[The self-perception of their professional role of the primary care physicians of Estonia and Finland]. / Autopercepción del rol profesional de los médicos de atención primaria de Estonia y Finlandia.

OBJECTIVE: To find out how experienced primary care physicians working in different societies see themselves as doctors. DESIGN: A cross-sectional study. SETTING: Primary health care in Estonia and Finland. PARTICIPANTS: Estonian district doctors (n = 110) and Finnish specialists of general practice (n = 211). METHODS: In a postal questionnaire the respondents were asked to evaluate how well 18 different expressions described them as doctors on a 5-step scale from "1 = very poorly" to "5 = very well". RESULTS: Four of the five expressions that were thought most accurate and telling--"Listener", "Vocational doctor", "Helper", and "Family physician"--were the same in Estonia and Finland. CONCLUSIONS: Even though there are differences in health care systems, the self-images of primary care doctors in both countries were more or less consistent with the international definitions of the general practitioner's job and role.

How Estonian and Finnish primary care doctors rate their need for common drugs.

OBJECTIVE: To compare ratings of the necessity of drugs in the daily practice of experienced primary care doctors in Estonia and Finland to find out the differences and similarities in the therapeutic traditions of the two different societies. METHODS: A questionnaire was sent to all Estonian district doctors born in the 1940s and to all Finnish specialized general practitioners born in the 1940s, who then evaluated the necessity of the listed drugs on a visual analogue scale. The ratings, from 0 to 100, were entered into a computer, using a graphic tablet and a pressure sensitive pointer. RESULTS: The six most highly-evaluated drugs among the Estonian respondents were digoxin, glyceryl trinitrate, aspirin, calcium-channel blockers, beta-adrenoceptor blockers and frusemide; and among the Finnish general practitioners (GPs) were penicillin, insulin, glyceryl trinitrate, beta-adrenoceptor blockers, frusemide and angiotensin-converting enzyme (ACE) inhibitors. The ratings of 15 out of 33 drugs/drug groups were very similar both in Estonia and Finland. The biggest differences between the opinions of the Estonian and Finnish doctors appeared in the ratings regarding the necessity of antacids, cimetidine, insulin, sulphonylureas, reserpine. ACE inhibitors, oral contraceptives, penicillin, metronidazole, trimethoprim, indomethacin, phenobarbital and theophylline. CONCLUSION: The revealed differences are suggested to be related to the different health care systems (different task profiles of doctors, different pharmaceutical services), different education of doctors, different availability of drugs in the past and different prices, all of which influence therapeutic traditions.

[Prevalence of selective lactose malabsorption in Khants]. / Rasprostranennoct' selektivnoi mal'absorbtsii laktozy sredi khantov.

The aim of the study was to determine the prevalence of selective lactose malabsorption (SLM) in Khants, a small finno-ugric nation living in West Siberia. A total of 80 Khants from the Surgut region (Tyumen territory) were studied. The diagnosis of SLM was based on the evidence obtained at a 50 g lactose and, if possible, a 25 g + 25 g galactose-glucose loads. In 6 cases electron-microscopic examination of the duodenal mucosa was performed. The prevalence of SLM in the Khants reached 93-94% being the highest in CIS.

Lactose malabsorption in Khants in western Siberia.

BACKGROUND: We wanted to estimate the prevalence of selective lactose malabsorption (SLM) in Khants, a small Finno-Ugric population living in Western Siberia who have traditionally consumed no milk in adulthood. METHODS: A total of 80 Khants, aged 8-57 years and living on the middle reaches of the River Ob, were studied. The diagnosis was based on a lactose tolerance test; general malabsorption was excluded by a glucose-galactose tolerance test whenever possible. In six subjects electronmicroscopic examination of the duodenal mucosa was performed. RESULTS: The prevalence of SLM in the Khants was 94%. CONCLUSION: This is the highest prevalence found in the previous Soviet Union.