The Diagnosis and Therapy of Helicobacter pylori Infection in Hungary: Comparison of Strategies Applied by Family Physicians and Internists.

BACKGROUND AIMS: Most patients with Helicobacter pylori infection are consulted for the first time by family physicians. We aimed to survey the adherence to the newest guidelines of the management of H. pylori infection in the primary and secondary care settings in Hungary. METHODS: From a total of 793 physicians, 94 trainees in family medicine, 334 family physicians without and 195 with board certification in internal medicine, 87 internists, 78 family paediatricians were invited to take part in the study. Diagnostic and therapeutic attitudes towards H. pylori infection were compared by a voluntary and anonymous questionnaire. RESULTS: Participants test for H. pylori infection in 92.8% of cases with a family history of peptic ulcer or 76.9% of gastric cancer, 68.9% of dyspepsia and 49.9% of non-specific abdominal complaints, before initiation of non-steroidal anti-inflammatory drug (NSAID; 17.3%) and antiplatelet treatment (14.5%), respectively. They confirm the success of eradication therapy in 88.1% mainly by urea breath test. Most of them initiate eradication therapy by themselves and only 22.4% refer their patients to a gastroenterologist. Clarithromycin-based standard triple therapy is the most preferred (62.1%) and only 3.7% choose quadruple combination with bismuth as first-line and 48.1% as second-line therapy. We found significant differences between groups with respect to the physicians' own infection, localization of practice, and sources of information on H. pylori infection. Internists are more likely to clarify H. pylori status before the initiation of NSAID and antiplatelet therapies, initiate second-line therapies and use bismuth compared to the other groups. Family physicians with board certification in internal medicine are also prone to start eradication therapy and less prone to refer patients to a gastroenterologist. Family paediatricians prefer stool antigen determination, screen family members and prefer gastroenterologist consultation more often, and use bismuth less frequently than the other groups. Family physicians with previous infection check for H. pyloriinfection more frequently before the initiation of NSAID treatment and are more likely to use histology to detect H. pylori. Postgraduate trainings were the most popular source of information. CONCLUSION: The adherence to the recent recommendations of current guidelines is moderate. There is a need to increase adherence to current recommendations by family physicians and internists.

[The role of physical activity in health promotion of healthcare workers]. / A testmozgás szerepe az egészségügyi dolgozók egészségfejlesztésében.

INTRODUCTION: The health status of doctors, nurses and any other professionals working in the healthcare sector influences the quality of their work. Therefore, health promotion of healthcare workers is not only an occupational health program but it can be considered as an action towards improving the quality of care. AIM: The current study was designed to assess the efficacy of a health promotion intervention among healthcare workers after health status assessment. METHOD: Before and after the intervention a self-assessment questionnaire-based health survey and physical status examination were performed. Members of the intervention group were offered to use fitness facilities, professional psychological help, dietary counselling, and dental consultation. RESULTS: The intervention program lasted for 12 months with the participation of 79 health care professionals (based on their decision being in the intervention or in the control group). Significant decrease was found in the abdominal perimeter in participants of the intervention group and they ran a longer distance on the 12 minute-long-run test at the end of the study. CONCLUSIONS: The positive effect of regular physical exercise as part of active lifestyle has been demonstrated not only in the increase of physical capacity, but in the change of body shape, as well. Orv. Hetil., 2016, 157(39), 1563-1570.