Prevalence of Chronic Non-Communicable Respiratory Diseases in Mosul City

@#Introduction: Chronic non-communicable respiratory diseases (CNCRDs) encompass a group of conditions affecting the airways and lung structures, including Chronic Obstructive Pulmonary Disease (COPD), emphysema, allergic rhinitis, asthma, pulmonary arterial hypertension, and cystic fibrosis. CNCRDs pose a significant global health challenge, resulting in approximately four million deaths annually. This study aimed to identify the prevalence and risk factors associated with CNCRDs and measure trends in the prevalence of these risk factors over time. Methods: A cross-sectional epidemiological study was conducted using data collected from primary health centers on both sides of Mosul City. The study period extended from January 1 to July 31, 2022, with information obtained from (40) primary health centers, consisting of (20) centers on the right side and (20) centers on the left side of Mosul. Results: In 2021, the City of Mosul recorded a total of 13,005 registered cases, with 5,598 cases being attributed to asthma (43%), and 7,347 cases being associated with COPD (57%). Bronchial asthma constituted 43% of cases, with 5598 patients, and the highest incidence occurred in the age group between 20-44 years. Conclusion: The prevalence of bronchial asthma and COPD among patients with CNCRDs in Mosul is alarmingly high. It emphasizes the importance of implementing preventive policies and strategies targeting modifiable risk factors for these respiratory conditions.

Beneficios que reciben los pacientes asmáticos tras la aplicación de un tratamiento fisioterapéutico y rehabilitador

El asma bronquial sigue siendo la enfermedad crónica más frecuente en la infancia. Su prevalencia continúa aumentando a pesar de que en la actualidad se disponen de eficaces manuales terapéuticos para el correcto manejo de los principales síntomas de la enfermedad. El tratamiento no farmacológico de este padecimiento se fundamenta en tres pilares esenciales: la educación sobre la enfermedad, las guías para profesionales y pacientes y la fisioterapia respiratoria. Los pacientes que tienen un tratamiento fisioterapéutico y rehabilitador de manera habitual, tienen una mejoría significativa en el control del asma, especialmente si estos se practican bajo la supervisión de un fisioterapeuta. Los beneficios que los pacientes asmáticos logran con la fisioterapia y la rehabilitación son numerosos y uno de los efectos más importante es el impacto positivo sobre la calidad de vida.

Bronchial asthma continues to be the most common chronic disease in childhood. Its prevalence continues to increase despite the fact that effective therapeutic manuals are currently available for the correct management of the main symptoms of the disease. The non-pharmacological treatment of this condition is based on three pillars: education about the disease, guides for professionals and patients, and respiratory physiotherapy. Patients who have regular physiotherapy and rehabilitation treatment have a significant improvement in asthma control, especially if these are practiced under the supervision of a physiotherapist. The benefits that asthmatic patients achieve with physiotherapy and rehabilitation are numerous and one of the most important effects is the positive impact on quality of life.

Riesgo asociado al síndrome respiratorio agudo severo coronavirus 2 en adultos fallecidos, Hospital Municipal Boliviano Holandés, municipio El Alto, 2020 / Risk associated with severe acute respiratory syndrome coronavirus 2 in deceased adults, dutch bolivian municipal hospital, El Alto municipality, 2020

INTRODUCCIÓN: La Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2, es un problema de Salud Pública, por su alta tasa de mortalidad en la primera ola de la pandemia. OBJETIVO: Determinar los factores de riesgo asociados a la Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2 en pacientes fallecidos internados en el área Covid y Unidad de Terapia Intensiva del Hospital Municipal Boliviano Holandés, Municipio El Alto, en los meses de marzo a diciembre 2020. MATERIAL Y MÉTODOS: Estudio observacional analítico de casos y controles, los casos 25 fueron pacientes fallecidos de neumonía por SARS-CoV-2 durante la estadía hospitalaria y los controles 75 pacientes no fallecidos por la enfermedad. La fuente de información fue el expediente clínico, ficha de notificación epidemiológica y certificado médico único de defunción. Se clasificó las causas de fallecimiento según el Código internacional de enfermedades CIE 10. RESULTADOS: Se obtuvo información de 25 casos y 75 controles, relación 1:3. Pacientes fallecidos del sexo masculino 72% con p=0.040 (OR 2.77 IC 95% 1.042 - 7.449); La edad de 60 años con p=0.000 (OR 4.12 IC95% 1.596 - 10.664); lugar de residencia urbano 88%; el periodo infeccioso fue de 9.68 días (IC95%7.83-11.52), tiempo de internación 6.60 días p=0.010 (OR 4.03 IC95% 1.446 - 11.231); las Enfermedades Crónicas no Transmisibles 80% con p=0.040 (OR 2.98 IC95% 1.009 - 8.779); los pacientes internados en el área COVID tuvo una mortalidad de 68% con p=0.010 (OR 0.25 IC95% 0.083 - 0.774) y recibieron tratamiento farmacológico 72%. CONCLUSIÓN: El sexo masculino, mayor de 60 años y las enfermedades Crónicas no Transmisibles son un factor de riesgo para altas tasas de letalidad, resultados respaldados según Serra Valdés1.

INTRODUCTION: Pneumonia due to Severe Acute Respiratory Syndrome Coronavirus 2 is a Public Health problem, due to its high mortality rate in the first wave of the pandemic. OBJECTIVE: To determine the risk factors associated with Severe Acute Respiratory Syndrome Coronavirus 2 pneumonia in deceased patients hospitalized in the Covid area and Intensive Care Unit of the Bolivian Dutch Municipal Hospital, El Alto Municipality, from March to December 2020. MATERIAL AND METHODS: Analytical observational study of cases and controls, 25 cases were patients who died of SARS-CoV-2 pneumonia during their hospital permanence, and 75 controls were patients who did not die from the disease. The source of information was the clinical record. The method was documentary analysis, instruments were clinical histories, epidemiological notification sheet and official medical death certificate. The causes of death were classified according to the International Code of Diseases CIE 10. RESULTS: Information was obtained from 25 cases and 75 controls, ratio 1:3. 72% male patients who died with p=0.040 (OR 2.77 95% CI 1.042 - 7.449); The 60 years old with p=0.000 (OR 4.12 IC95% 1.596 - 10.664); urban area of residence 88%; the infectious period was 9.68 days (95%CI 7.83-11.52), hospitalization time 6.60 days p=0.010 (OR 4.03 95%CI 1.446 - 11.231); Chronic Noncommunicable Diseases of 80% with p=0.040 (OR 2.98 IC95% 1.009 - 8.779); The patients hospitalized in the COVID area had a mortality of 68% with p=0.010 (OR 0.25 IC95% 0.083 - 0.774) and 72% received pharmacological treatment. CONCLUSION: The male, over 60 years old and Chronic Non-Communicable Diseases are a risk factor for high-risk rates in high mortality rates, results are supported by Serra Valdés1.

Epigenética y enfermedades crónicas no trasmisibles: un nuevo enfoque preventivo

La prevención de las enfermedades crónicas no trasmisibles de elevada prevalencia a nivel mundial, como la hipertensión arterial, la diabetes mellitus, las enfermedades cardiovasculares y el cáncer, representa una prioridad en salud. La nueva perspectiva brindada por la epigenética sobre el origen intrauterino de las enfermedades que afectarán al ser humano durante la etapa posnatal, obliga a replantearse una nueva visión preventiva, que debe iniciarse desde el período prenatal de la vida. Con el objetivo de estructurar los referentes teóricos que sustentan la relevancia de un nuevo enfoque preventivo de las enfermedades crónicas no trasmisibles, basado en intervenciones modificatorias de los perfiles epigenéticos desfavorables durante la etapa prenatal del desarrollo humano, se realizó una actualizada búsqueda sobre el tema, consultándose 28 referencias bibliográficas. Condiciones maternas durante la gestación, como la malnutrición, el estrés, los hábitos tóxicos y la obesidad, constituyen factores causantes de modificaciones epigenéticas desfavorables, que serán trasmitidas a futuras generaciones e incrementarán en estas el riesgo de enfermedades durante la etapa posnatal de la vida. Se concluye que las intervenciones realizadas durante el período prenatal del desarrollo humano pueden contribuir a la prevención de enfermedades crónicas no trasmisibles, a lo que la epigenética aporta un nuevo enfoque en la prevención de este importante problema de salud.

The prevention of chronic non-communicable diseases with high prevalence around the world, such arterial hypertension, diabetes mellitus, cardiovascular diseases and cancer, represents a health priority. The new perspective given by epigenetics on the intrauterine origin of the diseases that will affect the human being during the post-natal stage, forces us to reconsider a new preventive vision which must begin from the prenatal period of life. With the aim of structuring the theoretical references that support the relevance of a new preventive approach to chronic non-communicable diseases, based on modifying interventions of unfavorable epigenetic profiles during the prenatal stage of the human development, an updated search on the subject was conducted, consulting 28 bibliographic references. Maternal conditions during pregnancy, such as malnourishing, stress, toxic habits and obesity, constitute factors that cause unfavorable epigenetic modifications, which will be transmitted to future generations and will increase in them the risk of disease during the post-natal stage of life. It is concluded that the interventions carried out during the prenatal period of human development can contribute to the prevention of chronic non-communicable diseases, to which epigenetics provides a new approach in the prevention of this important health problem.

Narrativa de um encontro com população indígena tapeba em Fortaleza- Ceará / Narrative of a meeting with indigenous tapeba population in Fortaleza- Ceará / Narrativa de una reunión con la población indígena tapeba en Fortaleza-Ceará

Objetivo: Relatar a experiência vivenciada no encontro sobre a saúde da população indígena Tapeba. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa sobre a Mesa-Redonda intitulada Os problemas vivenciados pelos portadores de Diabetes Mellitus e Hipertensão Arterial Crônica, realizada com profissionais atuantes junto a etnia, pesquisadores e representantes da população indígena Tapeba, Caucaia-Ceará, que ocorreu no Auditório da Escola de Saúde Pública do Ceará, em julho de 2022, com intuito de conhecer as narrativas cotidianas, mesclar saberes tradicional e científico e apreender sobre as Doenças Crônicas Não Transmissíveis (DCNT). Resultados: Participaram do encontro 22 profissionais de distintas áreas da saúde, observando-se que durante o encontro suscitou diferentes efeitos nos participantes, que se destacaram em três grandes categorias, a saber: 1)motivação de fala, 2) interação e representatividade com os temas ministrados, e 3) insegurança alimentar. Conclusão: O estudo demonstra que as DCNT configuram um problema de saúde em avanço entre as populações indígenas. Representantes do povo Tapeba puderam expor, para além do reconhecimento destes agravos na comunidade, a dificuldade encontrada em apreender as informações recebidas e aderir às orientações, além dos efeitos da pobreza, representadas na insegurança alimentar e desemprego. PALAVRAS-CHAVE: Povos Indígenas; Doenças Crônicas Não Transmissíveis; Pobreza; Insegurança Alimentar.

Objective: To report the experience of the meeting on the health of the indigenous population Tapeba. Methods: This is a descriptive study with a qualitative approach on the Round Table entitled The problems experienced by the sufferers of Diabetes Mellitus and Chronic Arterial Hypertension, carried out with professionals working with the ethnicity, researchers and representatives of the indigenous population Tapeba, Caucaia-Ceará, which took place at the Auditorium of the School of Public Health of Ceará, in July 2022, with the aim of knowing the daily narratives, merging traditional and scientific knowledge and learning about the Chronic Non-Communicable Diseases (CNCDs). Results: 22 professionals from different areas of health participated in the meeting, observing that during the meeting it produced different effects in the participants, which stood out in three major categories, namely: 1)speech motivation, 2) interaction and representativeness with the topics administered, and 3) food insecurity. Conclusion: The study shows that CNCDs are an ongoing health problem among indigenous populations. Representatives of the Tapeba people were able to explain, in addition to recognising these problems in the community, the difficulty they encountered in learning the information received and adhering to the guidelines, as well as the effects of poverty, represented in food insecurity and unemployment.

Propósito: Informar sobre la experiencia de la reunión sobre la salud de la población indígena Tapeba. Métodos: Se trata de un estudio descriptivo con un enfoque cualitativo en la Mesa Redonda titulada Los problemas experimentados por los portadores de diabetes mellitus e hipertensión arterial crónica, realizado con profesionales que trabajan con la etnia, investigadores y representantes de la población indígena Tapeba, Caucaia-Ceará, que tuvo lugar en el Auditorio de la Escuela de Salud Pública de Ceará, en julio de 2022, con el fin de conocer las narrativas cotidianas, fusionar los conocimientos tradicionales y científicos y aprender sobre la Diversidad Crónica No Transmisible (NSTD). Resultados: 22 profesionales de la salud asistieron a la reunión, señalando que durante la reunión se sintieron diferentes efectos en los participantes, que destacaron en tres grandes categorías, a saber: 1) motivación del discurso, 2) interacción y representatividad con los temas dados, y 3) inseguridad alimentaria. Conclusión: El estudio muestra que los DCNT constituyen por adelantado un problema de salud entre las poblaciones indígenas. Los representantes del pueblo Tapeba han podido explicar, además del reconocimiento de estas agravaciones en la comunidad, las dificultades encontradas para obtener la información recibida y adherirse a las directrices, así como los efectos de la pobreza, representadas en la inseguridad alimentaria y el desempleo.

Acompanhamento farmacoterapêutico no contexto das doenças crônicas e distúrbios menores em uma unidade básica de saúde de São Luís-Ma / Pharmacotherapeutic follow-up in the context of chronic diseases and minor disorders in a basic health unit of São Luís-Ma / Seguimiento farmacoterapéutico en el contexto de enfermedades crónicas y trastornos más pequeños en una unidad de salud básica de São Luís-Ma

As doenças crônicas não transmissíveis (DCNT's) são responsáveis por cerca de 74% da mortalidade global. Nesse contexto, o acompanhamento farmacoterapêutico surge como uma importante ferramenta para garantir uma farmacoterapia racional em prol da melhoria da qualidade de vida do paciente. Levando isso em consideração, este estudo tem como objetivo avaliar o impacto do acompanhamento farmacêutico na qualidade de vida de um paciente idoso com tratamento irracional da hipertensão arterial sistêmica (HAS), diabetes mellitus e outros sintomas da síndrome metabólica. Paciente M.M.D., masculino, 67 anos, hiperglicêmico, dislipidêmico e que se automedicava para hipertensão sem diagnóstico médico com uma série de medicamentos potencialmente inapropriados (PIM's). Após as intervenções farmacêuticas apresentou melhora nos quadros e maior adesão à terapia medicamentosa atrelada a melhores hábitos de vida. Dessa forma, o impacto positivo das intervenções durante o acompanhamento farmacêutico reforça a importância do profissional na atenção básica e na promoção da saúde.

Chronic non-communicable diseases (NCDs) account for about 74% of global mortality. In this context, pharmacotherapeutic follow-up appears to be an important tool for ensuring rational pharmacotherapy in favor of improving the patient's quality of life. Taking this into consideration, this study aims to evaluate the impact of pharmaceutical follow-up on the quality of life of an elderly patient with irrational treatment of systemic arterial hypertension (SAH), diabetes mellitus and other symptoms of metabolic syndrome. M.M.D. patient, male, 67 years old, hyperglycemic, dyslipidemic and self-medicating for hypertension without medical diagnosis with a series of potentially inappropriate medications (PIM's). After the pharmaceutical interventions showed an improvement in the conditions and greater adherence to drug therapy coupled to better habits of life. Thus, the positive impact of interventions during pharmaceutical follow-up reinforces the importance of the professional in basic care and health promotion.

Las enfermedades no transmisibles crónicas representan aproximadamente el 74% de la mortalidad mundial. En este contexto, el seguimiento farmacoterapéutico es una herramienta importante para garantizar una farmacoterapia racional para mejorar la calidad de vida del paciente. Teniendo esto en cuenta, este estudio tiene por objeto evaluar el impacto del seguimiento farmacéutico en la calidad de vida de un paciente de edad avanzada con el tratamiento irracional de la hipertensión arterial sistémica (HAS), la diabetes mellitus y otros síntomas del síndrome metabólico. Paciente con M.M.D. masculino de 67 años de edad, hiperglucemia, dislipidemia y automedicación para la hipertensión sin diagnóstico médico con una serie de medicamentos potencialmente inapropiados (PIMs). Después de las intervenciones farmacéuticas, mostró una mejoría en las tablas y una mayor adherencia a la terapia con medicamentos, junto con mejores hábitos de vida. De esta manera, el impacto positivo de las intervenciones durante el seguimiento farmacéutico refuerza la importancia del profesional en la atención básica y la promoción de la salud.

Association of child labor with risk and protective factors for Chronic Noncommunicable Diseases in Brazilian schoolchildren: National School Health Survey 2015 / Associação do trabalho infantil com fatores de risco e proteção para doenças crônicas não transmissíveis em escolares brasileiros: Pesquisa Nacional de Saúde do Escolar 2015

ABSTRACT Objective: To analyze the sociodemographic profile of adolescents working in Brazil and the association of child labor with risk and protection factors for Chronic Noncommunicable Diseases. Methods: Cross-sectional study with data from sample 2 of the 2015 National School Health Survey (PeNSE). The variables gender, age, ethnicity/skin color, administrative dependence on school and maternal education, eating habits, physical activity and drug use were analyzed by prevalence and respective 95% confidence intervals (95%CI) and calculation of crude and adjusted Odds Ratio. Results: A total of 10,926 students participated in the survey, of which 16.9% (95%CI 15.1-18.9) were currently working/employed. Child labor was higher among male adolescents (ORa: 1.82; 95%CI 1.55-2.15); aged between 16 and 17 years (ORa: 2.96; 95%CI 2.37-3.69); enrolled in public schools (ORa: 1.69; 95%CI 1.14-2.52); whose mothers had incomplete high school (ORa: 1.54; 95%CI 1.11-2.13); living in the South region of the country (ORa: 2.17; 95%CI 1.60-2.94). Adolescents who worked were more likely to smoke (ORa: 1.94; 95%CI 1.52-2.48); use alcohol (ORa: 2.01; 95%CI 1.71-2.36) and drugs (ORa: 1.76; 95%CI 1.35-2.31); perform physical activity (ORa: 1.24; 95%CI 1.07-1.44); consume sweets (ORa: 1.30; 95%CI 1.13-1.49), fried snacks (ORa: 1.41; 95%CI 1.15-1.74), and soft drinks (ORa: 1.23; 95%CI 1.06-1.44); however, they were less likely to present sedentary behavior (ORa: 0.68; 95%CI 0.59-0.79). Conclusion: Child labor in Brazil is related to sociodemographic differences. Those who worked were more likely to show risk behaviors for NCDs, but they were more physically active.

RESUMO Objetivo: Analisar o perfil sociodemográfico dos adolescentes que trabalham no Brasil e a associação do trabalho infantil com fatores de risco e proteção para doenças crônicas não transmissíveis. Métodos: Estudo transversal com dados da amostra 2 da Pesquisa Nacional de Saúde do Escolar de 2015. Analisaram-se as variáveis sexo, idade, raça/cor da pele, dependência administrativa da escola e escolaridade materna, variáveis acerca de alimentação, atividade física e uso de drogas. Realizaram-se análises por meio das prevalências e respectivos intervalos de confiança de 95% (IC95%) e cálculo da odds ratio bruta e ajustada. Resultados: Participaram da pesquisa 10.926 escolares, destes, 16,9% (IC95% 15,1-18,9) trabalhavam. O trabalho infantil foi maior nos adolescentes: do sexo masculino (ORaj: 1,82; IC95% 1,55-2,15); idade entre 16 e 17 anos (ORaj: 2,96; IC95% 2,37-3,69); que estudavam em escolas públicas (ORaj: 1,69; IC95% 1,14-2,52); com escolaridade materna igual ao ensino médio incompleto (ORaj: 1,54; IC95% 1,11-2,13); residentes da região Sul (ORaj: 2,17; IC95% 1,60-2,94). Esses adolescentes trabalhadores apresentaram maiores chances de: fumar (ORaj: 1,94; IC95% 1,52-2,48); consumir bebidas alcoólicas (ORaj: 2,01; IC95% 1,71-2,36); usar drogas ilícitas (ORaj: 1,76; IC95% 1,35-2,31); realizar atividade física (ORaj: 1,24; IC95% 1,07-1,44); consumir guloseimas (ORaj: 1,30; IC95% 1,13-1,49); consumir salgados fritos (ORaj: 1,41; IC95% 1,15-1,74), e refrigerantes (ORaj: 1,23; IC95% 1,06-1,44). Contudo apresentaram menor chance de comportamento sedentário (ORaj: 0,68; IC95% 0,59-0,79). Conclusão: Houve diferenças sociodemográficas em relação ao trabalho infantil no Brasil. Os que trabalhavam apresentaram maiores chances de manifestar comportamentos de risco para as DCNT, no entanto eram mais ativos fisicamente.

Epidemiological research progress on association of drought with mortality / 环境与职业医学

Drought is expected to be more severe and frequent due to climate change. Drought exerts not only extensive impacts on economy and environment, but also direct or indirect impacts on human health. This review systematically collected studies exploring the association between drought and human mortality, and summarized the associations between drought and all-cause mortality, chronic non-communicable disease mortality, communicable disease mortality, and injury mortality. The results revealed that drought was significantly associated with human mortality, leading to an elevated mortality risk of cardiovascular diseases, respiratory diseases, cancers, diarrhea, and injuries; serious drought increased much more mortality risk than mild drought; males in rural areas, the elderly, and children were vulnerable populations to drought. However, in-depth studies on the association of drought with human mortality are limited, which calls for related studies in the future. This review summarized the current research status and existing problems in drought and population death, and pointed out the future research direction, which can provide reference for future related research.

Correlation between chronic non-communicable disease and falls incidence among the elderly in urban and rural areas in Chongqing / 公共卫生与预防医学

Objective To analyze the correlation between the prevalence of chronic non-communicable diseases (NCDs) and fall incidence among the elderly in urban and rural areas in Chongqing, and to provide evidence for targeted intervention. Methods In 2019, a questionnaire survey was conducted among the elderly aged 65 and over in four districts and counties using multistage stratified cluster random sampling. The difference of NCDs prevalence and fall incidence was compared by Chi-square test. The correlation between NCDs and fall incidence was analyzed by multivariate logistic regression. Results A total of 806 and 801 elderly people aged 65 and above in urban and rural areas，respectively, were investigated The fall incidence among the elderly in rural areas (12.98%) was higher than that in urban areas (7.94%) (χ2=10.916, P=0.001). The multivariable logistic regression analysis showed that the prevalence of heart disease (OR=2.988, 95%CI:1.544-5.785), osteoporosis (OR=2.696, 95%CI:1.527-4.760) and vestibular dysfunction or deafness (OR=3.180, 95%CI:1.142-8.861) was associated with fall incidence among urban elderly people. Factors including need for care (OR=2.315，95%CI：1.130-4.744), diabetes (OR=3.067，95%CI:1.634-5.756), osteoporosis (OR=1.972, 95%CI:1.210-3.214), and arthritis (OR=2.975, 95%CI:1.901-4.657) were associated with fall incidence among rural elderly people. Conclusion The fall incidence among the elderly in rural areas is higher than that in urban areas in Chongqing. The prevalence of NCD is high among the elderly. Timely treatment of NCDs should be provided to reduce fall incidence among the elderly.

Caracterización clínico-epidemiológica de pacientes con cardiopatía hipertensiva

Fundamento: las enfermedades crónicas, como la hipertensión arterial, constituyen en la actualidad uno de los mayores retos que enfrentan los sistemas de salud en todo el mundo. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con cardiopatía hipertensiva ingresados en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López de Las Tunas. Métodos: se realizó un estudio descriptivo y transversal, en pacientes ingresados con cardiopatía hipertensiva en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López del municipio Puerto Padre, provincia Las Tunas, de junio de 2019 a junio de 2021. El universo estuvo conformado por la totalidad de los pacientes con el diagnóstico de dicha entidad. Se incluyeron las siguientes variables: edad, sexo, color de la piel, factores de riesgo, grados de la hipertensión arterial, tiempo de evolución de la hipertensión arterial, tipos y complicaciones de la cardiopatía hipertensiva. Se utilizó estadística descriptiva. Resultados: se encontró predominio de pacientes del sexo masculino (56,6 %) y del grupo etáreo entre 60 y 69 años (35,1 %). El tabaquismo se manifestó (35,9 %) como factor de riesgo más prevalente. Predominó la correlación entre el tipo lV y el grado lll (15,9 %). Así como el tipo lV en hipertensos de más de treinta años de evolución (42,7 %). La enfermedad cerebrovascular (33,2 %) y la insuficiencia cardíaca (25,5 %) predominaron como complicaciones. Conclusiones: los pacientes hipertensos del sexo masculino, con más de sesenta años y fumadores son propensos a desarrollar cardiopatía hipertensiva, acompañándose de otras enfermedades cardiovasculares, como complicaciones.

Background: chronic diseases, such as arterial hypertension, currently constitute one of the greatest challenges facing health systems throughout the world. Objective: to clinically and epidemiologically characterize patients with hypertensive heart disease admitted to the Internal Medicine Service of the Guillermo Domínguez López General Teaching Hospital in Las Tunas. Methods: a descriptive and cross-sectional study was carried out in patients admitted with hypertensive heart disease in the Internal Medicine Service of the Guillermo Domínguez López General Teaching Hospital in the municipality of Puerto Padre, Las Tunas province, from June 2019 to June 2021. The universe was made up of all the patients with the diagnosis of said entity. The following variables were included: age, sex, skin color, risk factors, degrees of arterial hypertension, time of evolution of arterial hypertension, types and complications of hypertensive heart disease. Descriptive statistics were used. Results: there was a predominance of male patients (56.6 %) and the age group between 60 and 69 years (35.1 %). Smoking (35.9 %) as the most prevalent risk factor. The correlation between type IV and grade III (15.9 %) predominated. As well as type IV in hypertensive patients with more than thirty years of evolution (42.7 %). Cerebrovascular disease (33.2 %) and heart failure (25.5 %) predominated as complications. Conclusions: it was concluded that male hypertensive patients, over sixty years old and smokers are prone to developing hypertensive heart disease, accompanied by other cardiovascular diseases, as complications.

Enfermedades crónicas no transmisibles en Argentina: modelo y pronósticos por sexo y edad

Las enfermedades crónicas no transmisibles (ECNT) son padecimientos intransferibles por contacto de persona a persona y se caracterizan por su evolución generalmente lenta. En Argentina, son la principal causa de muerte y discapacidad, solo dos grupos de estas (cardiovasculares y cáncer) son responsables de la mitad del total de las muertes y del 27 % de los años de vida potencialmente perdidos (AVPP). El objetivo general de este trabajo cuantitativo, transversal y descriptivo es describir y analizar el perfil según edad y sexo de las tasas de mortalidad por ECNT en Argentina, a partir del modelo para datos funcionales (MDF) de Hyndman y Ullah (2007). Dicho método permite, además, pronosticar el comportamiento de los índices al considerar los cambios relacionados con la edad y la tendencia observada a través del tiempo. La diferencia relativa en la mortalidad entre el inicio del periodo de estudio (1985 a 2014) y el pronóstico para el año 2025 indica que, de continuar el comportamiento imperante, se alcanzarían descensos de alrededor del 50 % para hombres de entre 30 y 50 años y del 20 % para mujeres de entre 20 y 35 años. Estos resultados apuntan, de un modo más general, a que las tasas de mortalidad de los grupos etarios menores de 70 años, cuyas defunciones se denominan prematuras, son claramente descendentes para ambos sexos, aunque el caso de los hombres destaca, pues, si bien presentan mayores tasas de mortalidad por ECNT, el descenso es más marcado.

Chronic Non-Communicable Diseases (NCD) are diseases that are not transmitted from person to person and that are characterized by their generally slow evolution. In Argentina, NCDs are the main cause of death and disability, only two groups of causes (cardiovascular and cancer) are responsible for half of all deaths and 27 % of years of life potentially lost (YPLL). The general objective of this work, a quantitative, cross-sectional and descriptive study, is to describe and analyze the profile by age and sex of the mortality rates due to NCD in men and women in Argentina, based on the implementation of the model for functional data (MDF) by Hyndman and Ullah (2007). This model also makes it possible to forecast the behavior of mortality rates for both sexes, taking into account the changes related to age and the trend observed over time during the period 1985-2014. The relative difference in mortality between the beginning of the study period and the forecast for the year 2025 indicates that, if the prevailing behavior in rates continues, decreases of around 50 % would be achieved for men between 30 and 50 years of age. While for women the greatest decreases (of around 20 %) would be observed between the ages of 20 and 35. These results would indicate, in a more general way, that the behavior of the mortality rates of the age groups under 70 years, whose deaths are called ''premature", is of a clear decrease for both sexes, highlighting that, in the case of men, although they have higher NCD mortality rates, this decrease is more marked.

Factors associated with food insecurity in older adults in Ecuador

ABSTRACT The objective was to determine the relationship between various factors and food insecurity, using a cross-sectional analytical study of 400 older adults living in rural and urban areas of the Azuay province in Southern Ecuador. Food security was measured using the Latin American and Caribbean Food Security Scale (ELCSA). The data was analyzed using version 15 of the Statistical Package for the Social Sciences (SPSS) program, and the odds ratio with 95% confidence interval (CI) was used to determine statistical association. The incidence of food insecurity was higher in older adults who live in households comprised only of members above the age of 18 (43.7%) and in rural zones (65%). Food insecurity is high in older adults, especially in individuals who live in rural areas and who have low levels of education and low socioeconomic levels. It is necessary to implement public policy and preventative strategies to mitigate the risk of food insecurity in older adults.

RESUMEN El objetivo fue determinar la relación entre diversos factores y la inseguridad alimentaria, con un estudio analítico transversal en 400 adultos mayores que viven en zonas rurales y urbanas de la provincia de Azuay en el sur de Ecuador. La seguridad alimentaria se midió utilizando la Escala de Seguridad Alimentaria de América Latina y el Caribe (ELCSA). Los datos fueron analizados en la versión 15 del programa Statistical Package for the Social Sciences (SPSS), y se utilizó el Odds Ratio con IC 95% para determinar la asociación estadística. La incidencia de la inseguridad alimentaria fue mayor en los adultos mayores que viven en hogares compuestos únicamente por miembros mayores de 18 años (43,7%) y en las zonas rurales (65%). La inseguridad alimentaria es alta en los adultos mayores, especialmente en individuos que viven en zonas rurales y que tienen bajos niveles educativos y niveles socioeconómicos bajos. Es necesario implementar políticas públicas y estrategias preventivas para mitigar el riesgo de inseguridad alimentaria en los adultos mayores.

Prevalencia de enfermedades crónicas en consulta preoperatoria del Hospital Oftalmológico Amistad Argelia-Cuba. El Oued, Argelia / Prevalence of chronic diseases in preoperative consultation from Algeria-Cuba Friendship Ophthalmological Hospital. El Oued, Algeria

RESUMEN Introducción: las enfermedades crónicas no transmisibles constituyen un problema de salud para adultos mayores, a considerar en pacientes tributarios de cirugía oftalmológica. Objetivo: identificar la prevalencia de enfermedades crónicas no transmisibles en los pacientes que requieren cirugía ocular, atendidos en consulta preoperatoria del Hospital Oftalmológico Amistad Argelia-Cuba, en El Oued, Argelia, entre mayo de 2018 y julio de 2019. Materiales y métodos: se realizó un estudio observacional descriptivo de corte transversal. El universo estuvo conformado por 1 978 pacientes que acudieron a la consulta preoperatoria. Se analizaron las variables: edad, sexo, diagnóstico clínico y diagnóstico oftalmológico preoperatorio. Resultados: gran parte de los pacientes atendidos con enfermedades crónicas no trasmisibles fueron mayores de 45 años y del sexo masculino. Prevalecieron los casos con hipertensión arterial y cardiopatía isquémica. Conclusiones: la hipertensión arterial, la cardiopatía isquémica y la diabetes mellitus fueron las enfermedades mayormente encontradas. Los diagnósticos oftalmológicos preoperatorios más frecuentes fueron la catarata senil, las enfermedades de retina y el glaucoma neovascular.

ABSTRACT Introduction: chronic non-communicable diseases constitute a health problem for elder people, to be considered in patients requiring to ophthalmological surgery. Objective: to identify the prevalence of chronic non-communicable diseases in patients requiring eye surgery attended at the Algeria Cuba Friendship Ophthalmological Hospital, in El Oued, Algeria, between May 2018 and May 2019. Materials and methods: a cross-sectional, descriptive, observational study was performed. The universe was formed by 1 978 patients who attended the pre-surgery consultation. The analyzed variables were: age, gender, clinical diagnosis and pre-surgery ophthalmological diagnosis. Results: a large part of the patients treated with chronic non-communicable diseases were over 45 years of age and male. Cases with arterial hypertension and ischemic heart disease prevailed. Conclusions: arterial hypertension, ischemic heart disease and diabetes mellitus were the most commonly found diseases. The most frequent pre-surgery ophthalmological diagnosis were senile cataract, retina diseases and neo-vascular glaucoma.

Ansiedad y miedo ante la COVID-19 en adultos con hipertensión arterial / Anxiety and fear of COVID-19 in adults with arterial hypertension

RESUMEN Introducción: La COVID-19 ha producido un incremento en los índices de mortalidad. Uno de los principales grupos de riesgo lo constituyen las personas con hipertensión arterial. Objetivo: Explorar las reacciones de ansiedad y miedo ante la COVID-19 en adultos con diagnóstico de hipertensión arterial. Métodos: Se empleó un diseño cuantitativo, transversal y descriptivo mediante cuestionarios, en 400 adultos hipertensos. El muestreo fue no probabilístico e intencional. Se emplearon The Coronavirus Anxiety Scale y The Fear of COVID-19 Scale. El procesamiento se realizó mediante el paquete estadístico SPSS-25/Windows, a partir de análisis de frecuencia. Se aplicó la prueba T para muestras independientes y se calcularon los tamaños de efecto. Se empleó el coeficiente de correlación de Pearson. Resultados: Se encontraron bajos niveles de ansiedad ante la COVID-19; y moderados y bajos niveles de miedo. Los índices de ansiedad y miedo ante la COVID-19 fueron superiores en el sexo femenino. Los adultos que presentaron otras enfermedades crónicas no transmisibles fueron quienes exhibieron mayores niveles de miedo y ansiedad ante la COVID-19. Se encontraron asociaciones entre el miedo y la ansiedad ante la COVID-19. La presencia de otras afecciones crónicas se relacionó con las manifestaciones de ansiedad y miedo ante la COVID-19. Conclusiones: No hubo signos clínicos de ansiedad y miedo asociados a la COVID-19 en pacientes con hipertensión arterial.

ABSTRACT Introduction: COVID-19 has produced an increase in mortality rates. One of the main risk groups is made up of people with high blood pressure. Objective: To explore the anxiety and fear reactions to COVID-19 in adults with a diagnosis of arterial hypertension. Methods: A quantitative, cross-sectional and descriptive design was used through questionnaires in 400 hypertensive adults. The sampling was non-probabilistic and intentional. The Coronavirus Anxiety Scale and The Fear of COVID-19 Scale were used. Processing was carried out using the SPSS-25 / Windows statistical package, based on frequency analysis. The T test was applied for independent samples and effect sizes were calculated. Pearson's correlation coefficient was used. Results: Low levels of anxiety were found in the face of COVID-19; and moderate and low levels of fear. The anxiety and fear indexes before COVID-19 were higher in the female sex. Adults with other chronic noncommunicable diseases were those who exhibited the highest levels of fear and anxiety about COVID-19. Associations were found between fear and anxiety about COVID-19. The presence of other chronic conditions was related to manifestations of anxiety and fear in the face of COVID-19. Conclusions: There were no clinical signs of anxiety and fear associated with COVID-19 in hypertensive patients.

La dispensarización de pacientes hipertensos en el Policlínico Rafael Echezarreta / The classification of hypertensive patients at Rafael Echezarreta Polyclinic

Introducción: Uno de los principales problemas de salud que afectan a la población de Cuba y del mundo es la hipertensión arterial. En San José de Las Lajas aparece dispensarizada como hipertensa el 14 por ciento de su población, pero se observan múltiples deficiencias en su dispensarización. Objetivo: Determinar la situación de la dispensarización de las personas que padecen hipertensión arterial en los consultorios del médico y la enfermera de la familia del policlínico Rafael Echezarreta del municipio San José. Métodos: Se realizó una investigación descriptiva rápida de corte transversal, en enero de 2020. Se revisaron las historias clínicas individuales de una muestra de 379 pacientes hipertensos, que representaron el 11 por ciento de los 3446 hipertensos registrados en el policlínico. Resultados: Solo cerca del 20 por ciento de los hipertensos estaba dispensarizados. A excepción de los grupos de edades extremas, en el resto predominó el sexo femenino. Con el aumento de la edad aumentó la proporción de pacientes hipertensos. Ninguno de los pacientes tenía evidencia registrada en su historia clínica de haber sido atendido en los últimos cuatro meses y casi el 68 por ciento del total no había sido visto hacía más de un año. Conclusiones: La dispensarización mantiene insuficiencias que no garantizan atención médica integral a la población, no se cumple la frecuencia mínima de evaluación establecida para cada grupo dispensarial y el método clínico presenta fallas en su aplicación. Por lo que se puede afirmar que existe un número potencial de pacientes hipertensos aún sin controlar(AU)

Introduction: One of the main health problems that affect Cuban and worldwide population is high blood pressure. In San José de Las Lajas municipality, 14 percent of its population appears to be hypertensive, but there are multiple deficiencies in its classification. Objective: To determine the situation of the classification of people suffering from arterial hypertension in the Family Doctor´s Offices belonging to Rafael Echezarreta polyclinic, San José municipality. Methods: A rapid cross-sectional descriptive research was conducted in January 2020. The individual medical records (HCIs) of a sample of 379 hypertensive patients were reviewed, representing 11 percent of the 3446 hypertensive patients registered in the polyclinic. Results: Only about 20 percent of hypertensive patients were classified. With the exception of the extreme age groups, the female sex predominated in the rest. With increasing age, the proportion of hypertensive patients increased. None of the patients had evidence recorded in their medical records of having been attended in the last four months and almost 68 percent of the total had not been attended more than a year ago. Conclusions: The classification has insufficiencies that do not guarantee comprehensive medical care to the population, the minimum frequency of evaluation established for each classification group is not met and the clinical method presents failures in its application. So it can be said that there is a potential number of hypertensive patients still uncontrolled(AU)

Evaluación del estado de salud mental de los cuidadores de pacientes con enfermedades crónicas no transmisibles de la comunidad de El Llano, provincia Peravia, República Dominicana, durante el período noviembre-diciembre 2019 / Evaluation of mental health status in caregivers of patients with chronic non-communicable diseases of the community of El Llano, Peravia Province, Dominican Republic, during the period November-December 2019

Introducción: el Síndrome del cuidador (CIE-11 QF27) se define como una respuesta inadecuada al estrés emocional crónico, que no aparece exclusivamente en los cuidadores y cuyas principales características son el agotamiento físico y/o psicológico1. Es una entidad de gran prevalencia en la actualidad, y ello se debe tanto al aumento de la esperanza de vida como al auge de las enfermedades crónicas no transmisibles, estas últimas incapacitando a la población y aumentando el número de cuidadores formales e informales, que surgen para atender las necesidades de los afectados2. Objetivos: evaluar el estado de salud mental en cuidadores de pacientes con enfermedades crónicas no transmisibles de la comunidad de El Llano, provincia de Peravia, República Dominicana. Metodología: estudio transversal, prospectivo, observacional y analítico. Se seleccionó una muestra de 115 personas, con un nivel de confianza del 95 % y un margen de error del 8 %, a las que se les aplicaron los cuestionarios. Las variables del cuestionario incluyeron edad, sexo, fecha de la información recolectada, así como los cuestionarios estandarizados de Goldberg para depresión y ansiedad en atención primaria, Cuestionario para la sobrecarga de Zarit y fragmentos del Cuestionario para cuidadores primarios. Además, se incluyó un formulario para adquirir el consentimiento informado. Resultados: se encontró que el 63 % de los cuidadores podía sufrir depresión, el 52 % podía sufrir ansiedad y el 71 % de los cuidadores no presentaba sobrecarga. Sin embargo, la sobrecarga no es suficiente para explicar el comportamiento de depresión (r2=-0,27) o ansiedad (r2=-0,14), ya que ambos demostraron una correlación positiva muy baja. Se demostró que un 76 %, correspondiente a 87 cuidadores, eran del sexo femenino. También la edad fue una variable importante, el 45 % de los cuidadores se encontraron entre las edades de 41-60 años. Conclusiones: la sobrecarga presentada por los encuestados no fue suficiente para explicar los niveles de depresión y ansiedad, por lo tanto, se debe correlacionar con más variables.

Introduction: The Caregiver Stress Syndrome (ICD-11 QF27) is defined as an inadequate response to chronic emotional stress, which does not appear exclusively in caregivers and whose main features are physical and/or psychological exhaustion1. It is an entity of great prevalence nowadays, and this is due both to the increase in life expectancy and to the rise of chronic non-communicable diseases, the latter disabling the population and increasing the number of formal and informal caregivers, who emerge to meet the needs of those affected2. Objectives: Evaluate the mental health status in caregivers of patients with chronic non-communicable diseases of the community of El Llano, Peravia province, Dominican Republic. Methodology: Cross-sectional, prospective, observational, and analytical study. A sample of 115 people was selected, with a 95% confidence level and 8% margin of error, to which the questionnaires were applied. The questionnaire variables included age, gender, date of collected information, as well as Goldberg's standardized questionnaires for depression and anxiety in primary care, Zarit Burden Interview, and fragments of the Primary Caregivers Questionnaire. Additionally, a form to acquire informed consent was included. Results: It was found that 63% of caregivers could suffer from depression, 52% could suffer from anxiety, and 71% of caregivers did not present burden. Meanwhile, the overload is not enough to explain the behavior of depression (r2=-0.27), or anxiety (r2=-0.14) since both demonstrated a very low positive correlation. It was shown that 76% corresponding to 87 caregivers were female. Age was also an important variable, 45% of the caregivers were between the ages of 41-60 years. Conclusions: The overload presented by the respondents was not sufficient to explain the levels of depression and anxiety, hence should be correlated with other variables.

Complicaciones crónicas y enfermedades asociadas en adultos mayores con diabetes mellitus tipo 2 en Punta Brava, Cuba de enero a junio de 2019 / Chronic complications and associated diseases in older adults with type 2 diabetes mellitus in Punta Brava, Cuba from January to June 2019

Introducción: Con el envejecimiento de las poblaciones se produce un aumento de las enfermedades crónicas no trasmisibles, entre ellas la diabetes mellitus tipo 2. Esta constituye un serio problema de salud pública a nivel mundial por su elevada prevalencia, crecimiento constante, complicaciones crónicas y mortalidad. Objetivo: Identificar las complicaciones crónicas de la diabetes mellitus tipo 2 y las enfermedades asociadas en personas de 60 años y más en el poblado de Punta Brava. Métodos: Se realizó un estudio descriptivo y transversal a partir de los gerontes con diabetes que asistieron a la consulta de Medicina Interna en el periodo de enero a junio de 2019. Con la información recopilada de las historias clínicas se creó una base de datos en Visual FoxPro 8.0. Resultados: Predominó el grupo de edad de 60 a 69 años y el sexo femenino. La hipertensión arterial fue la enfermedad asociada más frecuente con 86,0 por ciento, seguida por la cardiopatía isquémica con 70,6 por ciento y la enfermedad cerebrovascular con 67,0 por ciento. La polineuropatía diabética fue la complicación crónica más representativa (79,3 por ciento), seguida de la nefropatía (15,0 por ciento) que aparece a mayor tiempo de evolución de la enfermedad. Conclusiones: Predominó la hipertensión arterial y la enfermedad cerebrovascular como padecimientos asociados en adultos mayores con diabetes tipo 2. La polineuropatía y la nefropatía diabéticas fueron las complicaciones crónicas más frecuentes con diferencias según el sexo y relacionadas con el mayor tiempo de evolución(AU)

Introduction: The aging of populations also brings an increase in chronic non-communicable diseases, including type 2 diabetes mellitus, which constitutes a serious public health problem worldwide due to the high prevalence, constant growth, chronic complications and mortality. Objective: To identify the chronic complications of type 2 diabetes mellitus and associated diseases in people aged 60 years and older in Punta Brava town. Methods: A descriptive and cross-sectional study was carried out from the elderly with diabetes who attended the Internal Medicine consultation from January to June 2019. A database was created in Visual Fox Pro 8.0 with the information collected from the medical records. Results: The age group of 60 to 69 years and the female sex prevailed. Hypertension was the most frequent associated disease (86.0 percent), followed by ischemic heart disease (70.6 percent) and cerebrovascular disease (67.0 percent). Diabetic polyneuropathy was the most representative chronic complication (79.3 percent), followed by nephropathy (15.0 percent), appearing later in the course of the disease. Conclusions: Hypertension and cerebrovascular disease predominated as associated conditions in older adults with type 2 diabetes. Diabetic polyneuropathy and nephropathy were the most frequent chronic complications, with differences according to sex and related to the longest evolution time(AU)

Exposição a agrotóxicos e desenvolvimento de câncer no contexto da saúde coletiva: o papel da agroecologia como suporte às políticas públicas de prevenção do câncer / Exposure to pesticides and cancer development in the context of public health: the role of agroecology as a support for public cancer prevention policies

RESUMO Atualmente, a agricultura brasileira é caracterizada pelo crescente consumo de agrotóxicos e fertilizantes químicos, inserindo-se no modelo de produção baseado nos fundamentos do agronegócio. As novas técnicas de cultivo baseadas no agronegócio resultaram na expansão das monoculturas sobre os ecossistemas naturais, com o consequente desmatamento, desequilíbrio e perda da biodiversidade; e o aumento da contaminação do solo, da água e do ar pelos agrotóxicos. No que tange à saúde humana, a literatura científica tem demonstrado que a contaminação química decorrente do uso de agrotóxicos na agricultura implica adoecimento dos trabalhadores rurais expostos ocupacionalmente aos agrotóxicos, dos moradores da área rural, além de consumidores de alimentos contendo resíduos de agrotóxicos. Entre os efeitos sobre a saúde humana associados à exposição a agrotóxicos, os mais preocupantes são as intoxicações crônicas, caracterizadas por infertilidade, abortos, malformações congênitas, neurotoxicidade, desregulação hormonal, imunotoxicidade, genotoxicidade e câncer. Sendo assim, neste ensaio, apresenta-se uma revisão narrativa com dados presentes na literatura científica nacional e internacional referentes à associação entre a exposição a agrotóxicos e o desenvolvimento de câncer no contexto da saúde coletiva e o papel da alimentação saudável e da agroecologia como suporte às políticas públicas de prevenção do câncer.

ABSTRACT Currently, Brazilian agriculture is characterized by the growing consumption of pesticides and chemical fertilizers, forming part of the production model based on the fundamentals of agribusiness. The new farming techniques based on agribusiness resulted in the expansion of monocultures over natural ecosystems, with the consequent deforestation, imbalance, and loss of biodiversity; and the increased contamination of soil, water, and air by pesticides. With regard to human health, the scientific literature has shown that chemical contamination resulting from the use of pesticides in agriculture implies the illness of rural workers occupationally exposed to pesticides, of rural residents, in addition to consumers of food containing pesticide residues. Among the effects on human health associated with exposure to pesticides, the most worrying are chronic intoxications, characterized by infertility, abortions, congenital malformations, neurotoxicity, hormonal dysregulation, immunotoxicity, genotoxicity, and cancer. Therefore, in this essay, we will present a narrative review with data from national and international scientific literature regarding the association between exposure to pesticides and the development of cancer in the context of public health and the role of healthy eating and agroecology as a support for public cancer prevention policies.

Analysis of consecutive patient visits in a community health service station in Beijing / 中华全科医师杂志

Objective:To analyze consecutive patients visits in a community health service station in Beijing.Methods:The basic information and behavior of the patients who visited Sanliheerqu Health Service Station in Beijing Xicheng district from January 1, 2015 to December 31, 2019 were retrieved from the electronic health records. The visiting situation, the stratification of the number of visits, and the correlation between the basic information and the consecutive visit was analyzed.Results:A total of 4 696 patients visited 202 560 times during 2015 to 2019, of whom 1 162 were consecutive patients (24.7%) with a total of 100 083 visits (49.4%).The annual number of visits, the total number of visits and the number of consecutive visits all showed an upward trend during the five years.The top 5 reasons for consecutive visit were all chronic diseases (hypertension, type 2 diabetes, dyslipidemia, coronary heart disease, and stroke) with median annual visits of 11 to 18, and it was increasing with the year. The rates of incidental visits (1-3/year, 66/1 162, 5.7%) and continuous visits (4-26/year, 1 020/1 162, 87.8%) in 2015 were higher than those in other years; while the rates of frequent visits (27-52/year, 71/1 162, 6.1%) and very frequent visits (>52/year, 5/1 162, 0.4%) were lower. The rates of frequent visits (181/1 162, 15.6%) and very frequent visits (78/1 162, 6.7%) in 2019 were higher than those in other years (χ 2=182.40, P<0.001).Compared with the non-consecutive visit group, the proportion of women (38.1%,735/1 930) and overweight/obesity (39.6%, 777/1 960) in the consecutive visit group was higher (χ 2=36.09, 69.69, P <0.001). Conclusion:The consecutive visit rate of residents in this institution needs to be improved. The utilization rate of primary medical resources for patients with consecutive visit is high and the number of medical visits is on the rise. Gender and BMI of patients may be related to consecutive visit.

Relación entre la obesidad y la COVID-19 / Relationship between obesity and COVID - 19

Existen evidencias crecientes que indican que la obesidad actúa como factor de riesgo independiente para padecer la COVID-19, los pacientes obesos tienen mayor incidencia de complicaciones, tiempo de hospitalización y riesgo de muerte. El objetivo de este trabajo es exponer la relación entre la obesidad y las formas graves de COVID-19, así como exponer los posibles mecanismos implicados. Se realiza una revisión de la literatura mundial y de las publicaciones nacionales referidas a la obesidad y la COVID-19. Se identifican las características que hacen a los obesos más susceptibles a infectarse por SARS-CoV-2 y a tener peor pronóstico. Se concluye que la obesidad constituye un desafío permanente en nuestro medio, que su prevención, tratamiento temprano y oportuno, permitirían reducir los tiempos de hospitalización, evolución desfavorable y mortalidad por COVID-19 grave(AU)

There is growing evidence that obesity acts as an independent risk factor for Covid-19. Obese patients have higher incidence of complications, hospitalization time and risk of death. The objective of this paper is to describe the relationship between obesity and severe forms of COVID 19, as well as to expose the possible mechanisms involved. A review of the world literature and national publications referring to obesity and COVID-19 is carried out. The characteristics that make obese people more susceptible to being infected by SARS-COV-2 and having a worse prognosis are identified. It is concluded that obesity constitutes a permanent challenge in our environment. Early and timely prevention would allow reducing hospitalization times, unfavorable evolution and mortality due to severe Covid-19(AU)