Halotherapy as asthma treatment in children: A randomized, controlled, prospective pilot study

Haloaerosoltherapy: Mechanisms of Curative Effect and Place in the Respiratory Rehabilitation

Introduction. Management of patients with chronic pathology requires development of long-term programs with organic combinations of medicamental and non-medicamental influences. Haloaerosoltherapy is a group inhalation of rock salt aerosol with concentration of more than 2-3mg/m3 and certain dispersion (with presence of large-, medium- and small-grained aerosol) aboveground. Material and method. On the basis of literature data review and results of own researches a comprehensive description of haloaerosoltherapy, its mechanisms, available technologies, indications and effectiveness at pulmonary pathology was given. Results and discussion. Basis of haloaerosol curative influence is hyperosmolar stimulus that improves drainage function of bronchi and provides sanitizing effect, which causes further changes at local and systemic levels. This justifies haloaerosoltherapy usage as method of rehabilitation treatment. Comparison of haloaerosoltherapy and other methods of halotherapy (use of halite), in particular, "salt rooms (caves)" was made. It has been proven that "salt rooms" can be used only as spa procedure. Conclusions. Application of term "halotherapy" to all methods that use halite or underground treatment is incorrect. This determines necessity for stop using this term. It is necessary to differentiate clearly applied methods of treatment using terms that reflect the essence of therapeutic effect. Haloaerosoltherapy should be considered a method of respiratory rehabilitation with a proven mechanism of action and effectiveness. Haloaerosol is obtained using specific devices - halogenegenerators. The effectiveness of haloaerosoltherapy immediately after the course of treatment and in remote period is testified. Keywords: Respiratory rehabilitation, halotherapy, haloaerosoltherapy, speleotherapy,

Origin, distribution, and perspective health benefits of particulate matter in the air of underground salt mine: a case study from Bochnia, Poland

The composition and distribution of airborne particles in different locations in a salt mine were determined in terms of their origin, the distance from the air inlet, and the adaptation of post-mining chambers and corridors for tourists and general audience. The composition of aerosols in air was also evaluated from the perspective of human health. Air samples were collected on filters by using portable air pumps, in a historical underground salt mine in Bochnia (Poland), which is currently a touristic and recreation attraction and sanatorium. The particulate matter (PM) concentration was determined using the gravimetric method by weighing quartz filters. The content of carbon, water-soluble constituents, trace elements, and minerals was also determined. A genetic classification of the suspended matter was proposed and comprised three groups: geogenic (fragments of rock salt and associated minerals from the deposit), anthropogenic (carbon-bearing particles from tourist traffic and small amounts of fly ash, soot, and rust), and biogenic particles (occasional pollen). The total PM concentration in air varied between 21 and 79 μg/m³ (with PM₄ constituting 4-24 μg/m³). The amount of atmospheric dust components coming from the surface was low and decreased with the distance from the intake shaft, thus indicating the self-cleaning process. NaCl dominated the water-soluble constituents, while Fe, Al, Ag, Mn, and Zn dominated the trace elements, with the concentration of majority of them below 30 ng/m³. These metals are released into air from both natural sources and the wear or/and corrosion of mining and tourists facilities in the underground functional space. No potentially toxic elements or constituents were detected. The presence of salt particles and salty spray in the atmosphere of salt mine, which may have anti-inflammatory and antiallergic properties, is beneficial to human health. This study will allow for a broader look at the potential of halotherapy in underground salt mines from a medical and regulatory point of view.

[Halotherapy in patients with vasomotor rhinitis after surgical treatment]

The problem of rehabilitation of a patient with vasomotor rhinitis after surgery due to the high percentage of relapses is relevant in the practice of an otorhinolaryngologist. The use of halotherapy in the postoperative period is pathogenetically substantiated in connection with its multifactorial effect on the nasal mucosa.

THE PURPOSE OF THIS STUDY

Was to investigate the effectiveness of using dry sodium chloride in the postoperative period in patients with vasomotor rhinitis.

MATERIAL AND METHODS

56 patients were examined after bilateral submucosal vasotomy with laterofixation of the lower turbinates. Patients were divided into 2 groups depending on the ongoing rehabilitation. The 1st group (comparison) included 28 patients who underwent standard measures, the 2nd (main) group included 28 patients who were additionally prescribed a course of halotherapy. The clinical effectiveness of the treatment was evaluated on a 4-point scale according to subjective and objective signs on the 5th, 8th and 10th postoperative days.

RESULTS

After treatment on the 10th day, the total score in the group of patients undergoing halotherapy was significantly lower than in the comparison group - 245 and 310 points, respectively. Significantly in the main group, in comparison with the 1st group, the patency of the nasal passages improved (1.8±0.7 points versus 3.2±0.7 points), the swelling of the lower turbinates was reduced (1.0±0.3 points versus 1.5±0.6 points). The average score by the criterion «mucociliary transport time» was 1.5±0.6 points in patients in the 1st group and 1.0±0.3 points in the 2nd group. In the 2nd group, the normalization of mucociliary transport time occurred faster than in patients who underwent standard therapy.

CONCLUSION

Halotherapy has shown high efficiency and safety, therefore it is advisable to use it in clinical practice along with generally accepted treatment regimens to reduce the drug load, including the need for decongestants. In addition, halotherapy contributes to an earlier restoration of the functional state of the nasal cavity.

Inhalations with Brine Solution from the 'Wieliczka' Salt Mine Diminish Airway Hyperreactivity and Inflammation in a Murine Model of Non-Atopic Asthma

Inhalations with brine solutions are old but underestimated add-ons to pharmacological treatments of inflammatory lung diseases. Although widely used, not all features underlying their action on the respiratory system have been explored. The aim of the present study was to elucidate the mechanism of the beneficial action of inhalations of brine solution from the 'Wieliczka' Salt Mine, a Polish health resort, in a murine model of non-atopic asthma. Asthma was induced in BALB/c mice by skin sensitization with dinitrofluorobenzene followed by an intratracheal challenge of cognate hapten. All animals underwent 12 inhalation sessions with brine solution, pure water or physiological saline. Control mice were not inhaled. We found that brine inhalations reduced, as compared to non-inhaled mice, the typical asthma-related symptoms, like airway hyperreactivity (AHR), the infiltration of pro-inflammatory cells into the bronchial tree, and the inflammation of the airways at the level of pro-inflammatory cytokines IL-1α, IL-1β and IL-6. The level of the anti-inflammatory IL-10 was elevated in brine-inhaled mice. Inhalations with pure water increased AHR, whereas saline had no influence, either on AHR or cytokine concentrations. These observations indicate that inhalations with a brine solution from the 'Wieliczka' Salt Mine diminish the asthma-related symptoms, mostly by reducing the inflammatory status and by decreasing AHR.

Complementary therapeutic approaches in asthma

Asthma is defined by The Initiative for Asthma (GINA 2018) as a heterogeneous disease, which include chronic airway inflammation and a history of respiratory symptoms. In the last decades asthma had a rise in prevalence, becoming one of the most frequent diagnosed diseases in the world. The main goals of asthma management are to achieve good symptom control, minimize the risks of exacerbations, decrease rescue medication intake, improve the quality of life by decreasing respiratory system inflammation and ameliorating the patient’s lung function. Beside effective medications, asthma continues to impair quality of life for most patients. Due to the difficulty of controlling symptoms and exacerbations, the need of developing complementary options of treatment is increasing in order to achieve an optimum control and a lower risk of acute episodes or fatal events. Pulmonary rehabilitation is suggested for asthma patients when adequate medical therapy poorly control the symptoms and mental, physical or social consequences of illness persist during the daily life. The following non-drug therapy components are included in the rehabilitation program: physical training, comprehensive smoking cessation program, comprehensive patient education, respiratory physiotherapy, psychosocial support and comprehensive nutritional counseling. These complementary therapies have been proven to improve muscle strength, exercise capacity and symptomatology. Also, it has been associated to fewer exacerbations and a lower use of rescue medication, leading to a better quality of life. Key words: asthma, quality of life, symptomatology, rehabilitation, physiotherapy,

Complementary and alternative medicine use in children with asthma

PURPOSE

To estimate the overall prevalence of complementary and alternative medicine and specific modalities used among children with asthma, identify predictors of use, and perceived positive or negative effects of therapies.

RESULTS

Of the 161 children enrolled in the study, 76.4% had ever used complementary and alternative medicine. Humidifiers, air purifiers, and multivitamins were the most common modalities used. Complementary and alternative medicine use in children was associated with family use, younger child age, and disease severity, indicated by recent asthma exacerbation. The majority of participants perceived benefit from their complementary and alternative medicine use, with very few reporting negative side effects. Only 36.7% of participants reported discussing their complementary and alternative medicine use with the asthma clinic healthcare team.

CONCLUSIONS

The prevalence of complementary and alternative medicine use in children with asthma is high, with the majority of families perceiving benefit from its use. This study offers clinicians a reference to inform families regarding the subjective helpfulness of various types of complementary and alternative medicine modalities that can facilitate the dialogue between health care professionals and families interested in complementary and alternative medicine use.