THE INFLUENCE OF SPELEOTHERAPY ON BRONCHI PASSAGE IN CHILDREN WITH BRONCHIAL ASTHMA USING A PHARMACO-FUNCTIONAL TEST WITH SALBUTAMOL.

OBJECTIVE: The aim: To investigate the reaction of the bronchi to inhalation of salbutamol in children with different severity of bronchial asthma under the conditions of speleotherapy. PATIENTS AND METHODS: Materials and methods: 40 children aged 6-15 years were examined, 20 of them had an intermittent course of the disease, 20 had a mild course, and the children were in the inter-relapse period. Determining the function of external respiration (FER) with a pharmaco-functional test (PFT) with salbutamol was carried out in the dynamics of observation before and after treatment and compared with the indicators of 40 healthy children. Speleotherapy was performed based on the children's department of the Ukrainian Allergological Hospital of the village Solotvino. RESULTS: Results: A decrease in increased bronchial tone and restoration of bronchial patency at all levels of the bronchi in all patients with an intermittent course of the disease and a partial decrease in bronchial hyperreactivity with the improvement of bronchial patency in children with a mild course of bronchial asthma under the influence of speleotherapy was established. CONCLUSION: Conclusions: Thus, speleotherapy contributes to a positive reaction of the bronchi to inhalation of salbutamol, which is reflected in the normalization of disturbed bronchial tone and the restoration of bronchial patency at all levels of the bronchi, in all patients with an intermittent course and partially with a mild course of the disease.

Dynamic Balance and Chest Mobility of Older Adults after Speleotherapy Combined with Pulmonary Rehabilitation, Endurance and Strength Training-A Prospective Study in Chronic Respiratory Diseases.

BACKGROUNDS: As people age, they are more likely to experience balance disturbances. Pulmonary rehabilitation is recognized as a core component in the management of older adults with chronic respiratory diseases. The aim of the study was to assess the dynamic balance and chest mobility of older adults participating in speleotherapy combined with pulmonary rehabilitation, endurance and strength training. METHODS: The study group consisted of 51 older adults with chronic respiratory disorders who participated in a 3-week pulmonary rehabilitation programme in underground salt chambers in the 'Wieliczka' Salt Mine Health Resort. These individuals underwent the Four Square Step Test (FSST) and circumferential chest mobility measurement before and after the outpatient rehabilitation programme conducted 135 m underground. RESULTS: Before rehabilitation in the underground salt chambers, half of the results (50%, 22 patients) were below the norm in the assessment of chest mobility between maximal inhale and exhale. The average time needed to perform FSST decreased significantly (p ≤ 0.05) from 10.2 ± 1.9 s before the stay to 9.1 ± 1.7 s after the stay and the average increase in chest mobility increased significantly (p ≤ 0.05) from 4.5 ± 5.5 cm to 5.4 ± 2.8 cm. CONCLUSIONS: Speleotherapy combined with pulmonary rehabilitation, endurance and strength training increased the dynamic balance and chest mobility of older adults with chronic respiratory diseases, as measured by the FSST and circumferential chest expansion assessment.

The influence of speleotherapy combined with pulmonary rehabilitation on functional fitness in older adults - preliminary report.

OBJECTIVE: Our aim was to determine the influence of pulmonary rehabilitation conducted in therapeutic salt mine chambers on the functional fitness of older adults. METHODS: The study included 22 individuals of age >65 years with chronic respiratory conditions. The patients underwent the Fullerton test before and after a 3-week outpatient pulmonary rehabilitation in the "Wieliczka" Salt Mine Health Resort. RESULTS: After the rehabilitation stay, the results showed statistically significant improvements within five of the six parameters evaluated. In the Arm Curl, the mean number of repetitions within 30 s increased from 14.55 ± 3.63 to 16.68 ± 3.83 and in the Chair Stand from 11.86 ± 2.55 to 14.41 ± 2.95. Beneficial changes were observed in the Back Scratch, but without statistical significance. In Sit and Reach results increased from -2.3 ± 11.11cm to 2.14 ± 9.19 cm. Time for performing the 8-Foot Up and Go decreased from 6.63 ± 1.27 s to 5.8 ± 0.86 s and in 2-Minute Step results increased from 88.27 ± 20.64 to 96.55 ± 16.38 repetitions. CONCLUSION: Functional fitness of examined older adults with pulmonary disorders has increased after a rehabilitation and treatment stay in underground salt mine chambers. The reviews of this paper are available via the supplemental material section.

Subterranean Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease.

Pulmonary rehabilitation (PR) has been recommended as an integral part of treatment for patients with chronic obstructive pulmonary disease (COPD). Climate therapy in salt mine chambers has been found of benefit in chronic respiratory diseases. The study compares long-term effects of underground PR in the Wieliczka Salt Mine with that conducted on the surface. There were 42 COPD patients enrolled in the study, with FEV1/FVC <0.7 predicted and post-bronchodilator reversibility <12%, randomized into pulmonary rehabilitation in the mine (Group I, n = 23) and PR on the surface (Group II, n = 19). The outcomes consisted of lung function variables, exercise performance (6-min walk test - 6MWT), dyspnea (mMRC), and compliance with the disease and quality of life (COPD Assessment Test - CAT) and BODE index, compared at baseline (P0), end (P1), and 6 months after pulmonary rehabilitation (P2). The findings were that subterranean pulmonary rehabilitation significantly reduced CAT score (p < 0.001), BODE index (p = 0.004), and dyspnea (mMRC) (p = 0.001) and increased distance in 6MWT (p < 0.001), compared with its equivalent conducted on the surface. Further, beneficial effect of subterranean treatment was sustained during the following half a year as opposed to the effect noticed on patients treated on the surface. We conclude that subterranean pulmonary rehabilitative treatment reduces symptoms and improves exercise tolerance to a greater and sustained extent, compared to a similar treatment on the surface, in patients suffering from COPD.

Particulate Matter in the Air of the Underground Chamber Complex of the Wieliczka Salt Mine Health Resort.

This study evaluates the mass concentration and chemical composition of particulate matter (PM), collected in the chamber complex of the underground health resort located in the Wieliczka Salt Mine in southern Poland. Physical and chemical properties of PM were examined from the standpoint of their possible connection with therapeutic effects of the subterranean air in the mine. We found that in three underground spots we measured the average concentration of PM did not exceed 30 µg/m3. Chemical composition of PM was dominated by sodium chloride, making up 88 % of its mass, on average. It was shown that the underground ambient concentration of PM and its chemical composition depended mostly on the nature of the rock material present in the ventilation tunnel of the health resort, filtering the incoming air. The presence and effect of external sources of PM, including patients' activity, also had an impact on the underground PM concentration.

[THE HYGIENIC CONDITIONS OF THE INTERNAL ENVIRONMENT OF SYLVINITE CHAMBERS OF VARIOUS MODIFICATIONS].

The performed comparative physiological-hygienic assessment of the conditions of the internal environment of salt sylvinite structures allowed to establish the complex of physical factors that have a favorable influence on the functional condition of the basic systems of the organism of patients.

Cuando el radón es beneficioso para la salud / When radon is beneficial to health

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The overview of the radon and environmental characteristics measurements in the Czech show caves.

This paper focuses on the measurement and assessment of absorbed doses of radiation in caves of the Czech Republic, some of which exhibit high activity concentration of radon in air. Presented is an analysis and recommendations based on measurement results obtained in the underground caves over the past 12 y. The most important results for cave environments were as follows: integral radon monitoring using RAMARN detectors can provide more consistent results for calculating the effective dose; no major differences were shown in the average radon activity concentration during working time as opposed to non-working time; the unattached fraction of radioactive particles in air ranged from 0.03 to 0.6, with arithmetical average fp = 0.13; the direct dependence between equilibrium factor F and the size of the unattached fraction fp was described using the Log-Power expression ln(1/fp) = a*ln(1/F)(b); the calculated values for coefficients a and b were 1.85 and -1.096, respectively. The individual cave factor for each investigated underground area was calculated.

[The immediate and long-term results of sylvinite speleoclimatotherapy in the children presenting with pollinosis].

The present open randomized comparative study had the objective to compare the effectiveness of two strategies for the treatment of early spring pollinosis in 23 children at the age varying from 2 to 17 years in the phase of exacerbation. The patients of the study group underwent 10 sessions of sylvinite speleoclimatotherapy 60 min in duration each in addition to conventional pharmacotherapy. The children included in the control group were treated by traditional medicamental therapy alone. The estimation of clinical symptoms on day 10 after the onset of the treatment with the use of a scoring system has demonstrated a marked decrease in the severity of allergic rhinitis (p = 0.003), conjunctivitis (p = 0.01), and the total number of signs and symptoms of the disease (p = 0.002) in the children managed with the use of sylvinite speleoclimatotherapy. Positive dynamics in the patients of the control group was less pronounced (p < 0.05). The aeropollinological data are presented giving evidence of the absence of a high pollen concentration in the air of the speleoclimatic chamber and its high content in the atmospheric air at the height of thepollen season of early spring allergens. The clinical manifestations of the allergic conditions were shown to depend on the concentration in the atmospheric air of the causative allergens from their principle plant sources (r = 0.66, p = 0.039 in the control patients in comparison with r = 0.42, p = 0.22 in the children treated by sylvinite speleoclimatotherapy. It is concluded that the results of the present study confirm the clinical effectiveness of sylvinite speleoclimatotherapy used in the acute phase of pollinosis. The combination of this modality with traditional medicamental therapy accelerates elimination of clinical symptoms of allergic rhinitis and conjunctivitis; moreover, it reduces the frequency of recurrent respiratory disorders.

A review of halotherapy for chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a chronic, progressive disease and is treated with inhaled medication to optimize the patient's lung health through decreasing their symptoms, especially breathlessness. Halotherapy is the inhalation of micronized dry salt within a chamber that mimics a salt cave environment. Recent media reports suggest that this therapy may help with the symptoms of COPD. OBJECTIVE: To critically evaluate and summarize the evidence for the use of halotherapy as a treatment for COPD. DESIGN: A review using systematic approach and narrative synthesis. DATA SOURCES: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar were searched. Two reviewers independently reviewed abstracts and selected eligible studies based on predetermined selection criteria. RESULTS: Of the 151 articles retrieved from databases and relevant reference lists, only one randomized controlled trial met the inclusion criteria. A meta-analysis was unable to be conducted due to the limited number of published studies. Inclusion criteria were subsequently expanded to allow three case-control studies to be included, ensuring that a narrative synthesis could be completed. From the pooled data of the four studies, there were 1,041 participants (661 in the intervention group and 380 in the control group). The assessment of methodological quality raised issues associated with randomization and patient selection. Three themes were identified from the narrative synthesis: respiratory function, quality of life, and medication use. CONCLUSION: Themes generated from the narrative synthesis data reflect outcome measures regularly used for interventional research associated with COPD. From this review, recommendations for inclusion of halotherapy as a therapy for COPD cannot be made at this point and there is a need for high quality studies to determine the effectiveness of this therapy.

[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.

Speleotherapy - modern bio-medical perspectives.

UNLABELLED: Speleotherapy - a special form of climatotherapy - uses certain conditions specific to caves and salt-mines to treat several medical conditions, especially respiratory and skin-related. This reduces all types of irritations and therefore disease symptoms are mitigated or fully suppressed while the patient is accommodated into the salt-mine. OBJECTIVE: Influence of microclimate in salt-mines of Turda, Dej and Cacica on morphology and electrophoretic expression of in vitro lung and skin fibroblasts acquired from the lung and hypodermic tissues of Wistar rats, in normal conditions and after ovalbumin-induced asthma, respectively after experimental injuries and burns. MATERIALS AND METHODS: skin fibroblast cultures acquired from lung and hypodermic tissue sampled from Wistar rats. Cultures acquired are developed in fibroblast monolayer attached to the culture dish. Wistar rats with weight between 75 -100 g were divided in three groups: one control group, one group with experimental asthma, one group with injuries and burns. 10 animals from each group were sent to salt-mines in Turda, Dej and Cacica for 14 days and kept in a saline environment, similar to speleotherapy. RESULTS: Speleotherapy applied to Wistar rats determined significant differences in cellular morphology and in electrophoretic expression of lung and skin fibroblasts from primary cultures. CONCLUSIONS: Results of this survey indicates that speleotherapy induces changes in morphology and protein expression of in vitro lung and skin fibroblasts, and these changes support the therapeutic effects of speleotherapy.

Surveys on therapeutic effects of "halotherapy chamber with artificial salt-mine environment" on patients with certain chronic allergenic respiratory pathologies and infectious-inflammatory pathologies.

Halotherapy (HT), derived from speleotherapy in salt mines, is also a drug-free therapeutic method. HT effects vary depending on the therapeutic method and the structure of halotherapy environment. The purpose of this article is to show the HT effects of "halotherapy chamber with artificial salt-mine environment" of the National Institute of Rehabilitation, Physical Medicine and Balneoclimatology (INRMFB), on patients with bronchial asthma and other chronic, infectious-inflammatory and allergic respiratory diseases, describing the clinical effects on certain nonspecific resistance factors, on markers of inflammatory processes and on certain immunological changes. Patients were clinically assessed, with the application of hematologic investigations, analysis of nonspecific resistance to infection and of inflammatory process markers, immunologic assessments, analysis of sodium and potassium concentrations, of mineralocorticoid function and other biochemical tests. For the experimental HT therapy performed in the "halotherapy chamber with artificial salt-mine environment" of INRMFB, 15 patients suffering from bronchial asthma, allergic rhinitis, chronic bronchitis, chronic obstructive bronchopneumopathy were selected, based on specific medical indications and contraindications and applying ethical principles, as well as 4 patients with similar pathologies for the control group, who underwent in-home drug treatment. After the specific halotherapy treatment on patients with bronchial asthma, chronic bronchitis and chronic obstructive bronchopneumopathy, which also showed other chronic, infectious-inflammatory and allergic respiratory pathologies, triggering of anti-inflammatory (and also anti allergic) mechanisms and healing effects on inflammatory process were noted. Data acquired also proved the halo therapeutic effect causing the reduction of sensitiveness of body in patients with bronchial asthma.

[Rehabilitation features in the prevention of asthma exacerbations in patients with different body weight].

Bronchial asthma patients with excessive body weight compared to persons with normal weight had more severe course of the disease, associating with more pronounced inflammation (increased level of the proinflammatory interleukin-6, interferon-gamma, tumor necrosis factor alpha). After the rehabilitation treatment including speleotherapy we observed the improvement of clinical manifestation and reduction of the studied immune parameters.

[The hygienic characteristic and effectiveness of the application of natural sylvinite screens for the combined treatment of the patients presenting with vulgar psoriasis].

The objective of the present study was to provide hygienic assessment of hospital wards equipped with the therapeutic sylvinite screens (TSS) and compare the results of the treatment of 80 patients suffering vulgar psoriasis with the use of TSS and without them. The sylvinite screens made it possible to create comfortable microenvironment in the wards and moderately increased the radiation background (0,15+/-0,005 Sv/hour) thereby promoting saturation of the ward atmosphere with aeroions dominated by the light negative particles (491,5+/-14,4 units/cm3). Such healthy environment hadc beneficial effect on the clinical course of the psoriatic process, the state of functional systems of the patients and their quality of life. It is concluded that the introduction of halotherapy in the treatment in patients presenting with vulgar psoriasis makes it possible to achieve clinical remission in 65% of them compared with 20% of the patients given the traditional treatment.

[The rationale for the combined application of cryomassage and silvinite speleotherapy for the rehabilitative treatment of the patients with bronchial asthma].

The present study is devoted to the estimation of therapeutic and prophylactic effects of cryomassage and silvinite speleotherapy in the patients with partially controlled asthma. Advantages of the combined application of rehabilitative technologies are illustrated by their well-expressed anti-inflammatory and immunocorrecive actions, reduced obstruction and hyper-reactivity of the bronchi, improved pulmonary cardiohemodynamics, enhanced physical tolerance and better psychological adaptation.

Study on endocronological effects of radon speleotherapy on respiratory diseases.

BACKGROUND: Radon, as a radioactive noble gas of natural origin, is generally present in the atmosphere of caves during the speleotherapeutic treatment of different diseases. However, the role of radon in the therapeutic effect is not fully clarified yet. Endocrine parameter levels may be influenced by radon-like endocrine levels in balneotherapeutic treatments (bath treatment). For this reason changes of these parameters were examined in this study. PATIENTS AND METHOD: A total of 81 speleotherapy patients were involved in the survey. They spent four hours daily in Tapolca Cave, five days a week, for two weeks. In this study, the thyreoiedea stimulating hormone, free triiodine-tironin, free thyroxine, prolactine, cortisol, dehydroepiandrosterone sulphate, adrenocorticotropic hormone, and beta endorphine levels of the body were examined before and after the treatment. RESULTS: After statistical analysis of the data a significant decrease of cortisol levels of patients was found, which was not directly correlated with radon concentration. In the case of thyroid hormones, there were no significantly detectable changes of the hormone levels except for low radon concentration levels a significant decrease in the free thyroxine and the thyreoiedea stimulating hormone level of male patients was observed. CONCLUSION: Speleotherapy has an effect on the level of endocrine hormones; however, no direct correlation with differences in radon level was found. For patients whose endocrine levels fell outside the normal endocrine parameter values, more striking changes in endocrine hormone levels were seen, but changes of these parameters could not be statistically analyzed due to the small number of cases.