Agreement between Family Members and the Physician's View in the ICU Environment: Personal Experience as a Factor Influencing Attitudes towards Corresponding Hypothetical Situations.

BACKGROUND: It is not known whether intensive care unit (ICU) patients' family members realistically assess patients' health status. OBJECTIVES: The aim was to investigate the agreement between family and intensivists' assessment concerning changes in patient health, focusing on family members' resilience and their perceptions of decision making. METHODS: For each ICU patient, withdrawal criteria were assessed by intensivists while family members assessed the patient's health development and completed the Connor-Davidson Resilience Scale and the Self-Compassion Scale. Six months after ICU discharge, follow-up contact was established, and family members gave their responses to two hypothetical scenarios. RESULTS: 162 ICU patients and 189 family members were recruited. Intensivists' decisions about whether a patient met the withdrawal criteria had 75,9% accuracy for prediction of survival. Families' assessments were statistically independent of intensivists' opinions, and resilience had a significant positive effect on the probability of agreement with intensivists. Six months after discharge, family members whose relatives were still alive were significantly more likely to consider that the family or patient themselves should be involved in decision-making. CONCLUSIONS: Resilience is related to an enhanced probability of agreement of the family with intensivists' perceptions of patients' health progression. Family attitudes in hypothetical scenarios were found to be significantly affected by the patient's actual health progression.

Manganese(II) complexes with 5-nitro-2-hydroxy-benzaldehyde or substituted 2-hydroxy-phenones: Structure and interaction with bovine serum albumin and calf-thymus DNA.

A series of Mn(II) complexes of 5-nitro-salicyladehyde or substituted 2-hydroxy-phenones (HL) were synthesized in the absence or presence of a N,N'-donor co-ligand such as 2,2'-bipyridine, 1,10-phenanthroline, or 2,2'-bipyridylamine. The resultant coordination compounds were formulated as [Mn(L)2(CH3OH)2] (1-3) and [Mn(L)2(N,N'-donor)] (4-14), respectively, and characterized by diverse techniques. The crystal structures of three complexes were determined by single-crystal X-ray crystallography. Diverse techniques were employed to study the interaction of the complexes with calf-thymus DNA and showed intercalation as the most possible mode of their tight interaction. The affinity of the complexes for bovine serum albumin was investigated by fluorescence emission spectroscopy in order to calculate the binding constants which suggested a tight and reversible binding.

Prevalence of inflammatory bowel disease related dysplasia and cancer in 1500 colonoscopies from a referral center in northwestern Greece.

BACKGROUND AND AIM: To report on the prevalence of inflammatory bowel disease (IBD) related intestinal dysplasia and cancer in northwestern Greece. PATIENTS AND METHODS: Single referral center retrospective study. The policy among all gastroenterologists of the area regarding medical treatment, patient follow up and bowel surveillance strategies including risk factors is the same. RESULTS: We analyzed 1494 colonoscopies from 696 consecutive IBD patients (494 UC). The follow up time [median, IQR] was 16 [8-23] years and the age at diagnosis was 28 [21-49] years. The number of patient years at risk was 16.219. Disease location for UC was: pancolitis 761 (59%), left sided colitis 455 (35%), and proctitis 69 (6%). Disease location for CD was: colitis 142 (66%), ileitis 45 (22%) and ileocolitis 21 (10%). Disease activity was in remission in 1240 (83%) of them. In total, 498 (72%) patients were on mesalazine, 169(24%) on immunosuppression and 29 (4%) on biologicals. Biopsies were taken randomly in 1429 (96%) endoscopies and were targeted in 65 (4%) of them. We recorded 69 (9.4%) cases with dysplasia and 10 (1.4%) cases with intestinal cancer (9 in UC). No difference was found for dysplasia and cancer in patients who followed up for 10-20 years or for more than 20 years. CONCLUSIONS: The prevalence of dysplasia and cancer is increased in UC compared to CD but the prevalence of high-grade dysplasia is comparatively low. Intestinal cancer prevalence is increasing after the first decade and then practically remains stable.