8. Mihajlović D, Stanković A, Marković Z, Karadžić M, Dimić A. Dejstvo prirodnih faktora u prevenciji, lečenju i rehabilitaciji reumatskih bolesti, Klinička studija,Medicinski fakultet u Nišu,1989. 9. Pizzoferrato A, Garzia I, Cenni E, Pratelli L, Tarabusi C: Beta-endorphin and stress hormones in patients affected by osteoarthritis undergoing thermal mud therapy. Laboratorio di Patologia Clinica Istituti Ortopedici Rizzoli, Bologna. Minerva Med 2000 Oct;91(10):239-45 10. Stamenković B, StojanovićA, Stojanović S, Dimić A, Karadžić M.: C- reactive protein-marker disease activity in rheumatoid arthritis during balneotherapy, Health resort medicine in 2nd Millennium, I.S.M.H. Verlag, Matz 2004; 1<strong>35</strong>-136, ISBN 3-934043-05-4 11. Strauss-Blasche G, Ekmekcioglu C, Klammer N, Marktl W. Department of Physiology, University of Vienna, The change of well-being associated with spa therapy. Forsch Komplementarmed Klass Naturheilkd 2000 Dec;7(6):269-74 ___________________________ SUMMARY The <strong>Institut</strong>efor Prevention, Treatment and Rehabilitation of Rheumatic and Cardiovascular Diseases "Niška Banja" THE PLACE OF BALNEOTHERAPY IN THE TREATMENT OF RHEUMATIC DISEASES ALEKSANDAR DIMIĆ Spa therapy comprises the use of natural factors such hydrotherapy, mud therapy, gas, as well as the change of the surrounding and climate, active and passive rest and the combination with physical and medicaments therapy. Spa therapy has a significant place in the treatment of almost all kinds of rheumatic diseases. The effects of balneotherapy are based on the chemical and mineral structure of the components and their absorption. The effects like vasodilatation, the increase of stroke volume, stimulation of metabolism as well as the immune system are well documented. Significant variation of endorphin, cortisol and ACTH the increase of the insulin growth factor 1, decrease of the alpha tumor necrosis factor, decrease of serum levels of azoth oxide and mieloperoxidase are found, and this the explanation for favorable effect of spa therapy in various forms of arthritis. The approach to these patients should be cautious, with the reduction of all elements of so called balneotherapeutic dosage. In the treatment of OA the most favorable influence have carbondioxid, sulphuric and radon waters in the combination with mud therapy. Spa therapy can be also used in the prevention and treatment of OP. Physical activity and exercises have a great impact in the prevention and treatment of established OP. Swimming is especially favorable. During spa treatment an education concerning diet rich in calcium should be performed. After vertebral compression fracture due to OP the use of moist heat can be very useful in order to alleviate the pain and to prepare the patient for exercises that increase the strength of dorsal and abdominal muscles. All these activities are more acceptable during spa treatment in the specialized centers. Spa therapy should be used isolated or in so called balneophysical and balneophysicomedicamentous complex, respecting the principle of the individual dosage. Key woords: balneotherapy, rheumatic diseases
KLINIČKI ČASOVI
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Rezultati: Pregledom ramena RA paci
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pojačavao se u toku narednih dana
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iznosio je 48 h. Davan je Meloxicam
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osteoartrotične promene u radiokar
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smislu smanjenje bola i jačanja m.