Use of Google Trends to Track Online Behavior and Interest in Kidney Stone Surgery.

OBJECTIVE: To explore internet search trends data as a unique resource for monitoring online health information-seeking behavior. We utilized Google trends to sample population interest and search inquiries into surgical treatment options of kidney stones, and we examined the relative frequency of searches across the United States. METHODS: Google trends was queried via the Google Insights for Search (http://google.com/trends) using terms related to kidney stone surgeries from 2011 to 2017. "Kidney stone surgery" was identified to be the most common term. The search volume index graph for the U.S. was recorded as well as regional distribution and related queries. For specific surgical treatment modalities, the following medical terminology was used: percutaneous nephrolithotomy, extracorporeal shockwave lithotripsy, ureteroscopy, and laser lithotripsy. Each query was then compared and analyzed to assess changes in the interest in these search terms over time. RESULTS: The research trends for the search "kidney stone surgery" as well as specific surgical modalities remained constant over time. extracorporeal shockwave lithotripsy had the highest search volume index and laser lithotripsy had the lowest. The top 5 US states with greatest search volume was Tennessee, Indiana, Ohio, Michigan, and North Carolina, whereas the top 5 metropolitan regions were Atlanta, Tampa, Detroit, Philadelphia, and Boston. CONCLUSION: Google trends data is a useful tool to analyze online health information-seeking behavior. Despite an increase in stone prevalence over the past decade, search rates have remained relatively constant. High relative search volume was seen from states within and outside the traditional stone belt, suggesting a possible changing trend.

Urological Findings in Beckwith-Wiedemann Syndrome With Chromosomal Duplications of 11p15.5: Evaluation and Management.

Beckwith-Wiedemann Syndrome (BWS) is an overgrowth disorder with various congenital anomalies. Although the most classic constellation includes macrosomia, macroglossia, and omphalocele, nephrourological findings are commonly associated with BWS. Clinical presentation is highly variable because of its complex molecular heterogeneity, which involves changes in DNA methylation and disruption of growth regulatory genes. We report 3 pediatric patients, ages 13 months to 3 years old, who presented with clinical features consistent with BWS. A variety of nephrourological abnormalities were also noted, including posterior urethral valves, hydroureteronephrosis, and undescended testes. Genetic testing for all 3 patients revealed duplication of the region chromosome 11p15.5.

Metastatic Prostate Cancer Presenting as Lower Extremity Soft Tissue Mass: A Rare Case Presentation.

A 69-year-old homeless African American male with prostate cancer diagnosed 2 years prior presents a large mass in the right thigh. An evaluation of the patient revealed a prostate-specific antigen of 9362 ng/mL. Biopsy of the leg mass was performed and final pathology indicated metastatic adenocarcinoma of the prostate. Although metastatic prostate cancer presents most commonly in bone, lymph nodes, lungs, and liver, metastatic disease presenting as a soft tissue mass is extremely rare (Bubendorf et al, 2000; Molenaar et al, 1996; Ward and Bourken, 1984). The advent of screening with prostate-specific antigen has led to earlier diagnosis of lower-grade disease, yet underserved populations continue to present with aggressive and morbid disease (Winer et al, 2014).

Investigation of KIF6 Trp719Arg in a case-control study of myocardial infarction: a Costa Rican population.

BACKGROUND AND METHODOLOGY: The 719Arg allele of KIF6 (rs20455) was associated with coronary events in Caucasian participants of five prospective studies. We investigated whether this KIF6 variant was associated with non-fatal myocardial infarction (MI) in a case-control study of an admixed population from the Central Valley of Costa Rica. Genotypes of the KIF6 variant were determined for 4,134 men and women. Cases (1,987) had survived a first MI; controls (2,147) had no history of MI and were matched to cases by age, sex, and area of residence. We tested the association between the KIF6 719Arg allele and non-fatal MI by conditional logistic regression and adjusted for admixture of founder populations. PRINCIPAL FINDINGS: Compared with the reference Trp/Trp homozygotes, KIF6 719Arg carriers were not at significantly higher risk for non-fatal MI in this study after adjustment for traditional risk factors or admixture (OR= 1.12; 95%CI, 0.98-1.28). Heterozygotes of the KIF6 Trp719Arg variant were at increased risk of non-fatal MI: the adjusted odds ratio was 1.16 (95% confidence interval, 1.01-1.34), but this association would not be significant after a multiple testing correction. CONCLUSIONS/SIGNIFICANCE: We found that carriers of the KIF6 719Arg allele were not at increased risk of non-fatal MI in a case-control study of Costa Ricans living in the Central Valley of Costa Rica.