General Discomfort Research Articles

A Grade Ⅲ Severe Hypersensitivity Caused by Gadopentatic Acid Injection: A Case Report

BackgroundGadopentetic acid is a common contrast agent for enhanced magnetic resonance imaging. Adverse reactions due to gadolinium-based contrast agents are rare and easily overlooked by medical staff. A patient developed a rash as the first symptom and quickly developed a severe allergic reaction after receiving gadopentetic acid. Patient presentationA 74-year-old female patient was admitted on January 11, 2022, for femur magnetic resonance imaging. At 12:05 pm, a routine intravenous rapid injection of gadopentetic acid (15 ml) was given. Two minutes after administration, the patient developed skin itching. No obvious rash was found, but a 10 mg intravenous injection of dexamethasone was given. Recount of eventsAfter 1 minute, skin pruritus had not improved significantly, saliva secretion had increased significantly, and a general discomfort appeared. At 12:10 pm, outside the scanning room, the patient suddenly became unconscious; 1 mg of EPINEPHrine was injected intramuscularly, and oxygen was given through a mask. Heart rate, blood pressure, and oxygen saturation steadily dropped. The patient was transferred to the intensive care unit. After EPINEPHrine, norepinephrine, terlipressin, and dexamethasone treatments, the vital signs eventually stabilized. The patient was judged to have had a grade III severe allergic reaction according to the first aid guidelines for severe allergic reactions in China. The patient was discharged from the hospital on the morning of January 14. ConclusionThis case stresses the importance of being equipped with the medicines, items, supplies, and equipment needed for emergency treatments in all departments where contrast agents are used. Patients with apparently mild adverse reactions to contrast agents should not be overlooked.

Association Between Women’s Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand

Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. To examine associations between women's lifetime IPV exposure and self-reported health outcomes. The cross-sectional, retrospective 2019 New Zealand Family Violence Study, adapted from the World Health Organization's Multi-Country Study on Violence Against Women, assessed data from 1431 ever-partnered women (63.7% of eligible women contacted) in New Zealand. The survey was conducted from March 2017 to March 2019, across 3 regions, which accounted for approximately 40% of the New Zealand population. Data analysis was performed from March to June 2022. Exposures were lifetime IPV by types (physical [severe/any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types. Outcome measures were poor general health, recent pain or discomfort, recent pain medication use, frequent pain medication use, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Weighted proportions were used to describe the prevalence of IPV by sociodemographic characteristics; bivariate and multivariable logistic regressions were used for the odds of experiencing health outcomes by IPV exposure. The sample comprised 1431 ever-partnered women (mean [SD] age, 52.2 [17.1] years). The sample was closely comparable with New Zealand's ethnic and area deprivation composition, although younger women were slightly underrepresented. More than half of the women (54.7%) reported any lifetime IPV exposure, of whom 58.8% experienced 2 or more IPV types. Compared with all other sociodemographic subgroups, women who reported food insecurity had the highest IPV prevalence for any IPV (69.9%) and all specific types. Exposure to any IPV and specific IPV types was significantly associated with increased likelihood of reporting adverse health outcomes. Compared with those unexposed to IPV, women who experienced any IPV were more likely to report poor general health (adjusted odds ratio [AOR], 2.02; 95% CI, 1.46-2.78), recent pain or discomfort (AOR, 1.81; 95% CI, 1.34-2.46), recent health care consultation (AOR, 1.29; 95% CI, 1.01-1.65), any diagnosed physical health condition (AOR, 1.49; 95% CI, 1.13-1.96), and any mental health condition (AOR, 2.78; 95% CI, 2.05-3.77). Findings suggested a cumulative or dose-response association because women who experienced multiple IPV types were more likely to report poorer health outcomes. In this cross-sectional study of women in New Zealand, IPV exposure was prevalent and associated with an increased likelihood of experiencing adverse health. Health care systems need to be mobilized to address IPV as a priority health issue.

Changes in the visual display terminal syndrome of college students in online classes during the COVID-19 pandemic

Purpose: The purpose of this study was to identify changes in the experience rate and level of symptoms of visual display terminal syndrome in college students attending online classes during the COVID-19 pandemic. Methods: Data were collected from February 22 to June 8, 2021 at three measurement points. A total of 117 college students were administered a visual display terminal syndrome survey just before online classes (T1), one month after the start of online classes (T2), and three months after the start of online classes (T3). The collected data were analyzed by frequency and percentage, paired t-test, McNemar test, and repeated measures analysis of variance using the IBM SPSS 25.0 program. Results: The intensity of college students’ visual display terminal syndrome during online classes increased at T2 and T3 compared to T1. The rate of experiencing back discomfort or pain increased abruptly at T2 compared to T1. The intensity of college students’ eye related symptoms and skin related symptoms increased at T2 and T3 compared to T1, while the intensity of college students’ psychological symptoms, general body discomfort, and musculoskeletal symptoms increased at T3 compared to T1. Conclusion: The results of this study suggest that self-care programs are needed to prevent visual display terminal syndrome in college students who are in long-term online classes.

The impact of screen exposure among school-aged children in South India during the COVID-19 pandemic: an online survey

BackgroundThe impact of excessive screen time with personal listening devices (PLDs) on vision, hearing, balance, and overall health among adults has been reported in the literature. However, its impact on children is not well documented. A survey was undertaken to highlight the possible effects of screen time combined with transducers on vision, hearing, balance, and overall health complaints in children via parental proxy. This cross-sectional survey consisted of questions divided into four domains: vision, hearing, balance, and overall health. It was conducted online using social media to avail total maximum responses.ResultsA total of 136 responses were obtained from the parents of children studying from grade 1 to 8 through the survey conducted in south India. Increased negative impact on vision was observed in more than 50% of children. Similarly, the hearing and balance domain reported 16% ear pain, 4.4% tinnitus, 9.6% dizziness, 8.8% nausea, and 2.2% imbalance while walking. Likewise, the overall stress domain reported 26.5% general body discomfort, 37.5% neck pain and stiffness, 29.4% headaches, 43.4% lack of concentration, 39.7% overall changes in child’s health and 46.3% behavioral issues with various severity markings (slight to severe).ConclusionsLonger periods of screen exposure have various negative impacts on vision, hearing, balance system, and overall health. These effects have to be managed for the health of our children.

25-Year-Old Man With Fever, Diarrhea, and Weight Loss

A 25-year-old male immigrant from Central America presented to the emergency department with fever, general abdominal discomfort, nausea, watery diarrhea (10 to 15 bowel movements daily), and a 9-kg weight loss of 1 month’s duration. He did not have headache, photophobia or phonophobia, vision changes, dysphagia or odynophagia, chest pain, dyspnea, bloody stool, rash, or arthralgias. He had immigrated to the United States 3 years previously and lived in both Florida and Minnesota. He worked as a migrant laborer on a tomato farm.

Gastrointestinal pacing as a treatment of postoperative ileus following extensive surgery for peritoneal metastases - A prospective blinded randomized controlled clinical trial.

Background: Almost 10% of colorectal cancer patients present with or recur with peritoneal metastases. Currently, the only treatment with curative intent is extensive cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). More than half of patients undergoing CRS and HIPEC develop prolonged postoperative ileus (POI), defined as more than 5 days without gastrointestinal (GI) function. POI represents a major clinical challenge as it causes nausea, vomiting, stomach cramps and general discomfort for the patient. Currently no efficient treatment exists.

Psychological Nursing Combined with Biofeedback to Promote the Rehabilitation of Patients with Anxiety Disorder

Objective: To explore the effect of psychological nursing combined with biofeedback on the rehabilitation of patients with anxiety disorder. Methods: 100 patients with anxiety disorders in our hospital from January to December 2021 were randomly divided into two groups: control group (n = 50) and study group (n = 50). The control group was given routine nursing, while the study group was given psychological nursing combined with biofeedback. The changes of self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, symptom score, and quality of life of the two groups were compared before and after nursing. Results: Before nursing, there was no significant difference in the scores of SAS and SDS between the two groups, but after nursing, the scores of SAS and SDS in the study group were lower than those in the control group, and the degree of improvement in the study group was higher than that of the control group. Before nursing, there was no significant difference in the scores of symptoms between the two groups (P > 0.05), but after nursing, the scores of stress, crying spells, tremor, and general discomfort in the study group were lower than those of the control group (P < 0.05). Besides, before nursing, there was no significant difference in the quality of life between the two groups (P > 0.05), but after nursing, the scores of physical function, psychological activity, social ability, and material life in the study group were higher than those in the control group (P < 0.05). Moreover, the degree of improvement after nursing in the study group was better than that of the control group. Conclusion: Psychological nursing combined with biofeedback to promote the rehabilitation of patients with anxiety disorder effectively improves the negative emotion of patients, reduces stress, depression, tremor, and general discomfort, and improve the overall quality of life. Therefore, it is worth further popularization.

Conducting Goals of Care Conversations: Lessons From the COVID-19 Pandemic.

Objective: Internal medicine (IM) residents discuss a patient's goals of care (GOC) as part of their initial consultation. Residents have described inexperience, general discomfort, limited formal teaching, and prognostic uncertainty as barriers to effective GOC conversations. The early COVID-19 pandemic resulted in rapid changes to the healthcare system on the individual, patient, and systemic level that might exacerbate and/or introduce new barriers to IM residents' GOC conversations. This qualitative study examines how the early COVID-19 pandemic challenged IM residents' ability to have effective GOC conversations. Methods: Using a constructivist grounded theory approach, participants (n=11) completed a semi-structured interview. Data collection and analysis occurred simultaneously using an open coding, constant comparison process. Interviews were completed until no new themes were identified. Results: Residents self-described their GOC conversations in 5 steps: normalization of the conversation, introduction of expected clinical course, discussion of possible care plans, exploration of the patient's values, and occasionally providing a recommendation. Residents described limited structured teaching around GOC conversations and instead relied on observed role-modelling and self-practice to hone their skillset. Residents described an increased sense of urgency to have GOC conversations due to the uncertainty of clinical course and potential for rapid deterioration of patients with COVID-19. Residents identified restrictive visitor policies as a significant barrier that contributed to feelings of dehumanization. Residents felt that these limitations affected their GOC conversations and potentially resulted in discordant care plans which contributed to moral distress. Conclusion: The early COVID-19 pandemic resulted in several barriers that challenged residents' ability to conduct effective GOC conversations. This is on the background of previously reported discomfort and limited formal training in conducting GOC conversations. Based on our findings, we present a conceptual model involving teaching validated GOC frameworks, positive role-modelling, and experiential learning to support GOC conversation education in post-graduate medical education.

Association Between Men’s Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand

Health implications of intimate partner violence (IPV) against men is relatively underexplored, although substantial evidence has identified associations between IPV and long-term physical health problems for women. Given the gendered differences in IPV exposure patterns, exploration of men's IPV exposure and health outcomes using population-based samples is needed. To assess the association between men's lifetime IPV exposure and self-reported health outcomes. This cross-sectional study analyzed data from the 2019 New Zealand Family Violence Study, which was conducted across 3 regions of New Zealand. The representative sample included ever-partnered men aged 16 years or older. Data analysis was performed between May and September 2022. Lifetime IPV against men by types (physical [severe or any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types experienced. The 7 health outcomes were poor general health, recent pain or discomfort, recent use of pain medication, frequent use of pain medication, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. The sample comprised 1355 ever-partnered men (mean [SD] age, 51.3 [16.9] years), who predominantly identified as heterosexual (96.9%; 95% CI, 95.7%-97.8%). Half of the sample (49.9%) reported experiencing any lifetime IPV, of whom 62.1% reported at least 2 types. Of all sociodemographic subgroups, unemployed men had the greatest prevalence of reporting exposure to any IPV (69.2%) and all IPV types. After adjustment for sociodemographic factors, men's exposure to any lifetime IPV was associated with an increased likelihood of reporting 4 of the 7 assessed health outcomes: poor general health (adjusted odds ratio [AOR], 1.78; 95% CI, 1.34-2.38), recent pain or discomfort (AOR, 1.65; 95% CI, 1.21-2.25), recent use of pain medication (AOR, 1.27; 95% CI, 1.00-1.62), and any diagnosed mental health condition (AOR, 1.66; 95% CI, 1.11-2.49). Specific IPV types were inconsistently associated with poor health outcomes. Any physical IPV exposure was associated with poor general health (AOR, 1.80; 95% CI, 1.33-2.43), recent pain or discomfort (AOR, 2.23; 95% CI, 1.64-3.04), and frequent use of pain medication (AOR, 1.69; 95% CI, 1.08-2.63), which appeared to be associated with exposure to severe physical IPV. Exposure to sexual IPV, controlling behaviors, and economic abuse was not associated with any assessed outcomes after sociodemographic adjustment. Experience of a higher number of IPV types did not show a clear stepwise association with number of health outcomes. Results of this study indicate that exposure to IPV can adversely affect men's health but is not consistently a factor in men's poor health at the population level. These findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

Lateralized overgrowth as a guiding sign of abdominal neoplasms for pediatric orthopedic surgeons.

This study aims to increase the awareness of the association between lateralized overgrowth (LO) and abdominal tumor among the pediatric orthopedic community and to evaluate its incidence in our center. Between January 1997 and December 2021, a total of 166 patients with Wilms tumors and hepatoblastomas were retrospectively analyzed. Data including age, sex, initial clinical signs (hematuria, abdominal mass with or without general discomfort), type of asymmetric regional body overgrowth (isolated or in relation with any syndrome), and tumor stage at diagnosis were recorded. In addition, age at which asymmetric regional body overgrowth was described and age at the time of tumor diagnosis were noted. Of a total of 166 patients, 133 were diagnosed with Wilms tumors (nephroblastomas) and 33 were diagnosed with hepatoblastomas. In 94% of the cases, the initial clinical signs were an abdominal mass and/or hematuria. Overall, five (3%) patients presented with LO. Four patients with Wilms tumor presented it at the initial clinical examinations. In three of these cases (2.3%), we found it isolated and, in the remaining patient (0.75%), it was associated with Beckwith-Wiedemann spectrum. Only one patient affected from hepatoblastoma (3%) presented with an isolated LO at the time of tumor diagnosis. Our study results show an incidence of LO in relation to intra-abdominal tumors of 3%. The latest updates recommend genetic testing to identify subgroups with a higher risk for tumor development that are more likely to benefit from tumor protocol surveillance.

Vaginal Microbiota Changes in the Vulvar Lichen Simplex Chronicus

Background: The vulvar lichen simplex chronicus (VLSC) is a common condition in gynecologic clinics. Though VLSC is not life-threatening, it usually causes pruritus, soreness and dispareunia, which cause general discomfort. The exact etiology of VLSC is unclear. This study was performed to explore the vaginal microbiota of VLSC and to identify the possible microbial factors in attacks. Methods: Ninety women were recruited. 45 patients with VLSC and 45 women without vulvar symptom were identified as lichen simplex chronicus (LSC) and H groups respectively. The vaginal microbiota of the two arms were compared by the V3-V4 region of 16S rRNA sequencing. Results: The LSC group had less alpha diversity than H group (p < 0.05) and the beta diversity of LSC group was also distinct from the H group. Linear discriminant analysis effect size (LEfSE) analysis indicated that genus Sneathia and family Leptotrichiaceae were discriminant taxa in LSC group. Phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) analysis found that microbial genes related to the signal transduction, metabolism of terpenoids and polyketides, transporters, nervous system, energy metabolism and others were different in the LSC and H groups. Conclusions: VLSC was associated with dysbioss of vaginal microbiota profiles compared with healthy control cases.

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy.

Even after decades of research and pharmaceutical development, cancer is still one of the most common causes of death in the western population and the management of cancer will remain a major challenge of medical research. One of the most common types of cancer is colorectal cancer (CRC). Prevention by detection of early-stage precursors is the most reliable method to prevent CRC development. In dependence of age, familial predisposition, and other risk factors the preventative routine screening for CRC by colonoscopy should be performed at least twice in intervals of about ten years. Although colonoscopy is a life-saving clinical examination reducing both incidence and mortality of CRC significantly, it has still a bad reputation in the population as an uncomfortable procedure with unpleasant side effects lasting sometimes over days to weeks. These effects are most likely caused by the bowel preparation before colonoscopy, which is crucial for a successful colonoscopy with high quality. Beside pain, bleeding and other rare but severe complications of colonoscopy, cleaning of the intestinal mucosa alters the gut microbiome significantly and consistently. Abdominal pain, cramps, diarrhea, nausea, bloating, and constipation are common adverse events which can continue to affect patients for days or even weeks after the procedure. In this multicenter, placebo controlled, double blind clinical trial, we investigated the effect of an intervention with a multispecies probiotic formulation for 30 days on the adverse events due to bowel preparation. We show that the treatment of participants with the multispecies probiotic formulation decreases the number of days with constipation significantly, and reduced pain, bloating, diarrhea, and general discomfort. 16S based amplicon analyses reveal recovery of administered probiotic strains from stool samples and differences in alpha diversity dynamics with higher variability in the probiotic group compared to the placebo group. In conclusion, the probiotic ameliorates the side effects after colonoscopy and might be an important supplement to increase acceptance of this life-saving preventative examination. Further, we present here for the first time that probiotic intervention of only 30 days affects alpha diversity parameters in stool samples.

Afoxolaner (NexGard®) in pet snakes for the treatment and control of Ophionyssus natricis (Mesostigmata: Macronyssidae)

BackgroundOphionyssus natricis is the main species of mite that infests captive reptiles. High infestations may result in the host experiencing general discomfort and deleterious effects, even death. Moreover, O. natricis is an important vector of reptile vector-borne diseases and is considered to be the putative vector of the Reptarenavirus, the causal agent of the inclusion body disease. Despite the cosmopolitan distribution of O. natricis in captive reptiles, treatment options are limited. The aim of the present study was to assess the efficacy of afoxolaner (NexGard®; Boehringer Ingelheim, Ingelheim, Germany) in heavily infested, privately owned snakes, evaluate the prevalence of mites and drug availability in the plasma of treated snakes (pharmacokinetics) and perform a clinical examination of animals.MethodsThe study was conducted in two snake breeding facilities, where many snakes were infested with mites. Each animal was clinically examined and weighed, and mite infestations were assessed on the animals and in their enclosures (environment). Animals were treated with a dose of 2.5 mg afoxolaner per kilogram body weight (2.5 mg/kg) administered orally. All animals were examined pre-treatment (T0) and at various time points post-treatment (T1, 6 h; T2, 24 h; T3, 14 days; T4, 28 days). The collected mites were morphologically identified at the species level and the species identity also confirmed molecularly.ResultsOverall, 81 snakes from the two participating facilities (i.e. 70 from site 1 and 11 from site 2) were screened, and 31 (38.3%) snakes were found to have at least one mite. All mites were identified morphologically and molecularly as O. natricis. Lampropeltis was the genus of snakes with highest number of infested individuals. Mites were found to be alive on snakes at T1, but at T2 only dead mites were observed, and at T3 and T4 mites were no longer present on the animals or in their environment. No side effects were observed in the treated snakes.ConclusionsA single oral administration of afoxolaner at 2.5 mg/kg was a safe treatment for snakes and 100% effective for the eradication of natural O. natricis infestation without the need to treat the environment of the snake.Graphical

Management of Systemic Lupus Erythematous Through Panchkarma Modality W.S.R Pittaadhkiya Vatarakta : A Case Study

Defense mechanism (immune system) is a primary function to protect our body from external invaders (bacteria, virus), but in some situations our immune system attacks the body itself and it includes hypersensitivity reaction, autoimmune disorders and immunodeficiency Immune disorder (like SLE) is a dysfunction of immune system. SLE (systemic lupus erythematous) is autoimmune disorder which causes long term chronic inflammation of affected organs leading to degradation in overall quality of life. SLE is much more common in female than male. It may occur at any age, but appears most often in reproductive age. Its manifestation are fatigue, fever, rashes, general discomfort, uneasiness, Hair loss, Mouth sores, Sensitivity to sunlight, swollen lymph node .As discussed above, sign and symptoms of SLE have similarities with pittaadhkiya vatarakta in Ayurveda. An attempt is made to treat SLE with panchkarma procedure like Basti (patoladhi ghrita Anuvasan basti and yastimadhuadi ksheer niruh Basti).

СПЕЦИАЛЬНЫЕ ХИМИЧЕСКИЕ СПОСОБНОСТИ И АДАПТАЦИЯ СТУДЕНТОВ МЛАДШИХ КУРСОВ К УЧЕБНОЙ ДЕЯТЕЛЬНОСТИ В УСЛОВИЯХ МЕДИЦИНСКОГО ВУЗА

The article analyzes the relationship between special chemical abilities and actual academic performance. The problem of students’ adaptation to studying at the medical university is considered. Subjective self-evaluative components of adaptation associated with the general emotional discomfort of students during their undergraduate studies are well investigated in modern scientific literature. At the same time, objective criteria of student success in the learning process, special abilities, rarely act as a subject of research in this context. It is special abilities that act as prerequisites for a student's success in mastering the material and high academic performance. The given research presents the data of an empirical study of the level of development of special chemical abilities in 2nd year students of the medical faculty of the Ryazan State Medical University and their relationship with actual academic performance and self-assessment components of adaptation – satisfaction with one’s success and interest in the learning process. It has been established that developed chemical abilities have a statistically pronounced relationship with a high level of student satisfaction with their academic success, as well as with high academic performance. The conclusion is made about the high importance of the development of chemical abilities in the medical students’ adaptation to studying at a university.

The Appliance of A-PRF and CGF in the Treatment of Impacted Mandibular Third Molar Extraction Sockets—Narrative Review

Tooth extractions, especially of impacted lower third molars, are among the most common procedures performed in dental practices. The continuity of the patient’s oral mucosa, which is interrupted during them, can manifest itself in general discomfort, pain, swelling, and even trismus. In the age of cosmetic dentistry, when lost teeth are restored through implant, prosthetic, and orthodontic treatment, each tooth extraction actually reduces the amount of available alveolar bone. This has prompted researchers to develop extraction sockets treatment procedures that reduce the negative consequences of surgical intervention while also enhancing the rate of alveolar bone and soft tissue regeneration using minimally invasive approaches. This is expected to enable or significantly facilitate further stages of treatment. The aim of this paper is to review the literature on the use of autologous blood preparations, which are considered to aid regenerative processes when applied to extraction sockets.

Feasibility of clinical and electrocardiographic follow-up of prinzmetal angina using the metaverse

Abstract Background The recent pandemic triggered an acceleration in adopting innovative technologies and telemedicine novelties. The metaverse, representing a merge of digital worlds using augmented reality (AR) and virtual reality (VR), promises disruptive transformation in healthcare. The feasibility of combining the metaverse with cardiovascular telemedicine services empowering remote consultation as well as assisting heart disease prevention and diagnosis, has not been investigated yet in cardiology. Purpose We evaluated the feasibility of combined clinical and electrocardiographic follow-up inside the metaverse on top of standard of care for a patient who presented with prinzmetal angina. Methods A digital consultation room combining AR/VR was created in a metaverse platform (GDPR compliant, CE marked class I medical device). Patient and cardiologist were given a personal and secured login account. Interactions and connections were made via virtual avatars. Patient was instructed to ask for a consultation in case of any cardiac related symptom occurred. The patient was equipped with a previously validated portable hospital-grade 12-lead smartphone-based electrocardiograph device which was directly integrated to the metaverse platform. Results A 30 years old obese active smoker patient presented for recurrent episodes of typical cardiac chest pain at rest. ECG showed sinus rhythm, normal atrioventricular and intraventricular conduction and no repolarization abnormalities. Laboratory test were normal, echocardiography showed a normal biventricular function with no focal abnormalities or valvular disease. Coronary angiogram excluded the presence of coronary artery disease, and the most possible diagnostic scenario was prinzmetal angina from coronary artery spasm. The patient was therefore discharged under treatment with diltiazem 120 mg twice daily, a multiple lead smartphone ECG device as well as the access to metaverse via his avatar, since no ECG were available during the episodes. Ten days later, the patient experienced an episode of palpitation accompanied with general discomfort. He subsequently logged into the metaverse where the cardiologist was available. The anamnesis of the episode was collected as well as the auto-recorded ECG by the patient. Although the clinical and electrocardiographic data were reassuring, the physician proposed to seek for medical attention. Hospital work up was consistent with the diagnosis provided in the virtual consultation. Conclusions To our knowledge, we conducted the first medical act in cardiology inside the metaverse combining VR environment with existing cardiovascular technological innovations as support information to the standard of care. Exploiting the full potential of the metaverse could serve as an unparalleled leap in the way cardiovascular medicine is delivered and could introduce new dimensions to cardiology in terms of health education, disease prevention and diagnosis. Funding Acknowledgement Type of funding sources: None.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

ObjectiveTo evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings. MethodsIn this prospective randomized study, consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups, with three different operating room settings. Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory (in males) and Female Sexual Function Index-6 (in females), respectively. All the participants were stented following the procedure, and the stent was removed after 3 weeks. Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week, 3 weeks, and 12 weeks. The effect of surgery-related anxiety, preoperative sexual function, age, and general discomfort (including stent-related discomfort) on post-procedural sexual function were analyzed using multiple regression analysis. A p-value of less than 0.05 was considered statistically significant. ResultsTotally, 327 eligible patients were randomized into three groups. The group of patients who underwent the procedural with a screen separating the operating area from the patient vision, while the patient could watch the endoscopy through a separate monitor, had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked. This difference was statistically significant. This post-procedural reduction in sexual function could not be attributed to in situ stent alone. ConclusionsOur study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function, which can be reduced with proper preoperative counseling and an ideal operating room settings.

Clinical studies in Chinese subjects investigating the tolerance and soothing efficacy of a cream and balm containing 4-t-butylcyclohexanol on the sensitivity of facial skin.

Asian subjects are particularly prone to skin sensitivity. We developed a facial cream and balm containing 4-t-butylcyclohexanol to provide skin comfort and a soothing effect for sensitive skin. Assess the dermatological and ophthalmological tolerance and efficacy in improving skin sensitivity of face cream and balm under normal conditions of use by a population known to be particularly prone to this problem. In a monocentric non-randomized open trial, the cream or balm was applied twice daily to the face, neck, and eye contour of 33 stinger subjects with hypersensitive skin (22-63 years old). Assessments included dermatological and ophthalmological physical and functional signs on Day 1 (D1), D8, and D22, and cosmetic acceptability, cutaneous sensitivity according to a stinging test and the sensitive scale, and the soothing efficacy according to a questionnaire on D22. The cream and balm were very well tolerated. Immediately after application, subjects reported a reduction in the skin's hypersensitivity (93.9% of subjects for the cream and 81.8% for the balm), skin redness (90.9% of subjects for the cream and 87.9% for the balm), sensations of tightness (93.9% for the cream and 97.0% for the balm), and discomfort sensations (93.9% for the cream and 87.9% for the balm). After 21 days, the application of the cream and balm decreased the stinging scores by 65% and 41%, respectively, with 94% and 77% of subjects showing an improvement, respectively. The sensitivity scale questionnaire indicated that the cream and balm significantly and profoundly decreased all negative signs, for example, irritability, stinging, general discomfort, redness, and dryness on D22 compared to D1. On D22, all 15 parameters recorded were improved by 89%-100% by the cream and by 74%-100% by the balm. The majority (90.9% and 96.8% of subjects using the cream and balm, respectively) of the subjects noticed positive changes in their skin condition after using the product for 21 days. The cream and balm were very well-tolerated. This study demonstrated that both products controlled and markedly reduced skin hypersensitivity in Asian subjects, with an immediate and lasting skin soothing and repairing effect over 21 days.

Mask-Wearing Behaviors after Two Years of Wearing Masks Due to COVID-19 in Korea: A Cross-Sectional Study.

In Korea, wearing masks in public places has become the norm during the prolonged coronavirus disease 2019 (COVID-19) pandemic. This cross-sectional study investigated the mask-wearing behavior of Koreans (n = 433) via online mode living in Seoul and Gwangju after wearing a mask in public spaces for two years due to COVID-19. The respondents selected their face masks based on season, gender, age, occupation, mask-wearing hours, mask filter performance, mask shape, and mask color. The general discomfort caused by wearing a mask was divided into physical and speech discomfort, and it was not correlated with anxiety when not wearing a face mask. Speech discomfort caused by wearing a mask was correlated with general discomfort, clear speech, vocal pain, anxiety, and only-indoor mask-off plans. Anxiety when not wearing a mask appeared to affect both indoor and outdoor mask-off plans. The more uncomfortable and less anxious respondents were when not wearing a mask, the sooner they wanted to discontinue wearing masks indoors and outdoors. It is expected that the use of masks will continue in the future and that there may be differences in the place and time of use of masks in Korea and around the world due to new infectious diseases and fine dust. Facial masks can be worn more comfortably and conveniently if the discomfort and anxiety of wearing a mask are improved by considering various behaviors when wearing a mask in the future.