Laser irradiation is an active physical therapeutic factor used in a lot of nosologies including pulmonology. Meta-analyze of laser application in pulmonology based on the materials of 9 pulmonological congresses, literal data and the authors’ private experience was performed. It demonstrated that laser irradiation was highly effective for treatment and rehabilitation of pneumonia, bronchial asthma, COPD and lung tuberculosis patients. Laser therapy is basically applied to skin reflex-and-segment zones and spots and by the endobronchial and intravenous ways as well. It treats the main syndrome, resolves the inflammation and eliminates inflammatory residual changes. Multiple therapeutic effect of laser irradiation is based on anti-inflammatory action due to the activation of antioxidant system and the stimulation of reparative processes.

An influence of bicycle training on lung function and lipid peroxidazing process in a complex treatment of pneumonia patients was studied. The bicycle training was conducted by a method of free choice of the exercise. One hundred and thirty two patients were examined, of those 88 persons had mild pneumonia and 44 ones had moderate pneumonia. The patients were divided into 3 groups; the 1^st group included 69 patients who were treated with bicycle ergometer training under the free choice condition and medication simultaneously. The 2^nd group consisted of 22 patients treated with medication and breathing exercise and 41 patients included into the 3 rd group were given medication only. Over 7-8 treatment days the bicycle training facilitated lung function to become normal in mild pneumonia patients and to be improved in moderate pneumonia; lipid peroxidazing process was decreased independently on the pneumonia severity compared with the patients did not receive the bicycle training. While the bicycle training course was ended, lung function of moderate pneumonia patients became normal and the lipid peroxidizing process was decreased; the last one became normal in the mild pneumonia patients compared with those who were not given the bicycle training.

A choice of a respiratory rehabilitation regimen was studied based on the objective noninvasive investigation of 3 components of the respiratory failure, such as respiratory mechanics disorders, functional failure of inspiratory and expiratory muscles and neurorespiratory drive. The method’s entity is a measurement of airway occlusion pressure.
The examination of 112 COPD patients and 42 postoperative patients showed that a separate affection of lung mechanics, respiratory muscles function and central neurorespiratory drive is not almost encountered in the everyday clinical practice. The involvement of each component in the respiratory failure is different. Therefore, an application of the universal complex of respiratory rehabilitation, that is identical for all respiratory failure patients is not quite effective.
The choice of respiratory rehabilitation method and schedule based on the functional assessment of the three-component model gives good results, that is confirmed with everyday clinical practice. The high effectiveness of the incentive spirometry and inspiratory and expiratory muscles training as a part of respiratory rehabilitation was displayed.

Of 532 bronchial asthmatic (BA) patients examined, laser therapy (LT) was applied to 286 ones for rehabilitation purpose. The effectiveness of this treatment was evaluated based on the dynamics of clinical and cytochemical parameters such as catecholamines (CC), serotonin (S) and histamine (H) peripheral blood concentrations; lung function (LF) and bronchial reactivity. LT led to an improvement in clinical parameters and LF as well; bronchial hyperreactivity was decreasing, initially reduced CC concentrations were increasing and initially increased S and H levels were reducing. The best LT results were noted in mild and moderate atopic BA and in mild infectious-dependent BA as well.

The article considers main problems of irrational application of medicative physical factors in the treatment and secondary prevention of bronchial asthma. Abilities of the physical factors to control bronchial asthma are analysed. Basic principles of health resort therapy application are expounded. An improved practical classification of physiotherapeutic techniques is offered and analysed according to their roles in a complex therapy of bronchial asthma. The techniques having special indications and disease-modifying techniques that are reasonable to be involved in the basic therapy are assigned.
Organizing and methodical problems of the improvement of non-medicinai aicf for bronchial asthma patients are examined in detail.

Rehabilitation of patients with non-tuberculous lung diseases should be performed in several stages and differently according to the kind of pathology and with the outpatient observation followed the active rehabilitation. The rehabilitation should be undertaken in two main patients’ groups: “respiratory disabled patients” and “being often and prolonged ill”. The last case implies a preventive outpatient rehabilitation (an outpatient stage) for persons with torpid and complicated pathology to avert its transformation to a chronic disease including those with progressive course and fatal outcome.

The article expounds the haloaerosol therapy method the main acting factor of which is a dry highly dispersed aerosol of sodium chloride having a certain concentration range and taken out spelaean therapy. The study results of therapeutic action on respiratory system and accumulated experience of practical application of haloaerosol therapy were generalized. The given data show the efficiency of the method and its possibility for rehabilitative and preventive application in various respiratory patients. The dry sodium chloride aerosol could be used by two ways: under the condition of guided halochamber microclimate that is halotherapy and using a table haloinhaler that is haloinhaled therapy. Currently we can choose the most available and rational application of this method in practice.

The aim: the evaluation of psychological status changings in bronchial asthma (BA) patients against the background of basic therapy (ВТ) and their teaching at an asthma-school (AS). One hundred and seventy nine asthmatic patients were observed for 3 years: 51 of them (the 1^st group) had the 2^nd stage of the disease, 91 ones (the 2^nd group) had the 3rd stage and 27 patients (the 3rd group) were with the 4^th BA stage. Flunisolid in doses from 500 to 1500 meg daily was used as the ВТ. Clinical symptoms (CS), lung function parameters (LFP) and psychological status of the patients were monitored using the PQBI test (the personal questionnaire of the Bekhterev Institute). The dynamics of harmonic (H), neurotic (N) and other pathological types was analysed. Initially the H reacting type was registrated in 49.2% of all the asthmatic patients. One hundred and seven patients were taught at the traditional AS, 46 patients were educated with the traditional AS programme combined with the group psychotherapy and 26 patients formed the control group. While both of the educational programmes were applying, CS and LFP were improved, H-type patients’ number increased (p<0.001) and those of N-type reduced (p<0.001). Nevertheless, the combination of educational programmes and psychotherapeutic methods allows to diminish N-type patients’ amount due to the reliable increase of H-type patients’ group (p<0.001) compared with the traditional AS.

Clinical efficacy and safety of sodium nedocromil (Tilade Mint) were studied in 90 children aged from 2 to 15 years suffering from mild to moderate bronchial asthma. The criteria for assessment were clinical dynamics, need for bronchodilators, lung function test and exacerbation frequency anamnestically. Moreover, we investigated different ways of the drug delivery in infants. As a result, clinical efficiency of 3-month basic therapy with Tilade Mint was shown in 90% of the children. Day and night asthma symptoms reduced in 5.5-6 times. The need for bronchodilators was decreased in 5 times. The drug inhalations averted airway limitation on exercise in the children. A length of stable asthma periods increased significantly. According to lung function test results as volume as flow parameters increased reliably. Most patients reached clinical and functional stability of the disease maintained for 3 months and longer in 66% of the patients. Only in 10% of the moderate asthma patients the basic therapy with Tilade Mint was not effective enough and they needed inhaled corticosteroids to be administrated. No one child had any adverse effects using Tilade Mint. The modern delivery systems permitted to apply this drug successfully even in very young children. Good tolerability and high effectiveness allow to consider sodium nedocromil (Tilade Mint) as the first-line drug for mild to moderate bronchial asthma children starting with ones of 2 years old.

We examined 228 bronchial asthma (BA) patients taught at an “Asthma-school” by means of the Toronto alexithymie scale (TAS), and a brief version of the personality multilateral investigation method (PMIM), and the Spilberger-Khanin’s scale. Alexithymia was found in 54.9% of the BA patients. They were significantly higher neurotized compared with non-alexithymic persons. Smoking and excessive alcohol consumption as harmful behaviour features were noted reliably more often in alexithymie persons compared with non-alexithymic ones. Individual training of the alexithymie patients were aimed to the formation of “emotion bank” and to stress removal and increased the efficacy of the training and asthma management.

An open comparative research of the efficacy of traditional (based on theophylline) and modern (beta-agonists and anticholinergic drugs) medications in outpatients bronchial asthma exacerbations in children was performed. The observation involved 404 children aged from 1.5 to 15 years divided into two groups depending on a therapy. The groups were comparable on the age, demographic and functional parameters. Subgroups were separated into each of the groups regarding to the exacerbation seventy. The medication effectiveness was evaluated by clinical symptoms of the exacerbation (breathlessness, cough, remote wheezing, physical lung signs) and peak expiratory flow rate and/or lung function parameters as well.
The obtained results demonstrated that asthma attacks were stopped in 96.7% of the cases using nebulized short-acting beta agonists (Salbutamol or Salgim) and/or the combined drug Berodual which were given differentially in accordance with the exacerbation severity and the patient’s age: the peak expiratory flow rate became normal, the lung function main parameters tended to their normal values and clinical signs of asthma exacerbation regressed.
The nebulized treatment with Berodual was reliably confirmed to be the first-line therapy for moderate bronchial asthma exacerbations as it is optimal in sight of the effectiveness and safety.

Based on the antibacterial sensitivity of community-acquired pneumonia pathogens expenses for antimicrobial medication were prognosed. The expenses for the treatment of 100 patients were calculated according to the first-line antibiotics (ampicillin, azithromycin, or cefuroxime sodium) cost required for the treatment course of all the patients and those of second-line antibiotics for the patients whose pathogens were tolerant to the first drug. Ciprofloxacin was proposed as the second-line antibiotic. 58% of pathogens were sensitive to ampicillin and 71% and 85% of them were sensitive to azithromycin and cefuroxime correspondingly. We also investigated community-acquired pneumonia pathogens sensitivity to non-antihaemophylic macrolides but so long as it did not exceed 48% the further assessment of these drugs cost was not performed. The antibiotics expenditures were minimal when the first-line drug was Sumamed (azithromycin); they were greater for ampicillin and maximal for Zinnat (cefuroxime sodium). Thus, according to the data obtained Sumamed's efficacy and cost is thought to be optimal first-line antibiotic for the treatment of community-acquired pneumonia.

The randomized study was conducted evaluating an influence of Salmeterol (Serevent, Glaxo Wellcom) on quality of life in moderate chronic obstructive bronchitis patients. The assessment of quality of life was performed using the Respiratory questionnaire of Santa George hospital. The investigation included 2-week introductory period and 16-week treatment period. As a result the significant effect of Salmeterol on the principal parameters of the patients’ quality of life was found and the improvement in the quality of life exceeded the Salmeterol positive influence on bronchial passability parameters. The Salmeterol efficiency was not effected by a chronic bronchitis length. Meanwhile the smoking consumption and its intensity were combined with greater effect of Salmeterol on the quality of life.