Abstracts of scientific publications
1. Chervinskaya A.V., Biskys V. Aerosol respiratory hygiene as a main part of prevention of chronic obstructive pulmonary diseases (COPD) and health promotion for patients in hospitals // 14th International Conference on Health Promoting Hospitals, Palanga, Lithuania, May , 2006, II-5.3.
The experts of WHO forecast the subsequent increase of COPD and asthma on worldwide. Mainly it has been related to deteriorative ecologic situation. To stop this tendency aerosol methods with physical factors are preferable because of physiological action without system side effects. Dry salt inhalation therapy has a long history in Europe since 19-th century. Nowadays there are a number of resorts are exploiting salt caves for patients with pulmonary diseases. Halotherapy (HT) is the result of adapting natural salt aerosol from salt caves to flexible usage in other locations. In addition to availability the ability to deliver a specified varied dose of dry rack salt represents a major advantage of HT over the treatment in natural salt caves. Over 15 years, numerous expert groups have worked on standardization of halochambers based on exact understanding of condition in salt caves. HT was sanctioned by Ministry of Public Health in Russia and Lithuania.
The efficiency of HT for care of respiratory and allergic diseases, ENT-pathologies was proved by many scientists in controlled studies. The inclusion of HT into the rehabilitation course of pulmonary pathology patients (with asthma, COPD, bronchitis, pneumonia and others) allows achieving therapeutic effect by 82 –95% of cases along with the most optimal use of pharmacotherapy. It has shown that the application of the HT assured 1,5-2 times reduction of morbidity level in long term observation.
Dry sodium chloride aerosol has positive effect on the defence system of the respiratory tracts. It enhances mucociliary clearance in conjunction with normalization of bronchial micro flora and immunological benefits. Data from prevention studies showed strong efficacy of dry salt aerosol in reducing the risk of common cold during cold season. HT may be recommended to healthy persons and patients with chronic respiratory diseases prior to or during every cold season. Evaluation of respiratory symptoms, functional parameters, and local immunity in persons with risk factor of lung diseases, confirmed their significant changes under the action of HT. It can use as a sanitary method for respiratory airways.
We look at positioning of dry sodium chloride aerosol with HT as a main component of respiratory hygiene for prevention of respiratory diseases, relief of environment hazards and rehabilitation of chronic patients. As a consequence of clinical and mechanism acting understanding of HT, the concept of “maintaining bronchial health” appears to be helpful in health promotion activity of hospitals.
2. Chervinskaya Alina V. Respiratory Hygiene in Health Resort Medicine // 35th Congress of the international Society of Medical Hydrology & Climatology, Istanbul, and June 6-10, 2006: Congress book. – 2006. – OP-2, P. 86.
WHO forecasts the subsequent increase of lung diseases worldwide, related to deteriorative ecological situation. To stop this tendency aerosol methods with physical factors are preferable. Adapting natural salt aerosol from salt caves for flexible and comfortable usage has lead to Halotherapy and HaloSpa technology with dry sodium chloride aerosol (DSCA).
The aim of the study: Evaluation of the efficacy of DSCA on defence system of the respiratory tract and clinical state of the patients with respiratory diseases. 193 patients with pulmonary diseases and at risk of them received a course of DSCA (10-20 sessions daily 45-60 min each in the rooms, equipped with dry salt aerosol generators). 67 matched patients were given a placebo. The effect of the treatment was evaluated by clinical, functional, cytomorphological, bacteriological, immunological examinations, and rheological indices of the sputum.
Results: DSCA enhanced drainage of the bronchi, activated alveolar macrophages, improved biocenosis and local humoral immunity. Procedures resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% - of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. The number of common cold cases during the cold season was reduced in half. Evaluation of respiratory symptoms and functional parameters by persons with risk factor of lung diseases confirmed their significant changes under the action of DSCA. Conclusion. We look at positioning of DSCA as a main component of respiratory hygiene in Health Resort Medicine for prevention of respiratory diseases, as a relief of environment hazards and rehabilitation of chronic patients.
3. Chervinskaya A. V. Effect of dry sodium chloride aerosol on the respiratory tract of tobacco smokers // The Europ. Respir. Journ.-Abstracts 16th ERS Annual Congress, Munich, Germany, September 2-6, 2006. – P. 106s-107s.
The aim was to study influence of dry sodium chloride aerosol (DSCA) on the respiratory tract of tobacco smokers. 47 male were examined. They had the productive cough associated with smoking. The test group (TG) (24 male, 49,9±1,2 yrs; 27,0±1,7 pack/years) was treated with the DSCA (14 procedures). 20 procedures (10 min daily) were given using inhaler Haloneb, producing DSCA with particles size of 1-5 μm and 0,5 mg/min density. The placebo group (PG) (23 male, 49,5±1,5 yrs; 27,9±2,3 pack/years) received inhalations with plain air. 88% of smokers of TG by the end of inhalation course reported easier and/or decreased cough, changes in the character of sputum, which became lighter and clearer. Improvement in the character of sputum was noted only 22% volunteers of PG (p<0,001).
Cytobacteriologic study of brush biopsies taken from pharyngeal mucosa was carried out before and after procedures in the both groups. It was determined that the infection index (II - % of epitheliocytes with adhered cells of S. pneumoniae) and adhesion index (AI - the mean number of microbial cells per one epitheliocyte) decreased significantly in the TG (II before – 28,1±5,8 and after – 7,8±2,7%, p<0,01; IA before - 45,4±11,3 and after - 13,9±6,3 microbe cells, p<0,01). The amount of IgA in epithelial cells of the oropharyngeal mucosa (estimated by indirect method of fluorescent antibodies) increased significantly in the TG (before - 1,5±0,9 and after - 2,0±0,5, p<0,05). There were no significant changes at these indexes in the PG.
Conclusion. DSCA relieves the main symptoms (character of cough and sputum), improves local defence mechanisms and resistance of mucous membranes of tobacco smokers owing to decreased colonization activity of pathogenic bacteria flora.
4. Chervinskaya A. Mechanism of action of the dry sodium chloride aerosol and its clinical efficiency in prophylaxis and rehabilitation // Balneol. Pol. – 2007. – Vol. 49, N 3 (109). - P. 197.
Introduction: Dry sodium chloride aerosol is the main curative factor of treatment in the natural salt caves - speleotherapy. Halotherapy (HT) has been developed on the basis of speleotherapy. Curative effect of HT is caused by an air medium saturated with dry sodium chloride aerosol with predominance amount of particles of 1 to 5 micrometer in size and of a certain density range. HT is carried out in the premises equipped with medical facilities – dry salt aerosol generators and control devices.
It has been known, that nebulised sodium chloride solution is used with therapeutic and diagnostic purposes. There is a little doubt that inhalation of isotonic saline does not produce any evident therapeutic effects. Aerosolized hypertonic saline influences on of impaired mucociliary clearance but it is not used for therapy, because can provoke bronchio spasm in patients with asthma and even in healthy persons. Generally, hypertonic and hypotonic solutions are used to diagnose bronchial hyper reactivity. Due to the fact that physical properties of dry sodium chloride differ from nebulised solution, its therapeutic effect differs as well. The aim: assessment of the efficacy of the dry fine sodium chloride aerosol (halo aerosol) on defence system of the respiratory tract and clinical state of the patients with respiratory diseases.
Material and methods: 193 patients with respiratory disease and at risk of pulmonary pathology received course of HT. 67 matched patients were given placebo. The effect of the treatment was assessed by clinical and functional parameters dynamics, endoscope picture, cytomorphological and bacteriological characteristics of the bronchoalveolar lavage, contamination activity of the micro flora, activity of local humoral immunity in pharyngeal brush-biopsies and saliva, rheological indices of the sputum. The course of HT was consisted of 10-20 daily 1 hour procedures.
Results: It has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of dry salt aerosol an increase of the electrophysiological functional activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance. Dry aerosol of sodium chloride demonstrated anti-inflammatory activity in the respiratory tract, mucoregulating action. It enhances drainage of the bronchi, activates alveolar macrophages, and improves biocenosis and local humoral immunity. HT resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% -of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases the number and intensity of asthma attacks decreased, which allowed reducing the dosage of medication. The improvement in clinical state was accompanied by positive dynamics of the lung function measurements. None of the pts complained of bad condition during HT procedures. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. The changes in control group parameters after placebo were not statistically significant.
Evaluation of respiratory symptoms and functional parameters in persons with risk factor of COPD confirmed their significant changes under the action of HT. Relief of the cough in combination with improvement of sputum properties, positive dynamics of auscultative finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of HT.
Conclusion: Dry sodium chloride aerosol has positive effect on the defence system and function status of the respiratory tracts. Clinical efficacy of HT in prophylaxis and rehabilitation of respiratory patients is based on the medicating action of dry sodium chloride aerosol.
5. Chervinskaya A. Halotherapy in health resort medicine// 36th Congress of the International Society of Medical Hydrology&Climatology. Abstracts book. - Porto, 2008. - P. 29-30.
The paper presents the method of halotherapy which models the microclimate parameters of salt speleoclinics. It gives historical data on the method development, principles and advantages of halotherapy by means of controlled microclimate. The influence of the main curing factor — the dry fine-grained sodium chloride aerosol, and pathophysiological basis of curing effect of the halotherapy method are under review in the paper. The paper describes the method of controlled halotherapy and its technology, that is the halocomplex equipped with a controlled halogenerator. Scientific grounds for action mechanism, proven clinical efficiency verified by research on standards of evidence-based medicine and practical application in various fields of public health determine broad prospect of the method in rehabilitation, sanatoria and health resorts and preventive medicine. Data on clinical efficacy and the grounds for the method usage in the recovering treatment for bronchopulmonary and too-rhino-laryngological pathologies, skin diseases and combined cardiovascular pathology, as well as preventive measures against respiratory diseases are cited.
Efficacy of halotherapy in treatment and recovery of children is under review. Foundations for perspective usage of halotherapy in all kinds of medical and recovering establishments are given.
6. Chervinskaya A. Dry sodium chloride aerosol against acute respiratory viral infections// The Europ. Respir. Journ, – 2009. - 34: Suppl. 53. - 401s.
Aim of the study. The main objective was to estimate the preventing efficacy of inhaled dry sodium chloride aerosol (DSCA) against acute respiratory viral infection (ARVI). Objects and methods. 160 persons were recruited from personnel of an industrial enterprise through special questionnaire. They were randomized in 2 groups - test group (TG) (19 male, 61 female, 47.4±8.0 yrs) and control group (CG) (22 male, 58 female, 48.8±11.6 yrs). The persons of the TG were undertaken with inhalations (10 min) using Haloneb® inhaler, producing DSCA with particles size of 1-5 μm and 0.8-1.2 mg/min density flow. The CG received 10 min inhalations with plain air. Each subject was given 2 inhalations a week during 12 weeks. A physician regularly examined the subjects of the both groups for possible ARVI. Results. For three months observation there were only 14 cases of ARVI and 104 days marked by symptoms of ARVI in the TG. In the CG there were 55 cases of ARVI and 585 days of symptoms. TG subjects were affected by ARVI four times less frequently than CG subjects, and the number of days marked by symptoms of ARVI was 5.6 times less. Analysis of incidences of ARVI showed that they occurred in 60% of subjects with risk factors of COPD in CG subjects against 18% of subjects with risk factors in the TG (p<0.01). On the whole, 13 subjects (16%) developed ARVI in the TG against 50 subjects (63%) in the CG (p<0.001). Conclusions. Inhalations of DSCA, consisting of two weekly procedures for 12 weeks are an effective preventing measure against ARVI.
7. Chervinskaya A. V. Respiratory hygiene with the dry sodium chloride aerosol // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 2514.
Dry sodium chloride aerosol (DSCA) could be used as a method of respiratory hygiene for prevention of COPD. The aim was to study clinical and functional parameters of the persons with COPD risk on application of the DSCA. 54 persons (prs) with exogenous risk factors of COPD were examined. They had the productive cough associated with smoking and/or exposure to industrial pollutants. The main group (MG) (26 male, 8 female, 43±2,4 yrs) was treated with the DSCA (14 procedures). Procedures (10 min daily) were given using inhaler Haloneb®, producing DSCA with particles size of 1-5 μm and 0,8-1,2 mg/min density. The control group (CG) (15 male, 5 female, 46,5±2,8 yrs) received inhalation with room air. After the procedures the cough retained in 27% of the persons of MG and 91% - CG (p<0,001). Relief of cough and improvement of sputum properties were remarked in the 88% of MG and 22% - CG (p<0,05). The significant decrease of the number prs with dry rales (15%-MG, 55%-CG, p<0,05) was observed as well. Significant increase of parameters FEF25 (p<0,05), FEF50 (p<0,01) H FEF75 (p<0,05) was marked in MG. There were no significant changes of the average values of functional parameters in CG. Positive dynamics of the flow-volume indexes in 16 prs (47%) of MG was observed. That differed significantly from CG values (5%, p<0,01). Respiratory symptoms and functional parameters of the prs with risk of COPD had the significant changes under the action of DSCA. Relief of the cough, improvement of the sputum properties, positive dynamics of auscultative finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of the DSCA.
8. Mokina N. A., Geppe N. A. Alternative methods at bronchial asthma of children // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 1069.
The purpose: To estimate efficiency of halotherapy, physical training, massage at children with moderate bronchial asthma (BA). Methods: The open randomized comparative study lasted 4 months. Base antiasthmatic therapy was carried out with combined medicine Seretide (50 mcg salmeterol and 100 mcg fluticasone). Three groups were generated: 30 patients, received only the basic therapy, the other two groups, each of 32 of children, except this, received for 2 weeks: 2-nd group physical training and massage, 3-rd group halotherapy. The average age in the groups was accordingly: 9,5±0,5; 9,4±0,5; 9,5±0,3. The daytime and night displays of BA were estimated by scale from 0 up to 3 numbers. Results: The daytime and night symptoms were accordingly: 0,30±0,03 and 0,33±0,03 (Seretide group), 0,27±0,04 and 0,11±0,02 (Seretide + physical training+massage group), 0,16±0,04 and 0,15±0,04 (Seretide±halotherapy group), p < 0,05. Peak expiratory flow was higher in Seretide+halotherapy group (352±8 morning and 354±8 ml evening) and Seretide+physical training+massage: (347±3 morning and 347±3 ml evening), against 327±4 (morning) and 330±4 ml (evening) in Seretide group (p<0,05). The numbers of inhalations of salbutamol as needed were minimal per day in Seretide+halotherapy group: 0,03±0,02, against 0,20±0,04 in Seretide+physical training+massage group and 0,39±0,04 in Seretide group, (p<0,05). Conclusion: The application of halotherapy as well as physical training and massage on the background of the basic medicinal therapy in children with moderate BA renders to positive effect.
9. Lemko O. I., Lemko I. S., Kazankevich V. P., Reshetar D. V., Vatuh N. V., Meleha O. O., Slivko R. I. Some advances in COPD treatment and management// The Europ. Respir. Journ., -2004.-V.24:Suppl. 48. -85s.
The elaboration of the long-term programs of the COPD control is an important direction in the improvement of patients’ quality of life. The programs offered by us include rational bronchodilator therapy in combination with non-medicament methods of treatment. One of such methods is speleotherapy (the treatment in of the rock salt mines microclimate) and its artificial analogues (halotherapy). The rock salt aerosols improve the mucocellular clearance; they have antibacterial and anti-inflammatory influence and thus promote the reduction of broncho-obstruction. 123 patients with COPD of different stages have been investigated. The patients underwent complex examination, which included the research of pulmonary function tests (PFT), inflammation activity, immune reactivity, estimation of lipids peroxidation (POL) and antioxidant defence (AOD). The decrease of some unspecific defence factors, CD3- and CD4-cells independently of COPD stage was determined. But the number of B-lymphocytes, CD25- and CD71-cells was increased. The POL activation and AOD decrease have been observed. Two halotherapy regimes (HR) with different aerosol characteristics were used. The special laser-optical system for monitoring of aerosol characteristics was carried out. Halotherapy has positive influence on clinical COPD process, but significant increase of PFT-data and improvement of some immune indexes were found out only after HR-2. The improvement of AOD-data was observed after both HR. Besides that the rise of sensitivity to bronchodilatator therapy was noted.
10. Chervinskaya A.V., Silber N.A., Alexandra A.N. Halotherapy for treatment of bronchial asthma (abstract) // XIV World congress of asthmology - Interasma 93, Israel. – 1993. - P. 59.
Halotherapy (HT) is a method of treatment under conditions of artificial salt cave microclimate. Therapeutic effect is stipulated by aero dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5 micron particles. Particle density (1 - 5 mg/m3) varies depending on the type and stage of the disease. The other factors - comfortable humidified temperature regime, the hypo bacterial and allergen free environment saturated with aero ions enhance the therapeutic effect. Seventy-one patients (25M, 46F, average 39.1+2.4 years) with various types of asthma were treated by HT. The drug treatment of 60% patients did not give full effect. A control group of 15 patients (8M, 7F, average 38.4+1.5 years) received placebo. The HT course comprised of 10-20 daily one hour procedures. Treatment was conducted in a special room. No side effects were observed during the course of HT. The clinical state of 85% patients with mild and moderate and 75% patients with severe asthma improved after HT. Forty-seven percent of patients required fewer doses of drugs. The improvement in clinical state of patients was accompanied by positive dynamics in lung function tests. The changes in control group parameters after HT were not statistically significant. Thus, the results of HT application demonstrated its efficacy.
11. Konovalov S.I., Chervinskaya A.V. Saline aerosol effect on pulmonary phagocyte system (abstract) // International symposium of speleotherapy. Solotvino-Ukraine, 1993.-P. 24.
Halotherapy - the treatment under conditions of artificially created salt-cave microclimate. Therapeutic influence is stipulated by aero dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5 micron particles. Further development of the method is offered by the application of the controlled therapeutic microclimate in a halochamber. Particles density from 1 to 7 mg/m3 was used. On the basis of various parameters of aero disperse environments using, we have developed criteria of prescribing the treatment with due regard for nosological forms of respiratory diseases, their pathogen city variants, and the degree of obstructive impairment. Differential approach to the prescription of method allowed reducing the frequency and manifestations of undesirable bronchospastic reactions during treatment. The feasibility of using halotherapy to treat oto-rhino-laryngologic diseases was substantiated. At the same time, it has been established that further research is needed to verify the prescription of method for certain forms of respiratory diseases. Therefore, the application of controlled therapeutic microclimate of a halochamber improved the method of halotherapy and brought it nearer to the up-to-date medical technology.
12. Chervinskaya A., Alexandrov A., Zilber N., Stepanova N. Effect of halotherapy in patients with bronchial asthma and allergic rhinitis (abstract). XV International Congress of allergology and clinical immunology, Sweden, 1994. - P. 175.
Halotherapy (HT) - is mode of treatment in a controlled air medium which simulates a natural salt cave microclimate. The main curative factor is dry sodium chloride aerosol with particles of 2 to 5 micrometer in size. Particles density (0.5-7 mg/m3) varies with the type of the disease. Other factors are comfortable temperature- humidity regime, the hypo bacterial and allergen- free air environment saturated with aero ions. 106 patients (pts) (59- with allergic, 27- with non allergic bronchial asthma (BA) and 20 - with allergic rhinitis) were treated by HT. 15 pts of the control group was given placebo. HT course consisted of 10-20 daily procedures of 1 hour. The clinical state of 85% pts with BA and 90% - with allergic rhinitis improved after HT. The results of HT did not depend on BA type. The positive dynamics of flow-volume loop parameters and decrease of bronchial and nasal resistance measured by body plethysmography were observed. FVC and FEV1 initial values and the values of their changes during HT showed a significantly negative correlation - the more marked was bronchial obstruction, the better were the results of therapy. The changes in control group parameters after HT were not statistically significant. The results of HT application demonstrated its efficacy.
13. Chervinskaya A., Alexandrov A., Strashnova O. Effect of dry sodium chloride aerosol in patients with bronchial asthma // Allergy & Immunology (abstr. Interasma 95). - 1995. - V. 27, N. 7.- P. 221.
The effect of dry sodium chloride aerosol (DSCA) was evaluated in 125 patients (pts) with bronchial asthma (44 M, 81 F, mean age 34.3+2.5 years). 60% of pts received a base medication without full effect. The control group of 15 pts (8M, 7F, mean age 38.4+1.5 years) received placebo. Treatment was performed in a special room with salt coated walls. The pts breathed quietly while reclining in chairs. DSCA containing the dominating amount of 2 to 5 micrometer particles was produced by special nebulizer. The aerosol mass concentration (from 0.5 to 5 mg/m3) was prescribed according to the type of the disease. The DSCA course comprised 10-20 daily one hour procedures. Clinical symptoms analysis demonstrated that the number of asthma attacks decreased significantly. The cases with cough occurred more rarely, cough became easier and more productive. Reduction in bronchodilators and inhaled corticosteroid consumption was an indicator of clinical benefit. The pts showed significant increase of FVC, FEV1, PEF, FEF50 and decrease of Raw by the end of the treatment. The changes in control group parameters after placebo were not statistically significant. The pts were examined 6 and 12 months after the DSCA course. The average duration of remission was 7.6+0.9 months.
14. Chervinskaya A.V., Alexandrov A.N., Konovalov S.I. Application of dry rock salt aerosol in case of common cold // XYI Congress of the European Rhinologic Society. VII Congress of the International Rhinologic Society. Week of the Nose: Abstract Book.- 1996. – P. 104.
17 patients with common cold underwent dry rock salt aerosol (DRSA) therapy. DRSA with particles size of 1-5 micrometer and high negative charge is the main curative factor of Halotherapy (HT). Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m3). HT is drug-free method, which simulates natural salt cave microclimate. There were two ways of DRSA administration: in the room with the controlled air medium which is created with special equipment; the inhalation through nasal mask of individual inhalator. The method of HT was sanctioned by the Russian Ministry of Public Health in 1990. It has been known that DRSA improves rheological properties of the airways contents, decreases oedema of bronchial and nasal mucosa, it has a bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium. The common cold patients’ condition was assessed by daily clinical observation, functional and citobacteriological tests. In all cases we registered cold clinical symptoms disappear faster than in control group. The improvement in clinical state was accompanied by positive dynamics of laboratory tests.
15. Chervinskaya A., Norvaisas G., Pluskiene L., Noreikiene D. Halotherapy for rehabilitation of asthma patients in Russia and Litvania // Eur. J of Allergy and Clin. Immunol. suppl.- V.51.- № 30.- 1996. - P.39.
Halotherapy (HT) is a drug-free method which simulates natural salt cave microclimate. The controlled air medium is created in ordinary room with special equipment. The main curative factor- is a dry sodium chloride aerosol with density of 0,5 to 5 mg/m3, particles size of 1-5 micrometer and high negative charge. Sodium chloride aerosol improves rheological properties of the bronchial contents, decreases oedema of bronchial mucosa, it has a bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium.
The method of HT was sanctioned by the Ministry of Public Health in 1990. To study the efficiency of HT the data were collected from 15 Russia and 2 Lithuania hospitals. We have evaluated the results of HT in 3239 adults and children with various type of asthma (2320-from Russia, 919- from Lithuania). The HT results were assessed by physicians on the basis of clinical symptoms and functional parameters dynamics. The course of HT (12-21 daily procedures) resulted in improvement of clinical state in 79% of asthma cases in adults and 89% - in children. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases the number and intensity of asthma attacks decreased, which allowed cancelling or reducing the dosage of medication. The improvement in clinical state was accompanied by positive dynamics of the lung function measurements. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, HT can be used as a rehabilitation method in asthma management.
16. Chervinskaya A. Halotherapy for rehabilitation of pulmonary patients in Russia // The Europ. Respir. Journ.- V.10.- Suppl.25.-1997.- P.108.
Halotherapy (HT) is a mode of inhalation therapy with dry sodium chloride aerosol. The controlled air medium is created in an ordinary room with special equipment. The main curative factor- is a dry sodium chloride aerosol with particles size of 1-5 micrometer and high negative charge. Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m3). Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium. The method of HT was sanctioned by the Russian Ministry of Public Health in 1990. To study the efficiency of HT the data were collected from 15 Russia hospitals (during 1991-1994 years). We have evaluated the results of HT in 4780 adults and children with various types of pulmonary diseases. HT course consisted of 10-20 daily procedures of 1 hour. The HT results were assessed by physicians on the basis of clinical symptoms, functional parameters and the dosage of medication dynamics with the standard questionnaires use. HT resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% -of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, HT can be used as a rehabilitation method in pulmonary diseases management.
17. Chervinskaya A. V., Kvetnaya A. S. Therapeutical effects of the dry sodium chloride aerosol on physiological properties of the respiratory mucosa // Pulmonology. Supplement abstract book: 3-rd Congress of European Region International Union against Tuberculosis and Lung Diseases (IUATLD).– 2004. – Res. 322.
Dry fine sodium chloride aerosol (haloaerosol) is the main factor of Halotherapy. The goal was to study therapeutical effects of haloaerosol on the functional state of airway mucosa as well as on vitality and biological properties of microorganisms.
We used the standard S. pneumoniae strain as a test culture, which properties were studied in an experimental haloaerosol chamber. Properties of the respiratory tract epithelium were studied using a model of larynx-pharyngeal epithelium cells obtained from 10 healthy persons before and after haloaerosol inhalation. As the control substance, an aerosol of physiologic saline was used. Electro kinetic activity (EC) of epithelial cells and adhesive activity (adhesion index - AI) of S. pneumoniae were evaluated. During stay of S. pneumoniae strain in haloaerosol chamber the colony-forming units (CFU) parameter was reduced with increasing of exposition period from 5 to 30 minutes (р<0,001). The survived microorganisms had decreased virulence and hyaluronidase activity.
After haloinhalations an increase of the EC of the epithelial cells in the healthy persons was observed (before - 27,0±4,7%, after - 47,0±1,6%; р<0,01) as well as a decrease of AI in comparison with the initial one (29,3±4,3% и 8,3± 4,1% correspondingly, р<0,01). The study indicated the adhesive activity of S. pneumoniae was the least intensive at high level of EC cells (r=1,0).
As a result, it has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of haloaerosol an increase of the electrophysiological functional activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance.
18. J. Hedman , T. Hugg , J. Sandell , T. Haahtela The effect of salt chamber treatment on bronchial hyperresponsiveness in asthmatics Allergy Volume 61 Issue 5, Pages 605 – 610 Published Online: 30 Mar 2006
Background: Randomized controlled trials are needed to evaluate the effects of complementary treatments in asthma. This study assessed the effect of salt chamber treatment as an add-on therapy to low to moderate inhaled steroid therapy in asthma patients with bronchial hyperresponsiveness (BHR). Methods: After a 2-week baseline period, 32 asthma patients who exhibited BHR in the histamine inhalation challenge were randomized: 17 to 2-week active treatment, during which salt was fed to the room by a salt generator, and 15 to placebo. The salt chamber treatment lasted 40 min and was administered five times a week. Results: Median provocative dose causing a decrease of 15% in Fev1 (PD15FEV4) increased significantly in the active group (P = 0.047) but not in the placebo group. The difference in changes between the active and placebo groups was significant (P = 0.02). Nine patients (56%) in the active group and two patients (17%) in the placebo group exhibited at least one doubling dose decrease in BHR (P = 0.040). Six patients (38%) in the active group and none in the placebo group became non-hyperresponsive (P = 0.017). Neither the peak expiratory flow (PEF) values measured just before and after the treatment, nor FEV1 values measured before the histamine challenges, changed. The reduction in BHR was not caused by changes in the baseline lung function.
The experts of WHO forecast the subsequent increase of COPD and asthma on worldwide. Mainly it has been related to deteriorative ecologic situation. To stop this tendency aerosol methods with physical factors are preferable because of physiological action without system side effects. Dry salt inhalation therapy has a long history in Europe since 19-th century. Nowadays there are a number of resorts are exploiting salt caves for patients with pulmonary diseases. Halotherapy (HT) is the result of adapting natural salt aerosol from salt caves to flexible usage in other locations. In addition to availability the ability to deliver a specified varied dose of dry rack salt represents a major advantage of HT over the treatment in natural salt caves. Over 15 years, numerous expert groups have worked on standardization of halochambers based on exact understanding of condition in salt caves. HT was sanctioned by Ministry of Public Health in Russia and Lithuania.
The efficiency of HT for care of respiratory and allergic diseases, ENT-pathologies was proved by many scientists in controlled studies. The inclusion of HT into the rehabilitation course of pulmonary pathology patients (with asthma, COPD, bronchitis, pneumonia and others) allows achieving therapeutic effect by 82 –95% of cases along with the most optimal use of pharmacotherapy. It has shown that the application of the HT assured 1,5-2 times reduction of morbidity level in long term observation.
Dry sodium chloride aerosol has positive effect on the defence system of the respiratory tracts. It enhances mucociliary clearance in conjunction with normalization of bronchial micro flora and immunological benefits. Data from prevention studies showed strong efficacy of dry salt aerosol in reducing the risk of common cold during cold season. HT may be recommended to healthy persons and patients with chronic respiratory diseases prior to or during every cold season. Evaluation of respiratory symptoms, functional parameters, and local immunity in persons with risk factor of lung diseases, confirmed their significant changes under the action of HT. It can use as a sanitary method for respiratory airways.
We look at positioning of dry sodium chloride aerosol with HT as a main component of respiratory hygiene for prevention of respiratory diseases, relief of environment hazards and rehabilitation of chronic patients. As a consequence of clinical and mechanism acting understanding of HT, the concept of “maintaining bronchial health” appears to be helpful in health promotion activity of hospitals.
2. Chervinskaya Alina V. Respiratory Hygiene in Health Resort Medicine // 35th Congress of the international Society of Medical Hydrology & Climatology, Istanbul, and June 6-10, 2006: Congress book. – 2006. – OP-2, P. 86.
WHO forecasts the subsequent increase of lung diseases worldwide, related to deteriorative ecological situation. To stop this tendency aerosol methods with physical factors are preferable. Adapting natural salt aerosol from salt caves for flexible and comfortable usage has lead to Halotherapy and HaloSpa technology with dry sodium chloride aerosol (DSCA).
The aim of the study: Evaluation of the efficacy of DSCA on defence system of the respiratory tract and clinical state of the patients with respiratory diseases. 193 patients with pulmonary diseases and at risk of them received a course of DSCA (10-20 sessions daily 45-60 min each in the rooms, equipped with dry salt aerosol generators). 67 matched patients were given a placebo. The effect of the treatment was evaluated by clinical, functional, cytomorphological, bacteriological, immunological examinations, and rheological indices of the sputum.
Results: DSCA enhanced drainage of the bronchi, activated alveolar macrophages, improved biocenosis and local humoral immunity. Procedures resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% - of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. The number of common cold cases during the cold season was reduced in half. Evaluation of respiratory symptoms and functional parameters by persons with risk factor of lung diseases confirmed their significant changes under the action of DSCA. Conclusion. We look at positioning of DSCA as a main component of respiratory hygiene in Health Resort Medicine for prevention of respiratory diseases, as a relief of environment hazards and rehabilitation of chronic patients.
3. Chervinskaya A. V. Effect of dry sodium chloride aerosol on the respiratory tract of tobacco smokers // The Europ. Respir. Journ.-Abstracts 16th ERS Annual Congress, Munich, Germany, September 2-6, 2006. – P. 106s-107s.
The aim was to study influence of dry sodium chloride aerosol (DSCA) on the respiratory tract of tobacco smokers. 47 male were examined. They had the productive cough associated with smoking. The test group (TG) (24 male, 49,9±1,2 yrs; 27,0±1,7 pack/years) was treated with the DSCA (14 procedures). 20 procedures (10 min daily) were given using inhaler Haloneb, producing DSCA with particles size of 1-5 μm and 0,5 mg/min density. The placebo group (PG) (23 male, 49,5±1,5 yrs; 27,9±2,3 pack/years) received inhalations with plain air. 88% of smokers of TG by the end of inhalation course reported easier and/or decreased cough, changes in the character of sputum, which became lighter and clearer. Improvement in the character of sputum was noted only 22% volunteers of PG (p<0,001).
Cytobacteriologic study of brush biopsies taken from pharyngeal mucosa was carried out before and after procedures in the both groups. It was determined that the infection index (II - % of epitheliocytes with adhered cells of S. pneumoniae) and adhesion index (AI - the mean number of microbial cells per one epitheliocyte) decreased significantly in the TG (II before – 28,1±5,8 and after – 7,8±2,7%, p<0,01; IA before - 45,4±11,3 and after - 13,9±6,3 microbe cells, p<0,01). The amount of IgA in epithelial cells of the oropharyngeal mucosa (estimated by indirect method of fluorescent antibodies) increased significantly in the TG (before - 1,5±0,9 and after - 2,0±0,5, p<0,05). There were no significant changes at these indexes in the PG.
Conclusion. DSCA relieves the main symptoms (character of cough and sputum), improves local defence mechanisms and resistance of mucous membranes of tobacco smokers owing to decreased colonization activity of pathogenic bacteria flora.
4. Chervinskaya A. Mechanism of action of the dry sodium chloride aerosol and its clinical efficiency in prophylaxis and rehabilitation // Balneol. Pol. – 2007. – Vol. 49, N 3 (109). - P. 197.
Introduction: Dry sodium chloride aerosol is the main curative factor of treatment in the natural salt caves - speleotherapy. Halotherapy (HT) has been developed on the basis of speleotherapy. Curative effect of HT is caused by an air medium saturated with dry sodium chloride aerosol with predominance amount of particles of 1 to 5 micrometer in size and of a certain density range. HT is carried out in the premises equipped with medical facilities – dry salt aerosol generators and control devices.
It has been known, that nebulised sodium chloride solution is used with therapeutic and diagnostic purposes. There is a little doubt that inhalation of isotonic saline does not produce any evident therapeutic effects. Aerosolized hypertonic saline influences on of impaired mucociliary clearance but it is not used for therapy, because can provoke bronchio spasm in patients with asthma and even in healthy persons. Generally, hypertonic and hypotonic solutions are used to diagnose bronchial hyper reactivity. Due to the fact that physical properties of dry sodium chloride differ from nebulised solution, its therapeutic effect differs as well. The aim: assessment of the efficacy of the dry fine sodium chloride aerosol (halo aerosol) on defence system of the respiratory tract and clinical state of the patients with respiratory diseases.
Material and methods: 193 patients with respiratory disease and at risk of pulmonary pathology received course of HT. 67 matched patients were given placebo. The effect of the treatment was assessed by clinical and functional parameters dynamics, endoscope picture, cytomorphological and bacteriological characteristics of the bronchoalveolar lavage, contamination activity of the micro flora, activity of local humoral immunity in pharyngeal brush-biopsies and saliva, rheological indices of the sputum. The course of HT was consisted of 10-20 daily 1 hour procedures.
Results: It has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of dry salt aerosol an increase of the electrophysiological functional activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance. Dry aerosol of sodium chloride demonstrated anti-inflammatory activity in the respiratory tract, mucoregulating action. It enhances drainage of the bronchi, activates alveolar macrophages, and improves biocenosis and local humoral immunity. HT resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% -of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases the number and intensity of asthma attacks decreased, which allowed reducing the dosage of medication. The improvement in clinical state was accompanied by positive dynamics of the lung function measurements. None of the pts complained of bad condition during HT procedures. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. The changes in control group parameters after placebo were not statistically significant.
Evaluation of respiratory symptoms and functional parameters in persons with risk factor of COPD confirmed their significant changes under the action of HT. Relief of the cough in combination with improvement of sputum properties, positive dynamics of auscultative finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of HT.
Conclusion: Dry sodium chloride aerosol has positive effect on the defence system and function status of the respiratory tracts. Clinical efficacy of HT in prophylaxis and rehabilitation of respiratory patients is based on the medicating action of dry sodium chloride aerosol.
5. Chervinskaya A. Halotherapy in health resort medicine// 36th Congress of the International Society of Medical Hydrology&Climatology. Abstracts book. - Porto, 2008. - P. 29-30.
The paper presents the method of halotherapy which models the microclimate parameters of salt speleoclinics. It gives historical data on the method development, principles and advantages of halotherapy by means of controlled microclimate. The influence of the main curing factor — the dry fine-grained sodium chloride aerosol, and pathophysiological basis of curing effect of the halotherapy method are under review in the paper. The paper describes the method of controlled halotherapy and its technology, that is the halocomplex equipped with a controlled halogenerator. Scientific grounds for action mechanism, proven clinical efficiency verified by research on standards of evidence-based medicine and practical application in various fields of public health determine broad prospect of the method in rehabilitation, sanatoria and health resorts and preventive medicine. Data on clinical efficacy and the grounds for the method usage in the recovering treatment for bronchopulmonary and too-rhino-laryngological pathologies, skin diseases and combined cardiovascular pathology, as well as preventive measures against respiratory diseases are cited.
Efficacy of halotherapy in treatment and recovery of children is under review. Foundations for perspective usage of halotherapy in all kinds of medical and recovering establishments are given.
6. Chervinskaya A. Dry sodium chloride aerosol against acute respiratory viral infections// The Europ. Respir. Journ, – 2009. - 34: Suppl. 53. - 401s.
Aim of the study. The main objective was to estimate the preventing efficacy of inhaled dry sodium chloride aerosol (DSCA) against acute respiratory viral infection (ARVI). Objects and methods. 160 persons were recruited from personnel of an industrial enterprise through special questionnaire. They were randomized in 2 groups - test group (TG) (19 male, 61 female, 47.4±8.0 yrs) and control group (CG) (22 male, 58 female, 48.8±11.6 yrs). The persons of the TG were undertaken with inhalations (10 min) using Haloneb® inhaler, producing DSCA with particles size of 1-5 μm and 0.8-1.2 mg/min density flow. The CG received 10 min inhalations with plain air. Each subject was given 2 inhalations a week during 12 weeks. A physician regularly examined the subjects of the both groups for possible ARVI. Results. For three months observation there were only 14 cases of ARVI and 104 days marked by symptoms of ARVI in the TG. In the CG there were 55 cases of ARVI and 585 days of symptoms. TG subjects were affected by ARVI four times less frequently than CG subjects, and the number of days marked by symptoms of ARVI was 5.6 times less. Analysis of incidences of ARVI showed that they occurred in 60% of subjects with risk factors of COPD in CG subjects against 18% of subjects with risk factors in the TG (p<0.01). On the whole, 13 subjects (16%) developed ARVI in the TG against 50 subjects (63%) in the CG (p<0.001). Conclusions. Inhalations of DSCA, consisting of two weekly procedures for 12 weeks are an effective preventing measure against ARVI.
7. Chervinskaya A. V. Respiratory hygiene with the dry sodium chloride aerosol // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 2514.
Dry sodium chloride aerosol (DSCA) could be used as a method of respiratory hygiene for prevention of COPD. The aim was to study clinical and functional parameters of the persons with COPD risk on application of the DSCA. 54 persons (prs) with exogenous risk factors of COPD were examined. They had the productive cough associated with smoking and/or exposure to industrial pollutants. The main group (MG) (26 male, 8 female, 43±2,4 yrs) was treated with the DSCA (14 procedures). Procedures (10 min daily) were given using inhaler Haloneb®, producing DSCA with particles size of 1-5 μm and 0,8-1,2 mg/min density. The control group (CG) (15 male, 5 female, 46,5±2,8 yrs) received inhalation with room air. After the procedures the cough retained in 27% of the persons of MG and 91% - CG (p<0,001). Relief of cough and improvement of sputum properties were remarked in the 88% of MG and 22% - CG (p<0,05). The significant decrease of the number prs with dry rales (15%-MG, 55%-CG, p<0,05) was observed as well. Significant increase of parameters FEF25 (p<0,05), FEF50 (p<0,01) H FEF75 (p<0,05) was marked in MG. There were no significant changes of the average values of functional parameters in CG. Positive dynamics of the flow-volume indexes in 16 prs (47%) of MG was observed. That differed significantly from CG values (5%, p<0,01). Respiratory symptoms and functional parameters of the prs with risk of COPD had the significant changes under the action of DSCA. Relief of the cough, improvement of the sputum properties, positive dynamics of auscultative finding and functional parameters demonstrated stimulation of bronchial drainage and sanitary acting of the DSCA.
8. Mokina N. A., Geppe N. A. Alternative methods at bronchial asthma of children // 14th Annual Congress of the European Respiratory Society, Glasgow, September 2004: Abstract Book.- 2004. – Ref. 1069.
The purpose: To estimate efficiency of halotherapy, physical training, massage at children with moderate bronchial asthma (BA). Methods: The open randomized comparative study lasted 4 months. Base antiasthmatic therapy was carried out with combined medicine Seretide (50 mcg salmeterol and 100 mcg fluticasone). Three groups were generated: 30 patients, received only the basic therapy, the other two groups, each of 32 of children, except this, received for 2 weeks: 2-nd group physical training and massage, 3-rd group halotherapy. The average age in the groups was accordingly: 9,5±0,5; 9,4±0,5; 9,5±0,3. The daytime and night displays of BA were estimated by scale from 0 up to 3 numbers. Results: The daytime and night symptoms were accordingly: 0,30±0,03 and 0,33±0,03 (Seretide group), 0,27±0,04 and 0,11±0,02 (Seretide + physical training+massage group), 0,16±0,04 and 0,15±0,04 (Seretide±halotherapy group), p < 0,05. Peak expiratory flow was higher in Seretide+halotherapy group (352±8 morning and 354±8 ml evening) and Seretide+physical training+massage: (347±3 morning and 347±3 ml evening), against 327±4 (morning) and 330±4 ml (evening) in Seretide group (p<0,05). The numbers of inhalations of salbutamol as needed were minimal per day in Seretide+halotherapy group: 0,03±0,02, against 0,20±0,04 in Seretide+physical training+massage group and 0,39±0,04 in Seretide group, (p<0,05). Conclusion: The application of halotherapy as well as physical training and massage on the background of the basic medicinal therapy in children with moderate BA renders to positive effect.
9. Lemko O. I., Lemko I. S., Kazankevich V. P., Reshetar D. V., Vatuh N. V., Meleha O. O., Slivko R. I. Some advances in COPD treatment and management// The Europ. Respir. Journ., -2004.-V.24:Suppl. 48. -85s.
The elaboration of the long-term programs of the COPD control is an important direction in the improvement of patients’ quality of life. The programs offered by us include rational bronchodilator therapy in combination with non-medicament methods of treatment. One of such methods is speleotherapy (the treatment in of the rock salt mines microclimate) and its artificial analogues (halotherapy). The rock salt aerosols improve the mucocellular clearance; they have antibacterial and anti-inflammatory influence and thus promote the reduction of broncho-obstruction. 123 patients with COPD of different stages have been investigated. The patients underwent complex examination, which included the research of pulmonary function tests (PFT), inflammation activity, immune reactivity, estimation of lipids peroxidation (POL) and antioxidant defence (AOD). The decrease of some unspecific defence factors, CD3- and CD4-cells independently of COPD stage was determined. But the number of B-lymphocytes, CD25- and CD71-cells was increased. The POL activation and AOD decrease have been observed. Two halotherapy regimes (HR) with different aerosol characteristics were used. The special laser-optical system for monitoring of aerosol characteristics was carried out. Halotherapy has positive influence on clinical COPD process, but significant increase of PFT-data and improvement of some immune indexes were found out only after HR-2. The improvement of AOD-data was observed after both HR. Besides that the rise of sensitivity to bronchodilatator therapy was noted.
10. Chervinskaya A.V., Silber N.A., Alexandra A.N. Halotherapy for treatment of bronchial asthma (abstract) // XIV World congress of asthmology - Interasma 93, Israel. – 1993. - P. 59.
Halotherapy (HT) is a method of treatment under conditions of artificial salt cave microclimate. Therapeutic effect is stipulated by aero dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5 micron particles. Particle density (1 - 5 mg/m3) varies depending on the type and stage of the disease. The other factors - comfortable humidified temperature regime, the hypo bacterial and allergen free environment saturated with aero ions enhance the therapeutic effect. Seventy-one patients (25M, 46F, average 39.1+2.4 years) with various types of asthma were treated by HT. The drug treatment of 60% patients did not give full effect. A control group of 15 patients (8M, 7F, average 38.4+1.5 years) received placebo. The HT course comprised of 10-20 daily one hour procedures. Treatment was conducted in a special room. No side effects were observed during the course of HT. The clinical state of 85% patients with mild and moderate and 75% patients with severe asthma improved after HT. Forty-seven percent of patients required fewer doses of drugs. The improvement in clinical state of patients was accompanied by positive dynamics in lung function tests. The changes in control group parameters after HT were not statistically significant. Thus, the results of HT application demonstrated its efficacy.
11. Konovalov S.I., Chervinskaya A.V. Saline aerosol effect on pulmonary phagocyte system (abstract) // International symposium of speleotherapy. Solotvino-Ukraine, 1993.-P. 24.
Halotherapy - the treatment under conditions of artificially created salt-cave microclimate. Therapeutic influence is stipulated by aero dispersed medium saturated with dry sodium chloride aerosol containing the dominating amount of 2 to 5 micron particles. Further development of the method is offered by the application of the controlled therapeutic microclimate in a halochamber. Particles density from 1 to 7 mg/m3 was used. On the basis of various parameters of aero disperse environments using, we have developed criteria of prescribing the treatment with due regard for nosological forms of respiratory diseases, their pathogen city variants, and the degree of obstructive impairment. Differential approach to the prescription of method allowed reducing the frequency and manifestations of undesirable bronchospastic reactions during treatment. The feasibility of using halotherapy to treat oto-rhino-laryngologic diseases was substantiated. At the same time, it has been established that further research is needed to verify the prescription of method for certain forms of respiratory diseases. Therefore, the application of controlled therapeutic microclimate of a halochamber improved the method of halotherapy and brought it nearer to the up-to-date medical technology.
12. Chervinskaya A., Alexandrov A., Zilber N., Stepanova N. Effect of halotherapy in patients with bronchial asthma and allergic rhinitis (abstract). XV International Congress of allergology and clinical immunology, Sweden, 1994. - P. 175.
Halotherapy (HT) - is mode of treatment in a controlled air medium which simulates a natural salt cave microclimate. The main curative factor is dry sodium chloride aerosol with particles of 2 to 5 micrometer in size. Particles density (0.5-7 mg/m3) varies with the type of the disease. Other factors are comfortable temperature- humidity regime, the hypo bacterial and allergen- free air environment saturated with aero ions. 106 patients (pts) (59- with allergic, 27- with non allergic bronchial asthma (BA) and 20 - with allergic rhinitis) were treated by HT. 15 pts of the control group was given placebo. HT course consisted of 10-20 daily procedures of 1 hour. The clinical state of 85% pts with BA and 90% - with allergic rhinitis improved after HT. The results of HT did not depend on BA type. The positive dynamics of flow-volume loop parameters and decrease of bronchial and nasal resistance measured by body plethysmography were observed. FVC and FEV1 initial values and the values of their changes during HT showed a significantly negative correlation - the more marked was bronchial obstruction, the better were the results of therapy. The changes in control group parameters after HT were not statistically significant. The results of HT application demonstrated its efficacy.
13. Chervinskaya A., Alexandrov A., Strashnova O. Effect of dry sodium chloride aerosol in patients with bronchial asthma // Allergy & Immunology (abstr. Interasma 95). - 1995. - V. 27, N. 7.- P. 221.
The effect of dry sodium chloride aerosol (DSCA) was evaluated in 125 patients (pts) with bronchial asthma (44 M, 81 F, mean age 34.3+2.5 years). 60% of pts received a base medication without full effect. The control group of 15 pts (8M, 7F, mean age 38.4+1.5 years) received placebo. Treatment was performed in a special room with salt coated walls. The pts breathed quietly while reclining in chairs. DSCA containing the dominating amount of 2 to 5 micrometer particles was produced by special nebulizer. The aerosol mass concentration (from 0.5 to 5 mg/m3) was prescribed according to the type of the disease. The DSCA course comprised 10-20 daily one hour procedures. Clinical symptoms analysis demonstrated that the number of asthma attacks decreased significantly. The cases with cough occurred more rarely, cough became easier and more productive. Reduction in bronchodilators and inhaled corticosteroid consumption was an indicator of clinical benefit. The pts showed significant increase of FVC, FEV1, PEF, FEF50 and decrease of Raw by the end of the treatment. The changes in control group parameters after placebo were not statistically significant. The pts were examined 6 and 12 months after the DSCA course. The average duration of remission was 7.6+0.9 months.
14. Chervinskaya A.V., Alexandrov A.N., Konovalov S.I. Application of dry rock salt aerosol in case of common cold // XYI Congress of the European Rhinologic Society. VII Congress of the International Rhinologic Society. Week of the Nose: Abstract Book.- 1996. – P. 104.
17 patients with common cold underwent dry rock salt aerosol (DRSA) therapy. DRSA with particles size of 1-5 micrometer and high negative charge is the main curative factor of Halotherapy (HT). Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m3). HT is drug-free method, which simulates natural salt cave microclimate. There were two ways of DRSA administration: in the room with the controlled air medium which is created with special equipment; the inhalation through nasal mask of individual inhalator. The method of HT was sanctioned by the Russian Ministry of Public Health in 1990. It has been known that DRSA improves rheological properties of the airways contents, decreases oedema of bronchial and nasal mucosa, it has a bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium. The common cold patients’ condition was assessed by daily clinical observation, functional and citobacteriological tests. In all cases we registered cold clinical symptoms disappear faster than in control group. The improvement in clinical state was accompanied by positive dynamics of laboratory tests.
15. Chervinskaya A., Norvaisas G., Pluskiene L., Noreikiene D. Halotherapy for rehabilitation of asthma patients in Russia and Litvania // Eur. J of Allergy and Clin. Immunol. suppl.- V.51.- № 30.- 1996. - P.39.
Halotherapy (HT) is a drug-free method which simulates natural salt cave microclimate. The controlled air medium is created in ordinary room with special equipment. The main curative factor- is a dry sodium chloride aerosol with density of 0,5 to 5 mg/m3, particles size of 1-5 micrometer and high negative charge. Sodium chloride aerosol improves rheological properties of the bronchial contents, decreases oedema of bronchial mucosa, it has a bactericidal action, enhances functioning of alveolar macrophages. Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium.
The method of HT was sanctioned by the Ministry of Public Health in 1990. To study the efficiency of HT the data were collected from 15 Russia and 2 Lithuania hospitals. We have evaluated the results of HT in 3239 adults and children with various type of asthma (2320-from Russia, 919- from Lithuania). The HT results were assessed by physicians on the basis of clinical symptoms and functional parameters dynamics. The course of HT (12-21 daily procedures) resulted in improvement of clinical state in 79% of asthma cases in adults and 89% - in children. Patients showed positive dynamics of symptoms indicative of a better drain function of their airways. In the majority of cases the number and intensity of asthma attacks decreased, which allowed cancelling or reducing the dosage of medication. The improvement in clinical state was accompanied by positive dynamics of the lung function measurements. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, HT can be used as a rehabilitation method in asthma management.
16. Chervinskaya A. Halotherapy for rehabilitation of pulmonary patients in Russia // The Europ. Respir. Journ.- V.10.- Suppl.25.-1997.- P.108.
Halotherapy (HT) is a mode of inhalation therapy with dry sodium chloride aerosol. The controlled air medium is created in an ordinary room with special equipment. The main curative factor- is a dry sodium chloride aerosol with particles size of 1-5 micrometer and high negative charge. Density of aerosol depends on nosology, clinical features and FEV1 (0.5-1; 1-2; 3-5; 7-9 mg/m3). Other factors are comfortable temperature and humidity, hypo bacterial and allergen free air medium. The method of HT was sanctioned by the Russian Ministry of Public Health in 1990. To study the efficiency of HT the data were collected from 15 Russia hospitals (during 1991-1994 years). We have evaluated the results of HT in 4780 adults and children with various types of pulmonary diseases. HT course consisted of 10-20 daily procedures of 1 hour. The HT results were assessed by physicians on the basis of clinical symptoms, functional parameters and the dosage of medication dynamics with the standard questionnaires use. HT resulted in improvement of clinical state in 85% of mild and moderate asthma cases, 75% -of severe asthma cases and 97% - of chronic bronchitis and bronchiectasis. Long-term examination of patients (for one or more year) demonstrated the effect of HT on reduction in the frequency of exacerbations, reduction in chronic symptoms. Thus, HT can be used as a rehabilitation method in pulmonary diseases management.
17. Chervinskaya A. V., Kvetnaya A. S. Therapeutical effects of the dry sodium chloride aerosol on physiological properties of the respiratory mucosa // Pulmonology. Supplement abstract book: 3-rd Congress of European Region International Union against Tuberculosis and Lung Diseases (IUATLD).– 2004. – Res. 322.
Dry fine sodium chloride aerosol (haloaerosol) is the main factor of Halotherapy. The goal was to study therapeutical effects of haloaerosol on the functional state of airway mucosa as well as on vitality and biological properties of microorganisms.
We used the standard S. pneumoniae strain as a test culture, which properties were studied in an experimental haloaerosol chamber. Properties of the respiratory tract epithelium were studied using a model of larynx-pharyngeal epithelium cells obtained from 10 healthy persons before and after haloaerosol inhalation. As the control substance, an aerosol of physiologic saline was used. Electro kinetic activity (EC) of epithelial cells and adhesive activity (adhesion index - AI) of S. pneumoniae were evaluated. During stay of S. pneumoniae strain in haloaerosol chamber the colony-forming units (CFU) parameter was reduced with increasing of exposition period from 5 to 30 minutes (р<0,001). The survived microorganisms had decreased virulence and hyaluronidase activity.
After haloinhalations an increase of the EC of the epithelial cells in the healthy persons was observed (before - 27,0±4,7%, after - 47,0±1,6%; р<0,01) as well as a decrease of AI in comparison with the initial one (29,3±4,3% и 8,3± 4,1% correspondingly, р<0,01). The study indicated the adhesive activity of S. pneumoniae was the least intensive at high level of EC cells (r=1,0).
As a result, it has been established that dry fine sodium chloride aerosol produces an inhibitory effect on growth and vital capability of microorganisms and changes their biological properties. Under the influence of haloaerosol an increase of the electrophysiological functional activity of the respiratory epithelial cells was observed as well as a rise of their colonization resistance.
18. J. Hedman , T. Hugg , J. Sandell , T. Haahtela The effect of salt chamber treatment on bronchial hyperresponsiveness in asthmatics Allergy Volume 61 Issue 5, Pages 605 – 610 Published Online: 30 Mar 2006
Background: Randomized controlled trials are needed to evaluate the effects of complementary treatments in asthma. This study assessed the effect of salt chamber treatment as an add-on therapy to low to moderate inhaled steroid therapy in asthma patients with bronchial hyperresponsiveness (BHR). Methods: After a 2-week baseline period, 32 asthma patients who exhibited BHR in the histamine inhalation challenge were randomized: 17 to 2-week active treatment, during which salt was fed to the room by a salt generator, and 15 to placebo. The salt chamber treatment lasted 40 min and was administered five times a week. Results: Median provocative dose causing a decrease of 15% in Fev1 (PD15FEV4) increased significantly in the active group (P = 0.047) but not in the placebo group. The difference in changes between the active and placebo groups was significant (P = 0.02). Nine patients (56%) in the active group and two patients (17%) in the placebo group exhibited at least one doubling dose decrease in BHR (P = 0.040). Six patients (38%) in the active group and none in the placebo group became non-hyperresponsive (P = 0.017). Neither the peak expiratory flow (PEF) values measured just before and after the treatment, nor FEV1 values measured before the histamine challenges, changed. The reduction in BHR was not caused by changes in the baseline lung function.