Electrical stimulation and muscle strengthening

OBJECTIVES: To identify the effects of application methods and indications of direct muscle electrostimulation on strength gain. METHODS: Literature review and analysis of articles from Medline database with the following entries: muscular or neuromuscular, electromyostimulation, electrical stimulation, strengthening, strength training, immobilization, muscle dystrophy, bed-rest, bed-bound, knee or hip surgery, postoperative phase, cachexia, sarcopenia, and their French equivalent. RESULTS: Because of its specific muscle recruitment order, different from that of voluntary contraction, direct muscle electrostimulation is theoretically a complementary tool for muscle strengthening. It can be used in healthy subjects and in several affections associated with muscle function loss. Its interest seems well-established for post-traumatic or postsurgery lower-limb immobilizations but too few controlled studies have clearly shown the overall benefits of its application in other indications. Whatever the indication, superimposed or combined electrostimulation techniques are generally more efficient than electrostimulation alone. CONCLUSION: Even though widely used, the level of evidence for the efficiency of electromyostimulation is still low. For strength gains, it yielded no higher benefits than traditional strengthening methods. Its interest should be tested in medical affections leading to major muscle deconditioning or in sarcopenia.     

Maladie cœliaque

Celiac disease is an enteropathy due to gluten intake in genetically predisposed individuals (HLA DQ2/DQ8). Celiac disease occurs in adults and children at rates approaching 1% of population in Europe and USA. Clinical features observed in celiac disease are extremely various and anaemia, oral aphthous stomatis, amenorrhea or articular symptoms may be the only presenting manifestations. Diagnosis relies on the evidence of histological villous atrophy in proximal small bowel and the presence of specific serum antibodies. Treatment relies on eviction of gluten (wheat, barley, rye) from diet. Gluten free diet allows prevention of malignant complications such as small bowel adenocarcinoma and lymphoma, and osteopenia. The main cause of resistance to gluten free diet is its poor observance. If not the case, serious complications of celiac disease, such as clonal refractory celiac sprue and intestinal T-cell lymphoma should be suspected. Current therapeutic challenges concern alternative to gluten free diet and new efficient treatments of lymphomatous complications.     

“颞颥”部位义试诠

文章运用语言学知识和中医学原理,分析了唐代以前古医籍中“颞颥”的用法,认为“颞颥”的部位义指颞肌所在部位,即头侧、眼眶外后方的体表处。范围从额侧眼眶骨外后方、耳上方直到耳后。     

Céphalées chez un patient de 21 ans atteint d’une maladie de Goodpasture

The case of a 21-year old man who deceased due to an intracranial thrombosis just after diagnosis of Goodpasture's disease, is reported. Discussion deals with the putative mechanisms, which could be responsible for the thrombosis.     

Thymolipoma revelated by myasthenia

Thymolipomas are rare, often asymptomatic benign tumors; their revelation by myasthenia is exceptional. A 49-year-old patient with a one-year history of fluctuant muscular fatigability developed ptosis. Electromyography revealed a myasthenic neuromuscular block. The CT scan disclosed a thymic mass especially important on the left side. Thoracotomy under left mammary was performed for thymectomy. Pathology examination of the surgical specimen provided the diagnosis of benign thymolipoma. At 37 months follow-up, the myasthenia has remained unchanged.