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Öğe Arm circumference: Its importance for dialysis patients in the obesity era(2013) Akpolat T.; Kaya C.; Utaş C.; Arinsoy T.; Taşkapan H.; Erdem E.; Yilmaz M.E.; Ataman R.; Bozfakioglu S.; Özener C.; Karayaylali I.; Kazancioglu R.; Çamsari T.; Yavuz M.; Ersoy F.; Duman S.; Ateş K.Purpose: The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. Methods: 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. Results: Mean BMI and arm circumference of all participants were 25.0 kg/m2 and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). Conclusions: Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM. © 2012 Springer Science+Business Media, B.V.Öğe Factors affecting complication rates of ureteroscopic lithotripsy in children: Results of multi-institutional retrospective analysis by pediatric stone disease study group of Turkish pediatric urology society(2011) Dogan H.S.; Onal B.; Satar N.; Aygun C.; Piskin M.; Tanriverdi O.; Gurocak S.; Gunay L.M.; Burgu B.; Ozden E.; Nazli O.; Erdem E.; Yucel S.; Kefi A.; Demirci D.; Uluocak N.; Aridogan I.A.; Turunc T.; Yalcin V.; Kilinc M.; Horasanli K.; Tan M.O.; Soygur T.; Sarikaya S.; Kilicarslan H.; Turna B.; Doruk H.E.; Tekgul S.Purpose: We evaluated factors affecting complication rates of ureteroscopy for pediatric ureteral calculi. Materials and Methods: We retrospectively evaluated 642 children who underwent ureteroscopy at 16 Turkish centers between 2000 and 2010. Semirigid ureteroscopy was used with various calibers to treat 670 ureteral units in 660 sessions. Complications were evaluated according to the Satava and Clavien classification systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results: A total of 367 females and 265 males were studied. Mean ± SD patient age was 90.2 ± 51.4 months (range 4 to 204). Mean ± SD stone size, operative time and postoperative hospital stay were 8.9 ± 4.7 mm, 45.8 ± 23.8 minutes and 1.8 ± 2.8 days, respectively. At a mean ± SD followup of 13.3 ± 17.6 months 92.8% of patients were stone-free and efficacy quotient was 90.3%. Complications, which occurred in 8.4% of patients (54 of 642), were intraoperative in 25 (Satava grade I to II in 22), early postoperative in 25 (Clavien grade I to II in 23) and late postoperative in 4 (all grade III). While operative time, age, institutional experience, orifice dilation, stenting and stone burden were statistically significant on univariate analysis, multivariate analysis revealed that operative time was the only statistically significant parameter affecting the complication rate. Conclusions: Semirigid ureteroscopy is effective, with a 90% stone-free rate and efficacy quotient. Most complications are low grade and self-limiting. Our results confirm that prolonged operative time is an independent predictor of complications, and should be considered when choosing and performing the treatment modality. © 2011 American Urological Association Education and Research, Inc.Öğe Relative fecal abundance of extended-spectrum-ß-lactamase-producing Escherichia coli strains and their occurrence in urinary tract infections in women(2013) Ruppé E.; Lixandru B.; Cojocaru R.; Büke Ç.; Paramythiotou E.; Angebault C.; Visseaux C.; Djuikoue I.; Erdem E.; Burduniuc O.; El Mniai A.; Marcel C.; Perrier M.; Kesteman T.; Clermont O.; Denamur E.; Armand-Lefèvre L.; Andremont A.Extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli (ESBL E. coli) strains are of major concern because few antibiotics remain active against these bacteria. We investigated the association between the fecal relative abundance (RA) of ESBL-producing E. coli (ESBL-RA) and the occurrence of ESBL E. coli urinary tract infections (UTIs). The first stool samples passed after suspicion of UTI from 310 women with subsequently confirmed E. coli UTIs were sampled and tested for ESBL-RA by culture on selective agar. Predictive values of ESBL-RA for ESBL E. coli UTI were analyzed for women who were not exposed to antibiotics when the stool was passed. ESBL E. coli isolates were characterized for ESBL type, phylogroup, relatedness, and virulence factors. The prevalence of ESBL E. coli fecal carriage was 20.3%, with ESBL E. coli UTIs being present in 12.3% of the women. The mean ESBL-RA (95% confidence interval [CI]) was 13-fold higher in women exposed to antibiotics at the time of sampling than in those not exposed (14.3% [range, 5.6% to 36.9%] versus 1.1% [range, 0.32% to 3.6%], respectively; P<0.001) and 18-fold higher in women with ESBL E. coli UTI than in those with another E. coli UTI (10.0% [range, 0.54% to 100%] versus 0.56% [range, 0.15% to 2.1%[, respectively; P<0.05). An ESBL-RA of<0.1% was 100% predictive of a non-ESBL E. coli UTI. ESBL type, phylogroup, relatedness, and virulence factors were not found to be associated with ESBL-RA. In conclusion, ESBL-RA was linked to the occurrence of ESBL E. coli UTI in women who were not exposed to antibiotics and who had the same clone of E. coli in urine samples and fecal samples. Especially, a low ESBL-RA appeared to be associated with a low risk of ESBL E. coli infection. Copyright © 2013, American Society for Microbiology. All Rights Reserved.
