common skin diseases in the juvenile population; in fact, it is present in about 95%. The frequency is much higher certainly among adolescents, but acne can persist or appear in adulthood as well.

Types of acne

It typically makes its onset on the face, back, chest, and shoulders and affects both sexes in almost similar percentages. It typically manifests as closed and open comedones, so-called blackheads, papules, or whiteheads, pustules, better known as pimples, nodules i.e., furuncles, cysts, and unfortunately can also result in scarring in some cases. There are many causes of acne: increased activity of sebaceous glands, thickening of the wall of follicular ostium, bacterial colonization, in pjoint by Propionibacterium Acnes, and inflammation. In addition, various factors contribute to its occurrence such as family predisposition, stress, and smoking.

Especially in adolescence, it is important to be able to frame the degree of acne early, that is, whether it is mild, moderate, or severe, or, depending on the type of lesion, it can be classified into comedonic, papulo-pustular, nodular, and, in severe cases, conglobate. This avoids the development of scarring. In fact, this condition is often underestimated, which can therefore lead to psychological distress on the part of young patients and delay the benefits of treatment. It is known from studies conducted on patients’ quality of life that the acne-prone adolescent often suffers from low self-esteem, embarrassment, shyness, and in extreme cases even depression, emotional turmoil, shame about one’s appearance, resulting in difficulty relating to the opposite sex and a decline in school performance.

Therapies

Regarding treatment, the European Guidelines, published in 2012 recommend which drugs, topical and systemic, to use according to the degree of acne. Topical retinoids, derived from vitamin A, are the first choice in comedonic acne. An important role is also played by benzoylperoxide a keratolytic agent with antibacterial action but not inducing antibiotic resistance, which is recommended in acne vulgaris and comedo- or papulo-pustular-predominant forms.

The use of topical antibiotics is useful in inflammatory forms, but is limited by resistance, which unfortunately is increasing in Europe. therefore, as far as acne is concerned, their local use in combination with other topical drugs is advisable, avoiding the concomitant administration of oral antibiotics and limiting the use of the latter to periods not exceeding three months, discontinuing them if there is no improvement. Remembering to fixed combinations of topical preparations offers the possibility of acting more specifically on the mechanisms that cause acne, also increasing adherence to therapy, making the application of only one product sufficient.

Sex education : let’s address the issue

25 February 20246 January 2024 by MinnieLuongo

Talking about sex? Sure, but with whom? For years, we have witnessed the unfortunate back-and-forth between family and school, with neither taking responsibility for addressing the sensitive topic in depth with the youngest. In a new study supported by Bayer, GKF Health-a social and market research institute- surveyed 3,000 adolescents about their attitudes about sexuality and contraception. The results are both encouraging and alarming. And many of the responses turn out to be contradictory: on the one hand, respondents agreed, regardless of nationality, that the topic of sexuality should not be considered taboo, but on the other hand, many also said that they could not talk about it freely with their partners. According to the study, in many countries it is still teachers who provide the first information about sexuality through sex education in schools. However, adolescents say they are not totally satisfied with this kind of information and prefer to find it on the Internet. Difficult, therefore, is the dialogue between generations because of different habits and lifestyles, and to address the issue satisfactorily, a one-way exchange of information is not enough.

We at EducareYou have gone a step further and chosen to talk about sex thanks to two insightful specialists who, through videos and interviews, will take our readers by the hand and, with simplicity but rigor at the same time, regularly address not only evergreen issues that affect children and adolescents, but also new issues that arise in an age when life expectancy continues to lengthen and-unfortunately-the sexuality of third and fourth age is no longer (or almost) taboo.

Who are our experts? Two well-known names whose qualifications alone explain their experience and professionalism.

Marco Rossi, who in 2001 participated in the birth of a successful TV show on the sexuality, “Loveline“, is a specialist in psychiatry, clinical sexologist, and president of the Italian Society of Sexology and Sex Education. In addition, he is scientific director and lecturer of the master’s degree program in sexology PL (Psychologists of Lombardy), as well as president of Sises, Society for Sexology and Sex Education. (www.marcorossi.it. Facebook: Marco Rossi, sexologist and psychiatrist). He will have the arduous task of framing and explaining the most diverse topics especially from a psychological point of view.
And, among other things, he will explain what intramarital seduction consists of, whether indeed the so-called “macho” can be called uninhibited, when it is purported to be singletude
as a way of life.
Alexander G. Littara instead is a medical surgeon, a specialist in general surgery, genital plastic-aesthetic surgery, and an andrologist/sexologist. A firm believer in computerization, Dr. Littara is the author of the first Italian website dedicated to andrology, www.androweb.it, as well as www.falloplastica.net. Among Dr. Littara’s apps, that will provide us with explanations species organic, there is also SexOS (free, interactive and multimedia) which aims to popularize andrology to help men, who are often embarrassed when faced with certain situations, learn more about their bodies and sexuality.

Electronic cigarettes: how to help kids quit

20 February 20246 January 2024 by Redazione My Special Doctor

Generally touted as a “harmless pleasure,” electronic cigarettes are very successful among teenagers, partly because the many flavors available make them seem very smart. But recent studies indicate that this way of smoking also carries risks and quitting is not as easy as one might believe, especially for teens. In fact, the nicotine they contain is addictive, and most pharmacological supports to break the habit are not suitable for the under-18s. A’
analysis of the problem
and possible solutions.

Smoking and alcohol cause early damage to adolescents’ arteries

20 February 20246 January 2024 by rosanna.feroldi

Cigarettes always lit and group drinking, often to the point of being frankly drunk and feeling sick. These are all too common behaviors among adolescents, engaged in more to feel included and appreciated by peers than out of real individual pleasure or goliardic spirit. In the general belief that challenging the limits of one’s body and having the “courage” to dare more than others serves to assert one’s worth.

But this is as risky a belief as ever, as well as completely wrong, because even a young, healthy body suffers greatly from the toxic effects of smoking and alcohol. And not only after years of immoderate consumption, but also in the immediate term and for modest amounts, especially when their intake occurs at the same time, multiplying the damage at multiple levels, often synergistically.

The harmful effects on the organism

Even when taken individually, smoking and alcohol are harmful to the body on several fronts. The former, promotes respiratory diseases and several types of cancers (first and foremost that of the lung, but also of the mouth and throat, stomach, colorectum, and breast), reduces fertility, increases cardiovascular and metabolic risk, and complicates acute and chronic diseases already present, especially inflammatory and autoimmune diseases.

Alcohol, on the other hand, is neurotoxic (centrally and peripherally), harmful to the liver (promotes fibrosis and cirrhosis of the liver), the kidneys and the gastrointestinal system, and, if taken in excess, the cardiovascular system as well (where “excess” means more than a couple of glasses of wine a day, a limit beyond which any hypothetical benefit is lost). Not to mention the risks consequent to the psychotropic and sensory effects of alcohol (euphoria, reduced reflexes, drowsiness, altered vision, etc.), often the cause of traffic accidents and borderline behavior.

When the cigarette is in one hand and the glass in the other, the problems quickly multiply, even if the hands in question are those of beardless (or nearly so) teenagers, seemingly immune to acute or chronic ailments and diseases and far removed from vascular degenerative phenomena typical of old age, such as atherosclerosis.

Young arteries at risk

A collaborative study between a number of prestigious clinical institutions in the United Kingdom (University College and King’s College London, St. Thomas’ Hospital and the University of Bristol) and Queen Silvia Children’s Hospital in Gothenburg, Sweden, indicated that smoking and alcohol promote the early onset of stiffness and thickening of the walls of the arteries already in 17-year-olds taking only one or both of the two, even from relatively short periods of time (1-5 years).

The extent of the vascular damage mentioned, measured indirectly as blood flow velocity between carotid and femoral artery with pulsed Doppler (Pulse Wave Velocity, PWV), appeared to be correlated with the number of cigarettes smoked and the amount of alcohol consumed, being in both cases increasing with increasing consumption of each substance and particularly marked when smoking and alcohol were combined.

But there is also good news: quitting smoking and drinking when the atherosclerotic process is just starting allows it to regress completely, restoring the arteries of ex-smoking and “ex-drinking” teens to a condition comparable to those of never-smoking and lifelong teetotal peers. An outcome that cannot, however, be hoped for later in life, and which should lead to strong disincentives to smoking and alcohol use in young people, partly to prevent the consolidation of two decidedly harmful habits.

Sources:

Article: Charakida M et al. Early vascular damage from smoking and alcohol in teenage years: the ALSPAC study. European Heart Journal 2019;40:345-353
Editorial: Münzel T et al. Double hazard of smoking and alcohol on vascular function in adolescents. European Heart Journal 2019;40:354-356

Adolescents and mental distress: how it has changed in 30 years

14 February 20246 January 2024 by rosanna.feroldi

Adolescent mental health is causing no small amount of concern globally. Studies conducted from the 1980s to the present indicate a gradual increase in the prevalence of psychiatric distress, which can undermine peaceful psychoemotional growth and the building of positive interpersonal relationships: two fundamental elements, at this delicate stage of life, for developing a “solid” personality, achieving a good inner balance and maintaining a satisfactory quality of life in adulthood.

In particular, becoming increasingly common seem to be so-called “internalization” or “introjection” symptoms, i.e., feelings and behaviors indicative of inner or internalized suffering that is not actively or immediately expressed outwardly. For example, the following are symptoms of internalization: avoiding interaction with others; speaking little and shutting oneself in; feeling lonely and unloved/considered; being nervous and irritable; worrying excessively; suffering from discomfort not referable to an organic cause (such as headache, stomach ache, etc.); not being able to concentrate; feeling sad, low energy or down; lacking interest in most things/situations; sleeping or eating more or less than usual. Some, perhaps, will recognize in this list the typical picture of depression and anxiety. And he is not wrong, because the onset of these manifestations, in many cases, is a prelude to the very clinical diagnosis of these psychiatric disorders, which are also increasingly found among adults.

To delve deeper into the phenomenon, specify its characteristics and hypothesize its causes, a group of Swedish researchers from Umeå and Stockholm Universities analyzed how the incidence of psychiatric symptoms among adolescents has changed over 30 years by comparing two cohorts of students, residing in two medium-sized industrial towns in northern Sweden, who were attending the last year of compulsory school in 1981 and 2014. Each cohort, consisting of 1,083 and 682 boys and girls, respectively, was asked to answer identical questionnaires based on 4 scales assessing depressive, anxiety, and functional-somatic symptoms (i.e., related to physical complaints of possible psychic origin).

The comparison showed that from 1981 to 2014, the prevalence of internalizing disorders actually increased significantly in adolescents of both sexes, but particularly markedly among girls. Conversely, so-called “conduct disorders” (i.e., aggressive and violent attitudes, bullying, risky behaviors, etc.) have decreased among boys, while they have increased among girls, equalizing the prevalence between the two sexes and leaving the overall prevalence figure almost stable compared to 30 years earlier. The researchers also found that there was no obvious correlation between sociodemographic factors (family income, living environment, etc.) and adolescents’ psychiatric symptoms, with the only exception being a higher prevalence of conduct disorders among 1981 teens who had unemployed parents.

The underlying causes of the increase in depression and anxiety symptoms among teens remain to be determined, but the study authors believe that some profound socioeconomic changes since the 1990s may have played a role, even when they did not directly affect adolescents. The main ones include: the extremes of the liberalist economic model and its repercussions on the labor market (flexibility, job instability, driven competition, increased demands, reduced rewards, etc.); the deterioration of social relations and sense of community; family economic difficulties and uncertainty about the future resulting from the crises of recent years; technological evolution and the “virtualization” of interpersonal relationships through social media, resulting in isolation, distortion of perception of reality, and online frustration/harassment; and concern about one’s own future and that of the planet, which are increasingly difficult to predict and less and less rosy to assume.

According to the authors, in order to curb the phenomenon and ensure adolescents and adults greater psychoemotional well-being, it is necessary not only to recognize and address the symptoms of depression and anxiety on the level of “medical” prevention, but also to consider all the mentioned contextual aspects and try to modify them in a more “psychologically acceptable” sense. Certainly not an easy undertaking and one that does not immediately translate into practice.

Source: Blom H et al. Increase of internalized mental health symptoms among adolescents during the last three decades. Journal of Public Health 2019;29(5)925-931(doi.org/10.1093/eurpub/ckz028)

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