[Historical aspects of the formation and development of children's health resort medicine in the Samara region]. / Istoricheskie aspekty formirovaniya i razvitiya detskoi kurortnoi meditsiny v Samarskom regione.

Archive documents and sources in scientific electronic databases were analyzed in order to study the historical origins of the health resort business in terms of children's health resort medicine in the Samara government. It has been established that the period of origin and intensive development of balneology for children in the Samara region occurred at the beginning of the 20th century and the first children's sanatoriums began to function thanks to the initiative of the Society of Governmental Physicians for charitable funds of the Samara nobility and merchantry in territories with natural and climatic therapeutic factors, namely Sernovodsky resort, Barboshina glade and Postnikov ravine. A comparative analysis of the dynamics of morbidity structure of children admitted for sanatorium treatment, as well as general education institutions, from which information on the health of school pupils is received, has been conducted over a period of 120 years. Despite the change of years and generations, there is a general concept of sanatorium health improvement of school pupils as a future social and economic pillar of society, with the formation of a healthy generation for both the region and the country in general.

Push and pull factors influencing the choice of a health resort by Polish treatment-seekers.

BACKGROUND: The objective of the study was to indicate social and psychological (inner) motives associated with the desire and needs of travelling to health resorts (push) as well as external motives resulting from destination's attributes, and explaining the choice of the health tourism establishment (pull) by Polish treatment-seekers divided into two social groups: persons in employment and retired persons. The research hypothesis assumed the two groups of people differ very much in terms of preferences motivating them to participate in health resort tourism, destination choices and services offered by health resort establishments. METHODS: Of the 258 health resorts, 154 establishments were selected for research purposes taking into account a proportional distribution of health resorts throughout Poland. An authorial questionnaire was developed and it included three questions with multiple answers, each answer being assessed on a 5-point Likert scale. The research adds new insights by analysing motives associated with health resort tourism in terms of benefits sought by visitors. The main and strongest motive for choosing health resort tourism is concern for health. In addition to old age pensioners, it was legitimate to analyse the group of employed respondents as their stays at a health resort are undertaken to regain not only physical fitness but also work motivation. RESULTS: The present study has demonstrated that motives and age groups have a significant effect on destination choice. Based on the results, it can be concluded that these groups often have diverse needs, expectations and, as a result, motives for choosing this form of tourism and a given health resort. What follows is a possibility of dividing the visitors to health resorts in terms of push and pull motives. CONCLUSIONS: The research hypothesis assuming the two groups varied considerably in terms of preferences motivating them to participate in health resort tourism, destination selection and choice of services offered by the health resort establishment has been confirmed. The ramifications of the study's findings may also be relevant for health resort/spa tourism outside of Poland because healthy lifestyle promotion is a worldwide trend.

Exploring the potential role of health resort medicine in the management of breast cancer-related lymphedema: a viable alternative for innovative rehabilitation opportunities?

Lymphedema is a chronic and progressive disorder of the lymphatic system that impairs the return of lymphatic fluid. Breast cancer treatment can cause breast cancer-related lymphedema (BCRL), with axillary lymph node dissection and regional lymph node radiation being established risk factors. BCRL can cause severe morbidity, disability, and reduced quality of life. Early detection and treatment are essential to prevent the disease from progressing and causing complications. According to the International Society of Lymphology, complex decongestive therapy (CDT) is the most effective conservative treatment for lymphedema. Aquatic exercise is a safe and effective form of therapeutic CDT exercise that can improve joint range of motion, reduce pain, and positively impact limb volume. Additionally, health resort medicine and thermal mineral-rich waters may provide synergistic benefits for therapeutic exercise programs. Therefore, we believe that consideration should be given to whether the spa setting could represent a viable alternative for the rehabilitation of BCRL patients.

[Assessment of reserves of mineral water's geothermal sources in the south of Tyumen region]. / Otsenka zapasov geotermal'nykh istochnikov mineral'nykh vod yuga Tyumenskoi oblasti.

There are rich reserves of underground mineral waters in the south of Tyumen region, which are generally deep located, in the so-called difficult exchange water zone (on average at a depth of 1311.29±34.53 m). Currently, there is a lack of assessment of prognostic resources of underground mineral waters in the south of Tyumen region. The article provides an assessment of underground mineral (therapeutic) waters' reserves (2011-2019 yrs.) in the considered territory. It was shown that the number of deposits, their sites and underground mineral waters' well bores is 76, of which less than half are in operation, as at date of 01.07.2021. Moreover, the number of deposits is remained almost constant since 2011 yr. Meanwhile, underground mineral (therapeutic) waters' reserves are gradually decreasing. Thus, there is a necessity to intensify not only the stocktaking and identification of mineral waters' well bores, but also to develop the new medical technologies to use geothermal waters in rehabilitation and prevention. Monitoring for underground waters' condition should be continued with the use of modern research tools and techniques. The above mentioned will give a new impetus to the development of health resort sphere in the tourism industry, in addition to increasing the therapeutic effects of mineral waters.

[Review of methodological approaches for the assessment of social and medical rehabilitation in the cardio-respiratory system diseases at the post-COVID period]. / Obzor metodologicheskikh podkhodov otsenki sotsial'no-meditsinskoi reabilitatsii pri zabolevaniyakh kardiorespiratornoi sistemy v postkovidnyi period.

There is currently no systematic relationship between the quantification of funding for the treatment and rehabilitation of cardio-respiratory diseases and the length of a citizen's working life. The development of a universal evaluation methodology that can be used for qualitative and quantitative evaluation of the effectiveness of social and medical rehabilitation is a relevant area of research. The survey contains an analysis of the scientific approaches used in research on social and medical rehabilitation, as well as the development of medical and social rehabilitation and health resort and spa treatment, and to assess the impact of medical rehabilitation on restoration of ability to work. On the basis of the data obtained, a set of indicators for the assessment of the socio-medical rehabilitation of diseases of the cardio-respiratory system at the post-COVID period is proposed, which in the future will serve as a methodological tool in the field of medical and social rehabilitation, health resort and spa activities and at all stages of rehabilitation and preventive medicine.

[Non-mellow season of domestic health resort business in 1914-1922]. / Nebarkhatnyi sezon otechestvennogo kurortnogo dela, 1914­1922.

For a long time, balneotherapy and health resort treatment was considered the privilege of the well-to-do. In Russia, recreational areas developed much later than in Europe. Their development was directly related to restoring the health of the military, the more so since these areas, with few exceptions, were located near the outskirts of the country and the location of large military contingents. The outbreak of the First World War aggravated the lack of capacities of domestic health-resorts. The state expanded the benefits to private and cooperative capital for the development of old resorts and the establishment of new ones. Because of the prolonged delay typical for the tsarist bureaucracy, the work on the development of the domestic health resorts began only in 1916. The war showed the importance of health resorts for preserving the army's combat efficiency and, in some cases, prevented the implementation of these projects due to concern of the local authorities and people towards an increase in the number of outsiders in the formerly sparsely populated areas. After the revolution, the Soviet social support agencies were involved in the distribution of spa vouchers to cash-strapped workers. In the northern provinces, the meager budgets received state funding for the establishment of health resorts on the mined-out salt fields. The local councils of the South set up health resorts in nationalized private dachas. Health resorts of the Black Sea coast and Kavminvod have never stopped their work. They functioned as boarding houses for retired military personnel. After the Civil War, every effort was made to attract leisure travelers to the country's resorts. Voucher-holders and «savage¼ travelers had privileges in food provision. Later, the resort areas were assigned to the first supply category. Despite eight years of military operations on the Russian territory during these years, there were conditions for a sharp growth of mass health resort recreation. This article reviews a large number of original sources and is intended to show, using historical examples, the state importance of health resorts as a means of medical rehabilitation. Paradoxically, it is under difficult political and economic circumstances that health resort recreation has become available for the general population.

[The problems of development of medical health-improving tourism in modern conditions].

The analysis of main approaches to determining essence of health-improving tourism in works of national scientists and researchers is presented. The conclusions are made that the most widespread classification of health-improving tourism is its division into medical and health-improving tourism. The medical tourism includes such its types as medical and sanatorium-health resort, and health-improving tourism covers balneologic, SPA-tourism, Wellness-tourism. The difference between medical and health-improving tourism is determined in order to regulate received services. The author's structure of medical and health-improving services, types of tourism and specialized organizations is developed. The analysis of supply and demand for health-improving tourism in 2014-2020 is presented. The main trends of development of health-improving segment in context of such its directions as increasing of SPA and Wellness industry, development of medical tourism, increasing of return on health tourism are formulated. The factors constraining development and reducing competitiveness of health-improving tourism in Russia are identified and structured.

Effects of complex spa therapy in patients with osteoarthritis of the spine receiving treatments in health resorts in south-eastern Poland.

Management of patients with degenerative diseases commonly comprises health-resort based treatment programs, including spa therapies, balneotherapy as well as terrain therapy making use of microclimate factors. The study was designed to assess short- and long-term effects of spa therapy administered to patients with osteoarthritis of the spine who received treatment in health resorts located in Poland. The study involved 102 patients receiving treatment in health resorts, a group of subjects receiving outpatient treatment (100 patients) and a group receiving no therapy (100 patients). The assessment survey included: Pain VAS and Laitinen, LISAT-9 and HAQ-20 questionnaires. The assessments were carried out three times: at the start of the therapy program, as well as one month and six months after the end of the program. Short-term effects showed statistically significant improvement in all the outcome measures in spa group and outpatient treatment group. The long-term effects showed statistically significant improvement in all the outcome measures in spa group only. In conclusion spa therapy reduces pain, improves functional efficiency and increases the level of life satisfaction in patients with osteoarthritis of the spine. Its effects are sustained for at least six months. Spa therapy is more effective long-term, than outpatient treatment.Trial registration: The study was registered at Clinical Trials: NCT03974308. First registration: 04/06/2019.

[The role of health resort factors in preconception preparation of patients with reproductive disorders]. / Rol' sanatorno-kurortnykh faktorov v pregravidarnoi podgotovke patsientok s narusheniyami reproduktivnoi funktsii.

Reproductive dysfunction is a multifactorial problem, for the correction of which the most difficult are cases of pathology comorbidity. Individual preconception preparation, taking into account risk factors, is recognized as an effective measure to increase the chances of conception and prevent reproductive losses. OBJECTIVE: Optimization of treatment and rehabilitation measures at the preconception stage in patients with reproductive disorders. MATERIAL AND METHODS: The effectiveness of the use of natural and preformed physical factors in the preconception preparation of 180 women who underwent medical and rehabilitation measures in the health resort of the Altai Territory - the resort town of Belokurikha (Group 1, 79 patients) and outpatient conditions in the city of Barnaul (Group 2, 101 patients). Comprehensive spa treatment included climatotherapy, a combination of various methods: balneotherapy, peloidtherapy, physiotherapy and a prolonged course of herbal medicine. RESULTS: In patients of the 1st group, who underwent a course of rehabilitation treatment in a sanatorium-resort environment, compared with patients of the 2nd group, early reproductive losses were less common during pregnancy (7.1% and 20.7%, respectively; p=0.04) and more frequent term deliveries occurred (92.8% and 77.2%, respectively; p=0.02). The most significant predictors of the ineffectiveness of preconception preparation were the presence in patients of: chronic cystitis and autoimmune thyroiditis with hypothyroidism; oligomenorrhea at the time of pregnancy planning; aggravated by early reproductive losses and long-term wearing of intrauterine contraception history; burdened heredity for violation of carbohydrate metabolism. CONCLUSION: Comprehensive preconception preparation in the sanatorium-resort conditions of Belokurikha helps to increase the fertility of patients with reproductive disorders, the trophostimulating effect in the genital organs and the restoration of endometrial reception, which makes it possible to recommend this method for use in clinical practice.

[Therapeutic areas of the Republic of Tyva]. / Lechebno-ozdorovitel'nye mestnosti Respubliki Tyva.

The need to expand the resort and recreational potential in the Siberian Federal District is due to the growing need for sanatorium treatment and rehabilitation of the population. Balneological studies conducted in different regions of Siberia make it possible to position these territories as promising for resort and recreational activities. OBJECTIVE: Comprehensive integral assessment of the resort and recreational potential of the treatment areas of the Republic of Tyva. MATERIAL AND METHODS: Taking into account the requirements of the guidelines "Bioclimatic passport of the medical and recreational areas" No. 96/226, approved by the Ministry of Health of Russia on February 7, 1997, an integral medical and climatic assessment of the territories of the medical and recreational areas of the Republic of Tyva was carried out. The assessment of the quality of water resources was carried out in accordance with the criteria of the methodological recommendations "Control of the quality and safety of mineral waters by chemical and microbiological indicators" No. 96/225, approved by the Ministry of Health of Russia on 07.04.1997. The typification of water resources is given in accordance with GOST R 54316-2011 "Natural mineral drinking waters". RESULTS: The territory of the Republic of Tyva has the richest reserves of unique therapeutic hydro-mineral resources, and the existing features of landscape and climatic conditions determine the prospects for their widespread use. The surveyed areas are located on mid-mountain and low-mountain landscapes with favorable bioclimatic conditions for the organization of climate treatment and recreation, especially in the warm season. The prospects for the development of climate-balneological and climate-mud resorts in Tuva are shown, especially in terms of medical and health tourism. CONCLUSION: A detailed database has been developed on the components of the resort and recreational potential (bioclimate, mineral waters, therapeutic mud) of the treatment areas of Tuva. The data obtained formed the basis of proposals for updating the register of resorts and health-improving areas of the Siberian Federal District, which is formed on the basis of the results of many years of research.

[On the assessment of medical rehabilitation effectiveness in patients with chronic obstructive pulmonary disease in the resort setting]. / K voprosu ob otsenke effektivnosti reabilitatsii bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh na kurorte.

Despite significant successes of health resort rehabilitation in patients with chronic obstructive pulmonary disease (COPD), the assessment of rehabilitation effectiveness remains challenging for resort physicians in Russia. OBJECTIVE: To perform a comparative analysis of methods for assessing the medical rehabilitation outcomes in COPD patients in the resort setting. MATERIAL AND METHODS: The study involved 71 patients with stage I-II COPD, with bronchitis (66.2%) and mixed (COPD + asthma, 33.8%) phenotypes in the clinical remission phase. The mean age of the patients was 57.0±9.8 years, and the mean duration of disease was 7.8±5.1 years. Within 14 days, all patients received an identical set of rehabilitation measures with natural and preformed physical therapeutic resort factors. Before and after the medical rehabilitation course, clinical, laboratory, functional tests and questionnaires were performed on each patient. The effectiveness of course-based complex rehabilitation was assessed using one of three methods: CAT (COPD [chronic obstructive pulmonary disease] Assessment Test), the International Classification of Functioning, Disability and Health (ICF), the COPD control and control stability criteria system. RESULTS: Comparison of the three methods of assessment of COPD patients' rehabilitation outcomes in resort settings showed that the CAT score is the easiest to use, the least time-consuming, highly valid, and informative. According to the CAT score, the resort medical rehabilitation effectiveness was 96.4%, with «improvement¼ and «significant improvement¼ recorded in 82.1% of cases. The use of ICF provides reliable information about the rehabilitation complex effect on the main pathogenetic links of the disease, which allows proper adjusting of rehabilitation procedures to improve effectiveness in the resort setting. Specified grades of ICF domains make it possible to translate qualitative and quantitative attributes inherent to a particular subject into points. The points trend during the medical rehabilitation indicates its effectiveness in terms of recovery of specific functions impaired by the disease. At the same time, the ICF does not allow to rank the medical rehabilitation outcomes in the resort setting in terms of the currently accepted concepts of «significant improvement,¼ «improvement,¼ «slight improvement,¼ «no change,¼ «deterioration,¼ which limits its application in resorts. We believe that assessment of rehabilitation outcomes based on COPD control and control stability is not applicable to resort setting due to possible discrepancy between the impression formed in a short time (14 days) about these characteristics of the pathological process and the actual status, as well as due to lack of knowledge about the effect of achieved/not achieved disease control on the choice of rehabilitation technology. CONCLUSION: A simple and highly informative CAT score can be recommended to assess the effectiveness of resort medical rehabilitation in patients with chronic obstructive pulmonary disease.

[Aerobic exercise and fatigue indices in rheumatoid arthritis patients in the health resort care setting]. / Aerobnye uprazhneniya i pokazateli ustalosti u bol'nykh revmatoidnym artritom v usloviyakh sanatorno-kurortnogo lecheniya.

Fatigue is one of the most common symptoms of rheumatoid arthritis (RA). There is strong evidence that physical activity is an effective way to reduce fatigue. OBJECTIVE: To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients in the health resort setting. MATERIAL AND METHODS: The study involved 102 female patients with RA (age 54.38±11.3 years, body mass index 20-29 kg/m2, DAS28-ESR ≤3.2, with severe fatigue of VAS ≥50) who received 21 days of health resort treatment. The health-improving and therapeutic complex includes dosed physical activity, aerobic exercises (walking). Visual analog scale (VAS0-100) and Bristol Rheumatoid Arthritis Fatigue Scale-Numerical Rating Scale (BRAF-NRS V2) were used to assess fatigue, and the 50-meter walking test was used to evaluate the functional status of patients. RESULTS: A correlation between walking duration and the number of steps at a distance of 50 m (p<0.001) as well as between these indices and fatigue (p<0.001) was shown. A positive effect of a standard three-week medical rehabilitation program for patients with RA on fatigue NRS severity (p=0.003) and NRS effect (p=0.037), as well as on patients' functional status (reduced time spent on the 50-meter test, p=0.01) was demonstrated. When comparing groups of RA patients with low (group 1, <5000-6000 steps per day) and optimal (group 2, ≥7000-8000 steps per day) aerobic exercise, positive results were noted in the short term (at 3 weeks) (p<0.001). CONCLUSION: Aerobic exercise is a promising intervention for treating fatigue in rheumatoid arthritis patients. Medical rehabilitation in a resort setting is the best starting point to encourage performing regular physical activity, as well as the best way to develop exercise programs tailored to rheumatoid arthritis patients.

[Tumnin mineral spring. History of development]. / Tumninskii mineral'nyi istochnik. Istoriya osvoeniya.

The article dwells upon the history of the discovery of the Tumnin mineral spring, the establishment and development of the Far Eastern health resort «Goryachy Klyuch,¼ located in the basin of Chope creek, a tributary of the largest river in the eastern macroslope of Sikhote Alin, Tumnin river, located 25 km from the Strait of Tartary. A historical sketch since the first mentioning of the Tumnin mineral spring from 1903 to the present day, as well as the results of hydrogeological expeditions to determine the chemical composition and α-activity of Tumnin mineral water at different periods, are presented. A contribution of a geological expedition that established a large deep-lying tectonic structure permeable to upwelling thermal water flows is described. The role of the staff of the physiotherapy and balneology department of the Khabarovsk Medical Institute in the study of the mechanism of action and clinical effectiveness of the Tumnin mineral water is addressed. A balneological characteristic of nitric and siliceous thermal water, the basic therapeutic factor of «Goryachy Klyuch¼ health resort, which has always been popular among the Far East residents, but gained special importance and appreciation of patients during the pandemic of new coronavirus infection, is given. Currently, in the health resort «Goryachy Klyuch¼, patients with skin diseases, musculoskeletal, gynecologic, neurologic diseases, digestive tract disorders, metabolic conditions, upper airways, cardiovascular disorders, occupational diseases are treated using balneotherapy and other methods of non-drug therapy. At present, the health resort «Goryachy Klyuch¼ is going through a difficult but interesting period of improvement of recreation opportunities for the Far East residents.

Evaluating the Effectiveness of a One-Week Multimodal Prevention Program for Slowing down and Stress Reduction Performed in a German Health Resort: Results of a Randomized Controlled Trial.

BACKGROUND: Effective concepts are required to overcome the negative impact of daily stressful overwhelming. We investigated the effectiveness of a 1-week multimodal program for stress reduction. METHODS: We performed a randomized controlled trial including adults with above-average stress level. The intervention consisted of health coaching, relaxation, physical activity, and balneotherapeutic elements. Individuals were randomized either to the intervention group (IG) or to one of the two control groups B and C. The main outcome was change in stress (Perceived Stress Questionnaire [PSQ], Screening Scale of Chronic Stress of the Trier Inventory for Chronic Stress [TICS-SSCS]) at 6 months post intervention; further outcomes were well-being (World Health Organization 5-Item Well-Being Index [WHO-5]) and health status (EuroQol visual analog scale [EQ-5D VAS]). Data were collected pre/post intervention as well as after 1, 3, and 6 months. RESULTS: Data of 96 individuals (mean age 48.0 years, 74% female) were available for analyses. The IG improved overtime with -13.45 points for the PSQ and -6.44 points for the TICS-SSCS after 6 months. At 6-month follow-up the IG did not significantly differ from group B (PSQ: p = 0.2332; TICS-SSCS: p = 0.0805) or group C (PSQ: p = 0.0950; TICS-SSCS: p = 0.0607) when controlling for baseline (ANCOVA). Compared to group C, ANCOVA revealed significant differences in WHO-5 (p = 0.0292) and EQ-5D VAS (p = 0.0177) post intervention. At the 3- and 6-month follow-up and compared to group B, no substantial differences could be found for WHO-5 and EQ-5D VAS. CONCLUSION: The results indicate that even a short-term multimodal program for stress reduction appears to set a positive trend towards less perceived and chronic stress.

[Health resort care of people with disabilities in the Russian Federation]. / Sanatorno-kurortnoe lechenie invalidov v Rossiiskoi Federatsii.

OBJECTIVE: To analyze the health resort care (HRC) system for people with disabilities and provide the rationale of the HRC system improvements. MATERIAL AND METHODS: A content analysis of the regulatory framework and analysis of data from the Forms of Federal Statistical Monitoring of Rosstat, the Russian Ministry of Health, and the Russian Ministry of Labor were performed. RESULTS: The 19 main legal and regulatory documents are presented, and the 16 main areas of legal regulation on the HRC organization are highlighted. For 2014-2018, a twofold decrease in the number of people with disabilities whose individual rehabilitation and habilitation program included recommendations for HRC was observed. In 2019 and 2020, an increase in this indicator was recorded. An overall decrease in the number of persons (including children) with disabilities who received HRC was demonstrated. CONCLUSION: Ways to improve the HRC system for people with disabilities was identified.

[Weather and climatic factors at the resort of the Southern coast of Crimea in the medical rehabilitation of patients with hypertension]. / Pogodno-klimaticheskie faktory na kurorte Yuzhnogo berega Kryma v meditsinskoi reabilitatsii patsientov s gipertonicheskoi bolezn'yu.

OBJECTIVE: To evaluate the effect of weather and climatic factors of the South Coast of Crimea (SCC) on the effectiveness of health resort medical rehabilitation (MR) of patients with arterial hypertension (AH). MATERIAL AND METHODS: One hundred and thirty-four patients with AH were examined. The effect of weather and climatic factors of the SCC was assessed using the methods of Modified Clinical Weather Pathogenicity Index (CWPI-M, developed at the I.M. Sechenov Institute) and assessment of medical rehabilitation according to International Classification of Functioning, Disability and Health (ICF) criteria. RESULTS: The regression equations for the change of ICF domains b2401, b420, b4301, b4552, d240 and the change of mean values of all domains depending on air temperature and humidity, wind velocity, amount of clouds, variability of air temperature, and atmospheric pressure were developed. The equations permit the generation of reliable rehabilitation prognosis for patients with AH for all terms of health resort care at the SCC. CONCLUSIONS: The use of CWPI-M makes it possible to form a rehabilitation prognosis for patients with AH based on certain ICF domains. The best rehabilitation prognosis for the SCC resorts is for the warm period of the year.

[Dental care in health resort institutions]. / Okazanie stomatologicheskoi pomoshchi v sanatorno-kurortnykh usloviyakh.

Over the past decades, a small yet convincing evidence base has accumulated that demonstrates the effectiveness of dental care for patients in health-resort (HR) settings. In addition to a positive local effect, complex HR care increases nonspecific resistance and promotes desensitization. OBJECTIVE OF THE REVIEW: Addressing the HR rehabilitation in patients with various maxillofacial diseases for further consideration of the possibility of the increased use of HR care in dental practice. MATERIAL AND METHODS: Russian and English-language publications were analyzed without specifying the search timeframe. The search keywords were the following: «health-resort care¼, «balneotherapy¼, «peloid therapy¼, «physiotherapy¼, «magnet therapy¼, «laser therapy¼ in combination with «dental diseases¼, «maxillofacial diseases¼, «periodontal diseases¼, «temporomandibular joint diseases¼, «postoperative rehabilitation¼ «balneotherapy¼, «mud therapy¼, «peloid therapy¼, «spa therapy¼, «physiotherapy¼. A total of 21 articles were analyzed, including 10 related to periodontal disease, 5 to temporomandibular joint pathology, and 6 to rehabilitation in the postoperative period. Seventeen original studies (3855 patients) were selected, including 47.62% with evidence level C, due to lack of information on comparison group or randomization. RESULTS AND DISCUSSION: Available data from clinical studies suggest the effectiveness of natural and physiotherapeutic factors in the medical rehabilitation of patients with various dental diseases. Further randomized clinical trials and the development of clinical guidelines for various techniques in dental diseases are warranted.

[Climate-therapy at seaside resorts in modern medical and wellness practice]. / Klimatolechenie na primorskikh kurortakh v sovremennoi meditsinskoi i ozdorovitel'noi praktike.

A scientific review is devoted to the study of the coastal climate in the resort treatment role of patients with chronic diseases and its impact on the health and life quality of the population of the seacoasts. The sources were the Cochrane Library, PubMed MEDLINE, MedlinePlus, PedRO, Google Scholar, British Medical Journal, Elsevier, The Global Wellness Institute, eLIBRARY.ru. The review includes 40 publications including 22 domestic and 18 foreign ones on clinical and surrogate outcomes of climate-therapy at seaside resorts in the structure of spa treatment in patients with chronic diseases. The health problems among the population of the seacoasts are considered. The features of conducting evidence-based studies in assessing the effects of climate procedures are noted. The analysis of the therapeutic and health-improving effect results of the seaside climate and the associated forms of thalassotherapy - terrenkur, swimming, aqua gymnastics, sea bathing, heliotherapy, landscape therapy, and the use of maricultureis carried out. The article presents statistically reliable data on the favorable outcomes of treatment of chronic forms of musculoskeletal, skin, pulmonary and cardiac pathology under the influence of thalassotherapy methods. It was found that the effectiveness of climate-therapy in oncological practice, the treatment of pollinosis, the use of algae and other maricultures has been insufficiently proven: the possibility of percutaneous permeability to seawater and its components. The risk of developing negative meteorological reactions during climate-therapy was noted.

[National Medical Research Center of Rehabilitation and Balneology, Ministry of Health: 100 years of history for the benefit of the health resort industry development in the country]. / FGBU «NMITs reabilitatsii i kurortologii¼ Minzdrava Rossii: 100 let istorii vo blago razvitiya sanatorno-kurortnoi otrasli strany.

In 2021, the National Medical Research Center of Rehabilitation and Balneology celebrates its centenary. The article highlights the main historical stages of the formation of the Center, which is intended to be the leading scientific institution in the country in the field of balneology, the main directions of experimental and clinical research of the Center's employees and significant scientific achievements.

Outbreaks Associated with Treated Recreational Water - United States, 2015-2019.

Outbreaks associated with treated recreational water can be caused by pathogens or chemicals in aquatic venues such as pools, hot tubs, water playgrounds, or other artificially constructed structures that are intended for recreational or therapeutic purposes. For the pseriod 2015-2019, public health officials from 36 states and the District of Columbia (DC) voluntarily reported 208 outbreaks associated with treated recreational water. Almost all (199; 96%) of the outbreaks were associated with public (nonbackyard) pools, hot tubs, or water playgrounds. These outbreaks resulted in at least 3,646 cases of illness, 286 hospitalizations, and 13 deaths. Among the 155 (75%) outbreaks with a confirmed infectious etiology, 76 (49%) were caused by Cryptosporidium (which causes cryptosporidiosis, a gastrointestinal illness) and 65 (42%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms). Cryptosporidium accounted for 2,492 (84%) of 2,953 cases resulting from the 155 outbreaks with a confirmed etiology. All 13 deaths occurred in persons affected by a Legionnaires' disease outbreak. Among the 208 outbreaks, 71 (34%) were associated with a hotel (i.e., hotel, motel, lodge, or inn) or a resort, and 107 (51%) started during June-August. Implementing recommendations in CDC's Model Aquatic Health Code (MAHC) (1) can help prevent outbreaks associated with treated recreational water in public aquatic venues.