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Elderly patients with chronic obstructive pulmonary disease (COPD), neglected in terms of pulmonary rehabilitation some decades ago, have nowadays evidence-based recommendations to attend it. There are no serious limitations excepting the locomotor handicap (neurological and musculoskeletal disability), severe cardiovascular and cognitive impairment. Multiple outcomes are expected to show up, as improvement of cardiovascular fitness and exercise capacity, relieving symptoms as dyspnoea, depression and anxiety. Meeting people like them on pulmonary rehabilitation premises, with same limitations and life beliefs, benefiting of group support and staff encouragement, elderly patients with COPD will find out that a pulmonary rehabilitation course might be both pleasant and useful, despite of distance of journey and physical training.

This paper is a review of current approaches on pulmonary rehabilitation (PR) in chronic pulmonary diseases. Pulmonary rehabilitation is the most accepted method of non-pharmacological treatment in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma, bronchiectasis, cystic fibrosis, interstitial lung disease, neuromuscular degenerative disease and post-tuberculosis lung sequelae. Throughout its components, especially oxygen therapy, it is the most important intervention in chronic respiratory failure in order to improve exercise tolerance, lung function and self-management. Enrolling patients in pulmonary rehabilitation programmes is a consistent help to a better control of their illness and a step forward to the international standards of treating COPD and non-COPD chronic respiratory diseases. It is evidence-based that PR is effective in reducing dyspnoea, improving health-related quality of life, reducing the number of hospital days and the utilisation of costly healthcare resources; there are also psychosocial benefits from comprehensive PR programmes in patients with COPD. PR is currently considered as effective in patients with COPD and in some patients with chronic respiratory diseases other than COPD.

The discovery of the relationship between smoking and genetic factors has been the focus of research over the last 10 years. In the following material we will approach the intervention of genetic factors in nicotine addiction, but also the protection against starting and continuing smoking, the influence on smoking withdrawal, on tobacco-induced medical conditions, the implication in the association of smoking with other types of drugs intake and the way in which these discoveries will influence genetic therapies in the future.

The study of evaluation and rehabilitation of COPD patient (SERBOC) started in January 2004 in the 6th Medical Clinic of the Iaşi Rehabilitation Hospital. One of its goals is to evaluate the left cardiac morphology and function in the chronic obstructive pulmonary disease. The inn-patients have been complexly approached by physical examination, chest X-ray, rest electrocardiogram, echocardiography and Holter monitoring. The stage result is that physical examination, chest X-ray and rest electrocardiogram fails in offering satisfactory information regarding left cardiac dysfunction; it is necessary to add Holter monitoring and especially echocardiography. The conventional and Doppler echocardiography performed in our clinic allowed the possibility to identify diastolic dysfunction in all 9 patients and systolic dysfunction in 7 of them.