48 research outputs found
Changes in Antimicrobial Resistance of Urinary Tract Infections in Adult Patients over a 5-Year Period
No full textVahaboglu, H/0000-0001-8217-1767; Culpan, Meftun/0000-0001-8573-1192; caskurlu, hulya/0000-0002-6760-2052Objectives: We aimed to determine the most common bacteria that cause urinary tract infections (UTIs), the rate of antibiotic resistance of these uropathogens, and the changes in resistance rates over the years for adult patients diagnosed with UTIs. Methods: We retrospectively reviewed urine cultures and antibiotic susceptibility results of patients >17 years of age from our outpatient clinic between 2014 and 2018. The most common uropathogens and their antibiotic resistance rates were identified in different age groups (18-39, 40-59, and >= 60 years) and with respect to gender and date of admission. In addition, the change in antibiotic resistance of Escherichia coli between 2014 and 2018 was also examined. Results: A total of 9,556 positive urine cultures were included. The most common uropathogen was E. coli, and its prevalence was higher in females than males (70.6 vs. 53.4%, respectively). The majority of isolates were from patients >= 60 years of age. E. coli resistance was most pronounced for ampicillin (61.56%), followed by trimeth-oprim-sulfamethoxazole (49.80%), amoxicillin-clavulanic acid (34.69%), and cefazolin (30.72%). E. coli resistance to ampicillin, nitrofurantoin, cefepime, ciprofloxacin, fosfomycin, and amoxicillin-clavulanic acid increased significantly with time (all p = 0.001). For E. coli, resistance to ciprofloxacin, one of the most commonly used antibiotics for UTI, increased from 17 to 43% from 2014 to 2018. Conclusion: Most of the uropathogens displayed high resistance to ampicillin, tri-methoprim-sulfamethoxazole, and amoxicillin-clavulanic acid, and were susceptible to meropenem, ertapenem, and imipenem. Fosfomycin and cefepime were useful in the empirical treatment of community-acquired UTIs. A surprisingly high increase was observed in the resistance of E. coli to antimicrobial agents from 2014 to 2018
The role of serum testosterone to prostate-specific antigen ratio as a predictor of prostate cancer risk
No full textAbstractWe analyzed the ratio of serum total testosterone (sTT) to prostate-specific antigen (PSA) as a predictor of prostate cancer risk. One-hundred-four consecutive men with a normal digital rectal examination and a serum PSA level of 2.5–10 ng/ml underwent transrectal ultrasonography-guided biopsy using a 10-core scheme. The sTT level was determined before the procedure using a chemiluminescent assay, and the ratio of sTT to PSA (sTT/PSA) was calculated after transforming sTT measurements from ng/dL to ng/mL. The overall cancer detection rate was 17.3%. The median sTT level was 332 ng/dl in men with cancer and 413 ng/dL in those without (p = 0.032). The median sTT/PSA ratio in these groups was 0.55 and 0.74, respectively (p = 0.035). The receiver operator characteristic (ROC) method was used to evaluate the properties of the sTT/PSA ratio, with testosterone and PSA as predictors of prostate cancer risk. The accuracy of the sTT/PSA ratio in prostate cancer diagnosis, represented by the area under the curve (AUC), was 0.739 (95% CI 0.640–0.823, p < 0.05). Optimizing the sensitivity and specificity of the sTT/PSA ratio using the ROC provided a cutoff point of 0.60, which corresponded to 82% sensitivity and 62% specificity. When the patients were divided into normal- and low-sTT level groups according to testosterone value (300 ng/dl), the probability of detecting prostate cancer was 3.3-fold higher in hypogonadal men as compared with eugonadal men. These results support the use of the sTT-to-PSA ratio for predicting the risk of prostate cancer and increasing the specificity of PSA measurement
Is there a relationship between severity of coronary artery disease and severity of erectile dysfunction?
No full textIntroduction The correlation between erectile dysfunction (ED) and coronary artery disease has been emphasized and ED has been recognized as a potential independent risk factor and/or predictor of coronary artery disease (CAD). We evaluated the association between the number of occluded coronary arteries in myocardial infarction (MI) patients with the severity of ED, and investigated the influence of related risk factors in our study group. Materials and Methods 183 male patients who underwent coronary angiography because of acute MI from November 2009 to May 2011 were included. Following the stabilization of patients after the treatment, each patient was evaluated for erectile functionality. Risk factors such as age, diabetes, smoking, waist circumference, hypertension, and hematologic parameters were recorded. Results Among 183 patients with a mean age of 55.2 years who underwent coronary angiography due to acute MI, 100 (54.64%) had ED, while the ED rate was 45.36% (44/97) in cases of single-vessel disease, 64.5% (31/48) in cases of two-vessel disease, and 65.7% (25/38) in cases of three-vessel disease. The mean IIEF score was 24.2 ± 4.3, 20.4 ± 4.9 and 20.5 ± 4.2 for single or two or three-vessel disease, respectively. The presence of hypertension aggravated ED only in patients with three-vessel disease and increased total and LDL cholesterol levels in patients with single-vessel or two-vessel disease were accompanied by significantly decreasing IIEF scores. Conclusion The severity of ED correlated with the number of occluded vessels documented by coronary angiography, in male patients with acute myocardial infarction. In addition, the presence of hypertension had a significant influence over erectile function only in patients with three-vessel occlusion
Multilevel Memetic Hypergraph Partitioning With Greedy Recombination
No full textACM SIGEVO2022 Genetic and Evolutionary Computation Conference, GECCO 2022 -- 9 July 2022 through 13 July 2022 -- -- 181031The Hypergraph Partitioning (HGP) problem is a well-studied problem that finds applications in a variety of domains. In several application domains, such as the VLSI design and database migration planning, the quality of the solution is more of a concern than the running time of the algorithm. In this work, we introduce novel problem-specific recombination and mutation operators and develop a new multilevel memetic algorithm by combining these operators with kKaHyPar-E. The performance of our algorithm is compared with the state-of-the-art HGP algorithms on 150 real-life instances taken from the benchmark sets used in the literature. The experiments reveal that our algorithm outperforms all others, and finds the best solutions in 112, 115, and 125 instances in 2, 4, and 8 hours, respectively. © 2022 Owner/Author
Supraclavicular lymph node as the first presentation and late skin metastasis: an unusual clinical course for prostate cancer
No full textReducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?
No full textPURPOSE: To investigate whether the use of a disposable needle guide results in a decreased incidence of infectious complication after transrectal prostate needle biopsy (TPNB). MATERIALS AND METHODS: Fifty five patients who underwent 10-core TPNB were randomized into two groups. A pre-biopsy blood and urine examination was performed in both groups. Group 1 (25 patients) underwent biopsy with disposable biopsy needle guide and Group 2 (30 patients) underwent biopsy with reusable biopsy needle guide. All patients had a blood and negative urine culture before the procedure. The patients received ciprofloxacin 500 mg twice a day beginning the day before the biopsy and continued for 3 days after. Serum C-reactive protein levels and urine and blood specimens were obtained 48h after the biopsy. Primary endpoint of the study was to determine the effect of needle guide on the bacteriologic urinary tract infection (UTI) rate and secondary end point was to determine symptomatic UTI. RESULTS: The mean age of the patients was 63.46 (range 55 to 68) years. There were no significant differences regarding the prostate-specific antigen level, prostate size, existence of comorbidity in two groups before the procedure. Bacteriologic and symptomatic UTI was detected in 4% vs. 6.6% and 4% vs. 3.9% in Group 1 and 2 relatively (P > 0.05). CONCLUSION: The use of a disposable needle guide does not appear to minimize infection risk after TPNB. Large scale and randomized studies are necessary to determine the effect of disposable needle guide on infection rate after TPNB
Reconstruction of an Incompletely Amputated Penis with The Radical Penile Crural Dissection and Radial Forearm Free Flap
No full text
Essays on corporate finance
No full textThis dissertation contains two chapters that are related with corporate finance and
law. Below are the individual abstracts for each chapter.
Chapter 1: Do Patent Lawsuits Cause M&A? An Experiment Using Uncertain Lawsuits
I investigate whether there exists a causal relation between result of a patent lawsuit
and alleged infringer's subsequent M&A activity. I find that if the court gives an infringement
decision, then the infringer sharply increases spending on focused M&A and decreases on
diversifying M&A. Moreover, the infringer specifically acquires targets that have substitute
patents so that it can redesign its products or form a shield against future lawsuits. Patent
motivated acquisition channel is new to our literature and different than the traditional
knowledge transfer channel. For the experiment, I hand collect detailed data on all patent
lawsuits that were appealed to Court of Appeals for the Federal Circuit (CAFC). In this
court, decisions are given by majority in randomly assigned 3 judge panels. In a setting that
resembles regression discontinuity design, I use only the lawsuits where there was a dissenting
judge (i.e, decision was given by 2 to 1). Since CAFC is the only appellate court for patents
and has federal jurisdiction, my experiment is not subject to endogeneity problem stemmed
from court selection. This is the first paper to use dissenting judge lawsuits for identification
strategy. The same approach be can be generalized to other types of litigations.
Chapter 2: Do Uncertainties in Bankruptcy Law Affect Optimal Loan Contracts? A
Quasi Natural Experiment
I investigate whether uncertainties in bankruptcy procedures shape financial contracting in the U.S. syndicated loan market. Utilizing a novel hand-collected data set, I exploit
the application of substantive consolidation procedure in the U.S. bankruptcy courts. This
procedure has two unique features. First, it removes seniorities granted in the original con-
tracts, resulting unexpected huge losses on unsecured bank loans. Second, there is consensus
among practitioners that its application is unpredictable since there is no specific provision
in the U.S. Code. I find that after exposure, lenders transmit this shock to other clients as
requiring collateral more often in their new loans. Moreover, if exposed lenders issue new
unsecured loans, then they demand higher interest rate and tighter covenants, even control-
ling for bank capitalization, borrower and time fixed effects. To my knowledge, this is the
first paper to show that uncertainties in the bankruptcy procedures provide an important
friction in the loan market. Furthermore, this work complements the previous literature by
providing a new channel for the determinants of optimal financial contracts. Results of this
paper are also important for policy makers, who want to ease bank lending standards.Item withdrawn by Laura Spradlin ([email protected]) on 2014-06-30T15:31:10Z
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