Breathing Method Research Articles

Validation of different automated segmentation models for target volume contouring in postoperative radiotherapy for breast cancer and regional nodal irradiation

IntroductionTarget volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-segmentation tools into clinical routine. MethodsThree different commercially available, artificial intelligence-, ESTRO-guideline-based segmentation models (M1-3) were applied to fifty consecutive reference patients who received postoperative local RT including regional nodal irradiation for breast cancer for the delineation of clinical target volumes: the residual breast, implant or chestwall, axilla levels 1 and 2, the infra- and supraclavicular regions, the interpectoral and internal mammary nodes. Objective evaluation metrics of the created structures were conducted with the Dice similarity index (DICE) and the Hausdorff distance, and a manual evaluation of usability. ResultsThe resulting geometries of the segmentation models were compared to the reference volumes for each patient and required no or only minor corrections in 72 % (M1), 64 % (M2) and 78 % (M3) of the cases. The median DICE and Hausdorff values for the resulting planning target volumes were 0.87–0.88 and 2.96–3.55, respectively. Clinical usability was significantly correlated with the DICE index, with calculated cut-off values used to define no or minor adjustments of 0.82–0.86. Right or left sided target and breathing method (deep inspiration breath hold vs. free breathing) did not impact the quality of the resulting structures. ConclusionArtificial intelligence-based auto-segmentation programs showed high-quality accuracy and provided standardization and efficient support for guideline-based target volume contouring as a precondition for fully automated workflows in radiotherapy treatment planning.

Oral Breathing Facilitates Endoscopic Operability Compared With Nasal Breathing in Peroral Endoscopy: A Randomized Controlled Trial.

Unsedated peroral endoscopy, including ultrathin endoscopy (UE) and conventional endoscopy (CE), is feasible in clinical practice but requires improved endoscopic operability and patient tolerance. Currently, the impact of the breathing method on these factors remains unclear. We conducted the first randomized controlled trial comparing oral breathing (OB) and nasal breathing (NB) during both UE and CE to assess their influence. About 252 eligible patients undergoing CE or UE were randomly assigned to OB or NB groups. Endoscopists and patients rated endoscopic operability and patient tolerance using a 100-mm visual analog scale. Visibility from the oral cavity to the middle pharynx was recorded. OB led to a higher rate of improved visibility from the oral cavity to the middle pharynx compared with NB, ranging from 79.3% to 81.0%. Multivariate correlation analyses showed significantly lower visual analog scale scores for endoscopic operability with OB compared with NB in both UE and CE groups ( P < 0.05). No significant differences were found in the overall evaluation of patient tolerance between OB and NB groups in UE and CE, whereas the smaller diameter of UE exhibited better patient tolerance compared with CE. Discriminant analysis comparing endoscope types and breathing methods revealed that UE with OB outperformed other combinations in the overall evaluation of endoscopic operability and patient tolerance ( P < 0.05). OB facilitates endoscopic operability compared with NB in peroral endoscopy. UE with OB is recommended as the preferred choice for unsedated peroral endoscopy in daily practice.

Effectiveness of Cyclic Meditation on the Level of Respiratory Rate and Efficiency Level Among Ministerial Employees

Higher meditation technique (CM) is not a harder meditation procedure, it’s only a cluster of breath awareness, awareness of internal sensations, yoga asana, and relaxation, coined by Dr.H.R. Nagendra with the reference to Mandukya Upanishad 3.44. Various studies of CM depict a positive role in physical well-being and mental illness. This study was described to balance respiratory rate levels and improve efficiency levels through Cyclic Meditation. A total number of 104 male and female ministerial employees were selected in this study whereas 52 male and female ministerial employees as an experimental group and 52 male and female employees as the control group in this study in the age range of 21 to 45. The Higher meditation technique was assessed on respiratory rate and efficiency levels. Both group pre-post design was adopted. The level of respiratory rate levels and efficiency level were measured for all ministerial employees at the onset of the research and after three months. (I) higher meditation practice (CM) was given and (ii) duration was 35 minutes for 3 months. Observation or counting the breath method was used for this study and the quality of life (QOLS) questionnaire was used for assessing the efficiency levels for this study. Data were analyzed using Spss software and to find out the impact of cyclic meditation, a t-test was applied for statistical analysis of the data. There were significant changes in the scores of all respiratory rates (p&lt;0.05) and a significant enhancement in efficiency levels (p&lt;0.01) after the intervention in the experimental group among ministerial employees. A bunch of awareness as well as various asana (postures), stimulation, and relaxation in meditation balance Respiratory levels and improve efficiency levels after intervention among Ministerial employees.

Influence of Different Breathing Strategies on Plantar Pressure Distribution in Ballet Movements

PURPOSE This study investigated the differences in plantar pressure distribution when using three breathing techniques during heel raises.METHODS The subjects were 29 professional dancers aged 20 to 30 years with more than 10 years of experience. Pressure distribution according to breathing method during heel raise was measured for 10 seconds while controlling the raise speed and gaze. The three breathing techniques were randomly ordered. Peak pressure, contact area and time, displacement, and absolute velocity of the center of pressure trajectory were measured using Emed&lt;sup&gt;®&lt;/sup&gt;-le from Novel GMBH. Plantar pressure was analyzed by dividing it into a total of 12 areas (masks): five toes, five metatarsals, the midfoot, and the hindfoot.RESULTS Using the teeth occlusion breathing technique, the peak pressure on the first metatarsal was significantly reduced, the contact time of the second metatarsal was significantly longer, and the displacement of the center of pressure trajectory was significantly shorter. Additionally, during the phase of the forefoot retainer, the velocity of the center of pressure trajectory was significantly reduced.CONCLUSIONS The teeth occlusion technique reduces peak pressure, increases contact time and area, and decreases the displacement and velocity of the center of pressure trajectory, demonstrating an efficient method for maintaining balance in ballet movements. This technique can potentially enhance stability and prevent injuries in ballet dancers.

Does the Addition of Oral Sampling Improve Waveform Capnography When Compared to Traditional Nasal Sampling in Open-Airway Patients?

BackgroundEnd-tidal carbon dioxide (EtCO2) is an invaluable anesthesia measure due to minimal delay in monitoring ventilation. Oral and Maxillofacial Surgery (OMS) presents special challenges because oral exhalations are not sampled effectively via nasal cannula normally used to avoid interfering with procedures. PurposeThe purpose of the study was to compare EtCO2 waveforms obtained in subjects using nasal monitoring and combined nasal and oral monitoring under simulated ventilatory conditions. Study design, setting, sampleA single-blinded, randomized crossover controlled study was conducted at the University of Illinois Chicago with healthy volunteers, who were blinded to the monitoring system used. Inclusion criteria required subjects be >18 years of age, be consentable and English-speaking. Exclusion criteria required no airway abnormalities, no edentulism, no conditions that preclude undergoing an OMS procedure under sedation. Predictor variableThe primary predictor variable was the EtCO2 monitoring system: nasal with a standard nasal cannula, and combined with a nasal cannula and oral device. The secondary predictor variable evaluated three ventilatory states (nasal breathing, oral breathing, apnea) in each arm, standardizing by maintaining consistent breath counts across observation periods. Main outcome variableThe main outcome variable was the number of waveforms recorded over 30 seconds for nasal and combined monitoring. Each recording was standardized by dividing it by the baseline waveforms and multiplying by 20. Higher values, closer to baseline, were considered more accurate depictions of ventilation. CovariatesCovariates were body mass index (BMI), age, sex, Mallampati score, and breathing method. AnalysesANOVA, ANCOVA, and MANOVA were performed. P-value<0.05 was considered statistically significant. ResultsThe sample included 25 subjects (18 male, 7 female) with mean age 29.9+7.98 years and BMI 23.9+3.51 kg/m2. Combined sampling detected more waveforms during nasal and oral breathing (p<0.001). Higher BMI correlated with reduced waveform capture during nasal sampling in oral breathing (p=0.013). Combined sampling detected more waveforms during nasal breathing (p=0.005) in subjects with BMI < 23.5 kg/m2. Mallampati score correlated with increased waveforms during nasal breathing. Conclusions and RelevanceOral EtCO2 sampling may improve accuracy of capnography waveform capture. Further clinical studies in sedated subjects undergoing OMS procedures are needed.

Qanā‘ah al-Ghazālī sebagai Landasan Stabilitas Mental: Pendekatan Holistik-Psikosufistik dengan Teknik Pernapasan 4-7-8

This article examines al-Ghazālī’s concept of qanā‘ah—contentment—as a pathway to mental health stability, offering insights into the wisdom and meaning behind applying Sufism and holistic therapeutic practices to address emotions such as anger, sadness, and anxiety. The 4-7-8 deep breathing technique is proposed as a complementary solution to these mental health challenges. The research adopts a psycho-sufistic approach to healing, focusing on the management of mental stability issues related to anger, anxiety, and sadness through the integration of Sufi qanā‘ah and the 4-7-8 breathing method, tailored for the modern era. A qualitative methodology with descriptive analysis is employed, drawing on library-based research. The data is sourced from various forms of documentation, including books, newspapers, transcripts, and other written materials, analyzed using text and discourse analysis techniques. The findings suggest that the application of psycho-sufistic qanā‘ah combined with the 4-7-8 breathing technique can effectively address mental stability issues, offering a means to alleviate anger, sadness, and anxiety in contemporary society. This holistic and Sufi-informed psychological approach aims to harmonize the heart and mind, fostering a more meaningful and fulfilling life for individuals in the modern age.

Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization

Abstract Background: Pediatric medical procedures mostly cause pain and fear among hospitalized children. Many nonpharmacological pain strategies can used to decrease children’s fear and pain in addition to decreasing the burden of medication. Objectives: This study aimed to determine the effectiveness of the deep breathing technique on children's pain intensity during urine catheterization procedures, at Children Welfare Teaching Hospital in Baghdad city. Materials and Methods: A quasi-experimental study was selected to determine the effects of pain strategies through achieving the manipulation and control group, conducted with a nonprobability (convenience) sample of 60 children of both genders at the age range of 6–12 years, divided into three groups of 20 children in each group. The study was carried out at Children Welfare Teaching Hospitals, from the period October 13, 2021, to July 28, 2022. The numeric Pain Rating Scale was used to assess pain level before and after nursing intervention with three pain management methods that included deep breathing technique, pharmacological, and combination methods. Results: The result of the study revealed that the application of deep breathing techniques, pharmacological, and combination methods were effective in reducing children’s pain at different levels. The deep breathing method has a significant influence on reducing children’s pain. The most effective method to reduce children’s pain was a combination method. Conclusion: This study concludes that the application of all pain management methods in this study was effective in reducing children’s pain at different levels during catheterization. The combination method (pharmacological and nonpharmacological) was most effective in reducing children’s pain. However, the deep breathing method approved its significant influence on children’s pain.

Effect of 12-week head-down strong abdominal breathing on cognitive function in patients with stable chronic obstructive pulmonary disease: a single-centre randomised controlled trial protocol

BackgroundPatients with chronic obstructive pulmonary disease (COPD) often suffer from a combination of mild cognitive impairment (MCI) and a significant reduction in their quality of life. In the exercise programme of pulmonary rehabilitation (PR), pulmonary rehabilitation intervention is often carried out by enhancing respiratory function. Strong abdominal breathing is a kind of breathing method, through which the diaphragm can be exercised, thereby enhancing the deflection distance of the diaphragm during breathing and improving respiratory function. The inversion trainer can meet the different angles of head-down training and also has the characteristics of low cost, easy to operate, and use a wide range of scenarios. According to currently available data, strong abdominal breathing in combination with head-down position has not yet been used in pulmonary rehabilitation in this type of rehabilitation programme. It is valuable to use this device to study PR of cognitive function in patients with COPD.MethodsThis study was a 12-week single-centre randomised controlled trial and blinding the assessors and data processors of the test. Recruitment is planned for January 1, 2024. It is expected that 81 patients with stable COPD combined with MCI will be recruited and randomly assigned to the head-down strong abdominal breathing group (HG), the fitness qigong eight-duanjin group (BDJ), and the control group (CG) in a 1:1:1 ratio. Using fNIRS (functional near-infrared spectroscopy) to assess brain oxygen availability before and after pulmonary rehabilitation in three periods: before, during and after the intervention. Cognitive functioning is also assessed using the Overall Cognitive Assessment Scale, the Specific Cognitive Functioning Assessment Scale and the Cognitive Behavioural Ability Test.Trial registrationThe Specialised Committee on Scientific Research and Academic Ethics of the Academic Committee of Anqing Normal University approved the project (ANU2023001). China Clinical Trial Registry approved the study (ChiCTR2300075400) with a registration date of 2023/09/04.DiscussionThe aim of this study was to explore novel exercise rehabilitation methods to improve cognitive function in COPD patients. It results in a lower financial burden and higher participation in pulmonary rehabilitation and improves the quality of survival of patients with COPD.

The Effect of Diaphragmatic Breathing Exercises on Peak Expiratory Flow Rate in Bronchial Asthma Patients

Background: Asthma is a prevalent, chronic, and varied condition in which most people experience dyspnea, wheezing, chest tightness, and coughing due to reversible airway obstruction, airway inflammation, and bronchial hyperreactivity. cause the quality of life to diminish. The breathing method known as diaphragmatic breathing is tailored to the needs of asthmatics. During a deep inhale, a breathing method called diaphragmatic breathing relaxes the respiratory muscles. Objective: To determine the effect of diaphragmatic breathing exercises on peak expiratory flow rate (PEFR) patients with bronchial asthma. Method: This type of research is quasi-experimental with a one-group pre-test and post-test design. The sampling method used purposive sampling with 15 respondents. The PEFR measurement instrument uses a peak flow meter. Data were analyzed univariately and bivariately using the paired T-Test. Results: The average PEFR value before and after diaphragmatic breathing exercise therapy was 246.67 L/minute and 300 L/minute. There was a significant difference in PEFR before and after being given diaphragmatic breathing exercise therapy with an increase in PEFR value of 53.33 L/minute (p-value 0.00). Conclusion: Diaphragmatic breathing exercises have a significant influence on PEFR values in bronchial asthma patients

Application effects of armor chest straps in patients with sternal dehiscence after repair surgery

Objective: To investigate the application effects of armor chest straps in patients with sternal dehiscence after repair surgery. Methods: This study was a retrospective cohort study. The 11 patients who were admitted to the First Affiliated Hospital of Air Force Medical University (hereinafter referred to as the hospital) from March 2020 to March 2021 and used conventional chest straps after sternal dehiscence repair surgery were included in conventional chest strap group. The 12 patients who were admitted to the hospital from April 2021 to March 2022 and used armor chest straps after sternal dehiscence repair surgery were included in armor chest strap group. A special team for sternal dehiscence repair was set up, and the nurses in charge in the team instructed the patients in 2 groups on the correct abdominal breathing method, and the members of the surgical team performed the personalized surgery and wore the corresponding chest straps for the patients in 2 groups. The abdominal breathing frequency and chest breathing frequency on the first day after surgery were recorded. The pain intensity at 6, 24, 48, and 72 h after surgery was self-rated by the patients using numerical rating scale. The time of the first active cough and the time of wound healing after surgery were recorded. At postoperative suture removal, the cutting length of sutures induced by respiratory exercise was recorded. Whether there were complications such as redness, swelling, and exudation in flaps within 2 weeks after surgery were recorded, whether there were complications such as wound dehiscence or infection during follow-up of 3-12 months were recorded, and the incidence proportion of postoperative complications was calculated. At 6 months after surgery, the patients' scar status was evaluated by the Vancouver scar scale. Results: The abdominal breathing frequency of patients in armor chest strap group was (16.3±1.2) times/min on the first day after surgery, which was significantly higher than (5.3±1.4) times/min in conventional chest strap group (t=20.00, P<0.05), and the chest breath-ing frequency was (1.2±0.8) times/min, which was significantly lower than (12.4±1.5) times/min in conventional chest strap group (t=22.36, P<0.05). The pain intensity scores of patients in armor chest strap group at 6, 24, 48, and 72 h after surgery were significantly lower than those in conventional chest strap group (with t values of 15.07, 14.70, 13.66, and 11.03, respectively, P<0.05). The time of the first active cough and the time of wound healing after surgery of patients in armor chest strap group were significantly sooner than those in conventional chest strap group (with t values of 5.51 and 8.90, respectively, P<0.05). At postoperative suture removal, the cutting length of sutures induced by respiratory exercise of patients in conventional chest strap group was 2.0 (0, 5.0) mm, which was significantly longer than 2.0 (1.0, 2.0) mm in armor chest strap group (Z=4.10, P<0.05). There was no statistically significant difference in the incidence proportion of postoperative complications of patients between the 2 groups (P>0.05). At 6 months after surgery, the scar score of patients in armor chest strap group was 4.1±1.4, which was significantly lower than 5.6±1.4 in conventional chest strap group (t=2.71, P<0.05). Conclusions: The application of armor chest strap in patients with sternal dehiscence after repair surgery can increase the abdominal breathing frequency, reduce the wound cutting force, effectively relieve postoperative pain, increase the first active cough and wound healing speed, and alleviate postoperative scar proliferation, achieving good application effect.

Physical Therapist's Perception of Correct Breathing Method and the Effectiveness of Breathing Training

Physical Therapist's Perception of Correct Breathing Method and the Effectiveness of Breathing Training

Minimally Invasive Approaches to Diagnose and Monitor Eosinophilic GI Diseases.

This review seeks to understand novel avenues for eosinophilic GI disease management. Biomarkers offer a unique and non-invasive approach to tracking EoE disease progression. While no biomarkers have definitively met the diagnostic criteria for eosinophilic GI diseases, some biomarkers have been shown to be associated with disease activity. Here, we examine the potential of recently studied biomarkers. Current research shows advancements in blood, luminal fluid, and breath testing. Particular areas of interest include mRNA analyses, protein fingerprinting, amplicon sequence variants (ASVs), T cells and IgE receptors, eosinophilic cationic proteins, cytokines, and nitric oxide exhalation. Preliminary results showed that mucosal biomarkers, directly captured from the esophagus, may reflect the best representation of biopsy-based results, in contrast to biomarkers obtained from indirect or peripheral (blood, breath) methods. However, this is based on limited clinical studies without sufficient numbers to evaluate true diagnostic accuracy. Large-scale randomized trials are needed to fully ascertain both the optimal sampling technique and the specific biomarkers that reflect diagnostic status of the disease.

Does the Wim Hof Method have a beneficial impact on physiological and psychological outcomes in healthy and non-healthy participants? A systematic review.

Wim Hof, also known as the iceman, developed a method called Wim Hof Method (WHM) which he claims to have several benefits on physical and mental health. The aim of this systematic review is to identify and synthesise the results of the studies conducted on WHM on physiological and psychological health-related outcomes. This systematic review followed the PRISMA guidelines for systematic reviews. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42022333209. Medline and Web of Science were searched and included studies from January 1, 2014, to July 4, 2022. Studies were included if they met the predetermined inclusion/exclusion criteria. Inclusion criteria included RCTs and cohort studies published in peer-reviewed journals, studies conducted on healthy individuals and people with pre-existing medical conditions (adolescents and adults over the age of 14), studies that included all three pillars (breathing, cold exposure, and commitment) of the WHM, and studies that only focused on Wim Hof breathing method (WHBM). Exclusion criteria included studies that discussed WHM but are not original experimental research or are not peer-reviewed, studies that included children under the age of 14, and studies that used methods similar to WHM, but not actually WHM, such as tummo meditation. The articles were assessed for risk of bias using RoB 2.0 and Scottish Intercollegiate Guidelines Network (SIGN) tools. The effects of WHM were categorised into physiological or psychological related outcomes and narrative synthesis was conducted. Nine papers were included in this review which consisted of eight individual trials. The findings suggest that the WHM may reduce inflammation in healthy and non-healthy participants as it increases epinephrine levels, causing an increase in interleukin-10 and a decrease in pro-inflammatory cytokines. Additionally, effect of WHBM on exercise performance showed mixed findings. Effects on respiratory parameters of minute ventilation, tidal volume, and breathing frequency were mixed following bouts of exercise. Taken together, the findings of this review show promising use of WHM in the inflammatory response category. The focus of future studies should further investigate the benefits of WHM in non-healthy participants with inflammatory disorders and explore the use of Wim Hof breathing method to enhance exercise performance.

Breath Measurement Method for Synchronized Reproduction of Biological Tones in an Augmented Reality Auscultation Training System.

An educational augmented reality auscultation system (EARS) is proposed to enhance the reality of auscultation training using a simulated patient. The conventional EARS cannot accurately reproduce breath sounds according to the breathing of a simulated patient because the system instructs the breathing rhythm. In this study, we propose breath measurement methods that can be integrated into the chest piece of a stethoscope. We investigate methods using the thoracic variations and frequency characteristics of breath sounds. An accelerometer, a magnetic sensor, a gyro sensor, a pressure sensor, and a microphone were selected as the sensors. For measurement with the magnetic sensor, we proposed a method by detecting the breathing waveform in terms of changes in the magnetic field accompanying the surface deformation of the stethoscope based on thoracic variations using a magnet. During breath sound measurement, the frequency spectra of the breath sounds acquired by the built-in microphone were calculated. The breathing waveforms were obtained from the difference in characteristics between the breath sounds during exhalation and inhalation. The result showed the average value of the correlation coefficient with the reference value reached 0.45, indicating the effectiveness of this method as a breath measurement method. And the evaluations suggest more accurate breathing waveforms can be obtained by selecting the measurement method according to breathing method and measurement point.

Analysis of The Role of Emphasizing the Diaphragm on Breath Control in The Teaching of Beginning Children's Voices

In the teaching of children's vocal music to beginners, the control of breath by the diaphragm is a common topic. Some teachers believe that the use of the diaphragm can help students increase their volume, stabilize their pitch, extend their breathing, and increase their expressiveness. However, some teachers believe that overemphasis on the role of the diaphragm will cause students to neglect other vocal skills, and even cause tension and damage to the body and vocal cords. There are advantages and disadvantages in emphasizing the control of breath by the diaphragm in teaching beginners of children's vocal music. Teachers should flexibly use different teaching methods and techniques according to the specific circumstances and needs of each student. They should not only cultivate students' ability to perceive and control diaphragm movement, but also pay attention to avoiding some possible negative effects. Only in this way can students truly enjoy the fun of vocal music and develop their potential and personality. The diaphragm is the most commonly used vocal organ in vocal music teaching and plays an important role in its practice and singing. This article analyzes the necessity and feasibility of emphasizing the diaphragm in the teaching of vocal beginners from the basic theory of diaphragmatic breathing method and the issue of emphasizing the diaphragm in the teaching of vocal beginners. After analyzing the situation of the effect of diaphragm. This paper puts forward some inspirations for teaching suitable for vocal beginners, and hopes to be helpful to vocal teachers in teaching vocal beginners.

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

Use of a Nasal Cannula as a Preoxygenation Adjunct: A Randomized Crossover Study.

Preoxygenation prior to induction of general anesthesia is intended to increase the oxygen reserve in the lungs. This technique delays the onset of hypoxemia during the placement of the tracheal tube. To observe the benefits of oxygen through nasal cannula when used as an adjunct during preoxygenation. We enrolled 30 healthy volunteers and conducted a sequence of six preoxygenation tests. These included 3-minute tidal volume breathing and 8 vital capacity breaths, with and without oxygen flowing through the nasal cannula as an adjunct. Subjects were kept at a supine position with a face mask on their faces. Their baseline vitals were measured and end-tidal O2 (ETO2) was recorded at the end of each test. The comfort of each technique was also assessed. When comparing the efficacy of the two preoxygenation methods, we found that the addition of oxygen through the nasal cannula improved the efficacy of preoxygenation with both the 3-minute tidal volume breathing method and the 8 vital capacity method (p < 0.001). The three-minute tidal volume breathing technique had higher end-tidal oxygen when compared to the eight vital capacity breaths. The administration of oxygen through a nasal cannula during preoxygenation improves the efficacy of preoxygenation in healthy volunteers. Tidal volume breathing for three minutes achieves a higher end-tidal oxygen concentration compared to eight vital capacity breaths over one minute.

KRŪTIES VĖŽIO RADIOTERAPIJA TAIKANT INOVATYVŲ GILAUS KVĖPAVIMO KONTROLĖS METODĄ: KLINIKINIAI VAKARŲ LIETUVOJE SUKAUPTOS PATIRTIES ASPEKTAI

Radiation therapy is an important part of breast cancer treatment, reducing local recurrence and improving overall survival. About 1,500 cases of breast cancer are diagnosed in Lithuania every year. About 30% of all newly diagnosed cancers in women are breast cancer, and about 80% of early-stage breast cancers are treated with radiotherapy. New modern radiation techniques have been evaluated with a better understanding of the effects of radiation on the heart. The article reviews the implementation of the deep inhalation breath hold technique in the clinical practice of Klaipėda University Hospital. The purpose of this article is to analyse the results of the first two years after the implementation of the new methods. Assessing the importance of radiotherapy, the author reveals the importance of the innovative deep breathing method in the article, and shares the experience she has gathered. At the same time, scientific and practical assumptions are made that, after the introduction of innovative radiotherapy technologies into practice, new opportunities for optimising the treatment of patients by individualising it open up. The results of the study reveal the need for a prospective cohort study in order to optimise patient education, clarify selection criteria, and increase the availability of modern radiotherapy services. The presentation of this method in an interdisciplinary environment of social and health care specialists allows specialists to familiarise themselves with the achievements of oncological radiotherapy in west Lithuania.

Slow Breathing Reduces Biomarkers of Stress in Response to a Virtual Reality Active Shooter Training Drill.

Tactical occupations regularly encounter life-threatening situations while on duty. Although these occupations are often trained to utilize slow breathing (SB) during intense stress, there is no evidence supporting the effects on markers of stress in response to a virtual reality active shooter training drill (VR-ASD). The purpose of the study was to determine the impact of acute SB on biomarkers of stress in response to a VR-ASD. Seventy-nine (n = 79) subjects performed either slow breathing method 1 (SB1), slow breathing method 2 (SB2), or normal breathing (control) for five minutes, both pre- and post-VR-ASD. Saliva samples were analyzed for stress markers, including α-amylase (sAA) and secretory immunoglobulin-A (SIgA). Both methods of SB resulted in significantly lower sAA concentrations at 5 (p < 0.001) and 30 min post-VR-ASD (SB1: p = 0.008; SB2: p < 0.001) compared to the control. In the control condition, the sAA concentrations were significantly elevated 5 min post-VR-ASD (p < 0.001) but did not change across time in SB1 or SB2 (p > 0.05). Thus, both SB1 and SB2 reduced the sAA response and resulted in lower concentrations post-VR-ASD. This study was pre-registered as a clinical trial ("Impact of Breathing Interventions on Stress Markers"; NCT05825846).

Effect of physiotherapy and its frequency on the outcome of COVID-19 patients regarding acute care setting at isolation unit of Ain Shams University

Abstract Background Severe acute respiratory syndrome coronavirus 2 is a new strain of coronavirus that started in 2019 and causes a pandemic disease called coronavirus disease 2019 (COVID-19). The present report result was 80% of cases are asymptomatic or mild; 15% of cases are severe; and 5% are critical needing ICU and mechanical ventilation. Physiotherapy (PT) provides airway clearance techniques and improves physical fitness. Aim The aim of this study is to assess the effect of PT and the frequency of PT session on the outcome of patients with COVID-19 infection at an isolation unit of Ain Shams University. Patients and methods This is randomized controlled clinical trial that was applied on 264 confirmed adult patients with COVID-19, who were admitted to isolation units at Ain Shams University Hospitals over 6 months since March 2021 with 134 females and 130 males in the age range from 31 to 82 years. The breathing method was room air, oxygen mask and nasal cannula, HFNC, and ventilated patients (both invasive and noninvasive). The patients were divided randomly into two groups: one group received two sessions of PT per day and the other group received one session of PT per day. Results The patients were divided clinically into mild, moderate, severe, and severe-critical patients. In mild cases, the range of incentive spirometer (ml) after one daily PT became 2300–2800 ml, and for twice daily PT it became 2300–3300 ml with highly statistical difference (P=0.005) before and after one or two PT sessions. Regarding 6-min walking test (m) the range became 420–740 m for one PT session per day and 420–880 m for two PT sessions per day with significant statistical difference (P=0.010). In moderate cases, the SPO2 (%) became 88–98% after one daily PT session and 90–98% after twice daily PT sessions with significant statistical differences between the one and two PT (P=0.032) sessions. Regarding the incentive spirometer (ml) at the moderate group, after one daily PT session it became 1200–2500 ml and for twice daily PT it became 1500–2500 ml with significant statistical differences between one and two PT sessions (P=0.032). Conclusion Patients with mild and moderate COVID-19 infection had significant improvement in SPO2 (oxygen saturation), dyspnea scale, and incentive spirometer after receiving two daily sessions of PT compared with patients who received one daily PT session. There was no difference in both groups for severe and severe-critical cases.