How to express mental health problems: Turkish immigrants in Berlin compared to native Germans in Berlin and Turks in Istanbul.

The paper explores expressions used by Turkish immigrants in Berlin to delineate psychiatric illnesses and psychological problems. These are compared to expressions used by native Germans in Berlin and Turks in Istanbul to assess possible cultural differences in articulating mental disorders. For this purpose, results of a Free Listing carried out with the three above mentioned groups are presented. The data suggest that relevant items which are connected to mental health issues vary between the groups as well as within the groups, thus showing dependency on factors such as education. For the group of Turkish immigrants the data further suggest that this group connects psychic stress to family problems. Concerning help seeking, Turkish immigrants, like members of the other groups, mention professional psychological/psychiatric help as useful for solving mental health problems.

The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants.

Upper gastrointestinal system hemorrhage in the emergency department.

OBJECTIVE: In the present study, we aimed to investigate demographic and clinical characteristics of the cases presented to the Emergency Department with an acute upper gastrointestinal system hemorrhage, and to identify the initial evaluation and treatments along with explaining possible causes of hemorrhage. MATERIALS AND METHODS: This prospective study was conducted between October 1, 2006 and September 30, 2007. Characteristics of the patients were evaluated in terms of age, gender, presenting symptoms, medical history, risk factors, coexisting symptom and diseases, results of the rectal examination and nasogastric evaluation, endoscopy findings, received treatments, duration of Emergency Department stay, admitting departments, and outcomes. RESULTS: 128 patients who presented to the Emergency Department during the study period were included in the study. As 27.3 % of the patients were female, 72.7 % were male. The mean age was 59.3 (+/- 16). 51.6 % of patients had a history of NSAID and aspirin use. Endoscopy was performed in 111 (86.7 %) patients. The most common finding among endoscopy results was gastric ulcer with a rate of 20.4 % followed by duodenal ulcer in 18.3 %. The mean hospitalization period in the Emergency Department was found to be 18 hours. CONCLUSION: In conclusion, acute upper gastrointestinal hemorrhages are first evaluated and treated in Emergency Departments. Endoscopy was carried out on most of the patients during the monitoring in the Emergency Department. NSAIDs and aspirin are still the most important risk factors and peptic ulcer is the most frequently encountered underlying cause (Tab. 4, Fig. 1, Ref. 27). Full Text in free PDF www.bmj.sk.

Does Ramadan fasting increase acute upper gastrointestinal haemorrhage?

The epidemiological characteristics and clinical results of patients who presented with acute upper gastrointestinal haemorrhage (AUGIH) during the month of Ramadan (October 2007) were compared with those who presented with AUGIH during another, non-Ramadan, month (December 2007). The following were evaluated: age, gender, symptoms, gastrointestinal disease history, risk factors, co-existing diseases, results of rectal, nasogastric and endoscopic examinations, treatment modalities and clinical outcomes. Significantly more patients were diagnosed with AUGIH during Ramadan compared with the non-Ramadan month (43 versus 28, respectively). Significantly more patients diagnosed during Ramadan had a history of previous haemorrhage compared with the non-Ramadan month (72.1% versus 42.9%, respectively). Peptic ulcer was the most common event in both groups and overall endoscopy findings differed between the groups. No other significant differences were found. In conclusion, the number of patients presenting with AUGIH during Ramadan was significantly higher than that of an ordinary month, which suggests that fasting during Ramadan reactivates and aggravates pre-existing gastrointestinal diseases.

[Melatonin and the cardiovascular system]. / Melatonin ve kardiyovasküler sistem.

In recent years, melatonin, the most prominent product of the pineal gland, has evoked considerable interest. In this report we reviewed the effects of melatonin on cardiovascular system.