Evaluation of agreement between clinical and histopathological data for classifying leprosy.

BACKGROUND: The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy. METHODS: A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients. RESULTS: The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively. CONCLUSION: Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.

Diet composition is associated with obesity in active women / La composición nutricional de la dieta se asocia con obesidad en mujeres activas

This study evaluated the contribution of diet composition in physically active women to test the hypothesis that energy, lipids, carbohydrates and fiber are the nutrients that directly affect obesity in this population. We used a cross-sectional analysis of 165 adult women who practice at least 150 minutes of moderate physical activity per week. The outcome variables were body mass index (BMI) and waist circumference (WC). Individuals were classified into groups according to BMI as either obese or non-obese (BMI ≥ 30 kglm² or < 30 kglm², respectively), and by WC as either with risk or without risk (WC ≥ 88 cm or <88 cm, respectively). Dietary intake was assessed by a 24-hour dietary recall. A multiple means (ANOVA) was used to compare the mean consumption of the groups. In this study, 69.1% of women were overweight or obese. Obese women consumed significantly more energy and cholesterol and less carbohydrate (p <0.05) and tended to have a lower intake of fiber (p <0.10) than the non-obese women. Moreover, women with higher WC consume significantly more energy (p <0.05) and tend to have a lower consumption of carbohydrates and fiber (p <0.10) than women with minor WC. The results showed that, despite being physically active, the women studied had an average BMI indicative of obesity, showing that dietary patterns are highly correlated with this condition. We found that low consumption of carbohydrates andfiber and high consumption of energy and cholesterol contributed significantly to obesity among women.

El objetivo de este estudio fue avaluar la contribución de la composición de la dieta en el sobrepeso de mujeres que practican actividad física, basado en el supuesto de que el alto consumo de energía y lípidos y el bajo consumo de carbohidratos y fibras son factores preponderantes en la etiología de la obesidad de esta población. Se utilizó un análisis transversal en 165 mujeres adultas que practicaban, por lo menos, 150 minutos de actividad física moderada por semana. Las variables de resultado fueron el índice de masa corporal (IMC) y la circunferencia de la cintura (CC). Las personas se clasificaron en grupos según el IMC - obesos (IMC ≥ 30 kg/m2) y no obesos (IMC < 30 kg/m2) - y de acuerdo con CC - con riesgo ≥ 88 cm y sin riesgo <88 cm. La ingestión dietética se evaluó con una encuesta de recordatorio de 24 horas. Para hacer la comparación de las medias de consumo de los grupos se utilizó el análisis de varianza (ANOVA). Se observó que 69,1% de las mujeres presentaban sobrepeso/obesidad. Las mujeres obesas consumían significativamente más energía y colesterol y menos carbohidratos (p <0,05) y menos consumo de fibras (p <0,10), lo que no sucede en las mujeres no obesas. Además, las mujeres con mayor CC consumían significativamente más energía (p <0,05) y presentaron una tendencia para menor consumo de carbohidratos y fibras (p <0,10), lo que no sucede en las mujeres con menor CC. Los resultados mostraron que, aunque estas mujeres eran fisicamente activas, tenían un IMC medio de sobrepeso, lo que indica que los hábitos alimentarios están altamente correlacionadas con este factor. Se sugiere que el bajo consumo de carbohidratos y fibras y el alto consumo de energía y colesterol han contribuido expresivamente para la obesidad entre las mujeres.