Key Points Question Can educational virtual reality videos for patients improve the quality of bowel preparation before colonoscopy? Finding This randomized clinical trial including 346 participants found that patients educated by virtual reality videos had a higher mean Boston Bowel Preparation Scale score, indicating better bowel preparation, than patients educated by conventional methods. Meaning Virtual reality videos can be used as an effective patient education tool for bowel preparation before colonoscopy.

Bone brown tumors secondary to primary hyperparathyroidism (PHPT) are rare and only around 2-5% of PHPT patients have multiple bone brown tumor lesions, which are also uncommon in literatures. We found a female patient who got misdiagnosis of multiple malignant bone tumors in our clinical work, she was eventually diagnosed as a brown tumor secondary to hyperparathyroidism. This article records the diagnosis and treatment process, and summarizes similar case reports in the past decade to provide experience in diagnosis and treatment of similar cases that may occur in the future.

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Background Non-tuberculous mycobacterial (NTM) infection is usually observed in patients with immunosuppressive conditions. It may also cause unregulated immune responses. While there have been increasing numbers of reported tuberculosis-related HPS (haemophagocytic syndrome), HPS caused by NTM infection is still very rarely reported. Case presentation We report a previously healthy 21-year-old Chinese female with fever, night sweats and fatigue, in whom HPS was diagnosed according to the HLH-2004 criteria. Mycobacterium intracellulare was cultured from her peripheral blood. After treatment with corticosteroid, clarithromycin, rifampicin, ethambutol and amikacin, the patient finally recovered. We also reviewed relevant publications on NTM infection complicated with HPS and found 11 cases, including ours. Clinical presentations, diagnoses and prognoses were analysed and summarized to deepen our understanding of this rare condition. Conclusions Most reported NTM-related cases were caused by disseminated infection. The lack of localized symptoms might add to the difficulty involved in making the right diagnosis. While it usually takes time to obtain tissue or blood culture results, granuloma in a bone marrow biopsy might be an early indicator of possible mycobacterial infection. Although treatment varied, the overall prognosis of NTM-related HPS was promising.