The ongoing concern regarding the management of the metabolic syndrome and its complications requires the permanent approach of therapeutic solutions. Balneotherapy has been used for much time for treatment of different illness. The most common uses of mineral therapeutic waters are represented by drinking or bath cures. The positive influence of this form of therapy can be attributed to the water composition and its physical chemical properties of the water fi rstly, and second to the climatic, nutritional and social factors that are specifi c to the balneary resort. The aim of the study was to express our current experience regarding the impact that balneary support has in managing different metabolic conditions. We performed a review using online databases, and also hand research of the available studies regarding the subject, in order to acquire more information regarding the research that was conducted on this fi eld. The analysis indicates a signifi cant amount of data regarding the use of mineral therapeutic waters, resulting that through their specifi c composition it can provide a modulation of the parameters that defi ne the metabolic syndrome.

Background Posterior shoulder dislocations are rare injuries that are often missed on initial presentation. Cases left untreated for more than three weeks are considered chronic, cannot be reduced closely (they become locked) and are usually associated with a significant reverse Hill-Sachs defect. The aim of this study was to evaluate the outcomes of chronic locked posterior shoulder dislocations treated with the McLaughlin procedure (classic or modified). Methods This retrospective study included 12 patients with chronic locked posterior shoulder dislocation operated on between 2000 and 2021 by two surgeons in two institutions. Patients received a thorough clinical examination and radiological assessment before and after surgery. Shoulders were repaired with the McLaughlin or modified McLaughlin procedure. Outcomes were assessed by comparing pre- and postoperative values of clinical variables. Results Most of the dislocations were of traumatic origin. The average delay between dislocation and surgical reduction was 13.5 ± 9.7 weeks. Postoperative clinical outcomes were favourable, with an average subjective shoulder value of 86.4 ± 11.1 and a normalized Constant –Murley score of 90 ± 8.3. None of the patients had a recurrence of shoulder dislocation, but one patient developed avascular necrosis of the humeral head and two patients developed glenohumeral osteoarthritis. Conclusions In this group of patients with chronic locked posterior shoulder dislocation, the clinical outcomes of McLaughlin and modified McLaughlin procedures were satisfactory, even when surgery was significantly delayed.

Total knee arthroplasty is a frequently met replacement procedure for patients with degenerative knee disease. The main purpose of the intervention is to provide pain relief and to promote range of motion and joint stability for patients in which conservative options such as pharmacological treatment or physical therapy can’t accomplish any more an adequate symptom alleviation. Most guidelines regarding the first stage of the rehabilitation process recommend early mobilization in order to gain as quickly as possible functional independence, and also to promote muscle strength and coordination. This should be done from the first day post surgery, depending on the patients compliance. In the subacute stage, the emphasis is put on maintaining a progression of the weight-bearing status, and promoting normal walking without the use of an assistive device. Patient education will be focused on changes that need to be made in a domestic environment and also modifications regarding social and professional activities. The third phase of the rehabilitation process focuses on limb symmetry and equal weight bearing which represent absolute objectives that need to be obtained. Balance exercises will include progression from bilateral to unilateral, and integration of unstable surfaces if possible associated with cardiovascular training. This phase of the rehabilitation process is considered to be completed once all realistic functional goals are achieved.

Environmental problems that arise from acidic water containing aluminum generated from condensing thermal power plants can be suitably solved using membrane processes. In this paper, simultaneous neutralization with aluminum ion separation, from acidic waters containing aluminum traces, through permeation with polypropylene with inclusions of cellulose derivatives (PP / CellD)capillary composite membranes is approached. Cellulose derivatives considered are: acetylcellulose, carboxymethylcellulose, 2-hydroxyethyl cellulose, methyl 2 hydroxyethyl cellulose. The optimum working parameters for the best performance of composite membrane based on carboxymethylcellulose were determined: operating time and pH of the receiving phase. Simultaneously with the quantitative removal of the aluminum ions, it is obtained an almost neutral pH purified water, compatible with the natural waters in which it can be dispersed.