Abstract Title: Effect of electro-acupuncture, massage, mud, and sauna therapies in patient with rheumatoid arthritis. Abstract Source: J Ayurveda Integr Med. 2015 Oct-Dec;6(4):295-9. PMID: 26834431 Abstract Author(s): Geetha B Shetty, A Mooventhan, N Anagha Article Affiliation: Geetha B Shetty Abstract: A 48-year-old married woman diagnosed with rheumatoid arthritis (RA) in 2007, came to our hospital in July 2014 with the complaint of severe pain and swelling over multiple joints, especially over small joints, which was associated with stiffness (more in morning), deformities of fingers and toes, with disturbed sleep and poor quality of life (QOL) for the past 7 years. She received a combination of electro acupuncture (14 sessions), massage (18 sessions), mud (18 sessions), and sauna (3 sessions) (EMMS) therapies for 30-min, 45-min, 30-min, and 15-min per session, respectively for 3 weeks. During and postintervention assessment showed reduction in visual analog scale score for pain, Depression Anxiety and Stress Scales and the Pittsburgh Sleep Quality Index scores. It also showed an increase in the scores of 10-Meter Walk Test, isometric hand-grip test, and short form-36 version-2 health survey. This result suggest that, the EMMS therapy might be considered as an effective treatments in reducing pain, depression, anxiety, and stress with improvement in physical functions, quality of sleep and QOL in patient with RA. EMMS therapies were tolerated and no side effects were reported by the patient. Though the results are encouraging, further studies are required with larger sample size and advanced inflammatory markers. Article Published Date : Sep 30, 2015

Abstract Title: Effect of mud compress therapy on cartilage destruction detected by CTX-II in patients with knee osteoarthritis. Abstract Source: J Back Musculoskelet Rehabil. 2015 Sep 6. Epub 2015 Sep 6. PMID: 26406208 Abstract Author(s): Gonca Odemis Gungen, Fusun Ardic, Gulin Findikoglu, Simin Rota Article Affiliation: Gonca Odemis Gungen Abstract: BACKGROUND/OBJECTIVE: The aim of this study is to investigate the effect of mud compress (MC) therapy compared to hot pack (HP) therapy on cartilage destruction and subchondral bone alterations detected by urine levels of C telopeptide fragment of collagen type-II (uCTX-II) in patients with knee osteoarthritis (OA). METHODS: Fifty-nine patients between 49-74 years of age with bilateral knee OA divided into 2 groups. Twenty-five patients (16 females, 9 males) and 34 patients (22 females, 13 males) were given HP and local natural organic and mineral-rich MC therapy respectively for 2 weeks as a total of 12 sessions. uCTX-II, Visual Analog Scale (VAS), 15 m walking time, Western Ontario and McMaster Universities multifunctional (WOMAC) index were measured at baseline, after-treatment and 3 months after treatment. RESULTS: uCTX-II level did not show any difference between the two groups, however it decreased significantly in MC and HP groups 3 months after treatment (p<0.017). WOMAC stiffness sore was significantly lower in MC group 3 months after treatment (p<0.05). Both MC and HP therapies lowered VAS, WOMAC total and subscores significantly up to 3 months (p<0.017). CONCLUSIONS: HP and MC therapies for OA of knee are not superior to one another with respect to the level of uCTX-II. MC may probably decrease the ongoing cartilage destruction and related subchonral bone interactions earlier compared to HP treatment in patients with knee OA as evidenced by decreased uCTX-II levels after-treatment. Article Published Date : Sep 05, 2015

Abstract Title: Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Abstract Source: Int J Biometeorol. 2014 Jan ;58(1):79-86. Epub 2013 Jan 14. PMID: 23314489 Abstract Author(s): Antonella Fioravanti, Sara Tenti, Chiara Giannitti, Nicola Angelo Fortunati, Mauro Galeazzi Article Affiliation: Antonella Fioravanti Abstract: The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. 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 health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OAlast over time. Article Published Date : Dec 31, 2013

Abstract Title: A multidisciplinary approach to study the effects of balneotherapy and mud-bath therapy treatments on fibromyalgia. Abstract Source: Clin Exp Rheumatol. 2013 Nov-Dec;31(6 Suppl 79):S111-20. Epub 2013 Dec 18. PMID: 24373369 Abstract Author(s): Laura Bazzichi, Ylenia Da Valle, Alessandra Rossi, Camillo Giacomelli, Francesca Sernissi, Gino Giannaccini, Laura Betti, Federica Ciregia, Laura Giusti, Pietro Scarpellini, Liliana Dell'Osso, Donatella Marazziti, Stefano Bombardieri, Antonio Lucacchini Article Affiliation: Laura Bazzichi Abstract: OBJECTIVES: To study the effects of both balneotherapy and mud-bath therapy treatments in patients affected by primary fibromyalgia (FM) using rheumatological, psychiatric, biochemical and proteomic approaches. METHODS: Forty-one FM patients (39 females, 2 males), who fulfilled the American College of Rheumatology criteria received a 2-week thermal therapy programme consisting of therapy once daily for 6 days/week. Twenty-one patients received mud-bath treatment, while the other twenty balneotherapy. Pain, symptoms, and quality of life were assessed. Oxytocin, brain-derived neurotrophic factor (BDNF), ATP and serotonin transporter levels during therapy were assayed. Comparative whole saliva (WS) proteomic analysis was performed using a combination of two-dimensional electrophoresis (2DE) and mass spectrometry techniques. RESULTS: We observed a reduction in pain, FIQ values and improvement of SF36 in both groups of patients treated with mud-bath or balneotherapy. The improvement of the outcome measures occurred with different timing and duration in the two spa treatments. A significant decrease in BDNF concentrations was observed either after balneotherapy or mud-bath therapy when assayed after twelve weeks, while no significant change in oxytocin levels, ATP levels and serotonin transporter were detected. Significant differences were observed for phosphoglycerate mutase1 (PGAM1) and zinc alpha-2-glycoprotein 1 (AZGP1) protein expression. CONCLUSIONS: Our results showed that the thermal treatment might have a beneficial effect on the specific symptoms of the disease. In particular, while balneotherapy gives results that in most patients occur after the end of the treatment but which are no longer noticeable after 3 months, the mud-bath treatment gives longer lasting results. Article Published Date : Oct 31, 2013

Abstract Title: The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Abstract Source: J Int Med Res. 2013 Oct ;41(5):1418-25. Epub 2013 Sep 5. PMID: 24008567 Abstract Author(s): Hua Liu, Chao Zeng, Shu-guang Gao, Tuo Yang, Wei Luo, Yu-sheng Li, Yi-lin Xiong, Jin-peng Sun, Guang-hua Lei Article Affiliation: Hua Liu Abstract: OBJECTIVES: A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). METHODS: A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. RESULTS: A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. CONCLUSIONS: Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion. Article Published Date : Sep 30, 2013

Abstract Title: A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Abstract Source: Rheumatol Int. 2010 Apr 14. Epub 2010 Apr 14. PMID: 20390281 Abstract Author(s): Antonio Fraioli, Angelo Serio, Gioacchino Mennuni, Fulvia Ceccarelli, Luisa Petraccia, Mario Fontana, Marcello Grassi, Guido Valesini Article Affiliation: Dipartimento di Clinica e Terapia Medica, UOC Medicina Interna E, Terapia Medica e Medicina Termale, Scuola di Specializzazione in Idrologia Medica, Sapienza Università di Roma, Azienda Policlinico Umberto I, V.le del Policlinico 155, 00161, Rome, Italy, This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: Mud-bath therapy plays a primary role in the treatment and prevention of osteoarthritis that has been recognised since antiquity. Numerous studies have demonstrated its clinical benefits and its effects on inflammatory mediators (interleukins), the immune system, cenesthesic factors (endorphins), and the diencephalic-pituitary-adrenal axis. This study was conducted to assess the efficacy of mud-bath therapy with mineral water from the Sillene Spring at Italy's Chianciano Spa in patients with osteoarthritis of the knee. Patients (n = 61) were divided into two groups. Group A underwent three cycles of mud-based spa therapy over a year's time, whereas group B did not. Clinical conditions, visual analogue scale pain ratings, and Lequesne indexes of the two groups were compared. We also compared these same parameters in the patients of the two groups that were following the therapy with drugs and in the patients of the group A before and after spa treatment. The percentage of patients with no symptoms or mild symptoms was higher in group A than in group B. Within group A, this percentage was higher after treatment than before spa therapy. Even in the comparison between the patients of the two groups that were following the therapy with drug, the results was that in group A the percentage of patients with no symptoms or mild symptoms was higher than in group B. Statistical analyses based on various tests revealed that almost all these differences were highly significant. No adverse effects were observed in any of the patients in group A. In conclusion, the mud-bath therapy performed at Chianciano Spa with Sillene Spring water remarkably improved the clinical conditions of patients with knee arthritis and significantly reduces the frequency and severity of symptoms and the disability they cause. Article Published Date : Apr 14, 2010

Abstract Title: Water-retentive and anti-inflammatory properties of organic and inorganic substances from Korean sea mud. Abstract Source: Nat Prod Commun. 2010 Mar;5(3):395-8. PMID: 20420315 Abstract Author(s): Jung-Hyun Kim, Jeongmi Lee, Hyang-Bok Lee, Jeong Hyun Shin, Eun-Ki Kim Article Affiliation: Department of Biological Engineering, Inha University, Incheon, Korea. Abstract: Sea mud has been popularly used as an effective base in cosmetic preparations although its biologically-active materials and mechanisms on skin have not yet been fully determined. We isolated humic substances as the major organic substance of the sea mud from a tidal flat in Korea, and investigated their water-retentive properties. Among the three isolated humic substances, humic acid (HA) showed the highest water retentive property (approximately 50 % mass increase from water uptake). Based on the observations that mud pack therapy has been traditionally used to soothe UV-irradiated skin, we examined the antiinflammatory property of the sea mud on UVB-irradiated human keratinocytes (HaCaT cells) by measuring PGE2 levels produced by keratinocytes in the presence of either the total water or methanol extracts of the mud. The water extract showed higher inhibition of PGE2 production from HaCaT cells (30% inhibition) than the methanol extract at 200 ppm (microg/g). We further fractionated the water extract to determine the major components responsible for its anti-inflammatory effect. It was found that the minerals in the mud inhibited PGE2 production by 83 % at 200 ppm, which is comparable with the inhibitory effect of 1 microM indomethacin. No mud extract showed cytotoxicity at the tested concentrations. The mineral compositions of the mineral extract were determined by ICP-MS, revealing that the sea mud consisted of more than 19 different mineral components, rich in Na+, Mg2+, and Zn2+. These results imply that the anti-inflammatory effect of the sea mud is largely due to the minerals in the mud. Our research suggests the potential use of the organic and inorganic substances from the sea mud in various skin products as safe biological substances for skin protective purposes. Article Published Date : Mar 01, 2010

Abstract Title: Comparison of intra-articular hyaluronic acid injections and mud-pack therapy in the treatment of knee osteoarthritis. Abstract Source: Acta Orthop Traumatol Turc. 2010;44(1):42-7. PMID: 20513990 Abstract Author(s): Bora Bostan, Ufuk Sen, Taner Güneş, Seyyid Ahmet Sahin, Cengiz Sen, Mehmet Erdem, Unal Erkorkmaz Article Affiliation: Department of Orthopedics, Gaziosmanpaşa University, Tokat, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVES: Conservative treatment should be tried prior to surgical treatment in knee osteoarthritis. This study was designed to evaluate the short-term effects of mud-pack therapy on pain relief and functional improvement in knee osteoarthritis in comparison with intra-articular hyaluronic acid injections. METHODS: The study included 23 patients who were diagnosed as having knee osteoarthritis according to the ACR (American College of Rheumatology) criteria, and had complaints lasting for more than three months. All the patients had stage 2 or 3 osteoarthritis radiographically according to the Kellgren-Lawrence criteria. Twelve patients (3 males, 9 females; mean age 54+/-6 years; range 46 to 67 years) received mud therapy bilaterally. Mud packs were heated to 45 degrees C and applied on both knees for 30 minutes daily for a total of 12 weekdays. Eleven patients (2 males, 9 females; mean age 53+/-9 years; range 40 to 66 years) received a total of three bilateral intra-articular hyaluronic acid injections, each interspersed by weekly intervals. The patients were evaluated before and after treatment in terms of pain and functionality using the pain subscale of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index, Hospital for Special Surgery (HSS) score, and Knee Society clinical rating system (knee and function scores). The patients were followed-up for a mean of 5.9+/-6.3 months (range 4 to 8 months) after mud-pack therapy, and 5.8+/-0.8 months (range 5 to 7 months) after intra-articular hyaluronic acid injections. RESULTS: No significant differences were found between the two groups with respect to pre-and posttreatment WOMAC, HSS, and knee and function scores (p>0.05). The scores of all instruments showed significant improvements following treatment in both groups (p<0.001). Posttreatment changes in relation to baseline scores did not differ significantly between the two groups (p>0.05). CONCLUSION: Treatment of knee osteoarthritis with intra-articular hyaluronic acid injections or mud-pack therapy yielded similar results in the short-term in terms of functional improvement and pain relief. Mud-pack therapy is a noninvasive, complication-free, and cost-effective alternative modality for the conservative treatment of knee osteoarthritis. Article Published Date : Jan 01, 2010

Abstract Title: The efficacy of a topical gel prepared using Lake Urmia mud in patients with knee osteoarthritis. Abstract Source: J Altern Complement Med. 2009 Nov;15(11):1239-42. PMID: 19922256 Abstract Author(s): Nemati Mahboob, Kolahi Sousan, Azarmi Shirzad, Ghorbanihaghjo Amir, Varshoi Mohammad, Mokhtari Reza, Vatankhah Amir Mansour, Valizadeh Hadi Abstract: OBJECTIVES: Osteoarthritis (OA) is characterized by progressive cartilage degradation and secondary inflammation of the synovial membrane. Studies have shown that mud therapy may influence serum levels of several cytokines involved in the pathogenesis of OA and chondrocyte metabolism. The main targets of our research were to make use of Lake Urmia mud for topical gel formulation, evaluation of the possible therapeutic effects of this gel on symptoms of patients with knee OA and the evaluation of serum tumor necrosis factor-alpha (TNF-alpha) level after mud therapy in comparison with the application of a placebo. METHODS: Fifty (50) patients suffering from knee OA participated in this study and randomized into two groups: case group and control group. Patients in the case group received mud therapy and the placebo was applied to patients in the control group. Three (3) parameters including pain, morning stiffness, and joint functionality were assessed in all patients. Visual analogue scale and Western Ontario McMaster Osteoarthritis index (WOMAC) were the employed scales for pain assessment. Functional capacity was evaluated by using WOMAC functional capacity and WOMAC global index. All the mentioned steps were done before and after treatment. Blood samples, in both groups, were collected for measuring tumor necrosis factor (TNF)-alpha serum level. RESULTS: All the differences (for three parameters), in the case group, were statistically significant. TNF-alpha serum level reduction in both groups were detected: 19.41% in the case group and 1.76% in the control group. CONCLUSIONS: Mud therapy using formulated gel is an effective method in knee OA treatment and pain reduction. Further studies may be needed for the evaluation of possible synergism between pharmacological treatment and mud therapy. Article Published Date : Nov 01, 2009

Abstract Title: [Effect of peloid applications of different temperatures on the function of the cardiovascular system in patients with osteoarthrosis and concomitant hypertensive disease and ischemic heart disease]. Abstract Source: Vopr Kurortol Fizioter Lech Fiz Kult. 2009 Sep-Oct(5):11-3. PMID: 19882889 Abstract Author(s): N V L'vova, Iu Iu Tupitsyna, V K Orus-Ool, O D Lebedeva Abstract: This study investigated changes of systemic and intracardiac hemodynamics under effect of mud application at different temparatures (10, 20-24, and 36 degrees C) in patients with osteoarthrosis and concomitant hypertensive disease and coronary heart disease. It is concluded that combined treatment of this condition should include low-temperature peloidotherapy as a major component since it has the most beneficial effect on general and intracardiac hemodynamics. Article Published Date : Sep 01, 2009

Abstract Title: [Effect of naphthalan and therapeutic mud applications on clinical and roentgenological characteristics in patients with protracted pneumonia]. Abstract Source: Vopr Kurortol Fizioter Lech Fiz Kult. 2009 May-Jun(3):16-9. PMID: 19637834 Abstract Author(s): M A Rassulova, L A Siziakova, N S Aĭrapetova Abstract: The influence of application of naftalan and therapeutic muds on clinical and roentgenological parameters, external respiration function, biochemical and immunological characteristics of the inflammatory process was studied in 82 patients presenting with protracted pneumonia and compared with the outcome of therapy using no physical factors. The application of naftalan and therapeutic muds was shown to reduce activity of inflammatory processes, improve airway patency and the state ofbronchial mucosa. Naftalan produced better therapeutic effect than muds. Article Published Date : May 01, 2009

Abstract Title: Does mud pack treatment have any chemical effect? A randomized controlled clinical study. Abstract Source: J Altern Complement Med. 2008 Jun;14(5):559-65. PMID: 18564957 Abstract Author(s): Ersin Odabasi, Mustafa Turan, Hakan Erdem, Faruk Tekbas Article Affiliation: Department of Medical Ecology and Hydroclimatology, Gulhane School of Medicine, Ankara, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: The aim of this study was to reveal the efficacy of mud pack treatment in patients with knee osteoarthritis and to find the contribution of chemical factors to the build up of these effects. METHODS: Sixty patients were randomly assigned to directly applied mud pack (study) group or to nylon-covered mud pack (control) group. Thirty patients in the study group had mud application 15 times to both knees: heated mud, up to 43 degrees C, was applied to skin directly for 30 minutes. Thirty patients in the control group had the same treatment as the study group except heated mud was applied over an impermeable nylon pack. Primary outcome measures of the study were the Western Ontario and McMaster Universities (WOMAC) index, pain intensity on a visual analog scale (VAS), patient's assessment of disease severity index, physician's assessment of disease severity index, and analgesic consumption. The patients were evaluated before and after (end of 15th application) the intervention and followed up for 24 weeks at 4-week intervals. The results were assessed on an intent-to-treat basis. RESULTS: As compared to the baseline, significant decreases were observed in WOMAC, pain intensity, disease severity index scores, and analgesic consumption in both groups after the intervention. Observed improvements in the study group were found to be superior to the control during the whole postintervention follow-up, except for analgesic consumption in the third week. A significant number of patients in the study group showed minimal clinically important improvement as compared to the control group. CONCLUSION: Mud pack treatment significantly improved the pain and functional status of patients with knee osteoarthritis, whether applied directly or coated with nylon. Direct application was found to be superior, which implies chemical properties of the mud contribute to the build up of therapeutic effect. Article Published Date : Jun 01, 2008

Abstract Title: Mud compress therapy for the hands of patients with rheumatoid arthritis. Abstract Source: Biologics. 2008 Mar;2(1):143-9. PMID: 14618372 Abstract Author(s): Shlomi Codish, Mahmoud Abu-Shakra, Daniel Flusser, Michael Friger, Shaul Sukenik Abstract: OBJECTIVE: The aim of this study was to evaluate the efficacy of home treatment with mud compresses for the hands of patients with rheumatoid arthritis (RA). METHODS: Forty-five patients suffering from RA were enrolled in a double-blind, randomized, controlled study. Twenty-two were treated with true mud compresses (treatment group) and 23 were treated with attenuated mud compresses (control group). The compresses were applied in the patients' homes five times a week during a 3-week period. Patients were assessed four times: at baseline, upon completion of the 3-week treatment period, 1 month after the treatment, and 3 months after conclusion of the treatment period. Positive response was defined as reductions of 30% or more in the number of tender and swollen joints, 20% or more in physician global assessment of disease activity, and 20% or more in patient global assessment of the severity of joint pain. RESULTS: In the treatment group, significant reductions in the number of swollen and tender joints and patients' global assessments of pain severity was observed at all post-treatment assessments. Significant improvement in the scores of physician global assessment was seen at the end of therapy and 1 month later. In the control group, no improvement in the number of swollen and tender joints or physician global assessment was found in any post-treatment evaluation. However, a significant reduction in patient global assessment of joint pain severity was reported at the end of therapy and 3 months after concluding treatment. CONCLUSION: Treatment with mud compresses relieves pain affecting the hands and reduces the number of swollen and tender joints in the hands of patients suffering from RA. This treatment can augment conventional medical therapy in these patients. Article Published Date : Mar 01, 2008

Abstract Title: The efficacy of Brazilian black mud treatment in chronic experimental arthritis. Abstract Source: Rheumatol Int. 2007 Nov;28(1):39-45. Epub 2007 Jun 12. PMID: 17562044 Abstract Author(s): Zélia Maria Nogueira Britschka, Walcy Rosolia Teodoro, Ana Paula Pereira Velosa, Suzana Beatriz Veríssimo de Mello Article Affiliation: Department of Internal Medicine, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, São Paulo 0124-6903, SP, Brazil. Abstract: Studies have demonstrated the beneficial effects of fangotherapy on relieve of pain improving function of rheumatic patients. Herein, we investigated the effect of Brazilian black mud in protect articular damage in chronic arthritis induced in rats. Mud was daily applied (40 degrees C/30 min) during the course of arthritis and was compared with warm water and no treated groups. At 21th day after arthritis induction synovial fluid and membrane were analyzed regarding cellular influx, hyperplasia and vascular proliferation. Cartilage structure, cell count, proteoglycan and collagen amount were also analyzed by three pathologists blinded to the treatment. Mud treatment diminished leukocyte migration into the synovial membrane and articular cavity when compared with both control groups. Regarding cartilage, an increase in collagen, number of chondrocytes and more conserved tissue structure was observed in mud-treated animals. These results demonstrate a protective effect of Brazilian mud on this model of arthritis, suggesting that this therapy may be useful as a complementary approach to treat articular diseases. Article Published Date : Nov 01, 2007

Abstract Title: Mud-bath treatment in spondylitis associated with inflammatory bowel disease--a pilot randomised clinical trial. Abstract Source: Joint Bone Spine. 2007 Oct;74(5):436-9. Epub 2007 May 30. PMID: 17590368 Abstract Author(s): Franco Cozzi, Marta Podswiadek, Gabriella Cardinale, Francesca Oliviero, Lara Dani, Paolo Sfriso, Leonardo Punzi Abstract: OBJECTIVES: The objective of this study was to evaluate the effects and the tolerability of mud packs and thermal baths in a group of patients affected with this disease. METHODS: Twenty-four patients with spondylitis and Crohn's disease or ulcerative colitis, treated with 5-ASA or sulfasalazine, were randomised and assessed by an investigator independent from the spa staff: 12 were submitted to a cycle of mud-bath treatment (12 mud packs and 12 thermal baths over a period of two weeks) and 12 were enrolled as controls. Patients were evaluated by BASDAI, BASFI, BAS-G and VAS for back pain before, at the end of a cycle of mud-bath treatment, and after 12 and 24 weeks. C reactive protein serum levels detected by high sensitivity nephelometric method and gut symptoms evaluated by CDAI or Powell-Tuck index were assessed at the same time periods. RESULTS: A significant reduction of clinical evaluation indices of spondylitis was observed at the end of the cycle of mud-bath treatment. BASDAI50 improvement remained significant until the end of the follow-up (24 weeks). C reactive protein serum levels didn't show significant changes. No patient referred any gut symptom exacerbation. No significant changes in clinical evaluation indices, in IBD activity indices and in CRP serum levels were observed in the control group. CONCLUSION: Mud-bath treatment in patients with spondylitis associated with inflammatory bowel disease is well tolerated and may improve spinal symptoms and function for several months. Article Published Date : Oct 01, 2007

Abstract Title: The effect of physical therapy on beta-endorphin levels. Abstract Source: Eur J Appl Physiol. 2007 Jul;100(4):371-82. Epub 2007 May 5. PMID: 17483960 Abstract Author(s): Tamás Bender, György Nagy, István Barna, Ildikó Tefner, Eva Kádas, Pál Géher Article Affiliation: Polyclinic of Hospitaller Brothers of St. John of God, Budapest, Hungary. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Beta-endorphin (betaE) is an important reliever of pain. Various stressors and certain modalities of physiotherapy are potent inducers of the release of endogenous betaE to the blood stream. Most forms of exercise also increase blood betaE level, especially when exercise intensity involves reaching the anaerobic threshold and is associated with the elevation of serum lactate level. Age, gender, and mental activity during exercise also may influence betaE levels. Publications on the potential stimulating effect of manual therapy and massage on betaE release are controversial. Sauna, mud bath, and thermal water increase betaE levels through conveying heat to the tissues. The majority of the techniques for electrical stimulation have a similar effect, which is exerted both centrally and--to a lesser extent--peripherally. However, the parameters of electrotherapy have not yet been standardised. The efficacy of analgesia and the improvement of general well-being do not necessarily correlate with betaE level. Although in addition to blood, increased brain and cerebrospinal fluid betaE levels are also associated with pain, the majority of studies have concerned blood betaE levels. In general, various modalities of physical therapy might influence endorphin levels in the serum or in the cerebrospinal fluid--this is usually manifested by elevation with potential mitigation of pain. However, a causal relationship between the elevation of blood, cerebrospinal fluid or brain betaE levels and the onset of the analgesic action cannot be demonstrated with certainty. Article Published Date : Jul 01, 2007

Abstract Title: [Daily variation of some cardiovascular parameters in healthy children and in those with chronic cholecystitis, changes on mud cure]. Abstract Source: Med Tr Prom Ekol. 2007(3):42-8. PMID: 17494312 Abstract Author(s): Iu V Kochergin Abstract: Studies covered chronologic algorithm of physiologic parameters in healthy children and those with hepato-biliary diseases. 71.3% of children suffering from hepato-biliary diseases appeared to have significant desynchronization. The authors conducted time-wise optimization of mud care in children with cholecystitis. Findings are that mud care has considerable sanogenous effect and could be recommended as a treatment for children with ecologically mediated cholecystitis. Article Published Date : Jan 01, 2007

Abstract Title: Antimicrobial properties of Dead Sea black mineral mud. Abstract Source: Int J Dermatol. 2006 May;45(5):504-11. PMID: 16700781 Abstract Author(s): Zeev Ma'or, Yigal Henis, Yaacov Alon, Elina Orlov, Ketil B Sørensen, Aharon Oren Article Affiliation: Dead Sea Research Center, 86910 Dead Sea, Israel. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: The unique, black, hypersaline mud mined from the Dead Sea shores is extensively used in mud packs, masks, and topical body and facial treatments in spas surrounding the lake, and in cosmetic preparations marketed worldwide, but little is known about its antimicrobiological properties. METHODS: We performed detailed microbial and chemical analysis of Dead Sea mineral mud compounded in dermatological and cosmetic preparations. RESULTS: Using conventional bacteriological media (with or without salt augmentation), we found surprisingly low numbers of colony-forming microorganisms in the mud. The highest counts (up to 20,000 colonies per gram, mostly consisting of endospore-forming bacteria) were obtained on sheep blood agar. Test microorganisms (i.e. Escherichia coli, Staphylococcus aureus, Propionibacterium acnes, Candida albicans) rapidly lost their viability when added to the mud. Zones of growth inhibition were observed around discs of Dead Sea mud placed on agar plates inoculated with Candida or with Propionibacterium, but not with Staphylococcus or Escherichia. The effect was also found when the mud was sterilized by gamma irradiation. Using (35)S-labeled sulfate as a tracer, bacterial dissimilatory sulfate reduction could be demonstrated at a low rate (0.13 +/- 0.03 nmol/cm(3).d). CONCLUSION: The antibacterial properties of Dead Sea mud are probably owing to chemical and/or physical phenomena. Possible modes of antimicrobial action of the mud in relation to its therapeutic properties are discussed. Article Published Date : May 01, 2006

Abstract Title: [Effect of complex rehabilitation by physical factors (therapeutic mud, waves of millimeter range) on the indices of inflammation process and immune status in patients with traumas of peripheral nervous system]. Abstract Source: Georgian Med News. 2006 Mar(132):72-6. PMID: 16636386 Abstract Author(s): I D Tarkhan-Muuravi, N V Dzhakobiia Abstract: 82 patients with traumas of peripheral nervous trunks (middle, ulnar, radial, tibular and tibial nerves) were investigated, including 44 persons with neuroapraxia of those trunks and 38 with axonotmesis. It was established that the patients with traumas of peripheral nervous trunks showed the presence of inflammatory process and sensitization of the body which was exposed in the reaction of precipitation at C-reactive protein with the increase of the content of serum glycoides and total nonspecific immunuglobulin E in blood serum. The investigated patients showed also decrease in nonspecific resistance of organism and change in immune status. All the above-referred shifts were more expressed at axonotmesis of peripheral nervous trunks. Rehabilitation with the use of Kumisi therapeutic mud and electro magneto field of millimeter range resulted decrease of inflammation process and body sensitization in patients with traumas of peripheral nervous trunks almost to disappearance of inflammation process and body sensitization. Such rehabilitation increased nonspecific resistance, normalized the indices of immune reactivity. The above-referred positive shifts were comparatively well expressed at neuroapraxia of peripheral nervous trunks. Article Published Date : Mar 01, 2006

Abstract Title: [Psoriasis and mud bath therapy: clinical-experimental study]. Abstract Source: Clin Ter. 2005 Jul-Aug;156(4):145-9. PMID: 16342515 Abstract Author(s): M Costantino, E Lampa Abstract: OBJECTIVE: The psoriasis is chronic disease characterized from an acceleration of the kinetic of the cells of epidermis. To front of the empirical evidence of the benefits of the thermal therapy in the psoriasis, the experimentals-clinics studies is insufficient. The aim of research it has been that of quantify the benefits of the mud-bath therapy with mineral water in the psoriasis. PATIENT AND METHODS: The study has been channel on a champion of 30 subjects of which 19 of male sex and 11 of female sex with middle equal age to 56 years +/- 5.3 affected from psoriasis. The subjects of the examined champion have been divided to random in 2 groups: A and B. The group A has been treated with drugs used for psoriasis for 12 days; the B group has been treated, always for 12 consecutive days, with mud-bath therapy (FBT) with mineral water obtained from the mineral sources (chlorinate-sulphureous-bicarbonate) of the Spa of Stabia in Castellammare (NA). To the beginning and at the end of the advised treatments has been valued the prurient symptomatology and the PASI (Psoriasis and Severity Index). RESULTS: The data highlight an significant (P<0.05) reduction is of the prurient symptomatology and of the PASI in both the groups considered. CONCLUSIONS: The results of this first step of investigations seems to highlight that the FBT treatment, to the same way of the drugs anti-psoriasis, results useful in the ameliorate the quality of life of these patients. Article Published Date : Jul 01, 2005

Abstract Title: Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. Abstract Source: Am J Ind Med. 2003 Feb;43(2):212-20. PMID: 20237929 Abstract Author(s): Antonella Fioravanti, Luca Cantarini, Maria Romana Bacarelli, Arianna de Lalla, Linda Ceccatelli, Patrizia Blardi Article Affiliation: Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci, 1, 53100, Siena, Italy, This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: Adipocytokine, including leptin and adiponectin, may play an important role in the pathophysiology of osteoarthritis (OA). Spa therapy is one of the most commonly used non-pharmacological approaches for OA, but its mechanisms of action are not completely known. The aim of the present study was to assess whether spa therapy modified plasma levels of leptin and adiponectin in thirty patients with knee OA treated with a cycle of a combination of daily locally applied mud-packs and bicarbonate-sulphate mineral bath water. Leptin and adiponectin plasma levels were assessed at baseline and after 2 weeks, upon completion of the spa treatment period. The concentrations of leptin and adiponectin were measured by ELISA. At basal time, plasma leptin levels were significantly correlated with body mass index (BMI) and gender, but no significant correlation was found with patient age, duration of disease, radiographic severity of knee OA, VAS score or Lequesne index. There was no correlation between plasma adiponectin level and BMI, gender and age, duration of the disease, radiographic severity of knee OA and VAS score. A significant correlation of plasma adiponectin levels was found only with the Lequesne index. At the end of the mud-bath therapy cycle, serum leptin levels showed a slight but not significant increase, while a significant decrease (P<0.05) in serum adiponectin levels was found. However, leptin and adiponectin concentrations after treatment were not correlated with other clinical parameters. In conclusion, our data show that spa therapy can modify plasma levels of the adipocytokines leptin and adiponectin, important mediators of cartilage metabolism. Whether this effect may play a potential role in OA needs further investigations. Article Published Date : Feb 01, 2003

Abstract Title: Spa therapy for gonarthrosis: a prospective study. Abstract Source: Rheumatol Int. 1995;15(2):65-8. PMID: 7481482 Abstract Author(s): I Wigler, O Elkayam, D Paran, M Yaron Article Affiliation: Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler Faculty of Medicine, Israel. Abstract: The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior. Article Published Date : Jan 01, 1995