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Biomedical subjects

Selim Suner

Publications and source records attributed to Selim Suner.

11 recordsLinked to original sources
PubMed2005

To be vaccinated or not? A survey of Turkish emergency physicians regarding smallpox.

We investigated Turkish emergency physicians' opinions about the threat of smallpox, smallpox vaccination, and the treatment of patients with suspected smallpox, and sought to identify factors that affect willingness to receive smallpox vaccination. Anonymous surveys were sent by mail to university-affiliated Emergency Departments in Turkey. Ten of the 21 university-based Emergency Medicine programs participated in the study, and 125 physicians (48% of all emergency physicians in Turkey) completed the survey. The probability of a bioterror attack using smallpox within Turkish borders was viewed as none or minimal by 43.2% of participants. Only 22.4% of the participants stated that they would agree to be vaccinated. The only factor that affected the rate of participants' willingness to receive smallpox vaccination was the occurrence of a smallpox case within Turkish borders. Decisions about the treatment of patients with suspected smallpox are strongly influenced by whether or not the physician has been vaccinated against smallpox. At the time of the survey, even during the weeks leading up to and during the war in Iraq, Turkish emergency physicians' perceived risk of a bioterror attack using the smallpox virus was low. A significant number of Turkish emergency physicians were unwilling to participate in a hypothetical vaccination program. This study shows that the occurrence of a smallpox case within Turkish borders would significantly increase the willingness of emergency physicians to receive the smallpox vaccine. Decisions about treatment of patients with suspected smallpox are strongly influenced by whether or not the physician has been vaccinated against smallpox.

Adult↗
PubMed2005

Reliability of signals from a chronically implanted, silicon-based electrode array in non-human primate primary motor cortex.

Multiple-electrode arrays are valuable both as a research tool and as a sensor for neuromotor prosthetic devices, which could potentially restore voluntary motion and functional independence to paralyzed humans. Long-term array reliability is an important requirement for these applications. Here, we demonstrate the reliability of a regular array of 100 microelectrodes to obtain neural recordings from primary motor cortex (MI) of monkeys for at least three months and up to 1.5 years. We implanted Bionic (Cyberkinetics, Inc., Foxboro, MA) silicon probe arrays in MI of three Macaque monkeys. Neural signals were recorded during performance of an eight-direction, push-button task. Recording reliability was evaluated for 18, 35, or 51 sessions distributed over 83, 179, and 569 days after implantation, respectively, using qualitative and quantitative measures. A four-point signal quality scale was defined based on the waveform amplitude relative to noise. A single observer applied this scale to score signal quality for each electrode. A mean of 120 (+/- 17.6 SD), 146 (+/- 7.3), and 119 (+/- 16.9) neural-like waveforms were observed from 65-85 electrodes across subjects for all recording sessions of which over 80% were of high quality. Quantitative measures demonstrated that waveforms had signal-to-noise ratio (SNR) up to 20 with maximum peak-to-peak amplitude of over 1200 microv with a mean SNR of 4.8 for signals ranked as high quality. Mean signal quality did not change over the duration of the evaluation period (slope 0.001, 0.0068 and 0.03; NS). By contrast, neural waveform shape varied between, but not within days in all animals, suggesting a shifting population of recorded neurons over time. Arm-movement related modulation was common and 66% of all recorded neurons were tuned to reach direction. The ability for the array to record neural signals from parietal cortex was also established. These results demonstrate that neural recordings that can provide movement related signals for neural prostheses, as well as for fundamental research applications, can be reliably obtained for long time periods using a monolithic microelectrode array in primate MI and potentially from other cortical areas as well.

Action Potentials↗
PubMed2003

Medical counterbioterrorism: the response to provide anthrax prophylaxis to New York City US Postal Service employees.

STUDY OBJECTIVE: We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS: A description of the response effort is presented. Data were collected on standardized forms and included the numbers of postal employees screened and offered antibiotic prophylaxis, as well as the numbers of patients seen per worker hour by various medical professionals. RESULTS: One hundred members of 5 disaster medical assistance teams and other health professionals were deployed to New York City within 18 hours of activation. Over a 68-hour period, 7,076 patients were evaluated, representing all postal employees in the 6 major postal facilities in New York believed to be at risk for anthrax exposure. Of the total, 2,452 patients were seen during the first 24 hours, 3,875 during the second 24 hours, and the remaining 749 during the last 20 hours of operations. An average of 161 employees were screened per hour. The antibiotic most commonly dispensed was ciprofloxacin, followed by doxycycline and amoxicillin. CONCLUSION: The deployment of disaster medical assistance teams and other agencies to New York City to provide prophylaxis against inhalation anthrax to US Postal Service employees provides lessons for a rapid, efficient, and effective response to acts of bioterrorism. This deployment might also serve as a scaleable model for future events requiring medical prophylaxis.

Anthrax↗
PubMed2003

Rhode Island Disaster Initiative.

In summary, RIDI is a multi-year research project to identify and develop solutions to some of the challenges posed by disaster response, with a focus on WMD incidents. September 11, 2001, changed the RIDI timeline with increased pressure to produce tangible results and recommendations rapidly. Phase 1 was an effort to identify problems and potential solutions through vulnerability assessment, literature review and expert panel discussion. Many disaster response "solutions" may fail because of a rush to use untested equipment or processes. RIDI is working cooperatively with other Rhode Island disaster experts to avoid these failures. Informed by Phase 1, RIDI Phase 2 will carefully and progressively test potential "solutions" during research trial disaster drills. Only after research can RIDI identify best practices in disaster response. As RIDI progresses to Phase 3, the demonstration project phase, specific improvements are expected in Rhode Island's readiness for disaster. A main feature of Phase 3 is use of a RIDI demonstration vehicle to bring identified solutions to the scene as requested by Rhode Island EMS agencies. Together with others working to improve Rhode Island readiness for disaster threats, RIDI hopes to improve the outcome for patients and providers in Rhode Island as they face the current disaster threats.

Computer Systems↗
PubMed2003

CPR effectiveness in microgravity: comparison of three positions and a mechanical device.

BACKGROUND AND OBJECTIVE: Cardiopulmonary resuscitation (CPR) in microgravity via closed chest compression is thought to be possible by several techniques. This study examined the handstand, side, and waist straddle maneuvers, and a bear hug technique in performing CPR and meeting American Heart Association (AHA) recommendations in microgravity. We also hypothesized that one rescuer using a CPR bellows adjunct device is equivalent to two rescuers. METHODS: A pre-intubated mannequin model resting on the crew medical restraint system from the International Space Station was instrumented with transducers to measure airway pressure and chest compression depth. Microgravity conditions were provided through repetitive parabolic flight on the KC-135A. On identifying the most effective position, standard two-rescuer CPR was compared with one-rescuer CPR augmented with a bellows-on-sternum CPR adjunct device (Kendall CardioVent, Kendall Medizinische Erzeugnisse GMBH, Neustadt/Donau, Germany). RESULTS: Handstand position compression depth was 1.58 in +/- 0.20 in SD (4.01 cm +/- 0.51 cm), side straddle was 0.78 in +/- 0.44 in SD (1.98 cm +/- 1.12 cm), and waist straddle was 1.21 in +/- 0.47 in SD (3.07 cm +/- 1.19 cm) across rescuers with heights of 164-174 cm. Rates of compression were 98.3 +/- 6.3 SD, 100.0 +/- 3.0 SD, and 102.6 +/- 12.1 SD compressions per minute, respectively. Compression depth for one rescuer utilizing the Kendall CardioVent device in the handstand position was 1.48 in +/- 0.14 in SD (3.76 cm +/- 0.36 cm). Compression depth for two rescuers was 1.58 in +/- 0.20 in SD (4.01 cm +/- 0.51 cm) (p < 0.01). CONCLUSION: CPR in microgravity is most reliably performed in the handstand position and meets AHA guidelines for closed chest compression depth. One-rescuer CPR incorporating the Kendall CardioVent device appears promising in microgravity. CPR adjunct devices would positively impact resuscitative procedures like CPR by small crews with inherent manpower requirements.

Cardiopulmonary Resuscitation↗
PubMed2002

Cardiopulmonary resuscitation using the cardio vent device in a resuscitation model.

To compare the "Bellows on Sternum Resuscitation" (BSR) device that permits simultaneous compression and ventilation by one rescuer with two person cardiopulmonary resuscitation (CPR) with bag-valve-mask (BVM) ventilation in a single blind crossover study performed in the laboratory setting. Tidal volume and compression depth were recorded continuously during 12-min CPR sessions with the BSR device and two person CPR. Six CPR instructors performed a total of 1,894 ventilations and 10,532 compressions in 3 separate 12-min sessions. Mean tidal volume (MTV) and compression rate (CR) with the BSR device differed significantly from CPR with the BVM group (1242 mL vs. 1065 mL, respectively, p = 0.0018 and 63.2 compressions per minute (cpm) vs. 81.3 cpm, respectively, p = 0.0076). Error in compression depth (ECD) rate of 9.78% was observed with the BSR device compared to 8.49% with BMV CPR (p = 0.1815). Error rate was significantly greater during the second half of CPR sessions for both BSR and BVM groups. It is concluded that one-person CPR with the BSR device is equivalent to two-person CPR with BVM in all measured parameters except for CR. Both groups exhibited greater error rate in CPR performance in the latter half of 12-min CPR sessions.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

Diffuse reflectance spectra of the palpebral conjunctiva and its utility as a noninvasive indicator of total hemoglobin.

The palpebral conjunctiva is an attractive location to qualitatively examine for the presence of anemia; however, this method of diagnosis has not been shown to be accurate. A spectroscopic examination of the palpebral conjunctiva enables the use of a quantitative parameter as a basis for diagnoses. Visible range diffuse reflectance spectra from the palpebral conjunctiva are examined from 30 patients and hemoglobin levels are extracted from these signatures using both a partial least-squares (PLS) multivariate regression model and a discrete spectral region model. Hemoglobin concentration derived from both these models is compared to an in vitro measurement of hemoglobin. Root mean squared errors of cross validation for the two analytical methods are 0.67 g/dL and 1.07 g/dL, respectively. Conjunctival reflectance spectra coupled with a PLS analysis achieve an enhanced specificity and sensitivity for anemia diagnoses over reported observational studies using the palpebral conjunctiva and achieve improved accuracy to other reported methods of noninvasive hemoglobin measurement.

Anemia↗