[Physical activity and chronic diseases : how can motivational principles contribute to physically active behaviour ?] / Activité physique et maladies chroniques. Principes motivationnels pour contribuer à un comportement physiquement actif.

Although physical activity is perceived as an effective therapeutic agent in the management of chronic diseases, the literature reports a low participation rate in adapted physical activity programmes and a high drop-out rate during participation. There is room for improvement in supporting the engagement of chronically ill patients in an active lifestyle, especially in optimising the process from medical management to integration into a local adapted sports structure. Based on the motivational principles of the self-determination theory, we propose courses of action to optimise the support of the chronically ill patient in the process of behavioural change. This article emphasises the importance of placing the individual at the centre of his or her physical care and the importance of taking into account individual characteristics in order to act on intrinsic motivation.

Bien que l'activité physique soit perçue comme un agent thérapeutique efficace dans la prise en charge des maladies chroniques, la littérature rapporte un faible taux de participation aux programmes d'activité physique adaptée ainsi qu'un taux élevé d'abandon lors de leur participation. Le soutien à l'engagement des malades chroniques vers un style de vie actif semble perfectible, notamment en optimisant le processus allant de la prise en charge médicale vers l'intégration au sein d'une structure sportive locale adaptée. En regard des principes motivationnels liés à la théorie de l'auto-détermination, nous proposons des pistes d'action permettant d'optimiser l'accompagnement du malade chronique lors de son processus de changement de comportement. Cet article met l'accent sur l'intérêt de placer l'individu au centre de sa prise en charge physique ainsi que sur l'importance de prendre en compte les caractéristiques individuelles afin d'agir sur sa motivation intrinsèque.

Arteriovenous fistulae complicating central venous catheterization: value of endovascular treatment based on a series of seven cases.

OBJECTIVES: To point out the usefulness and effication of endovascular treatment of arteriovenous fistulae complicating the insertion of central venous catheter. MATERIAL AND METHOD: Retrospective study of 7 cases treated between 1983 and 1993. The central venous catheterization had involved the right internal jugular vein in 5 cases and the right subclavian vein in 2 cases. RESULTS: Isolated endovascular therapy was performed in 5 cases. Surgery was necessary in 1 case to remove an hematoma. In another case, occlusion of a large AVF was performed during intraoperative endovascular temporary occlusion of the AVF. The choice of the occluding agent was primarily dictated by the hemodynamic and anatomical conditions (releasable balloons, coils). Vertebro-vertebral fistulae (3 cases) could be treated with patency of this vessel. No complications were encountered. CONCLUSION: Endovascular approach is a reliable and safe method to perform occlusion of post catheter AVF.