How do general practitioners rate their relationship with gastroenterologists?

BACKGROUND: Relations between general practitioners and the hospital consultants are often considered difficult, and occasionally generate conflicts, potentially affecting the patient management and healthcare system organisation. These views, however, have partly been contradicted by structured surveys and qualitative studies. AIMS: We conducted a survey on the general practitioners' opinions regarding their relations with the gastroenterological-endoscopy services in order to explore current attitudes, any negative aspects and assess scope for improvement. SUBJECTS AND METHODS: Structured questionnaires were sent to 221 general practitioners in the Veneto region of Italy; the questionnaire was based on 26 questions concerning their subjective relations with the gastroenterologists, expertise in the gastroenterological problems and perceived efficiency of gastroenterological services. RESULTS: As many as 106 doctors answered the postal questionnaire (mean: 15 per province; range 5-20). Responses to the structured questions totalled to 2,339 items, out of which 1,234 (53%) presented positive responses, particularly with regard to admissions' management and the adequacy of referral reports. Many general practitioners reported of their participation in the meetings on gastroenterological problems. Homecare referrals were limited in number, even for the patients with tube feeding. CONCLUSIONS: Relations between the general practitioners in Veneto and local gastroenterological services were generally good, possibly reflecting the well-developed outreach network. This liaison could be further improved via closer interrelations based not only on the patient referrals but also on the professional and information exchange to promote successful practice.

Morphostructural relationships between bone and implant: comparative analyses by optical microscopy and microradiography.

This study assessed the relationship between the surfaces of a hollow cylindrical titanium implant and the consequent bone organization around it. A human bone maxillary specimen was taken that enclosed an implant which had lasted 28 months under prosthetic loading. The implant was removed because of fracture that prevented the implant from being used as a supporting element for new prosthetic aims. The bone block-section was fixed and embedded, several sections were obtained, and each section was analyzed using three different histologic analyses: optical microscopy under ordinary light and polarized light, and microradiography. Comparative analyses were required on every single section to provide a complete morphostructural analysis of the peri-implant bone. Data retrieved by this research showed the presence of woven bone in the bone layer facing the external implant surface several months after its surgical fitting and functionalization. This finding demonstrates the importance of woven bone, first as holding sheath in the immediate postsurgical stage, and second as a mold for the subsequent centripetal accrementition of secondary lamellar bone.

[Health demands in adolescence. The results of 2 epidemiological studies in the Padua area in 1990-1992]. / Domanda di salute in adolescenza. Risultati di 2 indagini epidemiologiche nel padovano negli anni 1990-1992.

UNLABELLED: In order to make a detailed analysis of the specific requirements of adolescent health in this country, local health unit n. 19 in Padua performed an epidemiological survey with the collaboration of 15 general physicians who were asked to record all ambulatory visits by 13-24 year olds on a special form. The survey, which lasted two years, revealed that of a total of 4748 records, 2112 (44.48%) were male and 2636 (55.51%) were female. The age at which the greatest number of visits was recorded was 18. The majority of adolescents attended alone (68.48%) and this pattern tended to increase with age. The frequency of annual attendance was 86.64%. In order of frequency, diagnoses included: requests for certificates and prescriptions (21.76%); respiratory disease and influenza (21.61%); obstetric and gynecological problems (8.61% of the total and 15.52% of female attendance) which together with auxoendocrinological problems amounted to a frequency of 10.55%; psychological problems (6.53%); dermatological diseases (6.324%); problems involving the osteomuscular structure, problem of the digestive tract (4.93%); nervous disorders and diseases of the sense organs (4.87%); medication and requests for information (3.60%); nephro-uro-andrological problems (3.26%). IN CONCLUSION: the high rate of attendance at medical clinics does not show that adolescents are an often ill population but that the doctor has been selected as the prime interlocutor for all health-related problems. It should also be pointed out that the majority of problems tend to be reported as somatic, whereas only a minimum part (6.53%) are classified as psychological. This analysis confirms, however, that the health requirements presented as somatic often involve a psychological component.