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ABSTRACT: The prescribing patterns depend on the physicians' attitudes and their subjective norms towards prescribing a particular drug, as well as on their personal experience with a particular drug. The physicians are affected by their interactions with pharmaceutical industry.
The objectives were to develop a scale for assessment of pharmaceutical sales representatives (PSRs) by the family doctors (FDs) and to determine factors for their evaluation.
Cross-sectional anonymous postal study. We included a random sample of 250 Slovenian FDs. Settings. Slovenian FDs' surgeries.
The score of various items regarding FDs' assessment of PSRs on a 7-point Likert scale.
We got 163 responses (65.2% response rate). The most important characteristic of PSRs, as rated by respondents on the scale from 1 to 7, was the fact that they did not mislead when presenting products' information. The second most important characteristic was the ability to provide objective information about the product. The first three most important characteristics, as rated by the respondents by themselves, were 'Shows good knowledge on the promoted subject', 'Provides objective product information' and 'Makes brief and exact visits'. Cronbach's alpha of the composite scale was 0.844. Factor analysis revealed three PSRs' factors: selling skills, communicating skills and sense of trustworthiness.
FDs evaluate PSRs mainly by their managerial skills and trustworthiness. The scale proved to be a reliable tool for assessing PSRs by FDs.
Family Practice 02/2011; 28(4):456-60. · 1.50 Impact Factor
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ABSTRACT: Data on emergency treatment of poisonings are scarce.
To determine the annual rate of poisoning-related emergency medical services (EMS) interventions and to determine the aetiology and demographic characteristics of poisoning cases.
A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001) in the Celje region, Slovenia, covering 125 000 inhabitants. Data were recorded on an EMS form.
Two hundred and forty-four poisoning-related EMS interventions were recorded among a total of 4486 interventions (5.4%) corresponding to an average annual rate of 0.56 poisonings per 1000 inhabitants per year. Psychoactive agents were detected in 56.5% of the cases. Two-thirds of the poisonings took place outside patients' home. In 30% of the cases, the administration of poison was because of suicidal intentions. The most common substance ingested was alcohol alone or in combination with prescription or illegal drugs in 42.6% of cases, followed by drugs alone or in combination with alcohol in 39.2% cases. More than one-fifth of the poisonings were because of the use of illegal drugs. At the time of the arrival of EMS 23.5% of the patients were in coma. EMS applied antidote in 23.2% of the patients. After emergency care, 9.3% of the patients were still in coma, 15.6% were comatose, 26.6% were somnolent, 18.6% were disoriented and 30% had complete consciousness. Of these, 84.4% of the patients were admitted to hospital or specialized care and 15.6% were sent back home.
The pattern of poisoning is contrasted with that in other countries. The EMS proved to be a valuable resource for treatment of acute poisoning.
European journal of emergency medicine: official journal of the European Society for Emergency Medicine 07/2009; 16(3):127-30. · 0.73 Impact Factor
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ABSTRACT: Background: Data on emergency treatment of poisonings are scarce.
Objective: To determine the annual rate of poisoning-related emergency medical services (EMS) interventions and to determine the aetiology and demographic characteristics of poisoning cases.
Methods: A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001) in the Celje region, Slovenia, covering 125 000 inhabitants. Data were recorded on an EMS form.
Results: Two hundred and forty-four poisoning-related EMS interventions were recorded among a total of 4486 interventions (5.4%) corresponding to an average annual rate of 0.56 poisonings per 1000 inhabitants per year. Psychoactive agents were detected in 56.5% of the cases. Two-thirds of the poisonings took place outside patients' home. In 30% of the cases, the administration of poison was because of suicidal intentions. The most common substance ingested was alcohol alone or in combination with prescription or illegal drugs in 42.6% of cases, followed by drugs alone or in combination with alcohol in 39.2% cases. More than one-fifth of the poisonings were because of the use of illegal drugs. At the time of the arrival of EMS 23.5% of the patients were in coma. EMS applied antidote in 23.2% of the patients. After emergency care, 9.3% of the patients were still in coma, 15.6% were comatose, 26.6% were somnolent, 18.6% were disoriented and 30% had complete consciousness. Of these, 84.4% of the patients were admitted to hospital or specialized care and 15.6% were sent back home.
Conclusion: The pattern of poisoning is contrasted with that in other countries. The EMS proved to be a valuable resource for treatment of acute poisoning.
European Journal of Emergency Medicine 05/2009; 16(3):127-130. · 0.90 Impact Factor
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ABSTRACT: In the period between the December 2000 and September 2004, altogether 13 patients underwent preoperative portal vein embolization (PPVE); 9 patients with colorectal metastases and 4 patients with hepatocellular carcinoma. The indirect splenic portography was performed after catheter was introduced into superior mesenteric artery via femoral artery approach. The portal vein was punctured percutaneously transhepatic under fluoroscopy. Following portography, selected portal vein segments were embolized by injecting polyvinil alcohol (PVA) particles until stasis of blood flow was achieved. Proximal parts of branches and the channel in the liver parenchyma were occluded with Gelfoam particles. The increase of the remnant liver parenchyma was measured by magnetic resonance imaging. iTwo patients experienced post-embolization syndrome and another one had subcapsular hematoma. The volume of the liver parenchyma increased minimally for 8% and maximally for 109%. Altogether, 10 patients underwent surgical resection. In two patients, the disease progressed and carcinoma spread to the previously healthy liver lobe and in one there was no hypertrophy and we decided for artery chemoembolization (AC). The results show that PPVE triggers a strong regenerative response resulting in hypertrophy of normal liver parenchyma and expand possibilities of curative surgery for patients who would not otherwise have been candidates for extended resection.
Collegium antropologicum 07/2005; 29(1):163-7. · 0.61 Impact Factor
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The European Journal of General Practice 04/2005; 11(1):35-6. · 1.13 Impact Factor
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ABSTRACT: There has been increased interest in the use of capnometry in recent years. During cardiopulmonary resuscitation (CPR), the partial pressure of end-tidal carbon dioxide (PetCO2) correlates with cardiac output and, consequently, it has a prognostic value in CPR. This study was undertaken to compare the initial PetCO2 and the PetCO2 after 1 min during CPR in asphyxial cardiac arrest versus primary cardiac arrest.
The prospective observational study included two groups of patients: cardiac arrest due to asphyxia with initial rhythm asystole or pulseless electrical activity, and cardiac arrest due to acute myocardial infarction or malignant arrhythmias with initial rhythm ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). The PetCO2 was measured for both groups immediately after intubation and then repeatedly every minute, both for patients with and without return of spontaneous circulation (ROSC).
We analyzed 44 patients with asphyxial cardiac arrest and 141 patients with primary cardiac arrest. The first group showed no significant difference in the initial value of the PetCO2, even when we compared those with and without ROSC. There was a significant difference in the PetCO2 after 1 min of CPR between those patients with ROSC and those without ROSC. The mean value for all patients was significantly higher in the group with asphyxial arrest. In the group with VF/VT arrest there was a significant difference in the initial PetCO2 between patients without and with ROSC. In all patients with ROSC the initial PetCO2 was higher than 10 mmHg.
The initial PetCO2 is significantly higher in asphyxial arrest than in VT/VF cardiac arrest. Regarding asphyxial arrest there is also no difference in values of initial PetCO2 between patients with and without ROSC. On the contrary, there is a significant difference in values of the initial PetCO2 in the VF/VT cardiac arrest between patients with and without ROSC. This difference could prove to be useful as one of the methods in prehospital diagnostic procedures and attendance of cardiac arrest. For this reason we should always include other clinical and laboratory tests.
Critical Care 01/2004; 7(6):R139-44. · 4.93 Impact Factor
