[Analysis of the effectiveness of the spa and health resort-based treatment of the patients presenting with broncho-pulmonary pathology at the southern coast of the Crimea depending on the period of flowering of Mediterranean Cypress (Cupressus sempervirens)]. / Analiz effektivnosti sanatorno-kurortnogo lecheniya patsientov s bronkholegochnoi patologiei na Yuzhnom beregu Kryma v zavisimosti ot perioda tsveteniya kiparisa vechnozelenogo.

AIM: The objective of the present study was to evaluate the influence of pollen of Mediterranean Cypress (Cupressus sempervirens) on the effectiveness of the spa and health resort-based treatment (SHRT) of the patients with broncho-pulmonary pathology at the southern coast of the Crimea (SCC). MATERIAL AND METHODS: This article presents the results of the analysis of the data on 122 patients presenting with broncho-pulmonary pathology who received SHRT under the conditions of the Southern Coast of the Crimea. Fifty one (41.8%) of these patients suffered from chronic obstructive pulmonary disease and 71 (58.2%) ones had bronchial asthma. The whole group was comprised of 44 men (36.1%) and 78 women (63.9%). The average (median) age of the patients was 55.8 years. All the participants of the study underwent the comprehensive examination including the general medical and physical examination, complete blood count, the study of sputum cytology and immunological properties of blood including the standard characteristics, IgE and lysozyme levels), evaluation of the respiratory and locomotor (physical) functions with the use of the 6-minute walking test. RESULTS: The aeropollenological study of the aerial environment of the southern coast of the Crimea in the region of Yalta showed that the «bloom¼ of the Mediterranean Cypress occurs during the period from February till April inclusive. The highest concentrations of cypress pollen are observed in March and early April. The overall effectiveness of SHRT for the patients with broncho-pulmonary pathology arriving for the treatment at the southern coast of the Crimea from other Crimean localities does not depend on the period of «flowering¼ (the presence of pollen in the air) of the Mediterranean Cypress. In these patients, the termination of the spa and health resort-based treatment during the «flowering¼ of the Mediterranean Cypress resulted in nothing more than a strained adaptive response manifested as the altered blood leukocyte count. Such reaction is considered to be a natural consequence of intake of antigenic substances into the human body.

[Our experience with the application of the speleotherapeutic treatment based at the state healthcare facility "Republican Speleotherapeutic Hospital"].

The non-medicamental therapeutic modalities find an increasingly wider application for the rehabilitation and maintenance of the health status in man. Speleotherapy is one of such methods. The Republican Speleotherapeutic Hospital of Belarus exploits the underground speleocomplex in which over 42,000 petients with respiratory diseases and allergic pathologies were given the required treatment. The clinical effectiveness of speleotherapy is estimated at 97.3%. Remission persists for 7.0±0.4 months on the average within one year after a course of speleotherapy. Repeated courses are followed by even longer periods of remission (up to 2.5-3 years). It is concluded that speleotherapy is the highly efficient method for the rehabilitation of the patients presenting with respiratory diseases and allergic pathologies.

O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais / The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents

OBJETIVO: Detectar o impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais. MÉTODOS: Trata-se de um estudo quase-experimental; foram randomizados 24 pacientes com asma, rinite alérgica e respiração oral, idade de 6 a 15 anos. Todos os pacientes usavam dipropionato beclometasona inalação oral. No momento em que aceitaram participar da pesquisa, a inalação oral foi substituída pela inalação exclusivamente nasal na inspiração e, após 1 mês, associou-se ao tratamento fonoaudiológico em metade dos pacientes. Esses receberam 16 sessões de tratamento fonoaudiológico em 8 semanas, além do dipropionato de beclometasona inalação exclusivamente nasal (grupo DBF). O grupo de comparação recebeu somente dipropionato beclometasona inalação exclusivamente nasal (grupo DBI). Os dois grupos foram avaliados em cinco tempos. Utilizou-se o escore clínico da rinite alérgica, da asma, o protocolo de avaliação miofuncional orofacial adaptado de Marchesan (2003), a observação dos responsáveis, dados de espirometria, de pico de fluxo inspiratório e de pico de fluxo expiratório. RESULTADOS: Houve melhora significativa do grupo DBF: escores clínicos da asma no tempo 5 (p = 0,046); valores do pico de fluxo inspiratório no tempo 4 (p = 0,030); pico de fluxo expiratório no tempo 3 (p = 0,008); modo respiratório e postura de lábios (p = 0,000) a partir do tempo 3; observação dos responsáveis, no tempo 2, tempo 4 e tempo 5 (p = 0,010; p = 0,027; p = 0,030). CONCLUSÕES: O tratamento fonoaudiológico associado ao dipropionato beclometasona por inalação exclusivamente nasal promoveu um controle clínico e funcional mais precoce e duradouro da asma, da rinite alérgica e da respiração oral entre os grupos estudados.

OBJECTIVE: To determine the impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents. METHODS: This was a quasi-experimental randomized study of 24 mouth breathing patients with asthma and allergic rhinitis, aged from 6 to 15 years. All patients were taking beclomethasone diproprionate through oral inhalation at the start of the study. At enrollment on the study, oral inhalation was substituted with exclusively nasal inhalation and 1 month later half of the patients began speech therapy. They attended 16 speech therapy sessions in 8 weeks and continued taking beclomethasone dipropionate through exclusively nasal inhalation (BDT group). The comparison group received only beclomethasone diproprionate through exclusively nasal inhalation (BDI group). Both groups were assessed five times. Clinical scores were calculated for allergic rhinitis and asthma, an adapted version of the Marchesan orofacial myofunctional assessment protocol was applied, and parents/guardians' observations were recorded, in addition to spirometry measurements of peak inspiratory and peak expiratory flow. RESULTS: There were significant improvements in the BDT group: clinical asthma score at T5 (p = 0.046); peak inspiratory flow at T4 (p = 0.030); peak expiratory flow at T3 (p = 0.008); breathing mode and lip position (p = 0.000) from T3 onwards; and parents/guardians' observations at T2, T4, and T5 (p = 0.010; p = 0.027; p = 0.030). CONCLUSIONS: Speech therapy in combination with beclomethasone diproprionate through exclusively nasal inhalation resulted in earlier and longer-lasting clinical and functional control of asthma, allergic rhinitis, and mouth breathing than was achieved in the group that only took beclomethasone diproprionate.

The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents.

OBJECTIVE: To determine the impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents. METHODS: This was a quasi-experimental randomized study of 24 mouth breathing patients with asthma and allergic rhinitis, aged from 6 to 15 years. All patients were taking beclomethasone diproprionate through oral inhalation at the start of the study. At enrollment on the study, oral inhalation was substituted with exclusively nasal inhalation and 1 month later half of the patients began speech therapy. They attended 16 speech therapy sessions in 8 weeks and continued taking beclomethasone dipropionate through exclusively nasal inhalation (BDT group). The comparison group received only beclomethasone diproprionate through exclusively nasal inhalation (BDI group). Both groups were assessed five times. Clinical scores were calculated for allergic rhinitis and asthma, an adapted version of the Marchesan orofacial myofunctional assessment protocol was applied, and parents/guardians' observations were recorded, in addition to spirometry measurements of peak inspiratory and peak expiratory flow. RESULTS: There were significant improvements in the BDT group: clinical asthma score at T5 (p = 0.046); peak inspiratory flow at T4 (p = 0.030); peak expiratory flow at T3 (p = 0.008); breathing mode and lip position (p = 0.000) from T3 onwards; and parents/guardians' observations at T2, T4, and T5 (p = 0.010; p = 0.027; p = 0.030). CONCLUSIONS: Speech therapy in combination with beclomethasone diproprionate through exclusively nasal inhalation resulted in earlier and longer-lasting clinical and functional control of asthma, allergic rhinitis, and mouth breathing than was achieved in the group that only took beclomethasone diproprionate.

Impairment in quality of life is directly related to the level of allergen exposure and allergic airway inflammation.

BACKGROUND: Allergic disease has been shown to impair health-related quality of life (HRQL). The relationship between HRQL and either allergen exposure or allergic inflammation has not been previously assessed. OBJECTIVE: To assess the relationship between HRQL and both grass pollen exposure and airway inflammation using the Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ). This is a novel questionnaire previously developed to assess the multi-system aspects of allergic disease. METHODS: Eighty-four subjects, aged 6-17 years, with seasonal allergic rhinoconjunctivitis, asthma and/or cutaneous manifestations were assessed before and during the grass pollen season. They were assessed with the PADQLQ, a visual analogue scale (VAS) to assess quality of life, symptom diary and exhaled nitric oxide (FENO). RESULTS: HRQL, as measured by the PADQLQ, significantly correlated with the average pollen count in the previous week (regression coefficient 0.038, 95% confidence interval (CI) 0.027-0.049, P<0.001). The PADQLQ score was also found to be significantly associated with airway inflammation as measured by FENO (regression coefficient 0.410, 95% CI 0.175-0.646, P=0.001). Additionally, PADQLQ showed a high degree of correlation with symptom scores and quality of life as measured by a VAS, good within-subject reliability and a small minimal important difference (0.20, 95% CI -0.09 to 0.49 on a seven-point scale). CONCLUSION: HRQL is related to both allergen load and allergic inflammation and the PADQLQ has excellent cross-sectional and longitudinal validity with respect to quality of life and symptoms.

[The efficacy of subterranean therapy in the salt chamber of Kinga Spa in Wieliczka for patients suffering from allergic rhinitis]. / Skutecznosc leczenia subterraneoterapia alergicznego niezytu nosa w komorach solnych Szpitala Uzdrowiskowego Kinga w Wieliczce.

42 patients (27 women and 15 men aged 14-65 years) suffering from atopic and non atopic rhinitis were submitted for 24 days to the subterraneo-therapy in salt chambers of Kinga Spa in Wieliczka during the exacerbation of their illness. 20 patients suffered from pollen or dust mites allergy and the next 22 patients from non atopic rhinitis with recurrent nasal polyposis. In the first week and at the end of the therapy rhinoscopy, peak nasal inspiratory flow and smell were evaluated as well as daily symptoms score was noted in each treated patient. The results of performed observations indicate that unrelatively to the type of the rhinitis: 1. the nasal symptoms (running nose, sneezing, block of the nose) resolved directly during the stay of the patient in the salt chamber but the more constant effect was visible with the time of the therapy. 2. an increase in the peak nasal expiratory flow was connected with the decrease of nasal mucosal edema, 3. the smell disturbances disappeared in the patients together with the decrease of mucosal edema. The observed changes seem to be connected with the influence of the salt chambers' microclimate on the cells osmolarity disturbances in the nasal mucosa provoked by the non infectious chronic inflammation.

[Difficulties in diagnosis of rhinitis in children treated at the Otorhingologic outpatient department of children's hospital in Bialystok]. / Trudnosci diagnostyczne w alergiczych niezytach nosa u dzieci leczonych w Poradni Laryngologicznej Dzieciecego Szpitala Klinicznego w Bialymstoku.

The aim of this study was an analysis of rhinitis etiology in 105 children treated in Otorhinolaryngology Outpatients Department, Children Clinical Hospital in Bialystok. In 58 patients seasonal allergic rhinitis, stimulated by grass antigens, in 37 patients infectious rhinitis and in 10 patients perennial allergic rhinitis stimulated by mites was recognised. The diagnosis in this last group was made using laryngological investigations skin "prick tests" and specific IgE level against mites.