Ołtarzewska Am

Perception of risk information. Similarities and differences between Danish and Polish general practitioners

Objective - The objective of the study was to gain better insight into how general practitioners (GPs) perceive risk reduction and the way this perception may be influenced by healthcare environment. Design - Questionnaires with clinical episodes were sent to Danish and Polish GPs, who were randomised into four groups, each receiving the same case story with differently phrased information about risk reduction achieved through medical treatment. The GPs were asked whether they would recommend medical treatment, knowing the case story and expected risk reduction. Subjects - Danish and Polish GPs. Results - A greater proportion of Polish GPs than Danish GPs would definitely or probably recommend treatment (93% versus 72%; p < 0.001). Both groups of doctors were more inclined to recommend treatment when the achievable benefits were presented in terms of relative risk reduction rather than absolute risk reduction or number needed to treat. Conclusion - Neither information on number needed to treat nor relative risk reduction alone provides doctors with all the information they need to recommend treatment or prevention to their patients. The present study showed that the professional handling of risk information is affected by differences produced by healthcare cultures.

Management of Sore Throat by Family Physicians in Northeastern Poland: Possible Benefits of Applying Clinical Algorithm

Background: The objective of this study was to describe current sore throat management practices among family physicians and to estimate potential benefits of applying clinical algorithm – Centor’s scale (presence of tonsillar exudates, fever, lymphadenopathy and absence of cough) in decision-making process. Methods: Each of 44 participating family physicians was asked to fill in questionnaires for 30 consecutive patients with respiratory tract infection. Results: Almost all decisions were made on clinical grounds. Among 169 adult patients with the clinical diagnosis of bacterial pharyngitis only 55% fulfilled 3 or more criteria on Centor’s scale. Conclusions: Family physicians overdiagnose bacterial pharyngitis. Screening adult patients with Centor’s criteria would probably lead to a reduction in the prescribing of antibiotics.

Management of sore throat in Polish primary care facilities: an example from the country with rare use of microbiological testing

Objective:  To describe sore throat management by primary care physicians in Poland.

Bone Metabolism Markers and Bone Mineral Density in Patients on Long-Term Acenocoumarol Treatment: A Cross-Sectional Study

The aim of this study was to evaluate levels of osteocalcin (OC), osteoprotegerin (OPG) and total soluble receptor activator of nuclear factor-κB ligand (RANKL), and bone mineral density (BMD) in patients on long-term acenocoumarol (AC) treatment. The cross-sectional study was carried out in 42 patients treated long-term with AC and 28 control subjects. Serum concentrations of OC, OPG, and sRANKL were measured using enzyme linked immunosorbent assay (ELISA) kits, and BMD at the femoral neck and lumbar spine were assessed by dual energy X-ray absorptiometry. A significantly decreased concentration of OC was found in AC users compared to control subjects (4.94 ± 2.22 vs. 10.68 ± 4.5; p < 0.001). Levels of OPG, sRANKL logarithm (log), sRANKL/OPG log ratio, and BMD were comparable between. In female AC users, positive correlations between OC and RANKL log, and between OC and RANKL/OPG log ratio (p = 0.017; p = 0.005, respectively), and a negative correlation between OC and OPG (p = 0.027) were found. Long-term AC anticoagulation significantly decreases OC concentration, but does not affect other bone metabolism markers or BMD. Our results also suggest the possibility that long-term treatment with AC may alleviate bone resorption in postmenopausal women.