Music and pain during endorectal ultrasonography examination: A prospective questionnaire study and literature review.

INTRODUCTION: Music interventions have been recognized as a method to reduce pain during medical procedures, but within medical imaging the subject has received little attention. Endorectal ultrasonography examination is in some patients associated with anxiety and pain, and since in Denmark pain relief is usually not administered by the Department of Radiology, it is important to find effective alternative methods to help patients manage their pain during imaging procedures. The primary aim of this study was to evaluate the effect of music on self-reported pain during endorectal examination of rectal cancer patients. METHODS: A prospective questionnaire study of patients undergoing endorectal ultrasonography was conducted. Patients were randomized into two groups: a music group (n = 66), and non-music group (n = 60). Standard endorectal ultrasonography was performed in all patients. Pain was self-assessed using a Visual Analogue Scale ranging from 0 to 10, with 0 representing "no pain" and 10 maximum pain. RESULTS: A total of 126 patients were included in the study, 81 (64.3%) men and 45 (35.7%) women. The demographics were similar in the two groups. The mean pain score during endorectal ultrasonography in the music and non-music group was 1.95 and 2.30, (p = 0.404). CONCLUSION: In this randomized study music did not significantly affect the pain level experienced by the patients. Endorectal ultrasound was not entirely painless but less painful than colonoscopy (Visual Analogue Scale 2.1 and 3.8, respectively). IMPLICATIONS FOR PRACTICE: Health care professionals may consider using music during painful procedures.

Vaginal and anal human papillomavirus infection and seropositivity among female sex workers in Amsterdam, the Netherlands: Prevalence, concordance and risk factors.

BACKGROUND: We studied prevalence, risk factors and concordance of vaginal and anal HPV infection and L1 seropositivity among female sex workers (FSW) in Amsterdam. METHODS: In 2016, FSW aged ≥18 years having a sexually transmitted infections (STI) consultation were invited to participate. Participation entailed taking vaginal and anal self-swabs. Demographics and sexual behaviour data were collected. HPV DNA was analysed using the SPF10-PCR-DEIA-LiPA25-system-v1. Serum was tested for HPV L1 antibodies using multiplex serology assays. Determinants of vaginal and anal high risk HPV (hrHPV) infection and L1 seropositivity were assessed with logistic regression analyses. RESULTS: We included 304 FSW; median age was 29 years (IQR 25-37). Vaginal and anal hrHPV prevalence were 46% and 55%, respectively. HrHPV L1 seropositivity was 37%. Vaginal-anal hrHPV concordance was strong, but no significant association between vaginal or anal hrHPV infection and seropositivity was found. Having had anal sexual contact was not associated with anal hrHPV infection (P = 0.119). DISCUSSION: Vaginal and anal hrHPV prevalence is high among FSW in Amsterdam, the Netherlands. Promotion of HPV vaccination, preferably at the beginning of the sex (work) career, may be a useful prevention method against hrHPV infection and disease.

Plasma essential fatty acids in pure and mixed race American Indians on and off a diet exceptionally rich in salmon.

Eskimos on a traditional diet have unusually low prevalences of cardiovascular disease and cancer. One possible reason is the high intake of eicosapentaenoic acid (EPA) which is thought to account for the high EPA and low arachidonic acid (AA) levels in Eskimo plasma. People who also consume a traditional diet exceptionally rich in EPA are the Indians of the west coast of Vancouver Island. There are about 12,000 of these people and their traditional diet has been affected much less than that of the Eskimos. When on their traditional diet the Vancouver Island Indians, like the Eskimos, have high EPA and low AA levels in plasma. When eating European food, EPA levels are in the European range, but AA levels are still exceptionally low, a finding also reported from Eskimos living in Denmark. In a small mixed race group, AA levels were intermediate between those in pure Indians and in Europeans. The high EPA levels in Eskimos and West Coast Indians are related to diet. The low AA levels, in contrast, are probably genetically determined. Unusual disease patterns in these populations cannot be entirely attributed to diet.