Treatment of Visceral Artery Aneurysms Using Novel Neurointerventional Devices and Techniques.

The presence of branching vessels, a wide aneurysm neck, and/or fusiform morphology represents a challenge to conventional endovascular treatment of visceral artery aneurysms. A variety of techniques and devices have emerged for the treatment of intracranial aneurysms, in which more aggressive treatment algorithms aimed at smaller and morphologically diverse aneurysms have driven innovation. Here, modified neurointerventional techniques including the use of compliant balloons, scaffold- or stent-assisted coil embolization, and flow diversion are described in the treatment of visceral aneurysms. Neurointerventional devices and their mechanisms of action are described in the context of their application in the peripheral arterial system.

Readability and Quality of Online Information on Osteoarthritis: An Objective Analysis With Historic Comparison.

BACKGROUND: Osteoarthritis (OA) is the most common cause of disability in people older than 65 years. Readability of online OA information has never been assessed. A 2003 study found the quality of online OA information to be poor. OBJECTIVE: The aim of this study was to review the readability and quality of current online information regarding OA. METHODS: The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analyzed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons), and nontext pages were excluded. Readability was measured using Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. Presence or absence of the Health On the Net Foundation Code of Conduct (HONcode) certification, age of content, content producer, and author characteristics were noted. RESULTS: A total of 37 unique websites were found suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7th to 8th grade level. Of the 37, 1 (2.7%) website met all 4 JAMA criteria. Mean DISCERN quality of information for OA websites was "fair," compared with the "poor" grading of a 2003 study. HONcode-endorsed websites (43%, 16/37) were of a statistically significant higher quality. CONCLUSIONS: Readability of online health information for OA was either equal to or more difficult than the recommended level.

Inefficiency, dignity and patient experience: is it time for separate outpatient diagnostics?

There is international and national variation in the location of diagnostic imaging centres relative to hospitals. Diagnostic cross-sectional imaging has traditionally been performed within a hospital, catering for both inpatient and outpatients. The resulting two-tiered system caters for emergent and complex inpatients, in addition to typically ambulatory outpatients. These outpatients are less complex, and often attend an acute hospital for the specific purpose of diagnostic imaging. In both the UK and the Republic of Ireland, outpatient radiology is often provided on-campus in state-funded hospitals, reflecting the allocation of resources nationally. In many other countries, hospitals provide acute and high-level care, with community centres addressing outpatients' clinical and diagnostic needs. Mixing inpatients and outpatients introduces variability into the scanning process, and many institutions struggle to provide for the very different needs of outpatients. Current strategies of mixing these two fundamentally different groups should be reassessed, and either in-hospital segregation or dedicated outpatient diagnostic imaging centres merit serious consideration in any future healthcare planning.