[The influence of the aeropalinological factors of the aerial environment at the southern coast of the Crimea on the results of the spa and health resort-based treatment of the patients presenting with bronchial asthma]. / Vliianie aéropalinologicheskikh faktorov vozdushnoi sredy Iuzhnogo berega Kryma na rezul'taty sanatorno-kurortnogo lecheniia bol'nykh bronkhial'noi astmoi.

THE RATIONALE: The clinical course of bronchial asthma (BA) largely depends on the environmental conditions. One of the biological factors of the environmental pollution is the plant pollen. The presence of plant pollen in the air exerts the negative influence on the human health via specific (allergenic) and non-specific effects. AIM: The objective of the present study was to evaluate the influence of the aeropalinological factors of the aerial environment of the Southern Coast of the Crimea (SCC) on the results of the spa and health resort-based treatment (SRT) of the patients with bronchial asthma (BA). MATERIAL AND METHODS: The study involved 168 patients presenting with BA including 119 (70.83%) women and 49 (29.17%) men; all of them were residents of the Crimea who underwent SRT while staying at the SCC during the period from 2011 to 2013. The average age of the patients was 52.94±11.78 years. The examination of all the patients included a questionnaire survey, general medical inspection, physical examination, complete blood cell count, analysis of sputum cytology, external respiration function testing, and the assessment of the disease control with the use of the Asthma Control Test (ACT) and the Asthma Control Questionnaire (ACQ). The duration of treatment was 21 days. The drug treatment of all the patients was carried out in accordance with the generally recognized protocols for the management of asthma. Four groups of patients were formed depending on the periods of plant dusting at the Southern Coast of the Crimea, viz. cypress (n=51), pine (n=24), ragweed (n=29), and cedar (n=47); in addition, one more group of patients was distinguished who resided at SCC outside the periods of these plants dusting (n=17). RESULTS: After the completion of the spa and health resort-based treatment, the highest frequency of the absence of cough (62.5%) and dry rales in the lungs (87.5%) was revealed in the patients treated during the pine dusting period (the cough and dry rales in lungs were absent in 31.0-49.0% and 55.3-79.3% of the cases respectively during the dusting seasons of other plants of interest). The aeropalinological factors were shown to have no significant influence on the values of the parameters obtained with the use of the general blood tests and the analysis of sputum cytology. The best characteristics of the external respiration function were documented in the patients who had been treated during the pine dusting period. At the end of the SRT, no significant differences were found as regards the results of the ACQ and AST tests between the patients of the groups being compared. Nor was there a significant dependence of the dynamics of the clinical, laboratory, and functional indicators achieved as a result of SRT on the magnitude of the aeropalinological factors at the Southern Coast of the Crimea. The worst immediate effectiveness of SRT was inherent in the patients suffering from bronchial asthma who had been treated during dusting of the ragweed. CONCLUSIONS: Certain results of the spa and health resort-based treatment of the patients presenting with BA under conditions of the Southern Coast of the Crimea depend on the character and composition of the aeropalynologic factors in this region. Specifically, the treatment based at a health resort facility during the dusting period of the pine leads to the achievement of the best clinical and functional status of the patients in comparison with those treated during the cypress, ragweed, and cedar dusting periods, or in the absence of dusting of these plants. The worst immediate effectiveness of SRT was documented in the BA patients who had been treated during the ragweed dusting period.

[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.

[The methodological aspects of assessing treatment efficacy at a health resort]. / Metodologicheskie aspekty otsenki éffektivnosti lecheniia na kurorte.

The paper provides analysis of the existing system of assessing short-term results of sanatorium treatment for nonspecific respiratory diseases. It is inferred that the system is unsatisfactory and requires revision. Methodological approaches are described which could guide in construction of a new system of deciding about the effectiveness of sanatorium treatment effectiveness.

[The mathematical aspects of constructing a system for choosing the treatment method at a health resort in chronic nonspecific lung diseases]. / Matematicheskie aspekty postroeniia sistemy vybora metoda lecheniia na kurorte pri khronicheskikh nespetsificheskikh zabolevaniiakh legkikh.

The paper presents the analysis of present-day approaches to solution of the problem of spa-treatment method choice. Principal mathematical means and methodological approaches consist of; formalization of the subject field; accumulation of sufficient clinical material; classification of the patients' condition, functional changes and methods of treatment, multivariate (cluster, factor), inductive formation of concepts, models of thinking, etc.

[The expediency of assessing the severity of the state of patients with chronic bronchitis at the rehabilitative treatment stage]. / O tselesoobraznosti otsenki tiazhesti sostoianiia bol'nykh khronicheskim bronkhitom na étape vosstanovitel'nogo lecheniia.

Notion of current gravity of patient's state was introduced in order to carry out aggregate estimation of pathological manifestations in patients with chronic bronchitis in rehabilitative stage of the treatment. There were suggested three degrees of patients' state: satisfactory, slightly compromised and moderately grave. Patients with different states were unlike with respect to most clinical, laboratory and instrumental parameters. Dependence of immediate and remote results of rehabilitation on initial and attained patients state proves advisability of its current estimation. Determination of patients state in chronic bronchitis allows to prognosticate effectiveness of the treatment.

[The characteristics of lysozyme and carbenicillin action on the clinico-immunological status of patients with chronic bronchitis]. / Osobennosti deistviia lizotsima i karbenitsillina na kliniko-immunologicheskii status bol'nykh khronicheskim bronkhitom.

Clinical, laboratory and immunological methods used to study 68 patients with chronic bronchitis revealed a normalizing effect of intratracheal administration of lyzozyme and its combinations with carbenicillin on the indices of cellular and humoral links of immunity. Treatment tactics is discussed.

[Inhalations of essential oils in the combined treatment of patients with chronic bronchitis]. / Ingaliatsii éfirnykh masel v kompleksnom lechenii bol'nykh khronicheskim bronkhitom.

The complex of health resort treatment of patients with chronic bronchitis was supplemented by inhalation of a complex of ether oils in natural concentration (0.1--0.5 mg/m3): ether oils of Mentha, Artemisia limonica, Salvia officinalis, Lavandula officinalis, Monarda (2:4:1:1:2). Inhalation course--10 +/- 4 procedures, duration: up to 30 min. The described treatment optimizes the result, increases the anti-inflammatory effect of health resort treatment.

[Rehabilitation of patients with chronic bronchitis who are engaged in agricultural work]. / O reabilitatsii bol'nykh khronicheskim bronkhitom, zaniatykh sel'skokhoziaistvennym trudom.

The efficiency was studied of rehabilitation of 115 patients with chronic bronchitis engaged in agricultural work under the effect of a complex of traditional health-resort climatic factors as well as this complex supplemented by breathing exercises with additional dead space or intensified graded physical exercises (cycling, running). Only the therapeutic complex including physical exercises proved efficient.