ABSTRACT Introduction: Chronic kidney disease is a global health problem. Its most serious manifestation, chronic kidney failure, affects the Cuban context and determines the growth of patients on hemodialysis. The objective of the text is to evaluate the main results of the diagnosis and characterization of the problematic situation in a psychosocial study with patients with Chronic Renal Failure in the Hemodialysis room of the Florida municipality, of the county of Camagüey. Method: It is an experimental participatory action research, which takes place between January 2023 and December 2024, which constitutes the output of the research project System of psychosocial actions for the improvement of comprehensive care for patients with non-communicable diseases. The universe is made up of 56 patients and the sample is made up of 22, who receive purifying and conservative treatment, 22 family members and 12 service professionals. The research instrument par excellence was the participant survey. Results: The age of the patients is not definitive of an age group; men predominate; A high percentage of patients are found to have low tolerance for adherence to treatment and insufficient development of psychosocial skills and declare the need to possess knowledge to achieve health states that lead to survival. Discussion: There is no coincidence with what was found in the determination of the prevalence age groups for the disease, but specialists insist that the disease is not exclusive to a specific period of life; recognize the importance of the patient's knowledge of risk factors for prevention, promotion and health education and highlight the need for communication and empathy between health personnel and the patient, to achieve favorable results and emotional states in the face of the disease and treatment.

RESUMEN Introducción: La enfermedad renal crónica es un problema de salud a nivel mundial, su manifestación más grave, la insuficiencia renal crónica, incide en el contexto cubano y determina el crecimiento de pacientes en hemodiálisis. El objetivo del texto es valorar los principales resultados del diagnóstico y caracterización de la situación problémica en un estudio de carácter psicosocial con pacientes con Insuficiencia Renal Crónica en la sala de Hemodiálisis del municipio Florida, de la provincia de Camagüey. Método: Es una investigación-acción participativa de corte experimental, que se desarrolla entre enero 2023 y diciembre del 2024 la cual constituye salida del proyecto de investigación Sistema de acciones psicosociales para el perfeccionamiento de la atención integral a los pacientes con enfermedades no transmisibles. El universo está constituido por 56 pacientes y la muestra por 22, que reciben tratamiento depurador y conservador, 22 familiares y 12 profesionales del servicio. El instrumento de investigación por excelencia fue la encuesta a participantes. Resultados: La edad de los pacientes no es definitiva de un grupo etario; predominan los hombres; se constata un elevado por ciento de pacientes con poca tolerancia a la adherencia al tratamiento e insuficiente desarrollo de las habilidades psicosociales y declaran la necesidad de poseer conocimientos para lograr estados de salud que conlleven a la sobrevida. Discusión: No existe coincidencia con lo constatado en la determinación de los grupos etarios de prevalencia para la enfermedad, pero los especialistas insisten en que la enfermedad no es privativa de un período de vida específico; reconocen la importancia del conocimiento de los factores de riesgo por el paciente para la prevención, promoción y educación en salud y resaltan la necesidad de la comunicación y la empatía entre el personal de salud y el paciente, para lograr resultados y estados emocionales favorables ante la enfermedad y el tratamiento.

BACKGROUND. In the absence of more recent national data on underlying causes of death in South Africa (SA), we examined mortality trends from 2010 to 2022 among members of a large private medical scheme. This analysis sheds light on the health profile of this specific demographic. OBJECTIVE. To investigate trends in Discovery Health Medical Scheme (DHMS) members' death rates and underlying cause of death patterns between 2010 and 2022. METHODS. All-cause deaths were compared across years accounting for demographic changes, by analysing age- and sex-standardised rates using 2019 age and sex population weightings. We used underlying cause-of-death data from death notifications. RESULTS. The 2019 age- and sex-standardised death rate was lower than the 2010 rate by 10%, with a steady decline experienced between 2010 and 2019. We have seen reduced age- and sex-standardised death rates from HIV/AIDS during this period, and despite the high prevalence, reduced age- and sex-standardised death rates from non-communicable diseases. Malignant neoplasms and cardiovascular disease have been and remained the two leading causes of death for Discovery Health Medical Scheme (DHMS) clients between 2012 and 2022. Age- and sex-standardised death rates, however, reached historic high levels during the first 2 years of the COVID-19 pandemic in SA. In 2020, overall age- and sex-standardised death rates for DHMS members increased to 542 deaths per 100 000 life years, which was higher than pre-pandemic levels. Age- and sex-standardised death rates went on to reach their highest level in the history of the scheme in 2021, at 767 deaths per 100 000 life years. Age- and sex-standardised death rates, however, had returned to near 2019 (pre-pandemic) levels by 2022, at 477 deaths per 100 000 life years. Males experienced a higher increase in age-standardised death rates during 2020 and remained at an increased risk of death in 2022 compared with pre-pandemic levels. When COVID-19 -related deaths are excluded, the age-standardised rates for both females and males in 2022 was lower than observed in the pre-pandemic years. While the low mortality experience could be related to competing causes and mortality displacement, further analysis over a longer period is needed to confirm this. CONCLUSION. DHMS experienced the highest level of age- and sex-standardised death rates during 2020 and 2021, the initial 2 years of the COVID-19 pandemic. Most of this increase was explained by COVID-19 deaths.

RESUMEN Introducción: sacha inchi es una planta oleaginosa nativa de la región amazónica, que cuenta con distintos usos relacionados con la salud. Objetivo: describir la importancia potencial de la planta de Sacha inchi en la salud del ser humano. Métodos: se realizó una revisión bibliográfica; se utilizaron las bases de datos Google Académico, SciELO y PubMed. Fueron incluidos trabajos de revisión, investigación y páginas Web, que en general tenían menos de diez años de publicados, en idioma español o inglés y que hacían referencia al tema de estudio a través del título. Esto permitió la consulta de 84 artículos, de los cuales 50 fueron referenciados. Resultados: sacha inchi, emerge como una fuente importante para elaborar productos con un gran valor nutricional por sus propiedades nutraceúticas y funcionales, a partir de sus hojas, semillas y derivados de esta. Entre sus principales propiedades medicinales se describen sus efectos antidislipidémicos, antioxidantes, antiinflamatorios, anti proliferativos y de modulación antitumoral, lo cual hace posible su empleo como coadyuvante en el tratamiento de diversas enfermedades no transmisibles. Su consumo es ideal para suplementar o evitar el déficit nutricional en población vegana o vegetariana, niños, adultos mayores, en personas con enfermedad celíaca y deportistas. Conclusiones: sacha inchi es una planta con un importante valor potencial en la nutrición del ser humano. Los efectos benéficos que desencadena su consumo producto de los multifacéticos mecanismos a través de los cuales actúa, hacen de ella un coadyuvante en la prevención y tratamiento de diversas enfermedades.

ABSTRACT Introduction: sacha inchi is an oleaginous plant native to the Amazon region, which has different uses related to health. Objective: describe the potential importance of the Sacha inchi plant in human health. Methods: a bibliographic review was carried out; The Google Scholar, SciELO and PubMed databases were used. Review works, research and Web pages were included, which were generally published less than 10 years ago, in Spanish or English and that referred to the topic of study through the title. This allowed the consultation of 84 articles, of which 50 were referenced. Results: sacha inchi emerges as an important source to produce products with great nutritional value due to its nutraceutical and functional properties, from its leaves, seeds and derivatives. Among its main medicinal properties are described its antidyslipidemic, antioxidant, anti-inflammatory, antiproliferative and antitumor modulation effects, which makes its use as an adjuvant in the treatment of various non-communicable diseases possible. Its consumption is ideal to supplement or avoid nutritional deficiency in the vegan or vegetarian population, children, older adults, people with celiac disease and athletes. Conclusions: sacha inchi is a plant with significant potential value in human nutrition. The beneficial effects that its consumption triggers as a result of the multifaceted mechanisms through which it acts, make it an adjuvant in the prevention and treatment of various diseases.

ABSTRACT Foundation: Diabetes mellitus has been considered by the World Health Organization a serious health problem to be solved throughout the world. Its prevention and educating about it is essential. Objective: To describe an educational intervention on type 2 diabetes mellitus results in patients with risk factors. Methods: Intervention study, with a before and after design, which included 120 patients over 18 years of age with diabetes mellitus risk factors, belonging to Medical Office No. 6, in Nuevitas, Camagüey province. A survey was applied to measure the level of knowledge, before and after the educational intervention. The variables: age, educational level, knowledge about diabetes mellitus, risk factors and prevention were analyzed. Results: Women, university education level and those over 60 years of age predominated. At the beginning of the study, around 75% of the participants showed fair or low knowledge about diabetes mellitus, risk factors and prevention. All of these parameters increased above 85% after the intervention. Conclusions: A notable increase in knowledge about diabetes mellitus, its risk factors and how to prevent it was achieved. These types of strategies, applicable from the primary level of care, imply a benefit in the prevention of this and other non-communicable diseases.

RESUMEN Fundamento: La diabetes mellitus ha sido considerada por la Organización Mundial de la Salud un grave problema de salud por resolver en todo el orbe. Su prevención resulta imprescindible, y educar al respecto es fundamental. Objetivo: Describir resultados de una intervención educativa sobre diabetes mellitus tipo 2 en pacientes con factores de riesgo. Métodos: Estudio de intervención, con diseño de antes y después, que incluyó a 120 pacientes mayores de 18 años con factores de riesgo de diabetes mellitus, pertenecientes al Consultorio Médico No. 6, en Nuevitas, provincia de Camagüey. Se aplicó una encuesta para medir el nivel de conocimientos, antes y después de la intervención educativa. Se analizaron las variables edad, nivel de escolaridad, conocimiento sobre diabetes mellitus, factores de riesgo y prevención. Resultados: Predominaron las mujeres, el nivel de escolaridad universitario y los mayores de 60 años. Al inicio del estudio, alrededor del 75 % de los participantes mostró regular o bajo conocimiento sobre diabetes mellitus, factores de riesgo y prevención. Todos estos parámetros aumentaron por encima del 85 % después de la intervención. Conclusiones: Se logró un incremento notable de los conocimientos acerca de la diabetes mellitus, sus factores de riesgo y cómo prevenirla. Este tipo de estrategias, aplicables desde el nivel primario de atención, implican un beneficio en la prevención de esta y otras enfermedades no transmisibles.

Abstract Introduction: Anredera cordifolia is a plant recognized as a non-conventional food plant. In folk medicine, it shows promise, being used in the treatment of skin diseases, diabetes, and hypertension. Objectives: To map the properties of the Anredera cordifolia plant in the therapeutic process of non-communicable chronic diseases. Materials and methods: The study was based on the Joanna Briggs Institute guidelines. The search was conducted in the Medline/PubMed, Scopus, Web of Science, and CINAHL databases in 2022 and updated in 2023. Selection criteria were primary studies, in any language, country of origin, and publication year, conducted with humans, animals, and/or cellular models, in a laboratory context, focusing on the properties of the plant. Selection was performed independently by two reviewers using the Rayyan software. Data were analyzed using content analysis. Results: In the 27 included articles, the results demonstrated that the plant has positive properties in the treatment of diabetes mellitus, arterial hypertension, chronic kidney disease, obesity, and cataracts, as well as being beneficial in controlling cholesterol, triglyceride, and uric acid levels. The main therapeutic properties identified were hypoglycemic effect and reduction in serum levels of triglycerides and total cholesterol. The plant also showed beneficial effects on the healing of diabetic wounds, reduction in heart rate, and obesity. Conclusions: Chronic diseases with evidence on the use of the plant include hypertension, diabetes, kidney disease, obesity, and cataracts. Additionally, the plant has beneficial properties regarding clinical markers such as triglycerides, cholesterol, and blood glucose.

Resumen Introducción: Anredera cordifolia es una planta reconocida como planta alimenticia no convencional. En la medicina popular, se muestra prometedora, siendo utilizada en el tratamiento de enfermedades de la piel, diabetes e hipertensión. Objetivos: Mapear las propiedades de la planta Anredera cordifolia en el proceso terapéutico de las enfermedades crónicas no transmisibles. Materiales y método: El estudio se basó en las orientaciones del Instituto Joanna Briggs. La búsqueda se realizó en las fuentes de datos Medline/PubMed, Scopus, Web of Science y CINAHL, en 2022 y se actualizó en 2023. Los criterios de selección fueron estudios primarios, en cualquier idioma, país de origen y año de publicación, desarrollados con seres humanos, animales y/o modelos celulares, en contexto laboratorial y con enfoque en las propiedades de la planta. La selección se realizó de manera doble-independiente, utilizando el software Rayyan. Se analizaron los datos mediante análisis de contenido. Resultados: En los 27 artículos incluidos, los resultados demostraron que la planta tiene propiedades positivas en el tratamiento de la diabetes mellitus, la hipertensión arterial, la enfermedad renal crónica, la obesidad y la catarata, además de ser beneficiosa en el control de los niveles de colesterol, triglicéridos y ácido úrico. Las principales propiedades terapéuticas identificadas fueron efecto hipoglucémico y disminución de los niveles séricos de triglicéridos y colesterol total. La planta también mostró efectos beneficiosos en la cicatrización de heridas diabéticas, reducción de la frecuencia cardíaca y obesidad. Conclusiones: Las enfermedades crónicas que tienen evidencia sobre el uso de la planta son hipertensión, diabetes, enfermedad renal, obesidad y cataratas. Además, la planta tiene propiedades beneficiosas en cuanto a marcadores clínicos, como triglicéridos, colesterol y glucemia.

Resumo Introdução: Anredera cordifolia é uma planta reconhecida como planta alimentícia não convencional. Na medicina popular, mostra-se promissora, sendo utilizada no tratamento de doenças de pele, de diabetes e de hipertensão. Objetivos: Mapear as propriedades da planta Anredera cordifolia no processo terapêutico das doenças crônicas não transmissíveis. Materiais e método: O estudo teve como base as orientações do Joanna Briggs Institute. A busca foi realizada nas fontes de dados Medline/PubMed, Scopus, Web of Science e CINAHL, em 2022 e atualizada em 2023. Os critérios de seleção foram estudos primários, de qualquer idioma, país de origem e ano de publicação, desenvolvido com seres humanos, animais e/ou modelos celulares, em contexto laboratorial e com enfoque nas propriedades da planta. A seleção ocorreu de modo duplo-independente, utilizando o software Rayyan. Os dados foram analisados por meio de análise de conteúdo. Resultados: Nos 27 artigos incluídos, os resultados demonstraram que a planta tem propriedades positivas no tratamento da diabetes mellitus, da hipertensão arterial, da doença renal crônica, da obesidade e da catarata, além de ser benéfica no controle dos níveis de colesterol, de triglicerídeos e de ácido úrico. As principais propriedades terapêuticas identificadas foram efeito hipoglicêmico e diminuição dos níveis séricos de triglicerídeos e colesterol total. A planta também demonstrou efeitos benéficos na cicatrização de feridas diabéticas, na redução da frequência cardíaca e na obesidade. Conclusões: As doenças crônicas que possuem evidência sobre o uso da planta são hipertensão, diabetes, doença renal, obesidade e catarata. Além disso, a planta tem propriedades benéficas quanto a marcadores clínicos, como triglicerídeos, colesterol e glicemia.

Abstract Ready-to-eat cereals (RTE) represent a significant part of the breakfast cereal market and are an important component of the diet. This update article aims to describe the nutritional aspects, processing and health effects associated with the consumption of RTE. The technological processes of RTE manufacturing involve ingredient blending, processing temperatures, and grain refinement and extrusion methods. In response to consumer demands, the industry has improved processing technologies, increasing the diversification of raw materials and using strategies such as fortification to improve their nutritional quality. There is ample evidence to support the effects of RTE consumption on human health, highlighting its contribution to meeting recommended macro- and micronutrient intakes in adult and child populations. Moreover, consumption of RTE, especially whole grains, is associated with lower incidence of obesity and lower risk of developing chronic non-communicable diseases. In the pediatric population, the relationship between RTE consumption and improved diet quality is highlighted, although its impact on body weight and adiposity is still under discussion.

Resumen Los cereales listos para consumir (CLPC) representan una parte significativa del mercado de cereales para el desayuno y son un componente importante en la dieta. Este artículo de actualización tiene como objetivo describir los aspectos nutricionales, elaboración y efectos en la salud asociados al consumo de CLPC. Los procesos tecnológicos de fabricación de CLPC involucran mezcla de ingredientes, temperaturas de procesamiento, refinamiento del grano y métodos de extrusión. En respuesta a las demandas del consumidor, la industria ha mejorado las tecnologías de procesamiento, aumentando la diversificación de materias primas y utilizando estrategias como la fortificación para mejorar su calidad nutricional. Existe amplia evidencia que respalda los efectos del consumo de CLPC en la salud humana, destacando su contribución al cumplimiento de las ingestas recomendadas de macro y micronutrientes en poblaciones adultas e infantiles. Por otra parte, el consumo de CLPC, especialmente de granos enteros, se relaciona con menor incidencia de obesidad y menor riesgo de desarrollar enfermedades crónicas no transmisibles. En cuanto a la población pediátrica, se destaca la relación entre el consumo de CLPC y la mejor calidad de la dieta, aunque su impacto sobre el peso corporal y la adiposidad sigue en discusión.

Abstract The consumption of ultra-processed foods has increased globally in recent years. The percentage of calories from these foods is directly associated with the risk of non-communicable chronic diseases. The objective is to evaluate the consumption of ultra-processed foods (UPF) among teachers during the COVID-19 pandemic. This is a cross-sectional study conducted in 2020 in Minas Gerais via digital form. Prevalence ratios between UPF consumption, demographic characteristics, working conditions, lifestyle and health were estimated using Poisson regression. Of the 15,641 teachers, the UPF increase was 27.6%, 28.1% women and 25.6% men. There was a higher prevalence among young women (PR=2.46), without children (PR=1.15), who worked more (PR=1.22), dissatisfied at work (PR=1.25), sedentary (PR=1.25 =1.25), with insomnia (PR=1.57) and overweight (PR=1.12). As for men, there was a higher prevalence among those who were young (PR=1.91), dissatisfied at work (PR=1.40), sedentary (PR=1.17) and insomnia (PR=78). Therefore, it is concluded that there was an increase in UPF consumption.

Resumen El consumo de alimentos ultraprocesados ha aumentado a nivel mundial en los últimos años. El porcentaje de calorías de estos alimentos está directamente asociado con el riesgo de enfermedades crónicas no transmisibles. El objetivo es evaluar el consumo de alimentos ultraprocesados (UPF) entre docentes durante la pandemia de COVID-19. Se trata de un estudio transversal realizado en 2020 en Minas Gerais a través de formulario digital. Los índices de prevalencia entre el consumo de UPF, las características demográficas, las condiciones de trabajo, el estilo de vida y la salud se estimaron mediante regresión de Poisson. De los 15.641 docentes, el incremento de la UPF fue del 27,6%, el 28,1% mujeres y el 25,6% hombres. Hubo mayor prevalencia entre las mujeres jóvenes (RP=2,46), sin hijos (RP=1,15), que trabajaban más (RP=1,22), insatisfechas en el trabajo (RP=1,25), sedentarias (RP=1,25=1,25), con insomnio (RP=1,57) y sobrepeso (RP=1,12). En cuanto a los hombres, hubo mayor prevalencia entre los que eran jóvenes (RP=1,91), insatisfechos en el trabajo (RP=1,40), sedentarios (RP=1,17) e insomnes (RP=78). Por tanto, se concluye que hubo un aumento en el consumo de UPF.

BACKGROUND. Medical schemes are required by the Medical Schemes Act No. 131 of 1998 to pay costs associated with the diagnosis, treatment, or care of a specified set of benefits known as Prescribed Minimum Benefits (PMBs). Medical scheme beneficiaries have the right to lodge complaints with the Council for Medical Schemes (CMS) when their claims are denied. OBJECTIVE. To determine and describe the pattern of PMB complaints received by the CMS from January 2014 to December 2018. METHODS. This was a cross-sectional study that utilised the CMS's clinical complaints database. Data for PMBs, complainants, medical scheme types, and reasons for payment denial were extracted. The CMS's lists of chronic conditions, PMBs, and registered schemes were used to confirm PMBs and to categorise schemes as either restricted (i.e. to members of specific organisations only) or open (i.e. to all South Africans). Extracted and coded data were analysed using SAS v.9.4 software. RESULTS. A total of 2 141 complaints were retrieved and 1 124 PMB complaints were included in the study. The median of PMB complaints per year was 225. Most of the complaints (43.6%, n=490/1 124) were lodged by members themselves. Non-communicable diseases constituted most of the PMB conditions that members complained about. Medicine and surgery were the services that were mostly denied full payment by medical schemes. Open medical schemes accounted for many (73.8%, n=830/1 124) of the complaints. CONCLUSION. Chronic conditions are the main diseases that medical scheme members complain about. Member education and clear definitions of PMBs should be prioritised by medical schemes and the CMS.

ABSTRACT Cultural diversity is the result of a process that is formed within the framework of social, economic and cultural relations. It is essential that university professors are prepared to address the cultural diversity of their students, taking into account the particularities of their national culture and that of other groups of different origins that coexist in the same educational setting. Cultural diversity is a challenge for the educational community and must be considered in the ongoing training of professors at medical universities, fundamentally due to their contexts, socioeconomic environments and health problems, especially chronic non-communicable diseases due to their high prevalence and its impact on the individual and his or her family, influenced by risk factors and social determinants, conditioned by their origins, beliefs, experiences and representations that color current intercultural contexts worldwide.

RESUMEN La diversidad cultural es el resultado de un proceso que se conforma en el marco de las relaciones sociales, económicas y culturales. Se hace imprescindible que los profesores universitarios estén preparados para atender la diversidad cultural de sus estudiantes, teniendo en cuenta las particularidades de su cultura nacional y la de otros grupos de diferentes procedencias que coexisten en un mismo escenario educativo. La diversidad cultural es un reto de la comunidad educativa y debe estar contemplada en la formación permanente de los profesores de las universidades médicas fundamentalmente por sus contextos, los ambientes socioeconómicos y los problemas de salud, sobre todo por las enfermedades crónicas no trasmisibles debido a su alta prevalencia y su repercusión en el individuo y su familia, en los que influyen los factores de riesgo y las determinantes sociales, condicionados por sus orígenes, creencias, vivencias y representaciones que matizan los contextos interculturales actuales a nivel mundial.

ABSTRACT Foundation: aging is a fact that affects the entire world population, and considerably, the most developed countries, in which life expectancy has been increasing as reflected in the United Nations report. Objective: to describe the social context and functional capacity in gerontos of clinic # 8 of Health Area I of the Cienfuegos municipality during the year 2022. Method: a descriptive cross-sectional study was carried out. A 30 % sample was randomly selected for a total of 131 elderly people. A structured interview was carried out, which included the general variables: age, sex, level of education, occupation, personal pathological history, support collaboration and to complete the social assessment, the Family Functioning Questionnaire was applied. Results: the age group of 60 to 65 years had the most prevalence, 45.5 % studied until they completed primary school, followed by those who completed secondary school with 29.0 %. Retirees were represented at 38.9 %, the main non-communicable diseases that prevailed were: high blood pressure, ischemic heart disease and type 2 diabetes mellitus, 40.4 % lived alone, 19.8 % had a caregiver, 14.5 % did not receive support and 9.9 % of the elderly who were in a probable state of social need. Conclusions: a well-nourished, loved, supported older adult, with all basic needs satisfied, as well as all associated diseases typical of this stage of life compensated, will have a better quality of life in any society.

RESUMEN Fundamento: el envejecimiento es un hecho que afecta a toda la población mundial, y de manera considerable, a los países más desarrollados, en los que la esperanza de vida ha ido aumentando tal y como se refleja en el informe de Naciones Unidas. Objetivo: describir el contexto social y capacidad funcional en gerontos del consultorio # 8 del Área de Salud I del municipio Cienfuegos durante el año 2022. Método: se realizó un estudio descriptivo de corte transversal. Se seleccionó aleatoriamente una muestra del 30 % para un total de 131 ancianos. Se realizó una entrevista estructurada, que recogió las variables generales: edad, sexo, nivel de escolaridad, ocupación, antecedentes patológicos personales, la colaboración de apoyo y para completar la valoración social se aplicó el Cuestionario de Funcionamiento Familiar. Resultados: el grupo de edad de 60 a 65 años tuvo más prevalencia, el 45,5 % estudió hasta la primaria terminada, seguidos de los de secundaria terminada con el 29,0 %. Los jubilados estuvieron representados en un 38,9 %, las principales enfermedades no transmisibles que prevalecieron fueron: la hipertensión arterial, la cardiopatía isquémica y la diabetes mellitus tipo 2, el 40,4 % vivía solo, el 19,8 % tenía cuidador, el 14,5 % no recibían apoyo y el 9,9 % de los ancianos que se encontraban en probable estado de necesidad social. Conclusiones: un adulto mayor bien nutrido, querido, apoyado, con todas las necesidades básicas satisfechas, así como todas las enfermedades asociadas propias de esta etapa de la vida compensadas, tendrá en cualquier sociedad una mejor calidad de vida.

ABSTRACT Non-communicable chronic diseases (NCDs) are considered one of the leading causes of death worldwide. During the COVID-19 pandemic, these diseases have been neglected due to the Brazilian Unified National Health System (BHUS) overload. In this context, this study aimed to analyze the bond between patients with NCDs and primary care during the COVID-19 pandemic while also seeking to identify the population's level of knowledge about health parameters and their relationship with the healthcare system. A cross-sectional and observational study was conducted, in which an online questionnaire was administered to collect socioeconomic information from patients and their bond with BHUS in the metropolitan region of Maringa, Parana, Brazil, encompassing individuals over 18 years of age. The survey was promoted on social media, and interested participants responded to the questionnaire, which addressed topics such as identification, medication use, disease information, knowledge about NCDs, and general data related to COVID-19. The obtained and analyzed responses revealed a low bond level between this population and primary care and a lack of knowledge about NCDs and their health during the pandemic. There was a notable decrease in seeking healthcare services during this period, which may be explained by the fear of contracting the novel coronavirus. This study is essential to understand patients' responses to public health challenges during the pandemic. It can become a valuable ally in dealing with future pandemics and endemic crises, enabling improvements in care and raising awareness among the population about NCDs and the healthcare system.

RESUMO As doenças crônicas não transmissíveis (DCNTs) são consideradas uma das principais causas de morte em todo o mundo. Durante a pandemia da COVID-19, essas doenças têm sido negligenciadas devido à sobrecarga das Unidades Básicas de Saúde (BHU). Neste contexto, o objetivo deste estudo é analisar o vínculo dos pacientes com DCNTs com a atenção primária durante a pandemia da COVID-19, ao mesmo tempo em que busca identificar o nível de conhecimento da população sobre os parâmetros de saúde e o relacionamento com o sistema de saúde. Realizou-se um estudo transversal e observacional, no qual foi aplicado um questionário online para coletar informações socioeconômicas dos pacientes e seu vínculo com as BHUs na região metropolitana de Maringá/PR, abrangendo indivíduos maiores de 18 anos. A divulgação foi realizada em mídias sociais e os interessados responderam ao questionário que abordou tópicos como identificação, uso de medicações, informações sobre doenças, conhecimento acerca das DCNTs e dados gerais relacionados à COVID-19. As respostas obtidas e analisadas revelaram um baixo nível de vínculo dessa população com a atenção primária, assim como uma falta de conhecimento sobre as DCNTs e a própria saúde durante a pandemia. Observou-se uma notável redução na procura por serviços de saúde durante esse período, o que pode ser explicado pelo receio da contaminação pelo novo coronavírus. Este estudo se apresenta como uma ferramenta importante para compreender a resposta dos pacientes frente aos desafios da saúde pública durante a pandemia. Ele pode se tornar um aliado valioso para lidar com futuras pandemias e crises endêmicas, possibilitando melhorias nos cuidados e na conscientização da população sobre as DCNTs e o sistema de saúde.

RESUMEN Las enfermedades crónicas no transmisibles (ENT) son consideradas una de las principales causas de muerte a nivel mundial. Durante la pandemia de COVID-19, estas enfermedades han sido desatendidas debido a la sobrecarga de las Unidades Básicas de Salud (UBS). En ese contexto, el objetivo de este estudio es analizar el vínculo entre los pacientes con enfermedades crónicas no transmisibles (ECNT) y la atención primaria durante la pandemia de COVID-19, buscando identificar el nivel de conocimiento de la población sobre los parámetros de salud y la relación con el sistema de salud. Se realizó un estudio transversal y observacional, en el que se aplicó un cuestionario en línea para recolectar información socioeconómica de los pacientes y su vínculo con las BHU en la región metropolitana de Maringá/PR, abarcando personas mayores de 18 años. La divulgación se realizó en las redes sociales y los interesados respondieron el cuestionario que abordó temas como identificación, uso de medicamentos, información sobre enfermedades, conocimientos sobre ECNT y datos generales relacionados con el COVID-19. Las respuestas obtenidas y analizadas revelaron un bajo nivel de vinculación de esta población con la atención primaria, así como un desconocimiento sobre las ECNT y su propia salud durante la pandemia. Hubo una notable reducción en la demanda de servicios de salud durante este período, lo que puede explicarse por el temor a la contaminación por el nuevo coronavirus. Este estudio se presenta como una herramienta importante para comprender la respuesta de los pacientes a los desafíos de salud pública durante la pandemia. Puede convertirse en un valioso aliado para enfrentar futuras pandemias y crisis endémicas, posibilitando mejoras en la atención y concientización de la población sobre las ECNT y el sistema de salud.

Resumen Objetivo: Determinar asociación y utilidad de medir la relación estradiol-testosterona en disfunción eréctil y libido. Método: Casos y controles, involucrando 32 pacientes con patologías crónicas que consultaron por disfunción sexual, definiendo casos como adultos con libido hipoactiva. Resultados: En los sujetos con diabetes mellitus se evidenció likelihood ratio (LR) significativo (6,58). Hubo diferencias significativas en testosterona entre casos y controles, sin diferencias en estradiol o la relación estradiol-testosterona. Se establecieron subgrupos según testosterona y hormona luteinizante (LH). Testosterona baja y LH inapropiadamente normal, mostraron una odds ratio (OR) de 13 y LR significativo. Análisis de LH normal e inapropiadamente normal, reveló diferencias significativas en la relación estradiol-testosterona y testosterona corregida. Curvas ROC evaluaron la eficacia de relación estradiol-tes-tosterona para diagnosticar hipogonadismo hipogonadotrópico y disfunción eréctil (DE). Un punto de corte de 5,98 para la relación estradiol-testosterona arrojó una sensibilidad del 0,85 y una especificidad del 0,79. Conclusiones: Se observaron diferencias al analizar en subgrupos basados en la respuesta de LH, sugiriendo que medir la relación estradiol-testosterona puede ser útil para estudiar la respuesta inapropiada de LH. Se requiere un tamaño de muestra más grande para extrapolar nuestros resultados.

Abstract Objective: Determine the association and utility of measuring estradiol-to-testosterone ratio on erectile dysfunction (ED) and libido. Materials and methods: This is a case-control study involving 32 adult male patients with chronic pathologies who consulted for sexual dysfunction. Cases defined as subjects with hypoactive sexual desire. Results: Diabetes mellitus showed a significant LR of 6.58. Testosterone levels differed between cases and controls, yet no differences emerged for estradiol or estradiol-to-testosterone ratio. Subgroups defined by testosterone and LH levels were established. Low testosterone and inappropriately normal LH showed an OR of 13 and significant LR. Analysis of normal and inappropriately normal LH categories revealed significant differences in E/T ratio and adjusted testosterone. ROC curves assessed E/T ratio effectiveness for diagnosing hypogonadotropic hypogonadism and SD. A cutoff point of 5.98 for E/T ratio yielded 0.85 sensitivity and 0.79 specificity. Conclusions: No significant differences were observed between cases and controls. Differences were observed when analyzed in subgroups based on LH response, indicating estradiol-to-testosterone ratio may be useful in studying inappropriate LH response. A larger sample size is warranted to be able to extrapolate our results.

Abstract Background: Aging, urbanization, and lifestyle changes have fueled the non-communicable diseases (NCDs) epidemic. Objective: Assess mortality, disability, risk factors and life expectancy in people aged ≥60 years (LE-60) in Mexico from 1990-2022 using estimates from the Global Burden of Diseases, Injuries and Risk factors study. Material and methods: Health loss/gain in terms of disability-adjusted life years, risk factors, LE-60 and healthy life expectancy (HALE-60) by sex and state were analyzed. Results: NCDs and metabolic risk factors were the main contributors of health loss, noting a high prevalence of non-lethal conditions related to functional decline (vision and hearing loss), oral conditions, and chronic pain (back pain and osteoarthritis). All-cause mortality and disability rates decreased among men and women while LE-60 and HALE-60 increased from 1990-2022, with state-level variations. States with greater development and healthcare had higher LE-60 and HALE-60. Conclusions: LE-60 increases were not accompanied by reductions in disability due to functional decline, highlighting the need for healthcare strategies to enhance healthy aging.

Resumen Antecedentes: El envejecimiento, la urbanización y cambios en los factores de riesgo han intensificado la epidemia de enfermedades crónicas no transmisibles (ECNT). Objetivo: Evaluar mortalidad, discapacidad, factores de riesgo y esperanza de vida en personas ≥ 60 años (EV-60) en México de 1990-2022, conforme a estimaciones del estudio de la Carga Global de Enfermedades, Lesiones y Factores de Riesgo. Material y métodos: Se analizaron las pérdidas/ganancias en salud en términos de años de vida saludable perdidos, factores de riesgo, EV-60 y esperanza de vida saludable (EVS-60) por sexo y estado de la República Mexicana. Resultados: La carga se centró en riesgos metabólicos y ECNT. Se observó una alta prevalencia de condiciones no letales relacionadas con el deterioro funcional de los órganos de los sentidos, padecimientos orales y asociados con dolor crónico (lumbalgia y osteoartritis). Las tasas de mortalidad y discapacidad disminuyeron en hombres y mujeres mientras que EV-60 y EVS-60 se incrementaron en el período 1990-2022, con variaciones estatales. Las entidades federativas con mayor desarrollo y mejor atención médica tuvieron mejor EV-60 y EVS-60. Conclusiones: El aumento en EV-60 no se acompañó de una reducción de la discapacidad por deterioro funcional, lo que resalta la necesidad de estrategias para promover un envejecimiento saludable.

RESUMO Introdução: na Colômbia foram desenvolvidos vários estudos e planos para determinar o impacto que a atividade física traz na vida diária. É importante reconhecer como o estilo de vida de uma pessoa ao ingressar na universidade sofre algumas mudanças, onde estas se refletem nos hábitos que a pessoa possui e também na saúde psicológica e física. Objetivo: identificar o nível atual de atividade física de estudantes universitários. Materiais e métodos: participaram dez estudantes universitários, a abordagem da pesquisa é o método empírico-analítico, não experimental, onde foi utilizado o Questionário Internacional de Atividade Física (IPAQ) em seu formato curto e a análise Mets como desenvolvimento da técnica. Resultados: constatou-se que mais de 70 % dos alunos do curso de graduação em Educação Física da Corporação Universitária do Minuto de Dios "UNIMINUTO" apresentam nível moderado de atividade física. Conclusões: a atividade física auxilia na saúde tanto mental quanto física, previne doenças não transmissíveis, melhora o desempenho acadêmico e profissional, aumenta até certo ponto o convívio social, são muitos os benefícios que o exercício físico traz.

RESUMEN Introducción: en Colombia, se han desarrollado varios estudios como también planes para poder determinar la incidencia que trae la actividad física en el diario vivir. Es importante reconocer cómo el estilo de vida de una persona al momento de ingresar a la universidad obtiene algunos cambios, donde estos se ven reflejados en los hábitos que tiene la persona y también en la salud psicológica y física. Objetivo: identificar el nivel actual de actividad física de los estudiantes universitarios. Materiales y métodos: participaron diez estudiantes universitarios, el enfoque de la investigación es empírico analítico, de método no experimental, donde se utilizó el cuestionario internacional de Actividad Física (IPAQ) en su formato corto y como desarrollo de la técnica se utilizó análisis Mets. Resultados: se determinó que más del 70 % de los estudiantes de licenciatura en Educación Física de la Corporación Universitaria del Minuto de Dios "UNIMINUTO" tienen un nivel moderado de actividad física. Conclusiones: la actividad física ayuda a la salud tanto mental como físicamente, previene enfermedades no transmisibles, mejora el rendimiento académico como laboral, incrementa en alguna medida la interacción social, son muchos los beneficios que trae consigo el ejercicio físico.

ABSTRACT Introduction: In Colombia, several different studies have been done to determine the effect of physical activity on everyday life. A person's lifestyle upon entry to the university changes affects the habits, and physical and psychological health of a person. Aim: To identify the current level of physical activity in university students. Materials and methods: Ten university students took part in the study, under an empirical and analytical approach based on a non-experimental method. The study conducted a short international questionnaire Physical Activity (IPAQ), and the Mets analysis technique. Results: More than 70 % of the students in the Physical Education bachelor's degree at the Minuto de Dios University Corporation UNIMINUTO had a moderate level of physical activity. Conclusions: Physical activity favors mental and physical health, prevents non-communicable diseases, enhances academic achievements and work performance, and increases social interaction, among others.