Evaluation of a school-based sun safety education program in Reunion Island, 2016-2017.

BACKGROUND: Sun exposure, especially during childhood, is the main environmental risk factor for skin cancers. This study evaluated the impact of the school-based sun safety education program "Living with the Sun" on the knowledge and behavior of primary school children regarding sun safety in Reunion Island. METHODS: This multicenter, comparative intervention study was conducted in selected primary schools of Reunion during the 2016-2017 school year. The intervention consisted of an in-class slide-show presentation on sun safety, a teaching guide, and school trips during which children were offered sunscreen and were requested to wear sunglasses, a T-shirt, and a cap. The children completed a questionnaire before and after the intervention. The percentage of children wearing a cap in school playgrounds at the end of the school year was compared between paired intervention and control schools. RESULTS: Seven hundred children from 7 Reunionese schools completed the questionnaire before and after the intervention. There was a statistically significant improvement in children's knowledge of sun safety, with differences between schools, teachers, school levels, and questionnaire responses. The percentage of children wearing a cap at the end of the school year was significantly higher in intervention schools compared to control schools. CONCLUSIONS: Children's knowledge and behavior regarding sun safety improved significantly as a result of the intervention.

[Treatment of femoral fractures on a total hip prosthesis using Charnley's "long stem" prosthesis. Apropos of 18 cases]. / Traitement des fractures fémorales sur arthroplastie totale de hanche par prothèse "longue-tige" de Charnley. A propos de 18 cas.

PURPOSE OF THE STUDY: This study was performed to analyse the clinical and radiological results obtained after the treatment of femoral fractures after total hip arthroplasties by a Charnley's extra long-stem prosthesis, and to compare these results with those obtained by alternative treatments proposed by various authors. MATERIALS: 18 patients, whose mean age was 68.5 years (extremes: 45 to 86 years). Cooke and Newman fractures classification showed a clear prominence of type III. In 8 cases we found a femoral loosening, prior to the fracture, divided as follows: 4 in grade III and 4 in grade IV, using Vives classification. Type I fractures were always associated to complete femoral loosening. METHOD: Clinical results were analysed by Merle d'Aubigné's scoring system, giving a pre-fracture global score of 13.5. Post-operative radiological analysis was made on the appearance of femoral radiolucent lines and/or modification of the femoral implant. RESULTS: 17 patients were followed, with a mean of 5 years (extremes: 1 to 14 years). Consolidation was always obtained. The global mean functional results were of 15.2, with score improvement, essentially, of soreness and stability. We found 12 good and very good results, 4 poor and 1 bad. Age (< 75 years) and fracture type (II and III) appeared to be important factors influencing the functional result, contrary to the lesional mechanism. 6 non-evolutive bone-cement radiolucent lines appeared, in immediate post-operative phase. One cement-prosthesis radiolucent line appeared later, leading to loosening and rupture of the implant. We deplore 3 stem twistings, of which only one led to implant rupture. Walking with support was possible at the 5th postoperative days. DISCUSSION: Our functional results are encouraging (12 good results, i.e. 71 per cent), compared with other treatments. This technique improved the global functional score. This is due to the simultaneous treatment of the fracture and of the eventual pre-traumatic associated femoral loosening. The technique allows a quick resumption of autonomy, a short hospitalization time for these elderly patients. The main disadvantage of the orthopaedic treatment is the prolonged decubitus and the important risk of secondary loosening. Osteosynthesis by plate has the advantage of keeping a maximum of osseous stock, but delays weight bearing, favours the non union by a large loss of periosteum. It never permits the treatment of the associated loosening during the same operation. It is also at the origin of a cement weakening, while fixing the proximal screws, leading to the difficulty of placing the prosthesis. Major disadvantage of proposed method is the use of a high quantity of cement to ensure stability of the implants; but this has never had negative consequences in our study. CONCLUSION: This surgical technique seems to be a satisfying alternative to the treatment of femoral fractures on total hip arthroplasty, due to the advantages obtained. It is reserved for elderly patients. However, these findings should be taken with caution, due to our small series.

[Acetabular implant in Charnley's total arthroplasty. Review of 309 cases with a minimum of 15 years follow-up]. / L'implant cotyloïdien dans l'arthroplastie totale de Charnley. Revue de 309 dossiers avec un recul minimum de 15 ans.

PURPOSE OF THE STUDY: The aim of this study was to appreciate the long term result of 309 acetabular components of total hip arthroplasty. MATERIALS AND METHODS: All were performed using Charnley's prosthesis and cement, by one surgeon, between January 1972 and December 1975. Clinical function was graded according to Postel-Merle-d' Aubigné's scoring system (PMA score). We measured wear of polythylene using a personal method, on anteroposterior radiographs of the pelvis. Radiolucent line were appreciated by Delee and Charnley's criteria, migration by Massin's criteria. Survivorship curves were calculated with radiolucent lines, as migration, on 15 years. We compared the effect of different parameters on wear and loosening of the sockets. RESULTS: At 15 years follow-up, we found 51.5 per cent hips with the highest PMA score (18). Revision for socket loosening was 3.88 per cent, the same for dislocations. Concerning 25 per cent of the sockets, wear of polyethylene was evaluated less than 0.065 mm a year, concerning 50 per cent of them, it was evaluated less than 0.11 mm a year, at last concerning 75 per cent of them, it was evaluated less than 0.16 mm a year. No significant correlation was established between the tilt of the acetabular component and the wear of polyethylene. We observed no radiolucent lines for 60 per cent of the implants, nor migration for 83 per cent of them. Statistical analysis proved the influence of the wear on radiolucent lines and migration. DISCUSSION AND CONCLUSION: The analysis confirms a moderate wear of polyethylene during 15 years. We introduce an original method for its measurement and its formulation. This method allows a truly description of wear in long term results. This analysis confirms also that several parameters intercede on loosening; these are different if one considers radiolucent lines or migration. We do think at last, that the best positionning of the socket in the A.P. view should approach 35 degrees.

Evaluation of possible first trimester prenatal diagnosis in lysosomal diseases by trophoblast biopsy.

The detection of enzymatic deficiency in cultured amniotic cells from second trimester pregnancies is presently used for prenatal diagnosis of lysosomal diseases. The possibility of obtaining and processing trophoblast tissue at 8-10 weeks of gestation would permit first trimester prenatal diagnosis. Using trophoblast tissue samples from normal fetuses before voluntary abortion and from placenta after therapeutic abortions of fetuses affected by several lysosomal diseases, we conclude that early diagnosis of lysosomal disorders would be possible.

[Retro-lunar luxation of the carpus associated with a Benett's fracture, fracture of the second metacarpal and of the radial styloid]. / Luxation péri-lunaire associée à une fracture articulaire du premier métacarpien, spiroïde du deuxième et à un arrachement de la styloïde radiale A propos d'un cas.

The authors report a case of peri-lunar luxation of the carpus, associated with a Bennett's fracture, a fracture of the second metacarpal and with an avulsion of the radial styloid. Even if, each injury alone is commonplace, we did not find this combination, in the literature. It reiterates the importance of not ignoring, on X-rays, one of the four wounds, and the problem of the surgical strategy, for the treatment of all of the injuries at a time. Peri-lunar dislocation of the carpus is quite an unusual injury, affecting mainly young men. In one third of cases, the peri-lunar dislocation is unnoticed at first examination. This problem is even more acute when associated wounds, which are evident on X-rays, exist. The operative technique, used in the treatment of such wounds, depends on the severity. For peri-lunar luxation on the small curve, closed reduction is used. For one on the large curve, it is better to use open reduction, as for, most probably, for associated lesions, operated on late.

[Treatment of unstable fractures of the distal extremity of the radius by Hoffmann's external fixation. Report of 68 cases]. / Traitement des fractures instables de l'extrémité distale du radius par fixateur externe d'Hoffmann. A propos de 68 cas.

Sixty-eight fractures of the distal extremity of the radius, mostly unstable, homogeneously treated by Hoffmann's radio-metacarpal external fixation, were reviewed in terms of functional, objective and radiological criteria. Mean follow-up was 4 years, with a range of 6 months to 10 years. Overall, this treatment achieved 56% of satisfactory results, 26% moderate results and 18% poor results. Open and comminuted fractures give the worst overall results, mostly in terms of functional parameters. From this study, it is clear that external fixation is effective for the treatment of unstable fractures, as it provides good restitution of anatomical integrity of the radius, ensures better stabilization and allows immediate physiotherapy, leading to restoration of a good range of movement. Moreover, compliance with certain technical aspects such as minimal distraction, limits the disadvantages of this technique.