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Treatment of chronic hypercapnic failure in COPD patients with home noninvasive ventilation (HNIV) remains unclear.To create a curated cohort of all COPD patients on HNIV in Catalonia, perform a cluster analysis, and evaluate mortality evolution.This study was a multicenter, observational study including all COPD patients on HNIV on 1st January of 2018. Patients were selected through the Catalan Health Service, and administrative and clinical data were obtained in the previous four years. Principal component analysis of mixed data and hierarchical clustering were performed to identify clusters of patients. Mortality was evaluated from 1 January 2018 until 31 December 2020.A total of 247 patients were enrolled. They were mostly male (78.1%), with a median (SD) age of 70.4 (9.4) years old. In 60%, 55% and 29% of patients, obesity, sleep apnea and heart failure coexisted, respectively. Cluster analysis identified four well-differentiated groups labeled for their clinical characteristics: (1) obese smokers, (2) very severe COPD, (3) sleep apnea and (4) older comorbid males. Patients belonging to Clusters (2) and (4) had a worse prognosis than patients in Clusters (1) and (3).A high heterogeneity in the prescription of HNIV was demonstrated. Cluster analysis identifies four different groups, of which only one had COPD as the main cause of ventilation, while the other three clusters showed a predominance of other comorbidities. This leads to different survival outcomes, including an overlapping phenotype of obesity-related disease and sleep apnea with better survival.

Introducción: Se ha reportado la presencia de conductas alimentarias de riesgo en adultos emergentes (como estudiantes universitarios de recién ingreso). Asimismo, la insatisfacción y el estado nutricio se han documentado como factor de riesgo en el desarrollo de conductas alimentarias de riesgo. Por tanto, el objetivo de este estudio es mostrar las correlaciones entre la presencia de conductas alimentarias de riesgo, insatisfacción corporal y estado nutricio, para identificar posibles predictores de conductas alimentarias de riesgo. Metodología: Diseñamos un protocolo observacional transversal para analizar los datos obtenidos con el Cuestionario Breve sobre Conductas Alimentarias de Riesgo y la Escala de Satisfacción-Insatisfacción con la Imagen, que se aplicaron a 1.399 estudiantes universitarios de reciente ingreso (rango de edad: 18-29 años). Su estado nutricional se determinó mediante medidas de peso, tamaño, índice de masa corporal y porcentaje de grasa corporal. Los datos se compararon mediante Kruskal-Wallis. Las variables predictivas para conductas alimentarias de riesgo se obtuvieron mediante un modelo Poisson reducido. Resultados: 7,2% de las mujeres y 5,0% de los hombres presentaron conductas alimentarias de riesgo. Las puntuaciones más altas en conductas alimentarias de riesgo e índice de masa corporal, grasa corporal y circunferencia de la cintura mostraron una correlación significativa. El modelo Poisson ajustado mostró que el índice de masa corporal, la circunferencia de la cintura y la satisfacción con el abdomen, la cintura y las piernas son los mejores predictores de conductas alimentarias de riesgo. Conclusiones: Las conductas alimentarias de riesgo están presentes en los nuevos estudiantes universitarios, por lo que la observación y atención a algunos indicadores como el índice de masa corporal y la satisfacción corporal, particularmente con el abdomen, la cintura y las piernas, podría ayudar a prevenir el desarrollo de conductas alimentarias de riesgo.

Background More than 20% of hospitalized patients with COVID-19 demonstrate ARDS requiring ICU admission. The long-term respiratory sequelae in such patients remain unclear. Research Question What are the major long-term pulmonary sequelae in critical patients who survive COVID-19? Study Design and Methods Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-min walking test [6MWT]), and chest CT imaging. Results One hundred twenty-five patients admitted to the ICU with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%) and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median distance in the 6MWT was 400 m (interquartile range, 362-440 m). CT scans showed abnormal results in 70.2% of patients, demonstrating reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT scan showed worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT scan were age and length of invasive mechanical ventilation during the ICU stay. Interpretation Three months after hospital discharge, pulmonary structural abnormalities and functional impairment are highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge.

Introduction: Acute dyspnea is one of the most frequently observed symptoms in emergency departments, which can be caused mainly by pulmonary or cardiac system involvement. Bedside ultrasound is postulated as an innovative tool for basic use by the physician, which can complement the physical examination and quickly explore the integrity of thoracic structures Objectives: To synthesize recent evidence on the use of bedside ultrasound in the evaluation of acute dyspnea Materials and methods: A bibliographic search was carried out using search terms such as "Bedside Ultrasound" and "Acute Dyspnea", as well as synonyms, which were combined with Boolean operators, in the databases PubMed, ScienceDirect, Embase, EBSCO, and MEDLINE. Results: During the literature review, 10 observational studies, 2 clinical trials and 2 systematic reviews met the inclusion criteria and were analyzed. The use of bedside ultrasound changes the main diagnosis associated with acute dyspnea in more than 60% of cases, the most frequent being acute decompensated heart failure and pneumonia. Protocols such as SEARCH 8Es for the evaluation of dyspnea in the emergency department, has a performance with sensitivity, specificity, positive and negative predictive value parameters above 95%. Conclusions: The current evidence on the use of bedside ultrasound in the management of patients with acute dyspnea in the emergency department is limited, Although the level of evidence is not the best, it suggests that this tool may promote the diagnostic perfomance of acute dyspnea of pulmonary or cardiac causes, improve the time to diagnosis, and enhance physician diagnostic confidence.

Resumen Objetivo Determinar el indicador antropometrico que presenta mayor fuerza de asociacion con el porcentaje de grasa corporal y la autorregulacion de alimentacion y actividad fisica en jovenes estudiantes universitarios, para su uso por personal de enfermeria en atencion primaria. Metodo Se realizo un estudio transversal en 3.869 estudiantes universitarios mexicanos, de los cuales el 53,9% fueron mujeres. Se siguieron procedimientos estandar para la antropometria incluyendo peso, talla y circunferencia de cintura. Con estos datos se calcularon indice de masa corporal (IMC), A Body Shape Index, indice cintura-talla, Body roundness index y Conicity index. Se aplicaron la Escala de autorregulacion de habitos alimentarios y la Escala de autorregulacion de actividad fisica. Se estimaron medias con desviacion estandar, porcentajes y coeficientes de correlacion de Pearson. Resultados El grupo de hombres presento prevalencia superior de exceso de peso en comparacion con las mujeres. Se encontraron correlaciones inversas entre la mayoria de los indices antropometricos y la autorregulacion de habitos alimentarios y de actividad fisica. Sin embargo, en todos los casos las correlaciones fueron bajas. El porcentaje de grasa corporal tuvo una asociacion media con Conicity index y fuerte con IMC, circunferencia de cintura, indice cintura-talla y Body roundness index, siendo el IMC el que presento el coeficiente de correlacion mas fuerte. Conclusiones De los indicadores analizados, el IMC muestra la fuerza de asociacion mas fuerte con el porcentaje de grasa corporal en estudiantes universitarios, por lo que se sugiere mantener su uso en enfermeria para la determinacion de obesidad por su simplicidad de estimacion.

Pyrethroid contact insecticides are mainstays of malaria control, but their efficacies are declining due to widespread insecticide resistance in Anopheles mosquito populations, a major public health challenge. Several strategies have been proposed to overcome this challenge, including insecticides with new modes of action. New insecticides, however, can be expensive to implement in low-income countries. Here, we report a simple and inexpensive method to improve the efficacy of deltamethrin, the most active and most commonly used pyrethroid, by more than 10 times against Anopheles mosquitoes. Upon heating for only a few minutes, the commercially available deltamethrin crystals, form I, melt and crystallize upon cooling into a polymorph, form II, which is much faster acting against fruit flies and mosquitoes. Epidemiological modeling suggests that the use of form II in indoor residual spraying in place of form I would significantly suppress malaria transmission, even in the presence of high levels of resistance. The simple preparation of form II, coupled with its kinetic stability and markedly higher efficacy, argues that form II can provide a powerful, timely, and affordable malaria control solution for low-income countries that are losing protection in the face of worldwide pyrethroid resistance.

To evaluate the sleep and circadian rest-activity pattern of critical COVID-19 survivors 3 months after hospital discharge.Observational, prospective study.Single-center study.One hundred seventy-two consecutive COVID-19 survivors admitted to the ICU with acute respiratory distress syndrome.Seven days of actigraphy for sleep and circadian rest-activity pattern assessment; validated questionnaires; respiratory tests at the 3-month follow-up.The cohort included 172 patients, mostly males (67.4%) with a median (25th-75th percentile) age of 61.0 years (52.8-67.0 yr). The median number of days at the ICU was 11.0 (6.00-24.0), and 51.7% of the patients received invasive mechanical ventilation (IMV). According to the Pittsburgh Sleep Quality Index (PSQI), 60.5% presented poor sleep quality 3 months after hospital discharge, which was further confirmed by actigraphy. Female sex was associated with an increased score in the PSQI (p0.05) and IMV during ICU stay was able to predict a higher fragmentation of the rest-activity rhythm at the 3-month follow-up (p0.001). Furthermore, compromised mental health measured by the Hospital Anxiety and Depression Scale was associated with poor sleep quality (p0.001).Our findings highlight the importance of considering sleep and circadian health after hospital discharge. Within this context, IMV during the ICU stay could aid in predicting an increased fragmentation of the rest-activity rhythm at the 3-month follow-up. Furthermore, compromised mental health could be a marker for sleep disruption at the post-COVID period.

Background: Up to 80% of patients surviving acute respiratory distress syndrome (ARDS) secondary to SARS-CoV- 2 infection present persistent anomalies in pulmonary function after hospital discharge. There is a limited un-derstanding of the mechanistic pathways linked to post-acute pulmonary sequelae. Aim: To identify the molecular underpinnings associated with severe lung diffusion involvement in survivors of SARS-CoV-2-induced ARDS. Methods: Survivors attended to a complete pulmonary evaluation 3 months after hospital discharge. RNA sequencing (RNA-seq) was performed using Illumina technology in whole-blood samples from 50 patients with moderate to severe diffusion impairment (DLCO

Question: We evaluated whether the time between first respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae. Materials and methods: Prospective cohort of critical COVID-19 patients on IMV. Patients were classified as early intubation if they were intubated within the first 48 h from the first respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge. Results: We included 205 patients (140 with early IMV and 65 with delayed IMV). The median [p25;p75] age was 63 [56.0; 70.0] years, and 74.1% were male. The survival analysis showed a significant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29-4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42-4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean difference of - 10.77 (95% CI - 18.40 to - 3.15), with a greater number of affected lobes (+ 1.51 [95% CI 0.89-2.13]) and a greater TSS (+ 4.35 [95% CI 2.41-6.27]) in the chest CT scan. Conclusions: Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the first respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up. The study was supported in part by ISCIII (CIBERESUCICOVID, COV20/00110), co‑funded by ERDF, “Una manera de hacer Europa” and Donation pro‑gram "estar preparados". UNESPA. Madrid. Spain David de Gonzalo Calvo acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII); Miguel Servet 2020: CP20/00041), co‑funded by the European Social Fund (ESF), “Investing in your future”. JdB acknowledges receiving financial support from Instituto de Salud Carlos III (Miguel Servet 2019: CP19/00108), co‑funded by European Regional European Social Fund (ESF), “Investing in your future"

Las conductas alimentarias de riesgo (CAR) son conductas compensatorias inapropiadas, caracteristicas de los trastornos de la conducta alimentaria (TCA). A pesar de que los adolescentes son el grupo mas vulnerable, en la etapa estudiantil universitaria las CAR son problemas de salud mental cada vez mas frecuentes. El objetivo del estudio fue identificar la prevalencia de conductas alimentarias de riesgo en la poblacion estudiantil universitaria de nuevo ingreso a la universidad. Se utilizo el Cuestionario breve de conductas alimentarias de riesgo (CBCAR), basado en los criterios para el diagnostico de TCA del Manual diagnostico y estadistico de los trastornos mentales (DSM IV). Las CAR presentaron una prevalencia de 3.7% en mujeres y 2.4% en hombres. Se propuso integrar el CBCAR al examen de salud integral a los estudiantes de nuevo ingreso de las diferentes regiones de la Universidad Veracruzana para detectar oportunamente las CAR en los estudiantes. Plabras clave: Conductas alimentarias de riesgo; trastornos de la conducta alimentaria; estudiantes universitarios; deteccion oportuna; Veracruz Abstract Eating behavior (CAR) are inappropriate compensatory behaviors, characteristic of Eating Disorders. Although adolescence is the most vulnerable group, in the university student phase, the CAR are a mental health problem that is becoming more frequent. The objective of the study was to identify the prevalence of eating behavior in the university student population of first admission to the University. The "Short questionnaire on risky eating behaviors" (CBCAR) was used, based on the criteria for the diagnosis of eating disorders in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM IV). The CARs had a prevalence of 3.7% in women and 2.4% in men. It was proposed to integrate the CBCAR to the comprehensive health exam for new students from the different regions of the Universidad Veracruzana, in order to detect CAR opportunely in the students Keywords: Eating behavior , eating disorders, university students, timely detection, Veracruz

Background: Patients with acute respiratory distress syndrome (ARDS) due to COVID19 may present physical and functional respiratory sequelae at short term follow-up. Objective: To evaluate the impact of a pulmonary rehabilitation program (PRP) on clinical and functional respiratory alterations in COVID19 patients with ARDS after hospital discharge. Methodology: Prospective interventional study that included patients with clinical and/or functional respiratory alterations after 3 month of hospital discharge. Patients underwent a 9-week PRP, two sessions per week. The following variables were measured pre and post PRP: pulmonary function tests, 6’ walking test (6MWT), sit to stand test, dyspnea (mMRC), fatigue (FACIT-F), physical activity (IPAQ) and anxiety and depression (HADS) questionnaires. Results: 21 patients completed the PRP to date. They were mostly male (66.7%), with a mean age of 56.5±12 years old. 76.2% needed ICU admission and 43% required invasive mechanical ventilation. After PRP, there was a significant increase in the lung diffusing capacity (62±12% to 72±11%, p=0.04) as well as in the mean distance covered in the 6MWT (421±75 to 465±93 meters, p=0.03). We observed an improvement in dyspnea (p=0.01), in IPAQ (1574±1168 to 3045±1816 METS, p Conclusions: nine-week PRP could improve respiratory function, exercise capacity, and symptoms such as dyspnea or fatigue in patients with ARDS caused by COVID19 after hospital discharge. Supported in part by CIBERESUCICOVID (COV20/0011)

Objective To evaluate the perinatal and maternal outcomes of pregnancies in SARS-CoV-2 infected women, comparing spontaneous and In Vitro Fertilization (IVF) pregnancies (with either own or donor oocytes). Design Multicentre, prospective, observational study. Setting 78 centres participating in the Spanish COVID19 Registry. Patients 1,347 SARS-CoV-2 positive pregnant women registered consecutively between February 26th and November 5th, 2020. Interventions Patient´s information was collected from their medical records, and multivariable regression analyses were performed, controlling for maternal age and the clinical presentation of infection. Main outcome measures Obstetrics and neonatal outcomes, pregnancy comorbidities, intensive care unit admission, mechanical ventilation need and medical conditions. Results The IVF group was composed of 74 (5.5%) women whereas the spontaneous group included 1,275 (94.5%) women. Operative delivery rate was high in all patients, especially in the IVF group, where C-section became the most frequent method of delivery (55.4%, compared to 26.1% of spontaneous). The reason for C-section was induction failure in 56.1% of IVF patients. IVF women had more gestational hypertensive disorders [16.2% vs 4.5% among spontaneous, adjusted Odds Ratio (aOR) 5.31, 95% Confidence Interval (CI) 2.45-10.93) irrespective of oocyte origin. The higher rate of ICU admittance observed in the IVF group (8.1% vs 2.4% spontaneous) was attributed to pre-eclampsia (aOR 11.82, 95% CI 5.25-25.87), not to the type of conception, Conclusions High rate of operative delivery has been observed in SARS-CoV-2 infected women, especially in IVF pregnancies; method of conception does not affect foetal or maternal outcomes, except for pre-eclampsia., CAPSULE: Method of conception does not affect foetal or maternal outcomes in SARS-CoV-2 infected women, except for pre-eclampsia.

OBJECTIVE Type 2 diabetes exerts a deleterious effect on lung function. However, it is unknown whether an improvement in glycemic control ameliorates pulmonary function. RESEARCH DESIGN AND METHODS Prospective interventional study with 60 patients with type 2 diabetes and forced expiratory volume in 1 s (FEV1) ≤90% of predicted. Spirometric maneuvers were evaluated at baseline and after a 3-month period in which antidiabetic therapy was intensified. Those with an HbA1c reduction of ≥0.5% were considered to be good responders (n = 35). RESULTS Good responders exhibited a significant improvement in spirometric values between baseline and the end of the study (forced vital capacity [FVC]: 78.5 ± 12.6% vs. 83.3 ± 14.7%, P = 0.029]; FEV1: 75.6 ± 15.3% vs. 80.9 ± 15.4%, P = 0.010; and peak expiratory flow [PEF]: 80.4 ± 21.6% vs. 89.2 ± 21.0%, P = 0.007). However, no changes were observed in the group of nonresponders when the same parameters were evaluated (P = 0.586, P = 0.987, and P = 0.413, respectively). Similarly, the initial percentage of patients with a nonobstructive ventilatory defect and with an abnormal FEV1 decreased significantly only among good responders. In addition, the absolute change in HbA1c inversely correlated to increases in FEV1 (r = −0.370, P = 0.029) and PEF (r = −0.471, P = 0.004) in the responders group. Finally, stepwise multivariate regression analysis showed that the absolute change in HbA1c independently predicted increased FEV1 (R2 = 0.175) and PEF (R2 = 0.323). In contrast, the known duration of type 2 diabetes, but not the amelioration of HbA1c, was related to changes in forced expiratory flow between 25% and 75% of the FVC. CONCLUSIONS In type 2 diabetes, spirometric measurements reflecting central airway obstruction and explosive muscle strength exhibit significant amelioration after a short improvement in glycemic control.

There are classical risk factors associated with arterial thrombosis (AT) or venous thromboembolic disease (VTD). However, less is known about these risk factors and AT or VTD episodes in patients with antiphospholipid syndrome (APS). Our aim was to elucidate whether APS-related thrombotic episodes are associated with the same risk factors as the non-APS population. We gathered demographics, medical history, complications, and causes of death associated with the risk factors for AT or VTD in patients with APS. We analyzed 677 thrombotic events in 386 patients. Type 2 diabetes mellitus and grade 3 obesity were associated with VTD instead of AT. There were no significant differences between the groups for almost all laboratory tests analyzed, although lupus anticoagulant was significantly higher in the VTD group. We suggest that thrombosis in APS is due to the APS itself and that the risks factors for AT or VTD do not have a main role. Our findings may have an ethnical background. Therefore, it may be difficult to elaborate predictive thrombotic clinical scores applicable to patients with different ethnical background.

Indications, selection and duration of inotropic support during and following cardiac surgery remain variable and controversial. Nevertheless, it is employed frequently for anticipated or manifest hemodynamic instability ranging from low cardiac output to established shock stages. This chapter provides a background, justification and overview of inotropic and vasopressor therapy with a strong clinical rather than molecular and pharmacological focus. Current treatment strategies and principles of crucial aspects of medical management are discussed. The main clinical classification of inotropes and to a lesser degree vasoactive agents is included as well as clinical utilities of the most frequently used agents are described. Due to the significance of right ventricular dysfunction a section is dedicated to the right ventricle and pulmonary circulation. Finally, a summary of treatment strategies for the most common clinical scenarios is provided.

Type 2 diabetes exerts a negative impact on sleep breathing. It is unknown whether a long-term improvement in glycemic control ameliorates this effect. We conducted an interventional study with 35 patients with type 2 diabetes and obstructive sleep apnea (OSA) to explore this. At home, sleep breathing parameters were assessed at baseline and after a 4-month period in which antidiabetic therapy was intensified. Patients who decreased their body mass index &ge, 2kg/m2 were excluded. Those with an HbA1c reduction &ge, 0.5% were considered good responders (n = 24). After the follow-up, good responders exhibited an improvement in the apnea&ndash, hypopnea index (AHI: 26-1 (95% IC: 8.6&ndash, 95.0) vs. 20.0 (4.0&ndash, 62.4) events/hour, p = 0.002) and in time with oxygen saturation below 90% (CT90: 13.3 (0.4&ndash, 69.0) vs. 8.1 (0.4&ndash, 71.2) %, p = 0.002). No changes were observed in the group of non&ndash, responders (p = 0.722 and p = 0.138, respectively). The percentage of moderate and severe OSA decreased among good responders (p = 0.040). In the wider population, the change in HbA1c correlated positively to decreases in AHI (r = 0.358, p = 0.035) and negatively to increases in the minimum arterial oxygen saturation (r = &minus, 0.386, p = 0.039). Stepwise multivariate regression analysis showed that baseline AHI and the absolute change in HbA1c independently predicted decreased AHI (R2 = 0.496). The improvement of glycemic control exerts beneficial effects on sleep breathing parameters in type 2 diabetes, which cannot be attributed merely to weight loss.

Objective We aim to determine the anthropometric indicator that is most strongly associated with the percentage of body fat and self-regulation of eating behaviour and physical activity among young university students. Methods A cross-sectional study was conducted on 3869 Mexican university students, of which 53.9% were women. Standard procedures for anthropometry were followed, including weight, height and waist circumference (WC). This data was used for calculating Body Mass Index (BMI), A Body Shape Index (ABSI), waist-to-height ratio (W/Hr), Body Roundness Index (BRI) and Conicity index (CI). The self-regulation of eating habits scale and the self-regulation of physical activity scale were used. Mean with standard deviation, percentages and Pearson correlation coefficient were estimated. Results The group of men shown a higher prevalence of excess weight compared to the women. Inverse correlations between most anthropometric indices and self-regulation of eating behaviour and physical activity were found. However, in all cases the correlations were weak. The percentage of fat had a medium frequency of association with CI and high with BMI, WC, W/Hr and BRI, where the BMI showed the highest correlation coefficient Conclusions The BMI shows the highest magnitude of association with percentage of body fat in university students among the indicators analysed. Therefore it is suggested that nurses use BMI to determine obesity because it is easy to calculate.

Los Trastornos de la conducta alimentaria (TAC) son un problema de salud pública a nivel internacional. Las conductas alimentarias “de riesgo” (CAR)- también denominadas “disfuncionales”- son manifestaciones similares a los TCA pero se dan con menor frecuencia. La adolescencia es el grupo etario más vulnerable, la Academia Americana de Pediatría ha descrito más de 40 complicaciones para la salud asociadas a los desórdenes alimentarios en niños y adolescentes. El objetivo de este estudio es identificar el riesgo para desarrollar CAR en un grupo de adolescentes de un bachillerato público, de la ciudad de Boca del Río, Veracruz. Se realizó un estudio transversal en 422 estudiantes de 15-19 años, que aceptaron participar de manera voluntaria. El riesgo para el desarrollo de las CAR se realizó mediante el "Cuestionario breve de conductas alimentarias de riesgo" (CBCAR), basado en los criterios para el diagnóstico de TCA del "Manual diagnóstico y estadístico de los trastornos mentales" (DSM IV, por sus siglas en inglés). La prevalencia de las CAR, se presentó en un 19.4% para riesgo moderado mientras que el 7.6% presentó riesgo alto. En cuanto a la distribución por sexo, el 22.2% de los hombres presentaron riesgo moderado, sin embargo son las mujeres las que presentaron riesgo alto en un 9.9%. Al igual que lo reportado en la literatura disponible, se observó que la prevalencia de CAR se presenta principalmente en el sexo femenino siendo la preocupación por engordar la conducta de mayor prevalencia. Los resultados de este estudio permitirán el diseño de estrategias de prevención de TCA en este grupo de edad.

A few studies showed that both adherence to Mediterranean diet (MedDiet) and physical activity practice have a positive impact on pulmonary function in subjects with lung disease. These associations are not well studied in subjects free from lung disease. In a cross-sectional study conducted in 3020 middle-aged subjects free of lung disease, adherence to the MedDiet using the Mediterranean Diet Adherence Screener, and physical activity practice using the International Physical Activity Questionnaire short form were recorded. Respiratory function was assessed using forced spirometry and the results were evaluated according to the Global initiative for Chronic Obstructive Lung Disease. Logistic regression models were used to analyze the associations between adherence to the MedDiet and physical activity practice with the presence of ventilatory defects. Participants with a high adherence to MedDiet, in comparison to those with low adherence, had both higher forced vital capacity (FVC, 100 (87&ndash, 109) vs. 94 (82&ndash, 105) % of predicted, p = 0.003) and forced expired volume in the first second (FEV1, 100 (89&ndash, 112) vs. 93 (80&ndash, 107) % of predicted, p &lt, 0.001). According to their degree of physical activity, those subjects with a high adherence also had both higher FVC (100 (88&ndash, 107) vs. 94 (83&ndash, 105) % of predicted, p = 0.027) and FEV1 (100 (89&ndash, 110) vs. 95 (84&ndash, 108) % of predicted, p = 0.047) in comparison with those with low adherence. The multivariable logistic regression models showed a significant and independent association between both low adherence to MedDiet and low physical activity practice, and the presence of altered pulmonary patterns, with differences between men and women. However, no joint effect between adherence to MedDiet and physical activity practice on respiratory function values was observed. Low adherence to MedDiet and low physical activity practice were independently associated with pulmonary impairment. Therefore, the lung mechanics seem to benefit from heart-healthy lifestyle behaviors.