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Biomedical subjects

B Unal

Publications and source records attributed to B Unal.

At least 19 recordsLinked to original sources
PubMed2006

The population mortality benefits of maximizing the number of eligible patients receiving appropriate cardiology treatments in Ireland.

BACKGROUND: Coronary heart disease (CHD) mortality rates have been decreasing in many industrialized countries since the 1980s. Up to half this decrease can be attributed to evidence-based medical and surgical cardiology interventions. However, recent studies suggest that modern cardiology treatment uptake levels remain disappointingly low in many patient categories. AIM: To determine the potential for further reductions in CHD mortality in Ireland from increasing the number of eligible patients receiving cardiology treatments. METHODS: A previously validated, cell-based IMPACT CHD mortality model was used to integrate large amounts of data describing CHD patient numbers, and the effectiveness and uptake levels of specific medical and surgical treatments. The CHD mortality reductions potentially achievable through the increased use of specific treatments were then calculated, stratified by age and gender and tested using sensitivity analyses. RESULTS: In 2000, medical and surgical coronary disease treatments together prevented or postponed approximately 1950 CHD deaths in the adult population aged 25-84. However, increasing treatment levels to reach 80% of eligible patients might have prevented or postponed a further 2280 CHD deaths in 2000 (minimum estimate 860, maximum estimate 4000). The biggest gain was from maximizing the treatment uptake of eligible heart failure patients, followed by those receiving statins and secondary prevention therapies. DISCUSSION: Many eligible patients are currently not receiving appropriate evidence-based treatments that would reduce CHD mortality and morbidity. Our results suggest that increasing cardiology treatment uptake in Ireland could at least double the current therapeutic reduction in CHD mortality.

Adult↗
PubMed2006

Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey.

The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional study, 524 people aged over 30 were selected from the population of Narlidere Health District, Izmir, Turkey. A questionnaire was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DM-positive and -negative groups. "DM-positive" group refers to respondents who either have diabetes themselves or whose relatives have it. "DM-negative" group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people were included in the study (response rate=87.6%). The mean age of the study group was 50.2+/-12.8 and 61% of them were women. Mean diabetes knowledge scores were 62.9+/-17.9 for the study group, 68.3+/-16.1 for the "DM-positive" group and 60.6+/-18.2 for the "DM-negative" group. The "DM-negative" group had a significantly lower mean score than the other two groups. Overall, diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding diabetes should be provided to not only diabetics, but also the population as a whole.

Adult↗
PubMed2005

Quantum size effects in metal thin films grown on quasicrystalline substrates.

We have investigated by scanning tunneling microscopy the growth of Bi and Ag thin films on the fivefold surface of Al63Cu24Fe13 and Al72Pd19.5Mn8.5 quasicrystal, respectively. For both systems, we observe the formation of islands with magic height, corresponding to the stacking of a specific number of atomic layers. We interpret this unusual growth morphology in terms of quantum size effects, arising from the confinement of the electron within the film. The magic island heights are thus a direct manifestation of the electronic structure of the quasicrystalline substrates.

Journal Article↗
PubMed2005

Cerebral haemodynamics in patients with pseudoexfoliation glaucoma.

PURPOSE: To evaluate the cerebral haemodynamics in patients with pseudoexfoliation glaucoma. METHODS: A total of 19 consecutive patients with pseudoexfoliation glaucoma and 19 age- and sex-matched healthy volunteers were recruited in a prospective comparative study. The affected eye in patients with unilateral glaucoma and the eye with more advanced lesions in patients with bilateral glaucoma were included in the study, and the ipsilateral middle cerebral arteries (MCA) were evaluated. While in the controls, the study eye and the ipsilateral MCA were chosen randomly. Measurements included systemic arterial pressure, heart rate, intraocular pressure (IOP), and transcranial colour Doppler parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistivity index (RI), and pulsatility index (PI). RESULTS: The mean PSV, EDV, and TAMAX were significantly lower in the patients with pseudoexfoliation glaucoma than in healthy controls (P<0.001, <0.001 and <0.001, respectively). Additionally, patients with pseudoexfoliation glaucoma had significantly higher PI and RI than healthy controls (P=0.001 and 0.04, respectively). Systolic and diastolic blood pressures (P=0.19 and 0.91, respectively) and heart rate (P=0.06) were not different between the groups. The mean IOP were significantly higher in the glaucoma patients compared with the controls (P<0.001). CONCLUSION: This study suggests that pseudoexfoliation glaucoma is associated with a reduction in the blood flow velocity and elevation in the resistance of the MCA.

Aged↗
PubMed2005

Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation.

In neurosurgery, ceftriaxone is a widely used, third generation cephalosporin for the treatment of CNS infections and perioperational prophylaxis. Recent studies have demonstrated that ceftriaxone induces reversible precipitates in the gallbladder. This complication is referred to as "biliary pseudolithiasis", and it has symptoms similar to the raised intracranial pressure (ICP) symptoms of the perioperative period. Symptomatic biliary pseudolithiasis should be kept in mind in all pediatric neurosurgery cases under ceftriaxone therapy in order to prevent unnecessary postoperative investigations and surgery.

Adolescent↗
PubMed2004

Chronic treatment of haloperidol causes vasoconstriction on basilar arteries of rats, dose dependently.

Haloperidol is a widely used antipsychotic drug, which exerts its effects via antagonizing the dopaminergic D2 receptors. Also it affects a number of receptors on vascular bed and other tissues. The impact of haloperidol on vascular bed seems still debatable and not clear. In the present study, haloperidol was given to adult rats in 0.5, 1, 2.5 and 5 mg kg(-1) doses, once a day, intraperitoneally in 1 ml volumes, for 9 weeks. After decapitation under Pentothal anesthesia, brains and basilar arteries were dissected out at midpontine level immediately. Conventional histopathology and morphometric analysis were carried out on the dissected artery branches. Medial and adventitial layers, endothelial cells and internal elastic membranes were observed as normal in the control group. It was determined clearly that the lumen of basilar artery in the control group was larger than in the other groups and also it was observed that is more regular the lumen contours of basilar artery in control group compared with other groups. Finally, wall thickness of basilar artery in all experimental groups decreased significantly due to the vasoconstriction. Regarding the total, lumen and wall volumes, 1 mg kg(-1) haloperidol induces vasoconstriction more than the other groups.

Animals↗
PubMed2004

The significance of immunohistochemistry in the skin pathergy reaction of patients with Behçet's syndrome.

BACKGROUND: Behçet's syndrome is a chronic systemic immuno-inflammatory disorder affecting multiple organs with generalized vasculitis of arteries and veins. Although the aetiology is still unknown, endothelial dysfunction is one of the most prominent features in Behçet's syndrome. The skin pathergy reaction (SPR) is a non-specific hyperreactive lesion formation that is one of the major features and diagnostic criteria of the disease. It develops after 24-48 h at the site of the needle-prick, especially in the exacerbation period, and it is very similar to the erythematous papules or pustules that appear spontaneously in patients with Behçet's syndrome. Therefore, an investigation into the formation of the SPR lesion may contribute to the pathophysiology of skin lesions of this unique disorder. OBJECTIVE: To evaluate the immunological features of SPR formation by assessing the immunohistochemical staining of cell adhesion molecules and endothelial growth factor markers such as E-selectin, P-selectin and endoglin (CD 105). METHODS: Patients with Behçet's syndrome showing positive (n = 15) or negative (n = 10) SPR and 15 age- and sex-matched hospital-based healthy control subjects from a similar ethnic background were included in this study. Patients were divided into active and inactive stage by clinical findings and acute-phase reactant parameters including erythrocyte sedimentation rate (ESR) and neutrophil count. Punch biopsy specimens were obtained both from the lesion site on the forearms at 48 h and from normal skin approximately 5 cm adjacent to the SPR site. A biopsy was also obtained from the test application site in Behçet's syndrome patients with negative SPR and healthy volunteers. Biopsy specimens were then evaluated by immunohistochemical staining. RESULTS: Immunohistochemical examination demonstrated a mixed inflammatory cell infiltrate around the vessels and skin appendages that extended somewhat into the deep dermis. A positive segmental staining of E-selectin and P-selectin was noted in the endothelial cells of biopsies obtained from the patients with positive SPR. A positive segmental staining of CD 105 in the endothelial cells was also observed in the same group of patients. However, the immunostaining of the same markers was found to be negative in the biopsies obtained from normal skin of SPR-positive patients, SPR-negative patients and healthy control subjects. Both acute-phase reactant levels were significantly higher in the active stage than in inactive patients or healthy controls. CONCLUSION: Interaction of cellular adhesion molecules together with endothelial proliferation may play an important role in the formation of SPR lesions in patients with Behçet's syndrome. The involvement of the vascular endothelium in a large number of diseases including Behçet's syndrome supports the importance of vascular-specific adhesion molecules for their aetiopathogenesis.

Adult↗
PubMed2003

Life-years gained from coronary heart disease mortality reduction in Scotland: prevention or treatment?

Coronary Heart Disease (CHD) death rates have fallen considerably in many countries. We estimated the life-years-gained (LYG) in Scotland between 1975 and 1994 attributable to cardiology treatments, and population reductions in major CHD risk factors, using a previously validated mortality model. This combines published effectiveness data with information on uptake of CHD treatments; risk factor trends; and median survival by age and sex. Compared with 1975, there were 4,536 fewer CHD deaths in 1994, resulting in approximately 48,016 LYG among those aged 45-84 (maximum estimate 53,317; minimum estimate 36,867). Medical and surgical treatments for CHD patients gained approximately 12,025 life-years; the largest contribution coming from pharmacologic secondary prevention. Population reductions in major risk factors (smoking, cholesterol, and blood pressure) accounted for some 35,991 LYG, reductions in smoking accounted for over 50% of this. Modern cardiologic treatments gained many thousands of life-years in Scotland, but modest reductions in risk factors gained almost three times as many life-years.

Age Distribution↗
PubMed2003

Missing, mediocre, or merely obsolete? An evaluation of UK data sources for coronary heart disease.

STUDY OBJECTIVE: Coronary heart disease (CHD) is the commonest cause of death in the UK. However, there is no single comprehensive source of information to support CHD prevention and treatment strategies. Therefore this study evaluated the availability and quality of UK CHD data sources since 1981. DESIGN: Data sources for England and Wales were identified and appraised on: (1) CHD patient numbers (myocardial infarction, angina, hypertension, and heart failure); (2) uptake of medical and surgical CHD treatments, and (3) population trends in major cardiovascular risk factors. SETTING: England and Wales (population 53 million). MAIN RESULTS: Population and mortality data were easily accessible from Office for National Statistics and British Heart Foundation Annual CHD Statistics; population based risk factor data came principally from the British Regional Heart Study, the General Household Survey, and the Health Survey for England. They were limited for 1981, but more extensive by 2000. Hospital admissions information since 1998 was available online from HES; but trend data and details of interventions were scant. Limited primary care data on consultation rates, prescribing, and treatment uptake were available from published audits and studies. CONCLUSIONS: Information on CHD in the UK is fragmented, patchy, and mixed in quality. Data for women, the elderly populatiom, and ethnic minorities were particularly scarce, exacerbating inequalities. Future CHD disease monitoring and evaluation will require comprehensive and accurate population based information on trends in patient numbers, treatment uptake, and risk factors.

Blood Pressure↗
PubMed2003

Health effects associated with smokeless tobacco: a systematic review.

BACKGROUND: It is believed that health risks associated with smokeless tobacco (ST) use are lower than those with cigarette smoking. A systematic review was therefore carried out to summarise these risks. METHODS: Several electronic databases were searched, supplemented by screening reference lists, smoking related websites, and contacting experts. Analytical observational studies of ST use (cohorts, case-control, cross sectional studies) with a sample size of >/=500 were included if they reported on one or more of the following outcomes (all cause mortality, oral and pharyngeal cancers, other cancers, cardiovascular diseases, dental diseases, pregnancy outcomes, surgical outcomes). Data extraction covered control of confounding, selection of cases and controls, sample size, clear definitions and measurements of the health outcome, and ST use. Selection, extraction and quality assessments were carried out by one or two independent reviewers. RESULTS: A narrative review was carried out. Many of the studies lacked sufficient power to estimate precise risks, mainly due to the small number of ST users. Studies were often not designed to investigate ST use, and many also had major methodological limitations including poor control for cigarette smoking and imprecise measurements of exposure. Studies in India showed a substantial risk of oral or oropharyngeal cancers associated with chewing betel quid and tobacco. Studies from other regions and of other cancer types were not consistent. Few studies have adequately considered the non-cancer health effects of ST use. CONCLUSIONS: Chewing betel quid and tobacco is associated with a substantial risk of oral cancers in India. Most recent studies from the US and Scandinavia are not statistically significant, but moderate positive associations cannot be ruled out due to lack of power. Further rigorous studies with adequate sample sizes are required, especially for cardiovascular disease.

Areca↗
PubMed2002

Therapeutic effects of intracarotid infusion of spermine/nitric oxide complex on cerebral vasospasm.

BACKGROUND: Vasospasm is one of the underlying causes of morbidity and mortality in subarachnoid haemorrhage (SAH). The therapeutic effects of intracarotid infusion of spermine/nitric oxide complex (SPER/NO) on cerebral vasospasm in an experimental model of SAH were investigated. METHOD: Twenty-four adult male New Zealand white rabbits (2.6-3.4 kg in weight) were randomly divided into four groups (n=6), as follows: (I) control group (without SAH and drug), (II) SAH alone group (with SAH, without drug), (III) SAH placebo group (with SAH and saline), and (IV) SAH-SPER/NO group (with SAH and SPER/NO). The fresh autologous non-heparinized blood was injected into the cisterna magna to induce a SAH, after 24 hour SAH, the substance (saline or SPER/NO) was delivered to animals. All rabbits were scarified at 48-hours of induced SAH. The basilar artery with surrounding tissue was removed from the cranium and processed for paraffin embedding. Histopathological and stereological examinations of the basilar artery were done. FINDINGS: In the SPER/NO treated group of rabbits, the histopathological changes were less severe than in the SAH-alone and SAH-placebo groups. Regarding the intracarotid pressure, there was a statistically significant difference between SAH-alone and SAH-SPER/NO groups and also between SAH-SPER/NO and control groups (p<0.05). The mean cross sectional area of basilar arteries was 0.26 mm(2) in the control, whereas in SAH alone, placebo and SAH-SPER/NO groups were 0.13, 0.15 and 0.20 mm(2), respectively. INTERPRETATION: It is well known that NO is a critical substance involved in cerebral vascular dynamics. Present results indicate that treatment of vasospasm with SPER/NO in SAH may be promising. However, further studies should be done on this substance to clarify its effect on vasospasm before using the drug in clinical situations.

Animals↗
PubMed2002

The effects of tamoxifen on rat skin.

BACKGROUND: Tamoxifen (Tx) is used mostly in the treatment of breast and gynecological cancers. It is also widely used in the treatment of different dermatological disorders. However, its effects on skin have not been investigated previously. OBJECTIVE: To investigate the effects of Tx administration on rat skin. METHODS: Forty Spraque-Dawley female newborn rats were separated into two control groups and two experimental groups (n 10). One day after birth, the control groups of newborn rats were given 0.02 ml saline subcutaneously (s.c.) daily whereas experimental litters were treated with 100 microg Tx citrate in 0.02 ml saline s.c. daily for five days. The first control group and experimental group of rats were anesthetized at 21 days whereas the second control group and experimental group of rats were anesthetized on the 28th day. Histopathological assessments were made and compared with the control groups. RESULTS: Abnormal hair follicles were observed in both experimental groups of rats. Epidermal atrophy together with increased dermal fibrosis was more prominent in the first experimental group. Dermal fibrosis and lymphohistiocytic inflammatory cell infiltration were found to be prominent around the hair follicles in the second experimental group. CONCLUSION: Considerable harmful effects of Tx administration were observed on rat skin.

Animals↗
PubMed2001

A simple technique to measure the movements of the microscope stage along the x and y axes for stereological methods.

Measurements of microscope stage movements in the x and y directions are of importance for some stereological methods such as the optical disector and optical fractionator. The length of stage movements can be measured with great precision and accuracy using a suitable motorized stage, which is generally a computer-assisted instrument. This type of equipment is generally too expensive for and not readily available in many laboratories. This paper describes a simple method to measure the movements of the microscope stage along the x and y directions, which can be used for purposes such as systematic uniform random sampling. It needs a microscope attachment consisting of two dial indicators; one of them is used to measure the amount of stage movement along the x-axis and the other measures the amount of movement along the y-axis. Movements of the stage on the micrometre-scale can be measured easily using this device.

Journal Article↗
PubMed2000

Isolation of Dermatophilus congolensis from a cat.

Dermatophilus congolensis was isolated from a cat with dermatitis. The isolate was sensitive to oxytetracyclin, streptomycin and penicillin but resistant to ampicillin, amoxicillin, gentamycin and cefoperazone.

Actinomycetales↗
PubMed2000

Effects of unilateral uterine artery ligation on skin development.

BACKGROUND: It has been previously demonstrated that intrauterine growth retardation (IUGR) due to vascular insufficiency in humans results in newborn infants with marked loss of subcutaneous fat and decreased content of differentiation-specific epidermal structural proteins. OBJECTIVE: In this study, the teratogenic effects of impaired maternal blood flow were investigated histologically on rat skin. MATERIALS & METHODS: Twenty Spraque-Dawley female rats were separated into two groups (n = 10), a control (sham-operated) and an experimental group. The experimental group of fetal rats were subjected to IUGR by unilateral ligation of the maternal uterine artery on the 18th day of pregnancy. The maternal rats were subjected to cesarean hysterectomy on the 21st day of pregnancy and a skin biopsy was taken from the respective litters of both groups. RESULTS: In histopathological examination, normal epidermis and dermis were observed in the control group of litters and littermate rats from the opposite uterine horn (non-ligated side). A statistically significant reduced body weight and height were noted in the ligated side of the litters. CONCLUSION: Our findings give further evidence to the concept that normal maternal blood flow is essential for fetal growth and decreased maternal blood flow may create an impairment in skin development.

Animals↗
PubMed2000

Effects of clomiphene citrate on neonatal rat skin.

BACKGROUND: Clomiphene citrate is chemically related to non-steroidal estrogens, and has antiestrogenic properties. It is used in the treatment of anovulatory female infertility and its therapeutic effect mainly depends on inhibiting the negative feedback effects of endogenous estrogen by stimulating the gonadotropin releasing hormone. Today, it is also used in the treatment of male infertility. OBJECTIVES: In this study the effects of clomiphene citrate on skin maturation in neonatal rats were investigated. METHODS: Forty Spraque-Dawley female newborn rats were separated into two control and two experimental groups (n = 10). One day after birth. experimental newborn rats were given clomphene citrate subcutaneously in a dosage of 100 mg/kg/day for five days. The first experimental group of rats were anesthetised at 21 days whereas the second experimental group of rats were then anestetised on day 28. Biopsies were taken immediately from the perineal skin. Histopathological assessments were made and compared with their control groups. RESULTS: In both the experimental groups of newborn rats, increased keratinization and irregular hypertrophy were observed in the epidermal cells. Disorganization of the basal layer cells and hyperplasia were found to be more prominent in the first experimental group and dermal fibrosis and lymphohistiocytic inflammatory cell infiltration were especially prominent around the sebaceous glands in the second experimental group. CONCLUSION: The administration of clomiphene citrate in newborn rats showed impaired skin maturation.

Animals↗