The aims of this study were to conduct a systematic literature review on balneotherapy about the specific therapeutic role of mineral elements and other chemical compounds of mineral waters and derivate peloids/muds and to discuss the study methods used to evaluate it (in musculoskeletal conditions). We searched Medline by PubMed using the following key words: "spa therapy" "balneotherapy" "mud" "peloid" "mud pack Therapy" in combination with "randomized controlled trial" "double blind trial." We also reviewed the reference list of articles retrieved by the Medline search. We selected the double-blind randomized clinical trials that assessed the effects of mineral water or mud treatments compared to tap water, attenuated peloid/mud therapy or similar treatments without the specific minerals or chemical compounds of the treatment group ("non-mineral"). We evaluated the internal validity and the quality of the statistical analysis of these trials. The final selection comprised 27 double-blind randomized clinical trials, 20 related to rheumatology. A total of 1118 patients with rheumatological and other musculoskeletal diseases were evaluated in these studies: 552 of knee osteoarthritis, 47 of hand osteoarthritis, 147 chronic low back pain, 308 of reumathoid arthritis, and 64 of osteoporosis; 293 of these participants were assigned to the experimental groups of knee osteoarthritis, 24 in hand osteoarthritis, 82 of low back pain, 152 with reumathoid arthritis, and 32 with osteoporosis. They were treated with mineral water baths and/or mud/peloid (with or without other forms of treatment, like physical therapy, exercise…). The rest were allocated to the control groups; they received mainly tap water and/or "non-mineral" mud/peloid treatments. Mineral water or mud treatments had better and longer improvements in pain, function, quality of life, clinical parameters, and others in some rheumatologic diseases (knee and hand osteoarthritis, chronic low back pain, rheumatoid arthritis, and osteoporosis) compared to baseline and non-mineral similar treatments. Internal validity and other limitations of the study's methodology impede causal relation of spa therapy on these improvements. Randomized clinical trials are very heterogeneous. Double-blind randomized clinical trials seem to be the key for studying the role of mineral elements and other chemical compounds, observing enough consistency to demonstrate better and longer improvements for mineral waters or derivate compared to tap water; but due to heterogeneity and gaps on study protocol and methodology, existing research is not sufficiently strong to draw firm conclusions. Well-designed studies in larger patients' population are needed to establish the role of minerals and other chemical compounds in spa therapy.

Caracterización del aerosol marino. Calvo AI, Castro A, Fraile R. RESUMENEn el lenguaje de las ciencias de la atmósfera, el término aerosol designa a las partículas sólidas y/o líquidas presentes en suspensión en una masa de aire, con exclusión de las gotas (o cristales) de nubes y de lluvia. El aerosol marino forma parte del ecosistema y condiciona el clima marítimo así como sus efectos sobre el organismo. En la talasoterapia, el aerosol marino presente en la atmósfera ambiental que se respira adquiere una gran importancia, puesto que el individuo no se puede sustraer a él.En el presenta articula se explica su formación, composición química, propiedades físicas y transporte así como la interacción con el ser humano y el clima.Palabras clave: Aerosol marino, agua, mar, talasoterapia AbstractIn the language of atmospheric sciences, the term aerosol refers to the solid and/or liquid particles present in an air mass, to the exclusion of the droplets (or glasses) of clouds and rain. Marine aerosols constitute a part of the ecosystem and determine the maritime climate; they also can affect the human health. In talasotherapy, inhaled marine aerosols are of great importance because the individual cannot be subtracted from it.In this article formation, chemical composition, physical properties and transport of marine aerosols and their interaction with the human being and climate are explained. Key words: Marine aerosol, water, sea, talasotherapy RésuméDans le jargon des sciences atmosphériques, le terme aérosol désigne les particules solides, ou liquides, présentes en suspensión dans une masse d'air, à l'exclusion des gouttelettes nuageuses et des cristaux de glace. L'aérosol marin constitue une partie de l'écosystème et conditionne le climat maritime ainsi que ses effects sur l'organisme.En thalassothérapie, l'aérosol marin que l'on respire est très important, puisque on ne peut pas s'y soustraire. Cet article traite de la formation, de la composition chimique, des propriétés physiques et du transport de l'aérosol marin, ainsi que de l'interaction avec l'être humain et le climat.

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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.

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Introduction: In the context of obesity pandemic, the health care providers involved in the primary care should have a significant role. Several guidelines for the management of obesity in primary care were proposed recently. In general lines, these guidelines include recommendation on the baseline assessment, therapy and algorithm for referral to specialized obesity clinic and follow-up. Nevertheless, at present there is no guideline or protocol that continuously and bidirectionally links the two settings: primary care and specialized obesity clinic. Methods: We present a model of continuous, bilateral and integrative interaction between primary care units and reference tertiary care setting in the chronic management of obesity that is already implemented in a public health system. Results: The novelty of our algorithm is that incorporates the support and continuous communication with the specialized obesity clinic of the tertiary care setting from the beginning in the management of a patient with obesity, in a bidirectional manner. Conclusion: This kind of bidirectional and continuous collaboration will help engage health care providers in the management of obesity, optimize efforts, shorten the time until proper intervention, personalize the approach and, finally, save costs for the health system.

Caracterización del aerosol marino. Calvo AI, Castro A, Fraile R. RESUMENEn el lenguaje de las ciencias de la atmósfera, el término aerosol designa a las partículas sólidas y/o líquidas presentes en suspensión en una masa de aire, con exclusión de las gotas (o cristales) de nubes y de lluvia. El aerosol marino forma parte del ecosistema y condiciona el clima marítimo así como sus efectos sobre el organismo. En la talasoterapia, el aerosol marino presente en la atmósfera ambiental que se respira adquiere una gran importancia, puesto que el individuo no se puede sustraer a él.En el presenta articula se explica su formación, composición química, propiedades físicas y transporte así como la interacción con el ser humano y el clima.Palabras clave: Aerosol marino, agua, mar, talasoterapia AbstractIn the language of atmospheric sciences, the term aerosol refers to the solid and/or liquid particles present in an air mass, to the exclusion of the droplets (or glasses) of clouds and rain. Marine aerosols constitute a part of the ecosystem and determine the maritime climate; they also can affect the human health. In talasotherapy, inhaled marine aerosols are of great importance because the individual cannot be subtracted from it.In this article formation, chemical composition, physical properties and transport of marine aerosols and their interaction with the human being and climate are explained. Key words: Marine aerosol, water, sea, talasotherapy RésuméDans le jargon des sciences atmosphériques, le terme aérosol désigne les particules solides, ou liquides, présentes en suspensión dans une masse d'air, à l'exclusion des gouttelettes nuageuses et des cristaux de glace. L'aérosol marin constitue une partie de l'écosystème et conditionne le climat maritime ainsi que ses effects sur l'organisme.En thalassothérapie, l'aérosol marin que l'on respire est très important, puisque on ne peut pas s'y soustraire. Cet article traite de la formation, de la composition chimique, des propriétés physiques et du transport de l'aérosol marin, ainsi que de l'interaction avec l'être humain et le climat.