Correlation of registered drug packs with Maastricht V/Florence Consensus Report and national treatment guidelines for management of Helicobacter pylori infection

High prevalence of Helicobacter pylori infection, the complexity for its treatment, poor correlation of registered drug packs or poor patient adherence to the treatment may contribute to antibiotic resistance and healthcare costs. The aim of the present study was to investigate whether registered drug packs are in accordance with European and national guidelines for H pylori eradication with reference to the number of drug units. In this study, we considered treatment options for the management of H pylori infection recommended by the Maastricht V/Florence Consensus Report and by national guidelines in the United Kingdom (UK), Croatia, Italy and Slovenia for adults. Drugs proposed by the guidelines were identified in national drug databases in July of 2019. When considering correlation for 10‐day treatment regimens, drug packs registered in Croatia could not be matched with recommendations for sequential therapies. A number of proposed treatments could not be matched due to small variety of drug packs in Croatia. Drug packs registered in the UK more often matched recommended 14‐day treatment regimens and national guidelines. With reference to European guidelines, 10‐day treatments could more frequently be matched in Italy and in Slovenia. Furthermore, results of this study indicate that there is smaller variety in drug pack sizes registered in Croatia and Slovenia when compared to UK and Italy. Considering poor correlation of drug packs with treatment guidelines for H pylori, adherence to antimicrobial treatment and proper disposal of antimicrobials is warrant. Discussing adherence to antimicrobial treatment with patients should be introduced as a standard of patient care and education.     

Evaluation of teleconsultation systems

The aim of this study was to identify criteria used for evaluation of teleconsulatation systems in evaluation studies, and to estimate trend of their changes. Evaluation of teleconsultation (TC) systems was made on the basis of 82 evaluation studies from the inventory of evaluation studies in medical informatics consisting of all the information and communication technology (ICT) evaluation studies published in 1982-2002. In order to estimate trend of changes in using evaluation criteria, the whole period with at least one evaluation study, it means the period of 1995-2002 was divided to 2 of 4 years, 1995-1998 and 1999-2002. Proportions of evaluation studies according to any single criterion were calculated. Index of changes I(ci) for ith criterion was defined as difference of proportion of studies evaluating teleconsultation by using a certain criterion in the second period and the same proportion in the first period divided by the number of all studies evaluating teleconsultation systems. This research showed that hardware and technical aspects were the leading evaluation criterion, but it has been decreasing (from 74.2% in the first period to 43.1% in the second one). Satisfactions of both health care provider and patient achieved the highest increase in the second period (from 3.2 to 19.6% and from 0 to 15.7%, respectively). Appropriateness and cost of patient care were on the second place (from 22.6 to 33.3% and from 16.1 to 23.5%, respectively). Considering defined index of changes it can be concluded that there are four criteria for evaluation of teleconsultation systems, having a positive trend (in frequency of evaluation studies): user satisfaction (Ic=0.20), satisfaction of patient with patient care (Ic=0.19), appropriateness of patient care (Ic=0.13) and cost of patient care (Ic=0.09). Hardware and technical aspects shows negative trend in the number of evaluation studies (Ic=-0.38), as well as cost of IT (Ic=-0.10).     

Immunological and respiratory changes in tobacco workers

BACKGROUND: Tobacco workers develop respiratory changes following occupational exposure to tobacco dust. METHODS: This study investigated 102 tobacco workers as well as a group of 30 matched control workers. Immunological testing, symptom questionnaire, and lung function measurements were performed in all workers. RESULTS: Increased total IgE was found in 12.7% of tobacco workers but in none of the controls (P < 0.05). Increased specific IgE (tobacco allergen) was recorded in 26.7% of tobacco workers with positive skin tests to tobacco extract but in none of the controls (P < 0.05). Regression analysis of ventilatory tests in female tobacco workers indicated a significant association of FEF75 to employment and smoking among workers with positive skin tests to tobacco. There were, however, no other associations between positive immunologic findings and lung function abnormalities and symptoms. CONCLUSIONS: Our study found increased immunological reactions in the tobacco workers. However, with the possible exception of lung function at low lung volume in female workers, these reactions do not appear to contribute significantly to the symptoms and lung function abnormalities seen in these workers. Am. J. Ind. Med. 45:76-83, 2004.     

Cell death and cell proliferation in mouse submandibular gland during early post-irradiation phase

The effects of irradiation on different cell compartments in the submandibular gland were analyzed in adult C57BL/6 mice exposed to X-ray irradiation and followed up for 10 days. Apoptosis was quantified using the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labeling method (TUNEL). Cell proliferation was detected using immunohistochemistry for proliferating cell nuclear antigen (PCNA). Radiation-induced apoptosis occurred rapidly, reaching a maximum 3 days post-irradiation. The percentage of apoptotic cells increased with the irradiation dose. At day 1 post-irradiation, cell proliferation was significantly reduced in comparison to sham-irradiated controls. After post-irradiation arrest of the cell cycle, proliferation increased in all gland compartments, reaching a maximum at day 6 post-irradiation. The proliferation response corresponded to the dose of irradiation. We suggest that the reason for gland dysfunction could be the coexistence of high apoptotic and proliferative activity in the irradiated gland.     

The cytotoxicity of RoekoSeal and AH plus compared during different setting periods

The aim of this study was to evaluate the cytotoxicity of the root canal sealers RoekoSeal Automix (RSA) and AH Plus in vitro on human cervical carcinoma (HeLa) cells and mouse skin fibroblasts (L929). The sealers were covered with a 3 x 10(4) cell suspension 1 h, 24 h, 48 h, 7 days and 1 month after mixing. Four samples and respective controls without sealer were prepared. After 5 days of incubation, the number of cells was determined using an electronic counter; the number of viable cells was determined under light microscopy following the addition of nigrosin dye. The experiment was repeated twice for each sealer and each period. AH Plus was significantly more cytotoxic after 1 h, 24 h, and 48 h, compared to the 7 day and 1 month setting period on both cell lines. RoekoSeal had no cytotoxic effect on either cell line at any setting time.     

Computerisation of general practice in the Republic of Croatia: experience gained in general practice use

Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.