[Effects of electrostimulation (Veinoplus) on lower limbs venous insufficiency-related symptoms during pregnancy. Preliminary study]. / Effets de l'électrostimulation par Veinoplus sur les troubles circulatoires des membres inférieurs chez la femme enceinte. Etude préliminaire.

OBJECTIVE: To assess if electrostimulation of lower limbs relieves lower limbs venous insufficiency-related symptoms during pregnancy. PATIENTS AND METHODS: A two-step study was conducted. First, a monocentric prospective preliminary study including 30 pregnant women was conducted to assess the effects of electrostimulation on fetal monitoring and uterine contractions. Then, a multicentric prospective non-randomised study including 58 pregnant women with a gestational age between 23 and 33 weeks of amenorrhoea was conducted to evaluate the electrostimulation treatment. This evaluation was based on a clinical examination performed pre- and post-treatment, a CIVIQ questionnaire filled out pre- and post-treatment and a daily diary filled out by the patient during treatment duration. Treatment duration was 21 days including two daily treatment sequences of 20 min. Three groups of patients were identified based on initial intensity of venous insufficiency-related symptoms (group 1 minor symptoms, group 2 moderate symptoms, group 3 severe symptoms). RESULTS: Preliminary study showed no interferences between electrostimulation and fetal cardiac rhythm, uterine contractions and maternal uterine and fetal umbilical arteries Doppler. Concerning the evaluation of the electrostimulation: in group 1, electrostimulation significantly reduced heavy legs sensation (p<0,001) and calves pain (p=0,02) between the beginning and the end of the treatment. The four scores calculated with the CIVIQ questionnaire decreased after treatment and a significant reduction was noted for generalised pain feeling (p=0,04) and psychological impact (p=0,03). In group 2, a significant decrease was noted for tiredness (p<0,001), heavy legs sensation (p<0,001), calves pain (p<0,001) and edema (p=0,02) between the beginning and the end of the treatment. The four scores calculated with the CIVIQ questionnaire significantly decrease after 21 days of treatment. In group 3, a significant decrease of heavy legs sensation (p=0,03) and calves and malleoli perimeters (p<0,05) was noted. After 21 days of treatment, the four scores calculated with the CIVIQ questionnaire significantly decrease (p<0,05). When comparing the three groups, beneficial effects of the treatment are most marked in group 2 regarding subjective symptoms, CIVIQ questionnaire scores and leg pain. According to the patients, effectiveness and tolerance of the treatment ranged from good to excellent in the three groups. DISCUSSION AND CONCLUSION: Electrostimulation is an effective and well-tolerated treatment of lower limbs venous insufficiency-related symptoms in pregnant women. Its use during pregnancy did not show any effects on fetus and pregnancy.

[Inflammation in peritoneal dialysis]. / Inflammation en dialyse péritonéale.

In patients on peritoneal dialysis, peritoneal membrane alterations with inadequate peritoneal membrane function may be induced during long-term therapy. Chronic inflammation triggers malnutrition and atherosclerotic cardiovascular disease contributing to high mortality. The role of catheter, peritonitis and peritoneal dialysis fluids is argued. A neutral pH, a lesser presence of glucose degradation products generated during heat sterilization and accelerating the production of advanced glycosylation end-products (AGEs) could be reduced with better biocompatibility of peritoneal dialysis fluids.

[Prevention of malnutrition in peritoneal dialysis patients]. / Prévention de la dénutrition chez les patients traités par la dialyse péritonéale.

Malnutrition is a frequent and serious problem for patients treated by peritoneal dialysis. Patients' survival depends on their nutritional status at the initiation of the dialysis treatment. Main malnutrition factors are inflammation, insufficient dialysis dose, peritoneal glucidic absorption and protein loss within the dialysate. These patients show a relationship between malnutrition, inflammation and cardiovascular diseases. To prevent malnutrition, it is necessary to reduce inflammation by improving dialysis solutions' biocompatibility and optimising the sodium regulation. The peritoneal membrane exposure to both glucose and its degradation products must also be reduced. In order to restrict protein losses, especially when peritoneal hyper permeability occurred, dialysis solutions containing amino acids can be used. Early dialysis treatment and a progressive increase of the dialysis dose corresponding to the decrease of the residual renal function can also be recommended.

Critical power of knee extension exercises does not depend upon maximal strength.

A possible dependence of critical power (CP) and the Y-intercept of the work/exhaustion time relationship (Y(intercept)) on maximal muscular strength of the same muscle group has been studied in nine endurance-trained subjects, seven gymnasts, and seven weight-lifters. CP was calculated as being equal to the slope of the linear relationship between exhaustion time and the work performed at exhaustion on a knee extension ergometer. Y(intercept) was equal to the intercept between this relationship and the work axis. The muscular strength of the knee was evaluated by measuring the torques exerted on a Biodex knee isokinetic dynamometer at four angular velocities: 0 degrees x s(-1) (T0), 90 degrees x s(-1) (T90), 180 degrees x s(-1) (T180) and 240 degrees x s(-1) (T240). The results of the present study do not support the hypothesis that CP depends upon maximal strength. Indeed, CP was not correlated with T0, T90, T180 or T240 (¿r¿ < 0.01). Y(intercept) was significantly and positively correlated only with T90.