Browsing by Author "Ozkayin, N"

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    Association of FAS-670A/G and FASL-843C/T Gene Polymorphisms on Allograft Nephropathy in Pediatric Renal Transplant Patients
    Ertan, P; Mir, S; Ozkayin, N; Berdeli, A
    Objective: FAS and FASL polymorphisms are suggested to play an important role in tubulitis that is a major component of acute rejection. The aim of this study was to investigate the role of FAS-670A/G and FASL-843C/T gene polymorphisms on allograft nephropathy in pediatric renal transplant patients Methods: Fifty three patients (22 males 31 females) aged 2 to 20 years (mean 12.3 +/- 0.6) who had renal transplantation and fifty healthy control subjects (25 males 25 females) were enrolled in the study. Pearson's Chi Square test was used for the statistical analysis. Survival rates were estimated with the Kaplan Meier method. Age, sex, chronic renal failure etiology, treatment modality and duration and donor type were recorded. FAS-670A/G and FASL-843C/T gene polymorphisms were compared between renal transplant patients and normal healthy population as well as between renal transplant patients with and without acute rejection. Findings: FAS-670A/G genotypes or alleles were not significantly different between control and transplant patients and among transplant patients with and without acute rejection (P>0.05 for all). FASL-843C/T genotypes and alleles were not different between transplantation and control groups (P>0.05 for all). However, FASL-843C/T alleles were significantly different between patients with and without AR (P=0.02). The percentages of C allele were higher in children with acute rejection (68.8% vs 44.6%). Conclusion: FASL gene polymorphisms may play a major role in acute rejection while FAS polymorphisms have not been found to be different between patients with and without acute, renal graft rejection.
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    Which Implant Is Better for Treating Reverse Obliquity Fractures of the Proximal Femur: A Standard or Long Nail?
    Okcu, G; Ozkayin, N; Okta, C; Topcu, I; Aktuglu, K
    Reverse obliquity fractures of the proximal femur have biomechanical characteristics distinct from other intertrochanteric fractures and high implant failure rate when treated with sliding hip screws. Intramedullary hip nailing for these fractures reportedly has less potential for cut-out of the lag screw because of their loadbearing capacity when compared with extramedullary implants. However, it is unclear whether nail length influences healing. We compared standard and long types of intramedullary hip nails in terms of (1) reoperation (fixation failure), (2) 1-year mortality rate, (3) function and mobility, and (4) union rate. We conducted a pilot prospective randomized controlled trial comparing standard versus long (a parts per thousand yen 34 cm) intramedullary hip nails for reverse obliquity fractures of the proximal femur from January 2009 to December 2009. There were 15 patients with standard nails and 18 with long nails. Mean age was 79 years (range, 67-95 years). We determined 1-year mortality rates, reoperation rates, Parker-Palmer mobility and Harris hip scores, and radiographic findings (fracture union, blade cut-out, tip-apex distance, implant failure). Minimum followup was 12 months (mean, 14 months; range, 12-20 months). We found no difference in reoperation rates between groups. Two patients (both from the long-nail group) underwent revision surgery because of implant failure in one and deep infection in the other. There was no difference between the standard- and long-nail groups in mortality rate (17% versus 18%), Parker-Palmer mobility score (five versus six), Harris hip score (74 versus 79), union rate (100% in both groups), blade cut-out (zero versus one), and tip-apex distance (22 versus 24 mm). Our preliminary data suggest reverse obliquity fractures of the trochanteric region of the femur can be treated with either standard or long intramedullary nails.
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    Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study
    Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R; Bayazit, AK; Litwin, M
    Background The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. Methods A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Results Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p < 0.0001). uHSP70 predicted UTI with 89% sensitivity and 82% specificity (AUC = 0.934). Among the 265 patients with suspected UTI, the uHSP70 > 48 ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Conclusions Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI.
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    MEMBRANOUS NEPHROPATHY IN CHILDREN: A RETROSPECTIVE OBSERVATIONAL MULTICENTRE STUDY IN TURKEY
    Gokce, I; Sak, M; Bayram, MT; Aksoy, O; Melek, E; Yildirim, ZNY; Tekcan, D; Pinarbasi, AS; Soyaltin, E; Goknar, N; Serdaroglu, E; Ozcelik, G; Nalcacioglu, H; Tulpar, S; Ozkayin, N; Ozdogan, EB; Ertan, P; Buyan, N; Aydog, O; Bayrakci, US; Bayazit, AK; Soylu, A; Kavukcu, S; Yilmaz, A; Anarat, A
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    CLINICAL, EPIDEMIOLOGICAL AND PROGNOSTIC FEATURES OF CHILDREN WITH HEMOLYTIC UREMIC SYNDROME: MULTICENTER EXPERIENCE OF TURKEY
    Ertan, P; Bulut, IK; Guven, S; Cicek, N; Tulpar, S; Coskun, S; Donmez, O; Dusunsel, R; Serdaroglu, E; Bek, K; Kucuk, N; Akinci, N; Celakil, ME; Dursun, I; Yigit, G; Soylu, A; Bayram, MT; Bayrakci, US; Bakkaloglu, S; Ozdogan, EB; Koyun, M; Tufan, AK; Sonmez, F; Delibas, A; Tabel, Y; Ozkayin, N; Melek, E; Erdogan, H; Uysal, B; Bastug, F; Yavascan, O
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    The relationship between urine heat shock protein 70 and congenital anomalies of the kidney and urinary tract: UTILISE study
    Aksu, B; Afonso, AC; Akil, I; Alpay, H; Atmis, B; Aydog, O; Bakkaloglu, S; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Cetinkaya, APG; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, F; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Topaloglu, R; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vitkevic, R; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Yilmaz, A
    Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are defined as structural malformations of the kidney and/or urinary tract. Heat shock proteins (HSPs) are expressed in the kidney in response to cellular changes, such as thermal, hemodynamic, osmotic, inflammatory, and mechanical stresses. This study aimed to assess uHSP70 levels during acute urinary tract infections (UTI) and non-infection periods in patients with CAKUT, and to evaluate whether uHSP70 is elevated in CAKUT subtypes. Methods: Among patients with CAKUT, 89 patients with UTI (CAKUT-A), 111 without UTI (CAKUT-B), and 74 healthy children were included in the study. uHSP70 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: uHSP70 level was significantly higher in the CAKUT-A group than in the CAKUT-B and healthy control groups (p < 0.0001). Moreover, the level of uHSP70 was significantly higher in the CAKUT-B group than in the control group (p < 0.0001), but was not different between the CAKUT subtypes (p > 0.05). Conclusion: Urine HSP70 can also be used to predict UTI in patients with CAKUT. Moreover, uHSP70 levels were higher in children with CAKUT during the non-infectious period than in healthy controls. This suggests that children with CAKUT are at risk of chronic non-infectious damage.
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    URINARY HSP70 IMPROVES DIAGNOSTIC ACCURACY FOR URINARY TRACT INFECTION IN CHILDREN: UTILISE STUDY
    Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R
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    Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study
    Aksu, B; Afonso, AC; Akil, I; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Obrycki, L; Omer, B; Oner, HA; Ozdemir, EM; Ozkayin, N; Paripovic, D; Pehlivanoglu, C; Saygili, S; Schaefer, F; Schaefer, S; Sonmez, F; Tabel, Y; Tas, N; Tasdemir, M; Teixeira, A; Tekcan, D; Topaloglu, R; Tulpar, S; Turkkan, ON; Uysal, B; Uysalol, M; Vitkevic, R; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Yilmaz, A
    Background One of the most common bacterial infections in childhood is urinary tract infection (UTI). Toll-like receptors (TLRs) contribute to immune response against UTI recognizing specific pathogenic agents. Our aim was to determine whether soluble TLR4 (sTLR4), soluble TLR5 (sTLR5) and interleukin 8 (IL-8) can be used as biomarkers to diagnose UTI. We also aimed to reveal the relationship between urine Heat Shock Protein 70 (uHSP70) and those biomarkers investigated in this study.Methods A total of 802 children from 37 centers participated in the study. The participants (n = 282) who did not meet the inclusion criteria were excluded from the study. The remaining 520 children, including 191 patients with UTI, 178 patients with non-UTI infections, 50 children with contaminated urine samples, 26 participants with asymptomatic bacteriuria and 75 healthy controls were included in the study. Urine and serum levels of sTLR4, sTLR5 and IL-8 were measured at presentation in all patients and after antibiotic treatment in patients with UTI.Results Urine sTLR4 was higher in the UTI group than in the other groups. UTI may be predicted using 1.28 ng/mL as cut-off for urine sTLR4 with 68% sensitivity and 65% specificity (AUC = 0.682). In the UTI group, urine sTLR4 levels were significantly higher in pyelonephritis than in cystitis (p < 0.0001). Post-treatment urine sTLR4 levels in the UTI group were significantly lower than pre-treatment values (p < 0.0001).Conclusions Urine sTLR4 may be used as a useful biomarker in predicting UTI and subsequent pyelonephritis in children with UTI.