Background
Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis.
Objective
...The aim of this study was to analyze sun‐related behaviors and knowledge in transplant athletes, examine the frequency of sunburns, and explore associations with a history of skin cancer.
Materials and methods
Cross‐sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer.
Results
The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1–2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn.
Conclusions
Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow‐up to prevent sun‐induced skin cancer in this population.
The objective of this study was to analyse the sun exposure habits of elite aquatics athletes, together with their sunburn history and skin examination habits, taking into account differences by sex ...and between sports. A cross-sectional health survey was conducted at world championship events during which elite surfers, windsurfers and Olympic sailors from 30 different countries were invited to participate. The athletes were asked to complete a self-administered questionnaire focused on sun protection habits, sun exposure and sports practices. The survey was completed by 240 athletes, 171 men (71.3%) and 69 women (28.8%), with a mean age of 22 years (SD 5.86) and skin phototypes I (6.3%), II (3.3%), III (22.0%), IV (32.5%), V (9.2%) and VI (1.7%). There were significant differences between male and female athletes in skin self-examination (
p
< 0.001) and in the use of sunglasses (
p
< 0.001). In sunburn history during the last season, there were significant differences (
p
< 0.001) among the three sports analysed, in both sexes. The mean rate of sunburn during the previous season was 76.7%, and 27.5% of participants reported having experienced three or more sunburns that lasted at least 1 day. This type of athlete is at high risk of sunburn and hence of future skin cancer. However, there is a general lack of awareness of this risk. This study highlights the need to inform such athletes and to raise awareness of the dangers, through educational interventions on the importance of protecting against sunburn in order to reduce the future incidence of skin cancer.
Introduction
In recent years, increasing use has been made of oral anticholinergics such as oxybutynin for the management of hyperhidrosis. The primary aim of this study is to determine the variables ...associated with adherence to this treatment, and secondarily to obtain data on its effectiveness, safety and adverse effects.
Material and methods
This is a prospective study of patients with hyperhidrosis, at any location, receiving treatment with oral oxybutynin in the period 2007–2016. Epidemiological variables, treatment details, effectiveness and adverse effects were recorded. Effectiveness was determined according to the Hyperhidrosis Disease Severity Scale (HDSS) at baseline, at 3 and 12 months and in successive visits. A descriptive analysis was performed, and Cox's bivariate and multivariate regressions were calculated to determine the variables associated with treatment adherence.
Results
A total of 201 patients (140 women) with a mean age of 34 years were included. The mean initial HDSS score was 3.8, and the median follow‐up period was 29 months. At 3 months, 84.57% of the patients had responded to treatment (excellent response: 72.94%), but adverse effects were reported by 68.2%. At 12 months, 54.23% had responded (excellent response: 79.82%), with adverse effects in 75.2%. The main variable associated with greater adherence was affected areas: palms of the hands and soles of the feet. The following variables were associated with poorer adherence: onset of hyperhidrosis in adolescence, failure to provide an incrementally increasing, individualized dose, initial HDSS score of 3 and partial initial response. The multivariate analysis confirmed the association between the onset of hyperhidrosis during adolescence, the failure to provide a progressively increasing dose and palmar affectation.
Discussion
This study was conducted to identify the variables associated with adherence to treatment by hyperhidrosis patients treated with oral oxybutynin. This information would facilitate selection of patients for this treatment and enhance our understanding of the biological behaviour of such anticholinergics when used to treat hyperhidrosis.
Background
The cost associated with treatment of non‐melanoma skin cancer is expected to rise considerably over the coming decades. This important public health problem is therefore expected to have ...an enormous economic impact for the various public health services.
Objectives
To estimate the cost of the surgical‐care process of non‐melanoma skin cancer at the Costa del Sol Hospital and seek areas to improve its efficiency, using the activity‐based costing (ABC) method and the tools designed for decision analysis.
Secondary objective
To compare the costs for hospitalized patients obtained using the ABC method with the data published by the Spanish Ministry of Health, using the diagnosis‐related groups (DRG) classification system.
Material and methods
Retrospective analysis of the cost of non‐melanoma skin cancer surgery at the Costa del Sol Hospital.
Results
The total estimated cost from 2006 to 2010 was 3 398 540€. Most of the episodes (47.3%) corresponded to minor outpatient surgery. The costs of the episodes varied greatly according to the type of admission: 423€ (minor outpatient surgery), 1267€ (major outpatient surgery), and 1832€ (inpatient surgery). The average cost of an inpatient episode varied significantly depending on the calculation system used (ABC: 2328€ vs. DRG: 5674€).
Conclusions
The ABC cost analysis system favours standardization of the care process for these tumours and the detection of areas to improve efficiency. This would enable more reliable economic studies than those obtained using traditional methods, such as the DRG.
Summary
Introduction
The Skin Cancer Index (SCI) is the first specific patient‐reported outcome measure for patients with cervicofacial nonmelanoma skin cancer. To date, only the original English ...version has been published.
Objectives
To develop a Spanish version of the SCI that is semantically and linguistically equivalent to the original, and to evaluate its measurement properties in this different cultural environment.
Material and methods
A cross‐sectional study was conducted of the cultural adaptation and empirical validation of the questionnaire, analysing the psychometric properties of the new index at different stages.
Results
Of 440 patients recruited to the study, 431 (95%) completed the Spanish version of the SCI questionnaire, in a mean time of 6·3 min (SD 2·9). Factor analysis of the scale revealed commonality and loading values of < 0·5 for three of the 15 items. The remaining 12 items converged into two components: appearance/social aspects (seven items) and emotional aspects (five items). Both domains presented a high level of internal consistency, with Cronbach's alpha values above 0·8. The convergent–discriminant validity analysis produced correlations higher than 0·3 for the mental component of the Short Form Health Survey‐12v2 Health Questionnaire (correlation coefficient 0·39) and the Dermatology Quality of Life Index (correlation coefficient −0·30). In the test–retest, nine of the 12 items produced a weighted kappa value exceeding 0·4, and for the remaining three items, the absolute agreement percentage exceeded 60%.
Conclusions
The Spanish version of the SCI quality of life scale has been satisfactorily adapted and validated for use in Spanish‐speaking countries and populations.
What's already known about this topic?
The first questionnaire specifically focused on the quality of life for patients with cervicofacial nonmelanoma skin cancer, the Skin Cancer Index (SCI), has been developed recently in the U.S.A.
This questionnaire represents a valuable tool not only in clinical practice but also in the field of epidemiological and clinical research.
At present only the original English version is available.
What does this study add?
We have obtained the first Spanish version of the SCI that is semantically and linguistically equivalent to the original and that guarantees validity and reliability.
This new version will enable use of the SCI in research on quality of life of patients with nonmelanoma skin cancer to other countries and to Spanish‐speaking population worldwide.
SOS: Medical Students Get Sunburn Too Troya Martín, M. de
Actas dermo-sifiliográficas (English ed.),
June 2019, 2019-Jun, 2019-06-00, Letnik:
110, Številka:
5
Journal Article
Skin cancer prevention campaigns in schools have been shown to be both effective and cost-effective. The success of such programs depends on the use of an appropriate design informed by a prior ...survey of the target population (pupils, teachers, and parents). There are, however, very few validated Spanish-language questionnaires designed to study the habits and knowledge of this population with respect to sun exposure in childhood and none designed for use with a young adult population. OBJECTIVESTo construct and validate a questionnaire designed to explore sun exposure behaviors in a young adult population. METHODOLOGYTwo questionnaires were developed, one for adults (18+) and the other for young adults (11-17); both included demographic information, skin color, Fitzpatrick skin type, and history of sunburn as well as questions on knowledge, attitudes and practices related to sun exposure. The content was then piloted and its validity analyzed. The subsequent validation study was divided into 2 phases as follows: 1) analysis of the validity and internal consistency of the items in a cross-sectional study of 1,482 adults and adolescents, using exploratory factor analysis to test construct validity and Cronbach α to measure internal consistency; and 2) evaluation of test-retest reliability in 39 individuals. RESULTSThe pilot study demonstrated the content validity of both questionnaires. Principal component analysis revealed that 2 components in each of the dimensions studied accounted for over 50% of the variance. A good correlation was found between the items studied. Validity was demonstrated in the first phase of the analysis with a Cronbach α of between 0.45 and 0.8 for all components except knowledge (0.335). In the second phase, test-retest reliability was demonstrated (absolute agreement>60%). CONCLUSIONSThe psychometric properties of the questionnaire make it a valid and reliable tool for the study of knowledge, attitudes, and habits with respect to sun exposure in the young adult school population.
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