Resumen El síndrome metabólico (SM) se asocia con alteraciones metabólicas e inflamatorias que imprimen un mayor riesgo de desarrollar diabetes y enfermedades cardiovasculares y tiene como base la resistencia insulínica. La alimentación, sedentarismo, educación y distribución del ingreso pueden influir en la aparición del SM. El objetivo del estudio fue conocer la prevalencia del SM y los factores de riesgo cardiovascular asociados en una población vulnerable, adulta y urbana, que acudió voluntariamente luego de una campaña de difusión, a un hospital de atención primaria en la ciudad de San Luis, Argentina. En 451 sujetos, 205 hombres y 246 mujeres (45,5±12,4 años) se analizaron datos personales, antropométricos y biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicéridos, glucosa, insulina, proteína C reactiva ultrasensible (PCRus), apolipoproteínas A y B, ácido úrico e índices subrogados de insulina. El SM se estableció empleando la definición armonizada de SM (2009). El 80% de la población no completó la educación formal. Los hombres estaban desempleados o con trabajo informal (70%). El 51,4% de la población cumplía con el criterio de SM (50,0% mujeres y 53,1% hombres). Entre los componentes del SM, la tríada más frecuente en mujeres y hombres, fue: c-HDL disminuido, circunferencia de cintura elevada e hipertrigliceridemia. El SM aumentó con la edad en los hombres. Las mujeres con SM presentaron niveles altos de PCRus. El conocimiento de la prevalencia local, tanto de la obesidad como del SM, permite valorar la magnitud del problema en cada comunidad, establecer medidas de prevención, control y compararlo con otras realidades epidemiológicas.

Resumo A síndrome metabólica (SM) está associada a alterações metabólicas e inflamatórias que aumentam o risco de desenvolvimento de diabetes e doenças cardiovasculares, considerando a resistência à insulina. A alimentação, o sedentarismo, a escolaridade e a distribuição de renda podem influenciar o aparecimento da SM. O objetivo do estudo foi conhecer a prevalência da SM e os fatores de risco cardiovascular associados em uma população vulnerável, adulta e urbana, que compareceu voluntariamente a um hospital de atenção primária na cidade de San Luis, Argentina, após uma campanha de divulgação. Em 451 indivíduos, 205 homens e 246 mulheres (45,5±12,4 anos), foram analisados dados pessoais, antropométricos e de biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicerídeos, glicose, insulina, proteína C reativa ultrassensível (PCRus), apolipoproteínas A e B, ácido úrico e índices substitutos de insulina. A SM foi estabelecida utilizando a definição harmonizada de SM (2009). Oitenta por cento da população não concluiu a educação formal. Os homens estavam desempregados ou em trabalho informal (70%). 51,4% da população atendia os critérios da SM (50,0% mulheres e 53,1% homens). Dentre os componentes da SM, a tríade mais frequente em mulheres e homens: c-HDL diminuído, circunferência abdominal elevada e hipertrigliceridemia. SM aumentou com a idade nos homens. Mulheres com SM apresentaram níveis elevados de PCRus. O conhecimento da prevalência local da obesidade quanto da SM permite avaliar a magnitude do problema em cada comunidade, estabelecer medidas de prevenção e controle e compará-lo com outras realidades epidemiológicas.

Abstract Metabolic syndrome (MS) is associated with metabolic and inflammatory alterations that increase the risk of developing diabetes and cardiovascular diseases, based on insulin resistance. Diet, sedentary lifestyle, education and income distribution can influence the appearance of MS. The objective of the study was to know the prevalence of MS and associated cardiovascular risk factors in a vulnerable, adult and urban population, that voluntarily attends after diffusion campaign, to a primary care hospital in the city of San Luis, Argentina. In 451 subjects, 205 men and 246 women (45.5±12.4 years), personal, anthropometric and biomarker data were analysed: total cholesterol HDL cholesterol (HDL-c), LDL cholesterol, triglycerides, glucose, insulin, ultrasensitive C-reactive protein (usCRP), apolipoproteins A and B, uric acid and insulin surrogate indices. The MS was established using the harmonised definition of MS (2009). Eighty percent of the population did not complete formal education. Men were unemployed or in informal work (70%). A total of 51.4% of the population had the MS criteria (50.0% women and 53.1% men). Among the components of MS, the most frequent triad in women and men, were: decreased HDL-c, elevated waist circumference and hypertriglyceridemia. The prevalence of MS increased with age in men. Women with MS presented high levels of usCRP. Knowledge of the local prevalence of both obesity and MS would allow enable the assessment of the magnitude of the problem in each community, establish prevention and control measures, and compare it with other epidemiological realities.

RESUMEN Introducción: las enfermedades del pie relacionadas a la diabetes mellitus representan una de las causas de mayor morbilidad e incapacidad en las personas con diabetes mellitus tipo 2, siendo la causa más frecuente de ingreso hospitalario en dicho grupo. Objetivo: describir las características clínicas de los pacientes con enfermedad del pie relacionadas a la diabetes mellitus del Hospital Nacional 2022-2023. Metodología: se seleccionaron 113 pacientes portadores de diabetes mellitus tipo 2 con pie diabético mayores de 18 años. Se evaluaron las variables demográficas, medidas antropométricas, características de la enfermedad, comorbilidades y características clínicas del pie. Resultados: de los 113 estudiados 42 pacientes (37 %) correspondieron al sexo femenino y 71 (63 %) al sexo masculino, promedio de edad fue de 65 años DE 12,191. 75 pacientes (66 %) presentaron pie diabético, con lesión Wagner grado 4. El 81 % (92) tenía hipertensión arterial, sedentarismo 65 % (84), en menor frecuencia pacientes con sobrepeso 38 % (43), obesidad 25 % (38), tabaquismo 23 % (26) y dislipidemia 18 % (20). Conclusión: las características clínicas de los pacientes con diabetes tipo 2 con lesión en el pie coinciden con otros trabajos obtenidos a nivel mundial. Es muy importante prestar atención a este grupo de riesgo, mediante medidas preventivas y realizar el tratamiento precoz para disminuir las complicaciones.

ABSTRACT Introduction: foot diseases related to diabetes mellitus represent one of the causes of greatest morbidity and disability in people with type 2 diabetes mellitus, being the most frequent cause of hospital admission in said group. Objective: to describe the clinical characteristics of patients with foot disease related to diabetes mellitus at Hospital Nacional 2022-2023. Methodology: 113 patients with type 2 diabetes mellitus with diabetic foot over 18 years of age were selected. Demographic variables, anthropometric measurements, disease characteristics, comorbidities, and clinical characteristics of the foot were evaluated. Results: of the 113 studied, 42 patients (37 %) were female and 71 (63 %) were male, average age was 65 years SD 12,191. 75 patients (66 %) presented diabetic foot, with Wagner grade 4 lesion. 81 % (92) had high blood pressure, sedentary lifestyle 65 % (84), less frequently overweight patients 38 % (43), obesity 25% (38) ), smoking 23 % (26) and dyslipidemia 18 % (20). Conclusion: the clinical characteristics of patients with type 2 diabetes with foot injury coincide with other works obtained worldwide. It is very important to pay attention to this risk group, through preventive measures and carry out early treatment to reduce complications.

RESUMEN Introducción: la obesidad, la edad, el estilo de vida sedentario y los antecedentes familiares de diabetes mellitus se han descrito como factores de riesgo para la diabetes mellitus tipo 2 (DM2). Objetivo: determinar el riesgo probable de desarrollar DM2 en los próximos 10 años en mujeres trabajadoras de un hospital de referencia en Asunción, Paraguay. Metodología: este estudio descriptivo observacional de corte transversal se llevó a cabo entre médicos, enfermeras y personal administrativo. Se recopilaron datos durante tres meses utilizando la prueba FINDRISK para evaluar el riesgo de diabetes, la cual consta de ocho preguntas sobre la edad, el índice de masa corporal, el perímetro de la cintura, la actividad física, el consumo de frutas y verduras, antecedentes de presión arterial alta y glucosa elevada, y diabetes diagnosticada en familiares. Para el análisis de los datos se utilizaron estadísticas descriptivas en forma de frecuencias y porcentajes, así como estadísticas analíticas con la prueba de Mann Whitney y Kruskal Wallis. Resultados: un total de 112 mujeres participaron en el estudio, con más del 40% en el rango de edad de 31 a 40 años. El perímetro de cintura de 80-88 cm. fue el más común, con 38,4%. Se encontró que el 33% de las participantes tenían sobrepeso. Casi el 60% no realizaba actividad física diaria. Más del 38% tenían antecedentes de diabetes en familiares de primer grado. El 67,9% de las encuestadas tenían algún riesgo de desarrollar DM2 en los próximos 10 años, y 22 de ellas presentaron un riesgo alto o muy alto según la prueba FINDRISK. Las participantes de 35 años o más tenían un riesgo significativamente mayor (Chi; p=0,008). Conclusión: se detectó una alta prevalencia de sobrepeso y obesidad, siendo el 67,9% de las encuestadas quienes mostraron algún grado de riesgo de desarrollar DM2 en los próximos 10 años, de los cuales casi el 20% presentaban un riesgo categorizado como alto o muy alto.

ABSTRACT Introduction: Obesity, age, sedentary lifestyle, and family history of diabetes mellitus are risk factors for type 2 diabetes mellitus (T2DM). Objective: determine the probable risk of developing T2DM in the next 10 years in working women at a reference hospital in Asunción, Paraguay. Methodology: This cross-sectional observational descriptive study was conducted with physicians, nurses, and administrative staff. Data were collected over three months using the FINDRISK test to assess diabetes risk, which consists of eight questions about age, body mass index, waist circumference, physical activity, fruit and vegetable consumption, history of blood pressure, high blood pressure and high glucose, and diabetes diagnosed in family members. Descriptive statistics in the form of frequencies and percentages, as well as analytical statistics using the Mann-Whitney and Kruskal-Wallis tests, were used to analyze the data. Results: A total of 112 women participated in the study, with more than 40% in the age range of 31-40 years. The waist circumference of 80-88 cm was the most common (38.4%). It was found that 33% of participants were overweight. Almost 60% of the participants did not perform daily physical activities. More than 38% of the first-degree relatives had a history of diabetes. Of the surveyed participants, 67.9%had some risk of developing T2DM in the next 10 years and 22 had a high or very high risk according to the FINDRISK test. Participants aged 35 years had a significantly higher risk (p=0.008). Conclusion: A high prevalence of overweight and obesity was observed, with 67.9% of the respondents showing some degree of risk for developing T2DM in the next 10 years, of which nearly 20% were categorized as high or very high risk.

ABSTRACT The aging process is marked by a sedentary lifestyle and little physical activity, which is associated with the rapid and continuous decline in functional capacities, dependency and fragility. The objective of the work is aimed at assessing, through the test of maximum repetitions with non-extreme weights, the effect of the application of exercises with weights for the care of sarcopenia. Methods from the theoretical and empirical levels such as synthetic analytical, inductive-deductive, documentary review, documentary analysis, observation, survey and interview were applied. As a working instrument, a set of strength endurance and aerobic physical exercises was applied that allowed the measurement method to be used in seven older adults with sarcopenia, treated at the Center for Physical Activity and Health of the University of Sciences. of Physical Culture and Sports ¨Manuel Fajardo¨. The muscular strength work was evaluated using the aforementioned test, which made it possible to identify the real weight of the physical load with which they must train and, on that basis, the set of exercises with weights was developed. In the preliminary results recorded, through the application of the test, it was confirmed that the integration of weight work and aerobic work favorably influences strength gain in the older adults.

RESUMO O processo de envelhecimento é marcado por um estilo de vida sedentário e pouca atividade física, o que está associado ao declínio rápido e contínuo das capacidades funcionais, à dependência e à fragilidade. O objetivo do trabalho visa avaliar, por meio do teste de repetições máximas com pesos não extremos, o efeito da aplicação de exercícios com carga no tratamento da sarcopenia. Foram aplicados métodos dos níveis teórico e empírico como analítico, sintético, indutivo, dedutivo, revisão documental, análise documental, observação, levantamento e entrevista. Como instrumento de trabalho foi aplicada uma bateria de exercícios físicos resistidos de força e aeróbios que permitiu a utilização do método de mensuração em sete idosos com sarcopenia atendidos no Centro de Atividade Física e Saúde da Universidade de Ciências da Cultura Física e. Desporto ¨ Manuel Fajardo. O trabalho de força muscular foi avaliado por meio do referido teste, que possibilitou identificar o real peso da carga física com a qual devem treinar e, com base nisso, foi desenvolvida a bateria de exercícios com pesos. Nos resultados preliminares registrados, por meio da aplicação do teste, foi confirmado que a integração do trabalho com pesos e do trabalho aeróbio influencia favoravelmente o ganho de força em idosos.

RESUMEN El proceso de envejecimiento está marcado por el sedentarismo y la escasa actividad física, lo que se asocia a la disminución rápida y continua de las capacidades funcionales, la dependencia y la fragilidad. El objetivo del trabajo se orienta a valorar, mediante el test de repeticiones máximas con pesos no extremos, el efecto de la aplicación de ejercicios con pesas para la atención de la sarcopenia. Se aplicaron métodos de los niveles teóricos y empíricos como el analítico, sintético, inductivo, deductivo, revisión documental, análisis documental, observación, encuesta y entrevista. Se aplicó, como instrumento de trabajo, una batería de ejercicios físicos de resistencia a la fuerza, y aeróbicos que permitieron utilizar el método de medición en siete adultos mayores con sarcopenia, atendidos en el Centro de Actividad Física y Salud de la Universidad de las Ciencias de la Cultura Física y Deportes ¨ Manuel Fajardo. Se evaluó el trabajo de fuerza muscular mediante el test mencionado, lo que permitió identificar el peso real de la carga física con la que deben entrenar y, sobre esa base, se elaboró la batería de ejercicios con pesas. En los resultados preliminares registrados, mediante la aplicación del test, se constató que la integración del trabajo con pesas y el aeróbico influyen de manera favorable en la ganancia de fuerza en el adulto mayor.

Resumo: O retorno às atividades presenciais acendeu o alerta para o sedentarismo que se desenvolveu durante o período de confinamento, devido à inclinação ao conforto de permanecer no ambiente familiar. O manuscrito examina o impacto que a pandemia de Covid-19 teve nas instituições educacionais do sul do Peru. Após uma breve introdução, exploramos o medo desenvolvido em relação à interação presencial por parte dos principais agentes impulsionadores do corpus educacional e do desenvolvimento específico da educação nos Andes. Como ramificação da construção teórica, há entre os estudantes uma saudade do passado invernal abalado pelas ondas vibratórias do morcego de Wuhan, pois com o retorno à presencialidade, seu conforto na Internet e usar como desculpa o fato de estar num ambiente virtual para não cuidar de certas responsabilidades acadêmicas e domésticas não será mais possível. No âmbito do ensino, retoma-se o combate frontal aos múltiplos problemas educacionais do país abandonado há dois longos anos; finalmente, para os pais, abre-se no túnel da preocupação, a luz da esperança de ver novamente os filhos com o sagrado uniforme escolar.

Resumen El retorno a la presencialidad ha hecho sonar las alarmas del sedentarismo construido durante el confinamiento debido a la tendencia por la comodidad de no salir del nido. Este ensayo delibera la derivación que ha tenido la pandemia del COVID-19 en las instancias educativas en el sur del Perú. Tras una breve introducción, se aborda el miedo al cara a cara de los principales actores que dinamizan el corpus educacional y el desarrollo específico de la educación en los Andes. Como ramificación del constructo teórico, existe en las personas estudiantes la añoranza hacia el pasado invernal sacudido por las ondas vibratorias del murciélago de Wuhan, porque, con el retorno a la presencialidad, sus comodidades en la red de internet y la excusa de estar en clases virtuales para no ocuparse de ciertas responsabilidades académicas y domésticas ya no serán posibles. En cuanto a la esfera magisterial, se reanuda el combate frontal hacia los múltiples problemas educativos en el país, abandonado por dos largos años; finalmente, para el estrato de progenitores, se aparece en el túnel de la preocupación, la luz de esperanza de ver a sus hijos(as) nuevamente con el sagrado uniforme escolar.

Abstract: The return to presentiality has raised the alarms of the sedentary lifestyle that was built during the confinement and the tendency to the convenience of not leaving the nest. The manuscript explores the repercussions that the Covid-19 pandemic has had on educational institutions in Southern Peru. After a brief introduction, it addresses the face-to-face fear felt by the main actors in the educational corpus, also addressing the specific development of education in the Andes. As a ramification of the theoretical construct, students long for the winter past shaken by the vibrational waves of the Wuhan bat, because with the return to face-to-face, their comforts in the Internet network and the excuse of being in virtual classes to avoid taking care of certain academic and domestic responsibilities, will no longer be possible. As for the teachers’ sphere, the frontal fight against the multiple educational problems in the country, abandoned for two long years, will be resumed. Finally, regarding the parents’ stratum, a light of hope to see their children again wearing the sacred school uniform is starting to shine in a tunnel of worry

Resumo Introdução: As complicações micro e macrovasculares da diabetes são resultado de um processo de caráter longo sobre a falta dos cuidados da diabetes, de que resultam problemas cardiovasculares, oftalmológicos e neuropáticos, requerendo por essas questões elevada atenção no tratamento. Descrição do caso: Apresenta-se o relato de caso de um paciente adulto de meia-idade, ex-fumador, com diagnóstico de diabetes mellitus, além da hipertensão e obesidade. A sua alimentação não saudável ao longo dos anos, sedentarismo e altos níveis de estresse resultou num quadro de isquemia vascular periférica, que intensificou as complicações da diabetes, ou seja, problemas micro e macrovasculares, entre eles, a retinopatia e a neuropatia. Por esse histórico, a farmacoterapia do paciente resultou entre as insulinas (regular e NPH), antiagregante plaquetátio, estatina, fibratos, psicotrópicos e os anti-hipertensores. Além disso, detetou-se que seus níveis glicémicos e hemoglobina glicada estão elevados. Ainda se verificaram alterações na lipoproteína de alta densidade (HDL) e triglicéridos. Algumas queixas do paciente no período noturno, como boca seca, tontura e sonolência, são problemas que podem estar relacionados com a terapia concomitante de venlafaxina, gabapentina e amitriptilina. Comentários: De forma geral, recomenda-se a este paciente a prática de exercício físico, como caminhada, por exemplo, diminuição do consumo de hidratos de carbono e sódio, além de algumas alterações na farmacoterapia do paciente.

Abstract Introduction: The micro and macrovascular complications of diabetes are the result of a long process of the lack of diabetes care, which results in cardiovascular, ophthalmological, and neuropathic problems, and for these reasons requires high attention in treatment. Case description: This article presents a case report of a middle-aged adult patient, ex-smoker, diagnosed with diabetes mellitus, in addition to hypertension and obesity. Their unhealthy diet over the years, sedentary lifestyle, and high levels of stress resulted in peripheral vascular ischemia, which intensified the complications of diabetes, that is, micro and macrovascular problems, including retinopathy and neuropathy. Due to this history, the patient’s pharmacotherapy resulted in insulins (regular and NPH), antiplatelet agents, statins, fibrates, psychotropics, and antihypertensives. In addition, his blood glucose levels and glycated hemoglobin were found to be elevated. Furthermore, alterations were observed in high-density lipoprotein (HDL) and triglycerides. Some patient complaints at night, such as dry mouth, dizziness, and drowsiness, are problems that may be related to concomitant therapy with venlafaxine, gabapentin, and amitriptyline. Comments: In general, this patient is recommended to practice physical exercises, such as walking, for example, reducing the consumption of carbohydrates and sodium, in addition to some changes in the patient’s pharmacotherapy.

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.

ABSTRACT Foundation: acute coronary syndromes constitute a health problem due to their high morbidity and mortality. It would be reasonable to assume that health workers take care of and control their own coronary risk factors, however, research results show that this is not always the case. Objective: to characterize coronary risk factors in workers at the Guillermo Domínguez López General Teaching Hospital in Las Tunas. Method: a descriptive cross-sectional study was carried out at the Guillermo Domínguez López General Teaching Hospital in Las Tunas between December 2019 and December 2022. The study population was 912 workers and the sample was 200. It was a probabilistic, simple random sampling divided into two groups: A (with acute coronary syndrome) and B (without acute coronary syndrome). The following variables were analyzed: age, sex, coronary risk factors. The information was obtained from clinical records and analyzed in percentage, mean, standard deviation and the z statistic to obtain the influence of risk factors on the disease. Results: the average age of group A: 56.5 (±5.03), group B: 46.4 (±11.33) years with a predominance of the male sex (54.5 %). The predominant risk factors were: sedentary lifestyle (57 %), smoking (36.5 %) and high blood pressure (34 %). Those with the greatest influence were: a history of ischemic heart disease, vascular disease, abdominal obesity (z: 0.99), diabetes mellitus (z: 0.92) and arterial hypertension (z: 0.70). Conclusions: coronary syndrome predominates in the fifth decade of life and is more common in males.

RESUMEN Fundamento: los síndromes coronarios agudos constituyen un problema de salud debido a su alta morbilidad y mortalidad. Sería razonable asumir que los trabajadores de la salud cuidan y controlan sus propios factores de riesgo coronario, no obstante, los resultados obtenidos en investigaciones muestran que no siempre es así. Objetivo: caracterizar los factores de riesgo coronario en trabajadores del Hospital General Docente Guillermo Domínguez López de Las Tunas. Método: se realizó un estudio descriptivo de corte transversal en el Hospital General Docente Guillermo Domínguez López de Las Tunas entre diciembre de 2019 y diciembre de 2022. La población de estudio fue de 912 trabajadores y la muestra de 200. Fue un muestreo probabilístico, aleatorio simple, dividido en dos grupos: A (con síndrome coronario agudo) y B (sin síndrome coronario agudo). Se analizaron las siguientes variables: edad, sexo, factores de riesgo coronario. La información se obtuvo de expedientes clínicos y se analizó en porcentaje, media, desviación estándar y el estadígrafo z para obtener la influencia de los factores de riesgo en la enfermedad. Resultados: la media de edad del grupo A: 56,5 (±5,03), grupo B: 46,4 (±11,33) años con predominio del sexo masculino (54,5 %). Los factores de riesgo que predominaron fueron: sedentarismo (57 %), tabaquismo (36,5 %) e hipertensión arterial (34 %). Los de mayor influencia fueron: los antecedentes de cardiopatía isquémica, la enfermedad vascular, la obesidad abdominal (z: 0,99), la diabetes mellitus (z: 0,92) y la hipertensión arterial (z: 0,70). Conclusiones: el síndrome coronario predomina en la quinta década de la vida y con mayor frecuencia en el sexo masculino.

ABSTRACT Foundation: cerebrovascular disease is any alteration of one or more brain areas, whether temporary or permanent, secondary to a cerebral circulation disorder of ischemic or hemorrhagic origin. For many years it has been considered one of the main causes of death worldwide. It is among the main causes of death in Ecuador. Objective: to describe the risk factors for cerebrovascular diseases in adult patients diagnosed with cerebrovascular diseases at the Tulcán Sur Health Center over a period of 1 year. Methods: a descriptive and cross-sectional study was carried out at the Tulcán Sur Health Center, over a period of 1 year, from September 2022 to September 2023. The universe consisted of 130 patients. The sociodemographic variables were analyzed: age and sex; clinical: presence or absence of high blood pressure, smoking, alcoholism, diabetes mellitus, dyslipidemia, atrial fibrillation and sedentary lifestyle. The normality of the data distribution was analyzed using the Kolmogorov-Smirnov test. Categorical variables were expressed in absolute and relative frequencies. Quantitative variables were described using the mean and standard deviation. Results: the mean age of the population was 61.0 ± 16.5. The male sex predominated with 70 patients (53.8 %). High blood pressure, smoking and obesity were the most common cardiovascular risk factors with 73 (56.5 %), 79 (60.7 %), 64 (49.2 %) patients respectively. Conclusions: high blood pressure, smoking and obesity were the most prevalent risk factors.

RESUMEN Fundamento: la enfermedad cerebrovascular es toda alteración de una o varias áreas encefálicas, ya sea de forma transitoria o permanente, secundaria a un trastorno de la circulación cerebral de origen isquémico o hemorrágico. Por muchos años ha sido considerada una de las principales causas de muerte a nivel mundial. Está entre las principales causas de muerte en Ecuador. Objetivo: describir los factores de riesgo de enfermedades cerebrovasculares en pacientes adultos diagnosticados con enfermedades cerebrovasculares en el Centro de Salud Tulcán Sur en un periodo de 1 año. Métodos: se realizó un estudio descriptivo y transversal, en el Centro de Salud Tulcán Sur, en un periodo de 1 año, desde septiembre del 2022 a septiembre del 2023. El universo lo constituyeron 130 pacientes. Se analizaron las variables sociodemográficas: edad y sexo; clínicas: presencia o no de hipertensión arterial, tabaquismo, alcoholismo, diabetes mellitus, dislipidemia, fibrilación auricular y sedentarismo. La normalidad de la distribución de los datos fue analizada utilizando la prueba de Kolmogorov-Smirnov. Las variables categóricas fueron expresadas en frecuencias absoluta y relativa. Las variables cuantitativas se describieron utilizando la media y la desviación típica. Resultados: la media de edad de la población fue de 61,0 ± 16,5. El sexo masculino predominó con 70 pacientes (53,8 %). La hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo cardiovascular más frecuentes con 73 (56,5 %), 79 (60,7 %), 64 (49,2 %) pacientes respectivamente. Conclusiones: la hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo con más prevalencia.

Abstract Objectives To present observational studies investigating associations between the consumption of ultra-processed foods and health outcomes in childhood and adolescence. Data source Observational, cross-sectional, or longitudinal studies were considered, and identified in the Scopus, Web of Science, Pubmed and Scielo databases, without date restrictions. Data synthesis The most frequent combinations of risk factors in children and adolescents involved an unhealthy diet, with regular consumption of ultra-processed foods to the detriment of a diet based on fresh or minimally-processed foods and insufficient levels of physical activity; records on alcohol and tobacco use were identified. Combined, these practices contribute to the findings that indicate an increase in the prevalence of obesity in children and adolescents and a sedentary lifestyle, with a decrease in physical activity, in addition to representing a risk for the development of chronic non-communicable diseases, such as cardiovascular diseases and periodontal disease in childhood and adolescence. Conclusions The present study maps the current literature on the topic and indicates the direction of the approach for health promotion and prevention of NCDs in children and adolescents. Among the different risk factors that negatively affect the full development of this population, frequently eating breakfast and practicing physical activity is most strongly associated with a lower consumption of ultra-processed foods and should be part of an integrated approach to promoting eating practices that favor the reduction of diseases also in adult life. ultraprocessed ultra processed adolescence Observational crosssectional, crosssectional cross sectional, sectional cross-sectional considered Scopus Science databases restrictions minimallyprocessed minimally Combined lifestyle noncommunicable non communicable population life

Abstract Objective: To know the scientific evidence to identify patterns of changes in lifestyles during childhood and their association with various anthropometric parameters in infants caused during confinement by COVID-19. Materials and methods: A systematic analysis was carried out following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide in the PubMed and Google Scholar databases, the keywords used were diabetes mellitus tipo 2 or diabetes mellitus type II, hipertensión or hypertension, cuarentena or quarantine, covid-19, infantes or child, estilos de vida saludables or healthy lifestyles, sedentarismo or sedentarism, comportamientos alimentarios or eating behaviors. The search was carried out from April 2019 to June 2022. Results: The search yielded 221 articles, only 5 articles met the inclusion, exclusion and quality criteria, which show that the COVID-19 confinement caused changes in lifestyles. life that were mainly associated with a sedentary lifestyle during childhood. Conclusions: There is little information on the effects that COVID-19 confinement has caused on the lifestyles of infants, the existing information shows changes in pro-healthy eating habits in infants and decreased physical activity; therefore, activities aimed at guardians or responsible adults are recommended so that they can supervise feeding and improve nutrition, as well as carry out activities that encourage physical activity.

Resumen Objetivo: Conocer las evidencias científicas que evidencian cambios en los patrones de estilos de vida durante la infancia y su asociación con el confinamiento causado por la COVID-19. Materiales y métodos: Se realizó un análisis sistemático siguiendo los lineamientos de la guía Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) en las bases de datos de PubMed y Google Académico, las palabras claves utilizadas fueron diabetes mellitus type II o diabetes mellitus tipo II, hypertension o hipertensión, quarantines o cuarentena, covid 19, infants o infantes, child o niños, healthy lifestyle o estilo de vida saludable, sedentary behavior o sedentarismo, feeding behaviors o comportamientos alimentarios. La búsqueda se realizó de abril 2019 a junio 2022. Resultados: La búsqueda arrojó 221 artículos, sólo 5 artículos cumplieron los criterios de inclusión, exclusión y criterios de calidad, los cuales muestran que el confinamiento por COVID-19 causó cambios en los estilos de vida que se asociaron principalmente al sedentarismo durante la infancia. Conclusiones: Existe poca información sobre los efectos que ha causado el confinamiento por la COVID-19 en los estilos de vida de los infantes, la existente muestra cambios en los hábitos alimentarios pro-saludables en infantes y disminución de la actividad física; por lo que se recomiendan actividades dirigidas a los tutores o adultos responsables para que supervisen la alimentación y la mejora de la nutrición, así como realizar actividades que fomenten la actividad física.

ABSTRACT The increase in obesity in the world demands a strategic plan aimed at its prevention in the immediate, medium and long term, given that children who present with obesity from an early age tend to maintain this state in subsequent periods of their lives, which leads to acquiring other so-called non-communicable diseases. Advanced studies have identified strategies based on the development of technological proposals that contribute to the promotion of physical activity through active games for children. These proposals constitute postmodern alternatives that motivate a change in sedentary behaviors to consolidate healthy lifestyle habits. It is necessary to implement programs aimed at preventing obesity in pediatric ages, mediated by active video games as educational alternatives that promote the reduction of periods of sedentary lifestyle and the control of chronic non-communicable diseases.

RESUMEN El incremento de la obesidad en el mundo demanda de un plan estratégico dirigido a su prevención en el inmediato, mediano y a largo plazo, dado que los niños que desde edades tempranas presentan condiciones de obesidad, tienden a mantener este estado en periodos siguientes de su vida, lo que conlleva a adquirir otras enfermedades denominadas no transmisibles. Estudios adelantados han identificado estrategias fundamentadas en el desarrollo de propuestas tecnológicas que aportan a la promoción de la actividad física mediante juegos activos para los niños. Estas propuestas constituyen alternativas postmodernas que motivan a un cambio de conductas sedentarias para la consolidación de hábitos de vida saludables. Es necesario la implementación de programas orientados a la prevención de la obesidad en edades pediátricas, mediados por videojuegos activos como alternativas didácticas que promuevan la disminución de los periodos de sedentarismo y el control de enfermedades crónicas no transmisibles.

RESUMEN Objetivo: Identificar factores de riesgo asociados al primer infarto cerebral en pacientes hospitalizados en el Hospital Herminda Martín de Chillán, Región de Ñuble. Método: Estudio de caso-control con base hospitalaria realizado en el Hospital Herminda Martín de Chillán. Se seleccionaron 89 casos incidentes de Accidente Cerebrovacular y 178 controles pareados por edad y sexo. Los factores de riesgo estudiados fueron presencia de hipertensión, presión arterial sistólica y diastólica, presencia de diabetes mellitus tipo 2, malnutrición por exceso, consumo de tabaco, exposición a ambiente con humo de tabaco, consumo de alcohol, sedentarismo en tiempo libre, inasistencia a controles de salud y baja adherencia a dieta mediterránea. Se realizó una regresión logística condicional y se determinó el riesgo atribuible en expuestos y poblacional. Resultados: 69% son de sexo masculino, la edad promedio fue 71,8+13,9 años. Se observó una asociación significativa entre el consumo de alcohol (OR 1,98 IC95%1,07-3,64) y la probabilidad de ocurrencia de un primer infarto cerebral. De cada 100 personas de la población estudiada, se evitan 19 casos de infarto cerebral (RAP 0,19 IC95% 0,09-0,27) si se mantiene la presión arterial sistólica por debajo de los 140 mmhg y 28 casos (RAP 0,28 IC95% 0,009-0,27) si se elimina el consumo de alcohol. Conclusión: La presión arterial elevada y el consumo de alcohol son factores de riesgo modificables a través de políticas públicas estructurales e individuales, las cuales junto a un fortalecimiento de la red de salud son necesarios para generar un plan de prevención primaria del infarto cerebral.

ABSTRACT Aim: To identify the risk factors associated with the first cerebral infarction in patients hospitalized at the Herminda Martín Hospital. Methods: Hospital-based case-control study conducted at Herminda Martín Hospital. We selected 89 incident cases of stroke and 178 controls matched by age and sex. The risk factors studied were the presence of hypertension, systolic and diastolic blood pressure, presence of type 2 diabetes mellitus, overweight, tobacco consumption, secondhand tobacco exposure, alcohol consumption, sedentary lifestyle in leisure time, non-attendance at health controls and low adherence to the Mediterranean diet. Data were analyzed using conditional logistic regression and attributable risk was determined in exposed and at population levels. Results: 69% were male, mean age was 71.8+13.9 years. A significant association was observed between alcohol consumption (OR 1.98 CI95%1.07-3.64) and the probability of occurrence of a first cerebral infarction. For every 100 people in the study population, 19 cases of stroke are avoided (PAF 0.19, 95% CI 0.09-0.27) if systolic blood pressure (SBP) is maintained below 140 mmHg and 28 cases (PAF 0.28 95%CI 0.009-0.27) if alcohol consumption is eliminated. Conclusion: High blood pressure and alcohol consumption are modifiable risk factors through public and individual policies, which, together with a strengthening of the health system, are necessary to generate a primary prevention plan for stroke.

ABSTRACT Objective This pilot study investigated whether single nucleotide polymorphisms (SNP) in the NOX5 gene (NADPH oxidase 5) are associated with the type 2 diabetes (T2D) risk. Subjects and methods A total of 1579 patients with T2D and 1627 age- and sex-matched healthy subjects were recruited for this study. Genotyping of common SNPs, namely rs35672233, rs3743093, rs2036343, rs311886, and rs438866, was performed using the MassArray-4 system. Results SNP rs35672233 was associated with an increased risk of T2D (OR = 1.67, 95% CI 1.29-2.17, FDR = 0.003). The H3 haplotype (rs35672233T-rs3743093G-rs2036343A-rs311886C-rs438866C) increased T2D risk (OR = 1.65, 95% CI 1.27-2.13, FDR = 0.001). The rs35672233 polymorphism and H3 haplotype were found to have an association with T2D risk only in subjects with a body mass index greater than 25 kg/m2 (FDR < 0.01). Environmental risk factors, such as chronic psycho-emotional stress, sedentary lifestyle, high-calorie diet and SNP rs35672233 were jointly associated with T2D susceptibility. A haplotype comprising the allele rs35672233-C and conferring protection against T2D, was associated with elevated levels of antioxidants such as total glutathione and uric acid, as well as reduced levels of two-hour postprandial glucose in the plasma of patients. The NOX5 polymorphisms showed no associations with diabetic complications. Conclusion The present study is the first to establish associations between polymorphisms in NOX5 and the risk of type 2 diabetes mellitus, and provides a new line of evidence for the crucial role of oxidative stress-related genes in disease susceptibility. (SNP NOX NADPH 5 TD T D (T2D 157 162 age sexmatched sex matched SNPs rs rs3743093 rs2036343 rs311886 rs438866 MassArray4 MassArray 4 MassArray- system rs3567223 OR 167 1 67 1.67 95 1.292.17, 129217 1.29 2.17, 29 17 1.29-2.17 0.003. 0003 0.003 . 0 003 0.003) H rs35672233Trs3743093Grs2036343Ars311886Crs438866C rsTrsGrsArsCrsC rs35672233T rs3743093G rs2036343A rs311886C rs438866C G C (rs35672233T-rs3743093G-rs2036343A-rs311886C-rs438866C 165 65 1.65 1.272.13, 127213 1.27 2.13, 27 13 1.27-2.13 0.001. 0001 0.001 001 0.001) kgm2 kgm kg m2 m kg/m 0.01. 0.01 01 0.01) factors psychoemotional psycho emotional stress lifestyle highcalorie high calorie susceptibility rs35672233C rsC acid twohour two hour complications mellitus stressrelated related 15 16 rs374309 rs203634 rs31188 rs43886 rs356722 6 1.6 9 292 1.292.17 12921 129 1.2 217 2.17 1.29-2.1 000 0.00 00 Trs Grs Ars Crs rsT rsG rsA 272 1.272.13 12721 127 213 2.13 1.27-2.1 0.0 rs37430 rs20363 rs3118 rs4388 rs35672 1. 1.292.1 1292 12 21 2.1 1.29-2. 1.272.1 1272 1.27-2. 0. rs3743 rs2036 rs311 rs438 rs3567 1.292. 2. 1.29-2 1.272. 1.27-2 rs374 rs203 rs31 rs43 rs356 1.292 1.29- 1.272 1.27- rs37 rs20 rs3 rs4 rs35 rs2

Resumen Introducción: Frente al COVID-19 se adoptaron medidas de restricción social que influyeron en los hábitos de vida de la población, aumentando el sedentarismo. Considerando la alta complejidad y la dedicación exigida por la carrera de Medicina, se torna relevante investigar el efecto pandémico sobre la práctica de ejercicio físico y la conducta sedentaria de estos estudiantes. Objetivos: Identificar los cambios en la actividad física y en la conducta sedentaria auto-reportados por los estudiantes de Medicina de la ciudad de Salvador, Bahía, Brasil, antes y durante el auto-confinamiento impuesto por la pandemia de COVID-19. Métodos: Estudio longitudinal, prospectivo, cuantitativo, realizado con estudiantes de medicina regularmente matriculados, mayores de 18 años. Foi aplicado um questionário virtual, estruturado, anónimo, autocompletado, contendo aspectos sociodemográficos e académicos. Além disso, foi aplicado o International Physical Activity Questionnaire (IPAQ), em sua versão curta, considerando o período antes e durante a pandemia. A través de éste, se midió el nivel de actividad física, el comportamiento sedentario y el tiempo dedicado a caminar, así como las actividades moderadas y vigorosas. Resultados: Se incluyeron 268 estudiantes de medicina, predominantemente mujeres (65,7%), blancas (50,0%) y morenas (38,8%), de 24,2 ± 5,5 años de edad, solteras (90,7%), en el ciclo clínico (59,0%), en instituciones privadas (78,4%). No se identificaron diferencias estadísticamente significativas en el nivel de actividad física y el tiempo dedicado a actividades moderadas y vigorosas. Sin embargo, hubo una reducción en el tiempo de caminata (p<0,00001) y un aumento en la conducta sedentaria (p=0,001) durante la pandemia COVID-19, siendo mayor el impacto entre las mujeres (p=0,0009). Conclusión: Las repercusiones de la pandemia COVID-19 se manifestaron en el aumento de la conducta sedentaria entre los estudiantes de medicina, especialmente entre las mujeres, además de la reducción del tiempo de actividad dedicado a caminar. Son necesarios estudios longitudinales para analizar las consecuencias a medio y largo plazo de este cambio en los hábitos de vida saludables de los estudiantes de medicina. Nivel de evidencia II; Estudio Prospectivo Comparativo. Introducción COVID19 COVID 19 COVID-1 población sedentarismo Objetivos autoreportados auto reportados Salvador Bahía Brasil autoconfinamiento confinamiento COVID19. 19. Métodos longitudinal prospectivo cuantitativo matriculados 1 virtual estruturado anónimo autocompletado académicos disso IPAQ, IPAQ , (IPAQ) curta éste caminar vigorosas Resultados 26 65,7%, 657 65,7% 65 7 (65,7%) 50,0% 500 50 0 (50,0% 38,8%, 388 38,8% 38 8 (38,8%) 242 24 2 24, 55 5 5, edad 90,7%, 907 90,7% 90 (90,7%) 59,0%, 590 59,0% 59 (59,0%) 78,4%. 784 78,4% . 78 4 (78,4%) embargo p<0,00001 p000001 p 00001 (p<0,00001 p=0,001 p0001 001 (p=0,001 COVID19, 19, p=0,0009. p00009 p=0,0009 0009 (p=0,0009) Conclusión II Comparativo COVID1 COVID- (IPAQ 65,7 6 (65,7% 50,0 (50,0 38,8 3 (38,8% 90,7 9 (90,7% 59,0 (59,0% 78,4 (78,4% p<0,0000 p00000 0000 (p<0,0000 p=0,00 p000 00 (p=0,00 p0000 p=0,000 000 (p=0,0009 65, (65,7 50, (50, 38, (38,8 90, (90,7 59, (59,0 78, (78,4 p<0,000 (p<0,000 p=0,0 p00 (p=0,0 (p=0,000 (65, (50 (38, (90, (59, (78, p<0,00 (p<0,00 p=0, p0 (p=0, (65 (5 (38 (90 (59 (78 p<0,0 (p<0,0 p=0 (p=0 (6 ( (3 (9 (7 p<0, (p<0, p= (p= p<0 (p<0 (p p< (p<

ABSTRACT Introduction: In order to face COVID-19, social restriction measures were adopted that influenced the population's living habits, increasing sedentary lifestyle. Considering the high complexity and dedication required by the Medicine course, it becomes relevant to investigate the effect of the pandemic on the practice of physical exercise and sedentary behavior of these students. Objective: Identify changes in physical activity and sedentary behavior self-reported by medical students in the city of Salvador, Bahia, before and during the self-confinement imposed by the COVID-19 pandemic. Methods: Longitudinal, prospective, quantitative study carried out with regularly enrolled medical students over 18 years of age. A virtual, structured, anonymous, self-completed questionnaire was applied, containing sociodemographic and academic aspects. In addition, the International Physical Activity Questionnaire (IPAQ) was applied in its short version, considering the period before and during the pandemic. Through this, the level of physical activity, sedentary behavior and time spent walking and performing moderate and vigorous activities were measured. Results: 268 medical students were included, predominantly women (65.7%), white (50.0%) and mixed race (38.8%), aged 24.2 ± 5.5 years, single (90.7%), attending the clinical cycle (59.0%), in private institutions (78.4%). No statistically significant differences were identified in the level of physical activity and in the time spent with moderate and vigorous activities. However, there was a reduction in walking time (p<0.00001) and an increase in sedentary behavior (p=0.001) during the COVID-19 pandemic, with the greatest impact among women (p=0.0009). Conclusion: The repercussions of the COVID-19 pandemic have been shown to increase the sedentary behavior of medical students, especially among women, and to reduce activity time spent with walking. Longitudinal studies are needed to analyze the medium and long-term consequences of this change in the healthy lifestyle habits of medical students. Level of evidence II; Comparative prospective study. Introduction COVID19, COVID19 COVID 19, 19 populations population s course Objective selfreported self reported Salvador Bahia selfconfinement confinement COVID-1 Methods 1 age virtual structured anonymous selfcompleted completed aspects addition IPAQ (IPAQ version measured Results 26 included 65.7%, 657 65.7% , 65 7 (65.7%) 50.0% 500 50 0 (50.0% 38.8%, 388 38.8% 38 8 (38.8%) 242 24 2 24. 55 5 5. 90.7%, 907 90.7% 90 (90.7%) 59.0%, 590 59.0% 59 (59.0%) 78.4%. 784 78.4% . 78 4 (78.4%) However p<0.00001 p000001 p 00001 (p<0.00001 p=0.001 p0001 001 (p=0.001 p=0.0009. p00009 p=0.0009 0009 (p=0.0009) Conclusion longterm long term II COVID1 COVID- 65.7 6 (65.7% 50.0 (50.0 38.8 3 (38.8% 90.7 9 (90.7% 59.0 (59.0% 78.4 (78.4% p<0.0000 p00000 0000 (p<0.0000 p=0.00 p000 00 (p=0.00 p0000 p=0.000 000 (p=0.0009 65. (65.7 50. (50. 38. (38.8 90. (90.7 59. (59.0 78. (78.4 p<0.000 (p<0.000 p=0.0 p00 (p=0.0 (p=0.000 (65. (50 (38. (90. (59. (78. p<0.00 (p<0.00 p=0. p0 (p=0. (65 (5 (38 (90 (59 (78 p<0.0 (p<0.0 p=0 (p=0 (6 ( (3 (9 (7 p<0. (p<0. p= (p= p<0 (p<0 (p p< (p<

RESUMO Introdução: Foram adotadas medidas de restrição social para o enfrentamento da COVID-19 que influenciaram nos hábitos de vida da população, aumentando o sedentarismo. Considerando a alta complexidade e a dedicação exigida pelo curso de Medicina, torna-se relevante investigar o efeito da pandemia na prática de exercício físico e conduta sedentária desses estudantes. Objetivos: Identificar alterações na atividade física e na conduta sedentária autorrelatadas por acadêmicos de Medicina na cidade de Salvador, Bahia, antes e durante o autoconfinamento imposto pela pandemia de COVID-19. Métodos: Estudo longitudinal, prospectivo, quantitativo, realizado com estudantes de Medicina, maiores de 18 anos, regularmente matriculados. Foi aplicado um questionário virtual, estruturado, anônimo, de autopreenchimento, contendo aspectos sociodemográficos e acadêmicos. Além disso, foi aplicado o International Physical Activity Questionnaire (IPAQ), em sua versão curta, considerando o período antes e durante a pandemia. Através deste, foram mensurados nível de atividade física, conduta sedentária e tempo de realização de caminhada, além de atividades moderadas e vigorosas. Resultados: Foram incluídos 268 estudantes de Medicina, predominantemente mulheres (65,7%), da raça branca (50,0%) e parda (38,8%), com idade de 24,2 ± 5,5 anos, solteiros (90,7%), cursando o ciclo clínico (59,0%), em instituições privadas (78,4%). Não foram identificadas diferenças estatisticamente significantes no nível de atividade física e no tempo despendido com atividades moderadas e vigorosas. Entretanto, houve redução no tempo de caminhada (p<0,00001) e aumento da conduta sedentária (p=0,001) durante a pandemia de COVID-19, sendo o impacto maior entre as mulheres (p=0,0009). Conclusão: Foram demonstradas as repercussões da pandemia de COVID-19 no aumento da conduta sedentária dos estudantes de Medicina, principalmente entre as mulheres, além da redução do tempo de atividade despendido com caminhadas. Estudos longitudinais são necessários para analisar as consequências a médio e longo prazo dessa alteração nos hábitos de vida saudáveis de estudantes de Medicina. Nível de evidência II; Estudo Prospectivo Comparativo. Introdução COVID19 COVID 19 COVID-1 população sedentarismo tornase torna se Objetivos Salvador Bahia COVID19. 19. Métodos longitudinal prospectivo quantitativo 1 anos matriculados virtual estruturado anônimo autopreenchimento disso IPAQ, IPAQ , (IPAQ) curta deste vigorosas Resultados 26 65,7%, 657 65,7% 65 7 (65,7%) 50,0% 500 50 0 (50,0% 38,8%, 388 38,8% 38 8 (38,8%) 242 24 2 24, 55 5 5, 90,7%, 907 90,7% 90 (90,7%) 59,0%, 590 59,0% 59 (59,0%) 78,4%. 784 78,4% . 78 4 (78,4%) Entretanto p<0,00001 p000001 p 00001 (p<0,00001 p=0,001 p0001 001 (p=0,001 COVID19, 19, p=0,0009. p00009 p=0,0009 0009 (p=0,0009) Conclusão caminhadas II Comparativo COVID1 COVID- (IPAQ 65,7 6 (65,7% 50,0 (50,0 38,8 3 (38,8% 90,7 9 (90,7% 59,0 (59,0% 78,4 (78,4% p<0,0000 p00000 0000 (p<0,0000 p=0,00 p000 00 (p=0,00 p0000 p=0,000 000 (p=0,0009 65, (65,7 50, (50, 38, (38,8 90, (90,7 59, (59,0 78, (78,4 p<0,000 (p<0,000 p=0,0 p00 (p=0,0 (p=0,000 (65, (50 (38, (90, (59, (78, p<0,00 (p<0,00 p=0, p0 (p=0, (65 (5 (38 (90 (59 (78 p<0,0 (p<0,0 p=0 (p=0 (6 ( (3 (9 (7 p<0, (p<0, p= (p= p<0 (p<0 (p p< (p<