Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care.</p> <p>Methods</p> <p>A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality.</p> <p>Results</p> <p>Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such as the decision to withdraw or withhold treatments. The diagnosis, prognosis and end-of-life decisions are seldom discussed with the patient, and communication about pain and mental problems is often limited. Language barriers and the dominance of the family may exacerbate communication problems.</p> <p>Conclusions</p> <p>This review confirms the view that family members of patients with a Turkish or Moroccan background have a central role in care, communication and decision making at the end of life. This, in combination with their continuing hope for the patient’s recovery may inhibit open communication between patients, relatives and professionals as partners in palliative care. This implies that organizations and professionals involved in palliative care should take patients’ socio-cultural characteristics into account and incorporate cultural sensitivity into care standards and care practices<it>.</it></p

A new medical device to measure a stiffness of soft materials

An objective in vivo measurement technique for assessing the material properties of soft tissue would be a valuabe tool in diagnosing dermatological pathologies. In order to make advancements in this field, a new hand-held device was designed to measure the stiffness of soft materials. The device measures the reaction forces experienced by the soft tissue under constant indentation deformations at the time of stiffness measurement. Agarose gel samples were prepared in a range of molarities to mimic the stiffness variabilities found in vivo. The stiffness of each gel was evaluated using two different measurement techniques. The first method utilized an industry standard durometer, designed to measure the hardness of materials in shore type 00 scales of soft plastics. The second measurement was taken using an original custom-built soft tissue stiffness meter, designed specifically for the present study. These two devices were compared and a strong correlation was found between them (r2 = 1.00, Spearman rank test). Additionally, it was observed that gels of different stiffness could be distinguished by both devices. In conclusion, the soft tissue stiffness can be accurately evaluated using the proposed device. The new device should be evaluated on human subjects in future studies, before it can be used to assess soft tissue disorders

The role of platelet glycoprotein IIIa polymorphism in the high prevalence of in vitro aspirin resistance in patients with intracoronary stent restenosis

Objectives The aim of our study was to determine the relation between platelet glycoprotein Illa (pl(A)) polymorphism and aspirin resistance in patients with intracoronary stent restenosis

Does illness perception predict posttraumatic stress disorder in patients with myocardial infarction? | Hastali{dotless}k algi{dotless}si{dotless} myokard İnfarktüsü geçiren hastalarda travma sonrasi{dotless} stres bozukluǧunu öngörebilir mi?

INTRODUCTION: Myocardial infarction (MI) as a life-threatening event, carrying high risk of recurrence and chronic disabling complications, increases the risk of developing acute stress disorder (ASD), posttraumatic stress disorder (PTSD), or both. The aim of this study was to investigate the relationship between illness perceptions and having ASD, PTSD, or both in patients after MI. METHOD: Seventy-six patients diagnosed with acute MI were enrolled into our prospective study. We evaluated patients during the first week and six months after MI. Patients were assessed by using the Clinician Administered PTSD Scale (CAPS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Brief Illness Perception Questionnaire (BIPQ), and a semi-structured interview for socio-demographic characteristics during both the first and second evaluations. RESULTS: Acute stress disorder (ASD) developed in 9.2% of patients and PTSD developed in 11.9% of patients with MI. Illness perception factors of ‘consequences, identity and concern’ predicted the occurrence of both ASD and PTSD, whereas ‘emotion’ predicted only PTSD. CONCLUSION: The factors of illness perceptions predicted the induction of ASD and PTSD in patients who had acute MI

Differentiate two different cardiac hypertrophy by pulse tissue Doppler imaging: Hypertensive and athletic

Recently, myocardial performance index (MPI) which measured by TDI is a novel method for accurately evaluating systolic and diastolic ventricular function. The index of combined systolic and diastolic ventricular myocardial performance was proposed as a potentially useful predictor of global cardiac function. The aim of this study was to assess myocardial performance index by tissue Doppler imaging in highly competitive athletes and patients with left ventricular hypertrophy due to systemic hypertension in order to determine whether this variable might be used to define these groups. We compared 56 subjects with different types of left ventricular hypertrophy 14 patients with systemic hypertension, and 14 athletes with 28 normal subjects. The peak velocities of myocardial motion at inferior site of mitral annulus were measured by tissue Doppler echocardiography. Although hypertensive patients with left ventricular hypertrophy had lower systolic and diastolic velocities that those of athletes, mean MPI was higher in patients and controls than those of athletes (0.74+/-0.02, 0.46+/-0.01, and 0.27+/-0.02, respectively, p<0.001). MPI measured by TDI may facilitate to differentiate between pathologic and physiologic hypertrophy

Repolarization heterogeneity during strenous exercise in hypertensive patients and strenght-trained athletes

The interlead variation in QT interval (QT dispersion) can be used to assess regional inhomogeneity of ventricular repolarization. The spectrum of left ventricular adaptation to exercise, different types of hypertrophy patterns, and QT dispersion in different types of hypertrophy was investigated. We studied 23 male elite wrestlers, 30 patients with high-normal hypertensive and 30 gender-matched normal adults. Firstly, we measured echocardiographic parameters and then all subjects were performed strenuous exercise test and 12 lead ECG was taken at first minute of recovery period. Left ventricular mass and mass index were found to be significantly higher in athletes. However QT dispersion values at peak exercise were found to be decreased in the athlete group compared with hypertensive group (mean ::L SE, 38.8 +/- 3.3 versus 65.3 +/- 5.2 ms, respectively, p<0.01). Left ventricular hypertrophy in athletes is not cause to increase of repolarization heterogeneity. The measurement of QT dispersion could provide a screening method for cardiac problems in athletes

Developing an in-vitro mechanical stretching system for moleculer cell biology studies (in English)

14th National Biomedical Engineering Meeting -- MAY 20-22, 2009 -- Izmir, TURKEYWOS: 000274345400052The human mesenchymal stem cells can differentiate into cardiomyocytes, osteoblasts, chondroblasts, adipocytes, endothelial, hepatocyte and neuron cells, when hMSCs are exposed to certain physical and chemical stimulants. It is hoped that the differentiation of hMSCs into certain cell types in certain in-vitro conditions can provide for treatment of the certain disease and pathologic situation. The suitable cell culture conditions, which are needed for differentiation of hM5Cs into osteoblast, chondroblasts and adipocyte cells, are known. However, these cells do not reach to terminal differentiation but they can differentiate only into osteoblast, chondroblast and adipocyte-like cells. It is thought that these cells are precursor cells. Moreover, hMSCs can differentiate into different types of cells under the mechanical stress (mechanical stretching, pressure, shear stress) as the physical stimulus. However, it is not clear whether mechanical stretching provides for the hM3Cs to reach terminal differentiation or not. It was found that the tension on the cytoskeleton and/or the tension in the junctions between the cells caused hMSCs to choose the certain cells type differentiation way. Increasing acknowledge about parameters of the tension in the cells and/or between the cells can provide that these parameters can be used to follow the progression of pathologic situation and the diagnosis of some cardiac, bone, joint and muscle tissue diseases. Nowadays, there are several projects about finding mechanical properties of the soft and hard tissues in the biomedical fields To show properly working of in-vitro mechanical, 6 hours, 5% and 1 Hz of mechanical stress was applied for hMSCs. factin florescence stainin was done to see stress fibers. Stress fibers were observed after mechanical stress. In the present study, in-vitro mechanical stretching system (iMecS) was developed with experimental applications