Assessing the spiritual needs and practices of oncology patients in Turkey.

The purpose of this study was to assess the oncology patients' spiritual needs and activities. Besides, the study was to provide clinical evaluation of the feasibility and usefulness of the Patients Spiritual Needs Assessment Scale. This descriptive and cross-sectional study was performed by using a demographic and spiritual practices questionnaire, the Turkish version of the Patients Spiritual Needs Assessment Scale. The results of our study demonstrated that the most common spiritual needs of patients with cancer were "to address issues before death and dying" (100%), "feel a sense of peace and contentment" (94.8%), and "for companionship" (93.5%). Spiritually assessing a patient with cancer requires knowledge of how spiritual needs may manifest and how to talk with a client about his or her spiritual needs. These findings can help nurses to begin this process of providing spiritual care for patients with cancer.

Arsenic trioxide and methylprednisolone use different signal transduction pathways in leukemic differentiation.

Certain cell lines like HL 60 and K 562 are utilised as leukemic cell models for leukemogenesis research, which differentiate along the granulocytic and/or monocytic pathway when treated with certain inducer molecules. High dose methylprednisolone treatment has been shown to induce in vivo and in vitro differentiation of myeloid leukemia cells to mature granulocytes in patients with acute promyelocytic leukemia (APL) and other subtypes of acute myeloid leukemia (AML). Arsenic trioxide (As(2)O(3)) has been confirmed to have remission induction effects on APL. However, there are conflicting results on the effects with other AML subtypes. Also, it has been well established that the reversible phosphorylation of proteins is a major regulatory mechanism in the signal transduction pathways that control cell growth and differentiation. Serine/threonine protein phosphatases (PP) are major components of phosphorylation. In this study, we investigated the effect of As(2)O(3) on HL 60 and K 562 myeloid leukemic differentiation and compared the signalling cascades of the two inducers with respect to serine/threonine PP 1 and 2A. We utilised PP1 and PP2A inhibitors okadaic acid and calyculin A. In contrast to methylprednisolone, there was no effect of phosphatase inhibitors on As(2)O(3)-induced leukemic differentiation. Incomplete leukemic differentiation occurred with lower As(2)O(3) concentration as 10(-6)M. Unlike As(2)O(3), methylprednisolone induced complete granulocytic and/or monocytic differentiation of HL 60 and K 562 cells via upregulation of PP2A regulatory subunits. Therefore, As(2)O(3) and methylprednisolone are promising agents that have the potential to be used together in myeloid leukemic differentiation therapy.

Laparoscopic splenectomy using LigaSure in benign hematologic diseases.

Today laparoscopic splenectomy (LS) is considered the gold standard for the treatment of hematologic disorders of the spleen with the aid of advancements in laparoscopy technique and modern electrosurgical devices. LigaSure vessel sealing system permanently fuses vessels up to 7 mm in diameter by applying a precise amount of pressure and bipolar energy to the tissue. We performed 14 LSs (7 has autoimmune hemolytic anemia, 6 has idiopathic thrombocytopenic purpura, and 1 has hereditary spherocytosis) using LigaSure. The mean spleen weight was 247 g (range, 147 to 620) and the largest diameter of the spleen was 12.1 cm (range, 10 to 23). The average operative time was 84.7 minutes (range, 30 to 190) including combined laparoscopic cholecystectomy in 2 patients and transabdominal preperitoneal inguinal hernia repair in 1 patient. Conversion to open procedure was unnecessary in our series. Minor morbidity occurred in 2 patients; no perioperative hemorrhage or mortality was observed. The average postoperative hospital stay was 3.1 days (range, 2 to 8). LS is a safe and feasible procedure for patients with previous abdominal surgery; gallstones in association with hemolytic anemia can also be treated during LS. LigaSure vessel sealing system during LS is safe and cost-effective method and reduces operating time.