INTRODUCTION The global prevalence of obesity has reached alarming proportions. In Cuba, the rise in numbers of children who are overweight or obese, especially preschoolers and adolescents, is similar to that observed in developed countries. Beyond the physical risk factors, there is evidence that obesity has negative psychological, social, academic and economic effects.
OBJECTIVES Describe the psychological, behavioral and familial factors present in a group of obese children and adolescents in Cuba.
METHODS This is a qualitative cross-sectional study of 202 obese children and adolescents aged 3–18 years, with an average age of 9.9 years, seen at the Medical–Surgical Research Center (Havana) psychology service from January 2009 through December 2012. Techniques included interviews of patients and parents, projective drawings and the Rotter Incomplete Sentence Blank.
RESULTS Unhealthy eating habits were reported in 96% of obese children and adolescents, and sedentary lifestyles in 88.1%. Emotional state was affected in 80.2%, and in 72.3% there were family attitudes with potential to produce psychological disturbances in children.
CONCLUSIONS Psychological, behavioral, and familial factors known to foster development and perpetuation of obesity were observed in the majority of cases. This is a first diagnostic stage that will aid in design and implementation of a psychological intervention program for obese and overweight children and their families.
KEYWORDS Obesity, psychosocial factors, childhood, adolescence, projective techniques, Cuba
ABSTRACT
INTRODUCTION Congenital esotropia is a convergent deviation of the eyes when fixating on an object. It appears during the first six months of life and affects muscle structure and physiology, as well as the relation of the eyes with the environment, retinal relations and neural integration phenomena. Amblyopia develops in 30–50% of those affected. Timely surgery is effective in most cases.
OBJECTIVE Describe surgical results in congenital esotropia cases treated in the Pediatric Ophthalmology and Strabismus Service of the Ramon Pando Ferrer Ophthalmology Institute in Havana between January 2008 and May 2009.
METHODS A descriptive, retrospective study was carried out through review of 127 cases (aged 1–18 years, 55 male and 72 female) operated on for congenital esotropia from January 2008 to May 2009. Variables used were: age at surgery, degree of preoperative amblyopia, type of fixation, refractive error, associated conditions, type of surgery performed and pre- and postoperative deviation angles.
RESULTS The largest number of congenital esotropia cases were found in children <2 years old (38.6%). Before surgery, 37% of cases studied showed mild amblyopia; 22.8% moderate and 12.6% severe; 27.6% did not cooperate with visual acuity testing. With respect to fixation: 91.3% showed central fixation and 8.7% eccentric. Refractive errors found were: mild hyperopia (65.4%), moderate hyperopia (29.1%), and myopia (5.5%). Associated conditions were: overaction of the inferior oblique muscles (48%), latent nystagmus (16.5%), and dissociated vertical deviation (8.7%); no alterations were found in 26.8% of cases. The most frequently used surgical treatment was bilateral medial rectus muscle recession (92.1%). The most common preoperative deviation angle range was 31–40 prism diopters (PD) in 51.9% of patients; the postoperative deviation angle most commonly found after 12 months was <10 PD in 64.6% (orthotropia).
CONCLUSIONS Surgery, most commonly with medial rectus muscle resection, was effective in correcting congenital esotropia.
KEYWORDS Esotropia/congenital; esotropia therapy; oculomotor muscles/surgery; strabismus; squint; amblyopia; vision, binocular; Cuba
The following erratum has been corrected in all versions of this article.
