P. Cantista

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  • I com back again to our survey and we realize the magnitude of Balneology in Health in the majority of our countries
  • My presentation won’t be a list of thermal techniques or methodologies. There isn’t yet an international agreement about the different modalities or the way of their application. For example nomenclature, mineral water classification, time or temperatures of application, indications, counter indications, So ..What I will talk is about the need that we have to achieve a consensus in order to get a systematization of this important discipline that in many countries is included in PRM I can’t talk of them all during the discussion or during the congress
  • P. Cantista

    1. 1. Pedro Cantista El termalismo del siglo XXI, medicina y entornos saludables. Capital salud
    2. 2. COMO PLANIFICAR UM POLO TERMAL NOS DIAS DE HOJE? El termalismo del siglo XXI, medicina y entornos saludables. Capital salud
    3. 3. Pontos fundamentais <ul><li>Construir o futuro mantendo a tradição </li></ul><ul><li>(não descaracterizar a identidadade local) </li></ul><ul><li>A Água Mineral Natural como elemento diferenciador </li></ul><ul><li>(conservação dos aquíferos, perímetros de protecção) </li></ul><ul><li>Estância e Balneário: locais de saúde! </li></ul><ul><li>(supervisão médica; ligação aos sistemas de saúde- publicos ou privados; termalismo social) </li></ul><ul><li>Implementar e divulgar a Medicina Termal </li></ul><ul><li>(formação, especialização e investigação) </li></ul><ul><li>Não “matar” o termalismo clássico </li></ul><ul><li>(prevenção, tratamento e reabilitação) </li></ul><ul><li>Incluir o termalismo de bem estar numa óptica de saúde </li></ul><ul><li>(promoção de saúde, comportamentos de saúde) </li></ul><ul><li>Introduzir o Modelo ICF no termalismo </li></ul><ul><li>(Organização Mundial de Saúde; factores circunstanciais são também terapêuticos) </li></ul><ul><li>Conservar / melhorar o contexto Termal </li></ul><ul><li>(arquitectura, qualidade hoteleira, ambiente circundante, instalações, equipamentos, recursos humanos, modelo operativo, certificação ISO) </li></ul><ul><li>Defender o termalismo no campo jurídico </li></ul><ul><li>(aquífero, ambiente, boas práticas, modelo operativo </li></ul>
    4. 4. ICF MODEL
    5. 5. UM EXEMPLO DE BOA INTGRAÇÃO DOS FACTORES CIRUNSTANCIAIS Unhais da Serra
    6. 6.
    7. 7.
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    13. 13. Tradição / Investigação <ul><li>A tradição termal dá-nos uma base empírica sobre a qual devemos desenvolver uma aprofundada investigação em ordem ao atingimento do conhecimento científico </li></ul>
    14. 14. Tradição histórica
    15. 15. CALDAS DA RAINHA PORTUGAL XV century
    16. 16. Evolução científica
    17. 17. Francisco da Fonseca Henriques, 1726
    18. 18.
    19. 19. Realidade Termal Europeia na actualidade
    20. 20.
    21. 21. European Survey Bender Tamás; Cantista, Pedro
    22. 22. European Survey: Results <ul><li>According to this survey performed among the delegates of the UEMS-PRM section, in which 27 countries took part </li></ul><ul><li>Balneology and/or Medical Hydrology is officially recognized in 68% of the countries. </li></ul><ul><li>In 19% of the countries it is a medical “speciality” </li></ul><ul><li>In 44% is considered a medical “competence” </li></ul><ul><li>In 56% it is included in another medical specialities (e.g. PRM, Rheumatology, Dermatology). </li></ul><ul><li>Medical units using thermal water for therapeutic purposes exist in 76% and </li></ul><ul><li>Reimbursement of costs by health insurances is possible in 72% of the countries. </li></ul>Pedro Cantista
    23. 23. Balneology in Europe <ul><li>Some countries don’t recognize Hydrology as a medical discipline </li></ul><ul><li>They don’t accept its scientific character </li></ul><ul><li>Ex: England, Scandinavian Countries </li></ul>
    24. 24. Medical Education on Balneology <ul><li>In 56% of the European countries undergraduate medical education includes Balneology </li></ul><ul><li>Post-graduate courses also exist. </li></ul><ul><li>Research units exist in 48% of the countries. </li></ul>Pedro Cantista
    25. 25. Research <ul><li>Evidences on Crenotherapy </li></ul><ul><li>Methodology in Medical Hydrology Research </li></ul>Pedro Cantista
    26. 26.
    27. 27.
    28. 28. Portugal, 25-28 June 2008 www.ismh08.org
    29. 29. Opening Ceremony <ul><li>Water, science and culture </li></ul>
    30. 30.
    31. 31. Research and Evidence <ul><li>Thermal research suffered a decline in the second half of the 20th century. </li></ul><ul><li>But these last years very acceptable investigations have been performed </li></ul><ul><li>They concern the biological properties, the specificity, the security of thermo-mineral </li></ul><ul><li>products and components as well as the clinical efficiency of spa therapy; </li></ul><ul><li>in the international literature in these last ten years 60 controlled clinical trials can be found out of about 300 papers </li></ul>
    32. 32.
    33. 33. Teaching Balneology in Europe Pedro Cantista
    34. 34. <ul><li>Wider recognition </li></ul><ul><li>Scientific evidence </li></ul><ul><li>Publication of relevant papers </li></ul><ul><li>Standardization </li></ul><ul><li>Definitions </li></ul><ul><li>Glossary </li></ul><ul><li>Methodology </li></ul><ul><li>Consensus </li></ul><ul><li>Pedro Cantista </li></ul>Teaching Balneology in Europe
    35. 35. Which contents should we include ? <ul><li>Definitions and concepts within Hydrology, Climatology, Health Resort Medicine, Health behaviour (diet, exercise, relaxation, social interaction) </li></ul><ul><li>Therapeutic principles of Medical Hydrology and Climatology (physical, chemical, biological, psychological, sociological, environmental). </li></ul><ul><li>The physiologic effects of water immersion </li></ul><ul><li>The physiologic effects of mineral products (water, steam, gas, pelloids) </li></ul><ul><li>Characteristics and Classification of different mineral waters </li></ul><ul><li>The main Hydrotherapy and Crenotherapy techniques </li></ul><ul><li>The main complementary techniques </li></ul><ul><li>The indications, non indications and contra indications of thermal treatments </li></ul><ul><li>Knowing how to orientate a patient to a specific thermal station or program </li></ul>Pedro Cantista
    36. 36. * TERMALISM UNIVERSITY FACULTIES PRE GRADUATE POST GRADUATE INDEPENDENT DISCIPLIN PORTO 2 1 1 1 LISBOA 2 - 1 - COIMBRA 1 1 1 - BRAGA 1 - - - COVILHÃ 1 1 1* - TOTAL 7 3 3 1
    37. 37.
    38. 38. What about the Future ?
    39. 39. What do we already achived?
    40. 40. Consensus
    41. 41. GUTENBRUNNER C , BENDER T , CANTISTA P , KARAGÜLLE Z   A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology . Int J Biometeorol. 2010 Jun 9  
    42. 42. Thermal Certification
    43. 43.                                                                                                                                                                                                                                 © EOQ. Developed by MVEurope  
    44. 44. ISO <ul><li>INTERNATIONAL </li></ul><ul><li>ORGANIZATION FOR STANDARDS </li></ul><ul><li>ORGANISATION INTERNATIONALE DE NORMALISATION </li></ul>
    45. 45. Como poderemos então idealizar um balneário para o futuro?
    46. 46. O exemplo de Vidago
    47. 47. Vidago Hotel (1910)
    48. 48. Remodelação actual
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    70. 70. Vidago Conference Centre (antigo balneário)
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    74. 74.
    75. 75.
    76. 76. CÂMARA MUNICIPAL DE CHAVES Projecto novo balneário termal
    77. 77.
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    82. 82. FUNÇÕES E VALÊNCIAS <ul><li>Clinica (diagnóstica, assistencial) </li></ul><ul><li>Crenoterapica </li></ul><ul><li>Pedagógica (formativa, educativa) </li></ul><ul><li>Científica </li></ul><ul><li>Cooperativa </li></ul><ul><li>Cultural </li></ul><ul><li>Social </li></ul><ul><li>Turística </li></ul>
    83. 83.
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    86. 86. Outros pontos de intervenção <ul><li>Protecção do recurso </li></ul><ul><li>Sistemas de adução e armazenamento </li></ul><ul><li>Integração da população no projecto </li></ul><ul><li>Hotelaria e Restauração (dietas, exercício) </li></ul><ul><li>Renovação urbana </li></ul><ul><li>Ênfase na Hidropinia e Pista Medicalizada </li></ul>
    87. 87.
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    90. 90.
    91. 91.
    92. 92. Termas de Monte Real 10 e 11 de Junho, 2011
    93. 93. PEDRO CANTISTA Thermal Treatments and Methodologies
    94. 94. Hydropinia (oral intake / drinking) <ul><li>Variable doses </li></ul><ul><li>Different posologies </li></ul>
    95. 95. Ears, nose, throat <ul><li>Irrigation </li></ul><ul><li>Inhalation </li></ul><ul><li>Nebulization </li></ul><ul><li>Pulverization </li></ul>
    96. 96. Enteric Gynecological
    97. 97. Douches <ul><li>Jet douche </li></ul><ul><li>Circle douche </li></ul><ul><li>Pulverization </li></ul><ul><li>Douche massage </li></ul><ul><li>Sub aquatic douche </li></ul>
    98. 98. Imersion modalities
    99. 99. Imersion modalities
    100. 100. Steam
    101. 101. Flebology
    102. 102. Many others… <ul><li>Peloids </li></ul><ul><li>Psamitotherapy (sand) </li></ul><ul><li>Radon </li></ul><ul><li>Cavetherapy </li></ul><ul><li>Mophetas </li></ul><ul><li>Sauna </li></ul><ul><li>Turkish Baths </li></ul><ul><li>Massage </li></ul>
    103. 103. Glossaries Christoph Kirschner (German-English) Maria Ángeles Ceballos Hernansanz (Several Languages)

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