Peloideterapia en adultos mayores con osteoartrosis de rodilla. Yaguaramas, 2021

Fundamento el incremento de la esperanza de vida viene aparejado con la necesidad del adulto mayor de desenvolverse en su medio y garantizar una longevidad plena. Objetivo determinar la efectividad de la peloideterapia en adultos mayores con osteoartrosis de rodilla. Métodos se realizó un estudio de intervención, cuasi experimental, en 30 pacientes con osteoartrosis de rodilla, seleccionados mediante aleatorización simple, quienes fueron atendidos en el área de salud de Yaguaramas (Abreus, Cienfuegos), en el período comprendido entre marzo y junio de 2021. Se realizó una encuesta general. La evolución del dolor se determinó mediante la escala de Likert, y la limitación articular se analizó mediante la medición del arco articular de la rodilla con el goniómetro. Resultados predominaron los pacientes del grupo de edades de 66-70 años y del sexo femenino; con tiempo de evolución entre 5-10 años (60 %); y con ambas rodillas afectadas (56,7%). Los principales signos y síntomas fueron el dolor (100 %) y la limitación del movimiento articular (93,3 %), los cuales disminuyeron tras el tratamiento. El 53,3 % refirió dolor ligero antes del tratamiento; después del tratamiento el 83,3 % describió ausencia de dolor. El 76,7 % de los pacientes manifestó limitación en la flexión de la rodilla, que después del tratamiento disminuyó a 13,3 %. Conclusiones la peloideterapia influye positivamente en los adultos mayores con osteoartrosis de rodilla, al mejorar su estado funcional e independencia personal, además de reducir las demandas de servicios médicos.

Background the increase in life expectancy is coupled with the elderly's need to function in its media and guarantee full longevity. Objective to determine the effectiveness of peloidtherapy in older adults with osteoarthritis of the knee. Method a quasi-experimental intervention study was carried out in 30 patients with osteoarthritis of the knee, selected by simple randomization, who were treated in the health area of Yaguaramas (Abreus, Cienfuegos), between March and June of 2021. A general survey was carried out. The evolution of pain was determined using the Likert scale, and joint limitation was analyzed by measuring the knee joint arc with the goniometer. Results there was a predominance of patients in the age group of 66-70 years old and of the female sex; with evolution time between 5-10 years (60%); and with both knees affected (56.7%). The main signs and symptoms were pain (100%) and limitation of joint movement (93.3%), which decreased after treatment. 53.3% reported light pain before treatment; after treatment, 83.3% described absence of pain. 76.7% of the patients manifested limitation in knee flexion, which after treatment decreased to 13.3%. Conclusions peloidtherapy has a positive influence on older adults with osteoarthritis of the knee, by improving their functional status and personal independence, as well as reducing the demands for medical services.

Sexual dimorphism in the turtle Kinosternon scorpioides (Testudines: Kinosternidae) from Marajó Island, Brazilian Amazon / Dimorfismo sexual de la tortuga Kinosternon scorpioides (Testudines: Kinosternidae) en la isla de Marajó, Amazonia brasileña

Abstract Introduction: Morphometrics analysis is an efficient and low-cost technique used in studies of sexual dimorphism in turtles. Kinosternon scorpioides scorpioides, scorpion mud turtle, has a wide phenotypic variation, depending on the area of its occurrence. Objective: The objective of this work was to identify the anatomical sexual difference of K. s. scorpioides, adults and hatchlings, through morphometric analysis; and relate the weights of adult animals to environmental factors (temperature and rainfall) in Marajó Island, Brazil. Methods: The sample collection was carried out from March to September 2018, covering both the rainy season (January to July) and the dry season (August to December). For the biometric analysis, 95 adults and 21 hatchlings were used, in which the length and width of the carapace and plastron, height of the shell, and weight were measured (adults only). For the geometric morphometry analysis, 21 adults and 13 hatchlings were used, in which 27 coordinates of anatomical landmarks were inserted in each image of the carapace and 11 in the plastron. Hatchlings were sexed by histology which was enabled by the identification of the ovaries and testicles. Results: The results showed the existence of dimorphism in adults. The plastron and height were higher in females, which had a more rounded carapace than males. This characteristic may be related to the species' sexual strategy, where males impose copulation. Histologically, it was possible to identify the ovaries and testicles in the hatchlings, but there was no anatomical sexual difference, despite the tendency to differentiate in the analysis of carapace PCA. Conclusions: Sexual dimorphism in K. s. scorpioides may play an important role on its reproductive behavior, which is synchronized with environmental events. This fact suggests that the reproductive strategies of this species would be severely affected by changes in the ecosystem.

Resumen Introducción: La morfometría es una técnica eficiente y de bajo costo, utilizada en estudios de dimorfismo sexual en tortugas, mediante el marcado de puntos anatómicos. Este grupo incluye Kinosternon scorpioides scorpioides, con una amplia variedad fenotípica, dependiendo del área en la que se encuentra presente. Objetivo: Este estudio tuvo como objetivo identificar la diferencia sexual entre K. s. scorpioides, adultos y juveniles, a través del análisis morfométrico; y verificar la relación entre las medidas de peso para adultos y los factores ambientales (temperatura y precipitación) en la isla de Marajó, Brasil. Métodos: La recolecta se realizó de marzo a septiembre de 2018, cubriendo tanto la temporada de lluvias (enero a julio) como la estación seca (agosto a diciembre). Para el análisis biométrico, se utilizaron 95 animales adultos y 21 crías, en los que se midió la longitud y el ancho del caparazón y el plastrón, la altura del casco y el peso en adultos. Para la morfometría geométrica, se utilizaron 21 adultos y 13 juveniles, en los que se identificaron 27 coordenadas de puntos de referencia anatómicos en el caparazón y 11 en el plastrón. Los individuos recién eclosionados fueron sexados por histología de rutina, que permite identificar ovarios y testículos. Resultados: Los datos analizados mostraron que existe dimorfismo sexual en adultos. El plastrón y la altura fueron mayores en las hembras, que tenían un caparazón más redondeado que los machos. Esta característica puede estar relacionada con la estrategia sexual de la especie, donde los machos imponen la cópula. En los juveniles recién eclosionados fue posible identificar histológicamente los ovarios y los testículos, pero no hubo diferencias sexuales en relación con la morfometría corporal, a pesar de la tendencia a diferenciarse en el análisis de PCA de caparazón. Conclusiones: El dimorfismo sexual en K. s. scorpioides puede desempeñar un papel importante en su comportamiento reproductivo, que ocurre en sincronía con los eventos ambientales. Este hecho sugiere que las estrategias reproductivas de esta especie se verían gravemente afectadas por los cambios en el ecosistema.

AMPLIACIÓN DEL ÁMBITO GEOGRÁFICO Y DE LA TALLA MÁXIMA DE Kinosternon chimalhuaca (TESTUDINES: KINOSTERNIDAE) / Extension of geographic range and maximun size of Kinosternon chimalhuaca (Testudines: Kinosternidae)

RESUMEN Kinosternon chimalhuaca (Casquito de Jalisco) es una tortuga kinosternida endémica de México. La talla máxima de longitud de caparazón (CL) es de 160 mm en machos y de 130 mm en hembras. Tiene un pequeño rango de distribución en la costa del Pacífico de Jalisco y Colima (México), desde el río Tuito en Jalisco hasta el río Cihuatlán en el noroeste de Colima. Este nuevo registro en Puerto Vallarta, Jalisco, extiende su distribución al menos 32 km al norte de la localidad más septentrional conocida. Se registra un nuevo tamaño máximo (CL) para la especie de 172,00 mm (un macho).

ABSTRACT Kinosternon chimalhuaca (Jalisco Mud Turtle) is a kinosternid turtle endemic to Mexico. The previously recorded maximun carapace length (CL) is 160 mm in males and 130 mm in females. It has a small distribution range along the Pacific coast of Jalisco and Colima, Mexico, from the rio Tuito in Jalisco to the rio Cihuatlán in northwestern Colima. This new record in Puerto Vallarta, Jalisco, extends its distribution at least 32 km north from the northernmost known locality. A new maximun size (CL) for the species of 172.00 mm (one male) is recorded.

Distribution of archaeal community in the mud pit during strong-flavor baijiu fermentation / 生物工程学报

Multi-species solid-state fermentation in a mud pit is one of the typical features of strong-flavor baijiu, in which archaea plays important roles, however, the archaeal community distribution and diversity during fermentation are still lack of research. The biomass, composition and succession of archaea communities in fermented grains and pit mud were analyzed by high throughput sequencing. The potential interaction between archaea and bacteria was analyzed by co-occurrence network. Results demonstrate that the average biomass of archaea in pit mud was about 200 times higher than that of fermented grains. There was no significant difference in archaeal community structure between fermented grains and pit mud (r=0.017, P=0.074), but succession patterns between them showed significant correlation (r=0.30, P=0.03). Methanobacterium was the most abundant archaea in fermented grains and pit mud, and other dominant groups included Methanosarcina, Methanocorpusculum, Methanoculleus, and Methanobrevibacter. The co-occurrence network analysis showed that Methanobacterium was positively correlated with most bacteria in fermented grains and pit mud, especially with Hydrogenispora and Caproiciproducens, the dominant bacteria in pit mud. Our results revealed the temporal and spatial distribution characteristics and potential functions of the archaeal community in the mud pit of strong-flavor baijiu.

Differences of the structure, succession and function of Clostridial communities between jiupei and pit mud during Luzhou-flavour baijiu fermentation / 生物工程学报

Clostridia inhabiting in jiupei and pit mud plays key roles in the formation of flavour during the fermentation process of Luzhou-flavour baijiu. However, the differences of Clostridial communities between jiupei and pit mud remains unclear. Here, the species assembly, succession, and metabolic capacity of Clostridial communities between jiupei and pit mud were analysed by high-throughput sequencing and pure culture approaches. The ratio of Clostridial biomass to bacterial biomass in the pit mud was relatively stable (71.5%-91.2%) throughout the fermentation process. However, it varied widely in jiupei (0.9%-36.5%). The dominant Clostridial bacteria in jiupei were Clostridium (19.9%), Sedimentibacter (8.8%), and Hydrogenispora (7.2%), while Hydrogenispora (57.2%), Sedimentibacter (5.4%), and Caproiciproducens (4.9%) dominated in the Clostridial communities in pit mud. The structures of Clostridial community in pit mud and jiupei were significantly different (P=0.001) throughout fermentation. Isolated Clostridial strains showed different metabolic capacities of volatile fatty acids in pure culture. Spatial and temporal heterogeneity of Clostridial communities existed in the baijiu fermentation pit, which was closely related to the main flavour components of Luzhou-flavour baijiu.

Adsorção de Cd 2+, Ni 2+ e Zn 2+ em soluções aquosas usando anidrita e lama vermelha / Adsorption of Cd2+, Ni2+ and Zn2+ in aqueous solutions using anhydrite and red mud

RESUMO Vários minerais e resíduos industriais têm sido estudados para uso como adsorvente, entre eles a lama vermelha e a anidrita. A lama vermelha é um resíduo insolúvel gerado em grande quantidade durante o processamento da bauxita. A anidrita é um sulfato de cálcio (CaSO4) cristalizado sob a forma rômbica e usada como matéria-prima na indústria. Nesta investigação, a capacidade de adsorção de Cd2+, Ni2+ e Zn2+ pela anidrita e pela lama vermelha foi avaliada usando isotermas de adsorção de Langmuir e Freundlich. Os materiais empregados apresentaram adsorção ≥75±1% para todos os metais em soluções aquosas com concentração de 0,5 mmol.25 mL-1. As isotermas baseadas no modelo de Langmuir foram as mais apropriadas para descrever o fenômeno de remoção de Cd2+, Ni2+ e Zn2+ para a anidrita e a lama vermelha, com valores de capacidade máxima de adsorção de 0,47 e 0,51 mmol.g-1 para o Cd2+, 1,18 e 1,56 mmol.g-1 para o Ni2+ e 0,84 e 1,47 mmol.g-1 para o Zn2+, respectivamente. Esses valores foram superiores a outros valores exibidos por materiais empregados como adsorventes descritos em estudos prévios.

ABSTRACT Various minerals and industrial waste have been studied for use as an adsorbent, in particular the anhydrite and the red mud. The red mud is an insoluble residue that is generated in large quantities during the processing of bauxite. The anhydrite is a calcium sulfate (CaSO4), crystallized as a rhombic way, and used as raw material in the industry. In this study, the Cd2+, Ni2+ and Zn2+adsorption capacity by anhydrite and by red mud was evaluated using adsorption isotherms obtained by the Langmuir and Freundlich models. The materials used showed adsorption ≥75±1% for all metals in aqueous solutions with a concentration of 0.5 mmol.25 mL-1. The Langmuir isotherm was more appropriate to describe the phenomenon of Cd2+, Ni2+ and Zn2+ removal, with highest adsorption capacity at 0.47 and 0.51 mmol.g-1 for Cd2+, 1.18 and 1.56 mmol.g-1 for Ni2+, and 0.84 and 1.47 mmol.g-1 for Zn2+, respectively. These values were higher than those ones obtained for other materials described in previous studies.

Hidden impacts of the Samarco mining waste dam collapse to Brazilian marine fauna - an example from the staurozoans (Cnidaria) / Impactos ocultos do colapso da barragem de resíduos da mineradora Samarco para a fauna marinha brasileira - um exemplo em estaurozoários (Cnidaria)

The collapse of the Fundão tailings dam at Mariana (State of Minas Gerais, Brazil) started a huge human tragedy and likely the most serious environmental disaster in recent Brazilian history. The dam had contained waste from processing iron ore from mines owned by Samarco, a joint venture company of the Brazilian Vale S.A. and the Anglo-Australian BHP Billiton Ltd. Following ineffective attempts to contain the disaster, after 16 days the mud flood reached the sea, where its impact is expected to affect thousands of marine fauna and flora species. Here, we provide an example of one of these species, the cnidarian Kishinouyea corbini Larson 1980 (Staurozoa), emblematic because it is extremely rare, poorly studied, and its known distribution overlaps the threatened area on the Brazilian coast. Based on this case, we discuss the need for efforts to monitor and minimize the possible impacts of this socio-environmental crime, as well as to identify and punish all responsible players in this tragedy, including negligent licensing and supervisory state agencies, in order to prevent future similar tragedies.

O colapso da barragem de rejeitos de Fundão, em Mariana (Minas Gerais, Brasil) iniciou uma enorme tragédia humana e, provavelmente, o mais grave desastre ambiental da história recente do Brasil. A barragem continha rejeitos do processamento de minério de ferro de minas de propriedade da Samarco, uma empresa controlada pela brasileira Vale S.A. e pela anglo-australiana BHP Billiton Ltda. Apesar de tentativas ineficazes para conter o desastre, após 16 dias a lama atingiu o mar, onde provavelmente afetará milhares de espécies da fauna e flora marinhas. Este ponto de vista fornece um exemplo de uma dessas espécies, o cnidário Kishinouyea corbini Larson 1980 (Staurozoa), emblemática pois é extremamente rara, insuficientemente estudada e sua distribuição conhecida para a costa brasileira sobrepõe a área ameaçada pelo desastre. Com base neste caso, discutimos a necessidade de esforços para monitorar e minimizar os possíveis impactos desse crime socioambiental, bem como para identificar e punir todos os responsáveis por esta tragédia, incluindo agências estatais de fiscalização e licenciamento negligentes, a fim de evitar futuras tragédias semelhantes.

Salt treatment for recovery of the mud loach, Misgurnus mizolepis from transport stress

Due to the shortage of the fingerling/juvenile mud loach, Misgurnus mizolepis in Korea, these fish have been imported from China. However, the mortality rate during and after their transportation is very high. In this study, we examined various physiological and histological parameters to evaluate the effect of salt treatment on the survival and recovery of mud loaches in holding farms during the quarantine process. Glucose, osmolality, Na+, Cl−, and histological changes were assessed for three different salinities. Non-treated fish (control 0.0%) exhibited lower levels of osmolality, and Na+ and Cl− concentrations compared with those kept in solar salt solution (0.5% and 1.0%). Glucose levels in control fish were higher than those in fish exposed to 0.5% and 1.0% solar salt solution. Histologically, control fish showed thinner epidermis of skin, branchial hyperplasia and lamellar fusion with an abundance of eosinophilic granule cell-like cells. After solar salt solution treatment, damaged gill structures in the fish almost recovered within 5 days. The present study demonstrates that mud loaches transported from China suffer from skin and gill damage and physiological dysfunction which may increase the mortality and morbidity. Moreover, saline treatment might alleviate the stress responses and ionic/osmotic imbalances, and help heal gill damage.

Effect of electro‑acupuncture, massage, mud, and sauna therapies in patient with rheumatoid arthritis.

A 48‑year‑old married woman diagnosed with rheumatoid arthritis (RA) in 2007, came to our hospital in July 2014 with the complaint of severe pain and swelling over multiple joints, especially over small joints, which was associated with stiffness (more in morning), deformities of fingers and toes, with disturbed sleep and poor quality of life (QOL) for the past 7 years. She received a combination of electro acupuncture (14 sessions), massage (18 sessions), mud (18 sessions), and sauna (3 sessions) (EMMS) therapies for 30‑min, 45‑min, 30‑min, and 15‑min per session, respectively for 3 weeks. During and postintervention assessment showed reduction in visual analog scale score for pain, Depression Anxiety and Stress Scales and the Pittsburgh Sleep Quality Index scores. It also showed an increase in the scores of 10‑Meter Walk Test, isometric hand‑grip test, and short form‑36 version‑2 health survey. This result suggest that, the EMMS therapy might be considered as an effective treatments in reducing pain, depression, anxiety, and stress with improvement in physical functions, quality of sleep and QOL in patient with RA. EMMS therapies were tolerated and no side effects were reported by the patient. Though the results are encouraging, further studies are required with larger sample size and advanced inflammatory markers.

Thalassotherapy in Diabetic Polyneuropathy: a Study in Pomorie, Bulgaria / 日本温泉気候物理医学会雑誌

<b>Background:</b> Diabetes mellitus and its complications are a source of considerable morbidity and mortality, with important medical and social implications. The aim of our study was to establish the efficacy of combined application of seawater, Pomorie therapeutic mud and lye in diabetic polyneuropathy rehabilitation.<BR><b>Materials and methods:</b> The study was carried out during the 2011 and 2012 summer seasons in 43 patients (18 male and 25 female) with diabetic polyneuropathy from Germany, Russia and Bulgaria. The average age was 62±2.15 years and the average duration of diabetes was 16±3.4 years. All patients underwent combined treatment with mud baths (temp 37°C, duration 15-20min, 10 applications) and 10 lye electrophoresis procedures to the lower limbs, and sea water baths. The visual analogue scale (VAS) was used before and after the course of treatment to objectively measure the pain and parasthesiae of the lower limbs.<BR><b>Results:</b> Following a 2 week treatment course there was significant improvement in the clinical symptoms of diabetic polyneuropathy. 90% of patients reported improvement in pain, with VAS decreasing from 4.85±0.31 to 2.75±0.24, p<0.05. There was also a decrease in lower limb parasthesiae in 95% of patients, with VAS decreasing from 5.61±0.65 to 3.26±0.31, p<0.05.<BR><b>Conclusion:</b> The clnical symptoms and quality of life of patients with diabetic polyneuropathy imroved significantly following combined treatment with Pomorie natural resources as a result of the trophic and pain-reducing properties of therapeutic mud, lye and sea water. We support the combined application of these treatments in the rehabilitation of patients with diabetic polyneuropathy.

Thalassotherapy in Diabetic Polyneuropathy: a Study in Pomorie, Bulgaria / 日本温泉気候物理医学会雑誌

Background: Diabetes mellitus and its complications are a source of considerable morbidity and mortality, with important medical and social implications. The aim of our study was to establish the efficacy of combined application of seawater, Pomorie therapeutic mud and lye in diabetic polyneuropathy rehabilitation. Materials and methods: The study was carried out during the 2011 and 2012 summer seasons in 43 patients (18 male and 25 female) with diabetic polyneuropathy from Germany, Russia and Bulgaria. The average age was 62±2.15 years and the average duration of diabetes was 16±3.4 years. All patients underwent combined treatment with mud baths (temp 37°C, duration 15-20min, 10 applications) and 10 lye electrophoresis procedures to the lower limbs, and sea water baths. The visual analogue scale (VAS) was used before and after the course of treatment to objectively measure the pain and parasthesiae of the lower limbs. Results: Following a 2 week treatment course there was significant improvement in the clinical symptoms of diabetic polyneuropathy. 90% of patients reported improvement in pain, with VAS decreasing from 4.85±0.31 to 2.75±0.24, p<0.05. There was also a decrease in lower limb parasthesiae in 95% of patients, with VAS decreasing from 5.61±0.65 to 3.26±0.31, p<0.05. Conclusion: The clnical symptoms and quality of life of patients with diabetic polyneuropathy imroved significantly following combined treatment with Pomorie natural resources as a result of the trophic and pain-reducing properties of therapeutic mud, lye and sea water. We support the combined application of these treatments in the rehabilitation of patients with diabetic polyneuropathy.

Plant growth promoting capability and genetic diversity of bacteria isolated from mud volcano and lime cave of Andaman and Nicobar Islands

Twenty four bacterial strains from four different regions of mud volcano and lime cave were isolated to estimate their diversity, plant growth promoting and biocontrol activities to use them as inoculant strains in the fields. An excellent antagonistic effect against four plant pathogens and plant growth promoting properties such as IAA production, HCN production, phosphate solubilization, siderophore production, starch hydrolysis and hydrolytic enzymes syntheses were identified in OM5 (Pantoea agglomerans) and EM9 (Exiguobacterium sp.) of 24 studied isolates. Seeds (Chili and tomato) inoculation with plant growth promoting strains resulted in increased percentage of seedling emergence, root length and plant weight. Results indicated that co-inoculation gave a more pronounced effects on seedling emergence, secondary root numbers, primary root length and stem length, while inoculation by alone isolate showed a lower effect. Our results suggest that the mixed inocula of OM5 and EM9 strains as biofertilizers could significantly increase the production of food crops in Andaman archipelago by means of sustainable and organic agricultural system.

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.

07-3Effect of different 6-day spa therapy courses on the quality of life in the knee osteoarthritis treatment / 日本温泉気候物理医学会雑誌

<b>Objectives: </b>In medical spas different spa therapy courses are offered for treating knee osteoarthritis (OA). They contain approximately 10 daily sessions of 2-3 different treatments. During the last two decades, the length of the spa therapy time in Estonia has decreased from 12 days mainly to 6 days due to the changes in the economic situation. Spa therapy courses contain different treatments: massages, thermotherapies, kinesitherapies etc. Last research (Vaht et al. 2008) focused on the effect of 6-days spa therapy course in general. At the beginning and end of spa treatment HAQ-DI, VAS and Lequesne Index were used to assess the clinical status. There were no significant differences between the results of 6- and 12-day spa therapy courses. They both had positive effects by reducing pain and improving clinical status in patients suffering from OA. This study focused on mud therapy and the aim is to compare the therapeutic effect of different spa therapy courses in knee OA.<BR><b>Materials and methods: </b>374 patients with knee OA participated voluntarily in this controlled follow-up study, which included different medical spas of Estonia: Spa Hotel Laine, Värska Spa Hotel, Tervis Medical Spa Hotel, Fra Mare Thalasso Spa. Participants fulfilled the criteria of the American College of Rheumatology (ACR) and were at the age between 47-83. The patients with total knee prosthesis, and those who had received thermotherapy in the past three months or had started using analgesics or antidepressants in the past 2 weeks, were excluded.<BR>  The patients were allocated to the groups in order of their admittance:<BR>I - local mud application (40-42°C, 15-20 min, n = 52) or mud bath (41-43°C, 10 min, n = 74); massage therapy (25 min) and kinesitherapy (30 min). <BR>II - herbal bath (37-39°C, 10 min, ) and local mud application (n = 56) or mineral water bath and mud bath (n = 82) and massage.<BR>III - control group - herbal bath (n = 32) or mineral water bath (n = 78), massage therapy and kinesitherapy.<BR>  All therapies were administered once a day and six times a week. All patients were evaluated before and after 6 days of spa treatments and follow-up after 10 weeks of spa treatments (VAS, HAQ-DI, Lequesne Index). Data were analysed using SPSS statistical software.<BR><b>Results: </b>After 6 days, treatment of all packages reduced pain and diminished the value of Lequesne Index. The follow-up period gave better results for the package where mineral water bath, mud bath and massage therapy were used. <BR><b>Conclusions: </b>6-day spa therapy has a good result in the treatment of knee OA reducing pain and improving the quality of life. Better results are achieved when spa therapy course contains two thermal therapies daily in the II group. This work was supported by the Regional Competence Centre Development programme, European Regional Development Fund.

11-1Mud therapy in rheumatic diseases / 日本温泉気候物理医学会雑誌

<b>Objectives:</b> Mud Therapy or peloidotherapy is implemented to treat various diseases; rheumatic gynecological, dermatologic, gastrointestinal disorders etc. It is mostly used for treating rheumatic diseases in Turkey. We summarize the results of our studies that aimed to investigate the effects of mud therapy in rheumatic conditions.<BR><b>Materials and Methods: </b>In last five years (2008-2013) we conducted 6 study to investigate the beneficial effect of mud therapy in rheumatic diseases. These rheumatic conditions are knee osteoarthritis (two studies) ankylosing spondylitis, rheumatoid arthritis, hand osteoarthritis and fibromyalgia. The same mud was applied in all diseases and it is a kind of clay contains mineral water. Patients who participated to studies were recruited from among patients seeking medical advice in Outpatient Clinic of Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty. They are randomized to two groups with a computer method in each study. Research procedures were set according to property of each disease. Temperature of mud and water, treatments of control groups, number of application and application area showed differences. Outcome measures were carried out a blinded physician in certain measurement times (week 0, week 2, week 12, week 24). Results of studies were calculated and analyzed with SPSS statistical program.<BR><b>Results: </b>Ankylosing Spondilitis: Patients in Group 1(Hydrotherapy + mud therapy + home exercises) showed superior improvement on pain and Group 2(supervised exercises +home exercise) had superior development of flexibility and mobility comparing each other. <BR><b>Knee osteoarthritis 1:</b> Patients in group 1 (traditional group, had hydrotherapy + mud therapy five times per week for 2 weeks) and patients in group 2 (had hydrotherapy + mud therapy two or three times weekly for four consecutive weeks) showed similar improvements on patients with knee osteoarthritis.<BR><b>Knee osteoarthritis 2:</b> Patients in Group 1 (mineral water bath +mud therapy) and group 2 (tap water bath +mud therapy) showed statistically significant improvement on pain and WOMAC parameters besides Group 1 showed significant improvement on HAQ and SF-36 parameters at the end of therapy period and at week 12 comparing to baseline. <BR><b>Fibromyalgia: </b>Group 1 (hydrotherapy + mud therapy; consecutively) and group 2 (hydrotherapy + mud therapy; intermittently) had treatment totally same amount. The consecutive or intermittent delivery of ambulatory balneotherapy programs, both are affective in the treatment of fibromyalgia. <BR><b>Hand Osteoarthritis:</b> Group 1 (had balneotherapy with thermo mineral water) and Group 2 (had mud therapy) assessed as measuring pain, grip strength by hand dynamometer and hand functional indexes. They showed similar improvement after therapy period and it lasts 6 months in both groups. <BR><b>Rheumathoid arthritis: </b>Group 1 (mud pack therapy + conventional medication) showed superiror improvement on pain and HAQ compared to Group 2 (conventional medication). Mud therapy is an adjuvant therapy for rheumatoid artrhritis and it is an effective treatment modality to relieve pain and improve quality of life in short and middle term up to 12 weeks.<BR><b>Conclusions:</b> These results indicate that mud therapy has beneficial effects on these varius originated rheumatic diseases.

11-5Dead-Sea mud packs for chronic low back pain / 日本温泉気候物理医学会雑誌

  The wide spectrum of therapies offered in the Dead Sea region includes the use of the natural mud, which has an unique composition reflecting the magnesium and mineral richness of the Dead Sea waters. Mud pack therapy applied to the whole body, alone, or in combination with other modalities of balneotherapy has been shown to improve many rheumatologic symptoms. The “Ahava Laboratories Ltd.” company located in the Dead Sea area, recently developed mud compresses that can be used in patients’ homes.<BR>  The aim of the present study was to assess the efficacy of home application of such mud compresses onto the back of patients suffering from chronic low back pain (LBP).<BR>  All patients were above age of 18 and had LBP for more than a year. The pain was localized to the region below the 12th rib and above the gluteal line. Exclusion criteria included acute back pain, inflammatory LBP, malignant disease, disk herniation, patients under narcotics, sensitivity to mud, Spa treatment in the last 6 months, scoliosis, pregnancy, infections, heart failure and osteoporosis.<BR>  The patients were randomized into two groups: group 1 treated with mineral-rich mud compresses, and group 2 treated with mineral depleted compresses, serving as a control group. The study was double blinded, neither patients nor physicians were aware of which type of compresses a patient received. Heated mud compresses were applied 5 times a week (from Sunday to Thursday), for three consecutive weeks totaling 15 treatments; the duration of each treatment was 20 minutes.<BR>  The study showed an improvement in patients suffering from chronic LBP self-treated at home with natural-mineral-rich mud packs. This improvement was demonstrated by the self-assessment of pain severity, based on a visual analog scale and by the score obtained through a functional questionnaire. The improvement in pain severity and functional score in the treatment group maintained one month after completing the therapy. In the control group, no improvement in the visual analog scale score was seen in any assessment, except for the Ronald & Morris score.

11-4Osteoarthritis and Peat Mud Pack Therapy / 日本温泉気候物理医学会雑誌

<b>Objectives: </b>To conduct a pilot study assessing the impact of a peat mud pack therapy (PMPT) protocol on patients with osteoarthritis (OA) of the knee. <BR><b>Design:</b> Quasi-experimental, repeated measures design<BR><b>Patients:</b> Ten participants with previously diagnosed bilateral OA of the knees.<BR><b>Methods:</b> Participants will receive PMPT twice a week for six weeks. Single-use peat mud packs heated to 42°C will be placed on the knees of seated participants for 20 minutes. Blood biomarkers will be collected at the beginning and end of the first, the sixth and the last treatment visits. Serum biomarkers TNF-a and hsCRP will assess changes in inflammation, and IGF-1 will be measured to assess potential chondroprotective effects. Questionnaires will be given at the screening visit, and the first, third, sixth, and last treatment visits to assess subjective levels of pain, stiffness, and mobility throughout the study. <BR><b>Significance:</b> The majority of balneotherapy studies involve a 10-14 day course of daily spa therapy. Practical limitations (e.g. participants’ busy daily schedules, a lack of affordable access, insurance coverage to safe and effective spa therapies) in America make this type of approach infeasible.The current study is designed to reflect a more limited but realistic spa therapy schedule, given American cultural norms. Results will help researchers assess compliance to the proposed therapy regimen, and may improve understanding of the therapeutic activity of peat mud.

LS2The effects of hot spring bathing for mental and physical health / 日本温泉気候物理医学会雑誌

<b>Background: </b>Our hospital is located in Beppu city, which bears the most hot spring fountainheads in the world. Here we present two studies showing the therapeutic and preventive effects of hot spring bathing. Hot spring bathing has been reported to be therapeutically useful for mentally and physically pathophysiological conditions because of its thermal and pharmacological effects. (1) The verification of the therapeutic effect of pelotherapy for the patients with fibromyalgia. (2) The epidemiological study by a questionnaire with questions of past history of hot bathing and diseases including depression and lifestyle related diseases of citizens over 65 years old of Beppu city. <BR><b>Methods:</b> (1) Seven patients with fibromyalgia (age; 60-78 y.o.) were treated by pelotherapy for 30 days. The patients took mud-bathing at 40 C for 10 minutes a day on weekday. Geriatric Dementia Scale (GDS; 15 for full score) and Face Scale (FS; 20 for full score) for systemic pain were evaluated before and after pelotherapy. (2) Twenty thousand Beppu citizens over 65 y.o. were sent the questionnaire including questions of the participants’ past history of diseases including cancers, apoplexy, ischemic heart disease, diabetes mellitus, asthma bronchiale, collagen diseases, etc. and of their habits of hot spring bathing. The logistic analysis was used for statistical analysis. <BR><b>Results: </b>(1) The mean GDS score and the mean FS score before pelotherapy were 6.6+2.5 and 12.9+5.1, and those after pelotherapy 3.3+1.3, 6.1+5.5, respectively. (2) We received filled-out questionnaires from 4,706 men and 6,352 women. Forty-eight percent of the replying participants take a hot spring bath daily. Age adjusted, hot spring users showed less rate of some diseases, All (daily % : non-daily % (p-value), Ischemic heart disease 6.2 : 7.2 (0.047), Apoplexy 2.0 : 3.1 (<0.001), Hypertension 36.2 : 38.5 (0.016), Arrhythmia 7.9 : 9.5 (0.004), Bronchial Asthma 3.0 : 4.4 (<0.001), Diabetes Mellitus 12.4 : 14.2 (0.006), Renal disease 2.9 : 3.9 (0.009), Depression 1.5 : 2.7 (<0.001)), Men (daily % : non-daily % p-value, Apoplexy 3.1 : 4.2 (0.045), Renal disease 3.8 : 5.4 (0.011)), and Women (Ischemic heart disease 3.8 : 5.1 (0.018), Apoplexy 1.1 : 2.3 (0.001), Arrhythmia 6.7 : 8.4 (0.011), Bronchial Asthma 2.9 : 4.6 (<0.001), Diabetes Mellitus 8.6 : 10.8 (0.004), Depression 1.6 : 3.3 (<0.001)). <BR><b>Conclusion:</b> Pelotherapy raises efficiently body temperature leading to relieve mental and physical stress, that is, depression and pain. The study with questionnaire showed that hot spring bathing may be beneficial for lowering incidents of some diseases with gender association. The results of both studies highlightened the physical and mental effects of hot spring bathing for disease-prevention and -therapy.

04-2The combined action TVS mud index/TVS skin test as an evaluation marker of skin functionality and thermal mud effectiveness / 日本温泉気候物理医学会雑誌

<b>Introduction: </b>To evaluate the influence of the skin aging critical level on the development of objective thermal protocols, an improved integrated tensiometric approach was developed named as Tensiometric Versus Skin (TVS) modeling.<BR>  TVS modeling: (i) exploits the structure-surface correlations which are characteristic of all systems; (ii) applies the principle of permutability of the tensiometric technique, according to which unknown solids can be characterized by their known surface characteristics, and vice versa; (iii) is carried out in a non-invasive way by a tensiometric contact angle method.<BR>  TVS modeling involves TVS skin test as an objective evaluation marker of the epidermal functional state, and TVS mud index as an evaluation marker of thermal matrices.<BR><b>Objectives: </b>On the basis of these scientific evidences, the combined action of TVS mud index with TVS skin test was investigated to develop objective dose-response thermal protocols.<BR>  The first “OTP-TVS thermal protocol” was developed in the Euganean thermal area where fangotherapy is widely practiced.<BR><b>Materials and Methods: </b>Native Euganean thermal mud was firstly characterized from the chemical and mineralogical point of view. After maturation in controlled conditions, TVS mud index was obtained by contact angle method using PFPE as reference standard liquid, and finally, by repeated TVS skin test before and after a dose of fango application, the fango effectiveness was performed. <BR><b>Results: </b>The schematic OTP-TVS protocol pathway is shown in Figure 1.

04-7Thermal profile of three clays suitable to be used as solid components in the preparation of peloids / 日本温泉気候物理医学会雑誌

  There is little doubt that the main therapeutic action of the peloid’s, therapy depends on their thermal properties. For this reason is quite of interest getting to know the thermal properties of the materials that form peloids.<BR><b>Objective: </b>Study the thermal properties of three inorganic solids that can be used in the preparation of therapeutic peloids.<BR><b>Materials and Method: </b>The products used are aluminic Bentonite, Kerolita (Süd Chemie) and SPLF ELITE (Tolsa). <BR>  From the thermal point of view the specific heat was determined using a Scanning Calorimetry equipment, model DSC1, cooled by air of Mettler Toledo and it was used the software STARe for the collection and processing of data.<BR>  An extemporaneous product was prepared with a liquid phase of 60%, using distilled deionized water. Its cooling curves their relaxation and inertia times were studied.<BR>  For the determination of the cooling curves we have followed the Rambaud technique, obtaining graphs and equations that best fit the experimental curve, using the ORIGIN program 8. We used Thermostatic baths, models Lauda RA Alpha 8 and E-100 and a thermocouple Cole-Parmer, model 91100-50.<BR><b>Results and Discussion</b>: The following Table 1 shows the results of the specific heat measures of the three studied products, in the range of 45-36°C and its corresponding average value. We also include the inertia and relaxation time of peloids.<BR><b>Conclusions: </b>The SPLF, a sepiolite, presents the highest value of the specific heat, whose corresponding peloid with an equal percentage of water would provide the greatest amount of heat. The specific heat of the bentonite and kerolita is very similar. <BR>  Bentonite Al shows the most relaxation time of the three products, releasing therefore the heat more slowly.