Short- and long-term effects of spa therapy in knee osteoarthritis A. Fioravanti, F. Iacoponi, B. Bellisai, L.Cantarini, M. Galeazzi Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy OBJECTIVE: To assess both the short- and long-term effectiveness of spa therapy in patients with primary knee osteoarthritis in a prospective, randomized, single-blinded, controlled trial. DESIGN: Eighty outpatients were enrolled in this study; 40 patients were treated with a combination of daily local mud packs and bicarbonate-sulfate mineral bath water from the spa center of Rapolano Terme (Siena, Italy) for 2 wks, and 40 patients continued regular, routine ambulatory care. Patients were assessed at baseline time; after 2 wks; after 3, 6, and 9 mos after the beginning of the study and were evaluated by Visual Analog Scale for spontaneous pain, Lequesne index, Western Ontario and McMaster Universities Index for gonarthrosis, Arthritis Impact Measurement Scale-1, and symptomatic drug consumption. RESULTS: We observed a significant improvement of all evaluated parameters at the end of the cycle of spa therapy, which persisted throughout the whole of the follow-up period, whereas in the control group no significant differences were noted. This symptomatic effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of spa therapy seemed to be good, with light and transitory side effects. CONCLUSIONS: The results from our study confirm that the beneficial effects of spa therapy in patients with knee osteoarthritis lasts over time, with positive effects on the painful symptomatology and a significant improvement on functional capacities. Spa therapy can represent a useful backup to pharmacologic treatment of knee osteoarthritis or a valid alternative for patients who do not tolerate pharmacologic treatments. ostearticolare Am J Phys Med Rehabil. 2009 Oct 30 Beneficial effects of spa treatment on functional status and quality of life of patients with rheumatoid arthritis D. Mustur, V. Vesovic-Potic, N. Vujasinovic-Stupar, T. Ille 0 INTRODUCTION: Rheumatoid arthritis (RA) is a chronic constantly deteriorating disease of unpredictable clinical course, with exacerbations, remissions and damaged joints. It leads to the loss of self-sufficiency, independence in performing many daily activities, decrease of working ability and invalidity. Beside physical factors, which are regarded as most responsible for the poorer quality of life of RA patients, psychological changes are also significant, such as the feeling of helplessness, hopelessness and depression. The goal of the treatment of patients with RA is to decrease illness symptoms, slow down the development of illness progression, improvement of physical functioning and provision of expert help to the RA patients to adapt to life. OBJECTIVE: The aim of the study was to assess the influence of spa therapy on the functional condition and life quality of RA patients. METHODS: The study involved 69 patients with RA (51 female and 18 male, on average aged 55.2 +/- 11.4 years, with illness duration 12.5 +/- 7.5 years), and were a part of a cohort from Norway, suffering of inflammatory rheumatism. All the patients came for four-week rehabilitation at the Institute for Physical Medicine, Rehabilitation and Rheumatology "Dr. Simo Milosevic" in Igalo, Montenegro. The RA patients underwent treatment with mud compresses, mud, mineral and pearl baths, as well as with underwater shower massage (balneotherapy) kinesitherapy and certain forms of electrotherapy with analgesic effects. The evaluation was done on admission and after completed physical therapy when we assessed RA patients' functional condition and quality of life. The functional condition was determined using the Modified Health Assessment Questionnaire (MHAQ), and the quality of life using the Medical Outcomes Study Short Form 36-item Questionnaire (SF-36), which encompassed eight life domains. RESULTS: After completion of 28-dayspa therapy, RA patients showed a significant improvement in functional condition. Their quality of life was significantly improved in all dimensions of SF-36 Questionnaire (p mag 0.01), and the functional status (MHAQ score) was also significantly better (p mag 0.01). CONCLUSION: Balneotherapy, together with climatic factors in Igalo, leads to a significant improvement of functional status and quality of life in patients suffering from RA. osteoaticolare Srp Arh Celok Lek. 2008 Jul-Aug;136(7-8):391-6 An evaluation of the effect of differing lengths of spa therapy upon patients with osteoarthritis (OA) M. Vaht, R. Birkenfeldt, M. Ubner Health Resort Laboratory, Pärnu College, University of Tartu, Ringi 35, Pärnu 80010, Estonia. maivaht@hot.ee The use of spa therapy in Estonia commonly consists of courses up to 3-4 weeks in duration for the management of rheumatic diseases. This study sought to evaluate whether there was any difference in the alleviation of patients symptoms between 6 and 12 day courses of spa therapy in the management of osteoarthritis (OA). A total of 296 patients participated in the research. Spa therapies consist of a range of therapies including mud and paraffin-ozokerite applications; pearl baths; underwater shower-massage; manual massage; therapeutic exercises in the gym and in the swimming pool. The aim of this study was not to evaluate the effectiveness of specific therapies but to gain an insight into the length of time required to effect positive symptom relief through the use of a composite spa approach for patients with OA. At the beginning and end of spa treatment, a visual analogue scale (VAS) was determined in all patients and Lequesne Index used for patients with knee and hip osteoarthritis. In both 6 day (group 1) and 12 day (group 2) groups VAS and Lequesne Index decreased significantly. Whilst no significant differences were found when comparing the results of daily spa therapy in both groups 1 and 2, this study suggests that spa therapy has a positive effect by reducing pain and improving clinical status in patients suffering from osteoarthritis. osteoarticolare Complement Ther Clin Pract. 2008 Feb;14(1):60-4. Epub 2007 Nov 13 Variazione plasmatica delle HSPs70 in pazienti gonartrosici sottoposti a terapia termale con applicazione di fanghi caldi delle Terme di Castrocaro- FC G. Ronca, G. Agostini, F. Russo, M. Conti, D. Tagliazzucchi, A. Conte Dip. di Scienze dell'Uomo e dell'Ambiente, Dip. di Patologia Sperimentale, Biotecn. Med. Infett. Epidem. Università di Pisa, Terme di Castrocaro FC, Dip. Scienze Agrarie Università di Modena e Reggio Emilia Le proteine dello shock termico o hent shock proteins (HSP) sono proteine che aumentano nelle cellule in seguito a stress di varia natura (termico, osmotico, chimico..) il primo dei quali ad essere identificato deve essere quello termico. Sono diffuse in tutto il mondo animale, batterico e vegetale e hanno il compito di potenziare le difese cellulari in condizioni di stress. Tra le funzioni la più nota è di chaperone, mediante la quale favoriscono il raggiungimento della struttura biologicamente attiva di proteine native o danneggiate dallo shock. Tra le più studiate vi sono le famiglie delle HSP70 e delle HSP60. E' stato osservato che HSP sono presenti nei fluidi biologici ed in particolare nel sangue e diminuiscono con l'età. La funzione delle HSP extracellulari è dibattuta anche se uno dei loro ruoli sembra essere quello di modulare l'immunità naturale e inducibile. Le HSP70 extracellulari aumentano anche in seguitop all'attività fisica e a stress psichico oltre che nelle condizioni di ipertermia.In questa ricerca abbiamo volutato il livelloi di HSP70 e HSP60 nel plasma di 20 pazienti maschi gonartrosici trattati in ambiente termale con 9 applicazioni di fanghi caldi (50 gradi C) per 20 minuti sul 50-70% della superficie corporea. I pazienti non presentavano altre patologie e non hanno avuto eventi avversi. Le HSP70 plasmatiche aumentano già alla terza applicazione, l'aumento diventa significativo alla nona applicazione e permane significativo anche dopo 30-35 giorni. L'aumento si correla ai miglioramenti degli indici patologici della gonartrosi quali il dolore, l'indice di Lequesne , la funzione quotidiana, l'attività fisica, lo stato di benessere fisico e psichico. Le HSP60 non subiscono invece modificazioni. L'applicazione dello stimolo termuico in ambiente termale determina un aumento delle difese intracellulari, modula la risposta infiammatoria, sia in locale che generale, diminuendo il dolore e migliorando la funzione articolare e sotto il profilo dell'aumento delle HSP70 circolanti corrisponde a quanto avviene con l'esercizio di attività fisica intensa, senza quell'impegno, anche psicologico, che l'attività fisica e costante richiede. osteoarticolare Clin. Term. 52 Suppl.1 (1-2):33, 2005 Fangotherapy in chronic degenerative rheumatic diseases M. Grassi, M.C.Lucchetta, G.B. Rini, S. Raffa Dipartimento di Clinica e Terapia Medica applicata, Università di Roma La Sapienza, Italia. marcellograssi@hotmail.com The authors remind the historical role of the mud-therapy in the care of chronic degenerative rheumoartrhopaties, namely osteoarthritis. The main researches belong activity of muds on plasmatic hormones, cytokines, endorphins; a great deal of care is devoted to evaluation of efficacy of mud therapy and relating end points. The clinic outcomes of mud therapy, namely in osteoarthritis patients, were referred. Altogether the studies stress the employ of mud therapy in the treatment of osteoarthritis, the consequences of traumas, some dismetabolic chronic arthropaties, and fibromyalgic syndromes. osteoarticolare Clin Ter.Jan-Feb;154(1):45-8, 2003 Both serum receptors of tumor necrosis factor are influenced by mud pack treatment in osteoarthrotic patients. S. Bellometti, L. Galzigna, P. Richelmi, C. Gregotti, F. Bertè Pietro d'Abano Research Centre, Padova, Italy. simonab@intercity.it Several authors have demonstrated the pivotal role of proinflammatory cytokines in inducing progressive cartilage degradation and secondary inflammation of the synovial membrane in osteoarthritis (OA). It has recently been established that tumor necrosis factor (TNF)-alpha plays a well-defined role in the pathophysiology of inflammatory joint diseases and that binding to circulating soluble TNF-alpha receptors can inactivate it. We investigated the influence of mud pack treatment, which is able to diminish TNF-alpha serum values, on specific TNF receptor (sTNF-R) levels. Thirty-six patients with OA were enrolled and randomized into two groups. Group A underwent mud pack treatment and group B underwent thermal bath treatment. A group of 20 healthy untreated subjects was used as a control. Blood samples were collected at baseline and after treatment, and assays of sTNF-R55 and sTNF-R75 were performed in both groups. We found small changes in sTNF-Rs serum values but these were not statistically significant. sTNF-R55 serum values decreased by 0.4% after the therapy in group A, while in group B the decrease was -17.7%. sTNF-R75 was reduced by -21.17% in group A and by -10.6% in group B. In conclusion, through its thermic and ant/inflammatory activity mud pack treatment shows complex interaction with the most common factors of inflammatory and cartilage degradation. Our results suggest that the thermic component of this natural treatment is mainly involved in modulating inflammatory reaction and cartilage damage through binding of the circulating TNF, which controls the activation of the cells responsible for the production of proinflammatory cytokines. osteoarticolare Int J Tissue React. 24(2):57-64,2002 Cost effectiveness of combined spa-exercise therapy in ankylosing spondylitis: a randomized controlled trial. A. Van Tubergen, A. Boonen, R. Landewé, M. Rutten-Van Mölken, D. Van Der Heijde, A. Hidding, S. Van Der Linden University Hospital Maastricht, Maastricht, The Netherlands. avantubergen@yahoo.com OBJECTIVE: To evaluate the cost effectiveness and cost utility of a 3-week course of combined spa therapy and exercise therapy in addition to standard treatment consisting of antiinflammatory drugs and weekly group physical therapy in ankylosing spondylitis (AS) patients. METHODS: A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 was treated in a spa resort in Bad Hofgastein, Austria; group 2 in a spa resort in Arcen, The Netherlands. The control group stayed at home and continued their usual activities and standard treatment during the intervention weeks. After the intervention, all patients followed weekly group physical therapy. The total study period was 40 weeks. Effectiveness of the intervention was assessed by functional ability using the Bath Ankylosing Spondylitis Function Index (BASFI). Utilities were measured with the EuroQoL (EQ-5D(utility)). A time-integrated summary score defined the clinical effects (BASFI-area under the curve [AUC]) and utilities (EQ-5D(utility)-AUC) over time. Both direct (health care and non-health care) and indirect costs were included. Resource utilization and absence from work were registered weekly by the patients in a diary. All costs were calculated from a societal perspective. RESULTS: A total of 111 patients completed the diary. The between-group difference for the BASFI-AUC was 1.0 (95% confidence interval [95% CI] 0.4-1.6; P = 0.001) for group 1 versus controls, and 0.6 (95% CI 0.1-1.1; P = 0.020) for group 2 versus controls. The between-group difference for EQ-5D(utility)-AUC was 0.17 (95% CI 0.09-0.25; P minore 0.001) for group 1 versus controls, and 0.08 (95% CI 0.00-0.15; P = 0.04) for group 2 versus controls. The mean total costs per patient (including costs for spa therapy) in Euros (euro;) during the study period were euro;3,023 for group 1, euro;3,240 for group 2, and euro;1,754 for the control group. The incremental cost-effectiveness ratio per unit effect gained in functional ability (0-10 scale) was euro;1,269 (95% CI 497-3,316) for group 1, and euro;2,477 (95% CI 601-12,098) for group 2. The costs per quality-adjusted life year gained were euro;7,465 (95% CI 3,294-14,686) for group 1, and euro;18,575 (95% CI 3,678-114,257) for group 2. CONCLUSION: Combined spa-exercise therapy besides standard treatment with drugs and weekly group physical therapy is more effective and shows favorable cost-effectiveness and cost-utility ratios compared with standard treatment alone in patients with AS. osteoarticolare Arthritis Rheum.Oct 15;47(5):459-67, 2002 Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. A. Van Tubergen, R. Landewé, D. Van der Heijde, A. Hidding, N. Wolter, M. Asscher, A. Falkenbach, E. Genth, Thè HG, S. Van der Linden Department of Medicine, University Hospital Maastricht, The Netherlands. avantubergen@yahoo.com Department of Medicine, University Hospital Maastricht, The Netherlands. avantubergen@yahoo.com OBJECTIVE:To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). METHODS: A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean age 48 +/- 10 years; male:female ratio 25:15) was treated in a spa resort in Bad Hofgastein, Austria; group 2 (mean age 49 +/- 9 years; male:female ratio 28:12) in a spa resort in Arcen, The Netherlands. The control group (mean age 48 +/- 10 years; male:female ratio 34:6) stayed at home and continued their usual drug treatment and weekly group physical therapy during the intervention weeks. Standardized spa-exercise therapy of 3 weeks duration consisted of group physical exercises, walking, correction therapy (lying supine on a bed), hydrotherapy, sports, and visits to either the Gasteiner Heilstollen (Austria) or sauna (Netherlands). After spa-exercise therapy all patients followed weekly group physical therapy for another 37 weeks. Primary outcomes were functional ability, patient's global well-being, pain, and duration of morning stiffness, aggregated in a pooled index of change (PIC). RESULTS: Analysis of variance showed a statistically significant time-effect (P minore 0.001) and time-by-treatment interaction (P = 0.004), indicating that the 3 groups differed over time with respect to the course of the PIC. Four weeks after start of spa-exercise therapy, the mean difference in PIC between group 1 and controls was 0.49 (95% confidence interval [CI] 0.16-0.82, P = 0.004) and between group 2 and controls was 0.46 (95% CI 0.15-0.78, P = 0.005). At 16 weeks, the difference between group 1 and controls was 0.63 (95% CI 0.23-1.02, P = 0.002) and between group 2 and controls was 0.34 (95% CI--0.05-0.73; P = 0.086). At 28 and 40 weeks, more improvement was found for group 1 compared with controls (P = 0.012 and P = 0.062, respectively) but not for group 2 compared with controls. CONCLUSION: In patients with AS, a 3-week course of combined spa-exercise therapy, in addition to drug treatment and weekly group physical therapy alone, provides beneficial effects. These beneficial effects may last for at least 40 weeks. osteoarticolare Arthritis Rheum.Oct;45(5):430-8, 2001 Beta-endorphin and stress hormones in patients affected by osteoarthritis undergoing thermal mud therapy A. Pizzoferrato, I.Garzia, E. Cenni, L. Pratelli, C.Tarabusi Laboratorio di Patologia Clinica Istituti Ortopedici Rizzoli, Bologna. Laboratorio di Patologia Clinica Istituti Ortopedici Rizzoli, Bologna. BACKGROUND: Thermal mud is a therapeutic agent widely used in the treatment of painful arthritic processes. The mechanism by which mud therapy works is still not well known. Its effect continues for months after completion of treatment. In order to verify whether thermal mud treatment brings about changes in the production of hormone peptides from proopiomelanocortin, the levels of plasma beta-endorphin and some hormones of the pituitary-adrenal glands (ACTH and cortisol) were determined in patients affected by osteoarthritis undergoing thermal mud therapy. METHODS: The levels of plasma beta-endorphin and some hormones of the pituitary-adrenal glands (ACTH and cortisol) were assessed by radiometric methods in seventeen males affected by osteoarthritis. The patients underwent a cycle of twelve sessions of thermal mud therapy. The tests were carried out immediately before thermal treatment, immediately after the first session, twelve days after the start of treatment, and again one month after completion of the treatment. RESULTS: beta-endorphin levels decreased significantly twelve days after the start of treatment. The level was still lower, although not significantly, even thirty days after completion of the treatment. Plasma ACTH also decreased during treatment. The decrease of this hormone was progressive and persisted after completion of treatment. Significant variations compared to baseline were found only thirty days after completion of treatment. Plasma cortisol decreased significantly after only one session of mud therapy. This hormone did not decrease any further during treatment, however, after twelve days it was still significantly lower than baseline. After completion of treatment, cortisol slightly increased, but thirty days later it was still lower, although not significantly, than baseline. CONCLUSIONS: It may be suggested that thermal treatment, by reducing inflammation, reduced pain and therefore diminished the cause of stress. osteoarticolare Minerva Med.Oct;91(10):239-45, 2000 The effects of balneotherapy on fibromyalgia patients. D. Evcik, B. Kizilay, E. Gökçen A.K.U. Arastirma Hastanesi, Fiziksel Tip ve Reh A.D. Inönü Bulvan; 03200 Afyon, Turkey. ezgievcik@ixir.c Fibromyalgia syndrome (FMS) is a very common rheumatological diagnosis. There are various treatment modalities. This study was planned to investigate the effects of balneotherapy in the treatment of FMS. A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study. Their ages ranged between 30 and 55 years. Patients were randomly assigned to two groups. None of them had had a cardiovascular disease before. Group 1 n=22) received 20-min bathing, once a day and five times per week. Patients participated in the study for 3 weeks (total of 15 sessions). Group 2 (n=20) was accepted as the control group. Patients were evaluated by the number of tender points, Visual Analogue Scale for pain, Beck's Depression Index for depression, and Fibromyalgia Impact Questionnaire for functional capacity. Measurements were assessed initially, after the therapy, and at the end of the 6th month. In group 1, there were statistically significant differences in numbers of tender points, Visual Analogue scores, Beck's Depression Index, and Fibromyalgia Impact Questionnaire scores after the therapy program (P minore 0.001). Also, 6 months later in group 1, there was still an improvement in the number of tender points (P minore 0.001), Visual Analogue scores, and Fibromyalgia Impact Questionnaire (P minore 0.005). But there was not a statistical difference in Beck's Depression Index scores compared to the control group (P maggiore 0.05). Patients with FMS mostly complain about pain, anxiety, and the difficulty in daily living activities. This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients. osteoarticolare Rheumatol Int. Studio preliminare sull'azione dell'acqua salsobromoiodica sul comportamento delle prostaglandine sieriche nell'artrite sperimentale indotta nel coniglio. A.Zaccaroni, A.Peli, G.Cascio, GL. Stracciari Dep.Veter.- Pharmac. Toxicol, Vet.Serv- Uni.Bologna - Terme di Castel San Pietro Gli autori valutano gli effetti di un trattamento balneoterapico sulle concentrazioni sieriche di PGE2 nell'artrite sperimentale indotta nel coniglio, al fine di apportare un qualche contributo all'interpretazione nei livelli clinico-epidemiologici esistenti, che indicano un'azione benefica delle acque salso-bromo-iodiche in queste patologie. Dai risultati ottenuti emerge come, nonostante una notevole variabilità individuale dei tassi sierici di PGE2 queste ultime presentano un netto incremento a partire dal primo giorno dopo l'induzione dell'artrite. Nell'ambito della relazione diretta che sembra esistere tra stress di tipo psicologico, termico e meccanico ed incremento dei tassi sierici di questi mediatori, il trattamento attuato può ritenersi in grado di ridurre tale correlazione positiva. osteorticolare Acta Toxicol.Ther.-Vol.XVIII-N°2.3.4-74-84, 1997 Cytokine levels in osteoarthrosis patients undergoing mud bath therapy. S.Bellometti, S. Giannini, L.Sartori, G.Crepaldi Centro Studi Termali Pietro D'Abano, Abano Terme, Italy. Centro Studi Termali Pietro D'Abano, Abano Terme, Italy. Osteoarthritis is an important rheumatic condition characterized by the progressive destruction of cartilage. The pathophysiologic phenomena leading to the pathologic changes in the joint appear to result from biomechanical factors and activation of final common pathways of tissue damage influencing chondrocyte homeostasis and a functional program. Several cytokines and growth factors are reported to be responsible for inflammation and cartilage degradation. Among these, IL-1 and TNF alpha have been suggested as important in promoting cartilage inflammation and tissue destruction, while IGF I has a protective influence on cartilage structure. Chondrocytes and their metabolism have gained interest as targets of drug intervention; the results of this study confirm that mud bath therapy is also able to influence chondrocyte activities. Our data suggest that mud bath therapy influences cytokines related to osteoarthrosis pathomechanism and maintenance, and encourage further investigations to evaluate possible synergism between pharmacological treatment and mud bath therapy. osteoarticolare Int] Clin Pharmacol Res. 17(4):149-53,1997 The use of low-temperature pelotherapy in the treatment of patients with rheumatoid arthritis (II) V.D. Grigor'eva, D.R. Mamiliaeva ooooooooooo Low-temperature peloids (t = +13, +14, +15 degrees C) application in rheumatoid arthritis patients produces local antiinflammatory, analgetic actions, suppresses immunocompetent system, improves locomotor functions. The above balneotherapy is indicated for patients with articular seropositive or seronegative RA irrespective of its activity in the presence of exudative-proliferative manifestations in the affected joints. In articular-visceral RA it is better to apply peloids in minimal activity of the inflammation osteoarticolare Vopr Kurortol Fizioter Lech Fiz Kult.Jan-Feb;(1):20-3, 1995 Spa therapy for gonarthrosis: a prospective study I. Wigler, O. Elkayam, D.Paran, M.Yaron Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler Faculty of Medicine, Israel. Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler Faculty of Medicine, Israel.The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior. osteoarticolare Rheumatol Int. ;15(2):65-8,1995 Mud pack therapy in rheumatoid arthritis S. Sukenik, D. Buskila, L. Neumann, A. Kleiner-Baumgarten Rheumatology Unit, Soroka Medical Center, Beer-Sheva, Israel Rheumatology Unit, Soroka Medical Center, Beer-Sheva, Israel. Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40 degrees C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group 2 with washed out and less concentrated mud packs. The study was double blind and of two weeks duration. All patients were evaluated by one rheumatologist both before treatment and two weeks later at the end of the treatment period. Follow-up evaluations were made one and three months after conclusion of the treatment. The clinical indices evaluated included duration of morning stiffness, hand-grip strength, activities of daily living, patient's own assessment of disease activity, number of active joints and the Ritchie index. A statistically significant improvement (p less than 0.01 or p less than 0.05) was observed in Group 1 only in most of the clinical indices, lasting between 1 to 3 months. osteoarticolare Clin Rheumatol. June;11(2):243-7,1992 Effetti del trattamento con un'acqua salso-bromo-iodica sulle modificazioni di alcuni parametri sieroenzimatici rilevabili in corso di artrite sperimentale nel ratto J.Malvisi Stracciari - P.Marinelli - P.Anfossi Ist. Farmac. Farmacocin. Tossicol. Fac. Med. Vet.- Uni.Bologna - Terme di Castel San Pietro Gli autori valutano, dopo 5, 10, 15 e 20 giorni l'attività di alcuni sistemi enzimatici sierici nel ratto dopo inizione subplantare di adiuvante di Freund e l'influenza esplicata da un lutobalneoterapia con acqua salso-bromo-iodica ripetuta quotidianamente sulle variazioni che ne conseguono a carico di alcuni di essi. Mentre l'attività della GPT non subisce costantemente alcuna variazione, il trattamento con l'acqua salso-bromo-iodica in esame, a differenza di quello attuato con acqua distillata, si dimostra in grado di mantenere nella norma quelle della fosfatasi acida e della ICDH, rispettivamente diminuita ed aumentata nel ratto artritico e di riportarvi valori delle attività glutammico-ossalacetico transaminasica e lattico-deidrogenasica significativamente negli stessi animali. artroreumatica Biol. Med.,6,243-256, 1984 Attività di un'acqua salso-bromo-iodica nell'artrite da adiuvante di Freund nel ratto. G.Cervellati P. Marinelli A. Zaghini Ist. Farmac. Farmacocin. Tossicol. Fac. Med. Vet.- Uni.Bologna - Terme di Castel San Pietro Gli autori valutano, dopo 5, 10, 15 e 20 giorni di trattamenti quotidiani, l'influenza esplicita della balnoterapia salso-bromo-iodica sulle manifestazioni edematose che conseguono alla iniezione intradermica di adiuvante di Freund nel ratto e ne considerano altresi, al termine della sperimentazione, l'effetto sulle alterazioni rilavabili in questo modello sperimentale a carico di alcuni parametri ematici. I risultati acquisiti dimostrano che il trattamento attuato ਠin grado di inibire, sia pure con diversa entità e adattamento, lo sviluppo dell'edema podalico sia nell'arto iniettato che in quello controlaterale. Parimenti esso si dimostra efficace nel determinare un decremento altamente significativo della velocitàdi eritrosedimentazione, il cui aumento ਠun indice caratteristico di questa sindrome, ad un certo miglioramento della ipoalbuminemia e della iperglobulinemia, senza variazioni della protidemia totale, riscontrate negli animali di controllo e sottoposti ad uguale trattamento con acqua distillata artroreumatica Biol. Med.,4,271-286, 1982