Respiratory diseases are a serious health problem due to their wide prevalence, not always adequate treatment, sufficiently high probability of developing complications, and frequent formation of disability. One of the important tasks of the development of rehabilitation medicine in the resorts of Russia is to improve programs for the recovery treatment and prevention of respiratory diseases. The spread around the world of a new coronavirus infection, with the most frequent lung damage, has set a new task – the rehabilitation of patients who have suffered pneumonia caused by COVID-19. It is necessary to develop regional standards for sanatorium-resort medical rehabilitation, which made it possible to rationally use the recreational potential of the coastal climatic resorts of Crimea for patients with various respiratory diseases.

Introduction. The increase in the number of patients with post-COVID syndrome determines the relevance of their rehabilitation in sanatorium and resort institutions, of both local and climate-therapeutic resorts.Aim. To identify the possibility for the rehabilitation of patients with severe forms of COVID-19 in the conditions of the climatic pulmonological resort of the South Coast of Crimea in the winter season.Materials and methods. Clinical-anamnestic, laboratory, functional and computed-tomographic results of the examination of the thorax of a patient who had a severe form of COVID-19. Rehabilitation was carried out 21 days complexly using climatotherapy, therapeutic exercise, respiratory, medication and physiotherapy. The effectiveness of treatment was assessed using a 6-minute step test, Borg scale, mMRC dyspnea scale, oxygen assessment chart, rating of health status, Hospital Anxiety and Depression Scale (HADS), Fatigue Assessment Scale (FAS), dyspnea assessment index (DDI/TDI), questionnaires of life quality EQ-5D and SF-36.Results. At the end of the rehabilitation course, general well-being improved, shortness of breath decreased, exercise tolerance increased, positive dynamics of spirographic parameters, Borg scale scores and a 6-minute step test were noted. The indicators of depression on the HADS scale normalized, positive dynamics was noted according to the SF-36 questionnaire of the psychological component of health. The severity of pain/discomfort and anxiety/depression according to the EQ-5D questionnaire decreased. The X-ray picture has improved. When determining the diffusion capacity of the lungs (DLCО), an increase of 30% from the initial value was revealed.Conclusion. Rehabilitation of a patient who had a severe form of COVID-19 with bilateral lung damage in the conditions of the climatic pulmonology resort of the South Coast of Crimea in the winter season is effective. To assess the lung function of patients who have undergone COVID-19, the most effective method can be considered the determination of lung diffusion capacity (DLCО). Spirogram indicators do not always objectively reflect the severity of the condition.

Goal is to evaluate effectiveness of chlorogenic acids (CGA) of grape wines as a part of medical rehabilitation in chronic bronchitis (CB) patients with comorbid metabolic syndrome (MS). Material and Methods — Analysis of effectiveness of CGA of dry white wines “Rkatsiteli” and “Rkatsiteli Alma” and liquor red wine “Cahors” as parts of the health resort treatment was carried out in group of 182 patients with CB (42 patients with MS). Results and Conclusion — The beneficial effect of grape wine CGA was manifested in relation to dynamics of triacylglycerol, regardless of presence or absence of MS. The greatest metabolic effect of CGA was manifested in patients with MS with positive effect on dynamics of Quetelet index and cholesterol. The moderate consumption of wines rich in CGA can be recommended to patients with chronic bronchitis as a preventive measure to development of metabolic syndrome.

Aim. To evaluate the possibilities of physiotherapeutic syndrome-oriented medical rehabilitation (MR) for lung diseases (LD) in the climatic resort of the Southern Coast of Crimea (SCC).   Materials and methods. In a single-center retrospective observational study, an analysis was made of the rehabilitation effects of physiotherapeutic interventions in a contingent of 100 patients with LD. Examination and treatment of patients was carried out in accordance with the standard of health resort care for patients with LD. Additionally, psychological studies and therapeutic effects were carried out by transcranial electrical stimulation, dynamic electrical nerve stimulation, mud therapy with Saki therapeutic mud, aromatherapy with sage oil and breathing training with a breathing simulator “New Breath”. The assessment of the values of 23 domains of “International Classification of Functioning, Disability and Health” (ICF) was carried out according to the methodology developed in the “ARI n.a. I.M.Sechenov”. The values of domains at the beginning and at the end of the MR course were evaluated, as well as the dynamics of domains (equal to the result of subtracting the values of the domain at the end of the course from the value at the beginning of the course). Mathematical analysis of the obtaineddata was carried out using the methods of multivariate statistics.   Results. A statistically significant (at p < 0.05) positive dynamics of a number of domains was established, indicating the success of a comprehensive course of MR, including domains b2401, b410, b420, b450, b455, b4552, b4601 and an integrated assessment of the functional state (IAFS). The 18 equations of the positive effect of course doses of physiotherapeutic procedures (alternating magnetic field, DENS, ultrasound therapy, halotherapy, inhalation therapy, aromatherapy, pelopathy, short-wave ultraviolet irradiation and massage) on the effectiveness of MR for 12 domains and for IAFS were obtained.   Conclusion. The use of ICF domains as rehabilitation syndromes is substantiated. The complex of physiotherapeutic influences used in the treatment of patients with LD in the SCC climatic resort has significant potential for successful syndrome-oriented MR.

Aim. To assess the influence of the climatic and weather patterns at the South Coast of Crimea (SCC) on the effectiveness of health resort medical rehabilitation of patients with lung diseases (LD).Materials and methods. A study carried in a group of 197 patients with LD. The influence of climatic and weather patterns at the SCC were assessed using the methods developed by the Academician Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M. Sechenov – modified clinical index on weather pathogenicity and medical rehabilitation assessment according to the criteria of the “International Classification of Functioning, Disability and Health” (ICF).Results. Regression equations for the dynamics of the ICF domains b280, b430, b4303 and for the mean value of all domains on the values of air temperature, wind speed, cloudiness, and air temperature variability have been developed, which allow to reliably form a rehabilitation prognosis for patients with LD for all terms of health resort treatment in the SCC.Conclusion. The use of modernized clinical indices of weather pathogenicity allows one to adequately assess and predict the effect of weather dynamics and form a rehabilitation prognosis for patients with LD.