Sobrevivência e desenvolvimento de Pseudomonas aeruginosa em água mineral experimentalmente contaminada / Survival and growth of Pseudomonas aeruginosa in experimentally contaminated mineral water

Pseudomonas aeruginosa, agente patogênico oportunista, é frequentemente encontrado em águas minerais e pode causar infecções em indivíduos imunocomprometidos. Neste estudo foi avaliada a sobrevivência e/ou a multiplicação de P. aeruginosa em amostras de água mineral em embalagens plásticas de 1,5 L e 20 L, experimentalmente contaminadas, armazenadas a 35 ± 1ºC, 4 ± 2°C e em temperatura ambiente (20-25ºC), durante o período de validade do produto. Nas amostras de água mineral em garrafa plástica de 1,5 L, armazenadas a 35 ± 1ºC e 4 ± 2ºC, a população de P. aeruginosa manteve-se viável durante 370 e 100 dias, respectivamente. O maior aumento da população bacteriana ocorreu nas amostras de água mineral em galão de 20 L, armazenadas entre 20 a 25ºC, que passou de 3,8 para 6,6 log10 UFC/mL em um período de sete dias. Portanto, os galões de 20 L merecem atenção especial, pois além de serem retornáveis, normalmente são armazenados à temperatura ambiente. Os resultados reforçam a necessidade das empresas de águas minerais implantarem e implementarem as Boas Práticas de Fabricação (BPF) e o sistema Análise de Perigo e Pontos Críticos de Controle (APPCC) para eliminar ou minimizar os riscos do consumo deste produto.

Pseudomonas aeruginosa, an opportunistic pathogen, is often found in bottled waters and capable of infecting the immunocompromised patients. The present study aimed at evaluating the survival and/ or the growth of P. aeruginosa strain in 1,5 L and 20 L bottled mineral water samples experimentally contaminated, stored at 35 ± 1°C, 4 ± 2°C, and at room temperature (from 20 to 25°C) during the product shelf-life period. In the mineral water samples contained in 1.5 L bottles, stored at 35 ± 1ºC and 4 ± 2ºC, P. aeruginosa remained viable for 370 and 100 days, respectively. The major increase in the bacterial population occurred in mineral water samples in 20 L bottles stored at 20 to 25ºC, being from 3.8 to 6.6 log10 CFU/mL, in a period of seven days. Therefore, the 20 L bottles deserve a special attention because, in addition of being returnable, they are usually stored at room temperature. The results reinforce the need of the mineral water companies in implementing the Good Manufacturing Practice (GMP) and the HACCP (Hazard Analysis Critical Control Point) to eliminate and to minimize the risks of consuming the contaminated product.

Daily Water Consumption and its Contribution to Calcium Intake in Korean Adults / 대한지역사회영양학회지

OBJECTIVES: Although water is essential for life and can supply essential minerals, studies that evaluate calcium intake through drinking water are limited. The aim of this study was to assess calcium contents of natural mineral water (NMW) and its possible contribution to calcium intake in healthy adults. METHODS: This study examined water consumption in 640 Korean adults with selfselected diet, analyzed the calcium content of 10 different brands of bottled NMWs sold in Korea, and assessed the amount of calcium intake from drinking water and its daily contribution to the recommended nutrient intake (RNI) of calcium. RESULTS: Mean calcium content in 10 bottled NMWs was 20.9 mg/l. Daily water intakes from food composition database and calculated using energy intake based on 0.53 ml/kcal were 957.2 ml and 1109.8 ml for men and 848.3 ml and 951.6 ml for women, respectively, with a significant difference by gender (p < 0.001). Daily drinking water intake was significantly higher among men than women (1203.9 ml vs. 1004.3 ml, respectively, p < 0.001). Daily calcium intakes from foods were 564.0 mg for men and 534.2 mg for women. Daily possible calcium intakes from drinking bottled water were 25.2 mg for men and 21.0 mg for women (p < 0.001). The contribution of daily calcium intake from drinking bottled water to RNI of calcium was 3.3% for men and 2.9% for women without significant difference. CONCLUSIONS: One half of the daily total water intake was consumed as drinking water, and possible calcium intake through drinking water was about 3% of RNI.

Daily Water Consumption and its Contribution to Calcium Intake in Korean Adults / 대한지역사회영양학회지

OBJECTIVES: Although water is essential for life and can supply essential minerals, studies that evaluate calcium intake through drinking water are limited. The aim of this study was to assess calcium contents of natural mineral water (NMW) and its possible contribution to calcium intake in healthy adults. METHODS: This study examined water consumption in 640 Korean adults with selfselected diet, analyzed the calcium content of 10 different brands of bottled NMWs sold in Korea, and assessed the amount of calcium intake from drinking water and its daily contribution to the recommended nutrient intake (RNI) of calcium. RESULTS: Mean calcium content in 10 bottled NMWs was 20.9 mg/l. Daily water intakes from food composition database and calculated using energy intake based on 0.53 ml/kcal were 957.2 ml and 1109.8 ml for men and 848.3 ml and 951.6 ml for women, respectively, with a significant difference by gender (p < 0.001). Daily drinking water intake was significantly higher among men than women (1203.9 ml vs. 1004.3 ml, respectively, p < 0.001). Daily calcium intakes from foods were 564.0 mg for men and 534.2 mg for women. Daily possible calcium intakes from drinking bottled water were 25.2 mg for men and 21.0 mg for women (p < 0.001). The contribution of daily calcium intake from drinking bottled water to RNI of calcium was 3.3% for men and 2.9% for women without significant difference. CONCLUSIONS: One half of the daily total water intake was consumed as drinking water, and possible calcium intake through drinking water was about 3% of RNI.

O poder terapêutico das águas minerais em Minas Gerais: do conhecimento popular ao científico / The therapeutic power of mineral waters in Minas Gerais: from popular to scientific knowledge

O uso das águas minerais para tratamento de saúde é um procedimento dos mais antigos, utilizado desde a época do Império Grego, recebeu vários nomes ao longo dos anos: Hidrologia Médica, Crenoterapia e Termalismo. No Brasil, a Crenoterapia foi introduzida juntamente com a colonização portuguesa, que trouxe ao país os seus hábitos de usar águas minerais para tratamento de saúde. A princípio, principalmente nos séculos XVII e XVIII, as águas tinham o seu poder curativo comprovado por experiências práticas e eram relacionadas ao mundo religioso, sendo, por isso, consideradas sagradas e milagrosas. As fontes de águas minerais foram as responsáveis pela formação e desenvolvimento de muitas cidades em Minas Gerais, atraindo a vinda de vários viajantes interessados no poder curativo e milagroso das águas. O sucesso do tratamento de doenças, com os banhos de águas minerais transformou lugarejos em centros urbanos. O potencial econômico das águas minerais, ao logo dos anos, despertou a atenção dos governantes mineiros, que passaram a realizar investimentos nas cidades que possuíam estâncias hidrominerais. Essas cidades, aos olhos dos governantes, tinham potencial para representar o grau de progresso e civilização almejado pelo Estado de Minas Gerais. No entanto, além da higiene, segurança e conforto, fazia-se necessário atingir outros patamares quanto à cientificidade para a indicação terapêutica das águas minerais. Assim, entra em cena a Universidade de Minas Gerais, que foi criada em 07 de setembro de 1927, pela Lei 956, promulgada pelo então Presidente do Estado de Minas Gerais, Antônio Carlos Ribeiro de Andrada. A análise dos documentos durante a pesquisa revelou a existência de um acordo...

The use of mineral waters for health treatment purpose, is not a new procedure, being used since the Greek Empire times, has received several names over the years: Medical Hydrology, Cotherapy and Thermalism. In Brazil the crenoterapia was introduced by the Portuguese colonization, which brought to the country the habits of using mineral waters for health treatment. At first, especially in the seventeenth and eighteenth centuries, the waters had their curative power, proved by practical experience and was linked to the religious world, and therefore considered sacred and miraculous. The sources of mineral waters were responsible for the beginning and development of many cities in Minas Gerais, attracting several travelers interested in the curative and miraculous power of the waters. The success of disease treatment through mineral water baths has turned hamlets into urban centers. The economic potential of the mineral waters, at the turn of the years, attracted the attention of the mining rulers, who began to invest in the cities that had hydro-mineral spots. These, in the eyes of the rulers, had the potential to represent the degree of progress and civilization sought by the State of Minas Gerais. However, besides hygiene, safety and comfort, it was necessary to reach other levels as the scientific knowledge to correct therapeutic indication of the mineral waters. Thus, the University of Minas Gerais, which was created on September 7, 1927 by Law 956, was promulgated by the President of the State of Minas Gerais, Antônio Carlos Ribeiro de Andrada. The analysis of the documents during the research revealed the existence of an agreement between the President of the State in the year 1927 and the director of the Faculty of Medicine for the creation of the University of Minas Gerais. The importance of hydromineral stations to the state and the need to legitimize scientific knowledge for water therapy led the President of the State to support...

Condições higienicossanitárias de indústrias de águas minerais na ilha de São Luís ­ MA / Hygienic sanitary conditions of mineral water industries in São Luis- MA

da água consumida, tem mostrado o potencial crescimento do consumo de água mineral pela população, por acreditar ser um comportamento saudável e devido à insegurança em relação à qualidade e quantidade da água ofertada pelos serviços públicos. O consumo de água contaminada pode transmitir doenças como gastroenterites, hepatite, provocando vômitos, diarreia, náuseas, podendo levar à morte. Este estudo teve como objetivo avaliar as condições higienicossanitárias de indústrias de águas minerais na Ilha de São Luís- MA. Trata-se de um estudo descritivo, realizado com dados secundários de 2014 coletados na Superintendência de Vigilância Sanitário do Estado do Maranhão. Como parâmetro para classificação das indústrias por grupo de risco, utilizou-se a resolução 173/2006, da Agência Nacional de Vigilância Sanitária. Todas as indústrias pesquisadas foram classificadas em baixo risco, por atenderem a 100% dos itens referentes à higienização, e entre 76 e 100% dos demais itens. Diante dos dados pode-se concluir que a água mineral envasada e comercializada pelas indústrias pesquisadas na Ilha de São Luís- MA estão adequadas para o consumo humano.

Agua alcalinizante y con alto contenido de magnesio: los posibles efectos beneficiosos para la salud / Alkaline water and with high level of magnesium: possible benefits for health

Introducción: el consumo de dietas con un potencial alcalinizante ha sido asociado con varios efectos beneciosos sobre la salud. El potencial alcalinizante de un alimento en particular puede evaluarse mediante el cálculo del PRAL, una fórmula que tiene en cuenta el contenido de sulfato, fosfato, cloruro, sodio, calcio, potasio y magnesio de los alimentos. Objetivos: revisar la literatura para vericar el efecto del magnesio y alimentos/agua con potencial alcalinizante para la salud. También evaluar la capacidad de un filtro comercial para hacer el agua más alcalinizante y aumentar su contenido de magnesio. Materiales y métodos: se utilizaron cuatro filtros y el PRAL se calculó para todas las muestras; los valores se expresaron como media ± desviación estándar. Resultados: se encontró un aumento en el pH (IC 95%: 2,702 a -2,548; p<0,0001) y una reducción en el valor de PRAL (IC 95%: 1,418 a 2,081; p<0,0001). El magnesio fue el mayor predictor de un valor de PRAL alcalinizante dado que hubo un incremento estadísticamente significativo (IC 95%: 54,00 a -39,16; p<0,0001) en el contenido de magnesio después del proceso de filtración independiente de la fuente de agua. Conclusiones: la mayoría de los estudios sugiere que el consumo de alimentos alcalinizantes se asocia con una reducción de la resorción ósea y la inhibición de la actividad de los osteoclastos. El consumo de magnesio se relaciona con un menor riesgo de enfermedad cardiovascular, diabetes tipo II y determinados tipos de demencia como la enfermedad de Alzheimer.

Introduction: the intake of alkalizing potential diets has been associated with various bene¬cial effects on health. The alkalizing potential of a particular food can be evaluated by the PRAL calculation, a formula considering the content of sulfate, Phosphate, chloride, sodium, calcium, potassium and magnesium in food. Objectives: to check the scientific literature to verify the effect of magnesium and food/water with alkalizing potential for health. The capacity of a commercial filter to make water more alkalizing and increase the content of magnesium was also evaluated. Materials and methods: four filters were used and PRAL was calculated for all samples, and the values were reported as mean ± standard deviation. Results: an increase in pH was observed (CI 95%: -2,702 to -2,548; p<0,0001) and a reduction in the PRAL value (CI 95%: 1,418 to 2,081; p<0,0001). Magnesium was the major predictor of an alkalizing PRAL value, since there was a statistically significant increase (CI 95%: -54,00 to -39,16; p<0,0001) in the content of magnesium after the independent filtration process of water source. Conclusions: most of the studies suggest that the consumption of alkalizing water is associated with a reduction in bone resorption and inhibition of osteoclast activity. The consumption of magnesium is associated with a less risk of cardiovascular disease, type II diabetes and certain types of dementia such as Alzheimer.

07-4One-year effectiveness of mud-bath therapy in knee osteoarthritis / 日本温泉気候物理医学会雑誌

<b>Objective: </b>To assess both the short-term and the long-term effectiveness of spa therapy in patients with primary knee osteoarthritis (OA) in a prospective, randomized, single blind, controlled trial.<BR><b>Materials and Methods:</b> 103 outpatients with OA of the knee according to the ACR criteria (1) were enrolled. Patients were randomized 1 : 1 and allocated into two groups: 53 patients (Group A) received in addition to usual treatment (exercise, NSAIDs and/or analgesics, established SYSADOAs) a combination of daily local mud-packs applied on both knees for 20 min at an initial temperature of 45°C and bicarbonate-sulphate-calcic mineral bath water at 38°C for 15 min, from the spa centre of Chianciano Terme (Siena, Italy) for 12 applications carried out over a period of 2 weeks. 50 patients (Group B, controls) continued routine ambulatory care. Clinical assessments were performed at basal time after 2 weeks, after 3, 6, 9 and 12 months - end of the study. The primary outcome criteria were the change from baseline to month 12 in WOMAC - Total Pain Score (W-TPS) (range 0-20)* and in WOMAC - Total Physical Function Score (W-TPFS) (range 0-68)* scored by a 5-point Likert scale. A set of secondary outcomes was also assessed such as WOMAC Total Stiffness Score (W-TSS), Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-12 (ranges 0-100) and consumption of analgesic medications (paracetamol and/or NSAIDs).<BR><b>Results:</b> Ten patients (9.5%) withdrew from the study: 2 in the spa-group and 8 (16%) in the control group. The assessment of pain showed a very significant improvement (p<0.001) in patients treated with mud-packs until 6 months and a less significant reduction (p<0.05) after 9 and 12 months. The control group showed a significant improvement after 2 weeks and 3 months, however this improvement is less expressed than in group A.<BR>  The differences between the two groups were significant already from 2 weeks and lasted during the follow-up.<BR>  A similar trend was observed for the WOMAC - Physical Function in the group A, group B showed a significant worsening after 6 months persisting throughout the follow-up.<BR>  The results obtained from the quality of life, SF-12 survey showed a significant improvement (p<0.001) in Physical Component, persisting throughout the follow-up period in group A. No significant modifications were found in group B during the study period.<BR>  On the contrary, significant improvement of the Mental Component Summary of SF-12 was shown at the end of the therapy in group A, but no significant differences were observed in the other time of the follow-up.<BR>  These effect on pain and function were also confirmed by the observed reduction of symptomatic drugs consumption. Tolerability of spa therapy seemed to be good, with light and transitory side effects.<BR><b>Conclusions:</b> In conclusion our results, in keeping with other studies (2, 3) confirm that the beneficial effects of mud-bath therapy in patients with knee OA last over time, with significant reduction on the painful symptomatology and a significant improvement on functional capacities and on quality of life. Spa therapy can represent a useful backup to pharmacological treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments.

07-1Possible chondroprotective effects of mineral waters: Evidences from in vitro studies / 日本温泉気候物理医学会雑誌

<b>Objective: </b>Objective of this review is to summarize the currently available information on possible chondroprotective effects of mineral waters or mineral components on chondrocyte or cartilage cultures. <BR><b>Methodology: </b>We conducted a search of the literature by PubMed and Scopus (the period examined was 1980-2013) using the terms “chondrocyte” and/or “cartilage” in combination with ”mineral water”, “hydrogen sulphide”, “sulphur hydrogen”.<BR><b>Results: </b>A chondroprotective role of mineral water or mineral components was demonstrated by some pilot studies in chondrocyte cultures. Burguera¹⁾ studied the activity of hydrogen sulphide (H₂S) in human osteoarthritic (OA) chondrocytes stimulated with Interleukin (IL)-1β. They analyzed the effects of different concentrations of a fast (NaHS) or a slow (GYY4137) release H₂S donor demonstrating a significant reduction of Nitric Oxide (NO), Prostaglandin(PG)-E₂, and Reactive Oxygen Species (ROS) levels in culture medium and of inducible Nitric Oxide Synthase (iNOS) gene expression, induced by IL-1β. These data were confirmed by Li²⁾ in normal human chondrocytes stimulated by Lipopolysaccharide(LPS). GYY4137 decreased LPS-induced production of NO, PGE₂, Tumor Necrosis Factor (TNF)-α and IL-6, reduced the levels and catalytic activity of iNOS and of Cyclooxygenase-2 (COX-2) and reduced LPS-induced NF-kB activation. Furthermore GYY4137 showed a strong inhibition on oxidative stress-induced cell death³⁾. The incubation of chondrocytes cell line C-28/I2 with another H₂S donor, Natrium Hydrogen Sulphide (NaHS), proved that constitutive as well as IL-1β-induced IL-6 and IL-8 expression was partially and transiently blocked by the NaHS⁴⁾. Fioravanti studied the chondroprotective role of highly mineralized water, strongly acidic sulfate, rich in calcium, magnesium and iron [Vetriolo’s thermal water (VW)] in human OA chondrocytes cultivated with or without IL-1β⁵⁾. For this purpose chondrocytes were cultivated in Deionized Water (DW) (DW-DMEM, controls), or in one of three different VW-DMEM media, in which DW had been totally (100%) or in part (50% or 25%) substituted with VW. The results showed that VW alone at 25% or 50% concentration did not affect the viability of cultured chondrocytes, and determined a significant survival recovery rate in cultures stimulated with IL-1β. NO levels were low both in DW-DMEM cultures and in those reconstituted with 25% or 50% of VW, and were significantly increased by IL-1β. VW at 25% or 50% concentration significantly reduced the NO production induced by IL-1β. The data of NO levels were confirmed by the immunocytochemistry assay for iNOS. Furthermore, the authors demonstrated a protective effect of VW at 25% or 50% concentration on IL-1β-induced apoptosis. <BR><b>Conclusions: </b>Presented data are stimulating, but we don’t ignore the existence of a complex series of problems and limitations. One of the critical points is the controversial problem of the absorption of the minerals dissolved in mineral waters, furthermore, extrapolation of in vitro results to in vivo should be undertaken with caution.<BR>  Further studies are needed in vitro to confirm these preliminary findings.

16-7 An assessment of Ruwan Zafi−Numan for exploitation as a source of dietary water in Nigeria / 日本温泉気候物理医学会雑誌

Introduction: In the Upper Benue Trough of Nigeria near Numan is a thermal spring flowing to the surface under natural conditions. Geologically, it is believed that this water passes through the Continental Bima Sandstones of the Albian, the transitional to marine Yolde Formation of the Cenomanian, and eventually through the continental Gombe Sandstones of Maastrichtian age, thus deriving their unique chemistry. Bottled mineral waters have been served in several parts of the world as a dietary water. They are a common source of essential micro and macro nutrients, needed by the human body. Materials: A sample of the thermal spring water was taken and analysed using the following techniques- electrometric method to determine electrical conductivity, pH value, iodide and fluoride content, the spectrophotometric method for the determination of ammonium, iron, manganese, nitrate, nitrite, silicate, bromate, and sulphate content, the flame photometric method for the determination of sodium, and potassium content, and finally the complexometric titration to determine calcium, and magnesium, the argentometric titration to determinate chloride, while the acidimetric titration was used in the determination of hydrocarbonate. Results: The following results were generated from the analyses done; temp 44.2°C, pH 7.38, mineralisation 442.63mg/l, Ca2+ 9.62, SO42- <1.00, NH4+ <0.05, Na+ 93.34, K+ 10.00, Mg2+ 2.43, Fe2+3+ <0.01, Mn2+ <0.01, F- 0.69, Cl- 20.20, Br- <0.05, J- <0.02, HCO3- 273.80, NO2- <0.02, NO3, <0.88, HB2- <0.05, H2SiO3 32.55, Total Hardness (mg/cm3, CaCO3) 32. Comparing these with the results of two bottled mineral water from Poland, namely: Jurajska, Ca2+ 66.1, SO42- 40.5, Na+ 10.0, K+ 2.2, Mg2+ 32.8, F- 0.4, Cl- 7.8, HCO3- 329.9 and Polaris, Ca2+ 102.2, Na+ 11.25, K+ 2.34, Mg2+ 16.0, F- 0.23, Cl- 2.50, HCO3- 432.7. Conclusion: One can conclude that the Ruwan Zafi- Numan is possibly a good source of dietary water which if exploited will improve the health needs of its consumers as well as boost national GDP.

07-6 Study regarding the effects of Valcele mineral water / 日本温泉気候物理医学会雑誌

Objectives: The study was conducted from 10.11.2012 - 20.03. 2013 aimed both to research and analyze tolerance of mineral water VALCELE and the therapeutic effects of the water.   At the same time we aimed to identify potential clinical manifestations or adverse effects induced by the ingestion of this specific type of mineral water. Material and method: The study included 87 patients. Following informed consent they received water, used in internal cure.   Patients in the study had various musculoskeletal suffering, being hospitalized for rehabilitation program for rheumatic diseases - coxarthrosis and gonarthrosis, disco-vertebral sufferings, post trauma, a small number of patients with stroke and patients with manifestations of dysfunctionality of the reno-urinary tract.   There were administered to each patient 2 liters of bottled water per day ad libitum, depending on the condition and needs of hydration.   We followed the presence of specific or non-specific digestive symptoms, urinary flow rate, urinating dynamics and biological dynamics for key blood parameters (hemoleucogram, ESR, glucose, urea, creatinine, SGPT and SGOT, uric acid, electrolytes) and urine.   Following ingestion of mineral water "VALCELE" during two weeks of hospitalization in the IIIrd Rehabilitation Clinic of National Institute of Rehabilitation, there were not registered the emergence or exacerbation of clinical symptoms digestive type (gastrointestinal tract, hepatobiliary activity) urinary, metabolic or electrolyte type. Conclusions: During internal cure with mineral water “VALCELE” has been found satisfactory water tolerance, correction of some digestive symptoms or functional disorders (heartburn, esophageal reflux, constipation, flatulence or feeling distended abdomen) and a part of patients with significant variations in the level improvement of glucose has been found its dynamics.   Clinical trial results conducted on a group of patients (87) showed favorable tolerance, improvement of clinical and functional digestive and urinary symptoms in patients with associated locomotory diseases.

07-4 One-year effectiveness of mud-bath therapy in knee osteoarthritis / 日本温泉気候物理医学会雑誌

Objective: To assess both the short-term and the long-term effectiveness of spa therapy in patients with primary knee osteoarthritis (OA) in a prospective, randomized, single blind, controlled trial. Materials and Methods: 103 outpatients with OA of the knee according to the ACR criteria (1) were enrolled. Patients were randomized 1 : 1 and allocated into two groups: 53 patients (Group A) received in addition to usual treatment (exercise, NSAIDs and/or analgesics, established SYSADOAs) a combination of daily local mud-packs applied on both knees for 20 min at an initial temperature of 45°C and bicarbonate-sulphate-calcic mineral bath water at 38°C for 15 min, from the spa centre of Chianciano Terme (Siena, Italy) for 12 applications carried out over a period of 2 weeks. 50 patients (Group B, controls) continued routine ambulatory care. Clinical assessments were performed at basal time after 2 weeks, after 3, 6, 9 and 12 months - end of the study. The primary outcome criteria were the change from baseline to month 12 in WOMAC - Total Pain Score (W-TPS) (range 0-20)* and in WOMAC - Total Physical Function Score (W-TPFS) (range 0-68)* scored by a 5-point Likert scale. A set of secondary outcomes was also assessed such as WOMAC Total Stiffness Score (W-TSS), Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-12 (ranges 0-100) and consumption of analgesic medications (paracetamol and/or NSAIDs). Results: Ten patients (9.5%) withdrew from the study: 2 in the spa-group and 8 (16%) in the control group. The assessment of pain showed a very significant improvement (p<0.001) in patients treated with mud-packs until 6 months and a less significant reduction (p<0.05) after 9 and 12 months. The control group showed a significant improvement after 2 weeks and 3 months, however this improvement is less expressed than in group A.   The differences between the two groups were significant already from 2 weeks and lasted during the follow-up.   A similar trend was observed for the WOMAC - Physical Function in the group A, group B showed a significant worsening after 6 months persisting throughout the follow-up.   The results obtained from the quality of life, SF-12 survey showed a significant improvement (p<0.001) in Physical Component, persisting throughout the follow-up period in group A. No significant modifications were found in group B during the study period.   On the contrary, significant improvement of the Mental Component Summary of SF-12 was shown at the end of the therapy in group A, but no significant differences were observed in the other time of the follow-up.   These effect on pain and function were also confirmed by the observed reduction of symptomatic drugs consumption. Tolerability of spa therapy seemed to be good, with light and transitory side effects. Conclusions: In conclusion our results, in keeping with other studies (2, 3) confirm that the beneficial effects of mud-bath therapy in patients with knee OA last over time, with significant reduction on the painful symptomatology and a significant improvement on functional capacities and on quality of life. Spa therapy can represent a useful backup to pharmacological treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments.

07-1 Possible chondroprotective effects of mineral waters: Evidences from in vitro studies / 日本温泉気候物理医学会雑誌

Objective: Objective of this review is to summarize the currently available information on possible chondroprotective effects of mineral waters or mineral components on chondrocyte or cartilage cultures. Methodology: We conducted a search of the literature by PubMed and Scopus (the period examined was 1980-2013) using the terms “chondrocyte” and/or “cartilage” in combination with ”mineral water”, “hydrogen sulphide”, “sulphur hydrogen”. Results: A chondroprotective role of mineral water or mineral components was demonstrated by some pilot studies in chondrocyte cultures. Burguera1) studied the activity of hydrogen sulphide (H2S) in human osteoarthritic (OA) chondrocytes stimulated with Interleukin (IL)-1β. They analyzed the effects of different concentrations of a fast (NaHS) or a slow (GYY4137) release H2S donor demonstrating a significant reduction of Nitric Oxide (NO), Prostaglandin(PG)-E2, and Reactive Oxygen Species (ROS) levels in culture medium and of inducible Nitric Oxide Synthase (iNOS) gene expression, induced by IL-1β. These data were confirmed by Li2) in normal human chondrocytes stimulated by Lipopolysaccharide(LPS). GYY4137 decreased LPS-induced production of NO, PGE2, Tumor Necrosis Factor (TNF)-α and IL-6, reduced the levels and catalytic activity of iNOS and of Cyclooxygenase-2 (COX-2) and reduced LPS-induced NF-kB activation. Furthermore GYY4137 showed a strong inhibition on oxidative stress-induced cell death3). The incubation of chondrocytes cell line C-28/I2 with another H2S donor, Natrium Hydrogen Sulphide (NaHS), proved that constitutive as well as IL-1β-induced IL-6 and IL-8 expression was partially and transiently blocked by the NaHS4). Fioravanti studied the chondroprotective role of highly mineralized water, strongly acidic sulfate, rich in calcium, magnesium and iron [Vetriolo’s thermal water (VW)] in human OA chondrocytes cultivated with or without IL-1β5). For this purpose chondrocytes were cultivated in Deionized Water (DW) (DW-DMEM, controls), or in one of three different VW-DMEM media, in which DW had been totally (100%) or in part (50% or 25%) substituted with VW. The results showed that VW alone at 25% or 50% concentration did not affect the viability of cultured chondrocytes, and determined a significant survival recovery rate in cultures stimulated with IL-1β. NO levels were low both in DW-DMEM cultures and in those reconstituted with 25% or 50% of VW, and were significantly increased by IL-1β. VW at 25% or 50% concentration significantly reduced the NO production induced by IL-1β. The data of NO levels were confirmed by the immunocytochemistry assay for iNOS. Furthermore, the authors demonstrated a protective effect of VW at 25% or 50% concentration on IL-1β-induced apoptosis. Conclusions: Presented data are stimulating, but we don’t ignore the existence of a complex series of problems and limitations. One of the critical points is the controversial problem of the absorption of the minerals dissolved in mineral waters, furthermore, extrapolation of in vitro results to in vivo should be undertaken with caution.   Further studies are needed in vitro to confirm these preliminary findings.

Investigação de micro-organismos indicadores de qualidade e parâmetros físico-químicos, em amostras de água mineral comercializadas na região norte do Espírito Santo / Investigation of micro-organisms of quality indicators and physico-chemical parameters in mineral water samples commercialized in the northern region of Espírito Santo

A qualidade microbiológica e físico-química de amostras de água fora dos padrões legais permitidos tem contribuído para o aumento do consumo de água envasada por parte da população. Objetivou-se verificar a qualidade microbiológica e físico-química de quatro marcas de água mineral comercializadas no município de São Mateus, ES. Para a detecção de coliformes totais, Escherichia coli e Salmonella spp. utilizou-se kit microbiológico Tecnobac® e para contagem de bactérias heterotróficas utilizou-se a técnica de semeadura em profundidade. Para as análises físicoquímicas utilizou-se kit analítico Ecokit®. Verificou-se o pH, a condutividade, além da análise de ferro. Os resultados das análises microbiológicas demonstraram que todas as marcas de água mineral investigadas estavam em conformidade com a Portaria 2914/2011 em relação aos coliformes totais e E. coli. Constatou-se a ausência de Salmonella spp. em todas as amostras. Com relação à contagem de bactérias heterotróficas, 5 amostras (13,89%) excederam o limite máximo permitido, estando em desacordo com a legislação vigente. As análises físico-químicas demonstraram que 25 amostras (55,56%) obtiveram valores fora dos padrões preconizados pela portaria. Sugere-se a implementação de Boas Práticas de Fabricação (BPF) e de ações conjuntas com os responsáveis pelas empresas, de forma a garantir a saúde da população.

The microbiological and physicochemical quality of water samples out of permitted legal standards has contributed to the increased consumption of bottled water by the population. It has been our objective to verify the microbiological and physicochemistry quality of four brands of bottled water sold in the town of São Mateus-ES. We have used microbiological sekit Tecnobac® for detection of total coliforms, Escherichia coli and Salmonella spp and; for counting heterotrophic bacteria we have used the pour plate technique. For physical and chemical analyzes we have used Ecokit sekit ®. We have verified the pH and conductivity as well as analysis of iron. The microbiological analysis showed that all brands of mineral water were investigated in accordance with Ordinance 2914/2011 in relation to total coliforms and E.coli. We have noted the absence of Salmonella spp. in all samples. In relation to the count of heterotrophic bacteria, five samples (13.89%) exceeded the maximum allowed, which is in disagreement with the current legislation. The physical-chemical analyzes showed that 25 samples (55.56%) had values outside the standards recommended by the Ordinance. It is suggested the implementation of Good Manufacturing Practices (GMP) and joint actions with the companies and their staff to ensure the health of the population.

Concentração de flúor em águas minerais engarrafadascomercializadas no município de Ponta Grossa-PR / Fluoride concentration in bottled mineral water commercialized in themunicipality of Ponta Grossa-PR.

Introdução: A água é importante fonte de ingestão de flúor. Considerando-se o aumento no consumo de água mineral e a possibilidade de esta conter teores inadequados de flúor, o presente estudo teve o objetivo de avaliar a concentração desse elemento na água mineral engarrafada comercializada, comparando-a aos valores declarados no rótulo da embalagem. Material e método: Foram adquiridas 50 amostras de água mineral de cinco diferentes marcas disponíveis em diversos supermercados, mercearias e lanchonetes de grande circulação do município de Ponta Grossa-PR. A concentração de flúor foi determinada por análise em duplicata, utilizando-se potenciômetrocom eletrodo íon-seletivo. Resultado: A concentração de flúor variou entre 0,034 e 0,142 mg F.L-1, com diferenças pouco significativas entre os valores estipulados nos rótulos da maioria das marcas de água mineral e aqueles determinados na presente investigação. Conclusão: Apesar de os valores de flúor encontrados nas amostras analisadas se mostrarem seguros quanto aos riscos de fluorose dentária, estes não apresentaram ação preventiva anticárie.

Introduction: Water is an important source of fluoride intake. Considering the mineral water consumption increase and the possibility that they contain inadequate levels of fluoride, this study evaluated the concentration of fluoride in bottled mineral water, and compared to those values reported on the packaging label. Material and method: Fifty mineral water samples from the five different brands were purchased at several supermarkets; grocery stores, and restaurants of the highly frequented in Ponta Grossa-PR. The fluoride concentration was determined onduplicate analysis, using a potentiometer with selective-ion electrode. Result: The concentration of fluoride ranged from 0,034 to 0,142 mg F.L-1, and no significant difference was observed between the values reported on the labels and those found in the present investigation in samples from the majority of brands. Conclusion: In spite of thefluoride contents found to be safe for not causing a risk for dental fluorosis, there was no significant preventive meaning for tooth cavity.

Microbiological monitoring mf mineral water commercialized in Brazil

The quality of mineral water commercialized in Brazil regarding the microbial content was analyzed and the results were compared with the standards established by the current legislation. Results demonstrated there was no bacterial contamination, but several types of fungi were found. Therefore, bottled mineral water could be considered a possible route for the transmission of filamentous fungi and yeasts.

Evaluation of Selected Metal Elements in Commercial Drinking Water and Tap Water in Peninsular Malaysia / Jurnal Sains Kesihatan Malaysia

The present study was carried out to determine the concentrations of selected metal elements (lead, copper, manganese, zinc and iron) in 51 samples of commercial drinking water and tap water available in Malaysia. The results indicated that low metal elements were found in the studied water samples. Lead, manganese, zinc and iron were not detected in some of the studied samples, except copper. The concentrations of the metal elements in the studied samples were well below the maximum permitted concentrations as recommended. Therefore these drinking water are safe for consumption and do not pose adverse effect to the health of consumers due to metal toxicity.

Avaliação microbiológica de diferentes marcas de água mineral / Microbiological evaluation of different brands of mineral water / Evaluación microbiológica de las diferentes marcas de agua mineral

As bactérias do grupo coliformes são indicadoras de contaminação fecal, sendo empregadas como parâmetro para caracterização da qualidade das águas em geral, bem como monitoramento daquelas destinadas ao consumo humano. O objetivo deste trabalho foi avaliar a qualidade bacteriológica de água mineral. Foram analisadas sete diferentes marcas comercializadas no município de Alagoinhas (BA), no período de junho de 2008 a junho de 2009, pelo método de tubos múltiplos, para a determinação do número mais provável (NMP/100 mL) de coliformes totais e termotolerantes, contagem padrão e coloração de Gram, para análise das características morfotintoriais das bactérias mesofílicas. As análises foram realizadas no Laboratório de Biologia Experimental da Universidade do Estado da Bahia (UNEB), Campus II, Alagoinhas. Nos resultados obtidos, três amostras apresentaram contaminação por coliformes totais e, dentre estas, duas revelaram contaminação por coliformes termotolerantes. Na contagem de colônias, três amostras deram resultados insatisfatórios com mais de 500 UFC/mL. Verificou-se a presença de bactérias Gram positivas e Gram negativas, cocos e bacilos. Estes resultados mostram que 57,1porcento das amostras encontram-se em desacordo com um ou mais padrões e são contraindicadas para consumo humano.

The coliform group bacteria are indicators of fecal contamination, being used as a parameter for monitoring the quality of water in general, as those intended for human consumption. The objective of this study is to assess the bacteriological quality of mineral water. Seven different brands market in the municipality of Alagoinhas (BA), from june, 2008 to june, 2009 were analyzed using the multiple-tube method for determining the most probable number (NMP/100mL) of total coliforms and thermotolerant coliforms, standard score for mesophilic bacteria and Gram stain to analyze the morphology and staining characteristics characteristics of mesophilic bacteria. The tests were performed at the Laboratory of Experimental Biology, University of Bahia (UNEB), Campus II, Alagoinhas. Three samples showed total coliforms, and two of them were contaminated by coliforms thermotolerant. The colony count showed that three samples were found unsatisfactory withmore than 500 CFU/mL. It was observed the presence of Gram-positive and Gram-negative, cocci and bacilli. These results show that 57.1per cent of the samples are in disagreement with one or more patterns, indicating poor quality or at least dubious quality for human consumption.

Las bacterias del grupo coliformes son indicadores de la contaminación fecal y se utilizan como parámetro para la caracterización de la calidad de las aguas en general, así como el monitoreo de aquellas destinadas al consumo humano. El objetivo de este estúdio fue evaluar la calidad bacteriológica del agua mineral. Se analizaron siete marcas diferentes comercializadas en la ciudad de Alagoinhas (BA),en el perío de junio de 2008 a junio de 2009, por el método de tubos múltiplos para la determinación del número más probable (NMP/100ml) de coliformes totales y termotolerantes, recuento estándar y la coloración de Gram. Para analizar las características de las bacterias mesófilas morphotinctorial los análisis se realizaron en el Laboratorio de Biología Experimental de la Universidad de Bahia (UNEB), Campus II, de la ciudad de Alagoinhas. En los resultados, tres muestras presentaron contaminación por coliformes totales, y dentro de estos, dos mostraron contaminación por coliformes termotolerantes. En el recuento de colonias, tres muestras presentaron resultados satisfactorios con más de 500 UFC/ml. Se verificó la presencia de Gram-positivos y Gramnegativos cocos y bacilos. Estos resultados muestran que el 57,1por ciento de las muestras están em desacuerdo con una o más normas y están contraindicados para el consumo humano.

Avaliação da qualidade microbiológica de águas minerais consumidas na região metropolitana de Recife, Estado de Pernambuco / Evaluation of the microbiological quality of mineral water consumed in the metropolitan region of Recife, Pernambuco State

Águas minerais comercializadas em garrafões de 20 L na região metropolitana de Recife, Estado de Pernambuco foram analisadas microbiologicamente, no período de junho de 2002 a maio de 2003. As dez marcas escolhidas de água mineral foram avaliadas no tocante às bactérias heterotróficas, coliformes, Escherichia coli, Pseudomonas spp., Pseudomonas aeruginosa e Aeromonas spp. Os dados foram analisados estatisticamente por meio de Modelos Lineares Generalizados (GLM). As águas minerais apresentaram contaminação por E. coli, P. aeruginosa, A. hydrophila e A. caviae. Concluiu-se que, de todas as dez marcas analisadas, pelo menos uma amostra de cada marca apresentou-se imprópria para o consumo, por não atender aos parâmetros estabelecidos pela legislação em vigor em, no mínimo, duas análises; o Número Mais Provável (NMP) de Pseudomonas spp. e de P. aeruginosa foi influenciado pela sazonalidade e a contagem de bactérias heterotróficas; o Número Mais Provável (NMP) de coliformes totais e termotolerantes e a pesquisa de Aeromonas spp. não sofreram influência significativa da sazonalidade.

Mineral water sold in 20 L bottles in the metropolitan area of Recife, Pernambuco State were microbiologically analyzed between June 2002 and May 2003. The ten selected brands of mineral water were evaluated with regard to heterotrophic bacteria, coliforms, Escherichia coli, Pseudomonas spp., Pseudomonas aeruginosa and Aeromonas spp. Data were statistically analyzed using Generalized Linear Models (GLM). Mineral waters showed contamination by the following: E. coli, P. aeruginosa, A. hydrophila and A. caviae. It was concluded that of all ten tested brands, at least one sample of each brand was improper for consumption, for not meeting the parameters established by legislation in at least two tests; the Most Probable Number (MPN) for Pseudomonas spp. and P. aeruginosa was influenced by seasonality and the count of heterotrophic bacteria; the Most Probable Number (MPN) of coliform and thermotolerants and research of Aeromonas spp. suffered no significant influence of seasonality.

Evaluation of the fluoride concentration in mineral water and guaraná-based soft drinks in Manaus, Amazonas / Avaliação da concentração de flúor em águas minerais e refrigerantes à base de guaraná comercializados em Manaus-AM

Purpose: To evaluate the fluoride concentration in bottled mineral water and soft drinks marketed in Manaus, Amazonas state, Brazil. Methods: Fifteen commercial brands of mineral water and seven types of "guaraná"-based soft drinks sold in the Amazon region were analyzed. The beverages of three different batches were acquired from the local market. The samples were analyzed in duplicate, using an ORION 720-A ion analyzer with the ORION 96-09 ion-specific electrode, previously calibrated using standard solutions containing from 0.125 to 1.0g µF/mL. The readings in mV were converted into ppm of fluoride by linear regression. Results: The samples of mineral water and soft drinks displayed fluoride concentration ranges of 0.04-1.02 and 0.04-0.14 µF/mL, respectively. Only one brand of mineral water had a concentration of fluoride higher than the official Brazilian recommendation for human consumption. Conclusion: In general, the fluoride concentration in the bottled mineral water and soft drink beverages sold in the Amazon is negligible to provide any preventive effect in terms of caries control, even though the bottles of mineral water advertise the content as "Fluoridated Mineral Water".

Objetivo: Avaliar a concentração de flúor em amostras de águas minerais e refrigerantes comercializados em Manaus, AM, Brasil. Metodologia: Foram analisadas 15 marcas comerciais de água mineral e 7 tipos de refrigerantes à base de guaraná da Amazônia, adquiridos de três diferentes lotes, no mercado local. As amostras foram analisadas, em duplicata, utilizando um analisador de íons, ORION 720-A, e um eletrodo íon-específico, ORION 96-09, previamente calibrados com soluções-padrão, contendo de 0,125 a 1,0g µF/mL. As leituras foram obtidas em mV e transformadas em ppm de flúor por regressão linear. Resultados: Foram observadas concentrações de flúor variando de 0,04-1,02 e 0,04-0,14 µF/mL em águas minerais e refrigerantes, respectivamente. Apenas uma marca de água mineral apresentou concentração maior que a recomendada no Brasil para consumo humano. Conclusão: Em geral, a concentração de flúor nas águas minerais e refrigerantes, em Manaus, AM, é desprezível em termos de efeito preventivo para controle de cárie, embora os produtores destaquem na embalagem "Água Mineral Fluoretada".

Determination of Trace Inorganic Mercury in Mineral Water by Flow Injection On-line Sorption Preconcentration-Cold Vapor Atomic Fluorescence Spectrometry / 分析化学

Flow injection on-line sorption preconcentration and separation in a knotted reactor (KR) was coupled to cold vapor atomic fluorescence spectrometry for the determination of trace mercury in mineral water. Mercury was preconcentrated by on-line formation of mercury diethyldithiocarbamate complex (Hg-DDTC) and absorption of the resulting neutral complex on the inner walls of a knotted reactor. A 20%(V/V) HNO3 solution heated by electromagnetic induction heating technique was used as eluent to remove the absorbed Hg-DDTC from the KR, and then the vapor mercury generated by mixing the resulting solution and KBH4 was determined on-line by cold vapor atomic fluorescence spectrometry. The 20% HNO3 was employed as both the efficient eluent and the required acidic medium for subsequent mercury vapor generation in our work. Using 20% HNO3 instead of conventional organic solvent as eluent, the proposed method is simple, easy operational and environmentally friendly. Under the optimal experimental conditions, the sample throughput was approximatively 30/h with an enhancement factor of 35. The detection limit of mercury was 2.0 ng/L. The precision(RSD, n=11) was 2.2% at the 0.1 μg/L Hg2+ level.