Benefits of an accelerated climatotherapy programme for busy people: comparisons according to area and season

An accelerated climatotherapy programme was evaluated for use with busy people in mid-mountain and flat lowland areas. A total of 43 urban residents participated in this climatotherapy programme. Participants' blood pressure, pulse rate, peripheral skin temperature and levels of salivary amylase, salivary cortisol and blood lactate were measured, and they completed the Profile of Mood Status questionnaire. In the mid-mountain area, which had a cooler environment and long uphill paths, participants' percentage of maximum pulse rate (70.01%) to estimated maximum heart rate was higher than that (59.67%) of participants in the flat lowland area, suggesting that the mid-mountain area was suitable for endurance training. At both sites, the decrease in peripheral skin temperature during the climatic terrain cure suggested that our programme was properly implemented with a cool body surface in accordance with our purpose. Negative moods improved quickly, suggesting that the forest environment and the fresh-air rest cure may have relaxed participants. In late spring and early autumn, the mood of approximately 25% of participants improved to an Iceberg profile, which is associated with positive mental states and athletic peak performance, after climatotherapy. On the other hand, the weather in early spring and late autumn was more likely to facilitate maintenance of a cool body surface during the climatic terrain cure. With the support of individualized feedback provided after the climatotherapy sessions, three participants developed regular exercise habits, serving as a good example of the effectiveness of our climatotherapy programme to elicit behavioural change.

Climatotherapy for asthma: Research progress and prospect

Asthma affects over 300 million people globally and is a cause of substantial burden of disease, including both premature death and reduced quality of life in people of all ages. Although both genetic and environmental factors play an important role in the pathogenesis of asthma, the rising trend of asthma and other allergic diseases over recent decades is thought to be largely caused by alteration in environmental conditions. Thus, a considerable amount of attention has been paid to environmental modification for the treatment and management of asthma, including household allergen reduction and/or irritant removal. More advanced environmental modification strategies (e.g., health resort medical rehabilitation, high-altitude climate therapy and multiple-hit interventions) have also been suggested. Research advances have been made over the past decades, but major challenges and opportunities coexist in this emerging field. Concerted efforts are required to tackle these formidable challenges.

[The role of health resort factors in preconception preparation of patients with reproductive disorders]

Reproductive dysfunction is a multifactorial problem, for the correction of which the most difficult are cases of pathology comorbidity. Individual preconception preparation, taking into account risk factors, is recognized as an effective measure to increase the chances of conception and prevent reproductive losses.

OBJECTIVE

Optimization of treatment and rehabilitation measures at the preconception stage in patients with reproductive disorders.

MATERIAL AND METHODS

The effectiveness of the use of natural and preformed physical factors in the preconception preparation of 180 women who underwent medical and rehabilitation measures in the health resort of the Altai Territory - the resort town of Belokurikha (Group 1, 79 patients) and outpatient conditions in the city of Barnaul (Group 2, 101 patients). Comprehensive spa treatment included climatotherapy, a combination of various methods: balneotherapy, peloidtherapy, physiotherapy and a prolonged course of herbal medicine.

RESULTS

In patients of the 1st group, who underwent a course of rehabilitation treatment in a sanatorium-resort environment, compared with patients of the 2nd group, early reproductive losses were less common during pregnancy (7.1% and 20.7%, respectively; p=0.04) and more frequent term deliveries occurred (92.8% and 77.2%, respectively; p=0.02). The most significant predictors of the ineffectiveness of preconception preparation were the presence in patients of: chronic cystitis and autoimmune thyroiditis with hypothyroidism; oligomenorrhea at the time of pregnancy planning; aggravated by early reproductive losses and long-term wearing of intrauterine contraception history; burdened heredity for violation of carbohydrate metabolism.

CONCLUSION

Comprehensive preconception preparation in the sanatorium-resort conditions of Belokurikha helps to increase the fertility of patients with reproductive disorders, the trophostimulating effect in the genital organs and the restoration of endometrial reception, which makes it possible to recommend this method for use in clinical practice.

Evaluation of the Feasibility of a Two-Week Course of Aquatic Therapy and Thalassotherapy in a Mild Post-Stroke Population

Strokes are a leading cause of disability in developed countries. Patients with disabilities need rehabilitation to improve their physical functioning, mental status, and quality of life. Currently, no high-quality evidence can be found attesting the benefits of any of the interventions that are nowadays used. Water-based exercise may improve the physical conditions and quality of life of people in the post-stroke phase. The objective of this study is to test whether aquatic therapy in an enriched environment at the seaside (a thalassotherapy center) could play a role in this condition. A quasi-experimental prospective study consisting of a specific program assessed 62 patients with a mild–moderate disability pre- and post-2 weeks of intensive treatment. They followed a thalassotherapy regimen including aquatic therapy in a sea water pool at 32–34 °C for 45 min daily five times a week. The outcomes measured were the Berg Balance scale, the Timed Up and Go test, the 10-meter walking test, the 6-min walking test, the Pain Visual Analogue Scale, the WHO Well-being index, EuroQoL VAS and EuroQoL 5D. We observed a significant improvement in all outcomes measured (p < 0.001, except mobility EuroQoL p < 0.05), except in the other four dimensions of the EuroQoL 5D and 10-metre walking test (NS). Conclusion: A two-week intensive course of aquatic therapy and thalassotherapy may be beneficial in the short term by reducing pain and improving the functional status and overall well-being of post-stroke patients.

Predictors of benefit from high-altitude climate therapy in adults with severe asthma

BACKGROUND

High-altitude climate therapy has been shown to benefit patients with severe asthma but it is not known which patients benefit most from this treatment. In the current study we aimed to identify clinical, functional and inflammatory predictors of favourable outcome of high-altitude climate therapy.

METHODS

This is a secondary analysis of a prospective cohort including 136 adult patients with a diagnosis of severe refractory asthma, referred to the Dutch Asthma Centre in Davos (1600 metres above sea level), Switzerland. They had assessments of medication usage, asthma-related quality of life (Asthma-related Quality of Life Questionnaire, AQLQ), asthma control, body mass index (BMI), sino-nasal symptoms, fatigue, lung function (forced expiratory volume in one second, FEV1), exercise tolerance, allergy and inflammation (fraction of exhaled nitric oxide, blood eosinophils) at entry and after 12 weeks of treatment. Five clinically relevant outcomes were considered: AQLQ, oral corticosteroid dose, FEV1, body mass index and blood eosinophils. Independent predictors of beneficial outcome were identified by multiple linear regression analysis.

RESULTS

Lower blood eosinophil counts (p < 0.01), younger age (p = 0.02) and poorer asthma control (p < 0.01) were independently associated with greater reduction in the dose of oral corticosteroids. Lower fatigue score at baseline (p = 0.01) was associated with greater weight loss (reduction in BMI). Higher levels of total IgE at baseline (p < 0.01), and higher doses of inhaled corticosteroids (p = 0.03) were associated with greater decreases in blood eosinophils. There were no predictors for improvement in AQLQ or FEV1.

CONCLUSIONS

The beneficial effect of high-altitude climate therapy in adults with severe asthma can be predicted by patient characteristics, such as age, blood eosinophils and degree of asthma control before admission.

In vivo uptake of iodine from a Fucus serratus Linnaeus seaweed bath: does volatile iodine contribute?

Seaweed baths containing Fucus serratus Linnaeus are a rich source of iodine which has the potential to increase the urinary iodide concentration (UIC) of the bather. In this study, the range of total iodine concentration in seawater (22-105 µg L-1) and seaweed baths (808-13,734 µg L-1) was measured over 1 year. The seasonal trend shows minimum levels in summer (May-July) and maximum in winter (November-January). The bathwater pH was found to be acidic, average pH 5.9 ± 0.3. An in vivo study with 30 volunteers was undertaken to measure the UIC of 15 bathers immersed in the bath and 15 non-bathers sitting adjacent to the bath. Their UIC was analysed pre- and post-seaweed bath and corrected for creatinine concentration. The corrected UIC of the population shows an increase following the seaweed bath from a pre-treatment median of 76 µg L-1 to a post-treatment median of 95 µg L-1. The pre-treatment UIC for both groups did not indicate significant difference (p = 0.479); however, the post-treatment UIC for both did (p = 0.015) where the median bather test UIC was 86 µg L-1 and the non-bather UIC test was 105 µg L-1. Results indicate the bath has the potential to increase the UIC by a significant amount and that inhalation of volatile iodine is a more significant contributor to UIC than previously documented.

Climatotherapy in Japan: a pilot study

Twenty-nine urban inhabitants participated in a half-day climatotherapy programme at the moderate mountain area and lowland area in the northwest part of the main island of Japan. The current study was aimed to investigate physically and mentally the objective and subjective influence of our short programme, which was a prospective pilot study of single intervention. Blood pressure was significantly descended during terrain cure at the uphill mountain path and returned after fresh-air rest cure, while there was no significant change throughout the programme at lowland flat path. Heart rate was significantly ascended and descended at both area, and more clearly changed at the mountain path. Profile of Mood Status brief form Japanese version administered before and after our half-day programme. Age adjusted T score of negative subscales, 'tension-anxiety', 'depression', 'anger-hostility', 'fatigue' and 'confusion' were significantly lower after climatotherapy at both sites. Whereas, there was no significant change concerning 'vigour' score. This short-version climatotherapy programme has been designed for people without enough time for long stay at health resort. It turned out our half-day climatotherapy programme contribute to mood status improvement. In addition, repeated practice of our short-version programme including endurance exercise with cool body shell using uphill path can be expected that blood pressure will go toward the normal range and heart rate will decrease both in usual time and during exercise. Therefore, health benefits can be expected of this climatotherapy programme.

[Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study]

INTRODUCTION

Stroke remains the leading cause of acquired disability. Health and social planning and management may vary and although prevention is crucial, having better treatments and strategies to reduce disability is needed.

AIM

To determine the effect of an intensive program of thalassotherapy and aquatic therapy in stroke patients, valuing clinical parameters and functional validated scales.

PATIENTS AND METHODS

A quasi-experimental prospective study consisting of a specific program assessed pre- and post- 3 weeks treatment to 26 stroke patients with a mild-moderate disability. The outcomes measured were: Berg Balance scale, Timed Up and Go test, 10-meter walking test, 6-minute walking test and pain Visual Analogue Scale.

RESULTS

After intervention, participants had a significant improvement in all outcomes measured.

CONCLUSIONS

Our results suggest that an intensive program of thalassotherapy and aquatic therapy could be useful during stroke rehabilitation to improve balance, gait and pain.

[Not Available]

Zusammenfassung. In dieser Arbeit wird auf Kortikoid-Alternativen wie Calcineurin-Inhibitoren, sulfonierte Schieferöle, Ultraviolettlicht und Klimatherapie näher eingegangen. Topische Calcineurin-Inhibitoren lassen sich als Immunsuppressiva verstehen, die eine T-Lymphozytenaktivierung inhibieren und eine Freisetzung proinflammatorischer Zytokine über den Calcineurinweg verhindern. Die Entzündungshemmung sulfonierter Schieferöle soll auf einer Hemmung der 5-Lipoxygenase sowie der 5-Hydroxyeicosatetraensäure und des Leukotriens B4 beruhen. Die Rationale für den Einsatz einer UV-Lichtbehandlung liegt in deren antiinflammatorischer Wirkung u.a. auf Antigen-präsentierende Langerhanszellen, infiltrierende T-Zellen und proinflammatorische Zytokine. Eine Klimatherapie im Hochgebirge oberhalb von 1500 Höhenmeter vermag unter anderem eine Freiheit von Hausstaubmilben-Allergenen zu gewährleisten. Andere potente Allergene (z.B. Birken- und Gräserpollen, Schimmelpilzsporen) sind deutlich in der Konzentration als auch in der Zeitdauer ihres Auftretens reduziert.

[The possibilities for the correction of the co-morbid anxiety and depressive disorders in the patients suffering from chronic obstructive pulmonary disease by the methods of climatic therapy]

The present study included 142 patients presenting with grade I-III chronic obstructive pulmonary disease (COPD) treated based at a spa and health resort (SHR) facility located on the southern coast of the Crimea. The psycho-diagnostic testing was performed with the use of the Hamilton Rating Scale for Depression (HDRS) and the Ch.D. Spielberger - Yu.L. Khanin scale for reactive (situational) and personal anxiety. The anxiety-depressive disorders were diagnosed in 59,2% of the patients; their intensity correlated with the severity of COPD. The questionnaire study based at the Spilberger-Khanin made it possible to document the presence of moderate and severe anxiety in 68,3% of the patients. It was shown that a course of the spa and health resort-based treatment produced beneficial effect on the psycho-functional status of the patients with COPD that was especially well apparent in those with the mild form of COPD.

Positive changes in self-management and disease severity following climate therapy in people with psoriasis

The aim of this study was to investigate the impact of climate therapy on self-management in people with psoriasis. This was a prospective study of 254 adults with chronic psoriasis who participated in a 3-week climate therapy (CT) programme. The 8-scale Health Education Impact Questionnaire (heiQ) was completed at baseline, after 3 weeks of CT, and 3 months later. Change was assessed using paired sample t-tests mean (95% confidence interval) change scores (range 1-4). All heiQ scales showed statistically significant improvement after 3 weeks of CT. The greatest improvement was in Health-directed activity, followed by Emotional distress, and Skill and technique acquisition. At the 3-month follow-up, only the Emotional distress scale remained improved. In addition, disease severity (self-administered PASI; SAPASI) improved significantly from before CT to 3 weeks and 3 months after CT. This study suggests that CT provides a range of benefits that are important to people with psoriasis, particularly in the short term. A challenge is how to achieve long-term benefits.

The influence of pulmonary rehabilitation in the Wieliczka Salt Mine on asthma control--preliminary results

According to asthma treatment guidelines the main goal of pulmonary rehabilitation is optimum asthma control. The Asthma Control Test (ACT) is a standardised five-item questionnaire for the assessment of asthma control. The study compares the pre- and post-treatment (subterraneotherapy) ACT score with other conventional respiratory parameters. The study included 21 patients with bronchial asthma who underwent a 3-week long subterraneotherapy programme in the 'Wieliczka' Salt Mine. The patients completed the ACT questionnaire before and 2 weeks after subterraneotherapy. At the same time, they underwent testing for concentration of nitric oxide in exhaled breath (FENO), peak expiratory flow (PEF) and spirometry. Subterraneotherapy influenced significantly the change of MEF75 (p = 0.03255) and improvement of ACT score (N = 21, p = 0.0016). The differences in other parameters were not statistically important, but in the case of FEV1 and VC parameters, the differences found were close to the statistical significance (0.05 < p < 0.10). The differences of results before and after subterraneotherapy were higher in the group assigned as patient with poor or moderate asthma control (ACT score < 20, N = 10) than in the group with good control of asthma (ACT score ≥ 20, N = 11). For parameters FEV1, VC, MEF75 and ACT score the improvement was significantly higher in the poor control group. The pulmonary rehabilitation programme combined with subterraneotherapy helps to control asthma especially in patients suffering from poorly or moderate controlled asthma.

Clinical characteristics associated with illness perception in psoriasis

Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.

[Recreational resources of the Paratunka health resort region, Kamchatka Krai]

Recreational resources of the Paratunka health resort region, Kamchatka Krai, are considered. The data on the balneologic properties of nitrogen siliceous thermal waters from the Paratunka deposit and of therapeutic sulfide peloids from Lake Utinoye are presented. The results of evaluation of the bioclimatic conditions of the Paratunka health resort region are reported; it is shown that they account for 57% of the total therapeutic and health-improving potential of the territory of interest.

Increased vitamin D serum levels correlate with clinical improvement of rheumatic diseases after Dead Sea climatotherapy

BACKGROUND

Ultraviolet B (UVB) rays are required by the skin for the production of vitamin D. The intensity of UVB at the Dead Sea area is the lowest in the world. Low vitamin D levels are often associated with musculoskeletal symptoms.

OBJECTIVES

To assess the effectiveness of climatotherapy at the Dead Sea on the production of vitamin D in Norwegian patients suffering from various rheumatic diseases and to investigate possible associations between increased vitamin D serum levels, musculoskeletal symptoms and disease severity.

METHODS

Sixty Norwegian patients who came to the Dead Sea area for 21 days of medical rehabilitation were divided into three groups according to their diagnosis: chronic pain syndromes, i.e., low back pain or fibromyalgia (Group 1, n=33); rheumatoid arthritis (Group 2, n=16); and osteoarthritis (Group 3, n=11). Serum 25-hydroxyvitamin D (25-OH-D) levels were determined at arrival and prior to departure. The treatment protocol included daily sun exposure (climatotherapy), bathing in the Dead Sea and mineral spring water (balneotherapy), mud applications and fitness classes.

RESULTS

25-OH-D serum levels increased significantly from 71.3 +/- 26.6 nM at arrival to 89.3 +/- 23.2 nM prior to departure (P < 0.001). Adjusted for the initial levels of pain (assessed by a visual analog scale) and disease severity, a direct correlation was observed between increased 25-OH-D serum levels and pain reduction (P = 0.012) and reduction of disease severity (P = 0.02).

CONCLUSIONS

Climatotherapy at the Dead Sea induces significant changes in vitamin D. Increased 25-OH-D serum levels are associated with reduced musculoskeletal pain and disease severity.

[Atopic dermatitis and psoriasis: what is the benefit of in-patient high altitude climate therapy?]

Atopic dermatitis as well as psoriasis are characterized as common, chronic, often long lasting disorders of the cutis. In case of (a) a refractory out-patient therapy, (b) an acute severe exacerbation of skin lesions, (c) functional impairment of hands and feet, (d) suberythroderma or erythroderma, (e) complex topical as well as systemic treatment modalities, (f) complicating somatic or psychological co-morbidity, a referral to in-patient treatment at high altitude must be considered. The therapy at the Hochgebirgsklinik Davos (1,560 m above sea level) is characterized by application of natural-borne UV radiation all year round, missing house dust mite allergen, massive reduction of pollens and mycotic spores, improvement of skin perfusion as well as a reduction in itching (as compared to low altitude regions). Last but not least, silence and distance from home and company may show benefits for psychological and cutaneous well-being the 24-hour daily presence of dermatology experts, a broad armamentarium of topical and systemic treatment modalities as well as wide range of up-to-date diagnostic and therapeutic tools have to be further mentioned.

Chronic prostatitis/chronic pelvic pain syndrome: Symptoms are aggravated by cold and become less distressing with age and time

OBJECTIVES

To evaluate how age and the duration of the condition influence the distress caused by the chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and to study how heat and cold influence the symptoms associated with CP/ CPPS as reported by patients afflicted with the condition.

MATERIAL AND METHODS

Forty-eight men (median age 50 years; age range 27-70 years) who had suffered from CP/CPPS for a duration ranging from 18 months to 40 years were included in the study. The evaluation included determination of the serum prostate-specific antigen level, the National Institutes of Health's Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS).

RESULTS

The mean NIH-CPSI score was 23.0 +/- 4.8. The mean IPSS was 14.3 +/- 7.2. Dysuria was reported by 30 men (63%) and ejaculatory pain by 22 (48%). Men with dysuria had painful ejaculations more often (60%) than men without (22%) (p <0.01). There was a strong negative correlation between age and the NIH-CPSI quality of life (QOL) score (correlation coefficient 0.646; p < 0.001). Independent of age, the duration of the disease also correlated with the NIH-CPSI QOL score (correlation coefficient -0.48; p < 0.02). The total NIH-CPSI score did not correlate with either age or the duration of the disease. Nearly every other man stated that the disease had started in association with a specific event, which for 15 men (31%) included exposure to cold. Forty men (83%) reported that cold caused symptom aggravation and/or induced a relapse. Thirty men (63%) stated that taking a hot bath and 22 (46%) reported that spending time in a hot climate decreased the symptoms.

CONCLUSIONS

Age, as well as the duration of the condition, influenced the distress induced by CP/CPPS, suggesting an improved coping ability with time as well as age. The ambient temperature appears to play a role as cold was frequently reported as causing symptom aggravation and heat was often reported to be ameliorating. The mechanisms behind this association between CP/CPPS and temperature as well as the correlation between ejaculatory pain and dysuria require further study.

Climatotherapy of psoriasis

In the era when biological treatments for psoriasis are gaining more and more popularity, climatotherapy represents a safe and efficient alternative to the conventional therapeutic modalities. Climatotherapy comprises alternative treatment methods, which are based on the healing capacities of natural resources. This paper provides the reader with relevant information on the different climatotherapeutic methods, the intimate mechanisms of their action, and the cumulated clinical experience in the treatment of psoriasis. The positive effect of thalassotherapy for psoriasis has been known since ancient times. However, in the past decades a number of controlled studies revealed the efficacy of thalassotherpay in the treatment of psoriasis. Herein, it is exemplified on the experience in the centers at the Dead Sea and the Black Sea coast. Originating from Europe, balneo- and spa therapy are becoming popular alternatives for psoriasis treatment worldwide. A short review on the centers profiled for psoriasis therapy is provided. The unique sites of Blue Lagoon in Iceland and Kangal in Turkey are selected in this paper. Additionally, alternative nature-based treatments for psoriasis such as high mountain climatotherapy and naphtalotherapy are discussed.

Radiological significance of beach sand used for climatotherapy from Safaga, Egypt

As a part of national survey to evaluate natural radioactivity in the environment, concentration levels of radioactivity were analysed for sand samples from Safaga, Egypt, which is an ideal area for climatotherapy of psoriasis. Gamma dose rates of three beaches in Safaga were measured. The values ranged from 195.1 to 210.7 nGy h(-1). The activity concentrations (Bq kg(-1)) of radionuclides 238U series, 232Th series and 40K in three different sand profiles (0-5, 5-10, 10-15, 15-25 and 25 - 40 cm) were measured using gamma-ray spectrometry. The annual effective doses were 259 microSv y(-1) for Minveila, 255 microSv y(-1) for Ganet Safaga and 239 microSv y(-1) for Masab El-Ghazel beaches. The dose rates, radium equivalent activities and external hazard indices were evaluated and compared with the international data. These results may contribute to the determination of absorbed dose rate reference levels in Red Sea Coast at Safaga city.

The percentage of patients achieving PASI 75 after 1 month and remission time after climatotherapy at the Dead Sea

BACKGROUND

Dead Sea climatotherapy (DSC) is a highly effective treatment for psoriasis; however, there are scanty data concerning the duration of post-therapy remission.

OBJECTIVE

Assessment of the duration of remission in patients suffering from plaque-type psoriasis after a 4-week DSC.

METHODS

Sixty-four patients from Germany (66% men; average age: 41.5 years) underwent a 4-week course of DSC between September 2001 and November 2002. After returning home, patients were asked to inform their dermatologist immediately when new lesions appeared. In parallel, they were called every 3 months by telephone. All patients who reported new skin lesions underwent a physical examination, including a Psoriasis Assessment Severity Index (PASI).

OUTCOMES

(1) Time of recurrence of a psoriatic lesion after complete or almost complete clearance, defined as duration of remission; (2) time that elapsed until a relapse of 50% of the PASI improvement occurred, defined as duration of therapeutic effect.

RESULTS

Mean PASI value before and after treatment was 31.7 and 1.42, showing a 95.5% improvement. All patients reached PASI 50, and 75.9% of them reached PASI 75 after 1 month of DSC. The median time of remission was 23.1 weeks. The median time of duration of therapeutic effect was 33.6 weeks. Statistical multivariable analysis indicated that a patient's younger age at the time of treatment was associated with a longer period of remission.

CONCLUSION

Four-week DSC is an effective remittive treatment for plaque-type psoriasis. The period of remission induced compares favorably with other accepted modalities of treatment.

Algae-induced occupational asthma in a thalassotherapist

BACKGROUND

Algae powders have been increasingly used in therapeutic preparations. Their potential as inducers of occupational asthma (OA), however, remains to be demonstrated.

METHODS

A 33-year-old woman developed asthma following exposure to algae powder used for thalassotherapy. She had positive patch tests to nickel and cobalt in an evaluation for intermittent skin rash. At work, she had a normal forced expiratory flow in 1 s (FEV(1)) but moderate airway hyperresponsiveness. Bronchial provocation tests (BPT) were obtained.

RESULTS

On BPT, an isolated early response was observed after a 1-min inhalation of dry algae powder, with a 50% fall in FEV(1) after exposure; the control BPT with lactose powder was negative.

CONCLUSIONS

We report a case of algae-powder-induced OA. Such responses could be due to a sensitization to algae proteins or metal contaminants bioabsorbed by the vegetal particles.

[Individual heart functioning variability under exposure to equal physical factors in patients with different vegetative system tone]

The article describes changes in heart rhythm variability (HRV) as a response to equal complex physical factors (hyperthermia of 60 degrees C with low relative humidity of 8 to 15%, air ionization, thalasso, and relaxing music). The subjects of the study were 28 individuals having no verified chronic diseases, who underwent a course of five recovery procedures using exposure to a complex of weak physical factors realized in Ionic House technology (Japan). The study found that changes in heart functioning as a response to equal physical factors depended on the initial vegetative system tone. Patients with normotonic and sympathicotonic heart regulation displayed the activation of parasympathetic vegetative nervous system as a result of a single exposure to a complex of physical factors, whereas in vagotonic patients sympathetic heart regulation was activated under the same conditions.

Effectiveness of climatotherapy at the Dead Sea for psoriasis vulgaris: A community-oriented study introducing the 'Beer Sheva Psoriasis Severity Score'

BACKGROUND

Climatotherapy at the Dead Sea (CDS) is a therapeutic modality for moderate to severe psoriasis vulgaris.

OBJECTIVE

To evaluate the effectiveness of CDS in patients with psoriasis, using the PASI score and a novel simplified tool for the assessment of psoriasis - the Beer Sheva Psoriasis Severity Score (BPSS).

METHODS

A total of 70 patients with psoriasis vulgaris were treated by CDS. In all patients, the severity of psoriasis was assessed before and after CDS using PASI score and BPSS. BPSS includes eight items that are recorded by the physician (total severity of the disease, and seven items relating to the physical distribution of the disease) and eight items that are recorded by the patient (total severity, physical and psychological severity, pruritus and assessment of involvement in the face, nails, palms and soles and genital regions).

RESULTS

The study included 70 patients (40 men, 30 women; age 19-78 years). There was a 75.9% reduction in PASI score, from a mean of 16.6+/-11.0 before treatment to 4.0+/-4.2 after treatment (p<0.001). There was a 57.5% reduction in BPSS, from a mean of 72.8+/-19.6 before treatment to 31.0+/-21.2 after treatment (p<0.001). PASI score significantly correlated with BPSS before CDS treatment (r = 0.59, p<0.001) and after CDS treatment (r = 0.53, p<0.001).

CONCLUSION

CDS is an effective therapy for patients with psoriasis, as evaluated by either PASI score or BPSS. BPSS was considered shorter and more user-friendly by the participating physicians.

Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life

OBJECTIVES

To study the effect of a combination of thalassotherapy, exercise and patient education in people with fibromyalgia.

METHODS

Patients with fibromyalgia, selected from a rheumatology out-patient department and from members of the Dutch fibromyalgia patient association, were pre-randomized to receive either 2(1/2) weeks of treatment in a Tunisian spa resort, including thalassotherapy, supervised exercise and group education (active treatment) or treatment as usual (control treatment). Primary outcome measure was health-related quality of life, measured with the RAND-36 questionnaire. Secondary measures included the Fibromyalgia Impact Questionnaire, the McGill Pain Questionnaire, the Beck Depression Inventory, tender point score and a 6-min treadmill walk test.

RESULTS

Fifty-eight participants receiving the active treatment reported significant improvement on RAND-36 physical and mental component summary scales. For physical health, differences from the 76 controls were statistically significant after 3 months, but not after 6 and 12 months. A similar pattern of temporary improvement was seen in the self-reported secondary measures. Tender point scores and treadmill walk tests improved more after active treatment, but did not reach significant between-group differences, except for walk tests after 12 months.

CONCLUSIONS

A combination of thalassotherapy, exercise and patient education may temporarily improve fibromyalgia symptoms and health-related quality of life.

Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin

Magnesium salts, the prevalent minerals in Dead Sea water, are known to exhibit favorable effects in inflammatory diseases. We examined the efficacy of bathing atopic subjects in a salt rich in magnesium chloride from deep layers of the Dead Sea (Mavena(R) Dermaline Mg(46) Dead Sea salt, Mavena AG, Belp, Switzerland). Volunteers with atopic dry skin submerged one forearm for 15 min in a bath solution containing 5% Dead Sea salt. The second arm was submerged in tap water as control. Before the study and at weeks 1-6, transepidermal water loss (TEWL), skin hydration, skin roughness, and skin redness were determined. We found one subgroup with a normal and one subgroup with an elevated TEWL before the study. Bathing in the Dead Sea salt solution significantly improved skin barrier function compared with the tap water-treated control forearm in the subgroup with elevated basal TEWL. Skin hydration was enhanced on the forearm treated with the Dead Sea salt in each group, which means the treatment moisturized the skin. Skin roughness and redness of the skin as a marker for inflammation were significantly reduced after bathing in the salt solution. This demonstrates that bathing in the salt solution was well tolerated, improved skin barrier function, enhanced stratum corneum hydration, and reduced skin roughness and inflammation. We suggest that the favorable effects of bathing in the Dead Sea salt solution are most likely related to the high magnesium content. Magnesium salts are known to bind water, influence epidermal proliferation and differentiation, and enhance permeability barrier repair.

[Thalassotherapy effect on cardiovascular system and cardiac rhythm variability]

A complex study of physiological parameters allowed us to analyse reactions of cardiovascular system to dipping into a hot water varying in salt concentrations. These reactions differ from those to dipping into cold water. Dipping into hot water leads to depression of the tonicity of parasympathic nervous system in such a manner that increased heart rate does not cause vascular contraction. Effects of water salt concentrations on the above parameters need further investigations.

Heliomarinotherapy in psoriasis

Heliomarinotherapy is an important therapeutic option in the treatment of psoriasis. Investigations on heliomarinotherapy carried out in Veli Losinj, Croatia showed that the remissions of psoriasis after such treatment were long lasting, side effects slight, and use of corticosteroids not necessary.

Changes in Plasma Lactate and Pyruvate Concentrations after Taking a Bath in Hot Deep Seawater

The use of deep seawater (DSW) in thalassotherapy has begun in Japan. To clarify the health effects of DSW on the human body, we investigated the changes in plasma lactate and pyruvate concentrations, or subjective judgment scores, after bathing at rest in 9 healthy young men. Subjects were immersed for 10 minutes in DSW, surface seawater (SSW), and tap water (TW) heated to 42 degrees C. Plasma samples were collected before bathing, immediately after bathing, and 60 minutes after bathing. The scores were obtained by an oral comprehension test. In the DSW bathing, plasma lactate and pyruvate concentrations showed no significant changes immediately after bathing or 60 minutes after bathing. In contrast, subjects who bathed in SSW showed a significant decrease in lactate concentrations 60 minutes after bathing compared with immediately after bathing. Subjects who bathed in TW showed a significant increase in lactate concentrations immediately after bathing compared with before bathing, and they showed a significant decrease in lactate and pyruvate concentrations 60 minutes after bathing. We found no significant change in the thermal sensation score in the DSW bathing, though significant differences were found between before and immediately after bathing in the SSW and TW groups. Moreover, the score decreased significantly 60 minutes after bathing compared to immediately after bathing in the TW bathing. Higher concentrations of salts contained DSW such as sodium, nitrate-nitrogen, phosphate-phosphorus, and silicate-silicon may have a good influence on human health. Although additional studies are needed to support our findings, DSW is the mildest water to the human body among the three kinds of water, since no significant changes in the items measured were found only in DSW.

[Therapeutic efficacy of electrophoresis of humic acids from sea mud in osteoarthritis]

Therapeutic action and efficiency of electrophoresis of humic acids (HA) from Khaapsaluskaya sea mud were studied in 97 patients with osteoarthrosis in comparison with electrophoresis of physiologic salt solution (PS). HA electrophoresis was found more effective (p < 0.01) as providing more potent anesthetic effects and more beneficial effect on joint function than PS electrophoresis (p < 0.005 and p < 0.01).

[Changes in histamine levels in skin chambers. Application for clinical evaluation of atopic dermatitis--report 2]

We measured changes in histamine levels in fluids from children with moderate or severe atopic dermatitis by the skin chamber method and evaluated the correlation with clinical symptoms. Skin chambers were applied to the forearm skin which had been scratched with a needle, and extract of Dermatophagoides farinae (mite antigen) at 50 microns filters as a challenge. We measured the concentrations of histamine 2, 6, 12 and 24 hr after challenge. The skin chamber test was performed before and after beach camp therapy or hospitalization therapy. We treated 26 children with beach camp therapy, and compared the effects with hospitalization in Tokyo (20 children). All the children in both groups showed results of mediator releasability in skin chamber was different in the two groups. The histamine levels were dramatically increased 24 hr after challenge with mite antigen. The levels of histamine in the chambers 24 hr after challenge decreased with treatment along with improvements in skin condition. A marked increase in histamine levels in the skin chamber fluids was observed after 24 hours, whereas no increase was observed when they were challenged with vehicle saline. After 7 days of beach camp therapy, challenge with mite antigen produced only a very small increase in histamine levels even after 24 hours, which was significantly lower than the levels before therapy. In the cases involving hospitalization in Tokyo, histamine was observed to be increased at 24 hr (24.9 +/- 8.0 ng/ml SEM), similarly to the beach campgroup (19.0 +/- 7.3 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

[Liberation of human leukocyte elastase by hypertonic saline baths in psoriasis]

Human leukocyte elastase, a proteolytic enzyme of neutrophils, can be determined by a highly sensitive enzymatic assay. Bathing in hypertonic salt solutions allowed considerable amounts of human leukocyte elastase to be eluted from psoriatic lesions. Optimal elution was achieved with sodium chloride concentrations of 1 M and higher. Thirty patients with psoriasis of varying degrees of severity released significantly increased amounts of human leukocyte elastase following a 10-min bath in salt water. During daily treatment with salt water baths and UV-B radiation the elutable amounts of elastase decreased dramatically within a few days, reaching normal levels when the skin had cleared. Determination of human leukocyte elastase in salt water eluates of psoriatic skin seems to be useful for quantification of therapeutic effects. It appears conceivable that human leukocyte elastase plays a role in the psoriatic tissue reaction.

[Therapeutic possibilities of venolymphatic disorders using thalassotherapy]

Venolymphatic pathology of the lower extremities represents a major part of the recruiting of a specialized thalassotherapy center, such as "Les Cures Marines de Trouville". The various treatments are adjusted according to each clinical case. The main techniques which are prescribed, include alternatively: active rehabilitation in sea-water pool at 34 degrees C; underwater showers and manual massages of the connective tissue; shower sprays; microbubbles; algi baths. The temperature of the baths and showers ranges between 32 and 35 degrees C. An example of the treatments administered in Trouville consists in underwater lymphatic drainage, performed by the physical therapist in a large tank, at minimum pressure. It begins with a symmetrical drainage of the trunk (or basic protocol), then drainage of the lymphedema, always starting at the root of the limb. Hygiene-dietetic rules are discussed in detail during the consultation. A fitted elastic bandage is prescribed at the end of the treatment.