Quality of Patient Health Information on the Internet: reviewing a complex and evolving landscape

Background The popularity of the Internet has enabled unprecedented access to health information. As a largely unregulated source, there is potential for inconsistency in the quality of information that reaches the patient. Aims To review the literature relating to the quality indicators of health information for patients on the Internet. Method A search of English language literature was conducted using PubMed, Google Scholar and EMBASE databases. Results Many articles have been published which assess the quality of information relating to specific medical conditions. Indicators of quality have been defined in an attempt to predict higher quality health information on the Internet. Quality evaluation tools are scoring systems based on indicators of quality. Established tools such as the HONcode may help patients navigate to more reliable information. Google and Wikipedia are important emerging sources of patient health information. Conclusion The Internet is crucial for modern dissemination of health information, but it is clear that quality varies significantly between sources. Quality indicators for web-information have been developed but there is no agreed standard yet. We envisage that reliable rating tools, effective search engine ranking and progress in crowd-edited websites will enhance patient access to health information on the Internet. Key Words Internet; health; patient information; quality evaluatio

Characterising retinal ganglion cell response to injury

© 2016 Dr. Eamonn Thomas FahyGlaucoma is a group of progressive optic neuropathies that have in common the slow progressive degeneration and eventual death of retinal ganglion cells (RGCs). There is evidence, however, from clinical and laboratory work, to suggest that early dysfunction in glaucomatous RGCs may be reversible. This thesis explores characteristics of healthy, injured and recovered RGCs using a model of acute intraocular pressure injury in mice. Patch clamping was used to interrogate single cell electrophysiology. RGCs exhibited reversibly impaired excitability following injury. A study into differences manifest with age suggested that older mice undergo a slower recovery process following injury. This is the first evidence that single RGCs can undergo a period of reduced function with recovery at a later stage and provides insights into possible mechanisms for reversible ganglion cell dysfunction in early glaucoma

Prevention of Barrett\u27s Metaplasia in a Human Model of Duodenogastro-Oesophageal Reflux

The development of Barrett’s esophagus above the anastomosis following esophagogastrectomy has been reported in several studies. In this prospective study we set out to examine the prevalence of this phenomenon in a group of patients who have been strictly adherent to post operative proton pump inhibitor (PPI) therapy. Forty-six postoesophagectomy patients were prospectively assessed by upper gastrointestinal endoscopy. Four quadrant biopsies were taken 1 cm proximal to the esophago-gastric anastomosis in all patients and details of endoscopic appearance, biopsy pathology, operative pathology and PPI dose were recorded. All 46 patients had been commenced on a PPI in the immediate postoperative period. Two patients were not taking a PPI regularly. The average time from operation to endoscopy was 3 years (range 0.5 to 9). Mild (Grade 1) erosive oesophagitis was observed in 5 patients. Barrett’s epithelium was not identified in any patient. One patient who was taking a PPI intermittently had macroscopic columnar epithelium for 2 cm above the anastomosis without intestinal metaplasia. One other patient who had no macroscopic abnormality had columnar epithelium without intestinal metaplasia, seen in one of four biopsy specimens. This is the first study to assess for endoscopic evidence of neo-Barrett’s following oesophagogastrectomy, where PPI therapy has been commenced in the immediate postoperative period. Columnar epithelium was present in 2 patients and intestinal metaplasia was not detected in any of the cohort. These outcomes may be due to early commencement of PPI therapy and a high level of compliance