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OLGA SURDU SIBEL DEMIRGIAN

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In BRST elderly patients are admitted with a referral letter from their general physicians or with a balneal ticket from National House of Pension Patients scheduled for a physician will present the documents at the admissions committee The admissions committee is composed from two specialist s in Rehabilitation who established at the same time contraindications for balneal cure

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If the patients does not have contraindications will be registered by the admissions office After accommodation they go to physician for a complete medical examination The physician get the patients medical history and perform a general and specific musculoskeletal exam After that physician asseses the laboratory tests, radiological results, he diagnoses the patient and establishes the rehabilitation plan

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Local examination of osteoarticular system includes: articular and muscular evaluation and patient assessment using different scales, depending on pathology For patients with uncertain diagnostic the physician recommends laboratory tests, radiologic examination or rheumatologic consult An initial consult is recommended for patients with gynecological affections for diagnosis and treatment with specific factors

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Balneal treatment (usual applied in BRST): hydro-(kineto)-thermo-therapy: once a day;

Adjuvant treatment (physiotherapy): 2 4 adjuvant electrotherapy procedures; Kinetotherapy in the gym room 1-2 time a day and one session (daily) of massage

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hydro-kineto-thermotherapy in the swimming pool with salt water from the lake (3536C), applied individual or to a group of patients with similar deficiency or

hydro-thermo-therapy

bathing (without kinetotherapy) using salt water or plant extract (37 37.5C), or mud bath (3838.5C), or mud wrapping (4245C)

in special tubes using tap water/salt water (36-37C), applied individual;

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For mud bath we use 10 Kg mud put in 120-150L salty lake water. The temperature of mud bath is between 370-390C and stand 20-25 minutes. After bath the patients receive a warm shower for mud cleaning, and a short cold shower in order to stop reflex vein vasodilatations.
Salt bath can be done in a single tub, at 370-380C temperature, alternative with mud bath, or hydrokinetotherapy in pool with salty lake water at 350C.

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Mud wrapping is done using 10-15 kg mud, heated to 42C - 45C. Mud is spread all over the body, from the feet to the cervical region. The patient is covered with a sheet and a blanket and we apply a cold compress on his forehead to prevent excessive vasodilation of cerebral vessels. The time applications is 30 min. In the end of procedure the patients receive a warm shower for mud cleaning and a short cold shower in order to stop reflex vein vasodilatations.

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Fever; Infectious diseases - including the venereal diseases (syphilis, clap, AIDS, hepatitis acute type B, C, etc.); tuberculosis - except in cases with healing confirmed by the specialist physician; healthy carriers of pathogens - including parasitic agents; Cachectic states, by any causes; Cancers, in every location or stage; Bleeding from any cause; Hematological diseases; Epilepsy, psychopathy - including chronic alcohol or other drug addiction;

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Organ failure status (cardiac, renal, hepatic insufficiency difficult to control with medication, high blood pressure without therapeutic control; Lesions and/or skin diseases, with aggravation risk, areas with skin irritation, solutions of continuity; Patients who can not care for themselves; Patients recovering from serious and recent illness Pathological pregnancy no matter pregnancy age and normal pregnancy after three months

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Qualified staff must examine the patient before immersion in tub or in swimming pool. General warm procedures must not be applied secondary abundant meals (lunch), stress or physical exercises. It is preferred that application should take place in the morning.

If the patient has two major procedures in the same morning, it is necessary to have a 2 hours break between them.

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The cold mud application will be done only on warm skin or on sun heated skin Hot or warm mud applications will always be followed by a short cold shower, in order to avoid consecutive vasoplegia The assistant/therapist must supervise the patient carefully meanwhile the application, in order to prevent incidents or accidents which can happen.

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