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    C-reactive protein in early detection of bacteriemia and bacteriuria after extracorporeal shock wave lithotripsy
    (Elsevier, 2003) Yilmaz, E; Batislam, E; Tuglu, D; Kilic, D; Basar, M; Ozluk, O; Basar, H
    Objectives: To evaluate the value of plasma C-reactive protein (CRP) levels in early detection of bacteriuria and bacteriemia after extracorporeal shock wave lithotripsy (ESWL) of calcium and infection stones. Methods: A total of 75 patients who had infection stones (n = 27) and calcium stones (n = 48) were included in the study. All patients had sterile urine before ESWL. The mean age was 41.6 +/- 4.85 and male/female ratio was 2.12. Blood cultures were obtained within 1 hour post-ESWL period. Urine cultures were obtained 3 times just after and on the first and seventh day of ESWL. Results: Post-ESWL evaluations showed 3 positive blood cultures with 2 (2.66%) patients in infection stone and 1 (1.33%) patient in calcium stone groups, whereas urine cultures revealed 6 (8%) positive results in infection stones and 4 (5.33%) in calcium stones. The patients who had positive cultures also had elevated plasma CRP levels when compared to the levels in patients with negative cultures (P = 0.000). Conclusions: Bacteriuria and bacteriemia after ESWL have been well-identified entities and may be responsible from some of the post-ESWL complications. CRP can be useful for early detection of such complications. (C) 2003 Elsevier Science B.V. All rights reserved.
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    Fungal growth inside saline-filled implants and the role of injection ports in fungal translocation: In vitro study
    (Lippincott Williams & Wilkins, 2004) Saray, A; Kilic, D; Kaygusuz, S; Boyunaga, H; Ozluk, O
    Infection is a serious complication of breast. augmentation and tissue expansion with inflatable devices. Several reports have shown that fungi may be able to survive, colonize, and even cause infection in saline-filled devices. The mechanism of how them, penetrate, spread, and colonize inside the inflatable implants is not exactly understood. The authors assessed both the expander membrane and the port in terms of leakage and penetration of Candida albicans and Aspergillus niger in an in vitro model. Thirty saline-filled expanders connected to the injection port were placed in sterile containers filled with tryptic soy broth culture medium to simulate the clinical situation in phases I and II. Intactand multipunctured ports were used in the first and second phases of the study, respectivelv. Either the container or the implant was inoculated with one of these fungi, and six implants in containers without fungal inoculation served as controls. As a third phase, intraluminal survival of fungi was investigated in saline-filled containers (n = 12) in 21 clays. The silicone membrane, with its intact connecting tube and port, was impermeable to these fungi, whereas both fungi were able to diffuse inside-out or outside-in through the punctured ports. C. albicans did not Survive beyond 18 days in saline, whereas A. niger continued to multiply at day 21. Chemical analyses of the implant fluids revealed that the contents of the culture medium diffused into the implants in phases I and II. The data show that an intact. silicone membrane is impermeable to fungi, and punctured ports allow translocation of fungi into the implants. Fungi can grow and reproduce in a saline-only environment, and their survival periods differ among the species. Furthermore, their Survival maybe enhanced by the influx of substances through the implant shell.