No abstract

Medical research has developed remarkably in recent years, including the involvement of the glutathione peroxidase (GPx) family of enzymes in the course of human aging, with numerous clinical studies published in the literature reporting this particular fact. Thus, mud therapy and its effect on biological aging have been represented in papers that have been published to date. Papers published in the literature analyzing GPx vari-ation during sapropelic mud therapy suggest the beneficial effect of this family of en-zymes in diseases with an important inflammatory component, mainly monitored in patients with osteoarthritis. This study investigated the effects of sapropelic mud treat-ment on GPx values in patients receiving treatment with sapropelic mud at the Balneal and Rehabilitation Sanatorium of Techirghiol, Romania. We included 52 patients, split into two groups, who received treatment with cold mud baths and warm mud baths. Values close to statistical significance were found in patients who received treatment with cold mud baths in terms of mean GPx values at the four-time points studied. Fur-ther studies evaluating GPx in patients receiving sapropelic mud treatment are needed.

Obesity is a complex, multifactorial metabolic pathology, within the path of modification of the endocrine system plays a significant role. Changes in growth hormone (GH) and in-sulin growth factor (IGF) have been associated with obesity in various ways, mainly through changes in GH-binding proteins, insulin and ghrelin levels. The balneal treat-ment with Techirghiol Romanian sapropelic mud has an important impact on the endo-crine system, primarily through the action on the hypothalamic-pituitary-adrenal axis. We investigated the secretory changes of the IGF-1 hormone that appeared after the balne-al treatment. It was a total number of 52 patients, divided into two groups: 1 group who performed the treatment with Techirghiol sapropelic mud at thermoneutrality tempera-tures - warm mud baths, and the second group who followed treatment with the balneal therapeutic factor in a thermal contrast regime - cold mud baths. We studied whether there are correlations between the body mass index (BMI) and the secretion of this hor-mone. We also determined the serum levels of blood glucose at admission and discharge. In the cold mud baths- thermal contrast therapy, can be observed a statistically significant increase in IGF-1 values during the balneal treatment (p = 0.044 < α = 0.05). Comparative-ly, in the warm mud baths, the increase in serum IGF-1 reached values close to statistical significance at the end of the treatment (p = 0.067 > α = 0.05). There were no statistically significant correlations between BMI and IGF-1 hormone secretion at admission and at discharge. The results showed a statistically significant decrease in blood glucose values determined at admission and discharge in the group that performed warm mud baths. The balneal treatment with sapropelic mud of Techirghiol lake, from Romania, through the impact on the endocrine system, on the hypothalamic-pituitary-adrenal axis, can be registered as a treatment with a natural therapeutic factor with an impact on obesity, ther-apy carried out within the parameters of metabolic safety, and the conduct of future re-search in this direction it will help develop new concepts and approaches to obesity.

Different theories link chronic musculoskeletal pain with lifestyle components, including diet. However, nutritional assesment and optimization is not routinely included into the medical management of patients with muskuloskeletal diseases (MSKD). In this study we aimed to evaluate the diet and nutritional status of a group of women with MSKD and to assess the extent to which they comply with the general recommendations for a healthy diet. The results showed that 97% of the subjects included were overweight or obese, and the compliance to different general nutritional recommandations ranged between 3% to 57%. Furthermore, the quality of life of this patients measured through SF-36 question-naire was severly affected and the reported pain intensity on numeric pain scale had a mean of 8 (±1.3) in our study group. Although there are currently no specific guidelines for the nutrition of patients with chronic pain, an important first step would be to guide these patients towards an increase in diet quality and a healthy lifestyle by adhering to general nutritional recommendations regarding healthy eating.

It is well known that vitamin D deficiency increases the risk of osteoporosis and that vertebral compressions fractures are a manifestation of osteoporosis. This paper presents the case of a patient with severe osteoporosis associated with vitamin D deficiency who developed over the course of two years multiple vertebral compression fractures. Method: We present the case of a 76-year-old caucasian female diagnosed with osteoporosis and significant vitamin D deficiency who was investigated for mechanical pain and functional deficit at the level of the spine and walking disorders. The patient was hospitalized in our Rehabilitation department twice. At the first hospitalization two years ago, the deficiency of vitamin D was found and the treatment was initiated. During the sec-ond hospitalization, biochemical and radiological investigations were per-formed to establish the diagnosis. Numerous vertebral compression fractures were dis-covered which were not re-vealed in the imaging investigations performed two years earli-er. She underwent symptomatic and appropriate medical rehabilitation treatment. Results and discussion: The evolution was fa-vorable after the hospitalization period, with a decrease in pain and functional deficit, as well as walking improvement. After endocrinological consultation it was decided to initiate therapy with Teriparatide which can decrease the risk of future fractures and reduce the back pain. Con-clusions: Adequate and prompt treatment of vitamin D deficiency and osteoporosis is very im-portant to avoid vertebral compression fractures or other complications of this disease. Physical and rehabilitation medicine also plays an important role in management of these patients.