Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self-management strategies, quality of life, and unmet needs.

BACKGROUND: Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems. OBJECTIVE: To systematically review the needs, quality of life (QOL), and effectiveness of self-management strategies among young women (12-25 years) with DM or HMB. SEARCH STRATEGY: Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022. SELECTION CRITERIA: Qualitative and quantitative studies published in peer-reviewed journals, females aged 12-25, exploring DM or HMB, reporting supportive care needs, quality of life, self-treatment strategies, and/or treatment-seeking behavior. DATA COLLECTION AND ANALYSIS: Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self-care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment. MAIN RESULTS: The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%-63% and 42%-94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%-65%). Few studies explored needs, but they could be inferred and fell under school-related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies. CONCLUSIONS: HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL.

Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions.

OBJECTIVES: This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview. MATERIALS AND METHODS: A literature search across PubMed, Embase, and Cochrane Library informed the analysis. RESULTS: Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain. CONCLUSIONS: Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial. CLINICAL RELEVANCE: Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals.

Mindful self-compassion for psychological distress -associated with skin conditions: An online intervention study.

Background Chronic skin conditions are different from internal illnesses since they are often immediately visible to others. Patients feel self-conscious and often go through depression, anxiety, fear of stigma and a substantial psychological, social and economic impact. It is crucial for healthcare professionals to gather information about various strategies and psychosocial interventions that can be used to manage psychological distress associated with skin conditions and avoid it from being neglected amidst other health conditions. Mindful Self-Compassion (MSC) can be used for this. It is a resource-building mindfulness-based self-compassion training programme that uses a combination of personal development training and psychotherapy designed to enhance one's capacity for self-compassion by cultivating spacious awareness as a basis for compassionate action. Aims This study examined the impact of mindful self-compassion on depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being in a sample of 88 adults aged 18-55 years suffering from chronic skin conditions. Methods This study used an experimental waitlist control design. Participants were recruited from two skin clinics using purposive sampling in Mumbai, Maharashtra. Pre-test data was collected through self-reported questionnaires on psychological distress, dermatology-specific quality of life, self-esteem and well-being. Participants who were experiencing psychological distress were randomly assigned to either the experimental or waitlist control group. The intervention named 'mindful self-compassion' was delivered through an online platform, twice a week, over a period of 4 weeks. Post-test data was collected later on all variables. Results ANCOVA was utilised where pre-test scores were used as covariates. Differences in pre-test and post-test scores between the intervention group and waitlist control group for depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being were analysed. Participants in the intervention group were found to have lower levels of depression, anxiety and stress as compared to the waitlist control group and also had enhanced levels of self-esteem, well-being and dermatological quality of life. These differences were found to be statistically significant (p < 0.001). Limitations The sample reflected heterogenous skin conditions, not a specific skin condition. The study was quantitative in nature, and we could not use any qualitative methods to assess the subjective experience of participants. Due to time constraints, follow-up data could not be gathered from participants to assess long-term effects on participants. Conclusion Mindful self-compassion can be effectively used to manage psychological distress in skin conditions. Dermatologists can become acquainted with basic signs of mental distress and the importance of psychological interventions. By collaborating with mental health professionals, patients can be given holistic treatment.

Gerontechnology for better elderly care and life quality: a systematic literature review.

Gerontechnology as multidisciplinary research has expanded in recent years due to its significant role in ensuring better care and improved quality of life for older adults and their caregivers. With a substantial increase in studies on reasons behind less inclination of older individuals to accept gerontechnology, barriers to its non-acceptance appear to be persistent. In addition, there is a dearth of research on the adoption of gerontechnology from the perspectives of social caregivers, given that caregivers bear a substantial burden in the form of chronic stress, which adversely affects their health and that of older people. Therefore, the aim of this study is to present a holistic perspective of older adults and their caregivers by systematically reviewing literature on gerontechnology acceptance. Adopting the preferred reported items for systematic and meta-analysis (PRISMA) framework, publications specifically on gerontechnology from 2002 to 2022 in Scopus, Web of Science and PubMed, that focused on older people (50 years and above) and caregivers (informal and formal) were reviewed. We critically evaluated 25 publications and synthesised them thematically. The results highlight that gerontechnology acceptance by older adults and their social caregivers is highly contingent on certain personal, physical, socio-cultural and technological indicators. However, this paper concludes that a generalised policy approach for gerontechnology and a better quality of life may be ineffective, considering that older adults and social caregivers constitute two heterogeneous groups.

Auriculotherapy in prevention of migraine attacks: an open randomized trial.

Use of auriculotherapy to prevent episodic migraine pain has seldom been reported. The aim of this open study was to show that three sessions of auriculotherapy, 1 month apart, using semi-permanent needles decrease frequency and intensity of an attack in patients presenting episodic migraine. A total of 90 patients were randomized to the treatment group (AUR group, n = 58) or the control group (C group, n = 32). Four patients dropped out during the study (three in the AUR group and one in the C group). The number of days with migraine and non-migraine headache was similar when the analysis focused on the 3 months of the study or on the difference in each group of this number between the 3 months preceding the inclusion and the 3 months of the study (p = 0.123). AUR group patients had fewer days with non-migraine headache (p = 0.011) and took less Triptans (p = 0.045) than group C. Number of days with migraine, sum of the pain intensities of all migraines and non-migraine headaches, and total number of analgesics taken, other than triptan, were similar between groups. MIDAS score decreased with time in the AUR group while it increased in the C group whether in absolute values (p = 0.035) or as categories (p = 0.037). These contrasted results should lead to further study of the effectiveness of auriculotherapy for the prevention of migraine. Clinical trail registration: Protocol registered on the Clinicaltrials.gov, website (January 30, 2017, NCT03036761).

The long-term efficacy of heliotherapy in ameliorating disease severity and improving the quality of life in patients with atopic dermatitis.

Introduction: Atopic dermatitis is one of the most common chronic inflammatory skin diseases adversely affecting the quality of life of both patients and their families. Heliotherapy, a treatment modality with high anti-inflammatory effects, is unjustifiably neglected in a country that has plenty of sunshine days throughout the year, but does not own the Cabinet for artificial phototherapy. Aim: To evaluate the power of individual heliotherapy in ameliorating disease severity and improving the quality of life, as well as to compare the results with those obtained from the studies evaluating group heliotherapies. Material and methods: We assessed disease severity and quality of life at three times: before commencing heliotherapy (Time 1), immediately after heliotherapy (Time 2), and 3 months after heliotherapy (Time 3). The tools we used are authorized scoring systems and questionnaires: SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI) and Severity of Pruritus Scale (SPS). Results: A total of 24 patients were analysed in this observational study. Good clinical results were observed with a statistically significant decrease in SCORAD index by 40% and 31.1% at Time 2 and Time 3, respectively (p < 0.001). Improvement in the quality of life was statistically significant showing a decrease in DLQI score by 31.57% 3 months after heliotherapy, comparing to baseline values (p < 0.001). Conclusions: Our results revealed that 2-week heliotherapy has shown satisfying, long-lasting effects in clearing the skin changes, reducing and ameliorating pruritus intensity, as well as improving the quality of life.

Oral traditional Chinese medicine for vestibular Migraine: A systematic review and meta-analysis.

OBJECTIVE: Vestibular migraine is a common vertigo disease, and studies confirm that Traditional Chinese medical has unique advantages in treating vestibular migraine. However, there is no unified clinical treatment method and lacks objective outcome indicators. This study aims to provide evidence-based medical evidence by systematically evaluating the clinical efficacy of oral TCM in treating vestibular migraine. METHODS: Search journals related with clinical randomized controlled trials of oral traditional Chinese medicine for vestibular migraine in databases includes China Academic Journals full-text database (CNKI), China Biology Medicine disc (CBM), China Science and Technology Journal Database(VIP), Wangfang Medicine Online(WANFANG), PubMed, Cochrane library, EMBASE, MEDLINE, and OVID databases from their inceptions until September 2022. The quality of the included RCTs was assessed using the Cochrane risk of bias tool, then conduct the Meta analysis by using RevMan5.3. RESULTS: There were 179 papers left after selection. Moreover, according to the literature inclusion and exclusion criteria, 158 studies were filtered and the remaining 21 articles would be considered in this paper, which include 1650 patients in total and 828 of them were in the therapy group and 822 of them were in the control group.Furthermore,the therapy group outperformed the control group in terms of the total efficiency rate and TCM syndrome score, and the difference is statistically significant(P < 0.01). The number of vertigo attacks and the duration of each vertigo decreased compared to the control group, which difference is also statistically significant (P < 0.01). The funnel chart of the total efficiency rate was approximately symmetric and publication bias was low. CONCLUSION: The oral traditional Chinese medicine is an effective way for vestibular migraine, which would help with the clinical symptoms, reduce the TCM syndrome score, decrease the number of vertigo attacks and the duration of each vertigo, and improve life quality of patients.

The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic.

BACKGROUND: Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. METHODS: Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. RESULTS: The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. CONCLUSION: Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.

The psychosocial burden of hidradenitis suppurativa in Singapore.

Background: Hidradenitis suppurativa (HS) is a chronic debilitating inflammatory skin disorder known to result in significant psychological symptoms and impaired quality of life. However, most of these studies are limited to western countries, with limited data from other sociocultural regions. Objective: To understand the psychosocial burden of HS in the Asian context, by exploring the correlation between objective disease measures with psychosocial health and work productivity. Methods: A prospective single-center questionnaire study was conducted. A total of 45 patients with HS completed a questionnaire and examination by a dermatologist. Results: Higher objective disease severity scores (Hurley, physician global assessment, International Hidradenitis Suppurative Severity, and modified Sartorius) correlated with poorer quality of life (Dermatology Life Quality Index and Patient Global Assessment), increased anxiety and depression (hospital anxiety and depression scale) and at-work productivity loss. There was no significant correlation between objective disease severity and other domains Work productivity and activity impairment score or self-esteem (Rosenburg Self-Esteem Scale). Limitations: The main limitation of our study is the small sample size, assessment at a single time point, and lack of control cohort. Conclusion: Our findings demonstrate the impact of HS on a patient's psychosocial well-being and emphasize the importance of treating patients from a holistic standpoint.

Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types.

Background: Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. Objective: To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. Methods: In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. Results: A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P < .001), more often had follicular eczema (22.1% vs 2.6%; P < .001), higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; P = .009), less allergic contact dermatitis (30.9% vs 47.4%; P = .03), and less previous phototherapy use (39.7% vs 59.0%; P = .008). When comparing DST and LST corrected for covariates including baseline EASI, DST showed greater mean EASI reduction between baseline and 6 months with only dupilumab (16.7 vs 9.7; adjusted P = .032). No differences were found for adverse events for any treatments (P > .05). Limitations: Unblinded, non-randomized. Conclusion: Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.

Use and perception of ecosystem services on an urban river: a case from lower Gangatic plain, Eastern India.

Rapid urbanisation and climate change have emerged as serious threats to ecosystem services (ES), and the deterioration of ES is affecting the quality of life. The research on ES was long performed from monetary perspectives and neglected evaluation of ES from social perspectives. This study proposes a social appraisal approach for evaluating urban river ES on Mahananda River in English Bazar Urban Agglomeration (EBUA), Eastern India, through the social perception and preference (SPP) approach. SPP approach was performed using the importance-performance analysis (IPA) model and satisfaction index (SI). Mann-Whitney U test, correlation analysis, and a median regression were performed to better understand the overall scenario on the perception and preference for ES. The findings of the study showed that (i) the stakeholder residing along the left bank of the river were highly dependent on provisioning ES; (ii) there was limited access to cultural ES provided by the river; (iii) the stakeholders residing along the left bank and slum stakeholders residing along the right bank of the river were more dependent on rive ES; (iv) relatively higher discrepancy was reported from recreation, aesthetic, and bio-diversity; (v) satisfaction level on ES was relatively low to the stakeholder residing along the left bank (50%); and (vi) as per improvement index (II), recreation, aesthetic value, bio-diversity, and purification of water must be prioritised to meet the societal needs. Thus, the study's findings can be very effective in implementing actions for sustainable holistic river ES management through the SPP approach.

Management of Atopic Dermatitis in Adults in Saudi Arabia: Consensus Recommendations from the Dermatological Expert Group.

Background: Atopic dermatitis (AD) is a long-term, pruritic, recurrent, systemic, inflammatory skin disorder. In the Middle East region, the burden of AD is understudied, and there is a dearth of AD guideline documents for practitioners. Methods: An expert panel meeting, encompassing 12 dermatologists from the Kingdom of Saudi Arabia (KSA), was congregated to develop evidence- and experience-based consensus recommendations for AD management, especially in adults in KSA. They completed a questionnaire with seven clinical statements, and a consensus was defined when the responses of ≥75% of participants coincided. Results: The expert recommendations were as follows: American Association of Dermatology guidelines are to be followed for defining AD; Eczema Area and Severity Index or SCORing atopic dermatitis index may be used to quantify the disease severity; Dermatology Life Quality Index may be used to determine the impact of AD on patients' quality of life; Atopic Dermatitis Control Tool may be used to assess long-term disease control in AD patients; and the European guidelines are to be followed for the management of AD. In AD patients who are inadequately controlled with topical or systemic therapies, the preferred systemic agent for use either alone or in combination with topical treatments is dupilumab, cyclosporine, methotrexate, phototherapy, or other available systemic treatments that may include mycophenolate mofetil or oral corticosteroids. Conclusion: These expert recommendations assist physicians by providing a reference framework for optimal care of adult AD patients.

Sociodemographic, clinical and therapeutic factors as predictors of life quality impairment in psoriasis: A cross-sectional study in Italy.

Psoriasis is a chronic inflammatory skin disease showing a high burden due to its aesthetic, social, psychological, and quality of life (QoL) implications which also affect patient-physician relationship and, consequently, the adherence to treatments. Limited data on the natural history of psoriasis and factors predicting its prognosis are available. The aim of this study was to investigate patients' global characteristics, including treatments, associated with QoL impairment in psoriasis. Questionnaires evaluating sociodemographic features and Dermatology Life Quality Index (DLQI) were administered to patients. Multiple regression analysis was performed to evaluate factors associated with a large effect on patient's life (DLQI > 10), moderate effect on patient's life (DLQI ≥ 6 ≤ 10), small effect on patient's life (DLQI ≥ 2 < 6), and no effect on patient's life (DLQI < 2). Overall, 1052 consecutive patients affected by mild-to-severe psoriasis were recruited. Our logistic regression analysis showed that the influencing factors for a large effect on QoL were living in Southern Italy, depression, psoriatic arthritis, and psoriasis localization on facial, intertriginous, palmoplantar, trunk and scalp regions. For a moderate effect on patient's life, phototherapy and non-biological systemic therapies resulted to be the predictive factors. Mild psoriasis, living in social housing and the isolated involvement of scalp psoriasis had a small effect on QoL. Lastly, mild psoriasis and current biological therapies including anti-IL-12/23, anti-IL-17, and anti-TNF-α were positively associated with no life quality impairment. Perceived quality of life impairment in psoriasis not only depends on the skin disease but rather on patients' global characteristics. Therefore, the individual background of these patients should be respected in the selection of treatment options.

Assessment of Life Quality, Stress and Physical Activity Among Patients with Psoriasis.

INTRODUCTION: Psoriasis is a chronic, autoimmune, inflammatory skin disease affecting 2-4% of the general population, which nowadays is even perceived as a systemic illness. The nature of this dermatosis may negatively influence patients' general condition, life expectancy, and quality of life, which highlights the severity of the problem and the need to perform further investigation. We aimed to assess quality of life, stress severity, and physical activity of patients with psoriasis in relation to demographic and clinical data and comparison to the control group without dermatoses. METHODS: A set of surveys was conducted in 56 patients with psoriasis hospitalized at the Department of Dermatology, Medical University of Bialystok. Questionnaires used involved the Dermatology Life Quality Index, WHO Quality of Life questionnaire, International Questionnaire of Physical Activity, and a self-invented stress survey. Obtained data were compared to a sex- and age-matched control group without dermatoses. Statistical analysis was performed using GraphPad Prism. RESULTS: Patients with psoriasis were found to be significantly less satisfied with their health and had lower scores in WHO social, environmental, and psychological domains, comparing to controls. Patients reported higher stress severity and lower satisfaction with sex life and physical appearance than controls. Patients with psoriasis also tended to perform less intensive physical activity than controls. CONCLUSIONS: This study highlights the perception of psoriasis as not only affecting skin but also having a multifactorial impact on psychological and internal condition. Described lifestyle abnormalities can be easily evaluated with validated questionnaires, which could be introduced to patients in order to raise their awareness of comorbidities and mobilize them to modify incorrect lifestyle habits. Screening for other disorders and introduction of a holistic approach to every patient could be beneficial because the improvement of patients' life quality is one of the most important issues.

The effect of topical chamomile in the prevention of chemotherapy-induced oral mucositis: A randomized clinical trial.

OBJECTIVE: To clinically assess the effectiveness of topical chamomile oral gel in the prevention of chemotherapy-induced oral mucositis. MATERIAL AND METHODS: A parallel single-blind randomized clinical trial conducted on 45 patients who were undergoing chemotherapy. Patients were assigned to three equal groups. Group I received conventional symptomatic treatment that included antifungal agents (Miconaz oral gel, Medical Union Pharmaceuticals), topical anesthetics, and anti-inflammatory agent (BBC oral spray, Amoun Pharmaceutical Company) three times per day for three weeks, group II received 3% chamomile topical oral gel, whereas group III patients were given both conventional symptomatic treatment and chamomile topical oral gel. All patients were clinically assessed for pain and oral mucositis severity at three separate time intervals: 1 week, 2 weeks, and 3 weeks. RESULTS: Most patients experienced oral mucositis with more severity reported in the conventional group (grade III = 6.7%) compared to the other two groups, neither of which developed more than grade II. Mean pain scores showed no significant difference between the groups, but intragroup analysis showed that pain score increased in the conventional treatment group more than the other two groups. CONCLUSION: Topical chamomile 3% gel has demonstrated in this study to lower the severity of the mucositis with lower pain scores compared to the other two groups.

Efficacy of Yiqi Jianpi anti-cancer prescription combined with chemotherapy in patients with colorectal cancer after operation.

BACKGROUND: At present, colorectal cancer is routinely treated with adjuvant radiotherapy and chemotherapy postoperatively. The adverse effects (AEs) of chemotherapy usually interrupt the treatment of chemotherapy. Traditional Chinese medicine (TCM) has demonstrated great potential in improving patients' clinical symptoms, regulating the immune function, improving the life quality, and reducing the AEs of chemotherapy. AIM: To observe the clinical efficacy of Yiqi Jianpi anti-cancer prescription combined with chemotherapy in patients with colorectal cancer after operation. METHODS: Data from patients diagnosed with colorectal cancer between January 2019 and February 2021 were collected from Liaoning Cancer Hospital and Institute and the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. Patients receiving the chemotherapy regimen of capecitabine plus oxaliplatin (CAPOX) after radical resection of colorectal cancer were prospectively collected and randomly divided into an experimental group and a control group. The experimental group was given Yiqi Jianpi anti-cancer prescription combined with the CAPOX regimen, while the control group was given the CAPOX regimen alone. After six cycles of chemotherapy, the scores of TCM symptoms, Karnofsky performance scale (KPS) score, levels of T-cell subsets, and AEs after chemotherapy of the two groups were compared. RESULTS: A total of 70 patients were randomly divided into either an experimental group (n = 35, no dropout) or a control group (n = 33, with 2 dropouts). Compared with the control group, the experimental group improved significantly (P < 0.05) in scores of TCM symptoms, KPS score, levels of T-cell subsets, and AEs of chemotherapy. CONCLUSION: Yiqi Jianpi anti-cancer prescription can effectively improve spleen deficiency, regulate the immune function, and alleviate the AEs of chemotherapy, so as to improve the life quality of patients with good therapeutic effects and application prospect in clinical practice.

[Clinical trials of Xingnao Kaiqiao needling combined with respiratory training for post-stroke dysphagia].

OBJECTIVE: To observe the clinical effect of Xingnao Kaiqiao needling combined with respiratory training on swallowing function, quality of life and throat surface muscle function in patients with post-stroke dysphagia. METHODS: A total of 124 patients with post-stroke dysphagia were randomized into an observation group and a control group, 62 cases in each group. On the basis of conventional western medication treatment, respiratory training was applied in the control group, once daily, 5 times a week for 4 weeks. On the base of the treatment as the control group, Xingnao Kaiqiao needling was applied at Neiguan (PC6), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), Yifeng (SJ17), posterior pharyngeal wall, Shuigou (GV26) and Lianquan (CV23) in the observation group, once daily, 6 times a week for 4 weeks. Before and after treatment, the Kubota water swallowing test (KWST) scale, swallowing function, swallowing-quality of life (SWAL-QOL) scale, maximum amplitude of pharyngeal surface electromyography (sEMG), and complications of dysphagia were observed and recorded. RESULTS: After the treatment, self-comparison showed that the KWST and swallowing function scores were significantly decreased (P<0.05), the SWAL-QOL score and sEMG were notably increased in both groups (P<0.05) in comparison with their own pre-treatment. The KWST and swallowing function scores were obviously lower in the observation group than in the control group (P<0.05), whereas the SWAL-QOL score and sEMG were evidently higher in the observation group than in the control group (P<0.05). The total effective rate of the observation group was 95.16% (59/62), which was higher than 80.65% (50/62) of the control group (P<0.05). The incidence of dysphagia complications in the observation group was 24.19% (15/62), which was lower than 50.00% (31/62) of the control group (P<0.01). CONCLUSION: Xingnao Kaiqiao needling combined with respiratory training in the treatment of post-stroke dysphagia can increase the activity of throat muscles, promote the swallowing function, improve the quality of life, and reduce the incidence of dysphagia related complications.

Clinical effect of TESSYS technique under spinal endoscopy combined with drug therapy in patients with lumbar disc herniation and its effect on quality of life and serum inflammatory factors: results of a randomized trial.

BACKGROUND: This study was carried out based on the background that lumbar disc herniation seriously affects patients' quality of life but its clinical treatment effect remains unsatisfactory. METHODS: In total, 140 patients with lumbar disc herniation are randomly divided into a single operation group (SO) and a combined treatment group (CT). Among them, patients in the SO group received single treatment of TESSYS technique under spinal endoscopy, while patients in the CT group received combined drug therapy including coenzyme A, adenosine triphosphate, 10% glucose injection, 10% potassium chloride, vitamin B6, vitamin B12, dexamethasone, 20% mannitol and traditional Chinese medicine on the basis of the SO group. The clinical effect, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), recurrence rate, levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), and quality of life score were compared between the two groups. RESULTS: The treatment effectiveness rate of the CT group was markedly better than that in the SO group (P<0.01). At 3- and 6-month postoperatively, the JOA scores, VAS scores, World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF) and the levels of IL-1ß, IL-6, and TNF-α in the CT group were significantly better than those in the SO group (P<0.05). During the 6-12-month follow-up, the recurrence rate and WHOQOL-BREF scores in the SO group and CT group was no statistical difference (P>0.05). CONCLUSIONS: TESSYS technique under spinal endoscopy combined with drug therapy in the treatment of lumbar disc herniation has a significant clinical effect. Therefore, it is worthy of clinical popularization. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100049153.

[Physiotherapeutic and rehabilitative options for neuromuscular scolioses : Areas of physiotherapy techniques in the field of tension between hypertonic and hypotonic forms of neuromuscular scoliosis]. / Physiotherapeutische und rehabilitative Möglichkeiten bei neuromuskulären Skoliosen : Arbeitsfelder krankengymnastischer Techniken im Spannungsfeld hypertoner und hypotoner Formen neuromuskulärer Skoliosen.

Conservative treatment and physiotherapy (PT) of neuromuscular scoliosis and its underlying systemic causes is dominated by a pragmatic approach. In the choice of treatment, the observance of the underlying muscle tone sets the essential course to select an appropriate PT technique. Hypertonic forms need the reflex-modulation techniques included in Bobath or Vojta programmes. They sometimes necessitate tone-reducing medication and additional orthotics with a likely risk of pressure sores. In hypotonic forms of scoliosis on the other hand, gravity and spine collapse with pulmonal dysfunction are the key issues addressed by conservative treatment. Sustained quality of life and supported partaking in social life through maintenance of pulmonary function and upright sitting ability are of continuing concern. PT programmes with a neurophysiologic background such as those of Bobath and Vojta are of central significance.

[Usage evaluation of the biofeedback and electrical impulse stimulation of the pelvic floor muscles in patients after surgical correction of genital prolapse by the method of multi-parametric ultrasound]. / Otsenka primeneniya biologicheskoi obratnoi svyazi i elektroimpul'snoi stimulyatsii myshts tazovogo dna u patsientok posle khirurgicheskoi korrektsii genital'nogo prolapsa metodom mul'tiparametricheskogo ul'trazvukovogo issledovaniya.

Pelvic floor surgery is currently recognized as the only effective method for treating genital prolapse but it is not able to restore fully the qualitative characteristics of perineal tissues. The risk of recurrence of the pathological process in the long-term period remains a serious negative aspect. Optimization of pelvic floor rehabilitation after surgical correction of perineal ptosis remains an urgent problem in the female population. The validated method of questioning is a priority in assessing the dynamics of clinical manifestations of failure of the anatomical and functional structures of the pelvic floor, their impact on the life quality of patients before and after the biofeedback method (BFB therapy) and electrical impulse stimulation (EIS) of muscles. Multi-parametric ultrasound diagnostics of perineal tissues can confirm the improvement of the echo-structure of the anatomical and functional elements of the pelvic floor after the complex application of physiotherapeutic effects using modern high-tech hardware systems through an external feedback channel by means of acoustic, visual and tactile perception. OBJECTIVE: To evaluate the effectiveness of biofeedback therapy and EIS of the neuromuscular apparatus of the pelvic floor in patients operated on for stage III, IV of genital prolapse using mesh implants by means of validated questionnaire survey and measuring the parameters of perineal tissues by the method of multi-parametric ultrasound. MATERIAL AND METHODS: The study included 187 women after surgical correction of stage III and IV genital prolapse according to POP-Q using mesh technologies. The 149 women underwent the observation program; 36 patients of the control group were recommended to modify their lifestyle; 113 patients of the main group - biofeedback therapy and EIS. The indicators of validated questionnaires (determination of the of perineal structures failure influence index on the life quality, ILQ) and ultrasound multi-parametric examination were assessed at baseline, 6 months and 1 year after the program of observation and rehabilitation. RESULTS: The clinical effectiveness of biofeedback therapy and EIS was confirmed by validated questionnaire: after 1 year, the ILQ in the control group decreased by 7.7%, in the main group - by 43.3% (p<0.05). Multi-parametric ultrasound assessment of perineal tissues after surgical correction of stages III and IV of genital prolapse showed a positive effect of conservative rehabilitation on the anatomical and functional structures of the pelvic floor. The diagnostic advantage of endo-anal sonography in the analysis of the echo-structure of the pelvic floor elements, detection of pathologies that cannot be scanned endo-vaginally and trans-perineally has been established. There were 2 (5.5%) cases of recurrence of genital prolapse in the control group; there were no relapsesamong the patients of the main group. CONCLUSION: The validated questioning for the ILQ and ultrasound multi-parametric study by measuring the parameters of perineal tissues confirmed the effectiveness of biofeedback therapy and EIS after surgical correction of stage III and IV genital prolapse using mesh technologies. Endo-anal sonography is essential in the examination of gynecological patients. The adherence to the monitoring and rehabilitation program was 79.6%.