Survival study of treatment adherence by patients given oral oxibutynin for hyperhidrosis.

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.

[Pyogenic and tuberculous abscesses of the psoas muscle]. / Abscesos piógenos y tuberculosos del músculo psoas.

OBJECTIVES: To describe the clinical characteristics of patients with abscess on the psoas muscle (PA) and to identify the possible differences existing between pyogenic and tuberculous etiologies. PATIENTS AND METHODS: A retrospective review of patients diagnosed of PA in one hospital was conducted (1983-2009). Two groups were established, that is pyogenic and tuberculous, and the clinical findings, analyses and evolution were compared. RESULTS: Thirty PA were included, 83% pyogenic and 17% tuberculous, average age 53 years. On 9 occasions, 30% were primary and on 21 occasions, 70% secondary (to skeletal pathology in 8, to urological in 8 and to gastrointestinal in 8). No clinical differences were observed between both groups. Pyogenic and tuberculous etiologies were differentiated analytically through leukocyte values (13,871 vs. 8,560/mm(3), p=0.018), hemoglobin (11 vs. 14 g/dL, p=0.008) and erythrocyte sedimentation rate (ESR) (108 vs. 17 mm/h, p<0.0001). Abscesses were diagnosed by computed tomography (CT) in 29 patients (97%) and by magnetic resonance in 1 (3%), both with a diagnostic sensitivity of 100%, as opposed to 50% for ultrasound scanning. Left laterality was less frequent in pyogenic abscesses (44% vs. 100%, p=0.031). The blood cultures were positive in 22% and abscess pus culture in 82%. Gram negative bacilli, Streptococcus spp. and S. aureus were the most frequent isolations. A total of 67% were drained: transcutaneously 50%, surgically 13% and both techniques 3%. Two patients died (7%), both with pyogenic abscess. CONCLUSIONS: Secondary pyogenic abscesses constitute the most frequent PA group. CT is the diagnostic procedure of choice. Leukocytosis, anemia, raised ESR and right laterality suggest pyogenic etiology. Transcutaneous drainage is substituting surgical drainage and also makes it possible to obtain diagnostic samples.

Hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo en la Costa del Sol / Sun Exposure and Long-Distance Runners on the Spanish Costa del Sol: Habits, Attitudes, and Knowledge

A nivel dermatológico, la elevada exposición solar a radiación ultravioleta asociada a la práctica de actividades deportivas al aire libre, máxime en actividades recreativas de larga duración como son los corredores de fondo, aumenta el fotoenvejecimiento de la piel y la incidencia de cáncer de piel. El propósito del estudio fue evaluar los hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo de nuestra comunidad. Se realizó un estudio transversal descriptivo mediante encuesta con un muestreo de conveniencia entre aquellos participantes de las medias maratones populares de Fuengirola y Marbella celebradas en el mes de septiembre del año 2016. En la muestra evaluada se ha hallado una intensa exposición solar realizando actividades al aire libre, asociado ello a una prevalencia de quemaduras solares elevada (uno de cada 2 corredores) (AU)

Exposure to UV radiation during the practice of sports in the open air is especially high in sustained recreational activities such as long-distance running. UV exposure increases skin photoaging and the incidence of skin cancer. This study aimed to describe habits and attitudes related to sun exposure among long-distance runners in our area of southern Spain as well as to evaluate the runners’ knowledge of exposure. A cross-sectional descriptive study was designed to survey a convenience sample of participants in half marathons in Fuengirola and Marbella in September 2016. We found a high level of sun exposure among participants in this outdoor activity. The prevalence of sunburn was also high, experienced by half of the runners surveyed (AU)