44 research outputs found
Evaluation of Ureteral Stent Colonization in Live-Donor Renal Transplant Recipients
No full textSarier, Mehmet/0000-0002-8656-7416Background. Ureteral stent insertion during kidney transplantation is a matter of debate. Stenting has been proven to reduce the risk of surgical complications. In addition, it has been reported to increase risks such as urinary tract infections especially after operation. Ureteral stent colonization (USC) is known to play a role in the pathogenesis of stent related-infections. The aim of this study was (1) to assess the frequency of USC and values of urine cultures in identifying colonizing bacteria; (2) to assess the importance of indwelling time for USC in live-donor renal transplant recipients; and (3) to evaluate the biomarker role of neutrophil-to-lymphocyte ratio (NLR) on USC. Methods. A total of 107 live-donor kidney transplant patients were included in the study (76 men and 31 women). The mean age was 43.7 years, and average indwelling time of the ureteral stent was 24.7 days. Patients were divided into three groups according to indwelling stent time as group 1: 15 to 21 days (3rd week), group 2: 22 to 28 days (4th week), and group 3: 29 to 35 days (5th week). The decision to remove the stent was primarily based on clinical judgment. Ureteral stents were removed with the use of flexible cystoscopy. Midstream urine for urine culture and blood samples for NLR were taken prior to stent removal. The removed stents were divided into three parts and taken for bacteriological investigation. Results. Of 107 patients, USC was detected in 24 (22.4%) patients, whereas urinary proliferation was observed in 8 (7.4%) patients. The most common microorganisms found in USC was the Enterecoccus species. The most common microorganisms in urinary culture were Enterecoccus spp. and Klebsiella pnemoniae. All patients with isolated microorganisms in the urine had USC (P < .001). On the other hand, proliferation in urinary culture was observed only in 30% of patients. Urine culture was not significant in identification of USC (P = .063). The three patient groups that were determined according to indwelling stent time were compared in terms of USC, proliferation in urine culture, and NLR. The highest incidence of USC was found in group 3 (44%) and the least in group 2 (11%) (P < .05). No significant difference was found between the groups in terms of urine culture (P = .546). Although no significant difference was found between groups 1 and 2 in NLR values (P = .755), NLR was significantly higher in group 3 (P = .026). Conclusions. Colonization is common in ureteral stents inserted in live-donor kidney transplant patients, although routine urine culture is insufficient in identfying this colonization. The most common microorganism detected in ureteral stent colonization was Enterecoccus spp. The 4th week was the most convenient time for stent removal time in terms of USC among the 3rd, 4th, and 5th weeks. In addition, increased NLR might have value as a biomarker for USC
Security analysis of revocable and bipartite biotokens
No full textNeyire Deniz Sarıer (Saner) (MEF Author)##nofulltext##In this paper, we analyze the security of bipartite biotokens that release a secret key hidden in the biotoken by using biometrics. We show that the biotoken encoding of 80/112/128-bit symmetric encryption keys are vulnerable to brute force attacks, whose complexity is lower than cryptographic security. Also, we present the weaknesses in the design of revocable biotokens that form the basis for bipartite biotokens. Finally, we propose countermeasures to prevent these attacks and discuss the employment of other efficient cryptographic techniques that possess provable security guarantees.WOS:0003760875000142-s2.0-84966839172Conference Proceedings Citation Index- ScienceProceedings PaperKasımYÖK - 2015-1
Results of Real-time Multiplex Polymerase Chain Reaction Assay in Renal Transplant Recipients With Sterile Pyuria
No full textSarier, Mehmet/0000-0002-8656-7416; Goktas, Serdar/0000-0001-6538-7187Urinary tract infections are a major cause of morbidity and hospitalization after renal transplantation. Patients treated with immunosuppressive drugs suffer not only from common uropathogens but also from opportunistic infections caused by unusual uropathogens. Sterile pyuria is associated with numerous infectious agents including viruses, fungi, and atypical or fastidious organisms. The objective of this study was to investigate the pathogens using real-time multiplex polymerase chain reaction (rtMPCR) assay in sterile pyuria of renal transplant recipients. In this prospective controlled study, pathogen detection was performed with rtMPCR assay on October 2016 in 60 patients with sterile pyuria who had undergone kidney transplantation. A total of 40 renal transplant patients were determined as the control group. Male-to-female ratio was same. The mean age of the subjects with sterile pyuria was 45.7 +/- 12.1 (25-74). The mean duration after transplantation was 28.8 +/- 3.97 (3-102) months. Pathogens were detected with rtMPCR in 61.7% of sterile pyuria group. This rate was significantly higher compared with the control group (P < .001). Two or more different pathogens were found in 13 (21.7%) patients in sterile pyuria group. The pathogens found included cytomegalovirus in 10 patients (19%), Gardnerella vaginalis and obligate anaerobes in 20 patients (38%), Ureaplasma spp in 17 patients (33%), Candida spp in 2 patients (4%), Mycoplasma hominis in one patient (2%), herpes simplex virus-2 in one patient (2%), and Trichomonas vaginalis in one patient (2%). Sterile pyuria may indicate the presence of genitourinary pathogens that cannot be detected with conventional urine culture method in renal transplantation patients. rtMPCR is an accurate and convenient method for detection of multiple potential pathogens of sterile pyuria in renal transplant patients
The Manufacturing Of Polyamide- And Polypropylene-Organoclay Nanocomposite Filaments And Their Suitability For Textile Applications
No full textIn this study, we prepared polymer-clay monofilaments using a melt spinning technique in which organoclays were incorporated into polyamide 6 (PA6) and polypropylene (PP) homopolymer resins. The structural and thermal characterizations of the monofilaments were performed by Fourier transform infrared spectrometry (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and thermogravimetric (TG) analyses. The detailed mechanical and dynamic mechanical analyses (DMA) of the nanocomposite filaments were conducted to evaluate their mechanical performances in relation to the type and ratio of organoclays incorporated into the structure. Thermal analysis, tensile rest and dynamic mechanic analysis results show that the properties of the nanocomposite fibers were considerably more desirable compared with those of ordinary PP and PA6 fibers. (C) 2012 Elsevier B.V. All rights reserved
The necessity of voiding cystourethrogram for the evaluation of recipient candidates in adult renal transplantation
No full textObjective. While international guidelines necessitate Voiding Cystourethrogram (VCUG) for pediatric patients, it is unnecessary for the evaluation of adult patients without urological disorders as renal transplant candidates. The objective of this study was to evaluate the results of adult candidates who underwent VCUG before transplantation and to demonstrate the necessity for this imaging. Methods. A retrospective study of the data of 1265 adult candidates who underwent VCUG before transplantation at our center, was undertaken. VUR, the presence of Postvoiding residual urine (PVR) (>100 ml), Low bladder capacity (LBC) (<100 ml), and urethral pathologies were evaluated with VCUG. Results. The mean age was 42.3 ± 1.3. The mean dialysis period was 27.8 ± 4.2 months. According to the VCUG results, 19.2% of the patients had pathological findings. On the other hand, the rate of urological disorders was only 5.1%, according to end-stage renal disease (ESRD) etiologies. VCUG outcomes indicated bilateral high-grade reflux in native kidneys in 4.4% (n = 56) of the candidates, unilateral high-grade reflux in 4.1% (n = 52), bilateral low grade reflux in 2.1% (n = 26), unilateral low-grade reflux in 2.4% (n = 30), and reflux in rejected transplanted kidney in 2.3% (n = 29). In addition, significant LBC was noted in 4.8% (n = 61), significant PVR in 1.1% (n = 14), and urethral stricture in 0.5% (n = 6) of the candidates. Conclusion. VCUG should be considered as a part of routine evaluation in adult renal transplant recipient candidates as well as in pediatric candidates, even if their ESRD etiologies are not due to urological disorders
Comparision of Ureteral Stent Colonization Between Deceased and Live Donor Renal Transplant Recipients
No full textSarier, Mehmet/0000-0002-8656-7416;Background. The use of a ureteral stent can cause a urinary tract infection (UTI), although it reduces urologic complications. UTIs are associated with a higher rate of ureteral stent colonization (USC). The aim of this study was to compare USC in living and deceased donor renal transplant recipients. Material and Methods. We conducted a prospective study of 48 patients who underwent renal transplantation between January and December 2016. The stents were removed aseptically, the inner surface of proximal and distal ends of stents were irrigated with liquid culture medium, and then they were vortexed for bacteriological investigation. Urine cultures were taken at the same time. Results. A total of 45 renal transplantation patients (21 from cadavers, 24 from live donors) were evaluated in the study. The duration time of stent retention in patients with live donors was 25.04 +/- 4.55 and in patients with deceased donors was 26.19 +/- 4.08 days (P = .376). USC was observed in 12 (57.1%) and 6 (25%) patients while positive urine culture (PUC) was detected in 5 (23.8%) and 2 (8.3%) patients in deceased and live donor transplant recipients, respectively. Although the USC rate was significantly higher in the deceased donor renal transplant group (P = .022), there was no significant different in the rates of PUC (P = .137). Enterecoccus species was the common pathogen isolated from ureteral stent and urine. The micro-organisms isolated from ureteral stent in deceased and live donors, respectively, were distributed as follows: Enterococcus 5/3, Candida 3/1, Escherichia coli 2/1, Kebsiella pneumonia 1/1, and staphylococci in 1/0 patients. All E coli and K pneumoniae are extended spectrum beta-lactamase (ESBL)-positive isolates and resistant to sulfamethoxazole-trimethoprim (SMX/TMP). Conclusions. We report a high incidence of USC in deceased renal transplants. Enterecoccus instead of E coli is the most common pathogen during the first month after transplantation. Transplantation centers should be aware that deceased donor renal transplant recipients are more prone to stent-related infection and the antibacterial resistance rapidly increases in uropathogens
Comparison of nylon-flocked swabs and cotton swabs in the detection of human papillomavirus infection in men
No full textBackground: Human papillomavirus (HPV) is an oncogenic virus and the commonest sexually transmitted pathogen worldwide. Appropriate sampling is an important factor in infection management. This study aimed to compare the efficacy of cotton swabs (CS) and nylon-flocked swabs (NFS) in sampling for HPV-DNA PCR testing in male patients with genital warts. Methods: The study included men with genital warts who presented to the urology outpatient clinic of Antalya Medical Park Hospital. Before wart treatment, multisite sampling of the penis and genital area was performed separately with CS and NFS. The samples were analyzed for HPV-DNA using real-time PCR. Results: The study included 45 men with a mean age of 32.1 ± 8.6 years. At least one HPV type was detected in all 45 patients with NFS sampling and 44 patients with CS sampling (total HPV types detected: 106 and 84, respectively). NFS sampling detected 52 high-risk HPV types in 37 of the 45 patients, while CS sampling detected 37 high-risk types in 19 patients (p = 0.029). NFS sampling also detected a total of 54 low-risk HPV types in all 45 patients, versus 47 low-risk HPV types in 41 patients with CS sampling. Multiple HPV types were detected in 30 patients with NFS and 17 patients with CS (p = 0.001). Conclusion: NFS were more effective than CS for HPV-DNA testing in men with genital warts. NFS were superior to CS in detecting multiple-type HPV infection and high-risk HPV types. The use of NFS should be recommended for HPV-DNA PCR testing in men. © The Author(s), under exclusive licence to Springer Nature B.V. 2024
Labial Füzyonun Neden Oldu?u ? Işeme Zorlu? u
No full textIntroduction: Labial fusion is the complete or partial adherence of the vulval labia majora or labia minora in the midline. The condition is most frequently seen in girls between the ages of 6 months to 6 years The cause is unknown, but it may be related to the low levels of circulating estrogen and to irritation that erodes vulvar epithelium. The urinary tract is rarely affected in patient with labial fusion. Materials and Methods: We report a case of labial fusion that caused micturitional disturbance. She is treated by surgery. Conclusion: Therapy usually consists of estrogen cream application to the contact surface of the labia minor. If estrogen therapy fails, surgical therapy may be necessary
Необходимость проведения микционной цистоуретрографии для оценки взрослых кандидатов на трансплантацию почки
No full textObjective. While international guidelines necessitate Voiding Cystourethrogram (VCUG) for pediatric patients, it is unnecessary for the evaluation of adult patients without urological disorders as renal transplant candidates. The objective of this study was to evaluate the results of adult candidates who underwent VCUG before transplantation and to demonstrate the necessity for this imaging. Methods. A retrospective study of the data of 1265 adult candidates who underwent VCUG before transplantation at our center, was undertaken. VUR, the presence of Postvoiding residual urine (PVR) (>100 ml), Low bladder capacity (LBC) (<100 ml), and urethral pathologies were evaluated with VCUG. Results. The mean age was 42.3 ± 1.3. The mean dialysis period was 27.8 ± 4.2 months. According to the VCUG results, 19.2% of the patients had pathological findings. On the other hand, the rate of urological disorders was only 5.1%, according to end-stage renal disease (ESRD) etiologies. VCUG outcomes indicated bilateral high-grade reflux in native kidneys in 4.4% (n = 56) of the candidates, unilateral high-grade reflux in 4.1% (n = 52), bilateral low grade reflux in 2.1% (n = 26), unilateral low-grade reflux in 2.4% (n = 30), and reflux in rejected transplanted kidney in 2.3% (n = 29). In addition, significant LBC was noted in 4.8% (n = 61), significant PVR in 1.1% (n = 14), and urethral stricture in 0.5% (n = 6) of the candidates. Conclusion. VCUG should be considered as a part of routine evaluation in adult renal transplant recipient candidates as well as in pediatric candidates, even if their ESRD etiologies are not due to urological disorders.В то время как во всех международных протоколах при подготовке к трансплантации почки в педиатрической практике потенциальным реципиентам предписано обязательно проводить микционную цисто уретрографию (МЦУГ), нет никаких указаний относительно этого перед проведением трансплантации почки взрослым пациентам без урологических нарушений. Цель: оценить результативность МЦУГ, проведенной перед трансплантацией взрослым пациентам, и необходимость использования этого метода визуализации перед операцией. Материалы и методы. Было проведено ретроспективное исследова ние данных 1265 взрослых реципиентов почки, которым выполняли МЦУГ перед трансплантацией в нашем центре. С помощью МЦУГ оценивали наличие и степень пузырно-мочеточникового рефлюкса (ПМР), остаточный объем мочи после мочеиспускания (PVR) (>100 мл), емкость мочевого пузыря (низ кая емкость мочевого пузыря <100 мл) и патологию мочеиспускательного канала. Результаты. Средний возраст пациентов составил 42,3 ± 1,3 года. В среднем пациенты находились на диализе 27,8 ± 4,2 ме сяца. По результатам МЦУГ у 19,2% пациентов были обнаружены патологические изменения. С другой стороны, урологические нарушения были причиной терминальной почечной недостаточности (ТПН) всего в 5,1% случаев. По результатам МЦУГ были выявлены двусторонний ПМР тяжелой степени в нативных почках у 4,4% (n = 56) потенциальных реципиентов, односторонний ПМР тяжелой степени – у 4,1% (n = 52), двусторонний ПМР легкой степени – в 2,1% (n = 26), односторонний ПМР легкой степени тяжести – у 2,4% (n = 30) и рефлюкс в трансплантат почки при его отторжении – у 2,3% (n = 29). Кроме того, обнаружено значительное снижение емкости мочевого пузыря у 4,8% (n = 61), значительное сниже ние PVR – у 1,1% (n = 14) и стриктура уретры – у 0,5% (n = 6) потенциальных реципиентов. Заключение. Следует рассмотреть целесообразность включения в повседневную клиническую практику МЦУГ для оценки функционального состояния мочевыводящих путей взрослых потенциальных реципиентов перед трансплантацией почки, а также реципиентов-детей, даже если ТПН не обусловлена урологическими заболеваниями
Role of penile electrodermal activity in the evaluation of autonomic innervation of corpus cavernosum
No full textElectrodiagnostic tests measuring the activities of cavernous smooth muscle and sudomotor structures of penile skin are used in order to evaluate autonomic innervation of the penis. Owing to closeness of these tissues, the interference of sympathetic activity during recording is a possibility. In this study, we investigated this possibility in 10 patients whose cavernosal tissues were destroyed during penile prosthesis implantation by comparing the pre- and postoperative penile skin electrodermal activities. Penile electrodermal activities were recorded with surface electrodes before and after the operation. All of the patients had spontaneous and evoked penile electrodermal activity (EDA). The mean amplitude of evoked EDA decreased from 2159 +/- 700 to 1413 +/- 515 muV following penile prosthesis surgery ( P = 0.017). The decrease in the amplitude of penile-evoked EDA following penile prosthesis implantation suggests the contribution of cavernous smooth muscle activity to the sudomotor responses prior to operation. Although corpus cavernosum sympathetic activity contributes to the penile skin recordings, these recordings are mostly the result of penile skin sudomotor sympathetic activity. Therefore, surface potentials recorded from penile skin should not be used for the evaluation of autonomic innervation of corpus cavernosum
