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Objetivo: Evaluar el impacto económico que genera el tratamiento quirúrgico de la papilomatosis respiratoria recurrente en el tercer nivel de atención. La papilomatosis respiratoria recurrente es una entidad prevalente. El impacto económico que genera se encuentra principalmente en la necesidad de las repetidas intervenciones quirúrgicas que requiere a lo largo de su evolución, además de la morbilidad que ocasiona esta en el paciente. Materiales y métodos: Este estudio se realizó en el Hospital de Especialidades N° 2, Centro Médico Nacional del Noroeste, IMSS. Diseño retrospectivo, observacional, trasversal. Muestreo no probabilístico por serie consecutiva de casos. En la descripción general del estudio, se revisaron los expedientes clínicos de los pacientes con diagnóstico de papilomatosis respiratoria recurrente atendidos en el servicio de esta institución de enero de 2010 a enero de 2012. Se tomaron datos como la edad, sexo, manejo quirúrgico y/o terapia coadyuvante, y costo generado por su atención quirúrgica exclusivamente. Resultados: De un total de 103 expedientes revisados, solo 39 se encontraron completos y cumplieron con los criterios de inclusión: 16 (41%) eran de sexo femenino y 23 (59%), de sexo masculino. Se encontraron 27 casos (69%) juveniles y 12 (30.8%) adultos. Solo 19 casos (48.7%) recibieron terapia coadyuvante. En 15 casos (38.5%) se practicó traqueotomía. El costo directo por intervención quirúrgica de resecciones fue de $322,943.92 (22,190 USD) en el grupo juvenil y de $55,225.33 (3,790 USD) en el grupo adulto. Conclusiones: El tratamiento quirúrgico de la papilomatosis respiratoria recurrente representa una carga financiera y una gran morbilidad tanto para las instituciones de salud como para la familia.

Objective: To evaluate the economic impact generated by surgical treatment of recurrent respiratory papillomatosis in the tertiary care level. Recurrent respiratory papillomatosis is a prevalent entity. The economic impact it generates is mainly due to the need for repeated surgical interventions throughout its progression, in addition to the morbidity it causes to the patient. Materials and methods: This retrospective, observational, cross-sectional study was carried out at the Specialty Hospital No. 2, National Medical Center of the Northwest, Mexican Social Security Institute (IMSS), using a non-probability sampling by consecutive case series. In the general description of the study, clinical records of patients diagnosed with recurrent respiratory papillomatosis treated at this institution from January 2010 to January 2012 were reviewed. Data such as age, gender, surgical management and/or adjuvant therapy, and cost generated by exclusive surgical care, were collected. Results: Out of a total of 103 reviewed files, only 39 were complete and met the inclusion criteria: 16 (41%) were female and 23 (59%) were male. Twenty-seven (27) cases (69%) were juvenile patients and 12 (30.8%) were adults. Only 19 cases (48.7%) received adjuvant therapy. Tracheotomy was performed in 15 cases (38.5%). The direct cost for resection surgery was $322,943.92 (22,190 USD) in the juvenile group and $55,225.33 (3,790 USD) in the adult group. Conclusions: Surgical treatment for recurrent respiratory papillomatosis represents a financial burden and great morbidity for both health institutions and the family.

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BACKGROUND: Feeding modes and appetence toward certain foods are usually conditioned by the family. Obesity during adolescence usually persists during adulthood. AIM: To determine differences in family structure of adolescents according to their nutritional status. MATERIAL AND METHODS: A cross-sectional study was conducted in 60 overweight-obese and 60 normal weight adolescents. Family type was determined based on their conformation (kinship and cohabitation), development (if the mother had a remunerated job), demography (geographical area), integration (functions of the couple); life cycle stage and functionality. RESULTS: Fifty eight percent of normal weight adolescents had simple nuclear families and 47% of overweight-obese adolescents had an extended family. Thirty one and 21% of overweight/obese and normal weight adolescents lived with an overweight/obese individual, respectively. CONCLUSIONS: There are differences in the family structure of overweight/obese and normal weight adolescents.

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Background: Feeding modes and appetence toward certain foods are usually conditioned by the family. Obesity during adolescence usually persists during adulthood. Aim: To determine differences in family structure of adolescents according to their nutritional status. Material and Methods: A cross-sectional study was conducted in 60 overweight-obese and 60 normal weight adolescents. Family type was determined based on their conformation (kinship and cohabitation), development (if the mother had a remunerated job), demography (geographical area), integration (functions of the couple); life cycle stage and functionality. Results: Fifty eight percent of normal weight adolescents had simple nuclear families and 47% of overweight-obese adolescents had an extended family. Thirty one and 21% of overweight/obese and normal weight adolescents lived with an overweight/obese individual, respectively. Conclusions: There are differences in the family structure of overweight/obese and normal weight adolescents.

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BACKGROUND: Pediatric obesity has become a problem of epidemic proportions, due to the inadequate and excessive consumption of food, sedentary lifestyle, and the restricted socio-economic development. This causes a major risk in health complications that have an effect on the psychological and social spheres of the child, which makes him endure such diseases as depression and anxiety. The aim of this study was to determine the association between depression and the nutritional status of schoolchildren from a family medicine unit in Sonora. METHODS: Cross-sectional study performed during 2011 in 101 schoolchildren from Sonora. Kovacs test was applied to detect depressive symptoms; nutritional status was determined by weight and height; body mass index was calculated according to the Center for Disease Control and Prevention (CDC) percentiles. The results were analyzed in SPSS version 18 using Mann-Whitney U and chi-square. RESULTS: Of all the patients with depression, 19 were obese; the other 10 showed a normal nutrition status. Patients with low weight did not show depression. The odds ratio (OR) for depression in students with obesity was 3.16, 95 % CI = 1.13, 7.12. CONCLUSIONS: The detection and management of depression should be considered in the treatment of obesity.

INTRODUCCIÓN: la obesidad infantil se ha convertido en un problema cuyas proporciones son epidémicas, debido al consumo excesivo e inadecuado de alimentos, al sedentarismo y al limitado desarrollo socioeconómico. Esto ocasiona un mayor riesgo en complicaciones en la salud que repercuten en el ámbito psicológico y social del infante, lo cual lo lleva a padecer enfermedades como la depresión y la ansiedad. El objetivo de este estudio fue determinar la asociación entre la depresión y el estado de nutrición en escolares adscritos a una unidad de medicina familiar en Sonora. MÉTODOS: estudio transversal analítico que se llevó a cabo durante el 2011 en 101 escolares de Sonora. Se aplicó el test de Kovacs para detectar síntomas depresivos; se determinó el estado nutricional mediante peso y talla, y el cálculo del índice de masa corporal se hizo de acuerdo con los percentiles de las tablas del Centro para el Control y la Prevención de Enfermedades (CDC, por sus siglas en inglés) de Atlanta. El análisis de los resultados se realizó con U de Mann-Whitney y chi cuadrada en el programa SPSS, versión 18. RESULTADOS: del total de pacientes con depresión, 19 presentaron obesidad y el resto presentó estado de nutrición normal (10); los pacientes con bajo peso no presentaron depresión. La razón de momios para depresión en escolares con obesidad fue de 3.16 con un IC al 95 % de 1.13; 7.12. CONCLUSIÓN: la detección y manejo de depresión debe ser considerada dentro del tratamiento de la obesidad.

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BACKGROUND: The management of obesity is complex and it must be multidisciplinary. Behavioral treatments for control of childhood obesity are based on family; these have a high degree of efficiency. It has been argued that when children and their parents are the main goal of the changes of behavior as a group, results of weight loss generally are better. The objective of this study was to establish the effect of an intervention based on family to reduce weight in students with overweight or obesity. METHODS: Quasi-experimental study in schoolchildren from 6 to 12 years of age, from a family medicine unit in Ciudad Obregón, Sonora, México. The intervention group corresponded to 30 schoolchildren with overweight or obesity, and one or both of their parents with overweight or obesity; the control group included 30 schoolchildren with overweight or obesity, and normal-weight parents. Weight, height and body mass index (BMI) were measured at baseline, monthly, and at the end of the study. Student t test was used to contrast quantitative variables using the SPSS v.15 program. RESULTS: There were differences in weight, but not in BMI, probably due to the effect of size. Compared with the control group, a higher proportion of schoolchildren showed an improvement with regard to nutritional status. CONCLUSIONS: The family intervention is basic for the treatment of overweight and obesity in schoolchildren.

INTRODUCTIÓN: el manejo de la obesidad es complejo y debe ser multidisciplinario; los tratamientos conductuales basados en la familia para el control de la obesidad infantil tienen un alto grado de eficacia. Se ha argumentado que cuando los niños y los padres son blanco de los cambios de comportamiento en conjunto, los resultados de pérdida de peso generalmente mejoran. El objetivo es determinar el efecto de una intervención basada en la familia para la reducción de peso en escolares con sobrepeso u obesidad. MÉTODOS: estudio cuasi experimental en escolares de 6 a 12 años de la Unidad Médica Familiar 1 en Ciudad Obregón, Sonora. El grupo de intervención correspondió a 30 escolares con sobrepeso u obesidad, además de que uno o ambos padres presentaron sobrepeso u obesidad; en el grupo control se incluyeron 30 escolares con sobrepeso u obesidad, y padres con peso normal. Se midió peso, talla e índice de masa corporal (IMC) basal, final y mensual. Se utilizó t de Student para contrastar las variables cuantitativas, por medio del programa SPSS, versión 15. RESULTADOS: hubo diferencias en peso, pero no en IMC, probablemente por el efecto de la talla. Mayor proporción de escolares presentó mejoría en estado de nutrición comparado con el grupo control. CONCLUSIONES: es básica la intervención familiar para el tratamiento del sobrepeso y la obesidad en escolares.

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