Overweight, obesity and the metabolic syndrome are usual conditions treated in french balneotherapy care facilities. 42,507 patients were treated last year in France for metabolic conditions, most of them benefiting a social security reimbursed treatment. The therapeutic intervention core is made of hydro-thermal cares: drinking mineral water (alkaline sodium bicarbonated water), individual mineral water bathing, showers, massages under mineral water, mineral water pool collective exercise; education on nutritional concepts, adapted physical activity are also essential informations delivered in group or customized sessions. AFRETH promoted two clinical studies investigating the topic.   The randomised controlled trial Maathermes (1) assessed the benefit of the intervention on 257 overweight or obese patients randomized between balneotherapy (delivered in Brides, Capvern, Vals, Vichy, Vittel) and a control group (usual care and booklet on nutrition from the french health autorithy). At month 14th, the patients treated in the balneotherapy group showed a significant weight reduction (5.17 kg vs .54 kg ; p<.001) and they had more perspective to reach a stable weight loss of 5% (57.1% vs 18.6 % ; p<.001).   Prisme (2), a feasability cohort study, investigated the results of the intervention in 93 patients with a metabolic syndrome treated in Eugenie les Bains. At month 12th, 67 patients could be assessed. Metabolic syndrome had disappeared in 76% of the patients (glycemia normalised in 15%, waist circumference returned to acceptable in 15%, lipidic disorders disappeared in 33% ; blood pressure had acceptable values, without increased drug intake, in 67%.). 75 % of the patients were continuing the adapted physical activity, 65 % had a correct lipid intake.   Balneotherapy is useful for patients with overweight or obesity. Education during the stay is helpful for the weight and metabolic syndrome control. The medico-economic benefit of such an intervention remains to be established on scientific basis.

OBJECTIVETo evaluate the antimicrobial activity of the methanol extract from the stem bark of Drypetes tessmanniana, fractions (DTB1-5) as well as compounds [friedelin (2), 3,7-dioxofriedelane (3), 3,15-dioxofriedelane (4), 3beta- O-(E)-3,5-dihydroxycinnamoyl-11-oxo-olean-12-ene (6), and 3beta,6alpha-dihydroxylup-20(29)-ene (7).

METHODSAgar disc diffusion was used to determine the sensitivity of the above samples, whilst the microdilution method was used for the determination of the minimal inhibitory concentration (MIC) and the minimal microbicidal concentrations (MMC).

RESULTSThe diffusion test showed that the crude extract was able to prevent the growth of all tested organisms. All other samples showed selective activity. The inhibitory effect of the fraction DTB2 was noted on 63.7%, that of DTB1 and DBT3 on 54.6%, whilst DTB4 and DTB5 were active on 9.1% of the 11 tested organisms. The tested compounds prevented the growth of 81.8% of the tested microbial species for compounds 3 and 4, 36.7% for compound 6, and 18.2% for compound 7. The results of the MIC determinations indicated perceptible values for DTB and compound 4 on 81.8% of the tested organisms. For other samples, MICs were detected on 0-63.7%. The lowest MIC value (78.12 microg/mL) for the crude extract and fractions (DTB2) was observed on M. audouinii. The corresponding value for isolated compounds (156.25 microg/mL) was noted with compounds 3 on S. faecalis and 4 on M. audouinii audouinii. The results of the MMC determination suggested that the microbicidal effect of most of the tested samples on the studied microorganisms could be expected.

CONCLUSIONThe methanol extract from the stem bark of Drypetes. tessmanniana (Euphorbiaceae) as well as some of the isolated compounds might be potential sources of new antimicrobial drugs.

Anti-Infective Agents ; chemistry ; isolation & purification ; pharmacology ; Bacteria ; drug effects ; Disk Diffusion Antimicrobial Tests ; Euphorbiaceae ; chemistry ; Fungi ; drug effects ; Methanol ; chemistry ; Microbial Sensitivity Tests ; Plant Bark ; chemistry ; Plant Extracts ; pharmacology ; Plant Stems ; chemistry ; Reference Standards

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

  In developped countries ageing is a major challenge. In France, the AFRETH promoted several studies investigating the role of balneotherapy on ageing.   The (Multimodal Prevention Alzheimer Trial) MAPT programme is made of nutritional education, adapted physical activity, cognitive stimulation. The programme was proposed to patients of 70 years and more attending spa resorts. 35 % estimated to be concerned, 70% accepted to be included in the programme with remarkable levels of compliance (97%) and satisfaction (90%). Every year about 50,000 persons could be involved in such a programme in the French spa resorts. It has been established that 800,000 French persons complain with the disease for a global yearly coast of € 22,000 by patient (55% family supported) ; a 4 year delay on the onset of the disease could reduce by 50% the prevalence of the disease.   In the« TCap study »we could observe that adapted physical activity education delivered in spa resorts during a spa treatment was an effective way to promote adapted physical activity in old persons.   « Prevention consultation »: the time-span of the spa treatment could be used to perform a relevant clinical investigation to detect predictive factors of frailty and propose an accurate stategy of prevention, obtain public health useful relevant data.   The« Parenthese study »designed a complex programme to prevent or treat the burn-out of Alzheimer patients’ care givers: i)The care givers could receive an intervention made of hydro-thermal cares aiming to the treatment of the burn-out and musculo-skeletal conditions associated with the emotional and physical burden of the care-giving; an educational intervention would help the care-givers to manage every day life of the patients ; ii) the patients, when accompanying the care-giver, could be attended in a geriatric day facility; iii) when the patients would be unable to stay in ordinary venues, accommodation could be organised in an adapted night facility (eventually with the care-giver).