Comparative assessment of physicians’ and senior medical students’ basic knowledge in treatment of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the most common pathologies of the respira-tory system. This disease ranks third in the group of the main causes of death in the world. The effective treatment of COPD has been developed by today. However, a significant part of physicians has an insufficient amount of education in this matter

Korekciniai veiksniai, į kuriuos atsižvelgiama nustatant žemės sklypų nuomos mokestį, kaip biudžeto užpildymo įrankį savivaldybėje (Čeliabinsko miesto pavyzdys)

There is a lack of common and clear methods for calculating correction factors in determining the amount of rent for use of land plots located in the territory of the municipality on state property, and the rate of rent is therefore not delimited. Land plots which are under municipal ownership objectively necessitate the perfection of a technique of defining rent for use of land plots, taking into account the interests of both the tenants and the municipality as lessor. This often comes at the expense of correction coefficients which, on the one hand, can lead to the deterioration of the investment climate in the municipality due to the overestimated value of the coefficients. On the other hand, they can lead to a significant decrease in budgetary revenues due to the underestimated value of these coefficients in lease of land plots.Nėra bendrų ir aiškių korekcinių koeficientų apskaičiavimo metodų, kuriais remiantis būtų galima nustatyti savivaldybės teritorijoje esančių žemės sklypų nuomos mokesčio dydį. Neatriboti valstybei ir savivaldybei priklausantys žemės sklypai sukelia objektyvią būtinybę tobulinti žemės sklypų nuomos mokesčių nustatymo būdus. Reikalinga atsižvelgti į tiek nuomininkų, tiek savivaldybės, kaip nuomotojo, interesus per korekcinius koeficientus, kurie pablogina investicinį klimatą savivaldybėje, iš vienos pusės, dėl pervertintos apskaičiuotų koeficientų vertės, antrą vertus, dėl reikšmingo biudžeto pajamų sumažėjimo dėl žemės sklypų nuomos

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Introduction: The issues of rational antihypertensive therapy in pregnant women are always extremely relevant, since high blood pressure in a pregnant woman is associated with serious risks for a mother and a fetus. The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertension. Materials and methods: A multicenter study was conducted in 2018–2021 using an anonymous questionnaire among 411 doctors from 8 regions of Russia. Results and discussion: The levels of knowledge and preferences of specialists in the issues of diagnosing and formulating a diagnosis of arterial hypertension and preeclampsia in pregnant women, prescribing basic and additional drugs for the treatment and prevention of hypertension were revealed, and the degree of compliance with the current clinical guidelines was assessed. Conclusion: Due to the insufficient level of knowledge of specialists, it is required to pay increased and special attention to this problem, strengthen control over compliance with clinical guidelines, and introduce it into postgraduate recommendations and continuing education programs

Rational antimicrobial chemotherapy: assessment of the level of basic knowledge of general practitioners. Final results of the KANT project

Introduction: The irrational use of medicines leads to a decrease in the quality of care, an increase in treatment costs and side effects. In the case of antibacterial drugs, in addition to all the above-mentioned consequences, their improper use can lead to an aggravation of the existing and quite challenging problem of our time – the growth of antibiotic resistance among pathogenic microorganisms. The aim of the study: to determine the level of basic knowledge of medical specialists in the field of a rational use of antimicrobial drugs (AMD). Materials and methods: The study was based on an analysis of an anonymous multicenter survey in the framework of the KANT project (the full name of the project is “Physicians’ (Students’) Knowledge of Antimicrobials Usage”). It was conducted in 2018–2019 in 10 major centers of Russia. Results and iscussion: According to the results of the study, the respondents showed a low level of knowledge of the rational use of antibacterial drugs. The best results are obtained for questions No.1 (time interval for evaluating the effectiveness of the initial antimicrobial therapy (AMT)), No.2 (rationality and period of AMD change with a positive clinical effect), and No.9 (determining the mode of using the proposed drugs), whereas the worst results were obtained for questions No.3 (determining irrational combinations of AMD), No.4 (determining a situation requiring a long course of AMT), and No.7 (choosing auxiliary drugs for bacterial respiratory infections). Conclusion: The results obtained in the study indicate the need for additional educational activities among health professionals

Assessment of physicians’ and medical majors’ knowledge of asthma basics: Current results of the ASSA-II study

Introduction: Bronchial asthma is a disease characterized by chronic inflammation of the airways. At present, about 235-300 million people suffer from asthma, and this number continues to grow. This pathology is also common in children. It causes significant social and economic damage worldwide. Severe forms of asthma are difficult to treat. Thus, a continuous improvement of doctors’ knowledge in this field is of great importance. Methods: The analysis of an anonymous survey of physicians and senior medical students was used in the research. Results: The study revealed both an average level of basic knowledge in asthma etiology and pathogenesis among the physicians and senior medical students and the significant differences in their knowledge regarding clinical picture and treatment of asthma. Only 49.2% of students and 56.0% of doctors were able to choose the correct definition of asthma from the suggested answers; 65.7% of students and 69.9% of doctors correctly indicated the main clinical and laboratory markers of asthma; 60.2% of students and 91.0% of doctors determined the correct combination of drugs in one delivery device; and 75.9% of students and 91.2% of doctors selected the correct basic asthma therapy depending on the severity. Conclusion: Basing on the results obtained it was recommended to introduce additional educational activities on the diagnosis and therapy of asthma among medical majors and physicians

Correction to: Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

International audienceIn this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly as Athanasios Kollias in the Acknowledgements. The original article has been corrected

Patterns of oral anticoagulant use and outcomes in Asian patients with atrial fibrillation: a post-hoc analysis from the GLORIA-AF Registry

Background: Previous studies suggested potential ethnic differences in the management and outcomes of atrial fibrillation (AF). We aim to analyse oral anticoagulant (OAC) prescription, discontinuation, and risk of adverse outcomes in Asian patients with AF, using data from a global prospective cohort study. Methods: From the GLORIA-AF Registry Phase II-III (November 2011-December 2014 for Phase II, and January 2014-December 2016 for Phase III), we analysed patients according to their self-reported ethnicity (Asian vs. non-Asian), as well as according to Asian subgroups (Chinese, Japanese, Korean and other Asian). Logistic regression was used to analyse OAC prescription, while the risk of OAC discontinuation and adverse outcomes were analysed through Cox-regression model. Our primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACE). The original studies were registered with ClinicalTrials.gov, NCT01468701, NCT01671007, and NCT01937377. Findings: 34,421 patients were included (70.0 ± 10.5 years, 45.1% females, 6900 (20.0%) Asian: 3829 (55.5%) Chinese, 814 (11.8%) Japanese, 1964 (28.5%) Korean and 293 (4.2%) other Asian). Most of the Asian patients were recruited in Asia (n = 6701, 97.1%), while non-Asian patients were mainly recruited in Europe (n = 15,449, 56.1%) and North America (n = 8378, 30.4%). Compared to non-Asian individuals, prescription of OAC and non-vitamin K antagonist oral anticoagulant (NOAC) was lower in Asian patients (Odds Ratio [OR] and 95% Confidence Intervals (CI): 0.23 [0.22-0.25] and 0.66 [0.61-0.71], respectively), but higher in the Japanese subgroup. Asian ethnicity was also associated with higher risk of OAC discontinuation (Hazard Ratio [HR] and [95% CI]: 1.79 [1.67-1.92]), and lower risk of the primary composite outcome (HR [95% CI]: 0.86 [0.76-0.96]). Among the exploratory secondary outcomes, Asian ethnicity was associated with higher risks of thromboembolism and intracranial haemorrhage, and lower risk of major bleeding. Interpretation: Our results showed that Asian patients with AF showed suboptimal thromboembolic risk management and a specific risk profile of adverse outcomes; these differences may also reflect differences in country-specific factors. Ensuring integrated and appropriate treatment of these patients is crucial to improve their prognosis. Funding: The GLORIA-AF Registry was funded by Boehringer Ingelheim GmbH