Unmet clinical needs and challenges in the management of acute leukemia in Turkey: a modified Delphi study.

Aim: To determine the unmet needs and challenges in management, diagnosis, treatment, follow-up and patient-physician communication in acute leukemia (AL). Materials & methods: The study was based on a modified Delphi approach. A questionnaire including the major potential obstacles was circulated twice among 13 hematologists. Results: The obstacles in AL management were limited access to the novel treatments and genetic tests, limited bed capacity, insufficient level of knowledge among allied health personnel, limited availability of psycho-oncological support and low levels of awareness in the population about the importance of stem cell donation. Conclusion: The challenges in the management of AL are critical to guide the efforts to improve the quality of healthcare delivery and the evidence-based decision making at treatment of AL patients.

Self-assessment of residents in respect of attitudes to communication.

AIM: As communication skills are essential for medical practice, many medical schools have added communication skills training to their curricula in recent years. The aim of this study was to determine and compare the attitudes to communication skills of family medicine, internal medicine and general surgery residents. MATERIALS AND METHODS: Family medicine, internal medicine and general surgery residents of three training and research hospitals and one university hospital in Ankara were included in this cross-sectional study. A questionnaire was used for obtaining information about age, gender, marital status, graduation date and whether receiving any training for communication skills. The Turkish version of the Communication Skills Attitude Scale was used. RESULTS: In all, 58 (50%) family medicine, 30 (25.9%) internal medicine, and 28 (24.1%) general surgery residents were accepted to participate in the study. Of the 116 residents, 58 (50%) were female and 58 (50%) were male, with a mean age of 29.47±4.63 years, and 68 (58.6%) of them were married; 59.5% of the participants received training about communication skills and 56.5% of them received it at medical school. The mean positive attitude scale (PAS) score was 3.85±0.58, and the mean negative attitude scale (NAS) score was 2.42±0.52. The PAS scores of female residents were higher than those of males (P=0.01). The PAS scores of residents who received communication skills training were higher than the scores of those who had not (P=0.01). The PAS scores of family medicine residents were higher and the NAS scores were lower than those of internal medicine and general surgery residents. CONCLUSION: The communication skill attitudes of family medicine residents were better than those of internal medicine and general surgery residents.

Membranoproliferative glomerulonephritis associated with pseudoxanthoma elasticum.

Pseudoxanthoma elasticum (PXE) is a multiorgan disorder affecting mainly the skin, the eyes, and the cardiovascular system. A 51-year-old woman was admitted to our clinic complaining of weakness and swelling of her legs for the past two years. She had a proteinuria of 7.29 g/24 h. Renal biopsy was performed, and the histological diagnosis was membranoproliferative glomerulonephritis. Four weeks later, she was admitted to the hospital due to pain in her left hand and necrosis in the fourth and fifth fingertips of the left hand. A skin biopsy was performed from the forearm and was reported as PXE. Herein, we present a case of membranoproliferative glomerulonephritis accompanying PXE.