Is YouTube Propagating Concerns About Breast Implant Illness?

BACKGROUND: An increasing number of patients who underwent breast implant surgery are reporting a cluster of concerning physical and psychological symptoms-newly coined term breast implant illness (BII). YouTube is a popular educational tool for plastic surgery patients. OBJECTIVES: The purposes of this study were to assess the quality and reliability of YouTube videos on BII, compare the quality and reliability of different video categories and publishers, and determine the frequencies of reported BII symptoms. METHODS: On YouTube, videos were searched for the term breast implant illness , and the first 100 results were collected. Engagement parameters and symptoms of BII mentioned in each video were recorded. Video power index, a modified DISCERN instrument, and the Global Quality Scale (GQS) were used to assess popularity, reliability, and quality, respectively. RESULTS: Ninety videos met the inclusion criteria. More than half mentioned fatigue (66%), cognitive dysfunction (59%), or muscle and/or joint pain (57%). Videos with a plastic surgeon present had higher DISCERN ( P = 0.001) and GQS ( P = 0.002) scores than those without. Educational videos had higher DISCERN and GQS scores than patient experience ( P < 0.0001, P = 0.001) and entertainment and advertisement videos ( P = 0.014, P = 0.022). Videos published by plastic surgeons had higher Video power index ( P = 0.033), DISCERN ( P < 0.0001), and GQS scores ( P < 0.0001) than those by nonmedical publishers. CONCLUSIONS: The top YouTube videos for BII are generally of low reliability and low-to-moderate quality. Patients unaware of YouTube's limited quality control measures for health education videos are susceptible to misinformation. Additional social media content created by plastic surgeons can improve the quality and accuracy of videos viewed by patients.

Characterization of genital injuries secondary to foreign bodies from 2011 to 2020.

PURPOSE: To identify demographic trends of foreign object genital injuries presenting to emergency departments from 2011 to 2020. MATERIALS AND METHODS: The National Electronic Injury Surveillance System database reports consumer product-related injuries in United States ED visits. The database was queried to identify 375 cases of genital injuries from 2011 to 2020. Inclusion criteria consisted of cases reporting injuries involving the urethra, penis, or scrotum. Data was reported and analyzed using linear regression. RESULTS: Based on 375 cases, an estimated 13,170 (95% confidence interval, 10,817-15,522) patients in the US suffered genital injuries due to foreign bodies between 2011 and 2020. These injuries involved the penis (65.9%), urethra (30.7%) and scrotum (3.5%). Of all patients, 11.8% required hospital admission after treatment of which injuries to the urethra were most common (44.0%). Most of these patients were ages 19 to 64 (66.1%). Consumer products most implicated included rings (50.7%), zippers (17.1%), and pens and pencils (10.3%). Injuries due to zippers and swimming apparel occurred significantly more frequently in patients ages 0-18 (p<0.05). Injuries due to kitchen gadgets occurred significantly more in patients ages ≥65 (p<0.05). Pens, pencils, and massage devices were items that routinely resulted in urethral injuries, often requiring hospitalization. Linear regression showed genital injuries related to foreign objects significantly increased from 2011 to 2020 (p<0.001). CONCLUSIONS: Due to the nature of injury caused to genitalia by intentional and unintentional exposure to foreign bodies, educating individuals on this topic in sexual education classes is necessary for preventing future injuries.

Characterization of Pediatric Genital Injuries Due to Consumer Products From 2011 to 2020.

OBJECTIVE: To describe demographic trends of consumer product-related injuries in the pediatric cohort from 2011 - 2020. METHODS: The National Electronic Injury Surveillance System (NEISS) database surveying emergency department visits was retrospectively searched for all pediatric genitourinary injuries from 2011 to 2020. Data on demographics, diagnosis, products, disposition, and anatomy injured were collected on patients between the ages of 0-19 years. Statistical analysis was performed using linear regression. RESULTS: There were 12,953 reported pediatric cases involving injuries of the genital region from 2011 to 2020 with a national estimate of 324,636 (95% CI 241,527 - 407,746) pediatric genital injuries, comprising 0.76% of total pediatric injuries in the past decade. Of these patients, female (54.2%), white (39.7%) individuals sustained the most injuries, and items most commonly responsible included bicycles (9.4%), playground equipment (6.9%), toilets (4.6%), beds (4.5%), bathtubs and showers (4.4%), soaps (4.4%), chairs (4.1%), and razors and shavers (2.3%). Urethral injuries were due to chemical injuries from soaps (22%), furniture (17%), playground injuries (17%), insertion of foreign bodies into the urethra (13%), bicycles (10%), and swimming related injuries (4%). Genital injuries in children 0-5 years old were primarily caused by furniture (47.8%), while injuries in the 6-10, 11-15, and 16-19 age groups were attributed to sports and recreation (41.2%, 24.6%, 12.2% respectively). There was no significant change in the annual number of pediatric genital injuries from 2011 to 2020 (R2 = 0.38, P = 0.057). CONCLUSION: Identifying factors involved in pediatric genital trauma can allow for increased legislation, surveillance, and prevention of such injuries in targeted age groups.

A Single Center Review of Pediatric Nasal Bone Fractures - An Analysis of Concomitant Injuries, Management, and Outcomes.

Background: Pediatric nasal bone fractures presenting as isolated fractures or with concomitant facial injuries are rare and not well documented. Analysis of treatment at an urban, level-one trauma center provides insight into their management. Methods: Data were collected for pediatric nasal bone fractures diagnosed between January 2000 and December 2014. Patients were divided into groups based on presence or absence of isolated nasal bone fractures. Groups were compared using Chi-squared analysis, and a Bonferroni correction was used for a more conservative alpha (a = .004). Results: Assault was the most common etiology presenting in 46 of 122 pediatric nasal bone fractures. There was no significant difference in surgical versus non-surgical management of isolated and non-isolated nasal bone fractures (P = 0.98). Treatment for both was predominantly watchful waiting in 91% to 95% of the cases followed by closed reduction in 3.2% to 3.3%. In the patients with isolated fractures, 11.5% sustained intracranial hemorrhage, compared to 35.6% of multifracture cases (P = .002); 15.0% of isolated fractures sustained a traumatic brain injury, compared to 55.9% of multifracture cases (P = .000003). No significant difference in fatality existed between groups (P = 0.53). Conclusions: Multi-facial fracture cases were more likely to present with traumatic brain injuries and be admitted to the intensive care unit than isolated nasal bone fractures. Rates of surgical and non-surgical management were not significantly different between the 2 groups. Watchful waiting of pediatric nasal bone fractures was the management approach selected 92% to 95% of the time regardless of the presence or absence of concomitant facial fractures.

A Single Center Review of Pediatric Nasal Bone Fractures - An Analysis of Concomitant Injuries, Management, and Outcomes.

Background: Pediatric nasal bone fractures presenting as isolated fractures or with concomitant facial injuries are rare and not well documented. Analysis of treatment at an urban, level-one trauma center provides insight into their management. Methods: Data were collected for pediatric nasal bone fractures diagnosed between January 2000 and December 2014. Patients were divided into groups based on presence or absence of isolated nasal bone fractures. Groups were compared using Chi-squared analysis, and a Bonferroni correction was used for a more conservative alpha (a = .004). Results: Assault was the most common etiology presenting in 46 of 122 pediatric nasal bone fractures. There was no significant difference in surgical versus non-surgical management of isolated and non-isolated nasal bone fractures (P = 0.98). Treatment for both was predominantly watchful waiting in 91% to 95% of the cases followed by closed reduction in 3.2% to 3.3%. In the patients with isolated fractures, 11.5% sustained intracranial hemorrhage, compared to 35.6% of multifracture cases (P = .002); 15.0% of isolated fractures sustained a traumatic brain injury, compared to 55.9% of multifracture cases (P = .000003). No significant difference in fatality existed between groups (P = 0.53). Conclusions: Multi-facial fracture cases were more likely to present with traumatic brain injuries and be admitted to the intensive care unit than isolated nasal bone fractures. Rates of surgical and non-surgical management were not significantly different between the 2 groups. Watchful waiting of pediatric nasal bone fractures was the management approach selected 92% to 95% of the time regardless of the presence or absence of concomitant facial fractures.