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Objective: To evaluate whether temporary positive expiratory pressure provides benefit in patients with lung diseases and chronic hypersecretion., Design: Single blind multicentre randomized trial., Setting: Five Italian rehabilitation centres., Participants: Ninety-eight patients with chronic obstructive pulmonary disease and/or chronic bronchitis (n=78), or bronchiectasis (n=20), with a peak cough expiratory flow >150 l/min and sputum production >30 ml/day, randomly included into two treatment groups., Interventions: For 10 consecutive days, the active group performed twice a day 20-minute cycles of manually assisted breathing techniques in sequence with the addition of 15 minutes of temporary positive expiratory pressure, while the control group was treated by manually assisted breathing techniques alone., Measures: Within and between group changes of arterial oxygenation index, lung volumes and respiratory muscles strength were recorded at enrolment and after 3 and 10 treatment sessions. Pre-to-post treatment change of sputum volume and bronchial encumbrance (Δ-visual analog scale), sputum density and purulence were compared daily within the study period., Results: No significant changes were recorded for the oxygenation index, while dynamic lung volumes and respiratory muscle strength significantly (P <0.05) improved in the active group. The group comparison analysis of the pre-to-post change showed that inspiratory capacity was significantly higher in the active than in the control group (+19.5% and +2.2%, P=0.044) at day 10. A greater improvement in Δ-visual analog scale was recorded in the active group at day 3 and 8., Conclusions: These preliminary data suggest that temporary positive expiratory pressure improves lung volumes and speeds up the improvement of bronchial encumbrance in patients with lung diseases and hypersecretion.

There is now good evidence that the use of electromagnetic millimeter waves the following curative effects: analgesic, normalization of relations or increased formation of neurohumoral substances. The introduction of a therapeutic practice complex biological drugs that trigger, not overwhelming the body auxiliary immunological reaction, based on the activation of the regulation clones of T-lymphocytes and helper functions, is an important step in achieving a qualitatively level of health patients with chronic disease.

The study based on Rehabilitation Center No 2 in Rostov region covered 100 male patients with dust obstructive bronchitis. The authors considered organisational and legal problems of medical rehabilitation for patients with occupational diseases caused by dust. The authors also specified and suggested stages of individual medical rehabilitation and efficiency criteria for rehabilitation, exeplified by dust obstructive bronchitis patients. Data show that creation and accomplishment of individual medical rehabilitation programs for dust obstructive bronchitis patients enable to optimize rehabilitation process, provide continuity of medical rehabilitation, evaluate efficiency of rehabilitation measures on each step of medical rehabilitation. Higher efficiency of rehabilitation is achieved by individual rehabilitation added by nebulizer treatment, efferent therapy, psychologic correction and specialized education for chronic patients with obstructive lung diseases.

Aim: To evaluate the efficiency of the rehabilitation in patients with obstructive pulmonary disease (COPD) and occupational bronchitis (OB) and the disabled due to these diseases, which was based on the authors' developed procedure and criteria for evaluating the efficiency of rehabilitative measures., Materials and Methods: The efficiency of implementation of 55 individual rehabilitation programs (RP) elaborated by the Medicosocial Examination Bureau for the disabled due to COPD and OB was evaluated., Results: The authors have determined qualitative criteria for evaluating the efficiency of rehabilitation: the extent to which the recommended rehabilitation measures being implemented, the trend in the magnitude of various vital activity categories and social inadequacy and in the disability group on regular examination, the results of implementation of some parts of an individual RP, the conformity of the achieved results to the rehabilitation potential of a disabled patient. The evaluation procedure supposes a unified quantitative gradation of each criterion. Overall, rehabilitation is more effective in COPD than in OB., Conclusion: The developed criteria and procedures for evaluating the efficiency of rehabilitation in patients with COPD and OB show a great informative value and practical content richness, which permits one to make corrections into the rehabilitation process. Functional impairments, the degree of vital activity restrictions and social inadequacy, as well as the rehabilitation potential and rehabilitation prognosis are concomitantly evaluated, which allows minor changes to be assessed in the clinical, personality, and social status of a patient.

Background and Purpose: Pulmonary rehabilitation has been found to be an effective strategy for managing chronic obstructive pulmonary disease (COPD). However, attendance at such programmes is not optimal, therefore, this study aimed to develop an in-depth understanding of views regarding attendance at pulmonary rehabilitation and experiences which may have shaped these views., Methods: An inductive qualitative study was carried out within the framework of Interpretative Phenomenological Analysis. Five female and four male individuals with COPD who had been referred for pulmonary rehabilitation participated in semi-structured interviews. Interviews were conducted prior to participation in pulmonary rehabilitation., Results: Three main themes were identified that related to views about attending pulmonary rehabilitation. The first is entitled 'Desired benefits of attending pulmonary rehabilitation', which described realistic hopes about impact on daily life. The second theme was called 'Evaluating the threat of exercise', and it encompassed both positive and negative evaluations; some interviewees described fear and avoidance of exercise, while others were determined to overcome symptoms. These attitudes extended to views about pulmonary rehabilitation. The third theme was called 'Attributing value to pulmonary rehabilitation'. Contrasting opinions about the value of attending pulmonary rehabilitation appeared to be influenced by the nature of prior interactions with health personnel and systems as well as information about the programme provided at referral. The referrer's attitude towards pulmonary rehabilitation appeared to be particularly influential., Conclusion: In summary, when considering rehabilitation attendance, potential participants are able to identify possible benefits, but previous experiences of symptoms and attitudes towards their condition can influence views both positively and negatively. Information and enthusiasm conveyed by the referring clinician, as well as previous interactions with health professionals can have powerful impact on views about attending. Referral practices should be informative and enthusiastic to increase the likelihood of uptake., (Copyright (c) 2009 John Wiley & Sons, Ltd.)

The authors demonstrated efficiency of aerosol therapy using "Dovolenskaya" mineral water in treating patients with occupational pulmonary diseases. Results are improved bronchial drainage, normal pro- and antioxidant status, lower inflammatory activity in patients with pneumoconiosis and occupational dust bronchitis.

Clinical examination and laboratory tests performed on 708 patients with chronic obstructive and non-obstructive bronchitis (COB and CNB), demonstrated heterogeneous character of the group of these patients in clinical remission. This suggests that it is appropriate to distinguish between the stages of complete and partial remission, implying different tasks concerning treatment and rehabilitation. Remission of CNB is characterized by minimal deviation of clinical and laboratory parameters; functional balance between the lipid peroxidation-antioxidative activity (LP-AA) system and immunity is preserved. At the stage of rehabilitation of these patients the major attention is paid to the general sanitary measures (physiotherapy exercises, climate therapy). The stage of partial remission in COB and CNB is characterized by residual activity of the inflammatory process, a disbalance between the LP-AA system and immunity, most prominent in partial remission of COB. Rehabilitation of these patients, in addition to physiotherapy exercises and tempering of the organism, should include special activity, directed towards the normalization of LP and immunity parameters.

This case report describes occupational therapy intervention for three adult outpatients with chronic obstructive pulmonary disease (COPD) at one large urban hospital. The occupational therapy intervention was based on the Management of Dyspnea Guidelines for Practice (Migliore, in press). The learning and practice of controlled breathing were promoted in the context of physical activity exertion in a domiciliary environment. In addition to promoting dyspnea management, the controlled-breathing strategies aimed to facilitate energy conservation and to increase perceived breathing control. Although no causality can be determined in a case study design, the patients' dyspnea with activity exertion decreased and their functional status and quality of life increased following goal-directed, individualized occupational therapy intervention combined with exercise training.

Aim: To assess the changing impact of prenatal and perinatal factors with increasing age on first admissions for asthma and acute bronchitis., Methods: The Swedish Medical Birth Registry was linked to the National Hospital Discharge Registry for 214,276 Swedish children born in 1987 and 1988. The linkage comprised first admissions for acute bronchitis or asthma from 1987 to 1995. First admissions for gastroenteritis were included to distinguish between factors specific to asthma or bronchitis and non-specific factors related to an increased risk of hospital admission., Results: Admissions for asthma and acute bronchitis before 2 y of age had a close dose-response relationship with maternal smoking, low gestational age, low maternal age and older siblings. Very premature children exposed to more than 9 cigarettes a day in utero ran a 10 times higher risk of hospitalization than postmature children without exposure to maternal smoking. However, the proportion of admissions attributed to maternal smoking was only 4.7% after adjustments for significant covariates. The number of significant determinants declined in children with their first admission for asthma after 2 y of age but male gender and low educational level were independent determinants in all age groups. Older siblings were related to an increased risk of first asthma admission before 2 y of age but a slightly reduced risk of first admission after 2 y of age., Conclusion: This study illustrates the varied epidemiology of asthma in different age groups. Maternal smoking was an important determinant for admission before 2 y of age but mainly in combination with other factors. The decline in hospital admissions in early childhood would therefore be small, even after the elimination of maternal smoking, if other significant perinatal and socioeconomic factors were unchanged.

The author believes that adequate rehabilitation of patients with chronic obstructive bronchitis (COB) can be achieved only under staged approach, i.e. cooperation of outpatient, inpatient and sanatorium treatments. Each of the stages is characterized. This three-stage rehabilitation improves the patient's mobility due to higher physical performance and tolerance to dyspnea.

Background: Following successful voice restoration after laryngectomy either by a voice prosthesis, a surgical shunt or microvascular laryngoplasty, a further goal in rehabilitation is the insertion of a tracheostoma valve, which enables the patient to speak without using his fingers for closure of the tracheostoma. One important disadvantage of the tracheostoma valves, which are available today, is the necessity of removal of the valve in case of coughing, because the valve could be thrown from the stoma by the strong air flow during coughing. As many laryngectomies suffer from chronic bronchitis, this coughing problem is one of the reasons why only few patients could be provided with this useful aid., Method: At the department of biomedical engineering of the faculty of medicine at the university of Groningen, the Netherlands, 1994 two prototypes of a tracheostoma valve with an integrated cough lid were developed. These devices contain two separate valve systems: the normal speaking valve and a special coughing valve, which opens at a certain air flow and closes automatically after the coughing attack. Thus no manipulations are necessary during coughing, the patient can speak undisturbed. The ADEVA company (Lübeck, Germany) undertook the industrial production of this new type of tracheostoma valve creating different modifications of the prototype #2., Patients: In four series with 6-8 patients per group the modified tracheostoma valves were tested clinically and the occurring faults or lack of correct function eliminated by small changes in the production., Results: Meanwhile a suitable model for routine use is available, which was tested in 30 patients so far. This suitability was achieved by improvements in the valve mechanism, the valve seal and the adjustment mechanisms for the individual pressure level of the speaking and the coughing valve., Conclusion: The newly developed tracheostoma valve with integrated coughing lid (Window, ADEVA-medical Company, Lübeck, Germany) provides further improvement in speech rehabilitation of laryngectomies. The low acceptance of tracheostoma valves, which enable the patient to speak without using his fingers for closure of the tracheostoma, possibly may be raised by this new aid.

Studies in health economics especially economic evaluations of health care technologies and programmes are getting more and more important. However, in Germany there are no established, validated and commonly used instruments for the costing process. For the economic evaluation of a rehabilitation programme for patients with chronic lung diseases such as asthma and chronic bronchitis we developed methods for identification, measurement and validation of resource use during the inpatient rehabilitation programme and during the outpatient follow-up period. These methods are based on methodological considerations as well as on practical experience from conducting a pilot study. With regard to the inpatient setting all relevant diagnostic and therapeutic resource uses could be measured basing on routine clinical documentation and validated by using the cost accounting of the clinic. For measuring the use of resources during the follow-up period in an outpatient setting no reliable administrative data are accessible. Hence, we compared a standardised retrospective patient questionnaire used in a 20-minute interview (n = 50) and a cost diary for the continuing documentation by the patient over a period of 4 weeks (n = 50). Both tools were useful for measuring all relevant resource uses in sufficient detail, but because of higher participation rates and lower dropouts the structured interview appears to be more suitable. Average total costs per month were 1591 DM (interview), respectively 1867 DM (cost diary). Besides productivity loss, costs for medication and GP visits caused the relatively highest resource uses. Practicable instruments were developed for the costing process as part of an economic evaluation in a German rehabilitation setting for pulmonary diseases. After individual modification, these could also be used for different indications and in other institutional settings.

Objective: To compare the short-term effects of postural drainage (PD), oscillating positive expiratory pressure (using the FLUTTER device), and expiration with the glottis open in the lateral posture (ELTGOL) on oxygen saturation, pulmonary function, and sputum production in patients with an acute exacerbation of chronic bronchitis., Design: A prospective, randomized study., Setting: A clinical ward., Patients: Ten patients with chronic bronchitis exacerbation received PD, FLUTTER, and ELTGOL by the same respiratory therapist at about the same time of day on separate days and in random order., Main Outcome Measures: Oxygen saturation and pulmonary function were measured before, immediately after, and 15 minutes and 1 hour after each treatment. Improvement in sputum production was measured by total sputum wet weight immediately after and for 1 hour after treatment., Interventions: PD consisted of positioning the patients in a posture that allows bronchial drainage by gravity. FLUTTER is a device that is claimed to combine oscillating positive expiratory pressure with oscillations of the airflow. ELTGOL is an airway clearance technique that uses lateral posture and different lung volumes to control expiratory flow rate to avoid airway compression. The total time spent for treatments was 30 minutes., Results: All techniques were well tolerated, and oxygen saturation and pulmonary function did not change significantly during and after treatments. Thirty minutes after the beginning of treatment, sputum production increased significantly with all techniques, but during the 1 hour after the end of treatment, it was significantly larger with FLUTTER (from 15.0 +/- 8.6g to 19.0 +/- 9.3g, p < .01) and ELTGOL (from 17.0 +/- 7.0g to 20.6 +/- 6.9g, p < .02) than with PD (from 15.5 +/- 4.0g to 17.5 +/- 3.7g, NS)., Conclusions: All three treatments were safe and effective in removing secretions without causing undesirable effects on oxygen saturation, but FLUTTER and ELTGOL techniques were more effective in prolonging secretion removal in chronic bronchitis exacerbation than was the PD method.

The paper describes a new medical technique--halo-aerosol therapy, the main acting factor of which is dry highly dispersed aerosol of sodium chloride in natural concentration. Halo-aerosol therapy represents a new trend in aerosol medicine. It includes two methods: halotherapy and halo-inhalation. Biophysical and pathophysiological foundations of the new method, how it can be realized are outlined. Clinical reasons are provided for application of halo-aerosol therapy for prevention, treatment and rehabilitation of patients with respiratory diseases. Characteristics and differences of the two halo-aerosol therapy variants are analysed.

A hundred and twenty six patients with infiltrative destructive pulmonary tuberculosis were examined. In 62 patients of them, the vertebroosteosternal joints were exposed as part of multimodality treatment in order to arrest an exacerbation of chronic bronchitis. A control group included 64 patients. The exposure of vertebroosteosternal joints was found to enhance the efficiency of treatment for chronic bronchitis in patients with pulmonary tuberculosis. This treatment promotes lower inflammatory intensity, diminished antigenemia and anti-protein antibody production. To arrest lesions in the bronchial tree with the proposed package of methods also favours a higher efficiency of treatment of a tuberculous process.

67 patients with purulent and 63 with catarrhal chronic obstructive bronchitis (COB) were subjected to clinico-laboratory, functional and bronchoscopic examinations. 41% of the patients had COB exacerbation, 59% were in partial remission. As shown by improvement in clinical, immunological and morphological indices, blood biochemistry, sputum microscopy, spirometry, bronchoscopy findings, artificial sylvinite speleotherapy is effective in acute and purulent COB.

174 children aged 7-14 years in remission of recurrent asthmatic bronchitis and bronchial asthma took feet baths in addition to standard course of sanatorium treatment. Measurements of bronchial permeability and reactivity have demonstrated that foot baths have no negative effects on bronchial permeability in all the disease forms and maintain tolerance of the respiratory system to both cold and exercise.

Halotherapy proved to be a highly effective method in a complex sanatorium treatment of patients with chronic bronchitis. Its use promotes more rapid liquidation of clinical manifestations of disease, improves indices of vent function of lungs, especially those values that characterize bronchial conduction (volume of forced exhalations per second, index Tiffno), increases tolerance to physical load, normalizes indices of reduced immunity and leads to increasing the effectiveness of patient treatment in sanatorium.

Aim: To study short- and long-term clinicofunctional effects of primary and secondary courses of interval normobaric hypoxia (INH) in patients with chronic obstructive bronchitis (COB) and bronchial asthma (BA)., Materials and Methods: The study group of 45 COB and BA patients were exposed to INH. The control group of 20 COB and BA patients received conventional drugs. The INH patients were examined using the acute hypoxia test, return respiration test, peak-flowmetry, assessment of external respiration function (ERF), immune status, heart rate, blood pressure. Stange test ERF and the disease course within the last 2-3 years were analyzed., Results: INH proved more beneficial for COB and BA patients than the standard drugs. Bronchial obstruction reduced by 10-15%, exercise tolerance, general condition, ventilation, hemodynamic and immunological parameters improved, frequency of bronchopulmonary infection exacerbations dropped 2-fold., Conclusion: An INH course is effective in the majority of COB and BA patients. It is recommended for treatment and rehabilitation once or twice a year.

The authors' investigations show that inhalations of sodium chloride bromine-iodine water given in spray modify intrabronchial microflora of patients with chronic bronchitis reducing the number of the pathogenic bacteria and elevating the number of bacteria typical for physiological composition of the bronchial mucus.

Resource allocation in health care and rehabilitation has been increasingly influenced by medical outcome studies. In recent years, the importance of health-related quality of life (HRQOL) in the evaluation of medical care and intervention practice has been widely acknowledged. In particular for chronic diseases like asthma or COPD the multi-dimensional concept of quality of life (QOL) has adopted the role of an essential outcome parameter. Instruments used to measure QOL can be categorised as one of two types: a) generic instruments which assess overall QOL and b) disease-specific questionnaires which focus on specific aspects related to a particular disease. Over the last two decades more than 1,000 QOL-instruments have been developed, including nearly 20 disease-specific inventories for patients with chronical lung diseases. In clinical practice, both generic and specific questionnaires are used to assess quality of life in patients with asthma and COPD. Disease-specific QOL-instruments are considered to be more sensitive in establishing the specific restrictions related to asthma or COPD and in detecting possible improvements in QOL after treatment. To exemplify its properties, limitations, and special methodological issues, we chose two of the most widely used and well-validated disease-specific quality of life inventories: the "St. George Hospital Respiratory Questionnaire (SGRQ)" and the "Fragebogen zur Lebensqualität bei Asthma (FLA)". The FLA, representing the German revision of the "Living with Asthma Questionnaire (LAQ)" (Hyland et al., 1991), has been one of the first questionnaires available for measuring disease specific quality of life (QOL) in adults with asthma. The FLA contains 40 items in three dimensions ("physical symptoms", "functional status", "psychological distress"). The SGRQ (Jones et al., 1991) is a standardized questionnaire for measuring health related restrictions and quality of life in patients with chronical lung disease. In contrast to LAQ/FLA the SGRQ can be used both for patients with asthma and COPD. It includes 76 items, divided in three subscales ("symptoms", "activity", and "impacts") permitting to calculate different summary scores as well as a total score. Both questionnaires appear to be reliable, valid and efficient for the assessment of QOL in patients with asthma or COPD, and may facilitate decision making in the treatment process. On the other hand there are some unsolved methodological problems requiring further investigations and improvements in this research area.

The authors show that intensification of peloid therapy, i.e. more frequent procedures, in patients with pulmonary diseases imposes additional load on the regulatory systems: vegetative, cardiovascular, immune. Moderate balneological reactions become more frequent, therapeutic results worsen. How to correct the above negative effects is proposed.

Inhalations of 1% natural brine in combination with SMC electrophoresis of 1% natural brine above the lesion proved to ensure good correction of the defense of respiratory tract mucosa and to prolong remission to 15-18 months. This method can be applied in sanatoria, in rehabilitation centers, in pulmonary disease departments.

Objective: To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit., Design: A randomized clinical trial., Setting: A public hospital., Patients: Eighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40)., Intervention: Breathing exercises in the rehabilitation group., Main Outcome Measures: Preoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays., Results: The incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences., Conclusions: Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.

Principles of administration of physiotherapeutic methods in patients with chronic bronchitis are outlined. It is shown that combined treatment including electromagnetic field of extremely high frequency (millimetric waves) is beneficial.

The authors' studies show that sanatorium treatment contributes to normalization of bactericidal oxidant mechanism (BOM) of blood neutrophils in patients with chronic bronchitis. In a complete remission this normalization is complete, in partial remission positive trends were seen. In chronic obstructive bronchitis the effect was minor.

A course treatment with pulse running magnetic field generated by ALIMP-1 unit of patients with chronic obstructive bronchitis provides a subjective response, higher exercise tolerance due to improved function of the external respiration. The inductors-solenoids are fixed tangentially on the chest by means of the jacket.

Halotherapy was used for sanatorium rehabilitation in 29 patients with chronic obstructive pulmonary diseases (chronic bronchitis and asthma). Significant positive effects of this method resulted in the improvement of the flow-volume parameters curve of lung function and in hypotensive effects on blood pressure. Halotherapy is recommended for use in patients suffering from chronic obstructive pulmonary diseases with hypertension or coronary heart disease.

The effect of galvanization of the splenic area on immune system was studied in 31 patients with chronic bronchitis versus that of immunomodulating drug thymalin (25 patients) or combined rehabilitation without special immunocorrectors (39 patients). Galvanization produced a good response in disorders of cellular and humoral immunities (primarily in low count of T-lymphocytes and T-suppressors), of interactions between immunity components. Immunocorrective effect of galvanization was comparable with that of thymalin.

100 patients with chronic obstructive bronchitis were examined and treated in the therapeutic department of rehabilitation center. Combined treatment including low-energy laser radiation produced good results. Laser therapy has improved bronchial permeability, sensitivity of bronchial beta 2-receptors to sympathomimetics. As a result, their intake was reduced or discontinued. Laser radiation combined well with other non-pharmacological modalities.

To provide evidence for the potentialities of normobaric hypoxic training (NHT), oxygen cascades from the lung to tissues and responses to hypoxic and hypercapnic stimuli were analyzed in chronic bronchitis patients with Stages 1, 2, and respiratory failure. Since at Stages 2 and 3, compensatory responses are substantially decreased, there is arterial, and occasionally, venous hypoxemia, NHT is contraindicated in these patients. Compensatory responses are preserved only during early stages 0 and 1 respiratory failure, showing it expedient to employ NHT. NHT regimens (as many as 20 sessions) used in these patients improved the patients' condition and physical activity, normalized ventilation function. However, the concurrent diseases exacerbated in some cases. Medical monitoring is needed when the NHT regimen is used.

It has been shown that common clinical and paraclinical methods of diagnosis of recurring bronchitis in children fail to detect subclinical activity of the inflammatory process in the lungs, which fact poses rather difficult problem of treatment and rehabilitation in such pediatric patient populations. Cytochemical diagnosis relying on values for activity of acid phosphatase and labilization of membranes of blood multinuclear leucocytes lysosomes permits overcoming the above difficulties, enhancing efficiency of the treatment.

80 patients with chronic bronchitis took baths with sodium chloride concentration 20, 40, 60 g/l and temperature 37-38 degrees C. The baths produced a positive effect on central and regional hemodynamics, reduced inflammation and sensitization.

Patients treated in mid-altitude conditions for chronic bronchitis were exposed to EHF radiation. As shown by positive changes in external respiration, systemic and pulmonary hemodynamics, immune status, surface activity of lung surfactant, EHF therapy is effective in chronic bronchitis with ventilation disorders. The more severe these disorders were, the more marked the benefit was.

24 patients exposed to low-dose radiation after the Chernobyl accident were examined before and after 24-day treatment of chronic bronchitis in the high-altitude rehabilitation center (3200 m above the sea level) in Tien Shan. Sanogenic alpine climate improved the patients' general condition, physical performance and lung ventilation, corrected compromised immunity. After high-altitude adaptation tracheobronchial inflammation alleviated, cytologic composition and surface activity of bronchoalveolar fluid returned to normal. Therefore, high-altitude treatment of Chernobyl accident victims with chronic bronchitis is effective and can be recommended for such patients.

This work elucidates the questions upon the development of a new drug-free method of a respiratory diseases treatment. Halotherapy (HT)--is mode of treatment in a controlled air medium which simulates a natural salt cave microclimate. The main curative factor is dry sodium chloride aerosol with particles of 2 to 5 mkm in size. Particles density (0.5-9 mg/m3) varies with the type of the disease. Other factors are comfortable temperature- humidity regime, the hypobacterial and allergen-free air environment saturated with aeroions. The effect of HT was evaluated in 124 patients (pts) with various types of respiratory diseases. The control group of 15 pts received placebo. HT course consisted of 10-20 daily procedures of 1 hour. HT resulted in improvements of clinical state in the most of patients. The positive dynamics of flow-volume loop parameters and decrease of bronchial resistance measured by bodyplethysmography were observed. The changes in control group parameters after HT were not statistically significant. The specificity of this method is the low concentration and gradual administration of dry sodium chloride aerosol. Data on healing mechanisms of a specific airdispersive environment of sodium chloride while while treatment the respiratory diseases are discussed.

The benefit of chest physiotherapy in patients with cystic fibrosis has been well documented. However, the benefit of similar rehabilitation in patients with large amounts of sputum who have diagnoses other than cystic fibrosis has not been clearly demonstrated. The aim of this study was to evaluate the acute effectiveness of a device advised for home chest physiotherapy in comparison to postural drainage combined with chest percussion in removing secretions in patients with high sputum production due to diseases other than cystic fibrosis. Fourteen in-patients, known to spontaneously produce more than 25 mL sputum.day-1, underwent two sessions each of two treatment modalities in random order. Treatment A consisted of postural drainage and manual chest percussion. Treatment B included breathing through a commercial device claimed to combine oscillating positive expiratory pressure with oscillations of the airflow. Expiratory flows and oxygen saturation were monitored and recorded throughout the study. The amount of sputum produced in the 30 min preceding, during, and in the 60 min after completing each treatment session was recorded, together with the sensation of "chest unpleasantness due to secretions" as assessed by means of a modified visual analogue scale. The mean time that the patients tolerated treatment was not different for A and B (18.7 +/- 5 and 19.3 +/- 5 min, respectively). Sputum significantly increased during both treatment periods and in the same amount for the two modalities (2.9 +/- 2.9 to 10.9 +/- 7.1 and 2.8 +/- 3.1 to 10.1 +/- 10.8 mL for A and B, respectively). Visual analogue scale score significantly decreased at the end of each treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Galvanization and dalargin electrophoresis were examined for effects on external respiration, hemodynamics and oxygen-related energy metabolism of cardiorespiratory system of chronic bronchitis patients. Universal stress-limiting mechanism of these procedures, correcting cardiorespiratory function is based on more effective utilization of energy resources for support of self-cleaning activity of the body.

Halotherapy was used for rehabilitation in 25 patients with acute bronchitis of long-standing and recurrent types. The main therapeutic action was ensured by aerodispersed medium saturated with dry highly dispersed sodium chloride aerosol, the required mass concentration being maintained in the range of 1 to 5 mg/m3. Therapy efficacy was controlled through assessment of clinical, functional, immunological and microbiological findings. Metabolic activity values were taken into consideration as well. Positive dynamics of the function indices in the clinical picture resulted from elimination of pathogenic agents, control of slowly running inflammatory lesions and stimulation of some immune system factors. Favourable changes in metabolic activity were present: normalization of serotonin excretion, marked decrease of unbalance in lipid peroxidation-antioxidant system.

Single total (air bath, douche) and local (cooling of the feet with water) exposure to mild cold do not arise noticeable disorders of the respiration function in children suffering from recurrent and asthmatic bronchitis in remission. Local cold procedures improve bronchial patency while the exposure to heat results in its worsening.

Techniques and therapies intended to assist in the removal of excessive mucus from the lungs are now receiving greater attention in the medical practice. Flutter-VRP1 Desitin is a new pocket-sized personal therapeutic device used in the adjuvant treatment of respiratory diseases characterized by different degrees of bronchial obstruction, mainly due to disturbances of bronchial clearance and mucostasis. Used in a group of 20 patients with chronic obstructive bronchitis in whom the clinical and functional parameters were determined before and after regular use of the device for periods varying between two and eight weeks. The Flutter-VRP1 proved as a very promising technique, which can significantly ameliorate the evolution of chronic obstructive bronchitis, especially in the cases with mild to moderate deterioration.

Chronic bronchitis with obstructive syndrome was treated in 91 patients with contrast baths. The latter produced good results in 80.3% of the patients. This treatment is analysed as to clinical efficacy, the effect on the external respiration, right heart hemodynamics, inflammation activity, changes in immunity system. Principal contraindications are defined. A differential approach to contrast baths in chronic bronchitis after treatment is advocated.