[Pelotherapy and pelotherapy combined with intravenous laser blood irradiation at the sanatorium-resort stage of treatment of patients with psoriasis vulgaris]. / Peloidoterapiya i peloidoterapiya v sochetanii s vnutrivennym lazernym osvechivaniem krovi na sanatorno-kurortnom etape lecheniya bol'nykh vul'garnym psoriazom.

Search of new rational ways to increase the effectiveness of treatment and rehabilitation measures for patients with psoriasis vulgaris continues to be one of the urgent problems in modern clinical dermatology. OBJECTIVE: To carry out a comparative analysis of the impact of different variants of sanatorium-resort treatment (SRT) - pelotherapy and pelotherapy in combination with intravenous laser blood irradiation (ILBI) - on the level of IL-17 and TNF-a, dermatological status, psychoemotional state and quality of life (QL) assessment of patients with psoriasis vulgaris. MATERIAL AND METHODS: A naturalistic comparative study included 120 patients with psoriasis vulgaris, who were undergoing SRT: 57 patients in the pelotherapy group and 63 in the group of pelotherapy in combination with ILBI. The SRT effectiveness was assessed using the PASI index, the HARS and HDRS scales and the DLQI questionnaire. The dynamics of IL-17 and TNF-a plasma levels in blood plasma was studied. The study duration was 6 months 14 days. RESULTS: After 14 days of SRT, a decrease in IL-17 and TNF-a levels in blood plasma was statistically significant both in the pelotherapy group and in the group of pelotherapy in combination with ILBI, no statistically significant differences between the groups were found. Furthermore, the comprehensive use of pelotherapy in combination with ILBI has contributed to a more pronounced statistically significant decrease in the PASI index, the HARS and HDRS scales' total scores and an increase in the level of QL. The number of patients with clinical remission was statistically higher in the group of pelotherapy combined with ILBI compared to the pelotherapy group (87.3% versus 42.1%) six months after SRT. CONCLUSION: The advantage of comprehensive application of pelotherapy and ILBI in comparison with pelotherapy in patients with psoriasis vulgaris in SRT has been shown. The comprehensive application of pelotherapy and ILBI reduces the level of inflammatory biomarkers, improves dermatological and psychoemotional status, improves QL and is well tolerated by patients.

Microbial Composition Dynamics in Peloids Used for Spa Procedures in Lithuania: Pilot Study.

Despite peloids' acknowledged therapeutic and cosmetic potential, there remains a limited understanding of their microbial diversity and dynamics, especially concerning beneficial and non-beneficial microorganisms under different heating conditions. Our study employs both cultivation and metagenomic methods to assess the microbiota of peloids, focusing on lake sapropel and peat under heating conditions recommended for external application and safety assurance. By applying microbial indicators specified in national regulatory documents, we found that all peloids reached thresholds for sulphite-reducing clostridia and colony-forming units. Each peloid exhibited a distinctive bacterial composition based on metagenomic analysis, and temperature-induced changes were observed in microbial diversity. We identified beneficial bacteria potentially contributing to the therapeutic properties of peloids. However, the same peloids indicated the presence of bacteria of human faecal origin, with a notably higher abundance of Escherichia coli, pointing to a potential source of contamination. Unfortunately, it remains unclear at which stage this contamination entered the peloids. The findings underscore the importance of monitoring and controlling microbial aspects in peloid applications, emphasising the need for measures to prevent and address contamination during their preparation and application processes.

Circulating serotonin and dopamine concentrations in osteoarthritis patients: a pilot study on the effect of pelotherapy.

Balneotherapy has demonstrated clinical efficacy in the management of pathologies involving low-grade inflammation and stress. In rheumatic conditions such as osteoarthritis (OA), this therapy presents anti-inflammatory properties and potential to improve psychological well-being. Although the neurohormones serotonin and dopamine are known to be involved in these processes, surprisingly they have not been studied in this context. The objective was to evaluate the effect of a cycle of balneotherapy with peloids (pelotherapy) on circulating serotonin and dopamine concentrations in a group of aged individuals with OA, after comparing their basal state to that of an age-matched control group. In our pilot study, a pelotherapy program (10 days) was carried out in a group of 16 elderly patients with OA, evaluating its effects on circulating serotonin and dopamine concentrations (measured by ELISA). Individuals with OA showed higher levels of serotonin and lower dopamine levels, in line with the inflammatory roles of these mediators. After pelotherapy, serotonin concentrations significantly decreased, potentially contributing to the previously reported anti-inflammatory effects of balneotherapy.

Spa therapy and peripheral serotonin and dopamine function: a systematic review.

Spa therapy consists of multiple techniques based on the healing effects of water, including hydrotherapy, balneotherapy, and mud therapy, often combined with therapeutic exercises, massage, or physical therapy. Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies, especially rheumatic conditions due to its anti-inflammatory properties. The main objective of this investigation was to conduct a systematic review analyzing the available evidence on the effect of spa therapy on serotonin and dopamine function. The databases PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were used from June to July 2023. Exclusion criteria were (1) articles not written in English, (2) full text not available, (3) article not related to the objective of the review. JADAD scale was used for methodological quality evaluation. Four studies were included in the systematic review. Two studies were related to serotonin in healthy individuals, one to serotonin in fibromyalgia, and one to dopamine in healthy individuals. One of the studies evaluated hydrotherapy, another one balneotherapy and mud-bath therapy, and the other two assessed balneotherapy interventions. Studies were very heterogeneous, and their methodological quality was low, making it difficult to draw clear conclusions regarding the effect of spa therapy on peripheral serotonin and dopamine function. The findings of this review highlight the lack of studies evaluating these neurotransmitters and hormones in the context of spa therapy. Further research is needed to evaluate the potential effects of these therapies on serotonin or dopamine function.

Effectiveness of Mud-Pack Therapy and Mud-Bath Therapy in Osteoarthritis: A Systematic Review.

OBJECTIVES: Osteoarthritis has a tremendous socioeconomic impact in terms of drug spending, hospital admissions, work productivity, and temporary or permanent incapacity. Mud therapy has been discussed as potential conservative treatment options for osteoarthritis. However, findings from several trials still remain controversial. For this reason, we aimed to systematically review the highest evidence provided by published trials to estimate the clinical effect of mud-pack and mud-bath therapy for the treatment of osteoarthritis. METHODS: We searched PubMed, PEDro, and the Cochrane CENTRAL Register for Controlled Trials for articles published between 2000 and 2020 using the terms "orthopedics," "orthopaedics," "musculoskeletal," "osteoarthritis," and "mud bath," "mud pack." RESULTS: Of the 19 studies included, 15 examined the effects of mud-bath therapy in knee osteoarthritis treatment. One study focused on the treatment effect of mud bath on hand osteoarthritis, another study examined treatment effects in hip and knee osteoarthritis, and two studies enrolled patients with chronic low back pain caused by lumbar spine osteoarthritis. We systematically reviewed the data obtained from the literature and summarized the results on the basis of the main outcomes. The results show significant improvements in function, quality of life, and perceived pain for patients with osteoarthritis. CONCLUSION: Results of randomized controlled trials suggest that mud therapy is part of a promising integrated and synergistic multidisciplinary approach in combination with other treatment forms like pharmacotherapy or physiotherapy.Die sozio-ökonomischen Auswirkungen der Arthrose sind immens. Heiltorfbehandlungen sind seit einiger Zeit als mögliche Ergänzung der konservativen Therapieoptionen dieser Erkrankung Gegenstand wissenschaftlicher Untersuchungen. Ziel dieser Studie war es, die aktuellen Erkenntnisse zur Heiltorftherapie bei Arthrose zusammenzufassen.Wir führten eine systematische Literaturrecherche der Datenbanken Pubmed, PEDro und Cochrane CENTRAL Register of Controlled Trials durch. Hierbei wurden Artikel, die zwischen 2000 und 2020 publiziert wurden und mit den Schlagwörtern "orthopedics", "orthopaedics", "musculoskeletal", "osteoarthritis" und "mud-bath", "mud-pack" assoziiert waren, erfasst.Von den 19 näher untersuchten Studien beschäftigten sich 15 mit den Effekten der Heiltorftherapie bei Patienten mit Kniearthrose, eine Studie untersuchte Patienten mit Arthrose der Hand, eine weitere Studie untersuchte die Auswirkung der Therapie bei Arthrose der Hüfte. 2 Studien untersuchten den Effekt der Moorbäder bei Patienten mit chronischen Rückenschmerzen. Insgesamt zeigten sich signifikante Verbesserungen der Funktion, Lebensqualität und Schmerzlinderung bei den Patienten unter Heiltorftherapie.Die Ergebnisse der randomisierten, kontrollierten Studien zeigen, dass die Heiltorftherapie eine vielversprechende Ergänzung in einem multidisziplinären Ansatz der Arthrosetherapie ist.

Electrical Bioimpedance Analysis for Evaluating the Effect of Pelotherapy on the Human Skin: Methodology and Experiments.

BACKGROUND: Pelotherapy is the traditional procedure of applying curative muds on the skin's surface-shown to have a positive effect on the human body and cure illnesses. The effect of pelotherapy is complex, functioning through several mechanisms, and depends on the skin's functional condition. The current research objective was to develop a methodology and electrodes to assess the passage of the chemical and biologically active compounds of curative mud through human skin by performing electrical bioimpedance (EBI) analysis. METHODS: The methodology included local area mud pack and simultaneous tap water compress application on the forearms with the comparison to the measurements of the dry skin. A custom-designed small-area gold-plated electrode on a rigid printed circuit board, in a tetrapolar configuration, was designed. A pilot study experiment with ten volunteers was performed. RESULTS: Our results indicated the presence of an effect of pelotherapy, manifested by the varying electrical properties of the skin. Distinguishable difference in the measured real part of impedance (R) emerged, showing a very strong correlation between the dry and tap-water-treated skin (r = 0.941), while a poor correlation between the dry and mud-pack-treated skin (r = 0.166) appeared. The findings emerged exclusively in the frequency interval of 10 kHz …1 MHz and only for R. CONCLUSIONS: EBI provides a promising tool for monitoring the variations in the electrical properties of the skin, including the skin barrier. We foresee developing smart devices for promoting the exploitation of spa therapies.

Assessment of barium diffusion from therapeutic mud wrapped in micro-perforated polyethylene bags towards the human organism.

Barium is present within the clay-derived therapeutic mud packs deposed on the patient's skin for treating some rheumatologic conditions. We studied in twenty-four young healthy volunteers the diffusion of Ba from mud wrapped in micro-perforated polyethylene bags and soaked in mineral water. No significant systematic increase in plasma or urine Ba levels was evidenced when comparing pre- and post-treatment samples using inductively-coupled plasma mass spectrometry. These levels were markedly inferior to the recommended thresholds in nearly all the participants. Noticeably variability in blood and especially urine Ba concentrations was large and mainly explained by environmental exposure (alimentation). Interestingly, we evidenced an intense Ba accumulation within the therapeutic mud at the end of the regimen. Because we chose a clay with one of the highest Ba content available in France for medical therapy and participants with an optimal transcutaneous diffusion capacity (young individuals with low-fat mass), we conclude unambiguously that there is no risk of Ba overexposure in patients receiving pelotherapy according to the procedure used in French medical spas.

Geochemical and mineralogical characterization of Ria de Aveiro (Portugal) saltpan sediments for pelotherapy application.

The present study aims to characterize sediments textural, geochemical and mineralogical composition used in a SPA for pelotherapy applications. Six samples were collected in two areas of an open-air saline SPA, a former saltpan in Ria de Aveiro (Portugal). Sampling areas are predominantly composed by recent alluvium that had been affected by chemical industrial effluents for over 50 years. Samples < 2000, 63, and 2 µm fractions were analyzed by X-ray Diffraction (XRD) and X-ray Fluorescence (XRF), for identification of mineral phases and chemical composition. SEM analysis was used for individual particles morphological characterization and chemical semi-quantification. Texture, mineral phases and chemical composition showed the influence of SPA pond beneficiation works. The two SPA areas revealed distinct mineral phases, one with higher quartz content, and the other with higher halite content, consistent with their environmental conditions. Illite constituted the most abundant mineral phase of the clay fraction. Preliminary results suggested concentrations of potential toxic elements (e.g., As, Cd) above reference values, representing a risk to the ecosystem and humans.

Geoterapia no tratamento da dor crônica / Geotherapy in the treatment of chronic pain

Introdução: A argila é um material natural, terroso, proveniente do solo e é composta por argilominerais que conferem características próprias para a argila e formam diferentes tipos desse material com diferentes colorações. A geoterapia é uma técnica que está incluída na Política Nacional de Práticas Integrativas (PNPIC) que utiliza a aplicação da argila sobre a pele com diversas finalidades, como na saúde e na estética, existem relatos de que a geoterapia é uma técnica que pode ser utilizada no tratamento da dor crônica, devido aos diferentes argilominerais presentes nela que teriam capacidade anti-inflamatória e analgésica. Este estudo teve como objetivo verificar se a geoterapia é uma técnica eficiente no tratamento da dor crônica. Métodos: Trata-se de uma revisão de literatura que foi realizada no período de agosto a novembro de 2022. Foi realizada uma busca nas bases de dados de publicação científica PubMed, MEDLINE, LILACS e ScieELO que incluiu todos os trabalhos, exceto os de revisão, que utilizaram a aplicação da argila como tratamento para a dor crônica, para isso foram utilizados os descritores: "geoterapia", "argiloterapia", "argila medicinal", "dor crônica" e "dor", bem como suas respectivas traduções para o inglês e espanhol, utilizando os operadores booleanos "AND" e "OR". Resultados e Discussão: A busca retornou um resultado de 76 publicações, das quais 3 foram excluídas por estarem duplicadas, 60 publicações foram excluídas na triagem inicial, 4 foram excluídas por serem trabalhos de revisão e 3 publicações foram excluídas após a leitura na íntegra. Um total de 6 publicações foram incluídas no estudo para análise da revisão de literatura. Todos os estudos incluídos demonstraram efeitos positivos da geoterapia no tratamento da dor crônica com resultados estatísticos significativos. Considerações Finais: Apesar de todas as publicações demonstrarem que a geoterapia foi positiva no tratamento da dor crônica, mais estudos necessitam ser feitos a fim de contribuir para a produção científica dessa prática devido a quantidade e características dos estudos analisados.

Fibrous Clays in Dermopharmaceutical and Cosmetic Applications: Traditional and Emerging Perspectives.

Functionalization of natural clay minerals for high value-added pharmaceutical and cosmetic applications receives significant research attention worldwide attributable to a rising demand and ongoing search for green, efficient, economically sustainable and ecofriendly geomaterials. Fibrous clays, i.e. palygorskite and sepiolite, are naturally-occurring hydrated magnesium aluminum silicate clay minerals with 2:1 layer-chain microstructure and one-dimensional nanofibrous morphology. Due to their unique structural, textural and compatibility features, over the past decade, fibrous clays and their organic modified derivatives are increasingly used in the dermopharmaceutical and cosmetic fields as excipients, active agents or nanocarriers to develop novel skin delivery systems or to modify drug release profile for enhanced health effects. This comprehensive review presents the up-to-date information on fibrous clays used in topically-applied products for therapeutic and cosmetic purposes with the focus on their performance-related structural characteristics and the underlying mechanisms. The recent advancement of fibrous clay-based skin delivery systems was summarized in wide range of applications including pelotherapy, wound healing, antimicrobial action, coloration and UV protection. An overview of the commonly used topically-applied dosage forms (powders, hydrogels, films, peloids and Pickering emulsion) as well as the toxicological aspects was also included, which might provide guidance to the design and development of fibrous clay-based skin delivery systems.

Comparison of the efficacies of peloid therapy and paraffin treatment given as an adjuncts to exercise therapy in patients with hallux rigidus: a randomized, uncontrolled, prospective study.

Although it is thought that peloid and paraffin treatments may have positive effect on pain, functional status, and quality of life in patients with hallux rigidus (HR), there are no comprehensive and comparative studies with a high level of evidence. We aimed to compare peloid and paraffin treatments in symptomatic hallux rigidus patients. A total of 113 patients diagnosed with HR between May 2019 and June 2021 were included in the study. After exclusion criteria, the remaining 90 patients were randomly divided into two groups: the peloid therapy group (peloid therapy + home exercise) and the paraffin therapy group (paraffin therapy + home exercise). Peloid and paraffin treatments were applied for 2 weeks (5 days a week for a total of 10 sessions). Patients were evaluated before treatment, at the end of treatment, and one month after treatment. The groups were compared in terms of pain, functional status, quality of life, and joint range of motion. In the final analysis, 40 patients in each treatment group were compared. Statistically significant improvements were achieved for all parameters at the end of treatment and at follow-up, and the treatments were found to be highly effective. As a result of the comparison, the methods were not found to be superior to each other. The present study is the first randomized study comparing peloid therapy and paraffin therapy given as an adjuncts to exercise therapy. Exercise therapy plus peloid and exercise therapy plus paraffin treatments seem to have similar effects on HR; however, controlled trials are necessary for confirmation of our results.

Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial.

OBJECTIVES: Mud pack or compress is an easily accessible, cost-effective, efficient treatment modality used in naturopathy to manage and prevent various chronic illnesses. This study sought to elucidate the effectiveness of cold spinal mud packs on improving neuro-cardiac parameters among hypertensive individuals. METHODS: A total of 100 hypertensive subjects aged 30-50 years were randomly allocated into two groups: Cold spinal mud pack (CSMP) and prone rest. Blood Pressure (BP) and Heart Rate Variability (HRV) were assessed at three-time points: Baseline, After 20 min (T1), After 60 min (T2). This single-blinded randomized controlled trial was registered in the Clinical Trials Registry-India (CTRI/2019/12/022492). RESULTS: After 20 min of CSMP showed a statistically significant reduction (p<0.01) in mean values of Systolic BP, Diastolic BP, and in HRV attained statistically significant change (p<0.01) in mean score in the frequency domain except for Very low-frequency power (VLF) and a significant difference found in the mean score of time-domain values (p<0.01) when compared to control group and 95% confidence interval (CI) will be provided for each effect. CONCLUSIONS: CSMP reduces the sympathetic tone and shifts the sympathovagal balance in favor of parasympathetic dominance, contributing to a decrease in BP and effective changes in components of HRV.

Comparison of the effectiveness of peloid therapy and kinesio taping in tennis elbow patients: a single-blind controlled study.

This study aimed to compare the peloid therapy and kinesio tape treatments in chronic lateral epicondylitis. While home exercise program and cold application were applied to the control group, peloid therapy (5 days a week for 3 weeks at 45 °C for 30 min each day, a total of 15 treatment days) was applied in addition to the first group, and kinesio taping (6 treatment days 2 times a week) was applied to the second group. Patients were evaluated with visual analog scale (VAS), grip strength with Jamar hydraulic dynamometer, Arm, Shoulder, and Hand Disabilities (DASH), quality of life in Short Form-36 (SF-36), and Patient-Rated Forearm Evaluation Questionnaire (PRFEQ) was recorded before treatment, after treatment (third week), and 1 month after the end of treatment. In this study, 156 patients with chronic lateral epicondylitis were included. In the follow-up of the patients, there was a statistically significant improvement in the hand grip strength, DASH, PRFEQ, VAS, and SF-36 scores in the 1st month follow-up after the treatment compared to the pre-treatment control in all groups (p < 0.001). At the end of the treatment, the hand grip strength (p = 0.002), DASH (p < 0.001), PRFEQ pain (p < 0.001) and function (p = 0.007), SF-36 physical health (p = 0.002) scores were statistically significant in the peloid therapy group compared to the control group. At the 1st month after the end of treatment, hand grip strength, VAS, DASH, PRFEQ pain, function, daily activities, and SF-36 physical health scores (all of p < 0.001) were statistically significant in the peloid treatment group compared to the control group. Peloid treatment was found to be more effective than kinesio taping in SF-36 physical health (p = 0.007) and PRFEQ pain (p = 0.003) scores in the 1st month follow-up after treatment. Peloid therapy in addition to exercise seems more effective in chronic lateral epicondylitis. Randomized controlled long-term studies are needed.ClinicalTrials ID: NCT04687943.

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.

Mud Pack With Menthol and Arnica Montana Accelerates Recovery Following a High-Volume Resistance Training Session for Lower Body in Trained Men.

ABSTRACT: Bartolomei, S, Nigro, F, D'Amico, A, Cortesi, M, and Di Michele, R. Mud pack with menthol and Arnica montana accelerates recovery following a high-volume resistance training session for lower body in trained men. J Strength Cond Res 36(7): 1909-1915, 2022-The aim of this study was to compare the effects of a mud pack, containing menthol and Arnica montana, on the recovery responses following a high-volume resistance protocol. Ten resistance-trained men (mean ± SD: age = 25.3 ± 6.1 years; body mass = 79.1 ± 10.6 kg; height = 178.9 ± 7.5 cm) performed a high-volume resistance workout for lower body squat and leg extension, (5 sets of 10 reps at 70% of one repetition maximum for both exercises). All the subject used mud (MUD) or a placebo (PL) in randomized counterbalanced crossover design. MUD or PL were applied 4 times: 3, 19, 27, and 45 hours after the workout, on the skin surface above the quadriceps muscle of both legs. Muscle performance (countermovement jump power [CMJP], isokinetic leg press at 75 cm·s-1 and 25 cm·s-1 [ISOK75 and ISOK25, respectively], isometric squat [ISQ]), and morphology (muscle thickness of vastus lateralis [VLMT]), were measured before exercise (baseline [BL]), and 15 minutes (15P), 24 hours (24P), and 48 hours (48P) postexercise. In addition, muscle soreness was assessed at the same time points using a visual analog scale (VAS). No significant interactions (p > 0.05) between the trials were detected for CMJP, ISOK75, ISQ, and VLMT. A significant interaction between trials was noted for ISOK25 (p = 0.022) and for VAS (p = 0.001). ISOK25 was significantly (p < 0.01) reduced from BL at 15P, 24P and 48P in PL, whereas changes were significant (p < 0.05) at 15P and 24P only in MUD. The present findings indicate that MUD may enhance the recovery rate of strength and reduce muscle soreness after high-volume exercise. Muscle morphology do not seem to be influenced by mud packs.

Microalgal Peloids for Cosmetic and Wellness Uses.

Peloids have been used for therapeutic purposes since time immemorial, mainly in the treatment of locomotor system pathologies and dermatology. Their effects are attributed to their components, i.e., to the properties and action of mineral waters, clays, and their biological fraction, which may be made up of microalgae, cyanobacteria, and other organisms present in water and clays. There are many studies on the therapeutic use of peloids made with microalgae/cyanobacteria, but very little research has been done on dermocosmetic applications. Such research demonstrates their potential as soothing, regenerating, antioxidant, anti-inflammatory, and antimicrobial agents. In this work, a method for the manufacture of a dermocosmetic peloid is presented based on the experience of the authors and existing publications, with indications for its characterization and study of its efficacy.

[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.

Efficacy of mud plus bath therapy as compared to bath therapy in osteoarthritis of hands and knees: a pilot single-blinded randomized controlled trial.

The primary objective of this study was to assess the efficacy of mud plus bath therapy in comparison to bath therapy alone in hand and knee osteoarthritis (HOA and KOA). We conducted a single-blinded randomized controlled trial (RCT). Patients were randomly assigned to either mud plus bath therapy (group 1) or balneotherapy (group 2). The primary outcome was a change in AUSCAN questionnaire for HOA and in WOMAC for KOA at month 12. Evaluations were performed at baseline (B), immediately after the interventions (week 2, W2) and after 3 (M3), 6 (M6), 9 (M9) and 12 (M12) months. 37 patients with KOA and 52 with HOA were randomized in the study. In HOA patients, AUSCAN pain improved more in group 1 compared to group 2 at M3, M6 and M12 (p<0.001, p=0.001 and p=0.038, respectively). AUSCAN stiffness improved more in group 1 at M3 (p=0.001). AUSCAN function improved more at M3, M6, M9 and M12 (p=0.001, p=0.001, p=0.014 and p=0.018, respectively). Regarding, KOA, WOMAC function decreased more prominently in group 1 compared to group 2 at M9 (p=0.007). The absolute values of WOMAC function at M6 and M9 were lower in group 1 compared to group 2 (p=0.029 and p=0.001, respectively). WOMAC pain absolute values were lower in group 1 at W2 (p=0.044) and at M9 (p=0.08). We conducted a RCT on the efficacy of mud plus balneotherapy over balneotherapy alone in HOA and KOA. We found that mud plus balneotherapy was more effective than balneotherapy alone on clinical outcomes of HOA. Differences in clinical outcomes of KOA were not significant, yet numerically higher.

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.

Mineralogical, thermal and rheological characterization of some Tunisian green commercial clays and possible application as peloids with thermal and sea waters.

Many of therapeutic treatments in spas are concentrated on mud therapy. Clays are included in the formulation of thermal mud as vehicles of the mineral medicinal water. To be suitable for therapeutic use, some mineralogical, rheological and thermal properties should be respected in order to be topically applied. Our objective is to explore the suitability of three Tunisian commercial green clays traditionally used as facial and body masks by women in the region of Douiret (CD), Tozeur (CT) and Korbous (CK) in terms of their physicochemical structure chemical composition, heavy metals risk assessment, thermal properties, plasticity, rheology and their potential application as peloid with distilled and sodium chloride-rich sulfated thermal waters from hot spring in the region of hammam Lif and Korbous and sea waters. The mineralogy of samples (clay fraction and associated minerals) was determined by X-ray powder diffraction and FT-IR analysis, and the chemical composition was obtained by ICP. The main clay fraction of the samples was smectite and illite with significant amount of kaolinite. Regarding their mineralogical properties, the samples with a high amount of smectite fraction are more suitable for use in Tunisian spas and for the application as peloids. The thermal analyses of clay powders shows a specific heat value comparable to those use used in spas. Also the muds showed a low cooling rate which is necessary for therapeutic use. Rheological properties of peloids prove their thixotropic characteristics.