Social media are widely used information tools, including the medical/health field. Unfortunately, the levels of misinformation on these platforms seem to be high, with a medium-low quality of the ...proposed content, as evidenced by previous studies. You Tube is one of the most important platforms for audio/video content. It shows content to users through a recommendation algorithm system.
We have classified in two cohorts the first results obtained by researching "bladder tumor treatment" on You Tube through two different user profiles: "Cohort A" with a not logged-in session in incognito mode (46 videos enrolled) and "Cohort B" with a logged-in session with a physician profile (50 videos enrolled). The videos were evaluated using validated instruments such as DISCERN and PEMAT-AV Furthermore, we used a Likert's scale for the evaluation of levels of misinformation.
Overall quality of information was moderate to poor (DISCERN 3) in 54% of Cohort A and 24% of Cohort B. Moreover, a high degree of misinformation (Likert score 3) was found in 52% of Cohort A cases and 32% of Cohort B.
Levels of misinformation in both cohorts are positively correlated to the number of views per month. Globally, the levels of information quality, understandability and actionability are lower for the results obtained from searches performed with anonymous user profile (Cohort A).
Arterio-ureteralfistula (AUF) is an infrequent but potentially life-threatening condition. The aim of this study was reviewing the literature to build a flow-chart useful for an early and effective ...diagnosis and treatment of this pathology.
A literature search in PubMed was conducted. In addition, retrieved articles were cross-referenced. Data parameters included oncologic, vascular and urological history, diagnostics, treatment, and follow up were collected using a standard template by 2 independent reviewers.
A total of 140 cases of AUF out of 172 available in the literature at the time of the review, were considered. All patients presented gross hematuria. Chronic indwelling ureteral catheter (CIUC); history of pelvic surgery (HPS) and history of pelvic radiotherapy (HRT) were present respectively in 81%, 62.1%and 58.6% of the sample. The most predominant location of AUF was at the common iliac artery ureteral crossing. Angiography with provocative measures had the highest diagnostic sensitivity (50%) and endovascular treatment with stent-graft placement across the fistula is the current state of the art treatment choice.
Failure to diagnose can postpone a potentially life-saving targeted therapy and lead to complications. The identifi-cation of the Trifecta hematuria, history of pelvic surgery (HPS) and history of pelvic radiotherapy (HPR) would allow the identity-fication of patients at high risk of AUF, who may benefit from more sensitive early diagnostic investigations such as CT angiography and provocative angiography. The treatment of choice in case of AUF to date consist in endovascular prosthesis placement.
Double traumatic non-contiguous lesions of the subaxial cervical region are a rare event mostly caused by multiple, simultaneous or rapidly consecutive high-energy-impact traumas. The modality of ...treatment chosen for these lesions must be related to local lower cervical spine biomechanics. We present the case of a 59 year-old patient who suffered a subaxial cervical spine double fracture-dislocation following a complex-dynamic trauma. Radiological imaging displayed a C4-C5 and C7-T1 fracture-dislocation with cord signal intensity abnormalities. This patient showed a complete neurological deficit (ASIA A; mJOA 0) with a C4 sensory-motor level. He was urgently operated upon through an anterior approach, reduction of both dislocations and positioning of intervertebral cages and anterior plates at C4-C5 and C7-T1. At a 16-month follow-up he displays neurological improvement, moving his upper extremities at the C7-C8 motor level and a T5 sensory level (mJOA 3; Odom's Criteria 3). The check-CT scan at 24-month shows the correct positioning of the stabilization system and a complete bone fusion.Double traumatic lesions of the subaxial cervical spine, when interposed by healthy functional segments can be treated as two single independent lesions in order to allow a better outcome.
Chyluria occurs in all its forms with milky urine, recurrent episodes of acute urinary retention, left renal colic and proteinuria. In non-parasitic or iatrogenic diseases, it is secondary to ...communicate between the cisterna system of the chyli and the lymphatics of the calyx system of the left urinary tract with a retrograde passage of a kilo and its appearance in the urine which therefore take on a milky appearance 1, 2. Sometimes, episodically, especially after the ingestion of a high-fat meal, the quantity of kilo is so abundant that it can cause obstruction of the upper urinary tract and of the bladder, resulting in renal colic or acute urinary retention that may require their unblocking with double J stent or bladder catheter 3, 4. After conservative attempts with a fat-free diet or with the parenteral diet, in case of their failure, surgery must be performed by performing a para-aortic and renal hilum lymphadenectomy and, in severe cases, with intraperitonealization of the kidney and left ureter. This is the case of the patient reported below and successfully treated recently with an innovative “open” surgical technique.
Double traumatic non-contiguous lesions of the subaxial cervical region are a rare event mostly caused by multiple, simultaneous or rapidly consecutive high-energy-impact traumas. The modality of ...treatment chosen for these lesions must be related to local lower cervical spine biomechanics. We present the case of a 59 year-old patient who suffered a subaxial cervical spine double fracture-dislocation following a complex-dynamic trauma. Radiological imaging displayed a C4-C5 and C7-T1 fracture-dislocation with cord signal intensity abnormalities. This patient showed a complete neurological deficit (ASIA A; mJOA 0) with a C4 sensory-motor level. He was urgently operated upon through an anterior approach, reduction of both dislocations and positioning of intervertebral cages and anterior plates at C4-C5 and C7-T1. At a 16-month follow-up he displays neurological improvement, moving his upper extremities at the C7-C8 motor level and a T5 sensory level (mJOA 3; Odom's Criteria 3). The check-CT scan at 24-month shows the correct positioning of the stabilization system and a complete bone fusion.
Double traumatic lesions of the subaxial cervical spine, when interposed by healthy functional segments can be treated as two single independent lesions in order to allow a better outcome.
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