PULMONARY DISEASE DIAGNOSTIC AND REHABILITATION TREATMENT FOR PATIENTS WITH OVERLAP ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASES.

OBJECTIVE: Aim: To analyze the effectiveness of rehabilitation treatment in the conditions of halo aerosol therapy and when using different groups of fixed-dose aerosol inhalers in patients with asthma, chronic obstructive pulmonary diseases and asthma-chronic obstructive pulmonary diseases overlap. PATIENTS AND METHODS: Materials and Methods: A total 112 patients with asthma, chronic obstructive pulmonary diseases and asthma-chronic obstructive pulmonary diseases overlap. All patients carefully collected allergic history, anamnesis of life, and disease. The study includes assessment of resting anthropometric data, physical activity habits, blood pressure, structure and quality of nutrition, family and economic data. RESULTS: Result: After a course of rehabilitation treatment, lung ventilation improved in all groups of patients compared to controls. The dynamics of FER indicators after the rehabilitation treatment had some differences for each group of patients in relation to the control groups. If in all A groups (control) the increase in FER indicators was insignificant, then in all B groups of patients it was significant, and differed from 14,6% up to 36%. CONCLUSION: Conclusions: Thus, a differentiated approach to the use of fixed-dose aerosol inhalers increases the effectiveness of rehabilitation treatment under conditions of halo aerosol therapy in patients with various genesis of bronchi-obstructive syndrome.

THE BASIS FOR PROVIDING QUALITY MEDICAL SERVICES AT THE STAGE OF REHABILITATION TREATMENT FOR PATIENTS WITH ASTHMA.

OBJECTIVE: The aim: To analyze the quality of medical services provided to asthma patients as the stage of rehabilitation treatment and their legal support. PATIENTS AND METHODS: Materials and methods: A total 237 patients with asthma were examined on the basis of the SDC "Rehabilitation" of the Ministry of Health of Ukraine in Uzhhorod which has an accreditation. All patients were divided into three groups, depending on the type of rehabilitation treatment. The quality of the provision of medical services in rehabilitation in the treatment of asthma patients was evaluated by the percentage of positive clinical effect. RESULTS: Results: The quality of medical services provided in 237 patients with asthma after the rehabilitation treatment was different in percentages of positive clinical effect in different treatment complexes. In the first complex it amounted to 56.2%, in the complex two - 55.5%. These two monotherapy complexes proved to be ineffective rehabilitation services. Highly specialized for each phenotype of asthma rehabilitation service was of high quality and established in the third treatment complex 88.9% and for each asthma phenotype ranged from 87.3% to 93,4%. CONCLUSION: Conclusions: For the provision of quality rehabilitation services for asthma patients the existing regulatory acts are not enough, it is necessary to rely on international recommendations to specify the provision of differentiated treatment for different disease phenotypes.

Allergic rhinitis and asthma co-morbidity.

OBJECTIVE: Introduction: The combination of asthma and allergic rhinitis can affect the mutual encumbrance to which other pathogenetic mechanisms join, which worsen the course of both diseases. The aim of work is to analyze the features of the genotype and phenotype in patients with a co-morbidity of asthma and allergic rhinitis. PATIENTS AND METHODS: Materials and methods: In order to detect the features of asthma and allergic rhinitis, 115 patients were examined. Patients were divided into two groups: the first included 58 patients with allergic asthma and allergic rhinitis co-morbidity, the second - 57 patients with non-allergic asthma morbidity. RESULTS: Results: For the group of patients with allergic asthma with concomitant allergic rhinitis, the first manifestation of allergy in childhood is characteristic (allergic rhinitis, hay fever, atopic dermatitis). For this group of patients characterized by a heavy family allergic history. Symptoms of allergic rhinitis aggravate the course of asthma. Characteristic correlation of symptoms of allergic rhinitis with distal obstruction and pronounced lability of bronchi. In these patients, the total increase in IgE and blood eosinophilia, in 1,5 times increased blood histamine and the level of exhaled NO2 have been increased. Also, asthma control with concomitant allergic rhinitis was significantly worse than in an isolated asthma group (p <0.05). CONCLUSION: Conclusion: The obtained data allow to distinguishing the phenotype of patients with asthma and allergic rhinitis co-morbidity.

Cluster analysis of the phenotype of asthma and obesity.

OBJECTIVE: Introduction: The combination of asthma and obesity can affect the mutual encumbrance to which other pathogenetic mechanisms join, which worsen the course of both diseases. The aim of the work is to analyze the features of the genotype and phenotype in patients with a combined course of asthma and obesity. PATIENTS AND METHODS: Materials and methods: In order to detect the features of obesity asthma, 108 patients were examined. Patients were divided into two groups: the first included 50 patients with normal body weight, the second - 58 patients with obesity. RESULTS: Results: The analysis of the history of the disease revealed that 98% of women with obesity with asthma started the illness at the mature age (50.9 years) against the background of age-related hormonal dysfunctions. Relatively rarely in the obesity group, allergic rhinitis and eosinophilia in the peripheral blood were diagnosed. In analyzing the indicators of the function of external respiration, it has been established that in obese patients, restrictive bronchoconstriction disturbances and more significant distal bronchial obstruction are more pronounced than in patients with normal body mass. In the group of obese patients, the majority were women, the disease was more often complicated by pulmonary insufficiency, emphysema of lungs, and co morbid condition - hypertension. In this group, the symptoms of asthma were constantly persistent, but worse controls. CONCLUSION: Conclusions: The obtained data allow to distinguish the phenotype of patients with asthma with adjunctive obesity.