Functional and Histologic Assessment of Rat Gastric Mucosa after Chronic Treatment with Sulphurous Thermal Water Gabriella Coruzzi, Maristella Adami, Cristina Pozzoli, Elvira Solenghi, Daniela Grandi Anatomy, Department of Human Anatomy, Pharmacology and Forensic Medicine, University of Parma - COTER srl Consorzio del Circuito Termale dell'Emilia Romagna The effect of a chronic (4 weeks) administration of sulphurous thermal water on gastric acid secretion and mucosal defense was investigated in rats. Animals were randomized to receive daily intake of tap water or of thermal water obtained from a local spa center (Tabiano, Parma, Italy). Rats were followed for one month as for water and food consumption, body weight and general conditions. At the end of the watering period, the following study protocols were carried out: (a) study of basal and stimulated gastric acid secretion under general anesthesia, and (b) study of the gastric mucosal resistance against the damage induced by ethanol and indomethacin in conscious rats. Basal acid secretion and the acid response to pentagastrin or to histamine were similar in rats assuming ordinary drinking water or thermal water. As for resistance to gastric damage, histological, but not macroscopic, evaluation revealed that rats which assumed thermal water were slightly more resistant to the gastrolesive effect of ethanol (either absolute or diluted). Again, when indomethacin was used as a noxious stimulus, no difference was noted between the two groups as for macroscopic damage; only a nonsignificant reduction of damage was observed histologically in stomachs of rats assuming thermal water. In conclusion, these results indicate that chronic treatment of rats with thermal water, rich in sulphur compounds, may have only minimal effects on the rat gastric mucosa and did not significantly affect mucosal defense mechanisms. The observed tendency to gastroprotection would possibly need further investigation with longer periods of administration. farmacologia Pharmacology vol 85 n°3,2010 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 Combination treatment whith etanercept and an intensive spa rehabilitation program in active ankilosing spondylitis M. Colina, G. Ciancio, R. Garavini, M. Conti, F. Trotta and M. Govoni Reumathology section department of Clinical and esperimental Medice University of Ferrara, Presidio di Medicina Fisica e Riabilitazione delle Terme di Castrocaro The aim of this study is to determine the effects of a combination treatment with etanercept and spa rehabilitation versus etanercept alone on function, disability and quality of life in a group of patients with active ankylosing spondylitis (AS). Sixty patients AS underwent etanercept as suggested by ASAS/EULAR recommendations. As the clinical and laboratory conditions improved, 30 patients accepted the proposal of coupling the medical therapy with a 7-day rehabilitation program in a thermal baths centre; the remaining 30 subjects continued to take the biologic agent alone. The comparisons between the 2 groups were made after 3 and 6 months. The primary outcome was an improvement in BASFI. The secondary outcome was an improvement in the visual analogic scale of EuroQol (EQ-5Dvas). After 6 months a statiscally significant improvement in BASFI (p min 0.05) and EQ-5Dvas (p min 0.05) scores was observed in both groups. The mean change in EQ-5Dvas value showed a statiscally significant difference in favour of the combination therapy group versus the monotherapy group (22 vs32, p min 0.05). A therapeutic regimen combining etanercept whit an intensive rehabilitation program contributes to disability reduction and ameliorates quality of life for AS patients riabilitazione International Journal of Immunopathology and pharmacology. vol 22-n 4:1125-1129,2009 The In-vitro percutaneous migration of chemical elements from a thermal mud for healing F. Tateo, A. Ravaglioli, C. Andreoli, F. Bonina, V. Coiro, S.Degetto, A. Giaretta, A. Menconi Orsini, C. Puglia, V.Summa Ist. Geoscienza e Georisorse CNR Padova, Ist. Scienza e Tecnol. dei Materiali Ceramici CNR Faenza, Dipartim. Biol. Uni Padova, Dip. Scienze Farmac. Uni Catania, Dip. Med. Int. e Scienze Biomediche Uni Parma, Ist. Clin. Inorganica e delle Sup. Uni Padova, Coter srl Circuito Termale dell'Emilia Romagna, Ist. di Met. e di Analisi Ambientali CNR Padova In-vitro experiments have been developed to ascertain whether pelotherapy applications involve the transfer of chemical elements from the healing mud to the human body, across the skin. All the materials used for therapy (raw clay, mineral water and healing mud obtained after maturation) have been characterised from different points of view (mineralogy, chemistry, exchange properties, radioactivity, grain size and microbiology) in order to get an accurate knowledge of the natural media used for therapy and to follow the development of maturation in the spa centre. A polymineralic silty clay with rather a common mineralogical and chemical composition is used; the mud is matured in a very saline mineral water, of marine origin, for 5 months. Under these conditions the maturation process increases the dispersion of clay particles and allows cation exchange between clays and water, whereas neither microbiological nor mineralogical changes are detectable. In absence of the biologic indicators of mud maturity, the equilibration of clay with mineral water represents an objective quantitative criterion. In-vitro tests have been carried out by using the Franz-type diffusion cells, which show that the transfer of chemical elements across the skin is very well-developed, and also involving many essential or possibly essential elements. The amounts of chemical elements transferred were compared with toxicological guidelines and with world-wide daily requirement models. No concerns appear from the data, whereas a significant supply of some elements results from a typical application of thermal mud (20 minutes, full body). The elements which have been considered in order to represent a significant supply are Li, Sr, B, I, Rb, Br, Ba, Na, Cl, Se and Ca,some of these are essential nutrients. The biological effect of the main elements as well as their possible biological role are briefly discussed. farmacologia Elsevier Ed. System for Applied Clay Science - Clay n° 1601 - 2008 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 Influence of physical treatment on disease activity and health status of patients with chronic arthritis D.Mustur D, N.Vujasinovic-Stupar N, T. D. Ille 0 INTRODUCTION: This is an open uncontrolled study about effects of physical treatment on disease activity parameters of patients with rheumatoid arthritis and psoriatic arthritis. OBJECTIVE: The aim of the study was to establish if there was any improvement of disease activity parameters after four weeks of physical and spa treatment. METHOD: We compared morning stiffness, tender and swollen joint count, body pain level and Disease Activity Score 28 (DAS-28) in patients with rheumatoid and psoriatic arthritis, and assessed the effect of physical and spa treatment on those parameters. The research encompassed 109 patients: 69 with rheumatoid arthritis (RA group) and 40 with psoriatic arthritis (PA group). They were from Norway, staying for four weeks in June-September 2003. The groups served as their own controls--"one group pre-test post test" study. Disease activity measurement was made twice: at the beginning and at the end of treatment. The therapeutic set consisted of mud applications, kinesitherapy, mineral water pool and electrotherapy. RESULTS: At the beginning there was no significant difference in observed disease activity parameters between patients with rheumatoid and psoriatic arthritis (p min 0.05). After four weeks of physical and spa treatment disease activity was significantly reduced in all observed parameters in both groups: morning stiffness (p mag 0.001 RA + PA), tender joint count (p mag 0.01 RA + PA), swollen joint count (p mag 0.01 RA; p mag 0.05 PA), body pain (p mag 0.01 RA + PA) and DAS-28 score (p mag 0.01 RA+PA). CONCLUSION: Physical and spa treatment, together with climatic factors in Igalo, lead to a significant reduction of disease activity parameters of patients suffering from rheumatoid arthritis and psoriatic arthritis. farmacologia Srp Arh Celok Lek. 2008 Mar-Apr;136(3-4):104-9 Does mud pack treatment have any chemical effect? A randomized controlled clinical study E.Odabasi,M. Turan, H. Erdem, F. Tekbas Department of Medical Ecology and Hydroclimatology, Gulhane School of Medicine, Ankara, Turkey. ersinodabasi@hotmail.com OBJECTIVE: The aim of this study was to reveal the efficacy of mud pack treatment in patients with knee osteoarthritis and to find the contribution of chemical factors to the build up of these effects. METHODS: Sixty patients were randomly assigned to directly applied mud pack (study) group or to nylon-covered mud pack (control) group. Thirty patients in the study group had mud application 15 times to both knees: heated mud, up to 43 degrees C, was applied to skin directly for 30 minutes. Thirty patients in the control group had the same treatment as the study group except heated mud was applied over an impermeable nylon pack. Primary outcome measures of the study were the Western Ontario and McMaster Universities (WOMAC) index, pain intensity on a visual analog scale (VAS), patient's assessment of disease severity index, physician's assessment of disease severity index, and analgesic consumption. The patients were evaluated before and after (end of 15th application) the intervention and followed up for 24 weeks at 4-week intervals. The results were assessed on an intent-to-treat basis. RESULTS: As compared to the baseline, significant decreases were observed in WOMAC, pain intensity, disease severity index scores, and analgesic consumption in both groups after the intervention. Observed improvements in the study group were found to be superior to the control during the whole postintervention follow-up, except for analgesic consumption in the third week. A significant number of patients in the study group showed minimal clinically important improvement as compared to the control group. CONCLUSION: Mud pack treatment significantly improved the pain and functional status of patients with knee osteoarthritis, whether applied directly or coated with nylon. Direct application was found to be superior, which implies chemical properties of the mud contribute to the build up of therapeutic effect. farmacologia J Altern Complement Med. 2008 Jun;14(5):559-65 New evidences on spa therapy in fibromyalgia C.Giannitti, B. Bellisai, F. Iacoponi, A.Petraglia, A. Fioravanti UOC di Reumatologia, Dipartimento di Medicina Clinica e Scienze Immunologiche, Università di Siena, Siena, Italia Spa therapy is one of the most commonly used non-pharmacological approaches for many rheumatic diseases. In Fibromyalgia Syndrome (FS) it may be useful for the chronic widespread musculoskeletal pain. Because of the unknown aetiology and the not clear understood pathogenesis, there is no standard therapy regimen for FS. Also the mechanisms of action of spa therapy are not completely known, but most probably the benefits could be derived from mechanical, physical and chemical factors. Muscle tone and pain intensity can be positively influenced by mud packs and thermal baths. The review of international data from 2000 to 2007 confirms that spa therapy should be a valid tool in the multidisciplinary approach of the Primary FS. farmacologia Clin Ter. 2008 Sep-Oct;159(5):377-80 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 Lipophilic components of different therapeutic mud species E.Odabasi, H. Gul, E. Macit, M. Turan, O.Yildiz Department of Medical Ecology and Hydroclimatology, Gulhane School of Medicine, Ankara, Turkey. ersinodabasi@hotmail.com OBJECTIVE: Mud, which contains organic and mineral ingredients, is used for the treatment of several degenerative diseases. It has been proposed that beneficial effects of mud are not only related to its local thermal effects, but also to its chemical components. Unlike hydrophilic components, the lipophilic components of the mud extract have not been described precisely thus far. Thus, we aimed to determine the lipophilic components of the different mud species. METHODS: Three different mud species (e.g., krenogen, tone, and fango) were analyzed by using gas chromatography-mass spectrometry (GC-MS). RESULTS: There were organic substances with fatty-acid structures found in the structure of mud. Torf mud species contain the most compounds. The compounds of three mud species differ from each other. CONCLUSIONS: The chemical structure of mud does not only contain hydrophilic organic substances, such as humic, fulmic, and ulmic acids, but also low-molecular-weighted organic substances composed of fatty acids in the majority. Moreover, it would not be appropriate to explain mud with a single term, since it has different chemical structures and a new classification of the mud species is required. farmacologia J Altern Complement Med. 2007 Dec;13(10):1115-8 Is mud an anti-inflammatory? M.I.Giacomino, D.F. de Michele Departmento de Postgrado. Facultad de Ciencias de la Salud. Universidad Nacional de Entre Ríos. Argentina It s really hard to find a therapeutic tool used along 25 centuries; mud certainly is one. The remote empirism--not actually scientific--allows at least some kind of inferences; if the action of mud over the inflammatory process were neutral or harmful we should knew it. Mud has a place as a non-pharmacological tool in certain clinical settings, such as degenerative articular processes, skin disorders, and others. Babylonians knew its effects. Former scientific explanations regarding the mud action have been communicated in last years by some researchers. Fangotherapy in arthritis patients seems to cause variations in amino acid involved in cartilage homeostasis, and also produce reduction in pain ratings in gonarthrosis. Mud modifies nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients and beta-endorphin and stress hormones in patients affected by osteoarthritis by reducing inflammation, pain and therefore diminishes the cause of stress. Has been confirmed that the thermal stress associated with Fangotherapy, activates the pituitary gland and the biochemical effects of peat components have aside from their physical-thermal effects. Furthermore, steroids and antimicrobial activity of certain therapeutic mud has been suggested. farmacologia An Med Interna. 2007 Jul;24(7):352-3 Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation G. Gasbarrini, M. Candelli, R.G. Graziosetto, S.Coccheri, F. Di Iorio, G. Nappi Department of Internal Medicine, Catholic University of Rome, Italy. AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowel syndrome (IBS) accompanying predominant constipation. METHODS: A total of 3872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnaire to collect personal data on social and occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementation therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T(1/2) and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test. RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients. The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients. Both T(1/2) and T-lag were significantly reduced after the therapy compared to basal values [91 +/- 12 T(1/2) and 53 +/- 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study. CONCLUSION: Mineral water supplementation treatment for functional dyspepsia or constipation accompanying IBS can improve gastric acid output and intestinal transit time. gastroenterica World J Gastroenterol. Apr 28;12(16):2556-62,2006 A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis M.R.Elkins, M. Robinson, B.R. Rose, C. Harbour, C.P. Moriarty, G.B. Marks, E.G. Belousova, W. Xuan, P.T. Bye; National Hypertonic Saline in Cystic Fibrosis (NHSCF) Study Group Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia BACKGROUND: Inhaled hypertonic saline acutely increases mucociliary clearance and, in short-term trials, improves lung function in people with cystic fibrosis. We tested the safety and efficacy of inhaled hypertonic saline in a long-term trial. METHODS: In this double-blind, parallel-group trial, 164 patients with stable cystic fibrosis who were at least six years old were randomly assigned to inhale 4 ml of either 7 percent hypertonic saline or 0.9 percent (control) saline twice daily for 48 weeks, with quinine sulfate (0.25 mg per milliliter) added to each solution to mask the taste. A bronchodilator was given before each dose, and other standard therapies were continued during the trial. RESULTS: The primary outcome measure, the rate of change (slope) in lung function (reflected by the forced vital capacity [FVC], forced expiratory volume in one second [FEV1], and forced expiratory flow at 25 to 75 percent of FVC [FEF25-75]) during the 48 weeks of treatment, did not differ significantly between groups (P=0.79). However, the absolute difference in lung function between groups was significant (P=0.03) when averaged across all post-randomization visits in the 48-week treatment period. As compared with the control group, the hypertonic-saline group had significantly higher FVC (by 82 ml; 95 percent confidence interval, 12 to 153) and FEV1 (by 68 ml; 95 percent confidence interval, 3 to 132) values, but similar FEF25-75 values. The hypertonic-saline group also had significantly fewer pulmonary exacerbations (relative reduction, 56 percent; P=0.02) and a significantly higher percentage of patients without exacerbations (76 percent, as compared with 62 percent in the control group; P=0.03). Hypertonic saline was not associated with worsening bacterial infection or inflammation. CONCLUSIONS: Hypertonic saline preceded by a bronchodilator is an inexpensive, safe, and effective additional therapy for patients with cystic fibrosis. (ClinicalTrials.gov number, NCT00271310.) Copyright 2006 Massachusetts Medical Society. farmacologia N Engl J Med. Jan 19;354(3):229-40,2006 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 Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip. E. Stener-Victorin, C. Kruse-Smidje, K. Jung Department of Physiology and Pharmacology, Göteborg University, Göteborg, Sweden. elisabet.stener-victorin@fhs.gu.se OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of electro-acupuncture (EA) and hydrotherapy, both in combination with patient education or with patient education alone, in the treatment of osteoarthritis in the hip. METHODS: Forty-five patients, aged 42-86 years, with radiographic changes consistent with osteoarthritis in the hip, pain related to motion, pain on load, and ache were chosen. They were randomly allocated to EA, hydrotherapy, both in combination with patient education, or patient education alone. Outcome measures were the disability rating index (DRI), global self-rating index (GSI), and visual analogue scale (VAS). Assessments were done before the intervention and immediately after the last treatment and 1, 3, and 6 months after the last treatment. RESULTS: Pain related to motion and pain on load was reduced up to 3 months after last the treatment in the hydrotherapy group and up to 6 months in the EA group. Ache during the day was significantly improved in both the EA and hydrotherapy group up to 3 months after the last treatment. Ache during the night was reduced in the hydrotherapy group up to 3 months after the last treatment and in the EA group up to 6 months after. Disability in functional activities was improved in EA and hydrotherapy groups up to 6 months after the last treatment. Quality of life was also improved in EA and hydrotherapy groups up to 3 months after the last treatment. There were no changes in the education group alone. DISCUSSION: In conclusion, EA and hydrotherapy, both in combination with patient education, induce long-lasting effects, shown by reduced pain and ache and by increased functional activity and quality of life, as demonstrated by differences in the pre- and post-treatment assessments. farmacologia Clin J Pain. May-Jun;20(3):179-85, 2004 Improving homocysteine levels through balneotherapy: effects of sulphur baths. V. Leibetseder, G. Strauss-Blasche, F. Holzer, W. Marktl, C. Ekmekcioglu Department of Physiology, Faculty of Medicine, University of Vienna, Schwarzspanierstrasse 17, Vienna A-1090, Austria. Valentin.Leibetseder@univie.ac.at BACKGROUND: Plasma homocysteine (tHcy) is a risk factor for cardio-vascular diseases. Furthermore it has been associated with antioxidative status. Additionally balneotherapeutic sulphur baths have been shown to influence antioxidative status. METHODS: 40 patients with degenerative osteoarthrosis were randomised into two equal groups, a treatment group, receiving stationary spa therapy plus daily sulphur baths (sulphur group) and a control group receiving spa therapy alone (control group). Blood tHcy levels and urinary 8-OHdG (an indicator for oxidative stress) were measured at the beginning and the end of spa therapy. RESULTS: tHcy (micromol/l) was significantly reduced from 11.41 (+/-2.91) to 10.55 (+/-2.28) in the sulphur group (p=0.016) and rose insignificantly from 12.93 (+/-2.28) to 13.80 (+/-3.87) in the control group. 8-OHdG (ng 8-OHdG/mg creatinine) declined from 18.00 (+/-18.28) to 11.16 (+/-5.33) in the sulphur group (n.s.) and from 17.91 (+/-5.87) to 18.17 (+/-5.70) in the control group (n.s.). Differences between the two groups showed significant effects of sulphur baths for tHcy (p=0.006) but not for 8-OHdG (p=0.106). CONCLUSIONS: Sulphur baths exert beneficial effects on plasma tHcyt whereas effects on 8-OHdG seem to be unlikely. farmacologia Clin Chim Acta. May;343(1-2):105-11, 2004 Anti-inflammatory effect of mineral water inhalation: validity of identification of biochemical markers in nasal secretion I.N.Smirnova, T.N. Zaripova, D.I. Kuz'menko, I.I. Antipova o The study was made of therapeutic activity of silicon mineral water Tersinka inhalations on clinical symptoms, external respiration function and activity of inflammation in patients with chronic bronchitis and bronchial asthma as shown by biochemical markers of inflammation in the blood serum and nasal secretion. A correlation was found between treatment efficacy and concentration of sialic acids in the nasal secretion in pulmonological patients. ORL Vopr Kurortol Fizioter Lech Fiz Kult.Jul-Aug;(4):20-3,2003 Clinical efficacy and cost-effectiveness evidence of spa therapy in osteoarthritis. The results of "Naiade" Italian Project. A.Fioravanti, M.Valenti, F.Altobelli, F. Di Orio, G. Nappi, A.Crisanti, L.Cantarini, R. Marcolongo Institute of Rheumatology, University of Siena, Siena, Italy. fioravanti7@virgilio.it AIM: The "Naiade" Project was carried out in execution of the Decree of December 1994 by the Italian Ministry of Health, with the objective of defining the therapeutic role of spa therapy in the various sectors of medicine. In this study the authors refer to the results obtained in osteoarthritis (OA). METHODS: The OA study included the observation of patients for 2 consecutive years, with the compilation of a series of clinical and socio-economic data. The initial sample was of 11437 patients suffering from primary and secondary OA, and in the 2(nd) year the total number of assessable patients was 6111 (53.4%). All patients underwent 1 annual cycle of balneotherapy and mud packs therapy for 2 consecutive years. The thermal treatments were carried out in 98 Italian spas with sulphurous water, sodium chloride-bromide-iodide water, sulphate water, and bicarbonate water. Analysis of the data collected confirmed the clinical efficacy of spa treatments for OA, particularly for localisations in the cervical and lumbar spine. The benefits of these treatments and the persistence of the therapeutic effects over time were clearly demonstrated by the collection of some socio-economic indicators relative to the year before each cycle of thermal therapy. RESULTS: In fact, the analysis of these indicators showed a significant reduction in recourse to additional treatments (hospital admissions, physical and pharmacological therapies) and absence from work. CONCLUSION: The obtained data was particularly interesting for the number of samples examined, the follow-up over a period of 2 years, and the collection of clinical and, especially, socio-economic parameters. The results of the Naiade Project confirmed the value of spa therapies in the treatment of OA. farmacologia Panminerva Medica 45 n°3,211-217, 2003 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 Effect of mineral waters with different salt composition on changes in parenchymal-stromal ratio of the laryngeal wall glands in rats V.B. Shadlinskii, N.T. Movsumov Department of Human Anatomy, Azerbaijan Medical University, Baku The aim of the present investigation was to study the laryngeal glandular apparatus as influenced by the application of baths with different mineral composition. 100 mature outbred male rats aged 3-4 months with 180-200 g body mass were studied in this investigation (including 60 experimental and 40 control animals). After a 28-days-long balneologic course using mineral waters with different composition, the histological and morphometric study of laryngeal gland was performed in different parts of the organ to assess the relative contents of parenchyma and stroma. As a result of investigation performed it was demonstrated that course application of iodobromine and bituminous baths resulted in an increased parenchymal contribution to the glandular structure with a corresponding reduction in a relative stromal contents. However, course application of strong (concentrated) sulfide baths causes the stromal outgrowth and glandular epithelium reduction. farmacologia Morfologia;123(3):79-82. 2003 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 Experimental study on efficacy of thermal muds of Ischia Island combined with balneotherapy in the treatment of psoriasis vulgaris with plaques M. Delfino, N. Russo, G. Migliaccio, N. Carraturo Clinica Dermatologica, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli. A lot of studies show the efficacy of thermal therapy in psoriasis. The main indications concern all forms of psoriasis (except for pustolosa and eritrodermic) especially diffuse psoriasis, intensive itchy, artropatic psoriasis and gutted psoriasis child. Benefit effects of thermal water and muds, which are important parameters in psoriasis' treatment, they are excellent to reduce inflammation, scaling, and erythema. In this study we evaluated the clinical efficacy of thermal bath plus muds in patients affected by psoriasis. 18 patients has been examined and randomly divided in 3 group (A-B-C). All the patients received thermal therapy for 4 weeks. To evaluate the behaviour of the disease we performed (corneometry, sebometry, phmetry), as well as evaluation of P.A.S.I. At the end of the study, values of P.A.S.I. showed a reduction from 10 to 6 unites P.A.S.I. for patients belong to group A, more 12 to less 10 for patients belong to group C e no significant variations for group B (because represent control group). Results obtained can be considered useful, considering that thermal treatment was used alone in the treatment of all patients. dermatologica Clin Ter. May-Jun;154(3):167-71,2003 Terme e Cute - Health Resort and Skin A. Rossi, C. Cantisani, M. Carlesimo, S. Calvieri Dipartimento di Dermatologia-Venereologia Chirugia Plastica-Ricostruttiva Università degli Studi di Roma "La Sapienza", Roma Since ancient times, in every country and culture there have been healt resort specializing in dermatological applications. Unfortunately, many ancient procedures, methodologies and clinical applicathions have been lost to the sands of time unknown even to physicians considered to be experts in their field of practice. All over the world, throught historical research or the study of still practiced ancient tecnhiques passed down through generations, many ancient treatments once viewed with scepticism, shrouded in mystery or a "magic" aura and lacking in serius medical analysis, are now under careful review. In recent years, physicians have completed comprehensive studies including strict empirial verifications of many of the most important known ancient dermatological practices. An observational, longitudinal, clinica epidemiological study taking place within the Naiade project describes the middle to longterm impact on patients affected by psoriasis and trated with crenotherapy. dermatologia G Ital Dermatol Venereol 138:519-24,2003 L'inaloterapia termale nel trattamento delle broncopneumopaite croniche. Risultati del progetto NAIADE G. Melillo, G.Nappi, M. Valenti Progetto Naiade Il Ministro della Sanita ha emanato, in data 15 dicembre 1994, un decreto riguardante la ridefinizione delle patologie da trattare con acuqa minerali. A tale scopo veniva richiesta agli stabilimenti termali l’effettuazione di studi clinico.epidemiologici, osservazioni e/o sperimentali adatti a dimostrare l'efficacia delle terapie termali. E’ nato cosi il progetto NAIADE, con lo scopo di valutare se le terapie termali sono in grado di modificare lo stato di salutre, definito da parametri clinici soggettivi e obiettivi. E’ stato adottato un disegno osservazionale longitudinale con follow-up di almeno 2 anni. Sono poi stati presi in considerazione alcuni indicatori economico-sanitari osservati nei 12 mesi precedenti i trattamenti termali. Lo studio riguardante le vie aeree inferiori ha arruolato un gruppo iniziale di 5083 soggetti. I benefici clinici a breve e lungo termine sono stati gli effetti sugli indicatori economico-sanitari consistenti in una significativa riduzione dei ricoveri in ospedale, un diminuito numero di perdite di giornate lavorative e una significativa diminuzione nel consumo di farmaci specifici. respiratoria Rass. Patol.Appar. Resp. 17-1:37-42,2002 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 Behavior of serum IgE and IgA in patients with allergic rhinitis treated with iodine bromide thermal water M. Barbieri, A.Salami, F. Mora, A. Casazza, A. Sovatzis, R. Teglia, M.P.Cordone, R.Mora Istituto di Clinica Otorinolaringoiatrica, Università di Genova. Istituto di Clinica Otorinolaringoiatrica, Università di Genova. The aim of this study was to test the effects of the iodine bromide water of the thermal baths of Salsomaggiore on patients suffering from specific nonseasonal rhinitis (Dermatophagoides Farinae and Dermatophagoides Pteronyssinus). The patients, 80 in all, were divided in two groups (group A and group B). All of the patients underwent rhinoscopic examination, anterior rhinomanometry, prick test, rast screening, total IgE assay together with that of the other immunoglobulins (IgA, IgM, IgG), mucociliary clearance evaluation and were asked to evaluate their degree of nasal obstruction, before and after 30 days of treatment. Group A carried out the experiment by applying endonasal Acqua Sal spray seven times a day for 30 days; group B used oily drops for the same time and with the same frequency. At the end of the trial period, the patients in group A showed a 100% improvement in their subjective perception of their symptomatology, in comparison with a 33% improvement in the control group. A characteristic decrease in the IgE and increase in the IgA was observed in the serum of the patients who had been treated with Acqua Sal spray. Iodine bromide water has a general and local anti-inflammatory effect, which is also due to the activation of the corticosurrenal system (with a relative increase in cortisol). The cleansing action of hypertonic water in the nasal cavities must also be cited, as it minimizes contact between the mucosa and allergens. ORL Acta Otorhinolaryngol Ital. Aug;22(4):215-9, 2002 Bone remodelling in osteoarthrosic subjects undergoing a physical exercise program S.Bellometti, F. Bertè, P. Richelmi, T. Tassoni, L. Galzigna P.d'Abano Scientific Research Center, L.go Marconi 8, Abano T (PD), Italy. simonab@studitermali.org P.d'Abano Scientific Research Center, L.go Marconi 8, Abano T (PD), Italy. simonab@studitermali.org BACKGROUND: The connection between osteoarthritis (OA) and osteoporosis (OP) has attracted considerable attention but reports about bone mass density (BMD) in OA are often contradictory. Some data indicate that BMD is higher in OA patients than in healthy subjects, whereas other studies showed no differences. It has been observed that mud pack treatment (MPT) induces a decrease in cytokines with bone-resorbing effects. The aim of this study is to evaluate the response of bone and connective tissue to physical exercise and thermal treatment. METHODS: Forty osteoarthrosic patients were divided in group A (physical exercise and MPT), and group B (physical exercise alone). Blood and urine samples were collected before and after the treatments to assay blood metabolic markers and urinary hydroxyproline. RESULTS: In group A, some parameters show statistically significant differences before and after mud pack treatment (MPT). In group B, all parameters present no statistical significant changes before and after the physical exercise program. CONCLUSIONS: Few studies established the importance of exercise to maintain normal cartilage and bone metabolism. In group A of the present study, an influence on all the parameters of bone metabolism is evident. It is possible that physical exercise only if combined with MPT stimulates physiologic bone metabolism and favors skeletal health. Copyright 2002 Elsevier Science B.V. riabilitazione Clin Chim Acta. Nov;325(1-2):97-104,2002 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. osteoarticolari 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. osteoartrosi Arthritis Rheum.Oct 15;47(5):459-67, 2002 Effect of a gynaecological thermal treatment on the hypothalamic-pituitary ovarian axis in premenopausal women V. Coiro, L.Irali, G.Saccani Jotti, G.Varacca Department of Internal Medicine and Biomedical Sciences,University of Parma, Terme di Salsomaggiore, Department of Public Health University of Parma Objective:Premenopause is charactarized by colpocytologic deterioration, anovulatory menstrual cycles,progressive reduction in serum ovarian steroids and increased gonadotropin levels. Improvements in colpocytologic parameters and in menstrual cycle regularity have been observed in premenopausal women after thermal treatment with salsobromoiodic water. The aim of this study has been to establish whether these clinical observations could be associated with sex hormone change. Methods: Colpocytologic test and serum FSH, LHG,17-betaestradiol (E2) and progesterone (P) levels have been evaluated at the 22nd day of 2 following mestrual cycles in 65 healthy premenopausal women. During the month between tests, the were subdivided into two groups: A) 45 subjects (experimental group) underwent a gynaecological thermal treatment with salsobromoiodic water, whicht stardet after menstruation (15 morning immersion up to the neck in water at 37°C and 15 vaginal irrigations at 38°C with increasing water density); B) 20 subject (control group) receveid a standard pharyngeal inhalant teatment. Furthermore, in order to evaluate the effects of the treatment on clinical symptoms sensitive to estrogen deficiency, such as hot flush, palpitation, insomnia and genitourinary disturbances, all subjects answared a questionnaire at the time of recruitment and 6 months later. Result: All women showed low serum E2 an P levels and elevated gonadotropin concentrations before thermal treatments. While hormonal values did not change after pharingeal inhalations in the control group, the subjects on the experimental group showed a significant increase in both serum E2 and P concentartions, with a significant decrease in serum FSH levels. Two endocrine markers of ovulation, LH maggFSH and P magg5ng/mL, were simultanneously present in just 7 outof the 45 subjects of the experimental group in the first test, whereas they were present in 18 subjects after gynaecological thermal treatment a significant improvedment alterations and clinical symptoms was observed in the experimental group, where as no change wasd found in the control group. Conclusion: these data show a significant improvedement of the hypothalamic-pituitary ovarian dysfunctions in premenopausal women after gynaecological thermal treatment. The improved ovarian steroid milieu might be at least in part responsible for the clinically evident amelioration observed after thermal therapy. ginecologia It.J.Gynaecol.Obstet. 14:N°4:115-120,2002 Comportamento delle IGE e IGA sieriche in pazienti con rinite allergica trattata con acquee salsobromoiodiche M.Barbieri, A. Salami, F. Mora, A. Casazza, A. Sovatzis, R. Teglia. M.P. Cordone, R.Mora Istituto di Clinica Otorinolaringoiatrica, Università di Genova L'obiettivo dello studio condotto è quello di testare gli effetti dell'acqua Salsobromoiodica delle Terme di Salsomaggiore su pazienti affetti da rinite perenne specifica (Dermatophagoides Farinae e Dermatophagoides Pteronyssinus). I pazienti, 80 in tutto, sono stati suddivisi in due gruppi (gruppo A e gruppo B). Tutti i pazienti sono stati sottoposti sia prima che dopo i 30 giorni di terapia, ad esame rinoscopico, rinomanometria anteriore , prick test, rast screening, dosaggio delle IgE totali, delle altre immonogloblunine (IgA-IgM-IgG), test di trasportomucociliare e scala soggettiva per valutazione dell'ostruzione nasale. Il gruppo A ha condotto la sperimentazione assumendo per 30 giorni Acqua Sal spray per via endonasale, con una posologia di 7 applicazioni quotidian; il gruppo B ha assunto gocce oleose per lo stesso periodo e con la stessa posologia. Al termine della sperimentazione nei pazienti che rientravano nel gruppo A si è assistito ad un miglioramento della sintomatologia soggettiva del 100%, a differenza del 33% riscontrato nel gruppo di controllo. Caratteristica è stata la diminuzione delle IgE e l'aumento delle IgA nel siero dei pazienti a cui era stata somministrata Acqua Sal spray. Le acque salsobromoiodiche hanno un'azione antinfiammatoria generale e locale, dovuta anche all'attivazione del sistema cortico-surrenale (con relativo aumento di cortisolo) Va ricordata altresì l'azione di detersione a livello delle cavità nasali dell'acqua ipertonica che consente alla mucosa di venire il meno possibile a contatto con gli allergeni. ORL Acta Otorhinolaryngol Ital 22,215-219,2002 Progetto Naiade: patologia litianistica delle vie urinarie e terapia idropinica termale con acqua oligominerale S.De Luca, G.Nappi, A.Merconi Orsini Progetto Naiade Nell'ambito del progetto si verifica degli effetti terapeutici delle cure termali promosso dalle Autorità Sanitarie Italiane, una corte di 1102 pazienti affetti da “calcinosi delle vie urinarie e sue recidive” è stata sottoposta per due anni consecutivi a cicli di terapia idropinica con acque oligominerali. Attraverso l’analisi di indicatori clinici e socio-economici è stato evidenziato il valore terapeutico della cura termale ed il potenziale risparmio di spesa pubblica ad attribuire alla conseguente riduzione di altri interventi terapeutici e previdenziali. urinario Med. Clin. Term. 47:197-206,2001 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 Effects of mud-pack treatment on plasma cytokine and soluble adhesion molecule levels in healthy volunteers. S.Basili,F. Martini,P.Ferroni, M. Grassi, A. Sili Scavalli, P.Streva , G. Cusumano, A.Musca, G. Battista Rini Department of Medical Therapy, University of Rome La Sapienza, Viale Del Policlinico, 155 00161 Rome, Italy. stefania.basili@uniroma1.it Department of Medical Therapy, University of Rome La Sapienza, Viale Del Policlinico, 155 00161 Rome, Italy. stefania.basili@uniroma1.it BACKGROUND: The suggested hypothesis of a direct anti-inflammatory property of mud-pack treatment has led us to speculate that its action on the cytokine network might counteract the heat-stress-related effects on platelet and endothelial cell function often reported following hot-spring baths. Therefore, the present study was designed to investigate the effects of a cycle of 12 daily mud-pack treatments on bio-humoral markers of inflammation, as well as on markers of in vivo platelet and/or endothelial cell activation, in plasma samples obtained from healthy volunteers. METHODS: Blood samples were obtained before (T(0)), at the end of the first treatment (T(1)) and after a cycle of 12 daily mud-pack treatments (T(2)). Plasma cytokines (TNF-alpha IL-1beta, and IL-6) and adhesion molecules (sP-selectin, sE-selectin and sVCAM) levels, as well as hematocrit and complete and differential blood cell counts were determined at every time point. RESULTS: Plasma sP-selectin levels were not modified during treatment, as were not sE-selectin or sVCAM. Similarly, IL-1beta and TNF-alpha levels were unchanged through a 12 daily mud-pack treatment. Conversely, plasma IL-6 levels were significantly lowered at the end of a 20-min 47 degrees C mud-pack treatment (p minore 0.01). CONCLUSIONS: The lack of effects on in vivo platelet and/or endothelial cell activation suggests that hot mud-pack treatment might be used as a relatively safe procedure in patients with atherothrombotic disorders farmacologia Clin Chim Acta.Doc.314:209-14, 2001 Valutazione strumentale dell'efficacia della crenoterapia solfureo-salso-bromo-iodica nelle rinosinusiti croniche. G.Amabile, L.Pignataro, O.Pignataro Clinica ORL I e Clinica ORL II Università di Milano -Terme di Sirmione E'stato effettuato uno studio clinicoprospettico in aperto, non comparativo, per valutare l'efficacia della crenoterapia solfureo-salso-bromo.iodica con acqua si Sirmione nelle rinosinusiti croniche di pazienti adulti e pediatrici. Sono stati studiati 96 pazienti (46 maschi, 50 femmine, età compresa tra 6 e 79 anni, età media 44 anni) affetti sa rinosinusite cronica. La diagnosi era posta in base alla presenza di due o più sintomi o segni e di reperti radiografici di rinosinusite cronica. I pazienti sono stati esaminati prima, a metà e a fine terapia. Sono stati valutati mediante score e sintomi rinorrea, stenosi, irritazione nasale, cefalea ed i segni ipertrofia dei turbinati, iperemia della mucosa nasale, presenza di secrezione nelle fosse nasali. La pervietà nasale è stata valutata mediante rinomanometria anteriore attiva ed espressa in termini di resistenza nasale monolaterale alla preessione preselezionata si 100 Pascal e di resistenza nasale totale. Il tempo di trasporto mucociliare nasale è stato valutato per ciascuna fossa nasale con il test della polvere di carbone vegetale e di saccarina al 3%. L’analisi statistica è stata effettuata mediante test di Wilcoxon per dati appaiati. Le crenoterapia è stata effettuata mediante inalazioni a vapore, aerosols sonici e docce nasali ( un’applicazione al giorno di ciascuna cura per 12 giorni). Si è potuto constatare, dopo la crenoterapia, un miglioramento statisticamente significativo dei sintomi di rinorrea, strenosi nasale e cefalea e del segno iperemia della mucosa. Le resistenze nasali monolaterali e totali non sono variate significativamente dopo la terapia. Il tempo di trasporto mucocigliare nasale, valutato con il test della polvere di carbone, è diminuito significativamente dopo la cura termale. Le determinazioni con il test della polvere di saccarina al 3% si sono rivelate non affidabili. Lo studio a confermato che la terapia con l’acqua solfureo-salso-bromo-iodica di Sirmione determina un’attenuazione soggettiva delle rinosinusiti croniche. ORL Otorinolaringogia-50-Suppl.1 al n°4-27-34, 2000 L'Intervento Crenoterapico nell'otite media secretiva. Valutazione critica. V.Colletti, C.Calvelli, F.G.Fiorino, G.Cumer, L.Trombetta Clinica ORL Università di Verona - Terme di Sirmione Gli AA hanno seguito 100 pazienti di età compresa fra i 5 ed i 12 anni sottoposti a crenoterapia inalatoria ( inalazioni, docce micronizzate, insufflazioni endotimpaniche). E' stato valutato prima e dopo il trattamento il quadro clinico ed obiettivo ( iperemia della mucosa nasofaringea, congestione nasale, rinorrea, secrezione rinofaringea, iperemia e retrazione timpaniche, presenza di versamento endotimpanico), es. audiometrico, rinomanometria anteriore, tempo di trasporto mucociliare con test al carbone e saccarina. Si riscontrava diminuzione statisticamente significativa per la congestione nasale ( P=0,01 ), aumento ( P=0,01 ) dell'iperemia nasale, diminuzione ( P=0,01) della rinorrea e della secrezione rinofaringea. Migliorata anche la obiettivitàstrumentale timpanica, in particolare si ਠriscontrata una drastica riduzione ( dal 42 % al 2% ) del versamento timpanico (P=0,01 ), della audiometria. ORL Otorinolaringogia-50-Suppl.1 al n°4-35-39, 2000 Effects of one cycle of inhalation crenotherapy with radioactive fluoridated oligomineralT.Marullo, A. Abramo Università di Roma La Sapienza. The objective of the study was to test the effects of inhalation crenotherapy using the radioactive, fluoridated oligomineral waters from the Merano Spa on both subjects with specific upper respiratory tract phlogosis and normal subjects. The double-blind study was performed on a population of 27 adults of both sexes treated with radioactive-fluoridated water (group A) and 20 subjects, suffering from the same chronic catarrh pathology, selected with the same criteria but treated with inhalation of steam and an aerosol using drinking water from the municipal water supply (group C). In addition, a group of 13 subjects--which in terms of age and sex were statistically comparable to groups A and C but who did not show any signs of acute or chronic upper respiratory tract pathologies (group B) were also treated with the radioactive-fluoridated waters. All subjects included in the study underwent the following tests before and after the cycle of crenotherapy: Objective E.N.T. examination. Computerized Active Anterior Rhinomanometry. Detection of the ciliary mucous transport (CMT) time. Nasal cytology. Physical and immunochemical examination of the nasal mucous. The results of this study--seen in the trend in some parameters monitored both before and after the cycle of crenotherapy using Merano Spa water--clearly show that that the crenotherapy studied had an effect on aspecific chronic phlogosis of the upper respiratory tract. In fact, among other things, group A showed decreased nasal resistance, increased nasal respiratory flow, normalized mucociliary transport, decreased bacterial flora and an increased number of plasma cells in the rhinocytogram. In addition there was an increase in the following values in the nasal mucous: Albumin, non-secretory Immunoglobulin and the secretory portion of secretory Immunoglobulin A. None of these variations are seen in the results from the control group treated with municipal drinking water. After treatment with Merano spa water, the pathology-free subjects showed variations in the parameters in line with those found for group A. This biological reality can most likely be attributed to the favorable response of the respiratory mucosa, promoting anti-infection defenses. ORL Acta Otorhinolaryngol Ital. Aug;20(4 Suppl 63):1-13,2000 Balneotherapy with arsenical-ferruginous water in chronic cervico-vaginitis. A case-control study V.Danesino Istituto di Clinica Ostetrica e Ginecologia, Università degli Studi, Pavia, Italy. BACKGROUND: The aim of this study was to evaluate the efficacy and tolerability of vaginal irrigations with arsenical-ferruginose water from the spa at Terme di Levico in chronic cervico-vaginitis in order to assess the validity of balneotherapy in improving the symptoms and quality of life of patients. METHODS: An open comparative study was performed in 30 patients with symptoms attributable to aspecific chronic vaginitis (in child-bearing age) or vulvovaginal dystrophy (perimenopausal age). Twenty patients (Group A) received balneotherapy and 10 (Group B) were treated with placebo vaginal suppositories. All patients were required to fill in a questionnaire on symptoms. A thorough gynecological examination was performed, together with a Pap-test and vaginal secretion sample for bacterioscopic and microbiological tests. The same tests were repeated at the end of treatment. RESULTS: Post-treatment results showed a general reduction in the extent of gynecological symptoms reported by patients. A statistically significant reduction was only observed in patients receiving balneotherapy for the following symptoms: vaginal burning , vulvar burning , vaginal itch , vulvar itch , leukorrhea . An analysis of the cytological tests performed in patients enrolled in the study highlighted a high prevalence of phlogistic type findings, often in association with varying degrees of atrophy in postmenopausal patients. Those patients suffering from chronic vaginitis undergoing balneotherapy showed a reduction in the prevalence of phlogistic findings after treatment. CONCLUSIONS: Treatment with arsenical-ferruginose water led lo a marked reduction in the subjective symptoms reports by the study population (particular evident in patients with chronic leukorrhea), as was confirmed by objective signs (clinical, cytological and microbiological) of phlogosis. This was accompanied by excellent tolerability. These results justify the use of balneotherapy, according to the classic techniques and methods, in chronic cervicovaginal phlogistic processes. ginecologica Min Gin 53:63-9, 2000 L'importanza delle IGA secretorie nasali nei processi muconasali delle prime vie aeree. Loro correlazione con la terapia solfurea C.F. Gervasio, M.Bussi, G. Cortesina Clin.II ORL Università Torino - Terme di Sirmione Gli AA, fatto il punto sulla importanza delle IgA Secretorie nella immunità umorale a livello delle mucose, hanno seguito uno studio su 30 pazienti affetti da poliposi nasale su base non allergica sottoposti a 3 lavaggi narinali al giorno per 21 giorni. Un gruppo ha utilizzato soluzione fisiologica ed un gruppo acqua solfurea di Sirmione. Al controllo di base ed a fine trattamento sono state dosate le IgAS. Nelle condizioni di base 29 su 30 pazienti presentavano livelli inferiori alla norma. A termine trattamento si è registrato un aumento in entrambi i gruppi, più marcato e importante nel gruppo trattato con acqua solfurea. ORL Min. Med. ORL ,2000 Effects of water hardness on urinary risk factors for kidney stones in patients with idiopathic nephrolithiasis. V.Bellizzi, L. De Nicola, R. Minutolo, D. Russo, B. Cianciaruso,M. Andreucci, G. Conte, Andreucci VE. Div. Nefrol. Università II Napoli - Terme di Fiuggi Division of Nephrology, School of Medicine, University Federico II, Naples, Italy. Both amount and timing of dietary calcium intake influence the recurrence of renal calcium stones. We have evaluated whether the hardness of extra meal drinking water modifies the risk for calcium stones. The urinary levels of calcium, oxalate and citrate, i.e., the main urinary risk factors for calcium stones, were measured in 18 patients with idiopathic nephrolithiasis, maintained at fixed dietary intake of calcium (800 mg/day), after drinking for 1 week 2 liters per day, between meals, of tap water and at the end of 1 week of the same amount of bottled hard (Ca2+ 255 mg/l) or soft (Ca2+ 22 mg/l, Fiuggi water) water, in a double-blind randomized, crossover fashion. As compared with both tap and soft water, hard water was associated with a significant 50% increase of the urinary calcium concentration in the absence of changes of oxalate excretion; the calcium-citrate index revealed a significant threefold increase during ingestion of hard water as compared with respect to soft water (Fiuggi water), making the latter preferable even when compared with tap water. This study suggests that, in the preventive approach to calcium nephrolithiasis, the extra meal intake of soft water is preferable to hard water, since it is associated with a lower risk for recurrence of calcium stones. urinario Min. Med. ORL,2000 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 Studio oggettivo degli effetti di un ciclo di crenoterapia inalatoria con acque oligominerali radioattive fluorurate delle Terme di Merano T. Marullo, A.Abramo Terme di Merano Studio in doppio cieco su soggetti affetti da flogosi non specifiche delle V.A.S. trattati con acque oligominerali e acqua fontis. Monitorati i Rinomanometria anteriore attiva computerizzata, tempo di trasporto mucociliare, es. citologico nasale, es. fisico e immunochimico del muco nasale. Nel gruppo A: diminuzione delle resistenze, aumento del flusso respiratorio nasale, normalizzazione trasporto mucociliare, diminuzione tappeto batterico e aumento plasma cellule nel rinocitogramma, aumento Albumina, Immunoglobuline non secretive. ORL Acta Orl.Ital. suppl.N° 4, 2000 la crenoterapia con acque arsenicali-ferruginose nelle flogosi croniche cervico-vaginali V. Danesino Università degli Studi di Pavia, Istituto Clinica Ostetrica e Ginecologica Background:The aim of this study was to evaluate the efficacy and tolerability of vaginal irrigations with arsenical-ferruginose water from the spa Terme di Levicoin chronic cervicovaginitis in order to asses the validity of balneotherapy in improving the symptoms and quality of life of patients. Methods: An open comparative study was performed 30 patiens with symptoms attributable to aspecific chronic vaginitis (in child-bearing age) or vulvovaginal dystrophy (perimenopasal age). Twenty patients (group A) receveid balneotherapy and 110 (group B) were treated with placebo vaginal suppositories. All patients were required to fill in a questionnaire on symptoms. A thorough gynecological examination was performed, together with a Pap-Test and vaginal secretion sample for bacterioscopic and microbiological tests. The same tests were repeated at the end of treatment. Results: Post treatment results showed a general reduction in the extent of gynecological symptoms reported by patients. A statistically significant reduction was only observed in patients receiving balneotherapy for the following. ginecologica Min Gin 53:63-9, 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. Function of the hypothalamic adrenal axis in patients with fibromyalgia syndrome undergoing mud-pack treatment. S.Bellometti,L. Galzigna Thermal Research Center P. d'Abano, Padua, Italy. Thermal Research Center P. d'Abano, Padua, Italy. Fibromyalgia (FM) is a nonarticular rheumatological syndrome associated with diverse clinical and psychological features. One of the major complaints in FM is reduced pain tolerance, especially in tender points (TP) for which patients derive significant benefit from nonsteroidal antiinflammatory drugs or corticosteroids. Patients with FM also have altered reactivity of the hypothalamic pituitary adrenal (HPA) axis where the predominant feature is reduced containment of the stress response system through diminished adrenocortical output and feedback resistance. Our results show that mud packs together with antidepressant treatment are able to influence the HPA axis, stimulating increased levels of adrenocorticotropic hormone, cortisol and beta-endorphin serum levels. The discharge of corticoids in the blood and the increase in beta-endorphin serum levels are followed by a reduction in pain symptoms, which is closely related to an improvement in disability, depression and quality of life. It seems that the synergic association between a pharmacological treatment (trazodone) and mud packs acts by helping the physiological responses to achieve homeostasis and to rebalance the stress response system. To clarify and optimize the effectiveness of this synergic association, studies involving a larger number of FM patients and a different pharmacological treatment are needed. farmacologia Int] Clin Pharmacol Res.19(1):27-33,1999 Ultrasonic nebulization of sulphurous water decreases inflammatory cells in sputum of asthmatics D.Bertolotti, F.Strinati, G.Nappi, G.Melillo, E.Savini C. St. Ric. Med. Term. Università di Milano - Cli. Lavoro e Riab. Fond. S. Maugeri - Terme di Tabiano The aim of this study was to determine whether ultrasonic nebulization of sulphurous water (UNSW) modifies the inflammatory cells in the induced-sputum of asthmatics. Nineteen patients with stable asthema underwent an ultrasonic inhalation in an 80 m3 room in which the mineral water (Arvè – Tabiano SPA ) was nebulized by 3 ultrasonic nebulizers. The cycle of treatment included 2 session of 10 min. a day (with 30 min. of interval ) for 12 consecutive days. Sputum was induced before the inhalation session (TO), after the last session of the cycle (T1) and 3 weeks after the end ot the treatment. Results: a significant decrease of eosinophils (p minore 0.05, of lymphocytes (p minore0.05) ad an increase of macrophages (p minore0.05) was observent at T2 respiratorie XVI World Congress of ASTHMA, 1999 Urine volume: stone risk factor and preventive measure. L. Borghi, T.Meschi, T.Schianchi, A.Briganti, A. Guerra, F. Allegri, A.Novarini Ist. Semeiot. Med. Università di Parma - Terme di Fiuggi Istituto di Semeiotica Medica, Università di Parma, Italia. lborghi@ipruniv.cce.unipr.it BACKGROUND: A high fluid intake is the oldest existing treatment for kidney stones, and, up until a few decades ago, it was the only preventive measure at the physician's disposal for stone recurrences. METHODS: Using the data available in literature and partly unpublished personal research, we examine the role of urine volume as a stone risk factor, its impact on calcium crystallization mechanisms and its real importance as a means of prevention. RESULTS: To sum up, the most important findings are: (1) a low urine volume must be considered as a real risk factor, both as regards the onset of renal calculi and stone relapses; (2) an increase in urine volume induced by a high water intake produces favourable effects on the crystallization of calcium oxalate and does not reduce the activity of natural inhibitors; (3) a sufficiently high intake of water and probably other fluids such as coffee, tea, beer and wine has a preventive effect on nephrolithiasis and its recurrence, and (4) the role of fruit juice is still to be defined. CONCLUSIONS: A high intake of fluids, especially water, is still the most powerful and certainly the most economical means of prevention of nephrolithiasis, and it is often not used to advantage by stone formers. urinario Nephron. ;81 Suppl 1:31-7,1999 Aquatic therapy in the rehabilitation of athletic injuries. J.Prins, D.Cutner Department of Kinesiology and Leisure Science, University of Hawaii at Manoa, Honolulu, USA. Department of Kinesiology and Leisure Science, University of Hawaii at Manoa, Honolulu, USA. Water is the ideal environment for active physical therapy. By taking advantage of the physical properties of water, early resumption of rehabilitation is possible. An individualized program in aquatic rehabilitation requires the attending clinician to have specialized knowledge and experience in design and supervision. This article provides an overview of aquatic physical therapy and includes suggestions for the treatment of common athletic injuries. riabilitativa Clin Sports Med. Apr;18(2):447-61,1999 Effect of sulfur salt-bromine-iodine thermal waters on albumin and IgA concentrations in nasal secretions A. Staffieri, C.Miani, A.M. Bergamin, P. Arcangeli, P.Canzi Università di Padova. In chronic rhinopharyngotubaric phlogoses, the key pathogenic element sustaining phlogosis is a persistent modification of the biological, rheological features of the nasal mucus. For centuries sulphurous thermal waters have proved effective in clinically curing such phlogoses. In order to evaluate the effect of such sulphurous-salty-bromic-iodic thermal waters a randomized, double blind study was undertaken on a sampling of 50 patients. The effect such waters have on secretory IgA (sIgA) and albumin in the nasal secretions was tested against a placebo made of distilled water. Using the method of radial immunodiffusion, the response in the IgAs (mg/l) and albumin (mg/dl) concentrations in the nasal secretions was measured for 25 patients treated with the thermal waters and 25 patients treated with distilled water. The average concentrations were statistically compared using the Student t-test for paired samples. A significant increase (p minore 0.0001) was seen in the mean IgAs concentration in the patients treated with the thermal waters. On the other hand, there was a weak, not statistically significant increase in the same data mean for the group treated with distilled water. The average increase in the albumin concentration in the nasal secretions proved significant in both cases although the significance was much more marked in the group treated with the thermal waters (p = 0.001) vs. the placebo group (p = 0.039). ORL Acta Otorhinolaryngol Ital. Aug;18(4):233-8, 1998 Effect of thermal mud baths on normal, dry and seborrheic skin A. Carabelli, G. De Bernardi di Valserra, M. De Bernardi di Valserra, S.Tripodi, E. Bellotti, R. Pozzi, C. Campiglia, P. Arcangeli Università di Pavia, Italia. Università di Pavia, Italia.PURPOSE: To investigate the curative effects of thermal water and thermal muds in various cutaneous pathologies. PATIENTS AND METHODS: Modifications of phmetry and sebometry using sulphur thermal muds in normal, dry and seborrheic skin have been studied. The three groups of patients have been submitted to a 14 day treatment with thermal muds. RESULT: The application of thermal mud normalized the value of cutaneous pH and sebometry. CONCLUSIONS: These beneficial effects are long-lasting in individuals who have a prolonged treatment with thermal muds. dermatologico Clin Ter. Jul-Aug;149(4):271-5,1998 Serum levels of a prostaglandin and a leukotriene after thermal mud pack therapy. S.Bellometti,L. Galzigna Centro Studi Termali P. d'Abano, Italy. BACKGROUND: Mud pack therapy (MPT) influences the serum levels of several cytokines involved in chondrocyte metabolism and in the pathogenesis of osteoarthrosis. In fact, we have observed decreases of IL-1 and TNF-alpha, involved in cartilage inflammation and destruction, and increases of IGF-1 that have a protective influence on the cartilage. It is known that in osteoarthrosis MPT is also able to decrease pain, largely attributable to the inflammatory response. METHODS: We enrolled 31 subjects undergoing MPT and collected blood samples before and after the therapy to assay serum levels of prostaglandin (PGE2) and leukotriene (LTB4) compounds with potent inflammatory and algesic properties. RESULTS: The study shows a decrease in PGE2 and LTB4 serum levels in all the samples after MPT with no correlation between the PGE2 and LTB4 decreases. CONCLUSIONS: Mud pack therapy exerts a protective effect on the cartilage and is able to induce pain relief by reducing the inflammatory reaction. farmacologia J Investig Med. Apr;46(4):140-5,1998 Effetti indotti dalle acque termali sulfuree-salso-bromo-iodiche sulle concentrazioni di Albumine e IgA secretorie del secreto nasale A.Staffieri, C.Miani, A.M. Bergamin, P.Arcangeli,P.Canzi Clinica ORL Uni Padova, Clinica ORL Uni Udine, Terme di Riccione, Div. ORL Ospedale di Rimini In chronic rhinopharyngotubaric phlogoses, the key pathogenic element sustaining phlogosis is a persistent modification of the biological, rheological feautures of the nasal mucus. For centuries sulphurous thermal waters have proved effective in clinically curing such phlogoses. In order to evaluate the effect of such sulphurous-salsy-bromic-iodic thermal water a randomized, double blid study was undertaken on a sampling of 50 patients. The effect such water have on secretory IgA (sIgA) and albumin in nasal secretions was tested against a placebo made of distilled water. Using the method of radial immunodiffusion, the response in the IgAs (mg-l)and albumin (mg-dl) concentrations in the nasal secretions was measured for 25 patients treated with distilled water. The average concentrations were statistically compared using the Student t-test for paired samples. A significant increase (p magg 0.0001) was seen in the mean IgAs concentrations in the patients treated with the thermal waters. On the other hand,there was a weak,not statistically ignificant increase in the same data mean for the group treated with distilled water. The average increase in the albumin concentration in the nala secretions proved significant in both casee although the significance was much more marked in the group treated with the thermal waters (p uguale 0.0001) vs. the placebo group (p.uguale 0.039). ORL Acta Otorhinolaryngol Ital,18,233-238,1998 Valutazione degli ormoni regolatori del metabolismo osseo durante balneoterapia con acqua salsobromojodica di Salsomaggiore in donne in menopausa. V.Coiro, G.Varacca, R.Volpi, M.Passeri Ist. Clin. Med. Gen. Uni. Parma - Terme di Salsomaggiore Il presente studio è stato eseguito al fine di stabilire se nel corso di un ciclo di balneoterapia con acqua salsobromojodica avvengono modificazioni degli ormoni che regolano il metabolismo osseo. A tal fine abbiamo misurato i livelli plasmatici di calcinoma, di paratormone intatto (PTH) e di vitamina D3 in 8 donne normali in menopausa (età +/- SE: 54.8 +/- 0.3 ) prima, durante e dopo balneoterapia standard per 14 giorni con acqua salsobromoiodica a Salsomaggiore Terme (PR). Inoltre negli stessi soggetti sono stati misurati i livelli sierici di calcio totale (Ca), fosfatasi alcolina e osteocalcina e il Ca urinario delle 24 ore. I prilievi sono tati eseguiti alle ore 8,30 nei giorni 1, 8 e 15 prima di un abgno in acqua minerale (densità: da 4 a 8 beaumè(bè) durante la prima settimana, 10 bè durante la seconda settimana; senza ozono; temperatura: 37°C; durata 20 in. Risultati: le concentrazioni sieriche di calcitonina, fosfatasi alcalina e osteocalcina non si sono modificate durante il periodo di balneoterapia. La calcemia totale è aumentata in modo non significativo ( da 9.5 +/- 0.2 a 9.8 +/- 0.3 mg/dl), mentre la calciurina è aumentata significativamente da 249 +/- 7.35 ( giorno 1) a 290.0 +/- 7,32 mg/24 ore (giorno 15) (P minore 0.001). Inoltre abbiamo osservato un lieve, ma significativo declino del 26.7% dei livelli plasmatici di PTH (giorno 1: 46.12+/-6.37 pg/ml) al termine della terapia termale (giorno 15: 33.8+/-2.3; P minore 0.05), quando è stato anche osservato un simultaneo aumento del 268.7% della Vit D3 (5.9+/-0.41 ng/ml) rispetto ai livelli bassi ( giorno 1: 1.8 +/- 0.2; P minore 0.001).Discussione: al momento attuale non è noto il meccanismo responsabile dei cambiamenti ormonali evidenziati in questo studio. Tuttavia, considerando che sia la salinità dell’acqua del bagno che il calore potrebbero aver influenzato la sintesi di vitamina D3 a livello cutaneo, si può ipotizzare che questi meccanismi, associati all’attività revulsiva, vaso dilatante ed iperemizzante dell’acqua termale, possono essere stati attivati da due settimane di balneoterapia con acqua minerale salsobromoiodica calda ad alta concentrazione salina. Conclusioni: anche se da n punto di vista biologico sono stati osservati solo lievi cambiamenti ormonali, i nostri dati certamente smentiscono l’opinione che la balneoterapia termale con acqua salsobromoiodica si Salsomaggiore sia controindicata nell’osteoporosi. ginecologiche Med. Clin. e Term.,44-45:111-119,1998 The effect of a single inhalation of mineral water on the blood hormonal status in healthy volunteers B.P. Khinchagov, N.D. Polushina, V.K. Frolkov o Concentrations of ACTH, TTH, STH, LH, PSH, hydrocortisone, insulin, glucagone, triiodthyronine, thyroxine, aldosterone, glucose and unesterified fatty acids (NEFA) were measured in the blood of 23 healthy male volunteers aged 18 to 35 years 15, 30 and 60 min after a single nose inhalation and oral intake of mineral water Essentuki No. 17. Inhalation of Essentuki No. 17 stimulated secretion of the hormones and some parameters of metabolic reactions: the levels of glucose, NEFA, hydrocortisone, aldosterone, TTH, PSH and LH rose while those of insulin and growth hormone decreased. Oral intake of this water brought about the same changes in the hormone status except blood insulin the levels of which went up. farmacologia Vopr Kurortol Fizioter Lech Fiz Kult. Jan-Feb;(1):36-8. 1998 Aspetti neuroendocrini della terapia termale. Esperienze in corso di terapia inalatoria con acqua salso-bromo-jodica di Salsomaggiore. V.Coiro, G.Varacca, R.Volpi Ist. Clin. Med. Gen. Università di Parma - Terme di Salsomaggiore Dopo aver analizzato le analogie tra le fasi reattive dell’organismo della terapia termale e el fasi di adattamento allo stress, gli autori concludono che la crenoterapia rappresenta uno stimolo stressante capace di attivare i sistemi neuroendocrini ipotalamo-ipofisi-surrene e della beta-endorfina prodotta dall’ipofosic nel modulare la reattività genenrale dell’organismo e quella tessutale di antura flogistico-immunitaria. Vengono presentate osservazioni sperimentali personali sulla risposta si ACTH/cortisolo e beta-endorfina in soggetti normali sottoposti a terapia inalatoria con acqua salsobromojodica di Salsomaggiore Terme (PR), sottolineando della via etmoidaria di assorbimento in corso di terapia inalatoria nella stimolazione ipotalamo-ipofisaria. farmacologia Med. Clin. Term.,II Trim, 1997 Il ruolo della crenoterapia salso-bromo-jodica nella flogosi delle vie aree in pazienti con BPCO. G.Varacca, R.D’Ippolito, M.L.Piccoli, G.Marletta, V.Bocchino, F.Fagnoni, G.Bertorelli, M.Passeri, D.Olivieri Ist. Clin. Malattie App. Respiratorio- Ist. Clin. Med. Gen. Uni. Parma - Terme di Salsomaggiore Allo scopo di studiare gli effetti della crenoterapia salsobromoiodica sulla componente cellulare flogistica delle vie aeree, sono stati esaminati 8 pazienti (8F, età media +/- DS di 48,2 +/- 12 anni)affetti da broncopneumopatia cronica ostruttiva (BPCO) in fase di stabilizzazione clinica, rispetto ad una popolazione di controllo di 13 soggetti volontari sani (8F, età +/- 9,5 anni), selezionati tra una popolazione afferente alle Terme di Salsomaggiore. In entrambi i gruppi, in condizioni basali, e dopo 12 giorni di terapia inalatoria mediante aereosol con maschera ad aria compressa ed inalazioni con getto caldo umido di acqua salsobromoiodica, sono state valutate la capacità vitale (CV), il flusso espiratorio forzato al 1° sec (FEV 1), il flusso forzato dal 25-75% della Capacità Vitale (FEF 25-75), la conta cellulare totale e differenziale dell’escreato indotto mediante inalazione di soluzione ipertonica al 3 %per 20 minuti. Contestualmente, sono stati studiati parametri immunologici sistemici di ciascun soggetto priam e dopo il ciclo di terapia. A questo riguardo, la percentuale ed il numero assoluto dei linfociti T, suddivisi nelle relative sottopopolazioni CD4 e CD8, dei Linfociti B e e dei Linfociti Naturali Killer (NK) sono stati valutati mediante citometria a flusso, mentre i Linfociti T sono stati testati funzionalmente per la produzione di IL-2 da attivazione policlonale. In condizioni basali, tra il gruppo BPCO ed il gruppo di controllo, non si sono osservate differenze significative sia per la conta totale che per la conta cellulare differenziale dell’escreato indotto. Differenze significative si sono osservate per il FEV1 (1145 +/- 12 del controllo rispetto al 97% +/- dei BPCO, minore 0.01) e per il FEF25-75 (103% +/- 21 rispetto al 71% +/- 25 dei BPCO, p minore 0.01). Dopo 12 giorni la crenoterapia con acqua salsobromoiodica. Le prove funzionali respiratorie non si sono modificate significativamente sia nel gruppo di BPCO che in quello di controllo. Dopo crenoterapia, differenze significative si sono osservate nel gruppo BPCO per la conta cellulare differenziale: riduzione delle cellule infiammatorie (da 37.8% +/- 8 a 25.6 +/- 8, p minore0.01, riduzione dei linfociti ( da 6% +/- a 0.7% +/- 1, p minore 0.01, aumento delle cellule epiteliari ( da 18% +/- a 35% +/- 10, p minore0.01). per contro, le percentuali ed il numero di linfociti circolanti sono rimasti invariati dopo il ciclo di crenoterapia in entrambi i gruppi e la produzione di IL-2 non è variata in modo significativo. Queste osservazioni suggeriscono che la crenoterapia inalatoria con acqua salsobromoiodica, in pazienti con BPCO può avere un ruolo antinfiammatorio, nel senso di una riduzione della componente cellulare di tipo flogistico nelle vie aeree, in particolare nei linfociti, che non è accompagnata da variazioni significative livello sistematico. respiratorie Europ. Resp. News,V,n°2 Aprile-Giugno, 1997 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. artroreumatica Acta Toxicol.Ther.-Vol.XVIII-N°2.3.4-74-84, 1997 Effetti coleretico e colagono dell’acqua sulfureo-solfato calcica di Tabiano sulla colestasi nell’epatopatia alcool-correlata V.Coiro, R.Volpi, P.P.Vescovi Ist. Clin. Ter. Med. Gen. Uni.Parma - Terme di Tabiano Venti alcolisti maschi (40/60 anni) astinenti da due settimane e affetti da epatopatia steatosica con indici laboratoristici di colestasi alterati (aumentati valori di bilirubina totale e diretta, di gramma-glutamil-transpeptidasi e di fosfatasi alcalina) sono stati per 3 settimane con 500 ml/die p.o. di placebo ( acqua fontis) (N 10) (gruppo I) o acqua sulfureo- solfato calcica della fonte Pergoli di Tabiano (Pr) (N.10). gli indici laboratoristici di colestasi sono stati misuati prima e dopo il trattamento idropinico e sono stati paragonati ai valori ottenuti in 10 soggetti maschi normali di età simile a quella degli alcolisti. E’ stato anceh sottoposto a valutazione quantitativa soggettiva con metodo a doppio cieco il sintomo prurito negli alcolisti. Inoltre, al fine di valutare l’effetto della terapia idropinica sulla cinesi colecistica, le areee bidimensionali relative ai diametri massimi longitudinale e trasversale della colecisti sono state valutate ecograficamente negli alcolisti prima (tempo 0) e dopo 20.40 e 60 minuti dall’assunzione di un carico di 500 ml di placebo (gruppo I) o di acqua Pergoli (gruppo I). i risultati hanno dimostrato una significatica riduzione dell’area colecistica misuarata negli alcolisti del gruppo II, ma non in quelli del gruppo I. inoltre 3 settimane di trattamento con acuqa Pergoli hanno ridotto in modo significativo, riportando a livelli simili a quelli normali, le concentrazioni di birulina totale e diretta e gli indici enzimatici di colestasi, migliorando inoltre significativamente il sintomo prurito. Questi parametri sono invece rimasti immodificati negli slcolisti trattati con placebo. Questi dati dimostrano che nell’uomo la somministrazione per via orale dell’acqua sulfureo-solfato calcica Pergoli esercita attività colagoga. Questo effetto, unitamente alla già nota azione coleretica, fa di quest’acqua un possibile elemento terapeutico di supporto alla terapia della colestasi nell’alcolismo farmacologia Clin. Ter.148:15-22,1997 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 Mud pack therapy in osteoarthrosis. Changes in serum levels of chondrocyte markers. S.Bellometti, M. Cecchettin, L. Galzigna Centro Studi Termali P. d'Abano, Montegrotto Terme, Italy. Centro Studi Termali P. d'Abano, Montegrotto Terme, Italy. We have previously shown that thermal mud therapy is able to influence chondrocyte activity of osteoarthrosic patients by modulating the production of serum cytokines, such as interleukin 1, and this was related to the presence of an anti-inflammatory principle in mature thermal mud. Mud therapy influences many biochemical processes of the body, independently of the thermic stimulation alone and the present paper documents specific increases of insulin growth factor 1 and decreases of tumor necrosis factor alpha in serum of osteoarthrosic patients after 12 days of mud pack application. farmacologia Clin Chim Acta Dec 10;269(1-2):101-6,1997 Mud pak treatment increases serum antioxidant defenses in osteoarthrosic patients S. Bellometti, M. Cecchettin, A. Lalli, L. Galzigna Istituto Facoltà di Medicina Università di Padova- Dip. Patol. Clinica -Ist. G. Pini Milano- Centro Studi Termali P.d'Abano - Abano-Montegrotto Terme Alcuni studi suggeriscono un ruolo anche dei radicali liberi nella patogenesi dell'osteoartrosi. Gli AA hanno dosato i livelli serici di ceruloplasmina, transferrina e di malondialaldeide (MDA ) in 13 osteoartrosici prima e alla fine di un ciclo di 12 gg di fangoterapia, come indici della difesa antiossidativa i primi due e marker del danno ossidativo il terzo. Ceruloplasmina e transferrina risultano a fine ciclo statisticamente e significativamente aumentate e correlativamente la MDA diminuita. Il risultato suggerisce anche una azione antiossidativa della fangoterapia oltre alla classica attività antiinfiammatoria. farmacologia Biomed Pharmacother 1996:50-37 Elsevier,Paris Treatment of chronic inflammation of the upper respiratory airways by inalation thermal therapy with sulfur-sulfate-bicarbonate-alkaline earth mineral water: a study of nasal cytology G. Cristalli, A. Abramo, L. Pollastrini oo The purpose of the paper is better characterise changes occurred in nose cytology in a group of 50 subjects by chronic inflammation of upper respiratory airway. The patients were random shared in two groups:group A 40 subjects treated using sulphurous thermal water and a group B(control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of abserved a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in cronic inflammation of the nose. Throw pharmacological and physical actions, cause an improvement of the chronic inflammation and normalisation of nose cytology. ORL Acta otorhinolariyngol Ital.; 16/6 Suppl.55,1996 A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. J. Hall, S.M.Skevington, P.J.Maddison, K. Chapman o OBJECTIVE: The aim of this study was to evaluate the therapeutic effects of hydrotherapy which combines elements of warm water immersion and exercise. It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately. METHODS: One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month followup. RESULTS: All patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. Belief that pain was controlled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At followup, hydrotherapy patients maintained the improvement in emotional and psychological state. CONCLUSIONS: Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy. artroreumatica Arthritis Care Res. Jun;9(3):206-15,1996 Sindrome Rinusosino-bronchiale(RSB) e terapia termale. M.E. Berioli, F.Avanzini, F.G.Fiorino, G.Cumer, L.Trombetta Terme di Tabiano Gli AA. , dopo un inquadramento nosografico della materia, presentano i risultati della clearance muco-ciliare (TMC ), la reattività bronchiale al test di broncprovocazione da metacolina, nonchè la tolleranza alla inalazione aerosolica mediante spirometria giornaliera ( FEV1 ). Dopo trattamento con ciclo di terapia inalatoria con acqua solfurea si ha un miglioramento statisticamente significativo ( p 0,01 ) del TMC mentre buona appare la tollerabilità allarosol. Variazioni non significative della reattività bronchiale respiratorie Acta Otorhinol. Ital.- Suppl.55.16.58-67, 1996 The use of low-temperature pelotherapy in the treatment of patients with rheumatoid arthritis (II) V.D. Grigor'eva, D.R. Mamiliaeva o 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 Improvement of haemorrheological alterations in alcoholicistics by sulfureus water treatment V.Coiro, P.P. Vescovi Università di Parma Blood and plasma viscosy, and whole blood filterability (VB), were evaluated in 10 normale controls ( 40-60 years old) and 20 age- matched alcoholic patiens before and after treatment for 2 weeks with 500 ml/day p.o. of sulfurous water (n. 10) or a placebo (aqua fontis) (n.10). metabolic ( total cholesterol, triglyceride, uric acid, fasting glucose and fibrinogen levels) and haematological (red, white cell and platelet count; haematocrit; mean red cell volume) paramenters and plasma glutathione (GSH) levels were also measured in all experimental conditions. Plasma viscosity, fibrinogen and all examined metabolic and haematological (except platelets) paraments were similar in normal controls and alcoholic patients regardless of the use of sulfurous water or placebo. Platelets were always lower in alcoholics than in normal controls. In contrast, alcoholic men showed significantly higher levels of blood viscosity and lower values of VB and plasma GSH levels than normale controls. Two weeks of treatment with the placebo did not change haemorrheological alterations and plasma significatly increased VB values and plasma GSH levels. These data suggest the existence of alterations in red cell plasticity in alcoholics, which can reversed by treatment with sulfurous water, probably by reconstituction of normal cell membrane structure and function. farmacologia Alcologia,7(1),27-33,1995 Hydrotherapy of patients with intermittent claudication: a novel approach to improve systolic ankle pressure and reduce symptoms. S.Elmståhl, B.Lilja, D. Bergqvist, J. Brunkwall University of Lund, Malmö General Hospital, Sweden. OBJECTIVE.To study the effects of alternating cold and hot water therapy on walking ability and systolic blood pressure in claudicants. EXPERIMENTAL DESIGN. A prospective case study with repeated measurements before and 1, 4 and 12 months after treatment. The systolic blood pressure levels were measured with an occlusion cuff for brachial and ankle and with a strain gauge for the first toe.STUDY POPULATION. Twenty consecutively included patients, 11 women and 9 men; mean age 73.9 yrs, with intermittent claudication according to clinical examination and ankle-arm systolic blood pressure (AAI) below 0.90. INTERVENTION. Alternate hot and cold hydrotherapy of the legs were given at ten 25-minute treatments during a three-week period. The outcome measures were maximal walking ability (MW), walking ability before pain (PW) and systolic blood pressures of toe, ankle, arm and AAI. RESULTS. Fourteen patients (70%) reported reduced pain after treatment and their PW increased from 134 +/- 29 m to 415 +/- 119 m 12 months later (p minore 0.05) and the MW in the total group increased form 348 +/- 75 m to 523 +/- 103 m. Systolic blood pressure increased in right ankle and toe one month after treatment in the total group. Among those who reported improved walking ability one year after treatment, systolic blood pressure in both right and left ankles and toes increased; e.g. right toe increasing from 72 +/- 7 to 86 +/- 2 (p minore 0.001). Improvements of systolic blood pressure in left and right leg and changes of walking ability were correlated, in the order of 0.60 to 0.81, p minore 0.05. CONCLUSIONS. Showering the legs of claudicants improved walking ability and blood pressures which sustained up to 1-year later. This therapy might be an additional alternative to conservative treatment of intermittent claudication. riabilitazione Int Angiol.Dec;14(4):389-94.,1995 Effetti sulle flogosi croniche delle vie aeree superiori di un ciclo di crenoterapia con acqua delle Terme dei Papi di Viterbo: Studio della citologia nasale. G.Cristalli,L. Pollastrini,P. Alò, A. Abramo, F.Carluccio Clin. ORL I e IST. Patr. Università la Sapienza Roma - Terme di Tabiano Gli AA studiano il rinocitogramma nasale in un gruppo di pazienti affetti da flogosi cr. delle VAS sottoposti a crenoterapia inalatoria con acqua solfureo-solfato-bicarbonato-alcalinaterrosa e in un gruppo di controllo sottoposto allo stesso trattamento con aqua fontis. Nel primo gruppo si sono avute diminuzione ( 52,4 % P=0,005 ) dei neutrofili, aumento ( 66,6 % P=0,005 ) delle plasmacellule, diminuzione ( 57 % ) del tappeto batterico a paragone del gruppo di controllo che non ha registrato variazioni statisticamente significative se non un modesto aumento delle plasmacellule. ORL Riv. ORL Aud. Fon.,2, 1995 Flogosi croniche delle VAS: azione dul quadro biochimico ed immunologico del muco nasale indotta da un ciclo di crenoterapia con acqua solfureo-solfato-bicarbonato-alcalinoterrosa delle Terme dei Papi di Viterbo A. Abramo,L. Pollastrini, G.Cristalli,F.Carluccio Clin. I ORL Università la Sapienza Roma - Terme dei Papi Gli AA valutano a inizio e fine del ciclo di crenoterapia inalatoria in un gruppo di pazienti affetti da flogosi cr. delle VAS, rispetto ad un gruppo di controllo trattato con aqua fontis, la componente proteica totale, immunoglobulinica ed elettrolitica del muco. Nel primo gruppo si ha normalizzazione dei parametri fisico-chimici del muco, con aumento a termine delle IgAs e delle altre Ig non secretorie (verosimilmente da migliorato trofismo e ossigenazione tissutale). ORL Riv. it. ORL Audiol. Fon.,XV,2, 1995 Improvement of psychometric performance in alcoholics by sulfureous water tretment. V.Coiro, P.P. Vescovi The mean reacting times (+/- standard deviation) in response to 31 visual or auditory stimulations administred within 3 minutes were measured in 60 male alcoholics, matched for age ( 38-60 years), history and clinical conditions and in 30 normal control subjects. Alcoholics were tested twice; once after farmacologia Phys Rehab Kur Med (5),153-158, 1995 Valutazione del rapporto costo-beneficio delle cure termali nell'ambito dell'Azienda USL d Reggio Emilia G.Zanardi, V.Coiro, A.Germano Azienda USL di Reggio Emilia - Ist. Pneum., Ist. Clin Med. Uni.Parma- Terme di Monticelli, Terme di Montecatini,Terme di Tabiano, Terme di S.Andrea Bagni Gli AA hanno ricercato su un totale di 17.683 pazienti sottoposti a cure termali, n°1500 inviati dall'Azienda USl di Reggio Emilia ai vari stabilimenti termali. E' stato eseguito uno studio di ripartizione percentuale delle varie terapie termali, tenendo conto del sesso,dell'età e della professione del campione esaminato. Dal punto di vista clinico l'analisi è stata focalizzata sulla verifica delle richieste di prestazioni sanitarie e quindi del numero di ospedalizzazioni prima e dopo la trapia termale. Dal punto di vista economico si è analizzato se esistevano variazioni del numero delle giornate lavorative perdute e del costo delle terapie farmacologiche e riabilitatove nei soggetti sottoposti a crenoterapia.Il tutto per tipologie di patologie.. A sintesi viene valutato il rapporto costo-beneficio a risparmio di spesa per la USL farmacologia Progetto Naiade - Università di Parma 1995 Terapia inalatoria termale ed asma bronchiale M.E.Berioli, F.Strinati, G.Nappi, G.Melillo C. St. Ric. Med. Term. Università di Milano - Cli. Lavoro e Riab. Fond. S. Maugeri - Terme di Tabiano Per valutare la tolleranza e gli effetti dell’inalazione di acqua solfurea di Tabiano nell’asma bronchiale, dapprima 30 pazienti (16 M. età media 48.1 a. ) sono stati sottoposti a sedute di areosol ultrasonico collettivo per 12 gg. controllando la tosse durante le sedute e la variazione di FEVI % prima e dopo la sedua. Successivamente 13 pazienti (5M. età media 48.2 a. ) sono stati testati con metacolina (PD 20 FEV1) prima della cura suddetta, al termine della stessa e dopo un periodo di 30 giorni. I risultati evidenziano ottima tolleranza e miglioramento della PD20 FEV1 media. respiratorie Med. Clin. e Term.,33:103-108,1995 Short and long-term effect of spa therapy in chronic low back pain. F.Guillemin, F. Constant, J.F. Collin, M. Boulange School of Public Health, University of Nancy, France. School of Public Health, University of Nancy, France. The effect of spa therapy on chronic low back pain (LBP) was assessed in a randomized trial comparing patients undergoing a 3-week therapy programme in a spa resort in France (n = 50) with patients receiving ambulatory care (n = 52). After 3 weeks, patients in the spa group had significant improvement in their spine mobility and functional score (Waddell index) and a reduction in their daily duration of pain, pain intensity and drug consumption. The long-term effect was assessed after 9 months and showed continued reduction in pain and drug consumption, and improvement in spine mobility but no longer in functional score which returned to baseline level. It is concluded that spa therapy has a positive short-term and a moderate long-term effectiveness on chronic LBP. farmacologia Br J Rheumatol. Feb;33(2):148-51,1994 Gli effetti delle acque solfureo-salsobromoiodiche sulle flogosi catarrali delle vie aeree superiori. L.Pollastrini,F.Carluccio I Clinica ORL Università la Sapienza Roma - Div. ORL Osp. di Rimini - Terme di Riccione Nelle flogosi croniche rinofaringotubariche l’elemento patogenetico alla base del mantenimento della flogosi è rappresentato da modificazioni persistenti delle caratteristiche biologiche e reologiche del muco nasale. Da secoli l’utilizzo delle acque termali solforose, si è dimostrato efficace, in campo clinico, nel favorire le risoluzione della flogosi ai fini di valutare gli effetti delle acque termali sulfureee-salso-bromoiodiche è stato intrapreso uno studio randomizzato, in doppio cieco vs. placebo costituito da acuqa distillata, su 50 pazienti, sugli effetti prodotti da tali acuqe sulle concentrazioni di Iga secretorie (Igas) e albumine nel secreto ansale. Con la metodica dell’immunodiffusione radiale è stata valutata la risposta in concentrazione di Igas (mg/l) e albumine (mg/dl) nel secreto nasale di 25 pazieni trattati con acqua termale e 25 pazienti trattati con acqua distillata. I valori medi di concentrazione sono stati confrontati statisticamente con il test t di student per campioni appaiati. E’ stato possibile dimostrare un incremento significativo (p minore 0,001) della media dei vlaori di concentrazione di Iga nei pazienti trattati con acqua termale. Viceversa il debole incremento della media del medesimo valore nel gruppo trattato con acqua distillata non risulta significativo. L’incremento della media delle concentrazioni delle albumine nel secreto nasale risulta invece significativo in entrambi i gruppi, sebbene gli indici di significatività statistica risultano molto più incisivi nel gruppo trattato con acqua termale (p=0,001) vs. placemo (p=0,039). ORL Acta Otorhinol.Ital.- Suppl. 44,XIV,3,1994 Effect of hyperthermic and isothermic mud application on hormonal function of normal and insufficient corpus luteum in women D. Bromirska Kliniki Ginekologii Instytutu Poloznictwa i Ginekologii Pomorskiej Akademii Medycznej The aim of the paper has been to study the effect of a single procedure with hyper (42 degrees C) and isothermic (37 degrees C) mud exerted on the hormonal function of normal and insufficient corpus luteum in women. Procedure with mud was the first of its kind sanatorium treatment and consisted in simultaneous use of wrapping and vaginal pack. That was performed in the compartment from 18 to 22-nd day of menstrual cycle in 55 women with normal function of corpus luteum. The number included 32 with hyper, and 23 with isothermic mud. In a group of 41 studied women with insufficient corpus luteum, in 21 hyper and in 20 isothermic mud was used. In all the women prior to the procedure, 2 and 5 hours after the procedure, the accomplished radioimmunological determinations involved: concentration of FSH, LH, progesterone and estradiol in blood serum. Moreover, the level of adrenaline and noradrenaline in urine was established by fluorimetric method, calculated for gram of creatinine. In 10 of them concentration of FSH and LH was being determined every 15 minutes for the first 2 hours following the procedure. The employed procedure with hyper or isothermic mud in a similar manner led to transient increase in the concentration of progesterone and estradiol in blood sera of women with normal and insufficient hormonal function of corpus luteum. There was also a significant rise in excretion of adrenaline and noradrenaline in urine, particularly after hyperthermic mud application. The mentioned increase in the concentration of steroids was disconnected with the elevation affecting the concentration of gonadotropins, but likely due to their discharge from ovaries. ginecologica Ann Acad Med Stetin. 39:133-46,1993 Spa therapy improves ventilatory function in the small airways of patients with steroid-dependent intractable asthma (SDIA). Y.Tanizaki, H. Kitani, M. Okazaki,T. Mifune,F. Mitsunobu, K. Ochi, H. Harada,I.Kimura Division of Medicine, Misasa Medical Branch, Okayama University Medical School, Japan. The improvement of ventilatory function by spa therapy was examined in 37 patients with steroid-dependent intractable asthma (SDIA) in relation to clinical asthma types. All subjects had been on long-term corticosteroid therapy before spa therapy. Spa therapy was found to improve the values of ventilatory parameters. The percent improvement in all subjects was +4.1% in %FVC, +8.9% in FEV1.0%, +9.8% in %PEFR, +22.0% in %MMF, +19.7% in %V50 and +28.2% in %V25, respectively. Relating to clinical asthma types, moderate improvement in %MMF and %V25 from 16.7% to 16.9% was observed in type Ia cases, and marked increase in %MMF, %V50 and %V25 was observed from 42.2% to 43.2% in type Ib cases. However, no significant increase was found in these parameters of types Ia or Ib after spa therapy. In patients with type II, a significant increase was shown in %V50 (p less than 0.05) and %V25 (p less than 0.01) after spa therapy. The results show that spa therapy improves the condition of small airways disorder in patients with SDIA. respiratorie Acta Med Okayama. Jun;46(3):175-8, 1992 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 Nebulizzazione di un'acqua minerale salsobromoiodica versus aerosolterapia con tiopronina in pazienti bronchitici cronici riacutizzati. M.De Bernardi, E.Gribaldo,C.Miravalle,G.M.Pedrinazzi, A.Re, A.Zanasi Ist. farmacol. Idrologia Medica Università di Pavia- Ist. Fisiopatologia Respiratoria Uni. Bologna Si affronta il problema della rimozione delle secrezioni bronchiali per mezzo della crenoterapia inalatoria con un’acqua salsobromoiodica, su pazienti bronchitici cronici in fase di riacutizzazione flogistica. Lo studio è stato condotto su 40 pazienti usando come confronto l’effetto ottenuto con mucolitici (tiopronina) somministrati per via inalatoria. Nel corso della terapia è stato controllato l’andamento dei seguenti parametri strumentali e clinici di funzionalità respiratoria: VC. FEV1, MEF50, caratteristiche dell’escreato, della tosse, della obbiettività toracica. Dal confronto risulta che sai con la tiopronina che con l’acqua salsobromoiodica in studio si ottengono analoghi favorevoli effetti, in pazienti portatori di bronchite cronica riacutizzata. respiratorie Clin. Term.45:427-433,1992 Effect of sulfurous (thermal) water on T lymphocyte proliferative response. S.Valitutti, F.Castellino, P.Musiani Ist. An. Pat. Università di Chieti - Terme di Caramanico Department of Human Pathology, Università G. D'Annunzio, Chieti, Italy. We studied the effect of sulfurous water thermal therapy on the phenotype and the proliferative response of peripheral lymphoid cells from ten subjects affected by chronic upper respiratory disease and from six suffering from articular and periarticular disorders. Sulfurous water (S-H2O) therapy did not modify the phenotype and function of peripheral blood mononuclear cells (PBMC) nor did it modify systemic immunologic reactivity. A different result was obtained by analyzing the response to mitogens of peripheral blood mononuclear cells in cell cultures containing graduated amounts of S-H2O. These "in vitro" studies have shown an important dose-dependent inhibitory effect of S-H2O on mitogen induced T lymphocyte proliferation and on IL2 production. H2S present in S-H2O seems to be the primary component responsible for inhibition. Our results are consistent with a local immunosuppressive role of S-H2O, which may explain part of the observed therapeutic effect of inhalation therapy on upper respiratory allergic disorders. farmacologia Ann Allergy. Dec;65(6):463-8,1990 Inalazione di un'acqua minerale in ambiente termale nell'asma . S. De Luca, C.M. Sanguinetti, B.Farabollini, D.Compagnucci, C. Gualco, V. Massei Div. Pneum. Osp. Reg. S. Lucia di Tolentino Gli AA hanno misurato in pazienti asmatici FEV1, FVC, %FEV1/FVC, PEFR prima e dopo inalazione di un'acqua minerale ipotonica onde verificare l'eventuale insorgenza di broncocostrizione. La inalazione non ha prodotto variazioni statisticamente significative nei 12 giorni di studio. respiratorie Rass. Pat. App. Resp.,5,379-388, 1990 Influenza della crenoterapia sulfurea sull'olfatto e sul contenuto solfocianico del muco nasale. R.Calligaris Clin. ORL II Università di Genova - Terme di Salice L'AA ha seguito in 20 pazienti sottoposti a crenoterapia solfurea umida il potere olfattorio e la concentrazione solfocianica del muco. Entrambi risultano accentuati. ORL Med. Clin. e Term. ,13,51-57,1990 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 Studio allergologico ed immunologico su bambini affetti da OMS sottoposti a crenoterapia solfurea E.Chilardotti, E.Savini, G.Cavagni, C.Caffarelli, E.Conversi, F.Salaffi Clin. Pediatrica Serv. Allerg. - Clin. Med. Ge. Ter. Catt. Reumat. Uni. Parma - Terme di Tabiano Presso il centro audiologico delle Terme di Tabiano è stata condotta un’indagine su 43 bambini affetti da otite media secretiva (OMS) nell’intento di chiarire i seguenti aspetti: 1) quale ruolo svolge l’allergia nelle patogenesi del’OMS infantile 2) quali variazioni delle IGA secretorie possono essere indotte dalla crenoterapia colle acque solfuree di Tabiano. Per quel che riguarda il primo punto gli Autori ritengono che sussistano elementi validi per confermare un rapporto fra atopia ed otite media secretiva. Riguardo al seocndo punto in tutti i pazienti esaminati è stata registrata una significativa diminuzione della IGA a fine cura, rispetto ai livelli di inizio cura. Secondo gli autori una possibile spiegazione di questo fenomeno di non facile interpretazione, andrebbe ricercata nel contesto delle complesse modificazioni istologiche e strutturali che si determinano durante la cura termale. ORL Riv. Orl Aud. e Fon. VIII,4,345-350, 1988 Variazioni audio-impedenziometriche durante e al termine di un ciclo di crenoterapia solfurea per Sordità Rinogena L.Migliorini, R.Bozzelli, A.Castrataro Terme di Caramanico Gli AA. hanno valutato i miglioramenti, rispetto ad un gruppo di controllo di 31 pazienti non trattati, ottenuti in 58 pazienti affetti da ipoacusia rinogena sottoposti a cicli di crenoterapia inalatoria solfurea. I miglioramenti risontrati sono più evidenti nei soggetti giovani. ORL Clin. Term. 41,209-223, 1988 La terapia inalatoria nelle broncopneumopatie croniche ostruittive. G.Nappi, R.Femia - M.De Bellis Ist. Idrol. e Clin. Med. Università di Milano - Terme di Salice Un gruppo di 20 pazienti affetti da BPCO sono stati sottoposti a crenoterapia con acqua solfurea di Salice. Sono state monitorate quotidianamente le caratteristiche dell'espettorato, mentre CV, VEMS, PaO2, PaCO2 sono stati misurati all'inizio, a metà e alla fine del ciclo di 12 inalazioni. Lo studio ha evidenziato un incremento della CV e della VEMS e variazioni nella qualità dell'espettorato. respiratorie Med. Clin. e Term.,4-5, 1988 Some endocrine effect of balneotherapy M.Cecchettin, E.Molina, C.Costa, R.Zennaro, G.Varacca Ist. Fond. Clin. Lav. Pavia - Ist. Farmac. Università di Parma - Terme di Salsomaggiore The AA. studied the effects of balneotherapy on blood levels of phpsphorus, calcium, corticoadrenal and endogenous opioid in 24 female subjects attending the thermal baths at Salsomaggiore. Results show significant increases in cortisol, parathormone, osteocalcin, 1-25(OH)2 D3 and betaendorphin. farmacologia Int. J. Hormones and Metab.,1987 Influenza di un'acqua solfurea sulla motilità intestinale J.Malvisi Stracciari,G.Cervellati Ist. Farmacol. e Tossic. Università di Bologna - Terme di Castel S. Pietro La velocità del transito intestinale, il tono e la contrattilità della muscolatura sono stati testati sull'intestino di animali da esperimento dopo la somministrazione dell'acqua solfurea. Il primo elemento risulta aumentato in maniera altamente significativa. gastroenterica Biologia medica, 1987 La crenoterapia salsobromojodica nella congestione pelvica cronica G.Del Boca, E. Bersellini Terme di Salsomaggiore Gli AA. riportano le condizioni cliniche in condizioni basali, a fine trattamento e ad una visita di controllo a distanza di 3-6 mesi di 45 pazienti affette da congestione pelvica cronica e trattate con un ciclo di 15 giorni di bagni, irrigazioni vaginali e aerosols vaginali con acqua salsobromojodica. A termine trattamento il 48,8 % dei casi presentava un notevole miglioramento sia della sintomatologia soggettiva che dell'obbiettività clinica, il 22,2 % un discreto miglioramento, il29 % stazionarietà. A distanza di tempo il 55,5 % presentava un significativo miglioramento, il28,8 % discreto miglioramento, il 15,5 % risultavano stazionarie. ginecologia Medicina Termale Climat, 1986 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 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 Modificazioni indotte dalla crenoterapia inalatoria solfureo-salsojodica sulle IgA prodotte localmente nelle mucose delle vie respiratorie inferiori. G.Micconi, G.Mattioli, M.Bertoni, V.Boschi, A.Lenzi, A.Aprile, A.Lapilli, C.Bombi, B.Miccoli Terme di Porretta Vengono riportati i risultati di uno studio biochimico condotto sull’espettorato di 14 pazienti affetti da broncopneumopatie croniche ostruttive in fase intercritica, tutte associate a malattie professionali. L’indagine è stata effettuata al fine di meglio precisare l’efficacia terapeutica della crenoterapia inalatoria solfureo-salso-sodica nelle suddette affezioni. L’analisi dei risultati ha posto in rilievo un sensibile aumento delle IgA-S dopo solo 12 gg di crenoterapia. Questi dati hanno quindi confermato non solo la possibilità, ma anche l’importanza fondamentale del trattamento crenoterapico nelle broncopneumopatie croniche in fase intercritica. respiratorie Clin. Term.,37:215-221,1984 Comparison between in haled and ingested iodine metabilism A.Costa, F. Cottino, M.Ariano, A. Bacolla, V.Bellero, A.Chiecchio, P.Lorenzini Osp. Mauriziano di Torino - Clin. Ter. Fis. Riab. Uni.Parma - Terme di Salsomaggiore Ten patients with no patology of the respiratory tract inhaled I-131 in aerosol form. At the end of the inhalation experiment about 55 % of the inhaled Iodine remained in the organism, the rest having been exhaled. Of the Iodine wich remained, aboaut 62 % went to the circulation over a 24 hour period and was then withdrawn from the circulation through the thyroid and renal clearances. A fraction of the amount accumulated in the respiratory tract passes into the circulation even after 24 hour period. Three patients received a test dose of I 125 given orally. The passing of the Iodine into the circulation was higher, as higher was the percentage concentrated in the thyroid and tha eliminated in the urine, and lower the percentage left in the organism. farmacologica Journ. Nuclear Med. abd allied sciences, 1982 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 L'azione espettorale di un'acqua minerale salso-bromo-iodica. A.Zaghini,P.Marinelli, G.Cervellati Ist. Farmac. Farmacocin. Tossicol.- Uni. Bologna - Terme di Castel San Pietro Gli autori valutano nel coniglio l'influenza esplicita dal trattamento inalatorio con un'acqua salso-bromo-iodica sul volume e su alcune caratteristiche fisiche e chimiche del fluido del tratto respiratorio. I risultati acquisiti mettono in evidenza come l'azione di tale acqua si traduca in un incremento della quantitàdi fluido raccolto che, evidente soprattutto nei primi tempi dopo la somministrazione, si attenua progressivamente per annullarsi alla sesta ora dallâ'inizio della sperimentazione. Per quanto concerne le caratteristiche fisiche e chimiche considerate, variazioni significative sono viscositàrelative, che appare diminuita, della gravità specificare e delle concentrazioni di sodio e cloruri che subiscono incrementi più¹ o meno accentuati; costantemente dello stesso ordine di grandezza di quelle riscontrate nei controlli, risultano invece le concentrazioni dell'azoto proteico e non proteico e dei lipidi totali. respiratorie Biol. Med.,4,161-171,1982 Effetti neuroendocrini della terapia inalatoria con acqua salsobromojodiche di Salsomaggiore. Ist. Clin. Med. Gen. Uni. Parma - Terme di Salsomaggiore V.Coiro, G.Varacca, R.Vopi, A.Saccani, M.Bocchi, M. Passeri Gli autori indagano le modifiche eventuali indotte dalla terapia inalatoria a getto con acqua salsobromojodica di Salsomaggiore sulla attività dell’asse ipotalamo-ipofisi-surrene. 8 soggetti maschi normali (età media SE:44.25 + - 3.64 ) sono stati sottoposti ad un ciclo standard di 15 giorni di 2 inalazioni giornaliere a getto diretto. Campioni sanguigni sono stati prelevati prima e dopo la terapia inalatoria del mattino eseguita alle ore 8.30 nei soggetti a digiuno e a riposo dalla sera precedente nei giorni 1, 8, e 15, sono stati dosati i livelli circolatori di corticotropina (ACTH), cortisolo e betaendorfina, quali indici dell’attività dell’asse ipotalamo-ipofisi-surrene e quelli di prolattina (PRL) e ormone della crescita (GH), quali markers di sterss aspecifico. I risultati hanno mostrato ceh emntre GH e PRL non si modificano durante il ciclo di cure inalatorie, la beta endorfina aumenta leggermente dopo l’inalazione all’ottavo giorno (nei confronti del primo giorno) e in modo più evidente al 15° giorno. Anche l’ACTH e il cortisolo sono aumentati significativamente alal fine della cura (15°giorno) rispetto al 1° giorno. Inoltre si è osservato un aumento significativo, subito dopo l’inalazione, dei livelli ormonali circolanti. Una significativa correlazione positiva è stata inoltre osservata al 15° giorno tra la risposta della beta-endorfina e quella dell’ACTH sia prima che dopo inalazione. Questi dati dimostranoche un ciclo di terapia inalatoria di 15 giorni è in grado di attivare l’asse ipotalamo-ipofisi-surrene. farmacologia Med. Clin. Term.,III IV Trim, 1966