Systematic review of adapted physical activity and therapeutic education of patients with chronic venous disease.

BACKGROUND: Chronic venous disease (CVD), comprising impaired lower limb venous return, will lead to chronic distal venous pressure overload manifested by various clinical signs and symptoms and resulting in diminished quality of life. The CEAP (Clinical, Etiology, Anatomy, and Pathophysiology) classification of CVD distinguishes six stages (C0-C6) using clinical, etiologic, anatomic, and pathophysiologic parameters. In the present study, we analyzed the effects of adapted physical activity (APA) and patient-oriented therapeutic education (PTE) programs on the clinical signs, symptoms, and quality of life of patients with CVD. METHODS: Our analysis, in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) recommendations, included a search of PubMed, CINAHL and LiSSa databases, using a single search equation. RESULTS: A total of 21 studies were selected for analysis. The analysis revealed first, that patients at stage C0 to C5 had had access to an APA program. This therapy alleviated the clinical signs and symptoms and improved the patients' quality of life. The beneficial effects of APA were greater in the programs that had included aquatic activities than in the program that were exclusively dry-land programs. Second, patients at stage C6 had predominantly followed a PTE program. This therapy showed beneficial effects on the clinical signs and symptoms. However, the quality of life had rarely been assessed. CONCLUSIONS: At present, APA and PTE programs comprise useful and complementary therapeutic options for the care of patients with CVD. Two of the studies included in our review had evaluated the effects of combining these two approaches, notably in the context of balneotherapy, and reported promising results.

Computational fluid dynamics applied to the ventilation of small-animal laboratory cages.

Several studies based on in vivo or in vitro models have found promising results for the noble gas argon in neuroprotection against ischaemic pathologies. The development of argon as a medicinal product includes the requirement for toxicity testing through non-clinical studies. The long exposure period of animals (rats) during several days results in technical and logistic challenges related to the gas administration. In particular, a minimum of 10 air changes per hour (ACH) to maintain animal welfare results in extremely large volumes of experimental gas required if the gas is not recirculated. The difficulty with handling the many cylinders prompted the development of such a recirculation-based design. To distribute the recirculating gas to individually ventilated cages and monitor them properly was deemed more difficult than constructing a single large enclosure that will hold several open cages. To address these concerns, a computational fluid dynamics (CFD) analysis of the preliminary design was performed. A purpose-made exposure chamber was designed based on the CFD simulations. Comparisons of the simulation results to measurements of gas concentration at two cage positions while filling show that the CFD results compare well to these limited experiments. Thus, we believe that the CFD results are representative of the gas distribution throughout the enclosure. The CFD shows that the design provides better gas distribution (i.e. a higher effective air change rate) than predicted by 10 ACH.

Path instability of a rising bubble.

We model the problem of path instability of a rising bubble by considering the bubble as a spheroidal body of fixed shape, and we solve numerically the coupled fluid-body problem. Numerical results show that this model exhibits path instability for large enough values of the control parameters. The corresponding characteristics of the zigzag and spiral paths are in good agreement with experimental observations. Analysis of the vorticity field behind the bubble reveals that a wake instability leading to a double threaded wake is the primary cause of the path instability.