Guided self-help on the internet for turkish migrants with depression: the design of a randomized controlled trial

Background The Turkish population living in the Netherlands has a high prevalence of psychological complaints and has a high threshold for seeking professional help for these problems. Seeking help through the Internet can overcome these barriers. This project aims to evaluate the effectiveness of a guided self-help problem-solving intervention for depressed Turkish migrants that is culturally adapted and web-based. Methods This study is a randomized controlled trial with two arms: an experimental condition group and a wait list control group. The experimental condition obtains direct access to the guided web-based self-help intervention, which is based on Problem Solving Treatment (PST) and takes 6 weeks to complete. Turkish adults with mild to moderate depressive symptoms will be recruited from the general population and the participants can choose between a Turkish and a Dutch version. The primary outcome measure is the reduction of depressive symptoms, the secondary outcome measures are somatic symptoms, anxiety, acculturation, quality of life and satisfaction. Participants are assessed at baseline, post-test (6 weeks), and 4 months after baseline. Analysis will be conducted on the intention-to-treat sample. Discussion This study evaluates the effectiveness of a guided problem-solving intervention for Turkish adults living in the Netherlands that is culturally adapted and web-based

Similarity in depressive symptom profile in a population-based study of migrants in the Netherlands

Objective Depression is a clinical syndrome developed in Western Europe and North-America. The expression of symptoms and the impact of symptoms on functioning may therefore be expected to vary across cultures and languages. Our first aim was to study differences in depressive symptom profile between indigenous and non-Western immigrant populations in the Netherlands. We hypothesized that differences in expression of depressive symptoms would be more likely in the domains of mood and cognitions, and less likely in the domains of psychomotor and vegetative symptoms. Our second aim was to study ethnic differences in the association of depressive symptoms and general functioning. Method In a random community sample stratified for ethnicity in Amsterdam, the Netherlands, depressive symptoms were assessed by bilingual interviewers using the Composite International Diagnostic Interview (CIDI 2.1) and the Symptom Checklist-90-Revised (SCL-90-R). Impairments in functioning were measured by the World Health Organization Disability Assessment Schedule II (WHODAS II). Results were obtained from 812 subjects: N = 321 native Dutch, N = 213 Turkish-Dutch, N = 191 Moroccan-Dutch, N = 87 Surinamese-Dutch. Differences in depressive symptom expression were tested by differential item functioning. Results The prevalence of DSM-IV depressive disorder and the overall level of depressive symptoms were higher in the Turkish and Moroccan immigrant groups compared to native Dutch subjects. Ethnic differences in item functioning of depressive symptoms were rare, and equally unlikely in all four symptom domains. Depression was equally associated with functional impairment across ethnic groups. Conclusion Although depressive symptoms were more common among migrants than in the indigenous population, both the depressive symptom profile and the associated functional impairments were comparable. These findings may help diminishing concerns about the validity of using existing diagnostic procedures among ethnic minority groups

Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-? in the diagnosis of neonatal sepsis

PubMedID: 17479639Diagnosis of neonatal sepsis may be difficult because clinical presentations are often nonspecific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. In this study, we aimed to investigate the role of procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-?) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. Twenty-six neonates with blood-culture positivity and clinical sepsis, hospitalized for clinical suspicion of neonatal sepsis in neonatal intensive care units of Balcal? Hospital, Çukurova University and Adana State Hospital between May 2000 and January 2001 (Group I) and 29 healthy neonates followed at the neonatal units and outpatient clinics of these hospitals (Group II) in the same period were studied. Among the septic neonates, 13 had early-onset (Group Ia) and 13 had late-onset (Group Ib) neonatal sepsis, while 14 of the healthy neonates had perinatal risk factors (Group IIa) and 15 of them had no risk factors (Group IIb). The demographic and clinical characteristics of the septic and healthy neonates were recorded, blood samples for determining serum PCT, CRP, IL-6, IL-8 and TNF-? were collected from the healthy and the septic neonates before starting treatment, and these investigations were repeated on the 3rd and 7th days of treatment. In this study, it was found that: (a) pre-treatment mean serum PCT, CRP, IL-6, IL-8 and TNF-? levels were significantly higher in the septic neonates than in the healthy ones, (b) compared with the pre-treatment values, serum PCT, IL-6 and TNF-? had progressively decreased on the 3rd and 7th days of the treatment in the 17 recovered patients, though they progressively increased in nine patients who died during treatment, (c) the area under the receiver operating characteristic (ROC) curve (AUC) for PCT, TNF-?, IL-6, CRP, and IL-8 were 1.00, 1.00, 0.97, 0.90 and 0.68, respectively. For the cut-off value of PCT ?0.34 ng/ml, the test was found to have a sensitivity of 100%, specificity of 96.5%, positive predictive value of 96.2%, negative predictive value of 100% and diagnostic efficacy of 98.3% for bacterial sepsis in neonates. For the cut-off value of TNF-? ?7.5 pg/ml, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficacy were found to be 100%, 96.6%, 96.2%, 96.5% and 98.3%, respectively. It was detected that sensitivity, specificity and diagnostic efficacy values were lower for IL-6, CRP and IL-8. We conclude that PCT and TNF-? are the best markers in the diagnosis of neonatal sepsis, and these markers are also valuable in following the effectiveness of treatment and determining the prognosis of the disease

Fatal myocarditis due to diphteriae

Miyokardit, difterinin en ciddi fakat erken dönemde saptanması güç olan bir komplikasyonudur. Bu yazıda, son bir yıl içinde Balcalı Hastanesi Çocuk Enfeksiyon Kliniğinde izlenen üç difteri miyokarditli olgu sunulmuştur. Tümü fatal seyreden bu olguların klinik ve laboratuvar özellikleri tartışılarak, difterili olguların miyokardit yönünden dikkatle izlenmesinin gerekliliği ve hastalığın çocuk sağlığı açısından önemi vurgulanmıştır

Management of refractory hemorrhage in a kala-azar patient with thrombocytopenia and coagulopathy by using recombinant factor VIIa (rFVIIa)

47th Annual Meeting of the American-Society-of-Hematology -- DEC 10-13, 2005 -- Atlanta, GAWOS: 000233426100389…Amer Soc Hemato

Assessment of diagnostic enzyme-linked immunosorbent assay kit and serological markers in human brucellosis

This study was performed to evaluate commercial brucella immunoglobulin G and M-enzymelinked immunosorbent assay (IgG and IgM ELISA) kits for the diagnosis of human brucellosis and to suggest a candidate prognostic marker for human brucellosis. We determined the serum levels of brucella IgG, IgM, C-reactive protein (CRP), soluble CD14 (sCD 14), and neopterin in patients with brucellosis and compared them with those of normal healthy persons, patients with tuberculosis, and patients with other diseases. It was found that the sensitivity of ELISA to diagnose brucellosis was high when both IgG and IgM ELISA were used together. This study showed that serum CRP, sCD14, or neopterin levels were significantly high during the course of human brucellosis. The above markers, alone or in combination, might have the potential to evaluate treatment outcomes in human brucellosis. The markers that can predict the variability of agglutination titer was also determined. It was found that the titer value alone does not fully represent disease status

Extreme hypofractionated radiosurgery in recurrent inoperable High-Grade Ultra-Large gliomas

Background: To elucidate the efficacy and toxicity of brain re-radiotherapy for recurrent large inoperable gliomas using radiosurgery. Materials and Methods: Between 2014 and 2018, extreme hypofractionated radiosurgery was performed using Accuray's Cyberknife (R) system on 14 lesions (12 patients) grade 4 recurrence lesions of 6 patients with anaplastic astrocytoma and 6 patients with glioblastoma who had previously undergone surgery and cranial radiotherapy and had a local-regional recurrence. Six patients (8 lesions) were given a biologic effective dose (BED10) of 48 Gy and lower, and six patients were given a BED10 of 59.5 Gy and higher. The Response Assessment in Neuro-Oncology Criteria (RANO) were used for tumor response, and the Common Terminology for Adverse Events (CTCAE) was used for adverse effect assessment. The primary endpoint was determined as overall survival, and first treatment and salvage treatment time. Results: The median age of the patients was 43 years, and the median Karnofsky Performance Status (KPS) was 70. The median time from the first radiotherapy to death was 34 months. The median time from the previous radiotherapy was 29.5 months (R:17-40). The median survival was 10 months for those with recurrence before 29.5 months and 11 months for those with recurrence after 29.5 months. The median total tumor volume was 29.224 mL (similar to 30 mL). One grade 4 toxicity was observed. Conclusion: Radiosurgery can be used effectively as salvage therapy in ultra-large inoperable gliomas

The prevalence of mixed genotype infections in Turkish patients with hepatitis c: a multicentered assessment

AKTAS, OSMAN/0000-0002-7762-4108; Karsligil, Tekin/0000-0001-7672-3625; cekin, yesim/0000-0003-4393-5618; Sayiner, Ayca/0000-0001-6750-2353; Altindis, Mustafa/0000-0003-0411-9669WOS: 000463988900008PubMed: 30969089Background: HCV virus infections are one of the major health problems in the world that can cause cirrhosis and liver cancer at a higher rate than other hepatitis data. The aim of this study was to determine the prevalence of mixed infections with different HCV genotypes in Turkey and also to evaluate the current HCV genot pe and subtype distributions by a multicentered assessment. Methods: The HCV genotype data of 17,578 hepatitis C patients collected from 23 centers from different geographic regions covering all Turkey were collected. The data included information about the HCV genotypes in the last 10 years (bail een 2007 and 2016), demographic properties of the patients and the methods/systems used to determine the genotypes. Results: Two hundred twenty-eight of the patients (1.3%) had mixed genotype. The most common mixed genotype combination was 1b + 4 (0.83%) followed by 1a + 1b (0.26%). Genotype distribution varies according to geographical regions. However, genotype 1 (82.92%) was the most common genotype in all regions and all years. This was followed by genotype 3 (7.07%) and genotype 4 (5.43%). A variety of methods were used by the centers including sequencing, pyrosequencing, real-time PCR, in-house RFLP, reverse hybridization (LIPA), and hybridization. Conclusions: Infection with mixed HCV genotypes in Turkey is uncommon. Genotype distribution varies according to geographic regions; the most common genotype 1 is encountered all oN er the country, while genotypes 3 and 4 are only in some of the centers. Since there is limited information about mixed HCV infection, further investigations are needed to determine the clinical importance of mixed HCV infection

Symptom Correlates of Static and Dynamic Facial Affect Processing in Schizophrenia: Evidence of a Double Dissociation?

Schizophrenia patients have been shown to be compromised in their ability to recognize facial emotion. This deficit has been shown to be related to negative symptoms severity. However, to date, most studies have used static rather than dynamic depictions of faces. Nineteen patients with schizophrenia were compared with seventeen controls on 2 tasks; the first involving the discrimination of facial identity, emotion, and butterfly wings; the second testing emotion recognition using both static and dynamic stimuli. In the first task, the patients performed more poorly than controls for emotion discrimination only, confirming a specific deficit in facial emotion recognition. In the second task, patients performed more poorly in both static and dynamic facial emotion processing. An interesting pattern of associations suggestive of a possible double dissociation emerged in relation to correlations with symptom ratings: high negative symptom ratings were associated with poorer recognition of static displays of emotion, whereas high positive symptom ratings were associated with poorer recognition of dynamic displays of emotion. However, while the strength of associations between negative symptom ratings and accuracy during static and dynamic facial emotion processing was significantly different, those between positive symptom ratings and task performance were not. The results confirm a facial emotion-processing deficit in schizophrenia using more ecologically valid dynamic expressions of emotion. The pattern of findings may reflect differential patterns of cortical dysfunction associated with negative and positive symptoms of schizophrenia in the context of differential neural mechanisms for the processing of static and dynamic displays of facial emotion