Patient Discomfort Research Articles

Symptom networks analysis among people with Meniere’s disease: Application for nursing care

ObjectivesThis study aimed to explore and visualize the relationships among multiple symptoms in patients with Meniere’s disease (MD) and aid clinical nurses in the design of accurate, individualized interventions. MethodsThis study included 790 patients with MD at the Eye and ENT Hospital of Fudan University from October 2014 to December 2021. A self-designed symptom checklist was used to assess 15 MD-related symptoms and construct contemporaneous networks with all 15 symptoms in R software. Qgraph package and Fruchterman-Reingold layout were used for network visualization. Bootstrapping methods were performed to assess network accuracy and stability, and three centrality indices were adopted to describe relationships among symptoms. ResultsSymptom networks showed good accuracy and stability. “Anxiety and nervousness”(98.2%), “aural fullness”(84.4%) and “tinnitus”(82.7%) were the common symptom in MD patients, while “tinnitus”, “aural fullness” and “decline in word recognition”, were more serious. MD patients with longer disease duration had higher prevalence and severity for all symptoms (P < 0.05). Symptom networks showed good accuracy and stability. “Decline in word recognition,” “fatigue,” and “anxiety and nervousness” were at the center of the symptom networks, which had the largest strength values and closeness. “Decline in word recognition,” “headache,” and “spatial discrimination and poor orientation” were the symptoms with the highest betweenness with the strongest bridging effect. The ≥1-year disease group exhibited higher centralities for “drop attack” and “anxiety and nervousness,” and a lower centrality for “headache” compared with the <1-year disease group. ConclusionsThe symptom networks of MD patients with varying disease durations were revealed. Clinicians and nurses must provide precision interventions tailored to modifying symptom severity and centrality. Nursing interventions should focus on word recognition issues and associated discomfort in MD patients with multiple symptoms.

Polyvinylpyrrolidone hydrogel coating for ureteral stent: Safety and performance evaluation.

Ureteral stents are commonly used in urology. However, complications such as encrustation and infection on the surface of the stent, and injury to the ureteral mucosa can occur after implantation, causing discomfort for patients. We intend to confirm the biosafety of polyvinylpyrrolidone (PVP) hydrophilic coating and its lubrication properties for surface modification of ureteral stents to reduce friction and improve patient comfort. Based on our previous studies, we have developed a PVP hydrophilic coating for surface modification of ureteral stents. We firstly investigated the cytotoxicity, intradermal irritation, delayed type hypersensitivity, and acute systemic reactions of stent coating extracts. We further characterized the break strength, retention strength, and dynamic friction of the stent. The cell survival rate of all experimental groups was greater than 70%. No hypersensitivity reaction, systemic toxicity reaction, or obvious intradermal reaction were observed. The above results indicate that the test results of the modified stent meet the requirements of ISO 10993-5: 2009 (Cytotoxicity); ISO 10993-10:2021 (Sensitization and Irritation); ISO 10993-11:2017 (Acute Systemic Toxicity). After soaking in artificial urine for an extended period, there was no obvious change in its super-slip performance. Our results confirm the safety and lubrication characteristics of PVP hydrophilic coating for ureteral stent surface modification. The performance of this coating has the potential to reduce complications after stent implantation, thereby improving patient comfort, reducing medical burden, and has a good clinical application prospect.

Tissue Engineering Auricular Cartilage: A Review of Auricular Cartilage Characteristics and Current Techniques for Auricular Reconstruction.

Microtia and anotia are congenital auricular anomalies that negatively impact the psychosocial development of those affected. Because auricular cartilage is a type of elastic cartilage that lacks regenerative capacity, any notable defect in its structure requires a surgical approach to reconstructing the auricle. While there are several reconstructive options available between alloplastic and prosthetic implants, autologous rib cartilage grafts remain the most commonly used treatment modality. Still, this widely used technique is accompanied by significant patient discomfort in a young child and carries additional risks secondary to the traumatic process of rib cartilage extraction, such as pneumothorax and chest wall deformities, and the final esthetic results may not be ideal. To circumvent these limitations, tissue engineering approaches have been used to create a realistic-looking ear that mirrors the complex anatomy of the normal ear. This article reviews the biochemical and biomechanical properties of human auricular cartilage as they relate to design criteria. In addition, a variety of cell sources, biocompatible scaffolds, scaffold-free techniques, and mechanical and biological stimuli are discussed. This review aims to identify knowledge gaps in the literature related to auricular cartilage characteristics and make recommendations to drive the field of auricular tissue engineering.

Cardiac MRI: An Overview of Physical Principles With Highlights of Clinical Applications and Technological Advancements.

The purpose of this review is to serve as a concise learning tool for clinicians interested in quickly learning more about cardiac magnetic resonance imaging (CMR) and its physical principles. There is heavy coverage of the basic physical fundamentals of CMR as well as updates on the history, clinical indications, cost-effectiveness, role of artificial intelligence in CMR, and examples of common late gadolinium enhancement (LGE) patterns. This literature review was performed by searching the PubMed database for the most up-to-date literature regarding these topics. Relevant, less up-to-date articles, covering the history and physics of CMR, were also obtained from the PubMed database. Clinical indications for CMRinclude adult congenital heart disease, cardiac ischemia, cardiomyopathies, and heart failure. CMR has a projected cost-benefit ratio of 0.58, leading to potential savings for patients. Despite its utility, CMR has some drawbacks including long image processing times, large space requirements for equipment, and patient discomfort during imaging. Artificial intelligence-based algorithms can address some of these drawbacks by decreasing image processing times and may have reliable diagnostic capabilities. CMR is quickly rising as a high-resolution, non-invasive cardiac imaging modality with an increasing number of clinical indications. Thanks to technological advancements, especially in artificial intelligence, the benefits of CMR often outweigh its drawbacks.

Retrospective Long-Term Results After Dellon's Nerve Decompression In The Lower Leg For Polyneuropathy

Patients affected by polyneuropathy often report pain, paraesthesia and numbness and are at risk of having an increased propensity to fall with the corresponding complications. In case of persistent symptoms after all conservative and medical treatment options have been exhausted, a nerve decompression in the lower leg as described by Dellon can lead to an improvement of the discomfort for many patients. This article presents our long-term results with Dellon's operation. In this retrospective study, we included 33 patients with diabetic or idiopathic polyneuropathy in whom we performed Dellon's nerve decompression in the lower leg in the years 2011-2013. In 29 out of the 33 patients, we investigated the level of pain (according to the numeric rating scale NRS 0-10), paraesthesia, numbness, Hoffman-Tinel sign, and Semmes-Weinstein monofilaments three months postoperatively. 88 months postoperatively (range 78-111 months), we were able to contact 20 of the 33 patients with a questionnaire asking about their present pain level (NRS 0-10), satisfaction with the postoperative result (NRS 0-10, 0=most satisfied, 10=not satisfied at all) and whether the patients would recommend the surgical procedure to their friends or family. 1. Significant pain reduction three months postoperatively, NRS 4.5 to 2.2, (p=0.000). 2. Significant reduction of paraesthesia three months postoperatively from 84.8 to 24.2% (p=0.000) 3. Significant reduction of numbness three months postoperatively from 97% to 39% (p=0.000). 4. Significant improvement of sensitivity three months postoperatively from 91% no sensitivity to 28% no sensitivity (p=0.000). 5. Significant improvement of Hoffmann-Tinel sign three months postoperatively from 76% to 13% (p=0.000). 88 months postoperatively, we saw a significant pain reduction from an average preoperative pain level of NRS 4.5 to a postoperative pain level of 2.7 (p=0.048). 88 months postoperatively, 65% of the patients would recommend the surgical procedure to their family and friends, and patient satisfaction was high (NRS 3,4). Our long-term results show that Dellon's nerve decompression in the lower extremities leads to a marked, lasting pain reduction and a functional improvement.

Policies and Practices Regarding Preparative Fasting for Contrast-Enhanced Computed Tomography: A Nationwide Survey.

To evaluate current policies and practices regarding preparative fasting before contrast-enhanced computed tomography (CECT) and the knowledge and attitudes of radiology head nurses. Radiology head nurses in 499 Chinese hospitals participated in an online survey on preparative fasting for CECT, which mainly included current departmental policies and practices and their knowledge and attitudes. Response rate was 89.8% (448/499). All surveyed hospitals established preparative fasting protocols, mainly based on guidelines for iodinated contrast media (ICM) usage (68.8%). For the nongastrointestinal CECT scan, the most frequent fasting duration for solid food, semiliquid diet, liquid diet, and clear liquids was 4 to 6 hours (215/422 [50.9%]), less than 6 hours (332/396 [83.8%]), less than 6 hours (275/320, 85.9%), and less than 6 hours (151/189 [79.9%]), respectively. Forty-six percent of the respondents confirmed that unnecessary excessive fasting existed in practice, and the related patient discomfort occurred in 60.3% of the hospitals, mainly manifested as hypoglycemia (86.7%). Expert consensus and guidelines for iodinated contrast media usage (75%) were the leading approach to gain knowledge about preparative fasting; 90.6% of the respondents believed that the clinical scenarios requiring preparative fasting were the upper abdominal examinations. A majority of respondents (72.1%) believed that the current preparative fasting policies needed improvement. Preparative fasting policies varied among hospitals in terms of the fasting content and duration. Respondents' opinions differed on fasting requirements based on various CECT examination sites and patients. The latest guideline regarding no fasting before CECT has not been fully adopted. Further research is required to promote the transformation of guideline evidence.

Prospective Evaluation of Dental Practitioners' Knowledge, Attitude, and Practice Toward Adult Dental Pain Management: A Cross-Sectional Multicenter Study.

Background Dental pain among adults is a prevalent concern impacting oral health and quality of life. Dental pain management presents a significant challenge for dental practitioners in effectively alleviating patient discomfort. Among the medications available, non-steroidal anti-inflammatory drugs (NSAIDs) are considered the most effective analgesics in dental care. While numerous studies have been conducted to assess the role of antibiotics in dental practice, there is a scarcity of studies specifically examining the prescription patterns of analgesics. The primary aim of this study was to evaluate the knowledge, attitudes, and practices of dental practitioners (DPs) in India concerning the management of adult dental pain. Method This survey utilized a computer-aided questionnaire-based approach. A total of 110 dentists, including 16 from metropolitan areas and 84 from non-metropolitan cities practicing at dental healthcare setups, clinics, and hospitals, were interviewed as part of the survey. The participants comprised dental professionals specializing in prosthodontics, endodontics, orthodontics, periodontics, oral surgery, pedodontics, and oral medicine. The study was conducted between September 2022 and January 2023. Results The primary reason patients seek dental consultation, as reported by 95% of dentists, is tooth cavities, followed by tooth sensitivity, post-root canal treatment, and pulpitis. All surveyed dentists prescribed NSAIDs to their patients for managing dental pain. Local anesthesia (LA) was the second choice for 75% of dentists, prescribed to 23% of their patients. The primary use of NSAIDs was for patients experiencing severe pain and to manage post-procedure pain. Eighty percent of DPs recognized ketorolac as a fast-acting molecule, providing immediate relief within 10-15 minutes. Overall, analysis indicated that 98% of DPs are satisfied and 67% are extremely satisfied with ketorolac among monotherapies for dental pain management due to its quick onset of action, fast pain relief, and usefulness in post-surgical pain management. Conclusion NSAIDs like ketorolac, diclofenac, and aceclofenacwere the preferred prescriptions for overall dental pain management. Dental practitioners associated ketorolac with fast pain relief, quick onset of action, and effectiveness in post-surgical pain management, emphasizing its lasting effects. The insights from the study contribute to enhancing dental pain management strategies.

Medical CT image diagnosis and simulation of drug sedation during ultrasound-guided transbronchial needle aspiration process

CT image diagnosis is widely used in clinical practice, but the effect of drug sedation during bronchial aspiration has not been fully simulated and studied. The aim of this study was to simulate the effect of drug sedation in the process of transbronchial needle aspiration guided by medical CT images in order to explore its potential effect in clinical application. A diagnostic model based on medical CT images was established to simulate the sedation of drugs during bronchial needle aspiration. A series of parameters of sedation, including dose, route of administration and drug selection, were used to better simulate the actual situation. The simulation experiment observed that the effect of drug sedation in the process of bronchial needle aspiration under the guidance of medical CT image diagnosis can effectively relieve the pain and discomfort of patients, and improve the success rate of the operation process, and drug sedation can also reduce the occurrence of postoperative infection and complications. Therefore, under the guidance of medical CT image diagnosis, the simulation of drug sedation during the process of transbronchial needle aspiration can help doctors better perform relevant operations and improve the safety and success rate of surgery.

Research on product design of FAHP bone marrow aspiration needle

Bone marrow aspiration is a crucial medical procedure to obtain bone marrow samples for diagnosis and treatment. However, traditional bone marrow aspiration needles face several challenges such as operational difficulties, inadequate sample acquisition, and patient discomfort. To address these issues, we aimed to design a bone marrow aspiration needle product by using fuzzy analytic hierarchical process (FAHP). The FAHP method was used to identify key factors in the design of the bone marrow aspiration needle, including technicality, usage, and application characteristics. The importance weights and priorities of each factor were determined through questionnaires and interviews with experts. A new bone marrow aspiration needle product was developed based on the results of the FAHP. The new product design considers the weights and priorities assigned to key factors, resulting in improved convenience during operation and a higher success rate of sample acquisition. This was achieved by optimising the structure and material selection of the needle. This study presents a novel bone marrow puncture needle product that effectively integrates the importance and priority of the key factors. It successfully enhances operational performance and patient experience, thereby offering an innovative solution to improve the success rate and therapeutic effect of bone marrow punctures.

Spray nozzle for topical anaesthesia during flexible bronchoscopy: a randomised controlled trial.

The effectiveness of using a spray nozzle to deliver lidocaine for superior topical airway anaesthesia during non-sedation flexible bronchoscopy (FB) remains a topic of uncertainty when compared with conventional methods. Patients referred for FB were randomly assigned to receive topical lidocaine anaesthesia via the bronchoscope's working channel (classical spray (CS) group) or through a washing pipe equipped with a spray nozzle (SN group). The primary outcome was cough rate, defined as the total number of coughs per minute. Secondary outcomes included subjective perceptions of both the patient and operator regarding the FB process. These perceptions were rated on a visual analogue scale, with numerical ratings ranging from 0 to 10. Our study enrolled a total of 126 (61 CS group; 65 SN group) patients. The SN group exhibited a significantly lower median cough rate compared with the CS group (4.5 versus 7.1 counts·min-1; p=0.021). Patients in the SN group also reported less oropharyngeal discomfort (4.5±2.7 versus 5.6±2.9; p=0.039), better tolerance of the procedure (6.8±2.2 versus 5.7±2.7; p=0.011) and a greater willingness to undergo a repeat FB procedure (7.2±2.7 versus 5.8±3.4; p=0.015) compared with those in the CS group. From the operator's perspective, patient discomfort (2.7±1.7 versus 3.4±2.3; p=0.040) and cough scores (2.3±1.5 versus 3.2±2.4; p=0.013) were lower in the SN group compared with the CS group, with less disruption due to coughing observed among those in the SN group (1.6±1.4 versus 2.3±2.3; p=0.029). This study illustrates that employing a spray nozzle for the delivery of lidocaine provides superior topical airway anaesthesia during non-sedation FB compared with the traditional method.

Pilot Study to Demonstrate Improvement in Skin Tone and Texture by Treatment with a 1064 nm Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser.

The 1064 nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser was developed to treat unwanted pigmentation in the skin such as lentigines caused by photoaging, and tattoos from dye/ink insertion. This laser has also been used for non-ablative epidermal rejuvenation (skin toning). To evaluate changes in skin tone, skin texture and overall improvement after a series of treatments with the QS Nd:YAG laser. Participants received seven full-face treatments with M22 or Stellar M22, a 1064 nm QS Nd:YAG laser, at 2-week intervals. The investigators and participants evaluated the improvement in skin tone and texture at 1, 3 and 6 months after the last treatment. Patient satisfaction, patient discomfort, downtime and adverse events were recorded. Histological changes in the treated area were also evaluated. Thirteen women with a median age of 45 years (range, 34-61 years) were included in the study. The majority of the participants (53.9%) had skin type VI. One month after the last treatment session, 38% of participants reported good to very good improvement. This value increased to 100% participant improvement at both the 3-month and 6-month follow-up visits. The reduction in melanin index and the histological analysis demonstrated that the laser procedure contributed to a reduction in epidermal melanin content. Treatments were not associated with high levels of pain or discomfort. The most common immediate post-treatment response was erythema and edema. Most participants were satisfied with the resulting treatment outcome. Skin treatment with the 1064 nm QS Nd:YAG laser module on the M22 and Stellar M22 devices, using a large spot size, low fluence, moderately high repetition rate, improves skin tone and texture in patients with skin types II-VI.

Novel Virtual Reality App for Training Patients on MRI-guided Radiation Therapy

PurposePatients receiving respiratory gated magnetic resonance imaging-guided radiation therapy (MRIgRT) for abdominal targets must hold their breath for ≥25 seconds at a time. Virtual reality (VR) has shown promise for improving patient education and experience for diagnostic MRI scan acquisition. We aimed to develop and pilot-test the first VR app to educate, train, and reduce anxiety and discomfort in patients preparing to receive MRIgRT. Methods and MaterialsA multidisciplinary team iteratively developed a new VR app with patient input. The app begins with minigames to help orient patients to using the VR device and to train patients on breath-holding. Next, app users are introduced to the MRI linear accelerator vault and practice breath-holding during MRIgRT. In this quality improvement project, clinic personnel and MRIgRT-eligible patients with pancreatic cancer tested the VR app for feasibility, acceptability, and potential efficacy for training patients on using breath-holding during MRIgRT. ResultsThe new VR app experience was tested by 19 patients and 67 clinic personnel. The experience was completed on average in 18.6 minutes (SD = 5.4) by patients and in 14.9 (SD = 3.5) minutes by clinic personnel. Patients reported the app was “extremely helpful” (58%) or “very helpful” (32%) for learning breath-holding used in MRIgRT and “extremely helpful” (28%) or “very helpful (50%) for reducing anxiety. Patients and clinic personnel also provided qualitative feedback on improving future versions of the VR app. ConclusionThe VR app was feasible and acceptable for training patients on breath-holding for MRIgRT. Patients eligible for MRIgRT for pancreatic cancer and clinic personnel reported on future improvements to the app to enhance its usability and efficacy.

Embryo Transfer Procedural Parameters Do Not Predict IVF Cycle Outcome.

this study aims to assess the effect of embryo transfer (ET) performance parameters of a technical nature on IVF outcome. A total of 1417 ETs from a single IVF center were included in this prospective observational study. The parameters investigated were as follows: the presence of cervical mucus post catheter withdrawal, the presence of blood, catheter reload, the employment of a tenaculum and stylet, catheter resistance as experienced by the physician and patient discomfort. When ET performance parameters were associated with clinical outcomes on a singular level, none of the ET parameters presented with any statistical significance. The evaluation of covariates indicated that the number and the quality of transferred embryos, as well as maternal age, exerted a statistically significant effect on clinical outcomes. In a multivariate analysis, only the presence of mucus along with significant catheter resistance presented with statistical significance; however, when adjusting for covariates, this combination showed no statistically significant effect on clinical outcomes. the results indicate that the time-consuming process of recording and analyzing ET performance parameters fails to offer any additional value in predicting the cycle's outcome, while factors like embryo quality and number, as well as maternal age, seem to be the sole robust predictive factors of an IVF cycle.

Enhancing Power Generation for Solar-Based Cardiac Pacemakers: A Novel Approach with FOPID and HCMKH-BS2

Biomedical implants, such as implantable cardioverter heart monitors, rely on limited battery life, which necessitates costly replacements and patient discomfort. To address these challenges, a novel solar-based pacemaker model is proposed that is integrated with a fractional-order proportional integral derivative (FOPID) controller and a Hybridized Chaotic multiverse Krill Herd-based Backtracking Search Strategy (HCMKH-BS2) to enhance power generation for pacemaker operation. Our approach considers the impact of partial shading conditions on solar power. To mitigate these conditions, a FOPID controller with an HCMKH-BS2 model is developed which also addresses environmental issues through the adoption of a DC-DC converter. The gain parameters of the FOPID controller are determined using the proposed HCMKH-BS2 algorithm. The proposed technique is implemented to evaluate its performance using various measures in terms of duty cycle, convergence analysis, and power. The performance validation is performed based on the analyses of constant irradiance and changed irradiance. The proposed method achieved a fitness value of 0.01 from the convergence analysis and the duty cycle of 0.48D. These results demonstrate the superiority of our proposed technique over previous methods, highlighting its potential for enhancing the performance of solar-based cardiac pacemakers.

The many faces of a cough in a child: Issues of differential diagnosis and treatment

Studying the causes of cough, which is one of the most common respiratory symptoms when seeking medical help, remains a pressing problem for doctors of various specialties. Due to the growing interest in herbal remedies, in the current study we aimed to analyze the effectiveness of marshmallow root in the treatment of cough. We conducted a systematic search in modern scientific literature in electronic databases PubMed, EMBASE, Cochrane Library, Wiley, PubFacts, Springer Link platform, scientific publishing house Elsevier, CyberLeninka. An analysis of 80 full-text reviews on the use of herbal medicine in the treatment of cough showed higher quality of life scores, lower rates of adverse events and less severe cough. The authors also provide evidence that herbal therapy successfully complements traditional treatment methods, providing longer periods of remission for chronic cough. Although coughing is a protective reflex responsible for clearing secretions and foreign bodies from the airways, it can be an unpleasant symptom that causes discomfort in patients. The use of preparations based on root extract of Althaea officinalis L leads to the formation of a protective film, which promotes faster regeneration of the damaged mucous membrane of the respiratory tract caused by a dry cough. The mucous membrane of the respiratory tract is a highly vascularized tissue. In this regard, anti-inflammatory phytochemicals that improve lesion repair, such as local neovascularization, are critical to promote healing. The herbal medicinal product containing the active component marshmallow root extract fully meets safety requirements and can be successfully used in patients with acute and chronic respiratory diseases.

Colonoscopy and the psyche – pain and discomfort associations with affect and cognitive functions

Introduction: Colonoscopy is an important diagnostic and therapeutic procedure, however it causes considerable discomfort in patients. Their psychological functioning is sometimes not sufficiently taken into account by the medical staff, preoccupied with somatic conditions. The aim of this study was to reveal affective and cognitive aspects of how patients undergoing colonoscopy function in order to better understand periprocedural discomfort and pain and suggest interventions to reduce them. Material and methods: A total number of 101 patients, undergoing colonoscopy during their stay at the internal ward, were asked to participate in this prospective, observational study. Three measurements were made: the day before the examination, on the colonoscopy day (after bowel cleansing, before the procedure) and the following day. The State-Trait Anxiety Inventory, Beck Depression Inventory II, Montreal Cognitive Assessment, short version of The Illness Perceptions Questionnaire , as well as analog scales (measuring pain, sadness, anxiety, irritability, general discomfort and distress) were used. Ultimately, 50 people completed the study. Results: It has been shown that pain and discomfort on the colonoscopy day correlate positively with all measured aspects of negative affect. On the colonoscopy day 18% of the subjects revealed depressive symptoms matching a depressive episode, while 56.6% of the subjects displayed a high level of state anxiety. The worse the patient's understanding of the disease, the more periprocedural pain he/she experiences. Their cognitive functioning is worse on the colonoscopy day. Conclusions: The results suggest that it is advisable to educate patients early enough (not on the day of the procedure) about their ailments and planned colonoscopy. Keywords: psychiatry, colonoscopy, pain, emotions, cognitive function

Enhancing Calprotectin's Predictive Power as a Biomarker of Endoscopic Activity in Ulcerative Colitis: A Machine Learning Use Case.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. Using machine learning (ML) to combine fecal calprotectin with other clinical or biological tests can significantly enhance the non-invasive prediction of endoscopic disease activity (EDA) in UC. Aim: To prove that by fusing fecal calprotectin with other clinical data into an ML model, the performance of the non-invasive prediction of EDA can be significantly improved. Methods: We conducted a prospective, observational, single-center study encompassing 103 patients diagnosed with UC. We employed multilayer perceptron models as the core ML algorithm for predicting EDA. For the constructed models, we utilized the varImp function from the caret library in R to assess the significance of each variable in predicting the outcome. Results: Calprotectin as a sole predictor obtained an accuracy of 70% and an area under the curve (AUC) of 0.68. Combining calprotectin with the list of selected predictors that were fed to the MLP models improved accuracy and the AUC. The accuracy of the algorithm on the test set was 85%. Similarly, the AUC increased to 0.93. This is the first study to propose the use of calprotectin as a predictor in an ML model to estimate UC endoscopic disease activity. Conclusion: The deployment of this ML model can furnish doctors and patients with valuable evaluation of endoscopic disease activity which can be highly beneficial for individuals with UC who need long-term treatment.

Nasogastric tube after laparoscopic Heller-Dor surgery: Do you really need it?

BackgroundAchalasia is a rare esophageal motor disorder. Laparoscopic Heller-Dor surgery (LHD) is among the most effective treatments. The use of nasogastric tube (NGT) following LHD is still controversial. The aim of our study was to evaluate the role of NGT in achalasia patients undergoing LHD. MethodsWe prospectively enrolled achalasia patients treated with LHD from January 2019 until June 2022 at our institution and randomly assigned them to two groups: one group with NGT and group without (noNGT). Perioperative outcomes were compared between the two groups. ClinicalTrials.gov Identifier: NCT05729971. ResultsSeventy-nine patients who underwent LHD surgery were prospectively enrolled. Patients were divided in two groups: 38 with NGT and 41 noNGT. There were no significant differences between two groups in terms of demographic data, preoperative characteristics, length of stay, start of liquid and solid diet, intraoperative and postoperative complications. First flatus was shorter in the noNGT group (p= 0.03). ConclusionNasogastric tube placement following LHD surgery does not reduce nausea, vomiting and chest pain, while it increased patients discomfort and time of first flatus.

Versatile Platforms of Microneedle Patches Loaded with Responsive Nanoparticles: Synthesis and Promising Biomedical Applications

Microneedle array systems loaded with responsive nanoparticles have received increasing attention due to the advantages of good drug stability, targeting ability, controlled release of drugs, high bioavailability, painlessness, and good patient compliance. Compared with oral drug delivery, microneedle transdermal drug delivery eliminates the need to pass through the gastrointestinal tract and liver, reducing the metabolic consumption of drugs by first‐pass effect. While compared with intravenous drug delivery, microneedle transdermal drug delivery reduces patient discomfort and does not require professional administration. However, there are few review articles on microneedles loaded with responsive nanoparticles. Herein, the current researches on microneedles loaded with specific responsive nanoparticles such as glucose‐responsive, pH‐responsive, enzyme‐responsive, light‐responsive, magnetic‐responsive, ultrasound‐responsive, and multiresponsive, and the biomedical application of these microneedle array systems are summarized. In addition, the challenges and prospects of microneedle strategies loaded with responsive nanoparticles are briefly discussed, which will facilitate the development of such versatile drug‐delivery strategy.

A147 FACTORS ASSOCIATED WITH PATIENT COMFORT DURING ENDOSCOPIC RESECTION OF LARGE NON-PEDUNCULATED COLORECTAL POLYPS

Abstract Background Patient comfort is an important quality indicator in endoscopy, as it relates to patient satisfaction and adherence with endoscopic surveillance recommendations. Endoscopic resection techniques are now the primary treatment strategy for LNPCPs. However, factors associated with patient comfort are unknown. Aims To assess patient comfort during endoscopic resection of LNPCPs and factors associated with discomfort. Methods Consecutive patients ampersand:003E 18 years of age who underwent endoscopic resection for a LNPCP were enrolled in a prospective single center observation cohort study (clinicaltrials.gov ID: NCT05402696). The St. Paul’s Endoscopic Comfort Scale (SPECS) was used to assess patient comfort (total score; vocalization, body language, anxiety sub-scores). Patient discomfort was defined as a SPECS total or sub-score above 0. Results Between 06/2022 - 07/2023, 258 patients underwent 276 procedures to remove 318 LNPCPs. Median age was 67.0 years and 126 (48.9%) were female. Most patients were ASA II (168, 57.3%) and 268 (97.1%) received conscious sedation with midazolam and/or fentanyl. Median SPECS score was 0 (IQR 1) with a range of 0 (145, 56.6%) to 5 (2, 0.8%). Challenging access and proximal LNPCP location were associated with overall discomfort and vocalization respectively (both p ampersand:003C 0.03). Highest rate of discomfort corresponded to lesions with difficult reach and easy positioning (70.6% of patients with these lesions had SPECSampersand:003E0). Lesion size, resection technique or resection duration were not associated with discomfort. Conclusions Minimally invasive endoscopic resection techniques can be performed without patient discomfort in most patients with LNPCPs. Challenging access and proximal location should be taken into consideration when administering sedation. Funding Agencies None Gastrointestinal Oncology