Evaluación de la exposición solar y las medidas de fotoprotección en deportistas del Valle de Aburrá en el 2018 / Evaluation of solar exposure and photoprotection measures in athletes of Valle de Aburrá in 2018

RESUMEN Antecedentes: el cáncer de piel es el más común en humanos y su incidencia continúa en aumento. La radiación ultravioleta (RUV) es el principal factor ambiental asociado con este cáncer. Los deportistas presentan un mayor riesgo para desarrollar cáncer de piel; sin embargo en nuestro país, hasta el momento, no se ha estudiado esta población. Objetivo general: describir las conductas de riesgo del cáncer de piel en deportistas del Valle de Aburrá, a través de una encuesta realizada en los centros más importantes de la región. Materiales y métodos: estudio de corte transversal descriptivo; se evaluaron variables sociodemográficas, clínicas y relacionadas con hábitos de fotoprotección. Según el tipo de variable, se usó media y desviación estándar o conteos absolutos y relativos. Resultados: se incluyeron 122 deportistas, la edad promedio del grupo estudiado fue de 20 años, el 56 % de los incluidos fueron hombres. El 74 % de los deportes se realizaban al aire libre, el fútbol fue el deporte más frecuente. El 75 % de los participantes entrenaba cuatro o más veces por semana y el 55 % lo hacía en horas con muy alta RUV. El 27 % de los deportistas reportó de 1 a 3 insolaciones en la infancia. La fotoprotección química se utilizaba con más frecuencia que la física. Conclusiones: este es el primer estudio realizado en Colombia que evidencia la necesidad de mejorar la educación en prevención primaria y secundaria sobre el cáncer de piel en esta población.

SUMMARY Background: Skin cancer is the most common cancer in humans and its incidence increases. Ultraviolet radiation (UVR) is the main environmental factor associated with this cancer. Athletes have a greater risk to develop skin cancer. Up to date in Colombia, this population has not been studied. Objective: To describe the behaviors and photoprotection measures in athletes of Valle de Aburrá. Materials and methods: Cross sectional study. Sociodemographic, clinical variables and related to photoprotective habits were evaluated. Depending on the type of variable, mean and standard deviation or absolute and relative counts were used. Results: One hundred twenty two athletes were included, 56% were men, the whole group had an average age of 20 years. 74% of sports were played outdoors; soccer was the most frequent sport. 75% of participants trained four or more times per week and 55% did so in hours with very high RUV. 27% of athletes reported between 1 to 3 insolations in childhood. Chemical photoprotection was used more frequently than physical. Conclusions: This is the first study in Colombia that shows the need to improve skin cancer primary and secondary prevention strategies in this population.

Basal cell carcinoma treated with Mohs micrographic surgery in young Ibero-American patients.

BACKGROUND: The incidence of basal cell carcinoma (BCC) in younger individuals has increased in recent decades. However, the characteristics of BCCs in this population, especially in Ibero-Latin American countries, have not been completely defined. OBJECTIVE: To describe the demographic, clinical, and histopathological characteristics of BCCs in patients younger than 40 treated with Mohs Micrographic Surgery (MMS). MATERIALS AND METHODS: A multicenter, retrospective study conducted between January 2009 and December 2014, in five Ibero-American countries, included biopsy-proven BCCs in patients younger than 40 that were treated with MMS. Demographic, clinical, histopathological, and surgical characteristics were described. RESULTS: The study included 301 tumors in 241 patients, of whom 61% were female. The most common Fitzpatrick phototype was III. The most common histological subtypes were nodular (37.5%) and infiltrative (18.9%). Perineural invasion was encountered in 1.7%, and tumor clearance was achieved in 87.4% within two stages of MMS. CONCLUSIONS: This is the first Ibero-Latin American transnational study describing the characteristics of BCCs in young patients treated with MMS. Despite darker skin phototypes in this population, BCCs can occur in early ages and may present with aggressive features. Therefore, MMS may be considered an appropriate first-line treatment option in this population.

Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology.

Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses.