Objective: Olfactory dysfunction (OD) is a common and distinctive symptom in patients with COVID-19. To date, no standardized treatment for COVID-19-associated OD has been established, but olfactory training (OT) is a promising therapeutic intervention. Previous studies have demonstrated the efficacy of OT in the treatment of postinfectious OD, with several investigations demonstrating the effectiveness of OT in addressing OD associated with COVID-19. In this study, we conducted a retrospective investigation to evaluate the effectiveness of OT and to determine the optimal duration of OT for managing COVID-19-associated OD.

Methods: Patients received an OT kit containing four odorants (rose, eucalyptus, lemon, and clove) and were instructed to sniff each one for 10 seconds, twice daily. To assess olfactory function, participants completed the Self-Administered Odor Questionnaire (SAOQ), Visual Analog Scale for Smell (VAS), T&T olfactometry, and an intravenous olfactory test, which were performed at baseline (pre-OT) and at three post-OT intervals (3 months, 6 months, and 1 year).

Results: Seventeen participants (mean age: 39.7 years, SD: 13) completed the study. Significant improvements were observed in SAOQ, VAS and intravenous olfactory test following OT. Specifically, significant differences were identified between the pre-OT and 1-year post-OT for both SAOQ and VAS (p=0.021, p=0.021, respectively). Additionally, significant differences were noted between the 3-month post-OT and 1-year post-OT for the same measures (p=0.021, p=0.004, respectively). For the intravenous olfactory test, a significant difference was observed in detection time scores between the 3-month post-OT and 6-month post-OT (p=0.031). No significant changes were observed in the T&T olfactometry score.

Conclusion: These findings suggest that OT led to notable enhancements in olfactory function in patients with COVID-19-associated OD. In terms of the duration of OT, our results indicate there are progressive benefits of OT over time.

A man in his 20s was injured when a hard ball moving at roughly 100 kilometers per hour struck his left scrotum directly during a field hockey game. The initial diagnosis at another hospital was testicular contusion, and the patient was referred to our department on the third day post-injury for follow-up evaluation. However, based on the physical and ultrasound findings, we were unable to definitively diagnose his injury. Subsequently, we performed contrast-enhanced magnetic resonance imaging, which showed findings suggestive of tunica albuginea rupture. During emergency surgery, a tunica albuginea rupture was confirmed through scrotal exploration and visual inspection. The rupture was repaired, and orchiopexy was performed. Magnetic resonance imaging is effective in diagnosing testicular rupture when it cannot be identified through other medical assessments.

We report a rare case of surgery for double-outlet right ventricle (DORV) and right ventricular outflow tract (RVOT) stenosis in adulthood; we also present a review of the literature. A 65-year-old man who had been diagnosed with a ventricular septal defect when he was a child and had undergone catheter ablation for paroxysmal atrial fibrillation at 57 years of age presented to our hospital with exertional fatigue. Echocardiography revealed DORV, a ventricular septal defect (VSD), and RVOT stenosis caused by subpulmonary membrane. Cardiac catheterization revealed a pulmonary to systemic flow ratio (Qp/Qs) of 2.7, a mean pulmonary artery pressure of 42 mmHg, a pulmonary vascular resistance (Rp) of 5.25 unit・m², and a pressure gradient between RVOT and the right ventricular inlet of 30 mmHg. Right ventricular pressure was 80% of left ventricular pressure, and pulmonary hypertension with increased pulmonary blood flow was observed. During surgery, the patient underwent VSD closure and baffling of the left ventricle to the aorta, resection of the subpulmonary membrane in the right ventricular outflow tract, and closure of the left atrial appendage. The postoperative course was uneventful. The patient was extubated on the first postoperative day, transferred to the general ward on the sixth day, and discharged on the seventeenth day. Postoperative echocardiography indicated that the RVOT stenosis had improved, and that right ventricular pressure had decreased to less than 50% of the left ventricular pressure.

A 4-year-old boy was referred to our hospital with chief complaints of fever and leg pain. His body temperature was 38.8°C. He had spontaneous pain in the medial aspects of both thighs, which worsened with external and internal rotation. Blood tests revealed elevated C-reactive protein levels and erythrocyte sedimentation rate. Upon admission, a musculoskeletal infection was suspected, and cefazolin sodium was initiated. On day 4 of hospitalization, Salmonella enterica subsp. enterica serovar Enteritidis (O9) was detected in a blood culture. Magnetic resonance imaging revealed myositis of the lower extremities. Accordingly, the patient was diagnosed with infectious myositis. Cefazolin sodium was changed to ceftriaxone due to drug susceptibility. A second blood culture was negative, and the patient was discharged from the hospital on day 18 of illness with no recurrence of symptoms. Remission has been maintained following discharge. Pediatric myositis can be classified as bacterial, viral, or autoimmune. Gram-positive cocci are the most common causative organisms, and hematogenous spread is the most common route of infection in children. In this case, the bacterial culture and clinical findings indicated that the myositis was associated with a hematogenous Salmonella infection originating from the intestinal tract. A history of gastrointestinal disease and culture collection are important for accurate diagnosis of pediatric myositis.

We report a case of cardiac tamponade following the placement of a peripherally inserted central venous catheter (PICC) in a very low birth weight infant, successfully resuscitated by emergency pericardiocentesis. The female newborn, delivered at 29 weeks' gestation via operative delivery for placenta previa, weighed 1,191 g at birth. She required ventilatory support due to prematurity but was successfully weaned within a short period. On day 6 of life, she experienced sudden circulatory collapse due to massive pericardial effusion. Given that the episode occurred several hours after PICC insertion, cardiac tamponade was suspected. Rapid ultrasound assessment confirmed the diagnosis, and immediate pericardiocentesis successfully stabilized the infant, leading to an uneventful recovery. In preterm infants with a PICC, sudden unexplained circulatory collapse should prompt immediate ultrasound evaluation and intervention, as these are critical for successful resuscitation.