Sports Injuries While Wingfoiling.

Purpose: Wingfoiling is a new popular water sport. Data on the risk of injury or overuse injuries are not yet available. The aim of the study was to analyze the incidence, mechanisms and risk factors for wingfoiling related injuries and the acceptance of safety equipment. Patients and Methods: Data for this retrospective study were collected through an online standardized questionnaire. It was accessible from January 2022 to June 2022. Information on demographics, injury history, overuse complaints, use of (safety)equipment and fitness routines over the past 12 months were asked. Results: A total of 415 completed the questionnaire in full and could be included in the study. Fourteen percent (n = 59) were female, 86% (n = 356) were male. The average age was 43.5 years. Fourteen percent (n = 59) participated in competitions. Thirty-one percent (n = 129) of all participants suffered at least one injury in the past 12 months out of a total of 356 injuries. This corresponds to an injury incidence of 5.7/1000h. Typical mechanism of injury was contact with the own sports equipment. The most frequent cause was individual riding errors due to fatigue with 77.5% (n = 276). The most common acute injury types were contusions, strains, cuts and abrasions of the lower extremities. In the case of chronic complaints (n = 173), the shoulder and knee joint were mainly affected. Seventy-three percent (n = 304) of the participants regularly used a protective equipment, such as a helmet or impactvest. Conclusion: The injury rate of wingfoiling is comparable to windsurfing and kitesurfing. The majority of injuries are minor injuries to the lower extremities. In case of serious injuries, it is mainly the bony thorax that is affected. Most participants already use protective equipment. Overuse complaints mostly affect the large joints.

In Utero Chlordecone Exposure and Thyroid, Metabolic, and Sex-Steroid Hormones at the Age of Seven Years: A Study From the TIMOUN Mother-Child Cohort in Guadeloupe.

Background: Chlordecone is an endocrine-disrupting chemical with well recognized estrogenic and progestagenic properties. This organochlorine insecticide was extensively used in the French West Indies from 1973 to 1993 to control the banana root borer. Due to its poor degradation in the environment, permanently polluted soil is responsible for the current contamination of the food chain and human beings. We aimed to examine the relationship of in utero exposure to chlordecone and thyroid (thyroid stimulating hormone [TSH], free tri-iodothyronine [FT3], free thyroxine [FT4]), metabolic (insulin growth-factor 1, leptin, adiponectin), and sex-steroid (dehydroepiandrosterone [DHEA], total testosterone [TT], dihydrotestosterone [DHT], estradiol [E2]) hormone levels in children at the age of seven years who participated in TIMOUN, an ongoing birth cohort in Guadeloupe. Methods: Chlordecone concentrations were measured in cord-blood at delivery. Thyroid, metabolic, and sex-steroid hormone levels were determined in the blood of children at seven years of age. Associations between in utero chlordecone exposure and hormone levels at seven years of age were assessed by multiple linear or logistic regression, controlling for confounding factors. Results: Among the study population (210 boys and 228 girls), chlordecone and hormone measurements were available for 124 boys and 161 girls. We found the third quartile of in utero chlordecone exposure relative to the lowest quartile to be associated with elevated TSH levels in girls and elevated DHEA, TT, and DHT levels in both sexes. Complementary non-linear analysis (spline regression) confirmed a significant non-linear trend for TSH in girls and DHEA and DHT in boys. Conclusion: In utero chlordecone exposure was associated with elevated levels of selected thyroid (TSH) and sex-steroid (DHEA, TT, and DHT) hormones at seven years in a non-monotonic dose response (inverted U) relationship. The implications for future health and reproductive function in puberty and adulthood should be determined.

[Uterine arteriovenous malformation: about two cases at the University Hospital of Guadeloupe]. / Malformation artério-veineuse utérine: à propos de deux cas au Centre Hospitalier Universitaire de la Guadeloupe.

Uterine arteriovenous malformations are possible causes of persistent metrorrhagia, in particular in patients with a history of abortion and trophoblast diseases. We here report the diagnostic and therapeutic features of two patients with uterine arteriovenous malformations complicating post-abortion in the Maternity Ward of the University Hospital of Pointe-a-Pitre in Guadeloupe. Patients had metrorrhagias after abortion with curettage. Arteriovenous malformation was suspected based on ultrasound combined with Doppler. Arteriography confirmed the diagnosis and allowed, in the same time, for conservative treatment by arterial embolization. No complication was reported. The lack of knowledge about uterine arteriovenous malformations can lead to deleterious consequences ranging from haemostatic hysterectomy due to cataclysmic hemorrhage to death.

Leiomyomas in an African Caribbean hysterectomy population considered to be ethnically related to African Americans.

BACKGROUND: Uterine leiomyoma has been reported to be a worse problematic disease for African American than Caucasian women in the US. Data are almost non-existent for other populations of African ancestry. Our aim was to investigate the hypothesis of an equivalent influence of ethnicity on uterine leiomyomas for women of a French African-Caribbean population. BASIC PROCEDURES: Retrospective analysis of hysterectomies performed from 2010 to 2015 at the teaching hospital of Guadeloupe (French West Indies), where most inhabitants are of West African origin, was carried out. Data of the 899 hysterectomies, including those for malignancy, were collected, in particular, uterine weight. MAIN FINDINGS: The indications were leiomyoma in 66.5 % of cases and leiomyomas were found in 91 % of all cases. The mean age and uterine weight were 51.7 years and 464 g for the entire population, 50.2 years and 488 g for the population without malignancies, and 47.0 years and 567 g for the population with leiomyomas. PRINCIPAL CONCLUSIONS: The data were compared to those reported in the literature for several populations, notably African Americans and Caucasians in the US and mainland France. This comparison supports the hypothesis that Guadeloupean women, an African-Caribbean population, have characteristics in terms of uterine leiomyoma that are close to those of African Americans. Although confirmation is required, these results highlight the need for specific research, therapeutic approaches, and improved early management of these populations.

Prevalence and predictors of penile nodules in French Guiana's sole prison facility.

PURPOSE: Penile implants or nodules are objects inserted beneath the skin of the penis mostly for erotic purposes. The procedure is painful and there may be complications. It is often associated with prison. Our objectives were to describe the prevalence of penile nodules among inmates in French Guiana, and to study factors associated with this practice, notably psychiatric diagnoses. METHODS: The study was cross-sectional. All consenting new adult prisoners incarcerated between 01/01/2014 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses. RESULTS: Of 492, 29.6% declared having penile nodules. The median number was 4 (IQR = 2-7). The number of nodules correlated with age. There was no statistical link between the presence of penile nodules and the reasonforincarceration. Multivariate analysis showed that persons <45years with prior incarcerations, with substance addiction, and those with a history of death in the family were more likely to have penile nodules. Those with psychosis and those with suicidal risk were less likely to have penile nodules. Prisoners speaking English or Maroon languages seemed more likely to have penile implants in the multivariate model. CONCLUSIONS: Overall, 29.6% of arriving inmates had penile nodules. The practice was linked to drug addiction and was less frequent among those with psychosis and suicidal risk. Given the high HIV prevalence in prison, penile nodule may be an obstacle to condom-based prevention.

High prevalence rates for multiple psychiatric conditions among inmates at French Guiana's correctional facility: diagnostic and demographic factors associated with violent offending and previous incarceration.

BACKGROUND: French Guiana has the highest incarceration rate among French territories, it is higher than that of Brazil, Colombia or Venezuela. It is well known that mental health problems are over-represented in correctional facilities. Our objectives were to describe the prevalence of various psychiatric conditions and to study factors associated with violence and repeated offenses among arriving detainees at the sole correctional facility of French Guiana. METHODS: The study was cross-sectional. All consenting new adult prisoners incarcerated between 18/09/2013 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses. In addition sociodemographic data was collected. RESULTS: Overall 647 men and 60 women were included. The participation rate was 90%.Overall 72% of patients had at least one psychiatric diagnosis (Fig. 2). Twenty percent had three or more diagnoses. Violent index offences were not more frequent among those with a psychiatric diagnosis (crude odds ratio 1.3 (95%CI = 0.9-2), P = 0.11. Multivariate analysis showed that after adjusting for sex and age, psychosis, suicidality and post-traumatic stress disorder were independently associated with violent offences. Generalized anxiety disorder was less likely to be associated with incarceration for violent offences. Having a history of a previous incarceration was significantly associated with a psychiatric condition in general (any diagnosis) OR = 3 (95%CI = 2-4.3), P < 0.0001. Calculations of the population attributable risks showed that in the sample 31.4% of repeat incarcerations were attributable to antisocial personality disorder, 28.3% to substance addiction, 17.3% to alcohol addiction, 8.7% to depression and 7% to psychosis. CONCLUSIONS: The very high prevalence of psychiatric disorders observed in our sample, and the relative lack of psychiatric facilities, suggest that part of the problem of very high incarceration rate may be explained by transinstitutionalization. Improving psychiatric care in prison and coordination with psychiatric care in the community after release is likely to be important.

Suicide risk among prisoners in French Guiana: prevalence and predictive factors.

BACKGROUND: Suicide rates in prison are high and their risk factors are incompletely understood. The objective of the present study is to measure the risk of suicide and its predictors in the only prison of multicultural French Guiana. METHODS: All new prisoners arriving between September 2013 and December 2014 were included. The Mini International Neuropsychiatric Interview (MINI) was used and socio-demographic data was collected. In order to identify the predictors of suicide risk multivariate logistic regression was used. RESULTS: Of the 707 prisoners included 13.2% had a suicidal risk, 14.0% of whom had a high risk, 15.1% a moderate risk and 41.9% a low risk. Predictive factors were depression (OR 7.44, 95% CI: 3.50-15.87), dysthymia (OR 4.22, 95% CI: 1.34-13.36), panic disorder (OR 3.47, 95% CI: 1.33-8.99), general anxiety disorder (GAD) (OR 2.19, 95% CI: 1.13-4.22), men having been abused during childhood (OR 21.01, 95%, CI: 3.26-135.48), having been sentenced for sexual assault (OR 7.12, 95% CI: 1.98-25.99) and smoking (OR 2.93, 95%, CI 1.30-6.63). CONCLUSION: The suicide risk was lower than in mainland France, possibly reflecting the differences in the social stigma attached to incarceration because of migrant populations and the importance and trivialization of drug trafficking among detainees. However, there were no differences between nationalities. The results reemphasize the importance of promptly identifying and treating psychiatric disorders, which were the main suicide risk factors.

[Post-Traumatic Stress Disorder among Incomers in Remire-Montjoly Prison, French Guiana]. / Le trouble de stress post-traumatique parmi les détenus en centre pénitentiaire en Guyane française.

Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p < 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD.

Prevalence and risk factors of early onset of sexual intercourse in a random sample of a multiethnic adolescent population in French Guiana.

French Guiana, a French overseas department in South America, has been classified epidemic for HIV. This territory is consisting of a very young population with almost 45% of them being younger than 20 years of age. Delaying the onset of first sexual intercourse (SI) is one of the major objectives to fight HIV infection in adolescents. The objective of this study is to identify the age of first SI and the risk factors of early onset. A behavioural surveillance survey among students living on the coastline and alongside the Maroni River was conducted in 2011/2012. A total of 1603 students filled out the survey. While 60% had already SI, the mean age of first intercourse was 12.1 years for boys and 13.9 years for girls. Accordingly, over 90% had a premature onset of SI. Risk factors are age, male gender, living alongside the Maroni River, another language than the French being mother tongue, not being religious, alcohol and cannabis consumption and a bad attitude towards condom use. Risk factors for girls are an older first sexual partner, having more than three lifetime sexual partners and condom rupture. Evidence-based implementation with respect of local and socio-demographic aspects is necessary to improve youths' appreciation of SI and related risk of sexual transmitted diseases.