Search

Introduction: Development of regional surveillance programs is necessary for the development of community-acquired urinary tract infection (UTI) guidelines, especially for sub-urban and rural areas where empirical treatment is the mainstay in the absence of proper diagnostic modalities. Our aim was to evaluate the bacteriological profile and antibiotic sensitivity patterns in children with UTI prospectively from a tertiary care center. Methods: A total of 800 children up to 18 years of age with suspected UTI attending our center were included. For all suspected cases urine microscopy, gram staining, and culture were done. Antibiotic sensitivity was performed on selected antimicrobials using disk diffusion method following Clinical Laboratory Standards Institute guidelines. Results: Majority of pathogens were isolated from female (54.2%) patients. Pre-teens (52.1%) and teens (27.1%) were most commonly affected age group. The most common presentation in culture-proven UTI was fever with urinary symptoms (33.3%). In a group of 192 patients 26.7% had proven UTI. Escherichia coli (42.3%) was the most common aetiological agent, followed by Enterococcus fecalis (13.5%), Klebsiella spp. (11.5%) and Staphylococcus aureus (11.5%). Most active antibiotics against Gram-negative isolates were nitrofurantoin, cefotaxime, and amikacin. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Conclusion: E. coli was the commonest isolate. The organisms grown in significant numbers were E. fecalis, Klebsiella spp. and S. aureus, causing UTI in 0–18 years of age group. Gram-negative isolates were sensitive to nitrofurantoin, amikacin, and cefotaxime. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Prospective, regional studies are ensured periodically to explain bacteriological profile and antibiotic sensitivity patterns to be applicable for children with UTI over that geographic area.

Fuzzy set theory has been widely accepted in modelling of some of the vague phenomena and relationships that are non-stochastic in nature. The problem of machine-tool selection and operation allocations in a flexible manufacturing system usually involves parameters that are non-deterministic and imprecise in nature. This paper adopts a fuzzy goal-programming model having multiple conflicting objectives and constraints pertaining to the machine-tool selection and operation allocation problem, and a new random search optimization methodology termed Quick Converging Simulated Annealing (QCSA) is being used to resolve the underlying issues. The main feature of the proposed QCSA algorithm is that it outperforms genetic algorithm and simulated annealing approaches as far as convergence to the near optimal solution is concerned. Moreover, it is also capable of eluding local optima. Extensive experiments are performed on a problem involving real-life complexities, and some of the computational results are reported to validate the efficacy of the proposed algorithm. [ABSTRACT FROM AUTHOR]

A supply chain management model is presented in the context of a major household appliance manufacturer in Mexico. Specifically, it provides a capacitated, multistage, multiperiod, multicommodity, multifacility inventory planning model. The mixed-integer programming model deals with the efficient allocation of resources in the supply chain network under the premise that information is a valuable resource that also requires optimal allocation in order to enhance the flow of products and to minimize system-wide costs. The model employs the strategy of risk pooling or time postponement as a cost-reduction driver to account for the provision of safety stocks in the system. Numerical results are presented to demonstrate the feasibility of the application of the real-world, large-scale supply chain models. [ABSTRACT FROM AUTHOR]

Materials-handling systems are an integrating component of manufacturing operations and as such must be considered within a common framework in manufacturing systems design. This work proposes a first approach to the simultaneous consideration of the operation allocation and the materials-handling system selection problems in a flexible manufacturing system. The objective of the operation allocation model is to select a group of machines where the operations of the part types will be performed and then to assign those operations to the selected machines. The operation allocation model interfaces with the materials-handling system selection model by providing input data in the form of the manufacturing operations to be performed at each machining centre. The selection of the materials-handling system is centred on the matching of the parts visiting a machining centre to perform a manufacturing operation and the abilities of the handling equipment to perform the required materials handling functions of those part types. The objective is to select an optimal group of materials-handling equipment to be assigned to a cell. [ABSTRACT FROM AUTHOR]

In this paper a methodology is proposed to group the machines in cellular manufacturing systems based on the tooling requirements of the parts, toolings available on the machines and the processing times. Two 0-1 integer programming formulations are proposed. These formulations assume that the part families are known. 'The first formulation groups the machines based on the compatibility of parts with machines. The second formulation groups the machines in order to minimize the cost of allocating the machines and the cost of intercell movement. These formulations take into account the limitations on the number of machines in a group and the number of machines available of a particular type. The application of these formulations is illustrated using an example. [ABSTRACT FROM AUTHOR]

A linear, 0-1 integer programming model of the machine-tool assignment, and operation allocation in a flexible manufacturing system is presented. It is assumed that there is a set of machines with known processing capabilities, that a set of part types with known process plans is selected for manufacture and that each operation of a part type may be assigned to various machines using specified tools. The model determines the optimal plan by minimizing the total costs of operations, material handling and set-ups. A numerical example is provided to demonstrate the application of the model. [ABSTRACT FROM AUTHOR]

Introduction: Development of regional surveillance programs is necessary for the development of community-acquired urinary tract infection (UTI) guidelines, especially for sub-urban and rural areas where empirical treatment is the mainstay in the absence of proper diagnostic modalities. Our aim was to evaluate the bacteriological profile and antibiotic sensitivity patterns in children with UTI prospectively from a tertiary care center. Methods: A total of 800 children up to 18 years of age with suspected UTI attending our center were included. For all suspected cases urine microscopy, gram staining, and culture were done. Antibiotic sensitivity was performed on selected antimicrobials using disk diffusion method following Clinical Laboratory Standards Institute guidelines. Results: Majority of pathogens were isolated from female (54.2%) patients. Pre‑teens (52.1%) and teens (27.1%) were most commonly affected age group. The most common presentation in culture-proven UTI was fever with urinary symptoms (33.3%). In a group of 192 patients 26.7% had proven UTI. Escherichia coli (42.3%) was the most common aetiological agent, followed by Enterococcus fecalis (13.5%), Klebsiella spp. (11.5%) and Staphylococcus aureus (11.5%). Most active antibiotics against Gram-negative isolates were nitrofurantoin, cefotaxime, and amikacin. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Conclusion: E. coli was the commonest isolate. The organisms grown in significant numbers were E. fecalis, Klebsiella spp. and S. aureus, causing UTI in 0–18 years of age group. Gram‑negative isolates were sensitive to nitrofurantoin, amikacin, and cefotaxime. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Prospective, regional studies are ensured periodically to explain bacteriological profile and antibiotic sensitivity patterns to be applicable for children with UTI over that geographic area. [ABSTRACT FROM AUTHOR]

Aim: Achieving the optimal apposition of coronary stents during percutaneous coronary intervention is not always feasible. The risks and benefits of stent postdilation in primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI) have remained controversial. We sought to evaluate the immediate angiographic and long-term outcomes in patients with and without stent postdilation., Methods: A cohort of patients (n = 1,224) with STEMI, treated with PPCI (n = 500 postdilated; n = 724 controls), were studied. The flow grade, the myocardial blush grade, and the frame count were considered angiographic outcomes. The clinical outcomes were major adverse cardiovascular events (MACE)-comprising cardiac death, nonfatal MI, and repeat revascularization-and the device-oriented composite endpoint (DOCE)-consisting of cardiac death, target lesion revascularization, and target vessel revascularization., Results: The flow and myocardial blush grades were not different between the two groups, and the frame count was significantly lower in the postdilation group (15.7 ± 8.4 vs. 17 ± 10.4; p < .05). The patients were followed up for 348 ± 399 days. DOCE (2.2% vs. 5.8%) and cardiac mortality (1.2% vs. 3.2%) were lower in the postdilation group. In the fully adjusted propensity score-matched analysis, postdilation was associated with decreased DOCE (HR = 0.40 [0.18-0.87], p = .021)., Conclusions: Selective postdilation improved some angiographic and clinical outcomes and could not be discouraged in PPCI on patients with STEMI., (© 2019 Wiley Periodicals, Inc.)

Introduction: Some studies have demonstrated that post-PCI elevated cardiac enzymes are associated with worse outcomes. In this study, we aimed to determine if high-dose treatment with atorvastatin before planned elective PCI reduces PMI or MACE at 1-year median follow-up., Material and Methods: Eligible participants were randomly allocated to group A (80 mg atorvastatin 12 h and 40 mg 2 h before PCI) and group B (40 mg atorvastatin daily). Blood samples were obtained before and at 24 h after PCI to measure hsTnT. All patients were followed regarding MACE (combination of death, re-hospitalizations for ACS, and unplanned coronary revascularization) during one year after PCI., Results: 207 patients randomly assigned to Group A (n = 97) or group B (n = 110). The rate of PMI was lower in group A (5.2%) compared to group B (10.9%); despite near to 50% lower rate of PMI in group A, binary logistic regression showed no significant association between atorvastatin recapture and PMI. The occurrence of MACE in 97 patients of group A was 11 (11.3%), higher than 11 (10%) cases of 110 patients in group B. Cox proportional hazards regression model shows no significant difference in MACE of study groups., Conclusion: Pretreatment of patients with stable angina who were planned to undergo an elective PCI with 120 mg of atorvastatin before the procedure confer them the same benefit in terms of PMI and MACE as 40 mg routine daily dosage of this statin does.