Apendektomi Yapılan Hastaların Kültür ve Antibiyotik Duyarlılıkları, Antibiyotik Seçimleri ve Klinik Duruma Etkileri

Introduction: Generally, intraabdominal infections are infections where antibiotic therapy is initiated empirically. Increasing antibiotic resistance is important regarding empirical antibiotic selection. Current resistance status among the causative bacteria in the community must be known to make the correct selection. In current treatment guidelines, some appendicitis patients are treated with only antibiotic therapy. In these situations, empirical treatment choices are even more important. In this study, the causative bacteria cultured from intraoperative tissue samples of acute appendicitis patients and their antimicrobial susceptibility patterns were investigated. The results were compared with empirical antimicrobial selections and clinical outcome of the patients. Materials and Methods: Appendix tissue cultures taken intraoperatively from acute appendicitis patients between June 2015 and June 2017 in our hospital were included into the study. Antibiotic treatments and patient demographics were recorded. Aerobic cultures of the tissue samples taken during the operation were performed in our microbiology laboratory. Antibiotic susceptibility tests of the bacteria were performed by disk diffusion method, according to the EUCAST standards. Bacterial identification was done by using the Vitek 2 (BioMerieux, France) automated identification system. Results: A total of 90 patients were included into the study. Fifty-four (60.0%) of these patients were males, and mean age was 29.5 +/- 9.08 (16-51). Thirty-one (34.4%) of the tissue sample cultures did not grow any bacteria. Escherichia coli was the most common, (51/90, 69.9%) isolated microorganism. Extended-spectrum beta-lactamase (ESBL) producing gram-negative bacterial growth rate was 17 (18.9%). Twelve patients grew more than one bacterium in the culture. As empirical antibiotic therapy, twenty (22.2%) patients received cefazolin and metronidazole and 65 (72.2%) patients received ceftriaxone and metronidazole. The susceptibility rate of ceftriaxone, which was the most commonly used antibiotic, was 63.4%. Conclusion: One-third of the tissue cultures did not grow any bacteria. ESBL positive gram-negative bacteria growth rate was 18.9%. Neither of the empirical treatment regimens initiated was effective for infections caused by ESBL-producing bacteria. Since all of our patients were appendectomized patients, antimicrobial resistance did not cause any clinical treatment failures although empirical treatment choices were not suitable for patients whose cultures grew ESBL positive bacteria. However, among patients with widespread intraabdominal infection and in patients who are treated conservatively only with antibiotic therapy, unsuitable empirical treatment choices may cause clinical treatment failures

Perceptions and Dynamics Affecting Acceptance of 3D-Printed Bridal Lehenga in India

In India, the wedding industry is booming as a result of growing affluence. Indian brides are inclined towards spending an extravagant amount on exclusive, high-fashion, designer bridal wear. There is, however, almost no published research that examines the aesthetic and other preferences of bridal couples in India in respect of bridal wear, including how predisposed couples are to innovate in its design. 3D printing is a popular aid in visualizing prospective designs and in prototype testing, being gradually applied in the creation of haute couture and mass-produced fashion products. The paper reports research on consumers’ attitudes towards and use intention regarding 3D-printed bridal lehengas. Data was collected from Indian bridal wear consumers and decision-makers through semi-structured interviews. The results suggest that respondents had a positive attitude towards the technology, having a higher perception of the aesthetics and wearability of 3D-printed bridal lehenga

Identifying gene-environment interactions in schizophrenia: Contemporary challenges for integrated, large-scale investigations

Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular genetic variants is small. There are now also a limited number of studies that have investigated molecular genetic candidate gene-environment interactions (G 7 E), however, so far, thorough replication of findings is rare and G 7 E research still faces several conceptual and methodological challenges. In this article, we aim to review these recent developments and illustrate how integrated, large-scale investigations may overcome contemporary challenges in G 7 E research, drawing on the example of a large, international, multi-center study into the identification and translational application of G 7 E in schizophrenia. While such investigations are now well underway, new challenges emerge for G 7 E research from late-breaking evidence that genetic variation and environmental exposures are, to a significant degree, shared across a range of psychiatric disorders, with potential overlap in phenotype. \ua9 2014 The Author

The Chinese female tourist gaze: a netnography of young women's blogs on Macao

This paper offers insights into women travellers' experiences and discusses the gendered views of female travellers originating from China on cross border trips to Macao. The analysis is derived from a careful reading or ‘thick description’ of blogs posted by female tourists that may be characterised as a web ethnography or netnography. The study indicates that the perception of Macao by Chinese women travellers embodies their confusion concerning modern life and their memories of tradition. Furthermore, the analysis suggests that Chinese women travellers conceptualise travelling as a way of underpinning the status of their self-identity. Besides, travelling in Macao for them is not just a leisure practice but a means to improve and enhance personal relationships