Ozone therapy is a complementary treatment that has gained popularity due to its safety and wide range of applications. Systemic ozone therapy involves withdrawing 100 to 200 ml of blood, treating it with an oxygen-ozone mixture, and then reinfusing it. This process requires large-caliber venous access, which can be a limitation. To overcome this, alternative administration methods have been explored, including the use of ozonized solutions. The aim of this study is to evaluate the clinical effects of systemic ozone therapy on the perception of quality of life and to analyze the outcomes of different administration methods. Three groups of patients were treated: one group received classical systemic ozone therapy, another received ozone therapy via intravenous infusion of a 5% glucose solution, and the third group alternated between the two methods. The results showed an improvement in perceived quality of life in all groups, regardless of the method used. Thus, systemic ozone therapy showed efficacy in improving the perception of quality of life in our group. Moreover, intravenous infusion of a 5% glucose solution has made it possible to treat patients who could not be treated with the classical method, achieving similar results.

UNASSIGNED: Postoperative recovery in lung cancer patients is a complex process, where breathing exercises may play a crucial role in enhancing pulmonary function and quality of life (QoL). This study systematically reviews and meta-analyzes the impact of breathing exercises on post-surgical lung function and QoL in lung cancer patients.
UNASSIGNED: An extensive literature search was conducted across PubMed, Cochrane, Web of Science, and Embase databases using terms like \"Lung Neoplasms\", \"breathing exercises\", and \"randomized controlled trial\", supplemented by Medical Subject Headings (MeSH) and free words. The Cochrane risk of bias tool was used for quality assessment. A systematic review and meta-analysis on the effects of breathing exercises post-lung cancer surgery followed by data extraction and quality evaluation.
UNASSIGNED: From 384 retrieved studies, 10 met the inclusion criteria and were selected for detailed analysis. The main outcomes assessed were postoperative pulmonary function indices and QoL measures. The majority of studies were deemed \'low risk\' for random sequence generation and allocation concealment. However, due to the nature of the interventions, blinding was a \'high risk\' in most cases. The meta-analysis revealed significant improvements in key pulmonary function indices: forced vital capacity (FVC%) increased by an average of 1.73%, maximal voluntary ventilation (MVV) improved by 7.58 L/min, and maximal inspiratory pressure (MIP) enhanced by 0.95 cmH2O. Additionally, there was a notable alleviation of postoperative dyspnea and an enhancement in QoL, with anxiety scores decreasing by an average of 3.42 points and complication rates reducing correspondingly. However, the interventions did not significantly affect physical activity levels or performance on the 6-minute walk test (6WMT), with effect sizes for these outcomes being non-significant.
UNASSIGNED: This study indicates that breathing exercises significantly improve postoperative pulmonary function and QoL in lung cancer patients. Future research should delve into the mechanisms behind these exercises and evaluate their long-term rehabilitation effects. Customized programs could further optimize recovery and enhance patient QoL.

BACKGROUND: Music therapy, aromatherapy and massage therapy are widely used in palliative care in patients near end-of-life with the aim to reduce symptom burden and improve quality of life (QoL). Recent research shows an increase in popularity and use of complementary and integrative medicine however a more thorough evidence base about their usefulness is required.
OBJECTIVE: The aim of this study was to evaluate the available evidence on the use of music therapy, aromatherapy and massage therapy in palliative and hospice care and summarize findings.
METHODS: A defined search strategy was used in reviewing literature from two major databases, MEDLINE and Embase for the period between 2010 and 2022. Studies were selected for further evaluation based on intervention type and relevancy. After evaluation using quality assessment tools, findings were summarised, and potential benefits were identified.
RESULTS: Out of 1261 studies initially identified, 26 were selected for further evaluation. 16 evaluated music therapy, 4 aromatherapy and massage therapy. The most represented outcomes were pain, anxiety, well-being and QoL. Many studies demonstrated a short-term benefit in symptom improvement. Qualitative studies showed that these complementary methods are highly valued.
CONCLUSIONS: Main results found that music and massage therapy had the most potential benefits on a range of outcome parameters, including pain and QoL. Future studies may consider using more qualitative and/or mixed methods to provide a more comprehensive evaluation of treatment.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on the patient\'s quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, who were predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up, we observed a statistically significant improvement in angina control measured CCS class and SAQ-7 total questionnaire along with increased abolition of physical limitation-6-MWT (233.3 ± 107.1 vs. 305.2 ± 126.8; p < 0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

It is well established that the COVID-19 pandemic has had a substantial impact on ethnic minority communities and has worsened existing health inequalities experienced by these populations globally. Individuals from ethnic minority backgrounds have not only been more likely to become infected with COVID-19 throughout the pandemic, but they have also higher risk of adverse symptoms and death following infection. Factors responsible for these discrepancies are wide reaching and encompass all aspects of the social determinants of health (SDoH). Although always an area of concern among healthcare professionals, barriers to health care experienced by ethnic minority populations became a more pertinent issue during the COVID-19 pandemic when all individuals required sufficient and sustained access to a healthcare system (whether this be for COVID-19 testing, vaccination or treatment). These healthcare barriers exacerbated the increased COVID-19 burden experienced by minority populations and will continue to detrimentally impact the health of these populations during future COVID-19 waves or indeed, future novel pandemics. This chapter aims to summarise the major healthcare barriers experienced by minority populations throughout the COVID-19 pandemic, including COVID-19 prevention, vaccine rollout, care during hospitalisation and post-COVID care for long COVID patients. To end, this chapter will summarise lessons learned and future directions that need to be taken to improve health disparities and healthcare access for minority populations in relation to the COVID pandemic and beyond.

BACKGROUND: An intestinal stoma is a surgically created artificial opening in the abdominal wall that helps the large or small intestine end to divert the faecal matter for stoma patients with an underlying condition of inflammatory bowel disease and colorectal cancer. When a stoma is formed following surgery, one of the difficulties stoma patients confront has been identified as prolonged immobilization, which can eventually result in muscle inactivity that results due to their illness. Patients with stoma often experience an increase in pain and a decrease in quality of life. Patients can be mobilized and their muscles can be activated with the help of an early intervention called specific mobility exercises.
OBJECTIVE: The present study aimed to explore the specific mobility exercises that reduce pain and improve quality of life among stoma patients.
METHODS: This quasi-experimental study involved 21 patients who underwent stoma surgery and were selected according to the inclusion and exclusion criteria. The experimental procedures were explained to all the patients and their written informed consent was obtained. The patients performed specific mobility exercises for 30 minutes per day. Treatment was given for four weeks every day after three to four days of stoma surgery. The patient\'s pain and quality of life were assessed using the Numerical Pain Rating Scale and the Stoma-Quality of Life (QoL) Questionnaire and pre-test and post-test values were recorded before and after the exercises. The data were tabulated and evaluated.
RESULTS: The findings suggest that specific mobility exercises following four weeks of intervention have a significant effect (p< 0.001) in reducing pain except in young adult stoma patients as they were found to be anxious and depressed, which was reflected in the findings as not statistically significant for pain on the NPRS (t(1) = 7, p > 0.001). However, it has been demonstrated that these specific mobility exercises have a significant effect (p< 0.001) in improving the quality of life among all stoma patients.
CONCLUSIONS: The study evidenced that four weeks of specific mobility exercises in line with general medical treatment showed a significant reduction in pain and an improvement in quality of life among stoma patients. However, it should be noted that in the study, the majority of stoma patients were male and there were only a few patients with inflammatory bowel disease, which can limit the study findings. Future studies have to focus on equally distributing gender and conditions by emphasizing the importance of randomizing patients into the experimental and control groups and involving a combination of other exercises in rehabilitation for patients following stoma surgery.

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UNASSIGNED: Neuromuscular diseases (NMD) include different types of diseases depending on the deficient component of the motor unit involved. They may all be interested by a progressive and sometimes irreversible pump respiratory failure which unfortunately for some NMD may start soon after the diagnosis. Within this vast group of patients those affected by muscle diseases are a subgroup who comprises patients with an average earlier onset of symptoms compared to other NMD. Indeed it is also important to comprehend not just the patient\'s burden but also the surrounding families\'. Defining the end of life (EoL) phase in these patients is not simple especially in the young patient population. Consequently, the late stage of disease remains poorly defined and challenging.
UNASSIGNED: The aim of this review is to describe the EoL phase in NMD patients with attention to QoL and psycological status.
UNASSIGNED: The focus would be on one hand on the management of the psychological burden, the communication barriers, and tone of humor.
UNASSIGNED: Those topics have been described being crucial in this group of patients as they increase tensions and burden of both patient and family, and between them and the outside world. Thus also causing their social isolation, increasing anxiety and reducing their quality of life. On the other hand the use of cough clearance devices and all the respiratory supports and their withdrawn are carefully evaluated in the view of alleviating respiratory symptoms, improving patient quality of life and above all reaching the patient\'s goals of care.
UNASSIGNED: Although there is no cure, the advent of supportive interventions including multidisciplinary care (MDC) has improved all the aspects of dying for patients affected by NMD; nevertheless there still a long pathway ahead.

OBJECTIVE: This prospective study aims to provide further supportive evidence by assessing the sustained effectiveness and safety of sublingual immunotherapy (SLIT) using a vaccine containing house dust mite (HDM) extracts in patients diagnosed with allergic rhinitis (AR) with/without conjunctivitis (AR/C).
METHODS: AR/C patients (n = 111, SLIT group: 57, control group: 54) allergic to HDM were treated with standardized SLIT drops or symptomatic drugs from October to December in 2020. The patients were directed by the investigators to attend annual hospital visits for the assessment of various parameters including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), visual analog scale (VAS), total nasal symptom score (TNSS), total ocular symptom score (TOSS) and total medication score (TMS). During the study period, all participants were mandated to maintain comprehensive records of any adverse events (AEs) on diary cards, which were then communicated to the investigators via telephone.
RESULTS: At baseline (2020), TNSS, TOSS, TMS, VAS, and RQLQ scores were comparable between SLIT and control groups (P > 0.05). After one year of treatment (2021), significant reduction in all scores compared to the baseline for both groups (P < 0.001). At the end of the second year of treatment (2022), TNSS and RQLQ score in the SLIT group continued to decrease significantly compared to 2021 (P < 0.05). In the third year (2023), the control group showed a rebound in TNSS, TOSS, TMS, and RQLQ scores, significant differences compared to 2022 or 2021 (P < 0.05). Besides, the SLIT group had significantly lower scores across all domains of RQLQ compared to the control group (P < 0.001). Symptomatic treatment influenced the scores of Nasal Symptoms, Eye Symptoms, Practical Problems, and Emotions domains significantly in 2023 compared to 2021 or 2022 (P < 0.05). Within the SLIT group, no significant differences in TNSS, TMS, VAS, and RQLQ scores were observed between monosensitized and polysensitized patients throughout the three years of treatment (P > 0.05). All AEs were mild to moderate.
CONCLUSIONS: The 3-year course of HDM-SLIT has shown significant therapeutic efficacy and a favorable safety profile in patients with AR/C. Importantly, our study presents initial evidence suggesting that the greater impact of AR/C on quality of life (QoL) may primarily stem from nasal symptoms, eye symptoms, practical issues, and emotional well-being.

BACKGROUND: Lymphedema is a debilitating condition that significantly affects quality of life due to its chronic nature and visible symptoms. Lymphaticovenous anastomosis (LVA) has emerged as a promising surgical intervention, yet its effects on body image and spiritual health alongside physical symptoms have not been thoroughly examined. This study evaluates the efficacy of LVA in improving symptoms, quality of life (QOL), body image, and spiritual well-being in lymphedema patients.
METHODS: A prospective cohort study was conducted at Kaohsiung Chang Gung Memorial Hospital, Taiwan, involving 44 patients with lymphedema undergoing LVA surgery. Evaluations were made pre-surgery, one month post-surgery, and six months post-surgery using the 36-Item Short Form Health Survey (SF-36), Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and a spiritual health scale. Statistical analysis was performed using one-way repeated measures ANOVA.
RESULTS: Significant improvements were observed in lymphedema symptoms and QOL measures at six months post-operation. SF-36 results showed enhanced scores in nearly all domains, particularly in physical functioning and role-physical. The appearance orientation scores from the MBSRQ-AS significantly increased, indicating improved perceptions in some dimensions of body image.
CONCLUSIONS: LVA surgery significantly enhances physical and psychological outcomes in patients with lymphedema, with marked improvements in symptoms, QOL, and body image perceptions. The findings suggest that while LVA is effective in addressing the physical and psychological aspects of lymphedema, it does not impact spiritual dimensions. This underscores the need for holistic approaches in the management of lymphedema to address all facets of patient well-being.