Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia

AIM: To identify users' reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service 'Your Questions.' ----- METHODS: Users of a free internet medical consultation service 'Your Questions' (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). ----- RESULTS: The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P<0.001). ----- CONCLUSION: The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician's office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults

Chlamydia Trachomatis Study Group (CTSG) and Problems Related to Chlamydial Genital Infections

Chlamydia trachomatis najčešći je uzročnik spolno prenosivih infekcija bakterijske etiologije i svake godine diljem svijeta uzrokuje 92 milijuna novih infekcija. Što se tiče zemalja Srednje i Istočne Europe, epidemiološka slika klamidijske genitalne infekcije ne može se sa sigurnošću procjenjivati. Naime, prijavljivanje klamidijskih infekcija ne provodi se sustavno, studije o prevalenciji su sporadične i teško metodološki usporedive, a preventivni programi na asimptomatskoj populaciji uglavnom ne postoje. Procjenjuje se da je incidencija klamidijske genitalne infekcije u Srednjoj i Istočnoj Europi 21 do 276 slučaja na 100.000 stanovnika. Javnozdravstvena važnost klamidijske genitalne infekcije očituje se u činjenici da je njezina prevalencija najviša u mladoj populaciji, da je najvećim dijelom asimptomatska te da neliječena infekcija može rezultirati kasnim posljedicama u obliku kronične upalne zdjelične bolesti, sterilnosti ili izvanmaternične trudnoće. Osim toga, pokazalo se da su troškovi liječenja komplikacija klamidijskih infekcija veći od troškova liječenja svih drugih spolno prenosivih bolesti, osim liječenja HIV/AIDS-a. Danas se klamidijska infekcija otkriva jednostavnim, pouzdanim i neinvazivnim testovima, a terapija izbora, 1 g azitromicina primijenjen jednokratno, dokazala se učinkovitom i sigurnom, posebice u slučajevima akutnih infekcija. Azitromicin se također pokazao lijekom izbora i za kronične infekcije, klamidijski prostatitis, kao i za liječenje značajnih komplikacija, kao što je npr. upalna zdjelična bolest. Kako bi pridonijela podizanju svijesti i znanja o klamidijskoj genitalnoj infekciji, PLIVA je 2002. godine na Brijunima okupila 40 stručnjaka iz Srednje, Istočne i Zapadne Europe, kao i Sjedinjenih Američkih Država koji se, s različitih aspekata, bave klamidijom. U tom smislu osnovana je Chlamydia Trachomatis Study Group (CTSG) - radna skupina za istraživanje C. trachomatis, koja je, u međuvremenu, prerasla u međunarodnu mrežu znanstvenika povezanih u međunarodnu udrugu.Chlamydia trachomatis is the most common causative agent of sexually transmitted infections of bacterial etiology, causing annually 92 million new infections worldwide. As far as Central and Eastern European ("CEE") countries are concerned, the epidemiological picture of chlamydial genital infections cannot be reliably estimated since there is no systematic registration, prevalence studies are sporadic and methodologically hardly comparable, and prevention programs focusing on asymptomatic population are scarce. The incidence of chlamydial genital infections in CEE is estimated to be 21 to 276 cases per 100,000 inhabitants. The public health importance of chlamydial genital infections lies in the fact that their prevalence is the highest in young population, that they are mostly asymptomatic and that, if left untreated, they may later result in chronic pelvic inflammatory disease, sterility or ectopic pregnancy. Additionally, the costs of treatment of chlamydial infection complications have shown to be higher than those of treatment of all other sexually transmitted diseases, with the exception of HIV/AIDS. Today chlamydial infections are diagnosed by simple, reliable and non-invasive tests, and the therapy of choice is a single dose of 1 g azithromycin, which has proven to be safe and effective, especially in acute infections. Azithromycin also proved to be the drug of choice in the treatment of chronic infections, chlamydial prostatitis, and in the treatment of major complications, such as pelvic inflammatory disease. In order to contribute to raising the awareness and knowledge about chlamydial genital infections, PLIVA gathered 40 experts treating different aspects of chlamydial infections from CEE, Western Europe and the United States on the Brijuni Islands in 2002. They established a Chlamydia Trachomatis Study Group (CTSG), i.e. the group for research of C. trachomatis, which in the meantime grew into an international association of scientists

Chlamydia trachomatis Study Group i PLIVA na 24. europskom kongresu o spolno prenosivim infekcijama i AIDS-u

24. europski kongres o spolno prenosivim infekcijama i AIDS-u, IUSTI Europe, ove je godine održan od 4. do 6. rujna u Milanu. Kongres je okupio više od 400 vrhunskih stručnjaka, znanstvenika i kliničara iz cijeloga svijeta s ciljem razmjenjivanja novih znanja i postignuća iz područja spolno prenosivih infekcija. Zajednički naglasak kongresnih znanstvenih događanja stavljen je na podizanje svijesti o važnosti prevencije i liječenja spolno prenosivih infekcija s osvrtom na utjecaj na pojedinca i zajednicu. Prikazani su pozitivni pomaci u prevenciji, dijagnostici i terapiji, ali su i otvorene brojne teme za buduća istraživanja. Raznolik znanstveni program kongresa obuhvaćao je: brojna predavanja, 12 radionica, 11 simpozija te 81 postersku prezentaciju

Increased Demand for E-mail Health Consultation Service: Analysis of a Web Survey

The aim of the study was to explore characteristics of the users of the Interactive Service »Your Questions« that is based on E-mail health consultations. We wanted to find out what motivated users to use it, were they satisfied with it and what were its impacts on their health behavior. Therefore, we developed a Web survey and invited 2,747 users to take part in it. 919 (33.5%) of users responded. Results showed that the majority of respondents were women (79.1%) and that most hold at least a college degree (52.4%). The Service was mostly used for obtaining information about certain medical symptoms or medical conditions (50.1%), for a second opinion on a diagnosis (18.6%) and for more information about medical treatment (14.4%). In terms of Service features, it was used because of its convenience with regard to time (38.7%) and a sense of privacy (25.7%). Before posting a question to the Service, 93.2% of the respondents searched for health articles on the PLIVAzdravlje portal while 90% of them read the Questions and Answers database. Over half of them (61.8%) posted their question after they already visited their physicians on that particular issue. Nevertheless, 48% of them were encouraged to visit their physicians after they received the answer. The results show an important trend of increased demand for e-mail health consultation and the need for reliable medical information, with one thousand questions submitted to the Service in the observed period of 40 days. If the source of medical information is reliable, as in case of our Service as well as other forms of e-mail health consultations, it can have positive impact on valuable physician-patient communication based on knowledge and mutual understanding

From Chilblains (Pernio) to Coeliac Disease—Should We Still Consider It Random?

Coeliac disease (CD) is a gluten-triggered, immune-mediated inflammatory disease occurring in genetically predisposed individuals, causing a variety of gastrointestinal and extraintestinal symptoms. The most common cutaneous association of CD is dermatitis herpetiformis, although recent reports have sought to link CD with other dermatological and autoimmune diseases. Chilblain, also called pernio, is usually a benign, superficial and localized inflammatory skin disorder that results from a maladaptive vascular response to non-freezing cold. We present a patient with pernio (chilblains) and newly diagnosed CD, with a significant intestinal lesion–total villous atrophy, as there are only two known cases of this feature associated with CD published in the literature. In the workup of chilblains (pernio) in children, an active case finding for coeliac disease should be conducted with coeliac-specific serology testing