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[A case of unilateral elastosis with cysts and comedones. Favre-Racouchot syndrome].

INTRODUCTION: Cutaneous elastosis with cysts and comedones (Favre-Racouchot) is one of the oldest known manifestations of helioderma. Both sides of the face are usually involved symmetrically. CASE REPORT: We observed a 65-year-old woman with extremely severe Favre-Racouchot disease localized exclusively on the left side of the face. The diagnosis of elastosis with cysts and comedones was confirmed histologically. This elastosis with cysts and comedones was associated with spasms of the hemiface treated with injections of botulinic toxin. This association was fortuitous and we retained actinic irradiation as the causal agent in this woman who had worked for 15 years in the same room. The elastosis occurred on the side of the face which had been continuously exposed at the same orientation to the window. COMMENTS: This original observation is similar to cases where facial exposure to artificial light or sunlight is asymmetrical, leading to a higher incidence of lesions on one side of the face: colloid milium, actinic keratosis, Dubreuilh melanoma (malignant lentigo) or simple helioderma. The asymmetrical nature of the actinic lesions is often related to automobile driving. This case was particular since it demonstrated that Favre-Racouchot elastosis with cysts and comedones is due to actinic irradiation and not to skin aging.

Acne Vulgaris↗

Presbyopic drivers' vision through a convex rear view mirror.

BACKGROUND: Monovision is a commonly used modality for the presbyope who wants to wear contact lenses. If the add for near vision is in the left eye, driving an automobile creates a circumstance whereby the lens wearer cannot obtain a clear image in that eye of distant objects seen in the driver's side outside rear view mirror. METHODS: We have discovered that a stick-on convex mirror eliminates this problem by neutralizing either some or all of the power of the add. RESULTS: The driver wearing an add in the left eye can then obtain a clear image in that eye of objects behind and to the side of the automobile.

Automobile Driving↗

Are automobile head restraints used effectively?

Observation of 992 motor vehicles and their drivers revealed that most drivers do not have their head restraints effectively positioned. Improper positioning was more common with adjustable restraints, in commercial vehicles, and among male drivers. Some head restraints could not be adjusted properly. Improvements in headrest adjustment might help decrease morbidity in motor vehicle accidents.

Automobile Driving↗

Miles more troubles?

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Automobile Driving↗

Children's behavior during automobile rides: do car seats make a difference?

The behavior of children riding in automobiles with their mothers was assessed by having an observer accompany them on repeated 15-minute automobile rides. Children riding in car seats exhibited very high levels of appropiate or safe behavior, whereas children not riding in car seats exhibited very low levels of appropriate behavior. When car seats were introduced to those children who previously had not used them, the level of appropriate behavior improved dramatically. These results were maintained at three-month follow-up observations. Prevention or reduction of disruptive child behavior on car rides is an obviously important, but previously unreported, benefit of the use of child restraint seats. This fact might very well be used by the pediatrician to further encourage or persuade parents to purchase and use child restraint seats. The use of a child restraint seat to reduce disruptive behavior during automobile rides is an advantage, beyond the safety aspects, of introducing car seats to young children.

Accidents, Traffic↗

In-car education.

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Automobile Driving↗

Effect of fatigue on performance measured by a driving simulator in automobile drivers.

OBJECTIVE: To identify risk factors of performance decrement in automobile drivers. METHODS: 114 drivers (age <30 years, n=57; age > or =30 years, n=57) who stopped at a rest stop area on a freeway were recruited for the study. They filled out a questionnaire on their journey, sleep/wake patterns and performed a 30-min test on a driving simulator. The test evaluates, by computerized analysis, the lateral deviation of a virtual car from an appropriate trajectory on a virtual road. A sex/age matched control group was recruited in the community. Control subjects were studied at the same time of day as the index case driver. Controls had normal sleep wake schedule, absence of long driving and performed the same driving test. RESULTS: Drivers performed significantly worse than controls on the driving test. Age and duration of driving were the main factors associated with decreased performance. CONCLUSION: Our driving simulator can identify fatigue generated by driving but results must be considered in relation with age of subjects.

Adolescent↗