RESUMO
Duplications of the lower urinary tract are rare congenital anomalies that are usually accompanied by concomitant nonurologic anomalies; they are typically diagnosed in early childhood. In more rare cases these are isolated, leading to diagnosis later. We describe a 50-year-old man who remained asymptomatic and therefore undiagnosed for five decades. His is one of fewer than 20 cases in the literature describing urethral duplication in the coronal (collateral) plane, the more common variant being sagittal (dorsal-ventral) duplication. He is one of only four cases reported without concomitant midline anomaly. Furthermore, he is the sole case associated with adult polycystic kidney disease.
RESUMO
A large amount of EM information can be found on the Internet, but the accuracy of this information has not been determined. This study compares the "gold standards" of EM information on four common emergencies with top healthcare web sites. The study also examines the relationship of web sites' credentials and certification on content. Checklists were developed for four emergency medical topics: influenza, febrile child, chest pain, and stroke from the "gold standards" promoted by the American Stroke Association, the American Heart Association, the National Heart, Lung and Blood Institute, and the American College of Emergency Physicians. Information found at the 20 most visited health information web sites were compared with the "gold standards." Completeness of the information, certification, and credentials were used to judge the accuracy of the web sites. Inaccurate or incorrect information from these web sites were noted. Correlations between the site's credentials and its content were also measured. This study, conducted from January 18, 2002, to January 31, 2002, excluded eight of the top 20 health web sites because they did not cater to the lay public. MEDLINEplus was the most complete web site with 74.8% of the items noted contained in the web site; MayoClinic.com had 54.5% and Medscape had 50.9%. Half of the web sites fell between 35% and 50%, including WebMD at 46.9%, InteliHealth at 45.5%, HealthWorld Online at 44.8%, Yahoo! Health at 41.3%, AllHealth.com at 40.6%, and Health.excite.com at 36.4%. Healthcentral.com at 35%, Drkoop.com at 35%, and AskDrWeil at 26.8% were the bottom three sites. Information on stroke was the most complete overall in 11 of 12 web sites. Four web sites contained questionable or concerning information. No correlation was found between possession of certification and the completeness of content (Pearson correlation -0.264 with a two-tailed significance of .406). Despite recent efforts to improve web site content through certification, few web sites contained a significant amount of EM information on all four topics investigated. In fact, some of the information provided on these health information web sites has the potential to be dangerous. Thus, most web sites are not good sources of reference for the public to find out what to do in the case of a medical emergency.
