Relationship of vitamin D with the anthropometric indicators and lifestyle of adults. Medellín. Colombia

Introduction: Serum vitamin D levels depend on sunlight, diet, and other factors. Objective: We aimed to determine serum vitamin D levels and evaluate their relationship with anthropometric indicators and lifestyle habits in apparently healthy volunteers. Materials and Methods: In this cross-sectional study (n=75), socio-demographic, anthropometric, and lifestyle habit-related data were collected. Serum vitamin D levels were determined with high performance liquid chromatography, food intake was measured by semiquantitative frequency and nutritional status was assessed by anthropometry. Chi-square test and also principal component analysis were used to analyze the relationship between some variables and vitamin D status. Spearman's test was used to determine correlations between quantitative variables. Results: 73% were women and 61% belonged to medium socio-economic level. Median vitamin D intake was 137 (83.1­227.3) IU/day. Based on body mass index (BMI), 44% individuals had overweight/obesity. The 68% exhibited deficient/insufficient vitamin D levels (Hypovitaminosis D). BMI classification and waist circumference (CW) were not related with vitamin D status; however, activities with higher sun exposure were highly related (p = 0.013). Sun exposure time explained variation in component 2 (16.60%), where most of the individuals with normal level were grouped. Sun exposure time was positively correlated with vitamin D status (r = 0.263; p = 0.023). Discussion: Excess weight and abdominal obesity are not always associated with hypovitaminosis D. Conclusions: The majority of individuals showed hypovitaminosis D but their status was not related with anthropometric indicators. A Sun exposure time was the only factor positively correlated with vitamin D status.

Introducción: Los niveles séricos de vitamina D dependen de la luz solar, la dieta y otros factores. Objetivo: Nuestro objetivo fue determinar los niveles séricos de vitamina D y evaluar su relación con indicadores antropométricos y estilos de vida en voluntarios aparentemente sanos. Materiales y métodos: En este estudio trasversal (n=75) se recogieron datos sociodemográficos, antropométricos y aquellos relacionados con hábitos y estilos de vida. La vitamina D se determinó por cromatografía liquida de alta eficiencia; la ingesta de alimentos, mediante frecuencia semicuantitativa, y el estado nutricional por antropometría. Para analizar la relación entre algunas variables y el estado de la vitamina D se usó la prueba de Chi cuadrado y también el análisis de componentes principales. Se empleó la prueba de Spearman para determinar la correlación entre variables cuantitativas. Resultados: El 73% eran mujeres y el 61% pertenecían a un estrato socioeconómico medio. La mediana de la ingesta de vitamina D fue de 137 (83,1­227,3) UI/día. Según el índice de masa corporal (IMC), el 44% de los individuos tenían sobrepeso/obesidad. El 68% mostro deficiencia/insuficiencia de vitamina D (hipovitaminosis D). La clasificación del IMC y la circunferencia abdominal no se relacionaron con el estado de la vitamina D; sin embargo, las actividades con una mayor exposición solar estuvieron altamente relacionadas (p=0,013). El tiempo de exposición solar explico la variación en el componente 2 (16,60%) donde se agruparon la mayoría de los individuos con niveles normales. El tiempo de exposición solar tuvo una correlación positiva con el estado de la vitamina D (r = 0,263; p = 0,023). Discusión: El exceso de peso y la obesidad abdominal no siempre se relacionan con la hipovitaminosis D. Conclusiones: La mayoría de los individuos presentaron hipovitaminosis D, pero su estado no se relacionó con los indicadores antropométricos. El tiempo de exposición al sol fue el único factor que se correlaciono positivamente con el estado de la vitamina D.

Introdução: Os níveis séricos de vitamina D dependem da luz solar, da dieta e de outros fatores. Objetivo: Nosso objetivo foi determinar os níveis séricos de vitamina D e avaliar sua relação com indicadores antropométricos e hábitos de vida em voluntários aparentemente saudáveis. Materiais e métodos: Neste estudo transversal (n=75), foram coletados dados sociodemográficos, antropométricos e relacionados a hábitos de vida. Os níveis séricos de vitamina D foram determinados por cromatografia liquida de alto desempenho, a ingestão de alimentos foi medida por frequência semiquantitativa e o estado nutricional foi avaliado por antropometria. O teste do qui-quadrado e a análise de componentes principais foram utilizados para analisar a relação entre algumas variáveis e o estado da vitamina D. O teste de Spearman foi usado para determinar as correlações entre as variáveis quantitativas. Resultados: 73% eram mulheres e 61% pertenciam a um nível socioeconômico médio. A ingestão media de vitamina D foi de 137 (83,1-227,3) UI/dia. Com base no índice de massa corporal (IMC), 44% dos indivíduos tinham sobrepeso/obesidade. Os 68% apresentaram níveis deficientes/insuficientes de vitamina D (hipovitaminose D). A classificação do IMC e a circunferência da cintura (CW) não foram relacionadas ao status da vitamina D; entretanto, as atividades com maior exposição ao sol foram altamente relacionadas (p = 0,013). O tempo de exposição ao sol explicou a variação no componente 2 (16,60%), onde a maioria dos indivíduos com nível normal foi agrupada. O tempo de exposição ao sol foi positivamente correlacionado com o status de vitamina D (r = 0,263; p = 0,023). Discussão: O excesso de peso e a obesidade abdominal nem sempre estão associados com a hipovitaminose D. Conclusões: A maioria dos indivíduos apresentou hipovitaminose D, mas seu status não foi relacionado com indicadores antropométricos. O tempo de exposição ao sol foi o único fator positivamente correlacionado com o status da vitamina D.

[Evaluation of the usefulness of nail biopsy in the diagnosis of onychomycosis]. / Evaluación de la utilidad diagnóstica de la biopsia ungueal en las onicomicosis.

BACKGROUND: Onychomycosis affects between 2% to 30% of the world population. Nail biopsy may help in making a diagnosis and can distinguish between invasion and colonisation. AIMS: To evaluate the diagnostic usefulness of nail biopsy with Periodic acid-Schiff (PAS) staining for onychomycosis, compared to direct KOH examination, culture and its combination in a reference laboratory in Colombia. METHODS: The study included 66 patients in whom a blind and independent reading of the three tests was performed. The usefulness was defined based on the validity (sensitivity, specificity, Youden's index, likelihood ratios), performance (predictive values) efficiency (proportion of correctly diagnosed patients), and reproducibility (kappa coefficient). RESULTS: The mean age of the patients was 55±16 years, and included 76% women. The direct tests with KOH were positive in 66.7% (n=44), 62.1% (n=41) were positive with culture, and 56.1% (n=37) with the biopsy. The main causal agents were non-dermatophytes moulds in 36.4% (n=24). The most frequent species were Neoscytalidium dimidiatum (n=11), Trichophyton rubrum (n=11), and Candida parapsilosis (n=13). The sensitivity of nail biopsy, when compared to the standard (KOH and/or culture), was 71%, specificity 83%, Youden's index 0.54, positive likelihood ratio 4.25, negative likelihood ratio 0.35, positive predictive value 92%, negative predictive value 52%, efficiency 74% and kappa coefficient 0.45. When biopsy was evaluated only in patients with onycholysis of the nail plate greater than 50%, all the parameters of diagnostic usefulness increased. CONCLUSIONS: The overall usefulness of the biopsy was moderate for patients with more severe symptomatology, which makes its use advisable in cases of extensive onycholysis, and when discriminating colonisation from invasion is required.

Evaluación de la utilidad diagnóstica de la biopsia ungueal en las onicomicosis / Evaluation of the usefulness of nail biopsy in the diagnosis of onychomycosis

Antecedentes: La onicomicosis afecta a entre el 2 y el 30% de la población mundial; la biopsia ungueal facilita el diagnóstico y diferencia invasión de colonización. Objetivos: Evaluar la utilidad diagnóstica de la biopsia ungueal con coloración de PAS en las onicomicosis frente al examen directo con KOH, el cultivo y su combinación en un laboratorio de referencia de Colombia. Métodos: Se incluyó a 66 pacientes, a quienes se les realizó lectura ciega e independiente de las tres pruebas; la utilidad se definió a partir de los resultados de validez (sensibilidad, especificidad, índice de Youden, cocientes de probabilidad), desempeño (valores predictores), eficiencia (proporción de pacientes correctamente diagnosticados) y reproducibilidad (índice kappa). Resultados: La edad media de los pacientes fue 55 ± 16 años, el 76% fueron mujeres y el 66,7% (n = 44) de los exámenes directos con KOH resultaron positivos; para el cultivo, el 62,1% (n = 41) de las muestras fueron positivas y con la biopsia lo fueron el 56,1% (n = 37). Los principales agentes causales fueron mohos no dermatofitos en un 36,4% (n = 24) y las especies con la mayor frecuencia fueron Neoscytalidium dimidiatum (n = 11), Trichophyton rubrum (n = 11) y Candida parapsilosis (n = 13). La sensibilidad de la biopsia ungueal frente al KOH o el cultivo fue del 71%, la especificidad del 83%, el índice de Youden 0,54, el cociente de probabilidad positivo de 4,25, el cociente de probabilidad negativo de 0,35, el valor predictivo positivo el 92%, el valor predictivo negativo el 52%, la eficiencia el 74% y el coeficiente kappa 0,45. Al evaluar la biopsia solo en pacientes con onicólisis de la lámina ungueal superior al 50%, aumentaron todos los parámetros de utilidad diagnóstica. Conclusiones: La utilidad global de la biopsia fue moderada para pacientes con mayor sintomatología, por lo que se recomienda su uso en presencia de onicólisis extensa y en los casos en los que se requiera discriminar colonización de invasión

Background: Onychomycosis affects between 2% to 30% of the world population. Nail biopsy may help in making a diagnosis and can distinguish between invasion and colonisation. Aims: To evaluate the diagnostic usefulness of nail biopsy with Periodic acid-Schiff (PAS) staining for onychomycosis, compared to direct KOH examination, culture and its combination in a reference laboratory in Colombia. Methods: The study included 66 patients in whom a blind and independent reading of the three tests was performed. The usefulness was defined based on the validity (sensitivity, specificity, Youden's index, likelihood ratios), performance (predictive values) efficiency (proportion of correctly diagnosed patients), and reproducibility (kappa coefficient). Results: The mean age of the patients was 55 ± 16 years, and included 76% women. The direct tests with KOH were positive in 66.7% (n = 44), 62.1% (n = 41) were positive with culture, and 56.1% (n = 37) with the biopsy. The main causal agents were non-dermatophytes moulds in 36.4% (n = 24). The most frequent species were Neoscytalidium dimidiatum (n = 11), Trichophyton rubrum (n = 11), and Candida parapsilosis (n = 13). The sensitivity of nail biopsy, when compared to the standard (KOH and/or culture), was 71%, specificity 83%, Youden's index 0.54, positive likelihood ratio 4.25, negative likelihood ratio 0.35, positive predictive value 92%, negative predictive value 52%, efficiency 74% and kappa coefficient 0.45. When biopsy was evaluated only in patients with onycholysis of the nail plate greater than 50%, all the parameters of diagnostic usefulness increased. Conclusions: The overall usefulness of the biopsy was moderate for patients with more severe symptomatology, which makes its use advisable in cases of extensive onycholysis, and when discriminating colonisation from invasion is required

Historia de la micología médica en Colombia, 1930-1970 / History of medical micology in Colombia, 1930-1970

El objetivo general de esta investigación fue comprender algunos de los acontecimientos históricos que posibilitaron la instauración, difusión y apropiación de la micología médica en Colombia entre 1930 y 1970. Para ello se consultaron revistas científicas y tesis en diferentes bibliotecas, centros documentales y archivos históricos de Medellín y de Bogotá. Se incluyen en el informe los diferentes problemas enfrentados por los médicos y el personal de laboratorio para la clasificación taxonómica de los hongos, la relación entre la micología y la dermatología, el desarrollo del estudio de las micosis sistémicas y el papel de algunas personas en la institucionalización de la micología médica.

The overall objective of this research was to understand the events that made possible the creation, diffusion and appropriation of medical mycology in Colombia between 1930 and 1970. It was based on the review of scientific journals and theses in different libraries, archives and documentation centers in Medellin and Bogota. The report includes the different problems faced by physicians and laboratory personnel concerning the classification of fungi, the relationship between dermatology and mycology, the development of the study of systemic mycoses and the role played by some persons in the institutionalization of medical mycology.