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Balneotherapy (BT) is a therapeutic approach that utilizes various forms of water-based treatments to promote health and well-being. BT possesses a rich historical heritage and has garnered recognition from esteemed institutions such as the World Health Organization (WHO). Recent scientific research enables the identification of relevant diseases (obesity, metabolic diseases, sleep disorders, mental health conditions, Long-COVID-19, and cancer rehabilitation) that could potentially benefit from balneo-therapeutic treatments, thereby presenting new avenues of opportunity for SPA ("Salus per Aquam") medicine. These conditions exemplify the potential benefits of BT for ailments beyond the traditional scope of treatment associated with BT (most commonly osteoarthritis, fibromyalgia, rheumatic back pain, and chronic inflammatory respiratory or skin disorders). Overall, the current scientific evidence suggests that BT holds significant potential for enhancing both individual wellbeing and public health. However, further high-quality clinical trials are essential to corroborate these preliminary findings and to provide critical insights into the therapeutic benefits of BT, paving the way for its broader integration into healthcare practices and public health initiatives. [ABSTRACT FROM AUTHOR]

Balneotherapy, using heated natural mineral waters at 36–38 °C, presents a comprehensive treatment approach for Fibromyalgia Syndrome (FMS). This study aims to assess the effect of balneotherapy in reducing pain intensity, disability, and depression in patients with FMS. We want to assess this effect at just four time-points: immediately at the end of the therapy, and at 1, 3, and 6 months of follow-up. Following PRISMA guidelines, we conducted an aggregate data meta-analysis, registered in PROSPERO CRD42023478206, searching PubMed Medline, Science Direct, CINAHL Complete, Scopus, and Web of Science until August 2023 for relevant randomized controlled trials (RCTs) that assess the effect of balneotherapy on pain intensity, disability, and depression in FMS patients. Methodological quality was assessed using the Cochrane methodology, and the pooled effect was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. Sixteen RCTs were included in the meta-analysis. Balneotherapy is effective in reducing pain intensity (SMD − 1.67; 95% CI -2.18 to -1.16), disability (SMD − 1.1; 95% CI -1.46 to -0.7), and depression (SMD − 0.51; 95% CI -0.93 to -0.9) at the end of the intervention. This effect was maintained at 1, 3, and 6 months for pain intensity and disability. Balneotherapy improves both pain intensity and disability in patients with FMS, providing evidence that its positive effects are sustained for up to 6 months of follow-up. Nevertheless, it is important to note that the improvement in depression varies across different temporal phases. [ABSTRACT FROM AUTHOR]

The main objective of this review is to examine the impact of balneotherapy on serum and salivary cortisol concentrations. A systematic search was conducted in PubMed, Scopus, Web of Science, PEDro, and Google Scholar. The databases were screened from inception up until April 2024. After screening the scientific literature, 845 articles were retrieved and 17 studies, involving a total of 765 participants, were eventually included in the review. Among them, four were randomized controlled trials, five were non-randomized studies, and eight were pre-post studies with no control group. The evidence gathered in this review indicates a significant short-term reduction in cortisol levels in healthy individuals undergoing balneotherapy, particularly those experiencing high levels of stress. Conversely, in patients with rheumatic conditions (especially if elderly), increases in cortisol levels induced by balneotherapy can act as beneficial hormetic stress, reducing inflammatory mediators and improving pain and functional quality of life. The meta-analysis shows an overall trend of reduction in stress hormone levels, more pronounced in the intervention group undergoing mud-balneotherapy compared to the control group, a finding that, however, does not reach statistical significance (g=-0.11 [95% CI: -0.30; 0.08]; p > 0.05). Current scientific evidence demonstrates that balneotherapy has a positive impact on the regulation of cortisol levels. The regulation of the hypothalamic–pituitary–adrenal axis and the beneficial effects observed on health parameters and quality of life allow mud-balneotherapy to be classified as eustressful stimuli useful in preventing stress-related pathologies in healthy individuals and in alleviating symptoms in patients with chronic conditions. Future research on the topic is advised. [ABSTRACT FROM AUTHOR]

Depression and anxiety are common mental health problems that negatively affect the quality of life. Functioning, social relationships, daily activities, and physical health are negatively affected. Therefore, it is very important to manage these problems and to investigate effective treatments for individuals to lead a healthy life. This study aims to evaluate the effect of hydrotherapy and balneotherapy on anxiety and depression. Randomized controlled trials published in the last 20 years comparing hydrotherapy and balneotherapy with active control or waiting lists in adults with anxiety and depressive symptoms were included. Pubmed, Cochrane, Scopus, Web of Science, and CINAHL databases were searched until August 2023. The random effects model and fixed effects model were used for data analysis. The heterogeneity of the study was assessed using the I2 index, and publication bias was assessed using Egger and Begg tests and funnel plots. Seventeen eligible studies with a sample size of 977 participants were selected. After data analysis, the results showed that hydrotherapy and balneotherapy led to a statistically significant reduction in anxiety scores (SMD: 0.46 95% CI: 0.27, 0.65), depression scores (SMD: 0.53 95% CI: 0.38, 0.67). Subgroup analysis based on intervention type showed that balneotherapy reduced anxiety scores (SMD: 0.46, 95% CI: 0.27, 0.65) but not depression scores. Evidence suggests that hydrotherapy and balneotherapy can reduce anxiety and depression in adults. Based on these findings, hydrotherapy and balneotherapy can be applied as an adjunct to standard treatments to improve the mental health of adults. Registration: The study protocol was registered in the International Register of Prospective Systematic Reviews (PROSPERO) with accession number CRD42023448993. [ABSTRACT FROM AUTHOR]

Outpatient and inpatient rehabilitation, as a complex and multimodal treatment concept, makes significant use of methods that are assigned to conservative orthopedics, in particular the procedures of physical therapy. In contrast to physiotherapy and medical training therapy, physical therapy is a form of therapy provided with technology. The spectrum ranges from hydrotherapy, mechanotherapy and thermotherapy to balneotherapy, massage forms and electrotherapy. Climatotherapy, phototherapy and aerosol/inhalation therapy have less of an impact on the orthopaedic field. Although the forms of therapy are often referred to as passive, the effect is based on physical laws, physiological reactions and adaptation. In addition, these are predominantly forms of therapy, some of which have been in use for centuries, some for thousands of years, these efficient treatments with a good safety and tolerability profile gained by means of empiricism. [ABSTRACT FROM AUTHOR]

Background: The sulfide–hydrogen sulfide brine balneotherapy (HSBB), including a combination of dissolved hydrogen sulfide (H2S) gas, inorganic sulfur ions (S2−), and hydrosulfide ions (HS−), is one of the most important and most effective forms of spa treatment in patients with osteoarticular disorders (OADs). Some cardiovascular diseases (CVDs) are often considered to be contraindications to HSBB since the presence of thiol groups may lead to an increased quantity of reactive oxygen species (ROS), which damage the vascular endothelium, and endothelial dysfunction is considered to be the main cause of atherosclerosis. However, there are a number of literature reports suggesting this theory to be false. H2S is a member of the endogenous gaseous transmitter family and, since it is a relatively recent addition, it has the least well-known biological properties. H2S–NO interactions play an important role in oxidative stress in CVDs. The general objective of this study was to assess the cardiovascular safety of HSBB and analyze the effect of HSBB on selected cardiovascular risk markers. Methods: A total of 100 patients at the age of 76.3 (±7.5) years from the Włókniarz Sanatorium in Busko-Zdrój were initially included in the study. The following parameters were assessed: age, sex, height, body weight, body surface area (BSA), body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), heart rate, the diagnosis of OAD that was the indication for balneotherapy, creatinine (CREAT), glomerular filtration rate (GFR), lipid panel, C-reactive protein (CRP), uric acid (UA), and fibrinogen (FIBR) and cardiovascular markers: (cardiac troponin T (cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP). Results: A significant decrease in DBP and a trend towards SBP reduction were observed over the course of the study. A significant decrease was observed in CRP levels decreasing from 2.7 (±3.6) mg/L to 2.06 (±1.91) mg/L, whereas FIBR rose significantly from 2.95 (±0.59) g/L to 3.23 (±1.23) g/L. LDL-C levels decreased slightly, statistically significant, from 129.36 (±40.67) mg/dL to 123.74 (±36.14) mg/dL. HSBB did not affect the levels of evaluated cardiovascular biomarkers, namely NT-proBNP (137.41 (±176.52) pg/mL vs. 142.89 (±182.82) pg/mL; p = 0.477) and cTnT (9.64 (±4.13) vs. 9.65 (±3.91) ng/L; p = 0.948). A multiple regression analysis of pre-balneotherapy and post-balneotherapy values showed cTnT levels to be independently correlated only with CREAT levels and GFR values. None of the assessed parameters independently correlated with the NT-proBNP level. Conclusions: HSBB resulted in a statistically significant improvement in a subclinical pro-inflammatory state. HSBB has a beneficial effect in modifying key cardiovascular risk factors by reducing LDL-C levels and DBP values. HSBB has a neutral effect on cardiovascular ischemia/injury. Despite slightly elevated baseline levels of the biochemical marker of HF (NT-proBNP), HSBB causes no further increase in this marker. The use of HSBB in patients with OAD has either a neutral effect or a potentially beneficial effect on the cardiovascular system, which may constitute grounds for further studies to verify the current cardiovascular contraindications for this form of therapy. [ABSTRACT FROM AUTHOR]

The influence of uncertainty on the method adopted for the determination of radioactive radium concentration in water was analyzed due to the assessment of the radiation hazards of balneotherapy. For the calculation, we considered the influence of the bath in radioactive water containing only 226Ra. 226Ra concentration was determined with two γ-spectrometers armed with HPGe detectors with different relative efficiencies. Both spectrometers were energy-efficiency calibrated with a calibration source and based on numerical simulations. Different methods for qualitative γ-spectrum analysis were adopted. The emanation method and the liquid scintillation method were also used. The uncertainty of humans hazard assessment linearly depends on the adopted radiometric method precision. For effective dose calculation, two models were adopted: the model of external exposure proposed by ICRP Publication 144 and the Reference Men model proposed by ICRP Publication 23, respectively. [ABSTRACT FROM AUTHOR]

Balneotherapy includes practices and methods using medically and legally recognized mineral-medicinal waters, muds and natural gases from natural springs for therapeutic purposes. One of the most widely used method in balneotherapy is bathing with thermal mineral water. In the course of the years, scientific community has produced an increasing number of evidences that this practice is an effective method for treating signs and symptoms of several pathologies such as rheumatic, cardiovascular and dermatological diseases. This systematic review is aimed at evaluating the effect of balneotherapy with thermal water baths as a treatment to manage signs and symptoms of patients affected by all types of dermatological diseases. The systematic review was conducted according to the PRISMA Statement, and its protocol was registered on PROSPERO platform (CRD42022295913). The research was performed on the databases Pubmed, Scopus, Web of Science and Cochrane. We included clinical trials evaluating the effects of balneotherapy using thermal mineral water baths for managing dermatological diseases in humans, published in English and Italian language. Eight studies were included, seven of them enrolled adults affected by psoriasis and one studied atopic dermatitis patients. The common result of all the articles included was a clear improvement of signs and symptoms of psoriasis and eczematous diseases after use of thermal mineral water baths. These effects seem to be strictly related to physical and chemical properties of thermal water used for balneotherapy. However, studies in this field are still limited to support robust evidence of the effectiveness of balneotherapy using thermal mineral water baths and often their quality is low. Thus, new clinical studies need to be carried out, using more correct methods for conducting the studies and for processing statistical data. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are the leading cause of death globally accounting for 32 % of all global deaths. Addressing modifiable risk factors, including hypertension and stress, remains paramount in the prevention of CVD. This study aimed to assess the impact of the balneotherapy on blood pressure, heart rate, electrocardiogram parameters, utilization of antihypertensive medications, and stress levels. Methodology. Multicenter randomized controlled single-blind parallel group trial was made in 6 Lithuania resort centers. 373 participants with the stress level > 3 (10, VAS) randomly divided into 6 groups in two clusters for receiving a 6- or 11-day complex treatment using natural resources - mineral waters, peloids, salt, nature therapy; follow-up period was 6 months. The BP, HR, ECG, stress level and other parameters were analyzed in 131 participants who passed a full course of investigation. Results. The significant reduction of systolic blood pressure after treatment (7.8 mmHg) and during 6 months (7.3 mmHg) together with diastolic 5.5 after 6 month and heart rate (4 b/min) was achieved in 11-day ambulatory balneotherapy group. Increase in the activity of the parasympathetic nervous system was observed, which is reflected by an increase in the duration of the ECG indicators. The stress level decreased by up to 43%, and stress management improved by up to 41% following inpatient treatment. Conclusion. Therapy using natural resources could stand for additional cardiovascular disease prevention and management method in integrative therapy. [ABSTRACT FROM AUTHOR]

One of the oldest specialties in medicine is balneotherapy, which examines how to treat patients with mud and groundwater. Many nations use water therapy as a kind of treatment. The Blue Lagoon in Iceland, the Dead Sea in Israel, the Kangal hot springs in Turkey, several thermal pools in France, as well as Poland, are examples of natural balneotherapy locations. For the patient, this therapy is painless, and there are almost no adverse effects. Its positive effects have also been demonstrated in the management of lupus, psoriasis, atopic dermatitis, rosacea and other inflammatory skin conditions. The primary components of the mechanism are the deep water and peat baths' chemical, mechanical, thermal, and immunomodulatory impacts. It is desirable to use balneotherapies both alone and as a supplement to systemic therapy. Based on the most recent studies and clinical data, this article seeks to assess the present scientific understanding of the role of balneotherapy in dermatological care. [ABSTRACT FROM AUTHOR]

Background: In pancreatic ductal adenocarcinoma (PDAC), invasion of connective tissues surrounding major arteries is a crucial prognostic factor after radical resection. However, why the connective tissues invasion is associated with poor prognosis is not well understood. Materials and methods: From 2018 to 2020, 25 patients receiving radical surgery for PDAC in our institute were enrolled. HyperEye Medical System (HEMS) was used to examine lymphatic flow from the connective tissues surrounding SMA and SpA and which lymph nodes ICG accumulated in was examined. Results: HEMS imaging revealed ICG was transported down to the paraaortic area of the abdominal aorta along SMA. In pancreatic head cancer, 9 paraaortic lymph nodes among 14 (64.3%) were ICG positive, higher positivity than LN#15 (25.0%) or LN#18 (50.0%), indicating lymphatic flow around the SMA was leading directly to the paraaortic lymph nodes. Similarly, in pancreatic body and tail cancer, the percentage of ICG-positive LN #16a2 was very high, as was that of #8a, although that of #7 was only 42.9%. Conclusions: Our preliminary result indicated that the lymphatic flow along the connective tissues surrounding major arteries could be helpful in understanding metastasis and improving prognosis in BR-A pancreatic cancer. [ABSTRACT FROM AUTHOR]

Psoriasis has a clear and strong connection with smoking in both its pathogenesis and clinical course. Smoking can cause a serious worsening of both the disease itself and the systemic complications such as cardiovascular events, psoriatic arthritis (PsA), cancer and depression. Smoking also seems to alter the gut microbiota and thus promote psoriasis itself. The aim of our article is to review all the most interesting discoveries on its role and thus provide a good picture of the current state of knowledge. Furthermore, we provide some alternative and healthier coping mechanisms for stress and depression related to the disease such as exercise, meditation, balneotherapy and acupuncture. [ABSTRACT FROM AUTHOR]

The upcoming Congress of the International Society of Medical Hydrology and Climatology (ISMH) in Techirghiol, Romania aims to promote evidence-based practices in the field of Balneology. The Congress will highlight Romania's significant contributions to the field and provide a platform for participants to share their findings and experiences. It will focus on the therapeutic benefits of natural resources and emphasize the importance of rigorous scientific validation and personalized patient care. The Congress will also celebrate significant milestones in Romanian Balneology, including the centenary of the National Institute of Rehabilitation, Physical Medicine, and Balneoclimatology and the 125th anniversary of the Balneal and Rehabilitation Sanatorium of Techirghiol. The event will explore various topics, including the management of musculoskeletal and dermatological diseases, metabolic disorders, and Long-COVID symptoms. It will also discuss the implications of climate change on health and the integration of new technologies and methodologies in Balneology. The Congress aims to bridge the gap between traditional practices and modern advancements, fostering a holistic approach to wellness that combines the wisdom of natural therapies with scientific rigor and technological innovation. Romania's diverse landscape and rich therapeutic resources make it an ideal environment for exploring and applying balneological treatments. The Congress invites participants to contribute to the future of Balneology and shape a world where nature and technology harmonize for the betterment of humanity. [Extracted from the article]

Psoriasis is a chronic, inflammatory, immune-mediated disease of the skin and other organ systems, which affects 2-3 % of the entire world population and represents a significant public health problem. It is desirable that modern psoriasis therapy has longterm efficacy and a good safety profile, and today includes the use of local and systemic therapy, as well as phototherapy and photochemotherapy. Phototherapy is carried out by exposure to sunlight and ultraviolet A and B radiation, while conventional photochemotherapy involves using of ultraviolet radiation and a photosensitizing drug. Both forms of therapy have proven to be highly effective, especially when combined with certain local or systemic medications. Nowadays, a holistic approach to treating psoriasis, such as balneophototherapy, is also increasingly common, thanks to which numerous countries have become well-known health resort destinations. [ABSTRACT FROM AUTHOR]

Spa therapy consists of multiple techniques based on the healing effects of water, including hydrotherapy, balneotherapy, and mud therapy, often combined with therapeutic exercises, massage, or physical therapy. Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies, especially rheumatic conditions due to its anti-inflammatory properties. The main objective of this investigation was to conduct a systematic review analyzing the available evidence on the effect of spa therapy on serotonin and dopamine function. The databases PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were used from June to July 2023. Exclusion criteria were (1) articles not written in English, (2) full text not available, (3) article not related to the objective of the review. JADAD scale was used for methodological quality evaluation. Four studies were included in the systematic review. Two studies were related to serotonin in healthy individuals, one to serotonin in fibromyalgia, and one to dopamine in healthy individuals. One of the studies evaluated hydrotherapy, another one balneotherapy and mud-bath therapy, and the other two assessed balneotherapy interventions. Studies were very heterogeneous, and their methodological quality was low, making it difficult to draw clear conclusions regarding the effect of spa therapy on peripheral serotonin and dopamine function. The findings of this review highlight the lack of studies evaluating these neurotransmitters and hormones in the context of spa therapy. Further research is needed to evaluate the potential effects of these therapies on serotonin or dopamine function. [ABSTRACT FROM AUTHOR]

A protocol study was designed to examine cutaneous behavior after continuous application of a peloid in the dry mineral residue of Lanjarón-Capuchina natural mineral water. This study aims to analyze the biomechanical behavior of normal skin using various non-invasive bioengineering techniques after the application of this peloid. We determine the effects of its application for 3 months on 38 healthy volunteers (41.4 ± 5.9 years, range 32–58) without a previous history of skin diseases by courtmetry, sebumetry, pH-metry, reviscometry, and tewametry. It was shown that the production of cutaneous sebum is significantly reduced by 6%, trans epidermal skin loss (TEWL) by 21%, skin fatigue by 30%, elasticity increased by 19%, firmness by 5%, and a skin redensification by 6% was obtained under these experimental conditions. Disparate and non-significant results were obtained concerning pH and viscoelasticity. Continuous skin care with the Lanjarón-Capuchina natural peloid modifies skin behavior, normalizing sebaceous secretion, favoring the biomechanical properties of the skin and the skin barrier function without modifying skin homeostasis. [ABSTRACT FROM AUTHOR]

Thermal waters have a global distribution and find extensive therapeutic use. In Morocco, which boasts more than twenty high-quality therapeutic thermal springs, few studies have focused on the quality of these waters. In this context, the present study evaluated the water quality using physicochemical, bacteriological, and radioactive parameters for the Benkachour thermal spring waters in Morocco. The results indicate that all chemicals, bacteriological, and radiological parameters are below the standards, except for global beta activity and temperature, which makes it hyperthermal, with an annual average temperature of 50.54°C. According to the Piper diagram, the water type is chloride-sodium-potassium. On the basis on these results, it was concluded that thermalism in the Eastern region of Morocco, specifically Benkachour in Oujda, can contribute to sustainable tourist development at the national and international levels due to the quality of the parameters analyzed and can be an effective complementary approach in the treatment of low-grade pathologies. The data from this study can serve as a baseline for assessing future changes and defining standards for the quality of hydrothermal baths as well as balneotherapy worldwide. [ABSTRACT FROM AUTHOR]

Aim: This article aims to analyze the scientific understanding of the role of balneotherapy in the treatment of numerous urological conditions based on the latest research and clinical findings. Materials and Methods: A review of literature from PubMed and Google Scholar databases published between 2000 and 2023 on the use of balneotherapy for urological conditions was performed. The literature data was analyzed to identify the most common urological conditions such as chronic pelvic pain, urinary incontinence, urolithiasis, rehabilitation after prostatectomy and overactive bladder syndrome in which this field of physical medicine is applicable. Publications containing the following keywords were selected for analysis: balneology, urology, cpp, OAB, urolithiasis, post-prostatectomy treatment. Out of 90 papers, 26 sources containing key information related to the topic of the paper were selected. Conclusions: While the potential of balneotherapy in urology appears promising, it is crucial to approach these findings with cautious optimism. Many studies are in their early stages, and larger, multicenter, randomized, controlled trials are essential for a solid understanding of the role of balneotherapy in urology. In addition, it is essential to establish standard protocols to ensure patient safety and treatment efficacy. As our knowledge deepens, balneotherapy, with its rich history, may become a cornerstone of modern urologic care. [ABSTRACT FROM AUTHOR]

(1) Objectives: This pilot study aimed to evaluate the effectiveness of a 2-week rehabilitation program consisting of electrotherapy, physical therapy, and balneotherapy in patients with knee osteoarthritis (KOA); (2) Methods: A total of 98 patients were enrolled in the study and assigned to either an experimental group or a control group. The primary outcome measures were pain intensity and knee function scores, while secondary outcomes included functional tests such as the 30s chair stand test, stair climbing test, and 40-meter walk test; (3) Results: Results showed significant improvements in pain intensity, knee function scores, and the 30s chair stand test in both groups. However, the experimental group showed more significant improvement in the 40-meter walk test than the control group. Linear Model ANOVA test showed that after the 2-week treatment, participants receiving balneotherapy showed significant progress compared to the control group in pain intensity, knee function scores, and walking test. The results for the stair climbing test did not differ significantly between the two groups, but it improved in both; (4) Conclusions: Study findings suggest that a rehabilitation program consisting of electrotherapy, physical therapy, and balneotherapy can show significant improvement in regards to pain and function in patients with KOA. [ABSTRACT FROM AUTHOR]

BACKGROUND The degree of supervision and level of expertise required for performing cosmetic procedures differs significantly from state to state. Medical spas providing cosmetic procedures have seen exponential growth since 2020. OBJECTIVE To provide a representative sample of the medical spa industry in the Unites States regarding the expertise among providers performing cosmetic procedures and the degree of oversight at medical spas offering these procedures. MATERIALS AND METHOD Descriptive study based on a standardized telephone interview performed by a secret shopper in Chicago and surrounding suburbs. Data were then extracted and analyzed. RESULTS Of 127 medical spas reviewed, a supervising physician was not on-site at 81.1% of the facilities. Patients were informed of this at 64.6% of the surveyed medical spas. CONCLUSION There is considerable variation in the oversight and in the training among those performing cosmetic procedures at surveyed medical spas. As cosmetic procedures become increasingly popular among the public, further regulation of medical spas is warranted to protect patient safety. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to present physiotherapy and balneotherapy as an adjunct to treatment in reducing pain in women with endometriosis. Accordingly, databases were searched to find the most effective forms of physiotherapy for the treatment of endometriosis. Materials and Methods: Two independent reviewers have searched medical and public databases such as PubMed, Scopus and PEDro using search terms and MeSH such as endometriosis, pain, physiotherapy, physical activity, balneotherapy, marker miRNA. Subsequently, the data obtained after the queries were then evaluated with regard to the titles in order to remove works with other keywords. The inclusion and exclusion criterion was an article published in a peer-reviewed journal, limited as to the scope of the publication year 2020-2022. Conclusion: The literature review conducted here suggests that it is necessary to carry out multicentre studies in order to ascertain which forms of physiotherapy and balneotherapy may be most effective in reducing pain and improving the quality of life of women suffering from endometriosis. [ABSTRACT FROM AUTHOR]

The physicochemical properties, fractional composition, structural-group composition, molecular composition, and the content of individual SARA fractions were characterized for high-viscosity naphthenic crude oils of the Pokur Formation produced in Khanty-Mansi Autonomous Okrug (KhMAO), Russia in comparison with therapeutic oil from the Naftalan oil field, Azerbaijan. All the tested oil samples exhibited high density (0.922– 0.956 g/cm3), high boiling points (164–199°C), high molecular weights (302–424 g/mol), and low paraffin content (0.04–0.42 wt %). The greatest similarity in terms of compositions was observed between the samples from the Naftalan and KhMAO-1 oil fields. The SARA analysis revealed a high content of resins and asphaltenes in crude oils from the KhMAO-2 field. This explains the distinctive features of the fractional composition (examined by SimDis simulated distillation) and structural-group composition (n–d–M method) of this sample, specifically its higher content of unevaporated residue (i.e., components that boil above 500°C), higher concentrations of naphthenic and aromatic carbons, and increased ring numbers in ring structures. GC/MS characterization of the molecular composition showed, for all samples, identical sets of adamantane and its homologues, as well as sesquiterpanes, steranes, tricyclic terpanes, aromatic steroids, and, to some extent, naphthalenes. The paraffin-naphthenic fractions of the Naftalan and KhMAO-1 oils consisted mostly of isoprenoid alkanes, and phenanthrenes predominated among the aromatic fractions of these samples. Furthermore, the Naftalan and KhMAO-1 crude oils were similar in the concentrations of adamantanes and decalines. The revealed similarity in the molecular, structural-group, and fractional compositions and in the SARA analysis between the KhMAO and Naftalan crude oils offers good opportunities for alternative uses of the Pokur high-viscosity oils from the KhMAO oil fields as analogs of Naftalan oil and promising raw materials for the production of therapeutic products for the purposes of balneology and practical health care. [ABSTRACT FROM AUTHOR]

Objective: To examine the effectiveness of electrophysical agents in fibromyalgia. Data sources: CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. Methods: This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. Results: Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms (P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status (P = 0.018); and microcurrent (P = 0.001), repetitive transcranial magnetic stimulation (P = 0.022), and no treatment (P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). Conclusion: This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia. [ABSTRACT FROM AUTHOR]

Hand osteoarthritis (HOA) represents a common presentation of osteoarthritis, significantly affecting patients' quality of life and daily activities. The 2018 EULAR recommendations underline the importance of a multidisciplinary approach, combining non-pharmacological and pharmacological treatments. Yet, the role of balneotherapy (BT) in the HOA therapeutic regimen remains unclear. This review seeks to bridge the gap by exploring recent randomized controlled trials (RCTs) that investigate the potential benefits of BT as a complementary intervention for managing HOA. This scoping review investigates original research articles published between January 2003 and August 2023 through a comprehensive search across MEDLINE (PubMed), Google Scholar, and Web of Science. The findings from this scoping review contribute to the growing corpus of evidence indicating that BT, particularly when employing specific methods like mud packs and mineral-rich baths, presents a promising role in reducing pain and enhancing functionality and quality of life, particularly in the initial phases of the condition. These findings highlight the potential therapeutic efficacy of BT interventions and support their inclusion as a complementary approach in managing HOA and preventing its progression. However, further research and the undertaking of larger-scale trials are imperative to validate these preliminary findings. [ABSTRACT FROM AUTHOR]

Spa therapy is a medical treatment based on the use of natural mineral water. In France, spa therapy is delivered in spa care facilities (SCF) involving the intervention of several actors (stakeholders). Spa doctors are key stakeholders as they prescribe the treatments, follow spa patients and assess spa therapy with scientific studies. This study aimed to analyze the spa doctors' relationships in order to highlight their role in transferring information to other stakeholders, particularly to spa managers. For that purpose, we used the social network analysis (SNA) method by means of snowball data collection. We sent a questionnaire to all the spa therapy categories of actors. In total, 80 persons answered and declared 397 relationships. Our results, based on the categorization of respondents and of their relationships and on quantitative indicators (density, response rate), show that spa doctors demonstrate a very acceptable density of relations with spa managers and elected local authorities. However, they appear to be poorly involved in relations concerning the strategy and management of SCF, although they are essential actors in ensuring the medical relevance and sustainability of spa therapy. This research is of interest to patients' care as it recommends deeper involvement of spa doctors in the management of SCF in order to optimize access to informational resources, specifically regarding the evolution of treatments in accordance with scientific progress. Our data are of international scope because the organizational model of balneotherapy, based on the cooperation between spa doctors and SCF, is universal. [ABSTRACT FROM AUTHOR]

(1) Introduction. Disorders of peripheral blood circulation affect people all around the world. Balneotherapy, in the form of carbonated mineral water baths and mofettes, could be considered one of the treatment options. The current study aims to investigate, in an experimental study, the effects of carbonated natural mineral water, with a known composition, and natural mofettes from Băile Tușnad (Romania) on peripheral arterial blood flow. (2) Material and method. A total of 16 rat subjects were studied, divided equally into 4 groups, all evaluated at 2, 4 and 6 weeks after the intervention. Group 1 was considered the control-group, and no treatment was applied. Group 2 was taken to the mofettes daily, for 2 weeks, for exposure to carbon dioxide, dry gas, for 20 minutes/day. Group 3 performed daily mofettes and baths with carbonated mineral water, for two weeks, 20 minutes/day, each procedure. Group 4 took a daily bath with carbonated mineral water, for 2 weeks, 20 min/day. At the end of the two-week treatment, they were evaluated by doppler ultrasound at the femoral artery, respectively at 2 and 4 weeks, to evaluate the effect over time of these treatments. Femoral artery diameter (mm), peak systolic velocity (PVS, cm/s), heart rate (HR, bpm) were quantitatively determined in all 4 groups, at 2, 4 and 6 weeks respectively, and ultrasound images were captured. (3) Results and discussions. In the control group, there were no differences at 2 weeks vs. 4 weeks vs. 6 weeks regardless of the studied parameter. The diameter of the femoral artery increased significantly in group 3 (mofetta and carbonated mineral water, p=0.0183), respectively in group 4 (mineral water p=0.007). Heart rate changed significantly p=0.0183 in the mofette group, as well as in the one treated with carbonated mineral water p= 0.024. The results of the study suggest that carbonated mineral water and mofettes were responsible for the changes in femoral artery flow, compared to the data from the control group. (4) Conclusions. Carbonated mineral water baths and mofettes could increase the peripheral arterial blood flow, during repeated immersion, and the results were beneficial 2 weeks after the end of the treatment, and were maintained after treatment at 4 and 6 weeks, respectively. [ABSTRACT FROM AUTHOR]

Hypertension (high blood pressure) is one of the most common health conditions. When your blood pressure is high for a long term, it can cause health problems, such as heart disease. In addition to the main methods of treatment, there are various methods of adjuvant therapy, one of the most common of which is hydrotherapy. In this review study, we examined the effects of hydrotherapy, balneotherapy, and spa therapy on blood pressure. We searched the PubMed/MEDLINE, Web of Science, Scopus, and Science Direct databases until April 2022 using related keywords. In summary, the current study shows that different hydrotherapy methods may improve blood pressure. Hydrotherapy as one of the adjunctive therapy methods can be effective in lowering blood pressure. Blood circulation is smoothed by the warmth of the water. This improvement may be achieved by regulating heart rate, releasing hormones that control blood pressure, or regulating the activity of baroreceptors or chemoreceptors. In addition to using medications, hypertension patients also use non-pharmacological approaches in their care, including hydrotherapy, balneotherapy, and warm water foot soaks performed at home. Although several lines of evidence show the potential effects of hydrotherapy, balneotherapy, and spa therapy on blood pressure, many clinical trials are needed. [ABSTRACT FROM AUTHOR]

This systematic review is aimed to evaluate the effects of balneotherapy with thermal mineral water for managing the symptoms and signs of osteoarthritis located at any anatomical site. The systematic review was conducted according to the PRISMA Statement. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, DOAJ and PEDro. We included clinical trials evaluating the effects of balneotherapy as a treatment for patients with osteoarthritis, published in English and Italian language, led on human subjects. The protocol was registered in PROSPERO. Overall, 17 studies have been included in the review. All of these studies were performed on adults or elderly patients suffering from osteoarthritis localized to knees, hips, hands or lumbar spine. The treatment assessed was always the balneotherapy with thermal mineral water. The outcomes evaluated were pain, palpation/pressure sensibility, articular tenderness, functional ability, quality of life, mobility, deambulation, ability to climb stairs, medical objective and patients' subjective evaluation, superoxide dismutase enzyme activity, serum levels of interleukin-2 receptors. The results of all the included studies agree and demonstrated an improvement of all the symptoms and signs investigated. In particular, pain and quality of life were the main symptoms evaluated and both improved after the treatment with thermal water in all the studies included in the review. These effects can be attributed to physical and chemical-physical properties of thermal mineral water used. However, the quality of many studies resulted not so high due and, consequently, it is necessary to perform new clinical trial in this field using more correct methods for conducting the study and for processing statistical data. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the role of applying additional balneotherapy to fibromyalgia patients while receiving conventional physical therapy. Materials and Methods: 107 female patients diagnosed with fibromyalgia for the first time were studied in two groups. Group 1 included patients receiving Transcutaneous Electrical Nerve Stimulation and physical therapy modalities, including superficial hot and therapeutic ultrasounds. Patients in Group 2 received balneotherapy in addition to the therapeutic modalities given to the first group. All patients went through a 10-session treatment program. The evaluation was based on the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), and Quality of Life Short Form-36 (SF-36) before and after the treatment. The total amount of paracetamol tablets consumed was also recorded. Results: There were significant recovery in post-treatment pain VAS, FIQ, and PSQI scores in both groups, compared to before treatment, but the improvements were more pronounced after the balneotherapy. The drug consumption was also significantly lower, and patients treated with balneotherapy expressed better general health and social function scores of SF-36. Conclusion: A combination of balneotherapy with conventional physical modalities appears to be an effective treatment option for fibromyalgia as it positively contributes to the patient's pain, functional status, quality of life and sleep, and drug consumption.

Purpose: Despite indications of positive effects of sauna (SAU) interventions, effects on performance recovery are unknown. The aim of the current study was to investigate acute effects of SAU bathing after an intensive training session on recovery of swim performance. Methods: In total, 20 competitive swimmers and triathletes (3 female and 17 male) with a minimum of 2 y of competition experience (national level or higher) participated in the study. Athletes completed an intensive training session followed by either a SAU bathing intervention or a placebo (PLAC) condition in a randomized order. SAU consisted of 3 × 8 min of SAU bathing at 80–85°C, whereas during PLAC, athletes applied a deidentified, pH-balanced massage oil while passively resting in a seated position. Prior to training, swimmers conducted a 4 × 50-m all-out swim test that was repeated on the following morning. Furthermore, subjective ratings of fatigue and recovery were measured. Results: Swimmers performed significantly worse after SAU (4 × 50-m pre–post difference: +1.69 s) than after PLAC (−0.66 s; P =.02), with the most pronounced decrease in the first 50 m (P =.04; +2.7%). Overall performance of 15 athletes deteriorated (+2.6 s). The subjective feeling of stress was significantly higher after SAU than after PLAC (P =.03). Conclusion: Based on published findings, the smallest substantial change in swimming performance is an increase in time of more than 1.2 s; thus, the observed reductions appear relevant for competitive swimmers. According to the current results, coaches and athletes should be careful with postexercise SAU if high-intensity training and/or competitions are scheduled on the following day. [ABSTRACT FROM AUTHOR]

BACKGROUND: Medical spa and cosmetic procedure markets have grown substantially in recent years. The lack of consistent medical oversight at medical spas raises safety concerns. OBJECTIVE: To understand how the public views medical spas compared with physician's offices as places to receive cosmetic procedures with a focus on safety. METHODS: 1,108 people were surveyed on an internet platform about their perceptions of the safety of receiving cosmetic procedures at medical spas and physician's offices. Respondents were grouped by their past experiences. Chi-squared and analysis of variance models were used to determine statistically significant differences between groups at the 0.05 level. RESULTS: Respondents who had only received cosmetic procedures at physician's offices or had never received a cosmetic procedure cared more about being treated by a physician (p <.001) and rated safety as more important (p =.03). Total complication rates were numerically higher at medical spas compared with physician's offices (p =.41). Minimally invasive skin tightening (0.77 vs 0.0, p <.001) and nonsurgical fat reduction (0.80 vs 0.36, p =.04) had higher complication rates at medical spas. CONCLUSION: There were concerns among the public about the safety of cosmetic procedures at medical spas, and some procedures demonstrated higher complication rates in this setting. [ABSTRACT FROM AUTHOR]

The problem of this research stems from the fact that in Bihor County there are 75 localities that have one or more thermal water wells, of which only 8 locations can provide balneological treatment. The purpose of the research is to evaluate whether the geothermal potential of the region would be sustainable for the development of balneology in other localities as well. In order to meet the above-mentioned requirement, an interdisciplinary methodology was necessary, starting from geophysics and geology, including hydrogeology, chemistry, physics and ending with elements of tourism and balneological potential. The research methods refer to field work, the inventory of all locations that have geothermal resources, the creation of a database, the analysis of the stability and continuity over time of the source of thermalism, the analysis of the stability and time continuity of those physical-chemical properties that are suitable for balneology. In conclusion, out of the 67 locations that still cannot provide balneological treatment, only 20 could fulfil the sustainability criteria and are able to diversify the exploitation of thermal waters. There are 47 other locations that have unexploited boreholes, but despite this, we have come to the conclusion that balneology and tourism based on geothermal waters in Bihor County has a sustainable future in dozens of localities. [ABSTRACT FROM AUTHOR]

This study aims to analyse the development of the balneological phenomenon in Bihor County generated by its administration, consequent of which, a classification of rural settlements and new tourist resorts has been made. The objective is to identify the current trend in the exploitation of the balneological potential of the localities in Bihor County. A comparative analysis has also been carried out between the influence of the political regimes on the exploitation of geothermal water sources at the level of rural settlements and new tourist resorts during the last five decades. The comparative analysis has revealed that the development of the balneological phenomenon has been carried out sequentially. This sequence has been influenced by the political environment and the administrative factor from the period before and after the Revolution. In the period before the Revolution, all balneological sources were managed by the public administrative factor; they were maintained and kept functional, until the Revolution of 1989, against the background of a stable political environment. In the post-Revolution period, when the decision and involvement was sometimes undertaken on a small scale (private administration), and where the interest in development was focused exclusively on the valorisation of the balneological resources, it can be said that capitalist policy favourably influenced the evolution of the balneological phenomenon at the level of rural settlements and new tourist resorts. We have concluded that the capitalist period has been favourable because, when the thermal baths were found to be unanimously managed by the public administration, they were functional in greater numbers at the rural level as compared to the post-revolutionary period. We have not analysed any "policy" documents in order to make this statement. [ABSTRACT FROM AUTHOR]

Frailty is not limited to the elderly, as patients with rheumatic diseases can also experience this condition. The present scoping review aimed to investigate the possibility of using the health resort setting as an alternative location for managing rheumatic patients with frailty. The research resulted in finding several in vitro, in vivo, and clinical studies, resulting in evidence supporting the effectiveness of spa treatments in reducing pain, improving function, and managing comorbidity in rheumatic diseases. Additionally, spa treatments were demonstrated to modulate the MAPK/ERK pathway and the NF-kB pathway's activation and to reduce proinflammatory molecules' secretion in rheumatic diseases, thus suggesting their potential effective role in the regulation of inflammaging in frailty. Moreover, the health resort setting may offer potential resources to reduce risk factors, such as drug consumption, inactivity, and disease severity, and may serve as a setting for developing prevention protocols for frailty. Future research should explore innovative approaches, such as exercise training and early diagnostics, for the overall management of frailty in rheumatic patients in the spa setting. [ABSTRACT FROM AUTHOR]

Objective: This systematic review assessed the feasibility of American Indian traditional ceremonial practices (TCPs) to address problem substance use in both reservation and urban settings. Methods: Between September 24, 2021, and January 14, 2022, culturally specific review protocols were applied to articles retrieved from over 160 electronic databases—including PubMed, Global Health, Global Health Archive, CINAHL Complete, PsychInfo, Web of Science, Health and Wellness (Gale), Sage Online Journals, and ScienceDirect. Results: A total of 10 studies met the criteria for inclusion in the review. Studies were conducted with both urban (n = 7) and reservation (n = 3) American Indian and Alaska Native (AIAN) populations. The most common TCP activities reported were drumming (n = 9), sweat lodge (n = 7), and talking circles (n = 6). All 10 studies reported some type of quantitative data showing a reduction of substance use associated with TCP interventions or activities. Conclusions: The current status of the literature is emerging and does not allow for meta-analysis of existing studies. However, the existing literature does indicate promise for the use of TCPs to address problem substance use in AIAN communities in a way that is effective and also culturally congruent. [ABSTRACT FROM AUTHOR]

The incidence of atopic eczema in the population reaches generally up to 25%. Skin diseases such as Atopic eczema and Psoriasis vulgaris are a worldwide problem. Use of topical corticosteroids is the first-line treatment for atopic dermatitis flare-ups. Last individual case studies led to the hypothesis: Baths with microbubbles in tap water can significantly support the treatment of skin diseases. Microbubbles penetrate deep into the skin pores. Micro implosions occur on the pore walls, which mechanically affect nerve endings and vascular microcapillaries. In addition, due to the implosion of microbubbles, the mechanical effect leads to an increased release and flushing of substances contained in the skin pores. A total of 30 patients were selected for the study, of which 15 were included in the Study Group and 15 in the Control Group. The effects were monitored on the objectively evaluable dermatological calculators PASI, EASI, SCORAD, and DLQI Score, Quality of life, and Number and condition of foci. The project responded to the hypothesis that microbubbles in the water phase, produced by special generators, in the size range of 1-100 µm, may in the future become a fundamental innovation in balneological treatment in the form of new treatment procedures. [ABSTRACT FROM AUTHOR]

A longevity and balneotherapy treatment program has been initiated at the Cofrentes Medical Spa, including the development of the Rosita Longevity App. The objective of this study is to determine the health profiles (degree of frailty and pre-frailty) by means of Fried Frailty Phenotype questionnaire and the prevalence of geriatric syndromes in people over 60 doing balneotherapy at the spa, considering that the thermal environment is an ideal place to treat these types of syndromes and to delay their progress. Thermal/spa facilities often receive older patients with osteo-articular and musculoskeletal conditions. To assess the grade of the functionality, quality of life, depression, nutritional risk, cognitive state, insomnia, and the risk of falls, specific questionnaires were used. Out of a total of 43 participants, 30 were women (69.7%), and 22 older than 70 y (51.1%). There were 2 frail (4.6%) and 20 prefrail (46.5%). Conclusions: more than half of the people older than 60 who visit the Cofrentes spa present a functionality deficit condition. Women present a lower quality of life than men. The more affected items in the prefrail population were grip strength and physical activity. Health Resort Medicine is an ideal place to detect these aspects. [ABSTRACT FROM AUTHOR]

The purpose of this article was to review and assess the results obtained from human studies on the effects of hydrotherapy, balneotherapy, and spa therapy on sleep disorders. In this study, databases such as Pubmed, Embase, Web of Science, Google Scholar, Cochrane, Scopus, and sciences direct database were searched from the beginning to September 2022. All human studies that examined the effect of hydrotherapy, balneotherapy, and spa therapy on sleep disorders were published in the form of a full article in English. In the end, only 18 of the 189 articles met the criteria for analysis. Most studies have shown that balneotherapy, spa therapy, and hydrotherapy may by affecting some hormones such as histamine, serotonin, sympathetic nerves, and regulating body temperature led to increased quality and quantity of sleep. Also, the results obtained from Downs and Black show that 3 studies were rated as very good, 7 studies as good, 7 studies as fair, and 1 study as weak. The results of studies also showed that hydrotherapy leads to an improvement in the PSQI score index. Nevertheless, more clinical trials are needed to determine the mechanism of action of hydrotherapy on sleep disorders. [ABSTRACT FROM AUTHOR]

The St. Mauritius mineral spring has been used since the late Bronze Age times (1410/1411 BC), as dated on the wooden headworks using radiocarbon and tree ring (dendrochronology) methods. It became eminent during the late Middle Ages epoch of curative treatments. The water is renowned for its high iron content and high amounts of dissolved and gaseous CO2. This special character of the Mauritius spring made it attractive to be analyzed by esteemed chemists over more than two centuries. By these analyses transferred in coherent units, a comparison of the chemical composition of this Mauritius mineral spring during the entire interval from 1788 to 2022 became possible. It reveals that the chemical composition of the Mauritius mineral spring water has largely remained stable and apart from some minor changes in water quality caused by alterations to the spring capture headworks since that time. These capture remediation actions were aimed to maintain the original composition of the Mauritius mineral spring water, which since its first utilization is threatened by the prevailing mixing processes with the shallow, low mineralized groundwater. The mineral water can be characterized as being an acidic calcium–sodium–magnesium–bicarbonate-type water, rich in iron, with a total mineralization of about 1.8 g/l. The spring discharge with a temperature of about 4–6 °C and contains about 2500 mg/l of free gaseous carbon dioxide. This high concentration of free outgassing of CO2 is due to the emission of this gas from a great depth from the Engadine Fault Line which crosses the spring discharge area. [ABSTRACT FROM AUTHOR]

Beginning with the profound geopolitical changes created by the dissolution of the Austro-Hungarian monarchy and the creation of the Czechoslovak and Yugoslav states, this article examines how medical knowledge about maritime climate and sea-based therapies was mobilized in Czech popular touristic writing about Yugoslavia's Adriatic coast in the 1920s. The analysis of archival documents as well as non-specialist medical publications of Czech or Prague-trained doctors show that Czech tourists and curists (travelers in search of health treatments) were offered a freeform, all-encompassing therapeutic environmental approach. Inspired by Neo-Hippocratic principles, doctors stressed the importance of factors such as salt water, clean air, temperature variation, sunshine, flora, and modern facilities for disease prevention or the restoration of one's health. These doctors' relative success in promoting the therapeutic virtues of the Adriatic Sea is explained in large part, this article argues, by a broad nexus of intertwined interests (such as the growth of tourism, concerns about public health, and the influence of Neo-Slavism) embedded in the project of transforming the Adriatic Sea into a therapeutic site. [ABSTRACT FROM AUTHOR]

Reducing energy costs in Europe is more challenging than before due to extreme price increases. The use of local renewable energy sources is one way to contribute to this effort. In the case of spa resorts, the use of heat from hot springs for therapeutic baths is an option. It is necessary to cool down this thermal mineral water to a temperature acceptable to the human body. However, due to the high mineral content of this water, heavy fouling can be a problem for conventional heat exchangers. The purpose of this study is to identify the suitable cooling technology in terms of required cooling capacity and waste heat recovery capability. The cooling technology was selected on the basis of a literature search. A pilot cooling unit consisting of vacuum cooler and plate heat exchanger was designed and tested in a real spa resort for six months. Both selected technologies have demonstrated the ability to cool thermal mineral water in long-term operation, as well as the possibility to utilize waste heat for domestic hot water heating. However, fouling problems occur in the plate heat exchanger. The vacuum cooler demonstrated greater operational robustness and resistance to encrustation. [ABSTRACT FROM AUTHOR]

Balneotherapy comprises the use of natural mineral waters for health and/or well-being purposes. When balneotherapy is offered by the public health system, some countries with Latin-based languages call it social thermalism. The aim of this study is to compare balneotherapy in health systems of Spain, France, Italy, and Portugal. The study involves a qualitative systematic review of the literature using the systematic search flow method. Twenty-two documents, from 2000 to 2022, were included and its findings were described in seven categories: the first outlines the historical characterization of social thermalism in the systems analyzed and the others outline the components of the health systems: coverage/access, health financing, workforce, inputs and techniques, organization and regulation, and network provision of services. The models of insurance and social security that cover part of the thermal treatment are highlighted. Doctors with competence in medical hydrology constitute the majority of the workforce. Similarities regarding inputs and techniques are observed, with variation in the number of days of the balneotherapy treatment cycle. In the regulation of services, the Ministry of Health of each country is prominent. The provision of services is mainly performed in specialized care in accredited balneotherapy establishments. Despite the limitations of the method, the comparisons made may serve to support public policies for balneotherapy. [ABSTRACT FROM AUTHOR]

Introduction and aim. Drinking mineral waters are one of the environmental factors that affect the condition of the human body. Of particular interest are therapeutic waters of the Naftussya type, which contain autochthonous microbes and organic oil-like substances and can be considered as a kind of ecosystem. On the other hand, gastrointestinal tract also is an ecosystem that associates a resident microbiota and cells of various phenotypes lining the epithelial wall. We assumed that one of the mechanisms of the therapeutic effect of Naftussya water is the interaction of external and internal ecosystems. This article is the first in a series in support of the hypothesis. Material and methods. The object of clinical-physiological observation were residents of the city of Truskavets' (21 men aged 24-67 years and 8 women 33-76 years) with chronic pyelonephritis in remission. The objects of study: leukocyturia, bacteriuria, components of microbiota, phagocytosis function of neutrophils, leukocytary adaptation index, plasma and urine electrolytes and nitrogenous metabolites. Results. The weekly use of bioactive Naftussya water from the Opaka deposit causes a favorable normalizing effect on the stool microbiota: it increases the reduced content of Bifidobacteria and Lactobacilli, instead it reduces the increased content of pathogenic strains of Escherichia coli, as well as Klebsiela and Proteus. Reduction of dysbacteriosis is accompanied by an increase in the reduced bactericidal capacity of blood neutrophils against E. coli and Staphylococcus aureus, and reduction of bacteriuria and leukocyturia. At the same time, the elevated level of creatinine in the plasma decreases, instead, the decreased levels of sodium and chloride increase. As expected, the daily diuresis and excretion of urea, creatinine, phosphates, calcium, magnesium and chloride increases, but not sodium and uric acid, the concentrations of which in the urine decrease. The described physiologically beneficial effects are interpreted as adaptogenic, which is confirmed by an increase in the reduced leukocyte adaptation index. Conclusion. The healing effect of Naftussya bioactive water is the result of the interaction of external and internal ecosystems. The next article will consider the role of the nervous and endocrine systems in this interaction. [ABSTRACT FROM AUTHOR]

Obesity is a complex, multifactorial metabolic pathology, within the path of modification of the endocrine system plays a significant role. Changes in growth hormone (GH) and in-sulin growth factor (IGF) have been associated with obesity in various ways, mainly through changes in GH-binding proteins, insulin and ghrelin levels. The balneal treat-ment with Techirghiol Romanian sapropelic mud has an important impact on the endo-crine system, primarily through the action on the hypothalamic-pituitary-adrenal axis. We investigated the secretory changes of the IGF-1 hormone that appeared after the balne-al treatment. It was a total number of 52 patients, divided into two groups: 1 group who performed the treatment with Techirghiol sapropelic mud at thermoneutrality temperatures - warm mud baths, and the second group who followed treatment with the balneal therapeutic factor in a thermal contrast regime - cold mud baths. We studied whether there are correlations between the body mass index (BMI) and the secretion of this hormone. We also determined the serum levels of blood glucose at admission and discharge. In the cold mud baths- thermal contrast therapy, can be observed a statistically significant increase in IGF-1 values during the balneal treatment (p = 0.044 < α = 0.05). Comparative-ly, in the warm mud baths, the increase in serum IGF-1 reached values close to statistical significance at the end of the treatment (p = 0.067 > α = 0.05). There were no statistically significant correlations between BMI and IGF-1 hormone secretion at admission and at discharge. The results showed a statistically significant decrease in blood glucose values determined at admission and discharge in the group that performed warm mud baths. The balneal treatment with sapropelic mud of Techirghiol lake, from Romania, through the impact on the endocrine system, on the hypothalamic-pituitary-adrenal axis, can be registered as a treatment with a natural therapeutic factor with an impact on obesity, therapy carried out within the parameters of metabolic safety, and the conduct of future re-search in this direction it will help develop new concepts and approaches to obesity. [ABSTRACT FROM AUTHOR]

To preliminarily explore a nondrug intervention method and evaluate its effects (sleep quality, physical examination indicators, and general physical symptoms) on people with sleep disorders. The intervention was based on regular balneotherapy, coupled with targeted health education, appropriate exercise, diet management, and other sleep-promoting measures. It was the combined effects that we evaluated. We recruited 31 volunteers with sleep disorders to receive a 7-day sleep-promoting experience in Tianxing International Hot Spring City, Nanchuan District, Chongqing. The intervention adopted a plan that combined balneotherapy with various sleep-promoting measures. Persisting baths in hot springs 1–2 times per day targeted health lectures about 1 h every morning, appropriate exercise every day (sleep-aid yoga, forest hiking, morning exercises, etc.), and diet management (the principle is to control oil, salt, and sugar, diversify food, keep meat and vegetable balanced, and control total calories. The dinner is light and easy to digest). During the intervention period, all participants followed the above intervention plan, and they lived in the spa resort to accept unified arrangement. This study adopted a self-contrast method by comparing the changes in sleep quality, physical examination indicators, and general physical symptoms before and after the intervention through physical examinations and questionnaire surveys. After the intervention, the subjects' total score of Insomnia Severity Index (ISI) decreased significantly (P = 0.006), and all seven dimensions showed a decrease, four of which included early morning awakening, sleep dissatisfaction, noticeability of sleep problems by others, and distress caused by sleep problems decreased significantly (all P < 0.05). The subjects' body mass index, waist circumference, fasting blood glucose, and triglycerides decreased significantly (all P < 0.05), and systolic blood pressure increased significantly (P = 0.006). Total cholesterol, high-density lipoprotein, low-density lipoprotein, and diastolic blood pressure did not change significantly (all P > 0.05). To some extent, all general health problems were improved than before the intervention (the improvement rate was up to 70% or more). The non-pharmacological intervention of balneotherapy combined with various sleep-promoting measures showed positive effects on sleep quality, general physical symptoms, and some physical examination indicators of sleep disorders. This comprehensive intervention may be an effective way to improve people's health with sleep disorders. [ABSTRACT FROM AUTHOR]