Analysis of Answers to Queries among Anonymous Users with Gastroenterological Problems on an Internet Forum.

Internet forums are an attractive source of health-related information. We aimed to investigate threads in the gastroenterological section of a popular Polish medical forum for anonymous users. We characterised the following aspects in threads: the main problem of the original poster, declared ailments and rationale of the responses (rational, neutral, harmful or not related to the problem of the original poster). We analysed over 2717 forum threads initiated in the years 2010-2018. Users mostly asked for diagnosis of the problem [1814 (66.8%)], treatment [1056 (38.9%)] and diagnostic interpretation [308 (11.3%)]. The most commonly declared symptoms were abdominal pain [1046 (38.5%)], diarrhea [454 (16.7%)] and bloating [354 (13.0%)]. Alarm symptoms were mentioned in 309 (11.4%) threads. From the total 3550 responses, 1257 (35.4%) were assessed as rational, 693 (19.5%) as neutral, 157 (4.4%) as harmful and 1440 (40.6%) as not related to the user's problem. The original poster's declaration of blood in stool, dyspepsia, pain in the abdominal right lower quadrant, weight loss or inflammatory bowel disease was positively related to obtaining at least one potentially harmful response. Advice from anonymous users on Internet forums may be irrational and disregards alarm symptoms, which can delay the diagnosis of life-threatening diseases.

Clinical stage of acquired immunodeficiency syndrome in HIV-positive patients impacts the quality of the touch ECG recordings.

INTRODUCTION: HIV patients are at higher risk for cardiovascular disease and cardiac arrhythmias which can be recorded by a handheld single­lead ECG device. Quality of ECG depends on the skin condition, which worsens with the progression of HIV infection. OBJECTIVE: To study the quality of the ECG signal acquired by a mobile ECG device in patients with different clinical stages of human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS: We studied the quality of 30-second single lead ECGs obtained by a handheld ECG device (Kardia; AliveCor Inc., San Francisco, USA) in 263 Kenyan adults (203 women) in various stages of HIV. The recordings were made during routine check-ups at the outpatient clinics. ECG quality was categorized as readable (not interfering with clinical interpretation) or unreadable (impossible clinical interpretation). The progression of the HIV infection was estimated using the World Health Organization AIDS Clinical Staging (WACS) scale, ranging from stage 1 (asymptomatic generalized lymphadenopathy) to stage 4 (wasting syndrome and Kaposi sarcoma). RESULTS: The median age of patients was 46 (39-53) years. ECG was readable in 201 patients (76.4%) and unreadable in 62 (23.6%). The WACS score > 1 was associated with 3.95 odds ratio (95% confidence interval 2.14-7.29; p < 0.0001) for the acquiring an unreadable ECG (univariate logistic regression adjusted to age, sex, body mass index and time since HIV). CONCLUSIONS: ECG quality recorded by a touch ECG device worsens with advancing HIV infection. For this reason, the accuracy of arrhythmia diagnosis by mobile ECG appears to be limited in HIV patients.