[Influence of spray application of La Léchère mineral water on the cutaneous microcirculation in the lower limbs in healthy subjects]. / Influence de l'application locale d'eau thermale de la léchère en spray sur la microcirculation cutanée des membres inférieurs.

Spa treatment is commonly used in chronic venous diseases, to the satisfaction of many patients, but no scientific validation work has been performed up to now. This pharmaco-clinical study was designed to evaluate the specific influence of topical application of the mineral water of La Léchère on the cutaneous microcirculation. It was a controlled, randomized, double-blind study comparing the effects of the water of La Léchère to distilled water applied as a spray to the ankle in ten healthy subjects. Skin temperature and laser-Doppler perfusion index (mean and temporal variability) were the evaluated parameters. Under these conditions, the results show a cutaneous cooling with a mean value of 0.3 to 0.5 degrees C, whose duration is significantly longer with the thermal water (p<0.05). During this cooling, the laser-Doppler perfusion index remained stable when distilled water was applied, whereas an increase was observed when the thermal water was employed (p=0.005). No significant changes in vasomotion were observed with either treatment (p=ns). This study demonstrates the presence of a specific effect of topical application of the La Léchère mineral water on the cutaneous microcirculation. The explanation and the potential therapeutic interest of this effect were beyond the scope of this study and remain to be investigated.

["Vein School." A program of education for chronic venous insufficiency patients at the La Léchère Hotspring]. / "L'Ecole de la Veine". Un programme d'éducation pour les patients atteints d'insuffisance veineuse chronique à la station thermale de La léchère.

Chronic venous insufficiency is a frequent and invalidating condition, which also represents an important socio-economical burden. As it is a chronic disease with no effective curative therapy, the preventive and educational means are of particular interest. The present health policy insists on the education given to patients suffering from chronic disease, but contrasting with other chronic conditions (diabetes, asthma, chronic back pain), to our knowledge, there is no published structured educational training programme dedicated to people suffering from CVI. Such an educational programme was developed at the spa resort of La Léchère (Savoie, France), which is specialized in the treatment of CVI. Proposed to voluntary patients taking the waters and driven by a multidisciplinary team (doctors, nurses, pharmacists), the objective was to promote a better knowledge in venous disease by the patients and to make them adopt a more active behaviour in their treatment. Three topics were approached in interactive work-groups using a problem solving teaching technique: "anatomy and physiology of the circulatory system", "venous diseases", "practical aspects life with compression stockings". Comparison of pre and post-teaching evaluations was performed in 149 unselected patients, allowing a short-term appraisal of the knowledge improvement. It showed a 25 to 40% increase in right answers according to the tested topic. Further evaluation of long term beneficial effects is needed. However, the high interest of patients regarding this teaching method and the content of the programme provides good expectations regarding a real beneficial effect on health and quality of life.