Depressive and Other Adverse CNS Effects of Fluoroquinolones.

Fluoroquinolones (FQs) are widely used drugs around the world. This is a result of their broad spectrum of antibacterial activity, high bioavailability, and known efficacy. Since they appeared on the market, their prescribing frequency has gradually increased. In 2011, FQs became the third most prescribed class of antibiotics in the US. Widespread use of these drugs resulted in an increasing number of reported side effects. In 2016, the FDA warned about significant side effects, including mental disorders in the form of anxiety, psychotic symptoms, insomnia, and depression. Psychiatric adverse reactions to FQs occur with a frequency of 1 to 4.4% and the mechanism of their formation is not entirely clear. It is believed that the antagonistic effect of FQs on the GABA receptor or interaction with the main receptor for the glutamatergic system-NMDA-is responsible for this. The paper is a structured review of 68 selected publications and the latest summary of CNS adverse effects that occur during FQ use. Prescribers should be aware of the risk factors for FQ toxicity, including elderly patients with underlying medical conditions or receiving concomitant medication; however, these adverse events may also occur in other groups of patients.

Medical or Common Knowledge? Knowledge of Medical Professionals on Obesity Diagnosis Criteria and Treatment.

INTRODUCTION: Proper diagnosis of obesity, its severity, and complications and their effective treatment requires an interdisciplinary healthcare approach. Nevertheless, obesity remains under-identified and undertreated. Academic knowledge concerning obesity pathology, diagnosis, and treatment is advancing. It is not clear whether this translates into clinical practice. The goal of the study was to assess the knowledge of healthcare professionals (HCPs) on obesity and particularly on the criteria for diagnosis as well as for conservative and surgical treatment. METHODS: This cross-sectional study was conducted among active HCPs (N = 184), including physicians, nurses, physiotherapists, and paramedics who had contact with adult patients with obesity. The proprietary research survey, implemented in an online tool, was used to assess knowledge on the diagnosis and treatment of obesity and self-assessment of that knowledge. The analysis was limited to the following: body mass index (BMI) definition, BMI values, visceral obesity definition, bariatric surgery indications, choice of treatment method, role of diet and physical activity, knowledge of obesity pharmacotherapy, length of obesity pharmacotherapy, financing of bariatric procedures, and goals of bariatric treatment. The correct answers were determined according to the Polish guidelines for the diagnosis and treatment of obesity. RESULTS: Half of the respondents (52.2%) were doctors, 20.7% were nurses and midwives, 19.0% were physiotherapists, and 8.2% were other medical professionals. Among questions related to knowledge on obesity, 67.1% of respondents provided correct answers, with respondents answering questions concerning obesity diagnosis correctly more frequently (70.1%) than those concerning methods of treatment (64.6%). The largest number of correct answers was related to the definition of BMI and normal BMI values. The smallest number of correct answers pertained to the diagnostic criteria for visceral obesity and pharmacological treatment of obesity. There was no statistically significant impact of a responder's knowledge levels on the obesity of different HCPs. Workplace and participation in training sessions were found to have the largest impact on the level of knowledge on obesity. HCPs' own assessment of their knowledge on obesity was negatively correlated with their actual level of knowledge. CONCLUSION: The prevalence of overweight and obesity implies that essentially every HCP has daily contact with patients with excessive body weight. Knowledge of BMI values cannot be considered as exclusively medical knowledge: these values were established years ago and are present in widely available sources. Our research showed that 32.9% of HCPs did not have sufficient knowledge about how to diagnose and treat obesity.

Lack of association between rs1049353 polymorphism of the CNR1 gene and suicide attempt frequency in Polish population.

Suicidal behaviour is a major public health problem in Poland. There is compelling evidence that genetic factors contribute to the risk for suicidal behavior. Studies suggest a link between single nucleotide polymorphism (SNP) rs1049353 (1359 G/A; Thr453Thr) of cannabinoid receptor 1 gene (CNR1) and mental disorders, including suicide behaviour. AIM: The purpose of the study was to determine whether 1359 G/ A polymorphism of CNR1 is more frequent in people attempting suicide than in the general population. MATERIALS AND METHODS: A sample of 76 genetically unrelated participants were enrolled into the study: 48 patients after a suicide attempt and the control group - 28 individuals without a history of suicide attempts. The genotyping of 1359 G/A polymorphism of CNR1 gene was performed with the application of Restriction Fragment Length Polymorphism (RFLP) analysis. RESULTS: None of the 1359 G/A polymorphisms of CNR1 gene seem to occur more frequently among individuals who attempted suicide. CONCLUSIONS: Further research with larger samples with different racial and geographic origins are needed in the future.

Polish adolescents' right to confidential primary health care is not respected despite high public acceptance.

AIM: The right of underaged patients to confidential health care should be considered an inalienable human right. Access to such care is also advisable according to contemporary medical knowledge. The aim of this study was to verify the extent this right is exercised in Poland and to examine social attitudes towards this issue. METHODS: A sample of Polish school-age pupils and parents (n = 800) was surveyed using an online questionnaire. RESULTS: Only 4.2% of the surveyed adolescents were offered private time with a doctor during their last preventive visit (well-child visit), and this was more frequent for girls. At the same time, a very high level of acceptance for private time with a doctor was observed among Polish adolescents (90.8%) and their parents (84.3%). CONCLUSION: Our findings suggest serious deficiencies in the protection of adolescent patients confidentiality. It is necessary to change medical practice and adapt legal regulations to the provisions of the Convention on the Rights of the Child.

Prophylactic medical examination of 15/16 year old from the Warsaw Agglomeration. Evaluation of the implementation of standards in practice.

Prophylactic medical examinations - called well-child visit - are among the benefits guaranteed under basic health care. The prophylactic visit should include, among others: physical examination and an interview (with the adolescent and the parent), as well as individual pro-health education. AIM: The aim of the study was to answer the question whether preventive medical visits of 15/16 year olds from the Warsaw Agglomeration are carried out within the scope defined by the Minister of Health and in accordance with standards. MATERIALS AND METHODS: The course of well-child visit was evaluated on the basis of 359 anonymous questionnaires filled in by students from randomly selected 11 schools from the Warsaw Agglomeration. RESULTS: In 3.3% of the respondents, the doctor did not carry out any of the physical examinations asked in the questionnaire. The most often doctor auscultated chest organs (94.4% of respondents), the least frequently examined genitals in girls (2.1%). During the visit, the doctors raised less than 4 topics on average. The most frequent subjects of discussion were menstruation (80.0% of girls), chronic diseases in the adolescent's family (59.1%) and physical activity (51.0%); the rarest ones were depression and suicidal thoughts (3.1%), violence (1.9%) and the influence of the family on the patient's well-being (1.4%). The compatibility of the gender of the patient and the doctor increased the number of topics discussed. CONCLUSIONS: The confrontation of the data obtained by us with the content of the Minister of Health's regulation and the standards in force in Poland provides the basis for a negative assessment of the implementation of medical prophylactic examinations in the adolescents in the Warsaw Agglomeration.