Background: The way that parents relate to their children could be either protective or risk factor to adolescent´s contact with the consumption of certain substances. The objectives of this study were to verify the connections between the consumption of tobacco, alcohol and non-prescription drugs, the possible influence of parenting style in such consumption and sex differences between them.
Method: Determination of the associations between the consumption of tobacco, alcohol and non-prescription drugs and the dimensions of parenting styles through Pearson correlation coefficient from the data obtained from a sample of 665 adolescent with average age 15.5 years (D.T = 1.1) in educational centers of the Community of Madrid.
Results: Positive correlations were found between the consumption of tobacco, alcohol and non-prescription medicines. Negative correlations were found between the dimensions Affect-communication and Inductive norms for both parents and said consumptions, and positive with the Criticism-rejection dimension. Regarding to the progenitor and the substance, positive correlations were found between the consumption and the Indulgent Norms and Rigid Norms, as well as differences by sex.
Conclusions: Affect, communication and behavioral control act as protective factors against the adolescent consumption of substances with negative impact on health, while criticism, rejection or laxity in control are considered risk factors by said consumption.

Correspondencia: Y. Ortega Latorre. Escuela de Enfermería y Fisioterapia San Juan de Dios. Avda. San Juan de Dios, 1. 28350 Ciempozuelos. Madrid.
Correo electrónico: yol.ortega@comillas.edu

The worrying increase in sexually transmitted infections (STIs) among adolescents in recent years reveals the need for social self-criticism that promotes awareness and the joint approach of political institutions, teachers, health professionals and parents. The figure of the pediatrician of Primary Care as educational agent in affective-sexual health could be key in our environment.

Servicio Madrileño de Salud. Dirección Asistencial Oeste. C/Alonso Cano, 8. 28933 Móstoles (Madrid). Correo electrónico: mariacristina.hoyos@salud.madrid.org

In the prevention of drug use among adolescents, in addition to our authorities claim effective control of supply, the key lies in greater involvement of parents, teachers and health professionals, three pillars that help to strengthen the information and resilience adolescent, and therefore its ability to decide. Guidelines are proposed to improve from these perspectives and a description of current recreational drugs is performed.

Objective: To determine the knowledge of the "choking game" on a group of teenagers in the city of Cali.
Material and methods: A survey was conducted face to 350 students from two public schools and two private schools for training the 9th, 10th and 11th grade high school aged 12-17 years. Descriptive statistical analysis was conducted
Results: Most of the respondents were women. Knew about this game 260 and 190 of them had practiced. Curiosity is the most common cause for which began this practice yet occupies an important place on bullying. The technique used is the hanging caused by two people. Although it is considered the most dangerous technique almost 89% have performed more than once; 42% did not get the expected response. Headache and dizziness are the symptoms presented after the procedure. The 87% practical outside the home and 74% do not use any kind of stimulant for its realization. It is worrying that 68% of respondents recommend practicing this game.
Conclusion: The "choking game" is a dangerous, potentially deadly. His knowledge is important for prevention and early detection of risk behaviors among adolescents.

Objective: To study the prevalence of consumption and attitudes towards alcohol among adolescent students in the province of Valladolid.
Methods: From a total of 18,888 students schools during the 2011-2012 school year, we selected a sample of 2,412 schoolchildren. We conducted an extensive survey of anonymous and autofilled, extracting data related to alcohol.
Results: 77.2% of students had drunk alcohol at least once. The age of starting consumption was between 13 and 14 years. 64% of respondents reported having had an acute intoxication in the past year. Drunkenness was more common in older patients, with no differences in gender. The most common pattern of consumption was the weekend, in bars or pubs, combined or mixed drinks being the most consumed beverage. 8.3% of respondents had conducted (bike or car) under the influence of alcohol, and 20.4% had mounted in car or motorcycle where the driver had been drinking. The final regression model showed that alcohol consumption is associated with consumption of friendships, smoking, drug use and other factors. Instead maintain a good relationship with the father and teachers behave as a protective factor.
Conclusions: We met with devastating results regarding alcohol consumption and drunkenness in adolescents. We consider institutional priority efforts and resources in education, to curb alcohol habit among adolescents.

Introduction: Alterations in lipid and carbohydrate metabolism coupled with changes in nutrition, may appear in childhood and adolescence and which serve as markers to identify early in life may reduce the development of pathological events (type 2 diabetes, heart disease, nephropathy). Sonora, Mexico, is one of the states with the highest national prevalence of obesity at an early age, and chronic degenerative diseases and their complications. Therefore we decided to determine the metabolic profile and nutritional status in adolescents 15 to 18 years in a community of Sonora, Mexico.
Patients and methods: A cross-sectional survey of 56 adolescents aged 15 to 18 years who were weight, height, body mass index, glycemia, lipid profile, insulin, HOMA-IR (resistance index insulin) taking as cutoff consider 3.16 for IR (insulin resistance).
Results: Of the 56 teenagers got 25 (44.6%) males and 31 (55.4%) female; prevalence of overweight-obesity 32.1%, 17.9% had IR; 33.3% waist hip ratio high, 8.9% high cholesterol, 16.1% triglycerides, 25% decrease in HDL, high insulin 12.3% and only 1.6% high glucose. The 44.4% of patients with overweight-obesity presents IR.
Conclusion: 1 in 4 teens has at least some alteration in the metabolic profile and 1 in 3 in the state of nutrition.

Introduction: Alterations in lipid and carbohydrate metabolism coupled with changes in nutrition, may appear in childhood and adolescence and which serve as markers to identify early in life may reduce the development of pathological events (type 2 diabetes, heart disease, nephropathy). Sonora, Mexico, is one of the states with the highest national prevalence of obesity at an early age, and chronic degenerative diseases and their complications. Therefore we decided to determine the metabolic profile and nutritional status in adolescents 15 to 18 years in a community of Sonora.

Patients and methods: A cross-sectional survey of 56 adolescents aged 15 to 18 years who were weight, height, body mass index, glycemia, lipid profile, insulin, resistance index insulin, taking as cutoff consider 3.16 for IR (insulin resistance).

Results: Of the 56 teenagers got 25 (44.6%) males and 31 (55.4%) female; prevalence of overweight-obesity 32.1%, 17.9% had IR; 33.3% waist hip ratio high, 8.9% high cholesterol, 16.1% triglycerides, 25% decrease in HDL, high insulin 12.3% and only 1.6% high glucose. The 44.4% of patients with overweight-obesity presents IR.

Conclusion: 1 in 4 teens has at least some alteration in the metabolic profile, and 1 in 3 in the state of nutrition.

Objective: To study the breakfast model in a group of adolescents and to analyze its nutritional characteristics in order to design nutritional intervention strategies.

Material and methods: Randomized, academic-year-stratified distribution of a semi-quantitative questionnaire on the frequency of food intake for breakfast (on rising and mid-morn¬ing snack) to 400 adolescents (188 males and 212 females), aged between 13 and 16 years. The nutrient densities were calculated in proportion to established dietary recommend¬ations (%RDA).

Results: The great majority (93.5%) had breakfast on rising and 80% took a mid-morning snack on a daily basis. The most common foods were milk (89.3%) and baked goods containing sugar (45.7%) at breakfast time and a sandwich with cold meats and/or cured ham (74.6%) for the snack. The mean %RDA of the calorie intake was 14.9% in the early breakfast and 18.4% in the snack (NS). The mean %RDA of the cholesterol intake was 23.9% in the early breakfast and 27.5% in the snack (NS). Over two-thirds of the protein intake was from animal sources. The %RDA for calcium was greater (p

Conclusions: This breakfast model, while providing an adequate energy supply, differs from the prototype of a healthy diet owing to the excessive consumption of refined sugars (early breakfast) and meat and derivatives (snack), with a deficit in cereals and fruit. Nutritional advice should be increased in prim¬ ary care programs and nutritional education programs should be developed in compulsory education.

Thyroid hemiagenesis is a rare congenital abnormality, with a prevalence of 0.05%, that is characterized by the absence or hypoplasia of one of the thyroid lobes, more frequently the left lobe. It is usually discovered by chance, on thyroid ultrasound performed during the assessment of elevated plasma thyroid-stimulating hormone (TSH) concentrations or because of the presence of unilateral goiter. Compensatory hypertrophy of the existing lobe frequently develops, probably due to thyroid tissue overstimulation by endogenous TSH. Thyroid function remains normal in the majority of cases, but these patients usually have higher levels of TSH. Close long-term follow-up is necessary in all cases of thyroid hemiagenesis to prevent future complications. We review the clinical features and hormonal status of a group of five children diagnosed in our center over the last 15 years.

Following the ISAAC methodology, we studied 4,644 schoolchildren between the ages of 11 and 16 (2,435 boys and 2,209 girls).

The objective of our study is to determine the influence of the habit of tobacco smoking in the group of adolescents that at some point has suffered from asthma or from asthma symptoms.

Of the adolescents who at some point had suffered from asth¬ma 66.5% cohabited with a smoker in the home (59.5% in phase I). Of the adolescents who suffered from wheezing in the last 12 months 69% cohabited with a smoker in the home (58.2% in phase I).

Having suffered from asthma at some point (p= 0.074; OR 0.83), or having suffered from wheezing in the last 12 months (p= 0.54; OR 0.91) is not associated with the presence of a smoker in the home.

Of the adolescents studied 5.6% were smokers, and in 60.7% of the cases the parents were smokers (73.9% in phase I). Among the non-smoking adolescents, in 53.1% of the cases the parents smoked (56.8% in phase I). A significant association was found between the parents smoking and the adolescents smoking (p= 0.034).

In phase I, 8.1% smoked between 1-8 cigarettes per day, compared to 4.2% in phase III, showing significant statistical differences (p <0.05).

A significant statistical association was found between having suffered from asthma at some point and the habit of tobacco smoking (p <0.001; OR 1.75), although not between having suffered from wheezing in the last 12 months and the habit of tobacco smoking. These results are very similar to those of phase I.

The metabolic syndrome is a pathology with an increasing prevalence in children and teenagers. Nevertheless, its exact etiopathogeny is unknown, and diagnostic criteria vary depending on authors and experts' committees. Likewise, its prevalence varies depending on whether adult parameters or paediatric parameters are applied, and in case of using the latter it will vary depending on the chosen cut-point. These features, together with current matters of its treatment, are reviewed in the present article.

Clinical and subclinical rickets attributable to vitamin D deficiency is still reported all over the world. In this article, the new guidelines of the National Academy of Sciences have been reviewed and an intake of at least 200 IU per day of vitamin D is recommended to prevent clinical and laboratory findings secondary to vitamin D-deficiency rickets in infants, children and adolescents. Because of these recommendations, the American Academy of Pediatrics recommends the consumption of foods with a high content of calcium and vitamin D and supplementation with this vitamin in children without a minimum intake of 200 IU per day or in the absence of adequate exposure to sunlight.

Halitosis is an unpleasant odour emanating from mouth, nose or airway. This is not a usual reason for a direct consultation in pediatrics but is frequently mentioned by the patient´s family. On many occasions, health professionals are not concerned about this type of discomfort. Information about this problem is scarce.

This symptom should be taken into account as it can be the manifestation of several medical and odontological disorders and for the social, economical and psychological implications, mostly in adolescents. The intention of this work is to revise bibliography about etiology, physiopathology, diagnosis and different therapeutic options of halitosis including the newest ones, in order to facilitate the daily practice at a pediatric level. The education of the affected patient is necessary in order to acquire healthy and effective hygienic habits to cope with the halitosis.

Isolated imperforate hymen is a rare congenital malformation of the female genital tract. Diagnosis is usually done during adolescence in the context of a primary amenorrhea accompanied with lower abdominal or back pain. Echography is the key for the diagnosis. We report a case of a 13-year-old female referred to the emergency department with lower abdominal pain and an abdominal mass.

The convenience to recommend or not vitamin supplements is an issue that is presented frequently during consultation. The American Academy of Pediatrics recommends these supplements to determined risk groups and recently, they have also modified their vitamin D recommendations. In a small number of dietetic surveys carried out in our unit about a group of patients following general recommendations about a healthy diet, deficiencies in the intake of some micronutrients where observed. Though the promotion of healthy nourishment is the best way to prevent nutritional deficiencies, sometimes the supplementation is necessary. An individual supplementation must be recommended and pediatricians shall know the existing medications in the market as well as their compositions in order to adequate the dosage to the individual needs of each patient.