Quality of information regarding abnormal uterine bleeding available online.

INTRODUCTION: The Internet and electronic devices with Internet access allow for a greater fluidity of information and speed of communication, especially in the field of health. Abnormal uterine bleeding (AUB) affects approximately 3-30% of women and can negatively impact their health and quality of life. Information regarding AUB that is available on the Internet may not be clear or accurate, rendering it difficult to understand and likely to result in delayed medical evaluation, which subsequently leads to worsening of the AUB. OBJECTIVE: To evaluate the quality of the information regarding AUB currently available on the Internet, including information regarding treatments. METHODS: The Google Trends website was searched for the most widely used English terms related to AUB. The identified descriptors were searched individually on the Google, Yahoo!, and Bing search engines. The first 10 results of each search were pre-selected and evaluated for inclusion in this study. Selected websites were categorically divided into two groups (news/magazine and academic) and individually analyzed by three experts using the DISCERN quality criteria (reliability, general quality, and quality of information) and the presence or absence of the Health on the Net Foundation Code of Conduct (HONcode®) seal. RESULTS: Of the 168 websites included in this study, 60.1% were allocated to the news/magazine group and 39.9% were allocated to the academic group. Over half of the websites (54.2%) did not have the HONcode® quality seal. Websites in the academic group were more likely to include accurate information regarding AUB with greater reliability than websites in the news/magazine group. There were no statistical differences regarding the general quality of the websites. Most websites were rated as either moderate quality (70.8%) or low quality (28.6%). The HONcode® criterion was found to be a confounding factor of the analyses, as the grouping and quality results of websites without this seal were significantly associated. In addition, websites in the news/magazines group were 6.7 times more likely to provide low quality information than websites in the academic group (odds ratio: 6.7; 95% confidence interval: 2.1-21.4). CONCLUSION: The information regarding AUB that is available on the Internet is of low to moderate quality. Academic websites present more reliable information of greater quality. The presence of the HONcode® seal is considered important to determine the quality of the content of a website, especially for news/magazine websites, and may help Internet users identify websites that contain more reliable information. Algorithms and applications that categorize the quality of information and the reliability of health content may be useful tools that can help patients clarify their symptoms for several conditions including AUB.

Evaluating the quality of HPV vaccine-related information on the Portuguese Internet.

Human papillomavirus (HPV) is considered the second largest human carcinogen after tobacco and is responsible for 5% of all cancers, 10% of cancers in women, and 15% of all cancers in developing countries. Among these, cervical cancer is the most prevalent. An HPV vaccine has recently been developed to provide primary protection against the viral infection. In 2014, Brazil's National Immunization Program (Programa Nacional de Imunizações, PNI) started making a quadrivalent vaccine available to the public. However, after 2014, the vaccine coverage dropped and did not reach the PNI's targets. Among other factors, this low uptake was due to the quality of information on the Internet. Using Google Trends, the main search terms used to search for vaccine-related information on the Internet were identified. The content of the identified websites was analyzed using the DISCERN instrument and their reach was determined using their page authority score. Most of the texts analyzed were not of high quality. The data that most commonly reach the lay public are from sites that lack scientific rigor. We found a weak correlation between the DISCERN and page authority scores. Based on our analysis, we inferred that the information that reaches the user is not always the most accurate and can lead to harmful decisions on vaccination. The content that reaches the user most easily is not always of sound quality. New analyses are important, especially on the impact of social networks that present even fewer criteria in publications and are more easily accessible.

Randomized study of bipolar vessel sealing system versus conventional suture ligature for vaginal hysterectomy.

OBJECTIVE: This study was undertaken to compare the use of bipolar vessel sealing system (BVSS) with conventional suture ligature in vaginal hysterectomy (VH) on a non-prolapsed uterus. STUDY DESIGN: Women referred for VH for uterine myoma were randomized to BVSS (n=45) or conventional suture ligature VH (n=45). Exclusion criteria were uterine prolapse and indication associated surgical procedures. Main outcome measures were operative time, blood loss, hospital stay, pain status, peri and post-operative complications. Data of patients were collected prospectively. Statistical analysis was performed using chi-square and Student's t-test as appropriate. RESULTS: There were no differences in patients' mean age, parity and uterine size between groups. Patients in the BVSS group had a significantly reduced operating time (29.2+/-2.1 min vs. 75.2+/-5 min; p<0.001), operative blood loss (84+/-5.9 mL vs. 136.4+/-89.1 mL; p=0.001), requirement of surgical sutures (1.2+/-0.6 units vs. 7.4+/-0.3 units; p<0.001), pain status (1.6+/-0.4 vs. 3.6+/-0.4; p<0.001) and hospital stay (25.6+/-0.9h vs. 33.2+/-1.7h; p<0.001) compared to the control group. The overall complication rate in the study was 7.8% (7/90), and did not differ between patients of the BVSS and control group. CONCLUSION: Bipolar vessel sealing for vaginal hysterectomy appears to be an effective and safe haemostatic control method, with reduced operating time, peri-operative blood losses, post-operative pain and hospital stay.

Abdominal vs vaginal hysterectomy: a comparative study of the postoperative quality of life and satisfaction.

OBJECTIVE: To compare the short-term results of the quality of life and satisfaction of patients submitted to total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) for benign uterine disease. METHODS: Women referred for hysterectomy for uterine myoma were randomized to TAH (n=30) or VH (n=30). The exclusion criteria were uterine prolapse, indication associated surgical procedures and uterine size > or =300 cm3. After a month, follow-up questionnaires had a response rate of 100%, and consisted of an interview with application of SF-36 questionnaire (functional capacity, physical aspect and pain) and evaluation of satisfaction rate. RESULTS: There were no differences in the patients' mean age, parity, body mass index, preoperative hemoglobin levels and uterine size between groups. Lower postoperative quality-of-life scores were found in the TAH group when compared to the VH group in functional capacity (P=0.002), physical aspect (P=0.008) and pain (P=0.002). The general satisfaction rate with the surgery was similar in the two groups of patients (P=0.147). However, a higher rate of patients submitted to VH would choose the same therapeutic modality (65.5 vs 90%; P=0.021). CONCLUSIONS: A better postoperative quality of life (functional capacity, physical aspect and pain) and higher satisfaction rate was found in the VH when compared to TAH.