Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): results of a prospective multicentre study in 606 patients in Germany

Background: An effective cross-cultural doctor-patient communication is vital for health literacy and patient compliance. Building a good relationship with medical staff is also relevant for the treatment decision-making process for cancer patients. Studies about the role of a specific migrant background regarding patient preferences and expectations are lacking. We therefore conducted a multicentre prospective survey to explore the needs and preferences of patients with a migrant background (PMB) suffering from gynecological malignancies and breast cancer to evaluate the quality of doctor-patient communication and cancer management compared to non-migrants (NM). Methods: This multicentre survey recruited patients with primary or recurrence of breast, ovarian, peritoneal, or fallopian tube cancer. The patients either filled out a paper form, participated via an online survey, or were interviewed by trained staff. A 58-item questionnaire was primarily developed in German and then translated into three different languages to reach non-German-speaking patients. Results: A total of 606 patients were included in the study: 54.1% (328) were interviewed directly, 9.1% (55) participated via an online survey, and 36.8% (223) used the paper print version. More than one quarter, 27.4% (166) of the participants, had a migrant background. The majority of migrants and NM were highly satisfied with the communication with their doctors. First-generation migrants (FGM) and patients with breast cancer were less often informed about participation in clinical trials (p < 0.05) and 24.5% of them suggested the help of an interpreter to improve the medical consultation. Second and third-generation migrants (SGM and TGM) experienced more fatigue and nausea than expected. Conclusions: Our results allow the hypothesis that training medical staff in intercultural competence and using disease-related patient information in different languages can improve best supportive care management and quality of life in cancer patients with migrant status

The Effects of Topiramate Applied to the Nucleus Accumbens Region on Morphine Withdrawal Syndrome

Aim:Nucleus accumbens, one of the nuclei of the basal ganglia, and dopamine, the neurotransmitter play a critical role in opioid dependence and withdrawal. In opioid withdrawal, the importance of neurotransmitters such as glutamate and gamma aminobutyric acid (GABA), as well as dopamine, is known. In this study, we aimed to investigate the effects of local injections of topiramate, an antiepileptic agent affecting GABAergic and glutamatergic pathways, into the nucleus accumbens on withdrawal signs and locomotor activity during naloxone-induced withdrawal in morphine-dependent rats.Materials and Methods:Twenty male Sprague-Dawley rats were divided in topiramate treatment and control groups. All animals received morphine pellets and guide cannulas were placed bilaterally in the nucleus accumbens regions by stereotaxic surgery. On the last day of the experiment, following the bilateral topiramate or saline (control group) microinjections, morphine withdrawal was triggered by naloxone.Results:Topiramate microinjections into the nucleus accumbens region significantly suppressed the signs of naloxone-induced morphine withdrawal such as number of jumpings and weight loss. No significant difference was observed in wet dog shakes, one of the withdrawal signs, after local topiramate treatment. Although topiramate microinjections increased stereotypical activity it did not change locomotor activity behavior such as vertical and ambulatory activity, and total covered distance.Conclusion:These findings show that local microinjection of topiramate into the nucleus accumbens is effective in preventing opioid deprivation symptoms without significant effect on locomotor activity

Plasma flow modeling for Huels-type arc heater with turbulent diffusion

In this study, we developed an analytical model for the flow field in the Huels-type arc-heated wind tunnel (L2K) of the German Aerospace Center. This flow-field model can be used to accurately reproduce the discharge behavior in the heating section and expansion in the nozzle section of L2K. It includes the radiation transport and turbulent flow as well as thermochemical nonequilibrium models, which are tightly coupled with electric field calculations. In addition, we considered the turbulent diffusion model for the mass conservation of the species and performed numerical simulations for several cases with and without the turbulent diffusion model. Computations were conducted to obtain the general characteristics of an arc-heated flow containing an arc discharge and supersonic expansion. We verified that radiation and turbulence play important roles in the transfer of heat from the high-temperature core flow to the outer cold gas in the heating section of L2K. In addition, we performed parametric studies that involved varying the degree of turbulent diffusion. The results showed that turbulent diffusion has a large influence on the formation of the arc discharge in the heating section and on the enthalpy distribution at the nozzle exit

HBsAg/Anti-HBs seroconversion in cirrhotic patient

Chronic hepatitis B infection can lead to serious and mortal illnesses such as cirrhosis and hepatocellular carcinoma. HBsAg usually persists in chronic Hepatitis B patients. Spontaneous or being treated Anti-HBs seroconversion can be rarely observed and considered to be the endpoint of treatment if he is being trated. In this case study, it is mentioned that 63 years old patient who does not know that he has cirrhosis but Anti-HBs positive. The patient applied to our clinic to take some regular follow-ups which have not been taken for many years. In his first examination it was learned that the patient has been hepatises positive for 20 years and stopped follow-ups after taking two years medical treatment. The patient's whose physical examination is normal and it was detected that Anti-HBs pozitive and thrombocytopenia in blood tests. It was show that abdominal ultrasonography findings conform with cirrhosis. When it was investigated patient's earlier results with Anti-HBs positive to search in terms of cirrhosis etiology, his previous biopsy was reported as cirrhosis 19 years ago. The causes cirrhosis is hepatitis be HBsAg /Anti-HBs seroconversion developed after cirrhosis. The tenofovir treatment was started to patient who has low titer HBV DNA and treated with interferon previously. The Anti-HBs positivity can detract the specialists from hepatitis B infection when cirrhosis etiology is investigatedin patients. The patient whose previous anamnesis was not detailed can be misdiagnosis. HBVDNA test should considered when the cirrhosis etiology is investigated in Anti-HBs positive patient with cirrhosis. It was presented this case because there is no HBsAg/Anti-HBs seroconversion after cirrhosis published before

Voruntersuchungen zum Einfluß der Spaltströmung auf aerothermodynamische Phänomene an einem Rampenmodell

Zur Untersuchung der Spaltströmung im Hochenthalpieströmungsfeld des lichtbogenbeheizten Windkanals LBK wurden Vorversuche an einem Rampenmodell mit Spalt im kalten Hyperschallwinkel H2K durchgeführt. Bei den Messungen wurden die Spaltgeometrie und der Anstellwinkel des Modells bei gleichen Anströmbedingungen variiert. Schlieren-, IR- und Ölfilmbilder lieferten gut übereinstimmende Daten im Hinblick auf die Strömungsablösung vor der Rampe. Es wurde beobachtet, daß die Spaltströmung, abhängig von der Spaltgeometrie, eine starke Aufheizung der Spalthinterkante verursachen kann. Die Messungen zeigen, daß sich die Strömung entlang der Platte vor der Rampe zweidimensional verhält