Objective During the COVID-19 pandemic, emergency medicine (EM) teachers had to employ innovative methods to ensure the continuity of the education process. The purpose of this study was to explore the adequacy of the 360-degree video (video 360) technology in EM education in the context of: (a) students' attitudes towards the video 360; (b) students' academic performance in their required examination at the end of the EM course compared to the assessment results of students from the previous academic year. Methods A mixed-method research project enrolled the fourth-year medical students who attended the required EM course during the first semester of the academic year 2020–2021 when all activities with undergraduate students went online and teaching scenarios recorded in the video 360 format were employed. Data collection was two-fold: (a) anonymous questionnaires, complemented with basic YouTube analytics; (b) multiple-choice questionnaires (MCQ) and oral examination, contrasting the results with those in 2019–2020. Data analysis used descriptive statistics and non-parametric methods. Results Seventy-nine students (53 females and 26 males) participated in the project and all completed the EM course. Students' interest in and their acceptance of the video 360 technology were high (total scoring in the upper 20% of the respective scales), with consistently good performance in two parallel, independent, interview-based oral/practical evaluations (Spearman correlation coefficient R = 0.665, p < .001). The majority scored over 90% in the summative MCQ, with higher values compared to their colleagues’ during the previous academic year (with on-site teaching): scoring percentages with mean ± standard deviation of 92.52 ± 4.57 and 76.67 ± 18.77, respectively. Conclusion Our project showed that the video 360 scenarios were effective in teaching EM. In the long term, employing this accessible and inexpensive educational approach would add value to on-site training by enriching the exposure to a specific ED environment. KEY MESSAGES Medical students valued the 360-degree video scenarios as contributing substantially to their EM knowledge and preparedness. Examination results confirmed the 360-degree video scenarios as viable in EM teaching. The 360-degree video technology would be a sustainable solution for hybrid medical teaching in the long term.

Central Sleep Apnea Syndrome (CSAS) and Cheyne-Stokes breathing are prevalent in patients with heart failure with reduced ejection fraction (HFrEF). Positive respiratory pressure therapy (PAP) associated with drug therapy for heart failure can improve quality of life, although tolerance to PAP therapy can be difficult to achieve. Materials and method: Patients for this prospective, mono-center, cohort study were selected from patients with chronic heart failure who present at the Sleep Laboratory of the Medical Clinic of Pneumology, Oradea who underwent polysomnography. 38 HFrEF and CSAS patients were included between January 2019 to December 2021 in the study, with an apnea-hypopnea index (AHI) >=15/hour of sleep. Echocardiographic hemodynamic parameters (left ventricular ejection fraction-LVEF, mitral regurgitation score), PAP compliance, and quality of life using the severe respiratory failure questionnaire (SRI) at the initiation of PAP and after 3 months were included. Results: After 3 months of PAP therapy LVEF increased significantly (from 31.4% ±12.2to 38.0%±10.9, p=0.0181), AHI decreased (from 40.1±18.7 to 6.8±6.1 events/h, p<0.0001) and all the categories of SRI showed improvement with significant general score increase (from 57.0±15.1 to 66.6±16.9, p<0.0001). Conclusion: The association of PAP therapy with drug therapy in patients with HFrEF and CSAS improves hemodynamic parameters and quality of life. Keywords: Chronic heart failure, positive airway pressure therapy, central sleep apnea syndrome

(1) Background: Intrauterine insemination (IUI) is considered a first-line procedure for infertile or hypo-fertile couples among assisted reproductive techniques. In our retrospective study, we identified variables associated with a successful IUI and the probability of obtaining a pregnancy. This is useful to identify couples with a good chance of obtaining a pregnancy through an IUI procedure (2) Methods: The study was conducted at a university-level fertility clinic in Oradea, Romania. Patients eligible to participate in the study were infertile couples who underwent IUI treatment in the interval between January 2015 and October 2020. (3) Results: In our study, we found that duration of infertility, couple age, endometrium thickness, sperm concentration, and motility are important factors in determining the outcome of IUI. Several demographics were measured for each couple including maternal and paternal age, the type and duration of infertility, the number of procedures, the type of ovarian stimulation, number of follicles, endometrial thickness, the type and day of ovulation induction, associated pathology, tubal patency, and pre/post washes sperm count and progressive sperm motility. (4) Conclusions: Fertility prediction studies are necessary, and an individualized prognostic score should be applied for each couple for tailoring their expectations and better counseling.

Background Chronic Endometritis (CE) is a subtle pathology, likely infectious in most cases, with a negative impact on the female fertility, but often overlooked even among fertility specialists. The purpose of the study is to demonstrate the predominant infectious nature of CE and to find the best therapeutic option by comparing the results of oral antibiotic therapy versus intrauterine antibiotic infusion in patients with CE undergoing IVF procedures. The objective was to compare the cure rate of CE—defined as the percentage of patients without CE at the test of cure, between the two groups and, the hysteroscopic aspect with the positive CD 138 staining. Methods This was a prospective, case—control study that took place in a single university fertility clinic, in Oradea, Romania and included 57 patients with CE divided into 2 groups: orally administered antibiotics group who received a combination of antibiotics compared to intrauterine infusion group who received intrauterine infusion of antibiotic. Chronic Endometritis was diagnosed through hysteroscopy and immunohistochemistry for CD 138. Patients in both groups were tested for CE twice to evaluate the cure rate after oral combination antibiotic therapy versus intrauterine infusion of antibiotic. Results Out of 115 patients with endometrial biopsies 57 tested positive for CE, with a 49.6% chronic endometritis prevalence. Among the group that was administered oral antibiotics, 11 patients (45.83%) experienced CE resolution after triple antibiotic therapy. Of the intrauterine infusion group, 25 patients (89.29%) presented negative results (p 0.0020). The normal hysteroscopic aspect had a similar prevalence in the patients with immunohistochemical positive and negative CD 138. Conclusions Our study demonstrated the effectiveness and superiority of intrauterine antibiotic infusion over the use of oral combination antibiotic therapy for CE cure. Trial Registration: ISRCTN17542620/14.09.2022.

Carbocysteine and acetylcysteine are drugs with mucolytic and expectorant properties widely used in respiratory disease in adults but also in children. Acetylcysteine is also used as donor of SH groups in the drug overdose such as in the acetaminophen poisoning. Chronic cough is a vexing and common problem for children, their care givers, and health care providers. Effective treatment may be difficult, especially if the underlying cause of the cough cannot be determined. On the other hand, asthma, recurrent wheezing, bronchiolitis and both upper and lower respiratory tract disease are very common seen in paediatric emergency department. We have tried to found any relationship between use of drugs which are containing carbocysteine and some symptoms such as persistent cough, recurrent wheezing or bronchospasm. We are considering these symptoms as adverse drug reactions of carbocysteine. Our work was focused on 191 children divided in two groups: group A (who received carbocysteine) and group B (without carbocysteine). Our work shows that in all cases of worsening of cough, this effect was credited on the use of carbocysteine. On the other hand, worsening of cough (as frequency and duration) often causes the appearance of reflex vomiting. In case of the late condition the number of hospital admission is increased. Overall we believe that the use of carbocysteine in children exceeds the therapeutic benefit.