Promotion of a healthy diet, an active lifestyle and appropriate body weight are important components of cardio-vascular disease prevention and control.

Migraine is a disabling neurologic condition with a spontaneous clinical evolution into a chronic form. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. .According to the International Classification of Headache Disorders (ICHD-3) chronic migraine is a type of primary headache occurring on 15 or more days per month for more than 3 months, in which more than 8 days per month headache meet criteria for migraine with or without aura or respond to specific migraine treatment. The prevalence of chronic migraine is estimated between 13% of general population. Persons with chronic migraine are more likely to suffer from severe disability; chronic migraine has an important socio-economic impact. Diagnostic approach in chronic migraine includes exclusion of a secondary headache disorder and confirmation of a primary episodic headache. When a patient is found to overuse pain medication, diagnosis of both chronic migraine and MOH should be considered. Treating episodic migraine early and managing attack frequency using preventive medication and behavioural interventions will be benefic in reducing the risk of chronicisation. Lifestyle changes are important for avoiding triggers for migraine attacks; treatment of comorbidities is equally important because these conditions exacerbate patient’s tendency to have headaches. The initial relief step for drug abusers always relies in drug withdrawal. For migraine attacks treatment begins with non-pharmacologic interventions (staying in a quiet, dark room, pressure on painful areas, applying cold compresses ), simple OTC analgetics (NSAIDs, paracetamol, aspirin, acetaminophen). If these are not effective, triptans are the drugs of choice. Preventive treatment is always recommended in patients with chronic migraine because the high frequency of headache attacks. Treatment should be started with topiramate, because the drug has the highest level of evidence in treating CM; Onabotulinumtoxin A reduced the number headache days, headache severity, headache-related disability and improved functioning and quality of life. Additionally, complementary and alternative medicine treatments are available in CM prophylaxis, such as biobehavioral techniques (relaxation training, thermal biofeedback, electromyography feedback and cognitive-behavioral therapy). Invasive and non-invasive neurostimulation techniques have been studied in the treatment and prevention of various types of headaches, including chronic migraine. New treatment options for acute attacks and for prevention include calcitonin generelated peptide (CGRP) antagonists and antibodies.

Lumbar spondylarthrosis is a degenerative disease that affects the joint structures of the lumbar spine.In the course of time, numerous studies on the role of hydrokinesiotherapy in the treatment of lumbar spondylosis have been conducted.The aim of this research is motivated by the significantly high number of patients with chronic pain in the lumbar spine due to lumbar spondylosis, as well as by the negative impact on their quality of life through the impairment of the activities of daily living.The prospective longitudinal study was carried out at the Clinical Rehabilitation Hospital Cluj-Napoca.The study included 35 patients with chronic low back pain and mobility limitation in the lumbar spine.The patients were assigned to two groups: the study group formed by 20 patients and the control group consisting of 15 patients aged between 40-70 years.The treatment of the patients included in the study was performed over a two week period and consisted of a hydro-kinesiotherapy program, for the patients of the study group, the duration of a treatment session being 40 minutes.Both the subjects of the study group and of the control group also benefited from sedative massage of the lumbosacral spine, kinesiotherapy, laser therapy of the lumbar spine.The patients were evaluated using Schober's test, the Visual Analogue Scale, the Oswestry index.These evaluation methods were applied to the patients of both groups at the beginning of the rehabilitation programs and after two weeks.The results of the study demonstrated the therapeutic efficacy of the medical rehabilitation programs that included hydro-kinesiotherapy programs.The patients of both groups had improvements through a decrease of lumbar pain, an increase in lumbar spine mobility, as well as in the patients' ability to organize themselves in the activities of daily living.However, the patients of the study group, with a hydrokinesiotherapy program performed for two weeks, had better scores regarding lumbar pain, disability (from 45 to 25 points on the Oswestry scale) and joint mobility (from 13.5 to 14.5 cm using Schober's test).There is strong scientific evidence of the beneficial potential of hydro-kinesiotherapy in chronic lumbar pain.

Romania owns almost 30% of European natural resources for balneotherapy/health resort medicine consisting in climate (relief, hydrology and vegetation, including salt mines and caves microclimate), mineral/thermal waters (for bathing and drinking cure), mud/peat and gases.

Cancer related fatigue (CRF) is the most disabling and distressing symptom in cancer, throughout the whole history of the illness, including successfully treated cases. Rehabilitation medicine could have a positive impact on these patients’ outcomes, if well targeted. With these purpose, the rehabilitation clinician needs to correctly assess fatigue using standard, reliable scales. This review of articles and trials synthesizes the epidemiology, mechanics (including causes and effects), clinical presentation and means of assessment in CRF. CRF causes and mechanisms are not well known. Understanding them would provide specific targets to fatigue management. Clinical presentation is very variable, a wide range of features being found in literature. Poorly medical reports in assessing fatigue offer variable percentages of prevalence, inconsistent with patients’ daily burden due to CRF. There are many tools used to assess fatigue in clinical research and on them depends the percentages reported as fatigue prevalence. The hereby gathered information are useful in the approach of a patient that addresses to a rehabilitation clinician for CRF management.

Pulsed short waves are part of high frequency therapy; unlike continuous short waves, where the phenomenon of tissular endothermia occurs, they have therapeutic effects that seem to depend rather on the interaction of electromagnetic waves with biological tissue, as they act only through specific electromagnetic energy. The recommended work technique for the use of the Diapulse device is that regardless of the exposed somatic region, there will be an initial exposure of one of the following regions: prehepatic, epigastric or lumbar (for action on the adrenal glands). Considering the role and the effects of the hormones of the adrenocortical gland, particularly glucocorticoids, on the body, which influence the inflammatory response of the connective tissue, with a role in rheumatoid pathology, we monitored the changes in the function of this gland. The biochemical parameters cortisol and aldosterone were quantitatively assessed in patients with complex regional pain syndrome type I (algoneurodystrophy) treated with pulsed short waves, who were initially exposed to radiation of the lumbar region. In the same treatment session, all patients were exposed to radiation of the lumbar region, at a dose of 4/400 impulses/sec., for 10 minutes, followed by radiation of the affected region at a dose of 6/600 impulses/sec., for 10 minutes. There was one treatment session per day, for 14 days. It was demonstrated that radiation of the lumbar region at a dose of 4/400 impulses/sec. caused no changes in the hormonal function of the adrenal gland, i.e. no hypo- or hyperfunction; there was no overstrain or overstress after exposure to pulsed short waves, which is an important aspect, with applicability in clinical practice. Studies demonstrated both the local and the general, systemic influence of pulsed short waves, the induced changes being for the most part strictly dependent on the dose used.

Multiple sclerosis (MS) is a chronic progressive disease which is one of the leading causes of handicap in young subjects. Despite the availability of advanced disease-modifying and symptomatic therapies, there is still a need for complex rehabilitation interventions in order to compensate functional deficits, to minimize limitations in activity, to increase independence and quality of life of MS patients. Individualized programs elaborated by a multidisciplinary team of experts are the key to success of rehabilitation. Treatment should be adapted depending on: the individual patient's needs, demands of their surrounding environment, type and degree of disability, and treatment goals. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-performance and independence. The methods used are: function conservation , optimization of restant capacities, compensation of functional deficits and prevention of complications. Benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability. Outcome measures applied for patients with MS include: the EDSS score, the Barthel index and the FIM (Functional Independence Measure). The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. Rehabilitation is a valuable tool in the overall management of MS patients, the improvements obtained after treatment sessions often outlast the treatment period by several months. Neurorehabilitation methods are important tools in developing complex management strategies for patients with multiple sclerosis.

Pulsed short waves are part of high frequency therapy and have through their biological effects, the good therapeutic results and the lack of side effects many indications in various disorders: rheumatologic, traumatologic, burns, neurological (nerve tissue regeneration, ischemic vascular accidents), vascular disorders. The experimental study consisted of the exposure of laboratory animals to the action of pulsed short waves in different doses and the monitoring of changes in the brain cellular and subcellular structure. The study included 35 Wistar rats, assigned to four groups, three groups of 10 animals and the control group of five non-irradiated animals. Group I was exposed to a dose of 1/80 cycles/sec, group II to 4/400 cycles/sec, and group III to 6/600 cycles/sec, for 10 minutes/day, for 15 days. After the rats were sacrificed, nervous tissue fragments were collected. These were adequately processed for their examination by optical and electron microscopy. At structural level, in the control group and the groups exposed to the dose of 1/80 cycles/sec, the neurons were normally structured. In group II, a slight increase of brain metabolic activity was seen, in group III there was a significant increase of brain metabolism, with better myelinated white matter axons, which suggests a better protection for the rapid conduction of nerve impulses to effectors. In group II, electron microscopy revealed similar aspects to those of the control group. A high ribosome density was found in the neuroplasm, which means an intense protein synthesis process. In group III, there was an intense protein synthesis activity, and a strong axon myelination in the white matter, resulting in a better protection for the transmission of nerve impulses. Conclusions: pulsed short waves caused brain changes depending on the dose. The analysis of electron microscopic images showed that irradiation at a dose of 6/600 cycles/sec induced an intense protein synthesis activity and a better axon myelination, which conferred a better protection for the transmission of impulses, more obvious than in the group irradiated at a dose of 4/400 cycles/sec.

The intake of minerals are very important in maintaining health, but in returning to health either. Mineral waters represents a source of minerals with high bioavailability. There are evidence based studies for the efficency of mineral waters in a series of disorders for both internal and external cures. The advantage of mineral waters in renal lithiasis are significant and the risks of stone formation are neglectable if medical advise is respected. Amongst the patients- but unfortunately also the medical staff- there is the incorrect oppinion that mineral water is a factor that causes renal stones in all consumers. The purpose of the present paper is to present the factors that favour the renal stones, but also scientific arguments that support the value of mineral water, that has a part not only in ensuring the right mineral balance but