Bacteremia due to healthcare-associated urinary tract infections in children.

BACKGROUND: Epidemiological data on secondary bacteremia associated with nosocomial urinary tract infections generally include adult patients with urinary catheters. AIM: To evaluate the frequency and outcome of secondary bacteremia complicating healthcare-associated urinary tract infections. MATERIAL AND METHODS: This study was conducted between May 2013 and December 2017 at the Dr. Behçet Uz Children's Hospital and included symptomatic nosocomial urinary tract infections. A total of 117 patients with positive blood cultures were enrolled in the study. RESULTS: Six patients had bacteremia associated with nosocomial urinary tract infections yielding an incidence of 5.1%. The pathogens responsible for secondary bacteremia were: Klebsiella pneumonia in two patients, Enterococcus faecium in two patients, Klebsiella oxytoca in one patient, and Pseudomonas aeruginosa in one patient. CONCLUSION: The incidence of bacteremia associated with nosocomial urinary tract infections was not different from bacteremia associated with community-acquired urinary tract infections, and was approximately 5%.

Effect of sandblasting, silica coating, and erbium: Yttrium-Aluminum-Garnet laser treatment on the shear bond strength of self-adhesive resin cement to alumina ceramics.

OBJECTIVE: The aim of this study was to investigate the different surface treatments on the bond strength of self-adhesive resin cement to high-strength ceramic. MATERIALS AND METHODS: Ninety aluminum oxide ceramic (Turkom-Ceramic Sdn. Bhd., Kuala Lumpur, Malaysia) specimens were produced and divided into nine groups to receive the following surface treatments: control group, no treatment (Group C), sandblasting (Group B), silica coating (Group S), erbium: yttrium-aluminum-garnet (Er:YAG) laser irradiation at 150 mJ 10 Hz (Group L1), Er:YAG laser irradiation at 300 mJ 10 Hz (Group L2), sandblasting + L1 (Group BL1), sandblasting + L2 (Group BL2), silica coating + L1 (Group SL1), and silica coating + L2 (Group SL2). After surface treatments, surface roughness (SR) values were measured and surface topography was evaluated. Resin cement was applied on the specimen surface, and shear bond strength (SBS) tests were performed. Data were statistically analyzed using one-way ANOVA and Tukey's multiple comparisons at a significance level of P < 0.05. RESULTS: Group S, SL1, and SL2 showed significantly increased SR values compared to the control group (P < 0.05); therefore, no significant differences were found among the SR values of Groups B, BL1, BL2, L1, and L2 and the control group (P > 0.05). Group S showed the highest SBS values, whereas the control group showed the lowest SBS values. CONCLUSION: Silica coating is the most effective method for resin bonding of high strength ceramic, but Er:YAG laser application decreased the effectiveness.

Effects of verapamil and adenosine in an adjunct to tirofiban on resolution and prognosis of noreflow phenomenon in patients with acute myocardial infarction.

AIM: We aimed to investigate the effects of verapamil and adenosine in an adjunct to intravenous tirofiban on management and prognosis of no-reflow phenomenon during primary percutaneous coronary intervention (PPCI) and to compare their efficacies on reversing of no-reflow phenomenon and short and midterm survival. METHODS: We included 46 patients with acute ST-segment elevation myocardial infarction (STEMI) and occurrence of no-reflow phenomenon after PPCI. All patients received intravenous tirofiban and then randomized into one of the following 3 groups: intracoronary adenosine (N.=16), intracoronary verapamil (N.=15) or placebo (N.=15). RESULTS: Intracoronary verapamil therapy had significant effect in restoring impaired coronary blood flow by decreasing thrombolysis in myocardial infarction (TIMI) frame count from 73±44 to 52±48 (P=0.024). However, adenosine and serum physiologic administration were not found to be so effective in decreasing TIMI frame count (from 81±35 to 71±46, P=0.084; from 74±32 to 71±37, P=0.612, respectively). In-hospital and 6-month survival rates were similar among groups. CONCLUSION: In conclusion, intracoronary verapamil restored the impaired coronary blood flow more effectively than adenosine or placebo. However, none of them has changed the clinical course in the first 6 months.

Correlation of myocardial performance index assessed by different echocardiographic methods in patients with acute myocard infarction receiving different reperfusion treatment.

AIM: Myocardial performance index (MPI) is a well known prognostic parameter in acute myocardial infarction (AMI) patients, which has been used to assess global cardiac functions. In this study, we aimed to evaluate the corelation between the MPI levels obtained by PW doppler and Tissue doppler ultrasonography with reperfusion in AMI patients. METHODS: Fifty-four consecutive acute ST elevatation myocardial infarction patients, 26 treated with primary percutaneous coronary intervention (PCI) and 28 with thrombolytic therapy (TT); and 15 consecutive healthy controls were included in the study. MPI levels were measured with pulsed-wave (PW) doppler and tissue Doppler ultrasonography in all patients. The isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET) values used to measure MPI levels were determined. Corelation between the time intervals obtained with both methods were evaluated. MPI variations were evaluated in patients treated with PCI and TT. A significant corelation was observed in MPI levels obtained with PW doppler and tissue doppler ultrasonography (P<0.001) as well as between IRT, ICT and ET values (for all parameters; P<0.001). No significant corelation was observed between the MPI levels obtained with PW doppler and tissue doppler ultrasonography in patients treated with primary PTCA and TT (P=0.128, P=0.991, respectively). A significant corelation was observed between the MPI values obtained by PW doppler and tissue doppler ultrasonography with reperfusion interval (P=0.002, P<0.001, respectively). CONCLUSION: As a result, tissue Doppler ultrasonography may be used as an alternative to PW doppler to evaluate MPI, which is a well known prognostic factor in AMI. No relation has been observed between MPI values in early phases of AMI with reperfusion pattern, while a connection has been observed between MPI and reperfusion interval.

Apical hypertrophic cardiomyopathy--case report and review of the literature.

Hypertrophic cardiomyopathy is a well-known clinical entity. Hypertrophy engraving the left ventricular apex, so called, apical hypertrophic cardiomyopathy (characterized by the giant negative T waves at ECG and a "spade-like" view of left ventricle) is very rare variant of the pathology. In this report, we present a 51-year-old patient with apical hypertrophic cardiomyopathy together with a brief review of the literature. It was concluded that in patients presenting to the clinic with typical or atypical chest pain or dyspnea, in whom ECG indicating negative giant T waves, before an early invasive strategy, the diagnosis of ApHCM should be kept in mind and an echocardiography should be performed to confirm the diagnosis. Additionally; not only the ApHCM can easily mimic the life threatening condition of acute coronary syndrome but also these two may be seen simultaneously but independently in the same patient. For this reason before making the final diagnosis the physicians always exclude the conditions, which may lead to acute coronary syndromes.

Congenital absence of the left circumflex coronary artery and an unusually dominant course of the right coronary artery.

Congenital absence of the left circumflex artery (LCX) is a very rare congenital anomaly of the coronary circulation, and only a few cases have been reported in the literature. We report on a 55-year-old female with atypical chest pain. Routine coronary angiography showed a normal left anterior descending coronary artery (LAD), no LCX and a dominant right coronary artery (RCA), which continued beyond the crux, running the full course of the LCX and terminating in the left atrial branch. Neither aortography nor pulmonary angiography showed a separate ostium for the LCX. There were no atherosclerotic lesions in the coronary arteries, or ischaemia on stress myocardial perfusion imaging. Multidetector row computed tomography (MDCT) was performed to confirm the diagnosis.

Right coronary artery arising from the pulmonary trunk.

The prevalence of coronary artery anomalies is reported to be around 0.3-1 %. An anomalous origin of the right coronary artery (RCA) is a rare condition but may lead to myocardial ischemia and sudden death. Diagnosis is mainly made by conventional coronary arteriography. Nowadays, multislice computed tomography is a new noninvasive imaging technique with excellent spatial resolution which can detect the origin and course of an anomalous coronary vessel. Here we report on a 67-year-old woman with an anomalous origin of the RCA arising from the pulmonary trunk. The anomaly was diagnosed by cardiac catheterization and confirmed by multislice computed tomography.

Calculation of the brillouin frequencies close to phase transitions in NaNO2.

We calculate here the Brillouin frequencies of the L-mode [010], [001] and [100] of NaNO2 for the phase transitions from the paraelectric phase to the sinusoidal anti-ferroelectric phase near the Neel temperature (TN = 437.7 K) and to the ferroelectric phase near the critical temperature (TC = 436.3 K) in this crystalline system. For calculating the frequencies. we use the thermal expansivity data for the phase regions considered, under the assumption that the mode Gruneisen parameter determined for each mode remains constant across the phase transitions. Our calculated frequencies agree well with the observed frequencies for the modes studied in NaNO2.

Aphasia in multiple sclerosis.

Aphasia has rarely been reported in multiple sclerosis (MS). In this article a case with MS presenting as purely global aphasia during an exacerbation of MS is reported with clinical and MRI (magnetic resonance imaging) findings. MRI demonstrated giant plaques mimicking a cerebral tumour with surroundings characterised by oedematous transformations in the left frontal and parietal lobes.