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Biomedical subjects

M Akman

Publications and source records attributed to M Akman.

At least 19 recordsLinked to original sources

Providers' knowledge of, attitude to and practice of emergency contraception.

OBJECTIVES: Barriers to widespread use of hormonal emergency contraceptives (EC), such as lack of knowledge and prejudices held by health-care providers, still exist today. This study was initiated to evaluate the knowledge, attitudes and prejudices of family-planning (FP) providers. METHODS: This survey was conducted in FP units of primary-health-care centers in Istanbul. A total of 180 providers were interviewed in 80 units to whom a questionnaire was administered by face-to-face technique. RESULTS: One-hundred and fifty-two of the providers stated that they had heard of EC. The correct timing and dose interval of EC were known by 50% of them. The participants held the belief that EC caused abortion (39.4%), and that it was harmful for the fetus (31.1%). Other prejudices were the possibility of increased unprotected sexual intercourse (78.9%) and a tendency for men to give up condom use (75%); female providers were more prejudiced concerning these statements. The providers' tendency towards the provision of counseling was significantly related to their prejudices (p = 0.011, p = 0.033) and to the application rate (p = 0.000). Conclusion Providers need more detailed information about EC. During FP training courses, the providers should be encouraged towards counseling EC which would increase the application rate of the users and decrease their own prejudices.

Adolescent↗

The effects of iron deficiency on infants' developmental test performance.

AIM: To assess the effects of iron deficiency on developmental test scores in infants. METHODS: This prospective, single-blind, controlled clinical intervention study was made on 108 children aged 6-30 mo who applied to our paediatric outpatient clinic. The cases were classified as control (n = 31, haemoglobin > or = 11 g/dl, serum ferritin > 12 microg/l, MCV > or = 70 fl), non-anaemic iron deficiency (NAID, n = 40, haemoglobin > or = 11 g/dl, serum ferritin < or = 12 microg/l, MCV > or = 70 fl) and iron deficiency anaemia (IDA, n = 37, haemoglobin < 11 g/dl, ferritin < or = 12 microg/l, MCV < 70 fl) due to their anaemia status. In each group, MCV, haemoglobin and ferritin levels were measured, and Denver Developmental Screening Test (DDST) and Bayley Scales of Infant Development (BSID-I) were administered before and after a 3-mo follow-up. IDA and about half of the NAID subjects were treated with oral iron for 3 mo. RESULTS: Subjects with iron deficiency showed significantly lower developmental test scores both with BSID-I and DDST-II compared to their iron-sufficient peers (p < 0.05). After 3 mo of iron treatment, lower mental developmental test scores were no longer observed among the IDA and NAID groups whose anaemia and iron deficiency were also corrected. No significant differences were found between control NAID and control IDA groups on DGTT-II results after treatment. The difference in motor and mental developmental scores did not appear to depend on environmental and family factors considered in the analyses. CONCLUSION: These findings support the conclusions that iron deficiency may cause lower mental and motor test scores in infants and these adverse effects can be improved by iron therapy.

Anemia, Iron-Deficiency↗

Is intestinal ischemia a risk of laparoscopy? An experimental study in rabbits.

BACKGROUND AND PURPOSE: In the literature, there are few reports documenting intra-abdominal organ necrosis following laparoscopic procedures. This experimental study was planned to investigate whether intestinal ischemia develops during laparoscopic procedures and if laparoscopy could cause intestinal necrosis. MATERIAL AND METHODS: Two experimental groups, each consisting of 10 adult New-Zealand rabbits, were used in this study. The first group comprised the study group which had pneumoperitoneum, the second group comprised the normal animals serving as the controls. A cervical tracheostomy was performed to achieve successful general anesthesia in both groups. In the study group, intraperitoneal CO2 insufflation was carried out and intraabdominal pressure (IAP) was adjusted so as not to exceed the arterial blood pressure. After 20 min high IAP period, the intraabdominal gas was aspirated. Five minutes later, samples of both small intestine and colon tissue were taken. In the control group, tissue samples were taken 25 min after anesthesia was achieved. Xanthine oxidase (XO) and malondialdehyde (MDA) levels were measured as indicators of intestinal ischemia and lipid peroxidation in the intestinal tissues. Statistical analysis was done to compare the XO and MDA levels of the small intestines and colons of both groups. RESULTS: The mean colonic XO levels were 1.323+/-1.17 and 0.217+/-0.27 (U/mg protein) in study and control groups, respectively. This difference was statistically significant (t = 2.60, p<0.05). The other comparisons with regard to XO and MDA levels were statistically not significant. CONCLUSION: Our results demonstrate that intraperitoneal CO2 insufflation in which intraabdominal pressure was adjusted to be lower than arterial blood pressure may affect oxygenization of the colon.

Animals↗

Experience with laparoscopy in nonpalpable testis.

AIM: The aim of this study was to investigate the feasibility and benefits of diagnosis and interventional laparoscopy in those paediatric patients with nonpalpable testes (NPT). PATIENTS AND METHODS: Between 1992 and 1999, 75 patients with NPT (mean age 3 years, range 6 months to 14 years) were treated. 86 testes were evaluated. RESULTS: According to the laparoscopic findings 4 groups of testes were identified: Vanishing testis (n = 32), low abdominal testis (< 2 cm to the internal ring) (n = 26), high abdominal testis (> 2 cm to the internal ring) (n = 24) and intersex patients (n = 4). Of the first group, 19 testes (one bilateral) had blind-ending spermatic cord and vessels and if an atrophic testicular tissue was identified, it was removed laparoscopically. For those with spermatic cord and vessels beyond the internal ring (13 testes), atrophic testes were removed through a high scrotal incision. 19 testes of the second group had a laparoscopy-assisted orchidopexy. In the same group a laparoscopic orchidopexy was performed on 7 testes. 24 testes in the 3rd group had a Fowler-Stephens (FS) stage 1 and 18 testes had a laparotomy performed for FS stage 2 procedure (laparotomy and orchidopexy) after 6 months. At laparotomy there was no evidence of testicular atrophy in all but one testis, which was removed and the FS stage 2 procedure was completed in 17 testes. The follow-up period was between 6 months and 4 years, and two more testicular atrophies were noted after FS stage 2. The results were satisfactory in 15 out of 18 testes (83%). In the intersex group, the patient with testicular feminization underwent laparoscopic orchiectomy. The other patient with bilateral nonpalpable testis was identified as having an uterus and two intraabdominally located gonads on laparoscopy and gonadal biopsies were obtained for diagnosis. Histology demonstrated bilateral ovotestes, confirming the diagnosis of a true hermaphrodite. CONCLUSION: We are of the opinion that laparoscopy decreases the number of laparotomies in NPT, allows a single-stage procedure in low abdominal testis, and facilitates clip ligation of the testicular artery in high abdominal testis. Laparoscopy also provides diagnostic and therapeutic options for vanishing testis and intersex patients.

Adolescent↗

The effects of sucralfate and selective intestinal decontamination on bacterial translocation.

Sucralfate is widely used as a cytoprotective agent in patients with peptic ulcer and other intestinal mucosal damage. In this study, the effects of sucralfate and/or selective intestinal decontamination with gentamycin on bacterial translocation (BT) in rats with experimentally-induced mechanical jaundice were investigated. Seventy-five adult male Wistar albino rats were divided into five groups of 15 each. In all except a sham group, we performed ligation of the common bile duct (CBD) via a vertical laparatomy. After surgery, the rats in group 1 were treated with oral sucralfate (5 mg/kg per day); those in group 2 underwent oral gentamycin therapy (5 mg/kg per day) for 5 days. Group 3 rats were treated with sucralfate and gentamycin for 5 days subsequent to the operation. The rats in group 4 served as controls, and received only 0.9% saline solution. Group 5 was a sham group. After 5 days of surgery, all rats were killed; the mesenteric lymph nodes (MLN), liver, and a segment of terminal ileum were harvested aseptically. The collected tissues were cultured in McCaunkey medium and chocolate agar. For each specimen, the colony-forming units (CFU) were calculated and the percentage of viable translocated micro-organisms was counted. In all rats who had ligation of the CBD, high numbers of bacteria were demonstrated in the liver, MLN, and ileum. In the liver of rats with sucralfate and/or gentamycin treatment, there was a marked reduction in CFU compared to the control group. Similarly, in the MLN measurements of CFU were higher in the control rats than the study groups. In both McCaunkey and chocolate media, the numbers of bacteria in control rats were significantly higher than in the study groups (P < 0.001). However, among the study groups themselves there was no significant difference in CFU in any of the specimens or culture media (P > 0.05). Experimentally-induced mechanical jaundice from ligation of the CBD causes significant BT in rats. Sucralfate and/or gentamycin may reduce the degree of BT from the bowel mucosa. We did not find any difference in protection from BT between sucralfate and gentamycin or both in rats with experimentally-induced mechanical jaundice.

Animals↗

Anorectal manometry during the neonatal period: its specificity in the diagnosis of Hirschsprung's disease.

In this study the reliability of anorectal manometry (ARMM) in Hirschsprung's disease (HD) in the neonatal period is evaluated. ARMM was performed in 59 patients (age ranging between 2 to 90 days) in whom HD was suspected. Rectal biopsy was performed in 23 newborn whose rectoanal inhibitory reflex (RAIR) was not identified in the ARMM study and in 13 RAIR-positive newborn due to strong clinical signs supporting HD or persistence of symptoms during their follow-up. Other RAIR-positive patients were followed up to 4 months to 3.5 years and no problems were encountered. Among the 36 newborn with rectal biopsies, if the results were compared to ARMM studies, there were one false-positive and two false-negative results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ARMM in the diagnosis of HD are 91.6%, 95.6%, 84.6% and 91.6% respectively. We conclude that ARMM can be used as a screening test in patients in whom HD is suspected during the neonatal period, but for definitive diagnosis it must be combined with other diagnostic tests.

Anal Canal↗

Determination of the etiological organism during acute exacerbations of COPD and efficacy of azithromycin, ampicillin-sulbactam, ciprofloxacin and cefaclor. Turkish Thoracic Society COPD Working Group.

Acute exacerbations, most of which are due to lower respiratory tract infections, cause great morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD) and most of these are due to lower respiratory tract infections. The aim of this study was to determine the causative organism and the effects of azithromycin, ampicillin sulbactam (sultamicillin), ciprofloxacin and cefaclor monohydrate therapy in COPD. One hundred and six patients with COPD in acute exacerbation were randomized into four groups for empiric antibiotic treatment following lung function tests and sputum examination. The most common strains isolated from sputum were Haemophilus influenzae (30.8%), Streptoccocus pneumoniae (12%) and Moraxella catarrhalis (7.7%). Azithromycin, sultamicillin, ciprofloxacin and cefaclor monohydrate were found to be effective in treating COPD exacerbations.

Ampicillin↗

Plasma thrombomodulin levels in lung cancer patients.

BACKGROUND: Thrombomodulin (TM) is a glycoprotein and besides its anticoagulant property it is accepted as an onco developmental antigen. Considering these properties we hypothesised that active TMB might have a role in cancer cell behaviour. METHODS: We measured serum TMB levels by the enzyme immunoassay method in 40 patients with lung cancer and 20 healthy subjects. RESULTS: TMB levels were found as 54.6 +/- 11.5 in controls and 60.9 +/- 31.2 ng/ml in lung cancer patients TM levels were 59.4 +/- 24.2 ng/ml in 24 epidermoid carcinoma patients, 65 +/- 50.2 ng/ml in 10 small cell carcinoma patients and 60 +/- 18.4 ng/ml in 6 adenocarcinoma patients. Patients with stage 4 and distant metastasis had a value of 65 +/- 33.9 ng/ml. No significant differences were found between healthy subjects and cancer patients. Also the differences between 3 groups of patients were insignificant. CONCLUSIONS: It was concluded that serum TMB levels could not be accepted as a tumour marker in lung cancer patients.

Adult↗

[Antibody titers in the serum of patients suspected of typhoid using the classical Widal and microagglutination tests].

Blood serum samples taken from typhoid fever suspected patients during the last typhoid fever epidemic in Ankara in 1981 were tested comparatively with classical Gruber-Widal test and microagglutination technique using safranin-stained Salmonella typhi O and H antigens. Results showed that microagglutination technique was more reliable, less time and antigen consuming and permitted a more objective evaluation of agglutinin titers.

Agglutination Tests↗

[Amikacin - resistance in some bacteria isolated in Ankara, and its relation to R plasmids].

Four acinetobacter and 5 Ps. aeruginosa strains which were isolated in Clinical pathology Lab. of Hacettepe Univ. Med. School, and found to be resistant to Amikacin were tested for infectious drug resistance, using conventional in vitro transfer technique repeatedly. E. coli K12 Nalr (for Acinetobacters), and Ps. aeruginosa (for Pseudomonads) strains were used as recipients. For cultures and transfer experiments NB No : 2, and for the selection Mc Conkey Agar plates with nalidixic acid and proper antibiotics were used. Inspite of some variable and curious positive findings, it was not possible to transfer Amikacin - resistance to recipients with certainty. Results suggest that this characteristic was not controlled by R plasmids and hence was not "infectious", or at least could not been transferred by the technique we used.

Acinetobacter↗

[The increase of resistant enteric bacteria and the role of R plasmids (author's transl)].

As elsewhere in the world, the number of resistant enteric bacteria is rapidly increasing in this country. In a survey made in 1977 on about 40,000 strains of enteric bacteria in Clinical Pathology Laboratory of Hacettepe University Medical School, Ankara, Turkey, 70% to 97% of enteric bacteria were shown to be resistant to conventional antimicrobic agents. Also the rates of multiple-resistant strains of enteric bacteria are increasing quite rapidly. In most of these strains this increase proved to depend on the presence of R plasmids. In this paper, these and related facts were summarized and some precautions were suggested to lessen the increase of resistant strains in this country.

Anti-Bacterial Agents↗

The growth of salmonellas on cooked cured pork.

With the use of streptomycin-resistant mutants to facilitate recovery, 5 strains of 4 species of Salmonella were shown to grow rapidly at 22 degrees C. on low salt ham even from an inoculum of 10-20 organisms. S. pullorum did not grow well. All 6 strains of Salmonella survived but did not grow on ;high salt ham'. We conclude that cooked ham containing approximately 2.8 g. NaCl/100 g. H(2)O once infected is more likely to give rise to food poisoning than is ham with the higher salt content traditionally used.

Animals↗