Search Results (17)

Background: In the 19th century, pulmonary tuberculosis was the leading cause of death in Europe, responsible for up to one-quarter of all mortality. Before Robert Koch’s discovery of the tubercle bacillus in 1882 and the advent of effective therapies, treatment relied on rest, high-caloric diets, and sanatoria. Objectives: This study aims to reconstruct the medical biography of Dr. Șerban Eminovici (1841–1874), Romanian physician and elder brother of poet Mihai Eminescu, and to contextualize his life and death within the broader history of tuberculosis and pre-antibiotic medical practice. Methods: We conducted a historical case study using archival sources, including university registers from Erlangen, Munich, and Vienna, hospital admission records from the Charité Hospital in Berlin, and contemporaneous correspondence. Secondary literature on the history of tuberculosis and the Eminovici family was also reviewed. Results: Eminovici pursued medical studies across Central Europe, obtaining his doctorate in Vienna and later practicing medicine in Berlin, where he was a member of the Berliner Medizinische Gesellschaft. Despite early signs of respiratory illness, treated at spa resorts such as Gleichenberg, his condition progressed to advanced pulmonary tuberculosis with neuropsychiatric complications. Hospital records confirm his admission to the Charité on 10 October 1874, and his death from “Lungenschwindsucht” (pulmonary tuberculosis) on 29 November 1874, at age 33. His trajectory illustrates both the transnational mobility of Romanian intellectual elites and the therapeutic limitations of pre-antibiotic medicine. Conclusions: The case of Dr. Șerban Eminovici highlights the devastating impact of tuberculosis on 19th-century intellectuals, the reliance on lifestyle-based therapies before the discovery of the tubercle bacillus, and the importance of Central European medical networks in shaping Romanian professional identities. Beyond its biographical significance, this case underscores the persistent social and cultural burden of tuberculosis in Eastern Europe. Full article

Background/Objectives: Interstitial lung disease (ILD) is a frequent complication of rheumatoid arthritis (RA), representing the most common extra-articular manifestation (with a prevalence of about 10–60%) and the second cause of mortality. Spondyloarthritides (SpAs) are chronic arthritides that share with RA both a similar disease burden and similar therapeutical approaches. The evaluation of ILD is challenging, given the low sensitivity of X-ray and pulmonary function tests, and the radiation exposure linked to repetitive HRCT. Lung ultrasound (LUS) has shown potential in the evaluation of ILD in autoimmune diseases. The purpose of this study is to assess the prevalence of ILD in a cohort of SpA patients (pts) using LUS in comparison with healthy subjects (HSs). The secondary aim is to evaluate potential correlations between ILD and clinical features within the SpA cohort using LUS. Methods: Consecutive SpA out-patients were examined by LUS, applying the definition for pleural line irregularity (PLI) recently provided by the OMERACT taskforce for LUS in systemic sclerosis. Seventy-one intercostal spaces were studied (14 in the anterior chest, 27 lateral and 30 posterior) in all the pts/HS using an Esaote MyLab25 Gold US machine with a linear 7.5–10 MHz probe. A total pleural score was calculated. Each patient answered to Italian-validated PROs on respiratory function (Leicester and Saint-George), global health (SF-36) and dyspnea (mMRC scale). Clinical data on disease duration, disease onset, disease activity (at the moment of the examination) and methotrexate (MTX) or biologics treatment were collected from the medical records. Results: Seventy-three SpA pts (46 psoriatic arthritis -PsA- and 27 ankylosing spondylitis -AS-) and 56 HS were studied. No significant differences were demonstrated between groups (SpA vs. HS and PsA vs. AS) for age, sex, BMI and smoking habits. The total PLI score was significantly higher in SpA pts than in HS (p < 0.001). A positive correlation was found between the total PLI score and the PLI score from anterior, posterior and lateral chest. The posterior region of the chest showed a higher PLI score than the anterior and lateral regions. No statistically significant differences were found between PsA and AS. MTX use was not a risk factor for PLI (no differences were found between SpA MTX+ and SpA MTX- patients). PROs (Leicester, Saint-George and SF-36) were not related to the PLI total score. A significant correlation was found only between the SF36 score and the presence of PLI in the anterior chest. PROs were instead correlated with each other, showing a good concordance for absence/presence of symptoms. Disease activity, disease duration and age at disease-onset were not related to PLI total score. Smoking habit was found to be predictive of a significantly higher PLI score both in SpA patients and HSs. Conclusions: LUS examination shows a higher amount of PLI in SpA patients with respect to HSs. Smoking habit was the only clinical feature correlated to PLI on LUS examination in our population. Full article

Objectives: Epistaxis is a common condition affecting up to 60% of the population, with approximately 6% requiring medical intervention. Posterior epistaxis is particularly challenging, often necessitating endoscopic or endovascular treatment. Sphenopalatine artery (SPA) embolization is an effective treatment option, though concerns remain about the risks associated with nonselective or bilateral approaches. This study evaluates the efficacy and safety of unilateral superselective SPA embolization in managing severe posterior epistaxis. Methods: A prospective study of patients undergoing unilateral superselective SPA embolization for refractory posterior epistaxis over a four-year period was conducted. Demographic data, clinical history, prior treatments, and procedural characteristics were analyzed. The primary endpoint was clinical success, defined as the absence of recurrent bleeding within 24 h post-procedure. Secondary outcomes included recurrence at one month and complication rates. Results: Thirty-two patients with severe posterior epistaxis were included. All required nasal packing prior to embolization. Half had undergone previous endoscopic cauterization. Hypertension was present in 69%, and 56% were receiving anticoagulant or antiplatelet therapy. Clinical success was achieved in 100% of cases, with no rebleeding in the first 24 h. Two patients (6%) experienced early recurrence within seven days, requiring readmission. Minor complications included nasal dryness in two cases (6%); no major complications occurred. Mean fluoroscopy time was 19.9 ± 11 min. Conclusions: Unilateral superselective SPA embolization is a safe and highly effective treatment for severe posterior epistaxis, offering high initial success and low complication rates. Its adoption may reduce the need for bilateral procedures and surgical interventions. Full article

Background: In our modern era, stress has become a pervasive challenge, affecting individuals across all ages and backgrounds. Acute or chronic stress and elevated cortisol levels are known to impair neurological function and hinder rehabilitation outcomes. Therefore, effective treatment methods that reduce stress, enhance mental health, and promote overall well-being are urgently needed. The aim of this study was to evaluate the seasonal impact of balneotherapy on distress, as measured by the General Symptoms Distress Scale (GSDS), and well-being, as assessed using the Arizona Integrative Outcomes Scale (AIOS), and the effect of winter balneotherapy on salivary cortisol levels. Methods: In 2023, a multicenter, single-blind, parallel-group, randomized controlled trial was carried out across six medical spa centers in Lithuania. Participants with a stress intensity greater than 3 points on the Visual Analogue Scale (VAS) underwent combined natural resource-based therapies over a 1- to 2-week treatment period. Outcomes were assessed using the General Symptom Distress and Arizona Integrative Outcomes scales, along with salivary cortisol measurements after winter intervention. Results: The results demonstrated a significant reduction in distress intensity by 1–3.5 points (VAS), with winter interventions showing greater efficacy compared to summer. Participants also experienced an increase in well-being by up to 3 points (VAS), improved stress management by up to 1.9 points (VAS), and a reduction in salivary cortisol levels by 0.9 units following winter-based treatments. Some gender differences emerged in specific groups. Conclusions: Our study provides robust evidence for the stress-reducing effects of balneotherapy, particularly highlighting the enhanced efficacy of winter interventions. These findings are especially relevant for neurological rehabilitation, where stress reduction and improved autonomic regulation can support neuroplasticity, recovery processes, and overall quality of life. This research offers valuable insights for developing holistic, seasonally optimized strategies to aid stress management and promote neurological health. Full article

Integrating modern and innovative technologies such as the Internet of Things (IoT) and Machine Learning (ML) presents new opportunities in healthcare, especially in medical spa therapies. Once considered palliative, these therapies conducted using mineral/thermal water are now recognized as a targeted and specific therapeutic modality. The peculiarity of these treatments lies in their simplicity of administration, which allows for prolonged treatments, often lasting weeks, with progressive and controlled therapeutic effects. Thanks to new technologies, it will be possible to continuously monitor the patient, both on-site and remotely, increasing the effectiveness of the treatment. In this context, wearable devices, such as smartwatches, facilitate non-invasive monitoring of vital signs by collecting precise data on several key parameters, such as heart rate or blood oxygenation level, and providing a perspective of detailed treatment progress. The constant acquisition of data thanks to the IoT, combined with the advanced analytics of ML technologies, allows for data collection and precise analysis, allowing real-time monitoring and personalized treatment adaptation. This article introduces an IoT-based framework integrated with ML techniques to monitor spa treatments, providing tailored customer management and more effective results. A preliminary experimentation phase was designed and implemented to evaluate the system’s performance through evaluation questionnaires. Encouraging preliminary results have shown that the innovative approach can enhance and highlight the therapeutic value of spa therapies and their significant contribution to personalized healthcare. Full article

Spa therapy is a medical treatment based on the use of natural mineral water. In France, spa therapy is delivered in spa care facilities (SCF) involving the intervention of several actors (stakeholders). Spa doctors are key stakeholders as they prescribe the treatments, follow spa patients and assess spa therapy with scientific studies. This study aimed to analyze the spa doctors’ relationships in order to highlight their role in transferring information to other stakeholders, particularly to spa managers. For that purpose, we used the social network analysis (SNA) method by means of snowball data collection. We sent a questionnaire to all the spa therapy categories of actors. In total, 80 persons answered and declared 397 relationships. Our results, based on the categorization of respondents and of their relationships and on quantitative indicators (density, response rate), show that spa doctors demonstrate a very acceptable density of relations with spa managers and elected local authorities. However, they appear to be poorly involved in relations concerning the strategy and management of SCF, although they are essential actors in ensuring the medical relevance and sustainability of spa therapy. This research is of interest to patients’ care as it recommends deeper involvement of spa doctors in the management of SCF in order to optimize access to informational resources, specifically regarding the evolution of treatments in accordance with scientific progress. Our data are of international scope because the organizational model of balneotherapy, based on the cooperation between spa doctors and SCF, is universal. Full article

Maintaining periodontal and peri-implant soft tissues health is crucial for the long-term health of teeth and dental implants. New biomedical strategies aimed at avoiding connective tissue alterations and related diseases (e.g., periodontitis and peri-implantitis) are constantly evolving. Among these, collagen-based medical products have proven to be safe and effective. Accordingly, the aim of the present study was to evaluate the effects of Dental SKIN BioRegulation (Guna S.p.a., Milan, Italy), a new injectable medical device composed of type I collagen of porcine origin, on primary cultures of human gingival fibroblasts (hGF). To this end, hGF were cultured on collagen-coated (COL, 100 µg/2 mL) or uncoated plates (CTRL) before evaluating cell viability (24 h, 48 h, 72 h, and 7 d), wound healing properties (3 h, 6 h, 12 h, 24 h, and 48 h), and the activation of mechanotransduction markers, such as FAK, YAP, and TAZ (48 h). The results proved a significant increase in cell viability at 48 h (p < 0.05) and wound closure at 24 h (p < 0.001) of hGF grown on COL, with an increasing trend at all time-points. Furthermore, COL significantly induced the expression of FAK and YAP/TAZ (p < 0.05), thereby promoting the activation of mechanotransduction signaling pathways. Overall, these data suggest that COL, acting as a mechanical bio-scaffold, could represent a useful treatment for gingival rejuvenation and may possibly help in the resolution of oral pathologies. Full article

Background: Kivach Clinic has developed a special medical spa program to prevent aging-related conditions in metabolic, cardio-vascular, and neurological states. Spa programs modify diet, physical activity, and lymphatic drainage, as it deteriorates with aging. We investigated its influence on the blood markers of biological age of patients during their stay to objectify the potential of spa treatment for influencing the risk of age-related events. Methods: The artificial deep learning model Aging.ai 3.0 was based on blood parameters. The change in the biological age of 43 patients was assessed after their 14-day spa treatment at Kivach Clinic. Results: Biological age decreased in 29 patients (median decrease: 8 years, mean: 8.83 years), increased in 10 patients (median increase: 3 years, mean: 5.33 years) and remained unchanged in 4 patients. Overall mean values for the entire patient group were as follows: median value was −3 years, and mean was −4.79 ± 1.2 years (p-value = 0.00025, t-test). Conclusions: The capability of specially selected medical spa treatment to reduce human biological age (assessed by Aging.AI 3.0) has been established. Full article

Spondyloarthritis (SpA) patients suffer from joint inflammation resulting in tissue damage, characterized by the presence of numerous neutrophils in the synovium and synovial fluid (SF). As it is yet unclear to what extent neutrophils contribute to the pathogenesis of SpA, we set out to study SF neutrophils in more detail. We analyzed the functionality of SF neutrophils of 20 SpA patients and 7 disease controls, determining ROS production and degranulation in response to various stimuli. In addition, the effect of SF on neutrophil function was determined. Surprisingly, our data show that SF neutrophils in SpA patients have an inactive phenotype, despite the presence of many neutrophil-activating stimuli such as GM-CSF and TNF in SF. This was not due to exhaustion as SF neutrophils readily responded to stimulation. Therefore, this finding suggests that one or more inhibitors of neutrophil activation may be present in SF. Indeed, when blood neutrophils from healthy donors were activated in the presence of increasing concentrations of SF from SpA patients, degranulation and ROS production were dose-dependently inhibited. This effect was independent of diagnosis, gender, age, and medication in the patients from which the SF was isolated. Treatment of SF with the enzyme hyaluronidase strongly reduced the inhibitory effect of SF on neutrophil activation, indicating that hyaluronic acid that is present in SF may be an important factor in preventing SF neutrophil activation. This finding provides novel insights into the role of soluble factors in SF regulating neutrophil function and may lead to the development of novel therapeutics targeting neutrophil activation via hyaluronic acid or associated pathways. Full article

Study: Soft robots can achieve the desired range of motion for finger movement to match their axis of rotation with the axis of rotation of the human hand. The iterative design has been used to achieve data that makes the movement smooth and the range of movement wider, and the validity of the design has been confirmed through practical experiments. Limitation: The challenges facing this research are to reach the most significant inclined angle and increase the force generated by the actuator, which is the most complicated matter while maintaining the desired control accuracy. The motion capture system verifies the actual movement of the soft pneumatic actuator (SPA). A tracking system has been developed for SPA in action by having sensors to know the position and strength of the SPA. Results: The novelty of this research is that it gave better control of soft robots by selecting the proportional, integral, and derivative (PID) controller. The parameters were tuned using three different methods: ZN (Ziegler Nichols Method), GA (Genetic Algorism), and PSO (Particle Swarm Optimization). The optimization techniques were used in Methods 2 and 3 in order to reach the nominal error rate (0.6) and minimum overshoot (0.1%) in the shortest time (2.5 s). Impact: The effect of the proposed system in this study is to provide precise control of the actuator, which helps in medical and industrial applications, the most important of which are the transfer of things from one place to another and the process of medical rehabilitation for patients with muscular dystrophy. A doctor who treats finger muscle insufficiency can monitor a patient’s ability to reach a greater angle of flexion or increase strength by developing three treatment modalities to boost strength: Full Assisted Movement (FAM), Half Assisted Movement (HAM), and Resistance Movement (RM). Full article

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016–2018 in the form of a questionnaire interview among patients—consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities (N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients’ lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients. Full article

Peat is the main type of peloid used in Polish cosmetic/healing spa facilities. Depending on treatment and origin, peat waste can be contaminated microbiologically, and as a result, it must be incinerated in medical waste incineration plants without energy recovery (local law). Such a situation leads to peat waste management costs increase. Therefore, in this work, we checked the possibility of peat waste upcycling to carbonized solid fuel (CSF) using torrefaction. Torrefaction is a thermal treatment process that removes microbiological contamination and improves the fuel properties of peat waste. In this work, the torrefaction conditions (temperature and time) on CSF quality were tested. Parallelly, peat decomposition kinetics using TGA and torrefaction kinetics with lifetime prediction using macro-TGA were determined. Furthermore, torrefaction theoretical mass and energy balance were determined. The results were compared with reference material (wood), and as a result, obtained data can be used to adjust currently used wood torrefaction technologies for peat torrefaction. The results show that torrefaction improves the high heating value of peat waste from 19.0 to 21.3 MJ × kg⁻¹, peat main decomposition takes place at 200–550 °C following second reaction order (n = 2), with an activation energy of 33.34 kJ × mol⁻¹, and pre-exponential factor of 4.40 × 10⁻¹ s⁻¹. Moreover, differential scanning calorimetry analysis revealed that peat torrefaction required slightly more energy than wood torrefaction, and macro-TGA showed that peat torrefaction has lower torrefaction constant reaction rates (k) than wood 1.05 × 10⁻⁵–3.15 × 10⁻⁵ vs. 1.43 × 10⁻⁵–7.25 × 10⁻⁵ s⁻¹. Full article

The present paper consists of a co-word analysis of the previous research in the medical spa field published in the Web Science Core Collection database. The study’s main purpose is to identify the past trends in the medical spa field from the tourist and medical perspectives and to anticipate the future research focuses in the field. In this regard, the article is based on four objectives that create a descriptive picture of the research in the medical spa area, such as (i) studying the current state of the art, (ii) analysing the most visible articles in the field, (iii) highlighting the leading research interests in medical spa research and (iv) anticipating new possible research trends that link cost-effective medical spa activity to COVID-19 post-recovery treatments. A total of 627 articles, published between 1997 and 2021 (March), were analysed, and the data were interpreted using the VOS Viewer software. The study results indicate that high interest in medical spas started to become observable in 2015, when the funding bodies became interested in this field and began supporting publishing and research regarding medical spas. The main subjects investigated in previous studies were related to the specific issues of the industry and tourism activity. They also considered the medical approach of the spa and the use of natural resources in treating different diseases. Except for these main interests, since 2020, it has started to become evident that another approach in the published studies may lead to a new trend in research. The study results show that researchers have begun to investigate the possibility of using medical spa resorts to aid post-COVID-19 recovery, which is considered a cost-efficient option for completing traditional treatment. This new focus in research proves that the medical spa field can rebrand itself as playing a supportive role in national healthcare systems in countries with a long tradition in balneotherapy, and gives a new developing trajectory to the medical spa industry. Full article

The use of peloids as heat-providing therapeutic systems dates back to antiquity. Such systems consist of a liquid phase and an organic or inorganic solid phase. The latter facilitates the handling, preparation and stability of the solid–liquid system, modifying its organoleptic and phy-sicochemical properties, and improves its efficacy and tolerance. Peloids enable the application of heat to very specific zones and the release of heat at a given rate. The aims of this work are to study 16 reference peloids used in medical spa centers as thermo-therapeutic agents as well as to propose nine raw materials as a solid phase for the preparation of peloids. The physical properties studied are the centesimal composition, the instrumental texture and the thermal parameters. In conclusion, the peloids of the medical spas studied are used as thermotherapeutic agents in the treatment of musculoskeletal disorders, especially in knee osteoarthritis and to a lesser extent in back pain and psoriatic arthropathy. The clinical experience in these centers shows that the main effects of the application of their peloids are the reduction of pain, an increase in the joint’s functional capacity and an improvement in the quality of life. As thermotherapeutic agents, all the peloids of the me-dical spas studied and the pastes (raw materials with distilled water) examined showed a heat flow rate of up to four times lower than that shown by the same amount of water. The raw materials studied can be used as solid phases for the preparation of peloids with mineral waters. Full article

The article deals with the financing of spa undertakings through the health insurance system. The analysis is based on the financial statements of 28 spa undertakings operating in the Slovak Republic, their contracts with the individual health insurance companies and secondary data sources (accommodation statistics of these undertakings, the number of medical stays paid by clients themselves and of those covered by public health insurance, the spa treatment expenditure of the health insurance companies, the percentage of this expenditure out of the total expenditure spent by the health insurance companies on health care). The still significant percentage of revenues from the health insurance companies out of the total revenues of spa undertakings shows the prevalence of the medical nature of spa care. At the same time, it reflects the current tax measures related to the spa industry and shows that the introduction of a recreation allowance might influence the future development of spa care. Full article