Medical Chamber Research Articles

INVESTIGATION OF COVID-19 ANXIETY LEVELS OF PHYSICIANS

Background:The Coronavirus Anxiety Scale is a self-reported scanning tool used to detect dysfunctional anxiety about the COVID-19 pandemic. In this study, our aim was to determine the anxiety levels of members of the Medical Chamber of the Sivas and Erzincan provinces of Turkey during the pandemic. 
 Methods:The Coronavirus Anxiety Scale questionnaire was e-mailed to members of the Sivas-Erzincan Medical Chamber. According to the scores obtained from the questionnaire, the participants were divided into two groups: those without anxiety (Group 1) and those with anxiety (Group 2). The Mann-Whitney U test was used to compare two independent groups for continuous data, and Pearson’s chi-square test was used for frequency data. A p value of

Diurnal functional and anatomical changes in X-linked retinoschisis

BackgroundTo investigate the changes in macular cystic schisis (MCS) and sensitivity during the day in X-linked retinoschisis (XLRS) patients.MethodsTreatment-naïve patients with genetically verified XLRS underwent best-correlated visual acuity (BCVA) testing with ETDRS charts, spectral domain optical coherence tomography, and microperimetry (MP) twice a day, at 9 a.m. and 4 p.m., to measure changes in central retinal thickness (CRT), macular volume (MV), average threshold (AT), and fixation stability parameters (P1 and P2).ResultsAt baseline, the BCVA of the 14 eyes of 8 patients amounted 0.73 (± 0.23) LogMAR. Between timepoints, the BCVA increased in 3.21 letters (p = .021), the AV improved in 1.84 dB (p = .03, 9.73%), the CRT decreased in 24.43 µm (p = .007, − 4.05%), and the MV dropped in 0.27 µm3 (p = .016, − 2.68%). P1 and P2 did not variate. The collapse of the MCS led to the reduction of macula thickness. CRT at baseline correlated with the decrease of CRT (Spearman’s ρ: − 0.83 [p = .001]). Age and change of BCVA, CRT, and AV did not correlate among one another. Eyes with disrupted ellipsoid zone showed a more prominent change in CRT (p = .050). Photoreceptor outer segment length and integrity of the external limiting membrane and cone outer segment tips were not associated with BCVA, AT, or CRT variation.ConclusionEyes of treatment-naïve XLRS patients show diurnal macular thickness and function changes. Eyes with pronounced macular thickness show a greater reduction of the MCS. These results should be taken into consideration in upcoming clinical trials in XLRS.Trial registration numberInstitutional Review Board of the Hamburg Medical Chamber (Ethik-Kommission der Ärztekammer Hamburg): 2020–10,328.

Prospective Pilot study of Quality of Life in patients with severe late-radiation-toxicity treated by Low hyperbaric-oxigen-therapy

Background/purposeThe aim of this study is to assess for the first time the immediate and long term impact on quality-of-life of HBO treatments(HBOT) at 1.45 ATA (Absolute Atmospheric Pressure) Medical Hyperbaric chamber. MethodsPatients over 18 years-old, suffering of grade 3 Common Terminology Criteria for Adverse Events (CTCAE) 4.0 radiation induced late toxicity and progressing to standard support therapy were included in this prospective study. HBOT was given daily, sixty minutes per session by a Medical Hyperbaric Chamber Biobarica System at 1.45 ATA at 100% O2. Forty sessions were prescribed for all patients given in 8 weeks. Patients reported outcomes (PROs) was assessed by the QLQ-C30 questionnaire, before starting, in the last week of the treatment, as well as during follow up. ResultsBetween February-2018/June-2021, 48 patients fulfilled the inclusion criteria. A total of 37 patients (77%) completed the treatment prescribed HBOT sessions. Patients with anal fibrosis (9/37) and brain necrosis (7/37) were the most frequently treated. The most common symptoms were pain (65%) and bleeding (54%). In addition, thirty out of the 37 patients who completed the pre- and post-treatment Patients Reported Outcomes (PROs) assessment also completed the follow up European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire C30 (EORTC-QLQ-C30), and were evaluated in the present study. Mean follow up was 22,10 (6–39) months.The Median score of the EORTC-QLQ-C30, at the end of HBOT and during follow-up, was improved in all assessed domains, except in the cognitive aspect (p = 0.106). ConclusionsHBOT at 1.45 ATA is a feasible and well tolerated treatment, improving long term quality of life in terms of physical function, daily activities and general health subjective state of patients suffering severe late radiation-induced toxicity.

Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany

IntroductionOlder people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing...

Initiative for the implementation of planetary health in postgraduate medical training and continuing medical education in Switzerland.

The Swiss Medical Association FMH drew up the strategy "Planetary health - Strategy on the courses of action on climate change for the medical profession in Switzerland" in collaboration with the Swiss Institute for Medical Education SIME, the umbrella organisations and students. On 7 October 2021, the strategy was approved by the Swiss Medical Chamber with a budget of over CHF 380,000 (approx € 365,000). The first step in implementation involved setting up an advisory group which will tackle the concrete implementation of the strategy. This article provides an insight into the current state of work on the project with a focus on the measures in the areas of postgraduate medical training and continuing medical education. It is a work in progress.

Fatigue Among Family Medicine Physicians in Slovenia.

Different authors define fatigue in different ways even though it is considered a very common symptom in the primary medical care. To explore level of fatigue among Slovene family physicians and factors contributing to fatigue. Modified Fatigue Impact Scale was used in our research. The link to the questionnaire website was sent through the mailing list of Medical Chamber of Slovenia, the Family Medicine Union - Praktik.um, the Family Medicine Association and the Young Physicians. 231 physicians answered the questionnaire in full. There were 180 (77.9%) females and 51 (22.1%) males. The average age was 45.3±10.4 years and their capitation amounted to averagely 2245.8±544.2. On average they had spent 13.1±11.3 years working as specialists. Women have significant higher levels of fatigue, 57.2% have scored above the threshold of 38 points. Working in the office after working hours at least three times in a week was significantly associated with total fatigue, adding 10.07 points to the score. The years working as a specialist is not an important statistical factor in differentiating fatigue among physicians, nor is the level of patient load. Working irregular hours is also not an important statistical factor. Slovenian family physicians are tired, as they have exceeded the limit given in the literature. Women are more tired, the most characteristic factor that contributes to fatigue is the extension of work in the clinic at least three times a week.

Fatigue Among Family Medicine Physicians in Slovenia.

Different authors define fatigue in different ways even though it is considered a very common symptom in the primary medical care. To explore level of fatigue among Slovene family physicians and factors contributing to fatigue. Modified Fatigue Impact Scale was used in our research. The link to the questionnaire website was sent through the mailing list of Medical Chamber of Slovenia, the Family Medicine Union - Praktik.um, the Family Medicine Association and the Young Physicians. 231 physicians answered the questionnaire in full. There were 180 (77.9%) females and 51 (22.1%) males. The average age was 45.3±10.4 years and their capitation amounted to averagely 2245.8±544.2. On average they had spent 13.1±11.3 years working as specialists. Women have significant higher levels of fatigue, 57.2% have scored above the threshold of 38 points. Working in the office after working hours at least three times in a week was significantly associated with total fatigue, adding 10.07 points to the score. The years working as a specialist is not an important statistical factor in differentiating fatigue among physicians, nor is the level of patient load. Working irregular hours is also not an important statistical factor. Slovenian family physicians are tired, as they have exceeded the limit given in the literature. Women are more tired, the most characteristic factor that contributes to fatigue is the extension of work in the clinic at least three times a week.

Can we hit prenatal depression and anxiety through HIIT? The effectiveness of online high intensity interval training in pregnant women during the COVID-19 pandemic: a randomized controlled trial

BackgroundIn recent years high intensity interval training (HIIT) has grown in popularity. However, it rarely represents training interventions in experimental studies in pregnant populations. Therefore, in this study we aimed to assess changes in depressive symptoms, fear of childbirth, fear of Covid-19 and quality of life after an 8-week supervised online HIIT program, compared to an educational (self-performed physical activity) program.MethodsWe conducted a randomized control trial among 54 Caucasian women in uncomplicated, singleton pregnancy (age 32 ± 4 years, 22 ± 4 week of gestation; mean ± SD). There were 34 women in the experimental group, who participated in an 8-week high intensity interval training program (HIIT group). The comparative group was constituted of 20 pregnant women who attended 8-week educational program (EDU group).ResultsThe most important finding was that mental health improved somewhat in both groups after the intervention, but only the HIIT group improved statistically significantly. The positive trends in lowering the severity of depressive symptoms, fear of childbirth, and fear of Covid-19 were observed in both groups. However, the positive response to the intervention was stronger in the EDU group. As a secondary outcome, there was a significant decrease in cardiorespiratory fitness level in the EDU group, while the HIIT group maintained unchanged level of maximal oxygen uptake.ConclusionsHIIT seems to be beneficial for women with uncomplicated pregnancies to maintain adequate quality of life and mental health. However, more research is needed to determine the effectiveness of prenatal HIIT in pregnant women in various psychological conditions.Trial registration: We conducted this study in Poland, in 2021. It was approved by the Bioethics Commission at the District Medical Chamber in Gdansk (KB-8/21). The full study protocol was registered in ClinicalTrials.gov (NCT05009433).

Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study

BackgroundOlder individuals tend to include less physical activity in their routine and are more prone to chronic diseases and severe medical complications, making them the most burdened group that is losing years of life due to pandemic-related premature mortality.This research aimed to assess the lifestyle factors that affect the COVID-19 course among patients ≥ 65 years old. MethodsThe study included 568 convalescents (64.1% women and 35.9% men) with persistent clinical symptoms after isolation. The mean age was 70.41 ± 4.64 years (minimum: 65 years; maximum: 89 years). The patients completed the questionnaire during their in-person visit to the medical center. The survey included questions regarding their health status when suffering from COVID-19, basic sociodemographic data, and medical history concerning chronic conditions and lifestyle. ResultsPhysical inactivity (p < 0.001) and feeling nervous (p = 0.026) increased the risk of having a severe disease course. Coronary artery disease raised both the risk of a severe disease course (p = 0.002) and the number of present symptoms up to 4 weeks (p = 0.039). Sleep disturbances increased the number of symptoms during infection (p = 0.001). The occurrence of any symptoms was also associated with the female sex (p = 0.004). The severity of the course was associated with longer persistent symptoms (p < 0.001) and a greater number of symptoms (p = 0.004); those with a more severe course were also at a greater risk of persistent symptoms for up to 4 weeks (p = 0.006). Senior citizens in the third pandemic wave suffered with more severe disease (p = 0.004), while illness during the fourth (p = 0.001) and fifth (p < 0.001) waves was associated with a lower risk of persistent symptoms for up to 4 weeks. The disease duration was significantly shorter among vaccinated patients (p = 0.042). ConclusionsElderly COVID-19 patients should re-think their lifestyle habits to consider a physical activity level that is adjusted to their abilities, in order to decrease the risk of a severe disease course and to further limit both the number and duration of symptoms.The research was carried out in accordance with the Declaration of Helsinki, and approval from the Bioethics Committee of Lodz Regional Medical Chamber to conduct the study was obtained (approval number 0115/2021). The PoLoCOV-Study ClinicalTrials.gov identifier is NCT05018052.

Long-term fasting: Multi-system adaptations in humans (GENESIS) study-A single-arm interventional trial.

[ClinicalTrials.gov], identifier [NCT05031598].

Attitudes of doctors of medicine and dental medicine towards contacting patients via social networks

Abstract Background As the use of social networking sites (SNSs) has greatly increased among health professionals, it is necessary to investigate their use of SNSs. The aim of this study was to identify the patterns of SNS use for contact with patients between medical doctors (MD) and doctors of dental medicine (DMD) in Croatia. Methods In collaboration with the Croatian Medical Chamber and the Croatian Chamber of Dental Medicine, a quantitative cross-sectional study was conducted on the use of SNSs and the attitudes of MDs and DMDs towards e-professionalism. Data were collected using online questionnaires. The data were analyzed using descriptive statistics. Results A total of 753 responses were processed, 507 (67,3%) MDs and 246 (32,7%) DMDs. DMDs were significantly more likely to visit patients or their family members’ profiles on SNSs (60,6% vs 33,3%, P &amp;lt; 0.001). The main reason for visiting a patient’s or family member’s profile is social communication, which is significantly more common among DMDs (46,3% vs 29,0%, P &amp;lt; 0.002). DMDs are significantly more likely to send friend requests from private SNS profiles to patients or their family members (15,0% DMDs vs 3,4% MDs, P &amp;lt; 0.001). Patients are much more likely to send friendship and connection requests on SNS to DMDs (91,1% DMDs vs 62,7% MDs, P &amp;lt; 0.001) who are also significantly more likely to accept these requests (76,8% DMDs vs 41,5% MDs, P &amp;lt; 0.001). MDs and DMDs would find the presence of e-professionalism guidelines useful (72,2% MDS vs 78,0% DMDs, P = 0.103). Conclusions The results show that DMDs are more open to communicating with patients via SNSs. Results showed a difference between MDs and DMDs in both directions - in sending requests to patients or their family members and in positive responses to their requests for connection. The findings point to the need to develop guidelines for health professionals regarding e-professionalism. Key messages • There are differences between MDs and DMDs toward communicating with patients using SNSs, DMDs being more open to the communication with patients. • There is a need to develop guidelines for health professionals on e-professionalism with emphasis regarding how to professionally communicate with patients on SNSs.

Specialization training of doctors in the surgical specialties in Poland

Introduction: The specialisation education system in Poland is subject to constant changes, the aim of which is to adapt it to changing needs, while ensuring the highest quality of education. The need for reform is indicated by the doctors themselves who undergo specialisation training, and who know its strengths and weaknesses best. Potential changes should be evaluated and implemented on an ongoing basis to ensure the continuous development of the specialisation education system. Moreover, the quality of education should be constantly monitored to maintain its appropriate level.&#x0D; Aim of the article: The study aims to characterize the changes taking place in the system of specialisation education in nine selected treatment areas of medicine as well as in anaesthesiology and intensive therapy in 2011-2020, with particular emphasis on quantitative changes.&#x0D; Material and methods: The material for analysis consists of data from the register of doctors undergoing specialisation training conducted by the Centre of Postgraduate Medical Education of Warsaw (CMKP) from 2011 to 2020, data provided by The Supreme Medical Chamber (NIL) and the Medical Examinations Centre (CEM) in 2011-2018. The material analysis was quantitative and was carried out with the use of Microsoft Excel.&#x0D; Results: The data analysis carried out indicates that in the analysed set of specialisations in 2011-2020:&#x0D; &#x0D; the number of doctors undergoing specialisation training has increased,&#x0D; the share of doctors undergoing specialisation training as part of residency has increased,&#x0D; the share of women in the group of doctors undergoing specialisation increased,&#x0D; the number of training places has increased,&#x0D; the number of accredited units has increased,&#x0D; the use of training places has decreased (the number of training places per specialist doctor has increased), and&#x0D; the average age of a person undergoing specialisation has decreased.&#x0D; &#x0D; Conclusions: The postgraduate education system for doctors in Poland in 2011-2020 was subject to numerous reforms and was constantly developing. Modular Specialisations have been introduced to improve accessibility and reduce the time to complete Specialisations that were formerly Detailed Specialisations. The number of doctors in in the surgical specialisations in Poland shows a growing trend.

Effect of Whole-Body Cryotherapy on Iron Status and Biomarkers of Neuroplasticity in Multiple Sclerosis Women.

The aim of the study was to compare the effect of a series of 20 whole body cryotherapy (WBC) sessions on iron levels and neuroplasticity biomarkers in women with multiple sclerosis (MS) and healthy women. Consent was obtained from the Bioethics Committee at the Regional Medical Chamber in Krakow (87/KBL/OIL/2018; 8 May 2018). The study was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12620001142921; 2 November 2020). The study included 30 people: 15 women with multiple sclerosis (mean age 41.53 ± 6.98 years) and 15 healthy women (mean age 38.47 ± 6.0 years). Both groups attended cryotherapy sessions. Venous blood was collected for analysis before the WBC session and after 20 sessions. In women with MS and healthy women, no significant effect of WBC on changes in the level biomarkers of neuroplasticity was found. There were also no statistically significant differences between the groups of the analyzed indices at the beginning of the study.

Disordered eating behaviours and eating disorders in adults with type 1 diabetes (DEBBI): rational and design of an observational longitudinal online study

IntroductionDisordered eating behaviours (DEB) and eating disorders (ED) are among the most common mental health comorbidities of type 1 diabetes. However, research on diabetes-specific risk and protective factors is limited....

ACTonDiabetes: study protocol of a pragmatic randomised controlled trial for the evaluation of an acceptance and commitment-based internet-based and mobile-based intervention for adults living with type 1 or type 2 diabetes

IntroductionLiving with diabetes can be burdensome and lead to serious emotional distress and impaired mental health. Acceptance and commitment therapy (ACT) can support people facing the challenges of living with...

Editorial introductions.

Editorial introductions.

Bulletin of the Regional Medical Chamber as a forum for ethical discourse in psychiatry and sexology

IntroductionSince last year there has been a lively ethical discussion in Poland about the influence of religion and new cultural currents on medical ethics. There are many ways to work towards increasing ethical sensitivity in education of mental health care professionals.ObjectivesThis paper presents the ethical discourse in the bulletin “Primum” of Bydgoszcz Medical Chamber (24 chambers in Poland associate doctors and dentists): www.bil.org.pl/primum - English translations: www.dropbox.com/s/xthu7wyt56ecjwp/Primum_translations.docx?dl=0.MethodsAll texts dealing with issues described were collected and divided into three groups: promoting new currents of thought, faithful to tradition, others. Presented views were analyzed basing on Polish Code of Medical Ethics (nil.org.pl/uploaded_images/1574857770_kodeks-etyki-lekarskiej.pdf) and compared with dominating philosophical schools.ResultsA total of 33 articles were published: 20 presenting new approach to medical ethics, supported by the Editorial Board (72% of the total), 7 embedded in traditional values (22%), 6 without a clear stand or denying the discourse on ethical issues (6%). Articles presented philosophical views (personalism, virtue ethics, utilitarianism, constructionism), discussed ethical standards, actions contrary to the dignity of medical profession, value of human life, compliance of arguments with medical knowledge, principles of dealing with patients in terminal states, the duty of care for the pregnant woman and her child.ConclusionsAll texts show dilemmas in our environment, reflect views in Polish society and in ethical discourse around the world. Thanks to them, readers familiarize themselves with the contemporary ethical debate and form their own opinions; also they are encouraged to reach for the indicated sources and their own research.DisclosureNo significant relationships.

Evaluation of Complaints Reflected to Medical Chamber of Bursa Honor Board: 1995 – 2005

Aim: To evaluate the complaints in the honor board files of a medical chamber which has an important place in determining the disruptions and violations experienced in the healthcare delivery system. Materials and Methods: The study is of cross-sectional type and the files reflected in the Bursa Medical Chamber Honor Board files between the years 1995-2005 were analyzed by archive analysis method. Results: It was found that 89% of the 121 cases obtained from the 111 files examined consisted of behaviors contrary to Turkish Medical Association Laws/decisions. The reasons for the complaints in the files were listed under three main headings and the Bursa Medical Chamber Administrative Board made the highest number of complaints with 46.3%. It was determined that 67.5% of the physicians who caused the complaint worked in a private institution and 67.6% were specialists. General surgery and gynecology and obstetrics took place in the top 2 places of specialization. A statistically significant relationship was found between the causes of complaints and age. It’s found that fines were given at the highest rate. 27 of the 42 files submitted to the Turkish Medical Association High Honor Board are due to complaints of violation of the laws/decisions of Turkish Medical Association. Conclusion: Evaluation of the complaints reflected in the medical chambers, which have an important place in the disciplinary process, is important for professional ethics and determining the place of deontology and medical ethics in medical education.

Automatic Control System of Oxygen Concentration in Medical Hyperbaric Oxygen Chamber Based on ZigBee

In order to effectively prevent the damage to the human body caused by abnormal oxygen concentration in the medical hyperbaric oxygen chamber, a ZigBee-based medical hyperbaric oxygen chamber oxygen concentration automatic control system is designed. The data acquisition module uses the microprocessor STM32F103C8T6 to receive the oxygen concentration data of each acquisition point, and the ZigBee of the data processing module transmits the processing results to the MSP430G2553 single-chip microcomputer at the receiving end of the slave. The MSP430G2553 single-chip microcomputer uses a self-organizing TS fuzzy neural network (SOTSFNN) and adds activation. The intensity concept realizes automatic control of the oxygen concentration in the hyperbaric oxygen chamber, and controls the buzzer to give an alarm when the oxygen concentration is lower than 19 mg/L and higher than 23 mg/L, and displays the current real-time oxygen concentration through LCD12864. The experimental results show that as the communication distance increases, the packet loss rate of the system is always lower than 5%, and the signal strength under the same communication distance is better; the system can effectively control the oxygen concentration value within the set range, and the oxygen concentration. The control accuracy is high and the stability is good.

Ocena efekta Kovida-19 na društvene i dnevne aktivnosti porodičnih lekara u Kajzeriju u Turskoj

Objective: We aimed at determining the effects of Covid-19 disease on family physicians' (FPs) daily work and life. Methods: We searched for GPs who had Covid-19 by making inquiries in the Medical Chamber, Association of GPs in Kayseri, and local health authorities. Our study period covers the first year of the Covid-19 pandemic in Türkiye (March 11th, 2020 - March 11th, 2021). The descriptive characteristics, we looked into, were the use of preventive measures, location of family health centers, the transmission route of Covid-19, the symptoms they experienced, FP's general health status, and additionally details of isolation, diagnosis, and hospitalization procedures. Results: A total of 85 FPs (18.2% of all FPs in the Kayseri region) had Covid-19 in the first 12 months of the Covid-19 pandemic in Kayseri/Türkiye. FPs who gave consent to participate in our study made up 60.8% of Kayseri's FPs. Washing hands, keeping distance, using face masks, and frequent indoor ventilation were the most frequently used measures (&gt;75%). More than 2/3 of FPs stuck to the preventive measures. The most frequent symptoms experienced by the FPs were muscle and joint pain, weakness, and fever (more than 1/5 of FPs, respectively 35.4%, 30.4%, 29.1%). The transmission sites were mostly Family Health Centers. Conclusion: About 1/6 of FPs were infected with Covid-19. Almost all of them were working in the urban area. The mean hospitalization stay was 7.7 days and in more than 50% the symptoms of fever and cough were detected. The disease transmission was the most prevalent at the workplace and the most common concern of FPs was the protection of their families.