Quality of the Italian Websites for Parental Guidance on the Indications for Tonsillectomy in Children.

Introduction The quality of information on websites about tonsillectomy regarding the knowledge level may be low. Tonsillectomy is a surgical procedure to hypertrophy of the palatine and pharyngeal tonsils. So, it is an invasive procedure with possible complications, which creates insecurity in parents. Significantly, Internet searches have been increased to address possible health concerns, questioning the quality of websites about tonsillectomy. Objective To evaluate the readability, reliability, and comprehensiveness of the Italian websites dedicated to parental guidance regarding the indications for tonsillectomy in children. Methods The search engine google.it was used to search the websites. The Gulpease index, which is a widely used readability formula ranging from 0 (difficult) to 100 (easy readability), was employed to evaluate these websites. The Health on the Net Code of Conduct (HONcode) was used to assess the quality of information, by taking ethical principles into account, with values ranging from 0 to 13. The content comprehensiveness of the web pages was assessed by assigning points ranging from 1 (very insufficient) to 5 (very satisfying) to each page. A final comparison with previous studies on tonsillectomy published on websites from other countries was performed. Results Fourteen Italian websites were selected, and the Gulpease index showed a mean average of 40.77 ± 8.45. The mean of the HONcode analysis was 6.00 ± 1.92, in which the principles with the poorest scores were Attribution and Update . As far as the comprehensiveness of the websites is concerned, the resulting mean was 2.57 ± 0.77, in which Indications was the topic with the highest mean, whereas Benefits was the one with the lowest. Conclusion The Italian websites were characterized by a lower readability level, a middle position regarding ethical principles, and the same (insufficient) comprehensiveness of tonsillectomy when compared with websites from different countries.

Comprehensiveness, readability, and reliability of Brazilian websites available for lay people's guidance on adenotonsillectomy.

INTRODUCTION: Adenotonsillectomy is an invasive surgical procedure, which may encourage the search for information by the lay population through online search engines. The quality of this information, however, requires an evaluation due to the wide diversity of the available content. OBJECTIVE: To evaluate the quality, in terms of ethical principles, readability and comprehensiveness, of the most accessed websites concerning guidance to parents/guardians related to their children's recommended adenotonsillectomy. METHODS: The websites mentioned on the first 10 pages obtained after the search using "removal", "tonsils" and "adenoids" as keywords, after applying the inclusion and exclusion criteria, were selected. All were assessed using the Flesch Readability Index and Health on the Net Code tools, in addition to an evaluation of the content by two independent evaluators. The data were described, and the inter-rater agreement was calculated by the Kappa coefficient. RESULTS: 34 websites were found, of the 100 assessed ones, which met the inclusion and exclusion criteria using the Google and Yahoo! Tools. Sixteen (47%) pages were considered reasonably difficult/difficult to read according to the Flesch Readability Index. Most of them met less than half of the analyzed ethical requirements according to the Health on the Net Code, and the overall comprehensiveness average was considered insufficient. CONCLUSION: A deficit of overall quality (comprehensiveness, readability, and ethical principles) was demonstrated for the websites available to parents or guardians about the adenotonsillectomy procedure in children.

An unusual case of short-lasting unilateral neuralgiform headache attacks.

BACKGROUND: Short-lasting unilateral neuralgiform headaches include those with conjunctival injection and tearing and with cranial autonomic symptoms. Most frequently reported as idiopathic, there is a growing number of symptomatic cases described. CASE REPORT: A 57-year old man presented a 16-year history of right hemifacial short-lasting pain attacks accompanied by ipsilateral autonomic symptoms and simultaneous malar contractions. Brain MRI disclosed a right acoustic neuroma compressing the right facial nerve and a venous developmental anomaly perpendicular to the right facial nerve root entry zone, without lesions affecting the trigeminal nerve. He was started on lamotrigine, resulting in complete remission of pain attacks, autonomic signs and facial contractions. CONCLUSIONS: This patient presents a typical short-lasting unilateral neuralgiform headache with response to lamotrigine. The uniqueness of the case is the co-occurring malar contractions, evocative of facial nerve involvement. We speculate whether facial nerve compression renders this nerve more susceptible to triggering during a short-lasting unilateral neuralgiform headache attack.

Acute ischemic stroke secondary to glioblastoma. A case report.

Glioblastoma is a malignant infiltrative glial tumor occurring most often over 50 years of age, with diverse clinical presentations. We describe a case of temporal lobe glioblastoma with a rare presentation as an acute ischemic stroke, discussing the imaging and histopathological findings, and reviewing the literature. A 77-year-old woman had sudden onset of left hemiparesis and hemihypoesthesia. The neuroradiological studies revealed an acute ischemic lesion in the right lenticulostriate arteries territory and a right anterior temporal lobe tumor, enhancing heterogeneously after contrast with enhancement of the right middle cerebral artery wall. Histopathological analysis of the resected temporal lesion revealed a glioblastoma multiforme with tumoral infiltration of the vascular wall. Glioblastoma should be considered in the etiology of acute ischemic stroke, where neuroimaging plays an important diagnostic role, enabling a more immediate therapeutic approach, with a consequent impact on survival.

Recurrent temporal bone tenosynovial giant cell tumor with chondroid metaplasia: the use of imaging to assess recurrence.

Tenosynovial giant cell tumor (TGCT) is a benign proliferative lesion of unclear etiology. It is predominantly monoarticular and involves the synovium of the joint, tendon sheath, and bursa. TGCT of the temporomandibular joint (TMJ) is rare and aggressive resulting in destruction of surrounding structures. The diagnosis may be suggested by imaging, mainly by the MR features and PET/CT, and confirmed by histopathology. We describe the case of a 50-year-old man who presented with right-sided hearing loss, tinnitus and TMJ pain. Pathology revealed tenosynovial giant cell tumor with chondroid metaplasia. Six years later he developed a recurrence, which was documented to our knowledge for the first time with CT, MR and FDG PET/CT imaging.

[Arterial spin labelling: initial experience, clinical impact and difficulties]. / Arterial spin labeling: experiência inicial, indicações clínicas e dificuldades.

UNLABELLED: Arterial spin labelling (ASL) is a MR perfusion technique that uses protons from water molecules of the arterial blood as an endogenous tracer. It is fast, non-invasive and does not require gadolinium administration. Due to the increasing robustness of the results, it is becoming an important clinical tool.In this article we present our initial experience with ASL, highlighting some technical aspects, the main clinical applications, some achieved results and most important difficulties. METHODS: Review of the examinations performed during eight months, using a pulsating ASL technique in a 3T machine. Perfusion maps were evaluated qualitatively. RESULTS: The most frequent clinical applications were epilepsy, neurodegenerative disorders and tumours. Although perfusion data from ASL had never been crucial for diagnosis, it still provided substantial information. We highlight two epileptic patients who had had recent seizures, in which ASL depicted distinct post-ictal hyperperfusion areas (with the results being confirmed by SPECT studies).The impact was also remarkable in patients with neurodegenerative disorders in which ASL depicted hypoperfusion areas, typical of each nosological entity. The main difficulties were related to the lack of quantitative evaluation and to the clinical interpretation of the results obtained. CONCLUSION: ASL perfusion studies have a great potential in several clinical conditions. In this article we show that, with a fast acquisition and easy post-processing, it can integrate routine MRI examinations.

Aplicación del proceso de enfermería en la práctica hospitalaria y comunitaria en instituciones del Distrito Federal / Application of the nursing process in the hospital and communitarian practice in institutions of the Federal District

Introducción: Este reporte forma parte del estudio multicéntrico sobre conocimiento y aplicación del proceso de enfermería en la práctica hospitalaria y comunitaria, en el que participan 12 estados de la República Mexicana. Objetivo: Analizar el conocimiento de las enfermeras sobre el proceso de enfermería y su relación con la aplicación en la práctica profesional. Metodología: Por muestreo convencional, en la región Distrito Federal, se encuestó a 2268 enfermeras que laboran en instituciones públicas y privadas, a través de un cuestionario con 73 preguntas planteadas en escala de Likert. Resultados: El índice de conocimiento en promedio fue de 83.55 con un valor mínimo de 52.0 y un máximo de 93.43 El índice de aplicación mostró una media de 82.4, valor mínimo 42.3 y máximo de 89.47. La prueba Rho de Spearman mostró una correlación positive significativa (rs=0.204, p<0.05) entre ambas variables. Al aplicar la prueba U de Mann-Whitney se encontró diferencia significativa entre los resultados del Distrito Federal, zona centro (83.55) con los de la zona norte (80.51) y zona sur (78.13), en ambas variables. Conclusiones: Un tercio de las enfermeras afirmó que la principal barrera para aplicar el Proceso de Enfermería es la sobrecarga de trabajo, otro tanto considera que es la falta de recursos humanos y materiales, y admite que el principal problema es la falta de conocimiento sobre el tema.

Introduction: This report is part of a multi-centric study about knowledge and application of the nursing process in hospital and communitarian practice in 12 participants' status from the Mexican Republic. Objective: To analyze the nurses' knowledge about the nursing process and its relation with the application in the professional practice. Methodology: For conventional sampling, within the region of the Federal District, 2268 nurses who work in private and public institutions, were surveyed through a questionnaire with 73 questions set them up in the Likert' scale. Results: The average of knowledge was83.55 with a minimum value of 52.0 and a maximum value of 93.43. The index of application showed a media of 82.4, minimum value of 42.3 and a maximum of 89.47. The Spearman Rho test showed a positive, significant correlation of (rs=0.0204, p=0.05) between both variables. When applying the Mann-Whitney U test, it was found a significant difference among the results in the Federal District, centric zone (83.55) with those from north zone (80.51) and south zone (78.13), in both variables. Conclusions: A third part of nurses agreed that the main barrier to apply the nursing process is the working overload, another umber of nurses considered that is the lack of human and material resources, and admitted that the main problem is the lack of knowledge about the topic.