A quality-control Internet-based study using recognized quality scoring systems. To evaluate the quality of information available on the Internet. The quality of information available is of poor quality and unreliable, and this study was to determine if it has improved in line with the exponential increase in Internet-based information since the last time it was reviewed in 2005. To identify potential Web sites, the 5 most commonly accessed search engines were identified and a search for “scoliosis” was performed on each. The top 100 Web sites were reviewed. Each Web site was categorized according to its authorship and assessed using recognized scoring systems (Journal of American Medical Association [JAMA] and DISCERN criteria, scoliosis-specific content quality). The presence of the Health on the Net code, a reported quality-assurance marker, was noted. Forty-one unique Web sites were identified and analyzed. Five were academic, 11 were produced by physicians, 5 were commercial, 3 were nonphysician sites, 6 were attached to discussion groups or social media sites, 3 were media related, and 8 were not otherwise classifiable. There were significant differences noted between the authorship categories on the DISCERN score, JAMA benchmark criteria, and scoliosis-specific content quality score, (P = 0.001, <0.0001, and 0.009, respectively) with academic- and physician-related Web sites containing better-quality information. Internet sites with a Health on the Net code demonstrated higher-quality scoliosis-specific information than those without the code (P = 0.1368). The overall quality of information regarding scoliosis remains poor despite an exponential increase in the number of sites available. Patients need to be educated about appropriate Internet use—academic- and physician-provided sites have been shown to contain better-quality information. We have a potential role as clinicians to not only direct patients to appropriate sites but also to help in developing content on the Internet.

Background: In this paper, we identify and analyze the top 100 cited articles in urology since 1965 and assess changes in the top 100 since 2007.Methods: We selected highest impact journals in both urological and general medicine journals from the 2011 edition of Journal Citation Reports: Science edition. We identified and analyzed the 100 most cited articles using the Science Citation Index Expanded (1965-present).Results: The top 100 articles were cited a mean of 892 times (range: 529-2088) and published between 1966 and 2009, with 21 published since 2000. In 2012, 19 new articles appeared in the updated top 100 cited articles. Also, 16 journals were represented, led by the New England Journal of Medicine (n=36), the Journal of Urology (n=16) and the Lancet (n=12). In total, 81 articles were published from North America (USA=77, Canada=4). From the United States, the following institutes were among the top 5 represented: Johns Hopkins University (n=12), Harvard University, Memorial Sloan Kettering Cancer Centre, National Institute of Health and Washington University (all 5). Only one institute outside the United States published more than one article in the top 100 (Institut Gustave Roussy, France). Nine urologists were first authors of 2 or more articles. Oncology (n=54) and transplantation (n=22) were the most common subspecialties represented.Conclusion: It is important to acknowledge the top cited articles as they mark key topics and advances in urology. There has been a 19% change in the top 100 cited articles in the past 5 years. Oncology and transplantation remain the most highly cited topics.

To evaluate the quality of health-based information available to patients and their parents on the Internet regarding hydrocele, a common paediatric condition, an Internet search was performed and a questionnaire distributed. The top 100 websites from the five most accessed search engines were reviewed by entering the term "Hydrocele" into each search engine. Website authorship was determined by close examination of each website. Websites were assessed for accuracy and validity according to the Health On the Net Foundation Code (HONcode), DISCERN score and JAMA benchmark criteria, recognized scoring systems. A voluntary written questionnaire was distributed to parents of patients on two consecutive days outside a paediatric clinic. After duplicate and inaccessible sites had been excluded, 37 unique websites were identified: 11 were academic, eight were produced by physicians not affiliated with an academic institution, three were commercial, four were attached to discussion groups or social media sites, four were media related and seven were unspecified. There was a significant difference between the academic and the physician-related sites compared with the other categories, with academic and physician sites scoring highest on the recognized scoring systems (p = 0.0001). It was found that 56.7% of patients accessed the Internet regarding their condition and 33% believed this information to be accurate. The quality of health-related information overall is of a poor quality. Academic and physician-provided websites were shown to contain better quality information. Clinicians have a potential role not only to direct patients to appropriate sites, but also to help to develop content on the Internet.

Objective.Acute scrotal pain is a common presentation to the paediatric emergency department. Testicular torsion is one of the most common causes of acute scrotal pain. Testicular torsion is a surgical emergency requiring immediate surgical exploration to prevent permanent testicular damage or loss. The aim of this study was to determine the surgical outcome of all scrotal explorations and to assess the use of colour Doppler ultrasound (CDUS) in the assessment of acute scrotal pain in two tertiary referral paediatric units. Material and methods. A retrospective review of a prospectively maintained database was carried out for all scrotal explorations between 1999 and 2010. Results.In total, 155 scrotal explorations were carried out for acute scrotal pain. The mean age was 9.1 years (range 0–15 years). The pathology in 46.5% (n = 72) was testicular torsion, 30.3% (n = 47) were torsion of a testicular appendage, 16.1% (n = 25) were epididymitis, 3.3% (n = 5) had no obvious pathology identified and other pathology accounted for 4%. There was a significant difference in age of presentation between those with testicular torsion and those with torsion of a testicular appendage (9 vs 10 years, p = 0.0074). CDUS was performed by a trained radiologist on 40 patients. Overall sensitivity, specificity, positive predictive value and negative predictive value for CDUS predicting testicular torsion were 96.9%, 88.9%, 96.9% and 89%, respectively. Overall, 36 patients (23%) with acute scrotal pain (50% of patients in the group with confirmed testicular torsion at exploration) required orchidectomy. Conclusion. This study supports the practice of immediate surgical exploration with a clinical suspicion of testicular torsion in a paediatric population.