A review of mesothelioma information on the World Wide Web.

INTRODUCTION: The Internet is a widely used information resource for patients with mesothelioma. The goal of this study is to assess the content and quality of mesothelioma information presented on the internet using Google as a search engine, as well as to test the hypothesis that more popular sites (i.e., higher Google rank) are of higher quality. METHODS: The top 100 websites appearing in Google using the terms "mesothelioma" were included in the study. Websites were evaluated using (a) JAMA benchmarks (authorship, references, currency, and disclosure), and (b) an Information score (IS) that awarded websites points (0-100) for specific information on various aspects of mesothelioma. RESULTS: Of the top 100 websites identified, 84 websites were suitable for scoring. Only 5 (6.0%) sites met all 4 criteria of the JAMA benchmarks. The mean IS was 23.8 (range, 0-86). There was a weak but significant positive correlation with Google ranking of websites and IS (r = 0.275, p = 0.006). CONCLUSIONS: There is marked variation in the quality, integrity, and currency of the information in educational websites for mesothelioma patients. Google ranking has shown a weak but significant positive correlation to the quality of medical information relating to mesothelioma.

Conservative management of iatrogenic oesophageal perforations--a viable option.

OBJECTIVE: Iatrogenic Oesophageal perforations are a dreaded complication and there is no consensus as to their best management. The aim of our study was to assess the results of conservative management in these cases. METHODS: Twenty-six patients with iatrogenic perforations of the oesophagus treated over a 10-year period were reviewed retrospectively. They were managed conservatively by keeping them nil by mouth on intravenous fluids and intravenous antibiotics. Out of these 26, nine were patients of carcinoma of the oesophagus while the remaining 17 had benign pathologies. Twenty-two were diagnosed within 6h, while the remaining four were diagnosed over 24h after perforation. Twenty-three of the 26 were caused by oesophageal dilatations. RESULTS: Twenty-two (84.6%) of the 26 survived on this regimen. Out of the four that died, two had advanced carcinomas and died of chest complications, one died of a myocardial infarction and the fourth was an old debilitated man who died of renal failure. All four who died had extension of the leak into the pleural cavity. Early diagnosis and treatment is of critical importance and is only possible by maintaining a high index of suspicion. CONCLUSIONS: Conservative management when applied to cases of iatrogenic oesophageal perforations gives results comparable to or better that those reported in series where early surgical intervention was practised. Extension of the leak into the pleura carries a worse prognosis.

Tension pneumocephalus: an unusual complication after lung resection.

On day 5, after right upper lobectomy, the patient developed headache, confusion and right hemiparesis and there was clear fluid drainage from the chest tube. Computed tomography (CT) scan of the head showed gas in the ventricles and subarachnoid space. The fluid from the drain was positive for Beta-2 transferrin signifying cerebrospinal fluid (CSF) fistula. Patient recovered completely with conservative management.