Summary To better understand outcomes in postpartum patients who receive peripartum anaesthetic interventions, we aimed to assess quality of recovery metrics following childbirth in a UK‐based multicentre cohort study. This study was performed during a 2‐week period in October 2021 to assess in‐ and outpatient post‐delivery recovery at 1 and 30 days postpartum. The following outcomes were reported: obstetric quality of recovery 10‐item measure (ObsQoR‐10); EuroQoL (EQ‐5D‐5L) survey; global health visual analogue scale; postpartum pain scores at rest and movement; length of hospital stay; readmission rates; and self‐reported complications. In total, 1638 patients were recruited and responses analysed from 1631 (99.6%) and 1282 patients (80%) at one and 30 days postpartum, respectively. Median (IQR [range]) length of stay postpartum was 39.3 (28.5–61.0 [17.7–513.4]), 40.3 (28.5–59.1 [17.8–220.9]), and 35.9 (27.1–54.1 [17.9–188.4]) h following caesarean, instrumental and vaginal deliveries, respectively. Median (IQR [range]) ObsQoR‐10 score was 75 ([62–86] 4–100) on day 1, with the lowest ObsQoR‐10 scores (worst recovery) reported by patients undergoing caesarean delivery. Of the 1282 patients, complications within the first 30 days postpartum were reported by 252 (19.7%) of all patients. Readmission to hospital within 30 days of discharge occurred in 69 patients (5.4%), with 49 (3%) for maternal reasons. These data can be used to inform patients regarding expected recovery trajectories; facilitate optimal discharge planning; and identify populations that may benefit most from targeted interventions to improve postpartum recovery experience.

There are significant emotional problems in patients with systemic sclerosis (SS) and rheumatoid arthritis (RA), including most expressed symptoms of anxiety and depression that complicate the process of social and psychological adaptation of patients, reduce the level of subjective control as an attribute of personal responsibility for controlling their disease. The effectiveness of the biofeedback (BFB) training inthe treatment of patients with rheumatoid arthritis and systemic sclerosis is analyzed. Analysis of the effectiveness of treatment was conducted by studying the dynamics of a number of psychological indices (the level of subjective control, reactive and personal anxiety, depression) and their comparison in patients of the main and control groups before and after the treatment. Correction of the psycho-emotional state of patients with SS and RA was carried out using biofeedback (BFB), based on the principle of self-regulation of body functions using external feedback systems. There was a significant reduction in anxiety and depressive reactions in patients, during the process of BFB therapy, accompanied by a significant decrease of scoresby Spielberger–Khanin and Beck psychological tests, noted a significant effect of increasing the level of subjective control that can improve the effectiveness of therapy and long-term disease prognosis. Thus, the additional application of BFB training in complex treatment of SS and RA patients promoted the improvement of the efficiency of the treatment and rehabilitation carried out and the improvement of the patients’ quality of life. Keywords: BFB training, systemic sclerosis, rheumatoid arthritis, rheumatic diseases, reactive anxiety, personality anxiety, depression, level of subjective control

Background Various methods of non-medicinal therapy of systemic sclerosis (SS) were offered, but any of them does not allow achieving desirable success. It is known that active participation of patient in treatment can improve efficiency of the therapy. One of promising method is biofeedback, referred on active participation of patient in the therapy. Objectives Our aim was to improve the efficiency of complex therapy of SS patients by means of biofeedback therapy. Methods We observed 90 SS patients. The middle age of patients was equal to 38,19±12,1 years, average duration of illness 11,2±3,4 years. The minimum degree of activity of disease (I) has been diagnosed for 47 (52,2%), medium (II) degree - in 38 (42,2%) and high (III) degree - in 5 (5,6%) patients. A chronic course of the disease was diagnosed in 39 (43,3%), subacute - in 48 (53,3%), and acute - in 3 patients (3,3%). The stage of initial changes has been diagnosed in 37 (41%), a stage of generalization of process - in 50 (55,5%), a late (terminal) stage – in 3 patients (3,5%). Depending on degree of skin changes limited SS has been diagnosed in 66 (73,3%), and diffuse SS form - in 24 (26,7%) patients. SS patients have been divided on two groups randomly: the basic (n=60) and control (n=30). Patients of basic group received 12-14 sessions of multimodal (temperature and EEG) biofeedback training using “Reacor” rehabilitation complex. Clinical assessment of biofeedback efficiency was assessed by dynamics of following clinical and laboratory indices: skin count by G.P.Rodnan, capillaroscopies of nails, pain by VAS, joint count, number of swelling joints, swallow index, ESR, antibodies to Scl-70, SF-36 questionnaire was applied for quality of life evaluation. Results Reliable changes of capillaroscopy index (morphological variations of capillary tubes (χ2=6,19, p=0,013), a pain by VAS, ESR were noted in control group of SS patients after the course of conventional therapy. At the same time reliable positive dynamics of the skin count, joint count, number of swelling joints, swollen index, ESR was founded in patients of basic group after biofeedback therapy. Besides, capillaroscopy indices, namely angiectasia (χ2=8,192, p=0,004), morphological variations of capillary tubes (χ2=4,14, p=0,042) and hemorrhages (χ2=7,906, p=0,005) were reliable improved after the treatment. There is the evidence that biofeedback therapy has positive influence on microcirculation disturbances. It was founded that indices reflecting a physical component of quality of life - physical functioning (p<0,001), role physical functioning (p<0,01), somatic pain (p<0,001), and also overall health (p<0,001), social (p<0,05) and role emotional functioning (p<0,01) were reliable raised in SS patients of basic group. The results of assessment of physical and psychological health are similar in group of SS patients receiving conventional therapy, but changes of smaller quantity of indices were reliable. Conclusions Thus, results of the researches are the evidence of considerable efficiency ...

Results Nearly all FM were female (98%); main reason for exclusion was the inability to interrupt drugs with analgesic properties for >10 days. Age [FM mean 49(SEM1) vs C 46(2) y.], gender and socio-demographic characteristics were similar in both groups. Mean duration of symptoms was 8 y (range 0.4-49). RPS was 64(13-98), VAS was 5.7 (SD 2). Means for clinical examination were: TP 16(0.3), MS 29(0.9) and PGI 2.7(0.1). R-III reflex threshold was reduced in FM [26(2) vs 38(2) mA, p < 0.01]. Thermal perceptions (hot and cold) were similar in both groups, whereas thermal pain thresholds and latency (hot, cold, and cold pressure test) were drastically decreased in FM(p < 0.001). Correlation analysis showed a significant relationship between PGI, and central QST(Pearson r = -0.28; p = 0.02) and between PGI, MS and TP(r = 0.34 and r = 0.66, respectively p < 0.01). Correlation with CYP2D6 activity is under analysis. Conclusion Physician global impression, but not the other clinical scores, correlates with the extent of central sensitisation. Supported by the SNSF (3200-056028.98).

BackgroundMicrocirculatory disorders are one of the most important clinical symptoms of systemic sclerosis (SSc), therefore we found it feasible to evaluate the clinical efficacy of biofeedback (BFB) in the complex therapy of patients with SSc based upon analysis of nailfold capillaroscopy.ObjectivesTo study the impact of the method of biofeedback therapy on microcirculation disturbances in patients with SSc.MethodsThe study included 40 patients with SSc under observation. Among the patients examined, 95% were women and 5% were men. The average age of the patients - 38±3,3 years, duration of illness - 14±2,6 years. Raynaud's phenomenon (RP) was observed in all the patients. A severe form of RP was seen in 80% of the patients. The effectiveness of biofeedback therapy was analyzed by studying the dynamics of the measures from the nailfold capillaroscopy and comparing the data obtained of patients from the main and control groups.ResultsIt was found that, patients who were under biofeedback therapy, showed significant positive dynamics in the following signs of capillaroscopic picture: dilation of the capillaries (c2 =9,643 p=0,026), morphological changes of the capillaries (c2 =4,90 p=0,027), and hemorrhage (c 2 =4,514 p=0,034). In the control group of patients, in only one indicator of capillaroscopy that a significant change was noted, particularly by the presence of dilated capillaries (c2 =5,833 with p=0,016). These findings suggest that treatment results were significantly better in the main study group of patients with SSc.ConclusionsThe implementation of biofeedback therapy favors a decrease in reflex musculo-tonic syndromes, improvement of microcirculation and peripheral blood flow and significantly allows an amelioration in the results of SSc therapy.Disclosure of InterestNone declared