Effects of mud pack treatment on skin microcirculation. D. Poensin, P.H. Carpentier, C. Féchoz, S. Gasparini La Léchère University Research Center, Joseph Fourier University, 73260 La Léchère, Savoie, France OBJECTIVES: The objective of this study was to conduct a laser-Doppler flowmetry investigation of skin microcirculation changes induced by mud pack therapy. The magnitude of the changes, potential remote effects, and potential influence of mud pack thickness were studied. METHODS: Twenty female spa therapy patients aged 28-67 years (median, 51 years) participated in the study. The reason for spa therapy was lower limb venous insufficiency in 14 patients and osteoarthritis in six patients, none of whom had involvement of the shoulders. Mud pack treatment was associated with a significant elevation in skin temperature, by 1.8 +/- 0.2 and 1.0 +/- 0.2 degrees C with the 30- and 15-mm packs, respectively (P minore 0.001 for both comparisons; nonsignificant difference between the two packs). Skin blood flow increased significantly, by 619 +/- 82 and 410 +/- 124 mV with the 30- and 15-mm packs, respectively (P minore 0.0001 for both comparisons; nonsignificant difference between the two packs). The vasomotion score increased markedly on the treated side, by 16.7 +/- 2.8 and 13.0 +/- 1.6 with the 30- and 15-mm packs, respectively (P minore 0.005 for both comparisons; no significant difference between the two packs). Furthermore, low-frequency vasomotion waves of a type not described previously were recorded. The microcirculatory changes lasted longer than did the temperature increase. No significant changes were noted in the other shoulder or in central body temperature. RESULTS: The patients were volunteers receiving spa therapy and free of diabetes mellitus, vasoactive drug treatment, and inflammatory shoulder disease. Two mud packs, 15 and 30 mm in thickness, respectively, were applied at an interval of 48 h, at the same time of day in a given patient, and at a distance from other spa treatments. The packs were centered on the deltopectoral groove. The side and order of application of the two packs were determined at random. Superficial skin blood flow was measured by laser-Doppler flowmetry (Perimed PF4001, wavelength 82 nm) and recorded by the Perisoft computer program with a 3-s time constant downstream from a broadband filter (12 MHz). CONCLUSION: These results suggest that the vascular changes induced by mud pack therapy are not fully explained by vasodilation in response to local temperature elevation. Further studies are in order to identify the other mechanisms involved. circolatoria Joint Bone Spine.;70 (5):367-70,2003 Changes in the use of health resources by patients with chronic phlebopathies after thermal hydrotherapy. Report from the Naiade project, a nation-wide survey on thermal therapies in Italy. S.Coccheri, G. Nappi, M. Valenti, F. Di Orio, E. Altobelli, S. De Luca, Naiade Study Group Cardiovascular Department, Division of Angiology, University Hospital St. Orsola, Bologna, Italy BACKGROUND: Chronic venous disorders carry lifelong medical and social burdens. Within conservative approaches, spa hydrotherapy is popular among patients with venous disorders in Europe, but whether the practice is associated with health or social benefits remains controversial. METHODS: The present work is a substudy of the nation-wide Italian Naiade Project, a large multicenter observational exercise on spa treatments in different disease groups. The "Chronic Phlebopathies" substudy included 2504 patients with primary or secondary varicosis or non-varicose venous insufficiency. After a first visit and administration of a detailed questionnaire, patients underwent a "thermal cycle" of 15-20 days consisting of underwater active and passive physical therapy with mineral waters. The same procedures were repeated after 1 year on the 1352 patients (54%) who spontaneously returned to the same spa. Primary endpoints of the study were some indicators of the use of health resources related to the year after the first thermal cycle, compared with the same indicators recorded at first visit using appropriate statistical methods. RESULTS: The occurrence of acute venous episodes, working days missed, number and duration of hospital admissions, consumption of drugs and physical therapies were all significantly reduced in the year after thermal therapy, thus indicating lesser use of health resources. CONCLUSIONS: The study suggests that thermal hydrotherapy in patients with chronic venous disorders is associated with health and social benefits. circolatoria International Angiology 21 n°2,196-200, 2002 Trattamento delle flebopatie degli arti inferiori con acque bicarbonato alcalino-solfuree F.La Vecchia, G.Corbucci Vitolo III Clin. Chir. Uni.Bologna - Euroterme Gli AA. valutano i risultati ottenuti su 238 pazienti flebopatici sottoposti a balneoterapia con acqua bicarbonato-alcalino-solfurea associa a idromassaggio ozonizzato. Sono stati valutati sia la soggettività che parametri oggettivi ( circonferenza alla caviglia ). Nel 30.7 % dei casi si è avuto una diminuzione fino a cm 1,5, nel 35,3 % da 1,5 a 2,5, nel 32,7 % oltre 2,5, rimanendo invariati solo l'1,3 % dei casi. circolatoria Med. Term. Climat.,1989 La rieducazione funzionale nelel vasculopatie periferiche. G.Mattioli, M.Bertoni, V.Boschi, A. Aprile, A. Lapilli, B. Miccoli, G.Miccoli Terme di Porretta Ci siamo soffermati a puntualizzare nel vasto quadro delle vasculopatie periferiche, le “arteriopatie degli arti inferiori” e la loro riabilitazione in ambiente termale. Trattasi di patologie a carattere evolutivo, che presentano dolore e minacciono l’autonomia funzionale dell’individuo; noi ci siamo avvalsi di un intervento riabilitativo restauratore, stabilizzatore, compensatore. La riabilitazione vascolare effettuata presso il nostro Stabilimento Termale agisce su alcuni punti cardine: il fattore psichico di rilassamento, il fattore locale di miglioramento dell’ossigenazione, il fattore nervoso, il fattore meccanico. Il nostro programma terapeutico preceduto da un accurato depistage diagnostico, consta di un trattamento in piscina vascolare con acqua salso-bromo-iodica ozonizzata a temperatura variabile, seguito da un riposo su appositi lettini, quindi attività fisica in palestra o passeggiate in programmi prestabiliti. L’efficacia di tale nostra riabilitazione è valutata attraverso asame oscillografico, Doppler e la valutazione dello stato cardico e respiratorio del paziente. Anche sugli amputati i risultati di riabilitazione del moncone sono stati soddisfacenti, con l’eliminazione dell’edema e il ripristino di un migliore trofismo muscolare. Concludiamo riaffermando il chiaro effetto immediato della nostra terapia riabilitativa sulle forme ischemiche degli arti inferiori. circolatoria Clin. Term.38:105-110, 1985