This study evaluates YouTube videos (YTVs) focused on male infertility to assess information quality and identify highquality content that can reliably facilitate care. Top 50 YTVs based on relevance were identified using the keyword "male infertility." A checklist, adapted from American Urological Association guidelines addressing male infertility, was developed to assess YTV content. Two investigators extracted YTV features (including duration, likes, views, upload date), classified creators and ranked YTVs based on checklist scores. YTVs were then assigned grades A-D based on checklist scores. Kruskal-Wallis test and ANOVA were employed to draw associations between grades, content creator, and YTV features. Higher grades were associated with shorter video duration (p = 0.0305). Most YTVs (23/42) were created by healthcare-related organizations. Of the 42 YTVs included in the final analysis, 31% (13/42) explicitly defined infertility as an inability to conceive after 12 months of unprotected intercourse. Ninety percent (38/42) discussed male infertility evaluation methods, while 71% (30/42) discussed various interventions. Various content creators have adopted YouTube to discuss male infertility, and healthcare practitioners should be aware of YouTube's potential influence on patient understanding of male infertility. Knowledge gaps identified in YTVs can help improve patient counseling and enable practitioners to direct patients to reliable content.
Background
Intranasal injection of epinephrine and placement of topical epinephrine pledgets are methods to improve visualization during endoscopic sinonasal surgery. Studies comparing the hemodynamic effects of these vasoconstrictors using intraoperative arterial line monitoring are lacking.
Methods
Twenty‐eight patients undergoing endoscopic skull‐base surgery were enrolled in a prospective, randomized study. Patients were randomized to have either 2 mL of 1:100,000 or 2 mL of 1:200,000 epinephrine injected intranasally. Hemodynamic parameters, including pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were collected using intraoperative arterial line monitoring for 5 minutes. Afterward, 1:1000 topical epinephrine‐soaked pledgets were placed in both groups, and the same parameters were collected for another 5 minutes.
Results
There was no statistical difference in change in pulse, SBP, DBP, and MAP between the 1:100,000 and 1:200,000 epinephrine groups. However, epinephrine injections did cause an increase in all hemodynamic parameters when compared with baseline (p < 0.05). Topical epinephrine pledgets placed after injection of epinephrine did not have any significant hemodynamic effects, except for 2 of 28 patients who had a >75‐mmHg increase in SBP. No preoperative characteristics were identified that predicted sensitivity to epinephrine.
Conclusion
There is no statistical difference in changes in hemodynamic parameters between injecting epinephrine 1:100,000 compared with 1:200,000 during endoscopic sinonasal surgery. In a subset of patients, placement of topical 1:1000 epinephrine pledgets had significant hemodynamic elevation requiring intervention and thus should be used judiciously depending on patient comorbidities.
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