General Well-being Of Patients Research Articles

Comparison of Perceptions of Skin Condition, Product Use and Allergen Reactivity Between People with Psoriasis and Controls in the European Dermato-Epidemiology Network (EDEN) Fragrance Study.

Psoriasis, a chronic inflammatory skin disease, goes beyond visible symptoms and affects the general well-being of patients. The aim of this study is to understand how patients with psoriasis perceive their skin characteristics and reactivity to allergens. The study population includes 11,283 participants within the European Dermato-Epidemiology Network (EDEN) Fragrance study, covering several European regions. The study compared perceptions of skin dryness, sensitivity, product avoidance and reactivity to allergens between patients with psoriasis and controls, evaluating the potential influence of psoriasis severity. The results showed that subjects with psoriasis reported dry skin (71.1%) and sensitive skin (49.4%) more often than did controls (51.6% and 38.5%, respectively). Psoriasis patients were more likely to avoid specific products. Interestingly, there were no significant differences in patch-test results between the 2 groups and the severity of psoriasis did not have a consistent impact on these perceptions. In conclusion, people with psoriasis tend to perceive their skin as drier and more sensitive. Notably, the severity of psoriasis did not consistently influence these perceptions and objective reactivity to allergens did not align with subjective perception. Understanding these aspects is crucial for tailoring treatments to improve the well-being of patients with psoriasis, which warrants further research to explore subjective perceptions of skin well-being in patients with psoriasis.

ALGORITHM OF SECONDARY PREVENTION OF KIDNEY DISEASES AND URINARY TRACT IN OUTPATIENT CLINICS

Aim effectiveness evaluation of the medical staff actions algorithm an outpatient polyclinic institution during the secondary prevention of kidney and urinary tract diseases.
 Material and methods. This article presents an assessment of the effectiveness of the algorithm developed on the basis of a previously conducted medical and social study, which consists in conducting secondary prevention of exacerbations of the urinary system by prescribing drinking mineral water, diet, physical activity and a protective regimen under the remote control of medical workers with the determination of indicators of the quality of life of patients (on the Wisconsin Questionnaire). The developed algorithm represents the sequence of actions of medical personnel during remote monitoring of patients with pyelonephritis, urolithiasis, urethritis and cystitis. To assess the effectiveness of the proposed algorithm, a survey was conducted among outpatient clinic doctors with more than 10 years of experience using a specially developed questionnaire (score from 1 to 10). To assess the consistency of doctors' opinions, the concordance coefficient was calculated; a high degree of agreement between doctors' opinions in assessing the main indicators was considered at the value of the Kendal W coefficient 0.7. To assess the significance of the obtained concordance coefficient, the 2 criterion was calculated at a significance level of 0.05.
 Results. An analysis of the answers of doctors showed that this algorithm can be used as an alternative to sanatorium treatment for the prevention of exacerbations of diseases of the urinary system.
 Conclusions. The study of the possibility of using medical and organizational measures for the secondary prevention of exacerbations of diseases of the kidneys and urinary tract, presented in the algorithm, makes it possible to achieve an improvement in general well-being in patients under dispensary observation. Algorithm received a positive assessment from doctors of outpatient clinics.

Anesthesia Patient Monitoring 2050.

The monitoring of vital signs in patients undergoing anesthesia began with the very first case of anesthesia and has evolved alongside the development of anesthesiology ever since. Patient monitoring started out as a manually performed, intermittent, and qualitative assessment of the patient's general well-being in the operating room. In its evolution, patient monitoring development has responded to the clinical need, for example, when critical incident studies in the 1980s found that many anesthesia adverse events could be prevented by improved monitoring, especially respiratory monitoring. It also facilitated and perhaps even enabled increasingly complex surgeries in increasingly higher-risk patients. For example, it would be very challenging to perform and provide anesthesia care during some of the very complex cardiovascular surgeries that are almost routine today without being able to simultaneously and reliably monitor multiple pressures in a variety of places in the circulatory system. Of course, anesthesia patient monitoring itself is enabled by technological developments in the world outside of the operating room. Throughout its history, anesthesia patient monitoring has taken advantage of advancements in material science (when nonthrombogenic polymers allowed the design of intravascular catheters, for example), in electronics and transducers, in computers, in displays, in information technology, and so forth. Slower product life cycles in medical devices mean that by carefully observing technologies such as consumer electronics, including user interfaces, it is possible to peek ahead and estimate with confidence the foundational technologies that will be used by patient monitors in the near future. Just as the discipline of anesthesiology has, the patient monitoring that accompanies it has come a long way from its beginnings in the mid-19th century. Extrapolating from careful observations of the prevailing trends that have shaped anesthesia patient monitoring historically, patient monitoring in the future will use noncontact technologies, will predict the trajectory of a patient's vital signs, will add regional vital signs to the current systemic ones, and will facilitate directed and supervised anesthesia care over the broader scope that anesthesia will be responsible for.

Challenges and Opportunities in Developing Tailored Pain Management Strategies for Liver Patients.

Chronic liver illnesses pose a substantial worldwide health challenge, with various causes that span from viral infections to metabolic problems. Individuals suffering from liver problems frequently face distinct difficulties in pain control, requiring a customized strategy that takes into account both the fundamental disease and the complexities of liver function. The liver, a vital organ responsible for metabolic control and detoxification, is pivotal in multiple physiological processes. Chronic liver illnesses, such as cirrhosis and non-alcoholic fatty liver disease (NAFLD), are marked by a gradual process of inflammation and fibrosis, resulting in reduced liver function. These disorders often come with pain, varying from internal discomfort to intense abdominal pain, which impacts the quality of life and general well-being of patients. The review explores the complex aspects of pain perception in liver illnesses, including inflammation, modified neuronal signaling, and the influence of comorbidities. It highlights the significance of a detailed comprehension of the pain experience in individuals with hepatic conditions for the implementation of successful pain management treatments. In addition, the review emphasizes the difficulties involved in treating pain in this group of patients, such as the possible complications linked to commonly prescribed pain relievers and the necessity for collaboration between hepatologists, pain specialists, and other healthcare professionals. Moreover, it examines new possibilities in the domain, such as the significance of innovative pharmacological substances, non-pharmacological treatments, and personalized medicine strategies designed for specific patient characteristics. This study thoroughly analyzes the difficulties and possibilities involved in creating personalized pain management approaches for individuals with liver conditions. Its purpose is to guide physicians, researchers, and healthcare providers, enabling them to implement more efficient and patient-focused interventions. As our comprehension of liver-related pain progresses, the potential for enhancing the quality of life for persons with chronic liver disorders through tailored pain management measures becomes more and more encouraging.

HEART RATE VARIABILITY AS A MARKER OF MAXIMUM PHYSICAL LOAD IN PEOPLE WITH OBESITY

Introduction. Heart rate variability (HRV) and the autonomic nervous system are essential indicators of assessing the body's functional state. Physical activity and obesity, which are current problems of modern society, affect these indicators, but research on the relationship between them is limited.
 Purpose: to determine the maximum level of physical activity in obese people in the preoperative period.
 Materials and methods. A group of obese individuals who were scheduled for weight loss surgery were involved. The participants performed special tests and physical exercises that allowed them to determine their maximum level of physical exertion. Using a step test, which included walk-up stairs to complete exhaustion, indicators of heart rate variability, heart rate, and recovery time after exercise were recorded.
 Results. Based on the analysis of the obtained data, it was established that overweight patients can tolerate a high level of physical exertion without significant changes in heart rate variability and blood pressure. At the same time, in obese patients, there is a decrease in exercise tolerance and heart rate variability, which requires introducing a safe level of physical activity into preoperative preparation with monitoring of the patient's general well-being.
 Conclusion. Obese people are characterized by a low level of physical activity, which complicates preoperative preparation and prolongs its duration

Cardiotone: pharmacological properties of hawthorn blood-red, possibility of use in patients with cardiovascular diseases

Objective. To analyze the literature, which reflect the results of the study of the pharmacological properties of hawthorn blood-red and the possibility of using the above-ground part of the plant in the Russian drug Cardioton in patients with cardiovascular disease. Material and methods. An analysis was made of more than thirty scientific publications of Russian and foreign researchers, reflecting the use of blood-red hawthorn, as well as rose hips and royal jelly, which are components of the drug Cardioton, in patients with cardiovascular diseases. Results. The hawthorn-blood-red preparations have cardiotonic, coronary dilation, hypotensive, antiarrhythmic, antispasmodic and antioxidant effects. The drug Cardioton combines in its composition whole above-ground parts of hawthorn-blood-red - fruits, flowers and leaves. Conclusions. Use hawthorn-blood-red is associated with improvement in the general well-being of patients. The drug Cardiotone, produced by the Russian company "Parafarm" has antioxidant, cardioprotective, hypotensive, hypocholesterolemic, anti-inflammatory, metabolic effect and can be recommended for the complex prevention and treatment of cardiovascular diseases.

Implication of Lupeol in compensating Sorafenib-induced perturbations of redox homeostasis: A preclinical study in mouse model

AimsCancer chemotherapeutic drugs can potentially cause several adverse effects that influence a patient's general well-being. Sorafenib, an approved drug used in clinics against multiple cancers whose overall efficacy suffered a serious setback due to various side effects, leading to its frequent discontinuation. Lupeol has recently been considered an important prospective therapeutic agent due to its low toxicity and enhanced biological efficacy. Hence, our study aimed to evaluate whether Lupeol can perturb the Sorafenib-induced toxicity. Main methodsTo test our hypothesis, we studied DNA interaction, level of cytokines, LFT/RFT, oxidant/antioxidant status, and their influences on genetic, cellular, and histopathological changes using both in vitro and in vivo models. Key findingsThe Sorafenib-treated group showed a marked increase in reactive oxygen and nitrogen species (ROS/RNS), an increase in liver and renal function marker enzymes, serum cytokines (IL-6, TNF-α, IL-1β) macromolecular damages (protein, lipid, and DNA), and a decrease in antioxidant enzymes (SOD, CAT, TrxR, GPx, GST). Moreover, Sorafenib-induced oxidative stress caused marked cytoarchitectural damage in the liver and kidney and increased p53 and BAX expression. Interestingly, combining Lupeol with Sorafenib improves all the examined toxic insults caused by Sorafenib. In conclusion, our findings suggest that Lupeol can be used in combination with Sorafenib to reduce ROS/RNS-induced macromolecule damage, which might result in hepato-renal toxicity. SignificanceThis study presents the possible protective effect of Lupeol against Sorafenib-induced adverse effects by perturbing redox homeostasis imbalance and apoptosis leading to tissue damage. This study is a fascinating finding that warrants further in-depth preclinical and clinical studies.

Quality of Life and General Well-being in People Receiving Hemodialysis Treatment: A Cross-sectional Study

Background: End-stage renal disease and hemodialysis treatment are debilitating and progressive and can significantly impact patients’ general well-being and quality of life. Understanding the impact of end-stage renal disease and hemodialysis on Jordanian patients may help healthcare providers improve the type of care delivered. Purpose: This study aimed to examine the quality of life and general well-being of patients undergoing hemodialysis treatment and to examine the differences in quality of life and general well-being scores based on participant age and gender. Methods: This was a cross-sectional study in which 203 patients were recruited from different dialysis units across Jordan. Valid questionnaires were used to collect data on quality of life and general well-being, along with a demographic data sheet. Results: Participants scored moderately low on general well-being, with the highest mean for the social dysfunction and the depression sub-scales, respectively. The highest reported score was on the social relationships domain of quality of life, while the lowest was for the physical domain. Age groups significantly differed in their scores of general well-being and all domains of quality of life apart from the environmental domain. Female participants had significantly higher (worse) scores than males in terms of the total scores on general well-being and on somatic symptoms and depression sub-scales of general well-being. Conclusion: It was shown that hemodialysis treatment negatively influences patients’ quality of life and general well-being and interferes with their day-to-day lives. Implications for Nursing: Dialysis nurses play a vital role in monitoring and supporting their patients and might provide an avenue by which they can optimize patients’ quality of life and general well-being. Hence, working with patients to find the best possible care plan may positively impact patients’ lives and health outcomes. Keywords: Cross-sectional study, Hemodialysis, Quality of life, General well-being.

ПРИМЕНЕНИЕ ОРГАНИЧЕСКИХ СОЕДИНЕНИЙ В ТЕРАПЕВТИЧЕСКОЙ ПРАКТИКЕ ПРИ НАРУШЕНИЯХ ФУНКЦИИ ПЕЧЕНИ

Introduction. The nonspecificity of the clinical manifestations of the initial stage of non-alcoholic fatty liver disease (NAFLD) - the stage of steatosis, is the reason for the untimely correction and progression of this disease. Aim. The aim of the study was to conduct a randomized open comparative study to determine the effectiveness of the use of the food supplement FanDetox as a source of organic compounds in liver function disorders. Material and methods. This study was a single-center randomized open one and included the study of the possibility of using the herbal product FanDetox in the complex therapy of NAFLD in patients aged 18 to 75 years with a verified diagnosis of obesity and the presence of signs of steatohepatosis, against the background of basic therapy with Carsil Forte. The study was conducted with the involvement of 68 people matched by sex and age, 34 of whom made up the main observation group, whose participants took the study product 1 sachet 2 times a day after meals, in the form of a suspension obtained after mixing the powder in 100 ml of water. The rest 34 patients made up the comparison group. Carsil Forte was chosen as a background drug for both groups. The duration of therapy for each study participant was 3 months. The follow-up process included patient visits with a detailed medical history, therapeutic examination, and laboratory and instrumental examinations. Statistical analysis was carried out using the IBM SPSS Statistics 23 program. Results and discussion. As a result, an improvement in the subjective well-being of patients, a decrease in the echoscopic manifestations of fatty hepatosis, a decrease in the longitudinal size of the liver, a decrease in the manifestations of the cytolysis syndrome and bilirubin levels, as well as a significant positive dynamics of the lipid spectrum in the blood of patients who received complex therapy, including the use of the FanDetox biologically active additive, compared with the comparison group undergoing therapy with the background drug Carsil Forte, were shown. Conclusion. It has been established that taking the food supplement FanDetox helps to reduce the manifestations of fatty hepatosis, reduce the longitudinal size of the liver, blood biochemistry indicators and the general well-being of patients.

IDF21-0234 The Virtual COVID In-patient (VCIP) Care and Post Covid Symptoms: a Comparison with Conventional Care

Background: VCIP is a home based interventional economic model wherein a consenting patient will remain in their home and consult the VCIP team via audio-video consultations to treat COVID-19 in a manner similar to inpatient care. While the widely prevalent home-based care that is currently available is often limited to monitoring of vital signs, the VCIP program described here involves active therapeutic intervention. Aim: We assessed the impact of VCIP in the management of COVID and post COVID symptoms. Method: Since September 2020, our center has been practicing VCIP for our patients with diabetes, already enrolled in our hospital, to treat COVID and Post COVID symptoms. This is a retrospective analysis of the data of 243 COVID-19 positive patients who enrolled in VCIP. A 24/7 dedicated WhatsApp group of patients, their relatives, doctors, nurses, dietitian and a psychologist was created for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms and then to follow up them for 4-6 months post-COVID. The vital parameters and general wellbeing of patients are monitored once every 4 hrs. Contrary to conventional domiciliary care, in VCIP, lab investigations, corticosteroids and other interventions were carried out as and when necessary, at home for the successful management of COVID-19. For patients with diabetes on insulin, the dosages were titrated based on SMBG values or real time CGM. We also assessed the post-COVID symptoms in these patients. Results: Out of 243 patients who availed of the VCIP facility, all 243 of them recovered. However, 2 hospitalizations were there, one, due to the impending fear of death and the other one, due to intolerance to oral corticosteroids, yielding a 99.5% success rate in preventing hospitalization. There was a wide range of post-COVID-19 symptoms and illnesses experienced by <10% of the patients, which was very low compared to patients in conventional care, including headache(5%), generalized itching(7%), fatigue(20%), vertigo(<1%), urticaria(<1%), exacerbation of sinusitis(<1%), insomnia(15%), and bacterial infection(30%). The patients recovered from these symptoms within 2-3 months. Some patients who experienced more severe complications such as atrial fibrillation and ventricular ectopics (<1%) picked up in Apple watch ECG was referred to a cardiologist for evaluation. The arrhythmias disappeared spontaneously with clinical improvement in the majority of the patients. Discussion: VCIP when compared to hospitalizations have proven to be cost effective, with significantly better immediate outcomes. With regular and structured teleconsultations and lab assessments, patients likely to deteriorate are identified quite early and treatment initiated without wasting any time. The comorbidities were also aggressively managed. The significantly less occurrence of post Covid symptoms in the VCIP group compared to hospitalized patients could have resulted from these early interventions.

A Complex Combination Therapy for a Complex Disease–Neuroimaging Evidence for the Effect of Music Therapy in Schizophrenia

Schizophrenia is a disease characterized by clinical polymorphism: a combination of diverse syndromes defined by differences in structure, course and outcome. The etiology and pathogenesis of this mental disorder is still not completely understood, in spite of the achievements in the fields of neuroscience, genetics, neuroimaging and others. Different treatment strategies have been developed for patients with schizophrenia, but the search for new pharmacological agents continues with the mission of achieving a more effective control over the disease manifestations (positive and negative symptoms), improvement of the patients' social functioning and quality of life. The accumulated clinical experience has revealed that drug treatment and the inclusion in various rehabilitation programs and social skills training shows promising results in these patients. In recent years a plethora of evidence has been compiled regarding the role of music therapy as a possible alternative in the combination treatment of patients with mental disorders, schizophrenia included. Thus, the purpose of this review is to present the reader with a more detailed and science-based account of the beneficial effect of music therapy on the general wellbeing of patients diagnosed with schizophrenia. To fulfill our goal, we will focus mainly on the evidence provided by modern neuroimaging research.

Оптимізація лікування стабільної ішемічної хвороби серця у разі супутнього цукрового діабету 2 типу з використанням кверцетину та емпагліфлозину

The risk of developing cardiovascular complications is the same in people with diabetes mellitus and in patients with coronary artery disease. Diabetes mellitus is usually referred to as cardiovascular pathology and is considered as a pathogenetic link of the most common disorders of the human organism. Comprehensive correction of glycemia, hyperlipidemia and hypertension is the main target of therapy aimed at reducing the risk of progression of stable coronary artery disease (SCAD) in patients with type 2 diabetes mellitus. It remains relevant to study the possibility and feasibility of using drugs with multimodal action, which could effectively affect the many pathogenetic components of combined pathology. Study aim – to evaluate the effectiveness of drug therapy of stable coronary artery disease and concomitant type 2 diabetes mellitus using bioflavonoid quercetin and empagliflozin, considering the impact on modified risk factors and left ventricular remodeling processes. Methods. 96 patients were examined, all of them had SCAD FC II-III and type 2 diabetes mellitus. Depending on the treatment received, patients were divided into four groups: group I (n = 22) – patients who received basic therapy, group II (n = 26) – received quercetin with basic therapy, group III (n = 25) – took empagliflozin, and group IV (n = 23) – patients who received quercetin on the with basic therapy and empagliflozin. Duration of therapy was 12 weeks. Results. The use of quercetin probably helped to reduce angina pain, palpitations, shortness of breath, and empagliflozin helped to eliminate the manifestations of diabetic polyneuropathy, polydipsia and polyuria, and contributed to weight loss. In patients receiving empagliflozin, HbA1c reduction results in optimized carbohydrate metabolism. In addition, empagliflozin is likely to contribute to the normalization of high-density lipoproteins, and quercetin to both low and high-density lipoproteins. The use of empagliflozin has been shown to have a positive effect on intracardiac hemodynamics, which is contributed by the regression of left ventricular hypertrophy and the improvement of diastolic function. Conclusions. 1. The use of quercetin and empagliflozin in patients with coronary artery disease and concomitant type 2 diabetes mellitus contributed to a significant improvement in the general well-being of patients, the elimination of leading symptoms. 2. Patients with SCAD and concomitant type 2 diabetes mellitus have more profound changes in the lipid spectrum of the plasma, which is characterized by dyslipidemia being more atherogenic in nature. Studied therapy enhanced the antiatherogenic effect of statins, helped to reduce the level of total cholesterol and normalized the ratio of its fractions. 3. Additional administration of empagliflozin allowed to improve the components of transmitral diastolic flow: decreased IVRT, increased the E/A ratio. The improvement in LV diastolic function was accompanied by a decrease of LV mass index, a decrease in LV end diastolic diameter, an improvement in LV systolic function.

Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials.

Serenoa repens (SR) is a plant used to treat benign prostatic hyperplasia and prostatitis. We know that SR act as a 5α-reductase inhibitor, moreover, several studies have proved that SR has anti-inflammatory and antioxidant properties. There is some belief among patients that SR may negatively impact male sexual function. Such belief is circulating in non-medical social networks and is perhaps maintained by patients as a result of incorrect web surfing. However, it is also possible that SR may exert a "nocebo" effect thus negatively impacting on the general well-being of patients. The aim of this study is to investigate whether SR is causing negative effects on male sexual function. To ascertain the effect of SR on male sexual function, we conducted a systematic review and meta-analysis, by performing an electronic database search in accordance with the PRISMA guidelines. Out of 20 included papers, 8 papers reported comparisons of SR with placebo, and 7 studies reported comparisons of SR with tamsulosin. The standardized mean difference of changes from baseline scores of sexual function was not significantly different between SR and placebo (SMD: 0.43, 95% CI: 0.18 to 1.05; I^2 = 95%). Similarly, no significant mean differences in the Male Sexual Function-4 (MSF-4) test scores were found between SR and tamsulosin (SMD: -0.31, 95% CI: -0.82 to 0.19; I^2 = 90%). We found no statistically significant differences between negative effects on sexual function in patients treated with SR compared to patients who received placebo. The results of our meta-analysis are similar to those of other systematic reviews. Studies are warranted to ascertain whether any such effects might occur as a result of a nocebo effect.

Mortality and Exacerbation Risk by Body Mass Index in Patients with COPD in TIOSPIR and UPLIFT.

RationaleThere is an association between body mass index (BMI) and mortality in chronic obstructive pulmonary disease (COPD), with underweight individuals having higher mortality risk. Mortality and exacerbation risks among individuals with higher BMI are unclear.ObjectivesTo examine the relationship between BMI and adverse outcomes in COPD.MethodsThis post hoc analysis included data from TIOSPIR (Tiotropium Safety and Performance in Respimat) (N = 17,116) and tiotropium-treated patients in UPLIFT (Understanding Potential Long-term Impacts on Function with Tiotropium) (N = 2,986). BMI classes (underweight [BMI < 20 kg/m2], normal weight [BMI 20 to <25 kg/m2], overweight [BMI 25 to <30 kg/m2], obesity class I [BMI 30 to <35 kg/m2], obesity class II [BMI 35 to <40 kg/m2], and obesity class III [BMI ⩾ 40 kg/m2]) were examined for adjusted associations with mortality, exacerbation, and nonfatal cardiovascular event risk using over 50,000 patient-years of cumulative follow-up data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression models.ResultsIn TIOSPIR, obesity prevalence was 22%, overweight 32%, and underweight 12%. The proportion of females was highest in obesity classes II and III. Overweight and obese participants had better baseline lung function versus other BMI classes; underweight participants were more likely to be current smokers. Underweight participants had a significantly higher risk of death (HR, 1.88; 95% CI, 1.62–2.20; P < 0.0001) and severe exacerbations (HR, 1.31; 95% CI, 1.16–1.47; P < 0.0001) versus normal-weight participants; however, overweight and obese participants were at lower to no additional risk. Results from UPLIFT were similar to TIOSPIR.ConclusionsThese results suggest that there is a strong association between body weight, COPD events, and risk of death. A holistic management approach taking into account respiratory and cardiovascular risk factors and nutritional status is needed to improve the general well-being of patients with COPD.

The mediating effect of psychological resilience on the level of mindfulness and general well-being in patients with inflammatory bowel disease.

The incidence of inflammatory bowel disease (IBD) increases annually, and IBD patients may experience various psychological symptoms. People with higher levels of psychological resilience tend to cope with negative events in a positive way. So here we explored the correlation of mindfulness level, psychological resilience, and general well-being in patients with inflammatory bowel disease (IBD), and the mediating effect of psychological resilience on mindfulness level and happiness in IBD. Five Facet Mindfulness Questionnaire (FFMQ), Connor-Davidson Resilience Scale (CD-RICS), and General Well-Being Schedule (GWB) were used for investigation among the randomly selected IBD patients. Pearson correlation analysis and the structural equation model by Amos 24.0 were applied to explore the relationship between mindfulness level, psychological resilience, and general well-being. The mediating effect of psychological resilience was detected by bootstrap method. A total of 159 of the 184 distributed questionnaires were recovered (recovery rate 73.3%), and 135 of them were used for subsequent investigations. In IBD patients, the score of mindfulness level, psychological resilience, and general well-being were (119.95±8.64), (58.37±19.32), and (73.59±13.88), respectively. Both male and female score were lower than ordinary model (52.7% and 42.9%, respectively). Pearson results displayed that mindfulness level (r=0.312-0.390, P<0.01) and overall well-being (r=0.490-0.590, P<0.01) were positively related to psychological resilience and its 3 dimensions, respectively. Similarly, mindfulness level was positively correlated with overall well-being (r=0.391, P<0.01). Mediating effect of psychological resilience between mindfulness level and overall well-being was 0.232 (P=0.001). The 95% confidence interval (95% CI) of psychological resilience as mediating effect (59.3% of total) was (0.138 to 0.332). We concluded that psychological resilience in IBD patients has a partially mediating effect between mindfulness level and overall well-being.

Telemedicine platform COVIDREHAB for remote rehabilitation of patients after COVID-19.

The world's practice has shown the importance of medical rehabilitation, which allows increasing the effectiveness of treatment of patients with COVID-19, and also significantly reduce the risks of developing complications after COVID-19. Moreover, timely medical rehabilitation reduces the frequency of disability retirement. We developed and investigated the effectiveness of the telemedicine platform “COVIDREHAB” in order to enhance the effectiveness of the recovery period during self-isolation, as well as to provide access to rehabilitation for patients residing in remote areas or unable to undergo in-person medical rehabilitation. This pilot open clinical study includes 178 patients (108 women and 70 men) aged 32 to 82 years [mean age 50 (33-56) years] who had a moderate disease of COVID-19. We used the specialised platform COVIDREHAB for remote monitoring of the rehabilitation efficiency of patients who suffered from COVID-19. During the study, the supervising doctor assigned the patient a set of specialised questionnaires, which were filled in online. The questionnaires distributed to the patient included questions specifically designed for the COVIDREHAB remote platform as well as the mMRC (Modified Medical Research Council) questionnaire. Patients who completed the remote rehabilitation programme were found to have positive dynamics of indicators of the respiratory system functional state, and complaints.Pulmonary rehabilitation is an important part of case management for patients with respiratory diseases and plays an active role in improving lung function and general well-being of patients. Patients who completed the comprehensive medical rehabilitation program using the information and analytical system COVIDREHAB, were found to have positive dynamics of indicators of the respiratory system functional state, and complaints. Hence, at the end of the course the shortness of breath severity decreased (from 34.8% to 12.4%, as well as the feeling of lack of oxygen from 32% to 17.4%, p <0.05). We anticipate the online approach to rehabilitation will improve the functioning of the respiratory and cardiovascular systems, restore physical function, reduce anxiety and depression, and restore quality of life. An essential benefit of this program is the prevention of secondary complications and reduction of serious adverse effects of COVID-19 treatment.".

A Prospective, Controlled Study to Assess Effect of Spiritual Therapy in Patient Undergoing Hemodialysis at Bhaktivedanta Hospital.

End-stage renal disease (ESRD) introduces physical, psychological, social, emotional, and spiritual challenges into patients' lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QoL) and well-being in especially in terminal, life-threatening, and chronic diseases. The current study was planned to assess the effect of Spiritual therapy in patient undergoing hemodialysis (HD). Post approval from Ethics Committee, the study was commenced at Dialysis Center, Bhaktivedanta Hospital and Research Institute and conducted for 12 weeks. Participants were divided into two groups (one with spiritual intervention and other being control). Spiritual chanting and listening to it was the intervention. The outcome was assessed by kidney diseases QoL (KDQoL), spiritual well-being [Functional assessment of chronic illness therapy (FACIT) Sp 12] score, certain components of ESRD targeted area, 36 item health survey, and laboratory and nutritional parameters. Statistical analysis was done using IBM SPSS Statistics version 20.0 at 5% significance. A total of 100 participants were included in study; males were outnumbered. KDQoL, ESRD targeted areas, components of 36-item health survey, and FACIT Sp 12 scores were significantly different on better side in interventional group at six weeks and 12 weeks. There was no significant difference in laboratory and nutritional parameters. The findings from this study contribute knowledge to increase our understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD currently receiving HD treatment. The current study adds to the evidence in support of the use of spiritual therapy in chronic kidney disease patients on HD.

Application of the ICF in assessing the effectiveness of magnetotherapy in patients with viral pneumonia associated with COVID-19

To assess the effectiveness of the use of low-frequency magnetotherapy in the complex medical rehabilitation of patients who have had pneumonia in the phase of convalescence according to the International Classification of Functioning, Disability and Health. The study included 200 patients who had suffered from pneumonia associating by COVID-19 and whose average age was 54.3±5.8 years. 1st (main) group (n=100), against the background of standard therapy on the 16th day after discharge from the hospital, received low-frequency magnetotherapy on the ALMAG-02 apparatus («Elamed», Russia) daily for 10-20 minutes, a course of 15 procedures. The 2nd group(control) included 100 patients who underwent low-frequency placebo-magnetotherapy on the ALMAG-02 apparatus («Elamed», Russia). In order to assess the dynamics of clinical and laboratory data and the effectiveness of treatment, control methods were used in this study in accordance with the Temporary Clinical Recommendations of the Ministry of Health of the Russian Federation. Each patient was evaluated for the severity of the initial manifestations of respiratory failure using the mMRC scale (Degree of Shortness of breath) and the Borg scale, and the quality of life of patients was assessed on the EQ-5D scale. Also, at the time of inclusion in the study and during the control examination after the completion of prospective follow-up, the Individual profile of patients was determined in accordance with the international classification of functioning (ICF) with the data of the «Individual Registration Card of the clinical trial participant». In 43% (43 people) of patients of the 1th group, an improvement in respiration functions was noted with lung auscultation and with spirometry, an increase in the vital capacity of the lungs by 28.2% (p=0.0021), an increase in chest excursion by 53.1% (p=0.0019) a decrease in the level of shortness of breath by 50% and Borg by 33.3% (p=0.0016). According to the data of the quality of life questionnaire (EQ-5D), the patients of the main group showed an improvement in the quality of life by 23% (p=0.0019). In the 1st group of patients, there was a decrease in moderate disorders in the domains «b152 - emotion functions» in 45% of patients; «b440 - respiratory functions» in 87% of patients; «b455 - exercise tolerance functions» in 74% of patients; «b134 - sleep functions» in 30% of patients; «d450 - walking» in 100% of patients. In the general blood analysis of patients of the 1st (main) group, there was a relief of leukocytosis, normalization of the erythrocyte sedimentation rate (ESR). In the 1st group a decrease in the duration of being on the sick list was observed for 3.4±0.2 days. The inclusion of low-frequency magnetic therapy in the complex rehabilitation of patients who have suffered pneumonia associated by COVID-19 contributes to improving the function of external respiration of patients, regression of residual infiltrative changes in the lungs after pneumonia, relief of residual manifestations of the inflammatory process, reducing the duration of the rehabilitation period and the duration of disability, improving the general well-being of patients, increasing tolerance to physical exertion, normalization of the psycho-emotional state and, as a result,, restoring activity in everyday life and improving the quality of life of patients. The researchers did not register any side effects and side effects of magnetic therapy from ALMAG-02 apparatus (Elamed, Russia).

Healthcare support worker assistantships should form a mandatory part of medical school curricula: A perspective from UK medical students

This personal view, regarding the value of healthcare support worker (HCSW) assistantships, is based on our experiences as medical students entering our final year, having both worked as HCSW’s during the COVID-19 pandemic, and from SC’s experience as a HCSW before and throughout medical school. HCSW’s provide a large proportion of the basic care patients receive on the wards, in clinics and primary care. The proximity to patients attracts individuals with excellent communication skills and bedside manner, and means they are well-positioned to assist in the management of both the general wellbeing of patients and equally, to recognise the signs of a deteriorating patient making them a versatile and invaluable member of the multidisciplinary team (MDT). This piece aims to highlight the value of our time spent working as a HCSWs, thus promoting the formation of a mandatory assistantship for medical students, like that seen in Germany. Through this, essential communication skills, empathy, ‘ward smarts’ and an appreciation for the wider MDT can be gained in a way that typical clinical attachments and classroom teaching do not replicate.

Two-person screening of mental well-being before primary breast augmentation: Can we do more?

Patients choosing aesthetic surgery are asymptomatic individuals opting for surgery. Psychologists and surgeons have been interested in identifying characteristics of these individuals' preoperative as well as postoperative psychological changes. It was identified that a small number of patients have a primary issue with self-body image, which resulted in altered perceptions and attitudes such that the preoccupation with perceived deficiencies continued even after surgery. The recommended course is to attempt to screen for the patients' mental well-being, as surgery alone does not improve the patients' symptoms. In the first author's practice, each prospective patient is reviewed by two individuals on separate occasions in order to discuss surgery and assure their mental and physical suitability. However, we encountered four patients who exhibited a strong negative reaction to their new shape, to the point that it necessitated explanation in the immediate postoperative phase in two of them. To our knowledge, this situation has not been described in the literature. We discuss the available literature as well as our consent process for breast augmentation. The first author has since introduced BREAST-Q to assess general patient well-being in the pre- and post-operative phases as a result of this experience. We also discuss the results for each of its domains and offer our thoughts about the management of such a situation.