Background Massive screening campaigns for SARS‐CoV‐2 are currently carried out throughout the world, relying on reverse‐transcriptase‐polymerase chain reaction (RT‐PCR) following nasopharyngeal swabbing performed by a healthcare professional. Yet, due to the apprehension of pain induced by nasopharyngeal probing, poor adhesion to those screening campaigns can be observed. To enhance voluntary participation and to avoid unnecessary exposition to SARS‐CoV‐2, self‐swabbing could be proposed. To date, no data have been published concerning pain induced by conventional‐ or self‐swabbing. Thus, the primary objective of the present study was to evaluate pain induced with the conventional swabbing method and compare it to self‐swabbing. Secondary objectives focused on swabbing‐induced discomfort and acceptability of the two methods. Methods The study was conducted in Clermont‐Ferrand medical school (France). Overall, 190 students were randomised into two groups and experienced either self‐ or conventional‐swabbing. Each subject had to rate pain, discomfort and acceptability of such swabbing on a 0–10 numeric rating scale. Results No significant difference was found between the two methods. The mean pain level was 2.5 ± 1.9, 28% rating pain as ≥4/10. Discomfort was 4.8 ± 2.2, 66% indicating significant (≥4/10) discomfort. Higher pain and discomfort were associated with female sex. Acceptability was ≥8/10 for 89.0% of the subjects and all would have accepted to undergo a new test with the same technique if necessary. Conclusion Both conventional and self‐swabbing induce low levels of pain for most young healthy volunteers whereas discomfort is very frequent. Nonetheless, both methods are indifferently well‐accepted in medical students. Future studies amongst symptomatic subjects are awaited. Significance Using the thinnest available swabs, procedural pain induced by nasopharyngeal swabbing for SARS‐CoV‐2 screening is very low for most subjects and should not limit voluntary participation in screening campaigns. Self‐swabbing does not lead to more pain or discomfort compared to conventional swabbing, is well‐accepted, and could be proposed to optimize screening campaigns, at least in healthcare professionals.

Objectives To evaluate the safety and efficacy of ketamine‐magnesium combination to reduce attacks in a series of patients with refractory chronic cluster headache (rCCH). Background Refractory chronic cluster headache (CCH) is a rare but highly debilitating condition that needs new treatment options. A previous publication reported that a single infusion of ketamine‐magnesium combination was effective in 2 patients with rCCH. Methods The treatment was proposed to consecutive patients with rCCH seen in 2 French hospitals between November 2015 and February 2020 and who were resistant to at least 3 preventive treatments. They received a single ketamine infusion (0.5 mg/kg over 2 hours) combined with magnesium sulfate (3000 mg). The main outcome was a comparison of the number of daily attacks 2 weeks prior to the ketamine‐magnesium infusion and 1 week after (on days 7 and 8). The second outcome was the percentage of responders (patients with ≥50% reduction in the frequency of daily attacks). Safety was assessed by the recording of adverse events during infusion. Descriptive statistics are presented as mean ± standard deviation. Results Seventeen patients (14 men), with an age of 35.2 ± 8.1 years, were included. They presented with CCH for 6.6 ± 4.3 years. The number of daily attacks decreased from 4.3 ± 2.4 before treatment to 1.3 ± 1.0 after treatment (difference: −3.1 (95% CI: −4.5 to −1.6), P < .001). Seventy six percent (13/17) were responders. Transient and mild sedation was reported by 7/17 patients (41.2%). Conclusions The ketamine‐magnesium combination seems an effective and well‐tolerated therapy for rCCH. Placebo‐controlled studies should be conducted to further confirm these findings.