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Objectives: The increasing number of refugees in various regions of our country has led to socio-economic issues and challenges in the healthcare system. This study aims to investigate family physicians' perspectives in Turkey regarding refugees' social lives and healthcare services. Design: This is a qualitative cross-sectional study using phenomenological research design. The study was carried out with family physicians in health care centers. Three online focus group interviews were conducted to collect the data. The interviews proceeded with semistructured questions about their perceptions of refugee health and their challenges while working with refugee patients. The research data were descriptively presented and supported by quotes obtained from interviews with the participants. Results: A total of 24 family physicians were reached through three online sessions for data collection. Of the 24 participating family physicians, 10 were men and 14 were women. On average, the physicians had eight years of medical experience, and the average number of registered immigrant populations in the family health units was around 100 patients. After consulting the domain experts, a final determination of 4 different themes was made. These themes were identified as follows: experience, emotions, and thoughts; encountered challenges, and proposed solutions. Conclusions: Family physicians face difficulties adapting to healthcare systems and face challenges in scheduling appointments and accessing advanced medical investigations when seeking hospital services.

Objectives: We previously found large variations in general practitioner (GP) hypertension treatment probability in oldest-old (>80 years) between countries. We wanted to explore whether differences in country-specific cardiovascular disease (CVD) burden and life expectancy could explain the differences. Design: This is a survey study using case-vignettes of oldest-old patients with different comorbidities and blood pressure levels. An ecological multilevel model analysis was performed. Setting: GP respondents from European General Practice Research Network (EGPRN) countries, Brazil and New Zeeland. Subjects: This study included 2543 GPs from 29 countries. Main outcome measures: GP treatment probability to start or not start antihypertensive treatment based on responses to case-vignettes; either low (80 years of age). • In this study including 1947 GPs from 29 countries, we found that a high country-specific cardiovascular disease (CVD) burden (i.e. myocardial infarction and/or stroke) was associated with a higher GP treatment probability in patients aged >80 years. • However, the association was modified by country-specific life expectancy at age 60. While there was a positive association for GPs in countries with a low life expectancy at age 60, there was no association in countries with a high life expectancy at age 60. • These findings help explaining some of the large variation seen in the decision as to whether or not to treat hypertension in the oldest-old.

Indomethacin is used in the treatment of ankylosing spondylitis, osteoarthritis, tendinitis, and other inflammations. However, it has been reported indomethacin has nephrotoxic, gastrotoxic, and hepatotoxic effects. The aim of this study is to investigate the effect of nimesulide on indomethacin-induced liver damage in rats biochemically and histopathologically. Experimental animals (21 rats) were divided into 3 groups: the healthy (HG) group receiving distilled water as a solvent, the 25 mg/kg indomethacin administered (IDO) group, and the 50 mg/kg nimesulide + 25 mg/kg indomethacin administered (NIDO) group. Malondialdehyde (MDA), total glutathione (GSH) levels and cyclooxygenase-1 (COX-1), cyclooxygenase (COX-2) enzyme activities were determined from liver tissues. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were also measured in serum. The data obtained in the IDO group were compared with the data obtained from the NIDO and MDA and decreased tGSH levels with indomethacin HG groups. Increased application in liver tissue approached the HG group with nimesulide application, and the difference was found to be insignificant. Nimesulide prevented the decrease in COX-1 and COX-2 levels observed with indomethacin administration. Again, the increase in ALT and AST levels, which increased with indomethacin administration, was prevented by nimesulide. As a result of the histopathological evaluation, it was observed that nimesulide reduced the damage caused by indomethacin. Nimesulide at 50 mg/kg prevented oxidative liver damage induced with indomethacin at 25 mg/kg. Our results suggest that nimesulide may be useful in the treatment of hepatotoxicity and COX-1 inhibition side effects without suppressing analgesic and anti-inflammatory activity due to indomethacin use. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to measure the perceived stress level of family caregivers of patients in palliative care units, and to reveal the socio-cultural and health-related characteristics that might affect their perceived stress. Methods: The population of this cross-sectional study consisted of family members who had taken care of their patients who were hospitalized in palliative care units between March 1, 2018, and June 1, 2018. A sociodemographic questionnaire and Perceived Stress Scale-14 (PSS-14) was applied face-to-face to all participants. Moreover, the Patient Health Questionnaire (PHQ-2) was applied to all participants. Results: Seventy-five family caregivers attended to the study. Twenty-two (34.7%) of family caregivers were patients' children. Fifty-seven (75.0%) of family caregivers struggled with problems during care processes. Fifteen (19.5%) participants gave positive responses to both questions of the PHQ-2. The number of family caregivers who had chronic diseases was 49 (64.5%). The mean score of PSS-14 was 46.9±5.7. Conclusion: Difficulties in the management of care processes may have increased perceived stress levels and may adversely affect the caregivers' health and social life. Providing early psychological support to family caregivers by health professionals may help to reduce perceived stress. [ABSTRACT FROM AUTHOR]