Browsing by Author "Ensari E."
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Item The ureteral diameter ratio as a predictive factor in renal scarring associated with primary vesicoureteral reflux(Elsevier Ltd, 2023) Akyol Onder E.N.; Ensari E.; Ozkol M.; Yilmaz O.; Taneli C.; Ertan P.Introduction: The ureteral diameter ratio (UDR) is reported to be effective in predicting the outcomes of vesicoureteral reflux (VUR) in several studies. Objective: The objective of the current study was to compare the risk of scarring in patients with VUR relative to UDR and the VUR grade. We also aimed to demonstrate other associated risk factors in scarring and investigate the long-term complications of VUR and their relationship with UDR. Study design: Patients diagnosed with primary VUR were retrospectively enrolled in the study. UDR was calculated by dividing the largest ureteral diameter (UD) by the distance between L1-L3 vertebral bodies. Demographic and clinical data, laterality, VUR grade, UDR, delayed upper tract drainage on voiding cystourethrogram, recurrent urinary tract infections (UTI), and long-term complications of VUR were compared between the patients with and without renal scars. Results: A total of 127 patients and 177 renal units were included in the study. There was a significant difference between the patients with and without renal scars according to age at diagnosis, bilaterality, reflux grade, UDR, recurrent UTI, bladder bowel dysfunction, hypertension, decreased estimated glomerular filtration rate, and proteinuria. The logistic regression analysis revealed that UDR had the highest odds ratio among the factors affecting scarring in VUR. Discussion: VUR grading based on the evaluation of the upper urinary tract is one of the most important predictors for treatment options and prognosis. However, it is more likely to reflect ureterovesical junctional anatomy and function, which play a crucial role in the pathogenesis of VUR. Conclusion: UDR measurement seems to be an objective method that can help clinicians predict renal scarring in patients with primary VUR. [Table presented] © 2023 Journal of Pediatric Urology CompanyItem Factors Affecting Colchicine Adherence in Pediatric Familial Mediterranean Fever(Galenos Publishing House, 2023) Önder E.N.A.; Ensari E.; Bilaç Ö.; Ertan P.Aim: Familial Mediterranean Fever (FMF) is the most frequent monogenetic autoinflammatory disorder. It is characterized by fever and serositis. The first line treatment of FMF is colchicine. Adherence to colchicine is one of the main factors affecting colchicine response. In this study, we aimed to evaluate drug adherence in children with FMF using the medication adherence scale in FMF (MASIF). We also assessed the clinical characteristics of drug-adherent patients and factors affecting drug adherence. Materials and Methods: Eighty-two children with FMF under colchicine therapy were included in this cross-sectional observational study. The patients were divided into two groups according to medication adherence and compared according to their demographic and clinical data. Results: According to MASIF, 31 (38%) patients had non-adherence to colchicine. There was a significant difference between the colchicine-adherent and non-adherent groups in terms of age, disease severity according to the International severity score for FMF, attack rate, colchicine dosage, M694V homozygosity, and family type (p=0.005, p=0.04, p=0.025, p=0.045, p=0.04, and p=0.046, respectively). Conclusion: Patients with FMF should be questioned about their medication adherence at every visit, and children with a high risk of colchicine non-adherence should be followed up more closely. © Copyright 2023 by Ege University Faculty of Medicine, Department of Pediatrics and Ege Children’s Foundation The Journal of Pediatric Research, published by Galenos Publishing House.Item 10 Years of Antenatal Hydronephrosis Experience: Comparing Two Different Guidelines(Georg Thieme Verlag, 2024) Ensari E.; Yavascan O.; Alparslan C.; Oncel E.P.; Maden A.A.; Demir B.K.; Alaygut D.; Ozdemir T.Background Antenatal hydronephrosis refers to the dilation of the renal pelvis and/or calyces in the developing fetus. The challenge lies in distinguishing between cases that warrant long-Term follow-up or surgical intervention and those with transient hydronephrosis that require minimal invasive investigations. Materials and Methods Our study aimed to assess and contrast the efficacy of the 2015 Congenital Anomalies of Kidney and Urinary Tract Guideline from the Turkish Society of Pediatric Nephrology with the Tepecik Antenatal Hydronephrosis Guideline, which was previously employed in our hospital. We conducted a comparative analysis of demographic data, outcome conditions, additional imaging requirements and quantities, radiation exposures, and rates of surgical interventions between two groups. Results Group 2 had a significantly higher detection rate of Vesicoureteral Reflux via voiding cystourethrogram at 38.5% compared to Group 1's 13.4% (p<0.01). The incidence of abnormal findings with dimercaptosuccinic acid was similar between Group 1 (28.5%) and Group 2 (26.4%) (p>0.01), but Group 2 had a higher rate of obstruction diagnosis at 68.8% versus Group 1's 29.4% (p<0.01). Group 1 had greater median radiation exposure (500 mrem vs. 200 mrem, p<0.01), and a higher proportion of patients underwent surgery (34.2% vs. 21.9%, p<0.01). Conclusion This study showed that the new guideline required fewer tests, was less invasive, and exposed patients to less radiation than the old guideline. © 2024. Thieme. All rights reserved.Item The Quality of Life in Patients with Familial Mediterranean Fever and Their Parents Perception; [Die Lebensqualität von Patienten mit familiärem Mittelmeerfieber und die Wahrnehmung ihrer Eltern](Georg Thieme Verlag, 2024) Ensari E.; Akyol Onder E.N.; Bilac O.; Ertan P.Background Familial Mediterranean fever (FMF) is a chronic disease characterized by recurrent episodes of fever and polyserositis. This study aimed to assess children's quality of life (QoL), as reported by children and their parents, and to compare the results according to clinical variables. Material and Methods The study examined 107 children with FMF, evaluating their demographic and genetic data, utilizing the Pediatric Quality of Life Inventory (PedsQL) to assess QoL, and comparing scores based on disease severity. Results The severity of FMF is inversely correlated with QoL scores, with mild cases having the highest scores (97±4), followed by moderate (76±11) and severe cases (52±10.3) (p<0,001). Disease severity, treatment adherence, healthcare utilization, genetic mutations, family income, and maternal age at birth all significantly impact perceived quality of life in FMF patients (p<0,001). Additionally, parents reported lower QoL for children with FMF who experienced various adverse factors such as low family income, household smoking, frequent attacks, hospitalizations, irregular medication use, and low maternal education levels (p<0,001). Conclusion Children's daily activities, academic performance, and family functioning are all significantly impacted by FMF. Physicians caring for patients with FMF should be aware of the QoL changes in the management of these patients. As a result, medical therapy, patient education, and indicators of psychological and social support can all be offered more effectively. © 2024. Thieme. All rights reserved.Item Response to commentary on: ChatGPT-4o's performance on pediatric vesicoureteral reflux(Elsevier Ltd, 2025) Onder E.N.A.; Ensari E.; Ertan P.[No abstract available]Item ChatGPT-4o′s performance on pediatric Vesicoureteral reflux(Elsevier Ltd, 2025) Akyol Onder E.N.; Ensari E.; Ertan P.Introduction: Vesicoureteral reflux (VUR) is a common congenital or acquired urinary disorder in children. Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence-driven platform offering medical information. This research aims to assess the reliability and readability of ChatGPT-4o′s answers regarding pediatric VUR for general, non-medical audience. Materials and methods: Twenty of the most frequently asked English-language questions about VUR in children were used to evaluate ChatGPT-4o′s responses. Two independent reviewers rated the reliability and quality using the Global Quality Scale (GQS) and a modified version of the DISCERN tool. The readability of ChatGPT responses was assessed through the Flesch Reading Ease (FRE) Score, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Results: Median mDISCERN and GQS scores were 4 (4–5) and 5 (3–5), respectively. Most of the responses of ChatGPT have moderate (55 %) and good (45 %) reliability according to the mDISCERN score and high quality (95 %) according to GQS. The mean ± standard deviation scores for FRE, FKGL, SMOG, GFI, and CLI of the text were 26 ± 12, 15 ± 2.5, 16.3 ± 2, 18.8 ± 2.9, and 15.3 ± 2.2, respectively, indicating a high level of reading difficulty. Discussion: While ChatGPT-4o offers accurate and high-quality information about pediatric VUR, its readability poses challenges, as the content is difficult to understand for a general audience. Conclusion: ChatGPT provides high-quality, accessible information about VUR. However, improving readability should be a priority to make this information more user-friendly for a broader audience. © 2024 Journal of Pediatric Urology Company