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Biomedical subjects

S Sener

Publications and source records attributed to S Sener.

At least 19 recordsLinked to original sources
PubMed2006

Case of the month: rivastigmine (Exelon) toxicity with evidence of respiratory depression.

Rivastigmine, which has been approved by the US Food and Drugs Administration for the treatment of Alzheimer's disease, is a non-competitive reversible inhibitor of acetylcholinesterase. We present a case of rivastigmine toxicity at a dose of 90 mg, with evidence of respiratory depression. To our knowledge, this case report provides evidence of the highest rivastigmine ingestion recorded (90 mg) that caused respiratory depression but requiring only supportive intervention without the need for ralidoxime. Emergency physicians should strongly consider cholinesterase inhibitor (rivastigmine, galantamine, and tacrine) ingestion in patients who present with short and temporary organophosphate-like toxidromes.

Adult↗
PubMed2005

Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department.

BACKGROUND: Shoulder dislocations account for almost 50% of all joint dislocations, which are most commonly anterior (90-98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the scapular manipulation technique (SMT) to reduce traumatic anterior shoulder dislocations. METHODS: Between March 2002 and March 2003, SMT was applied to 41 patients who presented with traumatic anterior shoulder dislocation to the Gulhane Military Medical Academy, Department of Emergency Medicine, Ankara, Turkey, which is a level 1 trauma centre with an annual attendance of 85,000 patients. The technique was applied to patients in the prone position by a single operator. Where necessary, a procedural sedation/analgesia (PSA) protocol was followed. RESULTS: The study population consisted of 26 (63.4%) male patients aged between 17 and 76 years (SD 15.6). History of recurrent shoulder dislocations at the same site were taken from seven (17.1%) of the patients. Mean (SD) trauma to reduction time was approximately 61.5 (72) minutes (range 10-480). Five patients (12%) had a greater tuberosity fracture. SMT was attempted twice to only four (9.8%) patients by a standard PSA protocol. We experienced a success rate of 90.2% at the first attempt and 100% overall. None of the patients encountered any complication. CONCLUSIONS: We report the successful use of SMT in the prone position for the reduction of traumatic anterior shoulder dislocations, mainly without requirement of any sedatives or opiate analgesics. We believe that SMT may also be applied by inexperienced physicians, as it is simple, applicable, and easily understood. As no single method has a 100% success rate, SMT is a useful one to know.

Adolescent↗
PubMed2004

Surface modification of pyrophyllite with amino silane coupling agent for the removal of 4-nitrophenol from aqueous solutions.

The surface of naturally hydrophobic mineral pyrophyllite was modified to hydrophilic by treatment with prehydrolyzed N-(2-aminoethyl)-3-aminopropyltrimethoxysilane (APEO) coupling agent to prepare a novel and effective adsorbent for the removal of 4-nitrophenol (4-NP) from aqueous solutions. XRD, FTIR, and SEM analyses were used to characterize the surface modification. It was found that after the grafting procedure, heat treatment at 110 degrees C results in condensation reaction between the OH groups of the APEO molecule and the hydroxyl groups and/or oxygen atoms on the pyrophyllite surface and the adsorption of 4-NP by APEO-modified pyrophyllite involves interactions between dissociated 4-NP molecules and protonated amine groups of APEO molecules attached to the mineral surface. Adsorption equilibrium data for 4-NP adsorption on APEO-treated and untreated pyrophyllite were most satisfactorily fitted using the Freundlich adsorption isotherm and adsorption capacity was found to be 0.268 mg/g for modified pyrophyllite whereas it was only 0.105 mg/g for untreated pyrophyllite.

Journal Article↗
PubMed2004

MRI characteristics of anterior disc displacement with and without reduction.

OBJECTIVES: The aim of this study was to investigate the differences between magnetic resonance imaging (MRI) characteristics of anterior disc displacement with reduction (ADDR) and without reduction (ADDWR). METHODS: A clinician and a radiologist, blinded to the results of the clinical examination, independently evaluated the MRI scans of 100 subjects with symptoms of temporomandibular joint (TMJ) disorders. The final sample included 88 subjects in whom there was consensus of disc displacement both between observers and between MRI and clinical examination. There were 130 joints with ADDR and 45 joints with ADDWR in the study. The MRI characteristics such as position, signal intensity and morphology of the disc, degenerative changes, effusion, scar tissue, osteonecrosis and condylar hypermobility were evaluated in the cases of ADDR and ADDWR. The chi(2) test was used to determine the differences between ADDR and ADDWR for these MRI characteristics. RESULTS: There were no significant differences between ADDR and ADDWR for effusion and degenerative changes. There were significant differences between ADDR and ADDWR for sideways displacement, disc deformation, signal intensity changes, scar tissue, osteonecrosis and condylar hypermobility. CONCLUSIONS: Degenerative changes and effusion did not appear to be markers of either ADDR or ADDWR. However, the severity of these abnormalities may be correlated with the type of internal derangement. The prevalence of sideways displacement, disc deformation, signal intensity changes, scar tissue, and osteonecrosis was greater in ADDWR than ADDR. These conditions may be considered to be indicators of more advanced and complicated stages of internal derangement. Because the percentage of subluxation was greater in ADDR, localized joint laxity and internal derangement may be correlated.

Chi-Square Distribution↗
PubMed2001

Is increased D2 receptor availability associated with response to stimulant medication in ADHD.

The purpose of this study was to estimate striatal dopamine (D2) receptor availability in non-drug treated children with attention-deficit-hyperactivity disorder (ADHD) before and after methylphenidate therapy, and to examine correlations between severity of symptoms and response rates to stimulant medication with levels of striatal D2 receptor binding. Nine children (six males, three females; mean age 9.8 years, SD 2.3 years) with ADHD participated. All underwent iodobenzamide (123I IBZM) brain SPECT within 2 hours following intravenous injection of 123I IBZM before and 3 months after methylphenidate therapy. A semiquantitative approach was used to generate indices of specific D2 receptor binding in the basal ganglia. Specific binding ratios at baseline were higher than the previously reported specific binding values obtained in studies using young healthy adults. D2 availability reduced significantly (paired t-test,p<0.05) as a function of methylphenidate therapy in patients with ADHD in all four regions of the striatum. When the relation between therapy response and D2 availability was investigated, we observed that the higher the baseline D2 levels were, the higher the response rate was (detected as the percentage reduction of hyperactivity scores and Conners Teacher Rating Scale scores), while no such trend was observed between the initial D2 binding levels and the response in attention-deficit scores. Results indicate that in non-drug treated children with ADHD, higher D2 receptor availability is observed at baseline which is down-regulated back to reported near-normal values after methylphenidate therapy. The effect of methylphenidate on D2 receptor levels in patients with ADHD is similar to that observed in healthy adults; a down-regulation phenomenon within 0 to 30%. In addition, initially higher values of D2 availability seem to indicate better response to methylphenidate therapy in ADHD.

Adolescent↗
PubMed1999

The risk of coronary heart disease in men with androgenetic alopecia.

BACKGROUND: The meaningful association of androgenetic alopecia and coronary heart disease has been well documented, but few studies have focused on the importance of lipid parameters, such as total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, lipoprotein (a), apolipoprotein A1 and apolipoprotein B in patients with androgenetic alopecia. OBJECTIVE: The aim of this study is to investigate the relation between androgenetic alopecia and coronary heart disease and to determine the significance of certain lipid parameters on this relationship. SUBJECTS: Forty-one men with vertex type androgenetic alopecia (study group) and 36 men, age-matched, with normal hair status (control group) were the subjects of this study. RESULTS: We found significant differences in serum lipoprotein (a) and triglyceride levels between the study and control groups (P < 0.05). Forty-seven percent of patients and 30% of controls had a lipoprotein (a) level more than 30 mg/dl higher than the level critical for atherosclerotic heart disease. CONCLUSION: Dermatologists should investigate lipid profile, especially lipoprotein (a), of patients with androgenetic alopecia and refer to a cardiologist if necessary.

Adult↗
PubMed1993

Staging procedures, clinical management, and survival outcome for ovarian carcinoma.

OBJECTIVE: To evaluate the relationship between survival and patterns of clinical management for ovarian carcinoma. DESIGN: Retrospective analysis of cancer registry data including follow-up, operative reports, and pathology reports. SETTING: Seventy-seven Illinois hospitals with active cancer registries. PATIENTS: A total of 2669 women with newly diagnosed ovarian carcinoma from 1983 through 1988. MAIN OUTCOME MEASURES: Frequency of use of specific staging procedures and treatment options. Survival was estimated using the Kaplan-Meier product-limit method. RESULTS: Thirty percent of 632 stage I patients, 31% of 233 stage II patients, and 45% of 516 stage III patients underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, sampled peritoneal washings, and node biopsy. Five-year survival for those receiving this extensive surgery (who were therefore pathologically staged) was as follows: stage I, 80%; stage II, 63%; and stage III, 28%. For those not receiving this extensive surgery (who were therefore clinically staged), the 5-year survival at these stages was 76%, 62%, and 21%, respectively. The overall survival curves were not significantly different between those who were pathologically staged and those who were clinically staged for stage I patients (P = .27) or stage II patients (P = .47), but were for stage III patients (P = .01). Platinum-based combination chemotherapy was given to 76% of 221 patients with pathological stage III disease. Their 5-year survival--50% for the group with no residual disease and 20% for the group with residual disease--was better than for those receiving regimens without platinum--37% and 5%, respectively, for the two groups--and the overall survival curves were significantly better for those receiving platinum (P < .0005 for both groups). The groups receiving platinum had younger patients. CONCLUSIONS: Extensive surgery for pathological staging was not usually done for management of ovarian cancer, while platinum-based chemotherapy was commonly used. Failure to undergo extensive surgery had little impact on survival for stage I and II patients. However, use of extensive surgery and platinum-based chemotherapy improved survival for stage III patients. The improved survival for this group receiving platinum-based chemotherapy may be explained in part by selection of younger patients for this treatment.

Female↗
PubMed1992

Renal pelvic transitional cell carcinoma. The role of the kidney in tumor-node-metastasis staging.

Renal pelvic carcinoma is a rare tumor. There are several staging systems currently in use based on a bladder cancer staging model. An analysis of the American Cancer Society, Illinois Division, experience with 611 cases of renal pelvic transitional cell carcinoma suggested that the kidney parenchyma may be a determinant in the anatomic spread of disease. A tumor-node-metastasis system for renal pelvic (separate from ureteral) cancer is recommended.

Carcinoma, Transitional Cell↗
PubMed1992

Renal pelvic cancer: a review of 611 patients treated in Illinois 1975-1985. Cancer Incidence and End Results Committee.

Renal pelvic transitional cell carcinoma constitutes about 7 percent of all kidney cancer. This report is a summary of 611 Illinois patients with this tumor treated between 1975 and 1985. Overall, the five-year relative survival rate was 62 percent and the observed five-year rate was 48 percent. Stage was a major determinant of survival, as expected, in these cancer patients. The Illinois experience is reviewed and compared with the accumulated literature experience with renal pelvic cancers since 1944.

Age Factors↗
PubMed1991

Hospital variables associated with quality of care for breast cancer patients.

OBJECTIVE: To determine the degree of compliance with clinical standards among hospitals for care of breast cancer patients and account for variations in compliance. DESIGN: Analysis of cancer registry data submitted to the American Cancer Society, Illinois Division, Chicago, for a concurrent prospective descriptive study of breast cancer, supplemented by other hospital data from public sources. SETTING: Ninety-nine Illinois hospitals evenly distributed among rural counties, counties with small cities outside the Chicago metropolitan area, exurban counties in the Chicago metropolitan area, suburban Cook County, and urban Chicago. PATIENTS: A total of 5766 newly diagnosed patients with histologically confirmed breast cancer in 1988, representing 84% of the estimated 6900 new cases in the state for that year. MAIN OUTCOME MEASURES: Descriptive statistics and multiple linear regression analyses of five dependent quality variables from clinical indicators related to early diagnosis, hormone receptor determination, adjuvant therapy, radiation therapy, and axillary lymph node dissection. RESULTS: At the hospitals studied, (1) late stage (IIb through IV) at diagnosis was associated with urban location, higher proportion of poorly insured patients, fewer breast cancer cases treated, and lower oncology charges (proportion of variance explained, R2 = .50, P less than .00001); (2) omission of hormone receptor test for stages II through IV was associated with urban location and higher proportion of poorly insured patients (R2 = .18, P less than .00003); and (3) omission of indicated radiation therapy was associated with urban location and fewer breast cancer cases (R2 = .21, P less than .00001). Omission of adjuvant therapy and omission of axillary lymph node dissection were not significantly associated with any of the hospital variables examined. CONCLUSIONS: The findings suggest that there is a group of urban hospitals, generally small and marginally reimbursed, where comprehensive diagnosis and treatment of breast cancer are not obtained.

Breast Neoplasms↗
PubMed1983

A systematic approach to the evaluation and management of breast masses.

Between 1975 and 1980, 392 patients with a palpable mass or masses were referred for breast evaluation, including risk factor assessment, physical examination, and selective utilization of aspiration cytology and mammography. Three-hundred and thirty-one (85%) were biopsied, with a benign diagnosis in 65% of the patients and cancer in 35%. The 61 patients (15%) who were not biopsied consisted of 32 patients in whom the mass disappeared on follow-up examination, 20 with stabilization on long-term follow-up, and nine with decreased mass size. Most breast masses must be biopsied, but a few can be followed and biopsy avoided. However, a decision not to biopsy requires more precise clinical judgement and experience than a decision to proceed with biopsy. Absolute indications for breast biopsy include a clinically suspicious mass, a mammogram considered malignant or suspicious, aspiration cytologic findings reported as malignant or suspicious, and a persisting, dominant mass, even if clinically benign.

Biopsy, Needle↗
PubMed1983

Effect of transferrin absence on in vitro globin chain synthesis in reticulocytes of beta-thalassemic patients.

The effect of transferrin absence on in vitro globin chain synthesis and on the alpha/beta ratio were investigated in four patients with beta-thalassemia intermedia and one heterozygote with "silent" beta-thalassemia. With one exception the lack of transferrin in the incubation medium resulted in the reduction of the globin alpha/beta ratio which paralleled a reduction in overall protein synthesis. In one patient with beta-thalassemia intermedia, however, the absence of transferrin failed to affect this ratio.

Adult↗
PubMed1979

[Protection against mercuric chloride nephropathy by sodium selenite in the rat].

Daily intraperitoneal injection of 2.5 or 5 mumole HgCl2 to male Rats weighing 250 to 350 g induces an early intense increase of urine gamma-glutamyl transferase activity. In the same conditions, equimolecular administration of sodium selenite and mercuric chloride induces no increase of the enzymuria for the low dose: for the high dose- a minor and more persistent increase of urine GGT is observed. Thus, the activity of urines GGT allows, in vivo, to establish that sodium selenite protects Rat kidney against toxic effects of mercuric chloride.

Animals↗