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[Effect of health resort treatment on the circadian rhythm of follicle-stimulating hormone (FSH), lutropin (LH), and testosterone in male patients with diabetes mellitus].

In diabetic patients disturbances of pituitary-gonadal axis are observed. The aim of the study was to investigate whether in male diabetic patients the circadian rhythms of FSH, LH and testosterone are maintained normal and whether the treatment in a health resort affects the circadian rhythms of investigated hormones. The study regards 5 male patients with insulin dependent diabetes mellitus type I and in 10 male patients with diabetes mellitus type II. In order to assess the circadian rhythm serum FSH, LH and testosterone were determined four times a day at 6.00, 12.00, 18.00 and 24.00. Serum concentration of FSH and LH was determined by LIA and testosterone by RIA. The investigation was done twice: on the third day of a health resort treatment and then on the 23rd day of the treatment. The results were analysed using the Cosinor test. It has been shown that the circadian rhythm of LH, FSH and testosterone is maintained in diabetic patients. During the health resort treatment the midline value (mesor) of serum concentration and the amplitude of of circadian rhythms of LH and testosterone increased in diabetic patients, whereas the FSH circadian rhythm did not change. During the health resort treatment a significant change of testosterone circadian rhythm acrophase from 7.32 to 5.16 was observed in diabetic patients.

Adult↗

Influence of health resort treatment on insulin and C-peptide concentration in girls with insulin-dependent diabetes.

The influence of treatment in health resorts on the behaviour of C-peptide and insulin concentrations was evaluated in serum and urine of diabetics. The group examined comprised 68 girls with insulin-dependent diabetes estimated by radioimmunological methods. The study was carried out during and after health resort treatment. C-peptide initial concentrations constituted the basis for the examined and comparative group division into the following sub-groups: A--C-peptide secretion within standard limits, B--C-peptide trace secretion, and C--patients whose C-peptide concentrations were not determined. After health resort treatment a statistically significant difference of C-peptide secretion was found in serum in the groups with the well preserved secretion and that with only traces of C-peptides. A statistically significant difference in insulin concentrations was also found. Summing up, after health resort treatment of insulin-dependent diabetics with preserved only insignificant secretion of endogenous C-peptide, the secretion of this hormone increased.

Adolescent↗

Choice of medicine and hierarchy of resort to different health alternatives among Asian Indian migrants in a metropolitan city in the USA.

UNLABELLED: Medical pluralism is common among Asian Indians and the increasing popularity of complementary and alternative medicines in the USA has now provided Asian Indian immigrants with a wide variety of treatment options to choose from for their ailments. Many a times, these options are used simultaneously with each other. OBJECTIVE: The objective of the study was to examine the choice of medicine and the hierarchy of resort to the different health alternatives by a selected Asian Indian immigrant population in the USA. DESIGN: In-depth interviews were conducted with 21 informants from a metropolitan city in the USA regarding their choice of alternatives and the order in which they choose the different health alternatives. Thematic analysis was carried out to interpret the data. RESULTS: The different choices for treatment of illness included folk remedies, ayurveda, homeopathy and allopathic medicine. Home remedies and Indian medical alternatives were the first resort in case of minor ailments while allopathic medicine was the first choice for serious and chronic illnesses. CONCLUSIONS: The decision to choose from among different alternatives for treatment of illness depends on people's beliefs about the severity of illness and the effectiveness of treatment options while the hierarchy of resort depends on the kind of illness. The hierarchy of resort to treatment followed the counter-acculturative pattern for minor illnesses and acculturative pattern for major or chronic illnesses.

Acculturation↗

Isolation of Vibrio cholerae O1 strains similar to pre-seventh pandemic El Tor strains during an outbreak of gastrointestinal disease in an island resort in Fiji.

Five strains of Vibrio cholerae O1, one each from an Australian and a New Zealand tourist with gastrointestinal illness returning from an island resort in Fiji and the remaining three from water sources located in the same resort, were extensively characterized. Conventional phenotypic traits that are used for biotyping of O1 V. cholerae categorized all five strains as belonging to the El Tor biotype. Genetic screening of 11 regions that are associated with virulence in V. cholerae showed variable results. The absence of genes comprising Vibrio seventh pandemic island-I (VSP-I) and VSP-II in all the strains indicated that these strains were very similar to the pre-seventh pandemic V. cholerae O1 El Tor strains. The ctxAB genes were absent in all strains whereas orfU and zot were present in four strains, indicating that the strains were non-toxigenic. Four strains carried a truncated CTX prophage. Although epidemiological and molecular studies suggested that these strains did not cause cholera amongst tourists at the resort, their similarity to pre-seventh pandemic strains, their prior association with gastrointestinal illness and their presence in the island resort setting warrant more attention.

Adult↗

Spa resort use and health-related quality of life, sleep, sickness absence and hospital admission: the Japanese civil servants study.

OBJECTIVE: To examine whether spa resort use is associated with the health of Japanese employees. DESIGN: Cross-sectional survey. PARTICIPANTS: 3341 employees (2280 males and 1061 females) aged 20-65 in local government in Japan. MAIN OUTCOME MEASURES: The physical and mental component summary scores (PCS and MCS) of the Short Form 36 (SF-36), sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), sickness leave (> or =7 days in the previous year), and hospital admission in the previous year. RESULT: The PCS and MCS increased with the frequency of spa resort use in men and women. Less frequent use was associated with poor sleep quality for men and women and sickness leave for men. There was no significant relationship between use frequency and hospital admission. CONCLUSIONS: Spa resort use may have beneficial effects on physical and particularly mental health. Longitudinal research is necessary to clarify the causality.

Adult↗

An outbreak of cryptosporidiosis associated with a resort swimming pool.

An outbreak of cyptosporidiosis occurred in late April 1993 among resort hotel guests which was temporally associated with, but geographically distant from, a massive waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, that occurred in late March and early April of 1993. A case-control study was performed among groups with members who reported illness and among a systemic sample of groups who stayed at the resort hotel during the risk period. Of 120 persons interviewed, 51 (43%) met the case definition. Swimming in the resort hotel's pool was significantly associated with case status (OR = 9.8; 95% Cl 3.4, 29.7), as was consumption of ice from the hotel's ice machines (OR = 2.3; 95% Cl 1.01, 5.2). When analysis was restricted only to laboratory-confirmed cases and controls, swimming pool use was the only risk factor significantly associated with illness (OR = 13.0; 95% Cl 2.6, 88.7). Following waterborne outbreaks of cryptosporidiosis associated with water supplies, swimming pools should be considered as possible ongoing sources for transmission regionally.

Adolescent↗

Potential use of oxygen enrichment of room air in mountain resorts.

Oxygen enrichment of room air has proved to be valuable for people who need to work at altitudes of 4000 m and above. In the present study the feasibility of using the same technique in ski and other mountain resorts at the lower altitudes of 2500 to 4000 m is considered. Although many people find these altitudes invigorating, some are distressed by the hypoxia, especially at night. The analysis shows that all resorts up to an altitude of 3250 m (10,600 ft) can have the equivalent altitude reduced to 1000 m (3280 ft) by oxygen enrichment without incurring a fire hazard. (The equivalent altitude is that which provides the same inspired P(O2) during air breathing.) Even resorts or laboratories as high as 4250 m can have the equivalent altitude safely reduced to 1500 m, that is, lower than the altitude of Denver, Colorado. This application of oxygen enrichment is likely to be most valuable for improving sleep and assisting in the initial acclimatization process.

Acclimatization↗

Measuring the outcome of health resort programs.

OBJECTIVE: To evaluate the metric properties and practicability of valid, internationally available outcome instruments in the special setting of health resort programs. METHODS: A cohort study in a convenience sample of patients with low back pain, upper back pain, conditions of the lower extremities, and conditions of the upper extremities was conducted. Their functioning and health were assessed before and after a health resort program by the disease-specific North American Spine Society (NASS) instruments Lumbar NASS and Cervical NASS; WOMAC Osteoarthritis Index; Disabilities of Arm, Shoulder and Hand Questionnaire; and the general instrument, Medical Outcome Study Short Form-36 (SF-36). RESULTS: Completeness on the scale level ranged between 1% and 10%. Criterion validity of condition-specific instruments was confirmed by stronger associations of the pain and function scales to the Physical Health component of the SF-36 (r = -0.59 to -0.79, p < 0.001 for all scales) than to the Mental Health component (r = -0.11, NS, to r = -0.42, p < 0.001). Reliability (Cronbach's alpha coefficient) was higher than 0.8 for all scales of condition-specific instruments and for 6 of 8 SF-36 scales. Floor and ceiling effects ranged between 0% and 7%. The condition-specific instruments demonstrated a good responsiveness with an effect size ranging between 0.28 and 0.55 and with a standardized response mean between 0.32 and 0.94. The responsiveness of most SF-36 scales was similar, but the Physical Function scale showed a lower responsiveness than the condition-specific scales. CONCLUSION: The evaluated instruments can be recommended for use in clinical trials that assess the outcome of health resort programs.

Aged↗

[The principles of health resort treatment].

"Cures" prescribed in spas and health resorts are useful especially for patients who are chronically ill. The differences between pharmacotherapy and physiotherapy are discussed. The treatment in health resorts produces adaptations to repeated irritations, which need time, mostly four weeks. However, the changes of the function of circulatory system, lungs, metabolism etc. do not disappear after the end of the cure. To this extent, the principles of treatment in health resorts are comparable to sporting training. The days of incapacity to working are reduced to 50-60% in the following two years after a successful cure.

Chronic Disease↗

[Comparative study of the effect of intal and zaditen in patients with atopic bronchial asthma at Sandanski health resort].

Forty patients with atopic bronchial asthma were studied, aged from 16 to 54 (average age 34,4 years), with a duration of the disease from 1 to 22 years (average duration 10,8 years). The patients studied were divided into two groups of 20 patients each, treated with intal and zaditen respectively, in the course of 3 months, under the conditions of Sandanski resort. The study of the three month experiment revealed excellent and very good effect in 80 per cent of the patients with atopic bronchial asthma, both with intal and zaditen, started during an incomplete clinical remission. The treatment with both preparations proved to be effective in the patients with a concomitant corticosteroid treatment. The better results obtained by us as compared with similar studies are due to the established potent sanative mechanisms of climate therapy at Sandanski resort, with a gained reputation as a resort for the treatment of allergic respiratory diseases.

Adolescent↗

[Differentiated methods of treating atherosclerotic patients at the Kislovodsk health resort at early periods after transient cerebral circulatory disorders].

A dynamic examination of 135 patients with transient disorders of cerebral circulation (TDCC) was conducted in conditions of a sanatorium-resort treatment in Kislovodsk in early stages following the last attack (from 2-3 months). The method of a phasic examination and treatment was accomplished according to the following principle: polyclinic -- hospital -- resort -- polyclinic. Apart from the clinical dynamic examinations such methods as EEG, REG studies of blood coagulation and basic metabolism, and if necessary angio- and dopplerosonography were used. During their stay at the resort diadynamic currents werer used according to the method of a weak effect on the projection of spinal arteries, sinusoidal modulated currents on the cervical sympathetic nodes and plexus, carbon dioxide Narzan baths, and terrain cure. A significant improvement was seen in 10, improvement in 115, insignificant improvement in 9 patients. One patient showed no changes.

Adult↗

[Homes for the aged and health resorts. Reflections on the quality of life in old age homes].

The quality of living in homes for the elderly and health resort institutions must be assessed in accordance with subjective and objective criteria. From the medical point of view, stress factors in the living area should be avoided, and health-promoting factors introduced. In this connection, consideration must be given to the biological, psychological and sociological aspects of ageing. Both in homes for the elderly and in health resort institutions, the particularly features of variability of interior design, compactness, clarity, safety, separation of functional rooms, furnishability and domestic comfort should be taken into account. The question of comfort (homeliness) in the health resort clinics, would appear to be an important factor, since it promotes patient contentment and willingness to cooperate, and thus also patient compliance.

Aged↗

[Influences of health resort rehabilitation and psychotherapy on the self-concept of patients (author's transl)].

Which effects of rehabilitative/preventive treatment and psychotherapy during health resort rehabilitation procedures can be demonstrated in self-concept of patients? Are the effects of preventive/rehabilitative treatment sufficient to stabilise psychologically impaired patients? Both at the beginning and at the end of health resort rehabilitation, 123 non-selected patients without psychotherapy, and 76 psychologically impaired patients who had received an average 7.5 hours of psychotherapeutic care, answered the Giessen test. Significant differences in initial and retest values are interpreted as effects of the rehabilitative/preventive treatment, and as combined treatment plus psychotherapy effects. In order to obtain those effects that are attributable solely to psychotherapy, 29 persons showing equivalent values had been selected from each of the main sample populations, and comprised in two parallel samples. 1. Reduced depressiveness and an increase in positive social responsiveness are interpretable as effects of the treatment, with initial values having however been relatively inconspicious. 2. Psychotherapy patients are more compulsive, considerably more depressive, as well as more withdrawn and reduced in social potential than the other patients. The combined effect of treatment and psychotherapy achieved a marked decrease in depressiveness and compulsive behaviour, with positive social responsiveness and social potential increasing. 3. These same effects are present in the control group, and therefore are shown to be attributable to psychotherapy, not to the rehabilitative/preventive treatment received. If the psychologically impaired patients are left without psychotherapeutic care, depressiveness and compulsive behavior will on the whole persist. They continue to feel rejected and despised, and remain unable to use the social opportunities available during health resort rehabilitation procedures. Their social potential does not increase.

Aged↗

[A little about the nineteenth-century history of a health resort in Ciechocinek].

Impression of a Warsaw physician, hygienist and social worker Ludwik Natanson (1822-1896) from his journey to Ciechocinek in 1853 was reported. Brief history of this resort as well as contemporary indications and contraindications to treatment there were described. A role which in creation of this resort was played by Roman Ignatowski (1805-1889), who was a resort-doctor for many years, was presented.

Health Resorts↗

Ibiza uncovered: changes in substance use and sexual behaviour amongst young people visiting an international night-life resort.

Background: Each year more young people travel to international resorts where levels of substance use, sex and associated health risks are unknown. This study measures changes in levels of substance use and sexual behaviour of young people from the UK when on holiday in a youth orientated international resort, Ibiza. Methods: Data were collected through a cross-sectional survey collecting matched information on individuals' behaviour in the UK and abroad. Questionnaires were administered to 846 individuals aged between 15 and 35 at Ibiza Airport prior to their returning to the UK. Results: Young visitors to Ibiza significantly alter patterns of drug, alcohol and tobacco use. For ecstasy, in the UK 2.9% of users (9/313) used 5 or more days a week, while in Ibiza this rises to 42.6% (127/298). Fewer individuals use amphetamine, ketamine, cannabis, LSD, cocaine and GHB (gamma-hydroxybutyrate) in Ibiza although those continuing to use in Ibiza consume at substantially higher rates than when in the UK (P<0.001). Using multiple drugs over a 1 or 2 week stay was common (31.9%). Most individuals (53.8%) had sex while in Ibiza; 26.2% had sex without a condom and 23.2% had more than one sexual partner. Overall, 7.3% of individuals went to hospital or to see a doctor while in Ibiza with male (P<0.001), older (P<0.05) and staying for shorter times (P<0.005) being the key risk factors. Conclusions: While the potential for substance related ill health is dramatically elevated in Ibiza, harm minimisation measures in such resorts remain scarce. Equally, although holiday companies attract a sexually active cohort, safe sex messages are either absent or ineffective. Coordinated information campaigns to protect the health of young people are urgently needed and will require European cooperation across both public and private organisations.

Journal Article↗

Correlates of recent unprotected anal sex among men having sex with men attending a large sex resort in the South.

BACKGROUND: Published studies have not investigated sexually transmitted disease-associated risk behaviors among men who have sex with men (MSM) attending U.S. sex resorts. GOAL: We conducted an exploratory study to identify demographic and behavioral correlates of recently engaging in unprotected anal sex (UAS) among MSM attending a sex resort in the southern United States. STUDY DESIGN: A cross-sectional survey of 150 men. RESULTS: In multivariate analyses, men were more likely to practice risky sex if they also recently engaged in the practices of having group sex (adjusted odds ratio [AOR], 3.0), rimming (AOR, 2.0), or if they used public restrooms to meet potential sex partners (AOR, 2.6). UAS was also more likely among men vaccinated against hepatitis B (AOR, 1.9). Men who reported having primary partners and men who reported being HIV-positive were no less likely than other men in the sample to report recent UAS. CONCLUSION: Sex resorts can be an important venue for sexually transmitted disease and HIV prevention among MSM. Tailored prevention messages could be warranted for men who report group sex, rimming, meeting partners in public restrooms, or being vaccinated against hepatitis B.

Adult↗

Sexual behaviour of young people in international tourist resorts.

BACKGROUND/OBJECTIVES: Increasingly, young people travel abroad to experience nightlife in international resorts. Although media coverage of such resorts suggests high levels of sexual activity, little empirical data are currently available. We have measured: 3 year trends in sexual behaviour of young people visiting Ibiza, levels of sexual risk taking, and their relation to substance use. Additionally, in 2002 we identified levels of homosexual sex and sexual interactions between UK residents and individuals from other countries. METHODS: Data were collected from visitors to Ibiza between 2000 and 2002 just before they left the island. Information on sexual health was surveyed using a short anonymous questionnaire. RESULTS: Over half of individuals (56.0%) visiting Ibiza had sex with at least one person, with 26.2% of males and 14.5% of females having sex with more than one individual. However, of those arriving without sexual partners (75.5%) just under half (47.5%) have sex in Ibiza and most of these (62.4%) always used condoms. Having any sex abroad was associated with using illicit drugs and having more sexual partners in the 6 months before visiting Ibiza. However, having unprotected sex or sex with more than one person was associated with smoking as well as having higher numbers of sexual partners before their visit. Overall, 8.6% of individuals had sex with a non-UK resident in Ibiza although such individuals were no more likely to have sex without condoms. CONCLUSIONS: Substantial numbers of individuals visiting international nightlife resorts have unprotected sex with people they meet while abroad. This poses an increasing threat to the sexual health of UK residents but as yet little attention has been paid to developing interventions that might reduce sexual risk taking among young people holidaying abroad.

Adolescent↗

Gay men who attend sex resorts: a typology associated with high-risk sexual behaviour.

Our objective was to determine a sociodemographic profile (typology) of men for whom a relatively greater number of sex partners was associated with engaging in unprotected anal sex. A cross-sectional survey of 150 men who have sex with men (MSM) attending a large sex resort was conducted. The sex resort was located in the Southeastern United States. Men from 14 states attended the resort and completed an anonymous, self-administered, questionnaire. The typology that emerged showed that the co-occurring risk behaviours (greater number of partners and having unprotected sex) were reported by older men (P = 0.002), men with incomes of at least US 50,000 dollars (P = 0.018), men growing up in rural areas (P = 0.005), men who were not knowingly HIV positive (P = 0.004), and men who had received the full series of vaccinations against hepatitis B (P = 0.029). This typology may be useful for more efficient targeting of prevention and counselling programmes designed to reduce sexually transmitted infection incidence among this high-risk (and understudied) population of MSM.

Adult↗