Browsing by Author "Onder, ENA"

Now showing 1 - 12 of 12
  • No Thumbnail Available
    Item
    ChatGPT-4o's performance on pediatric Vesicoureteral reflux
    Onder, ENA; 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), ColemanLiau 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.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Comparison of diagnostic criteria for children with familial Mediterranean fever
    Onder, ENA; Ozcan, KE; Sahin, FI; Gulleroglu, KS; Baskin, E
    Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent attacks of fever and serositis. Diagnosis is made according to clinical findings and supported by genetic analysis. The most commonly used adult diagnostic criteria are the Tel-Hashomer criteria. Pediatric criteria for FMF diagnosis were described in 2009, but their reliability should be supported by additional reports. In this study, we aimed to compare the pediatric criteria and the Tel-Hashomer and 2019 Eurofever/PRINTO classification criteria using our FMF cohort. A total of 113 patients diagnosed with FMF were included. Demographic features and laboratory findings were retrospectively collected from the patients' files. The patients were evaluated with the Tel-Hashomer, pediatric and Eurofever/PRINTO classification criteria. At least two of five new pediatric criteria were as sensitive (89%) and specific (85%) as the Tel-Hashomer criteria (sensitivity 70%, specificity 96%). We also evaluated the Eurofever/PRINTO classification criteria using our cohort and found a sensitivity of 94% and specificity of 91%. Conclusion: Using pediatric criteria for the diagnosis of FMF in children is a feasible and simple approach that can diagnose the disease based on at least two criteria. Therefore, our study supports the use of pediatric criteria in FMF diagnosis of children. Our results also confirm that the Eurofever/PRINTO classification criteria can be successfully applied for the diagnosis of FMF due to their high sensitivity (94%) and specificity (91%). What is Known: center dot The FMF diagnosis is made according clinical findings and supported by genetic analysis. center dot The use of adult diagnostic criteria in pediatric FMF patients is controversial since classical clinical presentation is often absent in children. What is New: center dot Our study supports both the use of pediatric criteria and Eurofever/PRINTO classification criteria in clinical practice.
  • No Thumbnail Available
    Item
    Relationship between C-reactive Protein/Albumin Ratio and Subclinical Inflammation in Patients with Familial Mediterranean Fever
    Onder, ENA; Cam, FS; Ertan, P
    Background Familial Mediterranean Fever (FMF), which is characterised by recurrent episodes of fever with serositis, is associated with ongoing inflammation without clinical findings during attack-free periods, leading to amyloidosis, the most important complication of FMF. The objective of this study was to investigate the C-reactive protein/albumin ratio (CAR) as a marker to identify subclinical inflammation in symptom-free FMF children and compare the CAR with other systemic inflammatory markers such as mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). Material and Methods We included 100 patients and 70 healthy subjects. Hospital records were obtained to collect data on laboratory findings and genetic mutations. Results We found that the CAR levels of our FMF patients were significantly higher than those of the control group. We also evaluated that the CAR values had a higher area-under-thecurve value than the other systemic inflammation parameters including CRP, MPV, RDW, NLR, PLR based on Receiver-Operating Characteristics (ROC) analysis. Conclusion It is important to identify subclinical inflammation in FMF patients with simple, reliable, easily accessible markers to avoid amyloidosis. Although the CAR might be used to assess subclinical inflammation in paediatric FMF patients, the prognostic value of CAR is not superior to CRP. Merging CRP and albumin into a single index thus provides no additional benefit in detecting subclinical inflammation in FMF.
  • No Thumbnail Available
    Item
    Outcomes of children with isolated antenatal hydronephrosis
    Onder, ENA; Yilmaz, O; Taneli, C; Ertan, P
    BackgroundAntenatal hydronephrosis (ANH) is one of the most common abnormalities detected during prenatal ultrasound. There is significant variability in the postnatal management of ANH. Our objective was to report the outcomes of patients with ANH, spontaneous resolution rates, surgical intervention rates, and factors contributing to these parameters.MethodsA total of 227 patients and 264 renal units with ANH were included in this study. We used the renal pelvis anteroposterior diameter and the Society for Fetal Urology grading system to classify and compare ANH as mild, moderate, and severe.ResultsThe patients' median follow-up period was 48 months (with a minimum of 6 months and a maximum of 136 months). Of the 264 renal units, 123 (46.6%) had mild, 101 (38.26%) had moderate, and 40 (15.15%) had severe antenatal hydronephrosis. The spontaneous resolution rate was 91.9% in the mild hydronephrosis group (n = 113), 81.2% (n = 82) in the moderate hydronephrosis group, and 37.5% (n = 15) in the severe hydronephrosis group. The patients with higher hydronephrosis grades required a longer time to resolve. Only one patient with a posterior urethral valve had reduced estimated glomerular filtration. None of the patients had proteinuria or hypertension.ConclusionAlthough the outcome of the patients with mild hydronephrosis was excellent, there was a progression of the disease, especially within the first 6 months, and 6% of our cases required surgical intervention. Additional prospective studies are needed to define the risk of urinary tract abnormalities with any degree of ANH.
  • No Thumbnail Available
    Item
    The Quality of Life in Patients with Familial Mediterranean Fever and Their Parents Perception
    Ensari, E; Onder, ENA; 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.
  • No Thumbnail Available
    Item
    The ureteral diameter ratio as a predictive factor in renal scarring associated with primary vesicoureteral reflux
    Onder, ENA; 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.
  • No Thumbnail Available
    Item
    Follow up of renal outcomes in children with solitary kidney
    Onder, ENA; Yilmaz, O; Taneli, C; Ertan, P
    Background: Solitary kidney (SK) affects 1/1000 people worldwide, and there are controversies concerning renal outcomes in these patients. This study aimed to investigate clinical findings and renal outcomes in children with SK and to compare the results for congenital (CSK) and acquired SK (ASK) groups.Methods: The study included patients that presented to our pediatric nephrology department with SK between January 2010 and January 2021. Demographic and clinical data were recorded retrospectively.Results: Of the 101 patients with SK, 71 had CSK (55 had unilateral renal agenesis and 16 had a multicystic dysplastic kidney) and 30 had ASK (17 had previously undergone unilateral nephrectomy due to a renal tumor and 13 had urological structural anomalies). There were nine patients (9%) with renal injury. The serum uric acid level was significantly higher and the estimated glomerular filtration rate was significantly lower in the patients with ASK compared with those with CSK (p = 0.005 and p < 0.001, respectively). There was a positive correlation between renal injury and the uric acid level (p < 0.001, r = 0.45).Conclusion: In addition to the management of blood pressure and proteinuria, it is important to control uric acid levels in patients with SK, especially those with ASK, to prevent renal injury. The ASK group has a greater risk of renal injury than the CSK group. There is a need for new markers to predict early stage renal damage in SK.
  • No Thumbnail Available
    Item
    The nailfold dermoscopy findings of patients with atypical haemolytic uremic syndrome
    Onder, ENA; Gokyayla, E; Ermertcan, AT; Ertan, P
    Introduction: Hemolytic uremic syndrome (HUS) is a severe disease characterized by microangiopathic anemia, thrombocytopenia, and acute renal failure.Objectives: Atypical HUS (aHUS) that results due to genetic disorders of the alternative complement pathway results in inflammation, endothelial damage, and kidney injury. Therefore, simple and non-invasive tests are needed to evaluate the activity of the disease by assessing the microvascular structure in aHUS.Methods: A dermoscope (x10) is an inexpensive and easily portable device used to visualize nailfold capillaries and has high clinical performance and interobserver reliability. In this study, the nailfold capillaries of patients with aHUS who were in remission under eculizumab treatment were examined, and the findings were compared to those of a healthy control group to evaluate disease characteristics. Results: All children with aHUS had decreased capillary densities even if they were in remission. This may be indicative of ongoing inflammation and microvascular damage in aHUS.Conclusion: A dermoscopy can be used as a screening tool for disease activity in patients with aHUS.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    YouTube as a source of information on COVID-19 and dialysis
    Onder, ENA; Ertan, P
    Introduction The coronavirus 2019 pandemic has become a serious threat to the global health and spreading rapidly. Dialysis patients may have developed anxiety because of their disease characteristics during this pandemic. The aim of this study was to assess the reliability and quality of the most viewed English-language YouTube videos on COVID-19 and dialysis link. Methods A YouTube search was achieved using the key words COVID-19 dialysis, SARS CoV-2 dialysis, coronavirus hemodialysis, and COVID peritoneal dialysis. Results Among the 43 videos analyzed, 24 (55.8%) were high quality, 11 (25.6%) were moderate quality, and 8 (18.6%) were of low quality according to global quality score. Significant differences were found between the groups in modified DISCERN scores and the number of views, likes, comments. Conclusion The most reliable sources such as universities, governments, professional societies should better use YouTube for dissemination of accurate, reliable, and useful health-related information to the general public.
  • No Thumbnail Available
    Item
    Focal Xanthogranulomatous Pyelonephritis in Brachydactyly Mental Retardation Syndrome (2q37 Deletion Syndrome)
    Onder, ENA; Ozkol, M; Nese, N; Taneli, C; Cankorur, OO; Ozunan, I
    Xanthogranulomatous pyelonephritis (XGP) is characterized by destruction of the renal parenchyma and granulomatous inflammation with lipid-laden foamy macrophages as well as inflammatory infiltration and intensive renal fibrosis. It generally occurs in adults, especially those in the fifth and sixth decades of life, but is occasionally seen in children as well. Brachydactyly mental retardation (BDMR) syndrome (OMIM 600430) is caused by a small deletion of chromosome 2q37 and is a rare condition, with roughly 100 cases reported worldwide. Here, we describe the case of a patient with deletion of chromosome 2q37, which is known as the BDMR syndrome, and XGP.