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.

Case of Renal Aspergillosis after Heart Transplant: Diagnosis and Treatment.

Invasive aspergillosis (IA) is a severe complication after heart transplantation (HTx), with a high mortality rate. Invasive pulmonary aspergillosis (IPA) is the most common presentation. We herein describe a unique case of Renal aspergillosis (RAsp) diagnosed on month 10 post-HTx with no known risk factors for IPA in cardiac transplant recipients. The diagnosis of RAsp was made based on radiographic findings, renal biopsy, and tissue cultures. The patient initially received combined antifungal therapy (caspofungin and voriconazole) without radical or partial nephrectomy, followed by voriconazole maintenance monotherapy with favorable clinical outcomes.

Inhibitory role of alveolar macrophages in colony-stimulating factor production by the lung tissue from bacillus Calmette-Guérin-treated animals.

Production of colony-stimulating factors (CSF) by lung tissue from rats injected by bacillus Calmette-Guérin (BCG) and the role of alveolar macrophages (AM) in this process was studied. Injection of BCG at 10, 100, or 1,000 mg/kg changed the CSF production by the lung in a time-dependent manner. Maximum stimulation was observed at 10 mg/kg and 3 days of interval between BCG injection and animal sacrifice. Longer periods or higher concentrations had no effect or actually depressed CSF production. BCG injection also changed the number of AM in a time- and dose-dependent manner. When AM from BCG-treated animals were lavaged out and the AM-depleted lung tissues were cultured, an increase in CSF production with respect to controls was observed at 10 mg/kg of BCG. On the other hand, in control animals removal of AM had no effect on CSF production by the lung. The results suggest that BCG treatment alters the number of AM and CSF production by the lung. AM, in BCG-injected animals, inhibit CSF production by the lung tissue while in non-injected animals they do not play any role in this process.