Salt water and skin interactions: new lines of evidence

Biophysical effects of a natural peloid on normal skin

A protocol study was designed to examine cutaneous behavior after continuous application of a peloid in the dry mineral residue of Lanjarón-Capuchina natural mineral water. This study aims to analyze the biomechanical behavior of normal skin using various non-invasive bioengineering techniques after the application of this peloid. We determine the effects of its application for 3 months on 38 healthy volunteers (41.4 ± 5.9 years, range 32-58) without a previous history of skin diseases by courtmetry, sebumetry, pH-metry, reviscometry, and tewametry. It was shown that the production of cutaneous sebum is significantly reduced by 6%, trans epidermal skin loss (TEWL) by 21%, skin fatigue by 30%, elasticity increased by 19%, firmness by 5%, and a skin redensification by 6% was obtained under these experimental conditions. Disparate and non-significant results were obtained concerning pH and viscoelasticity. Continuous skin care with the Lanjarón-Capuchina natural peloid modifies skin behavior, normalizing sebaceous secretion, favoring the biomechanical properties of the skin and the skin barrier function without modifying skin homeostasis.

The visual perception of wetness: Multisensory integration of visual and tactile stimuli

A multitude of sensory modalities are involved in humans' experience of wetness, yet we know little of the integratory role of vision. Therefore, the aim was to quantify the effect of physical stain volume, chroma and size on wetness perception, and to compare wetness perception under different sensory conditions, including visuotactile and visual only interactions. Eighteen participants visually observed and/or used their index fingerpad to dynamically interact with stimuli varying in physical wetness (0, 2.16 × 10-4 or 3.45 × 10-4 ml mm-2), stain chroma (clear, light, dark) and stain size (1150 or 5000 mm2). After interaction participants rated wetness perception using a visual analogue scale (very dry to very wet). In visual only conditions participants were able to differentiate between dry and wet stimuli, and could also discriminate between different magnitudes of wetness with the addition of tactile cues. In both visual only and visuotactile conditions greater stain chroma resulted in increased wetness perception. Stain size did not have a significant effect in either condition. These results show that visual cues influence wetness perception (R2 = 0.29), but indicate that visual dominance does not apply in these sensory integrations. Findings are relevant for the design of products with wetness management properties.

Bioaccessibility by perspiration uptake of minerals from two different sulfurous peloids

The risks associated with the use of peloids in thermal centers, spas, or at home, must be tested to develop appropriate safety guidelines for peloids formulations and the release of substances of high concern. Additionally, the beneficial effects of some elements on human health should be assessed to aid in interpreting the therapeutic action and effectiveness of pelotherapy on dermatological or osteomuscular disorders. Therefore, a methodology was developed to better understand the biogeochemical behavior of the elements in formulated peloids. Two peloids were formulated with the same clay and two different sulfurous mineral-medicinal waters for 90 days, with light stirring every 15 days. Bentonite clay, with a high content of smectite and Ca and Mg as the main exchangeable cations, and high heat capacity, was used. The selected mineral-medicinal waters were collected from two Portuguese thermal centers with recognized therapeutic efficacy for rheumatic, respiratory and dermatological pathologies. The peloids were used without drying and withdrawn directly from the maturation tank, and a mixture of bentonite and demineralized water was prepared as a reference sample. A stabilized, ready-to-use, artificial perspiration test was used to simulate the peloids' interaction with skin. Thirty-one elements extracted from the two prepared peloids were analyzed using ICP-MS. The data were analyzed and related to the mineralogical composition of the original clay and supernatant composition of the maturation tanks. The content of some potentially toxic elements and metals' bioaccessibility by perspiration showed very low solubility and undetectable amounts extracted from the studied samples. This analytical method provided reliable information on dermal exposure and the identification of some elements that may enter the systemic circulation, requiring implementation of surveillance and control measures.

A Novel Approach to Assess Balneotherapy Effects on Musculoskeletal Diseases-An Open Interventional Trial Combining Physiological Indicators, Biomarkers, and Patients' Health Perception

The present study aimed to evaluate whether a 14-day period of balneotherapy influences the inflammatory status, health-related quality of life (QoL) and quality of sleep, underlying overall health state, and clinically relevant benefits of patients with musculoskeletal diseases (MD). The health-related QoL was evaluated using the following instruments: 5Q-5D-5L, EQ-VAS, EUROHIS-QOL, B-IPQ, and HAQ-DI. The quality of sleep was evaluated by a BaSIQS instrument. Circulating levels of IL-6 and C-reactive protein (CRP) were measured by ELISA and chemiluminescent microparticle immunoassay, respectively. The smartband, Xiaomi MI Band 4, was used for real-time sensing of physical activity and sleep quality. MD patients improved the health-related QoL measured by 5Q-5D-5L (p < 0.001), EQ-VAS (p < 0.001), EUROHIS-QOL (p = 0.017), B-IPQ (p < 0.001), and HAQ-DI (p = 0.019) after balneotherapy; the sleep quality was also improved (BaSIQS, p = 0.019). Serum concentrations of IL-6 were markedly decreased after the 14-day balneotherapy (p < 0.001). No statistically significant differences were observed regarding the physical activity and sleep quality data recorded by the smartband. Balneotherapy may be an effective alternative treatment in managing the health status of MD patients, with a decrease in inflammatory states, along with positive effects on pain reduction, patient's functionality, QoL, quality of sleep, and disability perception status.

The Biological Role of Dead Sea Water in Skin Health: A Review

Applying natural mineral water to skin care is a popular tendency and many cosmetics products based on thermal spring water have been developed. The special location and environmental conditions provide Dead Sea water (DSW) with unique ion composition and concentrations, which bring comprehensive positive effects on skin health. This article reviews two potential action modes of DSW, and the biological function of DSW and its related complex in dermatology and skin care. Previous studies have proved the functions of skin moisturization, anti-inflammation, skin barrier repair, and anti-pollution. Especially, the anti-aging effect of DSW and related complexes can act in three different ways: keratinocyte rejuvenation, photo-protection, and cellular energy elevation. Additionally, the issues that need further investigation are also discussed. We hope that this review will help to improve the understanding of DSW and its related complex, and further contribute to product development in the skincare industry.

Property of mud and its application in cosmetic and medical fields: a review

Mud is a semi-colloidal substance formed by the mixture of inorganic, organic and water under the influence of various physical and chemical factors through geological and biological processes. The chemical composition of mud is complex, rich in Ca²⁺, Zn²⁺, Mg²⁺, Na⁺ and other mineral elements, also contains organic matter such as humic acid, fulvic acid and acetic acid. In cosmetic field, mud can improve the activity of glutathione enzyme and superoxide dismutase in skin, which helps the skin anti-aging. Besides, it also can improve the skin microbial community, due to its distinctively physical properties, mineral ions, microorganisms, etc. In medical field, mud can treat osteoarthritis, especially knee osteoarthritis which has been studied extensively, and it can also increase the chemotaxis of macrophages. On the one hand, the use of clay (a kind of refined mud) can protect the gastrointestinal tract and treat some gastrointestinal diseases. On the other hand, clay is often used as carriers or composites in drug delivery, especially in skin drug delivery, showing very positive results. The purpose of this review is to present an overview of current knowledge about the application of mud in cosmetic and medical fields and to provide ideas for further research in mud.

Balneotherapy and Health-related Quality of Life in Adults with Knee Osteoarthritis: a Prospective Observational Study Into a Real Clinical Practice Condition

Aim: To analyze the influence of balneotherapy applied in conditions of real clinical practice in Fitero’s Thermal Station (Spain) on HRQoL in adults with KOA. Materials and Methods: This was a prospective observational study conducted under conditions of real clinical practice with a 9-month follow-up. The individuals were beneficiaries of the Spanish social thermalism programme. A total of 10 sessions were prescribed, individually, considering the clinical situation and preferences of each participant. In all cases, 10 bath sessions were administered, along with other techniques. The clinical assessments were conducted before initiating the balneotherapy and 1, 3, 6 and 9 months after. The main variable was HRQoL (Euroqol 5D-5L; WOMAC). The statistical analysis was performed by intention to treat. Results: The study included 71 users. At 6 months, improvements were found in the following dimensions of the WOMAC questionnaire: pain (24.47%), stiffness (30.75%) and functional capacity (26.66%) (p<0.05). Pain and anxiety/depression showed statistically significant differences in the EQ 5D-5L throughout the study. Conclusions: HRQoL in KOA would improve with the Balneotherapy, prevailing the effects for up to 6 months. The absence of adverse effects and the ease of completing the treatment provided by the Spanish social thermalism system make this treatment feasible.

A Review on Therapeutic Potential of Natural Phytocompounds for Stroke

Stroke is a serious condition that results from an occlusion of blood vessels that leads to brain damage. Globally, it is the second highest cause of death, and deaths from strokes are higher in older people than in the young. There is a higher rate of cases in urban areas compared to rural due to lifestyle, food, and pollution. There is no effective single medicine for the treatment of stroke due to the multiple causes of strokes. Thrombolytic agents, such as alteplase, are the main treatment for thrombolysis, while multiple types of surgeries, such ascraniotomy, thrombectomy, carotid endarterectomy, and hydrocephalus, can be performed for various forms of stroke. In this review, we discuss some promising phytocompounds, such as flavone C-glycoside (apigenin-8-C-β-D-glucopyranoside), eriodictyol, rosamirinic acid, 6″-O-succinylapigenin, and allicin, that show effectiveness against stroke. Future study paths are given, as well as suggestions for expanding the use of medicinal plants and their formulations for stroke prevention.

Anti-inflammatory effects of free and liposome-encapsulated Algerian thermal waters in RAW 264.7 macrophages

The main objectives of this work were to formulate liposomes encapsulating highly mineralized thermal waters (TWs) and to study anti-inflammatory effect of free and encapsulated thermal waters on RAW 264.7 macrophage cells stimulated with lipopolysaccharide (LPS). TWs-loaded conventional and deformable liposomes (TWs-Lip and TWs-DLip) were prepared by sonication and extrusion, respectively. They were considered for their vesicle size, zeta potential, entrapment efficiency, physical stability and in vitro anti-inflammatory effect. Formulated liposome suspensions have a low polydispersity and nanometric size range with zeta potential values close to zero. The vesicle size was stable for 30 days. Entrapment efficiency of TWs was above 90% in conventional liposomes and 70% in deformable liposomes. Pretreatment of LPS-stimulated murine macrophages, with free and liposome-encapsulated TWs, resulted in a significant reduction in nitric oxide (NO) production and modulated tumor necrosis factor-α (TNF-α) production suggesting an anti-inflammatory effect which was even more striking with TWs-Lip and TWs-DLip. Liposome formulations may offer a suitable approach for transdermal delivery of TWs, indicated in inflammatory skin diseases.

The economic and social value of spa tourism: The case of balneotherapy in Maresme, Spain

The aim of this article is to assess both the economic and social value of balneotherapy and spa tourism, being the first paper in carrying out this analysis. The study has been conducted in Maresme, a region of Catalonia, Spain. On the one hand, an Input-Output (IO) model with a Social Accounting Matrix (SAM) has been carried out to assess the economic value. On the other hand, a Cost-Benefit Analysis (CBA) has been used to monetise the social value in this region, taking into account, among other concepts, direct and indirect health profits, given that balneotherapy helps to alleviate various diseases. The results show that whereas the economic multiplier is 1.529 considering the direct and indirect effects and 1.712 taking into account also the induced effects, which are similar to health and medical tourism multipliers, social value generates additional positive value, given that the cost-benefit ratio is 1.858. The theoretical implications of the paper as well as the findings' implications for policy so as to encourage investments in spa tourism are discussed.

The role of friction on skin wetness perception during dynamic interactions between the human index fingerpad and materials of varying moisture content

Mechanosensory inputs arising from dynamic interactions between the skin and moisture, such as when sliding a finger over a wet substrate, contribute to the perception of skin wetness. Yet, the exact relationship between the mechanical properties of a wet substrate, such as friction, and the resulting wetness perception remains to be established under naturalistic haptic interactions. We modeled the relationship between mechanical and thermal properties of substrates varying in moisture levels (0.49 × 10⁻⁴; 1.10 × 10⁻⁴; and 2.67 × 10⁻⁴ mL·mm⁻²), coefficient of friction (0.783, 0.848, 1.033, 0.839, 0.876, and 0.763), and maximum thermal transfer rate (Q_max, ranging from 511 to 1,260 W·m⁻²·K⁻¹), and wetness perception arising from the index finger pad’s contact with such substrates. Forty young participants (20M/20F) performed dynamic interactions with 21 different stimuli using their index finger pad at a controlled angle, pressure, and speed. Participants rated their wetness perception using a 100-mm visual analog scale (very dry to very wet). Partial least squares regression analysis indicated that coefficient of friction explained only ∼11% of the variance in wetness perception, whereas Q_max and moisture content accounted for ∼22% and 18% of the variance, respectively. These parameters shared positive relationships with wetness perception, such that the greater the Q_max, moisture content, and coefficient of friction, the wetter the perception. We found no differences in wetness perception between males and females. Our findings indicate that although the friction of a wet substrate modulates wetness perception, it is still secondary to thermal parameters such as Q_max.

NEW & NOTEWORTHY Our skin often interacts with wet materials, yet how their physical properties influence our experience of wetness remains poorly understood. We evaluated wetness perception following naturalistic haptic interactions with materials varying in moisture content, friction, optical profiles, and heat transfer rates. We show that although mechanical parameters can influence wetness perception, their role is secondary to that of thermal factors. These findings expand our understanding of multisensory integration and could guide innovation in healthcare product design.

Cellular and Molecular Targets for Non-Invasive, Non-Pharmacological Therapeutic/Rehabilitative Interventions in Acute Ischemic Stroke

BACKGROUND

Cerebral circulation delivers the blood flow to the brain through a dedicated network of sanguine vessels. A healthy human brain can regulate cerebral blood flow (CBF) according to any physiological or pathological challenges. The brain is protected by its self-regulatory mechanisms, which are dependent on neuronal and support cellular populations, including endothelial ones, as well as metabolic, and even myogenic factors.

OBJECTIVES

Accumulating data suggest that "non-pharmacological" approaches might provide new opportunities for stroke therapy, such as electro-/acupuncture, hyperbaric oxygen therapy, hypothermia/cooling, photobiomodulation, therapeutic gases, transcranial direct current stimulations, or transcranial magnetic stimulations. We reviewed the recent data on the mechanisms and clinical implications of these non-pharmaceutical treatments.

METHODS

To present the state-of-the-art for currently available non-invasive, non-pharmacological-related interventions in acute ischemic stroke, we accomplished this synthetic and systematic literature review based on the Preferred Reporting Items for Systematic Principles Reviews and Meta-Analyses (PRISMA).

RESULTS

The initial number of obtained articles was 313. After fulfilling the five steps in the filtering/selection methodology, 54 fully eligible papers were selected for synthetic review. We enhanced our documentation with other bibliographic resources connected to our subject, identified in the literature within a non-standardized search, to fill the knowledge gaps. Fifteen clinical trials were also identified.

DISCUSSION

Non-invasive, non-pharmacological therapeutic/rehabilitative interventions for acute ischemic stroke are mainly holistic therapies. Therefore, most of them are not yet routinely used in clinical practice, despite some possible beneficial effects, which have yet to be supplementarily proven in more related studies. Moreover, few of the identified clinical trials are already completed and most do not have final results.

CONCLUSIONS

This review synthesizes the current findings on acute ischemic stroke therapeutic/rehabilitative interventions, described as non-invasive and non-pharmacological.

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.

[Climate-therapy at seaside resorts in modern medical and wellness practice]

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.

Skin wetness detection thresholds and wetness magnitude estimations of the human index fingerpad and their modulation by moisture temperature

Humans often experience wet stimuli using their hands, yet we know little on how sensitive our fingers are to wetness and the mechanisms underlying this sensory function. We therefore aimed to quantify the minimum amount of water required to detect wetness on the human index fingerpad, the wetness detection threshold, and assess its modulation by temperature. Eight blinded participants (24.0 ± 5.2 yr; 23.3 ± 3.5 body mass index) used their index fingerpad to statically touch stimuli varying in volume (0, 10, 20, 30, 40, or 50 mL) and temperature (25, 29, 33, or 37°C). During and after contact, participants rated wetness and thermal sensations using a modified yes/no task and a visual analog scale. The wetness detection threshold at a moisture temperature akin to human skin (33°C) was 24.7 ± 3.48 mL. This threshold shifted depending on moisture temperature (R = 0.746), with cooler temperatures reducing (18.7 ± 3.94 mL at 29°C) and warmer temperatures increasing (27.0 ± 3.04 mL at 37°C) thresholds. When normalized over contact area, the wetness detection threshold at 33°C corresponded to 1.926 × 10⁻⁴ mL·mm⁻² [95% confidence interval (CI): 1.873 × 10⁻⁴, 1.979 × 10⁻⁴ mL·mm⁻²]. Threshold differences were reflected by magnitude estimation data, which were analyzed using linear regression to show that both volume and moisture temperature can predict magnitude estimations of wetness (R = 0.949; R = 0.179). Our results indicate high sensitivity to wetness in the human index fingerpad, which can be modulated by moisture temperature. These findings are relevant for the design of products with wetness management properties.

NEW & NOTEWORTHY The perception of wetness is a fundamental sensory experience which underpins many aspects of life, from homeostasis to enjoyable experiences. Although previous research has highlighted the importance of cold sensations in human wetness perception, the maximum sensitivity of our wetness sensing system remains to be established. This research presents a novel methodology, which for the first time, has quantified the high sensitivity of the human index fingerpad to wetness and its modulation by moisture temperature.

The effect of warm salt water foot bath on the management of chemotherapy-induced fatigue

PURPOSE

Several studies have shown that the warm water bath can be a beneficial approach in the management of fatigue. This experimental study was conducted to evaluate the effect of warm salt water foot bath in the management of chemotherapy-induced fatigue.

METHODS

This randomized controlled trial was perfomed between November 2017-February 2018. Seventy five patients who experienced moderate or higher level chemotherapy related fatigue were randomly assigned to the intervention or control group. A training booklet about chemotherapy-induced fatigue was given to all patients. In addition, the experimental group performed 20 min warm salt water footbath for a week. The primary outcome was the change in fatigue level over 7 days after chemotherapy. The secondary outcome was the difference in physical, affective, emotional, and cognitive fatigue scores of patients.

RESULTS

The level of fatigue was grade 2 and grade 3 for 65.3% and 33.3% of patients, respectively. There was no statistically significant difference between groups regarding the mean of total fatigue score before and after bath (p > 0.05). However, the amount of decrease observed in the experimental group was found to be statistically significantly higher than the control group (p = 0.012; p < 0.05). In addition; the score in behavioral/severity, sensory, affective and cognitive dimensions related to fatigue decreased in the experimental group but did not decrease in the control group.

CONCLUSION

This study shown that warm salt water footbath can be an effective approach in enhancing fatigue related quality of life cancer patients. More studies should be conducted to assess the effectiveness of this intervention.

Effects of Sodium Chloride-Rich Mineral Water on Intestinal Epithelium. Experimental Study

Since knowledge concerning the cellular and tissue substrate that explains the therapeutic action of mineral waters is generally very scarce, we address the different effects that Lanjarón-Capuchina mineral water exerts on the intestinal epithelium in an experimental model as a prototype of the sodium chloride-rich mineral waters used in digestive disorders. In the experimental protocol, two groups of five adult Wistar rats received unrestricted mineral water in their diet or mineral water directly into the gastrointestinal tract through a catheter. A third control group was given a standard diet and water ad libitum. Intestinal samples for scanning electron microscopy were analyzed according to standardized methods. The observations carried out by microscope after the administration of the sodium chloride-rich mineral water clearly indicate that the hypertonic action of this mineral water affects the structure of the intestinal epithelium. It modifies the microvilli absorption in terms of the groups of enterocytes and the secretion of goblet cells, but it particularly affects the epithelial renewal process, accelerating and stimulating cell extrusion. The type of extrusion mechanism observed by microscope allows us to affirm that, although this increased after direct administration, it does not generate an epithelial disruption as it occurs in other circumstances with other extrusion modalities.

Chemical and mineralogical characteristics of peloids in Turkey

To investigate the physical, chemical, and mineralogical characteristics of peloids, which are being used traditionally and historically across Turkey, and evaluate their suitability and potential for use in peloidotherapy. Five peloid samples were gathered from their places of origin, namely Gölemezli, Dalyan, Köprüköy, Gökçeada, and Dikili. Mineral analysis and physical and chemical analyses including electrical conductivity, density, cations, anions, trace elements, organic matters, and water retention capacity at 105 °C were performed. The peloids contained a combination of clay minerals (mainly montmorillonite, kaolinite, and muscovite) and non-clay minerals (mainly quartz, calcite, dolomite, and albite) except for Gölemezli peloid, which was dominated by calcite. The other minerals (i.e., chloride-serpentine, sphalerite, pyrite, magnesium calcite, cristobalite) were also found in some peloids. Gölemezli, Dalyan, and Köprüköy peloids had high total organic matters, mainly humic substances. The water retention capacity was high in Dalyan, Köprüköy, and Dikili peloids. All peloids had a pH value slightly greater than 7 (range 7.93-8.69). Dalyan, Köprüköy, and Dikili peloids had a high water retention capacity. Dalyan and Gökçeada peloids had a high electrical conductivity, 22.040 and 9.020 μS/cm, respectively. The density of peloids was ranged between 1.240 (Gölemezli) and 1.450 (Gökçeada) g/cm³. Total mineralization of investigated peloids was greater than 1000 mg/L: Köprüköy, 2754.8 mg/L; Gölemezli, 3092.8 mg/L; Dikili, 4044.6 mg/L; Gökçeada, 6576.6 mg/L; and Dalyan, 11782.9 mg/L, mainly sodium, magnesium, calcium, chloride, sulfate, bicarbonate, and metasilicic acid. The levels of trace elements were low (≤ 2.0 mg/L) in all peloids. The peloids contained various amounts of clay minerals (mainly montmorillonite, kaolinite, and muscovite), non-clay minerals (mainly quartz, calcite, dolomite, and albite), organic matters (mainly humic acid), cations (mainly sodium, magnesium, and calcium), anions (mainly chloride, sulfate, and bicarbonate), and insoluble compounds (mainly metasilicic acid). The physical, chemical, and mineralogical properties of peloids suggest their suitability and potential for use in peloidotherapeutic applications.

Antioxidant, Antimicrobial, and Bioactive Potential of Two New Haloarchaeal Strains Isolated from Odiel Salterns (Southwest Spain)

Simple Summary

Halophilic archaea are microorganisms that inhabit in extreme environments for life, under salt saturation, high temperature and elevated UV radiation. The interest in these microorganisms lies on the properties of their molecules, that present high salt and temperature tolerance, as well as, antioxidant power, being an excellent source of compounds for several biotechnological applications. However, the bioactive properties from haloarcahaea remain scarcely studied compared to other groups as plants or algae, usually reported as good health promoters. In this work we describe the isolation and the molecular identification of two new haloarchaeal strains from Odiel salterns (SW Spain), and the antioxidant, antimicrobial and bioactive potential of their extracts. The results revealed that the extracts obtained with acetone presented the highest activities in the antioxidant, antimicrobial and anti-inflammatory assays, becoming a promising source of metabolites with applied interest in pharmacy, cosmetics and food industry.

Abstract

The need to survive in extreme environments has furnished haloarchaea with a series of components specially adapted to work in such conditions. The possible application of these molecules in the pharmaceutical and industrial fields has received increasing attention; however, many potential bioactivities of haloarchaea are still poorly explored. In this paper, we describe the isolation and identification of two new haloarchaeal strains from the saltern ponds located in the marshlands of the Odiel River, in the southwest of Spain, as well as the in vitro assessment of their antioxidant, antimicrobial, and bioactive properties. The acetone extract obtained from the new isolated Haloarcula strain exhibited the highest antioxidant activity, while the acetone extracts from both isolated strains demonstrated a strong antimicrobial activity, especially against other halophilic microorganisms. Moreover, these extracts showed a remarkable ability to inhibit the enzyme cyclooxygenase-2 and to activate the melanogenic enzyme tyrosinase, indicating their potential against chronic inflammation and skin pigmentation disorders. Finally, the aqueous protein-rich extracts obtained from both haloarchaea exhibited an important inhibitory effect on the activity of the acetylcholinesterase enzyme, involved in the hydrolysis of cholinergic neurotransmitters and related to several neurological diseases.

Sulfurous-arsenical-ferruginous balneotherapy for osteoarthritis of the hand: results from a retrospective observational study

Balneotherapy (BT) is a complementary therapy widely used in several rheumatic conditions, however, the evidence in hand osteoarthritis (HOA) is still scarce. The aim of this preliminary study is to retrospectively evaluate the symptomatic effects of a cycle of mud-bath therapy in HOA patients. Two hundred twelve outpatients with primary bilateral HOA treated with 12 daily local mud packs and generalized thermal baths with a sulfurous-arsenical-ferruginous mineral water added to usual treatment were included in the study. Each patient was examined at baseline and at the end of thermal therapy (2 weeks). Primary outcome measures were global spontaneous hand pain on a Visual Analogue Scale (VAS) and the Functional Index for Hand Osteoarthritis (FIHOA) score; secondary outcomes were handgrip strength, duration of morning stiffness, Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-12), tolerability and patients' and physicians' global impression of treatment efficacy and tolerability. Our results demonstrated that the efficacy of mud-bath therapy was significant in all the assessed parameters at the end of therapy, except for the physical component score of SF-12. The thermal treatment was well tolerated. The patient's and the physician's global assessments showed a high level of satisfaction in terms of efficacy and safety. In conclusion, our results may suggest a short-term effectiveness of mud-bath therapy in controlling pain and improving functionality in HOA patients, supporting the role of this treatment as a complementary strategy in the management of HOA; however, further randomized controlled trials with a long-term follow-up are needed.

Protocols and self-checking plans for the safety of post-COVID-19 balneotherapy

During the COVID-19 pandemics, balneotherapic establishments were closed in Italy like in the rest of Europe. The Italian Foundation for Research in balneotherapy (FoRST) was asked to prepare a safety protocol to be proposed to the National Health Authorities to allow the establishments to restart their activity when possible, under safe conditions (the so-called Phase-2). The group of experts proposed the following hygienic and sanitary protocols of risk management for the initial reopening of the balneology settings in Italy. The plan aims to define the operating procedures to be implemented at the balneology establishments for the beginning of Phase-2 and to keep them constantly updated in the different periods that will characterize Phase-2 in relation to the trends of the disease. To this end the procedures, defined on the basis of the scientific state-of-the-art available today, will be updated and revised from time to time whenever further scientific evidence and directives from the Health Authorities make it necessary and/or useful.

Balneotherapy for musculoskeletal pain: does the mineral content matter?

Musculoskeletal pain is a health challenge with various treatment strategies. The study has been accomplished with the aim to reveal the effect of mineral water with different mineral content on musculoskeletal pain and related symptoms experienced. A randomized controlled single-blinded parallel-group study has been performed (145 participants with pain; 5 groups). The duration of treatment was 2 weeks, whereas follow-up has taken 3 months. Change in pain after a single procedure and the pain parameters with related symptoms during the study period have been measured. The effect size using Cohen's d has been estimated. Small effect (0.2-0.4) on pain has been distinguished after each mineral water procedure. Tap water procedures have been effective in 60% of cases. Twenty grams per liter water baths have had a small effect on pain intensity and tender points, body flexibility, and spinal mobility, and a medium one on sleep quality, and reduced CRP. Forty grams per liter water has had a small effect on pain intensity, frequency, and spinal mobility, and a medium one on flexibility, fatigue, and sleep quality, and reduced ESR. Sixty grams per liter water has had a small effect on pain parameters and fatigue, and a medium one on flexibility and sleep quality, and reduced ESR. The effect lasting up to 2 months has been identified mostly in the 60 g/L group. Tap water has had a short time effect on pain intensity and tender points. There have not been any changes of sufficient significance identified in the control group and any differences between mineral water groups. Sufficient difference between mineral and tap water groups has been determined in pain intensity, spinal mobility, and sleep quality, whereas in the case of the control group, significant difference in pain intensity and frequency, flexibility, and spinal mobility has been identified. The consumption of pain medication has significantly decreased in all mineral water groups. The total mineral content of the water has no significant influence on the reduction of musculoskeletal pain. Mineral water baths have small effect on pain and medium effect on other musculoskeletal disease-related symptoms and pain medication consumption lasting up to 3 months; it is more beneficial than tap water or no treatment for the improvement of symptoms associated with musculoskeletal diseases. Even single balneotherapy procedure results in small pain reduction.

Mud therapy and rehabilitation - scientific relevance in the last six years (2015 – 2020) Systematic literature review and meta-analysis based on the PRISMA paradigm

Abstract Background. Balneotherapy is a stimulation - adaptation treatment method applied in the forms of bathing, drinking, and inhalation cures performed with natural therapeutic factors, a method which is acting in three main ways: thermally, mechanically, and chemically. Mud or peloids are natural therapeutic factors formed by natural processes under the influence of biological and geological phenomena, which in a finely dissolved state and mixed with water (mud) are used in medical practice in the form of baths or local procedures. Objective. This systematic review aims to rigorously select related articles and identify within their content, the main possible uses of therapeutic mud and physiological mechanisms, to see the main region of scientific interest for pelotherapy, and to discuss the value of mud therapy in rehabilitation medicine. Methods. The working method is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for open-access articles published in English, between January 2015 and December 2020, from the following databases: Cochrane, Elsevier, NCBI/PubMed, NCBI/PMC, PEDro, and ISI Web of Knowledge/Science (the latter was also used to identify ISI indexed articles). The contextually searched syntax used was ”Pelotherapy/Peloidotherapy/Mud-therapy/ /Fango-therapy AND Rehabilitation”. The selected articles were analyzed in detail regarding pathologies addressed by mud therapy and country scientific relevance for this therapeutic method. The meta-analysis proceeded was designated to estimate the prevalence of various pathologies in the use of mud therapy. Results. Our search identified, first, 394 articles. Based on the successive filtering stages and, respectively, on the classification criteria of the Physiotherapy Evidence Database (PEDro), we finally identified/retained and analyzed 68 articles. Although, in principle, a rigorous method – and we have followed the PRISMA type paradigm – there still might be some missing works of our related article selection. On the other hand, to augment/ consolidate our documentation base, we have used also 40 papers freely found in the literature, and even – aiming, too, at an as exhaustive knowledge underpinning as possible – derogatively, we have also considered some articles which, probably being very new, couldn't yet have reached the PEDro threshold score we have settled. Conclusions. This paper overviews the current state-of-the-art knowledge in the approach of peloidotherapy in rehabilitation, with a focal point on the therapeutic properties of peloids. Keywords: mud-therapy, pelotherapy, peloidotherapy, fango therapy, rehabilitation, balneotherapy, natural therapeutic factors,

Thalassotherapy today

Introduction. Thalassotherapy has many aspects in common with thermalism or balneotherapy but also some distinctive characteristics. Balneology has a long European and Asian tradition and Romania can be the cornerstone of international bridges in this area due to its geographical position, legendary tradition and extraordinary natural resources of all kind. Each Balneary Resort begins its story with the discovery of natural factors whose therapeutical value has been clinically and experimentally proven by scientific personalities of that time. (1). Material and method. This article is a systematic and summarizing review of all published articles related to the thalassotherapy and thermal medicine subject found in Web of Science Core Collection. The methodological work is focused on the development of a bibliometric study of the literature generated regarding “thalassotherapy” therm. The analysis process followed integrates the use of descriptive-quantitative statistical techniques, which constitute a series of bibiliometric indicators that allow explore the research dynamics followed so far by the scientific community. These bibliometric indicators are numerical data that enable the analysis of diverse features of the scientific activity, linked both to the production and consumption of information and are based on the so-called “bibliometric laws”. Results and discussions. Analyzing an article database can be of real impact on the development of the field of Thalassotherapy but also can drive the future implications in the scientific arena. Conclusions. In balneary tourism, the importance of researching natural resources is essential for the development of a balneary resort promotion plan, thus providing information on the therapeutic properties of natural factors, their contribution to our health and the biological mechanisms by which they act on our body.

Development of biocompatible and fully bioabsorbable PLA/Mg films for tissue regeneration applications

During recent years, Mg reinforced polylactic acid (PLA) composites have emerged as potential biocompatible and bioabsorbable materials for biomedical applications. It has been shown that Mg particles added to a matrix based on a biodegradable polymer can address the lack of bioactivity and the low mechanical properties of the polymers and, furthermore, it can counteract the detrimental effects associated to the high degradation rate of Mg, as alkalinization and elevated H₂ release. Additionally, the polymer can protect the Mg particles, by tailoring their degradation rate. Former processing of these composites performed by extrusion, compression and injection molding employed Mg contents up to 10 wt%. Higher amounts of Mg resulted in heterogeneous materials and thermally degraded matrices, with the corresponding higher degradation rate. In the present work, Mg reinforced PLA films with Mg content as high as 50 wt% were obtained without compromising the thermal stability of the polymer. Firstly, a successful dispersion of Mg microparticles was achieved by a breakthrough in processing introducing a colloidal step where organic additives were added to modify the Mg particle surface and promote a chemically stable suspension. The resulting colloidal suspension was then used as feedstock to obtain composite films by tape casting. The films show advantageous in vitro behaviour in terms of degradation, hydrogen release and oxygen permeability. In addition, the viability with fibroblast cells (MEF) opens a window of opportunity for these composite films as bioabsorbable material for tissue engineering and wound dressing applications. STATEMENT OF SIGNIFICANCE: Magnesium materials have extraordinary biodegradable properties and bioactive behavior due to release of Mg²⁺ ions, which offer a promising opportunity for their applicability as biomaterials for tissue regeneration. However, Mg is one of the most reactive metals with a high degradation rate. In contact with water produces H₂, associated with a risk of failure of the implant. One alternative to minimize this drawback is the use of Mg particles surrounded by a biodegradable biocompatible polymer such as polylactic acid (PLA) to obtain PLA/Mg composites. In this work we processed Mg reinforced PLA in the shape of films that would be suitable for tissue regeneration. In vitro behavior of PLA/Mg films demonstrated that Mg²⁺ ions increase the fibroblast cells growth.

Geothermal water for health state improvement: randomised controlled study

Abstract Introduction. Aim: to evaluate the effect of geothermal water of different mineralization on health state improvement. Material and method. A randomized controlled single blinded parallel groups interventional study was performed. 250 participants were divided into 5 groups: 3 balneotherapy (20, 40 and 60 g/l total mineralization), 1 tap water, and 1 control group. Hydrotherapy was carried out on an outpatient on everyday basis for 5 days a week over a 2-week period. The main effect on health state was measured using SHSQ-25 questionnaire after 2 weeks and each month during 3-month follow-up period. Examination by a physician and common blood and urine tests were done after the treatment period. Results and discussions. After a 2-week treatment, participants receiving all types of hydrotherapy showed a significant therapeutic response compared to the control group, especially in fatigue and mental state subcategories. The biggest total health enhancing effect after therapy was in seen in 40 g/l group, followed by 20 g/l group. The smallest effect was seen in tap water group. The most significant post-therapy effect during 3 months was given by 40 g/l procedures. Health self-rating after 2 weeks improved significantly only in geothermal water groups and lasted 2-3-month post-treatment. 2 weeks of balneotherapy had significant impact on Er, MCV, MCH, MPV, Eo, Tr, urine SG, and pH. According to the physician’s assessment, the best results after 2 weeks were in 20 g/l group, but 40 and 60 g/l water procedures gave more residual effect. Conclusions. The geothermal water of 40 g/l total mineralization has the best positive effect for health enhancement after 2 weeks and during 3-month period. 20 g/l water gives fast and short- term health effect, while 40-60 g/l water has long-lasting effect on health status. Key words: health status, balneotherapy, geothermal water, hydrotherapy,

Variations in the Texture Profile Analysis (TPA) Properties of Clay/Mineral-Medicinal Water Mixtures for Pelotherapy: Effect of Anion Type

A peloid’s liquid phase can be mineral, sea or salt-lake water. This study examines the interactions among three materials, two special clays (bentonite and sepiolite) and one common clay, and three chemically different mineral-medicinal waters. In all clay–water mixtures, the hardness and adhesiveness decreased with the amount of water in the mixture. For a given hardness or adhesiveness, sepiolite retained more water than the other clays, especially in the presence of sulphate-rich mineral-medicinal water (73%). In contrast, the common clay retained the least amount of water (26%), and the bentonite samples returned an intermediate value for the amount of retained water (52–53%). These differences had a strong influence on the thermal behaviour of the mixtures and, hence, should be taken into account for their use in thermotherapy applications. There were no significant differences in the instrumental texture of the clay pastes according to the predominant anion in the mineral-medicinal waters.