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 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 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 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 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 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 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 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 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