Search

We performed a survey on information management and reading routines in a random sample of Finnish doctors graduated during the last 2-10 years. The mean time spent on reading medical data sources and literature was three hours per week. The most appreciated sources of information were Current Care and other guidelines written in Finnish, especially among female doctors. The most important problem the doctors encountered was lack of time. Even though a physician who works as an expert needs continuous following of scientific literature the present medical education does not give sufficient expertise to use electronic data sources and international medical literature to solve problems faced with the patients.

For a physician working as an expert continuous following of scientific literature is required. We elucidated the competence of 5th and 6th year students for the development of expertise. The mean time spent on reading medical literature was seven hours a week. The most important source of information for the students were websites with short quidelines and introductions written in students' own language. International original articles or English textbooks were not so much appreciated and seldom read. The present curricula in our medical schools do not encourage the student to search and acquire knowledge wider than their patients themselves do.

This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urinary tract infections in adults and children. Sexually transmitted diseases are not addressed, but must be considered in differential diagnostics. The resistance prevalence of the causative microbes and the ecological adverse effects of antimicrobial agents were considered important factors in selecting optimal therapeutic choices for the guideline. Diagnosis and management of cystitis in otherwise healthy women aged 18-65 years can be based on structured telephone interviews. Primary antimicrobiotic drugs are nitrofurantoin, pivmesillinam and trimetoprim for three days.

Biofilm refers to an organized structure formed by microbes and attached either to an organic or a nonliving surface. The efficacy of conventional antimicrobial drugs against bacteria residing within the biofilm is poor, although planctonic bacteria would be susceptible to them. The biofilm format may also protect bacteria from the immune system. Typical biofilm infections include dental caries and foreign body infections. In the future, treatment of biofilm infections may in addition to antimicrobial therapy utilize drugs that weaken the signaling between bacteria and decrease the ability to form biofilm.

Teaching of differential diagnostic skills in medical education is often nonsystematic and touched only in a disease-based manner in the context of patient cases. We conducted a controlled study, in which a portion of fifth year students received systematic teaching of differential diagnostics and information retrieval for a period of ten weeks, whereas another portion continued in conventional basic training. We tested the students' problem-solving skills in both groups with a computer-assisted test. Students in the intervention group were more successful in the test and settled on the correct diagnosis more often than students in the control group.

In cases involving a febrile child having convulsions, the possibility of infections of the central nervous system should be considered and the necessary diagnostic investigations performed. If the febrile convulsion does not end by itself in five minutes, it will be treated as an epileptic seizure. Recurrences cannot be prevented by current treatments. Antiepileptic drugs should not be used, because their adverse effects are larger than the benefit. Antipyretics are not helpful in the prevention of seizures. An essential part of the treatment is informing and reassuring the parents.