Evaluation of Cases of Graft Nephrectomy After Graft Loss in Patients With Renal Transplantation.

INTRODUCTION: Renal transplantation is undoubtedly considered the best renal replacement therapy. Graft nephrectomy can be performed in patients with renal transplantation because of complications associated with the failed graft. We aimed to retrospectively investigate the characteristics of patients who underwent graft nephrectomy. MATERIALS AND METHODS: Between January 2000 and November 2013, the records of 757 patients who had renal transplantation in Ege University Faculty of Medicine Hospital Nephrology-Transplantation outpatient clinic were examined. Sixty-four patients who underwent graft nephrectomy were included in the study. Patients were divided into 2 groups according to the timing of graft nephrectomy. The group of 30 patients who underwent graft nephrectomy in the first 56 days after the renal transplantation was referred to as the "early group" and the group of 34 patients who underwent graft nephrectomy after 56 days was referred to as "late group." RESULTS: In our study, we found the body mass index to be significantly higher in those with early graft loss (P = .02). We found that there was a difference between the groups in terms of sex (P = .012). When the mortality and morbidity rates after graft nephrectomy were examined, mortality was observed in 3 of the 64 patients in the study and morbidity in 1 patient. CONCLUSION: According to our study, the body mass indices and ages of the subjects who need early graft nephrectomy are higher. However, male sex was significantly more prevalent in patients who underwent graft nephrectomy in the late period compared with the early period.

Effect of dried nut fortification on functional, physicochemical, textural, and microbiological properties of yogurt.

In this study, walnut, hazelnut, almond, or pistachio were incorporated to produce functional yogurts. The effects on physicochemical and instrumental textural characteristics and syneresis, contents of folic acid, selenium, tocopherols, and n-3 and n-6 (omega) fatty acids, and viable counts of Streptococcus thermophilus and Lactobacillus bulgaricus were evaluated during storage. Fortified yogurts demonstrated higher protein and total solid contents and lower syneresis compared with control yogurt on d 21. Addition of nuts, except walnut, also increased S. thermophilus and L. bulgaricus counts. The concentrations of folic acid, α-tocopherol, selenium, and n-3 and n-6 fatty acids were higher in fortified yogurts compared with the levels found in the respective nut types. However, a decreasing trend was observed in all components during storage. Consequently, each nut could be incorporated into yogurt because of a specific functional property. For instance, walnut could be preferred for omega acid enrichment.

Volatile compound profiling of Turkish Divle Cave cheese during production and ripening.

The formation of volatile compounds in Turkish Divle Cave cheese produced in 3 different dairy farms was determined during production and ripening, revealing 110 compounds including acids, alcohols, ketones, esters, and terpenes. The presence and concentration of these volatile compounds varied between specific phases of the production and the 120-d ripening process. Smaller differences were also detected between cheeses produced at different farms. Carboxylic acids were established as a major class at the end of ripening. The relative amounts of acids and ketones increased until d 90 of ripening, whereas alcohols increased for the first 30d and tailed off during the remaining part of the ripening process. The level of esters increased gradually until the end of ripening. Butanoic, acetic, and valeric acids, 2-butanol, 2-butanone, 2-heptanone, ethyl butanoate, α-pinene, and toluene were the most abundant compounds, likely contributing to the characteristic aroma of this traditional cheese.

Role of milk protein-based products in some quality attributes of goat milk yogurt.

Goat milk yogurts were manufactured with the fortification of 2% (wt/vol) skim goat milk powder (SGMP), sodium caseinate (NaCn), whey protein concentrate (WPC), whey protein isolate (WPI), or yogurt texture improver (YTI). Yogurts were characterized based on compositional, microbiological, and textural properties; volatile flavor components (with gas chromatography); and sensory analyses during storage (21d at 5 °C). Compared with goat milk yogurt made by using SGMP, the other goat milk yogurt variants had higher protein content and lower acidity values. Goat milk yogurts with NaCn and WPC, in particular, had better physical characteristics. Using WPI caused the hardest structure in yogurt, leading to higher syneresis values. Acetaldehyde and ethanol formation increased with the incorporation of WPI, WPC, or YTI to yogurt milk. The tyrosine value especially was higher in the samples with NaCn and YTI than in the samples with WPC and WPI. Counts of Streptococcus thermophilus were higher than the counts of Lactobacillus delbrueckii ssp. bulgaricus, possibly due to a stimulatory effect of milk protein-based ingredients other than SGMP on the growth of S. thermophilus. Yogurt with NaCn was the best accepted among the yogurts. For the parameters used, milk protein-based products such as NaCn or WPC have promising features as suitable ingredients for goat milk yogurt manufacture.

Emergency peripartum hysterectomy: our experience.

PURPOSE: To investigate the incidence of and reasons for emergency peripartum hysterectomy (EPH) between 2009 and 2013 in our hospital, one of the three hospitals with the highest rates of delivery in Turkey. METHODS: A retrospective study. Seventy-six peripartum hysterectomies were evaluated. We compared the modes of delivery and examined whether bilateral internal iliac artery ligation was performed. RESULTS: The incidence of EPH was 0.77 in 1000. The majority of cases involved multiparity, uterine rupture, placenta praevia, or placental invasion abnormalities. The most frequent reason for EPH was uterine atony (64.5 %). There was no statistically significant relationship with mode of delivery; however, the complication rate and requirement for fresh frozen plasma were significantly (p < 0.01) related to whether bilateral internal iliac artery ligation was performed. CONCLUSION: Uterine atony was the most common indication for EPH. The most important step to avoid performing EPH is to calculate patients' risks for postpartum bleeding. Postpartum haemorrhage may not be preventable, but when it happens, obstetricians must be prepared to perform EPH, and in high-risk patients, to perform internal iliac artery ligation.

The determination of carbapenem resistance in Escherichia coli and Pneumoniae isolates related to nosocomial infections and the evaluation of risk factors.

We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiological features of Escherichia coli and Klebsiella pneumoniae strains isolated from related infections in intensive care unit (ICU) patients. Carbapenemase activity was determined by MHT, MBL Etest and enzyme extraction methods. Presence of extended-spectrum beta-lactamase (ESBL) and carbapenemase-encoding genes were investigated by PCR and sequencing. Clonal relationship of the strains was investigated by pulse field gel-electrophoresis. Acquired AmpC and Qnr were investigated by PCR. Throughout this study, 1,657 patients, and 11,483 hospitalization days were followed by active surveillance in the ICU of our 1,000-bed training hospital. Out of 108 of 196 patients, 130 E. coli- and K. pneumoniae-related nosocomial infections were determined. Minimum inhibitory concentration (MIC) levels of ertapenem were > or = 1 mg/1 in 14 K. pneumoniae and 2 E. coli strains. The highest MIC level of carbapenem was found in K. pneumoniae and E. coli strains of > or = 128 mg/l and 8 mg/l, respectively. In the carbapenem resistant strains, KPC and MBL activity were not found. On the other hand, 14 strains of K. pneumoniae and one strain of E. coli exhibited OXA-48 beta-lactamase activity. Fifty-seven percent of K. pneumoniae isolates produced OXA-48 orginating from two clones and remaining isolates originated from different clones. Thus carbapenem resistance was determined as 22% and 3% in K. pneumoniae and E. coli strains, respectively. Invasive devices, duration of total parenteral nutrition, duration of hospitalization, presence of transfusions, ESBL and multiple drug resistance were found to be risk factors for carbapenem resistance.

Effects of infectious complications on patients' survival in peritoneal dialysis.

AIM: To investigate the impacts of infectious complications on mortality and morbidity; and to identify the other potential factors effective in mortality in peritoneal dialysis (PD) patients. PATIENTS AND METHODS: We included patients who initiated therapy between 2001-2011. Patients were divided into two groups regarding to presence or absence of infectious complications. Socio-demographic data and clinical courses were compared and the reasons for PD withdrawal were obtained. Survival analysis of all patients was performed and the effects of infectious complications on mortality were investigated. RESULTS: 301 patients were included in this retrospective study. 214 patients (mean follow-up time 28.7±16.5 months) had infection history, 87 patients (mean follow-up time 48.9±29.6 months) had no infection history. There were no statistically significant difference in comparison of the groups in terms age, gender, education levels, hemodialysis history. In patients with infection history, 465 peritonitis and 213 catheter exit site infection attacks were diagnosed. The most frequently agent was methicillin-sensitive Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus in both conditions, while 25% of catheter exit site infection and 25% of peritonitis attacks were culture negative. During follow-up period, 60 patients transferred to hemodialysis, 58 patients died, 18 patients had renal transplantation in patients with infection history. In other group, 27 patients died, 23 patients had renal transplantation and 11 patients transferred to hemodialysis. Mean survival times were 56.3±2.8 months in patients with infection history and 86.8±6.1 months in other group. Mortality rate was found higher in patients with infection history (long-rank: 0.030). PD preference (OR: 5.213, p < 0.001), pretreatment low serum albumin (OR: 0.378, p = 0.001), low hemoglobin levels (OR: 0.810, p = 0.029) were found as predictors of survival in patients with infection history. CONCLUSIONS: Infectious complications have negative effects on patient survival. Nature of PD preference, initial hypoalbuminemia and anemia were found to increase the mortality rate. The major causes of deaths were peritonitis and/or sepsis in patients with infectious complications, while the major cause of death was cardiac reasons in patients without infectious complications.

The prevalence of pediculus humanus capitis among the students of a secondary and three elementary schools in Karsiyaka-Izmir, Turkey.

During November-December 1993, 5347 students of a secondary and 3 elementary schools in Bostanli-Karsiyaka, where socio-economic and cultural status are relatively high, were examined for pediculosis capitis. In 225 students (4.2%) eggs and/or adults were detected. 181 (4.14%) out of 4365 elementary school students and 44 (4.48%) out of 982 secondary school students were infested with Pediculus humanus capitis. Comparison with results of previous results are shown in the text.

A comparative study on the efficacy of 0.4% Sumithrine and 1% Lindane in the treatment of Pediculus humanus capitis in Turkey.

Two different chemicals were used in the treatment of Pediculus h. capitis in cases, who were found to be infested during the screening of 1 secondary and 3 elementary schools in Bostanli-Karsiyaka, Izmir. Sumithrine was found to be more effective than Lindane according to the follow up control performed a month after the treatment. While the efficacy of Sumithrine in Emlakbank elementary school, Metin Asikoglu elementary school and Emlakbank secondary school was noted as 93%, 96% and 86.8% respectively. The efficacy of Lindane was found to be 67.5% in Murside Akyuz elementary school.