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Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.

Introduction: Hydrotherapy is the use of natural mineral water and other complementary means for the prevention, treatment, rehabilitation or welfare. The use of sulphurous water is the most therapeutically indicated type of water for users with rheumatic. Objective: Our main objective is to understand the state of the scientific evidence in the Hydrotherapy area of sulphurous thermal water in cases of rheumatic disease through the study of research protocols about the effects. Methodology: The selected articles were collected from the following data basis: Pubmed, Science Direct and Cochrane. The criteria used to select these articles were defined as being published in English, French or Portuguese between 2000 to the present day, being an experimental model and having mentioned the use of sulfur water throughout the article. The exclusion criteria were the research area of the article not being focused on physical therapy. We found a total of 51 articles related to rheumatic diseases. Results: Overall, the search resulted in 6 articles related to the effects of the sulphurous water in rheumatic disease. All articles showed a significant decrease in pain, such as an increase in functional capacity and life quality of patients. Conclusion: All the revised studies suggest a positive effects of using sulphurous waters in patients with rheumatic disease. However, the number of articles published in this area is very small so there’s a need of further studies in order to consolidate these results., Introducción: El termalismo consiste en el uso de agua mineral natural y otros medios complementarios con fines preventivos, terapéuticos, de rehabilitación o de bienestar. O uso de água sulfurosa é o tipo de água com maior número de indicações terapêuticas, com indicação para utilizadores com patologias reumáticas. El objetivo: analizar el estado del arte de los balnearios termales, a través del estudio de protocolos de investigación sobre los efectos del agua termal sulfurosa en casos reumáticos. Metodología: Los artículos seleccionados se recuperaron de las bases de datos Pubmed, Science Direct y Cochrane. Los criterios de inclusión fueron definidos como a) publicación en inglés, francés o portugués entre el año 2000 y la actualidad; b) modelo experimental y c) uso de agua de tipo sulfurosa. El criterio de exclusión fue que el área de investigación del artículo no estuviera dirigida a la fisioterapia. En total se encontraron 51 artículos relativos a patologías reumáticas. Resultados: La búsqueda realizada dio como resultado 6 artículos sobre los efectos de las aguas sulfurosas en patologías reumáticas. Conclusión: se constató que las aguas sulfurosas tienen efectos positivos en usuarios con patologías reumáticas. Son necesarios más estudios en este ámbito para reforzar estos resultados., Introdução: O termalismo consiste no uso da água mineral natural e outros meios complementares para fins de prevenção, terapêutica, reabilitação ou bem-estar. O uso de água sulfurosa é o tipo de água com maior número de indicação terapêutica, com indicação para utentes com patologias reumática. Objetivo: analisar o estado da arte na área do termalismo, através do estudo de protocolos de investigação relativos aos efeitos da água termal sulfurosa em casos do foro reumático. Metodologia: os artigos selecionados foram recolhidos das bases de dados Pubmed, Science Direct e Cochrane. Foram definidos como critérios de inclusão a) publicação em inglês, francês ou português entre o ano de 2000 até a atualidade; b) modelo experimental e c) utilização de água do tipo sulfurosa. O critério de exclusão foi a área de investigação do artigo não estar direcionada para a fisioterapia. No total foram encontrados 51 artigos relativos a patologias reumáticas. Resultados: A pesquisa realizada resultou em 6 artigos acerca dos efeitos das águas sulfurosas em patologias reumáticas. Conclusão: verificou-se que as águas sulfurosas têm efeitos positivos nos utentes com patologia do foro reumático. Mais estudos são necessários nesta área de forma a robustecer os resultados apontados.

The beneficial effects of balneotherapy have been proven by numerous clinical studies on locomotor disorders. To date, there is only scant data on changes in the microbiome system of the skin during balneotherapy. The aim of this study was to compare the effects of thermal water and tap water on the skin’s microbiome in healthy volunteers. 30 healthy female volunteers participated in the study. The experimental group (of 15 women) spent 30-min 10 times, in Gabriella Spring’s thermal baths (i.e., mineral water containing sodium hydrogen carbonate).The controlled group (15 women) had the same, but in tap water. The results of this study have proven that there is a difference in the influencing effects of tap water and medicinal water on the microbiome of the skin. After bathing in the thermal water of Lakitelek, Deinococcus increased significantly at the genus level, and the tendency for Rothia mucilaginosa bacteria also increased. At the species level, Rothia mucilaginosa increased significantly, while Paracoccus aminovorans and the tendency for Paracoccus marcusii decreased. When the values of the two trial groups after bathing at the genus level were compared, Rothia bacteria increased significantly, while Haemophilus tended to increase, Pseudomonas tended to decrease, Neisseria tended to increase significantly, and Flavobacterium tended to decrease. At the species level, Geobacillus vulcani decreased significantly, and the tendency for Burkholderia gladioli decreased. The growth of Rothia mucilaginosa and the decrease in the tendency of Paracoccus, Pseudomonas, Flavobacteroium, and Burkholderia gladioli confirm the beneficial effect of balneotherapy. In this study, trends are represented by the uncorrected p value. The main result was that the thermal water changed certain bacteria of the skin, both on the genus and species levels, but there were no significant changes in the tap water used, either at the genus or species level. We first compared the worlds of thermal water and tap water’s microbiome systems. The thermal water decreased the number of certain inflammatory infectious agents and could enhance some of their positive effects, which have been proven at the molecular level. Our results can provide an important clue in the treatment of certain skin diseases. The research of the skin microbiome during balneotherapy can be one of the most intriguing and exciting topics of the future and can bring us closer to understanding the mechanism of action of balneotherapy.

Florence Thirion,1,* Susie Guilly,1,* Sébastien Fromentin,1 Florian Plaza Oñate,1 Anne-Sophie Alvarez,1 Emmanuelle Le Chatelier,1 Nicolas Pons,1 Florence Levenez,1 Benoît Quinquis,1 Stanislav Ehrlich,1 Joel Doré,1,2 Richard Martin,3 Sophie Seité4 1University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France; 2University Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France; 3Mercurialis Biotech, Rochecorbon, France; 4La Roche-Posay Dermatological Laboratories, Levallois-Perret, France*These authors contributed equally to this workCorrespondence: Sophie Seit&#x00E9La Roche-Posay Dermatological Laboratories, 62 quai Charles Pasqua, Levallois-Perret, 92300, France, Tel +33 1 49 64 33 40, Email sophie.seite@loreal.comIntroduction: Balneotherapy (BT) is the treatment of disease through the use of thermal spring water (TSW). It has been used for centuries and remains a popular form of treatment for dermatologic diseases such as atopic dermatitis (AD). Recent findings highlighted the role of the gut microbiota in AD and the possible crosstalk between gut and skin microbiomes in this pathology. Nevertheless, changes in the composition of the gut microbiota after balneotherapy remain to be elucidated.Methods: A total of 96 patients, with moderate to severe AD according to the SCORAD, were enrolled. Stool samples were collected prior and post a 3-week balneotherapy at the thermal care center of La Roche-Posay (France). Composition of the gut microbiota was assessed by shotgun metagenomic sequencing.Results: Species associated with high gut microbiota richness tended to correlate negatively with disease severity (SCORAD) and positively with SCORAD reduction, while species associated with low richness displayed the opposite pattern. Relative abundance of 23 species was significantly altered during BT, these changes being significantly associated with SCORAD reduction during BT, suggesting that gut microbiota composition and AD progression were associated through the treatment. Microbial functions related to gut-brain axis such as GABA and tryptophan metabolism were also altered by the treatment. Long-standing AD patients exhibited a better gut microbial profile than recently diagnosed patients, with higher MSP richness and species associated with SCORAD reduction.Conclusion: In patients with AD, clinical disease parameters such as SCORAD or disease duration are intricately linked to the gut microbiota composition. SCORAD reduction occurring during BT was also associated with gut microbiota. The gut-brain-skin axis via neurotransmitter such as GABA should be further studied in diseases such as AD.Keywords: atopic dermatitis, balneotherapy, gut microbiota, shotgun metagenomics, thermal spring water

Мета: виявити супутні зміни параметрів нейроендокринно-імунного комплексу і мікробіоценозу товстого кишечника, що супроводжують діуретичний ефект бальнеотерапії на курорті Трускавець. Результати. У спостереженні за 22 чоловіками, хворими на хронічний пієлонефрит в поєднанні з холециститом, виявлено, що 10–12-денний курс бальнеотерапії (пиття біоактивної води «Нафтуся», аплікації озокериту, мінеральні ванни) збільшує добовий діурез на 28 % (p < 0,001). Це поєднується із збільшенням екскреції фосфатів на 103 % (p < 0,001), кальцію — на 76 % (p < 0,01), креатиніну — на 32 % (p < 0,02), сечової кислоти — на 29 % (p < 0,001), сечовини — на 21 % (p < 0,01), магнію — на 19 % (p = 0,05) при відсутності суттєвих змін екскреції хлориду, калію і натрію. При цьому знижується рівень у плазмі креатиніну на 14 % (p < 0,001) і сечовини на 11 % (p < 0,01). Лейкоцитурія зменшується на 16 % (p < 0,02). Екскреторно-депураційний і протизапальний ефекти бальнеотерапії супроводжуються відчутною модуляцією параметрів нейроендокринно-імунного комплексу. Зокрема, зменшується як абсолютна, так і відносна щільність спектральної потужності (PSD) δ- і α-ритмів (p < 0,05–0,01), і підвищується відносна PSD β-ритму (p < 0,05–0,02) базальної електроенцефалограми. Разом з тим знижуються індекси варіабельності ритму серця: (VLF + LF)/HF — на 34 % (p < 0,05) і LF/HF — на 32 % (p > 0,05) за рахунок підвищення PSD HF більшою мірою, ніж LF. Базальний рівень у плазмі кортизолу знижується на 20 % (p < 0,01), тестостерону — на 15 % (p = 0,01), натомість підвищується рівень трийодтироніну — на 4 % (p < 0,05) і особливо кальцитонінової активності — на 92 % (p < 0,001), розрахованої за екскрецією з сечею фосфатів і кальцію. Лейкоцитарний індекс адаптації Поповича зростає на 46 % (p < 0,02). Стосовно параметрів фагоцитарної функції нейтрофілів констатовано підвищення зниженого індексу кілінгу ними Staphylococcus aureus на 19 % (p < 0,001) і Escherichia coli на 18 % (p < 0,01) за відсутності змін початково нормальних фагоцитарних індексів. Мікробне число стосовно Staphylococcus aureus залишається нормальним, а початково підвищена на 15 % інтенсивність фагоцитозу Escherichia coli знижується на 8 % (p < 0,05). Стосовно параметрів імунітету виявлено значуще підвищення рівня в крові лише CD16+ лімфоцитів (+17 %, p < 0,01) при відсутності змін рівнів CD3+CD4+ і CD3+CD8+ Т-лімфоцитів і CD19+ В-лімфоцитів. Не змінюються суттєво ні рівні в сироватці Ig G, M, A, ні циркулюючих імунних комплексів. Імунотропний ефект супроводжується редукцією проявів дисбактеріозу: вміст Bifidumbacter зростає на 19 % (p < 0,02), Lactobacter — на 20 % (p < 0,05), а Escherichia coli — на 48 % (p < 0,01), при цьому доля штамів з ослабленими ферментативними властивостями зменшується на 47 % (p < 0,001), з гемолітичними властивостями — на 77 % (p < 0,01). Висновок. Бальнеотерапія на курорті Трускавець чинить відчутний діуретичний ефект, що поєднується з активацією екскреторної і депураційної функцій нирок та бактерицидної функції нейтрофілів, редукцією дисбактеріозу товстого кишечника, лейкоцитурії і нейроендокринних проявів стресу.

The purpose of the study was to investigate the quality and reliability of YouTube videos as a source of information in water treatments. We searched videos on YouTube ( www.youtube.com ) using the following keywords: "health resort medicine," "spa treatment," "spa therapy," "hydrotherapy," "thermal medicine," "balneology," and "balneotherapy" on June 17th, 2021. The global quality scale (GQS) was used to evaluate the quality of the videos. The assessment of reliability was evaluated using the modified DISCERN tool. Some other video parameters and sources of the videos were also recorded. One hundred twenty-one (121) videos were analyzed. The most common video source was advertisement (46.3%). GQS and modified DISCERN median scores were generally low. They were superior for "hydrotherapy" and "balneotherapy" and were also higher in videos uploaded by health-related persons or organizations (physicians, health-related professionals, and health-related websites). A statistically significant positive correlation was found between investigated parameters (like view ratio, number of likes, video power index, video length) and GQS. Only video length was correlated with modified DISCERN for investigated parameters. The median video power index scores were statistically higher for "spa therapy" and "spa treatment." The YouTube content linked with water treatments has poor quality and reliability most of time. The hydrotherapy and balneotherapy keywords have the best quality and reliability.We think that designers of water treatment videos should involve health professionals more often so that the content of their video will better explain the details of medical conditions or interventions.The scientific experts should ensure a consensus in terminology to straighten the awareness of water treatments for patients and physicians.

Objectives It has been known that the use of moisturizers is useful in preventing the onset and maintaining remission of atopic dermatitis (AD). We recently focused on the moisturizing effect of natural mineral dissolved water and have conducted various studies. In this study, we investigated whether the bath treatment using natural mineral dissolved water can improve dry skin in AD patient in prospective nonblind, nonrandomized controlled study. Methods Thirteen adults with almost clear to moderate AD took bath therapy using tap water for 13 days, followed by bath therapy using natural mineral dissolved water for 13 days. Changes in the severity scoring, patient‐oriented eczema measure, pruritus numerical rating scale, transepidermal water loss (TEWL) and hydration were evaluated at day1, 14 and 28. Results Tap water using bath treatment did not change the severity scoring and itch associated score, and it partially decrease TEWL when compared with baseline condition. Bath treatment using natural mineral dissolved water slightly decrease eczema area and severity index (EASI) score and significantly decrease TEWL with respect to baseline condition. Moreover, in relatively severe AD analysis, bath treatment with mineral dissolved water significantly decreased EASI and TEWL. Conclusions Based on these results, bathing with natural mineral dissolved water may be effective in improving the dry skin of atopic dermatitis. Further studies are needed to evaluate its effects more clearly.

Crenobalneotherapy is a treatment commonly used in Europe and Middle East. It uses mineral water sometimes combined with different hydrotherapy techniques. Most patients treated in spa centers suffer from low back pain. The purpose of this work is to identify clinical trials on crenobalneotherapy for low back pain. Publication research was performed on Medline, Cochrane, and PEDRO databases. Clinical trials were analyzed for internal validity, external validity, quality of statistical analysis, and quality of collection of adverse events. We present the best level of evidence. Bibliographic research identified 21 clinical trials and the coauthors added 5 references. The 26 trials represent 2695 patients. Some have good methodological quality and allow considering crenobalneotherapy as a potential treatment for low back pain, even if the role of mineral water remains uncertain. The methodological quality of therapeutic trials should be improved. These trials should be analyzed in the future guidelines on low back pain.

Objective: To study the eff ectiveness of medical and preventive schemes of spa rehabilitation of children with biliary tract diseases living in ecologically unfavorable areas of the Krasnodar region.Materials and Methods: The study was conducted among children aged 7 to 14 years old burdened with gallbladder pathology (dysfunctional disorders of the biliary tract (DRBT)). In 2017-2020, the eff ectiveness of the therapeutic-resort stage of rehabilitation was studied in 127 children. The children permanently resided in Krasnodar and were admitted to the therapeutic spa-resort center of mother and child “Diluch” in the resort city of Anapa. The authors selected 93 (73.2%) children with hypofunctional gallbladder disorder (GI) and 34 (26.8%) children with hyperfunctional GI disorder for spa treatment. The control group included children with the 1st group of health. The eff ectiveness of the applied methods of rehabilitation was evaluated based on laboratory and instrumental studies, as well as periodic dynamic medical examinations, which included the collection of complaints, physical examination, and palpation of the abdominal cavity.Results: Therapeutic spa-rehabilitation of children with DRBT included balneotherapy, physiotherapy, and aerophytotherapy without the use of pharmacological drugs. At the same time, there was an improvement in the condition of both children with DRBT of the hypertensive type (94.1%) and among the subjects with DRBT of the hypotonic type (90.1). There were no cases of the condition worsening in the observed children with DRBT that permanently resided in unfavorable conditions of the Krasnodar Region.Conclusions: Based on the obtained results, it can be suggested that diff erentiated comprehensive rehabilitation in the conditions of the balneological complex of the resort city of Anapa performed aft er the main treatment of gastrointestinal pathology is feasible for children and adolescents experiencing adverse environmental impacts at a permanent place of residence in the Krasnodar region.

Fibromyalgia is a highly heterogeneous condition, but the most common symptoms are widespread pain, fatigue, poor sleep, and low mood. Nonpharmacological interventions are recommended as first-line treatment of fibromyalgia. However which interventions are effective for the different symptoms is not well understood. The objective of this study was to assess the efficacy of nonpharmacological interventions on symptoms and disease-specific quality of life. Seven databases were searched from their inception until June 1, 2020. Randomised controlled trials comparing any nonpharmacological intervention to usual care, waiting list, or placebo in people with fibromyalgia aged >16 years were included without language restriction. Fibromyalgia Impact Questionnaire (FIQ) was the primary outcome measure. Standardised mean difference and 95% confidence interval were calculated using random effects model. The risk of bias was evaluated using the modified Cochrane tool. Of the 16,251 studies identified, 167 randomised controlled trials (n = 11,012) assessing 22 nonpharmacological interventions were included. Exercise, psychological treatments, multidisciplinary modality, balneotherapy, and massage improved FIQ. Subgroup analysis of different exercise interventions found that all forms of exercise improved pain (effect size [ES] -0.72 to -0.96) and depression (ES -0.35 to -1.22) except for flexibility exercise. Mind-body and strengthening exercises improved fatigue (ES -0.77 to -1.00), whereas aerobic and strengthening exercises improved sleep (ES -0.74 to -1.33). Psychological treatments including cognitive behavioural therapy and mindfulness improved FIQ, pain, sleep, and depression (ES -0.35 to -0.55) but not fatigue. The findings of this study suggest that nonpharmacological interventions for fibromyalgia should be individualised according to the predominant symptom.

The aim of the work was to study the feasibility of the use of non-medicamental factors for the correction of endothelial dysfunction in patients with chronic obstructive pulmonary disease. Results. Chronic obstructive pulmonary disease (COPD) is considered as a systemic disease, one of the pathogenetic components of which is endothelial dysfunction (ED), which contributes to the development of comorbid cardiovascular pathology. At the same time, the basic treatment of patients with COPD includes drugs that may adversely influence it, and some medicines for the cardiac pathology treatment can increase the bronchial obstruction. Therefore, a question of non-medicamental methods of ED correction is actual, especially beyond the acute period of the disease. Methods of hardware physiotherapy, including ozone therapy, singlet oxygen therapy and its combination with magnetic therapy, low-intensity laser radiation, ultrasound therapy, a combination of laser therapy with balneotherapy, are widely employed. These methods have antioxidant, bronchodilating and anti-inflammatory effects, promote improvement of hemodynamics, as well as rheological properties of blood and microcirculation. Interval hypoxic therapy is also used, because in response to the hypoxic stimulation, the mechanisms of the respiratory system regulation, gas exchange and blood circulation are activated. It is also promising to use haloaerosoltherapy (HAT), which due to the increase of bronchs drainage function and sanitizing effect leads to the inhibition of local inflammation, improves ventilation and gas exchange, and reduces the intensity of oxidative stress, which promotes decrease of systemic inflammation and ED, associated with it. Particularly, this effect is manifested by lowering of edothelin-1 level and the expression of adhesion molecules by lymphocytes (CD54+). Conclusions. The analysis shows that the inclusion of methods with non-medicamental influence on the endothelium can significantly increase the effectiveness of complex treatment of patients with COPD, without increasing the medicinal load on the organism, which helps to avoid undesirable side effects. The use of HAT in the rehabilitation treatment of COPD patients contributes not only to decreasing the activity of local and systemic inflammatory processes, but also is accompanied by a certain correction of ED. However, specific recommendations for the use of certain non-medicamental effects in the complex rehabilitation treatment of patients with COPD, taking into account the presence of ED, have not been developed.

Background. An active molecule in sulfurous mineral - therapeutic waters and also in sapropelic mud is H2S, a hormetic gaseous molecule that can actively penetrate the skin. While high levels of H2S are extremely toxic, low levels are tolerated and have potential cytoprotective effects, with anti-inflammatory and antioxidant applications. Objective. This systematic review aims to rigorously select related articles and identify within their content the main possible uses of hydrogen sulfide from balneary sources and to explain its physiological mechanisms and therapeutic properties. Methods. To elaborate our systematic review, we have searched for relevant open access articles in 6 international databases: Cochrane , Elsevier , NCBI/PubMed , NCBI/PMC , PEDro , and ISI Web of Knowledge/Science , published from January 2016 until July 2021. The contextually quested keywords combinations/ syntaxes used are specified on this page. The eligible articles were analyzed in detail regarding pathologies addressed by hydrogen sulfide. All articles with any design (reviews, randomized controlled trials, non-randomized controlled trials, case-control studies, cross-sectional studies), if eligible according to the above-mentioned selection methodology, containing in the title the selected combinations, were included in the analysis. Articles were excluded in the second phase if they did not reach the relevance criterion. Results. Our search identified, first, 291 articles. After eliminating the duplicates and non-ISI articles, remained 121 papers. In the second phase, we applied a PEDro selection filter, resulting in 108 articles that passed the relevance criterion and were included in this systematic review. Conclusions. H2S biology and medical relevance are not fully understood and used adequately for sanogenic or medical purposes. More research is needed to fully understand the mechanisms and importance of this therapeutic gase. The link between balneotherapy and medical rehabilitation regarding the usage of hydrogen sulfide emphasises the unity for this medical speciality.

Bu çalışmanın inceleme alanı, Doğu Anadolu Bölgesi’nde yer alan Bitlis, Van ve Bingöl illerinde bulunan jeotermal kaynakları kapsamaktadır. Bu kaynaklar, Çukur, Nemrut, Ilıcakoy (Bitlis), Erciş, Çaldıran, Gürpınar (Van), Kös, Karlıova ve Hasköy (Bingöl) sıcak suları olup tektonik rejime bağlı olarak gelişmişlerdir. Genelde sodyumlu, kalsiyumlu-bikarbonatlı, klorürlü, sıcak sular sınıfına giren kaynak suların sıcaklıkları 33 °C ile 80 °C arasında değişir ve elektrik üretimi için uygun değildir. Yine de bu sıcak sulardan, kaplıca ve balneolojik amaçlı ve daha çok konutların ısıtılmasında kullanılan şifalı su kaynaklarıdır., This study focused on the geothermal hot springs in the Bitlis, Van, and Bingöl provinces in the Eastern Anatolia Region of Türkiye. These geothermal hot springs are Çukur, Nemrut, Ilıcakoy (Bitlis), Erciş, Çaldıran, Gürpınar (Van), Kös, Karlıova, and Hasköy (Bingöl) which are mostly dependent on regional tectonic regime. These hot waters contains sodium, calcium, bicarbonate, and chloride and their temperature ranges from 33 °C to 80°C, which are not suitable for electricity generation. Nevertheless these hot waters are sources of healing water used balneological purposes in Turkish baths and mainly for residences heating.

Balneotherapy may be a relevant treatment for chronic low back pain (LBP) in individuals > 60 years old. This pilot study aimed to determine the effectiveness of balneotherapy for chronic LBP in people > 60 years old and to determine profiles of responders with trajectory model analysis. This was a pilot prospective open cohort study, with repeated measurements using validated questionnaires; participants were their own controls. The primary endpoint was the proportion of participants with a change in pain intensity between the start of treatment and 3 months after treatment assessed with a numeric scale (NS) from 0 to 100 mm, with an effect size (ES) > 0.5. The assessments involved questionnaires that were self-administered on days (D) 1 and 21 and at months 3 and 6. The secondary objective was to determine the profile of responders to balneotherapy. We included 78 patients (69.2% women), mean age 68.3 ± 5.3 years. The mean pain score on the NS was 48.8 ± 19.9 at D1 and 39.1 ± 20.5 at 3 months (p < 0.001). The ES was 0.47 [95% confidence interval [CI] 0.25 to 0.69] for the whole sample; 36% (28/78) had an ES > 0.5; 23% (18/78) had a moderate ES (0 to 0.5); and 41% (32/78) had an ES of zero (14/78) or < 0 (18/78), corresponding to increased pain intensity. The pain trajectory model showed that the change in pain between D1 and D21 for trajectory A (larger reduction in pain intensity) was −50% [95% CI −60 to −27], and for trajectory B (smaller reduction in pain intensity), it was −13% [−33 to 0] (p < 0.001). Between Day 1 and month 3, the change for trajectory A was −33% [−54; 0] and for trajectory B was −13% [−40 to 0] (p = 0.14). Finally, between D1 and month 6, the change for trajectory A was −50% [−60 to 0] and for trajectory B was −6% [−33 to 17] (p = 0.007). The patients in trajectory A reported performing more physical activity than those in trajectory B (p = 0.04). They were also less disabled, with a mean Oswestry Disability Index of 40.4 versus 45.7 for those in trajectory A and B, respectively, (p = 0.03) and had a higher total Arthritis Self-Efficacy Scale score. This real-life study of the effectiveness of balneotherapy on chronic LBP identified distinct pain trajectories and predictive variables for responders. These criteria could be used in decision-making regarding the prescription of balneotherapy, to ensure personalized management of chronic LBP.

In our study, we aimed to investigate the effectiveness of balneotherapy and aquatic exercises in patients with postoperative chronic low back pain. Forty-three patients over the age of 18 who had been operated on for herniated disc and who had at least 6 months of back and/or leg pain were included in the study. The patients have been distributed randomly into 2 groups prior to the treatment. The program comprising aquatic exercises distributed into 5 days a week for 2 weeks and 20 min (min) a day, in a 33 °C spa pool was applied to the first group. After the first group's treatment was completed, a program consisting of walking out of the pool and strengthening and stretching exercises for the hip, abdominal, back, and waist muscles was distributed into 5 days a week for 2 weeks for a total duration of 20 min per day was applied to both groups. The patients subjected to the study were evaluated before treatment, after treatment (2nd week), and at 1st and 6th months after treatment. The Visual Analogue Scale, Modified Schober Test, Finger-to-Floor Distance, Sorensen Test, Progressive Iso-inertial Lifting Evaluation, Rolland Morris Disability Index, Leeds Disability Scale, Beck Depression Inventory, Nottingham Health Profile, and Short Form 36 Health Survey parameters were evaluated. We detected a significant improvement in all parameters except for the Sorensen test, in both groups. We observed that the changes in VAS, Sorensen, NHP, and SF 36 tests in the aquatic exercise group were significantly better than those in the non-aquatic exercise group.

BACKGROUND: Peripheral blood circulation disorder is one of the global health problems. Balneotherapy that uses CO2 springs may be one of the complementary treatment options. The device to produce artificial CO2-rich water is needed to achieve an improvement effect, at least almost like the improvement effect of natural balneotherapy. AIM: This study aims to investigate the effect of artificial CO2-rich water immersion on peripheral blood flow using Bicarbonated JesC CREA BC-2000. METHODS AND MATERIALS: Thirty-nine healthy volunteers participated in this study. Each subject immersed both of their legs in a mixed solution from water and CO2 at temperature 38°C. This solution was mixed using a device, namely, “Bicarbonated JesC CREA BC-2000”. Peripheral blood flow was measured for 5 min before immersion (in this study, we denoted it as the mean basal blood flow), 10 min during immersion, and 5 min after immersion using pocket JMS laser Doppler flowmetry MBF-IIA. Repeated analysis of variance was used for statistical analysis. RESULTS: There is the difference in peripheral blood flow among before, during, and after immersing the legs into artificial CO2-rich water using Bicarbonated JesC CREA BC-2000 (p < 0.001). CONCLUSION: Bicarbonated JesC CREA BC-2000 may be used as the device to produce an artificial CO2-rich water bath that may affect peripheral blood flow in healthy volunteers.

Voice diseases occupy the third place among all of the diagnosed occupational disorders in Poland. There still exists the necessity to implement effective and economical methods of the primary and secondary prevention of voice disorders in teachers. The aim of this study was to assess the effectiveness of comprehensive voice rehabilitation in teachers, conducted within a health resort hospital.The results of comprehensive voice rehabilitation in 100 teachers with job seniority of 10-30 years (M = 17 years), conducted during 24-day-long staying in a sanatorium, are presented in this research. Phoniatrical and laryngological examinations (maximum phonation time [MPT], perceptual assessment of voice in GRBAS scale, laryngovideostroboscopy, and acoustic analysis of voice), self-assessment of voice (theImprovements of objective acoustic parameters, a perceptual assessment of voice, and a self-assessment of VHI and MPT were observed. Phonation style changes were confirmed in the laryngovideostroboscopic examination. Phonation closure improved significantly in 30% of the examined teachers. Moreover, 97% of the participants confirmed in the questionnaire the effectiveness and purposefulness of periodic recurrence of such rehabilitation courses.The results of this research as well as the positive feedback from the participants of inpatient rehabilitation confirmed the effectiveness of occupational voice disorder rehabilitation in sanatorium (inpatient) conditions. Treatment and rehabilitation in a stationary form should aim to achieve voice improvement and job continuation. Such a procedure may contribute to reducing the financial outlays related to treatment, health leaves and occupational pensions. Med Pr. 2021;72(4):399-405.Schorzenia narządu głosu zajmują 3 miejsce wśród rozpoznawanych chorób zawodowych w Polsce. Nadal istnieje potrzeba wdrażania skutecznych i ekonomicznych metod prewencji pierwotnej i wtórnej zaburzeń głosu u nauczycieli. Celem pracy była ocena skuteczności kompleksowej rehabilitacji głosu u nauczycieli prowadzonej w warunkach szpitala uzdrowiskowego.Przedstawiono wyniki kompleksowej rehabilitacji głosu przeprowadzonej podczas 24-dniowego turnusu sanatoryjnego u 100 nauczycielek ze stażem pracy 10–30 lat (M = 17 lat). W pierwszym i ostatnim dniu turnusu wykonano badania laryngologiczne i foniatryczne [czas fonacji (Stwierdzono poprawę obiektywnych parametrów akustycznych, oceny percepcyjnej głosu, samoceny głosu VHI i MPT. Zmiany w sposobie fonacji potwierdzono w badaniu laryngowideostroboskopowym, w którym obserwowane zwarcie fonacyjne poprawiło się znamiennie u 30% badanych. W ankiecie oceniającej korzyści z sanatoryjnej rehabilitacji głosu 97% uczestników potwierdziło skuteczność i celowość okresowego powtarzania takiej rehabilitacji.Wyniki przedstawionych badań i pozytywne oceny uczestników rehabilitacji sanatoryjnej potwierdzają skuteczność sanatoryjnej terapii zawodowych zaburzeń głosu. Leczenie i rehabilitacja w formie stacjonarnej powinny zmierzać do poprawy głosu oraz kontynuacji pracy zawodowej. Tak ukierunkowane postępowanie może przyczynić się do zmniejszenia nakładów finansowych związanych z leczeniem, urlopami dla poratowania zdrowia i rentami zawodowymi. Med. Pr. 2021;72(4):399–405.

Yusuf Haji,1 Fiker Taddesse,2 Simegn Serka,3 Achamyelesh Gebretsadik1 1Hawassa University, College of Medicine and Health Science, School of Public Health, Hawassa, Ethiopia; 2Hawassa University, College of Medicine and Health Science, School of Medicine, Hawassa, Ethiopia; 3Hawassa University, College of Natural and Computational Science, Department of Chemistry, Hawassa, EthiopiaCorrespondence: Yusuf HajiSchool of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, EthiopiaEmail yusufahaji438@gmail.comBackground: Low back pain (LBP) is an important musculoskeletal condition results in clinical, social and public health problems globally. Hydrotherapy, using water and heat together can be utilized to treat conditions, relieve pain and increase muscular power and a range of joint movement in patients with chronic lower back pain. Most patients with acute LBP improve spontaneously within four weeks; however, chronic LBP is extremely common and usually mechanical in nature.Objective: The objective of the current study was to assess effect of balneotherapy in decreasing the lower back pain and its improvements among adults using a spa in southern Ethiopia.Methods: We employed a single arm cohort study and convenient sampling method to select 442 study participants from four hot springs located in Sidama Region and Gedeo Zone, Southern Ethiopia. Structured and pretested questionnaire was used and administered face-to-face by trained data collectors. Data were entered using EpiData and transferred to SPSS for cleaning and analysis. Descriptive and bivariate analyses were made.Results: A total of 427 participants were included in the study giving response rate of 96.6%. The mean (standard deviation) age of respondents was 42.55 (± 14.92) years. Perceived improvement from back pain was 332 (77.8%) with 95% confidence interval (CI) of 74– 82%. Factors showing association with perceived improvement from back pain after spa therapy were, study site being near Hawassa (Burkitu) with crude odds ratio (COR) of 3.3 and 95%CI: 1.83– 5.98 and p-value < 0.001; and sex of respondents that the odds of perceived improvements among males were about twofold compared with females, (COR: 1.7, 95%CI: 1.07– 2.74, p-value 0.025.Conclusion: Our study shows significant perceived improvement from back pain after utilization of spa water. This is associated with type of hot spring used, male sex, and having neurological symptoms. Therefore, hot spring spa water had better therapeutic effect for back pain and emphasis should be given to integrate it with modern medicine and further experimental study to be conducted to recommend it for medical purposes.Keywords: balneotherapy, chronic back pain, hot springs, Southern Ethiopia

Yusuf Haji,1 Fiker Taddesse,2 Simegn Serka,3 Achamyelesh Gebretsadik1 1Hawassa University, College of Medicine and Health Science, School of Public Health, Hawassa, Ethiopia; 2Hawassa University, College of Medicine and Health Science, School of Medicine, Hawassa, Ethiopia; 3Hawassa University, College of Natural and Computational Science, Department of Chemistry, Hawassa, EthiopiaCorrespondence: Yusuf HajiSchool of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, EthiopiaEmail yusufahaji438@gmail.comBackground: Low back pain (LBP) is an important musculoskeletal condition results in clinical, social and public health problems globally. Hydrotherapy, using water and heat together can be utilized to treat conditions, relieve pain and increase muscular power and a range of joint movement in patients with chronic lower back pain. Most patients with acute LBP improve spontaneously within four weeks; however, chronic LBP is extremely common and usually mechanical in nature.Objective: The objective of the current study was to assess effect of balneotherapy in decreasing the lower back pain and its improvements among adults using a spa in southern Ethiopia.Methods: We employed a single arm cohort study and convenient sampling method to select 442 study participants from four hot springs located in Sidama Region and Gedeo Zone, Southern Ethiopia. Structured and pretested questionnaire was used and administered face-to-face by trained data collectors. Data were entered using EpiData and transferred to SPSS for cleaning and analysis. Descriptive and bivariate analyses were made.Results: A total of 427 participants were included in the study giving response rate of 96.6%. The mean (standard deviation) age of respondents was 42.55 (± 14.92) years. Perceived improvement from back pain was 332 (77.8%) with 95% confidence interval (CI) of 74– 82%. Factors showing association with perceived improvement from back pain after spa therapy were, study site being near Hawassa (Burkitu) with crude odds ratio (COR) of 3.3 and 95%CI: 1.83– 5.98 and p-value < 0.001; and sex of respondents that the odds of perceived improvements among males were about twofold compared with females, (COR: 1.7, 95%CI: 1.07– 2.74, p-value 0.025.Conclusion: Our study shows significant perceived improvement from back pain after utilization of spa water. This is associated with type of hot spring used, male sex, and having neurological symptoms. Therefore, hot spring spa water had better therapeutic effect for back pain and emphasis should be given to integrate it with modern medicine and further experimental study to be conducted to recommend it for medical purposes.Keywords: balneotherapy, chronic back pain, hot springs, Southern Ethiopia

Purpose The aim of our research was to study the effect of radon hormesis balneotherapy using natural thermal waters of Tskaltubo spring, practically, its effect on oxidant and antioxidant systems and anxiety reactions in rats. Radon is a natural gas with radioactive properties, which can have a hermetic effect when used in small doses. Radon was used to activate antioxidant mechanisms in rats, which resulted an anxiolytic effect and positively enhanced the effect of balneotherapy. Materials and methods To study the effect of radon in balneotherapy, groups of experimental animals (rats) were exposed to three different treatments. The radon-containing waters of Tskaltubo spring were inhaled in one group and 5 after taking the water in another group. Saline was used for inhalation in animals of the saline group. In animals of the control and sham control groups, inhalation was not used. To assess the anxiolytic effect of radon inhalation, the anxiety was induced and behavioral tests were performed (the open field and the elevated plus-maze test) after 24 h and 5 days of inhalation procedures. Results The anxiety test results showed that exposure to low doses of radon led to a decrease in the level of anxiety in rats. The data show that the total distance traveled by rats in the open field test after inhalation of radon was significantly greater than that by animals in the sham control and control groups. During the open field and elevated plus-maze tests, rats that had inhaled radon spent more time in the central part of the open field and on the open arms of the maze than did the other groups of rats. In the group of rats that had not inhaled radon, an increase in anxiety was observed. The basis of this reaction was an increase in the glutathione concentration. Conclusion Based on our research, it can be concluded that the inhalation of small doses of radon, associated with treatments of waters from the Tskaltubo spring, activated the antioxidant systems of the body and enhanced the positive effect of balneotherapy. Clinically, this is expressed as a decrease in anxiety. Inhalation of small doses of radon activated antioxidant processes in the brain, causing an increase in glutathione/glutathione disulfide ratio in the brain.

Today, one of the most common non-communicable diseases, which, according the World Health Organization experts, dominates the structure of human morbidity and mortality is osteoporosis. The aim of this study was to determine the effect of water from the hot springs of the Afyonkarahisar region on the calcium content and the levels of certain hormones in the blood of rats with experimentally induced osteoporosis. 25 female albino rats of the same age were used in the experiment. Ovaries were removed from all animals under anesthesia with ketamine (200 mg/kg) and xylazine (10 mg/kg), after which they were divided into two groups: control (10 animals) and experimental (15 animals). The animals of the control group were given tap water twice a day through an orogastric tube and they were bathed in it for 15 minutes at the same time, the water temperature was (35 ± 2) °C. The animals of the experimental group were given fresh water from the Süreyya I hot spring using the same method. Blood clinical, hematological and biochemical parameters were measured prior to the study, as well as on day 1, 7, 14, and 21 after the ovariectomy operation. The ovariectomy demonstrated inconsistence of the tested blood parameters with the standard ones. In the course of the treatment, by day 21 of the experiment, the parameters normalized, and the most noticeable changes were observed in the rats of the experimental group (p < 0.05). The results of the work performed showed that Süreyya I hot spring water contributed to a significant improvement in the clinical, hematological and biochemical blood parameters in rats with osteoporosis, therefore, it can be used for prevention and treatment of this disease in combination with other types of treatment.

Background. We have previously shown that nitrogenous metabolites have immunomodulatory effects in healthy rats and humans as well as in patients with encephalopatia. The purpose of this study is their immunotropic activity in patients with chronic pyelonephritis. Materials and Methods. The object of observation were 24 men (aged 23-76 years) with chronic pyelonephritis in remission. The plasma levels and urinary excretion of uric acid, urea and creatinine and parameters of immunity twice (on admission and after 10 days of balneotherapy at the Truskavets’ Spa) was performed. Results. Judging by the multiple correlation coefficient uricemia exhibits maximal immunotropic activity (R=0,772), followed by creatininemia (R=0,643), urea plasma (R=0,584) and creatinineuria (R=0,506) instead, urea and uric acid excretion correlate with immune parameters insignificantly (R=0,327 and 0,262 respectively). Nitrogenous metabolites together upregulate most parameters of phagocytosis by neutrophils Staph. aureus and E. coli, the level in the blood of CD8 T-lymphocytes, CIC, IgM, componentes of leukocytogram as well as entropy of leukocytogram and immunocytogram. Instead, they downregulate the relative level of lymphocytes in general and of CD4 T-lymphocytes in particular. Conclusion. Nitrogenous metabolites exhibit immunotropic activity in both healthy humans and in patients with chronic pyelonephritis in remission. Both common and distinctive features of immunomodulation were revealed.

Italian and Japanese public widely use balneotherapy. The population interest in balneotherapy in coronavirus disease-2019 (COVID-19) era should be investigated. Therefore, we aimed to exploit Google Trends analysis, as a measure of peoples’ interest in balneotherapy, in two countries, Italy and Japan. In this infodemiology study, Google Trends was queried for the lay terms widely used by the Italian population to refer to the balneotherapy setting (terme + termale) and by the Japanese to refer to the bathing place and balneotherapy facilities (温泉 + スパ). The internet searches in 2020 were compared to overlapping time spans in 2016–2019 and were correlated with new confirmed cases/deaths. This study demonstrated that from February 23 to June 20, 2020, and from October 4 to December 26, 2020, the internet searches of the Italian words corresponding to balneotherapy were statistically significantly decreased; however, the internet searches were not significantly different in June 21 to October 3, 2020, compared to overlapping time spans in 2016–2019 in Italy. The study also showed that from March 15 to September 5, 2020, and from November 29 to December 26, 2020, the internet searches of the Japanese words corresponding to balneotherapy were statistically significantly decreased; however, the internet searches were significantly increased in September 13 to November 7, 2020, and were not significantly different in November 8 to 28, 2020, compared to overlapping time spans in 2016–2019 in Japan. There were significant negative correlations between the relative search volume and number of new cases (rho=−0.634; p

Background. The medical relevance of therapeutic gases can range from use in burns and stroke victims to hypoxia therapy in children. However, medical gases such as oxygen, hydrogen, helium and xenon have recently come under increased exploration for their potential therapeutic use on various brain disease states, including traumatic brain injuries, hypoxia-ischemia and, cerebral hemorrhages. Objective. This synthetic review aims to rigorously select related articles and identify within their content the main possible uses of therapeutic gases and physiological mechanisms. The objective of this article is to present the various therapeutic mechanisms that have been proposed in the current literature and the medical relevance of various therapeutic gases used in balneotherapy or medical rehabilitation. Methods. To elaborate our synthesis review, we have searched for relevant open access articles in 6 international databases: Cochrane, Elsevier, NCBI/PubMed, NCBI/PMC, PEDro, and ISI Web of Knowledge/Science, published from January 2011 until December 2020. The contextually quested keywords combinations/ syntaxes used specified on this page. The eligible articles were analyzed in detail regarding pathologies addressed by therapeutic gases. All articles with any design (reviews, randomized controlled trials, non-randomized controlled trials, case-control studies, cross-sectional studies), if eligible according to the above-mentioned selection methodology, containing in the title or abstract the above-mentioned combinations, were included in the analysis. Articles were excluded in the second phase if they did not reach the relevance criterion. Results. Our search identified, first, 225 articles. After eliminating the duplicates, remained 180 articles. In the second phase, we applied a relevance criterion. Although our team - including the authors of this paper – have quite long and consistent expertise in achieving systematic literature reviews, the marked heterogeneity of both the item composing the subject we have approached and inherently the wase of presentations in the respective quite vast and diverse domain of medical gases, prevented us to fulfil, at least regarding this initial work, a systematic literature review. Instead, we succeeded to make a hopefully interesting and valuable narrative synthetic-related literature review. At the end of the second phase, 63 articles passed the relevance criterion and were included in this synthetic review. Conclusions. Therapeutic gases are not fully understood and used adequately for sanogenic or medical purposes. More research is needed to fully understand the mechanisms and importance of therapeutic gases. The link between balneotherapy and medical rehabilitation regarding the usage of therapeutical gases emphasises the unity for this medical speciality. Keywords: "Therapeutic gas"/ "Oxygen therapy"/ "Carbon dioxide"/ "CO2 therapy"/ "Carbon monoxide"/ "Mofette"/ "Hydrogen Sulfide"/ "H2S"/ "Helium"/ "Xenon"/ "Ozone therapy"/ "Radon"/ "Hydrogen therapy"/ "Nitric oxide"/ "Heliox" AND "Rehabilitation".

Introduction: The Autism Spectrum Disorders (ASD) are a neurodevelopmental disorder. This disorder is characterised by a symptomatic dyad described in the summary of the recommendations for good practice of the French Health High Authority. It is the observation of "persistent deficits in communication and social interaction observed in various contexts" and moreover of "restricted and repetitive characteristics of behaviours, interests or activities»[1]. In addition, these children suffer from many associated signs such as sleep disorders, anxiety and depression, gastrointestinal disorders and many others. The objective of this review is to evaluate the interest of physiotherapy and in particular group physical activities and balneotherapy have on improving the quality of life and social skills of children with ASD assessed by the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).Research methodology: Population : children between 6 and 18 years with autism spectrum disorder assessed by the DSM-V. Intervention: physical activity intervention in team sports and balneotherapy. Control group : children with the above eligibility criteria but not performing the intervention. Outcomes : quality of life (sleep, anxiety, emotionality); social skills (communication and social behaviour). In order to pool the eligible studies 4 databases were used and two search equations were formulated. As a result, it was possible to identify 5 eligible studies that answered our research question. Their quality and risk of bias were analysed using the Pedro scale.Results and Analysis: The results were heterogeneous for both the quality of life and social skills outcomes. This was due to the variability of the interventions in the included studies. However, we were able to demonstrate significant improvements in sleep quality, anxiety and social behaviour, whether through team sports or balneotherapy.Discussion: Despite the presence of significant results, further studies should be conducted with a more rigorous methodology to more reliably analyse the effectiveness of these interventions on the quality of life and social skills of children with ASD.; Introduction : les troubles du spectre de l’autisme (TSA) font partie des troubles du neuro-développement. Ce trouble est caractérisé par une dyade symptomatique relatée dans la synthèse des recommandations de bonne pratique de la Haute Autorité de Santé. Il s’agit de l’observation de « déficits persistants de la communication et des interactions sociales observés dans des contextes variés » et de plus de « caractères restreints et répétitifs des comportements, des intérêts ou des activités » [1]. De plus, les enfants souffrant de TSA présentent de nombreux signes associés comme des troubles du sommeil, des problèmes d’anxiété et de dépression, des troubles gastro-intestinaux et bien d’autres encore. C’est pour cela que dans cette revue nous voulons évaluer l’intérêt de la prise en charge kinésithérapique et en particulier les activités physiques de groupe et la balnéothérapie dans l’amélioration de la qualité de vie et des habiletés sociales des enfants atteints de TSA évalués par la dernière édition du manuel diagnostic et statistique des troubles mentaux, la DSM-V.Méthodologie de recherche : population : enfants entre 6 et 18 ans souffrant de Troubles du Spectre de l’Autisme ayant été évalués par la DSM-V. Intervention : activité physique en sports collectifs et balnéothérapie. Comparateur : enfants présentant les critères d’éligibilité cités au-dessus mais n’effectuant pas l’intervention). Critères de jugement : la qualité de vie (sommeil, anxiété, émotivité) ; les habiletés sociales (communications et comportements sociaux). Afin de regrouper les études éligibles 4 bases de données ont été utilisées et deux équations de recherches ont été formulées. Grâce à cela nous avons pu récolter 5 études éligibles répondant à notre question de recherche. Leurs qualités ainsi que leurs risques de biais ont été analysés par l’échelle Pedro.Résultats et Analyse : les résultats se sont avérés hétérogènes aussi bien pour le critère de jugement qualité de vie que celui des habiletés sociales. Cela étant dû notamment à la variabilité des interventions menées dans les études incluses. Nous avons pu cependant démontrer des améliorations significatives dans la qualité du sommeil, l’anxiété ou encore les comportements sociaux, que ce soit par la pratique de sports collectifs ou la balnéothérapie. Discussion : malgré la présence de résultats significatifs, d’autres études devraient être menées avec une méthodologie plus rigoureuse afin d’analyser de façon plus fiable l’efficacité de ces interventions sur la qualité de vie et les habiletés sociales des enfants atteints de TSA.

The effects of hydrogen sulfide baths and sulfide-silt mud applications on the abdominal wall were studied in outbred white rats. Heart preparations stained with hematoxylin and eosin were analyzed and the mean numbers of cells expressing Ki-67, Nkx-2.5, and mesenchymal stem cell markers were determined. Hydrogen sulfide balneotherapy promoted the development of blood capillaries in rat hearts and an increased the expression of CD34. A decrease in the regenerative potential of the myocardium was found due to a decrease in the content of proliferating cells and cells expressing CD73, CD90, and CD105, and also due to the absence of cells stained for cardiomyogenic differentiation marker Nkx-2.5.

The effects of bath therapy are complex and result from a unique interaction between the aquatic environment and the human body functions. The effect of bath therapy depends on both water temperature and chemical additives (mineral substances and humic substances). Värska Resort Centre, in south-eastern Estonia, uses for the balneotherapy the local curative mud and mineral water. The aim of the study was to evaluate and compare the effects of Värska's local mud bath and mineral water bath on moderate musculoskeletal pains in working-age people. The study involved 64 working-age subjects: within two weeks, 32 of them received five general mineral water baths, and another 32 received five general curative mud baths. Pain was assessed with the Nordic Musculosceletal Questionnaire, and muscle tension was measured with a myotonometer in m. erector spinae and m. trapezius. Measurements were performed three times: before the start of the study, immediately after the last procedure, and 2-3 weeks after the last procedure. Both the Värska curative mud bath and the Värska mineral water bath showed a positive effect on musculoskeletal pain and muscle tension. Both procedures can be recommended as drug-free interventions for mild to moderate musculoskeletal pain syndrome and muscle tensions, in both prevention and treatment.

This study aimed to investigate the effects of balneological outpatient treatment (hydrotherapy and peloidotherapy) on clinical status and serum cytokine levels in patients with chronic low back pain (CLBP). Seventy-four patients with CLBP who accepted to participate to the study were randomly divided into two groups. The study group was given ten sessions (in 2 weeks) of hydrotherapy, peloidotherapy, and home exercise, while the control group was given only home exercise. All patients were assessed before and at the end of therapy, at the 1st and 3rd months. The primary outcomes were pain intensity on the visual analog scale (VAS) (VAS-pain, VAS-rest, VAS-exercise) and Oswestry Disability Index (ODI). The secondary outcome measures included patient's and physician's global assessment (VAS-PGA), (VAS-DGA), finger-to-floor distance (FFD), modified Schober test, Short Form-36 (SF-36), and the use of analgesic drug. Venous blood samples were drawn from all patients before/1st day and after therapy/12th day to measure serum interleukin (IL)-6 and IL-10 levels. Significant improvement was observed in the study group in VAS-pain, VAS-rest, VAS-exercise, VAS-PGA, VAS-DGA, ODI, and SF-36 parameters after treatment and improvement maintained for 3 months. In the control group, significant improvement was observed in VAS-pain, VAS-exercise, VAS-PGA, VAS-DGA, and ODI scores on the 12th day and continued for 3 months. Decrease in pain, pain during rest and exercise, modified Schober test, VAS-PGA, VAS-DGA, ODI scores, and the increase in SF-36 pain and general health scores showed superiority in favor of the study group in all evaluations. There was a significant increase in IL-10 values from baseline at the end of treatment in the study group. The use of non-steroidal anti-inflammatory drug (NSAID) was significantly lower in the study group compared with the use of NSAID in the control group in the 3rd month. Balneological outpatient treatment improved clinical status in CLBP patients. Although no significant correlation was clearly determined between IL-10 levels and pain score, this effect might be related to the observed increase in the anti-inflammatory cytokine IL-10 levels that was observed only in the study group.

Background. Earlier, we found the multivariant nature of the Popovych’s step test change in children after a course of adaptogenic balneotherapy. In particular, the step test improved in 53,7% of children, remained unchanged in 28,8%, and worsened in 17,5%. The purpose of this study is to identify predictors that allow us to forecast each variation of the step test. Material and methods. Object of observation was 80 children of both sexes, ages 10-17, arriving at the clinical sanatorium "Dzherelo" of Truskavets’ spa from radionuclide contaminated territories. The main parameter of the study was the Popovych’s step test. State of autonomous nervous, endocrine and immune systems was assessed as well as others functional and metabolic tests. Results. Discriminant analysis was subsequently applied to identify constellations of parameters-predictors of each variant of change in step test. The program selected 16 initial parameters as predictors (primarily level of step test, next sex, body mass and temperature, levels of Gench’s and Teslenko’s tests, vagal tone, erythrocytes sedimentation rate, trombocytes level as well as 7 immune parameters). The correctly of forecasting of the positive actotropic effect is 90,7%; of neutral is 78,3%; of negative is 92,9%, and total correctness is 87,5%. Conclusion. Balneotherapy causes multivariate changes in Popopvych’s step test, which determined by constellation of 16 initial parameters.

Hot springs bathing is a $56 billion commercial industry worldwide, and systematic reviews suggest hot springs bathing (balneotherapy – BT) has a positive impact on chronic pain and musculoskeletal...

Winter swimming is a complex procedure that simultaneously includes the effects of cold, water itself, physical activity, and the climate factor. All these elements are used in thermal medicine in a milder form. They also have a lot in common with Kneipp hardening therapy. In winter swimming, belonging to extreme sports, extremely strong stimuli act simultaneously. Winter swimming positively affects the cardiorespiratory system, complete blood count, musculoskeletal system, endocrine system, immune system, the skin, metabolic processes, and the mental sphere. Empirically, many beneficial effects of winter swimming have been discovered, but there is very little scientific research showing this procedure’s mechanisms of action. Hence, they are often based on hypotheses. The mechanisms of action of winter swimming on complete blood count and the organism’s oxidative processes are best explained. However, the explanation of the mechanisms of action is mostly based on research conducted in cryotherapy. To obtain beneficial health effects, it is necessary to prepare properly for winter swimming and comply with the entire process’s rules, from preparation, through the treatment itself, to behavior after the procedure. In recent years, handbooks and guides have appeared in Poland that contain practical tips on the winter swimming procedure.

The aim of this study was to determine the efficacy of Afyokarahisar termomineral water in the treatment of nephritis. For this purpose, 40 Albino mouse at the same daily age were used. Nephritis was induced by adding adenine to their feed at a rate of 0.2% for 6 weeks. After nephritis was induced, a 21-day treatment period was started, and the mice were equally divided into two groups as control and study. While control group mice were received tap water daily and bathing in tap water, study group animals were given fresh Süreyya I hot spring water daily and bathing in this water. Clinical, hematological, blood biochemical and histopathological examinations were performed before the study, after nephritis formation, and on days of 1st, 7th, 14th and 21st of treatment period. Results of this study showed that WBC, NEUT and MCV levels increased significantly (p < 0.05) following nephritis formation, while RBC, HB, HCT, LYM, MCH and MCHC levels decreased significantly (p < 0.05). It was also determined that AST, GGT, GLU, BUN and IgG levels of blood biochemical parameters were significantly increased (p < 0.05) and TP, ALB levels decreased significantly (p < 0.05) after nephritis formation. At the end of the study, it was seen that all the measured parameters turned to the normal range in the study group animals, whereas problems still continuing with control group animals. Consequently, it was concluded that Süreyya I hot spring water was very successful in the treatment of nephritis and considered as an option in the treatment of nephritis.

Background/Aim: To develop and validate an easy-to-use and cheap method capable of producing placebo from tap water for medicinal water efficacy trials. Patients and Methods: Patients were divided into two groups, medicinal water and tap water group. A single 20-minute-long treatment was performed in bathtubs. Patients were asked four times during the bath to tell if they were treated with medicinal water, tap water, or could not decide. Patients were scored, one point was given for each correct answer. Results: A total of 174 patients were enrolled. No significant differences were found either between the average scores or the answers of the two groups. Being familiar with the Harkány medicinal water did not influence the rate of correct answers either. There was no statistically significant difference in the number of changes of opinions between the two groups. Conclusion: The used method is appropriate for producing a validated placebo from tap water.

Amaç: Bu çalışmada, balneoterapinin, ankilozan spondilitli hastalarda hastalık aktivitesi, ağrı, yaşam kalitesine ve inflamasyona etkisini araştırmak.Gereç ve Yöntem: Bu çalışma prospektif, kontrollü, tek kör bir çalışma olarak planlandı. Toplam 60 hasta iki gruba ayrıldı. I. gruptaki hastalara balneoterapi uygulandı. Kontrol grubuna ek bir tedavi uygulanmadı. Tüm hastalar günlük rutin yaşam tarzlarına ve farmakolojik tedavilerine devam etti. Hastalar tedavinin başlangıcında ve tedavinin sonunda (21. gün) Ağrı VAS, Hasta Global VAS, BASFI, BASDAI, ASQoL, WBC, ESR ve CRP ile değerlendirildi.Bulgular: Her iki grupta da; tedavi öncesine göre tedavi sonunda BASFI de, balneoterapi grubunda ağrı (VAS), hastanın global değerlendirmesi (VAS), ASQoL ve BASDAIde istatistiksel olarak anlamlı iyileşme tespit edildi.Gruplar arası karşılaştırmada tedavi öncesi verilerde ağrı (VAS), hastanın global değerlendirmesi (VAS), BASFI ve BASDAI de istatistiksel olarak anlamlı fark varken, tedavi sonrası iki grup arasında ağrı (VAS) hariç diğer verilerde istatistiksel anlamlı fark yoktu.Fark skorları karşılaştırıldığında ise ağrı (VAS), hastanın global değerlendirmesi (VAS), ASQoL, BASFI ve BASDAIde istatistiksel olarak anlamlı değişim varken WBC, ESR ve CRP arasında istatistiksel olarak anlamlı fark saptanmadı.Sonuç: Ankilozan Spondilitli hastalarda balneoterapi iyi tolere edilebilir ve uygun hastalarda farmakolojik tedaviler ile birlikte uygulanması tedavinin yararlı etkilerini artırabilir., Objective: This study aimed to investigate whether balneotherapy triggers inflammation and improves the disease activity, pain and quality of life in patients with ankylosing spondylitis Materials and Method: This study was planned as a prospective, controlled, single-blind study. A total of 60 patients were divided into two groups. Group I was treated balneotherapy. No additional treatment was applied to the control group. All the patients continued their daily routine lifestyles and pharmacological treatments. Assessments were made using the Pain VAS, Patient Global VAS, BASFI, BASDAI, ASQoL, WBC, ESR and CRP at the beginning of treatment and at the end of treatment (day 21).Results: Compared to the pre-treatment period, there was a statistically significant improvement in both groups’ pain at the end of the treatment in BASFI, in the Balneotherapy group (VAS), in the patient’s global assessment (VAS), in ASQoL and BASDAI. A comparison between groups before treatment revealed that there was a statistically significant difference in terms of pain (VAS), patient’s global assessment (VAS), BASFI and BASDAI whereas, after treatment, there was no statistically significant difference in the data except pain (VAS).A comparison of difference scores revealed that there was a statistically significant change in pain (VAS), patient’s global assessment (VAS), ASQoL, BASFI and BASDAI whereas there was no statistically significant difference between WBC, ESR and CRP.Conclusion: Balneotherapy is well tolerated and balneotherapy combined with pharmacological treatment may improve the beneficial effects of treatment in ankylosing spondylitis patients.

Tarih boyunca insanlar kaynak sularından dini arınma, dinlenme, temizlik ve tedavi gibi çeşitli şekillerde yararlanmışlardır. Kaynak suları ile tedavi eski bir sanat olup, muhtemelen en eski tıbbi işlemlerden biridir. Antikçağ’da güce dayalı yaşam mücadelesi ve ağır şartlar sebebi ile kas iskelet sisteminin aşırı kullanımına bağlı olarak ortaya çıkan hastalıklar oldukça sık görülmektedir. Günümüzde de teknolojinin gelişmesi, hareketsiz ve sedanter yaşam, beraberinde kas iskelet rahatsızlıklarını ön plana çıkarmıştır. Bu bağlamda hem antikçağ hem de modern çağda kas iskelet hastalıklarının tedavisi önem kazanmakta ve kaynak suları ile tedavi şaşırtıcı derecede benzer yöntemler içermekte olup, günümüzde hala önemini korumaktadır. Materyal olarak; 1995-2019 yılları Arkeometri Sonuçları taranarak, iskeletlerde görülen patolojik rahatsızlıkların büyük çoğunluğunun kas iskelet sistemi hastalıkları olduğu tespit edilmiştir. Antikçağ tıbbında Celsus başta olmak üzere, Hippokrates, Plinius The Elder, Soranus, Suetonius, Vitruvius, Strabon, Herodotos ve Homeros gibi antik yazarların aktardığı bilgiler, arkeolojik veriler ve modern tıp literatürü kullanılmıştır. Bu makalede ana amaç; Antikçağ’da kas iskelet sistemi hastalıklarının tedavisinde kaynak sularının kullanımı ve tedavi yaklaşımlarının günümüz modern tıp uygulamaları ile benzerliklerini saptamaya çalışmaktır. Günümüzde yaşam kalitesini daha da arttırmak için uygulanan yeniliklerin birçoğunun kökeninin tarih öncesi dönemlere kadar dayandığı düşüncesi, çalışmanın önemine dair kayda değer bir ayrıntıdır.

The region of Ouargla in the south-east of Algeria has many thermal hot springs that are still largely untapped. The aim of this pilot study is to assess the contribution of balneotherapy in the functional improvement of low back pain patients. Methods: This study concerned non-specific chronic low back pain patients treated at the balneotherapy and rehabilitation center in Ouargla, Algeria. The sample was divided into two groups for comparative purposes: the first one is the intervention group (A) receiving physical therapy combined with balneotherapy, and the second is the control group (B) receiving physical therapy alone. The response was assessed using the Oswestry Disability Index (ODI) in its Arabic version. The questionnaire was given at the beginning and end of treatment. An improvement in Oswestry is considered clinically relevant if it is above 30 %. The sensitivity to changes is estimated by the standardized response mean and effect size. Results: Ten patients meeting the eligibility criteria were split equally into the two groups. We observed that 60 % (3/5) patients had a clinically relevant improvement in Oswestry in group (A) versus 20 % (1/5) patient in group (B). The effect size for group (A) and group (B) is 1.20 and 0.71, respectively. The standardized response mean is 1.13 for group (A) versus 1.01 for group (B). Conclusion: The results of the present study reiterate that in addition to conventional rehabilitation, balneotherapy can be more effective in the treatment of patients suffering from non-specific chronic low back pain.

Chronic venous disorders (CVD) of the lower limbs can be treated with different strategies. Typically, conservative management is based on compression therapy, anticoagulants and venoactive drugs. Endovenous treatments remain the gold standard to treat saphenous insufficiency, with sclerotherapy and surgery maintaining a role in selected cases. In addition, several ‘unconventional’ approaches have been proposed to prevent CVD progression and complications, minimize symptoms and improve the quality of life and postoperative outcomes. Among these, balneotherapy and aquatic exercises are proving as valid and effective supporting treatments, as mentioned in a growing number of scientific publications. Moreover, aquatic protocols have been studied for both venous and lymphatic insufficiency. For these reasons, they were mentioned in the last CVD guidelines provided by the European Society for Vascular Surgery. The aim of this narrative review is to overview and summarize current literature evidences on the role and effectiveness of aquatic rehabilitative protocols in CVD, reviewing old and current literature. Furthermore, the physical basis of the effects of water immersion on lower limb venous and tissues modifications are also described.

Prirodni ljekoviti činitelji su dijelovi prirode koji imaju ljekovita svojstva. U Hrvatskoj su vrlo rasprostranjeni, međutim njihova iskoristivost je vrlo mala. Prirodne ljekovite činitelje možemo podijeliti u 3 skupine: klimatske, morske i toplične(balneološke). Jedno od najvećih prirodnih ljekovitih činitelja u Hrvatskoj je more i sve vezano uz njega(klima, biljni pokrov, alge i sl.) dok se najveći broj lječilišta smjestio u kontinentalnoj Hrvatskoj. Razlog tomu je tlo koje je vrlo bogato mineralima. Hidroterapija i balneoterapija konzervativne su metode liječenja koje imaju vrlo široku primjenu kod raznih bolesti od kojih su neke: reumatske, neurološke, dermatološke, itd. i vrlo često se primjenjuju u kombinaciji s drugim fizikalnim metodama kao što je npr. kineziterapija. Njihov učinak pripisuje se fizikalnim svojstvima vode i ljekovitim svojstvima minerala koji djeluju protuupalno, smanjuju bolnost, ukočenost mišića, potiču cirkulaciju, a samim time osoba se i psihički bolje osjeća. Neka od lječilišta koja su se smjestila u kontinentalnom dijelu Hrvatske su i Krapinske, Daruvarske Toplice te Lječilište Topusko. Navedena lječilišta imaju vrlo dugu povijest, veliki izbor fizikalnih metoda, ali i bogatstvo mineralima. Kako bi Hrvatska maksimalno iskoristila svoja prirodna dobra potrebna su daljnja ulaganja u modernizaciju cjelokupnog zdravstvenog turizma. Općenito, prirodni ljekoviti činitelji i njihova primjena još su nedovoljno istraženi, ali većina istraživanja prikazuje njihove pozitivne učinke na cjelokupni ljudski organizam., Natural healing factors are part of the nature that have healing properties. In Croatia they are very widespread, but their usability is very low. Natural healing factors can be divided into 3 groups: climatic, marine and thermal(balneological). One of the biggest natural healing factor in Croatia is the sea and everything related to it(climate, vegetation, algae, etc.), while most spas are located in the continental part of Croatia. The reason for that is the soil which is very rich in minerals. Hydrotherapy and balneotherapy are conservative therapy methods that have a very wide application in various diseases, some of which are: rheumatic, neurological, dermatological, etc. and are very often use din combination with other methods of physical therapy such as kinesitherapy. Their effect is attributed to the physical properties of water and the healing properties of minerals that have anti-inflammatory effects, reduce pain and muscle stiffness, stimulate circulation and thereby the person feels better mentally. Some of the health resorts located in the continental part of Croatia are Krapinske, Daruvar and Topusko spas. These spas have a very long history,large selection of physical therapy methods, but are also wealthy in minerals. In order for Croatia to make the most of its natural resources, further investments in modernization of entire health tourism are needed. In general, natural healing factors and their application are still insufficiently researched, but most research shows their positive effects on the entire human body.

Urolithiasis is a multifactorial metabolic disease caused by the interaction of genetic, environmental factors and is directly related to lifestyle. Multiple factors influencing the initiation of stone formation and the growth of urinary crystals are presented in the article. Based on the available data, an involvement of various specialists, including urologists, geneticists, physician office laboratory, radiation diagnostics specialists, nutritionists, endocrinologists, immunologists, physiotherapy and balneotherapy specialists, general practitioner, is necessary for effective treatment of patients with kidney stones.

In this article, based on brief information from Arab sources, as well as the achievements of hydrotherapy and balneology, the author attempts to analyze the practice of hydrotherapy in one of the regions of the Golden Horde, in the current Caucasian Mineralnye Wody, which was a health resort in the Golden Horde’s period. The purpose of this article is to characterize the practice of hydrotherapy in the region of Caucasian Mineralnye Wody by representatives of the Golden Horde elite. The research methodology is based on the historical-comparative method, the method of retrospective analysis, applied on the basis of an interdisciplinary approach, based on the achievements of modern scientific knowledge in physiotherapy, balneology, Spa treatment. Analysis of Ibn Battuta's brief reports suggests that water treatment was practiced in the Golden Horde, and the healing properties of the mineral waters of the North Caucasus were actively used. Hydrotherapy procedures were carried out in accordance with certain standards that could be developed both empirically and theoretically based on the works of famous doctors. In the Golden Horde were not only known, but also actively practiced water procedures for the treatment of various diseases, and it is possible that they were more common than was generally believed. In every region of the Golden Horde was its healing and mineral water sources, and each nation had its own ideas about water, health and healthy lifestyle, which determined the special techniques of hydrotherapy, but due to various objective factors, hydro- and balneotherapy found its greatest spread in the region of Caucasian Mineralnye Wody.

This study assessed the additional contribution of balneotherapy on physical therapy in subacute supraspinatus tendinopathy. Ninety patients with subacute supraspinatus tendinopathy were included. They were randomized into two equal groups. In group 1 (n = 45), transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound treatments, and Codman’s and range of motion (ROM) exercises were performed. In group 2 (n = 45), balneotherapy was added to the treatment program. In both groups, shoulder active ROM and handgrip strength were measured. Pain was evaluated using a Visual Analogue Scale (VAS) (rest, sleep, movement); functional assessment and quality of life were measured respectively with the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), and the Short Form-36 health survey (SF 36) form. All measurements were repeated before and after 15 treatment sessions. There were statistically significant differences between the before and after assessment parameters in group 1 (all p < 0.05), but not for SF-36 General Health Perceptions, SF-36 Mental Health sub-parameters, and handgrip strengths. However, there were statistically significant differences between all the evaluation before and after the treatment in group 2 (all p < 0.05). When the two groups were compared in terms of alpha gains, statistically significant differences were observed in favor of group 2 in all measurements (all p < 0.05) except for SF-36 Emotional Role Difficulty and SF-36 Mental Health sub-parameters. This study shows that the addition of balneotherapy to physical therapy for subacute supraspinatus tendinopathy can make additional contributions to shoulder ROM, pain, handgrip strength, functional status, and quality of life.

Objectives To identify literature reporting on thermal mineral water and mud therapy effectiveness on pain, stiffness and knee function in patients with knee osteoarthritis. Design Systematic evidence scan of MEDLINE and PubMed was performed to identify the randomized controlled trial studies published from 2004 to December 2018. Study selection Papers reporting the effect of balneotherapy and mud therapy for treating knee OA, a duration of ≥2 weeks and in which Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as an outcome measure. Data extraction Not RCT, Studies not in English. Results A quantitative meta-analysis of ten studies (831 patients) was performed. Five clinical studies (407 patients) measured effectiveness of balneotherapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of balneotherapy. Six clinical studies (500 patients) measured effectiveness of mud therapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of mud therapy. Conclusion This meta-analysis indicates that balneotherapy and mud therapy were clinically effective in relieving pain, stiffness, and improving function, as assessed by WOMAC score. Ziel Systematische Literaturrecherche zur Effizienz von Balneotherapie und Peloidtherapie hinsichtlich Schmerzen, Steifheit und Kniefunktion bei Patienten mit Kniearthrose. Design Systematische Datenabfrage in MEDLINE und PubMed zur Identifizierung randomisierter kontrollierter Studien, die zwischen 2004 und Dezember 2018 publiziert wurden. Einschlusskriterien Artikel uber die Auswirkungen von Balneotherapie und Peloidtherapie auf die Behandlung von Kniearthrose bei einer Behandlungsdauer von > 2 Wochen unter Verwendung der WOMAC-Arthroseindizes der Universitaten Western Ontario und McMaster. Ausschlusskriterien Keine kontrollierten klinischen Studien, Studien nicht in englischer Sprache vorliegend. Ergebnis Es wurde eine Metaanalyse von zehn Studien (831 Patienten) durchgefuhrt. In funf klinischen Studien (407 Patienten) wurde die Wirksamkeit der Balneotherapie beurteilt. Es fand sich ein signifikanter Unterschied zwischen den Gruppen hinsichtlich der WOMAC-Scores zu Schmerzen, Steifheit und Funktion zugunsten der Balneotherapie. In sechs klinischen Studien (500 Patienten) wurde die Wirksamkeit der Peloidtherapie beurteilt. Hier zeigte sich ein signifikanter Unterschied zwischen den Gruppen hinsichtlich der WOMAC-Scores zu Schmerzen, Steifheit und Funktion zugunsten der Peloidtherapie. Schlussfolgerungen Diese Metaanalyse zeigt die klinische Wirksamkeit von Balneotherapie und Peloidtherapie bei der Reduktion von Schmerzen und Steifheit und der Verbesserung der Funktion, beurteilt anhand der WOMAC-Scores.

BACKGROUND: Psoriasis is a common disease, and many of its forms are resistant to treatment. AIM: This study aimed to analyze the effects of complex treatment with Lake Saki sulfide peloids on the clinical and immunological parameters patients with psoriasis. MATERIALS AND METHODS: The study included 90 patients with steady-state psoriasis of mild or moderate severity (51 men and 39 women) aged 2365 (mean age 37.3 12.7) years, who received treatment at the N.I. Pirogov Saki Military Clinical Health Resort of the Russian Ministry of Defense. The control group consisted of 30 apparently healthy volunteers. RESULTS: Taking into account the clinical and immunological parameters of patients with mild and moderate psoriasis, we have developed a complex differentiated method of treatment using Lake Saki peloids and brine supplemented with an alpha-lipoic acid preparation. CONCLUSION: The presented complex method of peloid balneotherapy in combination with alpha-lipoic acid preparation intensifies the 14-day course of sanatorium-resort treatment, increases the duration of remission, and enhances the quality of life of patients with mild-to-moderate psoriasis.

Aim. The purpose of the article is to study the possibilities of MRI diagnosis of postprandial distress syndrome using the drinking test and its correction with mineral water.Materials and methods. Clinical observation is described. Patient A., 24 years old, came to the clinic with symptoms of functional dyspepsia. After a comprehensive examination, the diagnosis of Postprandial Distress Syndrome was established. The capabilities of MRI diagnostics of functional dyspepsia were assessed by drinking test. The study lasted 50 minutes. Scans were performed 5, 13, 20, 35 and 50 minutes after water intake. For the next 4 weeks, the patient ingested the non-carbonated mineral water “Uvinskaya” room temperature 30 minutes before taking a meal of 100 ml in the first 6-7 days, followed by an increase in volume to 200 ml 3 times a day.Results. An MRI study with a drinking test in dynamics showed an increase in the volume of water drunk. When assessing the morphofunctional state of the stomach, differences were revealed at the level of the fundus: before treatment - the wall is tense, after course therapy - relaxed, relaxation accommodation is more pronounced. An acceleration of evacuation of the received water into the duodenum after treatment was also found. The positive dynamics of the state of motor-evacuation function of the stomach is due to the chemical composition of mineral water and the regimen of balneotherapy.Conclusions. Gastric MRI is an informative and safe diagnostic method for Postprandial Distress Syndrome, which allows to evaluate the structural and functional features of the gastroduodenal zone. Drinking test can help in the MRI diagnosis of functional dyspepsia, increasing the information content of the study. The use of drinking mineral waters in postprandial distress syndrome is pathogenetically justified, but requires further research to develop rational balneotherapy regimens.

Due the increasing number of alcoholic fatty liver disease cases in the world, the development of methods for treating this disease is an urgent task. According to different publications mineral water from hot springs has a beneficial effect on liver cells. In this regard, an investigation was performed with the aim to assess the effectiveness of hot spring water from the Süreyya I spring (Afyonkarahisar province) in treatment of fatty liver disease. 50 one-day-old albino mice with an average body weight of 29.6 g were selected for the experiment. The tests of liver tissue, biochemical and hematological blood tests, as well as blood gas tests performed at this stage, demonstrated deterioration in all parameters. To prove the effectiveness of using hot spring water in the treatment of alcoholic fatty liver disease, two groups of 25 mice each were formed. The animals of the control group were given tap water to drink, and were also bathed (daily) in it for one hour. The mice of the experimental group were given the hot spring water to drink and bathed in it for 15 minutes every day. Histological tests and blood tests were performed on day 1, 7, 14, and 21 of the experiment using five animals randomly selected from each group. On day 21 of the experiment, the animals of the experimental group demonstrated a significant (p < 0.05) decrease in the total number of leukocytes, neutrophils, monocytes, as well as in the levels of aspartate aminostatesferase, alanine aminopenesferase, gamma-glutamyltransferase, low-density lipoproteins, total cholesterol, triglycerides. There was also an increase in erythrocyte, hemoglobin, hematocrit, total protein, albumin and high density lipoprotein levels (p < 0.05). The results of histopathological analysis also demonstrated positive dynamics. At the same time, no pronounced positive dynamics was observed in animals of the control group. Moreover, microscopy of liver samples showed an ongoing process of tissue degeneration. The data obtained allow us to conclude that it is advisable to use the hot spring water for the treatment of alcoholic fatty liver disease.

Asthma is a chronic inflammatory disease of the airways observed exclusively in humans and sometimes animals. In this study, 40 Albino rats of the same age were used. After 6 weeks of ovalbumin-induced asthma in all animals, 40 rats were randomly divided into two groups as control and study groups for a 21-day treatment period. At the treatment stage, the control group animals were treated with normal tap water, while the study group animals were treated with hot spring water. Clinical, hematological, blood biochemical and histopathological examinations were performed before starting the study, after asthma formation, and on days of 1st, 7th, 14th and 21st after treatment. Total leukocyte, neutrophil, monocyte, AST, ALT, GGT, total cholesterol, triglyceride levels were significantly decreased (p

Background The outbreak of COVID-19 - COronaVIrus Disease 2019 - has become a significant threat to public health worldwide, with high contagious capacity and varied mortality in different countries Diabetes mellitus (DM/ diabetes) is among the most frequently reported comorbidities in patients with COVID-19 In the field of physical and rehabilitation medicine and balneotherapy, specific rehabilitation procedures, natural therapeutic factors, and physical activity are known to be contributive to mitigating some of the DM clinical-patho-biological consequences Objective This systematic review aims to rigorously select related articles and identify within their content, the main possible interferences between DM and COVID-19's pathological mechanisms, and to discuss the value of physical and rehabilitation medicine and balneotherapy in the post-acute COVID-19 recovery of the surviving patients Methods This systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searched for open-access articles published in English, between January and May 2020, from the following databases: Cochrane, Elsevier, PubMed and Web of Science The contextually searched syntax used was "DIABETES AND COVID-19" The selected articles were analyzed in detail regarding both pathologies: COVID-19 and DM The meta-analysis proceeded was designated to estimate the prevalence of DM among COVID-19 patients Results Our search has been conducted on five stages, described by a PRISMA adapted flow diagram Within the first stage, using the syntax mentioned above resulted in 1,133 articles After eliminating, in the second stage, all the inevitable redundancies remained 1,058 articles In the third stage, we performed a PEDro qualitative analysis score weighted selection of all the papers and were kept 91 articles In the fourth stage, were selected relevant issues for a meta-analysis regarding the prevalence of DM diabetes among COVID-19 cases, resulting 32 papers The fifth stage of the PRISMA adapted flow diagram was dedicated to the analysis of the data regarding the use of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM, and COVID-19 patients in rehabilitation wards For enhancing the bibliographical sources pool, we added from external, free found sources, another 15 articles Discussion/ Limitation COVID-19 is an acute illness condition and DM is a chronic one Therefore, it is difficult for now, to have enough data enabling us to see all the repercussions of COVID-19 and to completely understand the significance of physical and rehabilitation medicine and balneotherapy, which applies in COVID-19 post-acute DM patients Conclusions This paper overviews the current state-of-the-art knowledge in the approach of DM /diabetes as COVID-19 comorbidity, with a focal point on the roles of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM and COVID-19 patients in rehabilitation wards, for possible actual and future connexions with the comprehensive management/ rehabilitation of such both chronic and post-acute survivors [ABSTRACT FROM AUTHOR] Copyright of Balneo Research Journal is the property of Balneo Research Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Psoriasis and eczema are most common diseses of human and seen some animals. In this research project, a total of 49 Albino rats, 25 of which were psoriasis and 24 of eczema, were used. The back of all the animals were shaved 3 cm x 2 cm in size, and were deepilated using a 50% barium sulfate solution and deepillation tape. Then, 5% imiquimod was applied to the area for 5-6 days in the rats in psoriasis group, whereas 2%, 4-dinitrochlorobenzene was performed 2 times per day for one week in eczema group animals along with 150 μg of mite extract (Dermatophagoides farinae). After diseases formation in both groups, animals were divided into control and study groups, and then treatment period was started. In the rats with psoriasis and eczema, clinical, hematological, blood biochemical and histopathological findings were determined. In the light of the data obtained; it was concluded that a 21-day spa treatment in rats with psoriasis and eczema was very successful and could be considered as an option in the treatment of these diseases or it would increase the success of the treatment when combinated with classical medical treatments.