Male Adolescents Research Articles

Obsessive-compulsive disorder with compulsive exercise leading to intensive care treatment in an adolescent male: a case report.

Obsessive-compulsive disorder (OCD) and eating disorders (ED) are compulsive disorders with overlapping symptoms. However, weight loss and over-exercise causing secondary medical complications are rarely seen in OCD. We report the case of a 15-year-old male who presented with atypical symptoms of OCD leading to severe medical compromise. Covid-19 related team sport restrictions led to compulsive exercise associated with intrusive thoughts. The onset of stress fractures limited exercise ability,prompting compensatory food restriction. Bradycardia, hypothermia and hypoglycaemia resulted from severe malnourishment and weight loss in the context of OCD. His weight was 85.8% of ideal body weight on admission, reflective of a weight 10-15 kg lower than his premorbid weight. During admission, he developed exercise-induced rhabdomyolysis with significantly elevated creatinine kinase and required intensive care unit treatment. Psychotropic medication included lamotrigine, olanzapine and high dose fluoxetine alongside cognitive-behavioural therapy. Medical stabilisation and weight restoration allowed discharge to an outpatient Child and Adolescent Mental Health Service. This atypical case of OCD highlights the potentially life-threatening risks associated with excessive exercise and malnutrition. This paper highlights the complexities of treatment in a patient who cannot adhere to bed rest and the differential diagnoses of anorexia nervosa, orthorexia nervosa and exercise addiction.

Gambaran Tingkat Stres Remaja Panti Asuhan di Kota Padang Ditinjau dari Perbedaan Jenis Kelamin

Is a critical developmental period characterized by significant physical and psychological changes. Teenagers living in orphanages, in particular, experience stress due to internal and external demands. This study aims to determine the description of stress levels in teenagers living in orphanages in Padang City in terms of gender differences. The type of research used is descriptive quantitative. The sample in this study was random sampling which amount 268 people in 6 different orphanages in Padang city. The instrument used was the DASS 14 questionnaire, with a cross-sectional study research design. The results of the hypothesis test using the Mann-Whitney test indicate a significance value of 0.001. Since the p-value (0.001) is less than 0.05, it can be concluded that there is a significant difference in stress levels between male and female adolescents living in orphanages in Padang City. The study results show that the stress levels of adolescents in the orphanage tend to be low. However, the orphanage management should still anticipate factors that could increase the stress levels of these adolescents.

Tes Kepribadian Online Membentuk Kepribadianku, Benarkah?: Barnum Effect Ditinjau Dari Perbedaan Jenis Kelamin

Online personality tests are commonly used by adolescents who are in the process of self-discovery. This leads to a tendency for teenagers to self-diagnose based on their personality feedback. This study aims to investigate whether female adolescents are more prone to experiencing the Barnum effect and self-diagnosis compared to male adolescents. The study used purposive sampling to select participants, consisting of 300 students from SMAN 16 Makassar, with an equal distribution of 150 female and 150 male students aged 15-18 years. The Barnum Statement was employed as the measurement tool. Data analysis was conducted using the Chi-Square test, processed with SPSS version 26 for Windows. The results indicate that there is no significant difference between genders in terms of the barnum effect, with a significance value of p = 0.339. This study provides insights into the differences in the barnum effect between adolescent girls and boys.

8768 Initiation of Exogenous Sex Hormones in a Pediatric Gender Clinic

Abstract Disclosure: C.M. Roberts: None. M.M. Knoll: None. G. Robertson: None. A. Egan: None. C. Moser: None. Introduction: The demographics of patients seeking care for gender dysphoria have changed significantly since care was started in 1987. The criteria for prescribing sex hormones have also evolved to allow a greater range of patients to receive gender-affirming hormones. We examined factors associated with prescription of gender-affirming hormones to patients presenting for gender-affirming care our clinic. Methods: Secondary analysis of sex hormone initiation as a minor among 14-17-year-old adolescents diagnosed with gender dysphoria, seen in the pediatric gender clinic between 2/19/2018 and 7/20/2022. We extracted demographic variables, appointment dates, and sex hormone prescription data from our electronic medical record. We collected patient reports of gender identity and suicidal behavior, and parent and adolescent reports of general adolescent well-being, months of gender dysphoria and social transition, and parental support for the adolescent’s gender identity from electronic clinic surveys. Results: We identified 273 adolescent-parent dyads with complete data. Most of our sample were assigned female at birth (74.4%), transgender male (59.3%), and white (83.5%) adolescents who lived in urban (86.4%) and lower-middle-income (64.5%) areas. The average age was 15.9+/-1.1 years. A minority of adolescents reported recent suicidal ideation 60/273 (22%), and prior suicide attempts 20/273 (7%). Parents reported a shorter duration of gender dysphoria (-16.7 months (95%CI: -22.0, -11.5)) and social transition (-4.7: -6.5, -3.0), and higher levels of parental support than adolescents. Approximately half, 146/273 (53.5%), of adolescents started sex hormones. The average age at initiation was 16.5 years +/- 0.9. Age at presentation, length of gender dysphoria or social transition, and the presence of suicidal ideation or attempts were not associated with initiation of sex hormones. Assigned males (OR:1.82:95%CI 1.04, 3.19), adolescents with higher parent-reported parental support for the adolescent’s identity (1.03:1.01, 1.04), and adolescents with private insurance rather than Medicaid (Blue Cross- 5.39:2.73, 10.64) were more likely to start sex hormones as a minor. Conclusion: Published criteria for the initiation of sex hormones among adolescents with gender dysphoria, including age, persistence of dysphoria, and the presence of suicidality, did not predict the prescription of sex hormones to minors in our clinic. Parent-reported support for the adolescent’s gender identity played a small role in predicting the prescription of hormones, but male sex assigned at birth and having private health insurance played larger roles. Further exploration of these findings is needed to ensure equity in the treatment of gender dysphoria. Presentation: 6/3/2024

8256 Early Life Stress and Pubertal Predictors of Youth Substance Use Initiation: Does Sex Moderate the Relationship Between ELS, Puberty, and Substance Use Initiation?

Abstract Disclosure: A. Donovan: None. S. Assari: None. M. Shaheen: None. C. Grella: None. L. Richter: None. T.C. Friedman: None. Background: Early life stress (ELS) is a construct composed of children’s experiences of abuse, neglect, and conflict. Approximately 20% of adolescents in the United States have experienced ELS at some point, and these experiences influence adolescent and adult health behavior outcomes. Adults with a history of ELS display higher rates of substance use disorders (SUD) and report earlier initiation of substance use. Additionally, ELS has been associated with early puberty, which in turn is linked to earlier substance use initiation. Our study examines the roles of pubertal status, sex hormones (estradiol, testosterone, and DHEA) and ELS as predictors of the initiation of substance use among a nationally representative sample of male and female adolescents in NIDA’s Adolescent Brain Cognitive Development (ABCD) database. Methods: Baseline measures from the ABCD database release 5.0 were used to generate an ELS score (0-60), puberty assessed via parental report on the Pubertal Development Scale (PDS, 1-4), and sex hormones (estradiol, testosterone, and DHEA) were analyzed via salivary samples. The relationship between these scores and time to first use of alcohol, nicotine, and marijuana was determined via survival analysis utilizing a cox regression. Age was tested as a covariate in the interaction of ELS and time to first use of alcohol, nicotine, and marijuana. Data were analyzed overall and for biological boys and girls separately (N=11,866, 52%M 48%F. ages 9-11 at baseline). Results: We observed additive effects of PDS score, estradiol measure, age, and ELS on time to first use of any substance (alcohol, nicotine, or marijuana) and found age (Exp β= 1.029, p<0.001) and ELS (Exp β= 1.017, p<0.05) to be significant predictors of time to first use. After separating by sex, ELS was no longer a significant predictor for males (Exp β= 1.014, p=0.054), but remained a predictor for females (Exp β= 1.019, p<0.05) indicating the overall effect was driven by females. Additionally, salivary estradiol was a significant predictor of first use for females (Exp β= 1.208, p<0.05), while salivary DHEA and testosterone were not predictors for males or females. Conclusions: Our results indicate sex does moderate the relationship between ELS and substance use initiation within our population, with females showing increased risk of initiation with increases in estradiol. Further findings from our study will help to describe sex differences among the factors that increase the risk of substance use initiation among ELS-exposed youth and explore how these vary by substance. ABCD provides an unprecedented opportunity to explore the mechanisms behind complex effects of ELS by sex on risk factors for adolescent substance use initiation. Presentation: 6/1/2024

Associations of black and sugar-sweetened coffee consumption with depressive symptoms: A longitudinal study of Chinese adolescents

BackgroundPrevious research revealed an association between coffee consumption and depressive symptoms. However, the results differed between studies in adults and adolescents. Additionally, limited research on coffee and depressive symptoms has distinguished between black and sugar-sweetened coffee. Furthermore, few studies have examined the potential sex differences in the abovementioned association. This longitudinal study aimed to explore the associations of black and sugar-sweetened coffee consumption with subsequent depressive symptoms in adolescents while also investigating sex disparities within these associations. MethodsIn this longitudinal study, 10,770 individuals completing standardized questionnaires at baseline and follow-up were included in the main analysis. The data were analyzed using generalized linear mixed-effects models, and subgroup analyses were grouped according to sex. ResultsAfter adjusting for covariates and baseline depressive symptoms status, adolescents who consumed black coffee daily (OR, 1.45; 95 % CI, 1.14–1.84) had a greater risk of experiencing depressive symptoms compared with those who did not consume it or consumed it monthly. Similarly, in comparison with none or monthly consumers, those who consumed sugar-sweetened coffee weekly (OR, 1.22; 95 % CI, 1.03–1.44) and daily (OR, 1.32; 95 % CI, 1.02–1.73) demonstrated an elevated risk of having depressive symptoms. Subgroup analyses showed that black and sugar-sweetened coffee consumption was associated with depressive symptoms only in males. LimitationsSelf-reported data on coffee consumption and depressive symptoms. ConclusionsAdolescents who consume black or sugar-sweetened coffee weekly or daily are at a higher risk of developing depressive symptoms, with this association appearing to be more pronounced in male adolescents. Future studies are needed to confirm these findings.

Male Gender Expressivity and Diagnosis and Treatment of Cardiovascular Disease Risks in Men

Male gender expressivity (MGE), which reflects prevalent sociocultural pressures to convey masculinity, has been associated with health. Yet, little is known about associations of MGE with the diagnosis and treatment of modifiable cardiovascular disease (CVD) risks. To investigate associations of MGE with modifiable CVD risk diagnoses and treatment in men. This population-based cohort study included data from waves I (1994-1995), IV (2008-2009), and V (2016-2018) of the US National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants were male adolescents (age 12-18 years) followed up longitudinally through younger adulthood (age 24-32 years) and adulthood (age 32-42 years). Data were analyzed from January 5, 2023, to August 28, 2024. Male gender expressivity was quantified in adolescence and younger adulthood using an empirically-derived and validated measurement technique that incorporates participants' responses to existing Add Health survey items to capture how similarly participants behave to same-gendered peers. Outcomes included self-reported diagnoses of CVD risk conditions (hypertension, diabetes, or hyperlipidemia) in adult men with elevated blood pressure, hemoglobin A1c, or non-high-density lipoprotein cholesterol levels, and self-reported treatment with antihypertensive, hypoglycemic, or lipid-lowering medications in adults reporting hypertension, diabetes, or hyperlipidemia. Multivariable regression was used to examine associations of adolescent and younger adult MGE with adult CVD risk diagnoses and treatment, adjusting for sociodemographic covariates. Among 4230 eligible male participants, most were non-Hispanic White (2711 [64%]) and privately insured (3338 [80%]). Their mean (SD) age was 16.14 (1.81) years in adolescence, 29.02 (1.84) years in younger adulthood, and 38.10 (1.95) years in adulthood. Compared with participants whose younger adult MGE was below average, those with higher younger adult MGE were overall less likely to report hypertension (22% vs 26%; P < .001), diabetes (5% vs 8%; P < .001), and hyperlipidemia (19% vs 24%; P < .001) diagnoses and diabetes treatment (3% vs 5%; P = .02) as adults. In multivariable models, every SD increase in adolescent MGE was associated with lower probabilities of adult hypertension treatment (MGE,-0.11; 95% CI, -0.16 to -0.6) and diabetes diagnoses (MGE, -0.15; 95% CI, -0.27 to -0.03). Higher younger adult MGE was associated with lower probabilities of adult hypertension diagnoses (MGE, -0.04; 95% CI, -0.07 to -0.01), hypertension treatment (MGE, -0.07; 95% CI, -0.13 to -0.01), and diabetes treatment (MGE, -0.10; 95% CI, -0.20 to -0.01). Adolescent and younger adult MGE outcomes were not associated with other adult CVD outcomes. In this cohort study of US males, higher adolescent and younger adult MGE was associated with lower adult hypertension and diabetes diagnoses and treatment. These findings suggest that males with high MGE may bear distinctive risks and correspondingly benefit from tailored public health efforts to prevent downstream CVD.

Sleep patterns in adolescents and associations with substance use

ObjectivesGood sleep during adolescence is crucial for maintaining physical and psychological health; however, sleep disturbance during this period may contribute to health risks, such as substance use. This study aimed to identify the latent sleep patterns across male and female adolescents, and their association with drug use. MethodA cross-sectional study was conducted involving 1391 high school students (aged 15-17; 56.4% female). Participants completed the brief Pittsburgh Sleep Quality Index alongside other sleep measures, and the Timeline Follow-Back and Drug Use History Questionnaire to measure substance use. A multiple-group latent class analysis was used to identify sleep patterns across sexes, and pairwise Logistic Regression models to compare their association with substance use. ResultsFour sleep patterns were identified with varying degrees of sleep difficulties: "Good Sleep" (43.3%), "Night Awakenings" (31.8%), "Poor Efficiency and Sleep Onset" (9.4%), and "Poor Sleep" (15.5%). Female adolescents were more likely to belong to Poor Sleep and Poor Efficiency and Sleep Onset patterns, and male adolescents to Good Sleep. Likewise, binge drinking and using alcohol for a longer period were associated with experiencing Poor Efficiency and Sleep Onset (OR=1.03 and 2.3, respectively); smoking tobacco within the past month was linked to Night Awakenings (OR=2.2); and using cannabis or illegal drugs to the Poor Sleep pattern (OR=2.4 and 2.6, respectively). ConclusionsVaried sleep difficulties exist among adolescents that significantly correlate with different aspects of drug use. Targeted interventions that address both sleep and drug prevention are recommended.

Dose-Response Relationships of Moderate to Vigorous Physical Activity and Sedentary Time With Renal Function Indices in Adolescents With Reduced Renal Function: A Cross-Sectional Study.

This study aimed to explore the associations between moderate to vigorous physical activity (MVPA) and sedentary time with renal function indices in adolescents with kidney disease. A cross-sectional study was conducted on 719 adolescents (median age 15y, 40.6% female) with kidney disease from the National Health and Nutrition Examination Survey 2007-2016. The exposures were MVPA time and sedentary time. Renal metabolic parameters included serum uric acid (SUA), creatinine, blood urea nitrogen, the estimated glomerular filtration rate (eGFR), and the albumin creatinine ratio. Weighted multivariate regression analysis was used to estimate associations between exposures and outcomes. After stratifying MVPA time, the regression effect values β (95% CI) for MVPA on SUA (Q2: -0.22 [-0.41 to -0.03]; Q3: -0.32 [-0.53 to -0.11]) and creatinine (Q2: -0.08 [-0.15 to -0.01]; Q3: -0.04 [-0.11 to 0.03]) gradually decreased with increasing MVPA time. In males (-0.76 [-1.19 to -0.32]), MVPA time was significantly associated with lower SUA levels compared with females (-0.14 [-0.38 to 0.10]). Notably, female adolescents who had an MVPA time exceeding 420minutes exhibited lower albumin creatinine ratio (-75.37 [-146.63 to -4.11]). In addition, both recreational MVPA time (-0.26 [-0.45 to -0.06]) and sedentary time (-3.15 [-5.83 to -0.46]) were negatively associated with eGFR. Our study found an association between MVPA and lower levels of SUA in male adolescents with kidney disease and albuminuria in female adolescents with kidney disease. In addition, MVPA was also negatively associated with creatinine and eGFR, whereas sedentary time was only associated with eGFR. Further studies are needed to confirm these findings.

Stochastic health risk assessment of aflatoxin M1 in cow's milk among Lebanese population

This study quantitatively assessed AFM1 exposure through consumption of cows' milk in Lebanese adolescents and adults. Lebanon-specific, non-aggregated data on (i) milk intake and body weight – from an existing survey for adults and from a new survey for adolescents, and (ii) AFM1 occurrence in milk, were fitted to distributions and incorporated into a probabilistic model. Risk of hepatocellular carcinoma (HCC) for milk consumers was estimated considering the incidence of hepatitis B virus in Lebanon and characterized using the margin of exposure (MOE). All subgroups’ mean risk estimates, expressed as additional HCC cases per 100 000 population per year, were significantly different (p < 0.05), and ranged from 2.2x10−4 for adult males to 4.9x10−4 for adolescent males. This variation is attributed to significant differences in body weight and milk intake. MOE identified adolescent males and females as at-risk populations (mean 9628 and 8108, respectively). For adults, levels of concern were only reached with extreme consumption and/or contamination events. Considering that exposure from other sources (e.g., dairy) is cumulative, control of AFM1 in milk in Lebanon should be a risk management priority to ensure protection of younger populations.

Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilizing Validated Scales and Innovative Sampling Methods

PurposeThis study aimed to estimate the prevalence of mental health problems and identify potential risk and protective exposures for adolescents in Indonesia. MethodsAn innovative sampling approach was applied to simultaneously recruit school- and community-based adolescents aged 16–18 years old from Jakarta (urban megacity) and South Sulawesi (remote province). We used multistage cluster sampling for in-school (N = 1,337) and respondent driven sampling for out-of-school (N = 824) adolescents. Mental health was measured using two validated scales: Kessler-10 and Center for Epidemiologic Studies Depression Scale-Revised. Psychiatric interviews were conducted in a subsample (N = 196) of students from Jakarta to validate the self-report scales. ResultsThe estimated population prevalence of psychological distress and depression were 24.3% (95% CI = 21.5–27.2) and 12.6% (10.5–14.4) for in-school and 23.7% (20.7–26.7) and 23.5% (20.4–26.5) for out-of-school adolescents, respectively. In participants who completed a psychiatric interview, common psychiatric morbidities were social anxiety, depression, and suicidality. Compared to in-school females, male in-school adolescents reported a lower prevalence of psychological distress (16.9% (13.1–20.7) vs. 30.4% (26.4–34.4)) and depression (10.1% (7.2–13.1) vs. 14.6 (11.4–17.8)). By contrast, for out-of-school adolescents, males reported a higher prevalence of psychological distress (25.2% (21.6–28.9) vs. 20.2% (15.1–25.3)) and depression (26.3% (22.5–30.1) vs. 16.9% (11.8–21.9)). In-school adolescents who did not seek healthcare despite a perceived need were more likely to report psychological distress and depression. DiscussionAdolescent mental health problems are highly prevalent in Indonesia, with substantial variation by gender, geography, and school enrolment. This study and its approach to sampling and measurement may serve as a model to improving mental health surveillance across other settings.

The effects of moderate alcohol and THC co-use during male and female rat adolescence on AKT-GSK3ß signaling in adulthood

Alcohol and cannabis are often taken in combination, and extensive co-use has been linked to enduring changes in cognitive and metabolic functioning. The underlying mechanisms for these effects are unclear, but we recently demonstrated that co-administration of ethanol and delta-9-tetrahydrocannbinol (THC) to adolescent rats caused lasting adaptations in GABA and glycogen synthase kinase 3ß (GSK3ß) signaling in the medial prefrontal cortex (mPFC). As a ubiquitous protein kinase, GSK3ß is downstream to the protein kinase B (also known as AKT) pathway that is activated by insulin receptor signaling in a main control center for metabolism and energy homeostasis, the mediobasal hypothalamus (MBH). Our goal here was to investigate if volitional co-use of low to moderate levels of ethanol and THC would impact the total and phosphorylated levels (p) of AKT and GSK3ß in the mPFC and MBH. Peri-adolescent Long Evans rats [postnatal day (P) 30–47] consumed 10 % ethanol, cookies laced with THC (3–10 mg/kg/day), both drugs, or vehicle controls. On P114, we modeled re-exposure to a behaviorally relevant dose of THC by challenging rats (i.p.) with 5 mg/kg THC (or vehicle) and sacrificed them 30 min later. Western blot analysis revealed that THC challenge increased pAKT and pGSK3ß compared to control similarly across all treatment groups, sexes, and brain regions; no effects on total levels of AKT or GSK3ß were found. Previously reported behavioral results from these rats showed no differences in working memory assessed in adulthood. Although future studies will be necessary to determine the role of exposure dose on drug-induced adaptations in AKT and GSK3ß signaling, the current findings suggest that moderate volitional co-use of alcohol and THC may not produce long-term deficits that persist into adulthood.

Engaging sexual minority adolescents in nationwide at-home HIV prevention research in the U.S

ObjectivesThis study examined research-related privacy and confidentiality concerns among adolescent sexual minority males (ASMM) and provides lessons learned to inform recruitment and enrollment strategies for this population. MethodsParticipants were a 2017–2018 internet-based U.S. national sample of sexual minority adolescents who responded to self-report measures of privacy and confidentiality concerns. Results: Bivariate chi-square tests were used to identify participants’ mean differences in worry and likelihood of privacy breach occurrences. Many participants reported privacy-related concerns within remote HIV prevention research. ConclusionsStudy protocols were designed to ensure participants felt safe participating in online HIV prevention research. However, there are challenges to enroll participants with rigorous protocols for ensuring safety and privacy.

Multisession tDCS combined with intrastimulation training improves emotion recognition in adolescents with autism spectrum disorder

Previous studies indicate that transcranial direct current stimulation (tDCS) is a promising emerging treatment option for autism spectrum disorder (ASD) and its efficacy could be augmented using concurrent training. However, no intrastimulation social cognition training for ASD has been developed so far. The objective of this two-armed, double-blind, randomized, sham-controlled clinical trial is to investigate the effects of tDCS combined with a newly developed intrastimulation social cognition training on adolescents with ASD. Twenty-two male adolescents with ASD were randomly assigned to receive 10 sessions of either anodal or sham tDCS at F3/right supraorbital region together with online intrastimulation training comprising basic and complex emotion recognition tasks. Using baseline magnetic resonance imaging data, individual electric field distributions were simulated, and brain activation patterns of the training tasks were analyzed. Additionally, questionnaires were administered at baseline and following the intervention. Compared to sham tDCS, anodal tDCS significantly improved dynamic emotion recognition over the course of the sessions. This task also showed the highest activations in face processing regions. Moreover, the improvement was associated with electric field density at the medial prefrontal cortex and social awareness in exploratory analyses. Both groups showed high tolerability and acceptability of tDCS, and significant improvement in overall ASD symptoms. Taken together, multisession tDCS improved dynamic emotion recognition in adolescents with ASD using a task that activates brain regions associated with the social brain network. The variability in the electric field might diminish tDCS effects and future studies should investigate individualized approaches.

Navigating treatment: A framework analysis of perspectives of male adolescents with disordered eating in clinical settings.

Navigating treatment: A framework analysis of perspectives of male adolescents with disordered eating in clinical settings.

Peruvian Adolescent Mental Health Across Two Years of the COVID-19 Pandemic: A Four Time-Point Longitudinal Study

PurposeThis study investigated symptoms of anxiety and depression, feelings of loneliness, and life satisfaction among low-to-middle income Peruvian adolescents during 2 years of remote schooling due to the COVID-19 lockdown. MethodsWe used a four-wave longitudinal observational approach. Data were collected in April 2020, October 2020, June 2021, and November 2021 in Perú. A total of 2,392 adolescents (ages 10–15; 57% female) participated in the study. We described longitudinal changes in symptoms of anxiety and depression, feelings of loneliness, and life satisfaction across the four time points and investigated sex and school grade differences. ResultsSymptoms of anxiety, depression, and loneliness increased, and life satisfaction decreased over the course of 2 years of remote education. The rate of change was different for each outcome of well-being. We found robust sex differences for all outcomes. In addition, we found school grade differences for anxiety and depression. DiscussionThe mental health and well-being of Peruvian adolescents, particularly female adolescents, declined during 2 years of remote education, despite loosening of other pandemic restrictions. Depression appears to have the earliest impacts, with anxiety levels showing even some improvement for male adolescents. School grade differences in levels of anxiety and depression for seventh and eighth graders in 2020 and 2021 provide initial evidence to disentangle pandemic from developmental effects.

Pilonidal granuloma formation after an incision and drainage procedure is associated with retained hair within the sinus – A case series

Introduction and importancePilonidal disease may present with a draining secondary sinus or granuloma, but the development of these findings is not well-characterized. Case presentationTwo adolescent males presented with pilonidal disease. The first patient had a gluteal cleft abscess, and an incision and drainage procedure was performed. Although the abscess resolved, the incision site formed a granuloma with intermittent draining wound with granulation tissue. He underwent a pit-picking procedure along with excision of the granuloma. A large amount of hair was also removed from within the pilonidal sinus. The second patient underwent an incision and drainage procedure to treat the pilonidal abscess. The incision site evolved into a granuloma with recurring drainage. A pit-picking procedure was performed, and the granuloma was excised. During the excision, a moderate amount of hair was evacuated from the pilonidal sinus. Clinical discussionMany pilonidal patients present with a granuloma or secondary sinus at the gluteal cleft, but there has been no documentation of the natural history of this development. The role of hair is central to pilonidal disease pathophysiology and is a known factor in foreign body granuloma formation – a cutaneous inflammatory response to endogenous or exogenous material in the dermis that is not broken down readily by macrophages. ConclusionEven though the pilonidal abscess was drained with an incision, a granuloma was able to form with recurrent drainage when hair was retained within the pilonidal sinus.

A geography of early vulnerabilities and exploitation in the narratives of adolescent males in England

Purpose The victimisation and criminal involvement of young people in organised criminal groups is a recognised form of child criminal exploitation (CCE) in the UK. Three phases of exploitation were identified (peer influence, adult street-level gangs and organised criminal groups). This paper aims to consider the locations associated with three stages of criminal exploitation and considers implications for safeguarding. Design/methodology/approach The research uses narratives of adolescent males and those of adults reflecting on their experiences as adolescents who had been immersed in street gangs and organised crime from northern England. Method Narratives of criminal action approach, a thematic analysis and multidimensional scaling (smallest space analysis) were undertaken to explore key locations in the planning and commissioning of a crime with at least one other person. Findings The narratives revealed that local and regional geographic locations relate to the stages of CCE. They offer an insight into the process of CCE and identify locations that could be used as a risk indicator for police forces and safeguarding teams. A clear pathway from involvement with street-level gangs to direct contact with organised criminal groups was found. This transition was represented by a move from outdoor to indoor locations. Research limitations/implications Out of the 30 participants, 29 came from the same region in Northern England, spanning a period of 30 years. It is possible that the findings may be limited to this region, or that there have been changes to criminal structures and opportunities over this time. Originality/value Although drug selling and the movement of victims across the UK is central to CCE, comparatively little attention has been given to the locations where early exploitation takes place at a micro level. Practical implications for policing and safeguarding will be discussed.

The Effect of a 12-week Plyometric Training on Growth Hormone, IGF-1 and Bone Health Indexes in Adolescent Boys

Background: During adolescence, physical activity influences bone mass, which is determined by both genetic and environmental factors. Objectives: This study examines the effect of plyometric exercises on serum markers in male adolescents, including growth hormone, vitamin D, parathyroid hormone, phosphate, and calcium. Methods: The study involved a sample of 30 male adolescents aged 15 years ± 6 months. The participants were divided into two groups: the first group, named the plyometric group (PG), included 15 adolescents who underwent plyometric training sessions three times a week for a duration of 12 weeks. The second group, called the control group (CG), consisted of 15 adolescents who only attended their normal school lessons without any physical training. Resting levels of GH, IGF-1, vitamin D, calcium, phosphate, and PTH were measured before and 48 hours after the last training session, along with bone mass density (BMD) measurements of the femoral neck, lumbar spine, and total body. To evaluate power, the vertical Sargent jump test was used. Results: The results indicate that the PG demonstrated significant improvements in BMD, explosive strength, GH, IGF-1, and vitamin D levels compared to the CG group (P &lt; 0.05). Changes in phosphate, calcium, and PTH were not significant in the PG compared to the CG after 12 weeks of plyometric training (P &gt; 0.05). Conclusions: The 12-week plyometric program resulted in notable enhancements in bone health, explosive strength, and anabolic hormones such as GH and IGF-1, as well as 25-hydroxyvitamin D serum levels.

Does Stress Affect Adolescent Anxiety by Mediating Sleep Time?

Background: Health is essential for the sustainable well-being, yet high stress, anxiety, and lack of sleep among Korean adolescents have become significant social concerns.Methods: This study examined the impact of stress on anxiety and investigated whether sleep time mediates this relationship in 46,870 male and female adolescents, ranging from first-year of middle school students to third-year high school students. Data were obtained from the "18th Korea Youth Risk Behavior Survey" conducted by the Korea Disease Control and Prevention Agency.Results: The analysis showed that increased stress was associated with reduced sleep time and higher anxiety levels, stress was found to heighten anxiety, partly by reducing sleep time.Conclusions: Based on these findings, the study recommends: ① developing mental health indicators to quickly identify adolescents at risk for mental health issues, ② encouraging cooperation between schools, government agencies, healthcare providers to enhance access to mental health programs for adolescents, and ③ implementing policies that promote healthy behaviors, ensure adequate sleep, and improve overall well-being.