A multidisciplinary approach for the physic-chemical characterization of peloids to new perspectives in the development for “hydrothermal Developing Countries” using partecipatory methodology

The Osservatorio Termale Permanente (OTP) operated from 1996 to 2014 in the Italian and international therapeutic thermalism field. The main aim of OTP was the development of a multidisciplinary approach for the characterization of the quality of peloids for cutaneous application and their maturation process using different qualitative and quantitative analytic techniques opening at the Integrated Analytical Approach in the field of therapeutic thermalism. The main innovation introduced by OTP were rheology and surface tensiometry applications on peloids. The introduction of surface tensiometry included the skin as a fundamental element for the development of mud therapy protocols based on the bioadhesive properties of peloids. The interfacial investigations between peloids and skin led to the characterization of the exchange activity occurring during pelotherapy on the cutaneous surface in a non-invasive and fast way. On these bases, our work linked each other the multidisciplinarity approach to the study of hydrothermal resources performed by OTP with the concept of the participative methodology commonly applied to the development of projects in the field of development cooperation. This combined approach led us to develop a scientific proposal for the development of therapeutic thermalism in countries not yet improved in this field and characterized by the presence of hydrothermal resources. Keywords: peloid, surface tensiometry, Rossi factor, rheology, Rheological Termal Mud, skin, integrated analytical approach, participative methodology, therapeutical thermal proposal, hydrothermal development countries

Viscero-somatic integration: new therapeutic proposals through integrated thermal cures (CIT)

Traditional thermal medicine, gold standard for some pathologies, focuses its therapeutic target mainly on a sectorial level, focusing only on the pathological symptom and neglecting man as a whole. The importance of the whole, of the phenomena of systemic, viscero-somatic and somato-visceral interrelation, has led to the creation of a new approach called "CTI" - Integrated Thermal Care, which uses all the thermal therapies, integrated and administered according to the individual needs to enhance their therapeutic effect. 235 subjects have received, on average, 40 treatments within about a year. They were treated with hydropinic treatment, inhalation treatments, hydrokinesitherapy, vascular pathways, mud therapy and manual neuromuscular therapy associated with the previous treatments. The results obtained in all the FIM, VAS, TINETTI, EUROQOL scales are positive and statistically significant, which suggests that a modification of the treatment protocols, which provides for a unique and integrated stimulation, is the new objective of thermal medicine for serious disabilities.

PARKINSON'S DISEASE MEDICAL REHABILITATION METHODS

Parkinson's disease ranks first among the neurodegenerative pathology. The approach to the treatment of Parkinson's disease must be comprehensive. Medical rehabilitation methods include not only basic drug therapy, surgical methods of treatment, but also methods of physiotherapy, reflexology, physiotherapy, speech therapy and psychotherapy. When prescribing physical factors in patients at different stages of the disease, it is possible to recommend those methods that will have a more pronounced effect on the clinical symptoms of Parkinson's disease. From physical factors, balneotherapy, thermal mud therapy, impulse currents, electrophoresis, electrostatic field, microwave therapy, phototherapy, barotherapy are prescribed. The use of transcerebral Electrotherapy methods and computer-stabilographic programs in complex treatment based on biofeedback by statokinesogram will reduce the severity of the main symptoms of the disease. Key words: medical rehabilitation, physiotherapy, Parkinson's disease

Nitrogen-siliceous thermal waters in the therapy of patients with psoriasis (On the 155th anniversary of the Annenskie Vody sanatorium)

In 2021 the sanatorium "Annenskie Vody" will be 155 years old. This is the oldest balneological institution in the Khabarovsk Territory, a Far Eastern health resort that helps restore health to the population using natural factors. Annenskie Vody sanatorium receives more than three thousand patients annually, and almost 7 % of the patients are patients with skin diseases. The main healing factor in the Annenskie Vody sanatorium is mineral water. The spring water is thermal (t 52 ºC), slightly mineralized (0.2–0.3 g/l), hydrocarbonate-sulphate-sodium, alkaline, with a high content of silicic acid. There were 560 psoriasis patients aged from 18 to 70 years under observation. Of these, 360 are women and 200 are men. To assess the severity and effectiveness of the therapy in patients with psoriasis, the PASI index was used, which decreased by 4 times during therapy. Biochemical parameters improved under the influence of AKTW. The effectiveness of therapy increased with the use of complex methods of exposure (mud therapy, physiotherapy).

Mud therapy for surgical diseases

Prof. VI Razumovsky (Med. Sat. Kavk. Min. V., issue 2, 1925), considers the following surgical diseases to be indicative of mud therapy; first of all, various forms of articular diseases, especially rheumatic ones with a chronic course, intra-articular and periarticular exudates, pain, stiffness, etc., as well as non-started gouty (on the contrary, infectious and toxic forms are more difficult to treat with mud), then chronic osteomyelitis and their consequences , thrombophlebitis (especially of gouty origin), consequences of varicose processes (dermatitis, leg ulcers, etc.), consequences of inflammatory processes in the abdominal cavity (perigastritis, pericholecystitis, periapendicitis, peri-and parametritis, etc.), ischias, chronic prostatitis, consequences trauma, some forms of tbc and, finally, angiosclerotic gangrene.

Efficacy of Balneotherapy and Mud Therapy in Patients with Knee Osteoarthritis: A Systematic Literature Review

Objectives To identify literature reporting on thermal mineral water and mud therapy effectiveness on pain, stiffness and knee function in patients with knee osteoarthritis. Design Systematic evidence scan of MEDLINE and PubMed was performed to identify the randomized controlled trial studies published from 2004 to December 2018. Study selection Papers reporting the effect of balneotherapy and mud therapy for treating knee OA, a duration of ≥2 weeks and in which Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as an outcome measure. Data extraction Not RCT, Studies not in English. Results A quantitative meta-analysis of ten studies (831 patients) was performed. Five clinical studies (407 patients) measured effectiveness of balneotherapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of balneotherapy. Six clinical studies (500 patients) measured effectiveness of mud therapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of mud therapy. Conclusion This meta-analysis indicates that balneotherapy and mud therapy were clinically effective in relieving pain, stiffness, and improving function, as assessed by WOMAC score.

Effective Doses of Ionizing Radiation during Therapeutic Peat Mud Treatment from a Deposit in the Knyszyn Forest (Northeastern Poland)

Radioactivity measurements of 61 therapeutic peat mud samples from the Podsokoldy deposits, near Suprasl, were performed using gamma spectrometry. The authors identified the presence of 13 isotopes with the arithmetic mean of activity (in Bq kg−1): 137Cs-7, 40K-24, 208Tl-1, 212Bi-3, 212Pb-2, 228Ac-2, 210Pb-33, 214Bi-11, 214Pb-11, 226Ra-53, 234Th–47. The effective dose obtained during treatment with 15 peat mud baths (lasting 30 min) was 0.078 μSv. Use of peat mud compresses in the same number and period of exposure to the entire body surface caused absorption of a dose of 0.153 μSv. The authors discuss the probability of tissue radiation from isotopes present in the peat mud. In light of radiobiological knowledge, the therapeutic effect of ionizing radiation during peat mud therapy appears to be very unlikely.

Effectiveness of mud-therapy in rheumatic and dermatologic diseases: a systematic review

Background Thermal mud therapy alone or in combination with thermal water baths is widely used in clinical practice for the management of rheumatic and dermatologic diseases in many countries. Despite its long history and tradition, its biological action and its clinical effectiveness are still not clear. The aim of this systematic review is to synthetize the current evidence on the mud therapy effects on pain, function and quality of life in patients with rheumatic and dermatologic diseases. Methods PubMed/Medline, Embase, and Cochrane Library were searched for articles about the comparative effectiveness of mud therapy alone or combined with other therapies on pain, function and quality of life in adults with rheumatic or dermatological diseases without any restrictions of severity. Studies were searched up to 15 October 2019. We included randomized and non-randomized trials and comparative cohort studies, as well as non-comparative case series and case reports only for safety outcomes. The following outcomes were considered: pain assessed by validated scales or through painkillers drugs consumption, function (i.e. muscle tone, joint motility and stiffness) assessed by validated scores, quality of life and autonomy assessed by validated scales and adverse events. Laboratory inflammation parameters were investigated as secondary outcomes. Results A total of 2,455 articles were retrieved through database search, remaining 1,914 records after duplicates removed. The selection by title and abstract led to include 140 studies for full-text evaluation. The screening of full-text is still being carried out. The majority of 140 records assess the effects of mud therapy in patients with osteoarthritis (51 articles), osteoarthrosis (12) and psoriasis (10). Conclusions Our results will provide a synthesis of the current evidence on the mud therapy effectiveness, useful to evaluate its inclusion within clinical protocols for the treatment of rheumatic and dermatologic diseases. Key messages The majority of studies report the treatment with mud for rheumatic diseases. The synthesis of the evidence is useful to evaluate the mud therapy as treatment for rheumatic and dermatologic diseases.

Comparative Study of SPA Mud from “Bacino Idrominerario Omogeneo dei Colli Euganei (B.I.O.C.E.)–Italy” and Industrially Optimized Mud for Skin Applications

The term “Salus per aquam (SPA) therapies” refers to therapeutic pathways that includes mud therapy. The therapeutic efficacy of a peloid depends on its chemical and mineralogical composition, as well as its technological properties. Considering the increasing use of clay-based products, it becomes essential to characterize peloids from a qualitative and quantitative point of view. Therefore, this research project aimed to develop a protocol that allows characterization of the chemical-physical composition of sludges collected from different areas of the Homogeneous Euganean Hills Hydromineral Basin (B.I.O.C.E.). The study established a comparative study both between different matrices and between the same matrices at different maturation times, including also a comparison with an industrialized product, that can be used at home, which maintains the characteristics of a natural mud. This research was developed studying the pH, grain size distribution, and chemical and mineralogical composition. Peloids are characterized by a neutral/basic pH and are divided into two categories from a granulometric point of view: The chemical composition allowed observation of numerous correlations between oxides present in the samples and to quantify the presence of heavy metals. Mineralogical analysis made it possible to identify and compare the composition of each sample, also according to the maturation time. Thanks to the methods adopted, important correlations were achieved.