Water, mineral, and blood acid-base balance in calves with naturally occurring diarrhea receiving two alternative oral rehydration solutions or a placebo.

Quantifying the water and mineral losses in feces is essential to determine the optimal composition of oral rehydration solutions (ORS) for diarrheic animals. In a randomized complete block design, this study evaluated water, mineral, and blood acid-base balance of calves with naturally occurring diarrhea receiving ORS or a placebo. On d 0, 45 calves (age: 18 ± 3.2 d; mean ± SD) were selected based on the presence of visual signs of diarrhea, such as dirty tail or wet feces, along with clinical symptoms evaluated by measuring the skin turgor and the degree of enophthalmos. On d 1, calves were divided into blocks of 3 animals based on blood base excess (BE) measured at 0900 h, and within each block, calves were randomly assigned to 1 of 3 treatments (15 calves per treatment) including (1) a hypertonic ORS (HYPER; Na+ = 110 mmol/L; 370 mOsm/kg; strong ion difference [SID] = 60 mEq/L), (2) a hypotonic ORS with low Na+ (HYPO; Na+ = 77 mmol/L; 278 mOsm/kg; SID = 71 mEq/L), and (3) a placebo consisting of lukewarm water with 5 g/L of whey powder (CON). Milk replacer (MR) was fed through teat buckets twice daily at 0630 h and 1700 h in 2 equally sized meals of 2.5 L from d 1 to 3 and of 3.0 L on d 4 and 5. Treatments consisting of 2.0 L lukewarm solutions were administered between milk meals from d 1 to 3 at 1200 h and 2030 h through teat buckets. Refusals of MR and treatments were recorded daily, and blood samples were collected from the jugular vein once daily at arrival in the afternoon of d 0 and at 0900 h from d 1 to 5 after arrival. Urine and feces were collected quantitatively over a 48-h period from 1200 h on d 1 to 1200 h on d 3, and a representative sample of each 24-h period was stored. In addition, the volume of extracellular fluid was evaluated on d 2 by postprandial sampling over a 4-h period relative to the injection of sodium thiosulfate at 1300 h. Total daily fluid intake (MR, treatment, and water) from d 1 to 3 was greater in HYPER (LSM ± SEM; 8.9 ± 0.36 L/d) and HYPO (7.8 ± 0.34 L/d) than in CON (6.6 ± 0.34 L/d). This resulted in a greater water balance (water intake - fluid output in urine and feces) in calves receiving ORS (59.6 ± 6.28 g/kg BW per 24 h vs. 39.6 ± 6.08 g/kg BW per 24 h). Fecal Na+ losses were greater in HYPER than in the other treatments (81 ± 12.0 mg/kg BW per 24 h vs. 24 ± 11.8 mg/kg BW per 24 h). Blood pH was higher in HYPO (7.41 ± 0.016) than CON (7.35 ± 0.016) over the 5 monitoring days, whereas HYPER (7.37 ± 0.017) did not differ with other treatments. In this experimental model, diarrheic calves were likely unable to absorb the high Na+ load from HYPER, resulting in greater Na+ losses in feces, which might have impaired the alkalinizing capacity of HYPER. In contrast, HYPO significantly sustained blood acid-base balance compared with CON, whereas HYPER did not. This suggests that low tonicity ORS with a high SID are more suitable for diarrheic calves.

[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.

Balneotherapy for osteoarthritis: a systematic review.

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

Heartburn relief with bicarbonate-rich mineral water: results of the randomised, placebo-controlled phase-III trial STOMACH STILL.

OBJECTIVE: We assessed whether the bicarbonate-rich mineral water Staatl. Fachingen STILL is superior over conventional mineral water in relieving heartburn. DESIGN: Multicentre, double-blind, randomised, placebo-controlled trial STOMACH STILL in adult patients with frequent heartburn episodes since ≥6 months and without moderate/severe reflux oesophagitis. Patients drank 1.5 L/day verum or placebo over the course of the day for 6 weeks. Primary endpoint was the percentage of patients with reduction of ≥5 points in the Reflux Disease Questionnaire (RDQ) score for 'heartburn'. Secondary endpoints included symptom reduction (RDQ), health-related quality of life (HRQOL, Quality of Life in Reflux and Dyspepsia (QOLRAD)), intake of rescue medication and safety/tolerability. RESULTS: Of 148 randomised patients (verum: n=73, placebo: n=75), 143 completed the trial. Responder rates were 84.72% in the verum and 63.51% in the placebo group (p=0.0035, number needed to treat=5). Symptoms improved under verum compared with placebo for the dimension 'heartburn' (p=0.0003) and the RDQ total score (p=0.0050). HRQOL improvements under verum compared with placebo were reported for 3 of 5 QOLRAD domains, that is, 'food/drink problems' (p=0.0125), 'emotional distress' (p=0.0147) and 'vitality' (p=0.0393). Mean intake of rescue medication decreased from 0.73 tablets/day at baseline to 0.47 tablets/day in week 6 in the verum group, whereas in the placebo group it remained constant during the trial. Only three patients had treatment-related adverse events (verum: n=1, placebo: n=2). CONCLUSION: STOMACH STILL is the first controlled clinical trial demonstrating superiority of a mineral water over placebo in relieving heartburn, accompanied by an improved HRQOL. TRIAL REGISTRATION NUMBER: EudraCT 2017-001100-30.

The effects of immersion in 42℃ radon, natrium, calcium, bicarbonate content thermal-mineral water on chronic low back pain. Controlled, follow-up study.

In our minimized follow-up trial with 137 participants with chronic low back pain, one group of participants received regular outpatient care, and the other group received balneotherapy by immersion in 42℃ thermal-mineral water in addition to regular outpatient care on 15 occasions for 3 weeks. Pain on movement and at rest on the 0-100 mm visual analogue scale (VAS), Oswestry index, the number of participants evaluating the symptoms clinically acceptable (Patient Acceptable Symptom State, PASS) and the EuroQol-5D-5L (EQ-5D-5L) quality of life questionnaire were assessed at basal time (at week 0) and after balneotherapy (at weeks 3 and 12). The VAS pain scores, the Oswestry index, the EQ-5D-5L index and the EQ-VAS significantly improved in the balneotherapy group after treatment at week 3 (p < 0.001) and week 12 (p < 0.001) compared to baseline, with a significant between group difference at week 3 (p < 0.001) and week 12 (p < 0.001). The pain VAS score on movement was 66.82 ± 11.48, 26.69 ± 21.49, and 20.09 ± 23.29 in the balneotherapy group, and 63.67 ± 14.77, 67.35 ± 15.44, and 70.23 ± 18.26 in the control group at the consecutive visits. The PASS increased in both groups at week 3 and week 12 compared to the baseline, with a significant between-group difference at week 3 and week 12 for the balneotherapy group. Our results suggest the therapeutic efficacy of immersion in 42℃ thermal mineral water on chronic low back pain.ClinicalTrials.gov Identifier: NCT05342051.

Metasilicate-based alkaline mineral water confers diarrhea resistance in maternally separated piglets via the microbiota-gut interaction.

Stress or stress-induced intestinal disturbances, especially diarrhea, are the main triggers for inflammatory bowel disease and irritable bowel syndrome. Diarrhea and intestinal inflammatory disease afflict patients around the world, and it has become a huge burden on the global health care system. Drinking sodium metasilicate-based alkaline mineral water (SM-based AMW) exerts a potential therapeutic effect in gastrointestinal disorders, including gut inflammation, and diarrhea, but the supportive evidence on animal studies and mechanism involved remain unreported. The maternally separated (MS) piglet (Newly weaned piglet) is an excellent model to investigate the treatment of diarrhea in infant. This study aims to determine whether drinking SM-based AMW confers diarrhea resistance in maternally separated (MS) piglets under weaning stress and what the underlying mechanisms are involved. 240 newly weaned piglets were randomly divided into the Control group and the sodium metasilicate pentahydrate (SMP) group. A decreased diarrhea incidence was observed in SMP treatment piglets. The intestine injury and activated stress hormones (COR and ACTH) induced by weaning was alleviated by SM-based AMW. This may be related to the improvement of intestinal microflora structure and function by SMP, especially the increase of s_copri abundance. Meanwhile, SMP maintained the integrity of the duodenal mucus barrier in MS piglets. Importantly, by targeting NF-κB inhibition via the microbiota-gut interaction, SM-based AMW alleviated intestinal inflammation, maintained fluid homeostasis by modulating aquaporins and fluid transporter expression, and enhanced barrier integrity by suppressing MLCK/p-MLC signaling. Therefore, drinking metasilicate-based alkaline mineral water confers diarrhea resistance in MS piglets via the microbiota-gut interaction.

[The effect of natural mineral bicarbonate sodium-calcium water «Tib-1¼ on the antioxidant status of rats with adjuvant rheumatoid arthritis]. / Vliyanie prirodnoi mineral'noi gidrokarbonatnoi natrievo-kal'tsievoi vody «Tib-1¼ na antioksidantnyi status krys s ad"yuvantnym revmatoidnym artritom.

The combination of traditional basic pharmacotherapy for rheumatoid arthritis (RA) and physiotherapeutic methods can reduce the activity of the disease and accelerate the onset of remission, and therefore the development of new non-drug methods for the treatment of RA is relevant. PURPOSE OF THE STUDY: Study of the effect of natural mineral water « Tib-1¼ on the lipid peroxidation system in an experiment with a model adjuvant-induced RA in rats. MATERIAL AND METHODS: The object of the study were Wistar rats, divided into three groups: negative control (solvents), positive control (model of adjuvant-induced RA by subcutaneous injection of complete Freund's adjuvant) and experimental (correction of RA with mineral water « Tib-1¼, diluted in a ratio of 1:3 during the first 2 weeks from the moment the model was formed in the ad libitum mode). On the 3rd and 7th weeks in the blood of the animals were determined: the total number of leukocytes, the content of hydroperoxides according to Gavrilov, the level of malondialdehyde (MDA), catalase activity. Pathological changes in the hip and knee joints were recorded using radiography. RESULTS: The inflammatory process in the positive control group by the 3rd week was characterized by an increase in the number of leukocytes by 66% (p<0.01) and was accompanied by an increase in MDA by 60% (p<0.001). By the 7th week, despite a relative increase in catalase activity (16%), the MDA level continued to be elevated compared to the negative control by 67% (p<0.001). Against the background of exposure to mineral water, inflammation decreased (the number of leukocytes in the "model/experiment" groups turned out to be reduced by 41%; p<0.01) and an increase in compensatory-adaptive reactions in the form of catalase activation was noted (by 8%; p<0.01), which was accompanied by a persistent (weeks 3 and 7) decrease in MDA output (by 20%; p<0.01). Using the method of radiation diagnostics, positive changes in the articular apparatus of experimental animals were revealed, consisting in the relief of signs of subchondral sclerosis of the bone heads, which were noted for animals of the model group. CONCLUSION: The use of natural mineral water «Tib-1¼ helps to reduce the acute inflammatory response during the formation of adjuvant-induced RA in Wistar rats, initiates the normalization of the balance of pro- and antioxidant processes in the body, and minimizes the intensity of degenerative-inflammatory joint lesions.

[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.

[EXPERIMENTAL JUSTIFICATION OF CORRECTIVE ACTION OF NATIVE AND SELENIUM-MODIFIED MINERAL WATERS ON METABOLIC SYNDROME MODEL].

The purpose of the study was to determine the effect of native and selenium-modified mineral waters on metabolic syndrome models. Combined metabolic syndrome (combMS) was simulated in 70 white rats of male gender under standard vivarium conditions, using high-calorie food and single administration of streptozotocin. During the random sampling study the following groups of animals were formed: in the control group 1 (n=6) the rats had standard forage during the experiment; in the control group 2 (n=10) there were rats with combMS model without treatment; in the main groups, starting at the 61st day of combMS, the rats received: the 1st group (n=11) - Essentuki mineral water №4; the 2nd (n=16) - the same water with selenium; in the 3rd (n=11) - Slavyanovskaya mineral water; in the 4th (n=16) - Slavyanovskaya with selenium. Registration of the effects was determined by carbohydrate, protein and lipid metabolism. Metabolic syndrome was monitored by recording animal weight gain and the level of glycemia by the express method at the beginning and the end of the treatment course. As a result, in main groups glucose increased 1.5-2 times, urea and lactate - 1.5 times, triglycerides - 30-40% compared, to the data in the control group 1, against the background of reduced content of contrinsular hormones. All the animals with combMS (control 2 and all the main groups) increased α-amylase activity. The most significant corrective parameters of the metabolic syndrome were established: in the main group 1 - a decrease in hyperglycemia, in the 3rd main group - urea, and in the main groups 2 and 4 the lipid spectrum recovered and the level of lactate decreased. Modification of different mineral waters by selenium provides leveling of differences between them in therapeutic effectiveness.

[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.

The therapeutic effect of Värska mud and Värska mineral water baths on the overuse pain and muscle tension syndromes in the working age population.

The effects of bath therapy are complex and result from a unique interaction between the aquatic environment and the human body functions. The effect of bath therapy depends on both water temperature and chemical additives (mineral substances and humic substances). Värska Resort Centre, in south-eastern Estonia, uses for the balneotherapy the local curative mud and mineral water. The aim of the study was to evaluate and compare the effects of Värska's local mud bath and mineral water bath on moderate musculoskeletal pains in working-age people. The study involved 64 working-age subjects: within two weeks, 32 of them received five general mineral water baths, and another 32 received five general curative mud baths. Pain was assessed with the Nordic Musculosceletal Questionnaire, and muscle tension was measured with a myotonometer in m. erector spinae and m. trapezius. Measurements were performed three times: before the start of the study, immediately after the last procedure, and 2-3 weeks after the last procedure. Both the Värska curative mud bath and the Värska mineral water bath showed a positive effect on musculoskeletal pain and muscle tension. Both procedures can be recommended as drug-free interventions for mild to moderate musculoskeletal pain syndrome and muscle tensions, in both prevention and treatment.

A meta-analysis of the effectiveness of mud-bath therapy on knee osteoarthritis.

OBJECTIVE: Osteoarthritis (OA) results from loss of cartilage in-tegrity in association with changes to the structure of the entire joint. Treatment of OA is based on different pharmaceutical and no phar-maceutical approaches and the latter include the use of spa-therapy. The biological effects of mud-bath therapy are mainly secondary to heat stimulation and to physic-chemical properties of mineral waters and mud-packs. Mud-bath therapy likely exerts its effects modulating several cytokines and other molecules involved in inflammation and cartilage degradation. Our aim was to perform an updated meta-analysis of the effectiveness of the mud-bath therapy on knee osteoarthritis and briefly to discuss the mechanisms of action of this treatment. MATERIALS AND METHODS: A MEDLINE on PubMed for articles on knee OA and spa therapy published from 1995 through up to April 2019 was performed. Then, we checked the Cochrane Central Register of Controlled Trials to find additional references included up to April 2019. Articles were included if in accordance with the eligibility cri-teria. Sample size and effect sizes were processed with the MedCalc software package. RESULTS: Twenty one studies met the inclusion criteria and were included in meta-analysis. We examined WOMAC Index and VAS pain. We found significant improvements in function scores and painful symptoms after mud-bath therapy in patients with knee joint osteoarthritis. CONCLUSIONS: Spa therapy is a non-drug treatment modalities, non invasive, complication-free, and cost-effective alternative modality for the conservative treatment of knee osteoarthritis. It cannot substitute for conventional therapy but can integrated or alternated to it. Treatment with mud-bath therapy may relieve pain, stiffness and improve functio-nal status in patients with knee OA.

Health properties of the Italian San Martino® mineral-rich water: A self-controlled pilot study.

The effect of hyper-mineral waters on human health has long been debated. This pilot study evaluated the influence of San Martino® water (Sardinia, Italy), on clinical and biological parameters, following the treatment of 10 hospitalized patients. Crenotherapy consisted of 1-2 L of the water daily for 10 days. A complete blood count, serum electrolytes, liver and kidney function tests, fasting lipid profile and plasma glucose, and abdominal ultrasound imaging were assessed before and at the end of treatment. In addition, body weight, dyspeptic symptoms, bowel movements, diuresis, uricuria and blood pressure were evaluated daily. According to its physico-chemical properties, the water is hyper-mineral (TDS 2808 mg/L) with a high content of bicarbonate and iron. At the end of the study, diuresis increased by 60% (850 vs 1295 ml/24 h, P = 0.009) and uricuria by 41% (362 vs 490 mg/24 h, P = 0.022) respectively, whereas plasma uric acid level decreased by 7% (4.7 vs 4.3 mg/dL, P = 0.043). Compared to the basal values, serum gamma-glutamyl transferase, alkaline phosphatase and total bilirubin levels, showed a reduction of 65% (31 vs 18 U/L, P = 0.022), 15% (96 vs 90 U/L, P = 0.041), and 11% (0.53 vs 0.45 g/dL, P = 0.041), respectively. Bowel movements improved in 62.5% of patients with constipation, and 80% of dyspeptic patients experienced symptoms relief. Compliance to the treatment reached 100%. Mild differences were observed in body weight and blood pressure, although not in ultrasound imaging during crenotherapy. These findings suggest that the San Martino® hyper-mineral water may have some benefits to human health. Additional studies with a larger-sized cohort and for a longer period are needed to confirm these preliminary results.

The effect of thermal mineral waters on pain relief, physical function and quality of life in patients with osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: To evaluate the effectiveness and safety of thermal mineral waters therapy for pain relief, and functional improvement, and quality of life (QoL) in patients with osteoarthritis (OA). METHODS: Cochrane Library, Web of science, EMBASE, ClinicalTrials.gov and PubMed were systematically searched for randomized controlled trials. Study inclusion criteria included assessment of the visual analog scale and Western Ontario and McMaster Universities scores and the lequesne index to evaluate the effects of thermal mineral waters on pain relief and functional improvement. Also, studies that used the European quality of life 5-dimension scale and health assessment questionnaire to assess the impact of thermal mineral waters therapy on improving QoL were included. RESULTS: Sixteen studies were included. A meta-analysis showed that thermal mineral waters therapy could significantly reduce pain as measured visual analog scale and Western Ontario and McMaster Universities assessments (P < .001). Thermal mineral waters significantly reduced the lequesne index (P < .001) and improved joint function. Finally, compared with a control group, European quality of life 5-dimension scale and health assessment questionnaire improved significantly in patients with OA receiving thermal mineral waters therapy (P  < .05). There is no evidence that thermal mineral waters is unsafe for treating OA. CONCLUSION: Thermal mineral waters therapy is a safe way to relieve pain, improve physical functions, and QoL in patients with OA.

Recuento histórico de la virtud curativa de las aguas minero-medicinales de San Miguel de los Baños / Historical review of the curative virtue of mineral-medicinal waters of San Miguel de los Baños

RESUMEN San Miguel de los Baños surgió y se desarrolló gracias a sus aguas mineromedicinales. Con el objetivo de determinar el origen, estudio y caracterización de estas se realiza revisión bibliográfica, mediante la consulta de bibliografías y documentos históricos recopilados; la información se buscó sin restricción de fecha de publicación, por descriptores, en bases de datos de la Biblioteca Virtual de Salud y por Google, en pos de hallar publicaciones, artículos y archivos que contuvieran en las palabras clave, determinándose que en los momentos fundacionales y durante el funcionamiento del balneario se realizaron estudios de caracterización, uso y terapéutica de las aguas provenientes de los manantiales: "El Tigre" y "La Salud"; desde 1962 no se brinda atención médica, desde 1984 a la fecha solo constan estudios geo- mineros, físico-químicos y bacteriológicos. La población local hace uso de estas aguas sin indicación, dosis y registro. No se han publicado estudios basados en la evidencia necesarios para la prescripción actual (AU).

Summary San Miguel de los Baños was founded and developed thanks to its mineral- medicinal waters. A bibliographic review was carried out with the objective of determining the origin, study and characterization of these waters consulting bibliography and historical documents, searching information without publishing date restriction, using descriptors in databases of the Virtual Health Library and Google for publications, articles and files having the used key words. The authors arrived to the conclusion that in the times of foundation and during the years of the spa functioning, there were carried out studies on characterization, use and therapeutic of the waters running from the springs "El Tigre" and "La Salud"; medical care is not provided since 1962; only geo-mining, physic-chemical and bacteriological studies were carried out from 1984 up to the date. Local population uses the waters without prescription, doses or recording. No evidence-based studies were published for their current prescription (AU).

Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis.

BACKGROUND: Chronic plaque psoriasis is an immune-mediated, chronic, inflammatory skin disease, which can impair quality of life and social interaction. Disease severity can be classified by the psoriasis area and severity index (PASI) score ranging from 0 to 72 points. Indoor artificial salt bath with or without artificial ultraviolet B (UVB) light is used to treat psoriasis, simulating sea bathing and sunlight exposure; however, the evidence base needs clear evaluation. OBJECTIVES: To assess the effects of indoor (artificial) salt water baths followed by exposure to artificial UVB for treating chronic plaque psoriasis in adults. SEARCH METHODS: We searched the following databases up to June 2019: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trial registers, and checked the reference lists of included studies, recent reviews, and relevant papers for further references to relevant trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) of salt bath indoors followed by exposure to artificial UVB in adults who have been diagnosed with chronic plaque type psoriasis. We included studies reporting between-participant data and within-participant data. We evaluated two different comparisons: 1) salt bath + UVB versus other treatment without UVB; eligible comparators were exposure to psoralen bath, psoralen bath + artificial ultraviolet A UVA) light, topical treatment, systemic treatment, or placebo, and 2) salt bath + UVB versus other treatment + UVB or UVB only; eligible comparators were exposure to bath containing other compositions or concentrations + UVB or UVB only. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We used GRADE to assess the certainty of the evidence. The primary efficacy outcome was PASI-75, to detect people with a 75% or more reduction in PASI score from baseline. The primary adverse outcome was treatment-related adverse events requiring withdrawal. For the dichotomous variables PASI-75 and treatment-related adverse events requiring withdrawal, we estimated the proportion of events among the assessed participants. The secondary outcomes were health-related quality of life using the Dermatology Life Quality Index, (DLQI) pruritus severity measured using a visual analogue scale, time to relapse, and secondary malignancies. MAIN RESULTS: We included eight RCTs: six reported between-participant data (2035 participants; 1908 analysed), and two reported within-participant data (70 participants, 68 analysed; 140 limbs; 136 analysed). One study reported data for the comparison salt bath with UVB versus other treatment without UVB; and eight studies reported data for salt bath with UVB versus other treatment with UVB or UVB only. Of these eight studies, only five reported any of our pre-specified outcomes and assessed the comparison of salt bath with UVB versus UVB only. The one included trial that assessed salt bath plus UVB versus other treatment without UVB (psoralen bath + UVA) did not report any of our primary outcomes. The mean age of the participants ranged from 41 to 50 years of age in 75% of the studies. None of the included studies reported on the predefined secondary outcomes of this review. We judged seven of the eight studies as at high risk of bias in at least one domain, most commonly performance bias. Total trial duration ranged between at least two months and up to 13 months. In five studies, the median participant PASI score at baseline ranged from 15 to 18 and was balanced between treatment arms. Three studies did not report PASI score. Most studies were conducted in Germany; all were set in Europe. Half of the studies were multi-centred (set in spa centres or outpatient clinics); half were set in a single centre in either an unspecified settings, a psoriasis daycare centre, or a spa centre. Commercial spa or salt companies sponsored three of eight studies, health insurance companies funded another, the association of dermatologists funded another, and three did not report on funding. When comparing salt bath plus UVB versus UVB only, two between-participant studies found that salt bath plus UVB may improve psoriasis when measured using PASI 75 (achieving a 75% or more reduction in PASI score from baseline) (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.24 to 2.35; 278 participants; low-certainty evidence). Assessment was conducted at the end of treatment, which was equivalent to six to eight weeks after start of treatment. The two trials which contributed data for the primary efficacy outcome were conducted by the same group, and did not blind outcome assessors. The German Spas Association funded one of the trials and the funding source was not stated for the other trial. Two other between-participant studies found salt bath plus UVB may make little to no difference to outcome treatment-related adverse events requiring withdrawal compared with UVB only (RR 0.96, 95% CI 0.35 to 2.64; 404 participants; low-certainty evidence). One of the studies reported adverse events, but did not specify the type of events; the other study reported skin irritation. One within-participant study found similar results, with one participant reporting severe itch immediately after Dead Sea salt soak in the salt bath and UVB group and two instances of inadequate response to phototherapy and conversion to psoralen bath + UVA reported in the UVB only group (low-certainty evidence). AUTHORS' CONCLUSIONS: Salt bath with artificial ultraviolet B (UVB) light may improve psoriasis in people with chronic plaque psoriasis compared with UVB light treatment alone, and there may be no difference in the occurrence of treatment-related adverse events requiring withdrawal. Both results are based on data from a limited number of studies, which provided low-certainty evidence, so we cannot draw any clear conclusions. The reporting of our pre-specified outcomes was either non-existent or limited, with a maximum of two studies reporting a given outcome. The same group conducted the two trials which contributed data for the primary efficacy outcome, and the German Spas Association funded one of these trials. We recommend further RCTs that assess PASI-75, with detailed reporting of the outcome and time point, as well as treatment-related adverse events. Risk of bias was an issue; future studies should ensure blinding of outcome assessors and full reporting.

Application of mineral waters in the complex treatment of patients with gastroesophageal reflux disease.

BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common gastric pathologies. Recently, there has been a growing interest in the healing effects of mineral waters (MW). METHODS: Ninety patients with GERD were under observation. The study used the following methods: anamnestic, clinical, studies of biochemical blood parameters, ultrasonographic studies of the digestive system, fibroesophagogastroduodenoscopy with intragastric pH-metric. After preliminary research, all patients were randomly divided into three groups of 30 people. The control group (group 1) who were prescribed a basic treatment complex-dietary and proton pump inhibitor group drugs. Patients of group 2 in addition to the standard course of treatment received boric highly mineralized bicarbonate sodium water. Patients of group 3 in addition to the basic therapy were prescribed an internal course treatment of highly mineralized sulfate-bicarbonate sodium-magnesium water. RESULTS: The use of the basic complex of treatment for a month in control group did not lead to a significant leveling of signs of dyspeptic and asthenic syndromes. The use of boron highly mineralized sodium bicarbonate water led to a significant leveling of signs of abdominal pain and dyspeptic syndromes, improvement of acid-forming function of the stomach, but no reliable dynamics were observed in eliminating signs of cytolytic, mesenchymal inflammatory and cholestatic syndromes. Application of highly mineralized sulfate-hydrocarbonate sodium magnesium water improves the elimination of dyspepsia and pain syndromes, normalization of the functional state of the liver. CONCLUSIONS: The obtained data confirm the prospects of using highly mineralized mineral waters in the complex treatment of GERD patients.

[Gastroesophageal reflux disease with cardial manifistations: perspectives of non-pharmacological treatment methods]. / Gastroézofageal'naia refliuksnaia bolezn' s kardial'nymi proiavleniiami: perspektivy nemedikamentoznykh metodov lecheniia.

In this article we present the review of the literature and our own research regarding gastroesophageal reflux disease (GERD) with cardiac manifestations. The methods of treatment of patients with GERD using mineral waters, physio- and balneotherapeutic factors, as well as acupuncture are discussed. The conclusion is drawn about the effectiveness of the use of non-pharmacological methods in mono- and complex therapy of GERD and the need for further research in this direction.

Which Type of Water Is Recommended for Patients with Stone Disease (Hard or Soft Water, Tap or Bottled Water): Evidence from a Systematic Review over the Last 3 Decades.

PURPOSE OF REVIEW: The role of the mineral constituents in water and their role in kidney stone disease (KSD) have been a long-standing subject of debate. The aim of our systematic review was to evaluate the relevance of different types of water in stone disease. RECENT FINDINGS: Studies to date have had varying results regarding the importance of hardness of water which is mostly determined by its calcium content. Other elements including magnesium and bicarbonate also play a crucial role in prevention of renal stones. Patients with stone disease are provided varying advice due to a lack of consensus on the types of water recommended. Increased fluid intake prevents stone formation. Our review of the literature suggests that hard water and bottled mineral water might be helpful for calcium stone formers. High calcium content in them leads to hypercalciuria; however, other factors also influence stone formation and the overall impact seems to be a reduction in calcium stone formation. The mineral content varies across different water types but high magnesium and bicarbonate content in water is also recommended for kidney stone patients.