[Systematic literature review on interventions in rehabilitation for children and adolescents with asthma bronchiale]. / Systematische Literaturanalyse zur rehabilitativen Behandlung von Kindern und Jugendlichen mit Asthma bronchiale.

Relevant data bases were used to collect and evaluate guidelines, meta-analyses, and reviews as well as primary studies dealing with asthma therapy for children and adolescents. Treatment approaches whose effectiveness with regard to bronchial asthma was empirically verified (i. e., evidence-based) were identified (medical and diagnostic procedures as well as drug trials were excluded from the analysis). 152 methodically sound studies referring to asthma treatment of children and adolescents were selected. Strong evidence was found for patient education, parent education, exercise therapy, inhalation, and tobacco withdrawal. Nutritional counseling and avoidance of allergens showed limited evidence. Psychotherapy, relaxation techniques, breathing exercises, climate therapy, clinical social work (social and legal counseling services, vocational reintegration counseling, aftercare) and integration counseling showed inconsistent evidence. No evidence was found for alternative medicine. Challenges regarding the development of treatment standards for children and adolescent rehabilitation are highlighted; these refer to limitations in report quality in some of the studies, the validity of treatments for comorbid conditions, a lack of differentiation for different age groups, and transferability of outpatient or international study results to inpatient rehabilitation.

[Assessment of the suitability of workers based on the Swiss Law on Accident Insurance--declaration of unsuitability / declaration of conditional suitability]. / Beurteilung der Eignung im Rahmen des UVG--Nichteignungsverfügung / bedingte Eignungsverfügung.

In order to prevent the development or aggravation of an occupational disease or an occupational accident risk lying in an individual employee the Swiss National Accident Insurance Fund (Suva) based on the Swiss Law on Accident Insurance is entitled to prohibit certain activities that have proven to be hazardous to the individual (declaration of "unsuitability" (DOU) or rarely declaration of conditional suitability). Occupational skin and respiratory diseases are the most frequent disorders, and flour; cement, isocyanates and hairdressing substances the most important occupational factors requiring a DOU. This measure also provides financial security to the employee for up to 4 years by the accident insurer in cooperation with the unemployment insurance. For retraining and occupational rehabilitation a special state insurance, the Invalidity insurance is responsible.

Physical Therapy Treatment of Impaired Chest Mobility in Patients with Airway Sensory Hyperreactivity.

BACKGROUND AND PURPOSE: In sensory hyperreactivity (SHR), patients have symptoms from the airways and the chest induced by environmental irritants like scenting products and cigarette smoke. They are characterized by increased cough reaction to inhaled capsaicin compared with healthy controls. Lung function tests are normal, and asthma medications have no or little effect. In a recent published article, patients with SHR were found to have impaired chest mobility and increased pain sensitivity. The purpose of this study was to evaluate if a physiotherapeutic intervention can increase chest mobility in SHR, influence these patients' symptoms and reduce capsaicin cough sensitivity. METHODS: Forty-one SHR patients were initially randomized in to groups, one for training and one for symptom registration in this controlled training study. It consisted of a daily training programme containing simple movements to increase the flexibility of the chest, a breathing exercise and a relaxation session as well as symptom registration. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using pressure algometry and a standardized capsaicin inhalation threshold provocation-evaluated cough sensitivity. RESULTS: Twenty seven patients were left for analyses after 12 weeks and 26 patients after 24 weeks. Chest mobility and upper thoracic respiratory movements improved (p < 0.01), feeling of chest pressure and the capsaicin cough sensitivity decreased (p < 0.01). The patients also showed of significantly lowered pain pressure thresholds measured with algometry, compared with healthy controls (p < 0.001). CONCLUSION: Improvement of chest mobility after physiotherapeutic intervention indicates that these patients may have acquired a dysfunctional breathing pattern. The regular use of a training programme and structural breathing instructions can be used to improve chest mobility, chest symptoms and capsaicin cough sensitivity in patients with SHR and signs of dysfunctional breathing. Copyright © 2016 John Wiley & Sons, Ltd.

[The dynamics of the persistence characteristics of staphylococci under the action of the microclimate of a speleotherapy mine]. / Dinamika persistentnykh kharakteristik stafilokokkov pod vozdeistviem mikroklimata speleoshakhty.

A decrease in the persistence characteristics of staphylococci under the influence of microclimate in a spelean pit has been demonstrated under experimental conditions. Clinical investigations have confirmed the capacity of speleotherapy to decrease the microbial contamination of the upper respiratory tract and to inhibit the persistence properties of staphylococcal microflora in children with respiratory allergosis, which seems to be the basis of the positive effect achieved by treatment with microclimate in a spelean pit.

[Asthma and obesity in childhood: what is the link?]. / Asthme et obésité : quelle relation chez l'enfant ?

According to the definition (body mass index>97 degrees percentile), overweight and obesity concern 15% of French children. The parallel trends in the increase in asthma and obesity may indicate a potential link between these two conditions. The purpose of this study was to review the epidemiological data indicating a relationship between asthma and obesity, to evaluate the consequences of obesity on asthma and to assess the mechanisms of this association. We conclude with the implications for treatment strategies.

Quality of life in patients with latex allergy.

BACKGROUND: Exposure to natural rubber latex (NRL) may lead to a variety of allergic clinical manifestations that may affect the quality of life (QOL). AIM: To assess QOL of patients with different clinical effects of NRL allergy including rhino-conjunctivitis, asthma, anaphylaxis and skin manifestations. METHOD: A questionnaire to assess QOL was mailed to 56 patients who had been assessed and managed for various clinical manifestations of latex allergy at a university affiliated hospital in Toronto, Canada. RESULTS: Thirty-one questionnaires were completed and returned. Thirty of the respondents were health care workers. Forty-one percent of the respondents had changed their jobs to reduce exposure to latex and 13% had stopped working. However the respondents did not report a great effect on the QOL related to latex allergy. CONCLUSION: The results of this study indicate that the various clinical manifestations of latex allergy can be managed so that there is no significant interference with QOL.

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.

[Occupational training measures for adolescents with asthma and allergy: one-year vocational education]. / Berufsvorbereitende Massnahmen für asthma- und allergiekranke Jugendliche: 1 jähriger Förderungslehrgang.

The "Förderungslehrgang" in our asthma center is a special training program for adolescents handicapped by asthma or allergic diseases who are therefore not able to start apprenticeship. The course takes one year. Besides vocational guidance and tryout of different occupations, medical and psychological diagnostics are performed. Medical service is provided all day, and a hospital with emergency unit is within the area. Though 41% of the participants did finish school without any qualified graduation after their compulsory school attendance, 79% were able to start apprenticeship after the course.

[Changes in the clinico-functional and immunological indices of patients with chronic obstructive lung disease, the allergic form, following combined climatotherapy at Sandanski health resort]. / Promeni v niakoi kliniko-funktsionalni i imunologichni pokazateli pri bolni s khronichna obstruktivna belodrobna bolest--alergichna forma, sled kompleksno klimatolechenie v kurorta Sandanski.

20 patients with chronic obstructive pulmonary disease who were treated in the resort of Sandanski, Bulgaria, during the autumn of 1988 were investigated for changes of some clinical, functional and immunologic indices--secretory immunoglobulins, lysozyme, serum bactericidal activity. The results revealed an improvement of the clinical indices mean in 50% of the patients, of the expiratory spirometric indices in mean 47% of the patients. Other findings were a distinct tendency towards a decrease of IgG and albumin in the saliva and an increase of the secretory IgA together with a statistically significant increase of the indices characterizing the nonspecific defence mechanisms of the lung.