Content Analysis of Idiopathic Pulmonary Fibrosis-related Information on Twitter.

Background: Information regarding idiopathic pulmonary fibrosis (IPF) on the internet is often outdated, inaccurate, and potentially harmful. Twitter is a social media platform that allows users to post content in the form of "tweets". Objective: We sought to assess the prevalence of inaccurate information regarding IPF on Twitter. We hypothesized that foundations and medical organizations would be the least likely to post inaccurate information and that inaccurate tweets would have higher user engagement. Methods: All tweets posted between 2011 and 2019 were gathered using "snscrape" on Python 3.8 while searching for the phrase "idiopathic pulmonary fibrosis". Quantitative analysis was performed to describe trends in IPF-related tweet frequency over time. A subset of tweets made between 2018 and 2019 was screened for verifiable medical statements, which were then analyzed for accuracy compared with contemporary clinical practice guidelines, with descriptive statistics reported. Logistic regression was used to compare tweet accuracy and recommendation of nonindicated therapies across sources, with adjustment for tweet age and character count. Wilcoxon rank-sum tests were used to determine if user engagement (favorites, retweets, and replies) differed between accurate and inaccurate tweets. Results: A total of 16,787 tweets were identified between 2011 and 2019. Between 2018 and 2019, 4,861 tweets were included, of which 1,612 (33%) contained verifiable medical statements. Tweets from sources other than foundations or medical organizations were more likely to contain inaccurate information and to recommend nonindicated therapies in both unadjusted and adjusted analyses. News and media sources had the highest odds of communicating potentially harmful information in both adjusted (odds ratio [OR], 12.00; 95% confidence interval [CI], 5.87-27.16) and unadjusted (OR, 11.62; 95% CI, 5.70-26.21) analyses when compared with foundations and medical organizations. Tweets containing inaccurate information had significantly lower numbers of favorites and retweets (P < 0.001 for both). Conclusion: Misinformation regarding IPF is present on Twitter and is more often presented by news and media sources. Medically inaccurate tweets displayed less user engagement than accurate tweets. This differs from findings on IPF-related information on YouTube and Facebook, which may reflect differences in both author and consumer qualities across social media platforms.

Social Media Content of Idiopathic Pulmonary Fibrosis Groups and Pages on Facebook: Cross-sectional Analysis.

BACKGROUND: Patients use Facebook as a resource for medical information. We analyzed posts on idiopathic pulmonary fibrosis (IPF)-related Facebook groups and pages for the presence of guideline content, user engagement, and usefulness. OBJECTIVE: The objective of this study was to describe and analyze posts from Facebook groups and pages that primarily focus on IPF-related content. METHODS: Cross-sectional analysis was performed on a single date, identifying Facebook groups and pages resulting from separately searching "IPF" and "idiopathic pulmonary fibrosis." For inclusion, groups and pages needed to meet either search term and be in English, publicly available, and relevant to IPF. Every 10th post was assessed for general characteristics, source, focus, and user engagement metrics. Posts were analyzed for presence of IPF guideline content, useful scientific information (eg, scientific publications), useful support information (eg, information about support groups), and potentially harmful information. RESULTS: Eligibility criteria were met by 12 groups and 27 pages, leading to analysis of 523 posts. Of these, 42% contained guideline content, 24% provided useful support, 20% provided useful scientific information, and 5% contained potentially harmful information. The most common post source was nonmedical users (85%). Posts most frequently focused on IPF-related news (29%). Posts containing any guideline content had fewer likes or comments and a higher likelihood of containing potentially harmful content. Posts containing useful supportive information had more likes, shares, and comments. CONCLUSIONS: Facebook contains useful information about IPF, but posts with misinformation and less guideline content have higher user engagement, making them more visible. Identifying ways to help patients with IPF discriminate between useful and harmful information on Facebook and other social media platforms is an important task for health care professionals.

Successful lung transplantation in an HIV seropositive patient with desquamative interstitial pneumonia: a case report.

BACKGROUND: Until recently, lung transplantation was not considered in patients with human immunodeficiency virus (HIV). HIV seropositive patients with suppressed viral loads can now expect long-term survival with the advent of highly active antiretroviral therapies (HAART); however, HIV remains a relative contraindication to lung transplantation. We describe, to our knowledge, the first HIV seropositive lung transplant recipient in Canada. We also review the literature of previously reported cases of solid-organ transplantation in patients with HIV with a focus on immunosuppression considerations. CASE PRESENTATION: A 48-year old man received a bilateral lung transplant for a diagnosis of desquamative interstitial pneumonia (DIP) attributed to cigarette and cannabis smoking. His control of HIV infection pre-transplant was excellent on HAART, and he had no other contraindications to lung transplantation. The patient underwent bilateral lung transplantation using basiliximab, methylprednisolone, and mycophenolate mofetil (MMF) as induction immunosuppression. He was maintained on MMF, prednisone, and tacrolimus thereafter, and restarted his HAART regimen immediately post-operatively. His post-transplant course was complicated by Grade A1 minimal acute cellular rejection, as well as an enterovirus/rhinovirus graft infection. Despite these complications, his functional status and control of HIV infection remain excellent 24 months post-transplant. CONCLUSIONS: Our patient is one of only several HIV seropositive lung transplant recipients reported globally. With growing acceptance of transplantation in this population, there is a need for clarification of prognosis post-transplantation, as well as optimal immunosuppression regimens for these patients. This case report adds to the recent literature that suggests HIV seropositivity should not be considered a contraindication to lung transplantation, and that post-transplant patients with HIV can be managed safely with basiliximab, tacrolimus, MMF and prednisone.

Neuromuscular conditions associated with malignant hyperthermia in paediatric patients: A 25-year retrospective study.

Malignant Hyperthermia (MH) is a rare pharmacogenetic syndrome that can be fatal and the risk of MH in non RYR1-related disorders is unknown. We conducted a retrospective study to determine the prevalence of neuromuscular disorders among patients with MH at our centre. Patients who were admitted to the Hospital for Sick Children during the study period of January 1, 1990 to April 1, 2015 with a CK level > 8000 IU/L, or who received dantrolene, or who had a clinical diagnosis of MH were included. Medical records of 166 patients who met the inclusion criteria were reviewed and 13 patients were identified with MH-like reactions. Nine patients were classified as having true MH after review of the anaesthesia record and genetic testing results were available for 7 patients, 5 of whom had mutations in RYR1. Of the four patients who had severe reactions to anaesthesia but did not meet the criteria for true MH, two had Duchenne muscular dystrophy (DMD). In this retrospective study over 25 years, RYR1 mutations were the most common cause of MH in our cohort, and of these, one third had an underlying neuromuscular diagnosis. Genetic testing of RYR1 is indicated for all patients with MH, and anaesthetic precautions should be considered for any child with symptoms of neuromuscular disease.